Post on 15-May-2015
transcript
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NORTHERN ARIZONA PUBLIC EMPLOYEES BENEFIT TRUST
Open
Enrollment
Plan Year
July 1, 2011 – June 30, 2012
May 2 – 31
2011
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OPEN ENROLLMENT OBJECTIVES
•NAPEBT Trends and History•Medical Plans •Dental Plans •Vision Plans •Life Insurance Plans •Flexible Spending Accounts•Health Savings Account•Considering Retirement?
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NAPEBT Medical PlansTrends & History
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NAPEBTNorthern Arizona Public Employees Benefit Trust
• Coconino County
• City of Flagstaff
• Coconino Community College
• Flagstaff Unified School District
• NAIPTA
Northern Arizona Intergovernmental Public Transit Authority
• Housing Authority
• Accommodation Schools
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NAPEBT – TrendsNAPEBT Health PremiumTrend versus National Health Premium Trend
$0
$100
$200
$300
$400
$500
$600
95-96
96-97
97-98
98-99
99-00
00-01
01-02
02-03
03-04
04-05
05-06
06-07
07-08
08-09
09-10
10-11
Plan Year
Mo
nth
ly E
mp
loye
e R
ate
NationalTrendNAPEBT
National health premium trend data is from the Hay Benefits Reports (Hay Group) adjusted from a calendar year basis to correspond with NAPEBT's fiscal year. The 2010 trend data was not available from Hay, therefore, the 2009 trend increase percentage was used. For the 2006-2007 plan year the NAPEBT contribution rates are a blend of the one plan offered (7/1/06-12/31/06) and three plans offered (1/1/07-6/30/07) weighted by enrollment. For the 2008-2009 and 2009-2010 plan years the NAPEBT rates are a blend of all three plans weighted by enrollment.
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NAPEBT – Total Medical Claims Paid
Claims per Employee per Month
$476.41$482.60
$525.59
$450.30
$400.00
$420.00
$440.00
$460.00
$480.00
$500.00
$520.00
$540.00
FY08 FY09 FY10 7/10-12/10
Fiscal Year Total Claims
Average # of
EmployeesClaims per Employee per
Month
FY08 $19,499,142 3,609 $450.30
FY09 $21,078,317 3,687 $476.41
FY10
7/10-12/10
$22,797,920
$ 9,967,061
3,615
3,442
$525.59
$ 482.60
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NAPEBT – Large Medical Claims PaidNorthern Arizona Public Employees Benefit Trust
Paid Claims > $75,000
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1
7
14
17
6 6
2
31
12
7
3
86
36
21
11
5 54
46
7
4
01 1
13
0
5
10
15
20
25
30
35
40
45
50
$75,000-$99,999 $100,000-$124,999 $125,000-$149,999 $150,000-$199,999 $200,000+ TOTAL
Num
ber o
f Cla
ims
7/1/2006-6/30/2007 7/1/2007-6/30/2008 7/1/2008-6/30/20097/1/2009-6/30/2010 7/1/2010-12/30/2010
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NAPEBT Medical PlansBlue Cross Blue Shield of ArizonaGroup # 19676
NAPEBT Rx PlansCVS/Caremark#31
72 Plan Year
July 1, 2011 – June 30, 2012
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MEDICAL PLAN EFFECTIVE July 1, 2011
In-Network Buy-Up Plan Base Plan HDHPCalendar Year Deductible: Per person Per family
$500$1,000
$750$1,500
$1,250**$2,500**
PCP Copay – Per visit $25 $35 80%/20%
Specialist Copay – Per visit $35 $45 80%/20%
Chiropractic Copay $35 $45 80%/20%
Urgent Care Copay $50 $75 80%/20%
Emergency Room Access Fee $100* $150* $100*
Inpatient Hospital Admit Fee $100* $100* 20% after ded
Member Coinsurance 20% after ded 20% after ded 20% after ded
Out of Pocket Maximum: Per person Per family
$3,000
$6,000
$3,000
$6,000
$4,000
$8,000
Rx Retail Copay $5/$35/$55/$105 $5/$35/$55/$105 After ded – 20%/$5 min
Rx Retail 90 day Copay 2.5x Copay 2.5x Copay After ded – 20%/$5 min
Rx Mail Order 90 day Copay 2x Copay 2x Copay After ded – 20%/$5 min
Out-of-NetworkCalendar Year Deductible: Per person Per family
$1,000$2,000
$1,500$3,000
$1,250**$2,500**
Member Coinsurance 40% after ded 40% after ded 40% after ded*Access/Admit Payment and Deductible applied prior to 80%/20% coinsurance **The In and Out-of-Network deductibles are combined for HDHP.
