2010-11 Open Enrollment Benefits Presentation
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2010-11 Open Enrollment
Benefits Presentation
OPEN ENROLLMENTOPEN ENROLLMENTApril 12 – April 30, 2010
Employees must make elections online
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Open Enrollment: April 12 – 30, 2010
New carrier for Health Insurance◦ CIGNA HealthCare effective July 1, 2010
Online enrollment – Enroll online for medical at: www.yourbenefitchoices.com/hcc
Online enrollment – Enroll in all other benefits at: http://hccfl.edu/benefits/benefits.cfm
Importance of the completion of Health Risk Assessment
2010 -11 Benefits
Medical Plan Benefits
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Plan HighlightsPlan Highlights
Open Access Plus In-Network (OAPIN)◦ Similar to an HMO◦ Use providers contracted with the OAP network
Open Access Plus (OAP)◦ Similar to a PPO◦ In and Out of Network benefits◦ Lowers costs if you use In-Network Providers
Open Access Plus w/ Health Savings Account (HSA)◦ HCC funds the first $625◦ You can add tax free contributions◦ The maximum contribution with what HCC provides
and what you contribute combined is $3,050 individual or $6,150 per family
◦ 100% Preventive Care Coverage with no maximum limits
◦ In and Out of Network benefits◦ Lower costs if you use In-Network Providers◦ CHANGE for 2010: Pharmacy Costs now apply to
deductible and Out of Pocket Maximum
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Provider Directory.Provider Directory. Go toGo to www.CIGNA.com
Click on either links to access Provider Directory
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Transition of CareTransition of Care
Transition of Care coverage allows you to continue to receive services for specified medical and behavioral conditions for a defined period of time with health care professionals who do not participate in the CIGNA network
◦ Must apply during enrollment or no later than 30 days after July 1, 2010
◦ Example of conditions include but not limited to Pregnancy Newly diagnosed or relapsed cancer Trauma Transplant candidate Recent major surgeries Durable medical equipment
Forms can be obtained by calling the pre-enrollment hotline at 800-569-4472 or online at www.yourbenefitchoice.com/hcc
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OAP IN OAP HSA PLAN
Open Access Plus (OAP)Health Savings Account (HSA) Current
rates 2010 RatesCurrent rates 2010 Rates
Current rates 2010 Rates
Employee $0 $0 $46.68 $0 $0 $0
Employee + Spouse $407.82 $479.33 $496.44 $413.17 $228.78 $324.82
Employee + Children $309.12 $359.50 $383.60 $309.88 $165.12 $243.62
Family $673.26 $789.81 $788.48 $680.79 $599.08 $535.21
Premiums
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Medical Plan HighlightsOpen Access Plus
In-Network(OAPIN)
Open Access Plus(OAP)
CIGNA Choice Fund® with Health Savings Account
(HSA)*
Single Family Single Family Single Family
Deductible $0 $0$500
Combined In and Out
$1,500 Combined In
and Out
$1,250 INN/
$2,500OON
$2,500INN/
$5,000OON
The most you’ll pay next year out-of-pocket
$2,000 $4,000$2,500 INN/
$5,000 OON
$5,000 INN/$10,000
OON
$5,000 INN/$10,000
OON
$10,000 INN/$10,000
OON
HSA contribution from employer
n/a n/a n/a n/a $625 $625
Preventive Care
Unlimited Unlimited Unlimited Unlimited Unlimited Unlimited
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Benefit
Open Access Plus
In-Network(OAPIN)
Open Access Plus(OAP)
IN-Network OUT of Network
OAP with Choice Fund (HSA)
IN-Network OUT of Network
Office Visits
PCP:
Specialist
$20
$35
$25
$35
CYD then 50% CYD then 20% CYD then 40%
Hospitalization$300 per day/5
day max$600 $1,000 CYD then 20% CYD then 40%
CoinsuranceN/A 20% 50% 20% 40%
Emergency Room
Urgent Care
$150
$35
$150
$40
$150
$40CYD then 20%
CYD then 20%(if a true
emergency)
Medical Plan Highlights (Cont’d)
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Karen• Single, in her 50s• Heart disease; controlling health through medication• Looking to save money for future health expenses
HSA Deposits by Karen $2425by HCC $625
Preventive Care $ 398
ER Visit $2,6004 PCP Visits $ 320Generic Rx (12) $ 288Brand Rx (3) $ 240Medical Expenses $3,448
How Expenses Are PaidPreventive (100%) $ 398Applied to deductible $1,250Paid by Plan (80%) $1,440
Paid by Karen (20%) $360
*In/Out-of-Network Coverage Level
Ou
t-of-
Max
100% after $5,000/$10,000*
Deductible$1,250/$25000*
HealthCoverage80%/60%*P
reven
tive C
are
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0%
Ded
ucti
ble
Contribution$500 Employer + Employee $2,550
Total HSA Contribution $3,050.00
What Karen Paid from HSA $1.610.00
Remaining HSA Balance $1,440.00
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Life Status Coverage Change During Plan Year
If Increasing Coverage:
Additional HSA funds are added and adjusted based on the effective date of the change in coverage level. Deductible and out-of-pocket levels also increase to the higher level.
