By: Don Zimmerman Director, Human Resources Ana B. Graci, HIA Kara Buell Benefit Consultants Hub International 2014 OPEN ENROLLMENT

By:Don Zimmerman

Director, Human ResourcesAna B. Graci, HIA

Kara BuellBenefit ConsultantsHub International

2014 OPEN ENROLLMENT

http://www.touro.com/content/

Agenda2014 Changes

Wellness BenefitsBe Smart About Your Benefits

Your Medical BenefitsYour Other Benefits

Your CostsWebsites

THINK TOURO!


2014 Changes• Your current medical ID card will expire 12/31/2013• Change in UHC Networks to the Choice Plus Options Network• New medical ID cards will be mailed to you in December• Be sure to present your new ID card to your physician• UMR will be the new administrator for FSA and will issue new debit

cards (new for CCPI)• AlwaysCare is the new voluntary fully-insured vision carrier and will

issue ID cards• Assurant dental is the new voluntary, fully-insured carrier with 2

plan options - high and low (new for CCPI)• NEW Wellness coverage – 100%, no office co-pays


Wellness Prevention• Wellness Prevention services will be covered at

100%, no co-pay, effective 2014• Related readings and interpretations will also be

covered at 100%.• There will no longer be any out-of-pocket related

expenses to you or your dependents for wellness check-ups.

• If you are enrolled in the Allstate Cancer plan, Allstate will pay you a $50 wellness incentive for an annual check-up


Be Smart About Your Benefits (cont’d)

THINK TOURO:• Touro offers two heath plan options.• The base plan and enhanced plan.• 92% of Touro employees participate in

the base plan. With this plan employees use Touro facilities, such as Touro Outpatient Lab and the Imaging Center EXCLUSIVELY! The enhanced plan allows employees to choose Touro facilities and any other provider covered by United Healthcare.


Be Smart About Your Benefits (cont’d)

THINK TOURO!• It is up to you to choose providers within

the coverage offered by your health plan.• A base plan member should always ask

to have diagnostic testing and lab work done at Touro.

• Keeping the services at Touro helps the hospital keep health expenses down and saves you money.


Touro Hospital & Children’s

Services NPAT excluding

Ochsner and Tulane

Services NPAT including Ochsner

and Tulane

Non-Network

Deductible

$0 $500 Individual$1000 Family

$500 Individual$1000 Family

Not Applicable

Office Co pay N/A $20 $20 Not Covered

Emergency Room

Ambulance Co pay

Urgent Care UHC Facility

$100 (waived if admitted)

$50.00

$20.00


$50.00

$20.00


$50.00

$20.00


$50.00

$20.00

CoinsuranceFacility ChargesHospital Copay inpt

Therapies

90%$100/Day -$300/Admit

90%

80% after deductible$150/Day - $450/Admit

80% after deductible



Not Covered

Out of Pocket $3,000 Individual$6,000 Family

$4,000 Individual$8,000 Family


No limit

Lifetime MaximumAnnual Maximum

UnlimitedUnlimited

UnlimitedUnlimited

UnlimitedUnlimited

UnlimitedUnlimited

NPAT – Not Provided at Touro

Base Plan (EPO)… THINK TOURO!



Services NPAT excluding

Ochsner and Tulane

Services NPAT including Ochsner

and Tulane

Non-Network

Prescription Drugs

Generic Formulary Brand Mail Order

N/A $100 deductible/individual$10 co pay (ded waived)$30 co pay$45 co pay2 co pays for a 90 day supply

$100 deductible/individual$10 co pay (ded waived)$30 co pay$45 co pay2 co pays for a 90 day supply

Not Covered

Mental & Nervous and Substance Abuse Inpatient

Outpatient

N/A80% after deductible$150/Day - $450/Admit

80% after deductible$20 Co pay


80% after deductible$20 Co pay

Not Covered

Routine Well Adult and Child Care Mammograms Diagnostic lab Reading & Interpretation

100%

100%100%100%

100%

50% after deductible80% after deductible100%

100%


Not Covered



Coverage LevelTouro MonthlyContribution

$ FT/$PT

EmployeeFull-Time $/Month

$/Pay Period

EmployeePart-Time $/Month

$/Pay Period

Single $277.26 Full-Time$217.70 Part-Time

$123.44/Month$61.72/PP

$183.00/Month$91.50/PP

Employee & Spouse

$529.03 Full-Time$384.32 Part-Time

$272.38/Month$136.19/PP

$417.09/Month$208.55/PP

Employee & Child(ren)


