2020 employee benefits open enrollment · 2020 employee benefits open enrollment summary of health...
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2020 Employee Benefits Open Enrollment
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2020 Employee Benefits Open EnrollmentSummary of Health Options
There will be NO CHANGES to any benefit plans for the plan year June 1, 2020 through May 31, 2021
1) Standard Plan –$1,500 single / $3,000 family deductible, 10% coinsurance after deductible, Prescriptions apply toward deductible
2) Premier Plan – $0 Single / $0 Family deductible, $25 copay for primary care, $50 Specialists, Copays for prescriptions
3) Dental and Vision Plans will remain the same
• No Referrals are needed for either plan
• Preventive care, subject to the Preventive Care schedule, is covered at 100% with no cost sharing
• The plan out of pocket maximum amounts and deductibles reset on June 1st.
• Open enrollment will be COMPLETELY ONLINE through BerniePortal
THE DEADLINE TO COMPLETE YOUR ENROLLMENT IS FRIDAY, APRIL 24th.
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2020 Employee Benefits Open EnrollmentSummary of Health Plans
*See full benefit summaries for complete details
Meritain/Aetna Plan Name Standard Plan 1500/90 Premier Plan 25/50
HRA Fundingn/a 50% of the In-Patient & Out-Patient Copay
Health Savings Account Funding $500 regardless of enollment tier n/a
In-Network (INN)
Referral Required No No
Deductible (DD) IND/Family $1,500 Single / $3,000 Family $0 Single / $0 Family
OOP Max (INN) IND/Family $3,000 Single / $6,000 Family $6,350 Single / $12,700 Family
PCP / Specialist Office Visit 10% after the deductible $25 / $50 Copays
Telemedicine $40 ; $10 after deductible $10 Copay
Urgent Care / Emergency Room 10% after the deductible $87 / $250 Copays
Hospital-Intpatient 10% after the deductible $500/Day; Maximum 5 days
Hospital-Outpatient 10% after the deductible$250 Ambulatory Surgical Facility
/ $450 all other facilities
Independent Lab (Freestanding) 10% after the deductible $0 Copay
Facility Lab 10% after the deductible $60 Copay
Diagnostic X-Ray (Freestanding/Facility) 10% after the deductible $0 / $60 Copay
Complex Imaging (MRI/MRA/CT/PET) 10% after the deductible $250 Copay
DME/Prosthetics 10% after the deductible 50%
Prescription (RX)
Deductible (DD) IND/Family Integrated with Medical None
Retail (PGeneric/Generic/Brand/NP Brand) $4 / $10 / $50 / $75 after the deductible $4 / $10 / $50 / $75
Mail Order $8 / $20 / $100 / $150 after the deductible $8 / $20 / $100 / $150
Specialty RX Paid Same as Above Paid Same as Above
Generic Substitution Clause Dispensed as Written Dispensed as Written
Out-of-Network (OON)
Deductible (DD) IND/Family $5,000 Single / $10,000 Family $5,000 Single / $10,000 Family
OOP Max (OON) IND/Family $15,000 Single / $30,000 Family $15,000 Single / $30,000 Family
Coinsurance 50% after the deductible 50% after the deductible
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2020 Employee Benefits Open EnrollmentPer Pay Health Costs
Employee contributions to medical are pre-tax. This money is NOT subject to federal income tax.
EMPLOYEE BI-WEEKLY DEDUCTIONS
Employee OnlyEmployee &
Child(ren)Employee &
SpouseEmployee &
Family
Standard Plan $0 $0 $0 $0
Premier Plan $46.15 $80.77 $96.92 $138.46
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2020 Employee Benefits Open EnrollmentHealth Savings Account Standard Plan ONLY
What is a Health Savings Account (HSA)?
An HSA works with a high deductible health plan (HDHP) and allows you to use before-taxdollars to reimburse yourself for eligible out-of-pocket medical expenses for you and yourfamily.
Benefits to you:
• It’s Yours. Funds in your HSA account stay with you wherever you go, even if you change jobs.
• Reduces your taxable income. The money is tax-free both when you put it in and when you take it out to cover qualified medical expenses.
• Grows with you. If you maintain a minimum balance of $2,000, your additional funds may be invested in mutual funds yielding tax-free earnings.
• Helps you plan for the future. Until you turn 65, withdraws for eligible expenses are tax-free. After 65, or if you are disabled, your HSA becomes similar to an IRA. Withdraws for non-eligible expenses will be taxed at but won’t incur additional penalties.
