Transcript s Rock ENROLL - Touchstone Home Page

2016 Open Enrollment
Benefits Summary and Education Session
November 23, 2015 – December 4, 2015
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Open Enrollment November 23 – December 4
If you are eligible for benefits you must log in to bSwift and either select or
decline coverages for 2016. This includes everyone even if you recently
enrolled in 2015’s plan for December.
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Open Enrollment – November 23 to December 4
*Spouses that are eligible for
medical benefits under their
employers are not eligible to
participate in Touchstone’s
medical plans.
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Increasing Healthcare Costs
•
Touchstone’s healthcare costs will increase 22.4% next year.
– Based on CIGNA’s actuarial analysis.
•
Touchstone’s 2016 medical plan changes and premium increases are a result of the
increase.
– Note: Touchstone did not increase employee healthcare costs in 2015
•
Touchstone spends over $12,000 per enrolled employee per year for health
Taxes
benefits.
$2,100
Salaries represent only
a portion of employees
total compensation.
This is an illustration of
the total compensation
paid to a typical
employee making
$30,000 in annual
salary:
401K
$900
1.98%
Benefits and Employer’s
Portion of Taxes Represents
33.9% ($15,383) of
Compensation.
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4.63%
Salary
$30,000
66.10%
Medical Benefits
$12,383
27.29%
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2016 Benefit Summary
Touchstone will continue to offer a market competitive benefits package to its
employees:
Medical Benefits – CIGNA
Dental Insurance – Delta Dental
Vision Insurance – CIGNA
Life and AD&D – CIGNA
Disability Insurance – CIGNA
TelaDoc
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Medical Plans
There are two medical plans offered!
-Premium Plan $3,000
-Value Plan $3,000 HSA
Consumer Driven Value Plan offering the employer funded HSA of $50 per month
through JPMorgan Chase
*Spousal Carve out – Spouses cannot be covered by Touchstone if they have access to creditable
insurance under their employer.
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Medical Plans
In-Network Deductible
Premium Plan $3,000
Value Plan $3,000
Employee Employee
Only
1 or more
Employee Employee
Only
1 or more
$3,000
$6,000
$3,000
$6,000
20.0%
20.0%
20.0%
20.0%
In-Network OOP Max
$4,000
$8,000
$5,500
$11,000
OON Deductible
$6,000
$12,000
$6,000
$12,000
40.0%
40.0%
40.0%
40.0%
In-Network Co-insurance
OON Co-Insurance
OON OOP Max
Unlimited Unlimited
Office Visit Co-Pay
Primary Care
Specialist
Unlimited Unlimited
$35.00
$50.00
$35.00
$50.00
Hospital/Outpatient Surgery/Imaging 20% after Ded
Emergency Room
$250.00
Urgent Care
$75.00
Retail Pharmacy (30 Day Supply)
$10/$60/$90
Mail Order Pharmacy (90 Day Supply) $20/$120/$180
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20% after Ded
$250.00
$75.00
$10/$60/$90
$20/$120/$180
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20% after Ded
20% after Ded
20% after Ded
20% after Ded
20% after Ded
20% after Ded
20% after Ded
20% after Ded
20% after Ded
20% after Ded
20% after Ded
20% after Ded
20% after Ded
20% after Ded
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Health Savings Account
Qualified Medical Expenses for complete information, please refer to the IRS
Publication 501 *Medical and Dental Expenses.* available online at www.irs.gov.
SAMPLE MEDICAL EXPENSES
Acupuncture
Home care
Pregnancy tests kits
Bandages
Lab fees
Prostheses
Birth control pills
Lasik eye surgery Therapy
Chiropractor
Nursing services Wheelchairs
COBRA payments
Optometrist
X-ray fees
Eyeglasses/contact
Orthodontics
2016 HSA
Contribution Limits:
Single $3,350
Family $6,650
Catch up Contributions
(age 55 and older)
$1,000
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Touchstone will contribute $50 per month to your
HSA account once your banking application has
been submitted and approved by JPMorgan Chase.
Your enrollment ID with JPMorgan for your banking
applications is: TouchstoneHSA
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At a glance: Premium Plan vs. Value Plan?