$251.96/Month$125.98/PP

$374.54/Month$187.27/PP

Family $793.01 Full-Time$610.43 Part-Time

$353.00/Month$176.50/PP

$535.58/Month$267.79/PP



Touro Hospital Children’s

In-Networkexcluding

Ochsner and Tulane

In-Networkincluding

Ochsner and Tulane

Non-Network

Deductible

$0 $500 Individual$1000 Family



Office Copay N/A $20 $20 Not Covered

Emergency Room (Life or Limb Threatening) Ambulance CopayUrgent Care UHC Facility


$50.00 $20.00


$50.00$20.00


$50.00$20.00


$50.00$20.00

CoinsuranceFacility ChargesHospital Copay

Therapies

90%$100/day-$300/admit

90%

80% after deductible$150/day-$450/admit


50% after deductible$500/confinement


50% after deductible$500/confinement


Out of Pocket $3,000 Individual$6,000 Family



No Limit

Lifetime MaximumAnnual Maximum

UnlimitedUnlimited

UnlimitedUnlimited

UnlimitedUnlimited

UnlimitedUnlimited

Enhanced Plan (PPO)



In-Networkexcluding Ochsner

and Tulane

In-Networkincluding Ochsner

and Tulane

Non-Network

Prescription Drugs

Generic Formulary Brand Mail Order

N/A $100 deductible/individual(waived for generic)$10 co pay$30 co pay$45 co pay2 co pays for a 90 day supply

$100 deductible/individual(waived for generic)$10 co pay$30 co pay$45 co pay2 co pays for a 90 day supply

Not Covered

Mental & Nervous and Substance Abuse Inpatient

Outpatient

N/A

80% after deductible$250/confinement80% after deductible

$20 co pay


$20 co pay


N/A

Routine Well Adult and Child Care Mammograms Diagnostic lab Reading & Interpretation

100%

100%100%100%

100%


100%


Not Covered

Enhanced Plan (PPO)


Coverage Level Touro MonthlyContribution

$ FT/$PT

EmployeeFull-Time $/Month

$/Pay Period

EmployeePart-Time $/Month

$/Pay Period

Single $321.68 Full-Time$229.21 Part-Time

$190.33/Month$95.17/PP

$282.80/Month$141.40/PP

Employee & Spouse


$413.30Month$206.65/PP

$619.96/Month$309.98/PP



$365.45/Month$182.73/PP

$548.17/Month$274.09/PP

Family $873.33 Full-Time$593.36 Part-Time

$591.03/Month$295.52/PP

$871.00/Month$435.50/PP

Enhanced Plan (PPO)


Low Option High Option

Calendar Year Maximum $1,000 per Individual $1,500 per Individual

Calendar Year Deductible $0 $25 per Individual

Preventive Care 85% 100% (deductible waived)

Basic Expenses 50% 80%

Major Expenses 30% 50%

Orthodontia (child only)

N/A 50% to $1,000 Lifetime Maximum

Dental Benefits through Assurant

http://www.assurant.com/


2014 Voluntary Dental Premiums

Coverage LevelLow Option High Option

Single $17.47/Month$8.74/PP

$29.97/Month$14.99/PP

Employee & Spouse

$34.17/Month $17.09/PP

$60.71/Month$30.36/PP


$39.65/Month$19.83/PP

$67.11/Month$33.56/PP

Family $59.45/Month$29.73/PP

$100.82/Month$50.41/PP

Greater benefits are received by using the Assurant network


Voluntary Vision Plan through AlwaysCare

Coverage Level

Frequency Co-PaysIn-Network

Out-of-Network

Exam 12 Months $10 Co-pay Up to $40 Allowance

Frames 24 Months$25 Co-pay up to $130 Allowance

Up to $50 Retail Allowance

Lenses 12 Months $25 Co-payAllowances: $40

Single/$60 Bifocal/$80 Trifocal

Contacts12 Months

$25 Co-Pay up to $130 Allowance

Up to $105 Allowance

Greater benefits are received by using the AlwaysCare network



Voluntary Vision Premiums

Coverage LevelEmployeeFull-Time $/Month

$/Pay Period

Single $5.47/Month$2.74/PP

Employee & Spouse

$10.48/Month$5.24/PP


$10.96/Month$5.48/PP

Family $16.80/Month$8.40/PP


• Pre-Tax Premium Contributions• Health Flexible Spending Account (FSA)

– Un-reimbursed Medical Expenses ($2,500.00 max).– Common items for reimbursement:

• Deductibles, co pays, out-of-pocket expenses, laser eye surgery, dental fees.

