2014-2015 Mesa Schools Open Enrollment AGENDA Open enrollment period Overview of Medical Plan Options Cigna Tools and Resources Questions 1

2014-2015 Mesa Schools Open Enrollment

AGENDA

• Open enrollment period

• Overview of Medical Plan Options

• Cigna Tools and Resources

• Questions

1

2014-2015 Open Enrollment

July 21 – August 8

Plan year: October 1, 2014 – September 30, 2015

Overview of Medical Plan Options

4

Medical Plan Highlights

OAP Copay (EPO) HDHP 1500 HDHP 2500

Single Family Single Family Single Family

Deductible $350

$700 per family of 2

$1050 for family

of 3 or more

$1,500In-network

$3,000Out-of-network

$3,000 In-network


$2,500 In-network

$5,000 Out-of-network

$5,000 In-network$10,000

Out-of-network

Out-of-pocket limit

$2,350 includes deductibles,

copayments and coinsurance

$7,050 includes deductibles,

copayments and coinsurance

$3,000 In-network


$6,000 In-network$12,000

Out-of-network

$2,500 In-network

$5,000 Out-of-network

$5,000 In-network$10,000

Out-of-network

Co-insurance20% up to OOP

limit20% up to OOP

limit

Office Visit$20 PCP

$35 Specialist

$20 PCP$35 Specialist

Deductible Applies

Deductible Applies

Deductible Applies

Deductible Applies

Preventive CareCovered at

100%Covered at

100%Covered at

100%Covered at

100%Covered at

100%Covered at

100%

Pharmacy (30 days supply)

$7 generic/$15 Preferred

Brand/40% to $100 max Non

Preferred Brand

$7 generic/$15 Preferred

Brand/40% to $100 max Non

Preferred Brand

20% after plan Deductible

20% after plan Deductible

0% (plan covers at 100%) after

plan Deductible

0% (plan covers at 100%) after

plan Deductible

HSA contribution from employer

n/a n/a $1,000 $1,500 $1,500

Prescriptions• Generic medicines available for $4 at Target, Wal-Mart,

and now Fry’s• CIGNA Tel-Drug (mail order) delivers prescription

medications directly to your home or other location you specify– Ideal for those who take medications regularly– Convenient home delivery– 90-day supply

• QuickSwitch Transfers means no more paperwork for you– Order online, by phone or mail– Free standard delivery shipping– Three ways to order:

– By Mail– By Phone – 1-800-Tel-Drug (835-3784)– Online – www.teldrug.com or myCIGNA.com

5

HEALTH SAVINGS PLAN AND YOU

• A tax-advantaged HDHP provides coverage for current health care expenses with the option to save for future health care expenses

• Combines a qualified high-deductible medical plan (medical/pharmacy coverage) with a Health Savings Account

• You, your employer, or both, can contribute to the Health Savings Account which is owned by you

• Money contributed to the Health Savings Account is generally not taxable*• You have investment options with the Health Savings Account

6

+ =Qualified high deductible medical plan (HDHP)

Tax-advantagedHDHP

Health Savings Account

* HSA contributions and earnings are not subject to federal taxes and not subject to state taxes in most states. A few states do not allow pretax treatment of contributions or earnings. Please consult your personal tax advisor or contact your plan administrator for information about your state.

Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2014 Cigna

ARE YOU ELIGIBLE TO PARTICIPATE?

Because HSA plans have certain tax advantages, the IRS defines specific rules

for participation. To be eligible, you:

• Must be enrolled in an IRS-qualified high-deductible medical plan (high-deductible medical plans offered with Cigna’s Choice Fund HSA meet IRS requirements)

• Cannot have any other health coverage – Not covered by spouse’s medical or pharmacy plan– Not covered through Medicare Part A or Part B– Not covered through a general-purpose Flexible Spending Account (FSA) plan (either

employer’s or spouse’s)

• Cannot be claimed as a dependent on another person’s tax return

7Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2014 Cigna

YOUR HSA MAXIMUM CONTRIBUTION

The IRS has set the following limits for 2014/2015:• Under age 55 (based on a 12-month period):

– Up to $3,300/$3,350 individual coverage*– Up to $6,550/$6,650 family coverage*

• Age 55 or older:– Maximum contribution increases by $1,000 (considered a “catch-up” contribution)– Up to $4,300/$4,350 individual coverage*– Up to $7,550/$7,650 family coverage*

8

*Contributions to your HSA that you receive from your employer and incentives count toward your maximum.