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2020 Employee Benefits Open EnrollmentHealth Savings Account Standard Plan ONLY
How does
an HSA
work?
If a tax audit occurs, note that you are responsible for saving receipts and Explanation of Benefits (EOB’s) to prove the money was spent correctly.
Once the plan's deductible is met, the HDHP will pay for services, subject to coinsurance and other cost-sharing requirements.
Employee may seek reimbursement from the HSA for amounts paid for medical services.
Employee is responsible for costs before deductible is met. The HDHP may cover costs for certain services, such as preventive care.
Employee obtains medical services.
Employee, employer, family member and/or someone else funds employee's HSA.
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2020 Employee Benefits Open EnrollmentHealth Savings Account Standard Plan ONLY
HSAs offer tax savings and investment options. That means that over time, your savings can really add up!
Your Annual HSA Contribution
$1,500Your Employer’s Annual HSA Contribution
$500
Interest and Investment Rate of Return
2%Current Age
35Amount Withdrawn From HSA per Year
$500
$0
$20,000
$40,000
$60,000
$80,000
35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66
HSA
Bal
ance
Age Until Retirement
Value of Your HSA Over Time
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2020 Employee Benefits Open EnrollmentHealth Savings Account Standard Plan ONLY
HSA Contribution Limits
2020 2019
HSA Contribution Limit Self Only - $3,550Family - $7,100
Self Only - $3,500Family - $7,000
HSA Catch-up Contribution(Age 55 or Older) $1,000 $1,000
To view full account details and learn more:
Register online by going to www.theharrisongrouponline.com
You will be prompted to update your password, complete security questions & sign your Terms & conditions.
Then follow the instructions to set up your investment sweeps.
Customer Service(610) 853-9075 or (855) 222-5727
Safegard’s contribution - $500 (Employee Only or Family)
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Healthcare FSA PREMIER PLAN ONLY• Available for employees enrolled in the POS medical plan or those who waive coverage.
*You cannot contribute to both an HSA and an FSA • Deduct up to the $2,750 with a rollover provision of up to $500 per year
Dependent Care • Available for employees enrolled including those who waive coverage and are not
enrolled in an HDHP. • FSA deduct up to $5,000 for qualified childcare expenses
• You do not have to be enrolled in the Medical plan to participate in the Flexible Spending benefit.
• The elected amount will be deducted from your paycheck each pay period, in equal installments throughout the year, until you reach the yearly maximum you have specified.
• The amount of your pay that goes into an FSA will not count as taxable income, so you will have immediate tax savings.
2020 Employee Benefits Open EnrollmentFlexible Spending Account (FSA)
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Deductible Expenses Vision ExamsBand Aids Lab WorkSunscreen Orthodontia Copays Chiropractic CareContacts First Aid KitsDental Work Acupuncture
Eyeglasses And much more!
NEW Over the Counter Medications (Advil, Cold Medicine, etc.)NEW Feminine Hygiene and Menstruation products
2020 Employee Benefits Open EnrollmentEligible Expenses – FSA and HSA
https://www.theharrisongrouponline.com/resource-library/#FSA
For a full list of eligible expenses visit:
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2020 Employee Benefits Open EnrollmentHealthcare Bluebook
1. Log Into your Meritain Portal to access Healthcare Bluebook or use the phone app
3. Type in your Zip Code
2. Click the “Go” button at the bottom right
4. Search for a Procedure, Doctor, or Hospital
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2020 Employee Benefits Open EnrollmentHealthcare Bluebook
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2020 Employee Benefits Open EnrollmentHealthcare Bluebook
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2020 Employee Benefits Open EnrollmentTelemedicine – Teladoc
What can be treated?
• Allergies• Skin rashes• Sinus Infection • Fever and Cold• Sore Throat• And much more!
*See the BerniePortal for instructions on how to register to use this option.
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2020 Employee Benefits Open EnrollmentAblePay – Discount Program
How does it work?
• You will receive an AblePay card which you will show to your clinician alongside your
insurance card
• After your visit, the bill is sent right to your carrier, and you receive an email of your
EOB and confirmation your provider has the bill
• You then have 5 days to change the payment method
Payment Plan Schedule Options and Discounts
1 Payment You save 13% (10% credit card)
3 Payments You save 10% (7% credit card)
6 Payments You save 8% (5% credit card)
12 Payments No Discount
TO GET STARTED, Visit https://enroll.ablepayhealth.com/apply
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2020 Employee Benefits Open EnrollmentGoodRx
Prescription drug prices are not regulated. The cost of a prescription may differ by more than $100 between pharmacies across the street from each other! GoodRxgathers the current prices and discounts available at pharmacies near you to help find the best deals possible.
