human resources office of 1 benefits open enrollment nov. 1 – dec. 2, 2013 debcp training
TRANSCRIPT
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Benefits Open EnrollmentNov. 1 – Dec. 2, 2013
DEBCP Training
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Presentation Overview
• UPlan Benefit Changes for 2014– Medical & Pharmacy– Wellness – Life Insurance
• Open Enrollment Basics• Open Enrollment Assistance• Common Questions
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UPlan Benefit Changes for 2014
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UPlan changes due to Affordable Care Act (ACA)
2011: • Adult child coverage to age 26 - $2M cost for UPlan
2013:• Healthcare Flexible Spending Account limited to
$2,500• Additional preventive benefits • New appeal processes• Value of your 2012 tax-exempt medical insurance
shows on W-2
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2014 UPlan changes also due to Affordable Care Act (ACA)
• 2014 UPlan changes are needed due to an ACA excise tax that begins in 2018
• Tax applies to high value plans such as the UPlan• If no changes, we would have a UPlan excise tax
liability of $48 million• University needs to avoid the excise tax • Changes need to be made in 2014 to assure we are
ready to avoid excise tax in 2018
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2014 Medical Plan changes• Out-of-Pocket costs will be increased• New deductibles on all non-copay items• $100/$200 on Medica Elect/Essential• $200/$400 on Medica Insights and Choice
• Primary care and related copays will increase by $10• Family medicine, internal medicine, OB/GYN, pediatrics• Also chiropractic, acupuncture, PT, OT, ST & MH/SA
• New higher copays for specialty care• $10 higher than primary care (+ $10 in ACO plan)
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2014 Medical Plan changes
• Higher out-of-pocket expenses in Health Savings Account Plan• $250 / $500 reduction in HSA account• $500 / $1,000 increase in
out-of-pocket maximum
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2014 Medical Plan Changes – Twin Cities
• A new ACO (Accountable Care Organization) Plan • High-quality; cost effective; care provided by a single group
of hospitals, doctors, and other medical providers• Benefits slightly higher than Base Plan• Costs slightly lower – a “buy down” plan• Four Twin Cities ACOs within this plan
• Fairview & North Memorial Vantage Plan (with UMP & Boynton)• Inspiration Health by HealthEast• Park Nicollet First (does not include HealthPartners)• Ridgeview Connect
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2014 Medical Plan Changes – Twin Cities• ACO Plan continued• Annual Elections - Employee & all family members will
select same ACO for the full year• Members can see any primary care or specialty provider
within ACO network.• Referrals outside the ACO are unlikely!• Travel benefit covers care outside service area
• Emergency, urgent & non-emergency care
• Care within service area, but outside of ACO, is out of network
• ACO providers will reach out to new members
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2014 Pharmacy Program Changes
• Tier 3 – Non-formulary brand copay increased to $75• Encourages use of Tier 1 and Tier 2 clinically appropriate,
cost effective medications• Current Prior Authorization and appeal provisions remain
in effect• The annual Rx Out-of-Pocket Maximum remains the same:
$750 per person, $1,500 per family (Does not apply to HSA Plan)
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Administrative Changes
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Administrative Changes
• Spouse/SSDP and Family tiers will be combined over two years
• Employee + Family costs go down slightly• Employee + Spouse/SSDP costs increase
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Medical Plan Costs
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2014 UPlan Medical Contributions
• UPlan Standard Medical Plan contributions are:• Employee only coverage• University pays 87% - Employees pay 13%
• Family coverage• University pays 80.5% - Employees pay 19.5%
• UPlan Wellness Achievement Rates are reduced by:• $300 for employee and employee plus children rates• $400 for employee plus spouse/SSDP and employee plus
spouse/SSDP and child/children• See the Guide for UPlan Benefits Enrollment for plan options
and rates
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Help for Lower Paid Employees to Pay Medical Costs
• 2014 Medical Cost Relief Program for lower income employees
• Credit based on plan selected and household income• Credits range from $200-$500• Credit appears in 2014 paychecks, beginning January 22,
2014• Final Deadline for Applications: December 17, 2013• New applications are required – even if you participated in the
past• See Employee Benefits website at www.umn.edu/ohr/benefits
for an application and program guidelines
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2014 Wellness Program Changes
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Wellness Assessment
• The Wellness Assessment will be available for a longer time period
• UPlan members will now be able to take the assessment between:
October 01, 2013 – March 31, 2014
