Chandler 2013 open enrollment presentation with voice kg (2)

Chandler Unified School District
Your 2013-2014 UnitedHealthcare Plan Benefits

Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
2
Reminder
Open Enrollment
April 22nd to May 10th

3
What We Will Cover Today
•Healthcare Reform Updates
•Medical Plan options & changes
•How medical plans work
•Voluntary Benefits employees can
purchase

Note: Condoms and spermicidal
agents, are not covered under
the health care reform law
because they are available
without a prescription. In
addition, the law only covers
women’s contraception, so male
contraception and sterilization
are not included in the
preventive care benefits.
UnitedHealthcare will cover tier-1 contraceptive methods for
women without cost-share:
* Hormonal methods
* Emergency contraception
The following Devices will be covered under the medical
benefit, when provided by a network physician, facility or
health care professional:
•Intrauterine devices (IUD)
•Diaphragms
•Sterilization procedures for women, such as tubal
ligations
Contraceptive Benefit - All Plans
Changes Effective July 1st

5
Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Breastfeeding Support – All Plans
Breastfeeding Equipment costs and Lactation
support and counseling are covered at 100%
through a network physician, hospital or durable
medical equipment provider (DME)
•Applies to lactation support by a
trained provider
•During pregnancy and/or in the postpartum
period
Note: Members will not be able to purchase supplies at retail
stores and send in the receipt for reimbursement. Please call
Customer Service number on back of card for instructions.
Changes Effective July 1st

Medical Option
• Choice Plus PPO Plan
• HDHP1500
• HDHP2700
6

7
Changes to the Choice Plus PPO
 No changes to the deductible or out of pocket maximums
 Decreased rates
 FAQ available
United Health Care – Choice Plus PPO
Number of
Deductions
Employee
Only
Employee+Spouse Employee+Child(ren) Employee+Family Spousal Share
22 $95.00/pay $490.35/pay $457.40/pay $720.97/pay $486.51/pay
19 $110/pay $567.77/pay $529.62/pay $834.80/pay $563.33/pay

8
Changes to the HDHP 1500
 No change to the deductible of out of pocket maximums
 Change to HSA contribution: Contribution will be $548 for the
fiscal year.
 First half of $274 deposited in August
 Final half of $274 deposited in January
United Health Care – HDHP1500
Number of
Deductions
Employee
Only
22 $0.00 $251.48/pay $230.52/pay $398.17/pay $188.61/pay
19 0.00 $291.18/pay $266.92/pay $389.61/pay $218.39/pay

9
Changes to the HDHP 2700
 No changes to deductible or maximum out of pocket.
 Change to HSA contribution: New HSA contribution will
be $1,262.
 First half of $631 deposited in August
 Final half of $631 deposited in January
United Health Care – HDHP2700
Number of
Deductions
Employee
Only
22 $0.00 $212.51/pay $194.80pay $336.48/pay $159.39/pay
19 0.00 $246.07/pay $225.56/pay $389.61/pay $184.55/pay

10
Your Medical Benefits at a Glance
Choice Plus PPO Plan
Type of coverage Network benefit Non-network benefit
Physician’s office services
$25 co-payment 50% after deductible
Specialist office visit $50 co-payment 50% after deductible
Urgent care center services $50 co-payment
50% after deductible
Emergency room services $500 co-payment $500 co-payment
Inpatient hospital stay
20% after $1,000
individual deductible,
$2000 family deductible
50% after $2,000 individual
deductible, $4000 family
deductible
Out of Pocket Maximum
$2,000 per individual,
$4,000 family per Plan
Year. (Deductibles and
copays do not apply)
$12,000 family per Plan Year
(Deductibles and copays do
not apply)

11
Choice Plus PPO Plan
Pharmacy Costs
Retail Mail order
Tier 1
$10 Member Cost
1-Month Supply
$25 Member Cost
3-Month Supply
Tier 2
$35 Member Cost
1-Month Supply
$87.50 Member Cost
3-Month Supply
Tier 3
$50 Member Cost
1-Month Supply
$125 Member Cost
3-Month Supply
Members are subject to $100 individual pharmacy deductible before copayment’s
apply.
Lowest
Cost
Highest
Cost

