HUMAN RESOURCES. This presentation is a summary of information and does not purport to present the complete details of all of the plan options offered

HUMAN RESOURCESHUMAN RESOURCES

This presentation is a summary of information and does not purport to present the complete details of all of the plan options offered by the Office of Group Benefits. For complete information on each plan option individuals should read the plan documents carefully and also consult other Office of Group Benefits and plan administrators’ publications.

Making the Right Choice….

Making the Right Choice….

Presentation Will Cover…Presentation Will Cover…

EligibilityEligibility

Plan OverviewPlan Overview

Life InsuranceLife Insurance

Invoicing Invoicing

Flexible BenefitsFlexible Benefits

Eligibility...Eligibility...

•Eligibility same for all Eligibility same for all plansplans

•Participation schedule Participation schedule not affected when not affected when changing planschanging plans


Dependents of Full Time Dependents of Full Time Active EmployeesActive Employees

•Legal SpouseLegal Spouse

•Never married children under 21 that Never married children under 21 that you supportyou support

•Never married children up to 24 that Never married children up to 24 that are full time students (proof of are full time students (proof of full time status required within 30 full time status required within 30 days of each semester start)days of each semester start)


Children include…Children include…•Legally adopted childrenLegally adopted children

•Children placed in home for adoption Children placed in home for adoption (claimed on taxes)(claimed on taxes)

•Children in home under your legal Children in home under your legal guardianship (claimed on taxes)guardianship (claimed on taxes)

•Grandchildren dependent on you, parent Grandchildren dependent on you, parent is your covered dependentis your covered dependent


Over-Age DependentsOver-Age Dependents

• Incapable of self-sustaining Incapable of self-sustaining employment prior to age 21employment prior to age 21

• Covered dependent prior to age 21Covered dependent prior to age 21

• Program must be notified prior to Program must be notified prior to dependent’s 21dependent’s 21stst birthday birthday

Pre-Existing ConditionsNew Hires or Re-Hires

Pre-Existing ConditionsNew Hires or Re-Hires

• If diagnosed or treated within 6 months prior to If diagnosed or treated within 6 months prior to enrollment date enrollment date

• Then that condition is pre-existing and no benefits Then that condition is pre-existing and no benefits payable for that condition in first 12 months of payable for that condition in first 12 months of coveragecoverage

• Must complete enrollment form within 30 days for a new Must complete enrollment form within 30 days for a new dependent otherwise pre-existing condition appliesdependent otherwise pre-existing condition applies

• May be exempt from PEC if continuously covered within May be exempt from PEC if continuously covered within 63 days of enrollment date 63 days of enrollment date


RetireesRetirees

• Coverage must be in effect prior to Coverage must be in effect prior to retirement dateretirement date

• Participation schedule applies to …Participation schedule applies to …Employees who joined program on or Employees who joined program on or after 1/1/02after 1/1/02

Dependents who joined program on or Dependents who joined program on or after 7/1/02after 7/1/02

Eligibility…Eligibility…

Timely ProcessingRetirement DocumentsTimely Processing

Retirement Documents

• When an employee retires the When an employee retires the agency must do one of the agency must do one of the following:following:Enter the termination information Enter the termination information in ISIS; ORin ISIS; OR

Enter the termination information Enter the termination information in e-Enrollment, AND…in e-Enrollment, AND…

TO AVOID A BREAK IN THE EMPLOYEE’S TO AVOID A BREAK IN THE EMPLOYEE’S HEALTH/DRUG COVERAGE:HEALTH/DRUG COVERAGE:

A GB-01 MUST be completed and A GB-01 MUST be completed and immediately forwarded to OGBimmediately forwarded to OGB

Special Enrollments – HIPAA

Employees or Dependents


Employees or Dependents• Loss of eligibility through Loss of eligibility through separation, divorce, termination separation, divorce, termination of employment, reduction in hours, of employment, reduction in hours, or death of the Participant or death of the Participant EmployeeEmployee

• Cessation of Participant Employer Cessation of Participant Employer contributions, unless the contributions, unless the contributions ceased for cause or contributions ceased for cause or for failure of the Employee to for failure of the Employee to make contributionsmake contributions


Employees or Dependents


Employees or DependentsAcquired DependentsAcquired Dependents

• Special enrollment will be permitted Special enrollment will be permitted for Employees or Dependents when the for Employees or Dependents when the Employee acquires a new Dependent by Employee acquires a new Dependent by marriage, birth, adoption, or placement marriage, birth, adoption, or placement for adoption for adoption

• A special enrollment application must A special enrollment application must be made within 30 days of either the be made within 30 days of either the termination of the prior coverage or termination of the prior coverage or the date the new Dependent is acquired. the date the new Dependent is acquired.

