Next Gen Medical Plan Changes 2015/2016 October 2014 Presented to Next Gen-Eligible Employees

Transcription

Next Gen Medical Plan
Changes 2015/2016
October 2014
Presented to Next Gen-Eligible Employees
Next Gen
Agenda
• Next Gen Changes for 2015 and 2016
• Change Summary
Open enrollment for 2015
benefits: Oct. 22 to Nov. 5, 2014
• Next Gen Plan Eligibility
• Next Gen Plan Changes
• Next Gen Special Incentives
• Other 2015 Benefit Changes
• Resources and Support
• Next Steps
• Q&A
2
For more details regarding what
else is changing and what’s
staying the same for 2015, review
the 2015 Benefits Open
Enrollment website:
www.unitedhrdirect.com/oe2015
Next Gen
Next Gen Change Summary for 2015 and 2016
Consumer-driven (or highdeductible) health plans
encourage individuals to play
a more active role in making
health care decisions and
informed choices, which can
lead to improved health
outcomes and lower costs for
individuals and the health
care system overall.
• Eligibility changes for 2015 Benefits Open Enrollment
• Next Gen plan changes (premium rates, base benefits,
deductibles, out-of-pocket maximums)
• Special financial incentives for changing plans during
2015 Benefits Open Enrollment
• Will not be offered as a medical plan option during 2016
Benefits Open Enrollment
• No plans to offer special incentives for changing plans
during 2016 Benefits Open Enrollment
There’s still time to earn the Your Rewards for Health 2015 premium incentive.
3
Next Gen
Next Gen Enrollment Eligibility Changes
Employees who are ELIGIBLE
to continue enrollment in
Next Gen for 2015:
Employees who are NOT ELIGIBLE
Next Gen for 2015:
Employees who are ELIGIBLE
Next Gen for 2016:
• Only those currently enrolled in Next
Gen as of the 2015 Benefits Open
Enrollment start date (Oct. 22,
2014)
• New hires with a benefit effective
date after Dec. 1, 2014
• None
• Any employee who is enrolled in
Next Gen in 2014 and receives a
salary grade promotion above grade
25 or SBA.
• No plans to offer special incentives
for changing plans during 2016
• New hires with a benefit effective
date between Oct. 1, 2014, and
Dec. 1, 2014, who enroll in Next
Gen for 2014
No new Next Gen
participants for 2015
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(Note: These employees can
continue in the Next Gen until
Dec. 31, 2014.)
• Any employee who does not meet
the 2015 eligibility requirements
Next Gen
Next Gen Plan Changes for 2015
• The premiums per-paycheck will increase for the Next Gen plan.
• The Next Gen base benefit per covered member will be reduced to $1,000 (currently $1,200).
• Deductibles and out-of-pocket maximums will increase:
Next Gen
5
2014
2015
Deductibles
$1,900 per person
$3,800 per family
$2,500 per person
$5,000 per family
Out-of-pocket
maximums
$4,000 per person
$8,000 per family
$5,000 per person
$10,000 per family
Next Gen
2015 Special Next Gen Financial
Incentives for Enrolling in an HSA Plan*
Extra company contribution into the employee’s HSA account
(Deposit timing: January 2015, lump sum, one time)
Advance deposit of the regular HSA base company contribution
(Deposit timing: January 2015, lump sum)
• If salary is less than $50,001:
Employee-only: $375 / Employee + Dependents: $750
• If salary is $50,001+:
Employee-only: $250 / Employee + Dependents: $500
Additional HSA contribution if employee and/or spouse/domestic
partner** reaches Your Rewards for Health Gold or Silver Status by
Dec. 31, 2014
(Deposit timing: April 2015, lump sum)
Employee: $100; Spouse/domestic partner: $100
Employees must have or open an HSA with
Optum BankSM to receive the company
contributions. No retroactive company-paid
contributions will be made.
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This incentive amount is in addition to the regular
Your Rewards for Health premium reduction.
*Basic w/HSA, Plus w/HSA or Max w/HSA
**must be covered under the current plan
Next Gen
Comparing Next Gen to HSA-Based Plans
Most current Next Gen enrollees will be better off financially in one of the HSA-based plans
• 75% of employees when we include the one-time incentives
• 67% ongoing
Which Employees Are Better Off?
