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2011-12 OPEN ENROLLMENTOCTOBER 12, 2011
Disclaimer
These notes apply to all information contained or presented in this presentation.
This presentation provides general information only and is not intended as legal advice.
In the case of any inconsistencies between the information presented here and the plan document, the plan document prevails.
For complete information, please see your plan document.
Agenda
2010-11 Open Enrollment
Open EnrollmentMedical BenefitsHSA ReviewPlan ExamplesSample IRS FormsOther BenefitsQuestions
2011-12 Renewal Information
BCBSTX Medical Renewal Initial = 33.3% / $116,219 annual increase to STRATFOR Negotiated = 19.4% / $67,685 annual increase to STRATFOR
Guardian Dental Renewal Initial = 9% / $3,858 annual increase to STRATFOR Negotiated = 6% / $2,573 annual increase to STRATFOR
Guardian Vision Renewal 4% / $410 annual increase to STRATFOR
To Accept ALL Renewals with NO CHANGES $70,668 annual increase to STRATFOR
2011-12 Renewal Information
By changing medical carriers – we were able to reduce the overall increase to STRATFOR $16,675 annual increase in premium Savings of $$53,993 to the company
This allowed us to renewal with Guardian and LFG and minimize the overall change for employees
STRATFOR will continue to pay 100% of all benefits for all tiers of coverage AND
STRATFOR will continue to make HSA contributions
Open Enrollment Overview
November 1st , 2011
Open Enrollment Begins Now
Qualifying Events
Benefit Provider
Medical Aetna: NEW CARRIER
Dental Guardian: No Changes
Vision Guardian: No Changes
Long Term Disability
LFG: No Changes
Life/AD&DLFG: No Changes
HSA BankingWells Fargo: No Changes
FSAFlexCorp: INCREASED MEDICAL MAXIMUM
Traditional PPO Copayment (E52)
You pay a fixed
amount.
Insurance pays the
rest.
The provider is paid in full
for the service.
In-Network Only
Office Visits
Prescription Drugs
Deductible
Catastrophic Event• House hit by lightning• Deductible – What you pay before the
insurance pays
Catastrophic Event• Car accident• Deductible – What you pay before the
insurance pays
Catastrophic Event• Broken Arm• Deductible – What you pay before the
insurance pays
Deductible
Surgery(Yes, even mole
removal!)
MRI, CT, Etc.(Big machines = Big
Expense)
Hospital(In-patient, Out-patient,
ER)
Out-of-Network(Yep, it’s catastrophic to
the insuranc
e company
!)CatastrophicEvent
Coinsurance Explained
Coinsurance
After your Deductibl
e
You pay a percentag
e
Insurance pays a
percentage
Until you reach your
coinsurance
maximum
PPO Health Insurance Plan
Aetna E52Managed Choice POS (Open Access)
2011-12 PlanIn-Network
Individual / Family Deductible $500 / $1,000
Preventive Care Visits 100%
Office Visits (PCP/Specialist) $20/$35
Coinsurance 80%
Prescription Drugs $15/$35/$50
Coinsurance Maximum $2,000/$4,000
Out-of-Pocket Maximum $2,500/ $5,000REMEMBER: Deductibles are CALENDAR YEAR (January-December)
HDHP/HSA Health Insurance Plan
Aetna C30Managed Choice POS (Open Access)
2011-12 PlanIn-Network
Individual / Family Deductible $3,000 / $6,000
Wellness (Deductible Waived) 100%
Medical Services – Deductible 1st 100%
Coinsurance 100%
Prescription Drugs – Deductible 1st 100%
Coinsurance Maximum N/A
Out-of-Pocket Maximum $3,000 / $6,000REMEMBER: Deductibles are CALENDAR YEAR (January-December)
Money Saving Ideas Expert Advice
Stay In-NetworkUrgent care vs.
Emergency RoomDrugs
Therapeutic equivalents Target, Wal-Mart Rx
plansAsk the Expert!
Be a wise consumer!
Health Savings Account (HSA)
Everything covered under your health plan goes towards the deductible first. There are no copayments for office visits or prescription drugs.
Wellness visits, like your annual exam and immunizations are covered at 100% and the deductible is waived, as long as you stay in-network.
Part 1:HDHP
• Aetna health insurance plan.
Part 2:HSA
• HSA Bank account that covers qualified medical expenses.
HSA
How to use your HSA
Health Savings Account Solution
Health Savings Account
ContributePre-Tax
Invest Tax-Free
AccumulateTax-Free
RemainTax-Free
Qualified ExpensesIRS 213 (d)
LTC &COBRA
High Deductible Health Plan
2011-12 HSA Eligibility & Maximums
Must be enrolled in a High Deductible Health Plan (HDHP)
Enrollment in a spouse’s Medical FSA will disqualify you, unless it is a Limited Purpose FSA.
