medical insurance regence blue cross/blue shield of utah, 2 options – option 1 $500 deductible...

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Medical Insurance Regence Blue Cross/Blue Shield of Utah, 2 Options Option 1 • $500 DEDUCTIBLE plan/3 individuals • Individual Out of pocket max $4,000 • Family Out of pocket max $8,000 • NO Annual Maximum Option 2 • HDHP/HSA Combination • $1,500 DEDUCTIBLE single coverage – Out of pocket max $4,000 (Inc. DED) • $3,000 DEDUCTIBLE 2-party or family coverage – Out of pocket max $8,000 (Inc. DED) • NO Annual Maximum

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Page 1: Medical Insurance Regence Blue Cross/Blue Shield of Utah, 2 Options – Option 1 $500 DEDUCTIBLE plan/3 individuals Individual Out of pocket max $4,000 Family

Medical Insurance • Regence Blue Cross/Blue Shield of Utah, 2 Options

– Option 1• $500 DEDUCTIBLE plan/3 individuals• Individual Out of pocket max $4,000• Family Out of pocket max $8,000• NO Annual Maximum

– Option 2• HDHP/HSA Combination• $1,500 DEDUCTIBLE single coverage

– Out of pocket max $4,000 (Inc. DED)• $3,000 DEDUCTIBLE 2-party or family coverage

– Out of pocket max $8,000 (Inc. DED)• NO Annual Maximum

Page 2: Medical Insurance Regence Blue Cross/Blue Shield of Utah, 2 Options – Option 1 $500 DEDUCTIBLE plan/3 individuals Individual Out of pocket max $4,000 Family

2013 Plan Changes$500 Deductible

ITEM 2012 2013Annual Out of Pocket Maximum

Individual/Family$1,500/$4,500 $4,000/$8,000

Emergency Room Copay $100 $250

Prescriptions (Rx)

Generic

Formulary

Non-Formulary

$7.00

20%

35%

$15.00

25%

45%

EMPLOYEE PREMIUM CONTRIBUTION CHANGES

Individual

2-Party

Family

$30.90

$55.15

$73.00

$33.00

$59.55

$79.00

Page 3: Medical Insurance Regence Blue Cross/Blue Shield of Utah, 2 Options – Option 1 $500 DEDUCTIBLE plan/3 individuals Individual Out of pocket max $4,000 Family

Examples of $500 vs. HDHPExamples: $500 Coverage HDHP Coverage

#1 - Month

Two Dr. Visits

Dr. visit = $130 x 2 = $260

$125.70 difference!!!

$20 copay (after tax $)

$20 copay (after tax $)

$95.70 premium difference

($135.70) Total spent for the month for healthcare

$260 Dr. Visit($250)HSA County contribution

$10.00 Total Spending for the month (No Tax paid)!

#2 - Month

1 Dr. Visit = $130

$300 Rx (Formulary)

$10.70 difference!!!

$20 copay (after tax $)

$75 for Rx (after tax $)$95.70 premium difference

($190.70) Total spent for the month for healthcare

$0 applied to deductible

$130* Dr. Visit

$300* for Rx($250)HSA County contribution

($180.00) Total

*450 applied to deductible!

#3 - Annual

$5,000 Broken Arm

$600 5 Office Visits

$4,400 Surgery

$10,000 Annual Expense

$3,428.40 difference!!!

Broken Arm:

$500 Deductible

$1,200 ($250 ER copay+20%)

Office Visits: $100 ($20 copay x 5)

Surgery: $880 (20%)

$1,148.40 premium difference

($4,828.40) Total

$3,000* deductible

$1,400 co. (20% of $7,000)

$4,400

($3,000) HSA UC Cont.

($1,400.00) Total

*Family Deductible is met & $ applied toward OOP Max.

Page 4: Medical Insurance Regence Blue Cross/Blue Shield of Utah, 2 Options – Option 1 $500 DEDUCTIBLE plan/3 individuals Individual Out of pocket max $4,000 Family

Part 1Health Savings

Account(HSA)

Part 2High Deductible Health

Plan(HDHP)

HSAConcept

Incentive to SAVE $ - You & your employer contribute pre-tax dollars

Incentive is to focus on PREVENTATIVE CARE and have coverage for major medical expenses.

VS.

TraditionalHealthcare Traditional

Health Plan

Flexible Spending Account(FSA)

YOU make all contributions & forfeit at the end of the year. Incentive to USE $ (or you will lose it)

Incentive to USE $ and Insurance

YourAccount

$ rolls overyear to year

Why have a consumer-driven health plan?

Page 5: Medical Insurance Regence Blue Cross/Blue Shield of Utah, 2 Options – Option 1 $500 DEDUCTIBLE plan/3 individuals Individual Out of pocket max $4,000 Family

Health Savings Account (HSA) – What is it?• Uintah County contributes money on a monthly basis

– MAKING IT A $0 DEDUCTIBLE PLAN!!!• A bank account in YOUR name• You can contribute PRE-TAX dollars through payroll• Receive a Debit Card (use as a credit card, no fee)• Checks (50 for $7.95)• $2.25 monthly admin fee (waived after you have $3,000 in

account)• Track spending online, keep records, tax forms• Use for health, dental and vision expenses or supplemental

income upon retirement• Visit www.hsabank.com for more information

Page 6: Medical Insurance Regence Blue Cross/Blue Shield of Utah, 2 Options – Option 1 $500 DEDUCTIBLE plan/3 individuals Individual Out of pocket max $4,000 Family

www.myregence.com

Page 7: Medical Insurance Regence Blue Cross/Blue Shield of Utah, 2 Options – Option 1 $500 DEDUCTIBLE plan/3 individuals Individual Out of pocket max $4,000 Family

www.myregence.com

Page 8: Medical Insurance Regence Blue Cross/Blue Shield of Utah, 2 Options – Option 1 $500 DEDUCTIBLE plan/3 individuals Individual Out of pocket max $4,000 Family

www.myregence.com

Page 9: Medical Insurance Regence Blue Cross/Blue Shield of Utah, 2 Options – Option 1 $500 DEDUCTIBLE plan/3 individuals Individual Out of pocket max $4,000 Family

www.myregence.com

Page 10: Medical Insurance Regence Blue Cross/Blue Shield of Utah, 2 Options – Option 1 $500 DEDUCTIBLE plan/3 individuals Individual Out of pocket max $4,000 Family

Status Changes

• Marriage, Divorce, dependent marriage, etc.• Change dependents AND beneficiaries • 30 Days from EFFECTIVE DATE• Materials & Forms• Open enrollment ends

December 14, 2012

Page 11: Medical Insurance Regence Blue Cross/Blue Shield of Utah, 2 Options – Option 1 $500 DEDUCTIBLE plan/3 individuals Individual Out of pocket max $4,000 Family

Enrollment• All employees MUST complete and submit new forms by FRIDAY

DECEMBER 14, 2012:– Medical Insurance

• $500 deductible• HDHP/HSA

– enroll online with/without assistance for no fee, $22 processing fee otherwise» Must have e-mail account» Must have information, SSN, spouse SSN, DL#

• Waive Insurance altogether

– Flexible Spending Account/Cafeteria Plan• Enroll• Waive

– Other forms• Available upon request