Saint Louis University Employee Benefits 2015 Annual Enrollment

Saint Louis UniversityEmployee Benefits 2015 Annual Enrollment

Benefits Overview—Coverages Offered

Medical/Prescription Drug

Vitality Wellness Program

Voluntary Dental

Health Savings Account

Flexible Spending Accounts

Basic Term Life and AD&D

Voluntary Term Life

Voluntary AD&D

Long Term Disability

Long Term Care

Business Travel Accident

New this year! (Non-Union Employees Only)

Voluntary Vision Voluntary Accident

Medical/Prescription Drug Benefits

Annual Enrollment 2015

Highlights Effective January 1, 2015

Medical - UnitedHealthcarePlus Plan: Medical and Prescription drug copays will accumulate

towards the out-of-pocket maximum in the Plus Plan QHDHP Plan

No plan changes Health Savings Account

The Vitality™ Wellness Program Participants save on medical premiums and earn rewards! Health screenings and HRA completion are needed to receive wellness

discount If covering your spouse, both must complete requirements Deadline: November 30

Prescription Drug – Express Scripts No plan change to prescription drug benefits Network continues to include Walgreens and Dierbergs

2015 Medical Plan Options

Plus Plan QHDHP Plan

SLUCare In-Network Out-of-Network

SLUCare In-Network Out-of-Network

Deductible Non-Embedded: (One member can satisfy entire family deductible)

Individual $0 $500 $750 $1,500 $1,500 $3,000

Family $0 $1,000 $1,500 $3,000 $3,000 $6,000

Coinsurance 0% 10% 40% 0% 10% 40%

Out-of-Pocket Maximum (includes deductibles and all copays) Non-Embedded: (One member can satisfy entire family OOP Max)

Individual $1,500 $1,500 $4,750 $1,500 $3,000 $6,000

Family $3,000 $3,000 $9,500 $3,000 $6,000 $12,000

Physician Office Visits

Primary Care $10 copay10% after ded. 40% after ded. 0% after ded. 10% after ded. 40% after ded.

Specialist Care $20 copay

Preventive Care 100% 100% 100% 100% 100% 100%

Inpatient Hospital

N/A 10% after ded. 40% after ded. N/A 10% after ded. 40% after ded.

Emergency Room

N/A $100 copay $100 copay N/A 10% after ded. 10% after ded.

Urgent Care Center

N/A $50 copay $50 copay N/A 10% after ded. 40% after ded.

2015 Pharmacy Plan Options

Plus Plan QHDHP Plan

Express Scripts

Retail

(34-day supply)

Express Scripts

Mail Order

(90-day supply)

Express Scripts

Retail

(34-day supply)

Express Scripts

Mail Order

(90-day supply)

Tier 1 $8 $16 Medical Deductible and Coinsurance



Tier 4 20% to $150 N/A Medical Deductible and Coinsurance

Preventive Medications Priced according to the tier in which they fall Covered at 100%, no copay or deductible

Under the QHDHP, certain preventive, or “maintenance,” medications are covered at 100%... No deductible or

coinsurance!

2015 Cost Sharing

No change to rates!!! Premium has remained the same for 3 years!

Wellness Incentive remains at $50 for employee only coverage and an additional $25 for spouse coverage (all or nothing discount)

Plan Monthly Premium Deductions With Monthly Wellness Discount

Plus Plan

Employee Only $143.79 $93.79

Employee and Spouse $386.97 $311.97

Employee and Child(ren) $332.25 $282.25

Family $520.66 $445.66

QHDHP Plan




Family $328.20 $253.20

Plus Plan – Employees earning up to $33,000

Employee Only $50.00 $0



Family $426.87 $351.87

2015 Cost Sharing

Bi-Weekly Premiums

Plan Bi-Weekly Premium Deductions With Bi-Monthly Wellness Discount

Plus Plan




Family $240.30 $205.68

QHDHP Plan




Family $151.48 $116.86

Plus Plan – Employees earning up to $33,000

Employee Only $23.08 $0



Family $197.02 $162.40

Health Savings Account


Health Savings Accounts

Health Savings Accounts (HSAs) are designed to help you save and pay for your healthcare now and when you retire

