ohio associated enterprises open enrollment · 1/10/2018 · medical expenses (qmes) for you and...

• Marianne Nicoletti, Oswald Companies

January 10, 2018

OHIO ASSOCIATED ENTERPRISES

OPEN ENROLLMENT

AGENDA

• 2018 Open Enrollment

• The Renewal Process

• What’s new for 2018

• Your Medical Plan

• Your Dental Plan

• Your Life Insurance Plan

• Next Steps

2

2018 OPEN ENROLLMENT

• Open Enrollment is January 10th – January 19th

• All enrollments and changes must be made during Open

Enrollment

Open enrollment is the one time during the year that you are able

to make changes to your plans. If you previously waived

coverage, you may now enroll in the plan. If you are currently

covered & wish to add dependents, you may do so as well

The only other time during the year that you have the ability to make

changes to the plan is if you experience a Qualifying Event, such as

a loss of coverage, divorce or marriage. If you do experience a

Qualifying Event, please contact HR within 30 days of the event to

complete the necessary paperwork

3

THE RENEWAL PROCESS

4

CIGNA – initial renewal request was an 18% increase,

based on claims, inflation and Healthcare Reform.

Initial negotiation reduced increase to 12%.

Marketed to all major carriers, and then used the offers

to negotiate further with CIGNA for a reduction to 7%.

Most other carriers were higher. Anthem came in lower,

however the concern was how we would be treated next

year at renewal.

We are moving the Dental and Life insurance to CIGNA

for a greater discount off of the Medical premiums

(reduction to 4%).

WHAT’S NEW FOR 2018

5

Medical – we will stay with CIGNA, their network

includes all of the major medical systems

Dental – we will move from Anthem to CIGNA:

no change in plan design

slight increase in cost

more expansive network

Life Insurance – we will move from Anthem to CIGNA

MEDICAL

6

WHAT’S NEW FOR 2018 - MEDICAL

• Medical Plan:

• We will remain with CIGNA

• Plan design - due to IRS rules – the deductibles will increase

slightly:

• Single will increase from $2,600 to $2,700

• Family will increase from $5,200 to $5,400

• Premium Contributions – adjustment based on increased

premium of 4%

7

2018 MEDICAL PLAN

8

BENEFITS H.S.A.

Deductible (Single/Family) $2,700/$5,400

Coinsurance 0% after Deductible

Out-of-Pocket Maximum

(Single/Family)

$3,500/$7,000

Office Visit

(PCP/Specialist)

0% after Deductible

Inpatient Hospital Services 0% after Deductible

Outpatient Surgical

Services

0% after Deductible

Diagnostic Services 0% after Deductible

Emergency Room

Services

0% after Deductible

Urgent Care 0% after Deductible

Retail Rx (30-day)

Mail Order Rx (90-day)

$10/$35/$70

$30/$105/$210

Reminder: All covered expenses (including Deductible, Coinsurance & both

Medical/Rx Copays) accumulate towards the Maximum Out-of-Pocket.

• This is an illustration of In-Network benefits, but please note that the plan does also provide

coverage outside of the network. Please refer to the plan documents for details & final

confirmation of coverage

HEALTH SAVINGS ACCOUNTS (HSA)

HSA overview:

An HSA is an Individual bank account to pay for qualified

medical expenses (QMEs) for you and your tax dependents

Earn interest, can be invested in stocks with balance over $1000

Individually owned

Portable – it goes with you if you resign or retire

You can keep the bank you are currently using for your H.S.A.!

Provide for future savings:

Account can grow from year to year (you keep what you don’t

spend)

9

TRIPLE TAX ADVANTAGES OF AN H.S.A.

10

11

ANNUAL HSA CONTRIBUTION

LIMITS SET BY IRS

11

Amount of Funding

Contributions above the annual limit are

subject to income taxes and a 20%

penalty.

Annual Contribution

Rules

2018: $3,450 for individuals & $6,900 for

families

Additional Funding

Those 55 years of age or higher, but not

entitled to Medicare benefits, can fund an

additional $1,000/year “catch-up”

contribution!

*Please note that annual contribution limits include contributions from both the employer & the employee. A

combination of these two cannot exceed the annual contribution limits.

• Preventive care is covered at 100%

• Flu shots are covered under preventive (at 100%)

• Regular preventive care helps reduce risk of disease

• Detect health problems early

• Protect you from higher costs down the road

• May potentially save your life

No deductible.

No copayment.

No coinsurance.

100% coverage.

PREVENTIVE CARE

12

CIGNA RESOURCES

13

Use the emergency room for true emergencies

• Emergency care is covered 24 hours a day, in or out of

the network.

• But avoid the emergency room for minor injuries –

visits to urgent care and convenience care clinics are

also covered and will cost less

Locate a convenience care clinic near you,

before you need it

• Walk right in. You can get quick, convenient access to

quality medical care.

