Att G1 - 2020 Dunn County OE Presentation.pdf

Open Enrollment Presentation

Agenda

1) Welcome to the 2020 Benefits Enrollment

2) Medical Plan Options and Costs

3) Healthcare Tools & Resources

4) Savings Accounts

5) Worksite Plans

6) Next Steps

7) Contact Information

WELCOME

►Open Enrollment Highlights

►Open Enrollment Process

►Qualifying Life Events

SECTION 1

Open Enrollment Highlights

Open Enrollment period runs:

Tuesday, October 1, 2019 –

Thursday, October 31, 2019 Any changes made during Open Enrollment will become effective January 1, 2020

Medical Insurance through Medica

Elimination of the Standard Plan

Changes to the HSA Eligible Plan

Addition of the High HSA Eligible Plan

Premium Changes

Dental Insurance through Anthem Blue Cross Blue Shield

No Plan or Premium Changes

Worksite Plans through The Standard

Accident Insurance

Critical Illness Insurance

Process If you want to make changes to your health and/or dental insurance plans or add accident and/or critical illness insurance you will need to complete a new application. For critical illness only you will also need to complete an evidence of insurability form.

ALL participants in the Standard Plan MUST complete an application to enroll in a new medical plan OR cancel coverage.

If you do not want to make changes to your existing coverage, no forms are required.

If you are currently receiving and would like to continue receiving or would like to apply for the monthly incentive for 2020 a new form and proof of other coverage is required.

If you are currently contributing to an HSA, your current contribution will remain the same. If you would like to start contributing to an HSA or make a change to your current contributions you will need to submit a new HSA Contribution Authorization form.

All applications and forms will be available on the Dunn County website at www.co.dunn.wi.us or by contacting Human

Resources at admin_hr@co.dunn.wi.us or 715-232-2429.

All applications/forms must be received by Human Resources no later than 4:30 pm local time on October 31, 2019.

http://www.co.dunn.wi.us/ mailto:admin_hr@co.dunn.wi.us

Qualifying Life Events

Qualified changes in status include:

• Birth of a child, adoption, marriage, death, divorce, loss of coverage (if you or your spouse/dependents are covered under another plan and then lose that coverage)

Should you wish to make changes to your elections due to a qualifying event, you have 30 days from the event to notify Human Resources and complete/turn in the appropriate paperwork.

Otherwise you will have to wait until the next annual enrollment to make any changes to your benefit elections.

2020 MEDICAL

UPDATES

►Medical Insurance Terms

►Medical Network Options

►Medical Plan Change Summary

►Medical Plan Summaries

►Medical Plan Rates

►Monthly Incentive Payment

SECTION 2

Copay – a fixed dollar amount you pay for covered services. Such services include but are not limited to physician office visits, urgent care, and prescriptions.

Medical Insurance Terms

Out-of-Pocket Maximum – is the most you will pay in a given plan year for your benefits, not including your premium. Your deductible, copays, and coinsurance all accumulate towards this maximum amount. Once this is met, all covered services will be paid at

100% for the remainder of the plan year.

Deductible – is the amount of money you pay for services before coinsurance applies. This does not apply to preventive services required under the Affordable Care Act.

Coinsurance – or cost sharing is the percentage you pay for certain services based of the allowed amount charged. Generally, the insurance company pays the larger portion of the percentage and you pay the smaller portion. Coinsurance applies after the deductible has been met.

Our National Network- Medica Choice® Passport

OVERVIEW STRENGTHS

Primary care physicians 100% access to 2 providers within 15 miles Hospitals: 99.1% access to 1 hospital within 20 miles

Seamless benefit administration

12,000+ employer groups and over 2 million members nationwide Fully integrated through

ESI

68,000+ pharmacies including 24-hour pharmacies

Convenience care and urgent care

Virtual Care: AmWell or Virtuwell

Medica Choice® Passport national open access network

Co-branded ID cards

See any network provider without a referral

100% pass-through of negotiated provider discounts

Medica Contracted Service Area

UHC Contracted Service Area

2020 Medical

Network Options

20 hospitals/medical centers 60 primary and specialty care clinics Medica’s standard networks for chiropractic, behavioral health, pharmacy

Care is supported by team of providers, based on member’s unique needs.