Triple tax savings: Put money in pre-tax Grow your savings tax free Pay for qualified medical expenses income tax free

Account is always yours

HSA Eligibility for Account Holders only

You are eligible to open and contribute to an HSA if you:

If you don’t meet one of these eligibility requirements, you can still enroll in the QHDHP plan, you just cannot open and contribute to a Health Savings Account

Are covered by a Qualified High Deductible Health Plan (QHDHP)

Are not covered by any other health plan that is not a QHDHP

Are not enrolled in Medicare, Medicaid, or TRICARE

Have not received VA benefits within the past 3 months

Are not claimed as a dependent on someone else’s tax return

Are not covered by a Health FSA(Must have $0 in your Health FSA before contributing to an

HSA)

HSA Contributions

2015 Maximum Contribution Limit

* 2014 Limits: $3,300 for Individual, $6,550 for Family

IRS maximum reflects a combined employer + employee contribution

55+ can fund an additional $1,000/year; “catch-up” contribution

Please note SLU will only put seed money into an OptumHealth administered HSA. If you choose to go to a financial institution of your choice, then you will not receive the seed money.

HSA must be established by November 30 in order to receive seed money on January 1

Funds must physically be in your account before disbursements can be made

Any money remaining in the account at the end of the calendar year rolls over into the next year

2015 IRS Maximum SLU Seed Money

Individual $3,350 $250

Family $6,650 $500

Taking Money OUT of an HSA

Issues in Distributions Reimbursement of expenses for employee, spouse and Tax Code dependents

are tax free Expense must be incurred on or after the date the HSA was established

Qualified expenses include: Health, dental and vision expenses COBRA premiums Medicare premiums Qualified long-term care premiums Retiree health insurance after age 65, but not Medigap/Supplement plans

Other withdrawals are taxable Income tax, plus… Subject to 20% excise tax if withdrawn prior to age 65 After you turn 65, or enroll in Medicare, you may withdraw money for non medical purposes

without a penalty. The withdrawal is treated as retirement income and is subject to normal income tax.

It is important to save your receipts in case you are audited by the IRS Account is between you and the IRS; OptumHealth bank does not substantiate your

claims

HSA & FSA Participation

IRS guidelines prohibit participants from contributing to a Health Care FSA and an HSA at the same timeSpouses are ineligible to participate in their employer’s Health Care

FSA Ok if a Limited FSA – used for dental and vision expenses only

In order for you to fund an HSA on January 1, there must be a $0 balance in your Health Care FSA on December 31

You can still enroll in the benefit plan, but cannot contribute to an HSA account

Making Deposits

Payroll Deduction

Arrange for an automatic payroll deduction into your account

Mail a CheckMake a deposit at any time on OptumHealth from your checking or savings account

e-ContributeArrange a regular electronic transfer from an account at another financial institution

Access Your HSA Funds

Use your UnitedHealthcare Health Savings Account Debit MasterCard®

Sign up for automatic bill pay and online banking

Use HSA checks

Pay with personal funds and reimburse yourself from your HSA

myuhc.com

Benefit summaries

Deductible accumulator

Treatment cost estimator

Check statements

Pay bills to health care providers

Update personal information

Learn about QHDHPs and HSAs

HSA calculators

Additional Programs

UnitedHealthcare:

Diabetes Prevention and Control Pre-diabetics work with YMCA lifestyle coaches to prevent the progression Diabetics work with Shop N’ Save pharmacists face-to-face to help control and

improve prescription compliance, set goals, and review lab work

Diabetes Health Plan Members incentivized to comply with recommended Medical and Rx guidelines Plus Plan: No office visit or pharmacy copays for diabetes-related eligible

expenses Available only when using SLUCare physicians

Vitality


www.powerofvitality.com

Earn points by: Review and activate your personal health goals Update or confirm your email contact information Complete an online Course to learn about a health topic Complete a Vitality Check™ biometric screening with a Vitality partner Schedule Healthy Habits and Preventive Screenings Track your workouts using a Vitality-approved fitness device Sign up at a Partner Health Club Get CPR or first aid certified

