School District of Slinger

Health Insurance Coverage Effective September 1, 2013

July 22, July 29 and August 5th

What will be covered in today’s meeting…• Introductions

• Why is a change taking place?

• 2013 Plan options and premiums

• Fundamentals of a Health Savings Account

• Banking arrangement – First National Bank

• Group Vision

• Section 125

• Next Steps

• Questions

Introductions

Ryan Barbieri – Senior Vice President

Sharon Schulteis-Senior Client Manager

Karen Becker-Account Executive

Clara Scheckel-Field Account Manager

Tammy Tongusi-Personal Banking Manager

First National Bank is the District sponsored bank for H S A contributions starting September 1 st.

Why the health insurance is changing•The members of the school board/teacher handbook committee agreed that it was in everyone’s interest to explore some of the innovative and consumer driven health options

•Change will offer an opportunity with reduced premium share for employees

•Puts District in a better position to maximize future savings

•Southeastern Wisconsin healthcare is trending at 12%

What has been done leading up to this point?• Employees will have the opportunity to participate in a

Consumer Driven Health Plan that will qualify them for an additional benefit…H S A contributions made to a First National account

• Those electing H S A plan will have an option for Limited Purpose FSA as of 1/1/2014

• Those electing not to participate in the health plan will continue to have the Full Purpose FSA option as of 1/1/2014

• Employees will be provided with a Group Vision Plan effective 9/1/2013

Benefit Plan Eff. 9/1/2013

In-Network Out-of-Network

$2,500 $5,000

$5,000 $10,000

90% 70%

$4,000 $10,000

$8,000 $20,000

90% after ded 70% after ded

100% 70% after ded

90% aft. ded. 70% aft. ded.

90% aft. ded. 70% aft. ded.

$10/$30/$50(after deductible is met)

Includes Deductible

90% after ded.

H S A Option

Choice Plus

Policy or Calendar Year Deductible

Provider Network

Deductible Single

Family

Coinsurance

Out-of-Pocket Max(Includes Deductible)

Office Visits (PCP / SCP)

Preventive Care

Single

Family

Prescription Drugs

Retail

Hospital Services

Urgent Care

Emergency Room

7Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

Preventive care services examples

Covered preventive care services include many types of exams subject to age and gender guidelines, which typically include:

Physician office services:Age- and gender-appropriate preventive

examinations

Well baby and well child preventive examinations

Immunizations

Health screening tests:Mammography screening

Colorectal cancer screening

Cervical cancer screening

Osteoporosis screening

8

Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

Expanded women’s preventive care services

Preventive ServiceExpanded Women’s

Preventive9/23 Provision

• Gestational Diabetes Screening

• All pregnant women (24-28 weeks); high risk screened twice

• Pregnant women at risk

• HPV DNA testing for women 30 years and older

• All women age 30+ every 3 years

• Women at risk; not mandated as preventive

• Counseling for sexually transmitted infections

• All sexually active women • Women at risk (teens, pregnant women, lifestyle)

• Screening and counseling for HIV

• All sexually active women • Women at risk (pregnant women, lifestyle)

• Screening and counseling for domestic violence

• All women • Women at risk

• FDA-approved contraception methods and counseling

• All methods, all women • Not specifically addressed; not mandated as preventive

• Counseling for breast-feeding and rental equipment and supplies

• Part of pre/post-natal counseling for pregnant women, coverage for rental of breastfeeding equipment

• Coverage for counseling only

• Well-woman exams • As many as necessary to obtain specified preventive services

• Yearly

myHealthcare Cost Estimator

The ultimate resource for life’s challenges

10

Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

Call Care24 services about:

•Routine illness•Minor injuries•Stress and anxiety•Relationship worries•Coping with grief and loss•Questions to ask your doctor•Personal legal concerns*•Men’s, women’s and children’s health•Prevention•Self-care information•Help Finding a doctor•Information on medications•General Health Information

11Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

UnitedHealthcare Health4Me™ makes it simpler for your employees to manage their health by providing:

• Easy access to their health plan information

• A mobile resource to find doctors and facilities anytime, anywhere

• Experienced Health Advisors to answer any questions they may have

• An interface that allows each plan member to be viewed independently

• Can be personalized with member photos

Health Insurance Full Premium

UHC H.S.A. Plan

$2,500 / $5,000 Deductible Plan September 1st, 2013

Coverage Amount per Month Employee Share per Month

Single $682.70 24 pays=$ 86 20 pays=$103.20

Family $1,547.61 24 pays=$195 20 pays=$234

Single Medicare $429.55 / $132.70*

Family Medicare $859.09 / $265.39*

Medicare Special $1,188.17

*Premium for medical only coverage where Medicare D is in place for drug coverage

What Is A H S A Plan

What Is A HSA?

