Office of Human Resources

Benefit Services

Open Enrollment 2006

Agenda

• Communication Materials• Open Enrollment Options

• Open Enrollment Online!• Select-Term Disability

• Benefit Plans• Changes and Premiums

• Your Plan for Health • Questions

Open Enrollment 2006

Benefit Changes Effective: January 1, 2006 through

December 31, 2006

October 31 – November 18, 2005

Communications

Communications

2006 Open Enrollment Brochure

Contents:– Open Enrollment Overview– Health Benefits– Health Plan Contribution Rates– Flexible Spending Accounts (FSA)– Your Plan for Health

Sent to home address during last week in October

Open Enrollment

2006•Overview

•Health Benefits

•FSA Benefits

•Contribution Rates

•Your Plan for Health

Benefits Eligibility byAppointment Classification

Regular

Auxiliary Faculty

Clinical Instructor

Post-Doc Fellow

Post-Doc Researcher

Special A

Special B

Returning Retiree

http://hr.osu.edu/hrpubs/ben/eligibilitysymbols.pdf

Open Enrollment Options

Enroll: • Medical, Dental, Vision • Flexible Spending Accounts

Make Changes:• Medical Plans• Add or Drop Dependents, Based on

Eligibility• Review Dependents Currently Enrolled

• Drop Current Health Coverage or Select-Term Disability Coverage

“Open Enrollment Online!”

http:/hr.osu.edu/oe

• Online Enrollment for:• Medical, Dental, Vision• Flexible Spending Accounts

• Advantages of Online Enrollment • “One-Stop Shop” for All Your Needs!• Accessible 24 hrs During Open Enrollment• Immediate E-mail Confirmation of Receipt of

Elections

“Open Enrollment Online!”

• Login Method:

• OSU User Internet ID (last name.#)

• Password designated for this account • Not yet activated – link from Open Enrollment Online!

home page to establish ID & password

• To reset password – contact OIT at688-HELP (4357) for assistance

New Feature!!

$171.27

$26.21

$17.44

$214.92

New Feature!!

$171.27

$26.21

$17.44

$214.92

Confirmation Screen with Election Summary

Select-Term Disability

Rate Changes Effective January 1, 2006

Base Annual Salary Employee Monthly Contribution

$29,000 or Less $12.00

$30,000 - $69,999 $23.85

$70,000 or More $49.04

Select-Term Disability

• Current Enrollees May Drop Coverage During Open Enrollment

• Available online at: • Select-Term Disability Election Form Must

Be Completed to Drop Coverage

http://hr.osu.edu/Forms/Ben/disabilityenrollment.pdf

Medical Plans Overview

Medical Plans

University Prime Care (UPC)Regional University Prime Care (RUPC)

Temporary Out-of-Area Benefit

OSU Health Plan (OSUHP)

Traditional Health Plan (THP)

Buckeye Health Plan (BHP)

University Prime Care (UPC)Regional University Prime Care (RUPC)

• Primary Care Physician Required (UPC only)

• Deductible - None

• Coinsurance - None (most services)

• Office Visit - $15 Copay

• Specialists - $25 Copay

• Emergency Room - $100 Copay

• Hospitalization & Outpatient Surgery-$250 Copay

• Annual Out-of-Pocket Max- $2,000 Per Person

UPC/RUPCMonthly Employee Contributions

2005 2006

Employee Only $53.47 $54.81

Employee + Child

$98.92 $101.39

Employee + Spouse

$112.29 $115.09

Family $167.09 $171.27

Temporary Out-of-Area Benefit

• Deductible - $500 Per Person

• Coinsurance - 20% (most services)

• Emergency Room - $100 Copay

• Hospitalization – 20%

• Annual Out-of-Pocket Max - $2,500 Per Person

OSU Health Plan (OSUHP)(Network Coverage)

(

• No Primary Care Physician Required • Deductible - None• Coinsurance - None for Most Services• Office Visit - $15 Copay• Specialists - $25 Copay• Emergency Room - $100 Copay• Hospitalization & Outpatient Surgery-$250 Copay• Annual Out-of-Pocket Max - $2,000 Per Person

OSU Health Plan(Non-Network Coverage)