Additional HSA funds are available to pay for claims incurred after the effective date of the new coverage level.
If Decreasing Coverage:
HSA funds are reduced to the lower coverage level amount based on the effective date of the change. The deductible and out-of-pocket maximum are also reduced to the lower level.
The higher amount will remain available to pay for claims incurred prior to the effective date of the new coverage level.
Prescription Drug Coverage
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Prescription Plan Highlights
Open Access Plus In-Network(OAPIN)
Open Access Plus(OAP)
CIGNA Choice Fund® with Health Saving Account (HSA)
In-NetworkRetail
(30-day supply)
Home Delivery* (90-day supply)
Retail(30-day supply)
Home Delivery*(90-day supply)
Retail(30-day supply)
Home Delivery* (90-day supply)
Generic You pay $15 You pay $30 You pay $15 You pay $30You pay 30%
after CYDYou pay 30%
after CYD
CIGNA Preferred brand
You pay $25 You pay $50 You pay $30 You pay $60You pay 40%
after CYDYou pay 40%
after CYD
Non-Preferred brand
You pay $40 You pay $80 You pay $50 You pay $100 You pay 50%
after CYDYou pay 50%
after CYD
*TEL-DRUG (Home Delivery)—saves the cost of 1 copay for a 90-day supply.
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Completely CONFIDENTIAL
Provides you a personal health report and access to health plan-sponsored programs
90% participation will qualify employees for a premium reduction
You and your covered dependents 18 years and older need to complete to be eligible for the reduction
Click Here to Register
Take the Health Assessment
Complete the Health Assessment and you’ll be entered in a drawing to win a Wii – Fit or IPOD
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QUESTIONS??
CIGNA Pre-enrollment line—available 24/7/365: 1.800.569.4472
FSA
Flexible Spending AccountFlexible Spending Account Medical Reimbursement
Dependent Care
A flex benefits plan increase your spendable income
Use tax free dollars for qualified expenses
Medical ReimbursementMedical Reimbursement What Qualifies?
◦ Medical – Deductibles, co-pay, prescriptions
◦ Vision – Exams. Glasses, contacts, contact lens solutions
◦ Dental – Co-pay, deductibles, orthodontics
Dependent CareDependent Care
Who Qualifies◦ Child(ren) under 13 years age◦ Child, spouse or other dependent who is
physically or mentally incapable of self care
Qualified expenses include◦ Adult & child daycare centers◦ Preschool and before/after school care◦ Care may be given in the home◦ Employee & spouse must be working
to use dependent care
FSA
Other Fee InformationOther Fee Information No cost to employee to participate Spouse and children expenses may be
reimbursed even if they are not on the HCC Health Plan
FSA
Debit card options•12 dollars per year will be deducted from your annually elections.
•Debit card allows 75 to 80 percent of claims to automatically adjudicated (no claim form required)
•Please refer to your brochure for complete information
FSA Debit CardFSA Debit Card
Hospital Indemnity Plus
Hospital Indemnity PlusHospital Indemnity Plus The costs associated with health care are on
the rise. A typical hospital stay averages more than $17,000.
FeaturesBenefits are paid directly to employeePays cash benefits directly to youCover your entire family
HI Plus Benefits► Guaranteed Issue – No Health Questions
► No Pre-existing condition (except pregnancy)
► Benefits Include:–Doctors visits (6 visits per year @ $50 each) –Daily Hospital Benefit ($200 per day – max 30 days)–Hospital Admission Benefit ($250 per admission)–Hospital Intensive Care ($250 per day – max 30 days)–Wellness Benefit ($50 per calendar year)–Medical Fees ($300/Accident)–Well Baby Care (4 visits per year @ $50 each)
Employee Only $16.05
Employee + Spouse
$31.30
Employee + Dependent
$28.09
Family $43.34
HI Plus Semi-Monthly Rates (24 times a year)
**Premiums will be payroll deducted on pre-tax basis**
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