1. Level of Claims
• Likely to be better off in HSA if you have low or very high claims
– Employee-only coverage is better in HSA: almost always, with claims of $1,000 or
lower; over 80% of the time with claims over $5,000
– Family coverage is better in HSA: almost always with claims of $2,500 or lower ;
about 65% of the time with claims over $10,000
2. Level of Prescription Drug (Rx) Claims
• Likely to be better off in Next Gen with moderate medical claims but significant Rx claims
• Likely to be better off in HSA with significant medical and Rx claims
3. How Claims are Spread Out Across a Family
Use the online tools to find the best plan based on your situation
Don’t forget to add the extra incentives for migrating in 2015: $200, $300 or $400
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Next Gen
2015 Employee Actions
Comparing Next Gen vs. Plus w/HSA
Meet Sarah:
• Sarah is eligible to continue coverage in Next Gen in 2015.
• Her coverage level is employee-only.
• Her annual salary is less than $50,001.
• Sarah chooses to change her plan for 2015 and enroll in the
Plus w/HSA medical plan instead of the Next Gen plan.
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Next Gen
Maximizing Plan Incentives by Sept. 30, 2014
Sarah maximizes the
plan incentives
Sarah doesn’t maximize
the plan incentives
Next Gen
Plus w/HSA
Next Gen
Plus w/HSA
2015 per-paycheck premium
$37.40
$31.27
$37.40
$31.27
Your Rewards for
Health Silver
OR
Silver Credit
2015 per-paycheck premium*
-$14.42
$22.98
-$14.42
$16.85
Your Rewards for
Health Gold
Gold Credit
-$23.08
$14.32
-$23.08
$8.19
into her HSA (January 2015,
lump sum)
Plus Extra Incentive: $200
extra Company deposit into her
HSA (January 2015, lump sum)
HSA (if she earns Gold or
Silver; April 2015, lump sum)
Plus: Company Match deposit
into her HSA (Jan. through Dec.
in 2015)
N/A
$375
N/A
$375
N/A
$200
HSA $$ Total for 2015
A Plus: Company Base deposit
Company contributions
to her Health Savings
Account (HSA)
Standard = $500
Extra for 2015 = $300**
B
C
D
+
N/A
$200
+
N/A
$100
N/A
$0
N/A
$125
N/A
$0
N/A
$800
N/A
$575
+
*assumes Sarah achieved Gold or Silver status in the Your Rewards for Health program by Sept. 30, 2014
**assumes Sarah maximized the incentives, including the company match and the Your Rewards for Health incentive
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Next Gen
Example Health Care Costs
Maximizing Plan Incentives by Sept. 30, 2014
Sarah maximizes the
plan incentives
Next Gen
1) Annual Premium
(w/Silver Incentive)
$597
Plus w/HSA
$438
OR
$972
$813
$825
$825
$825
$0
$825
$0
$825
5) Average Total Copays,
Coinsurance
$175
$0
$175
$0
6) Company-Paid Amounts
$650
$0
$650
$0
7) Amount Paid by Next Gen Base
Benefit or HSA
$650
$800
$650
$575
8) Total Paid by Employee
[(4) + (5) + (6) – (7)]
$175
$25
$175
$250
9) Total Employee Cost
[(2) + (8)]
$547
$238
$1,147
$1,063
2) Annual Premium
(w/Gold Incentive)
$372
$213
3) Average Claims*
$825
4) Average Total Deductible
*based on average member claims
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Next Gen
Annual Premium
Your Rewards for
Health Silver
Your Rewards for
Health Gold
Plus w/HSA
the plan incentives
Next Gen
Maximizing Plan Incentives by Dec. 31, 2014
Sarah maximizes the
plan incentives
the plan incentives
Next Gen
Plus w/HSA
Next Gen
Plus w/HSA
2015 per-paycheck premium
$37.40
$31.27
$37.40
$31.27
Your Rewards for
Health Silver
OR
Silver Credit
-$14.42
$22.98
-$14.42
$16.85
Your Rewards for
Health Gold
Gold Credit
-$23.08
$14.32
-$23.08
$8.19
into her HSA (January 2015,
lump sum)
HSA (January 2015, lump sum)
HSA (if she earns Gold or
Silver; April 2015, lump sum)
into her HSA (April through Dec.