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Fit Choices
• New points level: earn 125 wellness points for 12 visits per month for six months
• Current point level: continue to earn 75 points for 8 visits per month for six months
• Fit Choices runs from October 1, 2013, to July 31, 2014• Both points levels are eligible for $20 reimbursement
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Medication Therapy Management
• Face-to-face consultations with an MTM Pharmacist for UPlan members taking four or more covered prescriptions. – Wellness Points: 100– Minimum visits: Three
• Provider: MTM Pharmacy Network
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Specialty Therapy Management
• For members using specialty medications for the following disease states:
• Multiple Sclerosis, Rheumatoid Arthritis, Hepatitis C, Psoriasis, Psoriatic Arthritis, Crohn’s Disease, and Cystic Fibrosis.
• Telephone consultations with specialty pharmacy nurse
• Minimum calls: Three• Earn 100 Wellness Points• Provider: Fairview Specialty Pharmacy
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New Reimbursement Programs
• Heart Rate Express – through Twin Cities Rec Center• Mindfulness in Motion (MiM) – through Center for
Spirituality & Healing• Virtual Mindfulness Based Stress Reduction – for
coordinate campus employees – through Center for Spirituality & Healing
• You pay up front; then get reimbursed upon completion of program
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2014 Life Insurance Changes
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Two Types of Changes
• Changes to simplify human resources processes and improve efficiency
• Changes due to recent Life Insurance Request for Proposal (RFP)
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Life Insurance changes: simplify human resources processes & improve efficiency
• Full-time employee Basic Life benefit increased from 100% to 115%
• Part-time Basic Life benefit changed from full-time to part-time equivalent
• Basic Life maximum benefit capped at $200,000• Rounding feature changed from next higher $5,000 to next
higher $1,000• $5,000–$25,000 additional Basic Life benefit for faculty and
P&A eliminated• One-month U of M death benefit eliminated
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Life Insurance changes: simplify human resources processes & improve efficiency
• Most employees will benefit from the 2014 Life Insurance benefit changes
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Life Insurance changes: simplify human resources processes & improve efficiency• Those who do not benefit can transfer Basic Life
coverage difference to Additional Life coverage without the need to provide proof of good health– Example: • Employee has $75,000 of Basic Life coverage in 2013
and $58,000 of Basic Life coverage in 2014• Employee can transfer $17,000 of Basic Life coverage to
Additional Life for 2014• Additional Life rates are age-rated
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Life Changes due to Request for Proposal
• $10,000 Newborn Child benefit for first child – Applies prior to enrolling, up to 60 days
• Child Life added to annual open enrollment – without proof of good health
• New term life portability benefit (in addition to whole life Conversion policy)
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Open Enrollment Basics
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When and How to Enroll
• Open enrollment dates: November 1 – December 2, 2013
• You can make changes to your benefits selections online at http://hrss.umn.edu
• If you (or a dependent) are age 45 or older, you are required to provide your Social Security Number
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During Open Enrollment, You Can
• Add or cancel Medical or Dental coverage• Select a different Medical or Dental plan • Change your designated dependents– Verification of dependent eligibility will be requested
following Open Enrollment
• Choose to participate in the Health Care or Dependent Daycare Flexible Spending Accounts
• Enroll in Child Life
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During Open Enrollment,You Can:
• Increase your amount of Short-term Disability coverage up to $200 per month, if you are a current participant
• Select or change the benefit amount of your voluntary Long-term Disability Coverage (Civil Service and Labor Represented employees only)
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Don’t need to go online unless you want to:
• Set up a Flexible Spending Account for 2014• Change your Medical or Dental Plan or dependent
coverage– To change your clinic election only, just call Medica: 952-
992-1814 or 1-877-252-5558
• Add or increase your Long-term Disability coverage• Add Child Life• Note: to increase your Short-term Disability coverage,
you will need to complete a paper application
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Open Enrollment Assistance
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Open Enrollment Assistance
• Phone: 612-624-8647 or 1-800-756-2363• Email: [email protected]• Employee Health & Benefits Fairs• Computer Lab (Twin Cities): Room 315 Donhowe
Bldg.Nov. 25, 26, 27, and Dec. 2 (8 a.m. – 4:30 p.m.)
