Today’s Agenda
Discussion Topics
Open Enrollment – October 28th through November 15th
Healthcare Reform
Benefit Review• Medical: Blue Cross Blue Shield of Kansas City• Dental: Blue Cross Blue Shield of Kansas City• FSA: Phillips Resource Network• Life and Long-Term Disability: Lincoln Financial Group• Voluntary Vision: EyeMed• Voluntary Short-Term Disability: Aflac
Good News! There are NO benefit changes for 2014!!!
Open EnrollmentThis is the time to make benefit decisions. Changes outside of Open Enrollment are only allowed if you have a Qualifying Event:• Marital Status• Loss of Coverage• Birth of a Child• Adoption• Death
Pre-tax Premium laws require you make your elections for the Plan year with no changes unless you have a Qualifying Event.
Please notify the HR Department within 30 days of a qualifying event to make a change.
Health Care Reform – What does it mean for me?
• Beginning in January 2014, the Affordable Care Act (ACA) requires most individuals to obtain “minimum essential” health insurance coverage for themselves and their family members or pay a penalty, unless you qualify for an exemption.
• This is your opportunity to enroll in William Jewell College’s health plan to meet that requirement. Both of the health plans offered by Jewell meet the “minimum essential” coverage requirements for 2014. Therefore, employees (and their dependents) eligible for coverage through Jewell would not qualify for subsidies through the Marketplace (Exchange).
• The next opportunity you have to enroll in these benefits will not be until Open Enrollment next year which will take place in October of 2014. You may have an opportunity to enroll outside of the Open Enrollment period if you have a qualifying life event.
• Get more information on the Health Care Reform by going to www.healthcare.gov
William Jewell College Insurance Withholdings for 2014
HMO COST SHARING TABLE BY ANNUALIZED SALARY
Under $30,000At least $30,000 & under
$47,000At least $47,000 & under $61,500
At least $61,500 & over
1/2-3/4 Time Employees
2013 2014 2013 2014 2013 2014 2013 2014 2013 2014Employee Only $44.00 $46.20 $57.00 $59.85 $69.00 $72.45 $81.00 $85.05 $195.90 $205.70Employee + 1 $138.00 $144.90 $207.00 $217.35 $260.00 $273.00 $346.00 $363.30 $379.05 $398.00Family $159.00 $166.95 $224.00 $235.20 $293.00 $307.65 $361.00 $379.05 $538.75 $565.69
PCB COST SHARING TABLE BY ANNUALIZED SALARY
Under $30,000At least $30,000 & under
$47,000At least $47,000 & under $61,500
At least $61,500 & over
1/2-3/4 Time Employees
2013 2014 2013 2014 2013 2014 2013 2014 2013 2014Employee Only $41.00 $43.05 $53.00 $55.65 $64.00 $67.20 $75.00 $78.75 $181.65 $190.73Employee + 1 $132.00 $138.60 $197.00 $206.85 $250.00 $262.50 $341.00 $358.05 $359.13 $377.09Family $152.00 $159.60 $215.00 $225.75 $285.00 $299.25 $353.00 $370.65 $510.44 $535.96
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Your 2014 Medical Plan Options
Blue-Care – HMO (Health Maintenance Organization)• Select a Primary Care Physician (PCP); in-network only; metro Kansas City
area coverage only
Preferred-Care Blue – PPO (Preferred Provider Organization)• No selection of PCP; In and Out of Network; National and International
Coverage
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www.bluekc.com Blue-CareOffice Visits PCP: $30 (IM, GP, FP, PED)
Specialists: $60 (ENT, Derm, OB/GYN)
Inpatient Hospital Services/Outpatient Surgery $250 copay per day / per occurrence up to $1,250
per calendar year(applies to inpatient services at a hospital and outpatient surgeries
at a hospital or an outpatient facility)
MRI, MRA, CT and PET Scans Physician’s Office, Imaging Center, Outpatient Setting
$100 copayOnly one copay will apply for each provider on a specified date of
service even if multiple scans are performed
Routine Vision Exam $10 copay
