Open EnrollmentPresentation

for Milpitas Christian Schools

Presented by

BenefitEdge Insurance Services, Inc.

(888) 995-EDGE (3343)(408) 995-EDGE (3343)www.benefitedge.net

Lic#0F37564

Who is BenefitEdge Insurance?

We are the Benefits Broker for your Medical, Dental, Vision, Life, LTD, LTC Insurance Plans

We will work in support of your HR team to resolve any benefits related issues throughout the year

Reminder for 2010Website:

www.mcsihr.comEmail:

mcsi@benefitedge.net

2010 Benefit Enhancements Changing dental, vision, life, and LTD/STD to Guardian – larger network, better plan design. All benefit eligible employees will receive $25,000 of basic life insurance Voluntary life insurance with guarantee issue up to $100,000. MCSI will contribution $50 per month for employees that choose a Health Savings Account Plan

Medical Insurance This is our open enrollment period and your opportunity to make changes to your plans.

Any requested changes after open enrollment will require a “qualifying event”.

Any changes will take effect on July 1, 2010.

Medical Insurance

There are currently medical insurance plan options provided through two different insurance carriers – Kaiser Permanente & HealthNet

Medical Insurance - HMO Kaiser plan, you have to use their facilities

HealthNet HMO - You must use a primary care physician (PCP) for each of your family members

Your PCP will provide all of your routine care and with a few exceptions, must provide a referral in order for you to receive care from a specialist

Medical HMO Kaiser Health NetGroup # 602272 J9514A B1002APlan $40 Plan HMO 25 HMO 35Deductible None None None  Physician's Office CareOffice Visit Copay $40 $25 $35 Adult Preventive Care $40 $25 $35

Well Baby Care $5 $25 after 24 months $35 after 24 monthsLabs and Xrays No Charge No Charge No Charge  Prescription DrugsGeneric $10 $15 $15 Brand Name $30 $150 ded, then $30 $200 ded, then $30  Hospital CareIn-Patient Hospital $500 per admit 20% 30%Out-Patient Services $40 20% 30%Urgent Care Emergency $40 $50 $50 Hospital Emergency $100 $100 Copay $100 Copay  Maximum Out-of-PocketIndividual $1,500 $3,000 $4,000 Family $3,000 $6,000 $8,000 Max. Lifetime Benefit Unlimited No Maximum

HealthNet – With the PPO plan you can see any doctor of your choice and will save money using a contracted provider

You have access to a larger network of doctors and it also allows you to use non-contract physicians at a reduced coverage level

You do not need a referral to use a specialist. You may “self direct” your care as needed

Medical Insurance - PPO

  HealthNet Medical PPO Traditional PlanGroup # K9557APlan PPO 1750

  Contract Provider Non-Contract ProviderDeductible $1,750 EE / $3,500 FAM $3,500 EE / $7,000 FAM

  Physicians Office CareOffice Visit Copay $35 50%Adult Preventive Care $35 ($250 max) Not CoveredWell Baby Care $35 Not CoveredLabs and Xrays 40% 50%

  Prescription DrugsGeneric $15 50%Brand Name $30 + $200 ded (pp) 50% + $100 (pp)

  Hospital CareIn-Patient Hospital 40% + Deductible 50% + Deductible Out-Patient Hospital 40% 50%Emergency $50 copay + 40%Hospital Emergency $100 copay + 40%

  Maximum Out-of-PocketIndividual $5,000 $10,000 Family 2 per family 2 per familyMaximum Lifetime $5,000,000 combined with PPO & OON

Health Savings Account (H.S.A.)

What is an H.S.A?

Health Savings Accounts are tax-exempt accounts where funds grow to pay for medical expenses. They were created to help give control back to consumers and lower healthcare costs.

2 Parts

1. A High Deductible, IRS Approved Health Plan

2. A Health Savings Account (Bank Account)

Intended to cover serious illness or injury once the deductible has been met.

Used to cover all IRS approved medical expenses until the deductible is met.

Health Savings Account (H.S.A.)

Part 1

Medical HSA KaiserGroup # 602272Plan $1,500 PlanDeductible $1,500 / $3,000  Physician's Office CareOffice Visit Copay $0 after deductibleAdult Preventive Care $0Well Baby Care $0Labs and Xrays $0 after deductible  Prescription DrugsGeneric $0 after deductibleBrand Name $0 after deductible  Hospital CareIn-Patient Hospital $0 after deductibleOut-Patient Services $0 after deductibleUrgent Care Emergency $0 after deductibleHospital Emergency $0 after deductible  Maximum Out-of-PocketIndividual $1,500 Family $3,000 Max. Lifetime Benefit Unlimited

Part 1

HSA Eligible PPO PlansGroup # K9558A K9559APlan PPO 3000 (H S A-Compatable) PPO 4000 (H S A-Compatable)  Contract Provider Non-Contract Provider Contract Provider Non-Contract ProviderDeductible $3,000 EE / $6,000 FAM $4,000 EE / $8,000 FAM $4,000 EE / $8,000 FAM $5,000 EE / $10,000 FAM

