Open Employee Forum Medical Plans for 2012 September 14, 2011

Open Employee ForumMedical Plans for 2012

September 14, 2011

\EB\STLUN\2011\Employee Open Forum 9-14-11.pptx

2012 Medical/Prescription Drug Benefits•SLU will continue to offer two programs:

Plus PPO Plan (with a modified Rx component)

Health Savings Account (HSA) Qualified Plan


2012 Medical Plan Options

Plus Plan HSA Plan

SLUCare In-Network Out-of-Network SLUCare In-Network Out-of-Network

DeductibleNon-Embedded: (One member can satisfy entire family deductible)

Individual $0 $250 $750 $1,500 $1,500 $3,000

Family $0 $500 $1,500 $3,000 $3,000 $6,000

Coinsurance 0% 10% 40% 0% 10% 40%

Out-of-Pocket Maximum (includes deductibles)Non-Embedded: (One member can satisfy entire family OOP Max)

Individual $0 $1,250 $4,750 $1,500 $3,000 $6,000

Family $0 $2,500 $9,500 $3,000 $6,000 $12,000

Physician Office Visits

Primary Care $10 copay10% after ded. 40% after ded. 0% after ded. 10% after ded. 40% after ded.

Specialist Care $20 copay

Preventive Care 100% 100% 100% 100% 100% 100%

Inpatient Hospital

10% after ded. 40% after ded. 10% after ded. 40% after ded.

Emergency Room

$100 copay $100 copay 10% after ded. 40% after ded.

Urgent Care Center

$50 copay $50 copay 10% after ded. 40% after ded.


2012 Pharmacy Plan Options

Plus Plan HSA Plan

Express Scripts

Retail

(34-day supply)

Express Scripts

Mail Order

(90-day supply)

Express Scripts

Retail

(34-day supply)

Express Scripts

Mail Order

(90-day supply)

Tier 1 $8 $16 Medical Deductible and Coinsurance



Tier 4 20% to $150 Medical Deductible and Coinsurance

Preventive Medications

Priced according to the tier in which they fall

Covered at 100%, no copay or deductible

NEW! Under the proposed HSA plan, certain preventive, or “maintenance,” medications would be covered at 100%...

NO copay or deductible would need to be satisfied by you or your family!

Information on which drugs qualify as preventive will be distributed during open enrollment.


What is an HSA?

Health Savings Accounts (HSAs) are designed to help you save and pay for your health care


OptumHealth BankSM, Member FDIC

Focuses solely on health care banking

We administer over 600,000 individual Health Savings Accounts

Is one of the nation’s leading custodians of health savings accounts

We offer three HSA options to meet individual goals

UnitedHealthcare HSA Bank of Choice

Established in 2003

OptumHealth Bank serves thousands of employers, families and individuals

We have more than $1 billion in assets


HSA Overview

Require a High Deductible Health Plan

Used to pay for qualified

health care expenses

immediately

Grows over time and can be invested

Funded by you, your employer

or others

Account funds belong to you

Investments are not FDIC insured, are not guaranteed by OptumHealth Bank and may lose value.


HSA Eligibility

You are eligible to open and contribute to an HSA if you:

Are covered by an eligible high deductible health plan

Are not covered by a healthcare FSA

Are not claimed as a dependent on someone else’s tax return

Have not received VA benefits within the past 3 months

Are not enrolled in Medicare, Medicaid, or TRICARE

Are not covered by any other health plan that is not a high deductible plan


Amount of Funding

The IRS determines how much you can fund.

Contribution Limits

Rules For 2012, individuals can contribute up to $3,100 and $6,250 for families.

Additional Funding

Those 55 years of age or higher, but not entitled to Medicare benefits, can fund an additional $1,000/year “catch-up” contribution!


How an HSA Helps You Save

Steve

Steve puts his money into his HSA pre-tax

1

The amount not spent during this year carries over for use in future years.

4

Any money Steve withdraws from his HSA to pay for qualified medical expenses is withdrawn income tax-free.

2

Steve may earn interest on his account, and it is not taxable.

3

\EB\STLUN\2011\Employee Open Forum 9-14-11.pptx11

How Much Did Steve Save?

Steve does not have to pay income taxes on his interest.

Steve’s federal and state income tax savings on his contributions for the year are $2,291.

Steve will not have to pay income taxes on the $3,000 as long as he uses it to pay for qualified expenses.

With a traditional plan, Steve wouldn’t have this carryover option, which helps him save for the future.

In 2012, Steve will deposit $6,250 into his HSA, the maximum contribution for family coverage.

1

Steve will withdraw $3,000 to pay for qualified health care expenses for him and his family.

2

Steve earns interest on his account.

3

Steve will carry over $3,250 HSA dollars (contributions—expenses + account earnings) into the next year.

4


How You Can Make the Most of Your Coverage

Health Care Consumerism

Make informed choices

Look for ways to lower health care costs

Own your health care decisions

Understand your medical coverage

Maintain a healthy lifestyle

Use your preventive care coverage to catch health

issues early


HSA Qualified Medical Expenses

Any money you take out of your HSA for qualified medical expenses is income-tax free

Medical plan deductibles and

coinsurance

Medical, dental and vision care and

services

Use HSA dollars to pay for medical

expenses for your spouse or

dependents


Other HSA-Qualified Medical Expenses

Health coverage while

receiving unemployment

benefits

COBRA continuation

coverage

Eligible long-term care

Medicare premiums and out-of-pocket

expenses

1

2

3

4


Paying for Non-Qualified Expenses

Any funds used for purposes other than to pay for qualified medical

expenses are:

Taxable as income

Subject to a 20 percent tax penalty

The tax penalty increased from 10 to 20 percent in

2011. The penalty does not apply to account holders

age 65 and older, those who become disabled or enroll

in Medicare.


