2011 Open Enrollment Update & UPlan Changes

For Calendar Year 2012

What’s in this presentation? Benefit Changes for 2012

2012 Medical and Dental Plan Options Open Enrollment Basics Disability Program Changes Open Enrollment Resources Flexible Spending Accounts Other Open Enrollment Information HealthPartners Information Wellness Program Highlights for 2012

UPlan Benefit Changes for 2012

UPlan Cost Increases Change to Single Medical Plan Administrator

– Medica Changes for U Classic Plus by HealthPartners

members Medical and Pharmacy Changes University Contribution Changes Relief for Lower Paid Employees Disability Program Changes New Wellness Program Points Bank Program

What are the UPlan Benefit Changes for 2012?

4

UPlan cost increase requirement due to Minnesota State funding reductions for University: 5% of UPlan Medical Program expense $12.7 million first year, $11.4 million

ongoing, plus savings from the RFP process

Shift to employees necessary Premium/copays

Why are Changes Being Made to the UPlan for 2012?

5

Cost share for employee-only coverage 2011: Employee 10% / University 90% 2012: Employee 13% / University 87%

Cost share for family coverage 2011: Employee 15% / University 85% 2012: Employee 19.5% / University 80.5%

Medical trend (inflation) increase: 6.5% Premium increase due to University contribution shift +

trend: Insights by Medica – 25.0% Base Plans, National & HSA – 34.6%

How will the Medical Contribution Rates Change?

6

Cost share for employee-only coverage 2011: Employee 10% / University 90% 2012: Employee 12% / University 88%

Cost share for family coverage 2011: Employee 40% / University 60% 2012: Employee 48% / University 52%

Dental trend (inflation) increase: 2.9% Premium increase due to University contribution shift

+ trend: 19% for all plan options

What about the Dental Contributions?

7

Selecting a single administrator: MEDICA Saves more than $14 million over six years Gains uniformity of important variables across UPlan

offerings Streamlines internal administration

HealthPartners Medical Group (HPMG) clinics will continue to be available in UPlan All HPMG clinics are Tier 1 in Insights by Medica

Como, Riverside, etc. Limited HPMG clinics in Medica Elect/Essential, Medica

Choice and Medica HSA Other U Classic Plus by HealthPartners Providers (Allina,

Park Nicollet, Boynton, UMP, etc.) are available in other Medica Plans

Who will administer the UPlan medical plans for 2012?

8

Will our Copays Change? Copay / Deductible Changes

Increase in Pharmacy Copays (Generic Plus from $8 to $10; Formulary Brand from $25 to $30; Non-Formulary from $50 to $60)

Increase in Office Visit Copays (Base Plans from $11 to $15; Insights – No change; National from $25 to $30)

Increase in ER Copay ($75 to $90) Increase in Walk-In Clinic Copay ($5 to $10) Increase in MRI/CT Scan Copay ($25 to $30) Increase in Out-of-Network Deductible (Individual from $500

to $600; Family from $1,000 to $1,200).

Some benefit & contribution changes are subject to collective bargaining. 9

What if I need help paying the increased premiums for

2012?• New, one-year grant program to help

lower income employees offset 2012 medical premium increases

• Premium relief amounts based on medical plan coverage tier & total household income

• Amounts available range from $200 to $450–Paid as bi-weekly credits on paycheck

• Employees apply by submitting application form & 2010 federal tax form to Employee Benefits

10

2012 Medical Plan Options

What Medical Plans are available in 2012?

Medica Elect/Essential – Twin Cities & Duluth (Base Plan in Twin Cities and Duluth)

Medica Choice Regional – Greater Minnesota(Base Plan for Greater MN)

Insights by Medica (tiered network) Medica Choice National (open network) Medica Health Savings Account Plan

(HSA) 12

How are rates determined for UPlan Medical options?

UPlan: self-insured program Actuarial consultant: helps set

rates Costs reflect actual cost of care:

for employees, early retirees, and dependents

Costs include: Medical and pharmacy claims, external administrative fees, special insurance for high claims, internal costs, FrontierMEDEX, wellness program

13

How is the Base Plan the Key to Employee Cost?

