2 April 13 2015 through May 8 2015 Two network offerings ◦ United Healthcare Choice Plus and Options PPO Choice Plus network ◦ Intermountain Health

Know Your Benefits2015-2016Plan Year

Open Enrollment

2

April 13 2015 through

May 8 2015

Two network offerings◦ United Healthcare Choice Plus and Options PPO

Choice Plus network ◦ Intermountain Health Care Facilities

Options PPO covers ◦ IHC as well as the University of Utah Hospital and

IASIS facilities◦ Jordan Valley, Davis Hospital, Pioneer Valley, and

Salt Lake Regional Mountain Star hospitals only offered as an

out-of-network facility

Employee Choice

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Network Facilities

4

UHC Choice Plus UHC Options PPO Out-of-network

UVRMCAll UHC Choice Plus

FacilitiesHCA Facilities

American Fork University of Utah HospitalMountain View

HospitalIntermountain Medical Center Huntsman Cancer Center St. Mark's Hospital

Orem Community Hospital Jordan ValleyTimpanogos Regional

Hospital

Primary Children's Davis HospitalBrigham City

Community Hospital

Riverton Hospital Pioneer ValleyLone Peak Medical

Campus

Alta View Hospital Salt Lake RegionalOgden Regional Medical Center

Heber Valley MedicalCentral Utah Clinic of

American Fork Surgery Center

Central Utah Surgery Center (Provo)

Orthopedic Specialty Hospital IASIS Park City Medical

Dixie Regional LDS Hospital

Consumerism tools available through UMR◦ Healthcare Cost Estimator calculator◦ Teladoc◦ NurseLine◦ Maternity Management◦ Wellness - UVUfit◦ Disease and Case Management◦ Doc GPS app

Consumerism Tools

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Unbundled Plan Elements

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Medical Claims Administration – UMR◦ Best overall savings. Limited disruption for employees

Dental Claims Administration – EMI◦ Deepest savings on network claims. Best overall savings. ◦ No disruption to employees.

Vision – United Healthcare◦ Employee paid benefit◦ Co-pays for glasses and contacts vs. current plan with reimbursement

limits.◦ Lower premiums than current plan offerings, with richer benefit for

employees. Pharmacy Benefit Manager – Envision RX

◦ Best overall savings.◦ Large network offering (Walgreens, Walmart, Smiths, Costco, and more).◦ Specialized care covering 7 million lives.

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White/Green vs Traditional—Choice Plus Network

Choice Plus Network

White Single Two-Party Family

Employee Premium $45.38 $104.86 $151.42University

Contribution $408.48 $943.68 $1,362.90

Green Single Two-Party Family


Contribution $408.48 $943.68 $1,362.90Choice Plus Network

Traditional Single Two-Party Family


Contribution $425.19 $982.28 $1418.64

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White/Green vs Traditional—Options PPO Network

Options PPO Network

White Single Two-Party Family


Contribution $408.48 $943.68 $1,362.90

Green Single Two-Party Family


Contribution $408.48 $943.68 $1,362.90Options PPO Network

Traditional Single Two-Party Family


Contribution $425.19 $982.28 $1418.64

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High Deductible (HDHP)—Choice Plus Network

Choice Plus Network

High Deductible Single Two-Party Family


Contribution $408.48 $943.68 $1,362.90

Choice Plus Network



Contribution $425.19 $982.28 $1418.64

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High Deductible (HDHP)—Options PPO Network

Options PPO Network



Contribution $408.48 $943.68 $1,362.90

Options PPO Network



Contribution $425.19 $982.28 $1418.64

Traditional

Some services are covered outside the deductible through a co-pay system (office visits, lab work, emergency room, prescriptions, etc.) All preventative care is covered 100% by the plan.

Once the deductible is met, insurance pays 80% of most services and employee pays 20% up to the co-insurance maximum.

Separate deductible and OOP maximum for prescriptions.

