2014-2015 mesa schools open enrollment agenda open enrollment period overview of medical plan...
TRANSCRIPT
2014-2015 Mesa Schools Open Enrollment
AGENDA
• Open enrollment period
• Overview of Medical Plan Options
• Cigna Tools and Resources
• Questions
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Medical Plan Highlights
OAP Copay (EPO) HDHP 1500 HDHP 2500
Single Family Single Family Single Family
Deductible $350
$700 per family of 2
$1050 for family
of 3 or more
$1,500In-network
$3,000Out-of-network
$3,000 In-network
$6,000Out-of-network
$2,500 In-network
$5,000 Out-of-network
$5,000 In-network$10,000
Out-of-network
Out-of-pocket limit
$2,350 includes deductibles,
copayments and coinsurance
$7,050 includes deductibles,
copayments and coinsurance
$3,000 In-network
$6,000Out-of-network
$6,000 In-network$12,000
Out-of-network
$2,500 In-network
$5,000 Out-of-network
$5,000 In-network$10,000
Out-of-network
Co-insurance20% up to OOP
limit20% up to OOP
limit
Office Visit$20 PCP
$35 Specialist
$20 PCP$35 Specialist
Deductible Applies
Deductible Applies
Deductible Applies
Deductible Applies
Preventive CareCovered at
100%Covered at
100%Covered at
100%Covered at
100%Covered at
100%Covered at
100%
Pharmacy (30 days supply)
$7 generic/$15 Preferred
Brand/40% to $100 max Non
Preferred Brand
$7 generic/$15 Preferred
Brand/40% to $100 max Non
Preferred Brand
20% after plan Deductible
20% after plan Deductible
0% (plan covers at 100%) after
plan Deductible
0% (plan covers at 100%) after
plan Deductible
HSA contribution from employer
n/a n/a $1,000 $1,500 $1,500
Prescriptions• Generic medicines available for $4 at Target, Wal-Mart,
and now Fry’s• CIGNA Tel-Drug (mail order) delivers prescription
medications directly to your home or other location you specify– Ideal for those who take medications regularly– Convenient home delivery– 90-day supply
• QuickSwitch Transfers means no more paperwork for you– Order online, by phone or mail– Free standard delivery shipping– Three ways to order:
– By Mail– By Phone – 1-800-Tel-Drug (835-3784)– Online – www.teldrug.com or myCIGNA.com
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HEALTH SAVINGS PLAN AND YOU
• A tax-advantaged HDHP provides coverage for current health care expenses with the option to save for future health care expenses
• Combines a qualified high-deductible medical plan (medical/pharmacy coverage) with a Health Savings Account
• You, your employer, or both, can contribute to the Health Savings Account which is owned by you
• Money contributed to the Health Savings Account is generally not taxable*• You have investment options with the Health Savings Account
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+ =Qualified high deductible medical plan (HDHP)
Tax-advantagedHDHP
Health Savings Account
* HSA contributions and earnings are not subject to federal taxes and not subject to state taxes in most states. A few states do not allow pretax treatment of contributions or earnings. Please consult your personal tax advisor or contact your plan administrator for information about your state.
Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2014 Cigna
ARE YOU ELIGIBLE TO PARTICIPATE?
Because HSA plans have certain tax advantages, the IRS defines specific rules
for participation. To be eligible, you:
• Must be enrolled in an IRS-qualified high-deductible medical plan (high-deductible medical plans offered with Cigna’s Choice Fund HSA meet IRS requirements)
• Cannot have any other health coverage – Not covered by spouse’s medical or pharmacy plan– Not covered through Medicare Part A or Part B– Not covered through a general-purpose Flexible Spending Account (FSA) plan (either
employer’s or spouse’s)
• Cannot be claimed as a dependent on another person’s tax return
7Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2014 Cigna
YOUR HSA MAXIMUM CONTRIBUTION
The IRS has set the following limits for 2014/2015:• Under age 55 (based on a 12-month period):
– Up to $3,300/$3,350 individual coverage*– Up to $6,550/$6,650 family coverage*
• Age 55 or older:– Maximum contribution increases by $1,000 (considered a “catch-up” contribution)– Up to $4,300/$4,350 individual coverage*– Up to $7,550/$7,650 family coverage*
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*Contributions to your HSA that you receive from your employer and incentives count toward your maximum.
