• Marianne Nicoletti, Oswald Companies
January 10, 2018
OHIO ASSOCIATED ENTERPRISES
OPEN ENROLLMENT
AGENDA
• 2018 Open Enrollment
• The Renewal Process
• What’s new for 2018
• Your Medical Plan
• Your Dental Plan
• Your Life Insurance Plan
• Next Steps
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2018 OPEN ENROLLMENT
• Open Enrollment is January 10th – January 19th
• All enrollments and changes must be made during Open
Enrollment
Open enrollment is the one time during the year that you are able
to make changes to your plans. If you previously waived
coverage, you may now enroll in the plan. If you are currently
covered & wish to add dependents, you may do so as well
The only other time during the year that you have the ability to make
changes to the plan is if you experience a Qualifying Event, such as
a loss of coverage, divorce or marriage. If you do experience a
Qualifying Event, please contact HR within 30 days of the event to
complete the necessary paperwork
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THE RENEWAL PROCESS
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CIGNA – initial renewal request was an 18% increase,
based on claims, inflation and Healthcare Reform.
Initial negotiation reduced increase to 12%.
Marketed to all major carriers, and then used the offers
to negotiate further with CIGNA for a reduction to 7%.
Most other carriers were higher. Anthem came in lower,
however the concern was how we would be treated next
year at renewal.
We are moving the Dental and Life insurance to CIGNA
for a greater discount off of the Medical premiums
(reduction to 4%).
WHAT’S NEW FOR 2018
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Medical – we will stay with CIGNA, their network
includes all of the major medical systems
Dental – we will move from Anthem to CIGNA:
no change in plan design
slight increase in cost
more expansive network
Life Insurance – we will move from Anthem to CIGNA
MEDICAL
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WHAT’S NEW FOR 2018 - MEDICAL
• Medical Plan:
• We will remain with CIGNA
• Plan design - due to IRS rules – the deductibles will increase
slightly:
• Single will increase from $2,600 to $2,700
• Family will increase from $5,200 to $5,400
• Premium Contributions – adjustment based on increased
premium of 4%
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2018 MEDICAL PLAN
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BENEFITS H.S.A.
Deductible (Single/Family) $2,700/$5,400
Coinsurance 0% after Deductible
Out-of-Pocket Maximum
(Single/Family)
$3,500/$7,000
Office Visit
(PCP/Specialist)
0% after Deductible
Inpatient Hospital Services 0% after Deductible
Outpatient Surgical
Services
0% after Deductible
Diagnostic Services 0% after Deductible
Emergency Room
Services
0% after Deductible
Urgent Care 0% after Deductible
Retail Rx (30-day)
Mail Order Rx (90-day)
$10/$35/$70
$30/$105/$210
Reminder: All covered expenses (including Deductible, Coinsurance & both
Medical/Rx Copays) accumulate towards the Maximum Out-of-Pocket.
• This is an illustration of In-Network benefits, but please note that the plan does also provide
coverage outside of the network. Please refer to the plan documents for details & final
confirmation of coverage
HEALTH SAVINGS ACCOUNTS (HSA)
HSA overview:
An HSA is an Individual bank account to pay for qualified
medical expenses (QMEs) for you and your tax dependents
Earn interest, can be invested in stocks with balance over $1000
Individually owned
Portable – it goes with you if you resign or retire
You can keep the bank you are currently using for your H.S.A.!
Provide for future savings:
Account can grow from year to year (you keep what you don’t
spend)
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TRIPLE TAX ADVANTAGES OF AN H.S.A.
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ANNUAL HSA CONTRIBUTION
LIMITS SET BY IRS
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Amount of Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
Annual Contribution
Rules
2018: $3,450 for individuals & $6,900 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!
*Please note that annual contribution limits include contributions from both the employer & the employee. A
combination of these two cannot exceed the annual contribution limits.
• Preventive care is covered at 100%
• Flu shots are covered under preventive (at 100%)
• Regular preventive care helps reduce risk of disease
• Detect health problems early
• Protect you from higher costs down the road
• May potentially save your life
No deductible.
No copayment.
No coinsurance.
100% coverage.
PREVENTIVE CARE
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CIGNA RESOURCES
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Use the emergency room for true emergencies
• Emergency care is covered 24 hours a day, in or out of
the network.
• But avoid the emergency room for minor injuries –
visits to urgent care and convenience care clinics are
also covered and will cost less
Locate a convenience care clinic near you,
before you need it
• Walk right in. You can get quick, convenient access to
quality medical care.
