2018 Benefit Open Enrollment Presentation · Online Benefit Enrollment System Resources ... STI/Sexual Health ... Open enrollment is an ideal time to review 2018 . Part-Time

2018 Benefit Open Enrollment

� November 1st through November 17th

Jason DempsterAssociate Director, Compensation, Benefits & Recruitment

Kelly FangWell-being Program Manager and Wellness Coach

Emily HerronSenior HR Generalist

Today’s FocusDental Insurance Renewal

Health Plan Overview

•Affordable Care Act

•Health Plan Design Change

•Accessing and Obtaining Care

•Prescriptions and Introducing a New Tool

•Health Insurance Renewal

•HSA Contributions

New Benefit Offering

Benefit Changes•Action Items

Wellness Program Updates and Upcoming Opportunities

Benefit Fair

Online Benefit Enrollment System

Resources

Questions and Answers

Dental Insurance Renewal

Current Preventive Dental Rates

Per EE Premium

$4.55

$13.66

$21.29

Current Comprehensive Dental Rates

Per EE Premium

$26.40

$62.11

$99.48

2018 Preventive Dental Rates

Per EE Premium $ Change per Mo % Change

$4.64 $0.09 2%

$13.93 $0.27 2%

$21.71 $0.43 2%

2018 Comprehensive Dental Rates


$26.66 $0.26 1%

$62.73 $0.62 1%

$100.48 $0.99 1%



$4.64 $0.09 2%

$13.93 $0.27 2%

$21.71 $0.43 2%



$26.66 $0.26 1%

$62.73 $0.62 1%

$100.48 $0.99 1%

Vendor Design

Structure Network

No Change

Type % of Expected

Preventive 93%

Comprehensive 94%

Admin

0.0%

0.0%

Trend

6.6%

4.7%

Health Insurance Renewal

Total Claims Paid

Office

30%

Outpatient

28%

Pharmacy

20%

Inpatient

16%

Emergency

6%

Utilization

Claims by Relationship

Employee

47%Spouse

21%

Dependent

32%

Total Claimants

Employee

56%Spouse

26%

Dependent

18%

Claims Paid

Distribution of Claims

0% 20% 40% 60% 80% 100%

No Claims

$0 to $999

$1,000 to $9,999

$10,000 to $49,999

$50,000+

10%

35%

44%

9%

2%

0%

3%

27%

34%

35%

% of Claims Costs % of Members

Distribution of Claims

7%

18%

10%

15%

17%18%

9%

5%5%

8%

6%

12%

14%

21%

17% 16%

0.00

0.10

0.20

0.30

0 to 5 6 to 19 20 to 29 30 to 39 40 to 49 50 to 59 60 to 64 65 and over

% of Members % of Claims Costs

ACA Tax Form – 1095c

Cadillac Tax Provision

Effective:

�2020

Year

2018

2019

2020

# Over

$10,200

17

24

41

# Over

$27,500

3

13

32

Amount

Over

$11,003

$22,692

$47,395

Est.

Tax

$4,401

$9,077

$18,958

Total

Over

20

37

73

• Additional guidance will be

released over the course of

the next few years

• We will continue to monitor

and take action to update

our health plans accordingly

1. Health Insurance

2. HSA Contributions

3. FSA Contributions 40% Tax

Current Plan DesignCOVERAGE FOR:

In-Network* Out-of-Network In-Network* Out-of-Network

Single $3,000/person $6,000/person $500/person $2,000/person

Family $6,000/family $12,000/family $1,000/Family $4,000/Family

PREVENTIVE CARE SERVICES

Routine Health Exams, Cancer Screening,

Eye and Hearing Exams, Immunizations,

Prenatal & Postnatal Services

100% of charges incurred 75% of charges incurred 100 % of charges incurred No coverage

CONVENIENCE CLINICS

Minute Clinic

ALLERGY INJECTIONS Deductible, then 100% Deductible, then 75% No out of pocket cost 60% of charges incurred

PRIMARY CARE OFFICE VISITS

MD Visits (includes ancillary services

received in provider’s office and palliative

care)

BEHAVIORAL HEALTH/SUBSTANCE

ABUSE - OutpatientDeductible, then 100% Deductible, then 75% $30 co-pay, then 100% 60% of charges incurred

URGENT CARE VISITS Deductible, then 100% Deductible, then 100% $50 co-pay, then 100% $50 co-pay, then 100%

SPECIALTY OFFICE VISITS

Chiropractic, Physical Therapy, Speech

Therapy, Occupational Therapy,

Acupuncture, etc.

