2014-2015ARIZONA WESTERN
COLLEGE
Dr. Ruth Whisler and Mrs. Patricia Jimenez 1
The most important papers -
Ruth Notes (concept borrowed from Cliff Notes)
PowerPoint will be on the HR website
Most important Dates – (next slide)
Questions at the end, please.
BEFORE WE BEGIN -
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Dates to Remember!
Enrollment period: May 5th – May 15th
Deadline for making changes: May 15th
Changes effective: JULY 1, 2014
YOUR Benefits Expert: Patty Jimenez
[email protected] – x76037
2014/2015 BENEFIT YEAR
Dates are non-changeable
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Consortium – Self Insured
Yuma Area Benefits Consortium AWC, City of Yuma,
Crane Elementary District, Yuma School District One
Traditionally: Annual premium increase, absorbed by AWC
This year costs increased again – 12% for Plan A; 3% HDHP
(High Deduct ible Health Plan)
Cannot absorb – SO
AWC continues to keep premium costs to employees equitable
BRIEF HISTORY OF INSURANCE BENEFITS
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High Deductible Health Plan (HDHP) - (Misnamed)
Available with or without dental coverage
Vision is includedLife is part of AWC
packageHSA (Health Savings Account)
– auto rollover (Optional benefit)
Plan A (Needs a new name)
Available with or without dental coverage
Vision is includedLife is part of AWC
packageFSA (FLEX Spending Account)
- enroll each year (Optional benefit)
TODAY: TWO PLANS
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Not under AWC Control
Premium increases for both plans. Plan A – 12%
High Deductible Health Plan (HDHP) -- 3%
Under AWC Control
AWC will pay $510/month toward each full time employee’s health care benefi ts ($6,120/year)
Th is means :
I f you are on P lan A : AWC wi l l pay $510 /month for fu l l t ime employee premiums (with and without denta l )
I f you are on HDHP: AWC wi l l cont inue to pay the fu l l premium for the employee (w ith and without denta l coverage)
AND - AWC wi l l contr ibute $1 ,536 to each member ’s HSA account – Ju ly 1 , 2014
You reta in contro l over which p lan you choose for yourse l f and your dependents .
THINGS YOU SHOULD KNOW BEFORE WE CONTINUE…LOCUS OF CONTROL
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Medicare IRS Pub.969, p 6 2013 -
Bottom line: Medicare prohibits HSA.
You may participate in the HDHP even if you have Medicare.
But, beginning the first month you are enrolled in Medicare, you cannot contribute to an HSA
IRS 1040 FilingsIf you use the account
during the calendar year, you must fi le Form
8889 (very short). It simply reports contributions.
Box 12 of your W-2, Wage and Tax Statement from your employer will contain the amount AWC contributed to your HSA
IRS REGULATIONS : HEALTH SAVINGS ACCOUNTS
NOTE: These important items should be discussed with your tax preparer or financial consultant. AWC is not a tax service nor responsible for interpreting IRS regulations.
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HEALTH SAVINGS ACCOUNTFORM 8889
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Let’s look at the breakdown of costs and coverage
AWC CONTRIBUTES TO YOUR COVERAGE
REGARDLESS OF YOUR CHOICE OF
PLAN
9…
High Deductible with Dental
Arizona Western College Cost
Coverage Category
Employee Cost Subsidy + EE Rate
Total Premium
Employee ONLY
- $382.00 - $ 382.00
EE + Child(ren)
$291.00 $ 54.00 $382.00 $ 727.00
EE + Spouse $330.00 $ 59.00 $382.00 $ 771.00
EE + Family $509.00 $ 68.00 $382.00 $ 959.00
PREMIUMS FOR HIGH DEDUCTIBLE (HDHP) [EMPLOYEE & DEPENDENTS]
MEDICAL, VISION AND PRESCRIPTION
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High Deductible without Dental
Employee ONLY
- $345.00 - $ 345.00
EE + Child(ren)
$257.00 $ 54.00 $345.00 $ 656.00
EE + Spouse $292.00 $ 59.00 $345.00 $ 696.00
EE + Family $452.00 $ 68.00 $345.00 $ 865.00
Benefit DescriptionHigh Deductible (HDHP)
with Health Savings Account (HSA)[HSA Employer Contribution $1,536/year
- delivered to your account on July 1, 2014]
In-Network Out-of-Network
Annual Deductible $1,500/person$3,000/family
$3,000/person$6,000/family
Coinsurance 85% 60%
Office Visit After deductible is met insurance pays 85%
After deductible is met insurance pays 60%
Out-of-Pocket Max $3,000/person$6,000/family
$8,000/person$16,000/family
Maximum Annual Benefit
New: No ceiling (cap) for benefit coverage
HIGH DEDUCTIBLE – BENEFIT DESCRIPTION – IF YOU ARE NOT COVERED
BY MEDICARE
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IRS Pub. 969, p. 2 (2013) You can claim tax
deduction for contributions you or anyone except your employer make to your account
Employer contributions may be excluded from your gross income
Contributions remain in your account until you use them
And….Interest & other earnings
are tax freeDistributions may be tax
free if used for qualified medical expenses
HSA is portable – goes with you
Qualified Medical Expenses are those incurred by you, spouse, dependents claimed on your tax return
HEALTH SAVINGS ACCOUNT BENEFITS –IF NOT ON MEDICARE
NOTE: AWC and the presenters of these slides do not take responsibility for IRS changes in rules. DO speak with your financial consultant or tax preparer.
