10/19/2015

Oak Hills Local School District Medical Insurance OHEA & OAPSE – October 2015

Insurance Today Carrier = Anthem Renewal History: - 2012 = 0% - 2013 = 18% - 2014 = 4.5% - 2015 = 1% 2016 Renewal Rate = 11%

(ACTUAL = 5%)

(no plan changes)

1

10/19/2015

How to Reduce Insurance Premiums? - Plan design changes to current plan - Spousal Surcharges - Other alternate plans - Preventative Measures - Responsible Shoppers & Healthy Lifestyles Register at Anthem.com

Responsible Insurance Consumers

2

10/19/2015

Wellness Fitness Center Memberships

Insurance Today Preferred Provider Organization (PPO) Deductible

- $250/$500

Co-Insurance

- 80% / 20%

Out of Pocket Max - $1,250/$2,500 Prescription Tiers

- $15/$30/$45

3

10/19/2015

Insurance Today Preferred Provider Organization (PPO) Co-Pays Doctor Visit (PCP)

= $25

Specialist

= $50

Urgent Care

= $100

Emergency Room

= $200

Insurance Today - Example #1 (Low) Preferred Provider Organization (PPO)

Doctor Visit - Sore Throat Co-Pay $ 25 Tier 1 Prescription $ 15 Total Member Cost $ 40

4

10/19/2015

Insurance Today - Example #2 (Moderate) Preferred Provider Organization (PPO)

Urgent Care - MRI Co-Pay Deductible ** MRI (20%) Total Member Cost

$ 100 $ 250 $ 150 $ 500

** MRI Total Cost = $1,000

Insurance Today - Example #3 (Severe) Preferred Provider Organization (PPO)

Inpatient - Knee Replacement Deductible - Hospital ** Surgery (20%) Total Member Cost

$ 250 $ 1,950 $ 2,200

X

Maximum Payment = $1,250 ** Total Surgery Cost = $10,000

5

10/19/2015

Insurance Today - 2015 Preferred Provider Organization (PPO)

MONTHLY Premiums Plan

Total

Board Portion

Employee Portion

Single

$542

$459

85%

$83

15%

Double

$1,258

$1,065

85%

$193

15%

Family

$1,447

$1,225

85%

$222

15%

How much will my insurance increase if I stay with a PPO? Single = $360 Double = $828

Family = $960

6

10/19/2015

Insurance - 2016 Preferred Provider Organization (PPO) – 11%

MONTHLY Premiums Plan

Total

Board Portion

Employee Portion

Single

$602

$489

81%

$113

19%

Double

$1,396

$1,134

81%

$262

19%

Family

$1,606

$1,304

81%

$302

19%

Insurance Today - 2015 Preferred Provider Organization (PPO)

ANNUAL Premiums Plan

Total

Board Portion

Employee Portion

Single

$6,504

$5,506

85%

$998

15%

Double

$15,092

$12,776

85%

$2,316

15%

Family

$17,360

$14,696

85%

$2,664

15%

7

10/19/2015

Insurance - 2016 Preferred Provider Organization (PPO) – 11%

ANNUAL Premiums Plan

Total

Board Portion

Employee Portion

Single

$7,219

$5,863

81%

$1,356

19%

Double

$16,752

$13,606

81%

$3,146

19%

Family

$19,268

$15,651

81%

$3,618

19%

Insurance – Calendar Year 2016 2 Options 1. Preferred Provider Organization (PPO)

2. High Deductible Health Plan (HDHP)

8

10/19/2015

Insurance – Calendar Year 2016 High Deductible Health Plan: An insurance plan with lower premiums and higher deductibles than a traditional health plan. As an incentive to join a HDHP, employers often contribute funds into a Health Savings Account (HSA). - No Co-Pays - Employee Pays 100% (of the claim of the negotiated rate between Anthem & the doctor, facility, hospital or pharmacy)

- Preventive Care is covered at 100% - Out of Pocket Maximum $3,000 individual / $6,000 More than 1 individual

Insurance 2016 - Example #1 (Low) High Deductible Health Plan (HDHP)

Doctor Visit - Sore Throat Co-Pay $Total Visit $ 105 Tier 1 Prescription $ 65 Total Member Cost $ 170 *** Estimated Costs

9

10/19/2015

Insurance 2016 - Example #2 (Moderate) High Deductible Health Plan (HDHP) ) Urgent Care - MRI

Co-Pay Deductible ** MRI (100%) Total Member Cost

$ $

-

$ 1,000

$ 1,000

** Estimated Cost

Insurance 2016 - Example #3 (Severe) High Deductible Health Plan (HDHP)

Inpatient - Knee Replacement ** Surgery $ 10,000 Total Member Cost $ 10,000

X

** Estimated Cost

Maximum Payment = $3,000

10

10/19/2015

Where can I check the estimated cost of a prescription? www.anthem.com / Pharmacy / Estimate Your Cost

