Melissa DeWeese's Open Enrollment Presentation - Sample

Welcome to Widget Industries’Open Enrollment November 2012

Melissa DeWeese, Benefit Advisor Beneflex Insurance Services, Inc.

What we will cover in this session:

Healthcare Trends/Benchmarks

Medical Plans

Ben-e-lect

Dental

Vision

Open Enrollment Process

Life

BenAssist

Open Enrollment Period

• Specific period of time wherein you can change plans, add or delete coverage, add or delete dependents.

• During the plan year these changes can only be made if there is a “Qualifying Event.”

• Widget Industries’ Open Enrollment Period: November 15th thru November 30th.

Health Care Trends in the U.S.UBA National Healthcare Survey

$0

$1,000

$2,000

$3,000

$4,000

$5,000

$6,000

$7,000

$8,000

$9,000

$3,604$4,027

$4,739

$8,219

Average Annual Cost:

CA

Region

Nation

WI’s

Average annual medical premium cost per employee paid by Widget Industries’ is higher than Regional, National, and State Benchmarks

Health Care Trends in the U.S.UBA National Healthcare Survey

Average Employee Paid Medical Premium Cost (Average – Displayed in Dollar Amount)

$92

$94

$96

$98

$100

$102

$104

$106

$108

$110

Single

National, $107

Region, $98

State, $116

Industry, $110

$0

$100

$200

$300

$400

$500

$600

$700

Family

National, $561

Region, $666

State, $489

Industry, $516

Benefit Package Overview

• Anthem Blue Cross Medical•Elements Preferred PPO

• Benelect HRA• Lincoln Dental DHMO and PPO Options• VSP Vision Insurance• Lincoln Financial Life &Disability Insurance

Anthem Elements PPO

Coverage Benefit (In-Network Only)Deductibles $1,250 Ind / $2,500 Fam

Max Out of Pocket / Year Ind/Family

$5,000 Ind / $10,000 Fam

Office Visit Co-Pay50% (no copay for preventative)

Plan pays:

80%

Rx Co-Pays (Separate $250 Rx Ded.)Tier 1Tier 2 (includes diabetic supplies)Tier 3 Tier 4 (Specialty drugs)Mail Order NOTE

$10 (ded. waived)$35$5030% up to $150 copay$10/$70/$100- 90 day supplyWhen member selects a brand name drug when a generic is available, and the physician does not write a “DAW”, the member is responsible for the copay + the cost difference between the brand and the generic drug

Maximum Lifetime Benefit Unlimited

Anthem Elements PPO withBenelect HRA

Coverage Benefit (In-Network Only)Deductibles None

Max Out of Pocket / Year Ind/Family

$550 Ind / $850 Fam

Office Visit Co-Pay $20 (no copay for preventative)

Plan pays:

100%, and additional 10% after ded.Total after ded coverage of 90%

Rx Co-Pays GenericBrandMail Order (90 day supply)NOTE

$10$25$30/$75 (after ded. is met $10/$70/$100)When member selects a brand name drug when a generic is available, and the physician does not write a “DAW”, the member is responsible for the copay + the cost difference between the brand and the generic drug

Maximum Lifetime Benefit / Member

Unlimited

Health Care Trends in the U.S.UBA National Healthcare Survey

$0$100$200$300$400$500$600$700$800$900

$1,000

Single

CA, $500

Region, $750

Nation, $1,000

WI's, $0

Average PPO Plan Deductibles for In-Network Services (Area Based)

Lincoln Dental PPO

Coverage PPO (Contract Rate) Non PPO Cal Yr. Deductible Ind/Family

$50 /$150 (waived for preventative)

Preventive (x-rays/cleanings/exams)

100% 100% of Eligible Expenses

Basic (Periodontal/Endodontic)

80% 80% of Eligible Expenses

Major (Root canals/fillings/Bridges)

50% 50% of Eligible Expenses

Max Annual Benefit/Person

$1,000 per member

Lincoln Dental HMO

Coverage DHMO (In-Network ONLY)

Cal Yr. Deductible Ind/Family None

Routine Office Visit $5

Preventive - x-rays/cleanings/oral evaluations $0 - $45

Basic / Restorative - Resin-based composite $0 - $225

Endodontics / Periodontics - including root canal $0 - $270

Max Annual Benefit/Person Unlimited

Lincoln Dental PPOEmployee Share of Premium

Category of Coverage Monthly Rate

Single $24.96

Employee + Spouse $58.51

Employee + Child/ren $68.39

Employee + Family $112.79

Employee pays the

difference between the

DHMO premiums and the DPPO

premiums. Widget

Industries’ pays 100%

of employee premiums

for the DHMO

Lincoln Dental DHMOEmployee Share of Premium

Category of Coverage Monthly Rate

Single $0

Employee + Spouse $11.16

Employee + Child/ren $13.04

Employee + Family $24.09

Employee pays the

difference between the

DHMO premiums and the DPPO

premiums. Widget

Industries’ pays 100%

of employee premiums

for the DHMO

Vision Service Plan (VSP)Monthly Employee Share of Premium

Category of Coverage

VSP Vision

Single $0.00

Employee + 1 $5.50

Employee + 2 or more

$14.55

$25 copay for eye examExam – once every 12 months

Lenses – once every 12 monthsFrames – once every 24 months

Allowance for frames OR contacts is $130

Lincoln Life and AD&D and Long Term Disability

• Lincoln Financial is your Life, AD&D and LTD Carrier effective December 1, 2009

• Core Life amount for all employees is 150% of Annual Salary rounded to the next higher $1,000. This includes Accidental Death and Dismemberment. Maximum Benefit is $200,000. GI amount is $200,000.

• Should you become disabled, Long Term Disability (LTD) covers 60% of your salary up to $5,000 per month up to Social Security Age

• 90 Day elimination period before benefits begin from the date of disability

Lincoln Employee Assistance Program

• Access to EmployeeConnect• Personal referrals to specialists• Financial counseling and investment guidance• The Legal Reference Program

BenAssist™ Will Handle All Core Employee Benefit Related Questions

• Clarification of benefits/rates• Claims issues• Finding a doctor• Prescriptions• Benefit change support• Medical referrals• Copies of plan information• HSA Questions

Let us help you!

Questions