in 2015)
N/A
$375
N/A
$375
N/A
$200
N/A
$0
N/A
$125
N/A
$0
N/A
$800
N/A
$575
A Plus: Company Base deposit
to her Health Savings
Account (HSA)
Standard = $500
Extra for 2015 = $300**
B
C
D
+
N/A
$200
+
N/A
$100
+
*assumes Sarah achieved Gold or Silver status in the Your Rewards for Health program by Dec. 31, 2014
**assumes Sarah maximized the incentives, including the company match and the Your Rewards for Health incentive
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Next Gen
Example Health Care Costs
Maximizing Plan Incentives by Dec. 31, 2014
Sarah maximizes the
plan incentives
Your Rewards for
Health Silver
OR
Your Rewards for
Health Gold
1) Annual Premium
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Plus w/HSA
$698
$539
Next Gen
Plus w/HSA
Annual Premium
$972
$813
$825
$825
$825
$0
$825
$0
$825
5) Average Total Copays,
Coinsurance
$175
$0
$175
$0
6) Company-Paid Amounts
$650
$0
$650
$0
Benefit or HSA
$650
$800
$650
$575
[(4) + (5) + (6) – (7)]
$175
$25
$175
$250
[(2) + (8)]
$709
$400
$1,147
$1,063
2) Annual Premium
(w/Gold Incentive)
$534
$375
3) Average Claims*
$825
4) Average Total Deductible
*based on average member claims
Next Gen
the plan incentives
NETWORK SELECT
Network Select Plan Expansion
Plan highlights:
• Network-only coverage: No benefits are paid for care
or services outside of the network.
• Members must select a primary care physician.
• Coverage is provided at 100% for preventive care and
preventive prescription drugs (after copayment) when
using a network provider and/or pharmacy.
• Referrals are required for specialists*.
Network Select may not be
available in all markets in a state.
Availability is based on the ZIP code
where the employee lives.
For a detailed list of state/market
availability, visit the 2015 Benefits Open
Enrollment website:
• Certain services may require prior authorization.
• An HSA is not a part of this medical option.
*Referrals for services from the following network providers are not required: obstetricians/gynecologists (OB/GYNs), behavioral health and
substance use disorder clinicians, providers for routine refractive eye exams, convenience care clinics, urgent care clinics or emergency room
services. Emergencies are covered anywhere in the world, including non-network hospitals.
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NETWORK SELECT
NETWORK SELECT PLAN EXPANSION
As of Jan. 1, 2015, Network Select will be available in 28 states* plus the District of
Columbia.
Alabama
Arizona
Arkansas
Colorado
Florida
Georgia
Illinois
Indiana
Iowa
Kentucky
Louisiana
Maryland
Michigan
Mississippi
Missouri
New Jersey
New York
North Carolina
Ohio
Oregon
Pennsylvania
Rhode Island
South Carolina
Tennessee
Texas
Utah
Washington
Wisconsin
*Network Select may not be available in all markets in a state. Availability is based on the ZIP code where the employee lives. For a detailed list of state/market
availability, visit the 2015 Benefits Open Enrollment website (going live the week of Oct. 6): www.unitedhrdirect.com/OE2015
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Next Gen
2015 Special Next Gen Financial
Incentive for Enrolling in Network Select*
Additional payroll premium reduction if employee and/or
spouse/domestic partner** reaches Your Rewards for Health
Gold or Silver Status by Dec. 31, 2014
(Premium discount applied April through December, biweekly
through 2015)
• Employee: $100
• Spouse/domestic partner: $100
This incentive amount is in addition to the regular Your
Rewards for Health premium reduction.
*Where available. You can check availability for the ZIP code where you live using the 2015 Benefits
Open Enrollment website: www.unitedhrdirect.com/oe2015
**must be covered under the current plan
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Next Gen
If You Continue in Next Gen for 2015
• The Next Gen base benefit will be reduced from $1,200 to
$1,000 for 2015.
• The per-paycheck premium for the plan will be increased for
2015.
• The deductibles and out-of-pocket maximums will be increased
for 2015.
• You will not be eligible for special Next Gen financial incentives.
• Next Gen will no longer be an available plan option for 2016.
