choices: spring tour 2016. active employees
TRANSCRIPT
Spring Tour 2016
Montana University SystemEmployee Benefit Plan
TM
ANNUAL BENEFIT ELECTION PERIOD
For the FY2017 benefit year July 1, 2016 – June 30, 2017
2
Spring Tour 2016
Montana University System
3
Agenda for Today Important Changes for FY2017
1. Mid-Year Change Recap2. Rehabilitation Benefit Changes3. Medical Flexible Spending Account (FSA), Tax Advantaged Account (TAA), and Wellness reminders
Benefit Changes and your Decisions for FY2017
1. Medical, Dental, and Vision2. Rates and Fees
Time Frames for Making Benefit Change Decisions
4
Important Changes for FY2017MID-YEAR CHANGE RECAP
BENEFIT DESCRIPTION BENEFIT THROUGH DECEMBER 30, 2015
CHANGE AS OF DECEMBER 31, 2015
CopaymentsOffice Visits (non-specialty)
$15 $25
Specialty Visits $15 $40Emergency Room Facility Visits
$125 $250
Urgent Care Visits $50 $75URx Copays Tier A (retail/mail) $0/$0
Tier B (retail/mail) $15/$30Tier C (retail/mail) $40/$80Tier D (retail/mail) 50 %Tier F (retail/mail) 100%
Tier A (retail/mail) $0/$0Tier B (retail/mail) $25/$50Tier C (retail/mail) $60/$120Tier D (retail/mail) 50 %Tier F (retail/mail) 100%
URx Specialty Copays Specialty $50/ Specialty $200 Specialty $150/ Specialty $300Deductible
Increase In-Network Deductible
$500 (individual)/$1,000 (family)
$750 (individual)/ $1,500 (family)
Out-of-Pocket MaximumsIncrease In-Network Medical OOP
$3,500 (individual)/$7,000 (family)
$4,000 (individual)/$8,000 (family)
Increase Rx Out-of-Pocket
$1,650 (individual)/$3,300 (family)
$2,150 (individual)/$4,300 (family)
Other Benefit AdjustmentsInfertility Treatment Covered – see Summary Plan
Description for detailsNot covered – plan exclusion
Vision Hardware Benefit See full description at www.choices.mus.edu/Vision.asp
$300 frames and lenses maximum annual allowance , in lieu of contacts $150 contacts maximum annual allowance, in lieu of frames and lenses
5
Important Changes for FY2017REHABILITATION BENEFIT CHANGES Rehabilitative Services will be expanded to include Acupuncture and Chiropractic Services.
BENEFIT DESCRIPTION IN-NETWORK COPAY/COINSURANCE
OUT-OF-NETWORK COPAY/COINSURANCE
REHABILITATIVE SERVICES
Inpatient Services (Pre-certification is strongly recommended)
25% 35%
Max: 30 days per year (all therapies combined)
Outpatient Services $25 copay /visit 35%Max: 30 visits per year (all therapies combined)
Covered Rehabilitative Services Include: Physical Therapy Occupational Therapy Speech Therapy Cardiac Rehabilitation Respiratory Rehabilitation Pulmonary Rehabilitation Acupuncture Chiropractic
6
Important Information for FY2017
Selection Of Medical Plan - WE WILL CONTINUE OFFERING THREE MEDICAL
PLAN OPTIONS IN FY2017
Allegiance Managed Care Blue Cross and Blue Shield Managed Care Pacific Source Managed Care
7
Important Information for FY2017 (cont.)
Use In-Network Providers – Be sure to use In-Network providers to ensure you do not
incur “balance billing” charges. Network participation by
providers is changing in the health care market.
Always check - DO NOT assume participation “….but my doctor has always been In-Network!”
Check with your medical plan vendor, MUS Benefits Office, or your campus if you need help finding In-Network providers.
8
Important Information for FY2017 (cont.)
ELIGIBILITY Dependents up to age 26 may enroll
annually in medical, dental, and vision benefits. (Does not include spouses)
Proof of eligibility according to criteria in the Summary Plan Description will be required.
Mid-year disenrollment may onlyoccur with a “qualifying event” orduring a “Special Enrollment Period”.
MEDICAL FLEXIBLE SPENDING ACCOUNT REMINDERS… Only employee contributions may be made to the Medical Flexible Spending Accounts (FSAs).
The maximum amount an employee can deposit to a medical FSA in FY2017 will be $2,550. Medical FSAs are coordinated with your Tax Advantage Account (TAA) account. Funds are expended from the FSA first (since FSAs are “use-it-or-lose-it”) and then from the TAA.