  Physicians Office CareOffice Visit Copay $25 50% $35 50%Routine Physicals $25 Not Covered $35 Not CoveredWell Baby Care $25 ded waived Not Covered $35 ded waived Not CoveredLabs and Xrays 30% 50% 40% 50%

  Prescription DrugsGeneric $15 after ded 50% after ded $15 after ded 50% after dedBrand Name $30 after ded 50% after ded $30 after ded 50% after ded

  Hospital CareIn-Patient Hospital 30% + $250 Ded 50% + $250 Ded 40% + $250 Ded 50% + $250 Ded Out-Patient Hospital 30% + $250 Ded 50% + $250 Ded 40% + $250 Ded 50% + $250 Ded Urgent Care Emergency $50 copay + 30% $50 copay + 40%Hospital Emergency $100 copay + 30% $100 copay + 40%

  Maximum Out-Of-PocketIndividual $4,000 $4,000 $5,000 $5,000 Family $8,000 $8,000 $10,000 $10,000 Maximum Lifetime Benefit $5,000,000 combined with PPO & OON

Health Savings Account (H.S.A.)

Funds deposited and not used remain in your account and they roll over every year

Your H.S.A. funds can be used for any medically necessary expenses per IRS rules.

Part 2

Health Savings Account (H.S.A.)Who is Eligible?

Members covered by an HSA-compatible, IRS approved plan

Who is Not Eligible?

Anyone enrolled in Medicare or 65 or older If you are claimed as a dependent on another person’s tax return

Part 2

Acupuncture Chiropractic Blood testsBlood transfusionsContact Lenses Dental, Dental X-rays, DenturesDrugs (prescription) EyeglassesGum treatment

***Also pays for COBRA, long term care and Medicare part B & D premiums.

APPENDIX: SAMPLE OF HSA QUALIFIED EXPENSES (Short List)Source: IRS Code Sec 213(d) Publication 502 (WWW.IRS.GOV)

Hearing aids Hospital billsInsulin Lab testsOpticianOptometristOral surgeryPrenatal carePsychotherapyVaccinesVitamins (if prescribed)X-rays

Part 2

Accessing Funds

Signature Based Debit Visa CardReceived 2-3 weeks after account set up

Online AccessTrack deposits, balances, and claims

Part 2

Health Savings Account Limits

H.S.A. Deposit Limit Per IRS Code2010 Plan Year

IRS Annual LimitSingle $3,050 Family (2 or more) $6,150 Catch-UP (55 or older) $1,000

Part 2

MCSI will deposit $50 per month into your HSA bank account

HSA Comparison

Items for Consideration before making a change: Your monthly contributions from your paycheck Amount you typically spend out of pocket on

your medical expenses per year Medical plan deductible Medical plan out-of-pocket maximum

EE + SP Coverage

Current Plan HMO 40 HSA Plan 1500ACurrent Deductible $0 ADeductible $3,000BOut-of-Pocket Max $3,000 Out-of-Pocket Max $3,000

EE Monthly Cost $603 EE Monthly Cost $537CAnnual Cost $7,236 BAnnual Cost $6,444

    Savings from PPO $792

MCSI HSA Contribution $0 MCSI HSA Contribution $600

    C Total $1,392

Annual Scenarios   Annual Scenarios  

Worst Case (A+B+C) $7,736 Worst Case (A+B-C) $8,052

Low Utilization $7,236 Low Utilization $5,402

Family CoverageCurrent Plan HMO 40 HSA Plan 1500

ACurrent Deductible $0 ADeductible $3,000BOut-of-Pocket Max $3,000 Out-of-Pocket Max $3,000

EE Monthly Cost $1,005 EE Monthly Cost $895CAnnual Cost $12,060 BAnnual Cost $10,740

    Savings from PPO $1,320MCSI HSA Contribution $0 MCSI HSA Contribution $600    C Total $1,920Annual Scenarios   Annual Scenarios  Worst Case (A+B+C) $15,060 Worst Case (A+B-C) $11,820Low Utilization $12,285 Low Utilization $9,170

Employee Only CoverageCurrent Plan HMO 25 HSA Plan 3000

ACurrent Deductible $0 ADeductible $3,000BOut-of-Pocket Max $3,000 Out-of-Pocket Max $4,000

EE Monthly Cost $82 EE Monthly Cost $0CAnnual Cost $984 BAnnual Cost $0

    Savings from PPO $984

MCSI HSA Contribution $0MCSI HSA Contribution $600

    C Total $1,584Annual Scenarios   Annual Scenarios  Worst Case (A+B+C) $3,984 Worst Case (A+B-C) $2,416Low Utilization $1,434 Low Utilization $16

Family Coverage

Current Plan HMO 35 HSA Plan 3000ACurrent Deductible $0 ADeductible $3,000BOut-of-Pocket Max $4,000 Out-of-Pocket Max $4,000

EE Monthly Cost $1,050 EE Monthly Cost $470CAnnual Cost $12,600 BAnnual Cost $5,640

