Health Related Benefits - Rosecrance Health Network · Part‐Time Employees – Benefits Eligibility With the onset of the Affordable Care Act (ACA), the number of individuals that

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Health‐Related BenefitsEffective January 1, 2018

Benefits Overview

Medical and Prescription Insurance Dental Insurance

Voluntary Vision Insurance Health Spending Accounts Voluntary Term Life Insurance

Group Life Insurance Group LTD and AD&D Insurance

Benefits OverviewRosecrance values our employees, as you are our greatest asset. This is why we feel it is important to provide the best possible benefit to you.

Thank you to our Board of Directors and Executive Team for approving our benefits for the upcoming plan year!

As healthcare costs continue to rise across all industries and businesses, including at Rosecrance, we look at ways to continue to provide this benefit as well as contain the rising costs of healthcare.

For the 2018 Plan Year, Rosecrance’s projected cost for healthcare is $5.2 million.

The Rosecrance Plan is a self‐funded plan that means Rosecrance pays dollar for dollar for claims expense under the health insurance.

Rosecrance has underwritten the cost of premiums along with expenses associated with care. Rosecrance contributes approximately 82% of the total healthcare costs for employees. Employees contribute approximately 18% of healthcare costs through premium contribution, deductibles and co‐insurance.

Full‐Time Employees –Benefits Eligibility

Full time employees who work 40 hours per week are eligible to participate in the health benefits the first of the month after two full months of employment. Rosecrance Champaign/Urbana employees receive years of service credit for time worked under Community Elements. These employees are eligible to enroll in the following benefits:

Health and Prescription Insurance Dental Insurance Voluntary Vision Insurance Flexible Spending Accounts and Health Savings Accounts Voluntary Life Insurance Group Term Life Insurance Long Term Disability Insurance Accidental Death and Dismemberment (AD&D) Insurance

Enrollment eligibility in the various plans for this selection of employees will be documented as “Full‐Time Employee Eligible” throughout this presentation. Complete information related to these benefits is included in this presentation.

Part‐Time Employees –Benefits Eligibility

With the onset of the Affordable Care Act (ACA), the number of individuals that may be eligible for health benefits has expanded. If you are a part‐time employee, you may qualify for benefits if you work a minimum average of 30 hours per week over a six (6) month look‐back. You will be eligible to be covered under the Rosecrance plan for at least the next six (6) months based on your average weekly hours worked. Eligibility to continue coverage is reviewed every six (6) months. The HR Department will be determining this eligibility, so please don’t worry about tracking it yourself! For individuals that qualify for coverage that work part‐time, you will be eligible to enroll in the following benefits:

Health and Prescription Insurance Dental Insurance Voluntary Vision Insurance Flexible Spending Accounts and Health Savings Accounts Voluntary Life Insurance

Enrollment eligibility in the various plans for this selection of employees will be documented as “Part‐Time Eligible for Health Benefits” throughout this presentation. Complete information related to these benefits is included in this presentation.

Action Needed for All Benefits Eligible Employees

• Rosecrance is using FormFire in conjunction with NFP Corporate Services (IL), Inc. to ensure you're getting the best possible medical coverage at the best price. With FormFire, you'll enter your information online one time rather than filling out multiple paper applications. Since your information is stored securely from year to year, next time, you'll only have to verify your information and make any updates. Your personal health information is held confidentially.

• Log in to www.formfire.com and use Rosecrance’s employer code to register: A22D240

• You will receive an email after the Welcome & Introduction Meetings reminding you about this information.

• You need to log in and complete the FormFire no later than December 20, 2017.

2018 Enrollment Procedure• Enrollment for the 2018 Plan Year will take place on the Ultimate

Workplace. Ultimate Workplace is available 24/7 from any computer with internet access.

• Please log in to the Ultimate Workplace with your username and password and follow this path:

Myself > Open Enrollment Select “Open Enrollment for 2018”

• You will then be prompted to select make new benefit elections for 2018. Please select and follow the prompts on the screen.

• Your elections are due no later than December 20, 2017.

Forgot your Ultimate Workplace Password? Email [email protected] for a password reset

Eligible Dependents

Eligible dependents are able to participate in the plan. Eligible dependents include: the employee’s spouse and children up to age 26.