Most teams include physicians, nurses, nurse practitioners - all focused on providing right care at right time

24/7 access to a nurse

Online access to your Mayo Clinic health records

Complimentary Mayo Clinic diet program

MEDICA COMPLETEHEALTH℠ (FEATURING CARE AT MAYO CLINIC)

2020 Medical Network Options

Primary service area:

Southern Minnesota and western Wisconsin

Changes effective

1/1/2020

2020 Medical Plan

Change Summary

Elimination of the Standard Plan

Increase to the Deductible and Out-of-Pocket

Maximum on the HSA Eligible Plan (Plan #1) Current Deductible and Out-of-Pocket Maximum:

$2,000 Single/$4,000 Family

New Deductible and Out-of-Pocket Maximum:

$3,000 Single/$6,000 Family

Addition of a second HSA Eligible Plan - the High

HSA Eligible Plan (Plan #2) Deductible and Out-of-Pocket Maximum:

$5,000 Single/$10,000 Family

In-Network and Out-of-Network Deductibles and

Out-of-Pocket Maximums remain separate for both plans

Embedded Deductibles added to Family coverage on both plans Plan #1: $6,000 Family - $3,000 Embedded Ded.

Plan #2: $10,000 Family - $5,000 Embedded Ded.

Pharmacy Benefit Manager will change from

CVS Caremark to Express Scripts

Plan Summaries

DUNN COUNTY

2020 MEDICAL PLAN OPTIONS

Plan Design Summary

PLAN #1:

$3,000/$6,000

HSA ELIGIBLE PLAN

IN-NETWORK

PLAN #2:

$5,000/$10,000

HIGH HSA ELIGIBLE PLAN

IN-NETWORK

Annual Deductible

Individual

Family

$3,000

$6,000 $5,000

$10,000

Member Coinsurance 100% 100%

Annual Out-of-Pocket Maximum

Individual

Family

$3,000

$6,000

$5,000

$10,000

Preventive Care Covered 100% Covered 100%

Office Visit

Illness or Injury

Chiropractic Care

Physical, Occupational & Speech Therapy

Mental Health and Substance Abuse

100% after Deductible

100% after Deductible

100% after Deductible

100% after Deductible

100% after Deductible

100% after Deductible

100% after Deductible

100% after Deductible

Note: Out-of-network services will be subject to separate deductible and out-of-pocket maximums

Plan Summaries

DUNN COUNTY

2020 MEDICAL PLAN OPTIONS

Plan Design Summary

PLAN #1:

$3,000/$6,000

HSA ELIGIBLE PLAN

IN-NETWORK

PLAN #2:

$5,000/$10,000

HIGH HSA ELIGIBLE PLAN

IN-NETWORK

Convenience Care/Retail Health Clinics 100% after deductible 100% after deductible

Hospital Outpatient 100% after deductible 100% after deductible

Hospital Inpatient 100% after deductible 100% after deductible

Urgent or Emergency Care

Emergency Room

Urgent Care 100% after deductible

100% after deductible

100% after deductible

100% after deductible

Medical Equipment and Supplies 100% after deductible 100% after deductible

Home Health Care 100% after deductible 100% after deductible

Retail Prescription Drugs

Generic

Preferred Brand

Non-Preferred Brand

Specialty Drugs

100% after deductible

100% after deductible

100% after deductible

100% after deductible

100% after deductible

100% after deductible

100% after deductible

100% after deductible

Please note: This is only a summary. Review your Summary of Benefits and Coverage (SBC) or contact Medica for more detail about your coverage and costs.

Plan Rates

CompleteHealth Featuring Mayo Clinic Health Systems Network

Plan #1: HSA Eligible Total Premium County Contribution* Employee Cost

Single $912 $857 $55

Family $2,460 $2,362 $98

Plan #2: High HSA Eligible Total Premium County Contribution* Employee Cost**

Single $826 $801 $25

Family $2,229 $2,179 $50

Choice Passport Network

Plan #1: HSA Eligible Total Premium County Contribution* Employee Cost

Single $912 $812 $100

Family $2,460 $2,263 $197

Plan #2: High HSA Eligible Total Premium County Contribution* Employee Cost**

Single $826 $746 $80

Family $2,229 $2,129 $100

PUBLIC SAFETY EMPLOYEES ONLY: CompleteHealth Network or Choice Passport Network

Plan #1: HSA Eligible Total Premium County Contributions* Employee Cost**

Single $912 $832 $80

Family $2,460 $2,360 $100

Plan #2: High HSA Eligible Total Premium County Contributions* Employee Cost**

Single $826 $801 $25

Family $2,229 $2,179 $50

*The County contribution only applies to full-time active employees. The rate for part-time and former employees is the total premium cost.

Proposed rates shown are subject to County Board approval.

Monthly Incentive Payment

The monthly waiver payment applies to two groups:

Full-Time employees with a family who completely waive the County’s family health insurance plan, who provide proof of family coverage from another source, will receive a monthly amount of $75.

Full-Time employees with a family electing to take the County’s single health insurance coverage OR single employees electing to completely waive medical coverage through the County will receive a monthly amount of $50. Proof of other coverage is required.

Forms must be turned into Human Resources by October 31, 2018!

