2014/2015 Annual Benefits Enrollment Presentation

Disclaimer• Each person’s needs for health care vary. You are responsible for reviewing

and researching the information provided based on your own needs and circumstances.

• Decisions you make about your benefits should be made based on specific knowledge of your own needs.

• Information provided is illustrative only and is not to be used or mistaken for legal guidance.

• You should consult a financial or tax advisor to discuss your individual situation.

• All financial investment information should be reviewed with a financial professional.

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Session Objectives

• Provide you with overview of the 2014 Annual Benefits Program and enrollment process

• Explain any plan changes

• Help you understand your options

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What’s New Overview

• Annual Enrollment is April 22 through May 22, 2014– You must go online and make an election, even if you are waiving

medical coverage.– The effective date of benefits is July 1, 2014

• Employee contributions for both medical plans remain the same

• Employees will receive new Medical cards from Anthem.

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What’s New Overview Cont . . .

• Employees currently enrolled in the Buy Up Plan can elect to remain on the plan for the 2014-2015 plan year. The Buy Up Plan is not available for new enrollment.

• The Buy Up Plan deductibles, out-of-pocket maximums, and co-pays have increased.

• All co-pays will count towards the deductible and out-of-pocket maximum

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What’s New Overview Cont. . .• Our new pharmacy vendor is OptumRx.

• You will receive a new prescription card.

• Medication lists can be found on www.mcbenefits.org.

• Under the County plan, specialty drugs, excluding fertility, will be covered at 100% after deductible.

• Under the County plan, preventive care prescriptions obtained through mail order are covered at 100%

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What’s New Overview Cont. . . • Business Plans, Inc (myCafeteriaPlan), will be the new HSA

account administrator

• MetLife is the new dental provider. The plan has been enhanced and the costs have decreased.

• EyeMed remains the vision provider. The plan has been enhanced and the costs have slightly increased.

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What’s New Overview Cont. . . • Wellness incentives for County Plan - employees with an open

HSA account with myCafeteriaPlan, will have HSA deposits in two lump sum amounts; one half in July 2014 and the second half in January 2015.

• An annual rollover of up to $500 is now permitted with the Healthcare Flexible Spending Account and Limited Purpose Flexible Spending Account (FSA).

• The maximum amount of voluntary spousal life insurance has increased from $100,000 to $250,000. A spousal policy cannot exceed 50% of an employee’s supplemental life policy.

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Vendors and Providers effective July 1, 2014Things you need to know:

– Medical – Anthem– Pharmacy – Optum Rx– Dental – MetLife Dental– Life & Short-Term Disability – The Hartford – Vision - EyeMed– FSA/HSA/COBRA - Business Plans, Inc. (myCafeteriaPlan)– Employee Assistance Program (EAP)MC Work/Life Solutions – Value Options– Telemedicine and other Lifestyle Benefits –healthPERX– Wellness & Disease Management – OptumHealth

Things you need to do:– Review your Enrollment Guide– Make your Benefits Elections April 22 through May 22, 2014– Complete Incentive Activities if applicable

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Annual Enrollment is April 22 through May 22, 2014

Things you need to know: • The enrollment system will be available April 22 through April 30, 2014

on any Montgomery County computer• The enrollment system will be available May 1 through May 22, 2014

on any computer system.– Go to www.mcbenefits.org for detailed instructions on how to

access the system• All enrollment must be done online – including election of the waiver

option

Things you need to do: – Review your Benefits Enrollment Guide for detailed information– Everyone must make an active online election or you will be

enrolled by default in the County Plan, Single coverage

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What does default mean?Default occurs when you fail to enroll or to complete your on-line benefits enrollment by midnight May 22, 2014. You will automatically be enrolled in the County Plan with single coverage

If you default:• You will have no benefits coverage for your dependents• You will have no payroll deductions for your HSA• You will have no County Matching contributions to your HSA• You will have no incentives• You will have no dental, vision, supplemental life or short-term disability

benefits• This will occur even if you had coverage in the 2013-2014 plan year

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Dependent Eligibility Things you need to know:

Dependent eligibility documentation is required only for newly added dependentsDocumentation must be submitted directly to the County HR Department by May 22, 2014.