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Employee Health & Benefits Fairs
• Duluth: October 31– Ballroom, Kirby Student Center 10 a.m. to 2:30 p.m.
• Crookston: November 7– Bede Ballroom, Sargeant Student Center, 12 p.m. to 2 p.m.
• Morris: November 11– Oyate Hall, UMM Student Center, 11 a.m. to 1 p.m.
• St. Paul: November 12– North Star Ballroom, Student Center, 10 a.m. to 3:30 p.m.
• Minneapolis: November 13– Great Hall, Coffman Memorial Union, 10 a.m. to 3:30 p.m.
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Enroll Now
• Open Enrollment: November 1 to December 2, 2013• Enroll at http://hrss.umn.edu– See the Guide for UPlan Benefits Enrollment for more
information
• Coverage changes made during Open Enrollment are effective on January 1, 2014
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Open Enrollment Procedures and Deadlines
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New Hire Enrollment Procedures
Employees hired and in PeopleSoft by October 29, 2013:
• Will receive Open Enrollment email announcement • Can participate in Open Enrollment online• Can view Guide for UPlan Benefits Enrollment online
at www.umn.edu/ohr/benefits/openenroll
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Newly Hired Employees Enrollment Procedures
Recently hired employees may need to make two elections:
• For remainder of 2013 plan year• For Open Enrollment changes, if desired• Need two elections to participate in FSA for 2013 & 2014• Can make two elections online, but not at the same time:
wait a day or two between enrollments• Benefits will send email to these employees• Employees hired on Dec. 1, 2013, or later, can make one
election for 2014
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Termination Dates
• Employees with termination dates prior to January 1, 2014, are not eligible for Open Enrollment
• If employee’s appointment date changes to extend past January 1, 2014, please refer the employee to the online Open Enrollment information
• Employee may encounter problems enrolling online right after appointment changes are made
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Open Enrollment Communications
• Guide for UPlan Benefits Enrollment will be sent to all employees on Leave of Absence and to those in job codes who may not have regular computer access
• One set of medical & dental directories sent to each department
• Request additional sets for other locations• Twin Cities UPlan members will receive postcard for
Employee Health & Benefits Fair that can be used as entry for prize drawings
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Open Enrollment Communications
• Email announcing Open Enrollment will be sent on November 1 to all benefits-eligible employees
• Email reminding employees that December 2 deadline is approaching will be sent about November 21
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Benefits Materials for 2014
• 2014 Guide for UPlan Benefits Enrollment will be available by end of October for new employees
• 2014 COBRA instructions and rates will be updated and online by end of November
• 2014 Benefits Summaries for prospective employees will be updated and online by end of November
• 2014 Summary of Benefits for Medical and Dental Plans will be updated and online before end of December
• Check the Manager’s Toolkit on OHR website:http://www1.umn.edu/ohr/debcp/index.html
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DEBCP Responsibilities for COBRA
• 2014 COBRA Instructions and Rates will be emailed at end of November and will be available online
• 2013 COBRA Rates will stay on the website until end of year
• You must send COBRA notice and application to terminated employees by U.S. Mail within 10 days of the employment termination date
• Complete verification form and send, scan, or fax to Employee Benefits
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DEBCPs: Keep in Touch
• Help to keep the DEBCP email list current: if you are leaving or changing jobs, and you know who will be taking over as the DEBCP, please contact Employee Benefits
• Send updates to [email protected]
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Thank you for attending and for your assistance!
