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Wells Fargo Insurance
Pulsar Operational Boundaries2017 Open Enrollment Presentation – Field employees
Judy TurnerDirector of Human Resources
Joni BrownKey Account Executive
This presentation is intended to provide you with a general overview
of the benefit plan options available through your employer.
The presentation will address the advantages and disadvantages of
available plan options, but will not provide details regarding
coverage for specific medications or treatments.
For detailed coverage information, refer to the relevant plan
document or policy.
Questions regarding your eligibility to enroll in a benefit plan should
be addressed with your Human Resources or Benefits Department.
Agenda Company message New medical plan options with United Healthcare
– Medical plan benefits and changes– Health Savings Account Refresher
New dental plan with United Healthcare New vision plan with United Healthcare 2017 enrollment requirements
– Passive enrollment
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Company message
Pulsar Operational Boundary remains committed to providing employees with the most competitive and comprehensive benefit package possible. We feel we have exciting news to share with you today about the upcoming changes for 2017.
This year, some employees will see costs go down for health insurance and some will see costs rise. If you have not looked at one of the High Deductible with HSA options in the past, we encourage you to do so this year. All prices on the $3000 Ded option are going down and some pricing on the Base Plan HSA option are as well.
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Medical Benefits
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Key Medical Plan Changes
Pulsar will continue to offer three plans with a minimal amount of change to each; two of the options are HSA compliant plans
Low HSA plan will have lower deductible and out of pocket maximums
High HSA plan will have an embedded out of pocket
The $1500 ded plan will have lower out of pocket maximums and a lower family deductible
Any time you change carriers, there will be some changes to providers that are considered ‘in-network’ and to drugs that are on the ‘formulary’ list. Be sure to check these things out before incurring services
A representative from United Healthcare is on this call and can help provide answers to questions once the presentation is over.
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Medical plan comparison 2016 to 2017
Medical plan comparison 2017
2017 Per Paycheck Employee Costs
$4,000 (Low) HSA Plan $3,000 (High) HSA Plan
$1,500 Ded Plan
Employee $67.57 $118.57 $180.00
EE + SP $242.88 $258.23 $387.23
EE + Child(ren) $202.17 $216.05 $332.77
Family $333.79 $355.71 $540.00
Employees who get their preventive care visit will receive either a $25 (single
coverage or $50 (if covering any dependents) premium credit each month in 2017.
Ask your employer for details.
Medical plans through United Healthcare
Health Savings Account (HSA)
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Establishing a Health Savings AccountTwo of the plan options offered by Pulsar are qualified high deductible health plans. This means that if you are enrolled in one of the HSA compatible options, you may be eligible to establish a Health Savings Account (HSA) to pay for your medical expenses.
HSA administration will be transitioning to Optum as Wells Fargo Health Benefit Services sold that business earlier this year
You will receive mailings about this change at your home address
Pulsar will continue to pay the monthly fee on your behalf
Can make contributions into your account via pre-tax payroll deductions or direct deposits
Convenient access to your funds – debit card or direct withdrawals at any Wells Fargo branch location.
Once your account has a balance of $2,000, you are able to invest your dollars into several different fund options – ranging from low to high.
YOU own the account!
If you choose to enroll in one of the HSA options and wish to establish your account with Optum, there are additional forms that are required.
Advantages of an HSA
Long-Term Savings
Save for future medical needs
Your unused balance rolls over from year to year
Tax Savings
Pre-tax contributions: Deductions from your pay can be made on a pre-tax basis
Tax-free earnings: For as long as the money stays in your HSA
Tax-free withdrawals: For qualified health care expenses
Ownership
You control how you spend the money in your account
Use it for eligible expenses today
Save it for the future
You can change jobs and the HSA goes with you
Who is Eligible for an HSA?
To be eligible for a Health Savings Account you must :
Be covered by a qualified HDHP and not covered by other health insurance
Including a spouse’s medical FSA
NOT be enrolled in Medicare, Tricare, or have not received VA medical benefits in the last 3 months
NOT be claimed as a dependent on someone else’s tax return
Domestic Partners are not considered tax-dependents by the IRS and cannot contribute to an HSA account, nor can HSA funds be used to pay for expenses for Domestic Partners
How much can be contributed for 2017
2017 Health Saving Account Contribution Limits
Single $3,400 (up from $3,350 in 2016)
Family $6,750
Catch-up Contribution (over age 55) Addl. $1,000
Acupuncture Alcoholism treatment Ambulance services Birth control pills Chiropractors Contact lenses & solutions Dental treatment Doctor’s fees Drug addiction treatment Eye exams & glasses Eye surgery
Qualified medical expenses include:
Hearing aids (& batteries) Hospital services Laboratory fees Medicines & drugs (including OTC
medicines) Nursing home & services Operations or surgery Psychiatric care Therapy & counseling Wheelchair & crutches X-rays
Qualified Medical Expenses Examples
For a more detailed list of qualified medical expenses, visit:
http://www.irs.gov/publications/p502/ar02.html
HSA Distributions
Distributions are tax-free if taken for “qualified medical expenses”
Medical / dental/ vision
Tax-free distributions can be taken for qualified medical expenses of:
Person covered by the high deductible
Spouse of the individual
Any tax qualified dependent of the individual
Keep your receipts!