You will have to choose a different medical plan.
• There are no plans to offer special incentives for changing
plans during 2016 Benefits Open Enrollment.
There’s still time to earn the Your Rewards for Health 2015
premium incentive to help offset this increase.
Achieve Gold or Silver status by Dec. 31, 2014.
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Next Gen
Other 2015 Benefit Changes
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2015 Benefits Open Enrollment: Oct. 22 – Nov. 5, 2014
• Review information at
• Understand your options
• Know what benefits do not carry over from
year to year
• Use tools to help you choose what benefits are
best for you and your family
• Enroll in benefits online between
Oct. 22 – Nov. 5, 2014
Take
Action!
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• If you do nothing during 2015 Open Enrollment, you will be automatically enrolled in
your current 2014 medical plan at your current coverage level.
• Don’t miss out on these other benefits — re-enroll for 2015!
‒ Health Care Flexible Spending Account (FSA)
‒ Dependent Care Reimbursement Account (DCRA)
‒ Buying or Selling Paid Time Off (PTO) (not available in California)
• Review and reset your 2015 HSA contribution amount.
• Take steps to qualify for Your Rewards for Health incentive – there’s still time!
What’s Changing for 2015
Medical Plan Changes
• Premium increases affect all medical plans and
coverage levels
• Copays, deductibles and out-of-pocket limits
• New Prior Authorization requirement for certain
health care services*
• Changes to coverage for Preventive Care Services*:
For more details regarding
what’s changing and what’s not
for 2015, review the 2015
website:
– New age limits for certain services
– Several new screenings that will be covered at
100% as preventive care
There’s still time to earn the Your Rewards for Health 2015
premium incentive to help offset this increase.
Achieve Gold or Silver status by Dec. 31, 2014
*Applies to the Basic w/HSA, Plus w/HSA, Max w/HSA, Network Select, Next Gen, WellMed 1st Tier and Choice Transition.
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New
Mail Service Member SelectSM Program
• Provided through the OptumRx Prescription Drug
Benefits
• Automatic enrollment in mail order if you are
currently taking a maintenance medication on a
regular basis
• List of eligible maintenance medications available on
the pharmacy section of the 2015 Benefits Open
Enrollment website
• You have the option to opt out of this program.
See the 2015 Benefits Open
Enrollment website for more
information.
20
New
Accident Protection Insurance Voluntary Benefit
• Additional financial coverage for qualifying injuries on and off
the job
• Benefits are paid out as lump-sum checks on approved claims
• Coverage for employees and dependents is voluntary and
paid entirely by you, the employee
• Full-time employees (35 hours or more/week) are eligible to
purchase
Vision Benefits
Contact lens allowance will be increased to $130
Life Insurance — Child Coverage
Children will now be eligible for coverage up to age 26
Health Flexible Spending Accounts (FSA)
• Employees who enroll in an FSA only (no medical coverage)
and Network Select members will receive a Health Care
Spending Card in 2015
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See the 2015 Benefits
Open Enrollment
website for more
information.
Health Savings Account (HSA) IRS Contribution Limits
The HSA annual contribution limits for 2015 may not exceed:
• $3,350 for employee-only coverage
• $6,650 for family coverage
This annual HSA limit includes any funds the company will
contribute to your HSA, such as the Base and Matching
Company Contributions, which total $500 for employee-only
coverage and $1,000 for employee plus dependent
coverage.
Note: if you are 55 or older, you may contribute an additional $1,000 catch-up
contribution.
Baby Blocks Mobile App (Introduced in August 2014)
• Helps expectant moms keep track of recommended steps
to ensure a healthy pregnancy and healthy baby
See the 2015 Benefits Open
Enrollment website for more
information.
• Use it to schedule doctor appointments, prepare for what to
expect and learn how to take care of yourself and your
baby. Go to mybabyblocks.com on your smartphone to
learn more.
Affordable Care Act Transitional Reinsurance Fee
•
22
No longer applies to UnitedHealth Group Medical Plans
New
Rally for Health
A new wellness incentive program and platform will replace the
current Your Rewards for Health program.