• Combines a Qualifying High Deductible Health Plan (HDHP) with a Health Savings Account (HSA)

• Funded by the District and / or you

• Pre-tax basis by salary deferral and direct deposit for participants

• Pay for qualified expenses or save for the future

• Annual limit that can be contributed to account

• Catch-up contributions (Age 55 and up) up to $1,000

• Funds accumulate and earn non-taxable interest

• The dollars in the HSA are yours!

• It remains your money even if you leave the District or retire

What is the HSA Concept?

Part 1:

Qualifying High

Deductible Health

Insurance PlanPart 2:

Health Savings Account

HSA Concep

t Pays expenses until the

deductible is met.

Intended to cover serious

illness or injury after the

deductible has been met.

Two Basic Parts:

HSA Tax-Advantages

HSA

Name of account Health Savings Account

Who owns the account? Individual/employee

Who may fund the account? Employer or employee, can be both in the same yearEmployee can contribute pre-tax dollars through Section 125 plan

What plans may be offered with the tax-advantaged account?

An HDHP as follows:Min. Deductible$1,250 I $2,500 F**OPM$6,250 I $12,500 F**

Is there a limit on the amount that can be contributed per year?

$3,250 I $6,450 F**Catch-up contributions:$1,000 p/yr – age 55 by end of tax yearReduced by MSA contributions in same year

Does the uniform coverage rule apply? No

*Self-employed individuals, including partners, and more than 2% shareholders in a subchapter S-corporation cannot contribute.**For calendar year 2014.

HSA Tax AdvantagesHSA

Can unused funds be rolled over from year to year?

Yes

What expenses are eligible for reimbursement?

Section 213(d) medical expensesEffective 12/31/10, OTC medicine or drug expenses cannot be reimbursed unless they are prescribed or are insulin.-COBRA premiums-QLTC premiums-Health premiums while receiving unemployment benefits-If Medicare eligible due to age, health insurance premiums except medical supplement policies

Must claims submitted for reimbursement be substantiated?

No

(keeping in mind that receipts will be needed for IRS audits)

May account reimburse non-medical expenses?

Yes, but taxed as income and 20% penalty (no penalty if distributed after death, disability or eligible for Medicare)

Is interest earned on the tax-advantaged account?

Yes, accrues tax-free

 This Chart is provided to you for informational purposes only. Please seek qualified and appropriate counsel for adviceon how to apply the topics discussed herein to your employee benefits plan. (3/04, JS 5/09; 8/10; KP 9/10) © 2004-2010 Zywave, Inc.

 

How to Obtain Further InformationYou May Contact your Tax Advisor

You may reference the IRS website at: www.IRS.gov

Who is eligible for a HSA?

An “eligible individual” is any individual who,

for a given month…

• is covered under a qualified high-deductible health plan (HDHP)

• Is not also covered by any other health plan unless it is also an HDHP

• may not be claimed as a dependent on another person’s tax return.

• is not covered by Medicare and receiving benefits

Expense  

Deductible$2,500

Coinsurance 90% / 10%

For HSAReimbursement

Preventive Care - 1 Physical Exam

Covered at 100%

4 Office Visits (Non-Preventive)

$400 $400 — $400 (Deductible)

Emergency Room $800 $800 — $800(Deductible)

Diagnostics $2,000 $1300 Plan pays $630 Tom pays $70

$70

Totals $3,200 $2,500 Tom Pays $70 $1,270

Health Savings Account

Total Contribution

$2,000

Less - $1,270

Balance $730

Example of HSA Usage – TomEmployee Coverage

$2,000 District Contribution

Expense Deductible

$5,000Coinsurance

90% / 10%For HSA

Reimbursement

Preventive Care - 3 Physical Exams

Covered at 100%

6 Office Visits(Non-Preventive)

$600 $600 — $600

Out Patient Surgery for Dependent Child

$3,500 $2,500 Plan Pays $900Sarah Pays $2,500 +

$100=$2,600

$2600

3 Office Visits for Dependent Child

$1,000 $0.00* Child has met Single Deductible

Plan pays $900Sarah pays $100

$100

OutpatientSurgery

$10,500 $1,900 Plan Pays-$7,740Sarah pays $1900+

$860=$2,760

$700

3 Specialist Visits $3,600 $0 Plan pays $3,240Sarah pays $360

Totals $19,200 $5,000 Sarah pays $5,820 $4,000

Health Savings Account

Total Contribution $4,000

Less - $4,000

Balance $0

Sarah’s Responsibility $1,820

Example of HSA Usage – SarahEmployee + Family Coverage-with embedded deductible

$4,000 District Contribution

What form can contributions be made?