Save Your Receipts!

16

• Save your receipts for all qualified health expenses.

• OptumHealth Bank does not track or validate your expenses or verify eligibility.

Important Tips:


How Molly Uses Her HSA

Molly

Molly goes to the doctor

with her HSA

Molly presents her UnitedHealthcare health plan ID card at the doctor’s office

1

Molly receives and pays her doctor’s bill

4

Molly fills her prescription3

Molly keeps her receipts5

The doctor submits a claim to the health care plan

2


Managing Your HSA with myuhc.com

• Check monthly statements and interest rates

• Pay bills to health care providers

• Download forms needed to manage your account

• Update personal information

• Arrange deposits from another banking account

• Manage investment activities for your HSA

• Learn about HDHPs and HSAs

• Use HSA calculators

18

Investments are not FDIC insured, are not guaranteed by OptumHealth Bank and may lose value.


Common Questions

19

Yes. You can open an HSA at any time, as long as you are covered by an HSA-eligible health care plan

Can I open a Health Savings Account at any time during the year?

1

Can I take the funds in my HSA with me if I leave the company?

2

Am I required to contribute a specific amount each year?

3

Do I need to use all of the funds in my HSA during the year?

4

Yes. Funds in your HSA belong to you, including any contributions that your employer or anyone else has made.

No. You can contribute as much as you’d like up to the IRS maximums. Most people base contributions on the annual deductible required by their HDHP.

No. HSA plans are not subject to IRS “Use It or Lose It” regulations. This means that funds in the account continue to accumulate over time.


To Learn More Online

20

A series of short, online training sessions on HSAs are available at any time

You can access all Health Accounts Self-Guided Tours at the site below.

Access all Self-Guided Tours at: www.hsaenroll123.com/self-guided-tours/

http://www.hsaenroll123.com/self-guided-tours

http://www.hsaenroll123.com/self-guided-tours


2012 Cost Sharing

• If you enroll in the HSA Qualified Plan for 2012, SLU will contribute funds to help you build your balance:

$250 for Single Enrollees $500 for Enrollees with Family Members

• Wellness Incentive increased from $20 to $30 for 2012

Plus PlanMonthly Payroll Deductions With Wellness Incentive Without Wellness IncentiveSingle $94.34 $124.34Employee and Spouse $313.79 $343.79 Employee and Child(ren) $283.90 $313.90Family $448.26 $478.26

HSA Qualified PlanMonthly Payroll Deductions With Wellness Incentive Without Wellness IncentiveSingle $29.81 $59.81Employee and Spouse $178.28 $208.28 Employee and Child(ren) $161.30 $191.30Family $254.68 $284.68


2012 Cost SharingAnnual Contribution Difference vs. 2011 Plus Plan

Plus PlanAnnual Difference in Payroll Deductions With Wellness Incentive

Single $304.44

Employee and Spouse $181.92

Employee and Child(ren) $164.52

Family $259.80HSA Qualified Plan

Annual Difference in Payroll Deductions With Wellness Incentive

Single ($469.92)

Employee and Spouse ($1,444.20)

Employee and Child(ren) ($1,306.68)

Family ($2,063.16)

• If you enroll in the HSA Qualified Plan for 2012, SLU will contribute funds to help you build your balance:

▫ $250 for Single Enrollees▫ $500 for Enrollees with Family Members


Eligible DependentsDefinition of an Eligible Dependent

Legal spouse or dependent child under 26 years of age of the employee or the employee's spouse. The term child includes any of the following:

• A natural child• A stepchild• A legally adopted child• A child placed for adoption• A child for whom legal guardianship has been awarded to the

employee or the employee's spouse• Handicapped children over the age of 26 with certification from

a physician


Dependent Eligibility Audit• SLU has a responsibility to:

Administer the plan as stated in the plan document Administer the plan consistently for all employees Monitor the costs of the plan

• SLU will complete a Dependent Eligibility Audit in early 2012 Employees will be asked to provide verification for enrolled

dependents Ineligible dependent will be removed from the plan Claims paid for ineligible dependents may be recovered and

the expenses would become the responsibility of the employee

• Additional information will be provided


Vitality Program• Activity Distribution

▫ Members completing 2-5 activities April: 60% of total population May: 55% of total population June: 52% of total population

▫ Members completing over 10 activities April: 5% of total population May: 10% of total population June: 12% of total population

• Vitality Status Earned (YTD)▫ April/May/June

Blue: 1,874/1,897/1,868 Bronze: 740/722/757 Silver: 1,694/1,733/1,752 Gold: 16/20/28 Platinum: 1/4/6

• Verified Workouts ▫ April: 46▫ May: 334 Added Simon Rec Center

▫ June: 427• Education Activities

▫ April: 306▫ May: 342▫ June: 365

• Healthy Living Activities ▫ April: 40▫ May: 63▫ June: 70

• Prevention Activities ▫ April: 79▫ May: 118▫ June: 142


Contact Information

•Please email questions or comments to: [email protected] [email protected]

•Your feedback is important!!!

mailto:[email protected]

mailto:[email protected]

Documents

Open Employee Forum Medical Plans for 2012 September 14, 2011