Urgent Care(Minute Clinics, Take-Care Centers)
$60 copay(office visit/lab only)
Emergency Care $100 copay if treated and released(copay waived if admitted to hospital)
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Preferred-Care Blue In-Network Out-of-NetworkOffice Visit $40 copay* Deductible then 40%
Deductible: Individual $2,500
Deductible: Family $5,000
Coinsurance (your share): 20% 40%
Out-of-Pocket Maximum: Individual
$4,500 $9,000
Out-of-Pocket Maximum: Family
$9,000 $18,000
Hospital: Inpatient or Outpatient
Deductible then 20% Deductible then 40%
MRI, MRA, CT and PET Scans Physician’s Office, Imaging Center, Outpatient Setting, including hospital
Deductible then 20% Deductible then 40%
Emergency Room $100 copay then deductible then 20%
Urgent Care(includes Minute Clinics and Take Care Centers)
$40 copay* Deductible then 40%
*Copay includes Office Charge & Lab services in Physician’s office or Independent Lab
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Hospital Locator www.bluekc.com
Hospital Name HMOBlue Care Network
PPO - Preferred Care Blue Network
Center Point Medical Center X X
Children’s Mercy Hospitals X X
KU Medical Center X X
Lee’s Summit Hospital X X
Liberty Hospital X X
Menorah Medical Center X X
North Kansas City Hospital X X
St. Luke’s (All Locations) NO X
Olathe Medical Center X X
Overland Park Regional X X
Providence Medical Center X X
Research Medical Center X X
Shawnee Mission Medical Center X X
St. Joseph Medical Center X NO
St. Mary’s Medical Center X NO
Truman Medical Center (Hospital Hill and Lee’s Summit)
X X
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Preventive Care: What to Know!
Your BCBSKC plans will cover Preventive Care Services at 100%, according to established government guidelines:
• Annual Physicals• Childhood Immunizations• Well Women Exams• PSA Tests
Services MUST be Preventive and received by In-network providers
Effective: January 1, 2014• Generic Contraceptive drugs at 100%• Contraceptive implants, injectables & devices at
100%• Breastfeeding support, supplies (pumps) and
counseling at 100%
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Prescription Drug CoverageRetail and Mail-Order – Both Plans
Certain drugs may require prior authorization, have quantity limitations or require step therapy (Generics First). Refer to www.BlueKC.com for additional details.
34 day supply
In-Network Pharmacy
Tier 1: $10
Tier 2: $50
Tier 3: $70
102 day supply
Mail-Order
Tier 1: $20
Tier 2: $100
Tier 3: $140
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Urgent Care
• Receive care for non-life threatening conditions
• You are responsible for the $60 Urgent Care copay when using a Network Urgent Care Facility
• Use Take-Care Centers or Minute Clinics NOT the Emergency Room
• Outside of the BCBSKC service area? Contact your PCP prior to treatment
Emergency Care
• Go to the nearest Emergency Room or call “911”.
• Receive treatment and pay the $100 ER copay if treated and released. The ER copay is waived if admitted to an HMO hospital for the same condition within 24 hours.
• YOU MUST contact your PCP within 48 hours (or as soon as reasonably possible) after you receive medical attention.
Need To Know… HMO Blue-Care PlanUrgent Care and Emergency Care
Please Login to www.bluekc.com for a complete list of Urgent Care Facilities in your area.
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Worldwide Network of PPO Healthcare Providers
Welcomed in over 200 countries Worldwide
BlueCard PPO Network
National Network Access through BlueCard®
1,177,194 Physicians 6,776 Hospitals Access in ALL 50 States
2014 Wellness ProgramStep 1* Complete the Onsite Health Screening (or alternate means screening form)
for 25 PointsStep 2* Take the Health Risk Assessment (HRA) for 25 Points
*Steps 1 and 2 must be completed to be eligible to redeem My Rewards.