• Contributions to a HSA must be made in “cash”. For example, contributions may not be made in the form of stock or other property.

• Contributions to the HSA can be made through payroll deduction on a pre-tax basis.

• The District will contribute $2,000 for Employee coverage and $4,000 for Family coverage

District HSA Contributions 2013-2014

FAMILY

24 pays: $4,000/12 = $333.33/mo.

Sept. 10th : $333 x 4 = $1,332(Sept–Dec lump sum to get started)

Jan – Aug: $333/mo = $2,331

June: $337(to accommodate for rounding difference)

20 pays: $4,000/10 = $400.00/mo.

Sept 10th: $400 x 4 = $1,600

Jan - June: $400/mo = $2,400

SINGLE

24 pays: $2,000/12 = $166.67/mo.

Sept. 10th : $167 x 4 = $668(Sept–Dec lump sum to get started)

Jan – Aug: $167/mo = $1,169

June: $163(to accommodate for rounding difference)

20 pays: $2,000/10 = $200.00/mo.

Sept 10th: $200 x 4 = $800

Jan - June: $200/mo = $1,200

How are distributions treated for tax purposes?

• Tax Free

(Qualifying medical expense)

• Ordinary Tax

(Non-medical distribution after age 65)

• Ordinary Tax + 20% penalty

(Non-medical distribution prior to age 65)

When may I take distributions from my HSA?

• Your HSA dollars can be taken at any time to pay for qualifying medical expenses.

Note: If reimbursing expenses from previous years, you must maintain sufficient records to prove the expense was not previously reimbursed.

Qualified HSA Expenses• Medical, dental, vision deductibles and

coinsurance amounts

• Certain Long Term Care insurance premiums

• COBRA premiums

• Hearing aids

• Smoking cessation

• Wheelchairs

• Organ transplants

• Medicare premiums

What are qualifying Medical Expenses?

• A Qualifying Medical Expense (QME) is generally any expense incurred to maintain your health or your family’s health

• A partial list of expenses that can be reimbursed is included with the HSA information

• A complete listing provided in Section 213 of IRS Ruling.

Vision

A national network of over 54,000 access points

National reach, local providers

50% Private Practice Providers / 50% Retail Chain Providers

More than 100 national and local retail brands including 16 of the top 20*

* Vision Monday, May 18, 2009

Provider Network Access and Choice

Your Vision Program: In-Network Benefits

Eye Examination• Fully covered, after applicable copay

• Performed by a licensed optometrist or ophthalmologist

• Includes case history, examination for eye pathology and abnormalities, visual analysis (refraction), diagnosis, visual field testing, and prescription (if necessary)

Your Vision Program: In-Network Benefits

Lens Benefit• Standard single vision• Standard lined bifocal• Standard lined trifocal • Standard lenticular• Standard Scratch Resistant coating

Discounts on non-covered lens options including popular selections such as:• Polycarbonate lenses• Photo-chromatic lenses• Anti-reflective coating• Tints• Progressive lenses

Your Vision Program: In-Network Benefits

Frame Benefit• $130 allowance applied to the retail price of any frame of the

member’s choice. If members choose frames over $130 retail cost, they are only responsible for the difference between the allowance and the retail cost.

• Many providers offer a discount of 30% off of the difference between the retail cost and the $130 allowance. Providers offering this discount are indicated in the online provider directory.

Your Vision Program: In-Network Benefits

Industry-Leading Contact Lens Benefit

• Covered-in-full Contacts*

Fitting/evaluation fee, contacts (including up to 6 boxes of disposables, depending on prescription and frequency of disposable contact)

• Outside covered-in-full selection

$150 allowance for fitting/evaluation, purchase, and up to two follow-up visits

• Online ordering and discount on contact lenses

Online ordering with10% discount off already low prices from Vision Direct via www.myuhcvision.com

*Coverage for Covered Contact Lens Selection does not apply at Walmart, Sams Club and Costco. The allowance for non-selection contact lenses will be applied towards the fitting/eval fee and purchase of all contacts.

Your Vision Program: Out-of-Network Benefits

Standard Out-of-Network Benefits*

• Examination reimbursement up to $40

• LensesSingle Vision reimbursement up to $40Bifocal reimbursement up to $60Trifocal/Lenticular reimbursement up to $80

• Frames reimbursement up to $45

• Contacts Elective reimbursement up to $150Necessary reimbursement up to $210

*Out-of-network reimbursement not subject to plan copays.