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Two ID cards– Medical and Rx –Continue to use same pharmacies
Mail Order
–Will need a new prescription
–Fast Start program
90 days at Retail for 2-1/2 times copay
Grandfathering of drugs – first 6 months
– A small percentage of drugs will change tiers after 6 months (January 1, 2012)
– Will receive a letter if your drug is changing
Register at Caremark.com
– Check drug costs– Compare prices of Generic vs. Retail
CVS/Caremark New Rx Vendor
MEDICAL PLAN EFFECTIVE July 1, 2011
Dedicated NAPEBT
phone line available
on 6/13/11
877-456-0109
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MEDICAL PLAN EFFECTIVE July 1, 2011
Employee Cost SharingApproved & Adopted by NAPEBT
The Board of Supervisors has approved the payment of the $20 cost share on behalf of County employees for FY 12 only
• Historically, NAPEBT Employers funded 100% of employee base level premium
• NAPEBT Employers cannot continue to shoulder full cost
• $20 per month cost share applied to all medical plans offered by the Trust
•$240 savings for employees enrolled in medical plan
•County contribution - $20 per employee per month (1,042) =$229,240
•Trust Reserves – One month at $20 per employee (1,042) employees = $20,840
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Wellness Incentive Program July 2012 – June 2013
NAPEBT – Self-funded Plan• Rates driven by claims experience
• Increase of large claims
• Increased frequency of in-patient hospitalization
Improved Health of Employees• Long-term results
Return on Investment• Studies show a $4 return for every dollar spent on Wellness programs.
• Lower costs for everyone
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Wellness Incentive Program July 2012 – June 2013
Opportunity to Waive $20• Employee participates in Wellness Program
• Complete Biometric Testing
• Fall 2011 Health Fair
• Wellness participation Jan – May 2012
• Complete MyBluePrint Health Assessment
• www.azblue.com $20 Employee Cost Share
• $20 per month added to employee cost for Base and Buy-Up plans
• $20 decrease to HSA / FSA contribution on HDHP.
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MEDICAL PLAN EFFECTIVE July 1, 2011
Medical Plan FY12 Monthly Premium
County Contribution
FY12 Employee Cost Share
CountyContribution
Employee Cost
per Month
Effective
July 1, 2011
Employee
Cost
Per
Paycheck
Difference
Employee
Cost
Per
Paycheck
Buy-Up Plan - $500 Deductible
Employee $ 514.58 $ 452.78 $ 20.00 $ 41.80 $ 20.90 $ 1.57
Dependent $ 795.70 $ 402.07 $ 0.00 $ 393.63 $ 196.82 $ 14.74
Total for Family $1,310.28 $ 854.85 $ 20.00 $ 435.43 $ 217.72 $ 16.31
Base Plan - $750 Deductible
Employee $ 472.78 $ 452.78 $ 20.00 $ 0.00 $ 0.00 $ 0.00
Dependent $ 731.04 $ 402.07 $ 0.00 $ 328.97 $ 164.48 $ 12.31
HDHP/HSA - $1,250 Deductible * $47.68 per month/$572.15 per year employer contribution to HSA or FSA
Employee $ 425.10 $ 452.78* $ 20.00* $ 0.00 $ 0.00 $ 0.00
Dependent $ 657.30 $ 402.07 $ 0.00 $255.23 $ 127.62 $ 9.56
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Medical Plan FY12 Savings
Per Paycheck
Savings
For Month
Buy-Up PlanEmployeeDependent
Total for Family
$ 1.57$ 14.74$ 16.31
$ 3.14$ 29.48$ 32.62
Base PlanEmployeeDependent
$ 0.00$ 12.31
$ 0.00$ 24.62
HDHPEmployeeDependent
$ 0.00$ 9.56
$ 0.00$ 19.12
Employee Premium Holiday
The Month of December at Last Year’s Rates!
Total Cost to NAPEBT for Employee Premium Increase Holiday: $ 75,100
MEDICAL PLAN EFFECTIVE July 1, 2011
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Mayo Clinic in Arizona- Is an in-network Provider on all plans- Includes Mayo Clinic and Mayo Clinic Hospital Services- Identify as member of NAPEBT
Waivers of Medical Coverage
- other coverage under a qualified group employer’s plan that is not through another NAPEBT employer, under Medicare or a qualified public health plan such as AHCCCS
- Must provide enrollment confirmation
FYI… Useful Information
MEDICAL PLAN EFFECTIVE July 1, 2011
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Deductibles run on calendar year
- January 1st – December 31st
Dual-spouse Deductible Coordination- Husband and wife employed by a NAPEBT employer.- Base and buy-up plans only.- One spouse must have family coverage. - Indicate on the Blue Cross enrollment form that your spouse works for NAPEBT and provide the spouse’s ID number.
FYI… Useful Information
MEDICAL PLAN EFFECTIVE July 1, 2011
Member ID Cards
- Have available at every appointment!
