2017 Open Enrollment Presentation - College of the Holy Cross · 2018-07-20 · 2017 Open Enrollment Presentation ... •To ensure the sustainability of our benefit programs by managing

2017 Open Enrollment

Presentation

October 25, 2016

Benefit Program “Guiding Principles”

• To promote the physical, behavioral, and spiritual health of our faculty, staff

and their families by offering competitive benefits.

• To provide an appropriate level of choice to meet different life stage needs at

a reasonable cost for the College, its faculty and staff.

• To ensure the sustainability of our benefit programs by managing the cost of

our benefit plans in a fiscally responsible way.

• To communicate the College’s benefits effectively, so that faculty and staff

understand the value of the benefits that we provide.

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Multi-Year Initiatives

• Bring contributions in-line with higher education benchmarks (2017 is year

4 of a multi-year plan).

• Implement plan design changes that are competitive, provide choice and

manage cost.

• Expanded wellness programs & initiatives.

• Identify opportunities to reduce overall cost.

• Continue communications efforts.

• Annually to adjust employer contributions by 2% of the lowest cost

traditional HMO plan (but NOT for 2017).

3

4

Holy Cross’ plans are very competitive

when compared to peers… Educational Institutions Benchmarked

Amherst College Massachusetts Institute of Technology

Babson College Mount Holyoke

Bentley University Mount Ida College

Berklee College of Music Northeastern University

Boston College Simmons College

Boston University Stonehill College

Brandeis University Suffolk University

Cambridge College Tufts University

Clark University Wellesley College

Emerson College Wentworth Institute of Technology

Gordon College Western New England University

Hampshire College Wheaton College

Harvard University Williams College

Merrimack College Worcester Polytechnic Institute

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How do we stack up?

Value

Core

Buy Up

Holy Cross employee contributions are very competitive!

These are 2016 rates compared with 2016 benchmarks.

6

How do we stack up?

Value Core

Buy Up



7

How do we stack up?


Value Core

Buy Up


8

How do we stack up?


Value Core

Buy Up


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What’s New For 2017…

• 4 Tier Medical and Dental rate structure to meet the different life stage needs of our

faculty and staff.

60% of all employees in the Medical Plans will see their costs go down!

• Modest medical copay changes to mitigate premium increases.

• Increased dental calendar year maximum benefit to $2,000.

• New Employee Assistance Program (EAP) vendor, KGA, Inc.

2017 Plan Options

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This is a brief summary of benefits. If there are any discrepancies between this and the Fallon/HPHC certificate, the Fallon/ HPHC certificates will always take precedence.

Best Value Plan College Contributes into HSA: $500 Individual / $1,000 Family (all tiers)

2017 Copay Changes are indicated in Red Font

* MERP Reimburses: $125 Inpatient and $50 Outpatient

Medical Summary Effective 1/1/2017

Deductibles

Coinsurance

Out-of-Pocket:

Medical

Prescription Drug

Office Visits:

Annual Preventive Exam

Routine Vision Exam

Office Visits (PCP)

Specialist Visits

Chiropractic Care:

Emergency Care

Emergency Room

Urgent Care

Inpatient / Outpatient Services

Inpatient Hospital

Ambulatory Day Surgery

Diagnostic X-Ray/Lab

Imaging (CT/PET Scans, MRIs)

Durable Medical Equipment

Prescription Drugs

Retail (30 days)

Mail (90 days)

$20 copay

Plan pays 100% Plan pays 100%

$100 copay $100 copay

$30/$60/$100 $30/$60/$100

$125 copay *

(After MERP you pay $75)

$125 copay *

(After MERP you pay $75)Plan pays 100% after deductible

Plan pays 100%Plan pays 100%

$20 copay

$35 copay

$20 copay

Plan pays 100% Plan pays 100% $25 copayPlan pays 100%

$25 copay $25 copay$25 copay after deductible

$100 copay $100 copay $50 copay$100 copay after deductible

Included in Medical

$125 copay *


100% 100% 100%100%

$1,000 / $2,000 $1,000 / $2,000 $2,000/ $4,000$4,000 / $8,000



Plan pays 100% Plan pays 100%

$250 copay *


$250 copay *

(After MERP you pay $125)Plan pays 100% after deductible

HMO Direct Care HDHP or Select Care HDHP

Fallon Fallon Harvard PilgrimFallon

In-Network Only In-Network Only In-Network OnlyIn-Network Only

n/a n/a n/a $1,500/ $3,000

Direct Care HMO Select Care HMO

Included in Medical Included in Medical Included in Medical

$30/$60/$100$30/$60/$150

$100 copayPlan pays 100% after deductible

Plan pays 70% Plan pays 70% Plan pays 80%Plan pays 70% after deductible

Deductible applies then,

$15/$30/$50 $15/$30/$50 $15/$30/$50$15/$30/$50

Plan pays 100% Plan pays 100% after deductible


$250 copay *


Medical Plans 4 Tier Rates

Employee & Child(ren):

Employee, Spouse & Child(ren):

Employee:

Employee & Spouse:



Total

Monthly Cost

Employee

Monthly Cost

Employee

Annual Cost

Holy Cross

Annual

Contribution

Holy Cross

Monthly

Contribution

Best Value HDHP Fallon Direct

Best Value HDHP Fallon Select

Fallon Traditional HMO Direct

Fallon Traditional HMO Select

Fallon PPO (for those living outside of the Fallon Provider Service Area)

Harvard Pilgrim HMO

Employee:

Employee & Spouse:



Employee:

Employee & Spouse:



Employee:

Employee & Spouse:



Employee:

Employee & Spouse:



Employee:

Employee & Spouse:

$4,572.00

$532.43

$1,613.25

$532.43

$1,613.25

$532.43

$466.38

$1,413.12

$466.38

$1,413.12

$1,613.25

$233.16

$706.56

$1,215.36

$3,682.56

$15,362.64

$14,859.72

$7,465.32

$8,709.72

$3,918.60

$7,749.24

$19,615.08

$1,040.04

$3,151.44

$2,177.04

$6,596.52

$4,147.44

$12,566.88$1,047.24

$19.43

$58.88

$101.28

$306.88

$725.81

$326.55

$381.00

$156.01

$182.02

$86.67

$262.62

$181.42

$549.71

$345.62

$5,596.56

$16,957.44

$5,596.56

$16,957.44

$6,389.16

$6,389.16

$19,359.00

$6,389.16

$19,359.00

$6,389.16

$19,359.00

$11,752.68

$10,073.76

$11,500.44

$13,417.08

$11,500.44

$619.10

$1,875.87

$713.85

$2,162.96

$878.05

$2,660.49

$3,247.84 $1,613.25 $19,359.00

$532.43

$2,238.59

$2,356.40

$1,634.59

$13,417.08

$958.37

$1,118.09

$958.37

$1,118.09

$958.37

$645.77

$485.81

$1,472.00

$567.66

$1,720.00

$1,178.20

$1,020.20

$874.46

$1,114.38

$1,499.09

$1,284.92

$1,843.90

$1,580.48

$1,192.08

$1,021.79

$1,300.11

$489.72

$419.76

$2,187.72

$979.39

$839.48 $10,073.76

$11,752.68 $40.81

$34.98

$979.39

$839.48

$212.69

$182.31

$1,872.12

$2,184.24

$2,552.28

$13,417.08

$11,500.44 $1,280.22

$1,238.31

$622.11

$1,118.09

$958.37

$1,118.09 $13,417.08

$11,500.44

2017 Medical Costs by Plan

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You Pay

Value

Core

Buy Up

2017 Employee Premium Contributions

12

Best Value

Medical Plan 4 Tier Rates



Employee:

Employee & Spouse:


Employee & Spouse:



Employee:

Employee & Spouse:

Employee & Spouse:

Employee:

Employee:

Employee & Spouse:


$549.71

$1,280.22

$1,356.78 $1,634.59

Fallon PPO (for those living outside of the Fallon Provider Service Area)


Employee:

Employee & Spouse:



$645.78$527.18

$1,356.78

$919.91 $1,047.24

$345.62$354.64

$1,238.31$1,356.78

$919.91 $725.81

$919.91 $622.11

Harvard Pilgrim HMO

$181.42$186.16

$230.34 $262.62

$483.31 $381.00

$483.31 $326.55

$230.34 $182.02

$230.34 $156.01

Fallon Traditional HMO Select

$483.31

Best Value HDHP Fallon Select

$86.67$88.84

$101.28$103.93

Fallon Traditional HMO Direct


Employee:

$270.17 $306.88

$270.17 $212.69

$270.17 $182.31

$51.64 $34.98

$40.81$51.64

$19.43$19.94

2016 Employee

Monthly Cost

2017 Employee

Monthly Cost

Best Value HDHP Fallon Direct

$51.64 $58.88Employee, Spouse & Child(ren):


These plans provide a great opportunity for you to save money…

Employee premium contributions are much lower.

Upfront College HSA contribution of $500 per individual or $1,000 per family (all tiers).

HSA is a Tax-Free benefit; it is your money that carries over into next year; no “Use it or Lose

it”.

A great option for employees (and family members) looking to maximize tax advantaged

savings opportunities.

Facts about the 2017 Best Value Fallon High Deductible Plans

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Direct HMO Select HMO Direct HMO Select HMO Direct HMO Select HMO Direct HMO Select HMO

$86.67 $181.42 $182.02 $381.00 $156.01 $326.55 $262.62 $549.71

Direct HDHP Select HDHP Direct HDHP Select HDHP Direct HDHP Select HDHP Direct HDHP Select HDHP

$19.43 $101.28 $40.81 $212.69 $34.98 $182.31 $58.88 $306.88

Monthly Savings: $67.24 $80.14 $141.21 $168.31 $121.03 $144.24 $203.74 $242.83

Annual Contribution Savings:

(Assumes deposited into HSA)$806.88 $961.68 $1,694.52 $2,019.72 $1,452.36 $1,730.88 $2,444.88 $2,913.96