Value Plan $3,000 with HSA
–
–
–
–
Consumer-driven
Lower premiums (e.g. lower bi-weekly cost to employees)
HSA available
Company contributes $600 per year to your HSA
• HSA = Health Savings Account: A savings account that you can put money in pre-tax. Money in
this account can only be used to pay health care costs until the age of 65. At age 65 you are
able to take this money out of this account and apply it towards other expenses. This will be
taxed at a normal income rate at that time.
– There are no co-pays so you will pay ALL medical costs until your deductible is met
– Out-of-pocket maximum is higher
– Generally, people who don’t expect to use a lot of healthcare choose this type of plan
Premium Plan $3,000
–
–
–
–
–
Higher premiums bi-weekly cost to employee
No HSA or company contributions to out of pocket healthcare costs
Co-pays vs. first dollar rather than all costs incurred coming out-of-pocket
Lower out-of-pocket maximums
Generally, people who want minimize the risk of unexpected out-of-pocket healthcare
costs and believe they will consume more healthcare choose this type of plan
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Scenario 1 - Low Volume Healthcare Consumer
The Value Plan would save this employee over the course of the year
Patient Healthcare Expectations
$
# per Year
Coverage Elections
Healty/Average/Sick
Office Visits
Specialist Visits
Emergency Room Visits
Urgent Care Visits
Hospital Visits
Outpatient Surgery
MRI/CT/PET
Other Care Costs
Prescription Drug
Tier 1 Rx #1
Tier 1 Rx 2
Tier 1 Rx 3
Tier 2 Rx #1
Tier 2 Rx #2
Tier 2 Rx #3
Tier 3 Rx #1
Tier 3 Rx #2
Tier 3 Rx #3
Emp_Spouse
Healthy
$90
$150
$3,000
$200
$12,000
$2,500
$800
$500
3
0
0
1
0
0
0
0
$25
$30
$30
$75
$80
$85
$300
$350
$400
1
0
0
0
0
0
0
0
0
Premium Plan $3,000
Employee Emp_Spouse Emp_Child Emp_Family
Total Cost to Employee
Prescription Drug
Office Visits
Specialist Visits
Emergency Room Visits
Urgent Care Visits
Hospital Visits
Outpatient Surgery
MRI/CT/PET
Other Care Costs
Emp. Total Claim Cost
Value Plan $3,000
Employee Emp_Spouse Emp_Child Emp_Family
10
105
0
0
75
0
0
0
0
190
10
105
0
0
75
0
0
0
0
190
10
105
0
0
75
0
0
0
0
190
10
105
0
0
75
0
0
0
0
190
25
270
0
0
200
0
0
0
500
995
25
270
0
0
200
0
0
0
500
995
25
270
0
0
200
0
0
0
500
995
25
270
0
0
200
0
0
0
500
995
Annual Premium
HSA - Company Payment
Total Employee Cost
$1,040
$0
1,230
$5,590
$0
5,780
$4,030
$0
4,220
$6,890
$0
7,080
$650
($600)
1,045
$4,160
($600)
4,555
$2,990
($600)
3,385
$5,330
($600)
5,725
Total Cost to Company
Total Claim Cost
Less: Total Emp. Cost
Total Company Cost
$495
(1,230)
($735)
$495
(5,780)
($5,285)
$495
(4,220)
($3,725)
$495
(7,080)
($6,585)
$495
(1,045)
($550)
$495
(4,555)
($4,060)
$495
(3,385)
($2,890)
$495
(5,725)
($5,230)
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Scenario 2 - High Volume Healthcare Consumer
The Premium Plan would save this employee over the course of the year
Patient Healthcare Expectations
$
# per Year
Coverage Elections
Healty/Average/Sick
Office Visits
Specialist Visits
Emergency Room Visits
Urgent Care Visits
Hospital Visits
Outpatient Surgery
MRI/CT/PET
Other Care Costs
Prescription Drug
Tier 1 Rx #1
Tier 1 Rx 2
Tier 1 Rx 3
Tier 2 Rx #1
Tier 2 Rx #2
Tier 2 Rx #3
Tier 3 Rx #1
Tier 3 Rx #2
Tier 3 Rx #3
Emp_Spouse
Healthy
$90
$150
$3,000
$200
$12,000
$2,500
$800
$500
12
12
0
1
1
0
0
0
$25
$30
$30
$75
$80
$85
$300
$350
$400
24
1
12
0
0
0
0
0
0
Premium Plan $3,000
Employee Emp_Spouse Emp_Child Emp_Family
Value Plan $3,000
Employee Emp_Spouse Emp_Child Emp_Family
Total Cost to Employee
Prescription Drug
Office Visits
Specialist Visits
Emergency Room Visits
Urgent Care Visits
Hospital Visits
Outpatient Surgery
MRI/CT/PET
Other Care Costs
Emp. Total Claim Cost