• Deductible - $500 Per Person

• Coinsurance - 30% (most services)

• Emergency Room - $100 Copay

• Hospitalization - 30% to $2,000 − Does not apply to out-of-pocket maximum

• Annual Out-of-Pocket Max- $2,500 Per Person

OSU Health Plan (OSUHP)Monthly Employee Contributions

2005 2006

Employee Only $177.88 $182.33

Employee + Child

$329.08 $337.30

Employee + Spouse

$373.55 $382.89

Family $555.87 $569.77

Traditional Health Plan (THP) (Non-Network)

• Deductible - $500 Per Person

• Coinsurance - 20% (most services)

• Emergency Room - $100 Copay

• Hospitalization - $250 Copay

• Annual Out-of-Pocket Max - $2,500 Per Person

Traditional Health Plan (THP) Monthly Employee Contributions

2005 2006

Employee Only $177.88 $182.33

Employee + Child

$329.08 $337.30

Employee + Spouse

$373.55 $382.89

Family $555.87 $569.77

Buckeye Health Plan (BHP)(Non-Network)

• Deductible - $500 Per Person

• Coinsurance - 20% (most services)

• Emergency Room - 20%

• Hospitalization - 20%

• Annual Out-of-Pocket Max - $2,500 Per Person

Buckeye Health PlanMonthly Employee Contributions

2005 2006

Employee Only $29.10 $29.83

Employee + Child

$53.83 $55.18

Employee + Spouse

$61.11 $62.64

Family $90.93 $93.21

Dental Plan

• No Plan Changes

• 18-Month Plan Year continues through the end of 2006 (December 31, 2006)

• Deductible - $60 per person • 18-Month Benefit Maximum

• One-half annual benefit maximum for 2005 ($600) + Annual benefit maximum for 2006 ($1,200) = $1,800 (per person) – available any time during 18-month period

Dental Plan Monthly Employee Contributions

2005 2006

Employee Only

$0.00 $0.00

Employee + Child

$9.02 $9.24

Employee + Spouse

$13.27 $13.60

Family $25.58 $26.21

Vision PlanMonthly Employee Contributions

No Change to Benefit Coverage

2005 2006

Employee Only $0.00 0.00

Employee + Child

$6.16 $6.31

Employee + Spouse

$9.05 $9.28

Family $17.01 $17.44

Flexible Spending Accounts

• Expenses must be incurred during the 2006 plan year

• Current participants must re-enroll each plan year

• Minimum reimbursement request - $25

• $5,000 limit in each account per plan year

• Health Care FSA and Dependent Care FSA funds maintained in separate accounts

• Detailed list of eligible and ineligible expenses: http://hr.osu.edu/benefits/healthflex.htm

Your Plan for Health

Our Ultimate Goal: For Everyone to be Healthier!

Your Plan for Health

• Ohio State’s long-term plan of health awareness and personalized health management

• Capitalizes on the strengths of the university’s resources for wellness and healthy living

• Rewards employees for making good health choices

• Offers tools and resources that guide you toward new ways of behaving and thinking about your health

Prescription Drug Management

• No deductible at retail pharmacy• Generic copays reduced• Employee costs for brand name drugs

aligned at retail and mail order • Financial protection of out-of-pocket

maximum - $2,000 per person• More counseling and support for patients

taking specialty drugs

Prescription Drug Benefits

Prescription Drug

Employee Cost

Retail

(up to 34-day copay)

Mail Order

(up to a 90-day supply)

Generic $5 copay $10 copay

Formulary30% coinsurance,

$80 maximum

30% coinsurance,

$200 maximum

Non-Formulary 50% coinsurance,

no maximum

50% coinsurance,

no maximum

Personal Health Assessment (PHA)

• Your Plan for Health will introduce a powerful new health tool

• Online survey about your health and lifestyle• User-friendly• Voluntary• Available to all benefit-eligible employees and their

enrolled dependents over age 18• Confidential!

• Information will not be sent to your employer• Will be integrated with your lifetime medical record at OSU

Medical Center

PHA – What will it do for you?

• Provide you with a personalized health profile

• Help you to identify if you are at risk for certain conditions and take steps to avoid or delay the onset of illness

• Offers recommendations for your improved well-being

• Provide your doctor with information useful in treating you

• $50 gift card incentive to those who complete PHA with biometric data between Jan.1 and June 30, 2006.