Step 3 Engage In Additional Activities for 25 PointsYou may earn additional points by participating in the following activities:
• Lifestyle Coaching (goals met): 10 pts; max 30 pts• Health Advising Call: 10 pts• Self-Directed Coaching Assessments: 5 pts; max 15 pts• Tobacco Cessation Program: 20 pts• Onsite Classes or Webinars: 5-20 pts• Healthy Companion Condition Management (goals met): 10 pts; max 30 pts• Little Stars Prenatal Assessment: 5 pts; max 10 pts
My Rewards: Members and spouses on the plan can redeem up to a total of $75 when 75 points are achieved.
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www.bluekc.com
View Your Claims, Print a Temporary ID card & Find Added Value Info
24-Hour Nurse Line
Access to Care Advisors to help you with symptoms or answer health-related questions
How Can They Help?◦ Gain convenient access to quality care◦ Become better informed about healthcare◦ Gain confidence when speaking to providers◦ Become educated on self-care for non-urgent situations◦ Improve knowledge of drugs and medications
24 hours a day…365 days a year!
877-852-5422
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Exclusively For Our Members
• A value-added program exclusively for Blue KC members.
Helping you live healthy means more than regular doctor visits
Blue365® is a national program that is part of your Blue KC membership
Provides exclusive access to information, discounts, and savings
• Blue365 can: Add exclusive value-added extras to an already
attractive and competitive benefit package Be a strong health and wellness resource
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Preferred-Care DentalBluePremier Network
Type I Type II Type III Type IVDeductible None $50 / $150 None
Blue Cross Pays
(Preferred-Care Dental and Out-Of-Area Providers)
100% 80% 50% 50%
Blue Cross Pays
(Non-Preferred-Care Dental Providers within our Operating Area)
80% 70% 40% 50%
Covered Services Dental X-rays
Routine Oral Exam
Cleaning – two each calendar year
Root Canal
Tooth Extraction
Bridge Recementing
Complete or Partial
Dentures
Surgery of Gums
Periodontal Scaling
Orthodontia ( to age 19):
Cephalometric X-rays.
Diagnostic casts.
Calendar Year Maximum
$1,000 per person for all services N/A
Lifetime Maximum None $1,000 Preferred
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Explore the website for added value discounts,
Prescription drug costs, price health procedures
Choose the Right Health Care Setting
Generics vs. Brand Name Drugs.
Visit the website bluekc.com to find an In-Network
Provider
Call Nurseline
Annual PhysicalsCommunicate with your
Doctor
Open aFlexible Spending Account
Participate in a Wellness Program
Consumer-Driven Tools
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What is an FSA anyway? An FSA adds spendable income and covers many expenses.
You may redirect part of your paycheck into a pretax account.
FSA Benefit Buckets Available:IRS Determines Limits
1- HEALTHCARE FSA: Medical, Dental, Vision, Pharmacy & approved OTC.
$2,500
and/or
2- DEPENDENT CARE FSA: Daycare expenses.
$5,000
You can participate in one or both types of FSA
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How will it benefit me?
• Paycheck Advantages: - Increased take-home pay- Lower income taxes
$$ Double benefit $$
Average family of four in the U.S. can save hundreds of dollars in taxes. ….
• Immediate availability of Healthcare account funds
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Expenses covered?
Medical & Dental• Deductibles & co-pays• Prescription drugs• Vision (exams, glasses, laser eye surgery,
contact lens solution)• Diabetic supplies• Hearing Aids• Medical travel expenses• Chiropractic services • Dental (cleanings, fillings, orthodontia,
dentures)• And many more!
*Over the counter….what qualifies….
Dependent Care• Daycare (child under age 13)
• Private Nanny or Babysitter• Adult Daycare
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How to submit claims
Option 2: Paper Claims. Fax or mail a claim form to Phillips Resource Network with an Explanation ofBenefits (EOB) and/or receipt. Receipts must include a patient name, date of service, type of service and dollar amount.
2014 PLAN YEAR: On January 1, 2014, your Benny Card will be loaded with your new plan year dollars. Please DO NOT use your card to go back and pay for any services in 2013 past the 75 days.