IMPORTANT Process for all DependentsAll employees will need to supply substantiating documentation about any eligible dependent (spouse or child) they wish to have coverage for under the Rosecrance Plan. Documentation is to be submitted by the employee to the Human Resources Department no later than January 26, 2018.

The list of required documentation is on the next slide

Eligible DependentsRequired documentation for eligible dependents is as follows:

Spouses: Copy of marriage or civil union certificate as issued by a state or country

Children: Copy of birth certificate, adoption paperwork, or foster paperwork

Employees are responsible for securing these documents and submitting them to the Human Resources Department. If you do not already have a copy of these documents that you are able to provide, you will need to contact the Court Clerk of the county in which the marriage, civil union, birth, adoption or foster placement took place. If such required documents are not received by the Human Resources Department no later than January 26, 2018, your spouse or child will not be enrolled in coverage effective January 1, 2018 because we are unable to determine that the person is eligible for coverage under the Rosecrance Plan.

Working Spouses

Rosecrance Health Network feels very strongly that health insurance is a valuable employee benefit. We provide this benefit for our employees at a cost of several million dollars annually.

Rosecrance Health Network does not assume liability for claims of spouses who are eligible for coverage which is available from his/her employer.

If your spouse is eligible for health benefits from another employer, then that company should accept that responsibility for your spouse, just as Rosecrance Health Network accepts that responsibility for you.

Part‐Time Eligible for Health Benefits and Full‐Time Employee Eligible

A spouse is the term used to refer to any individuals who are lawfully

married or in a civil union under any state law.

Any covered spouses who have alternative coverage through their own employers are required to take their employer’s insurance. The Spouse Insurance Coverage Information Form must be completed ANNUALLY and turned back by any participant with a spouse being covered by the Plan. Documentation is to be submitted by the employee to the Human Resources Department no later than January 26, 2018. We have the spouse forms with us so please request a copy if you need this form.


Working Spouses

Wellness Program• Rosecrance has won the Interactive Health Healthiest Companies in America Award for the last

5 years ‐ 2012, 2013, 2014, 2015, and 2016.

• You may be eligible to receive a premium incentive on your medical insurance premium (SAVES YOU MONEY!!).

• For 2018 premiums, employees will need to complete the Health Risk Assessment from Blue Cross Blue Shield of Illinois in order to receive the lower premium on the medical insurance. You will receive the instructions for logging into the Blue Cross Blue Shield website in the beginning of January 2018. You will provide a copy of the confirmation page to [email protected].

• For 2019 premiums, Interactive Health, the Wellness vendor for Rosecrance, comes on‐site to do a 34‐panel blood draw and blood pressure check for all employees and covered spouses interested in being eligible to receive the premium incentive on the medical plan effective January 1, 2019. This screening will occur in the fall of 2018.

– In order to receive the premium incentive, both an employee and covered spouse in the medical insurance plan must participate in and be compliant with the Wellness Program.

– Details of the Wellness Program include:• The program is voluntary. Meaning you can choose to participate in the program or

not participate in the program.• For the first year, if you participate in the program you are eligible to receive the

premium incentive. If you do not participate in the program, you are not eligible to receive the premium incentive.


Wellness Program –On‐Site Wellness Screening

• For the first year, you are eligible to receive the premium incentive on the medical plan just for participating in the on‐site screening. Remember! In order to receive the premium incentive, both an employee and covered spouse in the medical insurance plan must participate in and be compliant with the Wellness Program.

• Subsequent years’ premiums will also be determined by the Wellness Program.Screening in the fall of the next year will once again take place. Employee and covered spouses must:

• “Improve” their health score or maintain a healthy range over exam from previous year.

• If scores do not improve or remain in the healthy range employees would pay a higher premium than persons within the well range.


Wellness Program –Services and Tools

• Online Health Management Tools:Members only medical web‐site; a medical database with information on symptoms, diseases, treatments, on‐line health consultations and more.

• Confidential Personal Health Report: Mailed to your home. Explaining your results, your goal, and what your results mean.

• Confidential Health Coaching Courses: Offered on a variety of topics including Smoke Free for Life, Better Nutrition, Managing Stress, Personalized Fitness, for example.