For Medical, employees pay: 13% of Base Plan rates for Employee Only 19.5% of Base Plan rates for Family Coverage Everything above the U’s Base Plan rate

contribution for “buy-up” (higher cost) plans Costs vary by Employee/Family tier Rate Information:

U & Your Benefits Newsletter — October & November 2011

www.umn.edu/ohr/benefits/openenroll

14

2011 Dental Plan Options

Are the same Dental Plans available in 2012?

All Dental options remain the same for 2012

The base plan choices are: Delta Dental PPO for the Twin Cities and

Duluth Delta Dental Premier for Greater

Minnesota

www.umn.edu/ohr/benefits/openenroll

16

What other Dental Plan options are available in

2012? All other plans also remain the same:

Delta Dental Premier HealthPartners Dental HealthPartners Dental Choice University Choice

Check with Delta Dental or HealthPartners to see whether your dentist is in the plan you are consideringNote: HealthPartners Dental Plans will continue to be available!

17

2011 Open Enrollment Basics for January 1,

2012

What are the Dates for Open Enrollment?

Your annual opportunity to review your benefit elections: November 1–30, 2011

Employees make changes online at: http://hrss.umn.edu/

Additional information on Employee Benefits Website at: www.umn.edu/ohr/benefits/openenroll 19

What Changes Can I Make During Open

Enrollment? Add or cancel Medical and Dental

coverage or elect a different plan option

U Classic Plus by HealthPartners members must elect one of the Medica plans to have coverage in 2012

Add, change, or cancel your dependents

Elect to participate in the Health Care or Dependent Daycare Flexible Spending Accounts

20

What Other Changes Can Be Made?

Enroll or increase the amount of Voluntary Short-term disability coverage without evidence of insurability

Elect to participate in Voluntary Long-term Disability coverage (Civil Service and Represented Staff employees), or

Increase or decrease your Long-term Disability benefit amount

21

Do I have to make changes during Open Enrollment ?

You need to go online and change your elections: If you are a U Classic Plus by HealthPartners

member and want to have medical coverage in 2012

If you are an FSA participant and want to have an account for 2012

If you want to change your Medical or Dental Plan, or coverage level

Otherwise, no changes are necessary To change your clinic election only, call Medica

health plan directly at 952-992-1814 or 1-877-252-5558 22

Who can I cover on my UPlan Medical & Dental Plans?

Yourself Your spouse or registered same-sex

domestic partner Your dependent child or children to age 26

Unmarried or married But not the spouse of a married child

Review detailed Dependent Eligibility Definition:

www.umn.edu/ohr/benefits/eligibility/index.html 23

Will I get new cards for 1/1/2012?

All members will receive a new card from Medica and from the HealthPartners Dental Plans

Only new enrollees will receive cards from the Prime Therapeutics Pharmacy Program and Delta Dental Plans

If you need a new or additional card any time during the year, contact the health plan directly and they will issue a new one 24

Will flu shots be available this year?

Seasonal Flu Shots will be available this year

Flu shots will be available at campus flu clinics and the Employee Health & Benefits Fairs

Seasonal Flu shots available at all Walk-in Clinics

No copay for flu shots at your own medical clinic

Flu shots at retail locations are full price and will often not be billed to your medical plan

On the Twin Cities campus: schedule appointment for flu shot online at: www.bhs.umn.edu/public-health/flu.htm

25

What is the Medication Therapy Management (MTM) Program? You are eligible for MTM if you take

Four or more medications for chronic conditions

UPlan-paid consultations with MTM Pharmacist

$10 copay reductions for all Generic Plus and Brand medications for six months

Note: HSA members pay full cost of MTM consultations www.umn.edu/ohr/benefits/

26

Disability Coverage

What are the Disability Program Changes?

New Disability Administrator - CIGNA During the 2011 Open Enrollment, for

plan year 2012 only, you can enroll in or increase your existing amount of short-term disability coverage without evidence of good health

Enroll or make your changes online in Employee Self-Service by November 30

In future years, open enrollment amounts will be limited

28

When Can I Enroll in Short-term Disability?

