Employee Benefits Open Enrollment 2016 - Explain ...
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Employee Benefits Open
Enrollment 2016
Agenda
Employee Benefits Update
2016 Medical Plans
2016 Ancillary Benefit Plans
Additional Benefits
Next Steps
2
Healthcare Cost Management
What is exp doing to help manage rising healthcare
costs?
Exp has designed a program that provides a
comprehensive level of benefits that promotes wellness
and offers choices to our employees
Exp currently pays a large portion of health care
coverage premiums for eligible employees and
dependents
Exp offers tools and incentives to empower members to
be responsible healthcare consumers
3
2016 Open Enrollment
There will be no changes in the benefit plans.
Exp will continue to offer Medical/Rx plans; administered
by UnitedHealthcare.
Payroll deductions will increase slightly = 5%
Exp will continue to offer Dental, Vision, Life and AD&D,
Short-term and Long-term Disability; administered by
Guardian.
4
What Can You Do?
Become better healthcare consumers
Be proactive with your health – get your annual exams
and preventive screenings
Go to your doctor or a convenience care clinic when ill;
don’t wait
Complete an online Health Risk Assessment
Use urgent care for non-emergencies instead of the
emergency room
Use generic medications when possible
Follow Rx dosage instructions
52016 Benefit Overview
Carrier Coverage
UnitedHealthcare Medical, Prescription Drugs
Guardian Dental, Vision, Life and AD&D, Short-
term and Long-term Disability
Trustmark Accident and Critical Illness Plans
Allstate Cancer Plans
myCafeteriaPlan Flexible Spending Accounts and
Health Reimbursement Accounts
Health Advocate Assists employees and families
navigate the healthcare system
Guardian Employee Assistance Program
6UnitedHealthcare Medical Options
Medical Plan
All of the plans will remain the same for 2016.
UnitedHealthcare will continue to be the national insurance carrier for
exp, with the exception of employees in Alaska.
You will have 3 options to choose from:
The Choice Plan offers in-network benefits with co-pays at the
physician’s office and pharmacy.
The Choice Plus Plan offers in and out-of-network benefits with co-
pays at the physician’s office and pharmacy.
The HRA Plan is a high deductible in-network only health plan that
offers a Health Reimbursement Account.
Preventive is covered at 100% with no co-pays on all plans.
7CHOICE PLAN
TYPE OF SERVICE YOU PAY:
Primary Care/Specialist office visit: $15/$40
Virtual Visit **NEW** $25
In-patient hospital care: 20% after deductible
Out-patient hospital care: 20% after deductible
Emergency room: $250 (any ER)
Urgent Care: $75
Lab and x-ray: Covered in full
Scans and Therapies 20% after deductible
Deductible (Individual/Family) $750/$1,500 per year
Out-of-Pocket (includes deductible) $3,750/$7,500 per year
Lifetime Maximum Unlimited
Prescription Drugs (Retail) $10 Tier 1/$35 Tier 2/$70 Tier 3
Mail Order (90 day supply) 2.5x Retail
8CHOICE PLUS PLAN
TYPE OF SERVICE YOU PAY:
Primary Care/Specialist office visit: $15/$40
Virtual Visit **NEW** $15
In-patient hospital care 20% after deductible
Out-patient hospital care 20% after deductible
Emergency room $250 (any ER)
Urgent Care $75
Lab and x-ray 100% covered
Scans and Therapies 20% after deductible
Deductible (Individual/Family) $500/$1,000 in-network; $2,000/$4,000 out-of-network
Out-of-Pocket (includes deductible) $3,500/$7,000 in-network; $5,000/$10,000 out-of-network
Lifetime Maximum Unlimited
Prescription Drug(Retail) $10 Tier 1/$35 Tier 2/$70 Tier 3
Mail Order (90 day supply) 2.5x Retail
Out of network coinsurance 40% after deductible
9CHOICE HRA PLAN
TYPE OF SERVICE YOU PAY:
Primary Care/Specialist office visit: $25/$50
Virtual Visit **NEW** $25
In-patient hospital care: 20% after deductible
Out-patient hospital care: 20% after deductible
Emergency room: $250(any ER)
Urgent Care: $75
Lab and x-ray: Covered in full
Scans and Therapies: 20% after deductible
Deductible (Individual/Family) $2,000/$4,000
Out-of-Pocket Maximum (includes deductible) $4,500/$9,000
Lifetime Maximum Unlimited
Prescription Drugs (Retail) $10 Tier 1/$35 Tier/ $70 Tier 3
Mail Order (90 day supply) 2.5x Retail
10Health Reimbursement Account
Exp is offering employees a Health Reimbursement Account (HRA) on the high deductible
plan option only to help offset the costs associated with out of pocket expenses.
