OPEN ENROLLMENT 2014STATE HEALTH CHANGES

2014 Health Insurance

HRA Plans Blue Cross Blue Shield

Wellness Incentive

HRA Plans Three plan selections, all very similar Each plan designed with the HRA credit

dollars HRA credits reduce the deductible Unused HRA credits carry over into the

next plan year-By March 2014 Preventative care paid at 100% and does

not reduce the credit dollars Provides both in-network and out-of-

network benefits Must meet the deductible before the co-

insurance will begin to pay

Blue Cross Blue Shield

• Only one carrier this year• United Health and Cigna no longer the

insurance provider

Wellness Incentive 2013 Wellness-For completing the wellness

pledge in 2013, members will add $240 credit dollars and spouses will add $240 credit dollars

2014 Wellness Incentive-For completing the wellness in 2014, members can earn up to $480 credit dollars and spouses can earn up to $480 credit dollars to add during 2014

No lower premiums this year, only the incentive of the credit dollars

2014 Wellness Incentive

TAKE ACTION

What you will EarnWhat Needs to be done

Complete BOTH and earn $240 in HRA fund

Contributions (The Well-Being Assessment MUST be completed PRIOR to the HRA

fund distribution

Earn up to $240 in HRA fund Contributions (The Well-

Being MUST be completed PRIOR to the HRA fund

distrubtion)

Its your choice! Complete the coaching or online pathway or a combination of both.

Create your Well-Being PlanActively engage in telephonic coaching

Create your Well-Being Pan Record 5 Online well- being activies using the same tracker in a month and earn $40 HRA funds. You can earn this for up to 6 months. Sample activies: track exercise five times, record daily steps five times, track your food five times.

Coaching Pathway

Online Pathway

Complete your Healthways Well-Being Assessment, a confidential, online questionnarie that takes about 20 minutes

Assess Your Health

Know Your NumbersComplete a biometetric screening and submit results (body mass index, blood pressure, cholesterol, glucose) The biometric screening must be completed by your physcian and the form submitted to SHBP.

Plan DesignNetwork Provider Out-of-Network Network Provider Out-of-Network Network Provider Out-of-Network

You $1,500.00 $3,000.00 $2,000.00 $4,000.00 $2,500.00 $5,000.00You + Child or Spouse $2,250.00 $4,500.00 $3,000.00 $6,000.00 $3,750.00 $7,500.00You + Family $3,000.00 $6,000.00 $4,000.00 $8,000.00 $5,000.00 $10,000.00

Plan Pays 85% 60% 80% 60% 75% 60%Preventive Care or Wellness Visits 100% Not Covered 100% Not Covered 100% Not Covered

You $4,000.00 $8,000.00 $5,000.00 $10,000.00 $6,000.00 $12,000.00You + Child or Spouse $6,000.00 $12,000.00 $7,500.00 $15,000.00 $9,000.00 $18,000.00You + Family $8,000.00 $16,000.00 $10,000.00 $20,000.00 $12,000.00 $24,000.00

You You + Child or SpouseYou + Family

Tier 1Tier 2Tier 3

Deductible*

15%, Min $20, Max $5025%, Min $50, Max $8025%, Min $80, Max $125

Pharmacy Benefits

Base HRA Contribution

Out of Pocket Limits

15%, Min $20, Max $5025%, Min $50, Max $8025%, Min $80, Max $125

$200.00$300.00$400.00

15%, Min $20, Max $5025%, Min $50, Max $80

25%, Min $80, Max $125

GOLD PLAN SILVER PLAN BRONZE PLAN

$400.00$600.00$800.00

$100.00$150.00$200.00

Medical Benefits

Pricing

Employee OnlyEmployee +

SpouseEmployee + Child(ren) Family

Gold $166.08 $405.52 $300.38 $539.84Silver $108.64 $284.90 $202.74 $379.00Bronze $66.28 $195.96 $130.74 $260.40

State Health Benefit PlanPricing per Month

What can you do to select the best coverage for you/your family?

• The first thing you need to do is find out how much of your current deductible you have meet this year. CIGNA-go to mycigna.com UHC-go to myuhc.com

• HRA Members Verify how many credit dollars will roll over

next year. Mycigna.com or myuhc.com

What am I looking for?

What does this tell me? The current deductible for this example family

of $4000 as of Oct 1st has not been met. No one individual has met their deductible The child (who has met the most) has only

met $522 of the $1600 deductible still leaving $1077 to be met before co-insurance would begin to pay

They have only met a total of $641 of the $4000 deductible

The family has $515.41 credit that will roll over for the 2014 plan year. This will add to any plan they choose.

Plan Selection Which plan offers a similar plan coverage?

