h.b. fuller company 2010 open enrollment: helping you buy well, use well, be well october, 2009
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H.B. Fuller Company
2010 Open Enrollment:
Helping you Buy Well, Use Well, Be Well
October, 2009
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Overview of 2010 medical options
Tools and resources
How and when to enroll
Incentives reminder and sales pitch
Today’s Discussion
PURPOSE OF TODAY’S MEETING:To help you understand your medical plan options
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1 Medical Plan
3 Options for Paying
Medical Plan
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Market 500 Value 750High Deductible
PlanPreventive care (in-network only)
100% 100% 100%
Office visit copay
$30 $30 N/A
Fuller HSA
Contribution*
N/A N/A $500 Single
$1,000 Family Prorated by pay period
Emergency Room Co-pay
$150 $150 NA
Medical Plan Options Summary
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Why change ER Co-pays?
• Our ER usage is higher than the general population
• Cost of emergency room is $550-750/visit versus $110-150 for regular office visit
• Most of our ER usage was considered preventable
• Emergency Room alternatives:
• Have a family doctor (Medical Home)
• Get regular preventive care
• Use Urgent Care or Walk In Clinics before the ER
Aetna’s DocFind has a link for alternatives to the ER
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Market 500 Value 750High Deductible
PlanIn-network $500 Single
$1,000 Family
$750 Single
$1,500 Family
$2,000 Single
$4,000 Family
Out-of-network* $1,000 Single
$2,000 Family
$1,500 Single
$3,000 Family
$2,000 Single
$4,000 Family
Family Deductible*
Imbedded single Imbedded single True family
Medical Plan Options Summary
Deductible – the amount you pay before the plan pays
* This is an additional deductible – not part of in-network.
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Deductible Example (Value 750)
Single imbedded
($1,500 Family deductible)
• First family member pays single deductible - $750 then 20% going forward
• Remaining deductible $750 (other family members meet)
True Family
($4,000 Family deductible)
• Cost for all family members $4,000 combined to meet deductible
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Market 500 Value 750 HDHP w/ HSA
Coinsurance – in-network
20% 20% 0%
Coinsurance – out-of-network
40% 40% 0%
Medical Plan Options Summary (cont.)
Co-insurance: The percentage of the cost you pay after you meet your deductible
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Market 500 Value 750 HDHP w/ HSA
OOP maximum - in-network
$1,500 Single
$3,000 Family
$3,000 Single
$6,000 Family
$2,000 Single
$4,000 Family
OOP maximum –out-of-network*
$3,000 Single
$6,000 Family
$6,000 Single
$12,000 Family
$2,000 Single
$4,000 Family
Medical Plan Options Summary (cont.)
Out of Pocket Maximum: The most you will pay out of pocket for the year
Separate maximum for in-network and out-of-network. *OOP Maximum for out-of-network does not include costs
over “reasonable and customary”
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Claims Payment Comparison
You Shared Plan
Plan Deductible Copay OOP Max Plan Pays
Market 500*
(family)
$1,000 20% $3,000 100%
Value 750*
(family)
$1,500 20% $6,000 100%
High Deductible (individual)
$2,000 0% $2,000 100%
High Deductible (family)
$4,000 0% $4,000 100%
* Office visit co-pays, ER co-pays pharmacy co-pays not included
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Market 500 Value 750 HDHP w/ HSA
Premium (Month)Employee
Employee + 1Family
$109.75$219.50
$329.25
$58.75$117.50$176.25
$54.80$109.60$164.40
Medical Plan Premiums
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Why is the Market 500 higher?
• We are self-insured. This means our rates are based on our volume of medical claims.
• Claims costs per employee for this option through July are considerably higher than the other options:
• $1,500/person for Market 400 versus $705/person for Value 750
• Premiums adjusted based on option costs
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Market 500 Value 750 HDHP w/ HSA
Pharmacy
Generic
Brand (30%)
Non-formulary (50%)
Specialty (50%)
Min Max
Cost $10
$20 $40
$40 $80
$80 $160
Min Max
Cost $10
$20 $40
$40 $80
$80 $160
You pay 100% of negotiated rate until you reach your deductible – then plan pays 100%
Pharmacy Coverage
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Pharmacy Example
Example cost for non-formulary drug:
Retail Drug Cost: $450Aetna Negotiated Rate: $292You pay: Market 500 (50%) $80 (ongoing)
Value 750 (50%) $80 (ongoing) High Deductible* $292
* Pay full amount until deductible is met
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Tax-free contributions to pay for current and/or future medical expenses
Interest earned tax free
Flexible – you choose when or whether to use the account for health care expense
Banking services provided by JPMorgan Chase Bank. Some fees required.
Easy access to funds through debit card
Key Features of an HSA
What is an HSA?It is a savings account that is owned by you
and is associated with a High Deductible Health Plan
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Includes expenses such as: Deductibles Coinsurance Not covered but eligible
IRS expenses Prescription drugs
It also includes expenses for: COBRA-continuation coverage Health plan coverage while receiving unemployment compensation Medicare premiums and out-of-pocket expenses Qualified long-term care insurance
Employees are responsible for keeping all receipts and records, demonstrating that HSA dollars were used for qualified health
care expenses.
HSA Tax-Qualified Expenses
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Changes for 2010:• This is an employee-paid benefit • You will be auto-enrolled for 50% coverage• The Company will reimburse your premium• No buy-up option
Why the change?Since this is a post-tax benefit, you will not pay taxes on any amount you receive while on long-term disability.
Long Term Disability Plan
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For 2010, our disability and Family Medical Leave programs will be
managed by UNUM
Why the change? To gain consistency throughout the country. To better manage our disability programs. To employ expertise for managing FML program.
Total Absence Management
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For help with your benefit plan questions: October 2009 For Your Benefit newsletter 2010 Open Enrollment Guide (online) Aetna:
Website
Aetna Navigator
Plan Selection and Cost Estimator Tool
Customer Service line (plan questions)
Benefits Connection (general benefits)
Resources and Tools
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You must enroll if:
You want to change your medical plan
You have a High Deductible Plan and want to put money into a Health Savings Account through payroll deduction
You want to put pre-tax money into a Flexible Spending Account for Health Care or Dependent Care
Do I need to enroll this year?
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If you don’t enroll, your benefit elections from last year continue, EXCEPT:
Flexible Spending Account deductions go to $0
Health Savings Account deductions go to $0
You are automatically enrolled in Long Term Disability
Those in the Market 400 plan in 2009 will be enrolled in the Market 500 plan for 2010
What if I don’t Enroll?
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To enroll online, you will need:
your 6-digit employee ID (on your pay stub)
Your PIN (Unless changed, PIN is last four digits of SSN)
To enroll by phone:
Call Benefits Connection weekdays between 8:00 am. And 5:00 p.m. Central time
How and When to Enroll
Enroll between October 28 and November 11
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Make sure that your enrollment is correct. To do so:
Print a copy of your enrollment elections at end of your online session
In early December, confirmation statements will be sent to everyone by mail
Review the statements carefully
Call Benefits Connection by December 14 if you need to make corrections.
What happens after I enroll?
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2009 Incentive Program Ends November 30
Make sure you:• Take your Health Assessment – learn about your health
and earn $150• Review incentives on Aetna Navigator• Complete programs by 11/30 to get an incentive• Aetna tracks doctor, dental and program completion• If you don’t have our medical coverage, see me
Watch for 2010 program details in December
Incentive Program Status
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Thank you for your time!
Questions?
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