– Dependent Care Flexible Spending Account (FSA)

– Dependent Care/Child Care ($5,000.00 max);– Daycare expenses for PRE-KINDERGARTEN and UNDER.– Before and After School expenses for any child 12 yrs of

age and under (No overnight camps - only day camps).– Elder Care expenses for a parent who lives with you and

needs round the clock care.

Flexible Spending Accounts - UMR


• Voluntary Participation

• Annual Enrollment – Calendar Year

• Careful Planning Required

• No longer use it or lose it! Funds can now be rolled over up to $500 maximum for the medical FSA only.

• Annual amount divided by 24 paychecks

• Reimbursements are administered through a third party administrator - UMR

• Medical & Dependent FSA Debit Cards – New Debit Cards will be issued for 2014!

• Debit Card transactions require substantiation of qualified expenses. You may receive notification from UMR requesting proof of qualified expenses.

How Does Flexible Spending Work?


♦ MarriageMarriage♦ Divorce Divorce ♦ Birth/adoption of childBirth/adoption of child♦ Part-time/full-time statusPart-time/full-time status♦ Termination/commencement of employmentTermination/commencement of employment♦ Loss of a dependentLoss of a dependent♦ SCHIP eligibilitySCHIP eligibility

FSA Qualifying Event

You can change your expense election during the plan year if there is a major change in your family status due to:


The benefits below will remain the same for the 2014 plan year

• Touro Medical Plans – Based and Enhanced • Life Insurance and AD&D through The Hartford.• Voluntary Life, Employee, Spouse and Child Insurance through The

Hartford.• Short and Long Term Disability through The Hartford.• Cancer Benefit through Allstate Workplace Benefits.• MetLife Tax Savings Annuity (TSA)

– Base limit employee deferral amount will remain at $17,500 for 2014– Age 50+ deferral amount will remain at $5,500.00 for 2014


REMINDER: Benefit Choices That Require Action

• Enrolling for the first time• Adding or dropping dependent coverage• Changing medical plans (Base to Enhanced or vice versa)• Enrolling in new Dental and Vision plans• Increasing life insurance coverage• Participation in the Flexible Spending Account (FSA)• Waiving coverage • All forms are due in Human Resources no later than 11/22/2013.• You must complete the proper enrollment forms and submit them to

Human Resources for changes to take effect on January 1, 2014.

REMINDER ~ NO ACTION IS REQUIRED: If you are currently enrolled in medical, cancer, or life and

disability and are not changing your coverage, you and your dependents coverage(s) will remain the same for 2014.


Medical - UMR • www.umr.com / 1-800-826-9781

Pharmacy Benefit Manager – CVS/Caremark• www.caremark.com / 1-800-334-8134

Dental - Assurant• www.assurant.com / 1-800-442-7742

Vision – AlwaysCare• www.alwayscarebenefits.com / 1-888-729-5433

Life, Long and Short Term Disability - The Hartford • www.groupbenefits.thehartford.com / 1-888-563-1124

Flexible Spending Account Plan - UMR• www.umr.com / 1-800-826-9781

MetLife Tax Sheltered Annuity • Julian Good, Financial Advisor - 504-224-2793

Websites

http://www.umr.com/

http://www.caremark.com/


http://www.alwayscarebenefits.com/

http://www.groupbenefits.thehartford.com/

http://www.umr.com/


Touro Infirmary will continue to provide a high quality level of

benefits to our employees at a cost that is

competitive among the local healthcare market.


QuestionsQuestions

Life Insurance & AD&D Exempt Employees

Senior Management

Hourly employees

Full-time employees only1.5 x annual earnings to a maximum of $300,000

3 x annual earnings

1 x annual earnings to a maximum of $50,000

Accelerated Benefits Up to 80% of life benefitSubject to maximum

Touro Paid Life Insurance through Hartford

Monthly Benefit Maximum Class I – Executives Class II – All Other Exempt

(one year eligibility period)

$15,000$ 7,000

Elimination Period 90 days

Benefit 60% of Monthly Earnings

Duration of Benefits SSNRA

Mental & Nervous Maximum 2 years

Alcohol & Drug Abuse Maximum 2 years

Pre-Existing Condition 3 months prior /12 months after

Survivor Benefit 3 months

Touro Paid LTD through Hartford – Exempt Employees

Life Insurance & AD&D Can be purchased in increments of $10,000 or 5

times your annual earnings to a maximum of $300,000. Guaranteed issue amount

$100,000Amounts in excess of $100,000

will require evidence of insurability.

