Employee Benefits

Presentation

2013

Open Enrollment

• Open Enrollment for 2013 Plan Year: Phone the Enrollment Center

December 3rd – 7th 9am-5pm EST

Online December 3th – 14th

• The open enrollment period is your opportunity each year to make changes to your benefits such as:• Adding / Removing dependents• Enrolling or canceling coverage • Changing plans

Benefit Changes During the Year• There are only a few “family status”

changes that allow you to make a change during the year (after open enrollment):

• Marriage or divorce • Birth or adoption of a child • Death of a spouse or dependent• Loss of spouse’s coverage with his/her employer.

• To make changes to your benefits as a result of a qualified family status change:

• Contact the Enrollment Center at 866-688-9727• Present required documents to Human Resources

• You must call the Enrollment Center within 31 days of the date the event occurred. Otherwise you will have to wait until the next annual enrollment period.

National Healthcare Trends• Healthcare costs will continue to increase under the Healthcare Reform Act.• The Healthcare Reform Act does not address cost. Federal and state efforts to

reform healthcare will continue to mainly address access to coverage, yet fail to solve healthcare cost issues or adverse population health.

• “Essential Benefits Package” of healthcare services that policies must cover will continue to increase.

• Population health is declining. The main concern centers around eight health risks and behaviors including poor diet, physical inactivity, smoking, and lack of health screening. The cost of chronic illness accounts for over 60% of healthcare costs.

• Based on Finding by Hewitt Study 2012

National Employer Benefit Trend• Shift to Consumer Driven High Deductible plan as only plan• Reset medical plan to meet only required minimum standard of 60% of

eligible health plan expenses• Mandatory Wellness Exam participation• Use of incentives or penalties to encourage participation in Health

Management Programs• Dependent Surcharges• Tobacco cessation requirements and surcharges

Employees will see only a few changes to the summary plans of the HDHP, HMO or PPO plans offered by BCBS. Additions to the preventive healthcare are a result of the Patient Protection and Affordable Care Act.

This year employees will again see increases in the cost of healthcare coverage due to medical inflation and utilization of health services.

As in the past, Winter will continue to absorb a significant portion of the cost.

Two plan options will be available for Dental and Vision for 2013.

WINTER BENEFIT UPDATE

WINTER BENEFIT UPDATE CONTINUEDDiscounted rate for Non-Tobacco users

• Random Tobacco Tests to be conducted in 2013• If found to be a Tobacco user, have option to enroll in Tobacco cessation

program or pay non-discounted medical contribution • Smoking Cessation Drugs covered at an RX copay

Discounted rate for completing a wellness (annual physical) by 12/31/13• Failure to complete for both employee & spouse will forfeit eligibility for

discounted rate in 2014

Dependent Audit• You must provide proof of eligibility for dependents enrolled in Winter’s

medical plan by 12/31/2012.

Spousal certification If your spouse is eligible for coverage under another employer-sponsored group

medical plan, your spouse must elect that coverage and not be covered under the Winter medical plan

Partners in Healthcare

Winter will… We need you to…

Provide access to high-quality healthcare programs.

Become an informed healthcare consumer and evaluate your benefits to ensure that they meet your needs every year.

Continue offering comprehensive and competitive wellness and health

management programs.

Participate in the wellness and health management programs managed by the carriers and take advantage of the low cost or free preventive healthcare offered through our plans.

Provide access to tools and resources to help you make smart decisions and get the

best value from the benefits you choose.

Get educated and stay informed about Winter benefits.

Know how to access all of your benefit websites. Contact Carriers for information concerning specific Doctors or Prescriptions.

Wellness Programs for BCBS

Log onto www.bcbsga.com to earn reward dollars to redeem gift cards at select retailers. You must qualify to be eligible for rewards.

Earn Rewards by:

• Completing the MyHealth Assessments online ($50)• Enrolling in a Health Coaching Program ($100)• Graduating from a Health Coaching Program ($200)• Completing Healthy Lifestyles Tobacco-Free Program ($50)• Completing Healthy Lifestyles Healthy Weight Program ($50)

Benefits Overview

• Medical – Blue Cross Blue Shield • Dental – Delta Dental

• Vision – Advantica

• Health Savings Accounts – Health Equity

• Flexible Spending Accounts – HealthSmart

• Life/AD&D Insurance - Unum

• Long Term Disability – Unum

• Employee Assistance Program - Unum

• Supplemental Benefits – Aflac

Medical Plans

Benefit Features   HDHP/HSA HMO PPO**In-Network Benefits        

Employee Deductible   $2,500 $500 $500

Family Deductible   $5,000 $1,500 $1,500

Employee Out-of-Pocket   $3,500 $2,500 $1,500

Family Out-of-Pocket   $7,000 $7,500 $4,500

Coinsurance   100% after deductible 80% after deductible 100%

Office Copay   100% after deductible $40 $25

Specialist Copay   100% after deductible $50 $25

Inpatient Services   100% after deductible 80% after deductible 80%

Emergency Room Copay   100% after deductible $150 $150 Out of Network Benefits   70% after deductible N/A 60% after deductibleIn Network Prescription Drugs        