Medical Eligibility – Children up to age 26 can be included on your medical plan– Employee contribution will be based on your enrollment level

Dental, Vision, and Supplemental Life– Children can be included on your plan, up to age 26

Dependent Changes After Annual Enrollment– Can only be made if you have a change in family status known as a

Qualifying Life Event (QLE)

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Dependent Eligibility

Things you need to do:

– Review the eligibility matrix in the Enrollment Guide for complete details regarding dependent eligibility and Qualifying Life Events

– Required documentation for dependent additions or changes must be received by the Benefits Department at 451 W 3rd St. by May 22, 2014, 5:00 p.m. or the dependent will not be covered for the new plan year

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Things you need to know – Medical Options

Waiver Option• You may choose not to be covered by a Montgomery County health

plan if you have coverage outside of Montgomery County– Select the waiver option on the enrollment screen– Provide “Other Coverage” information in the enrollment system as requested

• Monthly Waiver Credit:$ 57.50 Employee only$ 90.00 Employee + Child(ren)$100.00 Employee + Spouse$120.00 Family

• If you are covered on a Montgomery County plan as a dependent under a spouse or parent’s plan, you are NOT eligible for the waiver credit

– Select the “covered under another Montgomery County employee” option on the enrollment screen

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Medical Plan Coverage 2 Medical Plan Offerings: County Plan and Buy-Up PlanThings you need to know about both plans:

• Comprehensive coverage • Wellness and preventive care services are covered at

100% - In Network• Access to over 80% of doctors and 90% of hospitals

nationwide• Medical Services covered• Prescription drug plan• Discounted rates with medical providers

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Things you need to know – Medical Options

Buy-Up Plan – Current enrollees only• Anthem Blue Card PPO plan with co-pays for in-network doctor office

visits and prescription drugs• The co-payments, deductibles, and out-of-pocket maximums have

been increased for this plan year, including co-payments for prescriptions. Refer to Pg. 7 of the enrollment guide

• Member pays co-payment at the time of each visit. Co-payments are now applied to the deductible

• Deductibles, coinsurance and out-of pocket maximum for other services, i.e., x-rays, labs, hospitalizations

• Monthly employee contributions are based on enrollment level

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2013-2014 Buy-Up Plan Monthly Rates (Without Incentive Credits)

Employee Only $185.00

Employee + Child(ren) $245.00

Employee + Spouse $255.00

Family $315.00

Things you need to know – Medical Options County Plan• Qualified High Deductible Health Plan (HDHP)

• Member pays 100% of the costs for medical care and prescription drugs until the deductible is met

• All charges are applied toward deductible ($1500 – single; $3000 all other tiers) and out of pocket maximums

• Once the deductible is met, co-insurance is applied until you reach your out-of-pocket maximum

• After the annual out-of pocket maximums are reached ($3600 – single; $5200 all other tiers), no additional costs for in-network services

• Monthly employee contributions are based on enrollment level

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2013-2014 County Plan Monthly Rates

Employee Only $25.00

Employee + Child(ren) $30.00

Employee + Spouse $35.00

Family $45.00

Things you need to know – Medical Options County Plan• You will receive a new Anthem ID card

• Must show your Optum Rx card at the pharmacy to receive discount rate and to ensure that pharmacy charges are applied to the deductible

• County plan works well with Health Savings Account (HSA) if eligible

• County Plan enrollees who are ineligible for an HSA due to IRS guidelines should contact the HR office to discuss an alternative option.

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Things you need to know – Prescription Drugs

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OptumRx THE BUY UP PLAN THE COUNTY PLAN

Prescription Drugs:

Retail- 30 day supply: GenericBrand FormularyNon-formulary

Mail Order- 90 day supply:GenericBrand FormularyNon-formulary

Specialty DrugsPreventive Drugs

Co-payment applied to deductible

$7.50 co-pay30% co-insurance; $50 maximum30% co-insurance; $75 maximum

$15.00 co-pay30% co-insurance; $100 maximum30% co-insurance; $150 maximum

Covered according to formularyCovered according to formulary

100% of discounted rate until deductible is met

After Deductible is met:70% / 30%70% / 30%70% / 30%

70% / 30%70% / 30%70% / 30%

Covered at 100% after deductibleCovered at 100% with mail order

• Prescription drug coverage is included in your medical plan• Prescription drug plans are administered by Optum Rx• You will receive a new prescription drug card from Optum Rx• You do not have to make a separate election from the medical plan to access the pharmacy benefits and information

Plan Cost Comparison –Monthly Employee Contributions

Buy-Up Plan7/1/14 - 6/30/15

County Plan 7/1/14 - 6/30/15

Cost Difference7/1/14 - 6/30/15

Employee $185 Employee $25 Employee $160

Employee+ Child(ren)

$245 Employee+ Child(ren)

$30 Employee+

Child(ren)

$215

Employee + Spouse

$255 Employee + Spouse

$35 Employee + Spouse

$220

Family $315 Family $45 Family $270

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Rates shown do not include Wellness Incentives

Health Savings Account (HSA)County Plan Enrollees

• The Health Savings Account is a tax-advantaged medical savings account available to employees who are enrolled in a High Deductible Health Plan (HDHP), i.e. the County Plan

• HSA funds can be used to pay for approved medical expenses such as deductibles and coinsurance in The County Plan

• Contributions to your HSA may be made via payroll deductions that the County will administer on your behalf

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Health Savings Account (HSA) Cont. . .County Plan Enrollees

• You must have an active HSA with myCafeteriaPlan to receive funds via payroll deduction, including matching County contributions and incentive earnings.

