Your 2012 BenefitsEmployee Meeting

Partnering for a Healthier Community

November 2011

Content:

• Enrollment

• What’s new for 2012

• Introducing Health Advocate

• Choosing the right medical plan

• Incentives

• Flexible spending accounts

• Dental and vision

• Answer your questions

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Open Enrollment November 1 – November 30

What you can do during Open Enrollment

• Elect or change medical plan options– The HRA Plan or the Choice Plus PPO

Plan– Dental and vision benefits are included

• Set aside money in a flexible spending account– Health care or– Dependent care or– Both

• Add life insurance or increase coverage for you and your family

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Other benefits::• Employee Assistance

Program• No enrollment

• Long-term disability insurance

• University paid• No enrollment

• Tax-Deferred Retirement Savings Plan • Join• Increase contributions• Invest

Do you have to enroll?• Yes, if you want to:

– Change your current medical plan

– Add more life insurance

– Add dependents

– Add or continue a flexible spending account – your election does not carry over to next year

• No, if you want to continue your current elections and do not want to participate in a flexible spending account

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What’s new in benefits beginning January 1, 2012

• Introducing Health Advocate• New contribution rates• Changes to the pricing tiers in the

prescription drug plan

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Health Advocate

• Enroll in a medical plan and a Personal Health Advocate will be a resource for:– Learning more about your health condition or

diagnosis

– Identifying the right doctors and specialists

– Resolving medical billing and claim issues

– Assisting with elder care and Medicare issues

• You, your spouse and children, your parents and the parents of your spouse are all covered

• No cost to you

Who is Health Advocate?• National advocacy and

assistance company• Mission: to help

individuals get the very best health care services

A health care professional is a phone call away

866-695-8622

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What else is new beginning January 1, 2012• New payroll contribution rates for the medical plans

- See the rate sheet with your enrollment materials- Remember, you can lower your rates by completing your

Personal Wellness Profile

• Changes to prescription drugs- Some prescription drugs will change tiers or clinical programs

- Lipitor will have a generic-equivalent that will cost more than the Lipitor brand name, meaning the brand name will be in a lower-cost tier

- Go to myUHC.com or call the phone number on your ID card for more information

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Which medical plan is right for you?

Two choices in medical plans:

1. The HRA Plan

2. The Choice Plus PPO Plan

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The HRA Plan5 Steps to Managing Your Health Costs1. The University funds your Health

Reimbursement Account (HRA). Single $1,000Family $2,000

2. Pay out of pocket up to the Bridge Amount.In-Network Out-of-Network

Single $1,500 $1,500Family $3,000 $3,000

3. You reach the DeductibleSingle $2,500Family $5,000

4. Plan pays 80% in coinsurance.

5. Plan pays 100% when your out-of-pocket expenses reach the maximum.

In-Network Out-of-NetworkSingle $3,000 $4,500Family $6,000 $9,000

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TIP: Use your FSA to help you pay out-of-pocket expenses

after your HRA is spent

1 43

Present ID card

to doctor

1Doctor sends

claim to

UnitedHealthcare

UnitedHealthcare

applies network

discount

2UnitedHealthcare

pays provider from

HRA

If HRA is spent

1. Provider bills

you for payment

2. After deductible,

provider bills you

for your share of

coinsurance

3When you have

claim activity, you

will receive a

Statement.

4

The HRA PlanPayment process

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Learn more at Health Care Lane

Want more help to understand the The HRA Plan?

Talk with Paul, the mechanic, and he will give you the nuts and bolts on how this plan works

www.healthcarelane.com/valparaiso

Click on “Campbell’s Auto Care.”

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The Choice Plus Plan

When you use in-network providers Single Family

You pay out of pocket up to the annual deductible amount

$1,000 $2,000

You and plan share coinsurance

Plan pays 80%

Plan pays 80%

Except for copays, the plan pays 100% after your share reaches the out-of-pocket maximum

$2,000 $4,000

For example, the plan pays 100% of the cost of a visit to your doctor’s office after you pay a $20 copay. You pay the copayment each time, even after the out-of-pocket maximum is reached.

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Out –of-network providers have a separate annual deductible and out-of-pocket maximum.

For maximum value, use in-network providers.

See the Benefits Decision Guide for details.

Both plans cover Preventive Care at 100%Adult Child

Annual routine office visit and exam Six visits 0-12 months

Tetanus/Diphtheria booster Three visits 12-24 months

Annual influenza vaccination (flu shot)

Annual visits age 24 months through age 18

Cholesterol screening Annual Pap smear and pelvic exam, as appropriate by age

Annual mammogram after age 40 Lead-level testing

Annual Pap smear and pelvic exam Immunizations

Labs, pathology, chest X-ray, and EKG (when performed as preventive care)

Labs, pathology, chest X-ray, and EKG (when performed as preventive care)

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Preventive vs. non-preventive• Preventive care: Routine annual screenings to “prevent” illness or injury• Non-preventive care: If diagnosed with a condition, some screenings often

considered part of treatment. Be sure to talk to your doctor.