You can enroll or increase your short-term disability coverage during this Open Enrollment period without proof of good health

You can elect coverage any time during the year but would be required to submit evidence of good health

You can elect an amount to replace up to 66-2/3 percent of your salary but no more than $5,000 per month (Calculation = Annual Salary times 66.67%; divided by 12; rounded down to nearest $100)

See website for details on how to apply: www.umn.edu/ohr/benefits/disability/shortterm

29

Who can enroll in Long-term Disability during Open Enrollment? Civil Service and Represented Staff

Employees May enroll in or change the amount of Long-

term Disability during Open Enrollment. Maximum Benefit: 60% of salary up to

$5,000 per month. (Calculation = Annual Salary times 60%; divided by 12; rounded down to nearest $100)

Pre-existing Condition Limit: Disabilities related to medical issues during previous 12 months will not be covered for 24 months.www.umn.edu/ohr/benefits/openenroll

30

Open Enrollment Resources

What if I need help with open enrollment?

Telephone: 612-624-9090 or 1-800-756-2363 Option 2 ̶ General benefits questions Option 3 ̶ FSA questions

E-mail: benefits@umn.edu Benefit Fairs: Computer help, Plan

representatives, and Employee Benefits staff available to answer questions

Computer Labs (Twin Cities): Room 315 Donhowe Bldg. November 23, 28, 29, and 30: 8 a.m. to 4:30

p.m.32

What if I want to talk to Employee Benefits?

Employee Benefits Service Center612-624-9090 or 1-800-756-2363 Option 2 ̶ General benefits questions Option 3 ̶ FSA questionsTelephone Language Interpretation service available through Employee Benefits

Employee Benefits Websitewww.umn.edu/ohr/benefits/openenroll

33

What if I want to talk to the Health Plans?

Medica: 952-992-1814 or 1-877-252-5558

Prime Therapeutics: 1-800-727-6181

Fairview Specialty Pharmacy: 1-877-509-5115 and 612-672-5289

HealthPartners Dental: 952-883-5000 or 1-800-883-2177

Delta Dental: 651-406-5916 or 1-800-448-3815

34

When are the Employee Health & Benefits Fairs?

Duluth: November 2: Kirby Student Center – Ballroom – 10 a.m. to 2:30 p.m.

Morris: November 4: Oyate Hall, UMM Student Center – 11 a.m. to 1 p.m.

St. Paul: November 8: St. Paul Student Center – North Star Ballroom – 10 a.m. to 4:30 p.m.

Minneapolis: November 9: Coffman Memorial Union – Great Hall – 10 a.m. to 4:30 p.m.

35

www.bhs.umn.edu/public-health/flu.htm (Slide 1, 13)

www.umn.edu/ohr/benefits/openenroll/ (Slide 6, 23, 34, 47, 51)

http://hrss.umn.edu (Slide 6, 54)

www.umn.edu/ohr/benefits/eligibility/index.html (Slide 10)

www.wellness.umn.edu (Slide 41)

well@umn.edu to e-mail Wellness (Slide 42)

www.umn.edu/ohr/benefits/ (Slide 45)

www.umn.edu/ohr/benefits/disability/shortterm/ (Slide 48)

benefits@umn.edu to e-mail Employee Benefits (Slide 50)

Links to U of M Resources

36

Flexible Spending Accounts

37

What are Flexible Spending Accounts?

The UPlan includes: Health Care Flexible Spending Account Dependent Daycare Flexible Spending

Account Your contributions to both accounts

are made with pre-tax dollars No Federal, state, or Social Security

taxes are taken No FSA Enrollment = No FSA for 2012

38

How much can I contribute to a Flexible Spending Account?