May not be enrolled in Medicaid or Medicare.
Non-qualified expenses are taxed as income, plus 20% penalty.
Establish a HSA Bank Account Fund the account to pay for qualified
expenses (medical, dental, vision, etc.) Tax deductible on annual return or
Pre-Tax from your paycheck.
HSA Contribution Maximums Employee Only - INCREASED
$3,100 (2012 Calendar year) Family Coverage - INCREASED
$6,250 (2012 Calendar year)
Catch-Up Contributions Age 55 and above
$1,000 per year
Medical Premiums
Monthly PPO HSA
Employee Only $0.00 $0.00
Employee + Spouse $0.00 $0.00
Employee + Child(ren) $0.00 $0.00
Employee + Family $0.00 $0.00
HSA Contributions
Annual STRATFORIRS Calendar
Year Maximum
Employee Only $1,200 $3,100
EE + Spouse $2,400 $6,250
EE + Child(ren) $2,400 $6,250
EE + Family $2,400 $6,250
Note: The IRS calendar year maximum above is for January 1 to December 31.
Employees can choose to contribute to their HSA in on a pre-tax basis from their paychecks. Contributions can be in any frequency and amount (as long as you do not exceed the IRS Calendar Year Maximum).
Employee Only Example #1
*Employee carries over $375 in HSA funds to the next year
Service/Negotiated Price HSA COPAY
Well Check: $300 $0 $0
PCP: 3 x $75 $225 $60
Specialist: 2 x $150 $300 $70
Generic Rx: 2 x $25 $50 $30
Brand Rx: 2 x $125 $250 $70
Annual Premium $0 $0
TOTAL Expenses $825 $230
STRATFOR HSA Contribution $1,200 N/A
Total EE Cost* $0 $230
Employee Only Example #2
*Point @ which employee met the individual deductible and 100% coverage begins.
Service/Negotiated Price HSA COPAY
Well Check: $300 $0 $0
PCP: 3 x $75 $225 $60
Specialist: 4 x $150 $600 $140
Generic Rx: 4 x $25 $100 $60
Brand Rx: 6 x $125 $750 $210
Surgery: $25,000 $1,325 * $2,500
Annual Premium $0 $0
TOTAL Expenses $3,000 $2,970
STRATFOR HSA Contribution $1,200 N/A
Total EE Cost $1,800 $2,970
Employee Only Example: Tax Savings
HSA
Salary (single) $60,000
Salary (joint married) $100,000
Tax Bracket (single filer) 25%
Tax Bracket (joint filer) 25%
Example #2 OOP $1,800
Maximum HSA Contribution $1,900
Tax Savings Example #1 $450
Tax Savings Example #2 $475
Family Example #3
*Employee carries over $700 in HSA funds to the next year
Service/Negotiated Price HSA PPO
Well Check: 4 x $300 $0 $0
PCP: 6 x $75 $450 $120
Specialist: 4 x $150 $600 $140
Generic Rx: 6 x $25 $150 $90
Brand Rx: 4 x $125 $500 $140
Annual Premium $0 $0
TOTAL Expenses $1,700 $490
STRATFOR HSA Contribution $2,400 N/A
Total EE Cost* $0 $490
Family Example #4
*Point @ which employee met the individual deductible and 100% coverage begins.**Point @ which family deductible met and 100% coverage begins for everyone.
Service/Negotiated Price HSA PPO
Well Check: 4 x $300 $0 $0
PCP: 6 x $75 $450 $120
Specialist: 4 x $150 $600 $140
Generic Rx: 6 x $25 $150 $90
Brand Rx: 4 x $125 $500 $140
Surgery (Parent): $25,000 $2,600 * $2,500
ER Visit (Child): $2,000 $1,700 ** $100
Surgery (Child): $10,000 $0 $2,500
Annual Premium $0 $0
TOTAL Expenses $6,000 $5,590
STRATFOR HSA Contribution $2,400 N/A
Total EE Cost $3,600 $5,590
Family Example: Tax Savings
HSA
Salary (joint married) $100,000
Tax Bracket (joint filer) 25%
Example #2 OOP $3,600
Maximum HSA Contribution $3,850
Tax Savings Example #3 $900
Tax Savings Example #4 $963
Why Does the HSA Makes Sense
Are you over-insured?How do you use your
benefits?IRA / 401K for health
expensesMore control over
expenseTax savings for future
medical expensesLong Term Care /
COBRA
Sample: Individual 1040 Tax Return
Sample: IRS Form 8889
Deductible Credit
REMEMBER:
Medical deductibles run on a calendar year (January-December). You will receive credit for any deductible you have satisfied as of January 1, 2011 under your new medical election for the remainder of 2011 (11/1-
12/31). All deductibles will reset back to $0 on January 1, 2012.
