Office of Human Resources
Benefit Services
Open Enrollment 2006
Agenda
• Communication Materials• Open Enrollment Options
• Open Enrollment Online!• Select-Term Disability
• Benefit Plans• Changes and Premiums
• Your Plan for Health • Questions
Open Enrollment 2006
Benefit Changes Effective: January 1, 2006 through
December 31, 2006
October 31 – November 18, 2005
Communications
Communications
2006 Open Enrollment Brochure
Contents:– Open Enrollment Overview– Health Benefits– Health Plan Contribution Rates– Flexible Spending Accounts (FSA)– Your Plan for Health
Sent to home address during last week in October
Open Enrollment
2006•Overview
•Health Benefits
•FSA Benefits
•Contribution Rates
•Your Plan for Health
Benefits Eligibility byAppointment Classification
Regular
Auxiliary Faculty
Clinical Instructor
Post-Doc Fellow
Post-Doc Researcher
Special A
Special B
Returning Retiree
http://hr.osu.edu/hrpubs/ben/eligibilitysymbols.pdf
Open Enrollment Options
Enroll: • Medical, Dental, Vision • Flexible Spending Accounts
Make Changes:• Medical Plans• Add or Drop Dependents, Based on
Eligibility• Review Dependents Currently Enrolled
• Drop Current Health Coverage or Select-Term Disability Coverage
“Open Enrollment Online!”
http:/hr.osu.edu/oe
• Online Enrollment for:• Medical, Dental, Vision• Flexible Spending Accounts
• Advantages of Online Enrollment • “One-Stop Shop” for All Your Needs!• Accessible 24 hrs During Open Enrollment• Immediate E-mail Confirmation of Receipt of
Elections
“Open Enrollment Online!”
• Login Method:
• OSU User Internet ID (last name.#)
• Password designated for this account • Not yet activated – link from Open Enrollment Online!
home page to establish ID & password
• To reset password – contact OIT at688-HELP (4357) for assistance
New Feature!!
$171.27
$26.21
$17.44
$214.92
New Feature!!
$171.27
$26.21
$17.44
$214.92
Confirmation Screen with Election Summary
Select-Term Disability
Rate Changes Effective January 1, 2006
Base Annual Salary Employee Monthly Contribution
$29,000 or Less $12.00
$30,000 - $69,999 $23.85
$70,000 or More $49.04
Select-Term Disability
• Current Enrollees May Drop Coverage During Open Enrollment
• Available online at: • Select-Term Disability Election Form Must
Be Completed to Drop Coverage
http://hr.osu.edu/Forms/Ben/disabilityenrollment.pdf
Medical Plans Overview
Medical Plans
University Prime Care (UPC)Regional University Prime Care (RUPC)
Temporary Out-of-Area Benefit
OSU Health Plan (OSUHP)
Traditional Health Plan (THP)
Buckeye Health Plan (BHP)
University Prime Care (UPC)Regional University Prime Care (RUPC)
• Primary Care Physician Required (UPC only)
• Deductible - None
• Coinsurance - None (most services)
• Office Visit - $15 Copay
• Specialists - $25 Copay
• Emergency Room - $100 Copay
• Hospitalization & Outpatient Surgery-$250 Copay
• Annual Out-of-Pocket Max- $2,000 Per Person
UPC/RUPCMonthly Employee Contributions
2005 2006
Employee Only $53.47 $54.81
Employee + Child
$98.92 $101.39
Employee + Spouse
$112.29 $115.09
Family $167.09 $171.27
Temporary Out-of-Area Benefit
• Deductible - $500 Per Person
• Coinsurance - 20% (most services)
• Emergency Room - $100 Copay
• Hospitalization – 20%
• Annual Out-of-Pocket Max - $2,500 Per Person
OSU Health Plan (OSUHP)(Network Coverage)
(
• No Primary Care Physician Required • Deductible - None• Coinsurance - None for Most Services• Office Visit - $15 Copay• Specialists - $25 Copay• Emergency Room - $100 Copay• Hospitalization & Outpatient Surgery-$250 Copay• Annual Out-of-Pocket Max - $2,000 Per Person
OSU Health Plan(Non-Network Coverage)
• Deductible - $500 Per Person
• Coinsurance - 30% (most services)
• Emergency Room - $100 Copay
• Hospitalization - 30% to $2,000 − Does not apply to out-of-pocket maximum
• Annual Out-of-Pocket Max- $2,500 Per Person