Highlights of new program:
 Complete a health survey, biometric screenings, and other
health actions and receive financial rewards for each event as
completed
 New! Your earned financial incentives for health action
completions will be immediately available* — no waiting until
the next plan year for your reward
 New! Depending on your medical plan option for 2015,
incentives will be paid as lump-sum contributions to either a
Health Savings Account (HSA) or a Health Incentive Account
(HIA) — more to come on this
More details about the new
2015 program will be
shared in future
communications.
Note:
The launch of this new
program will not impact
2015 incentives you earn
during 2014.
 New! More rewards and opportunities to
win prizes
There’s still time to earn the Your Rewards for Health
2015 premium incentive — achieve Gold or Silver
status by Dec. 31, 2014
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* Incentives will be paid as soon as
administratively practicable; generally
within two months.
Employee Stock Purchase Plan (ESPP)
If you currently participate in the ESPP, your
contribution rate will automatically carry over to 2015.
If you have not previously participated in the
ESPP and want to enroll, log in on the NetBenefits®
website.
If you previously participated in the ESPP but are
not currently making contributions, you will need
to re-enroll in the plan.
If you were enrolled in the current purchase
period and subsequently withdrew, you will need
to enroll to participate in the next purchase period.
Enroll in the ESPP
Oct. 22 – Nov. 5
You can enroll in ESPP for the first
time or change your contribution rate.
Check out the meeting schedule on
the Benefits website for Financial
Fitness meetings planned in your
location.
NetBenefits® website — www.netbenefits.com
Enroll, review or change your contribution rate. Registration/login required
24
Next Gen
Resources and Support
Medical Plan Decision Toolkit (Online)
Find it on www.unitedhrdirect.com/oe2015
under “Quick Links.”
• Compare your options.
• Estimate your cost.
• Got 2 minutes? Get a suggestion.
• Grow your HSA.
• See what others did.
• Consider an FSA.
Call the special Next Gen phone number
for more assistance regarding your
enrollment options for 2015: 1-877-459-6157
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Next Steps
 Consider the right medical option for you and your
family.
 Review your other benefit options for 2015.
(Several require re-enrollment each year.)
 Enroll online between Oct. 22 – Nov. 5
(Don’t wait until the last day to enroll!)
 Call HRdirect at 800-561-0861 if you need more
assistance.
 Take steps to achieve a Your Rewards for
Health Premium incentive by Dec. 31, 2014.
Current Next Gen Enrollees: Consider the special incentives for
2015 when you choose a different medical plan option. Learn more:
www.unitedhrdirect.com/benefits/health-benefits/index.html
Go to www.unitedhrdirect.com/oe2015 for complete details.
26
Next Gen
Q&A
27
Appendix
Comparing Medical Options for 2015
Network Select
Next Gen
Benefit Feature
Basic w/HSA
Plus w/HSA
Max w/HSA
Not available in all locations^
Network-only coverage
Limited Eligibility for 2015
Eligible for Special
Next Gen Change
Incentive



 (partial)
Not applicable
Lowest Premium
Mid-Range Premium
Higher Premium
Higher Premium
Higher Premium
Employee
Premiums
Annual Company
Contributions to
Accounts
(provided per
paycheck)
• Paid to an employee’s Optum Bank HSA
• Use for expenses, like deductibles, or save the money
100%
Must select a Network Primary
Care Physician to oversee
treatment and to make network
referrals for services
100%
$3,150 EE-Only
$2,650 EE-Only
$1,850 EE-Only
Other Levels:
$3,150 per person
$6,300 per family
Other Levels:
$2,650 per person
$5,300 per family
Other Levels:
$2,600 per person
$3,700 per family
Network Cost Sharing
2015 Network
Out-of-Pocket
Maximums+
Prescriptions
Certain contraceptives
are free under any plan
New Mail Service
Member SelectSM
Program
$1,000 Base Benefit per covered
person – applies only to Network
providers
Employee pays 20% coinsurance
or copays ($0, $50, $50, $300)
while using Base Benefit
Annual Salary $50,001+
• Employee-only coverage level: $250 Base / $250 Match = $500 maximum*
• Other coverage levels: $500 Base / $500 Match = $1,000 maximum*
Preventive Care
2015 Network
Deductibles+
NA