$
Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2014 Cigna
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This is an example used for illustrative purposes only.
• Single, in her 50s• Heart disease; controlling health
through medication• Looking to save money for future
health expenses
meet KarenHDHP 1500
HSA
EMPLOYER
$1000
KAREN
$500
$1,500.00
+
PLAN
80%
KAREN
20%
+PLAN
100%
IN-NETWORK PREVENTIVE CARE IS COVERED BY THE PLAN AT 100%
$1,948.00
80% plan: $1,558.4020% Karen: 389.60
Deductible: –$1,500.00
TOTAL EXPENSES
Preventive care $ 398.00
ER visit 2600.00
4 PCP visits 320.00
12 Generic Rx 288.00
3 Brand Rx 240.00
TOTAL 3,846.00
100% covered –398.00
MPS HSA Contribution
-1000.00
Karen’sHSA Contribution
–500.00
80% plan –1558.40
20% Karen –389.60
BALANCE DUE 0.00
Karen pays $ 889.60
$0HSA BALANCE
Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2014 Cigna
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This is an example used for illustrative purposes only.
• Single, in her 50s• Heart disease; controlling health
through medication• Looking to save money for future
health expenses
meet KarenHDHP 2500
HSA
EMPLOYER
$1500
KAREN
$1000
$2500.00
+
PLAN
100%
KAREN
0%
+PLAN
100%
IN-NETWORK PREVENTIVE CARE IS COVERED BY THE PLAN AT 100%
$948.00
100% plan: $948.000% Karen: 0.00
Deductible: –2500.00
TOTAL EXPENSES
Preventive care $ 398.00
ER visit 2600.00
4 PCP visits 320.00
12 Generic Rx 288.00
3 Brand Rx 240.00
TOTAL 3,846.00
100% covered –398.00
MPS HSA Contribution
-1500.00
Karen’sHSA Contribution
-1000.00
100% plan –948.00
0% Karen 0
BALANCE DUE 0.00
Karen pays $1000.00
$0HSA BALANCE
Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2014 Cigna
$3448
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This is an example used for illustrative purposes only.
• Single, in her 50s• Heart disease; controlling health
through medication• Looking to save money for future
health expenses
meet KarenOAP Copay (EPO)
HSA – N/A
EMPLOYER
$0
KAREN
$0
$0
+
PLAN
Schedule
KAREN
Deductible
+ PLAN
100%
IN-NETWORK PREVENTIVE CARE IS COVERED BY THE PLAN AT 100%
Plan-Pays per schedule: $2,689
Copays:$309 Deductible: $350
RX Deductible: $100
TOTAL EXPENSES
Preventive care $ 398.00
ER visit 2600.00
4 PCP visits 320.00
12 Generic Rx 288.00
3 Preferred Brand Rx 240.00
TOTAL $3846.00
100% covered –398.00
Plan Pays -2689.00
ER Deductible and copay
-350.00-100.00
4 Copays-PCP Visits -80.00
Rx Deductible -100.00
12 Generic RX Copays 3 Brand Rx Copays
-84.00
-45.00
BALANCE DUE 0.00
Annual EO premium 480.00
Karen Pays $1239.00
Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2014 Cigna
+Copays
SAVING YOU TIME
myCigna.com– Print forms or print/order ID cards– Check your coverage and explanation of benefits– Track claims, payments and deductibles– Sign up for online coaching programs – Keep track of your health history and records with an online
personal health record– Find in-network doctors, specialists, hospitals and labs– Learn about common health problems and treatment options– Compare treatment and procedure costs– Find cost and quality ratings for doctors and hospitals – Switch a prescription to Cigna Home Delivery Pharmacy with
one easy phone call, and have your medications delivered to your door
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No claim forms needed in-network
Talk with a health specialist when you can’t reach your doctor – day or night
Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2014 Cigna
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If You Have Questions About Your Medical Plan Options…
Cigna’s Pre-Enrollment Hotline
24 hours a day, 7 days a week
365 days a year!
1-800-401-4041
Open Enrollment Ends August 8