Currently they have a $4000 deductible $1500 starting out in credit dollars (wellness HRA)

The Silver Plan is the closest plan to what they currently have $4000 deductible Credits dollars $400 + the $515.41 roll over would be

$915.41 With the wellness incentive the credit dollars would be

$915.41 + $480 for a total of $1395.41 2014 Wellness Incentive-Additional $960 credit dollars for a

total of $2355.41 Monthly Premiums

Currently $350.86 Silver $379.00

Plan Selection Since they didn’t meet their deductible, what if

they wanted to increase the deductible to try and save on their premiums?

They could try the Bronze Plan. This plan has a $5000 deductible, $1000 more They would get $200 credit dollars + $515.41

rollover + the $480 incentive for a total of $1195.41 Complete the 2014 wellness incentive add $960 for a

total of $2155.41 credit dollars Monthly Premiums

Currently paying $350.86 Bronze Monthly $260.40

What about the Gold Plan? Would the Gold Plan be an option for this family?

They did not meet their deductible last year. The deductible would lower, $3000 making it only $1000 less

They would have $800 credit dollars to add to their rollover and incentive for a total of $1795.41

2014 Wellness Incentive-Additional $960 credit dollars for a total of $2755.41

However their premium would go from $350.86 to $539.84

The total deductible they meet this year was only $643.64 of the $4000. This still left $3356.36 before co-insurance would begin to pay.

Would this justify a rate increase of $188.98 per month for this family. Probably not.

What if I had the HMO or HDHP? HMO Members

No more Co-Pays You will receive credit dollars to help meet the deductible If you completed the wellness pledge you will receive the

addition $240 per employee and spouse 2014 Wellness Incentive addition credit dollars available

HDHP Members You will receive HRA Credit dollars to help meet the

deductible If you completed the wellness pledge you will receive the

addition $240 per employee and spouse 2014 Wellness Incentive addition credit dollars available

How do you enroll? Myclarkebenefits.com

Click on the Red Button

What happens if I don’t enroll? If you currently have health insurance you will

default into the BRONZE Plan. If you don’t currently have Health Insurance, you

will NOT have health insurance again in 2014

Open Enrollment Dates October 21 through November 8

Price Comparison - HMOCurrent Gold

Gold Difference Silver

Silver Difference Bronze

Bronze Difference

HMO W UHC-SINGLE 139.38 166.08 26.7 108.64 -30.74 66.28 -73.1HMO W UHC-EE+SPOUSE 322.34 405.52 83.18 284.9 -37.44 195.96 -126.38HMO W UHC-EE+CHILD 300.88 300.38 -0.5 202.74 -98.14 130.74 -170.14HMO W UHC-FAMILY 413.86 539.84 125.98 379 -34.86 260.4 -153.46

Current GoldGold

Difference SilverSilver

Difference BronzeBronze

DifferenceHMO W CIGNA-SINGLE 132.38 166.08 33.7 108.64 -23.74 66.28 -66.1HMO W CIGNA-EE+SPOUSE 315.34 405.52 90.18 284.9 -30.44 195.96 -119.38HMO W CIGNA-EE+CHILD 293.88 300.38 6.5 202.74 -91.14 130.74 -163.14HMO W CIGNA-FAMILY 406.86 539.84 132.98 379 -27.86 260.4 -146.46

Current GoldGold

Difference SilverSilver

Difference BronzeBronze

DifferenceHMO S UHC- SINGLE 149.38 166.08 16.7 108.64 -40.74 66.28 -83.1HMO S UHC- EE + SPOUSE 347.34 405.52 58.18 284.9 -62.44 195.96 -151.38HMO S UHC- EE + CHILD 325.88 300.38 -25.5 202.74 -123.14 130.74 -195.14HMO S UHC- FAMILY 430.96 539.84 108.88 379 -51.96 260.4 -170.56

Current GoldGold

Difference SilverSilver

Difference BronzeBronze

DifferenceHMO S CIGNA-SINGLE 142.38 166.08 23.7 108.64 -33.74 66.28 -76.1HMO S CIGNA-EE + SPOUSE 340.34 405.52 65.18 284.9 -55.44 195.96 -144.38HMO S CIGNA-EE + CHILD 318.88 300.38 -18.5 202.74 -116.14 130.74 -188.14HMO S CIGNA-FAMILY 423.96 539.84 115.88 379 -44.96 260.4 -163.56

HMO-Wellness-UHC

HMO-Wellness-CIGNA

HMO-STANDARD-UHC

HMO-STANDARD-CIGNA

Price Comparison - HRACurrent Gold

Gold Difference Silver

Silver Difference Bronze

Bronze Difference

HRA W UHC-SINGLE 94.92$ 166.08$ 71.16$ 108.64$ 13.72$ 66.28$ (28.64)$ HRA W UHC-EE+SPOUSE 261.66$ 405.52$ 143.86$ 284.90$ 23.24$ 195.96$ (65.70)$ HRA W UHC-EE+CHILD 246.26$ 300.38$ 54.12$ 202.74$ (43.52)$ 130.74$ (115.52)$ HRA W UHC-FAMILY 350.86$ 539.84$ 188.98$ 379.00$ 28.14$ 260.40$ (90.46)$