What is GoodRx?
GoodRx is great for individuals that do not exceed their plan’s deductible as it provides an
opportunity to lower the cost of your Rx without going through an insurance provider.
*See the BerniePortal for additional details
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• Never be afraid to tell the doctor you have a High Deductible Health Plan and ask if a test is Necessary or Precautionary
• Shop around for a better price• Hospitals are typically more expensive• Use Urgent care and Freestanding Imaging centers when possible• Use independent lab facilities (Quest, Labcorp, etc.)• Take advantage of Healthcare Bluebook
• Call the billing office to see if they will:• Accept a lower amount as payment in full• Set up a payment plan• Use AblePay
2020 Employee Benefits Open EnrollmentHints for Maximizing Your Medical
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• Use Mail Order through CVS Caremark. You receive a 90-day supply for two copayments instead of three
You can register directly through CVS Caremark website at www.caremark.com/wps/portal
• Visit www.GoodRx.com to compare prices
• Ask your Doctor for samples and cheaper alternatives
• Call the Drug manufacturer for discounts or financial assistance
• IF YOUR DRUG ISN’T COVERED BY Caremark- Consider the following prescription drug programs (Outside of your Plan):
Blink Health - https://www.blinkhealth.com/ Needy Meds - http://www.needymeds.org/ Help Rx - https://www.helprx.info/
2020 Employee Benefits Open EnrollmentHints for Maximizing Your RX Deductible
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2020 Employee Benefits Open EnrollmentSummary of Dental Coverage
**Out of Network providers can balance bill you for services provided ***See full benefit summaries for complete details
Services Lincoln Financial – PPO Network
Annual Maximum $1500 per member
Deductible $50 Single; 3 x Family Maximum
Copay None
Preventive Services 100%Exams, cleanings, x-rays
Basic Services
80%Minor Restoration (amalgam fillings), Complex Oral
Surgery, Simple Extractions, Endodontics, Periodontal Maintenance, General Anesthesia
Major Services
50%Non-Surgical & Surgical Periodontics , Repairs &
Maintenance of Crowns, Bridges & Dentures; Inlays, Onlays, Bridges & Dentures, Implants
Orthodontics – up to age 19
50% Up to a Lifetime Maximum of $1000
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2020 Employee Benefits Open EnrollmentLife and Disability – Company Paid
Group Term Life Insurance
• 1 times annual salary to a maximum of $350,000
• Insurance amount reduces by 35% at age 65 & an additional 35% at age 70
Short Term Disability Insurance
• 66 2/3% of salary to maximum of $2,000 / week
• Elimination Period: 1st day for Accident / 8th day for Sickness
• Duration of Benefits: 13 weeks
Long Term Disability Insurance
• 60% of salary to maximum of $12,000 / month
• Elimination Period: 90 days
• Duration of Benefits: Later of Age 65 or SSNRA
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2020 Employee Benefits Open EnrollmentSummary of Vision Coverage – VSP
**See full benefit summaries for complete details
In-Network Out-of-Network
Eye Exams: every 12 months $10 Copay Up to $45 reimbursement
Frames: every 12 months Covered up to $130 Up to $70 reimbursement
Lenses: every 12 months• Single Vision• Bifocal• Trifocal• Lenticular
$25 Copay$25 Copay$25 Copay$25 Copay
$30 Reimbursement$50 Reimbursement$65 Reimbursement
$100 Reimbursement
Contact Lenses: every 12 months (In lieu of eyeglasses)
• Medically Necessary• Elective
$25 Copay$25 Copay
Up to $210 ReimbursementUp to $105 Reimbursement
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2020 Employee Benefits Open EnrollmentEmployee Assistance Program (EAP)
Call
(888) 628-4824
Visit the Web-Site
ww.GuidanceResources.com
User name: LFGSupport
Password: LFGSupport1
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2020 Employee Benefits Open EnrollmentConnectCare3 Overview
ConnectCare3 provides highly individualized care for each member at no charge as part of your medical plan. Their team of experienced nurses and advocates is available to help you with simple questions or complex diagnoses.
• Help understanding a diagnosis
• Prepare you for doctor appointments
• Locate top specialists and treatment facilities
• Setting and meeting health goals
• Ideas for healthy lifestyle changes
• Tobacco Cessation
Call
(877) 223-2350
Visit the Web-Site
www.connectcare3.com
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Questions?
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