    Savings from PPO $6,960

MCSI HSA Contribution $0MCSI HSA Contribution $600

    C Total $7,560

Annual Scenarios   Annual Scenarios  

Worst Case (A+B+C) $20,600 Worst Case (A+B-C) $6,080

Low Utilization $13,250 Low Utilization $80

New Dental Carrier – Guardian

Dental PPO $50 deductible which is waived for preventive care. Calendar year annual maximum is $3,000 in-network

and $2,000 out-of-network Preventive services are covered at 100% Orthodontia Benefit for Adult and Children

New Dental Carrier – Guardian

Dental PPO $50 deductible which is waived for preventive care. Calendar year annual maximum is $3,000 in-network

and $2,000 out-of-network Preventive services are covered at 100% Orthodontia Benefit for Adult and Children

New Dental Carrier – Guardian

Dental PPO $50 deductible which is waived for preventive care. Calendar year annual maximum is $3,000 in-network

and $2,000 out-of-network Preventive services are covered at 100% Orthodontia Benefit for Adult and Children

* Subject to UCR (Usual, Customary, Reasonable)

  Guardian Dental, Group # 458105 Benefits Preferred Provider Non-Contract Provider

Annual Maximum $3,000 $2,000

Calendar Year Deductible $50 (3 per Family)Preventive Services: 100% 100%*Exam, X-rays, Cleaning General/Basic Services: 90% 80%*Fillings, Endo, Perio Major Services: 60% 50%*Crowns, Bridges, Dentures Orthodontic Services: 50% 50%Child and Adult YesOrthodontics Lifetime Max. $2,000   Your Cost Per Month

Employee $0.00

New Vision Insurance – Guardian VSP  Guardian VSP, Group # 458105Benefits Contract Provider Non-Contract ProvdrExams $10.00 Materials $25.00 Lenses     Single Vision Covered in Full $47 Bifocal Covered in Full $66 Trifocal Covered in Full $85 Contacts    Medically Nec. Contacts Covered in Full $210 Cosmetic $120 Allowance $120 Frames $120 + 20% $47

  Benefit FrequencyExam Every 12 Months Lenses Every 24 Months Frames Every 24 Months

New Life Insurance – Guardian

MCSI will provide $25,000 of Basic Life Insurance for all Employees.

New Voluntary Life Insurance – Guardian

Additional life insurance up to $300,000 Guarantee issue up to $100,000, any amount

above $100,000 will be subject to underwriting Life insurance available for spouse and children Employee paid through payroll deductions

New LTD and STD Carrier - GuardianLong Term Disability Guardian, Group # 458105

LTD Benefit % 60% of Predisability EarningsMaximum Monthly Benefit $6,000 a monthElimination Period 180 DaysShort Term Disability Guardian, Group # 458105STD Benefit 66 2/3% to a maximum of $1,000 per month

Elimination Period 15 Days

LTD and STD is 100% Paid by Milpitas Christian School, Inc.

Long Term Care Insurance

Covers Expenses In the Event You are Disabled and Need Assistance With the Functions of Daily Life

Base Plan Provided By Milpitas Christian School After 10 Years of Service

You Can Increase the Coverage Level on a Voluntary Basis and Contribute the Difference in Premium

You May Also Purchase Voluntary Coverage Prior to Your 10 Year Anniversary

These Plans are available on a VOLUNTARY basis

 

Cancer ProtectionIntensive Care

Personal AccidentPersonal Life Insurance

Personal RecoveryMedical Bridge – HMO, PPO, HSA

Voluntary Benefits

Unlimited letters written on your behalfDirect access to a local law-firmVarious of hours of legal support based upon

your total length of time with PPL

Pre-Paid Legal Services

Five Common Types of Identity Theft

Drivers License

Medical FinancialSocial Security

Character/ Criminal

Monitor your credit on a monthly basisIdentifies possible breeches in your identityIf identity is stolen will work to repair your credit

Identity Theft Response

Pre-Paid Legal and Identity Theft Cost

Prepaid Legal - $15.95 per monthIdentity Theft - $12.95 per monthBoth - $25.90 per month

Flexible Spending Account - FSA

Optional FSA Plan Available

Personal Pre-Tax Contributions may be made to your FSA up to $3,000 for

Medical and $5,000 for Dependent Care.

Plan year begins July 1, 2010 through June 30, 2011

Thank you for your time.

Please make sure to submit your changes before May 21 to Leslie.

We look forward to serving you and helping with any benefit related issues.

Please don’t hesitate to call.

Frequently Asked Questions:How long will it take to receive my cards? It will take 2-3 weeks

What if I need to see a Doctor? If you need to see a Doctor before you receive your member cards, you may have your doctor contact our office to verify coverage. Also, the temporary card will suffice until the permanent one arrives.

What if I need a prescription? Try to refill prescription prior to June 30 if you are changing plans or carriers. If you need a prescription before you receive your member cards, you may need to pay the cost of the prescription and then do one of the following;

1. If you receive your member card with 1-2 weeks of purchasing the prescription, most pharmacies will allow you to present your member card and they will provide you with a refund.

2. If the pharmacy will not refund your cost, you can submit a claim directly to the insurance carrier. We will provide you with the claim form and assist you.