Annual Salary Less than $50,001
• Employee-only coverage level: $375 Base / $125 Match = $500 maximum*
• Other coverage levels: $750 Base / $250 Match = $1,000 maximum*
100%
$2,500 EE-Only
$1,100 EE-Only
$1,100 per person
$2,200 per family
$2,500 per person
$5,000 per family
Deductible applies after Base
Benefit is exhausted
80% / 20% after deductible
$6,250 per person
$12,500 per family
$5,250 per person
$10,500 per family
$3,650 per person
$7,300 per family
Preventive Meds (deductible does not apply):
Retail copay: $15 / $40 / $85
Mail copay: $35 / $90 / $190
Non-Preventive Meds: 80% / 20% after deductible
$3,300 per person
$6,600 per family
$ 5,000 person
$10,000 per family
Deductible does not apply
Retail copay: $15 / $40 / $85
Mail copay: $35/ $90 / $190
Specialty: 20%,
Rx copays and coinsurance apply
to Medical OOP Max
For more information, visit the 2015 Benefits Open Enrollment
*To receive the Matching Company Contribution, you must make an employee contribution of at least:
• Annual Salary less than $50,001: EE-Only: $4.81/paycheck ($125 annually); EE+Dependents: $9.62/paycheck ($250 annually)
website: www.unitedhrdirect.com/oe2015
• Annual Salary $50,001+: EE -Only: $9.62/paycheck ($250 annually); EE+Dependents: $19.24/paycheck ($500 annually)
+There are separate Deductibles and Out-of-Pocket Maximums for Non-Network services
^Network Select may not be available in all markets in a state. Availability is based on the zip code where the employee lives. Visit the 2015 Benefits Open Enrollment website at www.unitedhrdirect.com/OE2015 for a
29list of state/market availability.
detailed
Basic w/HSA, Plus w/HSA and Max w/HSA Medical Plans
Plan highlights:
• Freedom to use any doctor or hospital, in-network
or out-of-network (you will likely pay more for
out-of-network care or services)
• Not required to choose a primary care provider (PCP)
• A referral is not required to see a specialist
HSA highlights:
• A Health Savings Account (HSA) with Optum BankSM
(Member FDIC) is required to make contributions and
receive the company base and matching contributions
• Offers TRIPLE tax savings — pre-tax/tax-deductible
contributions, tax-free earnings growth and non-taxed
withdrawals for qualified* medical expenses
• It’s easy and convenient to use — pay for care and
services with UnitedHealthcare HSA MasterCard debit
card or online at myuhc.com or optumhealthfinancial.com
• You own the deposited funds and can use them to pay for
health care expenses now and in the future — you can
even invest them^
30
*See IRS publication 969 for rules about HSAs
^A minimum $2,000 balance is required to invest
HSA Base and Matching Company Contributions 2015*
No Changes for 2015
Employee-Only Coverage
Employee + Dependent Coverage
Annual/Per Paycheck
Annual/Per Paycheck
$375 / $14.42
$750 / $28.84
You contribute at least:
$125 / $4.81
$250 / $9.62
Then the company contributes:
$125 / $4.81
$250 / $9.62
$500 / $19.23
$1,000 / $38.46
$250 / $9.62
$500 / $19.23
You contribute at least:
$250 / $9.62
$500 / $19.24
Then the company contributes:
$250 / $9.62
$500 / $19.24
$500 / $19.24
$1,000 / $38.48
Company Contribution is paid biweekly, per paycheck
Salary is Less than $50,001
Base Company Contribution
Matching Company Contribution**
Maximum Company Contribution (Base and Match)
Salary is $50,001+
Base Company Contribution
Matching Company Contribution**
Maximum Company Contribution (Base and Match)
*Applies to Basic/HSA, Plus w/HSA and Max w/HSA medical plan options.
**You must have or open an HSA with Optum Bank to receive the company contribution. No retroactive company-paid contributions are provided.
31
HSA Base and Matching Company Contributions 2015
Applies to Basic/HSA, Plus w/HSA and Max w/HSA Medical Plans Only
Example: An employee earning more than $50,001 annually, with Employee-Only
coverage, and earning the available total $500 Company Base + Match Contribution:
COMPANY BASE
YOUR CONTRIBUTON
COMPANY MATCH
Base Company
Contribution: $250
Your Contribution:
$250 to $2,850
Company Match
Contribution: $250
1
Company
contribution of
$9.62 per paycheck
2
Your contribution of
$9.62 to $109.62
per paycheck
Minimum
contribution
requirement: $250
3
Additional company
contribution of
$9.62 per paycheck
Learn more by visiting www.unitedhrdirect.com/oe2015 and watching
the HSA Base and Matching Company Contributions Video.