Health Care FSA Minimum: $100 Maximum: $5,000

Dependent Daycare FSA $5,000 maximum per family

www.umn.edu/ohr/benefits/openenroll

39

What else do I need to know about Flexible Spending Accounts for

2012? 2012 contributions are made during

the calendar year 2012 claims can be incurred between

January 1, 2012, and March 15, 2013 “Use it or lose it”

Any amount remaining after March 15, 2013, is forfeited

Note: 2011 claims can be incurred through March 15, 2012

40

Are there any recent changes for Flexible Spending Accounts?

Reminder: Section 9003 of the Affordable Care Act has a new uniform definition of qualified medical expenses

Reimbursement will be made only if the medicine or drug (1) requires a prescription, (2) is available over the counter (OTC) and individual obtains prescription, or (3) is insulin

Note: Insulin does not require a prescription 41

What else do I need to know about Flexible Spending Accounts for

2012? Over the Counter (OTC) supplies and devices

(such as contact lenses and lens cleaning solutions), eyeglasses, Rx and office copays, bandages, blood sugar test kits, and out-of-pocket dental charges continue to be eligible for reimbursement.

Be conservative in estimating your health care account contributions for 2012: do not include amounts for OTC medications unless you will have a prescription from your physician

RFP in process for outsourced FSA services Debit card option 42

Other UPlan Information

Enrolling Online If hired before December 1, new

employees may make two elections to participate in FSA for 2011 and 2012 Multiple elections can be made online, but

not at the same time; wait a day between enrollments

Benefits will send an e-mail to affected employees

Employees with appointments ending prior to January 1, 2012, cannot enroll online - they are not anticipated to be active employees in 2012 44

Open Enrollment Communications

Employees with enrolled same-sex domestic partners will receive a letter and instructions for Open Enrollment. Elections can be made online if currently enrolled, or on paper, if not.

Materials are sent to employees on LOA & to those without computer access

An e-mail will be sent in November to announce the start of Open Enrollment

A final reminder will be sent near the end of November

45

Benefit Materials for 2012 U & Your Benefits newsletters Guide for UPlan Benefits Open Enrollment

Online for all employees Paper copies for new employees, retirees, other

former employees, and those without computer access

COBRA instructions & rates Benefit summaries for prospective

employees Summary of Benefits for Medical & Dental

Plans Managers Toolkit on OHR website

http://www.umn.edu/ohr/debcp/index.html

46

Applying for the Medical Premium Relief Program

Application on Employee Benefits website UPlan participants submit application & 2010 tax

forms to Employee Benefits Premium relief amounts range from $200 to $450

annually Paid as biweekly Medical Premium credits Applications received by December 15, 2011

Full year of Medical premium credit Applications received during 2012

Amounts are pro-rated Must be covered on January 1, 2012

47

Applying for the Medical Premium Relief Program Employee Benefits will contact those with incomplete

applications Costs are considered taxable income Per University budget office, costs will be charged to

departments, since income to the employee First payment on January 25, 2012 paycheck; last

payment on December 26, 2012 paycheck

48

Information for Current Members of U Classic Plus by HealthPartners

What are the Guidelines for Current U Classic Plus by HealthPartners

Members?

All U Classic Plus by HealthPartners members will need to re-enroll in a Medica plan option during Open Enrollment

Elections are made online in Employee Self-Service

A new election must be made in order to have coverage for 2012

50

Will HPMG Clinics be Available in Medica for 2012? All HealthPartners Medical Group Clinics

(HPMG) will be available in Tier 1 of Medica Insights Lowest cost tier - $15 copay Includes Como & Riverside Clinics &

Regions Hospital Tiers for Specialists and Hospitals can vary

Example: University of MN Physicians (UMP) is in Tier 3 of Medica Insights

Limited HPMG clinics are available in Medica Elect/ Essential and Medica Choice & Medica HSA 51

How does Insights by Medica work?

Providers submit bids to Medica Providers are placed in three tiers based on

cost/quality Insights Copays also vary by tier

Tier 1 - $15 copay Tier 2 - $30 copay Tier 3 - $50 copay

HealthPartners Medical Group clinics & Regions Hospital are in Tier 1 of Insights by Medica

Specialists and hospitals are also tiered. Example: UMP is in Tier 3

52

How does Insights by Medica work?