High Deductible Health Plans
(HDHP)
12

13
High Deductible Health Plans
(HDHP)
• Consumer Driven Health
• Half the cost of a traditional PPO
• Help you save for future medical expenses
• Protects from catastrophic medical expenses

14
*From www.healthcarelane.com
How the HDHP Works

15
HDHP 1500 – Non-Embedded Plan*
20% after deductible 50% after deductible
Specialist office visit 20% after deductible 50% after deductible
Urgent care center services 20% after deductible
Emergency room services 20% after deductible 20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible* (single deductible
does not apply for families)
50% after $3,000 single
deductible, $5,600 family
deductible* (single deductible
does not apply for families)
(single max does not apply
to families)
$3,900 single, $7,800 for
family coverage per Plan Year
(Deductibles and copays
apply)
$7,800 single, $15,200 for
family coverage per Plan Year
(Deductibles and copays
apply)

16
HDHP 2700 – Embedded Plan*
20% after deductible 50% after deductible
Specialist office visit 20% after deductible 50% after deductible
Urgent care center services 20% after deductible
Emergency room services 20% after deductible 20% after deductible
20% after $2,700
individual, $5,400
family deductible per
Plan Year (Individual
deductible applies for
each family member)
50% after $5,400
individual, $10,400 family
deductible per Plan Year
(Individual deductible
applies for each family
member)
$9,300 for family per
Plan Year. (Deductibles
and copays apply)
$18,200 for family per Plan
Year. (Deductibles and
copays apply)

17
HDHP Plan Pharmacy Costs
Retail Mail order
Tier 1
$10 Member Cost
1-Month Supply
$25 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$75 Member Cost
3-Month Supply
Tier 3
$50 Member Cost
1-Month Supply
$125 Member Cost
3-Month Supply
Members are subject to their Medical/Pharmacy deductible before copay’s apply.
Medications listed on Preventative Drug List are subject to copays.
Lowest
Cost
Highest
Cost

18
You are eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
such as a spouse’s plan
• You are not enrolled in Medicare
• You do not receive health benefits under TRICARE
• You have not received Veterans Administration (VA) benefits
within the past three months
• You cannot be covered by a health care FSA or HRA
HSA eligibility requirements

19
Annual HSA contribution limits
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
Annual
Contribution
Rules
2013: $3,250 for individuals & $6,450 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!
Annual contribution limits are set by the IRS

20
How you can use the HSA
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Pharmacy,
dental, vision
care services
Medical plan
deductibles and
coinsurance
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free

21
How you can use the HSA
1
Coverage while
receiving
unemployment
benefits
2
COBRA
continuation
coverage
3
Eligible long-
term care
4
Medicare
premiums and
out-of-pocket
expenses
Other qualified expenses

22
TIP: Use your HSA to help you pay qualified expenses
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
EOB.
Doctor bills you
for payment
1. You can use
your HSA to pay
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
How the HSA Plan Works
HSA Payment Process

23
Common HSA Questions
• Enroll during your Open Enrollment period
• Check your employer benefit information for
details
How do I enroll?
1
Can I take the funds in my HSA
with me if I leave the company?
2
Can others contribute to my
HSA?
3
How do I access the funds in
my account?
4
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
• Use your HSA debit card
• Pay by check, cash or credit card and
reimburse yourself later from your HSA

24
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
• Account holders will receive Health Savings
News e-newsletter
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
See your tax savings
And more

25
2013-2014
CUSD Voluntary Benefits

26
Voluntary Delta Dental Plan
•All employees who work 20 hours or more per week are
eligible to enroll in dental benefits.
3 Dental Plans Offered
• Premier Delta Dental Plan
• Core Delta Dental Plan
• (New) Total Dental Administrators(TDA)

