Application for Walgreens - PowerPoint
Application for Walgreens document sample
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Open Enrollment 2009 Welcome! Changing medical administrators from UnitedHealthCare to BlueCrossBlueShild of AZ. $500 PPO, or High Deductible HSA Plan New- Choice of the 2 medical plans. Some change to benefit deductions – Change is effective January 2009 We will be looking at creative ways to maximize benefits and will be asking for input Enrollment Forms Due To HR no later than: Monday, December 1st Employees who turn in completed forms by Monday, November 24th, will have their name put in a drawing for a $50 gift card to New Frontiers Benefits At-A-Glance Medical GAP Naturopathic Accident Vision Care Cancer Dental Voluntary Life STD / LTD Life Insurance Education – EAP – Tuition Waiver – Tuition Exchange Flex Spending (FSA) Cafeteria Plan (S125) Medical Insurance Welcome to Blue Cross Blue Shield of Arizona! Proprietary & Confidential 6 Agenda Provider Network Prescription Drugs Enrollment Packet Overview of Benefits HealthyBlue Programs Proprietary & Confidential 7 Provider Network Largest provider network Freedom of choice Emergency treatment Travel outside Arizona Travel outside the United States Proprietary & Confidential 8 BlueCard PPO Program PPO benefits available throughout the country and the world There are three ways to find a BlueCard provider: azblue.com www.bcbs.com 1-800-810-BLUE Proprietary & Confidential 9 Your Medical Benefit Plan at a Glance –Base Plan HSA Type of Coverage Individual Family Network/OON Network/OON Deductible $2,850 / $5,000 $5,700 / $10,000 Out-of-Pocket $2,850 / $6,000 $5,700 / $12,000 Maximum (Includes Deductible) Plan Maximum $5,000,000 $5,000,000 per member Proprietary & Confidential 10 Your Medical Benefit Plan at a Glance-Base Plan HSA (cont). Type of Coverage Network Benefit Non-Network Benefit Physician’s Office 100% after deductible 60%/40% after Services PCP & Specialist deductible Preventive Care 100% Deductible 60%/40% after waived deductible Emergency Room 100% after deductible Same as Network Services Benefit Inpatient Hospital Stay 100% after deductible 60%/40% after deductible Urgent Care Center 100% after deductible 60%/40% after Services deductible Outpatient Diagnostics 100% after deductible 60%/40% after Basic Labs & X-ray deductible Mammography Proprietary & Confidential 11 Mental Health and Substance Abuse Benefits-Base Plan HSA Type of Network Benefits Non-Network Coverage Benefits Outpatient Mental 100% after deductible 60%/40% after Health and deductible Substance Abuse Services Limited to 20 visits per calendar year Inpatient Mental 100% after deductible 60%/40% after Health Services/ deductible Inpatient Substance Limited to 30 days per year. Two Abuse Services admissions per year calendar year (up to 30 days total) Proprietary & Confidential 12 Pharmacy Benefit Highlights- HSA Plan RETAIL MAIL ORDER Tier 1 100% after deductible Tier 2 100% after deductible Tier 3 100% after deductible Proprietary & Confidential 13 Your Medical Benefit Plan at a Glance-Buy Plan $500 PPO Type of Coverage Network Benefit Non-Network Benefit Physician’s Office $35 Co-payment 40% after deductible Services Specialist Office Visit $55 Co-payment 40% after deductible Emergency Room $100 per visit Same as Network Services Benefit Inpatient Hospital Stay 20% after deductible 40% after deductible Urgent Care Center $50 per visit 40% after deductible Services Outpatient Diagnostics Basic Labs & X-ray 20% after deductible 40% after deductible Mammography Proprietary & Confidential 14 Your Medical Benefit Plan at a Glance – Buy Up Plan $500 PPO (cont). Type of Individual Family Coverage Network/OON Network/OON Deductible $500 / $1,000 $1,000 / $2,000 Out-of-Pocket $3,000 / $4,000 $6,000 / $8,000 Maximum (Includes Deductible) Plan Maximum $5,000,000 $5,000,000 per member Reminders: Co-pays do not count toward deductible Co-pays do not count toward Out-of-Pocket maximum (same as last year) Proprietary & Confidential 15 Mental Health and Substance Abuse Benefits- Buy Up Plan $500 PPO Type of Coverage Network Benefits Non-Network Benefits Outpatient Mental 100% after $15 co- 50% after deductible Health and Substance payment per visit Abuse Services Under BSA Network unlimited visits Or 50% after deductible for BCBS network providers Limited to 20 visits per year Inpatient Mental 20% after deductible 40% after deductible Health Services/ Inpatient Substance Limited to 30 days per