2013 Employee Benefits

Enrollment

Open Enrollment

– Changes effective January 1, 2013

– It’s the time of the year to:Add or change Medical and Dental plan Add or delete dependentsEnroll in Flexible Spending Accounts for 2013

– Changes must be received by Monday, December 3rd

Wellness Program Based on the Wellness Activities you

completed during 2012 determined whether you earned GOLD, SILVER or

BRONZE. The $$ you get in your Health Reimbursement Account is based upon your completion!

2013 HRA Contributions

What can I use this money for? Reimbursement for copays, prescriptions, vision,

dental expenses, etc.

How do I get this money?Complete HRA claim form, attach receipt (see

example on page 40) or EOB, and send to address on form or you use your Debit Card - more on this later!

What happens if I don’t use all the money?

The unused portion rolls to the next year.

So what do you have to do in 2013?

Cholesterol

Waist Circumference

Weight

Blood Pressure

Body Fat

Mayo Clinic Health Risk Assessment

Who Knows my INFO?

The Mayo Clinic & You!

What Does my Employer Know?

Unity House will receive a group report compiled and controlled by Mayo Clinic. This aggregate report is stripped of all personally identifying information and provides general direction in designing health programs that match employee needs.

How Do I Get to Mayo?www.relphhealth.com

Flexible Spending Account Flexible Spending Account

Flexible Spending Accounts• Participation in an FSA reduces the taxes you pay to

Uncle Sam

• “Use It or Lose It” – Prepare by budgeting your predictable expenses

• You Must re-enroll each year in order to participate

• Maximum Annual Election is $ 2,500 (CHANGE FOR 2013) for Health Care FSA and $ 5,000 for Dependent Care FSA

• Voluntary plans – you are not required to participate

Health Care FSASample Eligible Expenses (see pg 38):

Budgeting Your Expenses

Flexible Spending Account:Medical Expenses:

Medical Services $ 400Prescription Drugs $ 300Hearing Exams/Hearing Aids $

Over the Counter Items $ 100Dental Expenses:

Deductibles and Co-Insurance $

Orthodontia $

Vision Care Expenses:

Exams $

Eyeglasses/Contact Lenses/Supplies $ 500Lasek Surgery $

Total Estimated Health Care Expenses: $ $1,300

Annual Total $ 1,300 divided by 26 pays = $50 per Pay (approx. $340 savings in taxes)

Dependent Care FSA• Pre-Tax Funding of Dependent Daycare

Expenses• Participate only if care is necessitated for

work or school-related expense• Maximum Election is $5,000• $$ must be in account prior to

reimbursement• Provider must have a Tax ID #• Can’t use Childcare Tax credit & Dependent

Care – talk to your tax advisor!

Keep Your current Benny Card or

• You will need to sign up for a debit card if:

If you did not receive a card in 2012

If you lost your card and did not order a new one there is a $5 charge

Debit Cards

Debit Cards can be used for FSA and HRA Expenses

“All Claims MUST be substantiated!” So says the IRS!

When a purchase is NOT automatically substantiated (ie, vision), FBS will request receipts…* Do not use your debit card at the Dentist’s office

Please Respond!First Receipt Request

If you do NOT respond after two letters?

1.FBS will block your card 2.Your employer will garnish.

IRS Rules!

How to Respond to a Letter Requesting Debit Substantiation?

• Debit Substantiation Procedures• 1-Return a copy of the letter along

with the requested receipts.

• 2-Receipts must meet IRS acceptable “5-Point” receipt requirements

• 3-Reply directly by fax (585-641-7500) or US Mail as indicated on the letter.

Tired of Having Your Claims Denied?

What do we need to process a claim?Detailed Receipts!

For Over the Counter Items:1.Date of Purchase2.Store Name3.Eligible Item Purchased4.Amount Due by Employee5.Prescription if Medication

For Rx Claims:1.Employee or Dependent Name2.Fill Date3.Provider4.Amount Due by Employee5.Drug Name

Pull receipt off the bag!For Dental/Vision:1.Employee or Dependent Name2.Date of Purchase3.Provider4.Services Rendered5.Amount Due by Employee6.Amount paid by insurance

SEBF Medical & Dental• Aetna Medical Plan – No Change!