Insurance - Calendar Year 2016 High Deductible Health Plan (HDHP)

MONTHLY Premiums Plan

Total

Board Portion

Employee Portion

Single

$503

$428

85%

$75

15%

Double

$1,168

$993

85%

$175

15%

Family

$1,343

$1,142

85%

$202

15%

11

10/19/2015

Insurance – Calendar Year 2016 High Deductible Health Plan (HDHP)

ANNUAL Premiums Plan

Total

Board Portion

Employee Portion

Single

$6,036

$5,131

85%

$905

15%

Double

$14,014

$11,912

85%

$2,102

15%

Family

$16,121

$13,703

85%

$2,418

15%

Savings

12

10/19/2015

Insurance – Calendar Year 2016 2016 ANNUAL FULL Premiums PPO

HDHP

Savings

Single

$ 7,219

$6,036

$1,183

Double

$ 16,752

$14,014

$2,737

Family

$ 19,269

$16,121

$3,149

Plan

Insurance – Calendar Year 2016 2016 ANNUAL BOARD Premiums Board Portion PPO

Board Portion HDHP

Savings

Single

$ 5,863

$5,131

$732

Double

$ 13,605

$11,912

$1,693

Family

$ 15,651

$13,703

$1,948

Plan

13

10/19/2015

Insurance – Calendar Year 2016 ANNUAL EMPLOYEE Premiums Employee Portion PPO

Employee Portion HDHP

Savings

Single

$ 1,356

$905

$451

Double

$ 3,146

$2,102

$1,044

Family

$ 3,618

$2,418

$1,200

Plan

Insurance – Calendar Year 2016 What is a Health Savings Account (HSA)? A tax-advantaged medical savings account available to employees enrolled in a High Deductible Health Plan. The funds contributed are not subject to federal taxes at the time of deposit.

14

10/19/2015

Insurance – Calendar Year 2016

X

Board Savings = $1,948 New Board Savings = $448 Employee Savings = $1,200 + Employee HSA = $1,500 Employee Savings = $2,700

Insurance – Calendar Year 2016 Southwest Ohio Districts Offering an HSA - Fairfield - Forest Hills - Indian Hill - Lebanon - Mason - Milford - Northwest - Sycamore - West Clermont - Winton Woods

15

10/19/2015

Health Savings Account – Board of Education Contributions 2016 - Single = - Double = - Family =

$700 $1,050 $1,500

2017 & Beyond - Single = $600 - Double = $850 - Family = $1,000 Expenses cannot be incurred for reimbursement before July 1, 2016

Health Savings Account More HSA Facts - HSA network providers are available at www.anthem.com - HSA Funds are remitted to American Fidelity – through a pretax deduction - Funds are spent via a bank card (keep your receipts) - Full Flex Spending Accounts are prohibited for HSA’s - Unexpended HSA funds may accumulate & accrue interest. - HSA funds may be withdrawn for ineligible expenses but are taxable

16

10/19/2015

Eligibility for Health Savings Account Any Employee is Eligible for a HDHP -------------------------------------------------------------------------------------------------

2016 HSA Board Contribution 100% Board Contribution of Funds between June 15 - July 15 2016 Retirees – Any employee retiring on or before Sept 1 2016 will receive 50% of Board Contribution 2016 – New Hires – 50% of the Board Contribution will be disbursed between Dec 15 – Jan 15

Eligibility for Health Savings Account 2017 & Beyond HSA Board Contribution Summer Contribution à 50% Contribution paid to employee between June 15 – July 15 Winter Contribution à 50% Contribution paid to employee between Dec 15 – Jan 15 TO BE ELIGIBLE FOR BOARD CONTRIBUTION … Summer Payment à Employee must work on-site at least 80 days between Jan 1 – June 30 Winter Payment à Employee must work on-site at least 80 days between July 1 – Dec 31

17

10/19/2015

Health Savings Account Common Uses of HSA Office Visits Prescriptions Orthodontia Optical Needs (including Laser Surgery) Physical Therapy Eligible HSA Expenditures à http://www.afhsa.com/

Health Savings Account Contributions Employees may contribute to an HSA via payroll deduction Forms available at www.ohlsd.us Max Contributions (Employee & Employer) Single = $3,350 Double or Family = $6,750 PRE-TAX BASIS!!!

18

10/19/2015

Miscellaneous / Summary Open Enrollment - Health/Dental/ Voluntary Life & Vision November 9th – 18th - Medical Plans Offered in Calendar Year 2016: - PPO (single / 2 Party / family) - HDHP (single / 2 Party / family)

- ID Cards – Only provided to employees changing plans - Enrollment Forms – Emailed during open enrollment - Do I need to re-enroll if I stay with the PPO? NO

Where can I learn more? ohlsd.us (Treasurer’s Page)

19

10/19/2015

QUESTIONS??? Lisa Hauser (Benefits) or Steve Bain (Treasurer) 574-3200 or Email

20