• Monthly Health Newsletters and Webinars: Free webinars are offered every month. Also, receive targeted emails based on individual results.

• Medical Outreach: Engage, Consult, Support, Encourage during3 – 6 – 9 month Outreach calls.

• Quick Check: Free mid‐year check to see how you are progressing with your numbers. Note a new goal is not assigned during the Quick Check.

Wellness Program –Score Goals

How is my IHI goal set for second year and beyond:• If this year’s score is ‐20 to zero, next year’s goal will be to remain in that same range.

• If this year’s score is between 1 and 25, then next year’s goal will be zero (or less)

• If this year’s score is above 25 points, then next year’s goal will be a 60% improvement

If you feel you may have a medical condition which may prevent you from reaching your goal, please call Interactive Health and they will provide you with a form that must be completed by your personal physician. Interactive Health will review your individual situation in detail. This process must be completed no later than the designated , communicated due date after the fall screenings take place. This is typically a date in early December.

Medical Insurance

Health Savings Account Plan

$850 Deductible Plan

Value Plan

2018 Summary of Benefits

Please refer to Summary of Benefits for 2018.• Medical Coverage (includes Prescription)

– $850 Deductible– Health Savings Account Plan– Value Plan

• Medical and Prescription coverage is bundled together. You pay one premium (which will be discussed later in the presentation) and receive these two benefits.

• Dental coverage is a separate plan that you need to elect and separate premium to pay.


$850 Deductible Medical Coverage

• Deductible: $850 per individual covered by the plan

• Out of Pocket Maximum: $3,850.

• The Out of Pocket Maximum does include the Deductible.

• For Family Coverage, the Deductible and Out of Pocket Maximum are limited to 3 times the individual amounts listed above.

• You must meet your deductible before the Co‐Insurance begins. For example, there are no co‐pays for office visits.

– In Network Co‐Insurance: 20% after the Deductible is met. (Rosecrance pays 80%)Out of Network Co‐Insurance: 50% after Deductible is met. (Rosecrance pays 50%)

• Preventative Care is covered 100% with no maximum benefit.

• $150 co‐pay for accessing the Emergency Room. Co‐pay is waived if patient is admitted


This information reflects annual individual, in-network services.

Health Savings AccountMedical Coverage

• Deductible: $1,500 per individual covered by the plan or $5,400 for family coverage.

• Out of Pocket Maximum: $5,000 for individual; $11,000 for family.

• The Out of Pocket Maximum does include the Deductible.

• An individual family member will only have to meet $2,700 of the $5,400 family deductible.

• You must meet your deductible before the Co‐Insurance begins. For example, there are no co‐pays for office visits.

– In Network Co‐Insurance: 20% after the Deductible is met. (Rosecrance pays 80%)Out of Network Co‐Insurance: 50% after Deductible is met. (Rosecrance pays 50%)


• $150 co‐pay for accessing the Emergency Room. Co‐pay is waived if patient is admitted.



Value PlanMedical Coverage

• Deductible: $2,500 per individual covered by the plan or $5,000 for family coverage.

• Medical Out of Pocket Maximum: $5,600 per individual or $10,200 per family.

• Pharmacy Out of Pocket Maximum: $2,000 per individual or $4,000 per family.

• For Family Coverage, an individual family member will only have to meet $2,500 of the $5,000 family deductible.

• This plan features co‐pays:

– $30 co‐pay for primary care office visit to treat an illness or injury

– $60 co‐pay for specialist visit (i.e. cardiology, dermatologist)

– 20% coinsurance for other practitioner office visit (i.e. chiropractic)


• $150 co‐pay for accessing the Emergency Room. Co‐pay is waived if patient is admitted.



‘Generics Plus’Pharmacy Coverage

• Prescription coverage on all Rosecrance medical plans ($850, High Deductible Health Plan, or Value Plan) has been updated to 'Generics Plus' through Blue Cross Blue Shield of Illinois. Refer to the SBC for complete information on the pharmacy coverage.

• ‘Generics Plus’ is a 5‐tiered pharmacy structure. All medications fall into one of 5 categories as determined by BCBS and medication costs are determined by which tier the medication belongs to.