HEALTHCARE

TOOLS & RESOURCES

►Medica Resources

►Medical Coverage & Consumerism

SECTION 3

24/7 Member Access mymedica.com

Member

Resources

FIND OUT

WHAT’S

COVERED IN

YOUR PLAN

TRACK YOUR

CLAIMS

CHECK TO SEE IF

YOUR DOCTOR IS

IN YOUR

NETWORK

SEE WHICH

DRUGS ARE

COVERED

ORDER ID

CARDS

Medica CallLink®

NurseLine

Medica CallLink ® connects you with advisors and nurses around the clock. When you call, you’ll receive trusted answers, information and support for a wide range of health concerns. This service is available at no additional cost to you.

Getting the Best Care and the

Best Value

Learn more about a diagnosis

Decide what type of care meets your needs

Understand symptoms and treatment options

Create a plan for adding healthy habits to your routine

Understand how to take medications safely and effectively

Find a doctor or hospital and schedule an appointment

Get information about preventive screening services

AVAILABLE

24-7

VIRTUAL CARE OPTIONS*

CLINIC-BASED AMWELL VIRTUWELL CallLink Nurse Line

Many clinics offer virtual care, online care or e-visits

24/7 online clinic available in every state

Includes coverage for medical and behavioral health care services

24/7 online clinic available in select states Available 24/7

Prices vary

Medical: Each visit is $49 or less

Behavioral health: Price varies by type of service

Medical: Each visit is $49 or less

FREE

Check with your clinic to see if they offer virtual care and how you can connect with your provider online

Mobile, web and phone visits with a board-certified doctor

Online visits with a certified nurse practitioner

Phone visits with a certified nurse practitioner

Clinic’s website Amwell.com Virtuwell.com https://www.medica.com

/wellness/nurse-line

*Virtual care options can vary by your plan’s network. Check care options at medica.com/findadoctor.

Convenient And Cost Effective Online Treatment

DOWNLOAD

THE APP

SAVE YOUR

INTERESTS

TAKE THE HEALTH

ASSESSMENT

MY HEALTH

REWARDS

LEVEL

POINTS

EARNED

REWARD

1 2,000 $10

2 10,000 $20

3 25,000 $30

4 40,000 $40 Members 18 years and older can earn up to $100 in gift cards funded by Medica

GETTING STARTED IS EASY!

Incentives for Daily

Activity

SAVINGS ACCOUNTS

SECTION 4

►Health Savings Account

►Flexible Spending Account

Health Savings

Account (HSA)

1. A tax-exempt account

2. An individually owned, tax-advantaged account that may be used to pay for qualified expenses

3. Established for the purpose of paying qualified healthcare expenses of the account owner or dependents.

4. The account owner must be covered under a Qualified High Deductible

Health Care Plan to contribute to an HSA.

5. Portable, it stays with you for life.

6. All unused funds can rollover to use on future expenses.

You CANNOT receive/make contributions to an HSA if…

1. You are claimed as a dependent on someone else’s tax return

2. You are covered by another health insurance plan that is

NOT a QHDHP

3. You or your spouse have a Flexible Spending Account (FSA), even if the FSA dollars are not used for you

4. You or your spouse are covered by a Health Reimbursement

Arrangement (HRA)

5. You have medical coverage under TRICARE, or eligible for

Medicare, or Medicaid

6. You are in receipt of Veteran Administration (VA) benefits

Is there a limit to how much I can contribute?

ANNUAL MAXIMUMS

The annual contribution is established by law and subject to change each calendar year.

If you are between the ages of 55 & 65, you may also be able to make a $1,000 “catch-up” contribution to the HSA each year.

Contribute up to

$3,500 Single, or

$7,000 Family

Contribute up to

$3,550 Single, or

$7,100 Family

2019 2020

HSA Disbursements

You must retain all receipts in the event of an IRS Audit

Disbursements for qualified healthcare expenses are not subject to taxation

Disbursements for non-qualified expenses are subject to regular taxation plus a 20% penalty. The 20% penalty is waived upon attainment of age 65

Expenses incurred prior to establishing an HSA are NOT eligible for reimbursement

• Eligible health care expenses include expenses for the individual who open the account, his or her spouse and dependent children. The spouse and dependent children do not need to be covered under the QHDHP in order to have an eligible HSA expense.