370
420
600
0
75
2,535
0
0
0
4,000
370
420
600
0
75
6,535
0
0
0
8,000
370
420
600
0
75
6,535
0
0
0
8,000
370
420
600
0
75
6,535
0
0
0
8,000
990
1,080
1,800
0
40
1,590
0
0
0
5,500
990
1,080
1,800
0
200
6,930
0
0
0
11,000
990
1,080
1,800
0
200
6,930
0
0
0
11,000
990
1,080
1,800
0
200
6,930
0
0
0
11,000
Annual Premium
HSA - Company Payment
Total Employee Cost
$1,040
$0
5,040
$5,590
$0
13,590
$4,030
$0
12,030
$6,890
$0
14,890
$650
($600)
5,550
$4,160
($600)
14,560
$2,990
($600)
13,390
$5,330
($600)
15,730
Total Cost to Company
Total Claim Cost
Less: Total Emp. Cost
Total Company Cost
$16,070
(5,040)
$11,030
$16,070
(13,590)
$2,480
$16,070
(12,030)
$4,040
$16,070
(14,890)
$1,180
$16,070
(5,550)
$10,520
$16,070
(14,560)
$1,510
$16,070
(13,390)
$2,680
$16,070
(15,730)
$340
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TelaDoc
TelaDoc is available for $4.00 per month ($1.85 per pay period)
– Same price no matter how many people are in your family
– All members of your family can use TelaDoc, including those family members that are
not covered by Touchstone’s benefit plans
Available via phone or mobile phone APP 24/7/365, no matter where you call from
There is no limit to the number of times you can call them!
TelaDoc recoups its cost if you utilize it;
-As a Value Plan 3000 member, in lieu of 1 trip to the doctor
- As a Premium Plan member, in lieu of 2 trips to the doctor
TelaDoc is the ultimate in convenience for treating
minor healthcare issues. They can also prescribe
non-narcotic medications.
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Dental
•
Delta Dental remains our provider
•
Coverage
–
–
–
–
Diagnostic/Preventative = 100%
Basic Services = 80%
Major Services = 50%
Orthodontics = 50%
•
$50 Deductible per person total per calendar year on major restorative, repair of
cast restorations, endodontics, periodontics, tissue conditioning, prosthodontics
and implants.
•
$100 Deductible per person total per lifetime. Applies to diagnostic and
preventive, basic services, complex oral surgery, sealants and palliative treatment.
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Vision
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Life and Disability
Life AD&D Insurance
•
•
•
•
Voluntary Disability Insurance
Touchstone provides $50,000 of life
insurance for all full time benefits
eligible employees.
Employees can buy additional life
insurance in $10,000 increments up
to $500,000 ($100,000 coverage
guaranteed).
Voluntary Policies can be converted
to a private policy if employee leaves
company.
AD&D benefit equals your basic life
insurance amount.
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How To Make Changes After Enrollment
Unless you have a qualifying event you cannot make changes to the benefits you elect during
your initial enrollment period until the next annual enrollment period.
Qualified events include: marriage, divorce, legal separation, death of spouse, birth or
adoption of a child, change in child’s dependent status, change in residence due to an
employment transfer, commencement or termination of adoption proceedings, or change
in spouse’s benefits or employment status (applicable only to dental and vision).
Please login to bSwift using the
credentials previously provided to
request the processing of a qualified
event change to your benefit status.
Also note employees have 30 days
from a qualifying event to process a
change request. After this time period,
employees will have to wait until the
next annual open enrollment.
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Contact Information and Tools
www.myCignaplans.com -Medical Cost Calculator Comparison Tool
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