Employee must purchase voluntary life in order to cover

spouse and/or dependents.

Hartford Voluntary Life Insurance and AD&D

Life Insurance and AD&D A spouse is eligible for an amount in increments of $5,000 or up to 50% of the employee’s voluntary amount . Guarantee issue amount $30,000. Amounts greater than

$30,000 requires EOI.

Dependent Children $10,000 for children age 6 months to 19 years or to 25 if full-time student. $250 for children

age 14 days to 6 months, newborn children to age 14 days

are not eligible for a benefit

Hartford Voluntary Dependent Life Insurance and AD&D

Age Rate/1000

<30 $0.066

30 - 34 $0.075

35 – 39 $0.093

40 – 44 $0.120

45 – 49 $0.193

50 – 54 $0.284

55 – 59 $0.420

60 – 64 $0.685

65 – 69 $1.160

70 – 74 $1.840

75 – 99 $4.070

AD&D * $0.040

Child(ren) $1.00/mo

• Life Insurance Example• Employee age 36• $100,000 Life Insurance• Rate per $1,000 = $0.093• $100,000 x $0.093=$9,300• $9,300 divided by $1,000= $9.30• $9.30 monthly premium

*AD&D rate of $0.040 is included with life rates.

How to Calculate the Monthly Life Insurance Premium

Benefit 66 2/3% to a maximum of $1,500 per week

Payable 15th Day Accident15th Day Sickness

Maximum 11 Weeks(must exhaust EI & ETO)

Hartford Voluntary Short Term Disability

• $30,000 Annual Earnings• Employee age 36• $30,000 divided by 52 =• $576.92 Weekly Earnings• $576.92 x .6666= $384.57• $384.57 x .407 = $156.52• $156.52 / 10 = $15.65• Weekly Benefit = $384.57• Monthly Premium = $15.65

How to Calculate the Monthly Short TermDisability Premium

Age

Rate per$10 ofBenefit

<30 $0.482

30 - 34 $0.448

35 – 39 $0.407

40 – 44 $0.366

45 – 49 $0.366

50 – 54 $0.399

55 – 59 $0.457

60 – 64 $0.548

65 + $0.615

OPTION 1 OPTION 2

Benefit 60% of earnings in increments of

$500 to a monthly maximum of

$5,000, minimum of $500

60% of earnings in increments of

$500 to a monthly maximum of

$5,000, minimum of $500

Waiting Period 90 days 90 days

Payable Up to 5 Years Up to SSNRA

Pre-Existing Condition : 3 months prior/12 months treatment free / 24 months after.

Hartford Voluntary Long Term Disability

• LTD Example (Option 2)• Employee age 36• $30,000 Annual Earnings• $2,500 Monthly Earnings• $2,500 x .774 = $1,935• $1,935 / 100 = $19.35• $2,500 x .60 = $1,500• Monthly Benefit = $1,500• Monthly Premium = $19.35

How to Calculate the Monthly Long Term Disability Premium

Option15 years

Option 2To 65

<30 $0.264 $0.378

30 - 34 $0.343 $0.528

35 – 39 $0.484 $0.774

40 – 44 $0.598 $1.082

45 – 49 $1.109 $1.954

50 – 54 $1.681 $2.614

55 – 59 $3.018 $3.626

60 – 64 $4.630 $5.570

65 – 69 $4.140 $1.954

70 – 74 $1.408 $1.267

75 + $1.522 $1.382

• Covers you and your family for internal cancer.• Includes 29 other illnesses.• Pays you a benefit of $2,000 for first occurrence

of internal cancer.• Daily benefit for hospitalization• Radiation, chemo and experimental treatments.• Wellness benefit of $50 per year/member• Rates - $15.70 single; $26.34 family per month.• New Hires are guaranteed issue – not required to

complete evidence of insurability

Allstate Voluntary Cancer Protection

QuestionsQuestions

Documents

By: Don Zimmerman Director, Human Resources Ana B. Graci, HIA Kara Buell Benefit Consultants Hub International 2014 OPEN ENROLLMENT