Security…e-EnrollmentSecurity…e-Enrollment

• February 1, 2007, began the first February 1, 2007, began the first year of tightened security for use of year of tightened security for use of e-Enrollmente-Enrollment

• This new policy was implemented as a This new policy was implemented as a result of inappropriate use of IDs result of inappropriate use of IDs and passwords and passwords Sub-users using Master Users’ ID to Sub-users using Master Users’ ID to access e-Enrollmentaccess e-Enrollment

Master Users not being timely updatedMaster Users not being timely updatedSub-users inadequately trained (OGB Sub-users inadequately trained (OGB offers training classes each month and offers training classes each month and one-on-one training is available upon one-on-one training is available upon request)request)

Changes in 2007-2008Changes in 2007-2008

Changes in 2007-2008Changes in 2007-2008

TOP 5…All PlansTOP 5…All Plans

1.1. Total health care lifetime maximum of $5.0 Total health care lifetime maximum of $5.0 million per person including prescription million per person including prescription drugs drugs

2.2. All plans have the same prescription drug All plans have the same prescription drug benefit program through Catalyst Rxbenefit program through Catalyst Rx

3.3. All plans have the same mental All plans have the same mental health/substance abuse program offered by health/substance abuse program offered by United Behavioral HealthUnited Behavioral Health

4.4. Premiums have changed for all plansPremiums have changed for all plans

5.5. Directory of providers replaced by web site Directory of providers replaced by web site listing... listing...

www.groupbenefits.orgwww.groupbenefits.org

“ “2007 Annual Enrollment 2007 Annual Enrollment Information”Information”

Making the Right Choice of Plans…

Making the Right Choice of Plans…

Providers?Providers?

• Is my doctor/doctors in the Is my doctor/doctors in the plan?plan?

• Is my preferred hospital in the Is my preferred hospital in the plan?plan?

• Check Website for most current Check Website for most current informationinformation

Restrictions?Restrictions?

• Out of State vs. In StateOut of State vs. In State

• Cost of going Out of NetworkCost of going Out of Network

• Members in primary Medicare A Members in primary Medicare A and B can go out of network and B can go out of network in all plans except in Humana in all plans except in Humana HMO.HMO.

Costs?Costs?

Take Action…Control Premium Costs

Take Action…Control Premium Costs

• Married couplesMarried couplesIf both are state or school employeesIf both are state or school employeesIf both are eligible for coverageIf both are eligible for coverageMay save money by splitting coverageMay save money by splitting coverage

• RetireesRetireesIf plan to retire after 7/1/07If plan to retire after 7/1/07Check retiree premiums on plansCheck retiree premiums on plansSome plans have higher member costs for Some plans have higher member costs for retirees retirees

Take Action Control Out of Pocket Costs…

Take Action Control Out of Pocket Costs…

• Is the procedure covered by my plan?Is the procedure covered by my plan?

• Is the doctor, lab and anesthesiologist in the Is the doctor, lab and anesthesiologist in the network?network?

• Is a referral to a specialist or pre-cert Is a referral to a specialist or pre-cert required?required?

• Is there a deductible requirement?Is there a deductible requirement?

• Is there a co-pay or % of eligible charges Is there a co-pay or % of eligible charges payment?payment?

• Is this procedure meeting requirements in the plan Is this procedure meeting requirements in the plan document?document?