AMBULANCE SERVICES Deductible, then 100% Deductible, then 75% 80% of charges incurred 60% of charges incurred

INPATIENT HOSPITALIZATION Deductible, then 100% Deductible, then 75% 80% of charges incurred 60% of charges incurred

EMERGENCY ROOM VISITS

(coverage for emergency conditions only)

Single - Medical $3,000/person $12,000/person $3,000/person $12,000/person

Family Medical $6,000/family $24,000/family $6,000/family $24,000/family

Generic Formulary Drugs

- 31 day supplyDeductible, then 100% Deductible, then 75%

$15 co-pay and then 100%

thereafter60% of charges incurred

Brand Formulary Drugs




Specialty Drugs - Brand Non-Formulary


20% co-pay up to $300 per

perscription, 100%

covered thereafter

60% of charges incurred

Mail Order - Generic Formulary Drugs




Mail Order - Brand Formulary Drugs




OTHER COVERED SERVICES Deductible, then 100% Deductible, then 75% 80% of charges incurred 60% of charges incurred

LIFETIME MAXIMUM Unlimited $1,000,000 Unlimited $1,000,000

ANNUAL OUT-OF-POCKET MAX

PRESCRIPTION DRUGS

Deductible, then 100% Deductible, then 100% $50 co-pay, then 100% $50 co-pay, then 100%

Deductible, then 100% Deductible, then 100% $100 co-pay, then 100% $100 co-pay, then 100%

Deductible, then 100% Deductible, then 75% $10 co-pay, then 100% 60% of charges incurred

Deductible, then 100% Deductible, then 75% $30 co-pay, then 100% 60% of charges incurred

HDHP (2018) PPO (2018)

CALENDAR YEAR DEDUCTIBLE

E-visits - virtuwell Deductible, then 100% Deductible, then 75%

The first 3 visits free, then

$10 co-pay per visit

thereafter

No coverage

Deductibles & Out-of-Pocket Maximums Over Time

Year Deductible Out-of-Pocket Max

2012 $2,400/$4,800 $2,400/$4,800

2013 $2,500/$5,000 $2,500/$5,000

2014 $2,600/$5,200 $2,600/$5,200

2015 $2,600/$5,200 $2,600/$5,200

2016 $3,000/$6,000 $3,000/$6,000

2017 $3,000/$6,000 $3,000/$6,000

$3,000 $1,722 $1,278

$6,000 $3,444 $2,556

DeductibleMac

Contribution

Adjusted

Deductible

Plan Design ChangeOut-of-Pocket Maximums

Deductibles

COVERAGE FOR:


Single - Medical

Fami ly Medica l

COVERAGE FOR:


Single - Medical

Fami ly Medica l

COVERAGE FOR:

Calendar Year Deductibles

Single - Medical

Fami ly Medica l

COVERAGE FOR:

