GOOD, SMART PEOPLE EFFECTIVELY MANAGING

THE ENTIRE HEALTH CARE DOLLAR.

EMPLOYEE MEETING APRIL 22, 2016 OPEN ENROLLMENT

January 1st, 2019

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TODAY’S PRESENTATION

OPEN ENROLLMENT

EBC / BENEFIT ENROLLMENT

DEPENDENT AUDIT

BENEFIT REVIEW

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5 OVERVIEW OF ALL PLANS – QUESTIONS & CLARIFICATIONS

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OPEN ENROLLMENT

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FRIDAY, OCTOBER 12TH – THURSDAY, OCTOBER 25TH

Benefits effective January 1, 2019 All employees must make new elections for the 2019 plan year

Make any changes you want to your benefits Waived previously & want to enroll for 2019 Don’t want to change anything? You must still complete open enrollment.

The only time benefit changes can be made outside of Open Enrollment is in the case of a QUALIFYING EVENT: (within 30 days from date of the event)

Marriage Birth Death Divorce Adoption/Custody Involuntary loss of coverage

Employees must actively engage in enrollment or benefits will be lost!

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OPEN ENROLLMENT – EASY & CONVENIENT

ENROLLMENT PARTNER: EBC – Enrollment Benefit Concepts

THREE ways to enroll (ONLY ONE IS REQUIRED):

APPOINTMENT CALL CENTER SELF-SERVE

Benefit Specialists Reserve your slot at:

www.ebcoh.com/enroll

(937) 401-3739

Monday-Thursday: 8:30 am to 6:00 pm Friday: 8:30 am to 5:00 pm

www.aflacatwork.com Log in using SS # and PIN

(last 4 digits of SSN and

last 2 digits of birth year)

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OPEN ENROLLMENT – HOW TO BE PREPARED

Date of Birth Social Security Number

IF YOU ARE ENROLLING SPOUSE AND/OR DEPENDENTS: Date of Birth for each dependent Social Security Number for each dependent

NOTE: Expect to spend about 30 minutes to enroll, no matter how you decide to enroll.

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DEPENDENT AUDIT – CONSOVA

Any employee adding a dependent to the medical / dental plan / and vision plan, at any time, will be audited. “Open Enrollment” does not secure coverage for your dependents. Following enrollment, you will receive a letter in the mail from Consova with instructions on how to complete the required audit.

Failure to respond to the audit will result in termination of coverage for dependents!

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2019 BENEFIT UPDATE

WHAT IS STAYING THE SAME?

Medical

Anthem

Dental Superior Dental

Care

Vision

Eyemed

Pharmacy Rx Benefits /

Express Scripts

Life/Vol Life/AD&D

Voya

Worksite Aflac / Trustmark

Wellness Incentive

Wellvibe

WHAT IS CHANGING?

Educator Voluntary Disability

SunLife

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WHAT IS STAYING THE SAME

9 MEDICAL PLAN HIGHLIGHTS – HDHP High Deductible Health Plan IN NETWORK OUT OF NETWORK

Annual Deductible – Non Embedded $1,500 Single $3,000 Family

$4,000 Single $8,000 Family

Co-Insurance (after deductible) 100% 70% / 30%

Maximum Out-of-Pocket (includes deductible, co-insurance & copays)

$3,500 Single $7,000 Family

$5,000 Single $10,000 Family

Lifetime Maximum Unlimited Unlimited

Preventive Care Covered in Full Deductible

Hospital / Inpatient & Outpatient Deductible Deductible

Professional Services Deductible Deductible

Primary Care Physician (after deductible) $20 PCP / $40 Specialist

Deductible

Emergency Room (after deductible) $150 $150

Urgent Care (after deductible) $50 Deductible

Prescription Drugs $10 / $30 / $50 Deductible

Mail Order $30 / $90 / $150 N/A

ALL OTHER MEDICAL BENEFITS ARE SUBJECT TO DEDUCTIBLE & CO-INSURANCE

CO-PAYS ONLY APPLY TO OUT-OF-POCKET MAXIMUM

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ANTHEM – BENEFITS OF REGISTERING ONLINE

Blue Access PPO Network – anthem.com

www.anthem.com

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ANTHEM – TALK TO A DOCTOR NOW LiveHealth Online

24/7 healthcare when you need it $49 or less per consultant $10 co-pay after deductible ePrescribing to your local pharmacy Integrated with Anthem’s claims

system

LiveHealth Online Psychology Online non-prescribing licensed psychologist or therapist when you need it $80 – Social Worker / Therapist $95 – Psychologist $10 co-pay after deductible Available 7am to 11pm 7 days a week Visits last up to 45 minutes Integrated with Anthem’s claims system

Types of Conditions Treated: • Cough • Cold • Flu • Allergies • Suspected Sinus Infection • Pinkeye • etc.