9
Important Information for FY2017
MEDICAL FLEXIBLE SPENDING ACCOUNTS FY2017
$500 Annual FSA Roll-Over If you have funds remaining in your
FSA account as of June 30, 2016, therollover provision allows you to:
1. Carry up to $500 forward into the following plan year (for use beginning July 1, 2016) in your FSA. These funds will be placed in the FSA in October 2016 after FY2016 reconciliation is completed.
2. You may expend these funds on qualifying medical expenses incurred during the following plan year from your FSA.
10
Important Information for FY2017 (cont.)
TAX ADVANTAGED ACCOUNTS (TAAs) FY2017
Tax Advantaged Account (TAA) things to know… Only employer funds can be placed in a TAA; employee funds cannot be contributed (use the FSA instead). If your spouse has coverage through a HAS (Health Savings Account) or has a High-Deductible health plan, you may wish to talk to a tax advisor about whether to elect the TAA. An employer contribution to the TAA will not be made for FY2017. Wellness Incentives earned by employees participating in the MUS Wellness program will be made to the TAA. (Note: participants must elect the TAA each year.)
Account balances are not use-it-or-lose-it and can continue up to 24 months following the last day of employment with MUS (for terminating or retiring employees) and up to 24 months following the date that MUS ceases to make employer contributions (including Wellness Incentives).
11
Important Information for FY2017 (cont.)
MEDICAL SPENDING ACCOUNTS FY2017 WELLNESS INCENTIVE
Active employees who completed a WellCheck (biometric screening, HRA, and blood draw) during calendar
year 2015 and achieved the Trailblazer level will receive a $250 Wellness incentive contribution to their TAA .
Adult dependents completing a WellCheck during calendar year 2015 will receive an additional $250 in the TAA.
Maximum of $500 per individual household enrolled in the MUS Plan.
12
Important Information for FY2017 (cont.)
13
Important Information for FY2017 (cont.)
LIFE INSURANCE ELECTIONS Evidence of Insurability is Required
When:
1. An Active employee wishes to add Optional Supplemental Life Insurance in an amount above $300,000 or increase existing coverage more than one increment of $25,000 annually.
2. Adding Optional Supplemental Dependent Life for a spouse if not enrolled during the new hire election.
Optional Supplemental Life and Optional AD&D Coverage
premiums are paid on an after-tax basis.
14
Important Changes for FY2017 (cont.)
OPTIONAL VISION HARDWARE
BENEFIT Optional Vision Hardware Benefit covers ONLY hardware. Eyeglass frames and lenses, in lieu of contacts.
UP TO $300 ANNUAL ALLOWANCE. Contacts, in lieu of frames and lenses.
UP TO $150 ANNUAL ALLOWANCE Eye Exam is provided as part of the medical plan. No need to use a network for purchasing hardware – simply select a place to purchase the frames, lenses, or contacts and then submit claims to Blue Cross and Blue Shield.
15
Benefit Changes and
Your Decisions for FY2017RATES AND FEES
ACTIVE MEDICAL –• 19.9% Aggregate Increase• Employer contribution increases to $1,054 from $887 per month.• Premium changes after the employer contribution are applied range from a
decrease of $28 to an increase of $50 per month depending on which medical plan you select and whether you cover dependents.
ACTIVE DENTAL –• Rates increase by 2.5% or $1-$3 per month.• Benefits are unchanged.
OPTIONAL VISION HARDWARE PLAN – • Rates increase by 5.2% or $0.37-$1.07 per month. • Remember – the Medical Benefits cover vision exams!• Optional Vision Hardware Plan covers eyeglass frames and lenses or
contacts
Health Plans and Networks
16
To receive your best benefits, STAY IN-NETWORK with your health plan
Allegiance 1-877-778-8600, www.abpmtpa.com/musBlue Cross and Blue Shield 1-800-820-1674, www.bcbsmt.com PacificSource 1-877-590-1596, www.PacificSource.com/MUS
Changes to CHOICES Please watch for campus mailings/information regarding key dates benefit changes must be submitted by. BE SURE TO SUBMIT YOUR CHANGES ON/OR BEFORE THE DATE SPECIFIED BY YOUR CAMPUS! Reminder - Closed enrollment for spouses in FY2017 (qualifying event required to add spouses – children up to age 26 may be added).
If you do not submit any changes, then you will be re-enrolled in the prior year benefit elections (except for Flex or TAA). FLEX PLAN ENROLLMENT and TAA ELECTION
1. You must re-enroll in Flex each year and specify the dollars you
wish to go into your account.2. Remember that Flex is USE IT OR LOSE IT! – Rollover
provision permits up to $500 to carry forward to the following year.
3. TAA must be elected by employee annually – must elect TAA to be eligible for Wellness funds.
17
QUESTIONS?
Thank you for your time!
18