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Plan A with Dental Arizona Western College Cost
Coverage Category
Employee Cost Subsidy + EE Rate
Total Premium
Employee ONLY
$ 57.00 $510.00 - $ 567.00
EE + Child(ren)
$492.00 $ 75.00 $510.00 $1,077.00
EE + Spouse $549.00 $ 83.00 $510.00 $1,142.00
EE + Family $806.00 $103.00 $510.00 $1,419.00
PREMIUMS FOR PLAN A [EMPLOYEE & DEPENDENTS]
MEDICAL, VISION AND PRESCRIPTION
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Plan A without Dental
Employee ONLY
$ 20.00 $510.00 - $ 530.00
EE + Child(ren)
$421.00 $ 75.00 $510.00 $1,006.00
EE + Spouse $474.00 $ 83.00 $510.00 $1,067.00
EE + Family $712.00 $103.00 $510.00 $1,325.00
Benefit Description Plan A
In-Network Out-of-Network
Annual Deductible $750/person$1,500/family
$1,500/person$3,000/family
Coinsurance 80% 50%
Office Visit $20 copay 50%
Out-of-Pocket Max $5,250/person$10,500/family
$9,000/person$9,000/person
Maximum Annual Benefit
New: No ceiling (cap) for benefit coverage
PLAN A - BENEFIT DESCRIPTION
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Let’s look at actual out of pocket costs in and out of network,
Health Savings Accounts & Flexible Savings Accounts,
and more benefits provided at no cost to our employees!
LET’S COMPARE….
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Monthly Rates for Medical, Dental, Vision and Prescription
Plan A with Dental
Plan A without Dental
HDHP with Dental
HDHP without Dental
Employee $ 57.00 $ 20.00 -- --
Child(ren) $492.00 $421.00 $291.00 $257.00
Spouse $549.00 $474.00 $330.00 $292.00
Family $806.00 $712.00 $509.00 $452.00
2014-15 - WHAT WILL I PAY? EMPLOYEE AND DEPENDENT
COVERAGE
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OUT OF POCKET COMPARISON
Plan A: Out of Pocket (OOP) maximum: deductible, copays, and coinsurance all accumulate to the out of pocket maximum - In Network
Per Person : $5,250 per year (7/1/14—6/30/15)Per Family : $10,500When met: Insurance pays 100% of costs2013-14 Per Person: $3,000
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
HDHP : Per Person : $3,000 per year (7/1/14—6/30/15)
Per Family: $6,000 When met: Insurance pays 100% of everything2013-14 Per Person: Same
WHAT DOES IT REALLY MEAN? COMPARISON : IN NETWORK– HDHP & PLAN A
Remember – July-June, not calendar year 17
Plan A: Out of Pocket (OOP) maximum: deductible, copays, and coinsurance all accumulate to the out of pocket maximum - In Network
Per Person : $9,000 per year (7/1/14—6/30/15)Per Family : $9,000/person – total fi gure depends upon
persons in familyWhen met: Insurance pays 100% of costs2013-14 Per Person: $9,000
___________________________________________________________
HDHP: Per Person : $8,000 per year (7/1/14—6/30/15)
Per Family: $16,000 When met: Insurance pays 100% of costs2013-14 Per Person: Same
COMPARISON – OUT OF NETWORK
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Health Savings Account: HDHP Program Contribution Limits for 2014-15:
$3,300 for Single; $6,550 for Family (This includes the employer contribution.) If you are 55+, your contribution limit is increased by $1,000 (IRS Pub 969, p.5)
Benefi ts: AWC “up fronts” the fi rst level of deduction : $1,536. You can add to your HSA account through payroll deduction for the
time and amount you choose . Be sure to work with Mrs. Patty J imenez to make this happen: patricia. j [email protected]
Stays with you. It’s your money even if you change jobs. NO “use it or lose it” conditions. Your money rolls over into the next year. Reduces your taxable income: The money remains tax-free when you deposit and
withdraw for qualified medical expenses. Pays for insurance deductibles, medical care and supplies that are not typically
covered by medical insurance such as prescription medicines, dental, LASIK eye surgery and much more.
HSA Investment Account is available online at www.efl exgroup.com
HEALTH SAVINGS ACCOUNT (HSA) –
AWC GIVES TO EMPLOYEES
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How it Works: You and AWC deposit money into your eflexHSA for current
and future medical expenses.