Six Critical Questions…Pre-ProcedureSix Critical Questions…Pre-Procedure

Take Action… Control Drug and Hospital Costs

Take Action… Control Drug and Hospital Costs

Save Costs …Use Generic Save Costs …Use Generic

Sources of InformationSources of Information

Sources of InformationSources of Information

• OGB – 1-800-272-8451OGB – 1-800-272-8451

• Catalyst - 1-866-358-9530Catalyst - 1-866-358-9530

• Humana - 1-888-393-6765Humana - 1-888-393-6765

• Humana Medicare Advantage Plans - 1-866-396-8810Humana Medicare Advantage Plans - 1-866-396-8810

• United Behavioral Health United Behavioral Health - 1-866-492-7143- 1-866-492-7143

• United (current members) - 1-866-336-9374 United (current members) - 1-866-336-9374

• United (prospective members) - 1-866-336-9374 United (prospective members) - 1-866-336-9374 Option 1Option 1

• ASI (TRICARE Supp'l) - 1-800-638-2610 ext 255ASI (TRICARE Supp'l) - 1-800-638-2610 ext 255

OGB Funding ….Money In…Money Out System

OGB Funding ….Money In…Money Out System

OGB Keeps Administrative Costs Low

OGB Keeps Administrative Costs Low

Administrative Administrative costs are 3% costs are 3% of total costsof total costs

Factors in Increasing Premiums

Factors in Increasing Premiums

PLAN OVERVIEWPLAN OVERVIEWPLAN OVERVIEWPLAN OVERVIEW

Key PointsKey Points

• Active and retirees who are not changing Active and retirees who are not changing plans do not have to file an plans do not have to file an enrollment/Scantron formenrollment/Scantron form

• Active employees who are changing plans Active employees who are changing plans should follow e-Enrollment procedure should follow e-Enrollment procedure with the HR department at their agencywith the HR department at their agency

• Retired employees who are changing plans Retired employees who are changing plans should fill out a Scantron form and should fill out a Scantron form and mail it to the OGB address on the formmail it to the OGB address on the form

• FARA (MCO) and Vantage (HMO) plan FARA (MCO) and Vantage (HMO) plan members must select a new plan or they members must select a new plan or they will be placed in the PPO planwill be placed in the PPO plan

Key PointsKey Points

• Can only make the decision once a yearCan only make the decision once a year

• Must consider any possible changes Must consider any possible changes through the yearthrough the yearChild going to college out of stateChild going to college out of statePossible job transfer out of statePossible job transfer out of stateTravel a lot out of stateTravel a lot out of stateUse of medical specialistsUse of medical specialists

• Balance costs, benefits and Balance costs, benefits and restrictionsrestrictions

Plan Overview…Member Out of Pocket Expenses






Plan Overview…Prescription Drug Benefit for All Plans Plan Overview…Prescription Drug Benefit for All Plans

Medicare D…Why Decline? Medicare D…Why Decline?

• OGB plans offer more than OGB plans offer more than standard Medicare planstandard Medicare plan

• Prescription drug coverage is Prescription drug coverage is part of your OGB planpart of your OGB plan

• OGB will continue health and OGB will continue health and prescription coverage for prescription coverage for retireesretirees

Plan Overview…All PlansMental Health and Substance Abuse

CoverageMember Out of Pocket Expenses

Plan Overview…All PlansMental Health and Substance Abuse

CoverageMember Out of Pocket Expenses

More Choices for Active and Retired Employees


TRICARE Supplement Plan by ASITRICARE Supplement Plan by ASI• Voluntary health benefit option Voluntary health benefit option

• Available to active and retired Available to active and retired OGB plan members and their OGB plan members and their dependents who are eligible for dependents who are eligible for TRICARE—the military’s health TRICARE—the military’s health benefit programbenefit program

• Plan members voluntarily elect to Plan members voluntarily elect to transfer from PPO, EPO and HMOtransfer from PPO, EPO and HMO



More information onTRICARE Supplemental Plan

onOGB website

www.groupbenefits.org

More information onTRICARE Supplemental Plan

onOGB website

www.groupbenefits.org

More Choices for Retirees on Medicare


• Medicare Advantage Private Fee Medicare Advantage Private Fee for Servicefor Service– Nationwide Nationwide

• Medicare Advantage HMOMedicare Advantage HMO– Offered in Baton Rouge, New Offered in Baton Rouge, New Orleans and ShreveportOrleans and Shreveport

• Must complete Medicare Must complete Medicare Advantage application AND OGB Advantage application AND OGB formform



Medicare Advantage Private Fee for Medicare Advantage Private Fee for ServiceService