2013 PLAN YEAR: 75 day extension on allowable expenses with an additional 30 days to submit claims from any monies remaining from the 2013 bucket. Services must be incurred while actively employed and will be applied to the applicable plan year.
Option 1: The Benny Card. The card is used at the point of service at hospitals, doctor’s offices and pharmacies. The card cannot be used to purchase over-the counter medication without a prescription. Save all receipts as you may be asked to substantiate your expense. Keep your Benny Cards!
NEW !! Grace Period is now available on Benny Card Swipes and Manual Claims for 75 days
• For the 2013 plan year, the last day to use your 2013 funds is March 16, 2014• For the 2014 plan year, the last day to use your 2014 funds is March 16, 2015
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Things to remember…
• Choose plan election amounts carefullyUse it or Lose it Rule
• Contribution amounts can only be changed during the plan year due to a qualifying event (i.e., marriage or birth of a child)
• Expenses are reimbursed through an FSA after they are incurred; pre-
payments are reimbursed as services are received
Participation at any level will increase your take home pay!
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We’re here to help!
PLEASE DIRECT QUESTIONS TO PHILLIPS RESOURCE NETWORK, INC. OUR PHONE NUMBER AND EMAIL ADDRESS IS ON EVERY CLAIM FORM.
REMEMBER BY ENROLLING IN THIS PLAN, THE MONEY YOU REDIRECT IS NOT SUBJECT TO FEDERAL, STATE, OR SOCIAL SECURITY TAXES!
Every employee must complete a 2014 FLEX formeven if waiving coverage or not making any changes
William Jewell CollegeEmployer Paid Benefits(All Full-Time Employees and All Regular Part-Time Employees and Adjunct Faculty who are enrolled in the Employer’s Group Health Plan)
Basic Life Insurance • 1 times annual salary for employees• $50,000 minimum amount to $150,000 maximum
Dependent Life Insurance • $2,000 benefit for spouse• $1,000 benefit for children from 14 days to 20 (26 if full time student) years of age
Basic Accidental Death and Dismemberment • $25,000 for employees
Long Term Disability • 60% of monthly salary to $5,000 maximum monthly benefit• Payable after 120 days of disability• Payable to later of age 65 or SSNRA
William Jewell College Voluntary (Employee Paid) Options(All Full-Time Employees and All Regular Part-Time Employees and Adjunct Faculty who are enrolled in the Employer’s Group Health Plan)
Voluntary Life Choice of $10,000 increments of coverage for yourself not
to exceed the lesser of 5 times salary or $500,000 maximum benefit for employees.
Choice of $5,000 increments of coverage for your spouse not to exceed ½ of employee amount or $250,000.
Choice of $2,500 increments of coverage for children after 6 months of age to a maximum benefit of $10,000.
You or your spouse may elect or increase coverage by one or two increment levels on a guaranteed acceptance basis during your company’s defined annual open enrollment period, provided that you or your spouse have not been previously declined for coverage or withdrawn a previous application for coverage.
Voluntary AD&D Choice of $25,000 increments of coverage not to exceed
10 times salary or $500,000 maximum benefit for the employees on the Employee Only Plan or Family Plans
If elected, Spouse is provided 60% of employee amount when Children are not covered on the Family Plan.
If elected, Spouse is provided 50% of employee amount and Children are covered for 10% of the employee amount (not to exceed $15,000) when all are covered on the Family Plan.
If elected, Child is provided 15% of employee amount (not to exceed $15,000) if only Children are covered on the family plan.
There is an annual open enrollment for coverage on Voluntary AD&D.