year. Two admissions Abuse Services per year calendar year (up to 30 days total) Proprietary & Confidential 16 Pharmacy Benefit Highlights- Buy Up $500 PPO Plan RETAIL MAIL ORDER $10 Co-pay $20 Co-pay Tier 1 31 Day Supply 90 day supply $30 Co-pay $60 Co-pay Tier 2 31 Day Supply 90 day supply Tier 3 $50 Co-pay $100 Co-pay 31 Day Supply 90 day supply Proprietary & Confidential 17 Once you are enrolled The BCBS Certificate of Coverage will be sent directly to your home. Your new BCBS ID card will be mailed directly to your home. You will have immediate access to azblue.com after you register onto the site. Proprietary & Confidential 18 Prescription Drugs Retail Pharmacy Show pharmacy new ID card Participating pharmacy listing Mail Order 90 day supply for 2x copay Walgreens kit in packet Must obtain a new RX from doctor to file with Walgreens Proprietary & Confidential 19 Enrollment Packet Two benefit summaries (dual choice) Quick Reference Guide Employee Application (only needed for HSA) Walgreens Mail Order Kit Pharmacy & Urgent Care Facility listing Various services & tools available to our members Proprietary & Confidential 20 Precertification Inpatient Hospital Inpatient Extended Active Rehabilitation Medications provided through the Home Health benefit. Skilled Nursing Care Specialty Self-Injectable Medications through Specialty Pharmacies Failure to obtain precertification may result in an additional $300 deductible or denial of benefits Other services may require precertification. See your benefit plan booklet for details. Proprietary & Confidential 21 Internet Services azblue.com – Public website – Provider directory – Prescription medication guide – Speciality self- injectable medication and pharmacy list BlueNet – Secure website – Claims status – Benefit info – Eligibility information – Forms – Order ID cards/Print temporary ID cards – HealthyBlue Proprietary & Confidential 22 About HealthyBlue What is HealthyBlue? Integrated programs and services that include one-on- one support, self-paced tools and online resources that encourage a healthy lifestyle HealthyBlue Innovative services that educate and empower members • Total population health strategy to make healthy choices • Comprehensive health services Engaging programs for members include online health program assessments and behavior change programs • Wellness reporting • Motivates participation Support through care management, disease through incentive management and health coaching programs • Confidential Proprietary & Confidential 23 HealthyBlue Online What is HealthyBlue Online? 24-hour Web access to health tools Interactive and engaging online content HealthyBlue Online Searchable for health information and resources • MyBluePrintsm health assessment • WalkingWorks® • Access to the Healthwise® Knowledgebase • Online health guides • Pregnancy center • Nurse On Call Proprietary & Confidential 24 Healthy Living Programs What are Healthy Living Programs? Tailored, online behavior-change programs Offer step-by-step reinforcement of healthy behavior Healthy Living Provide members to-do lists and e-mails for continual Programs program engagement • Healthy Aging • Cancer-Fighting Provide programs for many health topics • Get In Shape • Easy Start • Healthier Diet Healthy Living Programs establish a personal health • Healthy Heart plan and provide motivation to remain engaged in healthy • Stress Relief behavior change. • Diabetes-Fighting • Smoke-Free • Weight Loss • And more Proprietary & Confidential 25 Nurse On Call Ready to Help: Nurse On Call Speak with an experienced registered nurse anytime, day or night. Online Services Ask a Nurse Up-to-date Health News Online Health Videos Searchable Healthwise Database Proprietary & Confidential 26 Health Coaching What is Health Coaching? Six-month personalized support via telephone for six areas of health A whole-person approach, addressing risk factors and Healthy Coaching conditions based on My BluePrint data • Weight Loss • Smoke-Free Provides motivation for members to take control of their • Get In Shape health • Stress Relief • Healthy Heart • Diabetes-Fighting Health coaching* provides one-on-one interaction, designed to guide members through integrated HealthyBlue tools to help them accomplish their overall health goals. Proprietary & Confidential 27 Disease Management What is Disease Management? One-on-one nursing support and health management via the telephone for members with chronic health conditions Disease Management Support