2016 Health Benefit Update

Health Plan Cost Comparison: Premiums

Single HMO: •  Midwest

Average: $543

•  Covenant: $518

Family HMO: •  Midwest

Average: $1,422

•  Covenant: $1,346

Statistics from Kaiser/HRET Survey of Employee-Sponsored Health Benefits, 2014

HMO Deductible

Single HMO: •  Midwest

Average: $619

•  Covenant: $150

Family HMO: •  Midwest

Average: $1845

•  Covenant: $300

Statistics from Kaiser/HRET Survey of Employee-Sponsored Health Benefits, 2014

HMO Plan § Increased Deductibles § Increased Premiums § Tier 2 coverage reduced from 90 to 80 percent after deductible is met

PPO Plan § Increased deductibles § Increased Premiums § Plan not offered to employees living in Bay, Midland, and Saginaw counties Health Savings Account PPO Plan – NEW for 2016

Covenant 2016 Health Plan Changes

A closer look at an HSA plan: § You own the account § You can contribute money pre-tax through payroll deduction § Money in the account can roll over from year to year § Federal regulations on:

§  Minimum annual deductibles ($1,300 – single $2,600 family) §  Maximum contributions ($3,350 – single $6,650 family)

§ Deductible is non-embedded – no individual deductible for family deductible – can be met by one family member or a combination § Can not participate in a HSA and a FSA (Benny card)

Covenant 2016 HSA PPO Plan

§  Employee Contribution Changes

§  HMO §  Individual coverage = $5 more per pay period §  Two-person coverage = $10 more per pay period §  Family coverage = $10 more per pay period

§  PPO §  Individual coverage = $5 more per pay period §  Two-person coverage = $10 more per pay period §  Family coverage = $10 more per pay period

§  All employees must enroll during Open Enrollment period

Impact to Employees

§  Tier 1 – All Plans §  Covenant network including all Covenant facilities and

Covenant Primary Care Physicians (PCP)

§  Tier 2 §  HMO – Covenant PCP approved referral §  Out of Network PPO and HSA - ASR Network (HAP &

Multiplan) physicians and facilities, No referrals necessary

§  Tier 3 – All Plans §  Self-directed services provided by out-of-network physicians

and facilities

Covenant 2016 Health Plan

Family of 4 Employee (age 42) Spouse (age 40) Two children (ages 12 and 10) Assumption – family not eligible for subsidies from government Comparison of a gold and bronze level plans offered through BCBS & Priority Health

Healthcare Marketplace Example

Cost of Healthcare

Covenant HMO

$ 249.17 per month

$ 2,990.00 annually

Covenant premiums are pre-tax, exchange amounts are after tax

Family Coverage – Premiums only

Average Exchange Gold

$ 1,060.25 per month $ 12,723.00 annually

Average Exchange Bronze

$ 691.66 per month $ 8,299.92 annually

Family of 4 Employee (age 42) Spouse (age 40) Two children (ages 12 and 10) Assumption – family is in enhanced deductible

Covenants’ HSA vs. HMO Comparison

Example 1 You take your child to Covenant ER. The allowed amount for the ER visit is $655.51 and the allowed amount for the ER Physician is $74.36. HSA Employee pays $729.87 Total out of pocket HSA $729.87 ($655.81+$74.36)

Health Savings Account (HSA) Examples

HMO Employee pays $150 co-pay HMO $150.00

Example 2 Your spouse needs a brand formulary prescription. The cost of the medication is $481.00. The prescription is picked up at the Covenant Outpatient Pharmacy HSA Employee pays $481.00 Total out of pocket HSA $1,210.87 ($729.87+$481.00)

Health Savings Account (HSA) Examples

HMO Employee pays $20.00 co-pay HMO $170.00 ($150.00+$20.00)

Example 1 You go to your Primary Care Provider for a routine visit. The allowed amount is $131.08. HSA Employee pays $131.08 Total out of pocket HSA $101.38

Another Perspective

HMO Employee pays $20.00 co-pay HMO $20.00

HSA – HMO Comparison

Some points to consider when selecting health plan coverage: §  Deductible amounts §  Out-of-pocket maximums §  Prescription usage §  Chronic conditions §  Overall health §  Physician usage

§  Please consider all of the options before making a decision for you and your family.

Covenant’s Culture of Health and Wellness

ASR will be administering the Wellness program at Covenant §  Focusing on chronic disease management §  Discounts through Covenant Cares

§  Covenant-cares.com §  Thrive! Coaching requirements will not apply

Requirements for the 2016 enhanced deductible are:

§  Annual physical between October 1, 2013 and October 31, 2015 §  Biometric screening between October 1, 2013 and October 31, 2015

If you are covering your spouse on the health plan, they must meet the requirements.

§  October 5 – October 22 Open Enrollment

§  To be compliant with Affordable Care Act, employees must actively select or decline health insurance coverage

§  Employees must enter family members Social Security Numbers

§  October 7 – 8 – Vendors at Open Enrollment §  Employees can enroll in the following ways:

1. The Covenant Benefit Center website: covenant.bswift.com

2. Calling bswift and speaking to a representative: 877-654-0404

Open Enrollment

QUESTIONS