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Patient Protection and Affordable Care Act Healthcare Reform
Pre-existing Condition Restrictions
- Removed for children younger than age 19
- Still applies for adults until 2014 Preventive Services
- No office visit co-pay for recommended screenings, general physicals and vaccinations
Lifetime Benefit Maximum
-Lifetime benefit limits removed
Eligible Dependents to Age 26
-Without regard to- Student Status- Marital Status- Financial Dependence
- Only applies to legal child of employee- Does not extend to the spouse or child(ren) of the adult child - Applies ONLY to Medical plan and Flexible Spending Accounts
MEDICAL PLAN EFFECTIVE July 1, 2011
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NAPEBT Dental PlansDelta Dental of ArizonaGroup # 1331
Plan Year
July 1, 2011 – June 30, 2012
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DENTAL PLAN EFFECTIVE JULY 1, 2011
Dental Plan FY12 Buy- Up Plan
Annual Maximum Benefit per Person
$2,000
Routine Services 100%
Basic Services 80%
Major Services 50%
Orthodontia
(Age 8 – 19)
50%
$1,000 Maximum Lifetime Benefit
Calendar Year Deductible $50 per person
$150 per family
Base Plan
$1,000
100%
80%
50%
50%
$1,000 Maximum Lifetime Benefit
$50 per person
$150 per family
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DENTAL PLAN EFFECTIVE JULY 1, 2011
Dental Plan FY12
Monthly Premium
County Contribution
Employee Cost per
Month
Effective
July 1, 2011
Employee Cost
Per Paycheck
Difference
Employee Cost
Per Paycheck
Buy-Up Plan - $2,000 Annual Benefit
Employee $ 48.58 $ 31.08 $ 17.50 $ 8.75 $ 0.25
Dependent $ 62.66 $ 0.00 $ 62.66 $ 31.33 $ 1.31
Total for Family
$ 111.24 $ 31.08 $ 80.16 $ 40.08 $ 1.56
Base Plan - $1,000 Annual Benefit
Employee $ 31.08 $ 31.08 $ 0.00 $ 0.00 $ 0.00
Dependent $ 40.12 $ 0.00 $ 40.12 $ 20.06 $ 0.97
Total for Family
$ 71.20 $ 31.08 $ 40.12$ 20.06 $ 0.97
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NAPEBT Vision PlansVSPGroup # 12239817
Plan Year
July 1, 2011 – June 30, 2012
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VISION PLAN EFFECTIVE JULY 1, 2011
Vision Plan FY12 Buy-Up PlanCore Plan
Employee OnlyIn-Network
Eye ExamOnce every 12 months
$15.00 Co-pay $15.00 Co-pay
Prescription LensesOnce every 12 months
$25 Material Co-payLenses and/or Frames
20% Discount on a complete pair of glasses.Frames
Once every 24 months
$25 Material Co-pay Lenses and/or Frames
$120 Allowance
20% off additional cost
ContactsInstead of Glasses
15% discount off contact lens exam
$120 allowance for exam & contacts
15% Discount on Contact Lens
Exam
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VISION PLAN EFFECTIVE JULY 1, 2011
Vision Plan FY12Monthly Premium County Cost Employee Cost
per MonthEmployee Cost per Paycheck
Buy-Up Plan
Employee $ 6.97 $ 0.77 $ 6.20 $ 3.10
Dependent $ 8.00 $ 0.00 $ 8.00 $ 4.00
Total for Family $ 14.97 $ 0.77 $ 14.20 $ 7.10
Core Plan -Employee ONLY
Employee $ 0.77 $ 0.77 $ 0.00 $ 0.00
So what’s the bottom line? There is no change to employee payroll deductions for
vision coverage for 2011-2012.
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NAPEBT Life Insurance PlansMinnesota LifePolicy # 33585
Plan Year
July 1, 2011 – June 30, 2012
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LIFE INSURANCE PLAN EFFECTIVE JULY 1, 2011
Basic Term Life & Accidental Death & Dismemberment Insurance$40,000 coverage
• Provided by Coconino County at no cost to the employee ($7.40 x 1,042 = $92,530/annual cost to County)
• May convert to an individual policy upon separation of employment
• Remember to keep Beneficiary information up to date
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Voluntary Term Life Insurance• Employee may increase elected coverage amount by $10,000 at Open Enrollment without underwriting (up to the Guaranteed Issue limit of $100,000)
•Insure spouse up to half of employee’s voluntary coverage election
• Insure children @ $10,000
LIFE INSURANCE PLAN EFFECTIVE JULY 1, 2011
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LIFE INSURANCE PLAN EFFECTIVE JULY 1, 2011
Voluntary Term Life Insurance• Rate Change
• % of Increase Varied by Age Bracket
• Child Rate – No Change
Previous Monthly Rate Effective July 1, 2011
Employee – Age 36
$80,000 Coverage
$ 5.60 $ 7.20
Employee – Age 52
$100,000 Coverage
$ 19.00 $ 23.00
Spouse – Age 47
$25,000 Coverage
$ 3.25 $ 4.75
Spouse – Age 59
$40,000 Coverage
$ 14.40 $ 21.20
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Flexible Spending Accounts
ASI Flex
Plan Year
July 1, 2011 – June 30, 2012
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Flexible Spending Accounts
Reduce Tax Liability
Health Care FSA (HCFSA) – allows you to set aside pre-tax dollars to pay for eligible health care expenses not covered by insurance or reimbursed from any other source.• Limited Purpose Health Care FSA (use with a High Deductible
Health Plan (HDHP) and Health Savings Account (HSA)
(dental, vision and preventive care expenses only)• General Purpose Health Care FSA (qualified health care
expenses)
Dependent Care FSA (DCFSA) – allows you to set aside pre-tax dollars to pay for eligible day care expenses for children up to the age of 13, disabled children over age 13, and elder care.