for diabetes, asthma, heart conditions and more • Diabetes Focuses on improving health and reducing medical cost • Asthma • Chronic Obstructive trend over time Pulmonary Disease • Coronary Artery Available in English and Spanish Disease • Congestive Heart Failure • Arthritis • Low Back Pain • Depression Proprietary & Confidential 28 Care Management What is Care Management? One-on-one interaction with a nurse case manager Assists members with acute, complex and catastrophic medical conditions Care Management • One-on-one Serves as a member advocate in navigating the health assistance care system • Guides members through the health care system Optimizes health plan benefits and assists with • Optimizes use of health plan benefits community resources • Member advocate in coordinating care Helps members develop healthier lifestyles through • English/Spanish HealthyBlue services Care Management is a member resource for counsel and advocacy during a sudden diagnosis or medical crisis. Proprietary & Confidential 29 Prescott College 2009 Medical Enrollment Thank you for your time! Any questions? Proprietary & Confidential 30 Prescott College Who is Eligible for an HSA? Individuals who are covered by a qualified high- deductible health plan are qualified if they are: Not covered by any other non-HDHP Not claimed as a dependent on another person’s tax return (excluding spouses via Internal Revenue Code) Not enrolled in Medicare part A or B Basic HSA Plan Concept Part I: High Deductible Health Plan For 2009 Single Family Covers serious Max. Out of Pocket $2,850 $5,700 illness or injury. HSA Concept Part II: Health Savings Account Pays for eligible For 2009 Single Family expenses not Max. Contribution $3,000 $5,950 covered by the health plan. •Out-of-pocket includes Deductible, Co-Insurance & Pharmacy Basic HSA Concept Compare to IRA HSA Tax-Deferred Earnings Growth Contributions Tax-Deductible / Contributions Pre-Tax Contributions Tax-Free Distributions (For Qualified Medical Expenses) Normal Tax* (NON-qualified expenses over age 65) Advantages of an HSA Funds roll over from year to year No “use it or lose it” philosophy Tax benefits on contributions, earnings and distributions Portability Funds follow you Tax-free even if qualifying coverage ends Long-term investment opportunities Control over your healthcare dollars How To Contribute Who Makes Contributions? Contributions can be made by the accountholder, employer or a third-party. Combined contribution sources can not exceed the Maximum Yearly Limit. How Are They Made? Maximum Yearly Limit (regardless of deductible) o Employer’s Payroll Vendor o Online Year Individual Family o Checks o Transfers from IRA 2009 $3,000 $5,950 o Catch-up Contributions Catch-Up Contributions Who is eligible? Individuals, and/or their spouses, over the age of 55 and not enrolled in Medicare can make yearly catch-up contributions. Year Catch-up Amt. 2009+ $1,000 If a husband and wife are covered by an HDHP, both over the age of 55, And not enrolled in Medicare they can both contribute an additional Catch-up contribution if they each open an HSA. Making Distributions HSA dollars can always be used to pay for qualified expenses on a tax-free basis, regardless of age or healthcare coverage HSA dollars can be withdrawn for any non-qualified expense prior to age 65, subject to a 10% penalty and regular income tax. After age 65, withdrawals can be made to pay for any non-qualified expense, subject to regular income tax. Upon death of accountholder If the spouse is the beneficiary, the HSA may transfer to the spouses name and remain a tax-favored account If the beneficiary is not the spouse, the funds are paid to the beneficiary as a taxable transaction Qualified Medical Expenses A qualified expense is an expense incurred to maintain an individual’s health or the health of their family, including: • Doctor and hospital visits • Medical equipment • Dental care, braces, dentures • Vision care, glasses, contacts • Medications, including some over-the- counter • Medical related transportation costs *A list of eligible medical expenses can be found in IRS Publication 502 Preventative Care Benefits Periodic health evaluations Routine prenatal and well-child care Immunizations Tobacco cessation programs Screening services Negotiating Payments Negotiate Payments With Healthcare Provider Negotiate Pay $300 $100 $200 Payments Monthly $200 Other Eligible Medical Expenses Premiums for long-term care insurance Limited to amount listed in 