• Offered by Humana, available nationwideOffered by Humana, available nationwide

• Significant savings on premiums/co-paysSignificant savings on premiums/co-pays

• Retiree and spouse must be in Retiree and spouse must be in Medicare A and B Medicare A and B

• Can see any doctor, hospital or provider Can see any doctor, hospital or provider that accepts Medicare and the plan payment that accepts Medicare and the plan payment termsterms



Medicare Advantage HMOMedicare Advantage HMO

• Offered by HumanaOffered by Humana

• Significant savings on premiums/co-paysSignificant savings on premiums/co-pays

• Available in Baton Rouge, New Orleans and Available in Baton Rouge, New Orleans and ShreveportShreveport

• Retiree and spouse must be enrolled in Retiree and spouse must be enrolled in Medicare A and BMedicare A and B

• MUST utilize Humana Medicare HMO Network MUST utilize Humana Medicare HMO Network ProvidersProviders

Life InsuranceLife InsuranceLife InsuranceLife Insurance

Life InsuranceLife Insurance

Life Insurance Plan will be OfferedLife Insurance Plan will be Offered

Vendor Selection is in ProcessVendor Selection is in Process

QuestionsQuestions

Flexible Benefits Flexible Benefits 2007-082007-08

Flexible Benefits Flexible Benefits 2007-082007-08

Why are Flexible Benefit Plans Important?

Why are Flexible Benefit Plans Important?

Reduce Taxes and Increase Spendable Income

Reduce Taxes and Increase Spendable Income

Current SalaryCurrent Salary- Flexible Benefit - Flexible Benefit Deduction (s)Deduction (s)= Taxable Salary Amount= Taxable Salary Amount

What are Flex Plan Options?

What are Flex Plan Options?

Premium ConversionPremium Conversion

Premium Conversion… Enrolling is easy

Premium Conversion… Enrolling is easy

• Give “Flexible Benefits Premium Give “Flexible Benefits Premium Conversion Enrollment” form to Conversion Enrollment” form to your agency Human your agency Human Resources/Payroll DepartmentResources/Payroll Department

• HR/Payroll personnel process HR/Payroll personnel process your enrollment formyour enrollment form

Dependent Care FSADependent Care FSA

Health Care FSAHealth Care FSA

Health Care FSAHealth Care FSA

• May set aside a minimum of $600 up to May set aside a minimum of $600 up to $5,000 for eligible out of pocket $5,000 for eligible out of pocket medical, dental, and vision care medical, dental, and vision care expensesexpenses

• The full amount of the account is The full amount of the account is available from the first day of the plan available from the first day of the plan year starting in Julyyear starting in July

• Your money is deducted evenly per pay Your money is deducted evenly per pay period over the full 12 monthsperiod over the full 12 months

Health Care FSA…Enrollment Rules

Health Care FSA…Enrollment Rules

• Must be a full-time active employee in Must be a full-time active employee in one of the participating payroll one of the participating payroll systemssystems

• Must be continuously employed by a Must be continuously employed by a participating payroll system at least participating payroll system at least twelve consecutive months from July 1, twelve consecutive months from July 1, 2006 to June 30, 2007 2006 to June 30, 2007

• Can only enroll during annual Can only enroll during annual enrollmentenrollment

• Transfer employees – check with your Transfer employees – check with your HR DepartmentHR Department

Health Care FSA…Enrollment Rules for Transfer

Employees

Health Care FSA…Enrollment Rules for Transfer

Employees

• Must have at least one year of Must have at least one year of public employmentpublic employment

• Were enrolled in a HCFSA with Were enrolled in a HCFSA with immediate former employerimmediate former employer

• Have 30 days within hire date Have 30 days within hire date to enrollto enroll

Health Care FSA…Health Care FSA…

Find out if your agency is Find out if your agency is participating…participating…

• OGB websiteOGB website

• Agency HR departmentAgency HR department

• ““Helpful Information” BookHelpful Information” Book

• Flexible Benefits Summary GuideFlexible Benefits Summary Guide

Easy… Debit CardEasy… Debit Card

Can be used…Can be used…• For Health Care and Dependent For Health Care and Dependent Care eligible expensesCare eligible expenses