Once you build up your points, go spend them! Rewards in the Vitality Mall:

Amazon Gift Cards Hotel discounts to Hyatt iTunes gift cards Movie theater ticket vouchers Fitbits, Fitbugs, Garmin, and Polar devices Charity

Please note: This list does not cover the program in its entirety. Please refer to the web site for complete program activities, rules and details.

Voluntary Dental Benefits


Voluntary Dental Benefits

Coverage will remain with Delta Dental

Choose among two dental plan options

Both plans include Delta’s PPO and Premier dentists

Option 1: Flex Plan No benefit changes

Last year the maximum was increased from $1,000 to $1,500

Option 2: Basic Plus No benefit changes

Combination of previous Basic Plus and Basic Plan Both in and out of network benefits

Voluntary Dental Plan—Delta Dental

Flex Option Basic Plus

PPO Network Out-of-Network PPO Network Only Out-of-Network

Deductible

Individual $50 $50 $25 $25

Family $150 $50 $75 $75

Calendar Year Maximum

Per person $1,500 $1,500 $1,000 $1,000

Preventive Care (Member Responsibility Shown)

0% no deductible 0% no deductible 0% no deductible 50% no deductible

Basic Restorative Care ( Member Responsibility Shown)

10% after deductible 30% after deductible 30% after deductible 65% after deductible

Major Restorative Services (Member Responsibility Shown)

40% after deductible 60% after deductible 60% after deductible 80% after deductible

Orthodontia

Lifetime maximum (per person) $1,000 $1,000 $1,000 $1,000

Orthodontia 50%

For adults and children to age 26

60% For adults and

children to age 26

50%For children to age 19

only

75%For children to age

19 only

2015 Dental Contributions

Flex Basic Plus

Monthly

Single $36.01 $21.07

Two-person $70.49 $40.52

Family $120.69 $72.60

Bi-Weekly

Single $16.62 $9.72

Two-person $32.53 $18.70

Family $55.70 $33.51

Voluntary Vision Benefits


Voluntary Vision Benefits

New benefit this year! (Non-Union employees only)

Offered through Vision Service Plan (VSP)

Plan includes benefits for eye exam, frames, contacts, etc.

In-Network vs. Out-of-Network In-Network = no claim forms to completeOut-of-Network = must submit claim form for reimbursement

VSP.comFind a provider

Network: ChoiceRegister and review benefit informationDiscounts availablePrint an ID card (not necessary to use benefits)

Plan is 100% employee paid

Voluntary Vision Plan—VSP

Vision Plan

In-Network Out-of-Network

Exam

Wellvision Exam $10 copay Up to $45 allowance

Lenses

Single $10 copay Up to $30 allowance

Bifocal $10 copay Up to $50 allowance

Trifocal $10 copay Up to $65 allowance

Frames

$150 allowance for a wide selection of frames; $170 allowance for

featured frame brands; 20% on the amount over your balance

Up to $70 allowance

Contacts (in lieu of glasses)

$150 allowance for contacts; including the contact lens exam

(fitting and evaluation)Up to $105 allowance

Frequency

Exam/Lenses/Contacts (in lieu of glasses)

Every calendar year

Frames Every other calendar year

2015 Vision Contributions

Vision Plan

Monthly

Employee Only $7.02

Employee and Spouse $12.76

Employee and Child(ren) $13.38

Family $20.33

Bi-Weekly

Employee Only $3.24



Family $9.54

Voluntary Accident Benefits


Voluntary Accident Benefits

New benefit this year! (Non-Union employees only)

Offered through Voya Financial (formerly ING)

Plan reimburses expenses that occur due to an accident

Coverage is guarantee issue – no health questions asked

No “Network”