213(d)(10) Premiums for "COBRA” Premiums for coverage while receiving unemployment compensation Premiums for individuals over age 65 Retirement Health Benefits Medicare Premiums Tax Savings Example Contribution $3,000 per year for 25 yrs Annual Medical Expenses $500 per year Tax Bracket 28% (Federal) 5% (State) Average Interest Rate 3% TAX SAVINGS ON CONTRIBUTIONS = $20,625.00 TAX SAVINGS ON DEFERRED GROWTH = $9,453.89 ACCOUNT BALANCE AT THE END OF 25 YEARS = $91,148.16 HSAs Change Spending Behavior? Based on HSA Bank’s customer base of over 186,000 accounts as of December 31, 2007 96.5% of all open accounts rolled over funds from 2007 to 2008 On average, accounts rolled $2,163 into 2008 Average contribution per month = $214 Average distribution per month = $173 Average monthly savings = $41 Nearly 18% of accountholders saved all contributed funds and rolled over an average balance of $4,013 into 2008. More than a third of accountholders saved at least 50% of their 2007 contributions. Accountholder Communication and Reporting Quarterly account statements Periodic account inserts with valuable legislative information, account features, and more IRS reporting Year-end status report 1099-SA (distributions) 5498-SA (contributions) Online Account Access through Internet Banking Account balance and transaction history (Up to 18 mo. for convenient tax reporting) View cancelled checks Year-to-date information (Including a breakdown of contributions by source.) Ability to download transaction history to Quicken or Money Email confirmation of account opening and ongoing activity Online address changes Access to Online Contributions Account Support Toll-free Bankline 24-hour account access via touch tone phone 1-800-565-3512 Toll-free Client Assistance Center 7 a.m. – 9 p.m., CST, Monday – Friday Toll-free Spanish Language Assistance line 1-866-357-6232 7 a.m. – 7 p.m., CST, Monday – Friday Special Note o Prescott College will contribute $200 toward your HSA Account. Please see Human Resources for more details. Thank you for choosing… SightCare - Vision Vision Coverage PPO Plan Nationwide Vision Network SightCare Doctor Network Walmart Providers Plan is for Vision, not eye health SightCare - Vision SightCare Out-Of- Nationwide Plan Feature Network Vision Doctor Allowance Eye Exam 100% Covered $10 Co-Pay Up to $25 Material Copay None $10 Co-pay Up to $25 Ancillary 100% Covered 100% Covered See exam allowance Testing Dilation $9 Co-Pay 20% Discount Not Covered Visual Field Testing Frame Up to $120 Up to $100 Sight Up to $35 Allowance Care Up to $74 Walmart Std Lenses Single Vision 100% Covered 100% Covered $25 Bifocal 100% Covered 100% Covered $40 Trifocal 100% Covered 100% Covered $50 Progressive $30 Co-Pay 20% Discount Bifocal Rate ($40) SightCare - Vision Out-Of- Nationwide SightCare Plan Feature Network Vision Doctor Allowance Contact Lens Elective / Cosmetic Up to $120 $100 Allowance toward $80 Allowance toward purchase and fitting exam, purchase and fitting Medically Necessary Up to $250 Up to $250 Up to $100 SightCare - Vision 12 Month Plan – 1 Exam and Glasses or Contacts per plan year Provider Info / Add’l Plan Info: sightcareaz.com Group Life Insurance / AD&D College Paid = $15,000 for each employee No Cost to Employee Name Beneficiaries Change Beneficiaries at any time Will Preparation Services available Administered by Principal Supplemental Insurance Voluntary Life – For Employee: Increments of $20,000 Guaranteed issue of $140,000 for new employees Price is based on age at Employees cost – For Spouse Increments of $10,000 – Health Questionnaire required for enrollments after initial eligibility—See HR for paperwork Principal - Dental Dental Coverage PPO Plan Choice of Providers Out of network benefits covered at the 90th Percentile Principal - Dental PPO Non-PPO Insurance EE Insurance Unit of Coverage Pays Pays Pays EE Pays Unit 1 100% of 0% + Preventative & 100% 0% R&C balance Routine Unit 2 80%* of 20%* + 80%* 20%* R&C balance Basic Restorative Unit 3 50%* of 50%* + 50%* 50%* Major Restorative R&C balance Unit 4 50% of 50% + 50% 50% Orthodontia ** R&C balance *$50/$150 deducible applies to these Units ** Dependents less than 19 yrs old Principal - Dental Calendar Year Maximums Unit of Coverage PPO Non-PPO Unit 1- Preventative & Routine Unit 2 - $1,500 Basic Restorative Unit 3 Major Restorative Unit 4 $1,200 Lifetime Orthodontia Principal - Dental Cleaning/Exam 2x per year Services over $300 ask for Treatment Plan (Estimate of services and what you’d owe) Principal - Dental How do I find a network provider? Can I access my dental benefit information and claims online? www.principal.com Long Term Disability Premium paid for by your employer LTD Benefit is administered by Principal Financial Group. 