If you are audited, the account holder must prove to the IRS that distributions from HSA were for qualified expenses and not otherwise reimbursed
If an HSA expenditure is not used for a qualified medical expense, the accountholder will be required to pay income tax and a 20 percent penalty on the amount used
Note: the 20 percent penalty does not apply if the accountholder is disabled or age 65 or older
What happens if I use my HSA for a non-qualified medical expense?
Additional Information and Products
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Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive care is covered 100% in our network.
Immunizations
Preventive exams and health screenings
www.uhcpreventivecare.com
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Search our NETWORK at welcometouhc.com
Our network is available in 96% of all U.S. counties.
800,000+doctors and health care professionals (clinics, labs, care centers, etc.)
5,700+ hospitals
30,000+ pharmacies
Look for the find a doctor button on myuhc.com®
Call the number on the back of your health plan ID card
Search using the Health4MeTM mobile app
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
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Search our NETWORK at welcometouhc.com
Searching our network is easy.
Online access to care
NETWORK
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
A virtual visit lets you see and talk to a doctor from your mobile device or computer
No driving or crowded waiting rooms
24/7 access
Log on to myuhc.com or the Health4Me app to learn more
You’ll be covered for a wide variety of medications from UnitedHealthcare. Best of all, we’ve made it easy for you to get your prescriptions filled and save money.
Access thousands of retail pharmacies
Save when you use a network pharmacy
Take advantage of special programs for complex conditions.
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Easily fill and save on your medications.
Filling Prescriptions
Mail Service Member SelectSM from OptumRx
With Mail Service Member SelectSM from OptumRx, you can get your long‐term medications delivered to your door at no charge, often for less than they cost at retail. You can cancel home delivery service at any time and fill prescriptions at a retail pharmacy for your standard co‐pay or cost. However, canceling this service may increase your medication costs.
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get more at myuhc.com
Refill prescriptions.
Find network pharmacies.
Estimate and compare costs.
Take advantage of no‐cost home delivery.
Prescription Drug ‐ Clinical ProgramsPromoting Safety and Appropriate Use
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Notification or Prior Authorization
• Requires your doctor to tell us why you are taking your medication in order to determine if you will receive benefit coverage
• To start the process talk to your doctor. Once we review the information, we will send you and your doctor a letter to let you know if the medication is covered
SupplyLimits
StepTherapy
• A supply limit is the largest quantity of medication covered per copayment or in a time period
• Based on FDA guidelines for medication dosage, clinical guidelines or usage patterns
• With this program you need to try a lower‐cost medication first, before a higher‐cost medication may be covered.
PRESCRIPTIONS
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Tier 1Lower‐costMedications
Tier 2 Midrange‐cost
Medications
Tier 3Higher‐costMedications
How we cover prescriptions.
Organized by cost tiers
Choosing medications in lower tiers may save you money
The UnitedHealthcare Prescription Drug List (PDL) is the list of prescriptions that are covered by the plan
Specialty PharmacyPRESCRIPTIONS
We focus on you and the total condition, not just drug utilization.
Conditions Include: Cancer, Hemophilia, Hepatitis C, Multiple Sclerosis, Rheumatoid Arthritis, HIV and more
Our Specialty Pharmacy Program provides the resources and the condition‐specific support you need to help you manage your complex condition and achieve your best help.
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Access to pharmacies, providing support focused on you
Adherence and clinical programs to help you better manage your condition
Online support and medication information
myuhc.com
OTHER BENEFITS
Track claims and expenses.
Pay health care bills.
Find network providers, care centers, and pharmacies.
Find and compare medications.
Refill prescriptions.
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Access your benefits and get help anytime, anywhere with the UnitedHealthcare HEALTH4METM app
Manage your benefits and health care at myuhc.com.®
Get your information on the go
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
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Health4Me provides instant access to your family’s health information — anytime and anywhere.
Find a physician near you
Check the status of a claim
Speak directly with a health care professional
Use myuhc.com wherever you are —download the UnitedHealthcare Health4MeTM
mobile app.
Online Tools
OTHER BENEFITS
Estimate health care costs.