• At providers who accept Master At providers who accept Master CardCard

• Full amount of health care funds Full amount of health care funds available immediately—“interest available immediately—“interest free loan”free loan”

• Dependent care funds available on Dependent care funds available on day of depositday of deposit

Easy…Debit CardEasy…Debit Card

• Fax receipts within two weeks upon Fax receipts within two weeks upon requestrequest

• Don’t need receipts for doctors’ Don’t need receipts for doctors’ offices and hospitalsoffices and hospitals

• Don’t need receipts for eligible Don’t need receipts for eligible medical expenses at…medical expenses at…

Walgreen'sWalgreen's Wal-MartWal-Mart MyDrugstore.com MyDrugstore.com List is expandingList is expanding

Facts to RememberFacts to Remember

• No fee for Premium Conversion optionNo fee for Premium Conversion option

• Minimum administrative fee charged per month Minimum administrative fee charged per month for Dependent and Health Care FSAs-covers for Dependent and Health Care FSAs-covers employee, spouse and dependentsemployee, spouse and dependents

• Locked in for 12 months, except for an IRS Locked in for 12 months, except for an IRS Qualifying EventQualifying Event

• Do not enroll if retiring or terminating in plan Do not enroll if retiring or terminating in plan yearyear

• Claim reimbursement available 90 days after Claim reimbursement available 90 days after June 30June 30thth

New in 2007-08New in 2007-08

““Use it or Lose Use it or Lose it”it”

• Money left over in account at the Money left over in account at the end of plan year will be lostend of plan year will be lost

• Grace Period...July 1, 2008-Grace Period...July 1, 2008-September 15, 2008 September 15, 2008 Money remaining in your July 1, 2007-Money remaining in your July 1, 2007-June 30, 2008 accountJune 30, 2008 account

May be spent in this grace periodMay be spent in this grace period• Roll Off Period...Roll Off Period...

September 16, 2008 to October, 30 2008 September 16, 2008 to October, 30 2008 submit claims formssubmit claims forms

Flexible Plan OptionsEnrollment Period

Flexible Plan OptionsEnrollment Period

April 1, 2007 to May 18, 2007April 1, 2007 to May 18, 2007

Where to Send Completed Flexible Spending Account Enrollment FormsWhere to Send Completed Flexible Spending Account Enrollment Forms

• Employees turn in their “Flexible Employees turn in their “Flexible Spending Account Enrollment” form to Spending Account Enrollment” form to their their human resources/payroll human resources/payroll department.department.

• Their human resource/payroll department Their human resource/payroll department faxes the faxes the completed formcompleted form to the Flexible to the Flexible Benefit ProviderBenefit Provider

• Payroll Systems will not have to fax Payroll Systems will not have to fax their Annual Enrollment FSA Enrollment their Annual Enrollment FSA Enrollment forms!forms!

Where to Send Request for Change to Flex Plan Elections

Form

Where to Send Request for Change to Flex Plan Elections

Form

• Employees are to turn in their “Request for Change to Flex Employees are to turn in their “Request for Change to Flex Plan Elections” form plus supporting documentation of the Plan Elections” form plus supporting documentation of the qualified event to their qualified event to their human resources/payroll department.human resources/payroll department.

• Human resources/payroll department can process requested Human resources/payroll department can process requested changes changes when they receivewhen they receive the form and supporting documentation the form and supporting documentation of the qualified event.of the qualified event.

• A copy of the form and supporting documentation is sent:A copy of the form and supporting documentation is sent:

ATTN: Flex Plan AdministrationATTN: Flex Plan Administration Office of Group BenefitsOffice of Group Benefits

PO BOX 44036PO BOX 44036Baton Rouge LA 70804Baton Rouge LA 70804

Where Do You Go for Answers?

Where Do You Go for Answers?

Ray Harrison, CFCIPhone: 225.925.3739E mail: [email protected]: 225.925.4860

Ray Harrison, CFCIPhone: 225.925.3739E mail: [email protected]: 225.925.4860

Lynette DelochPhone: 225.925.4686

E mail: [email protected]

Fax: 225.925.4860

Lynette DelochPhone: 225.925.4686

E mail: [email protected]

Fax: 225.925.4860

QuestionsQuestions