• Montgomery County will match your pre-tax HSA contributions made via payroll deductions dollar for dollar up to a total match of $1,000 per plan year.

• 50% of the plan year match will be available on July 1; the remaining 50% of the plan year match will be deposited on the first two pay checks each month throughout the plan year

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Health Savings Account (HSA) Cont. . .County Plan Enrollees

• Montgomery County will deposit incentive dollars earned by you and your spouse into your HSA account

• If you miss a payroll contribution the County will not make a matching contribution – this includes interruptions in contributions due to unpaid leave of absence, insufficient pay to cover scheduled contribution and/or receiving short term disability benefits

• You may make additional contributions to your HSA account by lump sum, Electronic Funds Transfer (EFT) or combination (MC will not match contributions you make to your HSA account that are not made via payroll deduction)

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Things you need to know about your HSA• myCafeteriaPlan is the HSA administrator and you must activate an account with

myCafeteriaPlan by August 31st if enrolled in the County Plan

• For calendar year 2014, you may contribute*:• Maximum Contribution* Coverage Level

» $3,300 Single» $6,550 EE+Child(ren), EE + Spouse, Family

*Employees age 55 years or older may make an additional $1,000 contribution to their HSA

• You will receive a debit card to access the funds in your account• myCafeteriaPlan charges a $2.00 per month account maintenance fee• Funds must actually be in your account before you have access to them – like a

regular checking account

• County Plan/HSA Informational Workshops are available to explain this option in more detail

• If you do not activate your HSA account with myCafeteriaPlan: attempts will be made to deposit contributions and incentives for 60 days. After 60 days, if the account is still not open or is inactive, you will forfeit county monies, including the 50% initial county match. If the account is opened at a later date, you will need to notify HR to begin your contributions. No retroactive contributions will be made.

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Am I Elig ib le for the HSA Plan?The IRS and the U.S. Department of the Treasury have specific rules on who can

open an HSA. Refer to www.irs.gov to review the rules before you sign up.

You can open an HSA if you: – Are enrolled in The County Plan, because it features all the components

necessary to be a qualified health plan – Are a U.S. resident but not a resident of Puerto Rico or American Samoa– Are not enrolled in Medicare– Are not claimed as a dependent on another individual’s tax return– Are not active military– Note: This is a partial listing of eligibility requirements. Review the full list of

eligibility requirements on the IRS website. You are responsible for determining your own HSA eligibility status

– Go to IRS.gov or www.mycafeteriaplan.com for more information

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Things you need to do concerning your HSA

• Attend a session of the County Plan/HSA Informational Workshops

• Check your eligibility status for the HSA

• Select a contribution amount during Annual Enrollment (if eligible)

• Visit www.myCafeteriaPlan.com to activate a new HSA account

• If you currently have an HSA account with Benefit Wallet, you can continue to use the funds or transfer them to your new account.

• Reply to correspondence for additional information from myCafeteriaPlan – your account may be frozen for failure to respond

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Flexible Spending Accounts (FSA)Things you need to know:

– myCafeteriaPlan is the FSA administrator– Types of accounts: Health Care, Dependent Care and Limited Purpose FSA

• Set aside tax-free money each pay period to meet eligible expenses incurred during the plan year

• Annual limit on employee pre-tax contributions is $2,500 for Health Care and Limited Purpose FSA

• Annual limit on pre-tax contribution is $5,000 for Dependent Care FSA• The IRS allows a rollover of up to $500 in a healthcare or limited purpose spending

account at the end of the plan year. Any amounts over $500 will forfeited

– Health and Dependent Care FSA accounts are available for use with the Buy-Up Plan• You may contribute to one or both accounts – health care and dependent care

– Limited Purpose FSA and Dependent Care FSA are available for use with the County Plan• Limited Purpose FSA - Reimbursements are limited to eligible vision and dental expenses

– Enrollees for Health Care FSA and Limited Purpose FSA accounts will automatically be enrolled in auto-reimbursement for medical, dental, and vision out of pocket expenses.

