City of Las Vegas 2012 Wellbeing Education &

Open Enrollment

Timeline for Submitting Forms Open enrollment is October 6 through November

14 Forms must be returned to Risk, Compensation &

Benefits by November 14, 2011 You can

Change medical plans Add or delete dependents Enroll in voluntary benefit programs Enroll in the Flex plan

You must enroll each year to participate in the flexible spending account program

Please Note: If you do not want to make a change to your Group Health plan, you do not have to do anything

PART IWellness & Prevention

• Behavior based – change your habits– Small steps result in BIG CHANGES

• Proactive management of health– Preventative health services– Wellness

• Long term approach

• Develop a plan, work the plan, monitor the plan, CELEBRATE your success

• Usually no or low cost

• Bottom Line– live longer, – live happier, – live wealthier

First Step

• Complete your Wellness Interest Survey!• Take a few minutes and allow us to identify

what you want and need for Wellness– Survey copies available from Wellness Coaches or

Human Resources- Return completed surveys to your coach, via email, or

send via interoffice mail– All information is confidential

If you return your survey by 11-14-2011 you will be eligible to win one of three $100 gift certificates.

Health Quiz I

79

Subtract your age

=The number of years you have left on the planet

6

Health Quiz II

How Many Of You Can “Say Yes” to All 5?

I am within 5 pounds of my ideal body weight

I exercise 30 minutes or more most days of week

I eat a healthy diet with 5 fruits/vegetables most days I don’t use tobacco products

I have 2 or fewer alcoholic drinks per day

Percent of Chronic Diseases That Are Caused by Poor Lifestyle

0%10%20%30%40%50%60%70%80%90%

100%

Cancers Stroke Heart Disease DiabetesSources: Stampfer, 2000; Platz, 2000; Hu, 2001

71% 70%

82%91%

Wellness• Key component of your health care

– Preventative & Proactive– Works one-on-one and confidential– Supports behavior change, designed to assist

each person at their own pace– Many of your fellow employees have been

successful• Our Wellness Coaches are here to assist

with:Stress Management Weight LossNutrition Tobacco/Smoking

CessationDisease Management Exercise

Lifesigns• A head to toe annual preventive physical exam

providing information you need to develop your personal care plan, putting you in control of your health.– Works hand in hand with Wellness Coaches, PCP and Behavior Health

Benefits, 100% confidential• Lifesigns seeks to complement your relationship with

your existing PCP and can forward results electronically to your physician at your request

• For CH/C participants test results will be sent to Care Coordinators.

Hearing and Vision tests

Electrocardiogram Blood tests

Screening ultrasound Chest x-ray Physician consult

Body fat percentage & BMI

Age/gender options Complete lab panel 60+ tests

Mines and Associates Counseling

• Problem Assessment• Short Term Counseling or Referral• Coaching for Behavior modification• After-Care Follow-Up• Crisis Intervention• 24 Hour Emergency Service• Workplace Reintegration• Child or aging parent

assistance

Employee Assistance Program

Health Quiz III• Wellness, Lifesigns, Employee

Assistance Program, Preventive health services and some Behavior health services cost each CLV employee?

• Nothing, these services are free to all CLV employees

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Choose a Family Doctor/PCP

• Primary Care Physician your “family” doctor– Specially trained to work with you to coordinate

your overall healthcare– Understands you and your needs best– Takes the confusion out of what to do next,

where to do it – An in-network PCP can help keep money in your

pocket by reducing your out-of-pocket expenses– Focus on preventive and scheduled health

maintenance services.

Live Longer – Live Better• Use the tools we have provided to

assist you in becoming well and engaged– Lifesigns– Wellness Coaches– PCP and Prevention– EAP– Dental/Vision– Health plan

PART II 2012 Group Benefit Plans

There when you need it!

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2012 Changes

By making small plan changes CLV has been able to keep 2012 premiums low – most are at or below 2011 rates. Sierra PPO Changes – increase Out-of-Pocket maximum

Increase in prescription co-paymentsLower premium rates

C H/C changes – increase Out-of-Pocket maximum Increase in co-insuranceNo change in EE only and EE + 1 premium rates

Dental Plan Changes – increase from $2,000 annual maximum benefit to $2,500 annual maximum benefit

Premium rate increase

Rate chart – Employee Bi-Weekly Contribution

CDHP Sierra PPO

HPN - HMO

Vision Dental

EE Only $0 $0 $0 $0 $0

EE + 1 $126.79 $124.62 $74.77 $1.01 $6.76

EE + 2 $256.99 $197.00 $118.38 $3.06 $15.69

HR

Claims

Network

Pharmacy

Providers

CareCoordinators

1-877-498-59815:30 AM – 6:00 PM PST

Monday – Friday

Health care is very confusingCall for Help…

What will the“Care Coordinators”

help me with?

• Benefits• Claims Questions• Find In-Network Providers• Patient Advocacy• Nurse Coaching

Single Point Patient Service

I can help you with all your healthcare questions.

