Open Enrollment Presentation

October, 2012

• Click to add text

Filice Insurance AgencyNina Gardner, Joyce Manansala

• Nina Gardner, J.D. – Your Employee Benefits Consultant – strategic benefit planning

• Joyce Manansala – Your Account Manager – day-to-day administration – questions, plan design inquiries, claims and coverage issues, billing questions, etc.

• Serena & Lily’s Customized Website – Your Own Intranet

www.filice.com/benefits/serenaandlily

What is Open Enrollment?

Once-per-year opportunity for employees to: Enroll or drop coverage Add or delete dependents

When Can I Change My Election?

OPEN ENROLLMENT OR A STATUS CHANGE…Marriage

Divorce or legal separation

Birth or adoption of a child

Death of a spouse or child

Change in your spouse’s employment

You or your spouse change from full-time to part-time,

You or your spouse experience an unpaid leave of absence

Major changes to your spouse’s benefit program

YOU MUST NOTIFY HR AND ENROLL WITHIN 30 DAYS

OF THE EVENT.

Challenges in Health Care

Drivers of Increased Health Care Cost: Aging population Medical inflation – driving 51% of the growth in healthcare spending New expensive technology and drugs Cost of expanding and improving health care facilities Less competition in the market place Increased utilization and demand for services Providers adjust prices charged to insurers to offset losses from non-

payers Government regulations:

Health Care Reform Mandated Benefits

Health Care Costs Controlled by You

Lifestyle Choices: Smoking Obesity Exercise (lack of) Stress Accessing preventive care Taking medications as prescribed Seeking care at the appropriate level (urgent care clinics and

physical office visits instead of emergency room care) Fraud prevention

Check your claims. If you need help, contact Joyce.

How can you help control costs?

Wellness: Eat, sleep and exercise appropriately. Check out your new wellness website with Filice. Monthly newsletters.

Utilize appropriate level of care: Call the 24-hour nurse line, only go to the emergency room for true emergencies, use urgent care as necessary, and schedule annual check-ups.

Engage: Manage your health and your health-related expenses. Always stay inside the network whenever possible.

Ways to Save on RX

Ask your doctor for generic alternatives Use mail order for long-term and maintenance

drugs Use over-the-counter medications instead of

prescription drugs when possible Ask physician for free samples Annually review your medications with your doctor

Benefits Overview Blue Shield – New plan names but similar to last year. Blue Shield

changed its small group portfolio.

Premier PPO 35 – Base Plan

Access HMO Enhanced 25 – Buy-up Option

Premier PPO 25 – Buy-up Option - New

Dental – Direct Dental (Assurant Network) - Enhanced

Vision – VSP – New Benefit

Life and disability – Mutual of Omaha

EAP

Travel Assistance

FSA – New Provider on 1/1/2013

401(k) – New Provider on 1/1/2013

Company Contribution Medical: Serena & Lily pays 100% of premium for employees and

50% of the premium for dependents for the Blue Shield Premier PPO 35 plan. If you choose the Access HMO Enhanced 25 or Premier PPO 25, you will pay the difference.

Dental: Serena & Lily pays 100% of premium for employees and 50% for dependents for your Direct Dental plan.

Vision: Serena & Lily pays 100% of premium for employees and 50% for dependents for your VSP vision plan.

To calculate your cost per paycheck, please multiply monthly cost by 12 and divide by 26.

Long-Term Disability: Paid by Serena & Lily Life Insurance: Paid by Serena & Lily EAP program: Paid by Serena & Lily Travel Assistance: Paid by Serena & Lily

Medical Plan Designs Blue Shield Premier PPO 35

Deductible: $750/member; $1,500/family ($500/$1,000 last year)

Office Visit Co-Pay: $35 (deductible waived) ($40 last year)

Preventive Care: No Charge

Hospitalization: 35% after deductible ($500/admit + 30% last year)

Surgery: 35% after deductible

($250/surgery + 30% last year)

Emergency Room: $100/visit (waived if admitted) + 35% after deductible ($100/visit + 30% last year)

Prescriptions: $10/$30/$50/30% up to $100 per fill ($250 deductible - last year)

Mail: $20/$60/$100/30% (90 day supply)

Annual OOP Max: $4,000 /member; $8,000/family (excludes deductible)

Medical Plan Designs Blue Shield Premier PPO 25

Deductible: $500/member; $1,000/family

Office Visit Co-Pay: $25 (deductible waived)

Preventive Care: No Charge

Hospitalization: 25% after deductible

Surgery: 25% after deductible

Emergency Room: $100/visit (waived if admitted) + 25% after deductible

Prescriptions: $10/$30/$50/30% up to $100 per fill

Mail: $20/$60/$100/30% (90 day supply)

Annual OOP Max: $3,000 /member; $6,000/family (excludes deductible)