• Convenience Care Clinics include:

• MinuteClinic

• RediClinic

• Sutter Express Care

• Take Care Health

• Target Clinic

• The Little Clinic

INFORMATION TO HELP YOU SAVE

MONEYSAVING ON HEALTH CARE COSTS

16

• Allergies

• Bladder infections

• Bronchitis

• Cold sores

• Ear infections

• Influenza

• Impetigo

• Laryngitis

• Minor burns, rashes

or skin infections

• Pink eye and styes

• Sinus infections

• Strep throat

When to use

Convenience Care?

Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2016 Cigna

Use the most appropriate health care professional

• Find network doctors, hospitals or other health facilities online, by

phone or with any web-enabled mobile device

• Lower your costs by choosing health care professionals who

participate in the Cigna network

Get information on the cost of treatment before receiving care

• myCigna.com has quality of care information and cost estimates for

over 200 medical procedures and treatments

• In-network health care professionals and facilities can give you

estimates that will show your actual out-of-pocket expenses

INFORMATION TO HELP YOU SAVE

MONEY

17

Using health care professionals with the

Cigna Care Designation will help you save money!


Quality designations, cost-efficiency, and other ratings reflect a partial assessment of quality and should not be the sole basis for decision-making.

They are not a guarantee of the quality of care that will be provided to individual patients. You are encouraged to consider all relevant factors and

consult with your physician when selecting a health care professional or facility for care. Health care professionals and facilities that participate in

the Cigna network are independent contractors solely responsible for the treatment provided to their patients. They are not agents of Cigna.

MYCIGNA.COM MOBILE SITE AND APP

DELIVER

HEALTH INFORMATION ON THE GO

• All customers can access

myCigna via mobile device

using internet browser

• myCigna mobile app

available

Features:

• Find a doctor, dentist, pharmacy or facility

• View, print, and email ID card information

• Search and view claims

• Search for medications

• View plan coverage and authorizations

• Organize and manage personal health

information with the Health Wallet

18

DENTAL

19

DENTAL PLANS - 2018

CIGNA

Benefits In-network Out-of-network

Deductible (Single/Family) $50/$150 $50/$150

Class I (Preventive) 100% 80%

Class II (Basic) 80% 50%

Class III (Major) 50% 50%

Class IV (Ortho) 40% 40%

Annual Maximum $1,000 $1,000

Lifetime Max. - Orthodontia $1,000 $1,000

20

USING DENTAL YOUR PLAN

• Choose a licensed dentist. NOTE: If you select a Cigna

Dental “DPPO Advantage” Network dentist from our

Provider Directory, you will typically spend less

• No ID card needed

• No referral needed to visit a specialist

• Most Cigna Dental “DPPO Advantage” dentists will submit

claims for you. Your plan will then pay the dentist or you

(based on the claim form)

• The amount your plan pays depends on the coinsurance

level for the service you received, if you’ve paid your

deductible and/or reached your maximum21

DPPO

Advantage −

In-network

dentists: Greater savings

on covered

procedures


HOW TO FIND A

CIGNA NETWORK DENTIST

• Search online at Cigna.com (or myCigna.com once you

have registered online)

• Click on the “Find a Doctor” link, then select “Dentist”,

then “Select a plan”

22

DPPO

Advantage −

In-network

dentists: Greater savings

on covered

procedures


You are in the PPO plan

LIFE INSURANCE

COMPANY PAID

• 100 % Employer Paid

• Life Insurance Benefit amounts are equal to “one time”

your annual salary

• Ensure that you complete the Beneficiary form

• If you do not have a named beneficiary, the insurance company

will not know where to send the money

23

VOLUNTARY LIFE INSURANCE

24

Voluntary Life Insurance – we will move from

Anthem to CIGNA

Current life insurance amounts are grandfathered

Initial offering for 2/1/18 – Guarantee Issue All enrolled employees can increase their current election by 1X

All enrolled spouses can increase their current election by $5,000

Next year’s open enrollment – Guarantee Issue All enrolled employees can increase their current election by one unit

of $10,000

All enrolled spouses can increase their current election by one unit of

$5,000

Premiums reduced for many age bands

New hires will have option for Guarantee Issue amounts: Employee - $100,000

Spouse - $25,000

Child - $10,000

WHAT PAPERWORK DO I NEED TO

COMPLETE?

All employees MUST complete:

Benefit Election Form – Please indicate whether you are electing or

waiving the medical, dental & voluntary life insurance coverage. This

form must be returned by January 18th

A Carrier (CIGNA) Enrollment Form – if you are enrolling in the

medical, dental or the voluntary life for the first time

All forms must be returned by January 19th

25

QUESTIONS?

26

ohio associated enterprises open enrollment · 1/10/2018 · medical expenses (qmes) for you and...

Documents