IT ALL STARTS HERE

Single 2-Person Family$1,000 $2,000 $3,000$500 $750 $1,00080% providers with discounts

60% of R&C with providers without discounts

$2, 500 $3,500 $4,500

Let’s Review How CDH WorksPr

even

tive

Car

e 10

0%10

0% c

over

age

– No

dedu

ctio

n fro

m H

RA

Traditional HealthCoverage

Coinsurance Maximum

Health ReimbursementAccount

(Annual Allocation)

Bridge(Employee’s responsibility)

$2500 $3750 $5000All employees enrolled in CDH must submit a City of Las Vegas Other Insurance Form

2012 Plan Changes

Co-Insurance (without Bridge)Current 2012

In-Network 90% 80%Out – Network 70% 60%

OPM In-NetworkEmployee $2000 $2500Employee + 1 $3000 $3500Family $4000 $4500

OPM Out of NetworkEmployee N/A $6000Employee +1 N/A $7000Family N/A $9000**in-network accumulates toward out-of-network max

2012 Plan Changes

Pre Notification is required for: Outpatient surgery MRIs, MRAs, & PET Scans Oncology services (chemotherapy and radiation therapy) Home health care and services Durable medical equipment rentals and purchases over $500 Hospice care Speech, physical and occupational therapies Dialysis

Prior Authorization is required for: Transplant services In Patient services Gastric bypass surgery

Early notification of high cost procedures notifies Care Coordinators to assist patients through a health care event, lowering cost and improving quality.

Note: Anytime a pre-notification/auth is submitted, you will receive a confirmation letter from the Care Coordinators.

Catalyst Rx Formulary Advantage Program

Complete Formulary Listing Price and Save Program -

www.catalystrx.com You can price and compare co-payments

at local pharmacies Helps you choose lower cost prescription

drug options

Coordinated Health/CarePharmacy Benefit

Catalyst Rx offers the Diabetic Sense program at no charge

Injectable insulin and syringes at no charge Home delivery of testing supplies Access to Diabetes Educators, Nutritionists

and Pharmacists To access this benefit, you must enroll To enroll call Liberty Medical at 1-866-896-

7303

Diabetic Sense Program

Health Plan of Nevada• HMO Health Plan • Required to have

PCP• Must stay in-

network• No Annual

Deductible and Out of Pocket Max

• Co Pays for various services

• Co Pay for Rx• No Out of Network

benefit23

2012 Sierra PPO Plan

Prescription Co-PayGeneric $15.00Preferred Brand $40.00Non Prefer. Brand $60.00

Deductible In-Network Out-of-NetworkEmployee $500 $1000Employee + 1 $1000 $2000Family $1000 $2000

OPM In-Network Out of NetworkEmployee $3000 $6000Employee +1 $6000 $12000Family $6000 $12000

Please refer to medical plan comparison chart in the 2012 open enrollment for more plan details.

Did you know?– Annual dental and vision exams are as

important as an annual physical– Dental and Vision exams can detect over 120

disease signs (usually at very early stages) including:

• Heart disease/Heart attacks• Diabetes• Respiratory disease• A weakened immune system that can slow healing of

wounds and reduce a person’s response to hepatitis B and flu vaccines.

• Cancers• Stroke

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Dental and Vision Benefits

DentalPreferred Dental NetworkIncrease in annual benefit to $2,500

VisionVision Service Plan Network

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Section 125 Flexible Spending Accounts

• Two types of funds (you must enroll annually)

• Health Care FSA – contribute up to $4,000 to pay for unreimbursed medical costs

• Dependent Care FSA – contribute up to $5,000 to pay for eligible day care expenses for child or dependent adult

• Contributions to your FSA are pre-tax– Your taxable income is decreased– Fewer taxes are withheld– Increase monthly cash flow– Use the money when you need it

• You must budget carefully, governed by IRS use-it –or-lose-it rule. CONFIDENTIAL27

Voluntary Life• For employees currently participating

in The Standard’s Voluntary Life plan, you can increase your benefit level:– $60,000 for employee, up to guaranteed issue

amount of $150,000– $10,000 for your spouse, up to guaranteed

issue amount of $50,000

Please update or complete your beneficiary designation.

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Deferred Compensation

• 457 plan – Pre tax employee contribution

• Reduces federal taxes• Provides savings for retirement

HartfordICMANationwide

Voluntary Programs• Discounts on Auto and Home Insurance

– F. Hayden Ray 702-736-8611  Ext. 58082

• Consult with Board Certified doctors on the telephone or via email regarding commonly treated short-term illnesses, such as: flu, allergies, colds, etc.

• Available 24 hours a day, 7 days a week• Can prescribe medications and refill recurring prescriptions• For information, contact Lori Wilkerson at 702.877.1177

• Pat Johnson or Amy Bechtel• Phone - 702-877-6388

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Putting it all together

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Stage 1 – Planning, Prevention and Identification• Wellness • Engagement – Behavior Change - EAP• Lifesigns• Primary Care Physician – Use available

preventative care services, Dental & Vision annual exams

• Virtually no costStage 2 Maintenance, Treatment and Management• Wellness• Primary Care Physician• Specialists• Dental, Vision, FSA• Bridge/Deductible/Out of Pocket/Co-

Insurance

Stage 3 – Health, Prosperity, Well Being• Enjoying a long healthy happy life• HEALTH = WEALTH

InformationCLV Intranet Site

Benefits tabSummary Plan DescriptionsClaim FormsChange and Enrollment FormsProvider contacts & web sitesResources

Insurance ServicesDan RigatoSandy RayMandee BowlerCandace Mbaye

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