• SEBF Dental & Vision Plans – No

Change!

MetLife Dental Plan

MetLife Dental PlanPlan Features• Deductible $50 (3 per family) for Basic & Major

Services only• $1,000 annual maximum• Dependent/Student - 19/25

• REMEMBER, while you can enroll for 1/1/2013, you would have waiting periods if not newly eligible :• 6 months on Basic Restorative (Fillings)• 12 months on all other Basic Services• 24 months on Major Services

Single Family

$2.88 $22.90

Per 26 Pay Costs

MetLife Dental Plan

Dependents to 20/26 – different than dental

In-Network

Exam – once per 12 months

$10 co-pay

Lenses – once per 12 months

$25 co-paySingleBifocalTrifocal

Lenticular

Frames – once per 24 months

$25 co-pay ($130 allowance)

Contacts – once per 12 months

$130 allowance

NEW for

2013! MetLife Vision Plan

MetLife Vision Plan

Vision Plan Employee Costs Per Pay (26) Single: $3.84 Family: $9.20

Life and Disability PlansCore - Company Paid Benefits

• Group Term Life & AD&D Insurance

– 1 times your annual salary to maximum of $150,000

• Statutory NYS Short Term Disability

– 50% of you weekly salary to a maximum of $170 per week

• Long Term Disability

– 60% of your monthly salary after 180 days of disability

• 14 day elimination period

• 40% of weekly salary up to $1,000 per week

• Does not integrate with NYS Disability

• 3/6 Pre-existing condition

• All employees will be Guarantee Issue – no medical questions

NEW Lincoln Short Term Disability

Voluntary Short Term Disability Example

• Sam Jones, $1500 monthly salary or $346 weekly salary

• Monthly benefit $600• This is in ADDITION to NYS

Disability• Per 26 Pay Deduction $6.20

(same rate $.97 per $10 regardless of age )

Sam’s Disability Payment

$1200

$1000

$800

$600

$400

$200

$0

After-TaxPaycheck$1,085

After-TaxPaycheck$1,085

VoluntaryShort-TermDisability$600

VoluntaryShort-TermDisability$600

NYSDisability$533

NYSDisability$533

Total Disability Payment $1,133

Total Disability Payment $1,133

Monthly Salary $1,500

ING Whole Life Insurance

• Qualified Issue Coverage for all eligible employees.–Qualified Issue Coverage Levels:–Employees – 3x salary to $100,000 max–Spouses – Death benefit amount what $5/wk will

purchase Children – Individual Polices for $10,000 or Term Riders for

$10,000• Affordable Level Premium(30 yr. old/$25,000/$4.65 wk)

• Loan Provision Cash Value Accumulation($9,025)

• Flexible Convenient Payroll Deduction• Portable

Cancer InsuranceIf you or a family member were diagnosed with

cancer, your medical insurance would cover your hospital and medical expenses, but not your "Indirect Costs".

Indirect costs can include:• Medical Related Expenses

– Co-payments• Non-medical Expenses

– Travel Expenses − Meals– Lodging − Care giver loss of income

• Out-of-Pocket Expenses– Car Payments − Mortgage or Rent

Payments– Utility Bills − Health Insurance

Premiums

VIEWMYBENEFITS.comAll your benefit information in one location! Forms, provider directories & questions

answered!

If you agree with Employee Information Statement and are

making these elections….1. Address Check2. Am I enrolled correctly? Sign Form3. Please list dependents with SSN4. Do I want FSA? Write in annual election5. Do I need Benny Card? Check box6. Do I want to enroll in MetLife Vision? Check box7. I understand pre-tax rules, Debit card rules and give my employer permission to deduct… Sign Form

Return to HR by

December 3, 2012

If you wish to sign up for Lincoln Short Term Disability or MetLife

Vision1. Do I want the Lincoln STD coverage? Fill in your address and information2. Sign Form

Also Return to HR by

December 3, 2012