College Contribution to HSA: $500 $500 $1,000 $1,000 $1,000 $1,000 $1,000 $1,000

INDIVIDUAL EMPLOYEE, SPOUSE, & CHILD(REN)

Traditional HMO Plans

2017 Monthly Contribution

EMPLOYEE & CHILD(REN)EMPLOYEE & SPOUSE

$3,914

Best Value Fallon High Deductible

2017 Monthly Contribution

Total Contribution Savings +

College Contribution into HSA:$1,307 $1,462 $3,445$2,452 $2,731$2,695 $3,020

Health Plan Offerings 2017 (Plan Comparison)

“Best Value” Fallon

High Deductible Health Plan w/ HSA

Lowest Traditional HMO

(Limited Network)

Moderate & High Traditional HMO

(Broader Network)

Fallon Direct

(Lowest Cost)

Fallon Select

(Low Cost)

Fallon Direct Fallon Select & Harvard Pilgrim

Benefits: • Option of either limited or broad network

• $1,500 individual & $3,000 family deductible

• Much lower employee contributions vs.

traditional offerings

• Tax advantaged Health Savings Account HSA

• College contributes to HSA in January:

$500/ Single; $1,000/ Family (all tiers)

• Limited network

• No deductibles

• Low contributions

• Moderate copays

• College reimburses a

portion of Inpatient &

Outpatient Surgery

copayments (MERP)

• Broadest network

• No deductibles

• Highest contributions (Harvard);

Moderate contributions (Fallon)

• Moderate copays

• College reimburses a portion of

Inpatient & Outpatient Surgery

copayments (MERP)

Who would

this plan

appeal to?

• Those interested in saving money

• People that are looking to maximize tax

advantaged savings opportunities – you can

contribute up to $3,400 /S & $6,750/F / year

• Employee, Spouse, and Child(ren), much

lower employee contributions with enough

savings between employee contributions and

HSA College contribution to more than pay

for the deductible.

• OK with limited provider

network

• Do not want to track claims

• Not willing to pay more for

provider choice

• High utilizers of health care &

prescription drugs

• Need access to broader provider

network

• Do not want to track claims

• Willing to pay much more for

provider access

Contributions: $( “Best Value”)

$$(Lower Cost)

$$$/$$$$(Moderate/Highest Cost)

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Want to Reduce Your Per Pay Period Contributions?

Evaluate the New Rate Tier Structure: Our new Employee & Spouse and Employee

& Child(ren) option may offer your family the opportunity to save money.

Consider the Network Options: Move from the Fallon Select plans to the Fallon

Direct plans and the Harvard Pilgrim plan to Fallon plans.

Be an Educated Consumer: Switch to one of the Best Value Fallon High Deductible

Health Plans. (Particularly true, if you are currently enrolled in full family coverage)

Consider These Ways to Save $$

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Employee Assistance Program (EAP)

Services

• Behavioral and Mental Health Consulting

• Financial Consultation

• Parenting Resources

• Career Assessment

• Crisis Response

• Work-Life Balance Research and Referrals

• Legal Assistance

• Eldercare Resources

• Nutrition Consultation

• Manager Consultations

Need to Know

• KGA services are confidential! KGA does not share with the College who has

called or what they called about.

• KGA counselors are licensed, skilled professionals.

• Family Members are eligible and encouraged to use this resources as well!

• KGA will be an active participant in the Worksite Wellness programming.

• Access to expanded and improved resources and tools for Faculty and Staff.

How do you

Contact the EAP?

Toll Free: 800-648-9557

Website: www.kgreer.com

Special Note: KGA services will begin 1/1/2017. Contact E4 Health at 800-828-6025 for any services prior to that date.

Our new vendor is KGA, Inc., the local leader in providing employment support and services!

Things to Remember…

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• Consider new rate tier structure and plan options available to meet your

specific individual or family needs.

• New ID Cards for those who are enrolled in the Traditional plans– If you have made a change in plan, you will also receive new ID cards.

• Visit Benergy for Benefit details and additional information– www.HCbenefits.benergy.com

– User ID: HCemployee

– Password: HCbenefits

• If on a Traditional HMO, submit your MERP claims for any Inpatient and/

or Outpatient Hospital Copays that you have paid.– Send to Sullivan Benefits a completed MERP claim form and a copy of your Explanation

of Benefits from either Fallon or Harvard indicating that you have incurred an inpatient

and/or outpatient service and a copayment applies.

• If enrolled in the FSA, submit claims for reimbursement “Use it or Lose it”– You have until March 15th to incur claims & until April 30th to submit for reimbursement.

http://www.hcbenefits.benergy.com/

Next Steps…

Do you Want to Save $$??

Sign-Up For a Seminar on the Best Value plans…

(Fallon High Deductible Health Plan(s) with HSA)

DATES & LOCATIONS TO FOLLOW

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Documents

2017 Open Enrollment Presentation - College of the Holy Cross · 2018-07-20 · 2017 Open Enrollment Presentation ... •To ensure the sustainability of our benefit programs by managing