Calendar Year Deductibles

Single - Medical

Fami ly Medica l

In-Network* Out-of-Network

$3,000/person $12,000/person

$6,000/family $24,000/family




2017 - HDHP

2017 - PPO







2018- HDHP

2018 - PPO





$500/person $2,000/person


2017 - HDHP

2017 - PPO





$500/person $2,000/person


2018- HDHP

2018 - PPO

Health Services Utilization

Service PMPM

Total

Office Visits

ER & Outpatient

Inpatient Hospital

Pharmacy

DME, Transportation,

Other, Prev. Dental

Annual Total

Norm

$498

$206

$121

$75

$83

$10

2015

$467

$190

$98

$73

$97

$9

4.96 Mil

2014

$505

$194

$88

$134

$80

$9

5.33 Mil

2013

$331

$148

$49

$70

$58

$6

4.21 Mil

2012

$316

$138

$62

$50

$54

$12

4.03 Mil

2016

$475

$193

$109

$73

$92

$8

5.37 Mil

High Cost ClaimantsNumber of Individuals

2128 27

3123 20

35

9

8 1112

15

10

12

0

37

6

4

1

6

0

10

20

30

40

50

60

2012 2013 2014 2015 2016 Through

9/30

Predicted

25k to 55K 55k to 110k Above 110k

Health Insurance

$0.00$45

$82

$130

$170

$220

$350

Average Expense For Sinus Infection

Ways to Reduce Health Care Costs

See your Doctor

Avoid Reactive

Care

Save Emergency Room for

Emergencies

Take Care of Yourself

Practice Safety & Healthy Habits

Ways to Reduce Health Care Costs

33% of ER or UC

visits

8 ER Visits

78 Urgent

Care Visits

350 Primary

Care Visits

20 Minute Clinic Visits

Savings of

$49,704

How Works

Log onto healthpartners

.com

Click on Start my visit in

Online care

Enter symptoms

Nurse Practitioner diagnoses

and creates treatment

plan within 30 minutes

Prescription sent to

pharmacy of choice

Pay for treatment.

No more than $45

Feel Better!

Conditions Treats Allergies

Bugs & Bites

Cold, Cough & Flu

Ear pain or infection

Pink Eye or Stye

Skin & Rashes (acne, cold sore, eczema, shingles,

chicken pox, rosacea, poison ivy, hives, athlete’s foot)

STI/Sexual Health

Women’s Health (birth control & infections)

Pharmacy Utilization

Type

Generic

Brand Formulary

Specialty

Average Cost

per Script

$21.97

$308.85

$5,210.56

Cost

Increase

+ 1.48%

+ 8.07%

+ 8.55%


$640,260

$714,059

$822,109

$1,056,704$1,013,719

$1,087,361

$0

$200,000

$400,000

$600,000

$800,000

$1,000,000

$1,200,000

$1,400,000

2012 2013 2014 2015 2016 2017

Total Pharmacy Spend

Projected increase of 7.26%


9,751 9,52910,068 10,145

10,56611,095

3,000 2,771 2,532 2,465 2,431 2,141

80 100 140 117 101 1200

2,000

4,000

6,000

8,000

10,000

12,000

2012 2013 2014 2015 2016 2017

# of Scripts by Type

Generic Brand Specialty


$132,792 $117,801

$131,200 $136,512

$121,257 $108,161

$32,918 $39,366

$121,702 $130,305

$38,218 $26,537

$474,549

$556,891

$569,207

$789,846

$854,244$869,018

$0

$100,000

$200,000

$300,000

$400,000

$500,000

$600,000

$700,000

$800,000

$900,000

$1,000,000

2012 2013 2014 2015 2016 2017

Expense by Type

Generic Brand Specialty

Ways to Save on Prescriptions

Ask About Generics

Ask for a Discount

Listen to Your Doctor

Shop Around

Try Mail-Order Medications

Visit the Manufacturer’s

Website

Introducing an Innovative Solution

Medicine is expensive

Don’t know how much

Costs vary greatly

Introducing an Innovative Solution

New online experience

Personalized communications

Guide to choices and alternatives

Better understanding of pharmacy costs

Member ExperienceLogin Open Explore

Mobile Member ExperienceLogin Open Explore

Explore Prescriptions

Ways to Save

Ways to save

Bundled savings

opportunity

Employee Assistance ProgramMacalester provides cost-free professional consultation and referral services for

employees who are experiencing work and personal-related difficulties

Confidential consultation is provided including:

Work relationships Conflict resolution

Mental health Interpersonal relationships

Family Loss and bereavement

Alcohol/substance abuse Finding child or elder care

Financial information,

resources and tools

Legal information, resources

and consultations

2018 Health Insurance RatesType

HDHP

PPO

Admin

5.04%

5.04%

Trend

7.92%

8.03%

Regression

5.13%

5.13%

Current Full-Time HDHP Rates

Per EE Premium

$109.75

$330.29

$482.30

Current Full-Time PPO Rates

Per EE Premium

$158.89

$482.58

$706.15

Renewal

2018 Full-Time HDHP Rates


$112.93 $3.17 3%

$340.08 $9.79 3%

$496.65 $14.35 3%

2018 Full-Time PPO Rates


$165.08 $6.20 4%

$501.72 $19.14 4%

$734.23 $28.09 4%

NEW



$112.93 $3.17 3%

$340.08 $9.79 3%

$496.65 $14.35 3%



$165.08 $6.20 4%

$501.72 $19.14 4%

$734.23 $28.09 4%

Pharmacy

7.26%

7.26%

2018 Health Insurance RatesType

HDHP

PPO

Admin

5.04%

5.04%

Trend

7.92%

8.03%

Regression

5.13%

5.13%

Pharmacy

7.26%

7.26%

Current Part-time HDHP Rates

Per EE Premium

$215.51

$547.82

$801.16

Current Part-Time PPO Rates

Per EE Premium

$313.78

$801.63

$1,174.25

2018 Part-Time

2018 Part-Time HDHP Rates


$221.85 $6.35 3%

$564.13 $16.31 3%

$825.08 $23.91 3%

2018 Part-Time PPO Rates


$326.17 $12.39 4%

$833.53 $31.91 4%

$1,221.06 $46.81 4%

2018 Part-Time

2018 Part-Time HDHP Rates


$221.85 $6.35 3%

$564.13 $16.31 3%

$825.08 $23.91 3%

2018 Part-Time PPO Rates


$326.17 $12.39 4%

$833.53 $31.91 4%

$1,221.06 $46.81 4%

Health Insurance Premium ChangesSince 2010

80.0

90.0

100.0

110.0

120.0

130.0

140.0

150.0

2010 2011 2012 2013 2014 2015 2016 2017 2018PPO family HDHP family PPO EE+1 HDHP EE+1 PPO EE HDHP EE Nat'l Avg

National Average = 4.9%

Macalester

2018 Insurance Rates

2018 Health



$112.93 $3.17 3%

$340.08 $9.79 3%

$496.65 $14.35 3%



$165.08 $6.20 4%

$501.72 $19.14 4%

$734.23 $28.09 4%

2018 Dental



$4.64 $0.09 2%

$13.93 $0.27 2%

$21.71 $0.43 2%



$26.66 $0.26 1%

$62.73 $0.62 1%

$100.48 $0.99 1%

Health Savings Account (HSA)What is a Health Savings Account (HSA)?

Contributions are made on a

“pre-tax” basis through

payroll deductions

Health Savings

Accounts are only available to those who have elected

the High Deductible Health Plan

(HDHP)

Macalester highly funds

HSA’s through employer

contributions to your HSA

account

A HSA is a true savings

account

Does not have the “use it or lose it” clause

HSA Contributions

Full-Time

.75 FTE and above

Employee Only

Employee + (1)

Employee + (2+)

Mac Monthly

Contribution

Level 1

EE Monthly

Contribution

Level 1

$100.00 $0.00

$200.00 $0.00

$200.00 $0.00

Mac Monthly

Contribution

Level 2

EE Monthly

Contribution

Level 2

$121.75 $21.75

$243.50 $43.50

$243.50 $43.50

Mac Monthly

Contribution

Level 3

EE Monthly

Contribution

Level 3

$143.50 $43.50

$287.00 $87.00

$287.00 $87.00

Open enrollment is an ideal time to review

and update your HSA contributions

2018 Full-Time HSA Contributions

Max Matched

Mac

Contribution

Annual

Out-of-Pocket

Maximum

2018

IRS Limits

Max Amount for

Unmatched

Contribution

Employee Only $2,244 $3,200 $3,450 $1,206

Family $4,488 $6,400 $6,900 $2,412

HSA Contributions

Open enrollment is an ideal time to review

and update your HSA contributions

Part-Time

.50-.74 FTE

Employee Only

Employee + (1)