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Flexible Spending Accounts (FSA)Things you need to do: – Make a contribution election for the FSA option(s) for which you are

eligible – You must make your election during annual enrollment April 22 through

May 22, 2014– Direct Deposit is mandatory if you elect an FSA

• Go to www.mcbenefits.org for direct deposit forms or • go to www.mycafeteriaplan.com to complete an on-line direct

deposit form electronically– You will not receive reimbursements until you have submitted banking

information for direct deposits– Employees with direct deposit for an existing myCafeteriaPlan account

will not have to resubmit their banking information– You must contact myCafeteriaPlan if you wish to opt-out of auto

reimbursement

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Comparing HSA vs. FSAHSA FSA Limited Purpose FSA

Your Medical Plan Election Requirement County Plan Buy-Up Plan County Plan Only

Primary Use •Current and future eligible expenses•Unused funds roll over from year to year

•Eligible expenses incurred during the plan year•Rollover up to $500 each plan year.

•Current year dental and vision expenses•Available in conjunction with an HSA•Rollover up to $500 each plan year.

Eligible Expenses Typically broader than under FSA (e.g., long term care premiums, acupuncture, medical, dental, and vision expenses)

Tied to specific IRS guideline Tied to specific IRS guideline

After Retirement Can be used to pay Medicare premiums, deductibles, coinsurance , and co-pays tax freeHSA is portable

•Unused money is not yours to take with you•If you leave, you may use FSA under COBRA for the remainder of the plan year

•Unused money is not yours to take with you•If you leave, you may use FSA under COBRA for the remainder of the plan year

Portability •Your account belongs to you• Continue to use the funds in your HSA• Roll it over to another HSA• Transfer to your spouse or your designated beneficiary, upon death•Limited Purpose FSA is not portable

•FSA is not portable•You may use FSA under COBRA only for the remainder of the plan year

•FSA is not portable•You may use FSA under COBRA only for the remainder of the plan year

Fund Growth You have a choice of investment options Not Applicable Not Applicable

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MC healthPERXThings You Need to Know• MC healthPERX is a telemedicine and lifestyle benefits program.• Available to all employees enrolled in a Montgomery County Medical Plan at

no additional cost• Consult A Doctor

– Offers 24/7 access to U.S. licensed physicians for medical consultations at no cost via telephone and secure e-mail

– Provides treatment of non-emergency, acute, short-term conditions involving routine primary care

– Provides medical advice and care for ailments such as cold and flu, upper respiratory infections, sinusitis, upset stomach, etc.

– Physicians can prescribe non-narcotic medication for a common illness or a refill

• Doctor’s Statements will not be provided• HealthPERX includes other services such as travel assistance and fitness

club discounts

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“Take Charge of your Health” is the Wellness Plan

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Things you need to know:• The Wellness vendor for the “Take Charge of Your Health” program is

OptumHealth• “Take Charge of Your Health” offers many programs including Disease

Management, Tobacco Cessation, Stress Management, Weight Management and Wellness Coaching

• All employees are eligible for the wellness program even if you don’t enroll in a Montgomery County Health Plan

• The wellness services are available to all employees and spouses at no cost• All information Optum collects is confidential, governed by Federal Privacy

Laws• Montgomery County will not see any of your personal health information• You can access the Optum Portal through www.mcbenefits.org

Employee Incentive Package 2014-2015 Plan Year

Things You Need to Know:• There are two Incentives available to eligible employees and spouses based on points

totals as of May 22, 2014:

1. Eligible Employees600 points = $ 65.00/per month

1000 points = $115.00/per month total2. Eligible Spouse

600 points = $10.00/per month1000 points = $20.00/per month total

• Incentives are awarded differently depending on medical plan:– Buy-Up Plan = Reduced Monthly employee contribution– County Plan = HSA deposit. 50% deposited July 2014, 50% deposited January 2015

• You must be enrolled in the Buy Up Plan or the County Plan; if you are in the County Plan you must elect a Health Savings Account with myCafeteriaPlan. If ineligible for a Health Savings Account, contact HR to discuss an alternative.