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Common Questions with Answers
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Will I receive a paper copy of the benefits guide?
• Guide for UPlan Benefits Enrollment will be posted online at www.umn.edu/ohr/benefits/openenroll
• Employees without regular access to a computer and those on LOA will receive a paper copy of the guide
• All employees will receive a paper copy of the U & Your Benefits newsletter with enrollment details, including medical and dental plan rates, in your campus mailbox
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Who can I cover on my UPlan Medical and Dental Plans?
• Yourself• Your spouse or registered same-sex domestic partner• Your dependent children up to age 26• For the dependent eligibility definition, visit
www.umn.edu/ohr/benefits/eligibility/index.html
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How do Wellness Points work?
• You accumulate points for participating in wellness points activities
• You must earn the minimum number of points by August 31, 2014:– 300 points for employee-only or employee plus children– 400 points for employees who cover a spouse/same-sex
domestic partner• Covered spouses/partners can contribute up to 100 of the 400 total
points required
• You will receive either a $300 or $400 reduction in your 2015 UPlan Medical Program rates if you earn the required number of points
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Will I need a referral to see a specialist with Medica?
• Some Medica Plans do not require a referral to see an in-network specialist– Medica Insights– Medica Choice National or Regional– Medica HSA
• Medica Elect/Essential have special guidelines– No referral needed in your care system– Referral needed to see an in-network provider who is not
in your care system
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Will I need a referral to see a specialist with Medica?
• New Medica ACO Plan– You can see any primary or specialty care provider within
the ACO you select– Referrals outside of your ACO are unlikely
• 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
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Will I receive new Medical and Dental ID Cards?
• Members will receive a new Medical ID card from Medica
• Members will receive a new Dental ID card from Delta Dental and HealthPartners if they make a change
• New enrollees will receive ID cards from Medica and Prime Therapeutics if they choose a medical plan, and a dental ID card from Delta Dental or HealthPartners Dental if they choose a dental plan
• Replacement cards can be obtained from your health or dental plans
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Will I receive a new FSA debit card?
• No. Current participants will have their new 2014 health care FSA election loaded on their current debit cards – Please retain your FSA cards!
• New Health Care FSA enrollees will receive new FSA debit cards
• Replacement cards can be obtained from ADP
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Will flu shots be available this year?
• Yes, seasonal flu shots will be available at no cost– On campus
• Walk-in clinics and flu clinics– On the Twin Cities campus, schedule an appointment
online at www.bhs.umn.edu/public-health/flu.htm • Employee Health & Benefits Fairs
– Your medical clinic – Convenience clinics and retail pharmacies (no cost if
pharmacy is in Prime Therapeutics’ network)
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Who is eligible for the Medication Therapy Management Program?
• You are eligible if you take four or more medications for chronic conditions
• The program offers:– UPlan-paid consultations with an MTM pharmacist (HSA
members pay full cost of consultations)– NEW: earn 100 Wellness Points if you visit your MTM
pharmacist at least three times before August 31, 2014
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How do I contact the Health Plans?• Medica
– 952-992-1814 or 1-877-252-5558– www.medica.com/uofm
• Delta Dental– 651-406-5916 or 1-800-448-3815– www.deltadentalmn.org/uofm
• HealthPartners Dental– 952-883-5000 or 1-800-883-2177– www.healthpartners.com/uofm
• Prime Therapeutics– 1-800-727-6181– www.myprime.com/MyPrime/umn
• Fairview Specialty Pharmacy– 612-672-5289 or 1-877-509-5115– www.fairviewspecialtyrx.org/uplan
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