• Using generic drugs, when right for you, can help save you money. Always ask your doctor or pharmacist if there is a generic or lower cost option for the medication you are taking.



• Prescriptions can be filled at your pharmacy of choice.

• BCBS of IL has a mail order pharmacy option available. This option allows you to receive a 90 day supply of your maintenance medication delivered to your home directly from the mail order pharmacy. Please contact BCBS for more information about this convenient option.

‐Note that this option should be used for maintenance medications only. Urgently needed medications should be filled at a retail pharmacy.



Here are the 5 tiers of the ‘Generics Plus’ Pharmacy coverage and associated costs:

$850 Deductible and Value Plan

Tier 1 Preferred Generic Drugs = $5 co‐pay for 1 month supply Tier 2 Non‐Preferred Generic Drugs = $10 co‐pay for 1 month supply Tier 3 Preferred Brand‐Name Drugs = 20% co‐insurance after member meets the deductible Tier 4 Non‐Preferred Brand‐Name Drugs = 30% co‐insurance after member meets the deductible Tier 5 Specialty Drugs = 20% co‐insurance after member meets the deductible

Health Savings Account Plan

Tier 1 Preferred Generic Drugs = 20% co‐insurance after member meets the deductible Tier 2 Non‐Preferred Generic Drugs = 20% co‐insurance after member meets the deductible Tier 3 Preferred Brand‐Name Drugs = 20% co‐insurance after member meets the deductible Tier 4 Non‐Preferred Brand‐Name Drugs = 30% co‐insurance after member meets the deductible Tier 5 Specialty Drugs = 20% co‐insurance after member meets the deductible


Where can you find out more information about the tiers?

• To find out which medication falls in to what tier, you should visit bcbsil.com and log into Blue Access for Members or call the customer service number on the back of your BCBS ID card to review the most up to date ‘Generics Plus’ formulary list.

• Please understand that formularies are regularly updated as generic drugs become available and with changes in the pharmaceuticals market so make sure you are using the most up to date formulary listing.

• Your physician will have access to the same formulary list through the Provider Portal at bcbsil.com


Premium Structure• The Premium Structure effective January 1, 2018 includes Medical and

Prescription coverage.

• For those employees who formally waive their coverage in the Medical Plan, an opt out bonus of $40.00 per pay period is paid to the employee. Please note this is taxable income and appear on your payroll check.

• Costs are listed on a per pay period basis and are determined by the following:

1. Wellness Program Participation (premium incentive) Salary range less than $45,000 annually Salary range greater than $45,000 annually

2. No Wellness Program Participation (full premium) – remember that both an employee and covered spouse must participate in and be compliant with the Wellness Program to be eligible to receive the premium incentive.


2018 Employee Premiums Costs Per Pay Check $850 Deductible

Premium structure includes Medical and Rx coverage.

Part-Time Eligible for Health Benefits and Full-Time Employee Eligible

2018 Employee Premiums Costs Per Pay Check Health Savings Account Plan



2018 Employee Premiums Costs Per Pay Check Value Plan



Dental Insurance• Dental Benefit is through Blue Cross Blue Shield of Illinois.• We have a Preferred Network for Dental Providers, you may

check online for In‐Network Providers.• Eligible Preventative Care is covered at 100% two times per year. • Please refer to the Summary of Benefits for complete Dental

Coverage details.

• Premiums:Rates (per pay period – 26 times per year)EE: $2.70EE+Child(ren): $7.52EE+Spouse $10.44Family: $14.01


Vision Insurance• Benefit offered through Eye Med.• Contact Eye Med for a complete list of providers in your area. We

participate in the SELECT network.• Plan allows for eye exam and replacement lenses every 12 months

and new frames every 24 months.• Discount on Lasik procedure.• Please see Handout for specific coverage information.

• Premiums:Rates (per pay period – 26 times per year)

EE: $2.28 EE+Child(ren): $4.56 EE+Spouse: $4.32 Family: $6.69


Flexible Spending Account (FSA)

A portion of your pay is set aside in a Flexible Spending AccountBEFORE taxes are calculated and withheld. Use this money to reimburse yourself for

out‐of‐pocket medical and/or dependent daycare expenses.