You’ll receive an eflex debit card to use for eligible medical expenses.
Acts as a debit card - swipe the card at the time of purchase and funds are automatically withdrawn from your account and paid directly to the provider. Card can also be used for on-line and
US mail bill payments (hospital or provider).
Even if you’re no longer covered under the HDHP, eflexHSA can remain active, you just won’t be able to contribute funds.
Reimbursement/Withdrawal – You can make a withdrawal at any time. Request your distribution online, funds will be sent via direct deposit to your checking or savings account within five days.
(1099 will be issued)
YOUR HEALTH. YOUR MONEY. YOUR CONTROL.
See your financial consultant for specific data.
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Reduce your taxable income by what you spend on non-reimbursable medical and dependent care expenses.
2014-15 Maximums: How much can I select? $2,500 Health $5,000 Dependent Care You select your deduction at the beginning of the
benefit year and it remains stable until the next Open Enrollment period
VERY IMPORTANT Even if you are currently enrolled in the Flexible
Spending Account, you MUST enroll for each plan year.
This is a “use it or lose it” account. It does not roll over nor follow you when you leave employment.
FLEXIBLE SPENDING ACCOUNT(FSA) – PLAN A
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Note: You can check the cost of your prescriptions to determine if this is the best plan for you. (Phone or on-line options.)
As easy as 1, 2, 3….1. Your doctor writes your prescription for a 90-day supply,
plus 3 refi lls within a single year2. Complete the order form3. Mail the form, original prescriptions and payment
information to: Catamaran Home Delivery – 1-800-881-1966
PO Box 407096 – Ft. Lauderdale FL 33340-7096 For additional information, please visit :
www.mycatamaranRx.comNote: You pay full cost of prescriptions until deductible is met.
MAIL ORDER OPTION -- PRESCRIPTIONS: CATAMARAN HOME DELIVERY
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AWC will continue to pay 100% of Life Insurance AND Short Term Disability Insurance premiums for full time employees.
Life Insurance Benefi t: $20,000 per individual/first two years of
employment 2.5 times your gross annual salary after two years
of service
Short Term Disability Benefi t: In the event of an illness or disability in excess of 60 calendar days: 66.67% (2/3) of weekly earnings up to a max of $1,000 For a maximum of 26 weeks - FMLA in the mix
AWC-PROVIDED LIFE INSURANCE & SHORT TERM DISABILITY
INSURANCE
Please see Mrs. Patty Jimenez for individual questions about this benefit.
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Sun Life Benefit – More than 100 Miles from Home - Part of the Package
Assist America – 24/7, 365
Med Consultation, Evaluation, Referral Hospital Admission Guarantee Emergency Medical Evacuation Critical Care Monitoring Medical Repatriation Prescription Assistance Emergency Trauma Counseling Compassionate Visit Care of Minor Children Legal & Interpreter Referrals Return of Mortal Remains
** EMERGENCY TRAVEL ASSISTANCE
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There’s
MORE WAIT, WAIT,
25….
SunLifeAvailable for full time employees and dependents Purchase additional Life Insurance through convenient
payroll deductions. Cost is based on age.
Employee – Guarantee to employee : $100,000 (no physical).
Spouse – 1/2 of employee coverage up to a maximum of $25,000.
Children – up to a maximum of $5,000 for each child. Your dependents may ONLY be covered if the employee is
enrolled in this optional benefit.
OPTIONAL (ADDITIONAL) LIFE INSURANCE BENEFITS
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AETNA EAP {Employee Assistance Plan}
Free, confidential support for you and anyone living in your household to help you balance the demands of work, life and personal issues.
Assessment & short term counseling – 10 Visits.
24 hour crisis intervention line.
Referrals to other resources as needed.
1-888-238-6232, or visit www.AetnaEAP.com
Note: There is an AWC security code required for this service. This code is available in Human Resources and your benefits packet.
EMPLOYEE ASSISTANCE PLAN
Log in: Aetna EAP27
MUST know:
ALL employees must complete an Election form– EVEN if you are NOT making any changes.
If you are switching from PLAN A to HDHP, you will need the following:
A new Enrollment An eflex form A voided check
and
FSA (Flexible Spending Account) – You will need to complete the PayFlex form in order to be or remain enrolled.
REMINDERS – “MUST KNOW” INFO -
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Final things to Remember: Patty Jimenez – x76037
FINAL HOT ITEMS --
These are definite dates; they cannot be altered. 29
Everyone must complete the Election Form. (Even if you have no changes.)
All forms are available on the Human Resources website, in this room today, and in the HR suite.
Submit all forms to H.R. no later than close of day,
May 15
All changes are effective July 1, 2014.
Thank You, Dr. Ruth Whisler
Mrs. Patty O. Jimenez
INDIVIDUAL QUESTIONS WILL BE ANSWERED AT THE CONCLUSION
OF THE PRESENTATION – OR COME TO HR
X76037 30…