FSA PLAN EFFECTIVE JULY 1, 2011
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FSA – Medical• Unreimbursed Medical, Prescription, Dental, & Vision expenses
• Up to $3,000 Per Year
• Debit Card
• Reimbursement by Check or Direct Deposit
• Full Amount Elected Available Immediately
• MUST RE-ENROLL EACH YEAR!
• Use or Lose – Be Conservative!
FSA PLAN EFFECTIVE JULY 1, 2011
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Ineligible Health Care Expenses• Cosmetic Expenses
• Rogaine, bleaching of teeth, cosmetic surgery (other than reconstructive surgery following a mastectomy for cancer)
• Dietary Supplements such as Vitamins
• Personal Use Items
• Health Club Memberships
• Tanning Salon
• Over-the-Counter Medications Unless Prescribed by a Doctor
FSA PLAN EFFECTIVE JULY 1, 2011
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FSA – Dependent Care• Up to $5,000 per year
• Reimbursement by Check or Direct Deposit
• Funds Available as Contributed
• MUST RE-ENROLL EACH YEAR!
• Use or Lose – Be Conservative!
FSA PLAN EFFECTIVE JULY 1, 2011
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Ineligible Dependent Care Expenses• School Expenses for Children in Kindergarten or Older
• Overnight Camping
• Expenses for a Child Age 13 or older (unless disabled)
• Expenses for Nighttime Babysitting
• Daycare Expenses During an Extended Leave of Absence
• When a Dependent is Providing Child Care
• Expenses Paid to Your Child Under the Age of 19
(even if child is not your dependent)
FSA PLAN EFFECTIVE JULY 1, 2011
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Health Savings Accounts
HealthEquity
Plan Year
July 1, 2011 – June 30, 2012
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• $47.68 per month ($572.16 per year)
• Health Savings Account if Eligible
• Who is NOT eligible for an HSA? Individuals entitled to Medicare (eligible & Individuals entitled to Medicare (eligible &
enrolled)enrolled)
Individuals covered under another non-HDHPIndividuals covered under another non-HDHP
Individuals enrolled in AHCCCS or Medicaid or Individuals enrolled in AHCCCS or Medicaid or have used IHShave used IHS
• If NOT Eligible for HSA you will be enrolled in Flexible Spending Account (Health)
HDHP Employer Contribution
HSA PLAN EFFECTIVE July 1, 2011
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HSA PLAN EFFECTIVE JULY 1, 2011
Health Savings Accounts
Only available with election of HDHP Reduce Tax Liability Use like flexible spending account for Medical,
Prescription, Dental and Vision Unspent money rolls over year after year; NOT use it or
lose it
Take it with you when you leave or retire• Pay for COBRA, Medicare or Long Term Care Premiums• Never pay taxes as long as used for qualified expenses
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• HealthEquity and Blue Cross Blue Shield of Arizona have created an integrated Health Savings Account (HSA) solution.
• Your claims information will now be available with your HSA account information for easier management of claims payment and review.
• When you login to the Blue Cross web site (www.blueaz.com) you can click on a link to take you to the HealthEquity portal where you can view your claims, see how much you owe, and process payment (pay a provider, or yourself) – all from the same website.
FYI… Useful Information
HSA PLAN EFFECTIVE JULY 1, 2011
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Considering Retirement?Coconino County Retiree Benefits
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Considering Retirement?• 10 Years of Continuous Service with Coconino County
• Retiring with a Pension through an AZ State Retirement System
• Medical, Dental and Vision Benefits end at age 65
•Life Insurance Reduces to ½ Face Value at Age 65; End at Age 70
• Contact Human Resources with retirement questions
RETIREMENT EFFECTIVE JULY 1, 2011
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Questions?
OPEN ENROLLMENT 2011