$


9

This is an example used for illustrative purposes only.

• Single, in her 50s• Heart disease; controlling health

through medication• Looking to save money for future

health expenses

meet KarenHDHP 1500

HSA

EMPLOYER

$1000

KAREN

$500

$1,500.00

+

PLAN

80%

KAREN

20%

+PLAN

100%

IN-NETWORK PREVENTIVE CARE IS COVERED BY THE PLAN AT 100%

$1,948.00

80% plan: $1,558.4020% Karen: 389.60

Deductible: –$1,500.00

TOTAL EXPENSES

Preventive care $ 398.00

ER visit 2600.00

4 PCP visits 320.00

12 Generic Rx 288.00

3 Brand Rx 240.00

TOTAL 3,846.00

100% covered –398.00

MPS HSA Contribution

-1000.00

Karen’sHSA Contribution

–500.00

80% plan –1558.40

20% Karen –389.60

BALANCE DUE 0.00

Karen pays $ 889.60

$0HSA BALANCE


10




health expenses

meet KarenHDHP 2500

HSA

EMPLOYER

$1500

KAREN

$1000

$2500.00

+

PLAN

100%

KAREN

0%

+PLAN

100%


$948.00

100% plan: $948.000% Karen: 0.00

Deductible: –2500.00

TOTAL EXPENSES


ER visit 2600.00

4 PCP visits 320.00


3 Brand Rx 240.00

TOTAL 3,846.00

100% covered –398.00

MPS HSA Contribution

-1500.00

Karen’sHSA Contribution

-1000.00

100% plan –948.00

0% Karen 0

BALANCE DUE 0.00

Karen pays $1000.00

$0HSA BALANCE


$3448

11




health expenses

meet KarenOAP Copay (EPO)

HSA – N/A

EMPLOYER

$0

KAREN

$0

$0

+

PLAN

Schedule

KAREN

Deductible

+ PLAN

100%


Plan-Pays per schedule: $2,689

Copays:$309 Deductible: $350

RX Deductible: $100

TOTAL EXPENSES


ER visit 2600.00

4 PCP visits 320.00


3 Preferred Brand Rx 240.00

TOTAL $3846.00

100% covered –398.00

Plan Pays -2689.00

ER Deductible and copay

-350.00-100.00

4 Copays-PCP Visits -80.00

Rx Deductible -100.00

12 Generic RX Copays 3 Brand Rx Copays

-84.00

-45.00

BALANCE DUE 0.00

Annual EO premium 480.00

Karen Pays $1239.00


+Copays

Cigna Tools & Resources

SAVING YOU TIME

myCigna.com– Print forms or print/order ID cards– Check your coverage and explanation of benefits– Track claims, payments and deductibles– Sign up for online coaching programs – Keep track of your health history and records with an online

personal health record– Find in-network doctors, specialists, hospitals and labs– Learn about common health problems and treatment options– Compare treatment and procedure costs– Find cost and quality ratings for doctors and hospitals – Switch a prescription to Cigna Home Delivery Pharmacy with

one easy phone call, and have your medications delivered to your door

13

No claim forms needed in-network

Talk with a health specialist when you can’t reach your doctor – day or night


14

If You Have Questions About Your Medical Plan Options…

Cigna’s Pre-Enrollment Hotline

24 hours a day, 7 days a week

365 days a year!

1-800-401-4041

Open Enrollment Ends August 8

Questions?

Documents

2014-2015 Mesa Schools Open Enrollment AGENDA Open enrollment period Overview of Medical Plan Options Cigna Tools and Resources Questions 1