Medical Plan Designs

Blue Shield Access Enhanced HMO 25 Deductible: None

Office Visit Co-Pay: $25/ $35 specialist

Preventive Care: No Charge

Hospitalization: 25% of allowed charges

Surgery: 25% of allowed charges

Emergency Room: $150 (waived if admitted)

Prescriptions: $10/$30/$50/ 20% up to $100 per fill ($300 Tier 2 & 3 Rx deductible)

($15/Generic; $30 Brand after $250 Rx deductible – last year)

Mail: $20/$60/$100 ($300 Tier 2 & 3 Rx deductible) – 90 day supply

Annual OOP Max: $3,000/member; $6,000/family ($3,500member; $7,000/family – last year)

Dental Plan Overview Direct Dental (Assurant Network)

$1,500 annual (plan year) maximum benefit

$50/individual (plan year) deductible

Ortho: $1,000 lifetime max for children and adults ($500 per year)

Plan design co-insurance levels

In Out

Preventative 100% 100%

Basic 90% 80%

Major 60% 50%

Ortho 50% 50%

Vision Plan Overview

VSP

Co-Pay: $10/$25

Exams: Every 12 months

Lenses: Every 12 months

Frames: Every 12 months (up to $130 + 20% off)

OR

Contact Lens Care: Every 12 months (up to $130)

Life, AD&D and Disability Overview

Life and AD&D Insurance – Mutual of Omaha Benefit: 1 x salary to a maximum of

$250,000

Long Term Disability – Mutual of Omaha Benefit: 60% of salary – maximum benefit of

$10,000/month

Elimination: 90 days

Voluntary and AD&D Term Life Insurance

  Minimum Maximum Guaranteed

For You $10,000 $250,000 $100,000

For Your Spouse $5,000 $50,000 $25,000

For Your Children 2,000 $10,000 $10,000

• Employee can elect up to 5 times their salary to a maximum of $250,000.

• Guarantee issue amount is 5 times salary up to $100,000. • Spouse can elect up to 50% of employee’s benefit to

$50,000. • Children can elect up to 50% of employee’s benefit to

$10,000.

EAP Program – Mutual of Omaha

24/7 online resources and confidential telephonic consultation with licensed EAP consultants who provide assistance and guidance on:• Family, relationship and parenting issues• Emotional and stress-related issues• Conflicts at home or work• Alcohol and drug dependencies• Financial issues• Depression• Parenting• On-line resources and tools

Up to 3 in-person counseling sessions each year with a licensed mental health professional.

The need for emergency travel assistance is growing.

■ Whether your travel is for business or personal reasons, our worldwide

emergency travel assistance program goes with you when you travel to a foreign country or just

100 miles or more from home.

■ If you, your spouse or your dependent children need immediate assistance anywhere in the world.

Worldwide emergency travel assistance services

FSA Vendor Change 1/1/2013 Provided by Benefit Resource, Inc., starting 1/1/2013 This move will enhance your current services with the following:

Online access to your account Phone app to submit claims and to check your balance Professional customer service via phone, email, and live chat Faster reimbursement process including direct deposit Just one debit card that holds both your medical FSA and your

commuter and parking elections

More details at the November enrollment meeting

New Benefit 1/1/13Pre-Tax Commuter and Parking

• Pay $125 of your monthly eligible commuter expenses and $240 of your monthly eligible parking expenses pre-tax.

• More details at the November enrollment meeting

Flex Plan Benefits

Insurance Premiums

Health Flexible Spending Account(Health FSA)

Dependent Care Assistance Account (DCAP)

Serena & Lily is also introducing a new-look 401(k) plan.

Enhancements will include:

- A lower cost, higher quality investment menu- A higher-touch servicing approach- One-on-one, customized advice

& Much More.

Our new retirement plan will be provided by Portico Wealth Advisors and Verisight

Will be meeting with you to determine how to best position your 401(k) account

Will be providing the website and all of the backend support for your account

401(k) Retirement Plan

More details will follow over the next few months.

Enrollment InstructionsFor Blue Shield, if you are staying on the most similar

plan to last year’s plan, you don’t need to do anything. If you are moving to a new plan, please fill out a change form. For dental, you only need to fill out the form if you are new or making changes. Please complete the VSP enrollment form. Please fill out the Mutual of Omaha form as well as the beneficiary form. No forms to fill out for group life, disability, EAP and travel assistance. Everyone must turn in rate sheet.

Forms, applications, plan designs, etc. can be found at www.filice.com/benefits/serenaandlily under the Forms section.

For questions, please call Joyce Manansala at 925-299-7203 or email at joyce@filice.com.

25

Q & A

Open Enrollment for your plans is the month of September, 2012. Please return all forms to the

office by Monday, September 24, 2012.

• Go to www.filice.com/benefits/serenaandlily to access all your benefit information