Guardian Dental Plan
Value Plan NAP Plan
Preventive100% No deductibleNot included in CYM
Basic 100%After $50 deductible
Major 60%After $50 deductible
Ortho (child only)
50%$1,500 lifetime max
Calendar Year Maximum (CYM)
$1,500Per person on the plan
Preventive100% No deductibleNot included in CYM
Basic 80%After $50 deductible
Major 50%After $50 deductible
Ortho (child only)
50%$1,500 lifetime max
Calendar Year Maximum (CYM)
$1,500Per person on the plan
Out-of-Network Charges are reimbursed at a lower negotiated fee. Balance bill will be higher when using Out-of-Network providers.
Out-of-Network Charges are reimbursed at the 90th% of UCR. Balance bill will be lower when using Out-of-Network providers.
Dental Reminders
Preventive Care excluded from CYMDependent Coverage
Up to age 26 if F/T studentRollover of Unused Benefit
$350 per year/per person Maximum of $1,250 per person
56 members qualified for rollovers for Plan Year 2011
Dual Option Plan Same Price Regardless of Plan Selection
National PPO Network 70,000+ Providers www.glic.com – DentalGuard Preferred
How To Find a Guardian Provider
www.glic.com1. Choose Provider Online Search2. Click “FIND A DENTIST”3. Select Your Dental Plan = PPO4. Enter Search Criteria & Click Continue5. Select Your Dental Network = DentalGuard Preferred6. Select Type of Dentist = General or Specialist7. Click Continue8. Results Will Be Displayed on the Following Page9. You Can Choose to Print Results or Have Them Emailed
Guardian Vision Insurance
Service In-Network Out-of-Network
Exam $10 copay
Reimbursement Varies by Services Received
Single Vision Lenses $10 copay
Bifocal Lenses $10 copay
Trifocal Lenses $10 copay
Lenticular Lenses $10 copay
Frames$120 allowance + 20%
off balance over allowance
Elective Contacts* Up to $120 (copay waived)
VSP Network www.glic.com
Frequency 12 month exam / 12 month lenses / 24 month frames
*Contact lenses are in lieu of glasses.
How To Find a Guardian Provider
www.glic.com1. Choose Provider Online Search2. Click “FIND A VISION PROVIDER”3. Select Your Vision Plan = VSP4. Enter Search Criteria & Click Continue5. Enter Additional Preferences (or Skip This Step)6. Click Continue7. Results Will Be Displayed on the Following Page8. You Can Choose to Print Results or Have Them Emailed
Guardian Premiums
Monthly Dental Vision
Employee Only $0.00 $0.00
Employee + Spouse $0.00 $0.00
Employee + Child(ren) $0.00 $0.00
Employee + Family $0.00 $0.00
Group Life/AD&D Long Term Disability
LFG Life and Disability Plans
Employer Paid = Taxable Benefit
Benefit 1x Salary to $250,000
Gross Up = Tax-Free Benefit
Benefit % 60%
Monthly Max $10,000
Elimination Period
90 Days
Benefit Duration SSNRA
Own Occupation 2 Years
LFG Voluntary Life Plan
Employee Paid
Employee Increments of $10k
EE Maximum 5x Salary or $300k
EE Guarantee Issue $80k*
Spouse Increments of $5k
SP Maximum 50% of EE or $100k
SP Guarantee Issue 50% of EE or $30k*
Child(ren) $10,000**
* Guarantee Issue (GI) will only apply to NEW employees. If you did not enroll when first offered, you will be required to answer medical questions before you are approved for any amount – GI does not apply.
** Child coverage is up to age 19 or 25 if a full-time student.
Section 125 Plan/FSA
Maximum Annual Election
Premium Only Plan Medical, Dental and Vision
Medical Expenses* $2,500
Dependent Daycare $5,000
• If you elect the HSA medical plan, you may only use the Section 125 plan for dental, vision and dependent daycare expenses.
•Effective January 1, 2011, OTC items are no longer considered to be an eligible expense under the plan.
Value Added Benefits
Aetna Member Payment Estimator – pg. 13 Aetna Mobile App – pg. 14 WhiteGlove House Call – pg. 15-16
Lincoln Financial EmployeeConnect EAP – pg. 32
www.EAPadvantage.comPassword: connect
TravelConnect Travel Services – pg. 33 BeneficiaryConnect – pg. 34
•CLS Partners Service Support Reliable Guidance Assistance Consistent Dependable
512.306.9300877.306.9305
ALL ENROLLMENT/CHANGE FORMS ARE DUE BACK BY:
October 17, 2011
RETURN FORMS TO:
Leticia [email protected]
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