You have easy‐to‐use tools so you can see what a treatment or procedure typically costs, [estimate costs of prescriptions,] and see what your share of expenses may be.
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get help finding quality care.The UnitedHealth Premium® Designation Program shows you doctors who meet quality and cost‐efficiency guidelines.
Benefits worthy of your favorites bar
Healthy Pregnancy
OTHER BENEFITS
Enroll in the Healthy Pregnancy Program by calling the number on your health plan ID card.
Access nurses
Get information to help you identify health risks
Get a complimentary gift
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get help though pregnancy and delivery.
OTHER BENEFITS
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Call or web chat with a registered nurse, master’s‐level counselor, or legal or financial professional 24/7
Health and pharmacy information
Help coping with grief, stress, relationship issues, and more
Financial management information
Legal support
Find a doctor or counselor
Help is a call, email or web chat away.Care24® is open 24/7
myHealthcare Cost Estimator
• Get simple, comprehensive estimates of your health care costs to help you make more informed decisions
• myHealthcare Cost Estimator helps gather the information to help you make more informed choices about the health care received.
• Results include cost estimates
32Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of
UnitedHealth Group
Dental and Vision Benefits
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*This is a summary of benefits only and does not guarantee coverage. For a complete list of covered services and limitations/exclusions, please refer to the plan Contract.
2017 Dental Benefits
General plan information PPO Non-PPOAnnual deductible
Individual $50 $50
Family $150 $150
Waived for preventive Yes Yes
Annual plan maximum $1,500 $1,500
Lifetime orthodontia plan maximum $1,500 $1,500
Reasonable & customary percentile 80th
Covered services Diagnostic and preventive services
Examinations 100% 100%
X-rays 100% 100%
Prophylaxis 100% 100%
Fluoride treatments 100% 100%
Basic services
Sealants, space maintainers 100% 100%
Endodontics, periodontics, oral surgery 80% 80%
Inlays and onlays 50% 50%
Major services
Crowns, bridges, dentures 50% 50%
Orthodontia
Dependent Children only 50% Up to age 19
2017 Vision Benefits
General plan information PPO Non-PPOCopay
Examination $15 NAMaterials $25 NA
Benefit frequencyExamination Once every 12 monthsLenses Once every 12 monthsFrames Once every 24 monthsContacts Once every 12 months
Covered services Examination 100% after copay Covered up to $40
LensesSingle vision lens 100% after copay Covered up to $40Bifocal lens 100% after copay Covered up to $60Trifocal lens 100% after copay Covered up to $80Lenticular 100% after copay Covered up to $80
Frames Covered up to $130 Covered up to $45
Contacts - in lieu of glasses
Medically necessary 100% after copay Covered up to $210
Elective Covered up to $125 Covered up to $125
Other Services
Corrective Vision Services (e.g. laser vision) 15% discount on standard or 5% on promotional prices
2017 Employee Costs Per Paycheck for Benefits
Dental
Single $23.70
EE + SP $46.42
EE + Child(r $46.91
Family $72.09
Vision
Single $3.28
EE + SP $6.55
EE + Child(ren) $5.38
Family $10.43
Plans are offered on a voluntary basis, meaning there is no employer contribution
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2017 Enrollment
Completing Enrollment for 2017…It is a “passive enrollment” this year meaning that you only need to enroll if you wish to make a change from your current elections.
If you are in the $5,000 deductible plan you will automatically be enrolled in the replacement $4,000 deductible plan
All enrollment elections must be completed via the online enrollment system: www.infinityhr.com Can be completed from any computer that has internet access.
The enrollment portal will open for all employees on Monday, Nov 7th.
All enrollments must be completed no later than Wednesday, November 23rd.
After open enrollment, changes will only be permitted if you experience a qualified life event, such as marriage, divorce, birth or adoption. Open enrollment in a spouse’s plan
is also considered a qualifying event.
www.infinityhr.com
For your first log-in, please click on the link “First Time User? Forgot or want to Reset your password?”
www.infinityhr.com
Next, enter your date of birth and social security number. Then, click “Find My Record.”
www.infinityhr.com
The system will then provide you with your UserID. Please write this down. Next, enter and confirm your new password.
www.infinityhr.com
You will then be redirected back to the login page. Login with your UserID and newly created password. You will then be able to begin your Open Enrollment Event.
www.infinityhr.comFollow the steps to complete your Open Enrollment event. Be sure to:
Click the Save and Continue button to complete each step.
Click the Save and Confirm button when you reach the last step.
Double check your information under the Personal tab and make any necessary changes.
www.infinityhr.comIf you will be enrolling dependents (spouse and/or children) on your plan, please have the following information available to complete their enrollment.
Name
Date of birth
Social security number
Thank you!
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Questions?