Deductible   After deductible is met:    

Tier 1   you pay $15 you pay $15 you pay $15

Tier 2   you pay $35 you pay $30 you pay $30

Tier 3   you pay $60 you pay $60 you pay $60 Mail Order Drugs (90 day supply)   you pay $15/$70/$180 you pay $15/$60/$180 you pay $15/$60/$180

Medical Rates

Non-Tobacco/Wellness Rates

  HDHP/HSA HMO PPO**

   Hourly (weekly)

Salary (bi-weekly)  

Hourly (weekly)

Salary (bi-weekly)  

Hourly (weekly)

Salary (bi-weekly)

Employee   $22.82 $45.64   $32.39 $64.77   $32.39 $64.77

Employee + Spouse   $89.82 $179.65   $116.99 $233.99   $116.99 $233.99Employee + Child(ren)   $66.39 $132.77   $85.52 $171.04   $85.52 $171.04

Family   $114.57 $229.14   $154.43 $308.86   $154.43 $308.86

Tobacco/Non-Wellness Rates

  HDHP/HSA HMO PPO**

   Hourly (weekly)

Salary (bi-weekly)  

Hourly (weekly)

Salary (bi-weekly)  

Hourly (weekly)

Salary (bi-weekly)

Employee   $40.45 $80.91   $48.53 $97.05   $48.53 $97.05

Employee + Spouse   $127.65 $255.30   $152.17 $304.34   $152.17 $304.34Employee + Child(ren)   $84.02 $168.04   $101.66 $203.32   $101.66 $203.32

Family   $162.54 $325.07   $200.46 $400.92   $200.46 $400.92

                   

**PPO: for employees that reside in an area without access to the HMO Network            

Think About:Here are some questions to think about when deciding if purchasing HDHP Coverage is right for you and your family

• How much freedom do you want in deciding who delivers your healthcare?

• Do you like the freedom to see a physician or specialist without a referral?

• How much did you pay out-of-pocket for healthcare last year: Did you meet (or would you have met) your individual or family deductible? How about your out-of –pocket limit?

• Do you want access to a medical plan that provides a means to reduce your taxable income while paying for medical expenses?

• Will you take advantage of the full coverage for preventive care?

• Are you or other members of your family covered under you spouse’s medical plan? What kind of coverage does this other Plan offer? At what Price?

• Are low contributions attractive given that your initial expenses are paid out-of-pocket until the deductible is met?

Think About:Here are some questions to think about when deciding if purchasing HMO Coverage is right for you and your family

• Do you want access to a regional or national healthcare network?

• How much freedom do you want in deciding who delivers your healthcare?

• Have you established a relationship with a doctor that you want to keep seeing? Is your doctor in-network in the HMO?

• Do you mind having no out-of network benefits?

• Does the convenience of fixed dollar copayments provide simplicity in budgeting for healthcare expenses?

• Are a low deductible and set co-pay attractive given that your yearly expenses out-of-pocket could be higher?

• Are you or other family members covered under you spouse’s medical plan? What kind of coverage does this other Plan offer? At what price?

Reminders

• Difference in Paycheck Deductions between the HDHP/HSA and the HMO (or PPO for those out of area)

EE Savings = $497.38 EE + Spouse Savings = $1412.84 EE + Child(ren) Savings = $995.02 Family Savings = $2,072.72

• Winter Makes Contributions to HSA (prorated amount funded semi-annually)

$625 Employee Only $1,250 Employee + Spouse, Child(ren), or Family

• Wellness Incentives Available to • HDHP/HSA Plan Participants Incentives provided by BCBS (see page 4 of Enrollment Guide)• HMO/PPO Plan Participants Incentives provided by BCBS (Health Assessment)

Health Savings Account Winter Contributes to your Health Savings Account

- Single Coverage: $ 625 annually

- Family Coverage: $1,250 annually

Tax Savings - Pre-tax Payroll deductions, so you pay less taxes

Long-term Savings - Account grows tax-deferred. After age 65, you may withdraw from your HSA for any reason without penalty (except applicable taxes)

Reduced Insurance Premiums - Your monthly premium is lower - Use savings to fund your HSA

Eligible Expenses – May be used for medical expenses not covered under your medical plan as well as dental and vision expenses not covered by other insurance

Flexible Spending Account

• Healthcare Account:

- Up to $2,500 per year

Eligible expenses include:

• Co-pays & deductibles

• Vision care (glasses, contact lens & supplies, Lasik Surgery)

• Doctor prescribed weight loss

• Prescription & some over-the-counter drugs

• Dental expenses, Orthodontia

• Chiropractic treatments

• Physical therapy

• Drug & alcohol rehab

• Obstetrical expenses

• Psychiatric & counseling costs

• Infertility treatments

An FSA allows you to set aside funds on a pre-tax basis for predictable out-of-pocket expenses not covered under a medical plan.

REMEMBER – These are “Use It or Lose It” Accounts. You must incur expenses during the plan year.