Employee + (2+)

Mac Monthly

Contribution

Level 1

EE Monthly

Contribution

Level 1

$80.00 $0.00

$160.00 $0.00

$160.00 $0.00

Mac Monthly

Contribution

Level 2

EE Monthly

Contribution

Level 2

$90.88 $10.88

$181.75 $21.75

$181.75 $21.75

Mac Monthly

Contribution

Level 3

EE Monthly

Contribution

Level 3

$101.75 $21.75

$203.50 $43.50

$203.50 $43.50

2018 Part-Time HSA Contributions

Max Matched

Mac

Contribution

Annual

Out-of-Pocket

Maximum

2018

IRS Limits

Max Amount for

Unmatched

Contribution

Employee Only $1,482 $3,200 $3,450 $1,968

Family $2,964 $6,400 $6,900 $3,936

Benefits with No ChangesMacalester Benefits

• Basic Life and AD&D Insurance

• Employer Retirement Contributions

Voluntary Benefits (Deducted through Payroll)

• Optional Life, AD&D, and Dependent Life Insurance

• MetLaw (Legal Plan)

• Retirement Contributions – Pre-Tax & Post-Tax Options

Voluntary Benefits (Paid for Individually Outside of Payroll)

• Long Term Care Insurance

• 529 College Savings Plan

New Benefit: Vision InsuranceEligibility

• Staff and faculty with 0.50 – 1.00 FTE

Coverage

• Annual Contacts/Lens Allowance = $130

• Annual Frame Allowance = $130

• Tints, UV, and polycarbonate lenses are covered

Co-Pays

• $10 Exam

• $25 Materials (Lenses and frames only, not contact lenses)

• $25 Contact Lens Fitting

2018 Monthly Premiums

Coverage Premium

Employee Only $6.48

Employee +1 $12.62

Employee + (2+) $22.38

Flexible Spending AccountsDependent Care FSAHealth FSA

All participants must

re-enroll annually

during open enrollment!

Disability Insurance

Short Term

• Employee Paid

• 8, 15, 30 days

• 60% of wages

• 0.5 - 1.00 FTE

Long Term

• MAC Paid

• 90 days

• 60% of wages

• 66.6% of wages

(CBU)

• 0.5 - 1.00 FTE

Automatic

Enrollment!

No Evidence of

Insurability (EOI)

Required!

Wellness & Well-being

Kelly Fang

Well-being Program Manager &

Certified Wellness Coach

Health Assessment Highlights

23%

35%

56%

48%

2013-2014 2014-2015 2015-2016 2016-2017

232completionsin 2016-2017

54Participants in

4-yr cohort

116Participants in

3-yr cohort

10 High-Risk Measures

0%

10%

20%

30%

40%

50%

60%

Optimal 0-1 Two-Three Four-Five Six-Ten

2014 cohort 2015 cohort 2016 cohort 2017 cohort 2017 all

Cohort vs All Participants

10 High-Risk Measures: 4-yr cohort

Modifiable Health Factors

• Low Physical Activity (1% better)

• Few Fruits & Vegetables (4% better)

• Tobacco Use (no change)

• Suboptimal Sleep (3% better)

Quality of Life

• Physical Health Concerns (3% better)

• Emotional Concerns(8% better)

• Back Pain (2% better)

• Low Life Satisfaction (1% better)

Obesity, Heart Disease & Diabetes

• Unhealthy Stress (4% rise)

• Weight (4% rise)

• High Risk for Heart Disease or

Diabetes (5% rise)

CDC Worksite Health Scorecard

2017-2018 Wellness Initiatives

Top 3 Priorities

Nutrition ResiliencyIncrease

Participation

Eligible Wellness Programs

Health Coaching

Fruit & Veggie Challenge (February)

Online & Mobile Trackers (Steps, Sleep, Stress, Tobacco)

Leonard Center 12x/month for any 2 months

6-week WHAM Class

Beating the Blues

(New) Paths to Positivity (Register by November 3)

(New) Run/Walk/Bike Event

Wellness Coaching

• Individual health concerns/goals

• Individual health assessment results

• Community programming

Support and planning to create lasting change that improves health and well-being.