60% of monthly benefit to a maximum of $6,000. 3 month waiting period Administered Through Principal Short Term Disability Premium paid for by Prescott College STD first 90 days of disability – 60% of wages – Processed with payroll check – Coordinates with FMLA – HR handles all STD Claims In Lieu of Medical Insurance If you have other coverage Provide Proof of Coverage $100 per month to TIAA/CREF account Naturopathic Benefit administered through PC Reimburse 75% per bill to a maximum of $300 per year per covered individual Chiropractic, Naturopathic Doctor, Massage, Acupuncture, Supplements Submit claim form through HR (no changes here!) Flexible Spending Account Administered through AdminPro Medical Reimbursement Medical Expenses – Deductibles, Co-pays, EE portion, Certain over the counter drugs. Up to $3,000 maximum per year ($125 per check) Can use entire election at any time in year Deducted pre-tax from pay check Use pre-tax funds for medical expenses Flexible Spending Account Dependent Care Dependent Care costs while you are working Can be used for child or elder care Up to $5,000 maximum per year ($208 per check) May only use balance available Flexible Spending Account How do I use it? – Flex Convenience Card – debit card – Reimbursement Save receipts! Receipts for items $50 and more, will be required to be submitted to AdminPro Flexible Spending Account Receive Monthly Reports via e-mail – Balance – Outstanding Receipts Use it within plan year or lose it (January 1– December 31) Submit claims for 2008 plan year by 3/31/09 Cafeteria Plan Allows us to withhold benefit premiums on a pre-tax basis Changes to any benefits can only be made at open enrollment or if there is a ―life or qualifying event‖ Birth, adoption Death Marriage Divorce Change of job (spouse or you) Life / Qualifying Events For all plans . . . MUST Notify HR and make changes within 30 days or they will not be allowed Employee Assistance Program Provided through ProEAP Free to all Employees and their dependents 8 visits per ―concern‖ per year Child, Elder, legal, work/life issues Available 24/7 ProEAP’s role: Define problem Organize resources Help resolve issue Confidential TIAA / CREF 403(b) Plan Managed by TIAA/CREF Teachers Insurance and Annuity / College Retirement Equities Fund Focused on needs of College and University clients TIAA / CREF “3 Buckets – 1 Cart” Institutional Voluntary In-Lieu 4%of base wages Employee College provides in- Provided by the Contribution lieu of medial insurance College election $50 per Pay Up to a additional Salary Reduction Period ($100 per month) 2% match available Agreement from Prescott College (*New*) Up to IRS Limitation Does not require you to contribute (match does) 3 year vesting schedule 100% vested after 3 years 0% prior to that time Educational Benefits Tuition Waiver – Attend Classes at PC – Employee / Spouse / Dependent – Eligible after Full-Time EE for 1 year – Complete and submit form to HR prior March 15 of new Academic Year Tuition Exchange – Tuition Exchange Organization & Council of Independent Colleges (CIC) – Employee / Spouse / Dependent attend another school within association – Full Tuition to a max amount – See HR for more information Supplemental Insurance Cancer Select – Pays for direct medical and indirect non-medical costs of cancer treatment. Hospital confinement, Attending Physician, Private Duty Nurse, Radiation Therapy, Chemotherapy, Experimental Treatments, Blood/Plasma, Lab Tests, Biopsies/Diagnostic Tests, Transplants – Receive $100 per year for Cancer Screening – Has pre-existing condition clauses Supplemental Insurance Accident Select – Pays benefits to assist with costs associated with certain accidents Benefits for: ER visits, 3 follow-up treatments, Ambulance, Initial Hospitalization, Hospital income benefit, Appliances, Physical Therapy& Intensive Care Benefit amount paid for certain types of accidents/injuries i.e.: dislocations, burns, tendons/ligaments, ruptured disc, torn knee cartilage – Wellness benefit for annual check-up $60 – after on plan for one year. Wrap-UP Election / Change reminder Forms Due no later than: Monday, December 1st Eligible for Drawing if completed and returned to HR by Monday, November 24th!!! Questions??? Thank you!