Get documents about "Application for Walgreens - PowerPoint
W
Description
Application for Walgreens document sample
Document Sample
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!
Related docs