If you are enrolled in the HDHP plan you may

either elect an FSA of an HSA

A prescription is needed for over-the-counter

drugs to be an eligible expense

Think About:When considering participation in the Healthcare FSA, think about these questions:

• Do you incur eligible medical, dental, or vision expenses which can be predicted ahead of time?

• Are you scheduling any elective procedures which are covered expenses in the Health FSA?

• Are you covered by an HMO or non-HDHP medical plan?

• Is the opportunity to put aside pre-tax dollars for eligible healthcare expenses important to you?

Dental Benefits

 Delta Dental

Base Plan

Delta Dental

Buy-Up Option

Annual Deductible(applies to Basic & Major Services) $50/$150 $50/$150 Preventive 100% 100% Basic (simple oral surgery/fillings) 80% 80% Major (crowns, bridges, dentures, inlays) 50% 50% Endodontics 80% 80% Periodontics 80% 80%Calendar Year Maximum $1,000 $2,000     Orthodontia (Dependent Children) N/A 50% Deductible N/A $50 Lifetime Maximum N/A $2,000     

Payroll Deductions  Weekly Salary Weekly Salary

Employee $1.80 $3.60 $3.96 $7.93Employee + Spouse $6.67 $13.32 $9.61 $19.23

Employee + Child(ren) $5.99 $11.98 $8.94 $17.89Family $8.51 $17.01 $13.49 $26.99

Vision Benefits

 Advantica

Base Plan

Advantica Buy-Up Option

Network Benefits    Eye Examination $10 copay; Once

every 12 Months$10 copay; Once every 12 Months

Lenses $25 copay; Once every 12 Months

$15 copay; Once every 12 Months

Frames $25 copay or $100 allowance;

Once every 24 Months

$15 copay or $150 allowance;

Once every 24 Months

Contacts (in lieu of Eyeglasses)     Elective $25 copay; $100

materials allowance

$15 copay; $150 materials allowance

Medically Necessary $25 copay; $250 materials allowance

$15 copay; $250 materials allowance

Payroll Deductions  Weekly Salary Weekly Salary

Employee $1.37 $2.74 $1.69 $3.39Employee + Spouse $2.74 $5.48 $3.21 $6.42

Employee + Child(ren) $2.74 $5.48 $3.21 $6.42Family $4.57 $9.14 $5.36 $10.73

Common Mistakes that Cost You $ Mistake # 1: Going Out-of-Network for Medical Services

What can you do to make sure you don’t make that mistake? Go to www.bcbsga.com to find an in-network provider.

Call Health Advocate for help finding an in-network provider.

Find out before you go – after services are rendered, it’s too late.

Mistake #2: Having Dental Work Performed Without Getting a Pretreatment Estimate

What can you do to make sure you don’t make that mistake? Find out how much it is going to cost you before you go.

Many dentists do not participate in insurance plans, but they will tell you that they will file the claims for you - - In this situation, it is even more important to get the pretreatment estimate.

Mistake # 1: Not Getting A Wellness Exam

What can you do to make sure you don’t make that mistake?

Make your appointment early

If your spouse is on Winter’s medical plan, they will also need to get an exam

Take the Preventive Care Sheet and Wellness Verification Form with you to your exam.

Life & AD&D Basic Term Life

Provided by Winter for yourself at 1 times your base salary (to maximum of $250,000)

Voluntary Term Life/AD&D • Available for yourself, your spouse, and/or your children. • Evidence of Insurability (EOI) forms are required for any amounts over the

Guaranteed Issue; changes to your coverage; or if you wish to enroll after you initial eligibility period.

Voluntary Term Life/AD&D Amounts Self - $10,000 increments up to $500,000. Guaranteed Issue: $140,000 to age 65

Spouse - $5,000 increments up to 100% of employee coverage, not more than $250,000. Guaranteed Issue: $25,000 to age 65

Child - $2,000 increments up to $10,000. Guarantee Issue: $2,000

Long Term Disability

Monthly Benefit60% of your monthly earnings, to a maximum of $6,000

Benefits begin after 90 days of disability

Benefit Durationto age 65, if disability occurs before age 60

Age Rates

0-29 $0.37

30-34 $0.42

35-39 $0.56

40-44 $0.84

45-49 $1.27

50-54 $1.64

55-59 $2.17

60-64 $2.34

65-99 $2.59

Health Advocate Provides assistance with the following:

•Locating qualified doctors and hospitals

•Schedule appointments with hard to reach specialists

•Help maximize your benefits

•Provide help using existing provider networks

•Help resolve eligibility, benefit and claims issues

•Assist with eldercare issues

Voluntary Products

• Accident

• Short Term Disability

To Enroll: Call Leslie Parker by December

16th

404-432-6174

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What if they got a job in your name? Crimes in your name? HIV test? Passport? The average victim spends 600 hours and $1500 clearing their good name.

LegalShield

Identity Theft Shield

Only $5.98 for both LegalShield & Identity Theft Shield (per week)

$3.68/week (LegalShield alone) $3.22/week (ID Shield alone)

Open Enrollment

Winter.empowHR.com or call 866-688-9727

Review all your enrollment selections for accuracy

Complete enrollment by 12/14

Dependent Audit – Submit your documents by 12/31

Spousal Certification due by 12/31