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Healthy Rewards Program 2015-2016 Plan Year

Things You Need to Know:• The program for the 2015/2016 plan year will launch on July 1, 2014• Healthy Rewards Program & Points Menu will be available in June 2014.• New Optum Challenges• Self-Reporting for local events and activities• More flexibility • More points opportunities

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Vision CoverageThings you need to know:

– EyeMed is the plan provider– Members receive an allowance and discounts on frames and contact lenses– Members pay a co-pay for the lenses and eye exam– The frequency for frames has been changed to once every 12 months, the same as

for contacts and lenses– Laser Vision Correction 15% off retail price or 5% of promotional price at select

providers– Members also receive a 40% discount off of a complete pair of eyeglasses and a 15%

discount off of conventional contact lenses once the funded benefit has been used– In-Network and Out-of-Network providers are included in the plan

(in-network discounts are much greater than out-of-network)

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Monthly Vision Contributions

Employee Only $6.01

Employee +1 $12.61

Family $19.22

Dental Coverage *Things you need to know: • MetLife is the new plan provider• You may participate if you are benefits eligible, even if you don’t participate in a

Montgomery County medical plan• Preferred Plan Network is the network of dentists• The two plan designs are: Core and Enhanced

Things you need to do: – Review detailed plan features in the annual enrollment materials – Compare the plans and make an informed decision– Make an election during annual enrollment April 22 through May 22, 2014

*Dental coverage does not apply to employees at MCBDDS and PHDMC**Core Plan does not apply to employees at ADAMHS

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Monthly Dental Contributions

Core** Enhanced

Employee Only $19.20 $27.52

Employee +1 $38.43 $55.12

Family $72.46 $93.67

Life Insurance Things you need to know:

• The Hartford is the life insurance plan administrator• $50,000 Basic Life and AD&D is provided to employee at no cost• You may purchase supplemental life insurance for you, your spouse or dependent

children at your own expense– Does not apply to PHDMC or MCBDDS

• To enroll or increase your supplemental life insurance, elect the increase during annual enrollment by 05/22/14. Your request to increase coverage is subject to approval by the Hartford.

• You may increase, decrease or cancel your Supplemental Life Insurance during annual enrollment

Things you need to do: • Review detailed plan features and rates in the annual enrollment guide or at

www.mcbenefits.org• Compare the plans and make an informed decision • Submit PHA to The Hartford if enrolling or increasing supplemental life insurance

by July 31, 2014• The enrollment system will be available April 22 through May 22, 2014

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Short Term Disability CoverageThings you need to know: • The Hartford is the plan administrator for Short Term Disability (STD) benefit• Provides benefit of 60% of your base pay for up to 26-weeks after

– 14 day waiting period for illness– 7 day waiting period for injury

• Rates are based on your age and base pay– Does not apply to ADAMHS, PHDMC or MCBDDS

• To request new enrollment for STD coverage, elect the STD during annual enrollment by 05/22/14. The Hartford will mail a Personal Health Application (PHA) to your home which you must complete and mail back to The Hartford by July 31, 2014

• Departmental policies vary regarding the use of earned leave prior to STD

Things you need to do: • Review detailed plan features and rates in the annual enrollment guide• If enrolling for the first time, submit completed PHA to The Hartford by July 31, 2014• Select STD option during the open enrollment period (April 22 – May 22, 2014)

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MC Work/Life SolutionsThings you need to know:

– MC Work/Life Solutions offers free and confidential counseling to you and your family members to help you deal with personal issues

– Counselors available 24 hours a day, 365 days a year– Work/Life services assist with daily issues such as

• choosing a child care provider• financial services and care for adults• selecting a school or a college• assisting with parenting issues• moving, relocation and home ownership

– Services are available at no cost – No enrollment is required

Things you need to do:– Visit the website @ www.achievesolutions.net/mcohio for a full list of services

and additional work/life resources

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Enrollment Checklist Review your 2014-2015 Annual Benefits Enrollment Guide

Attend an Annual Enrollment Meeting – schedule available at www.mcbenefits.org

Attend a County Plan / HSA meeting to learn more

Enroll online by May 22nd

Make an informed choice

Review your medical plan use from prior years to ensure you fully understand your personal use of your benefits

Determine which option will best help you Take Charge of Your Health!

Add / Change a dependent

Ensure required dependent documentation is received by the Benefits Department by May 22nd

Determine an HSA contribution amount (only if you enrolled in the County plan)

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ANNUAL ENROLLMENT – SUMMARY

• Review your annual enrollment guide

• Attend an annual enrollment meeting

• If considering the County Plan, attend a County Plan/HSA Informational session

• Check your HSA eligibility status

• Go to mcbenefits.org for more information

• GO ON-LINE AND ENROLL BETWEEN APRIL 22 AND MAY 22, 2014• Everyone must make an active online election by midnight, May 22, 2014 or

you will be enrolled by default in the County Plan, Single coverage

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Any Questions???

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