Covers ALL Dependents

www.livehealthonline.com Can also download the LiveHealth Online from the app store for your smartphones and iPads.

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PHARMACY – RX BENEFITS

PHARMACY BENEFIT MANAGER (PBM)

Express Scripts (ESI) You have access to the Members

Services Team 1-800-334-8134

Monday – Friday 7:00 am to 8:00 pm Is my drug covered? Is my Pharmacy in network? Are there lower cost alternatives? Can you assist me with my claim

questions?

MAIL ORDER

ESI HOME DELIVERY: 1-877-503-4073

Mail Order forms can be found at Express-Scripts.com New Prescriptions:

Can be mailed to ESI by using a mail order form

Physicians can phone in ESI Scripts

Physicians can e-scribe ESI Scripts

** NOTE: Mail Order can take up to two weeks for initial order, so members should make sure they have enough medication on hand to last until delivery.

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Health Management & Engagement

Wellvibe is a health engagement portal designed to

help administer your 2019 Wellness Program

Program is available to all employees enrolled in the medical / Rx plan

It is VERY easy for you to receive your incentive for 2019! Visit your physician for an annual physical

between January 1, 2019 and December 31, 2019, and Wellvibe will credit completion of your visit automatically.

You will receive a $75 gift card via the Wellvibe portal.

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OPTING OUT OF THE MEDICAL / RX PLAN

THE FOLLOWING OPTIONS ARE AVAILABLE IF YOU CHOOSE TO OPT OUT OF THE MEDICAL / RX PLAN:

1. $600 CASH (paid $150 per quarter) or

2. $600 deposited into a Healthcare Flexible Spending Account

IN ORDER TO RECEIVE OPT OUT FUNDS YOU AND ELIGIBLE DEPENDENTS / SPOUSE MUST BE COVERED UNDER OTHER GROUP HEALTH INSURANCE, MEDICARE, MEDICAID OR TRICARE.

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MEDICAL / RX PLAN CONTRIBUTIONS

NO CHANGE FROM 2018!!

Weekly Hours

Total Premium

Cost/Month

Employer Cost/Month

Employee Cost/Month

Employee Cost Per 20 pay period

Employee Cost Per 26 pay period

SINGLE

30+ 25-29 20-24 15-19 10-14

$740.44

$629.37 $614.57 $496.09 $370.22 $244.35

$111.07 $125.87 $244.35 $370.22 $496.09

$66.64 $75.52

$146.61 $222.31 $297.66

$51.26 $58.10

$112.77 $170.87 $228.97

FAMILY

30+ 25-29 20-24 15-19 10-14

$1,874.15

$1,593.03 $1,555.54 $1,255.68 $937.08 $618.47

$281.12 $318.61 $618.47 $937.08

$1,255.68

$168.67 $191.16 $371.08 $562.25 $753.41

$129.75 $147.05 $285.45 $432.50 $579.54

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HEALTH SAVINGS ACCOUNT

A health savings account or HSA is an individually-owned account used to save and pay for eligible medical expenses.

Who is eligible for an HSA?

Any individual:

Is NOT covered by any first dollar health coverage

Is NOT enrolled in

Medicare

Is NOT claimed as a dependent on someone else’s tax return

DPS employees can keep their HSA with Key Bank or elect to move their HSA to Wright Patt

Credit Union.

*Key Bank does have a $25 transfer fee

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HEALTH SAVINGS ACCOUNT

An HSA works with your HDHP

The HDHP covers illness or injury after your annual deductible is met, and certain preventive care services at no cost.

Funds in your HSA can pay for eligible medical expenses before AND after your annual insurance deductible is met.

Funds roll over year to year and earn interest tax free.

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HEALTH SAVINGS ACCOUNT

Eligible Medical Expenses Use your HSA to pay for a wide range of eligible medical expenses (as defined by the IRS) for yourself, your spouse or tax dependents.

