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2017 New Hire Powerpoint PresentationCity of SchertzNew Hire Presentation 1 Table of Contents How to Use Medical Plan Plan Details HSA information Humana Vitality Ancillary Employee Benefits When can I change my benefits? Additional City Benefits Choosing the Right Plan Open Enrollment Details 2 Choosing a Network Provider When you choose a doctor, you’ll need to make sure that the doctor is in the your network. If you go to a doctor that is not in your network (or non-network provider), you will be responsible for a larger portion of the bill! Always call your doctor & ask if he/she participates in your network. A provider list can be found at www.humana.com Go to the bottom of the page and select ‘Find a Doctor’ Enter your Member ID Number or search by Coverage & Network Go to www.humana.com and select ‘Find a Doctor’ at the bottom of the page. 3 4 5 Where should I go? Always try to go to your primary doctor instead of the emergency room unless it is a true emergency. ER visits are much more expensive than office visits for YOU and for the City. If your visit is considered a non-emergency, you’ll be charged a $100 co-pay up front. If you are admitted then the $100 co-pay will be waived Have chest pains? A broken bone? Go to the Emergency room! Need a couple of stitches? Got the flu? Call your doctor! Example: Got the Flu? Go to the ER? Facility Charge: $500 Physician Charge: $200 ER Co-Pay: $100 Rx Antibiotics: $20 co-pay Total Cost: $820 Time: Approx. 4 hours Go to your Doctor? Dr. Visit: $20 co-pay Rx Antibiotics: $10 co-pay Total Cost: $30 Time: Approx. 1 hour Don’t forget that some of the stand alone facilities are EMERGENCY ROOMS 6 Health Insurance Deductibles & co-payments are dollar amounts that you must pay before the plan pays. Deductibles are paid once per year per person and do not apply to the 100% maximum out-of-pocket payment. Deductible amounts are different based on whether you see a network or non-network doctor. Co-payments are smaller amounts of money that are paid each time a service is used. For example, you’ll typically pay a $20 co-pay when you go to a doctor’s visit. You’ll pay a co-pay when you pick up your prescription drugs at your pharmacy if you have a POS. 4 Level Rx Plan 1- low generic & brand-name = $10 2- high generic & brand-name = $30 3- high brand-name = $50 4- high-tech drugs and some brand-name = 25% of cost of drug Some drugs are not covered by insurance plans which means you may have to pay the entire cost. See formulary online or call Humana Work with your doctor on finding the best choice for you. Non-preferred, brand name drugs usually have equally effective and less costly generic Deductibles & Co-Pays Prescription Benefits 7 Humana Medical Insurance Employees may choose one of the following two medical insurance plan options through Humana: PPO High Deductible Health Plan (HDHP) Medical Insurance All regular full-time employees are required to sign up for health insurance unless they are already covered by a qualifying medical insurance plan. Coverage under the health programs may include your spouse and any dependent children up to age 26. Employees may choose among two (2) plans from Humana: PPO 90/60 Plan and PPO High Deductible Health Plan (HDHP) Medical Option #1: PPO 90/60 Employees use any in-network or out-of-network family doctor, general physician, or specialist without a referral from their primary care physician. Preventative services are covered at 100%. 8 Option #1: PPO 9 Humana Medical Insurance Employees may choose one of the following two medical insurance plan options through Humana: PPO High Deductible Health Plan (HDHP) Medical Option #2: PPO HDHP This is a high-deductible health plan Also a PPO Plan Higher Deductible ($3,000), so insurance gets involved later than PPO 90/60 ($1,000 deductible) No co-pays No co-insurance Preventative services are covered at 100% Dependent premiums are 20% lower than PPO 90/60 plan The HDHP will be connected to a Health Savings Account (HSA) 10 Humana Medical Insurance HSA money is your money. Contribute to your HSA tax-free from your paycheck What is an HSA? It is a Health Savings Account Used to pay for qualified medical expenses (See IRS limitations) Employer and employee can contribute to HSA Non-taxable at time of deposit Funds belong to Employee Accumulate and roll over year to year if not spent You can keep as much or as little money in your HSA as you want - no limits Employees can contribute more to HSA from paycheck, thus minimizing taxable income Funds will never be taxed as long as it is used for qualified medical expenses. 