32
=
Maximum Company
Contribution: $500
$19.24 per paycheck
Resources and Support
2015 Benefits Open Enrollment website: www.unitedhrdirect.com/oe2015
33
Example #1: Next Gen vs. Plus w/HSA—Employee-Only Coverage
Lower Cost: Next Gen
Annual salary is less than $50,001
Maximizing Plan Incentives by 12/31/2014
Employee maximizes the
plan incentives
Employee doesn’t maximize
the plan incentives
Next Gen
Plus w/HSA
Next Gen
Plus w/HAS
2015 per paycheck premium
(Jan-Mar)
$37.40
$31.27
$37.40
$31.27
Your Rewards for
Health Silver
OR
Silver Credit (Apr-Dec)
2015 per paycheck premium*
-$14.42
$22.98
-$14.42
$16.85
Your Rewards for
Health Gold
Gold Credit (Apr-Dec)
-$23.08
$14.32
-$23.08
$8.19
N/A
$375
N/A
$375
N/A
$200
N/A
$200
N/A
$0
A Plus: Company Base deposit into
your HSA (January, lump sum)
to your Health Savings
Account (HSA)
B
Standard = $500
Extra for 2015 = $300**
C
D
Plus Extra Incentive: $200 extra
Company deposit into your HSA
(January, lump sum)
(if you earn Gold or Silver (April,
lump sum))
+
+
N/A
$100
into your HSA (Jan-Dec)
N/A
$125
N/A
$0
N/A
$800
N/A
$575
+
* Assumes Employee achieved Gold or Silver level in the Your Rewards for Health program by 12/31/2014
** Assumes Employee maximized the incentives, including the company match and the Your Rewards for Health incentive
34
Example #1: Next Gen vs. Plus w/HSA—Employee-Only Coverage
plan incentives
Your Rewards for
Health Silver
OR
Your Rewards for
Health Gold
1) Annual Premium
2) Annual Premium
(w/Gold Incentive)
$698
$539
Next Gen
Plus w/HSA
Annual Premium
$972
$813
$375
$4,189
$4,189
$4,189
$4,189
$0
$2,650
$0
$2,650
5) Total Copays, Coinsurance
$1,440
$308
$1,440
$308
6) Company-Paid Amounts*
$2,749
N/A
$2,749
N/A
$2,749**
$800
$2,749**
$575
[(4) + (5) + (6) – (7)]
$1,440
$2,158
$1,440
$2,383
[(2) + (8)]
$1,974
$2,533
$2,412
$3,196
4) Total Deductible
Benefit or HSA
35
Plus w/HSA
$534
3) Total Claims
* Applies only to Next Gen
** Includes company-paid Rx costs of
$2,749 not charged to Base Benefit
Next Gen
the plan incentives
Example #2: Next Gen vs. Plus w/HSA—Employee + Children
Lower Cost: Plus w/HSA
plan incentives
the plan incentives
Next Gen
Plus w/HSA
Next Gen
Plus w/HAS
(Jan-Mar)
$78.82
$50.94
$78.82
$50.94
Your Rewards for
Health Silver
OR
-$14.42
$64.40
-$14.42
$36.52
Your Rewards for
Health Gold
-$23.08
$55.74
-$23.08
$27.86
N/A
$750
N/A
$750
N/A
$200
N/A
$200
N/A
$100
N/A
$0
N/A
$250
N/A
$0
N/A
$1,300
N/A
$950
Account (HSA)
B
Standard = $500
Extra for 2015 = $300**
C
D
(January, lump sum)
lump sum))
+
+
+
36
Lower Cost: Plus w/HSA
plan incentives
Your Rewards for
Health Silver
OR
Your Rewards for
Health Gold
1) Annual Premium
$1,775
$1,050
$1,324
$1,848
$1,848
$1,848
$142
$1,848
$142
$1,848
$485
$0
$485
$0
$1,221
N/A
$1,221
N/A
$1,221**
$1,300
$1,221**
$950
$627
$548
$627
$898
$2,238
$1,434
$2,676
$2,222
3) Total Claims