Health Management Services

Your Plan for Health will enhance existing programs and provide treatment alternatives for healthier living

1. Include a benefit for medical massage therapy and acupuncture (musculoskeletal coverage)

2. Enhance the weight management program

3. Increase the benefit for tobacco cessation

Musculoskeletal Coverage• New benefit for medical massage as an alternative to

physical or occupational therapy• New benefit for acupuncture as an alternative to

chiropractic treatmentService Benefit Coverage

Physical Therapy (PT)

Occupational Therapy (OT)

Medical Massage Therapy•Combined max total of 45 visits per plan year

•Network plans pay 100% after $15 copay •Non-network plans subject to deductible and coinsurance•Precertification required after 15 visits for PT/OT•Medical diagnosis and physician Px required before first medical massage visit

Chiropractic Care

Acupuncture•Combined max total of 30 visits per plan year

•Network plans pay 100% after $15 copay •Non-network plans subject to deductible and coinsurance•Precertification required after 5 visits

Weight Management

1. Hospital Based, Physician Directed Programs:• Pre-certification Required• Network Provider – OSU Comprehensive Weight Management

Program

2. Weight Watchers™: • No Pre-certification

Reimbursement for Both Programs: • 50% of MHCS fee schedule/UCR up to a $1000 annual maximum• Applies to Weight Loss Surgery & Related Services lifetime

maximum of $25,000• Submit proof of payment and attendance

Weight Management (cont)

3. Enhanced Nutrition Benefit• Provides 3 visits with a Registered

Dietician at no patient cost• Additional 3 visits after pre-certification• Network plans: $15 copayment• Non-network plans: subject to deductible

and coinsurance

Tobacco Cessation Program

• Your Plan for Health will enhance the incentive to quit using tobacco

• New benefit program paid through the medical plan will provide• $120 total maximum reimbursement for program

completion • $60 for OTC patches, gum, lozenges• $60 for program

• Generic prescription drugs will be more affordable under new plan • $5 retail/$10 mail order, no deductible

Health Coach/Care Coordinator Support

Your Plan for Health will introduce a brand new health and condition management approach

Healthy At Risk Chronic Illness

Health Coach Care Coordinator

Health Care Continuum

Services to be effective July 1, 2006

Health Coach/Care Coordinator Support

Health Coach• Available to anyone who

has completed a PHA

• One on one support and education

• Wellness resource education

• Wellness coaching in modifying behaviors

• Help members meet their individual needs

Care Coordinator• Available to those at high

risk or have a high risk for chronic conditions

• Typically RN’s, clinical pharmacists or other health care specialists

• Work one on one to support treatment plan in addition to doctor’s care

• Serves as a resource and advocate for patient

Be Sure to Read the Newsletters “Your Plan for Health ” for Updates and Additional Plan for Health

Details

Open Enrollment Forums

Columbus Campus:• Tuesday, November 8

9 a.m.

240 Scott Hall

• Monday, November 14

11:30 a.m.

1590 North High Street

Room 425A

Hospitals:• Thursday, November 3

3:30 p.m.

112 Meiling Auditorium

• Tuesday, November 15

3 p.m.

OSU East – Wallace Auditorium

Open Enrollment Presentation may also be seen online at http:/hr.osu.edu/oe

Open Enrollment Forums

Regional Campuses:

Lima• Monday, November 7 11 a.m. 212/213 Public Servicing Bldg.

Mansfield• Thursday, November 10 2 p.m. 117 Bromfield Hall

Marion

• Friday, November 4

Noon and 2:30 p.m.

290 Morrill Hall

Newark

• Tuesday, November 8

2 p.m.

Founders Hall Auditorium

Open Enrollment Presentation may also be seen online at http:/hr.osu.edu/oe

Wooster• Thursday, November 10 10 a.m. Fisher Hall Auditorium

Questions…

Why?When?

Open Enrollment

Additional Questions

• OHR Customer Service Center

Email: service@hr.osu.edu

– (614) 292-1050– 1-800-678-6010– TDD 688-3730

•Benefits•Medical

•Dental

•Vision

•FSA