Wellness Events

WHAM

• Nourish Your Work (September 20)

• Resilience (November 16)

• Choose Your Fish (December 6)

January Thaw

• ETC Circles (Embody the Change)

• Chef Marshall O’Brien

Chautauqua

• WHAM Walk/Bike Picnic Lunch

• Mammo a-go-go

2017-2018 Wellness Incentives

Step 1Health

Assessment

Weekly Drawings November 1 through 17• $25 gift card to Highlander: The Shop at Macalester• $100 French Meadow Bakery & Café gift card• Free Domestic Airline Ticket!!!

$50 added to your paycheck if completed before April 30

(Note: IRS requires taxation of the prize value)

2017-2018 Wellness Incentives

Step 1Health

Assessment

Bi-Monthly Drawings November 1 through April 30• $25 Dunn Brothers Coffee gift card • $40 Common Good Books gift card• $100 Coastal Seafood gift card• A week of meals prepared by an in-home personal chef ,

including cost of groceries (Approx. value $300-400)

The more programs you complete, the more chances you have to win.(Note: IRS requires taxation of the prize value)

Step 2WellnessProgram

For details visit: macalester.edu/wellness

To take your health assessment, log on to:

healthpartners.com/wellbeing

Benefits Fair• Tuesday, October 31, 2017

• 10:00 AM to 4:00 PM• Kagin Commons, Alexander G. Hall Ballroom

• Meet and talk directly with representatives from our benefit vendors and obtain answers to your benefits questions

• Complete the Health Assessment November 1st through November 17th

• Automatically entered into weekly drawings for prizes

• Attend the Benefit Fair and register for another chance to win prizes

• $200 towards one week of meal prep from a chef plus $150 for groceries

• Gift cards � Electric Toothbrush

+

Online Enrollment Process

Visit macalester.bswift.com

Username: Mac Username (first part of email address),

Password: Previously established personal password

Click on Start Your Enrollment

Once complete with elections, check the I agree, and I’m finished with my enrollment box

Click on Complete Enrollment to finalize your enrollment


Once your enrollment is complete, you may choose to view, email or print a confirmation statement

By clicking on the home button, you will see the status

of your enrollment as complete.

You have the option to make changes to your benefits if it is before 11/17/2017 by clicking Change by Elections on the home screen. Follow the prompts to make the necessary changes

To confirm whether you have completed your benefit enrollment, log in the new benefit enrollment system located at macalester.bswift.com. Once logged into your home landing page, a message in the upper left hand corner will say your enrollment is complete or Start Your Enrollment.

After the open enrollment period closes on 11/17/2017, you will receive an email to prompt you to review your benefit enrollment. Benefit confirmation statements will not be mailed.


If your 01/01/2018 benefit statement does not reflect your intentions, you have until 11/22/2017 at 4:00 PM

To contact Jason Dempster at [email protected] (or call 651-696-6454) or contact Emily Herron at [email protected] (or call 651-696-6689) to resolve any discrepancies.

No changes will be accepted after 11/22/2017.

Available at: macalester.edu/hr

Online Open Enrollment Guide

Link to online benefit enrollment system

2018 Open Enrollment Summary

Detailed Individual Benefit Information

Resources

Questions?

Open Enrollment is November 1st through November 17th

Documents

2018 Benefit Open Enrollment Presentation · Online Benefit Enrollment System Resources ... STI/Sexual Health ... Open enrollment is an ideal time to review 2018 . Part-Time