Members do not need to elect a Primary Care Clinic

No referrals required Copays are based on the tier for the clinic /

hospital from which you receive services If you want to stay with

HealthPartners Medical Group clinics, they are all available only in Insights by Medica

53

What if I use a different provider within U Classic Plus? Other U Classic Plus by HealthPartners Clinics (Example:

Park Nicollet, Allina, UMP) are available in other Medica products Medica Elect/Essential (base plan for Twin Cities &

Duluth – lowest copays at $15) Insights by Medica (plan with tiered providers &

copays) Medica Choice National (broad network plan with $30

copays) Medica HSA (high deductible plan with an HSA

account) Use Medica’s Find a Physician/Hospital feature to

locate the plan with your providers http://www.medica.com/uofm 54

What if I choose to change my plan and providers?

You can change your Medical plan and providers, if you elect to do so.

If you are in the midst of care for a serious medical condition (care received in the past 90 days) A short-term continuation of care with your current provider may

be available. Medica’s care coordinators will work with you if you have

An acute or life-threatening, A disabling, or chronic condition in an acute phase A confirmed pregnancy A physical or mental disability Culturally appropriate care or care in a certain language that Medica

doesn’t have available Use the transition of care form to submit your request

http://www.medica.com/uofm55

Will I need a referral to see a specialist with Medica?

You may want to have a recommendation from your primary care doctor before you see a specialist

However, these Medica Plans do not require referrals to see an in-network specialist: Insights by Medica (the plan with tiered providers & copays) Medica Choice National (the broad network plan) Medica HSA (the high deductible plan with an HSA account)

There are special guidelines for Medica Elect/Essential (the base plan) You do not need a referral to see a specialist in your care system You will need a referral approved by your care system’s referral

coordinator to see an in-network provider who is not in your care system

For all plans, you’ll need a referral from your care system and Medica to receive in-network benefits from an out-of-network provider

56

Will I still have access to my online HPMG medical record?

If you remain a HealthPartners Medical Group patient, you will still have access to your online medical record

This is a clinic/patient record, not a health plan record

57

If I decide to change to a new provider, can I ask my old provider

to transfer my medical records?

Yes, contact your new clinic’s Medical Records Department

They will give you a form to use Send that to your old provider The old provider will transfer your

records58

2012 Wellness Program

What Wellness Programs will continue in 2012?

Wellness Assessment: January through March 2012 Earn $65 Wellness Reward for Employee &

Spouse/SSDP Health Improvement Programs

Phone-based Health Coaching In-person Health Coaching – Twin Cities, Duluth, and

Morris Online Healthy Living Programs and Step It Up!®

walking program Earn $65 Wellness Reward for Employee &

Spouse/SSDP Fit Choices Program

$20 monthly subsidy for health club participants Farmers Market: Minneapolis and Duluth

60

What’s new in the Wellness Program in 2012?

New Wellness Points Bank program UPlan Members & Spouse/SSDPs can earn

wellness points in 2012 to reduce their UPlan Medical Program premiums in 2013 through the new Wellness Points Bank program

Wellness points are earned by participating in a wide range of Wellness Program-sponsored wellness activities

Spouse participation completely voluntary Also includes Early Retirees, COBRA, etc.

61

How Does the New Wellness Points Bank Work? Employee-Only and Employee Plus Child(ren)

coverage levels must earn 300 points by August 31, 2012, to qualify for a $300 premium reduction in 2013

Employee Plus Spouse/SSDP and Employee Plus Family coverage levels must earn 400 points by August 31, 2012, to qualify for a $400 premium reduction in 2013

$65 Wellness Rewards continue for 2012 but stop in 2013

62

What points can I earn for my Wellness Points Bank?