When you have an expense, you must submit a claim form; reimbursement will then be mailed as a check

24-hour coverage – accidents on or off the job are eligible

Plan is 100% employee paid

Voluntary Accident Plan—Voya

Service Benefit Amount

Accident Hospital Care

Surgery (open abdominal, thoracic)

$1,200

Hospital Confinement $250/day up to 365 days

Coma (14 or more days) $6,000

Follow-Up Care

Medical Equipment $120

Physical Therapy $30/treatment (6 max)

Prosthetic Device $6,000

Emergency Care

Ground Ambulance Transport $120

Air Ambulance Transport $600

Emergency Room Treatment $180

Common Injuries

Burns, Laceration, Torn Knee Cartilage, Paralysis, Tendon/Ligament/Rotator Cuff

Varies

Service Benefit Amount

Common Injuries – Dislocations

Hip Joint $2,400/$4,800

Knee $1,200/$2,400

Shoulder $360/$720

Common Injuries – Fractures

Hip $1,800/$3,600

Leg $960/$1,920

Ankle $360/$720

Kneecap $360/$720

Nose $120/$240

Other Benefits

Wellness Benefit(completion of health screening test)

$100/employee or spouse$50/child (max of 4)

Sickness Hospital Confinement Benefit

$100/day for employee or spouse

$75/day for children

Below is a sample list of benefits, it does not include all the benefits available under the policy.

2015 Accident Contributions

Accident Plan

Monthly

Employee Only $24.74



Family $56.78

Bi-Weekly

Employee Only $11.42



Family $26.21

Flexible Spending Accounts


Flexible Spending and Dependent Care Accounts

Administration will remain with ConnectYourCare

You must make a new election for the 2015 plan year; current elections cannot be carried forward

Debit card allows direct payment Eases payment, but does not substantiate claims – receipts may still be

needed! Use at authorized vendors (medical facilities, hospitals, pharmacies, etc.)

Remember if you are electing the QHDHP plan and open an HSA, the IRS requires your Health FSA balance to be $0.00 on January 1, 2015 before contributing to an HSA

Flexible Spending and Dependent Care Accounts

Due to health reform, annual maximum for the Health FSA will be remain at $2,500

Annual maximum for the Dependent Care Account will remain at $5,000 ($2,500 if married and filing separate returns)

For the Health FSA Total election amount less previous reimbursements is available at the time

of transaction

For the Dependent Care FSA Only the cash balance in your account is available at the time of transaction

You cannot roll over unused balances from one year to the next Use it or lose it rule applies

Eligible Medical FSA Expenses

Copays, coinsurance and deductibles for medical, prescription and dental plans

Eye exams, contacts and eyeglasses

Laser eye surgeries

Hearing aids

Over-the-counter medical supplies Bandages, splints, contact lens solution, etc.

Over-the-counter medical medications must be accompanied by a prescription

Insulin

Some expenses not covered by your medical plan


2015 Annual Enrollment

Plan elections are binding for the 2015 plan year, unless you experience a qualifying life event:

Marriage Birth/adoption Divorce Death Change in employment status Change in dependent status

Life status changes allow you to make benefit election changes

The Benefits Department must be notified within 31 days of life change

2015 Annual Enrollment

Enrollment season is November 1 through 30

If making changes, do so through Banner Self-Service Current medical and dental elections will carry forward Must actively enroll in vision and accident plans, if interested New and existing HSA, Dependent Care and Health FSA participants will

need to make an election for 2015. Current deductions will not carry forward.

New HSA participants will also need to establish an OptumHealth bank account by November 30 in order to receive seed money

Update beneficiary information if necessary

All enrollment elections must be completed online no later than Sunday, November 30, 2014 Benefits Office will be closed Thursday, November 27 and Friday, November

28

Contact [email protected] or [email protected] with questions!

mailto:[email protected]

mailto:[email protected]

Questions?

Documents

Saint Louis University Employee Benefits 2015 Annual Enrollment