HDHP:

Every medical/prescription expense is subject to the deductible before insurance payments begin, except for preventative care services, which is covered at 100%

Once the deductible is met, insurance pays 80% of most services and employee pays either a co-pay or co-insurance of 20%.

Two-party and family coverage all subject to $4,000 deductible.

Medical Plan Designs for UVU 2015-2016

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Medical Plan Designs for UVU 2014-2015

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White Plan Green Plan Traditional High Deductible

Medical Deductible

$1,000 Individual

$2,000 Family

$500 Individual

$1,000 Family

$750 Individual

$1,500 Family

$2,000Single only coverage

$4,000 Family

Medical Out-of-Pocket

Maximum

$5,000 Individual $10,000 Family

$4,500 Individual

$9,000 Family

$3,250 Individual

$6,500 Family

$3,000 Single only coverage

$6,000 Family

RX Deductible

$100 Individual

$200 Family

$100 Individual

$200 Family

$100 Individual

$200 Family

Subject to Medical

RX Co-Insurance

$2,000 Individual

$4,000 Family

$2,000 Individual

$4,000 Family

RX OOP MAX$1,250

Individual $2,500 Family

Subject to Medical

Employees can still receive medications at a pharmacy counter Mail order available through online account Diabetic Testing Supplies now available at pharmacy

EnvisionRx Options

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Pharmacy Plan Traditional HDHPDeductible $100/$200 Subject to medical

Rx OOP Max $1,250/$2,500 Subject to medical

Generic Co-pay

$4 (30-day supply)/$8 mail order (doesn’t apply to

deductible)$4/$8 mail order (after

deductible)Formulary Coverage 30% 30% after deductible

Non-formulary Coverage

50% 50% after deductible

Specialty50% (75 Min; $250 Max)

EMI Health Same premiums and plan design as 2014 -

15 $50 deductible per person up to $150 per

family $1500 plan year limit per person

Dental Administration

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Dental Plan Single Two-PartyFamil

yEmployee Premium $12.48 $15.96 $23.22

University Contribution $49.94 $63.86 $92.94

$30 copay for materials (glasses, contacts, etc.) $100 frame benefit Lenses, frames, and contacts (in lieu of glasses) every 24

months

United Healthcare Vision

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Vision Plan Single Two-Party FamilyEmployee Premium $2.98 $5.96 $9.69

Will provide UVU administration for:◦ Flexible Spending Account (FSA)◦ Health Savings Account (HSA)◦ COBRA

EZ receipts app and better tools for employees

Smart card for auto-adjudication of claims

WageWorks

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An employee owned tax-free savings account (triple tax savings).1. Payroll contributions to account are on a pre-

tax basis and reduce employee’s annual taxable income.

2. Tax-free withdrawals if used to help pay for qualified out-of-pocket medical, dental, and vision expenses, such as co-pays, deductibles, and coinsurance.

3. Earns interest tax-free. Investment threshold of $1,000 with BNY Mellon

What is a Health Savings Account (HSA)

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To be eligible for an HSA, an individual has to:• Be covered by a Qualified *HDHP• Not covered by a “*traditional” health insurance plan• Not enrolled in Medicare nor Tricare• Not claimed as a dependent on someone else’s tax return

*Traditional plan – Insurance plan helps pay from the first day*HDHP plan – Deductible must be met before insurance payments begin

What is a Health Savings Account (HSA) Cont.

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Since the account is owned by the employee, not the employer, the employee decides:◦ Whether he or she will contribute and how much to

contribute;◦ How much to use for qualified expenses;◦ Which expenses to pay for from the account;◦ Whether to pay from the account or save for future use;◦ Which company will hold the account;◦ What type of investments to grow the account (when

qualified). Employer cannot restrict use of HSA distributions.

Employee Owns and Controls the HSA

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No “use it or lose it” rules like Flexible Spending Accounts.◦ All amounts are fully vested.◦ Unspent balance in account remains in account until spent

(rollover). Encourages consumerism

◦ Encourages account holders to spend their funds more wisely.