$1,848
4) Total Deductible
[(2) + (8)]
Plus w/HSA
$2,049
$886
[(4) + (5) + (6) – (7)]
Next Gen
Annual Premium
$1,611
Benefit or HSA
37
Plus w/HSA
2) Annual Premium
(w/Gold Incentive)
$338 not charged to Base Benefit
Next Gen
the plan incentives
Michael maximizes the
plan incentives
Michael doesn’t maximize
the plan incentives
Next Gen
Plus w/HSA
Next Gen
Plus w/HAS
(Jan-Mar)
$78.82
$50.94
$78.82
$50.94
Your Rewards for
Health Silver
OR
-$14.42
$64.40
-$14.42
$36.52
Your Rewards for
Health Gold
-$23.08
$55.74
-$23.08
$27.86
N/A
$750
N/A
$750
N/A
$200
N/A
$200
N/A
$0
Account (HSA)
B
Standard = $500
Extra for 2015 = $300**
C
D
(January, lump sum)
lump sum))
+
+
N/A
$100
N/A
$250
N/A
$0
N/A
$1,300
N/A
$950
+
* Assumes Michael achieved Gold or Silver level in the Your Rewards for Health program by 12/31/2014
** Assumes Michael maximized the incentives, including the company match and the Your Rewards for Health incentive
38
Michael maximizes the
plan incentives
Your Rewards for
Health Silver
OR
Your Rewards for
Health Gold
1) Annual Premium
$1,775
$1,050
Next Gen
Plus w/HSA
Annual Premium
$2,049
$1,324
$4,049
$4,049
$4,049
$805
$4,049
$805
$4,049
$978
$0
$978
$0
$2,266
N/A
$2,266
N/A
$2,266**
$1,300
$2,266**
$950
[(4) + (5) + (6) – (7)]
$1,783
$2,749
$1,783
$3,099
[(2) + (8)]
$3,394
$3,635
$3,832
$4,423
$1,611
$886
3) Total Claims
$4,049
4) Total Deductible
Benefit or HSA
39
Plus w/HSA
2) Annual Premium
(w/Gold Incentive)
Next Gen
Michael doesn’t maximize
the plan incentives
Example #4: 2014, 2015 Next Gen vs. Plus w/HSA—EE + Children
Lowest Cost: Plus w/HSA
Your Rewards for
Health Silver
OR
Your Rewards for
Health Gold
2014 Next Gen
2015 Next Gen
2015 Plus w/HSA
Per paycheck premium
(Jan-Mar)
$56.10
$78.82
$50.94
Per paycheck premium*
-$14.42
$41.68
-$14.42
$64.40
-$14.42
$36.52
Per paycheck premium*
-$23.08
$33.02
-$23.08
$55.74
-$23.08
$27.86
N/A
N/A
$750
N/A
N/A
$200
+
Account (HSA)
B Company deposit into your HSA
Standard = $500
Extra for 2015 = $300**
C
(January, lump sum)
Company deposit into your HSA (if
you earn Gold or Silver (April,
lump sum))
D
N/A
N/A
$250
N/A
N/A
$1,300
+
N/A
N/A
+
40
$100
Example #4: 2014, 2015 Next Gen vs. Plus w/HSA—EE + Children
Lowest Cost: Plus w/HSA
Your Rewards for
Health Silver
Your Rewards for
Health Gold
OR
2014 Next Gen
2015 Next Gen
2015 Plus w/HSA
1) Annual Premium
$1,185
$1,775
$1,050
2) Annual Premium
(w/Gold Incentive)
$1,020
$1,611
$886
3) Total Claims
$1,848
$1,848
$1,848
4) Total Deductible
$142
$142
$1,848
$485
$485
$0
$1,221
$1,221
N/A
$1,221**
$1,221**
$1,300
$627
$627
$548
$1,647
$2,238
$1,434
7) Amount Paid by Next Gen Base Benefit
or HSA
[(4) + (5) + (6) – (7)]
[(2) + (8)]
41

Next Gen Medical Plan Changes 2015/2016 October 2014 Presented to Next Gen-Eligible Employees

Transcription

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