Preventive care Not preventive careMammogram – annually for women starting at age 40, or recommendation

Patient found lump in breast and doctor recommends mammogram to diagnose condition

Colonoscopy – every 10 years starting at age 50, recommendation

Patient has unexplained weight loss and constipation. Afraid it’s colon cancer; schedules colonoscopy

Annual physical/preventive care exam – includes height, weight, blood pressure

Office visit due to fever and rash

Pap smear – once annually for women who are 18 years of age or older

Abnormal Pap smear; returns for second exam. This second exam would be considered non-preventive

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More information on preventive care coverage can be found at www.uhcpreventivecare.com

Retail(30-day supply)

Mail order(90-day supply)

Tier 1 Greater of 10% or $6 Greater of 10% or $6

Tier 2 Greater of 20% or $20 Greater of 20% or $40

Tier 3 Greater of 30% or $30 Greater of 30% or $60

Pharmacy – Choice Plus PPO Plan

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Pharmacy - The HRA Plan

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Your HRA and you pay actual cost of medications until the HRA Plan’s annual deductible is met

Then, you pay 20% coinsurance for covered medications (pay coinsurance at the pharmacy)

Up to the HRA Plan’s annual out-of-pocket maximum; then the HRA Plan pays 100%

The pharmacy payment process – The HRA Plan

1 43

Present ID card

to pharmacy.

1

Pharmacy verifies

eligibility and

any amount

you owe at the point

of sale.

2

You pay pharmacy

any copayments or

amounts not

covered by

available

coinsurance

3

When you have

claim activity, you

will receive a Health

Statement.

4

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How can you reduce your medical plan’s payroll contributions?

Complete a Personal Wellness Profile questionnaire• Between November 10 and December 8,

2011• And reduce your rates for 2012 • Must complete every year to continue the

reduction

Your health information is confidential and protected by the HIPAA Privacy Rule. The University does not have access to individual health date or Personal Wellness Profiles.

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How to earn your discount

1.Schedule your appointment2.Show up for your 20-minute

screening3.Receive your Personal

Wellness Profile4.Go online to complete the

questionnaire5.Visit your doctor to discuss the

results – this consultation is covered as preventive care See the rate sheet for

rate comparison

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Incentives for HRA Plan participants

Complete these Health StepsRewards are added to your Health Reimbursement Account

Which Healthy steps are you ready to take? Reward

1 Complete onsite bio-metric screening and online health questionnaire

$100 per family, per year

2 Complete the Tobacco Cessation Program $100

3 Complete the Weight Loss Management Program $100

4 Participate in the Personal Health Coaching Program or Disease Management Program $300*

*$100 when you enroll into the program, $200 when you complete it.

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What is a Flexible Spending Account?

Flexible spending accounts, or FSAs, help you pay for out-of-pocket health care or dependent care expenses.

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How FSAs work

• You sign up each year to have a certain amount deducted pre-tax from each paycheck

• When you have out-of-pocket eligible expenses, you can use your FSA to reimburse yourself for those costs

• Eligible expenses are defined by the IRS

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How FSAs work• Plan carefully, start small until you gain

experience− FSA funds must be spent within the plan

year or balance is forfeited

− Funds do not roll over year to year

• But, you have a “grace period” of up to 2½ months following end of plan year − Spend by March 15 of the following year

− File by March 31 of the following year

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Health care FSA• You can set aside $8,000 for 2012

• Use it for (but not limited to):

– Copayments and deductibles

– Dental and vision expenses

– Hearing aids

– Prescription drugs

– Certain over-the-counter medications, if prescribed by a doctor

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Dependent care FSA• You can set aside up to $5,000 for 2012 • Use it for:

– Qualified day care expenses for children under 13

– Adult dependents not capable of caring for themselves

– Babysitters, day care and day camps may qualify

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Managing your FSA is easy with myuhc.com• View your medical and FSA claims online• Use direct deposit

• Money deposited right into your personal checking or savings account

• Saves paper … go green!• Turn on auto-rollover

• Pay out-of-pocket and money automatically transfers to your FSA

• If you enroll in the HRA Plan, eligible expenses are automatically paid from your HRA first, then your FSA

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Other resources at myuhc.com• Find network

doctors/hospitals

• Estimate costs

• Track claims status

• Build a health improvement program

• Keep a Personal Health Record

• Get health product discounts

• Review plan details

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Dental benefits

Included with medical plan

• Preventive care: Plan pays 100% (no deductible)• Deductible: $50 deductible for single or $150 for family• The plan covers

– Basic services at 80%, such as oral surgery and root canal therapy, after the deductible

– Major services at 50%, such as crowns, dentures and bridges, after the deductible

• Annual maximum benefit is $1,000

Vision care benefits

Included with medical planIn-network benefits• After $10 copay, the plan pays:

– 100% for lenses (single, line bifocal or trifocal or lenticular)– Up to $130 for frames (retail)– Up to $105 for contacts

• Once every 12 months

How to enroll• Go to secure.healthx.com/Valparaiso.aspx

to enroll by November 30• Returning users: see instructions as your

username and password will be reset• New users: see instructions for creating a

username and password• Be prepared –

• Have Social Security numbers and birthdates for everyone you enroll

• Your date of hire and Social Security Number and phone number

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Most important

• What you put into the system, is what you get• Be careful entering your benefits,

coverage information and dependent data

• An error may result in no benefits for 2012 or no coverage for you or a dependent

• Check your confirmation email

Enrollment Deadline is November 30

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Questions?

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