◦ Encourages account holders to shop around for the best value for their health care dollars.

Accounts can grow through investment earnings.◦ Same investment options and investment limitations as

IRAs.◦ Same restrictions on self-dealing as with IRAs.

Benefits of an HSA

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Contribution made by the employee reduces their annual taxable income and the contribution is not taxable to the HSA.

Contributions from all sources count toward the annual contribution limit. The contribution limits are: 2015 - $3,350 employee only & $6,650 family.

Catch-up $1,000 – age 55 by end of tax year. Employee can make a one-time transfer from

their IRA to an HSA (subject to annual contribution limits).

HSA Contribution Rules

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Elections for payroll contributions run through a cafeteria plan, unlike Flexible Spending Accounts, employee can change their election amount on a month-by-month basis.

Distribution is tax-free if taken for qualified expenses incurred on or after the date the HSA was established.


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Distributions can be taken for the employee, the spouse of the employee, and generally any tax dependent of the employee.

Distributions can be taken for non-qualified expenses. Distribution will be subject to:◦Income tax; and◦20% additional tax penalty.


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HSA v. FSA. What’s the difference?

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Health Savings Account (HSA)

Flexible Spending Account (FSA)

Availability of funds Funds available as employees make payroll contributions

Full funding amounts available on the first day of the plan year.

Who may fund the account

Employee, employer, or any third party

Typically the employee

Who owns the account?

The employee/account holder Employer

Is there an annual contribution limit?

For 2015, $3,350 employee only; $6,650 family.Catch up $1,000 – age 55 by end of tax year.

$2,500.

Can unused fund rollover from year to year?

Yes No

Do claims have to be substantiated for reimbursement?

No Yes

Ineligible Medical Expenses Include: Insurance premiums (other than the ones

listed under the qualified medical expenses) Over-the-counter drugs (unless a

prescription is obtained from a physician or if the drug is insulin)

Cosmetic surgery Expenses covered by another insurance

plan General health items such as tissues,

toiletries, hand sanitizer, etc

What Can’t I Use My HSA/FSA For?

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All enrollments entered online through OnlinEnroll – umr.workterra.net

No paper forms for Medical, Dental, Vision, and Flex-Spending, HSA, Life Insurance

Verify coverage level Add beneficiaries

Benefit Online Enrollment System

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Monday, April 13, 2015 1:00 PM – 2:15 PM, FS 147 Wednesday, April 15, 2015 1:00 PM – 3:00 PM, LI 205 Thursday, April 16, 2015 10:00 AM – 12:00 PM, BA 014 Tuesday, April 21, 2015 10:00 AM – 12:00 PM, BA 014 Thursday, April 22, 2015 1:00 PM – 3:00 PM, LI 205 Thursday, April 23, 2015 10:00 AM – 12:00 PM, West Campus HP

101Z

Tuesday, April 28, 2015 10:00 AM – 12:00 PM, BA 014 Wednesday, April 29, 2015 1:00 PM – 3:00 PM, LI 205 Wednesday, May 6, 2015 1:00 PM – 3:00 PM, LI 205 Thursday, May 7, 2015 12:00 PM – 2:00 PM, BA 014

Training Opportunities

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Life Changes

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Life Changes * Marriage * Divorce * Death * Birth * Adoption or Legal Guardianship * Loss of other insurance * Obtaining other coverage

Health insurance coverage adjustments can only be made within 31 days of a life change. Contact the

Benefits Office immediately if you have

experienced a life change.

Supplemental Benefit Options◦ Minnesota Life◦ AFLAC◦ Hyatt Legal◦ Met-Life◦ MedAmerica

Re-enroll in FSA◦ Must make new election each plan year

Open Enrollment◦ April 13 – May 8

Items to Remember

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Thank you and questions!

Documents

2 April 13 2015 through May 8 2015 Two network offerings ◦ United Healthcare Choice Plus and Options PPO Choice Plus network ◦ Intermountain Health