11 Humana Medical Insurance See IRS Publication 969 in your folder for more information on HSA qualifications Who Qualifies for the HSA? Must be on the HDHP / H S A qualified plan You are not enrolled in Medicare You cannot be claimed as a dependent on some else’s 2017 tax return You have no other medical coverage 12 Humana Medical Insurance See IRS Publication 969 for more information on HSA Contributions HSA Contributions City monthly deposits of $103.58 HSA monies can be used for qualifying medical expenses Employees can also contribute to HSA from paycheck on a pre-tax basis 13 Humana Medical Insurance See IRS Publication 969 for more information on HSA Contributions 2017 HSA Contribution Limits (employer and employee) 2017 Individual Contribution Limits = $3,400 2017 Family Contribution Limits = $6,750 Catch up Contribution Limits (age 55 or older) = $1,000 Subtract $1,242.96 (or the prorated amount) for what employee can contribute personally 14 Humana Medical Insurance See IRS publication 502 for a full list of qualifying medical expense deductions HSA Qualifying Expenses IRS publication 502 gives an exhaustive list of what you can include in figuring your medical expense deduction Here are some examples of qualifying medical expenses: Medical, dental or eye exams Glasses, contacts, braces Prescription medications Long-Term care Surgeries Special Education Transportation essential to medical care Home Health Care Stop-Smoking Programs 15 Humana Medical Insurance See IRS publication 502 for a full list of qualifying medical expense deductions HSA Non-Qualifying Expenses Here are some examples of non-qualifying medical expenses: Childcare, Baby Sitting Controlled Substances Unnecessary Cosmetic Surgery Funeral Expenses Household Help Insurance Premiums Illegal Operations and Treatments Nutritional Supplements Teeth Whitening Health Club Dues Non-Prescription Drugs and Medications Veterinary Fees 16 HDHP Plan with HSA 17 Navigation of the site 18 Navigation of the site Getting started is easy! You have two options to log into the site: Humana medical member – www.humana.com or Go365 member/Humana medical member - www.go365.com 19 Navigation of the site Interactive website Dashboard Activities Eat Healthy Shop Quick Links 20 Dashboard Easy access to what you can do today! Explore Activities Recent Device Activity 21 Dashboard Easy access to what you can do today! Recent Earnings Weekly View* Go365 Age HealthyFood Savings Go365 Mall Jackpot Achievement *Weekly View leads to calendar of activity and Go365 Statement 22 Activities Start by choosing a few Activities to get started Recommended Prevention Fitness Education Healthy Living 23 Eat Healthy Save when you play HealthyFood* Shopping Card Monthly Pick 6 game *The HealthyFood program is not available to all Go365 members and is only available with certain plans or products offered by Humana. 24 Shop Welcome to the Go365 Mall Bucks Balance Order History Customer Care Bucks/Cash 25 Quick Links Easy access to get started Connect and manage devices Participating Fitness Facilities Challenges Coaching Health Report 26 Ways to get out of Blue Status 27 Ways to get out of Blue Status Three options* to getting out of Blue Status! Complete a section of your Health Assessment Get a biometric screening Complete a verified workout *Adult children can only move a family out of Blue Status by completing a verified workout. 28 Tools & Resources 29 Tools & Resources All the resources you need at your finger tips! Engagement Source (Tool kits, flyers, etc.) http://engagementsource.go365.com Go365 Community https://community.go365.com/ 30 Take Action! Sign in to the Go365 website and begin to play around to get comfortable Share the Get Started flyer with your members Download the Health Assessment Tool kit along with the Biometric Screening Tool kit to get started 31 Go365 Education Series Join us for our monthly Education Series to learn more about… Devices, Apps and Fitness! Employer-sponsored Events Engagement Source, the tools you need! Earning Points and getting to Silver Status and beyond! Using the Challenges platform Biometric Screenings To register, go to the Engagement Source and select the link next to the webinar you wish to attend. 