Very Convenient! Use the WageWorks Debit Card to pay for eligible expenses. WageWorks also has very cool a mobile application to review your account and upload

receipts!

A key to saving money…

Annual MaximumsNon‐Reimbursed Medical

Up to $2,600 a calendar yearDependent Daycare

Up to $5,000 a calendar yearMarried, filing a separate return: $2,500 maximum


Calculating your FSA ContributionDo your homework!

Deductible

Co-Insurance responsibility

Vision Expenses – including glasses or contact lenses

Dental Expenses

Over-The-Counter MedicationsNote: Per the IRS, Over-The-Counter Medications require a prescription for

reimbursement under the FSA.


2018 FSA• The Rosecrance FSA is offered through Wage Works.• WageWorks has a debit card feature. You can use the debit card to pay

for eligible expenses at the time of purchase. There is no need to pay out of pocket then submit for reimbursement. Manual submission of expenses is still allowed, for example, if you forget your debit card at the time of purchase.

• Grace Period– You may still incur expenses for your 2018 Medical FSA account through March 15,

2019. – You may file claims for 2018 Medical Flexible Spending pledges through March 31,

2019.


Health Savings Account (HSA)Participating in the Health Savings Account Plan allows you to participate in a

Health Savings Account (HSA).

• Rosecrance will fund $500 annualized into Health Savings Account for those employees participating in the Health Savings Account Plan only.

• Triple tax savings—money goes into account tax preferred, accumulates tax free and disbursements used for qualified medical expenses are tax free. Any unused balance rolls over year‐to‐year.

• The HSA is an Interest Bearing Account. A good way to save for future health care expenses with tax deferred money.

• Maximum that can be deposited into the account in 2018 is $3,450 for single coverage or $6,750 for a family coverage.

• Participants over the age of 55 can contribute an additional $1,000 to an HSA Account (spouses would need to set up a separate account).

• Consult with your tax advisor prior to beginning an HSA.

• If you would like to learn more about HSA, please contact the Human Resources Department for educational materials.


Group Life Insurance• Rosecrance provides eligible full time employees with Group Life Insurance.

There is no cost to the employee for this benefit.

• Benefit: One times annual base salary rounded to the higher $1,000.

• If you would like to change your beneficiary, please complete the Sun Life Beneficiary Form to indicate who you would like your beneficiary(ies) to be for the Group Life Insurance.

• For those earning $50,000 or more annually, this is a taxable benefit. Please contact the Human Resources Department for more information.

Full-Time Employee Eligible

Voluntary Term Life Insurance

• Rosecrance provides eligible full‐time and part‐time employees with the ability to purchase Voluntary Term Life Insurance at the employee’s expense. This coverage is able to be purchased for employee, spouse and children.

• The rates for coverage are dependent on age and benefit amount desired. The rates are listed on a by pay period basis (26 times per year).

• Refer to the SunLife Voluntary Life Insurance Packet.


Long Term Disability and AD&D

• Rosecrance provides eligible full time employees with Long Term Disability and Accidental Death and Dismemberment Insurance (AD&D).

• There is no cost to the employee for these benefits.

Long‐Term Disability benefit: If disabled for more than 90 days and meet eligibility requirements, benefit pays 60% of monthly pay.

AD&D Insurance benefit: Provides coverage for loss of hands, feet, eyes or life due to an accident.

Full-Time Employee Eligible

Next StepsLog into Ultimate Workplace to make your elections for Open Enrollment. Ultimate Workplace is available 24/7 from any computer with internet access.

Myself > Open Enrollment Select “Open Enrollment for 2018”

You will then be prompted to select make new benefit elections for 2018. Please select and follow the prompts on the screen.

All eligible employees must complete the Open Enrollment process through the Ultimate Workplace no later than 5:00 PM on Wednesday December 20, 2017.

Contact us at [email protected] or call us at 815‐387‐5658 if you have any questions.

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Question and Answer

Questions after today? We want to hear from you!

Email: [email protected]

Telephone: (815) 387‐5658

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Thank you for your time!

Welcome to Rosecrance!

Documents

Health Related Benefits - Rosecrance Health Network · Part‐Time Employees – Benefits Eligibility With the onset of the Affordable Care Act (ACA), the number of individuals that