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HEALTH SAVINGS ACCOUNT – FLEXBANK

Employees must open an account through FlexBank in order to receive funding into the HSA from Dayton Board. Applications to open an account, must be completed and submitted to FlexBank no later than 12/31/18 in order to receive funding from Dayton Board.

Contributions from Dayton Board into the HSA will be based upon enrollment status for actively working employees as of January 1, 2019.

Dayton Board Contributions will be allocated in January: $750 Single/$1,500 Family

Employee contributions can change on a monthly basis. Employees who are not eligible for an HSA can open an HRA (Health Reimbursement Account).

2019 HSA Contribution Limits: Single: $3,500 $50 Family: $7,000 $100 Catch up Contribution: $1,000 No change (age 55 or older)

Maximum contribution limits include Dayton Board Contributions

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FLEXIBLE SPENDING ACCOUNT – FLEXBANK Healthcare Flexible Spending Account (FSA): Not contributing to an HSA Tax Free. General Purpose FSA: Medical, Vision, Dental, and Hearing Expenses. Maximum election = $2650 Can withdraw entire annual election at anytime regardless of year to date deposits. Use it or lose it! Limited Purpose Flexible Spending Account: Can use if contributing to HSA Dental and vision expenses only Maximum election = $2650 Work-Related Dependent Care Reimbursement Maximum contribution $5,000 if married/filing jointly or single. $2,500 if married/filing separately. Can withdraw up to what has been deposited to date….more like a regular bank account… but tax-free.

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DENTAL PLAN HIGHLIGHTS – SUPERIOR DENTAL CARE

NO CHANGE TO PREMIUM RATES

IN NETWORK

OUT OF NETWORK

Preventive Services 100% 100%

Basic Services 80% 80%

Major Services 50% 50%

Contract Maximum (per member per contract period)

$1,500

DEDUCTIBLE (applies to Basic and Major services and follows the contract period)

$25 / $75

Copayment (applies to preventive exams)

N/A

Orthodontics 50% 50%

Ortho Lifetime Maximum $5,000

Network Access Open Access – same level of coverage in & out of network

23 VISION PLAN HIGHLIGHTS – EYEMED

NO CHANGE TO PREMIUM RATES

IN NETWORK OUT OF NETWORK REIMBURSEMENT UP TO:

EXAM (with dilation as necessary)

$10 Copay

$40

FRAMES (any available frame at provider location)

$0 Copay $150 allowance

20% off over $150

$105

CONTACT LENSES (allowance includes materials only)

Conventional Disposable Medically Necessary

$0 Copay | $150 allowance | 15% $0 Copay | $150 allowance | 15%

$0 Copay | paid in full

$120 $120 $210

STANDARD PLASTIC LENSES Single Vision Bifocal Trifocal Lenticular Standard Progressive Premium Progressive Tier 1 Premium Progressive Tier 2 Premium Progressive Tier 3 Premium Progressive Tier 4

$25 $25 $25 $25 $90

$110 $120 $135

$90 Copay | 20%off charge less $120 allowance

$30 $50 $70 $70 $50 $50 $50 $50 $50

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VOL ACCIDENT / CRITICAL ILLNESS & HOSPITAL INDEMNITY

AFLAC

SUPPLEMENTAL LIFE / AD&D

VOYA

UNIVERSAL LIFE WITH LTC

TRUSTMARK

OTHER PLANS OFFERED DURING OE

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WHAT IS CHANGING

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EDUCATOR VOLUNTARY DISABILITY - SUNLIFE

WHAT IS CHANGING SunLife is moving platforms | Assurant SunLife Financial SunLife Connect Rates are increasing SHORT TERM DISABILITY Rates are increasing 13.5% Premiums changing from $100 of monthly benefit to $10 of weekly benefit Example:

If your current STD election is $1,000 a month you will now be getting $250 weekly

LONG TERM DISABILITY Rates are increasing 10%

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LET’S REVIEW …

OPEN ENROLLMENT : OCTOBER 12TH – OCTOBER 25TH

EBC : MAKE APPOINTMENT IN PERSON / CALL / SELF SERVE ONLINE

DEPENDENT AUDIT

BENEFIT REVIEW

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5 QUESTIONS??

Take Action!!

Respond Quickly!