EyeMed Exam & Materials PlanIn Network
Member’s CostOut of Network
Allowance
Exam with dilation as necessary $10 copay $30
Frequency:ExaminationLenses or Contact LensesFrame
Once every 12 monthsOnce every 12 monthsOnce every 24 months
Exam Options:Standard Contact Lens Fit and Follow-Up:*Premium Contact Lens Fit and Follow-Up:**
Up to $4010% off retail price
N/AN/A
Frames:Any available frame at provider location
$130 allowance, 20% off balance $65
Standard Plastic Lenses:Single VisionBifocalTrifocalStandard Progressives
$25 copay$25 copay$25 copay$90
$25$40$60 $40
Lens OptionsUV CoatingTint (Solid and Gradient)Standard Scratch-ResistanceStandard PolycarbonateStandard Polycarbonate-Kids under 19Standard Anti-Reflective CoatingOther Add-Ons and Services
$15$15$15$40$40$4520% off retail
N/AN/AN/AN/AN/AN/A
Contact Lenses (Materials Only)ConventionalDisposableMedically Necessary
$130 allowance, 15% off balance over $130$130 allowance, plus balance over $130$0 copay, paid-in-full
$104$104$200
EyeMed Materials Only PlanMaterials Only Plan In Network
Member’s CostOut of Network
Allowance
Frequency:Lenses or Contact LensesFrame
Once every 12 monthsOnce every 24 months
Frames:Any available frame at provider location
&0 Copay ; $130 allowance, 20% off balance over $130 $65
Standard Plastic Lenses:Single VisionBifocalTrifocalStandard ProgressivesPremium ProgressivesLenticulars
$0 copay$0 copay$0 copay$65$65,80%of charge less $120 allowance$0 copay
$25$40$63 $40 $40$63
Lens OptionsUV CoatingTint (Solid and Gradient)Standard Scratch-ResistanceStandard PolycarbonateStandard Polycarbonate-Kids under 19Standard Anti-Reflective CoatingOther Add-Ons and Services
$15$15$15$40$40$4520% off retail
N/AN/AN/AN/AN/AN/A
Contact Lenses (Materials Only)ConventionalDisposableMedically Necessary
$0 Copay $130 allowance, 15% off balance over $130$130 allowance, plus balance over $130$0 copay, paid-in-full
$104$104$200
EyeMed – Providers
• One of the largest, and most diverse vision panels• Includes thousands of private practice optometrists, ophthalmologists
and opticians• Composition of panel – 75% independent, 25% retail• Includes the nation’s top optical retailers, including:
Online Management for Members• Once registered online at www.eyemedvisioncare.com the member will
be able to:– Locate a provider – choose the “Select” network – View benefit details– Order replacement ID card– View claims
Voluntary Short-Term Disability
• Guaranteed-issue Short-Term Disability• Guaranteed, renewable to age 70• Benefits paid regardless of any other insurance• 3-Month Benefit for illness or off-the-job accident• $500 to $3000 in monthly benefit guaranteed issue• Waiting period defined by each individual’s needs• Partial disability benefit• Payroll deduction
Income Replacement Example
• Jewell employees are provided long-term disability that begins after 120 days for an illness or off-the-job accident.
• Aflac short-term disability can be purchased to provide income replacement for the first 90 days, reducing the income gap to only 30 days
Example: $34,000 Annual SalaryAge: 18 - 49
• 14/14 – 14 calendar days waiting for an off-the-job
accident– 14 calendar days waiting for an illness
• 3 Month Benefit period• Qualify for $1,700 Monthly Benefit• $28.73 monthly premium
Example: $50,000 Annual SalaryAge: 18 - 49
• 14/14 – 14 calendar days waiting for an off-the-job
accident– 14 calendar days waiting for an illness
• 3 Month Benefit period• Qualify for $2,500 Monthly Benefit• $42.25 monthly premium
Commerce Bank
Special employee banking benefits
No ATM fee when using the on-campus ATM located in Yates-Gill College Union
IMPORTANT• Forms to turn in:
• 2014 FLEX form• Any changes to other benefits*
Open Enrollment: October 28th through November 15th
ALL applications and changes must be turned in no later than November 15th to the Office of Human Resources
*Examples of changes include:• Changing plan options• Adding or Removing dependents• Address or phone number changes• Changing beneficiary designation
If you have any additional questions please contact the Office of Human Resources.