OSU Health Plan (OSUHP)Monthly Employee Contributions
2005 2006
Employee Only $177.88 $182.33
Employee + Child
$329.08 $337.30
Employee + Spouse
$373.55 $382.89
Family $555.87 $569.77
Traditional Health Plan (THP) (Non-Network)
• Deductible - $500 Per Person
• Coinsurance - 20% (most services)
• Emergency Room - $100 Copay
• Hospitalization - $250 Copay
• Annual Out-of-Pocket Max - $2,500 Per Person
Traditional Health Plan (THP) Monthly Employee Contributions
2005 2006
Employee Only $177.88 $182.33
Employee + Child
$329.08 $337.30
Employee + Spouse
$373.55 $382.89
Family $555.87 $569.77
Buckeye Health Plan (BHP)(Non-Network)
• Deductible - $500 Per Person
• Coinsurance - 20% (most services)
• Emergency Room - 20%
• Hospitalization - 20%
• Annual Out-of-Pocket Max - $2,500 Per Person
Buckeye Health PlanMonthly Employee Contributions
2005 2006
Employee Only $29.10 $29.83
Employee + Child
$53.83 $55.18
Employee + Spouse
$61.11 $62.64
Family $90.93 $93.21
Dental Plan
• No Plan Changes
• 18-Month Plan Year continues through the end of 2006 (December 31, 2006)
• Deductible - $60 per person • 18-Month Benefit Maximum
• One-half annual benefit maximum for 2005 ($600) + Annual benefit maximum for 2006 ($1,200) = $1,800 (per person) – available any time during 18-month period
Dental Plan Monthly Employee Contributions
2005 2006
Employee Only
$0.00 $0.00
Employee + Child
$9.02 $9.24
Employee + Spouse
$13.27 $13.60
Family $25.58 $26.21
Vision PlanMonthly Employee Contributions
No Change to Benefit Coverage
2005 2006
Employee Only $0.00 0.00
Employee + Child
$6.16 $6.31
Employee + Spouse
$9.05 $9.28
Family $17.01 $17.44
Flexible Spending Accounts
• Expenses must be incurred during the 2006 plan year
• Current participants must re-enroll each plan year
• Minimum reimbursement request - $25
• $5,000 limit in each account per plan year
• Health Care FSA and Dependent Care FSA funds maintained in separate accounts
• Detailed list of eligible and ineligible expenses: http://hr.osu.edu/benefits/healthflex.htm
Your Plan for Health
Our Ultimate Goal: For Everyone to be Healthier!
Your Plan for Health
• Ohio State’s long-term plan of health awareness and personalized health management
• Capitalizes on the strengths of the university’s resources for wellness and healthy living
• Rewards employees for making good health choices
• Offers tools and resources that guide you toward new ways of behaving and thinking about your health
Prescription Drug Management
• No deductible at retail pharmacy• Generic copays reduced• Employee costs for brand name drugs
aligned at retail and mail order • Financial protection of out-of-pocket
maximum - $2,000 per person• More counseling and support for patients
taking specialty drugs
Prescription Drug Benefits
Prescription Drug
Employee Cost
Retail
(up to 34-day copay)
Mail Order
(up to a 90-day supply)
Generic $5 copay $10 copay
Formulary30% coinsurance,
$80 maximum
30% coinsurance,
$200 maximum
Non-Formulary 50% coinsurance,
no maximum
50% coinsurance,
no maximum
Personal Health Assessment (PHA)
• Your Plan for Health will introduce a powerful new health tool
• Online survey about your health and lifestyle• User-friendly• Voluntary• Available to all benefit-eligible employees and their
enrolled dependents over age 18• Confidential!
• Information will not be sent to your employer• Will be integrated with your lifetime medical record at OSU
Medical Center
PHA – What will it do for you?
• Provide you with a personalized health profile
• Help you to identify if you are at risk for certain conditions and take steps to avoid or delay the onset of illness
• Offers recommendations for your improved well-being
• Provide your doctor with information useful in treating you
• $50 gift card incentive to those who complete PHA with biometric data between Jan.1 and June 30, 2006.