Voluntary Dental
Core Plan
No Orthodontics
6 month waiting period
Preventative 100%
Basic Services - 70%
Excludes sealants
Major Services - 40%
Calendar Year Max - $1500
Number of
Deductions
Dental
Plan
Employee
Only
Employee
+ Spouse
Employee+Child(ren) Employee+Family
22 Core $17.36/Pay $33.79/pay $38.49/Pay $62.90/Pay
19 Core $20.10/Pay $39.12/Pay $44.57/Pay $72.83/Pay
22 Premier $24.05/Pay $47.50/Pay $55.13/Pay $92.28/Pay
19 Premier $27.85/Pay $55.00/Pay $64.99/Pay $106.85/Pay
Premier Plan
Orthodontics
Lifetime Max - $1000 (Increased)
Preventative - 100%
Basic Services - 80%
Includes sealants
Major Services - 50%
Calendar Year Max - $1500

28
Total Dental Administrators
Health Plan, Inc. (TDA)
• Preventative Care Services are covered at 100%
• All other services have a predetermined set fee.
• No annual or lifetime benefit maximums
• Orthodontics for Children and Adults are provided
• Affordable premiums
• Dentist Provider must be designated
• Services are only available in the State of Arizona.

Vision - VSP
Covers eye exams once every year.
Lenses are covered 100% after a $20 co-pay.
Frame allowance $130.
Contacts in lieu of lenses and frames allowance $130.
Premium based on 22 or 19 payroll deductions.
Number of
Deductions
Employee
Only
Employee+1 Employee+2 or
more
22 $4.28/pay $6.21/pay $11.14/pay
19 $4.96/pay $7.19/pay $12.90/pay

30
ING Life Insurance
• New Insurance Carrier
• Basic life insurance provided to all benefit eligible employees in the
amount of $50,000
• Additional voluntary life insurance coverage available to purchase,
premiums based on age and amount of coverage
• Spouse/child coverage available
• If you are not currently enrolled in voluntary life insurance coverage but
wish to enroll now, during this open enrollment period only. ING will
guarantee coverage up to $150,000 for all employees without evidence of
insurability.
• Spouses are guaranteed up to $30,000 with no evidence of insurability
• Children are guaranteed up to $10,000 with no evidence of insurability

31
Assurant
Short Term Disability
• During this open enrollment period only all employees can purchase short
term disability coverage based on their salary not to exceed 66 2/3.
Coverage amounts up to $3,000 are guaranteed with no evidence of
insurability.
• The policy does not pay for disabilities within 12 months of your initial
enrollment plan, if you received medical treatment, consultation, care or
services (including diagnostic measures), or took prescribed drugs or
medicines for the disabling condition during the 12 months prior to your
initial enrollment date.
• To be eligible during pregnancy, you cannot be pregnant prior to the
benefit effective date.
• The plan provides monthly benefits ranging from $360 to $5,000, based
on your annual salary, not to exceed 66 2/3% of your salary.

32
BASIC
Flexible Spending Accounts
• An election must be made every year if you wish to enroll in a Flex
Plan
• Medical Flexible Spending account limit for 2013-14 plan year is
$2,500
• Dependent Care Flexible Spending account limit will remain at
$5,000 maximum.
• If you are enrolled in an HSA plan you are only able to use your
medical flex spending account for dental and vision expenses
• When making flex account elections please keep in mind that if
you do not use the funds by June 30, 2014 you will forfeit all
remaining money in the account

Long Term Care
•Monthly Benefit to assist with nursing home expenses or in home
licensed care.
•District Policy was $2,000 per month not to exceed $48,000 policy
•No longer offered
•If you wish to continue with the coverage you will need to download
the continuation of coverage form at:
www.cusd80/continueltc.com
• Mail directly to UNUM
• You will have 60 days from June 30th to send in your form to port
your service.

Chandler 2013 open enrollment presentation with voice kg (2)

Recommended

Recommended

More Related Content

What's hot

What's hot (20)

Viewers also liked

Viewers also liked (6)

Similar to Chandler 2013 open enrollment presentation with voice kg (2)

Similar to Chandler 2013 open enrollment presentation with voice kg (2) (20)

Chandler 2013 open enrollment presentation with voice kg (2)

Editor's Notes