• Convenience Care Clinics include:
• MinuteClinic
• RediClinic
• Sutter Express Care
• Take Care Health
• Target Clinic
• The Little Clinic
INFORMATION TO HELP YOU SAVE
MONEYSAVING ON HEALTH CARE COSTS
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• Allergies
• Bladder infections
• Bronchitis
• Cold sores
• Ear infections
• Influenza
• Impetigo
• Laryngitis
• Minor burns, rashes
or skin infections
• Pink eye and styes
• Sinus infections
• Strep throat
When to use
Convenience Care?
Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2016 Cigna
Use the most appropriate health care professional
• Find network doctors, hospitals or other health facilities online, by
phone or with any web-enabled mobile device
• Lower your costs by choosing health care professionals who
participate in the Cigna network
Get information on the cost of treatment before receiving care
• myCigna.com has quality of care information and cost estimates for
over 200 medical procedures and treatments
• In-network health care professionals and facilities can give you
estimates that will show your actual out-of-pocket expenses
INFORMATION TO HELP YOU SAVE
MONEY
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Using health care professionals with the
Cigna Care Designation will help you save money!
Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2016 Cigna
Quality designations, cost-efficiency, and other ratings reflect a partial assessment of quality and should not be the sole basis for decision-making.
They are not a guarantee of the quality of care that will be provided to individual patients. You are encouraged to consider all relevant factors and
consult with your physician when selecting a health care professional or facility for care. Health care professionals and facilities that participate in
the Cigna network are independent contractors solely responsible for the treatment provided to their patients. They are not agents of Cigna.
MYCIGNA.COM MOBILE SITE AND APP
DELIVER
HEALTH INFORMATION ON THE GO
• All customers can access
myCigna via mobile device
using internet browser
• myCigna mobile app
available
Features:
• Find a doctor, dentist, pharmacy or facility
• View, print, and email ID card information
• Search and view claims
• Search for medications
• View plan coverage and authorizations
• Organize and manage personal health
information with the Health Wallet
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DENTAL
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DENTAL PLANS - 2018
CIGNA
Benefits In-network Out-of-network
Deductible (Single/Family) $50/$150 $50/$150
Class I (Preventive) 100% 80%
Class II (Basic) 80% 50%
Class III (Major) 50% 50%
Class IV (Ortho) 40% 40%
Annual Maximum $1,000 $1,000
Lifetime Max. - Orthodontia $1,000 $1,000
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USING DENTAL YOUR PLAN
• Choose a licensed dentist. NOTE: If you select a Cigna
Dental “DPPO Advantage” Network dentist from our
Provider Directory, you will typically spend less
• No ID card needed
• No referral needed to visit a specialist
• Most Cigna Dental “DPPO Advantage” dentists will submit
claims for you. Your plan will then pay the dentist or you
(based on the claim form)
• The amount your plan pays depends on the coinsurance
level for the service you received, if you’ve paid your
deductible and/or reached your maximum21
DPPO
Advantage −
In-network
dentists: Greater savings
on covered
procedures
Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
HOW TO FIND A
CIGNA NETWORK DENTIST
• Search online at Cigna.com (or myCigna.com once you
have registered online)
• Click on the “Find a Doctor” link, then select “Dentist”,
then “Select a plan”
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DPPO
Advantage −
In-network
dentists: Greater savings
on covered
procedures
Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
You are in the PPO plan
LIFE INSURANCE
COMPANY PAID
• 100 % Employer Paid
• Life Insurance Benefit amounts are equal to “one time”
your annual salary
• Ensure that you complete the Beneficiary form
• If you do not have a named beneficiary, the insurance company
will not know where to send the money
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VOLUNTARY LIFE INSURANCE
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Voluntary Life Insurance – we will move from
Anthem to CIGNA
Current life insurance amounts are grandfathered
Initial offering for 2/1/18 – Guarantee Issue All enrolled employees can increase their current election by 1X
All enrolled spouses can increase their current election by $5,000
Next year’s open enrollment – Guarantee Issue All enrolled employees can increase their current election by one unit
of $10,000
All enrolled spouses can increase their current election by one unit of
$5,000
Premiums reduced for many age bands
New hires will have option for Guarantee Issue amounts: Employee - $100,000
Spouse - $25,000
Child - $10,000
WHAT PAPERWORK DO I NEED TO
COMPLETE?
All employees MUST complete:
Benefit Election Form – Please indicate whether you are electing or
waiving the medical, dental & voluntary life insurance coverage. This
form must be returned by January 18th
A Carrier (CIGNA) Enrollment Form – if you are enrolling in the
medical, dental or the voluntary life for the first time
All forms must be returned by January 19th
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QUESTIONS?
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