32 Humana Dental Insurance To see the list of approved dentists in your area, go to humanadental.com and click on “Find a Dentist” or call 800-233-4013. Traditional Dental Plus 100-80-50 Under the Humana dental plan, you will be able to visit any dentist in the Humana Dental Network. There is a $50 individual deductible ($150 Family) for all procedures, except for preventive procedures, which are covered at 100%. The annual maximum allowed per individual is $2,500 Increase to Traditional Dental Plus Plan for EC and EF due to Ortho being added. 33 Humana Dental Insurance To see the list of approved dentists in your area, go to humanadental.com and click on “Find a Dentist” or call 800-233-4013. Dental Preventative Plus 100-80-0 Under the Humana dental plan, you will be able to visit any dentist in the Humana Dental Network. There is a $50 individual deductible ($150 Family) for all procedures, except for preventive procedures, which are covered at 100%. The annual maximum allowed per individual is $1,000 See Humana rep at open enrollment for more information 34 Vision Care Plan Vision coverage is provided through Humana Vision at very affordable rates for employees and family members. See Summary of Benefits online 12/12/12 plan Discount for Lasik Surgery Employee Only = $0 Employee + 1 = $3.18 per paycheck Employee + Family = $5.34 per paycheck For more information please visit humanavisioncare.com or call 866-537-0229 Vision Care Monthly Rates By Tier 35 Other Benefits The City of Schertz also pays for: Worker’s Compensation Costs Unemployment Social Security Taxes in addition to the FICA that you pay. The City matches employee retirement contributions immediately upon hiring at 2 to 1 but requires a 5-year vesting period to receive City contributions. The benefits you choose will be in effect until our next enrollment period or until you have a qualifying event. A qualifying event can occur through marriage, divorce, birth, or adoption. You must inform HR or BDI within 30 days of these events in order to change your benefits. If you don’t let HR or BDI know on time, you run the risk of not having the benefits you may need for your loved ones. You may not realize…. When can I change my benefits? 36 Supplemental Benefits The City provides all employees with Long-Term Disability insurance at no cost to the employee through UNUM It provides 60% of pay to a maximum of $5,000/month Employees have the option to purchase at their own expense short-term disability Disability Insurance Life Insurance The City provides term life insurance coverage through Humana for all eligible Employees up to $25,000 immediately upon hire. The policy also includes Accidental Death and Dismemberment coverage (AD&D) up to $50,000 Voluntary Supplemental Life insurance for Employees and dependents is also available 37 Supplemental Benefits The City provides employees with a Medical Bridge through Colonial The medical bridge pays employees if they are hospitalized or have out-patient surgery Hospitalization pays $500 Out-Patient surgery pays $500 Colonial also offers other supplemental policies. Medical Bridge HSA Medical Bridge Per IRS rules, employees who choose the HDHP must be covered under the HSA compliant medical bridge This plan pays $1,000 per hospitalization but pays $0 for out-patient surgery 38 Which Plan is Right for Me?? Depends on your medical expenses Any expenses coming up? Family design Depends on your overall health Ultimately depends on your situation 39 40 SRA emailed to EVERYONE 41 ATTENTION! Defaults login’s are set as per instructions below: Web: https://secure.benebridge.com/assn/679 User: Your user name will be first letter of your first name, first three letters of your last name and last four of your social: (example for John Sommers would = jsom6789) Password: Full social with no dashes or periods (example would = 123456789) Pin: First 4 numbers of your social and last 2 of your birth year. Using the above password and 1970 as birth year. (example would = 123470) 42 43 Questions? If you have questions about your benefits, please call BDI at 830-303-8300, (Kathy Smith) ksmith@bdi-insurance.com or Human Resources Dept. at 210-619-1150, or the vendors. 44