• Hospitalization

• Prescription Drugs

• Doctor Office Visits

• Premiums for Medicare, Long Term Care, COBRA

• Dental expenses (Including Orthodontia)

• Vision (Including Lasik)

• Full list of eligible expenses available on the Treasury website at: www.IRS.GOV

HSA Eligible

Expenses http://www.irs.gov/

Healthcare Flexible Spending Account

LIMITED FLEXIBLE SPENDING ACCOUNT

2020 Maximum Conribution = $2,700

• Offers you the same pre-tax savings opportunity as the

Healthcare FSA

• However, it is limited to dental and vision expenses only

• You cannot use the funds from this account to pay for medical expenses

• This account is for individuals participating in one of the

QHDHP with a Health Savings Account (HSA)

Healthcare Flexible Spending Account

DEPENDENT CARE EXPENSE ACCOUNT

Maximum Conribution = $5,000

• Gives you the opportunity to redirect a portion of your annual pay on a pre-tax basis to pay for dependent care expenses

• An eligible dependent is any member of your household for whom you can claim expenses on your Federal Income Tax Form

• Children must be under age 13

• Care centers which qualify include dependent care centers, preschool educational institutions, and qualified individuals

WORKSITE PLANS

SECTION 6

►Accident Insurance

►Critical Illness Insurance

Accident insurance is an affordable way to cover the gap between what Medical insurance pays and what you’d owe out of pocket if you or a family member were to get injured.

Pays benefits following treatment for a wide range of accidents – 100+

Lump sum benefits paid directly to employees Money can be used wherever you need it most:

Deductibles/Copays Medical Bills Daily Expenses

Accident Insurance

Affordable monthly group rates through Dunn County

Employee Only: $7.39

Employee + Spouse: $10.67

Employee + Children: $13.05

Employee + Family: $19.93

Critical Illness

Insurance Critical Illness insurance pays a lump sum benefit to help fill the gap as a result of out of pocket costs from a serious illness, creating a financial safety net for you and your family

Employees elect a benefit amount that pays a lump sum upon the diagnosis of a covered critical illness — up to $50,000 for employees, $30,000 for spouses

$20,000 Guarantee Issue for Employees and

$10,000 for Spouses – Additional amounts require

Evidence of Insurability (EOI)

Dependent children are automatically covered at

25% of employee amount

It’s estimated that almost 1.8 million new cases of cancer will be diagnosed in 2019 in the U.S.

Every 40 seconds, someone in the U.S.

has a heart attack

Rates are Attained Age Rate - see Benefit

Booklet or Decision Support Tool for rates

Covered conditions include: heart attack, stroke, cancer, organ failure, and more

NEXT STEPS

SECTION 7

►Review

► Inquire

►Enroll!

1 2 3

REVIEW THIS PRESENTATION

Review this presentation and all insurance/benefits information available carefully.

ASK QUESTIONS

Make sure to utilize your HR Department, CBIZ

Representatives and the carrier contacts listed at the end of this presentation.

Open Enrollment will be held from October 1, 2019 –

October 31, 2019. The 2020 plan year is January 1 through December 31.

ENROLL

Next Steps

Recap

All applications/forms must be received by Human Resources no later than 4:30 pm local time on October 31, 2019.

If you want to make changes to your health and/or dental insurance plans or add accident and/or critical illness insurance you will need to complete a new application. For critical illness only you will also need to complete an evidence of insurability form.

ALL participants in the Standard Plan MUST complete an application to enroll in a new medical plan OR cancel coverage.

If you do not want to make changes to your existing coverage, no forms are required.

If you are currently receiving and would like to continue receiving or would like to apply for the monthly incentive for 2020 a new form and proof of other coverage is required.

If you are currently contributing to an HSA, your current contribution will remain the same. If you would like to start contributing to an HSA or make a change to your current contributions you will need to submit a new HSA Contribution Authorization form.

All applications and forms will be available on the Dunn County website at www.co.dunn.wi.us or by contacting Human

Resources at admin_hr@co.dunn.wi.us or 715-232-2429.

mailto:admin_hr@co.dunn.wi.us

CONTACT

INFORMATION

SECTION 8

Contact Information

MEDICAL CARRIER:

MEDICA

www.medica.com

952.883.5000 or 1.800.883.2177

FLEXIBLE SPENDING ACCOUNT (FSA) CARRIER:

EMPLOYEE BENEFITS CORPORATION (EBC)

www.ebcflex.com 1.800.346.2126

DENTAL CARRIER:

ANTHEM BLUE CROSS AND BLUE SHIELD

www.anthem.com 1.866.589.0582

WORKSITE PLANS CARRIER:

THE STANDARD

www.standard.com/edu/dunn-county/44031

If you have any questions regarding your benefits, please contact your carrier partners or your Human Resources

Department listed below.

DUNN COUNTY HUMAN RESOURCES

admin_hr@co.dunn.wi.us

715.232.2429

WEBSITE:

www.co.dunn.wi.us http://www.medica.com/ http://www.ebcflex.com/ http://www.anthem.com/ http://www.standard.com/edu/dunn-county/44031 mailto:admin@co.dunn.wi.us