63

Wellness Program Option Reward Points

Preventive Care Wellness Assessment Annual flu shot Tobacco-free pledge Biometric Health Screening participation

1002525

100

Health Improvement Programs On campus Weight Management Program Tobacco-cessation Program NextSteps Telephonic Health Coaching On-site Health Coaching Fit Choices if Credits Earned in 5 Months Healthy Pregnancy Program Disease Management Telephonic Health Coaching

1501501501505050

150

Health Action Campaigns Step It Up! Walking & Pedometer Program (available April 1, 2012) Online Healthy Living Program Bike Commuter Program

505050

What Weight Management Programs are offered for 2012? Create your Weight — offered through Fairview on

Twin Cities Campus and Weight Watchers at Work — offered on The Twin Cities and coordinate campuses You pay up front, Wellness Program will reimburse

you in full if you attend 80% of sessions (Costs: $186 to $235)

You can be reimbursed for up to three sessions per year; six total lifetime reimbursements

New this year: Complete a weight management session by August 31, 2012, and earn 150 points in your Wellness Points Bank

HIP (Health Improvement Program) available at UMD - no cost-Weight Management Focused Program

Details available at: www.wellness.umn.edu64

Would you like to be a Wellness Advocate for your Department?

Wellness Advocates Program: Looking for Wellness Advocates from each

College, Department Lead departmental Wellness initiatives Wellness Program to provide support,

materials, and training Plus special programs for wellness

advocates Interested? Email to well@umn.edu

65

Wellness Program Metrics

Return on Investment Analysis

Annual Return on investment (ROI) analysis assesses effectiveness of wellness programs in helping to control health care costs Overall study led by Professor John

Nyman (School of Public Health), and research assistant Nathan Barleen

Study on ROI for Fitness Rewards led by Jean Abraham 67

Programs Evaluated for Savings

Evaluated Phone-based Disease & Lifestyle

Management, Wellness Assessment, 10000 Steps

Not Evaluated Nurseline, flu shot clinics, Farmers

Market, Health Action Programs, Online Healthy Living Programs

68

Costs Evaluated for Savings De-identified costs evaluated for

changes based on:– Health care claims costs from U of

M claims data warehouse– Sick leave use by civil service and

bargaining unit employees as a proxy for absenteeism

69

Brief Methodology Statement Tracked “difference in differences” in costs

between participants and those eligible to participate who did not.

Used claims and absence data from 2004 – 2007 to reflect pre- and post-implementation data

Evaluated wellness program participation as one of many factors (age, gender, etc.) that could influence health care cost changes to isolate just the difference associated with participation. 70

2006-2008 ROI Analysis Disease management shows positive,

statistically significant return on investment. Continued smaller return on absenteeism. Claims: $8,064,960 Absenteeism: $480,988 Total Savings - $8,545,948 Total Program Costs - $7,809,984

Disease Management Claims Savings covered $1.09 for every $1.00 of program costs – First positive ROI

71

2006-2008 ROI Analysis Also evaluated participation by year

since many Wellness Program analyses indicate 3 years necessary for positive return DM participation in any one year

generated savings of $960 over all three years

DM participation in 2006 and 2007 or 2008 generated savings of $1,200 per year

Participation in all three years didn’t add significant savings

72

2006-2008 ROI Analysis No significant return on Lifestyle

Management or 10,000 Steps Did not put dollar impact on participant

health and include that in calculations – have included improved measure of participant health in most recent Wellness Assessments to make that calculation possible

Portion of the effectiveness is durable. Study does not include gains that would occur if program were stopped but effectiveness continued 73

Fitness Rewards ROI Analysis

“Fragile Evidence” Persistent Exercisers show Some Evidence of

Medical Claims Savings Exercise 5-9 of 12 Months 923 people – each saved $1,032 per year

Estimated Return on Investment $952,536 Total Savings $406,246 Incentives & Administrative

Expense $2.34 for Each $1 spent

74

Weight Management Programs

Metric Create Your Weight

Weight Watchers at Work

Totals

Participants 391 550 per session 941

Total Weight Lost 2,665.4 lbs. 12,555 lbs. 15,220.4 lbs.

Average Loss Per ParticipantPer Session

6.8 lbs. 10.8 lbs. 9.8 lbs.

Weight Loss Range 1-35 lbs. 1-70 lbs. 1-70 lbs.

75

Remember to enroll online for 2012!http://hrss.umn.edu