Current GoldGold

Difference SilverSilver

Difference BronzeBronze

DifferenceHRA W CIGNA-SINGLE 87.92$ 166.08$ 78.16$ 108.64$ 20.72$ 66.28$ $ (21.64)HRA W CIGNA-EE+SPOUSE 254.66$ 405.52$ 150.86$ 284.90$ 30.24$ 195.96$ $ (58.70)HRA W CIGNA-EE+CHILD 239.26$ 300.38$ 61.12$ 202.74$ (36.52)$ 130.74$ $ (108.52)HRA W CIGNA-FAMILY 343.86$ 539.84$ 195.98$ 379.00$ 35.14$ 260.40$ $ (83.46)

Current GoldGold

Difference SilverSilver

Difference BronzeBronze

DifferenceHRA S UHC- SINGLE 104.92$ 166.08$ 61.16$ 108.64$ 3.72$ 66.28$ $ (38.64)HRA S UHC- EE + SPOUSE 286.66$ 405.52$ 118.86$ 284.90$ (1.76)$ 195.96$ $ (90.70)HRA S UHC- EE + CHILD 271.26$ 300.38$ 29.12$ 202.74$ (68.52)$ 130.74$ $ (140.52)HRA S UHC- FAMILY 364.54$ 539.84$ 175.30$ 379.00$ 14.46$ 260.40$ $ (104.14)

Current GoldGold

Difference SilverSilver

Difference BronzeBronze

DifferenceHRA S CIGNA-SINGLE 97.92$ 166.08$ 68.16$ 108.64$ 10.72$ 66.28$ $ (31.64)HRA S CIGNA-EE + SPOUSE 279.66$ 405.52$ 125.86$ 284.90$ 5.24$ 195.96$ $ (83.70)HRA S CIGNA-EE + CHILD 264.26$ 300.38$ 36.12$ 202.74$ (61.52)$ 130.74$ $ (133.52)HRA S CIGNA-FAMILY 357.54$ 539.84$ 182.30$ 379.00$ 21.46$ 260.40$ $ (97.14)

HRA-Wellness-UHC

HRA-Wellness-CIGNA

HRA-Standard-UHC

HRA-Standard-CIGNA

Price Comparison - HDHPCurrent Gold

Gold Difference Silver

Silver Difference Bronze

Bronze Difference

HDHP W UHC-SINGLE 83.54 166.08 82.54 108.64 25.1 66.28 -17.26HDHP W UHC-EE+SPOUSE 242.34 405.52 163.18 284.9 42.56 195.96 -46.38HDHP W UHC-EE+CHILD 228.32 300.38 72.06 202.74 -25.58 130.74 -97.58HDHP W UHC-FAMILY 331.48 539.84 208.36 379 47.52 260.4 -71.08

Current GoldGold

Difference SilverSilver

Difference BronzeBronze

DifferenceHDHP W CIGNA-SINGLE 76.54 166.08 89.54 108.64 32.1 66.28 -10.26HDHP W CIGNA-EE+SPOUSE 235.34 405.52 170.18 284.9 49.56 195.96 -39.38HDHP W CIGNA-EE+CHILD 221.32 300.38 79.06 202.74 -18.58 130.74 -90.58HDHP W CIGNA-FAMILY 324.48 539.84 215.36 379 54.52 260.4 -64.08

Current GoldGold

Difference SilverSilver

Difference BronzeBronze

DifferenceHDHP S UHC- SINGLE 93.54 166.08 72.54 108.64 15.1 66.28 -27.26HDHP S UHC- EE + SPOUSE 267.34 405.52 138.18 284.9 17.56 195.96 -71.38HDHP S UHC- EE + CHILD 253.32 300.38 47.06 202.74 -50.58 130.74 -122.58HDHP S UHC- FAMILY 344.14 539.84 195.7 379 34.86 260.4 -83.74

Current GoldGold

Difference SilverSilver

Difference BronzeBronze

DifferenceHDHP S CIGNA-SINGLE 86.54 166.08 79.54 108.64 22.1 66.28 -20.26HDHP S CIGNA-EE + SPOUSE 260.34 405.52 145.18 284.9 24.56 195.96 -64.38HDHP S CIGNA-EE + CHILD 246.32 300.38 54.06 202.74 -43.58 130.74 -115.58HDHP S CIGNA-FAMILY 337.14 539.84 202.7 379 41.86 260.4 -76.74

HDHP-Wellness-UHC

HDHP-Wellness-CIGNA

HDHP Standard-UHC

HDHP Standard CIGNA

Visit us during open enrollment, schedule is up at myclarkebenefits.com

Email: benefits@clarke.k12.ga.us

QUESTIONS