Bridge2Health UnitedHealthcare Medical and Vision – Better Together

Taking care of your eyes benefits your overall health Because UnitedHealthcare provides both your medical and vision benefits, we

understand how the health of one part of your body affects the health of the rest of your body. We’re not just focusing on your eye health. We’re connecting the dots to help you understand and improve your overall health.

Get the most from your benefits Members have access to a wide variety of online health and wellness

information, easy-to-use tools and reminder programs.

• myuhc.com – find important information about your medical and vision plans, locate a provider, and access health and wellness education materials.

• myuhcvision.com – access your vision plan information, print and ID card, search for a provider, fine eye health and wellness information.

• Reminder call program: It’s important to have an annual eye exam, especially if you have a chronic condition such as diabetes, hypertension, high cholesterol and vascular disease. If you missed your annual exam, our program is here to remind you.

35Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

Health Savings Account1st National Bank of Hartford

Your Independent Local Community Bank since 1907

Three Convenient LocationsThree Convenient Locations

Hartford Location

116 W. Sumner Street

Hartford, WI 53027

262-673-5800

Richfield Location

1297 State Hwy 175

Hubertus, WI 53033

262-628-5500

Slinger Location

439 E. Washington Street

Slinger, WI 53086

262-644-7606

MEMBER FDIC

How does your bank account work?How does your bank account work?

$500.00 Minimum Daily Balance is required to earn interest $500.00 Minimum Daily Balance is required to earn interest

(If the balance falls below $500.00 a $2.50 monthly maintenance will be assessed)(If the balance falls below $500.00 a $2.50 monthly maintenance will be assessed)

Free debit card Free debit card (10 business days to receive)(10 business days to receive)

Free 24-hour internet banking Free 24-hour internet banking (Setup online or at the branch)(Setup online or at the branch)

Free bill pay Free bill pay (Setup online or at the branch)(Setup online or at the branch)

Free telephone banking Free telephone banking (Setup at the branch by calling or stopping in)(Setup at the branch by calling or stopping in)

Interest paid monthlyInterest paid monthly$500.00 or greater and less than $2,499.99$500.00 or greater and less than $2,499.99 .50% .50%APY .50% .50%APY

$2,500.00 or greater and less than $9,999.99$2,500.00 or greater and less than $9,999.991.00%1.00% 1.00%APY1.00%APY

$10,000.00 or more$10,000.00 or more 1.49%1.49% 1.50%APY1.50%APY

MEMBER FDIC

Rate of interest is subject to change at any timeRate of interest is subject to change at any time

Things to know:Things to know: Please fill out the application that was mailed to Please fill out the application that was mailed to

you completely. Authorized Agent and Beneficiary you completely. Authorized Agent and Beneficiary section is very important.section is very important.

Retain your receipts. You need to be able to show Retain your receipts. You need to be able to show for every dollar spent.for every dollar spent.

Limits per year. Your contribution limits will Limits per year. Your contribution limits will depend on the tax year and whether it is self-only depend on the tax year and whether it is self-only or family plan.or family plan.

You have until April 15You have until April 15thth of every year to make a of every year to make a previous year contribution.previous year contribution.

Debit cards. You will receive these before the Debit cards. You will receive these before the initial deposit. Beware they will not work until initial deposit. Beware they will not work until funded.funded.

Who do we contact?Who do we contact? Beverly Schatz at our Slinger LocationBeverly Schatz at our Slinger Location

262-644-7606262-644-7606 Tammy Tongusi at our Hartford LocationTammy Tongusi at our Hartford Location

262-673-5800262-673-5800 Kathy Schliepp at our Richfield LocationKathy Schliepp at our Richfield Location

262-628-5500262-628-5500

or any New Account Representative!or any New Account Representative!

We are here for you!We are here for you!MEMBER FDIC

What’s Next?•On track to have Health ID cards to members by September 1st

•Deductibles accumulate on a calendar year basis – they will reset and start over January 1st - for this year, September through December incurred deductibles will carryover into 2014

•You must complete a separate health and vision enrollment form to designate your level of coverage

•Information regarding the FSA benefit options will be provided by the district this fall - IF you intend to participate in the FSA benefit, you MUST re-enroll

What’s Next?•Your benefit election is an Annual Irrevocable Election unless there is a Qualifying Event

Qualifying Event, such as:

New Child – Adoption or Newborn

Change of Child Custody or Support Order

Marriage/Divorce

Spouse Loses/Quits their Job

Death of Spouse

NOTE:

Changes must be received within 31 days after the qualifying event

Questions…