Health Management Services
Your Plan for Health will enhance existing programs and provide treatment alternatives for healthier living
1. Include a benefit for medical massage therapy and acupuncture (musculoskeletal coverage)
2. Enhance the weight management program
3. Increase the benefit for tobacco cessation
Musculoskeletal Coverage• New benefit for medical massage as an alternative to
physical or occupational therapy• New benefit for acupuncture as an alternative to
chiropractic treatmentService Benefit Coverage
Physical Therapy (PT)
Occupational Therapy (OT)
Medical Massage Therapy•Combined max total of 45 visits per plan year
•Network plans pay 100% after $15 copay •Non-network plans subject to deductible and coinsurance•Precertification required after 15 visits for PT/OT•Medical diagnosis and physician Px required before first medical massage visit
Chiropractic Care
Acupuncture•Combined max total of 30 visits per plan year
•Network plans pay 100% after $15 copay •Non-network plans subject to deductible and coinsurance•Precertification required after 5 visits
Weight Management
1. Hospital Based, Physician Directed Programs:• Pre-certification Required• Network Provider – OSU Comprehensive Weight Management
Program
2. Weight Watchers™: • No Pre-certification
Reimbursement for Both Programs: • 50% of MHCS fee schedule/UCR up to a $1000 annual maximum• Applies to Weight Loss Surgery & Related Services lifetime
maximum of $25,000• Submit proof of payment and attendance
Weight Management (cont)
3. Enhanced Nutrition Benefit• Provides 3 visits with a Registered
Dietician at no patient cost• Additional 3 visits after pre-certification• Network plans: $15 copayment• Non-network plans: subject to deductible
and coinsurance
Tobacco Cessation Program
• Your Plan for Health will enhance the incentive to quit using tobacco
• New benefit program paid through the medical plan will provide• $120 total maximum reimbursement for program
completion • $60 for OTC patches, gum, lozenges• $60 for program
• Generic prescription drugs will be more affordable under new plan • $5 retail/$10 mail order, no deductible
Health Coach/Care Coordinator Support
Your Plan for Health will introduce a brand new health and condition management approach
Healthy At Risk Chronic Illness
Health Coach Care Coordinator
Health Care Continuum
Services to be effective July 1, 2006
Health Coach/Care Coordinator Support
Health Coach• Available to anyone who
has completed a PHA
• One on one support and education
• Wellness resource education
• Wellness coaching in modifying behaviors
• Help members meet their individual needs
Care Coordinator• Available to those at high
risk or have a high risk for chronic conditions
• Typically RN’s, clinical pharmacists or other health care specialists
• Work one on one to support treatment plan in addition to doctor’s care
• Serves as a resource and advocate for patient
Be Sure to Read the Newsletters “Your Plan for Health ” for Updates and Additional Plan for Health
Details
Open Enrollment Forums
Columbus Campus:• Tuesday, November 8
9 a.m.
240 Scott Hall
• Monday, November 14
11:30 a.m.
1590 North High Street
Room 425A
Hospitals:• Thursday, November 3
3:30 p.m.
112 Meiling Auditorium
• Tuesday, November 15
3 p.m.
OSU East – Wallace Auditorium
Open Enrollment Presentation may also be seen online at http:/hr.osu.edu/oe
Open Enrollment Forums
Regional Campuses:
Lima• Monday, November 7 11 a.m. 212/213 Public Servicing Bldg.
Mansfield• Thursday, November 10 2 p.m. 117 Bromfield Hall
Marion
• Friday, November 4
Noon and 2:30 p.m.
290 Morrill Hall
Newark
• Tuesday, November 8
2 p.m.
Founders Hall Auditorium
Open Enrollment Presentation may also be seen online at http:/hr.osu.edu/oe
Wooster• Thursday, November 10 10 a.m. Fisher Hall Auditorium
Questions…
Why?When?
Open Enrollment
Additional Questions
• OHR Customer Service Center
Email: [email protected]
– (614) 292-1050– 1-800-678-6010– TDD 688-3730
•Benefits•Medical
•Dental
•Vision
•FSA