The company will be adding an annual contribution of $500 automatically to your HRA on
January 1. You can use this money for co-pays, deductibles, or other out of pocket costs
associated with qualified medical, dental, or vision expenses. You will receive a debit card to
access the money.
You are able to earn an additional $500 one time contribution into your HRA fund. Each
employee that completes an on-line Health Risk Assessment will be eligible for an additional
$500 contribution to the HRA.
Spouses and dependents can use Health Reimbursement Account (HRA) funds only if they
are enrolled in a health plan that meets the minimum standards of the ACA (either with exp
or elsewhere). Spouses and dependents with no proper health insurance coverage will not
qualify for HRA use.
HRA funds do not roll-over into next plan year. Unused HRA funds will be forfeited at the
end of the plan year.
If you elect the Healthcare FSA also, your HRA funds will be used first.
11Health Risk Assessment
A Health Risk Assessment provides you
with an individual wellness score that
measures your overall health, will take
about 20 minutes to complete, and
includes 50 standard lifestyle questions.
The Assessment is confidential, and you
only need to complete the Assessment,
not achieve a certain score.
To start the Health Risk Assessment, you
will need to set up an account at
www.myuhc.com.
w.myuhc.com
No need to submit proof upon completion,
balances to the HRA will automatically be
credited the additional $500 on a monthly
12
basis.Scans and Therapies
Scans and Therapies are major diagnostic services such
as MRI, CT Scan, PET Scan, MRA and Nuclear Medicine.
They are typically performed at a hospital or out-patient
center, and sometimes in a doctor’s office.
They can cost several hundred dollars or more (if in-
network, more if out-of-network.)
Use the Treatment Cost Estimator on myUHC.com to
determine what your cost will be.
Regardless of where the test is done, the benefits are
subject to Deductible, then Coinsurance, even if
performed in a doctor’s office (“Covered” does not mean
“Paid at 100%.”)
##
13Saving money on Prescriptions
Mail Order Prescription Benefits:
You can order a 3 month supply of medicine to be shipped to you for
only the cost of 2.5 co-pays.
This saves you time and money for medicines you take on a routine
basis.
Generic Medications:
Several pharmacies now offer special prescription programs,
including $4 generic drugs and free antibiotics.
Generic drugs contain the same active ingredients and are
available in the same strength and dosage form as their brand-
name counterparts but could cost up to 50% less.
14myUHC.com
Look up network doctors /
hospitals
Estimate costs
Track claims status
Health improvement
program
Personal Health Record
Health product discounts
Review plan details
15Health Advocate
Information & Service Support
•Assist with eldercare issues Clinical Services
•Obtain health information to help make
•Find qualified healthcare providers
informed decisions
•Schedule appointments
•Assist with finding qualified wellness
•Locate and research the newest
programs treatments
•Help arrange transportation •Assist with complex medical condition
•Assist with understanding test results
Health Coaching Administrative
•Obtain unbiased health Services
information •Navigate within an insurance
•Help prepare patients for company
healthcare appointments You will be •Assist with correcting billing
mistakes
•Help members become active assigned a
participants in their healthcare Personal
Health
Advocate
(PHA)
24/7 Toll-free telephone support
Your privacy is protected
16Dental Benefits
Guardian is the provider for dental insurance.
There are 2 plans to choose from: a low and a high PPO option.
Please visit www.guardiananytime.com to look up dentists in the
network.
Dental Insurance - Guardian Life Insurance Company
Low Plan High Plan
Benefit Details You Pay: You Pay:
Preventive & Diagnostic Services Deductible waived for preventative Deductible waived for preventative
In-Network Covered in Full, no deductible Covered in Full, no deductible
Out-of-Network Covered in Full @ R&C*; no deductible Covered in Full @ R&C*; no deductible
Basic Services
In-Network 20% after deductible 20% after deductible
Out-of-Network 20% after deductible** 20% after deductible**
Major Services
In-Network 50% after deductible 50% after deductible
Out-of-Network 50% after deductible** 50% after deductible**
Orthodontic Services
In-Network & Out-of-Network 50% to $1,500 lifetime max, 50% to $1,500 lifetime max,
No Deductible No Deductible
Dependent Child Only up to age 19 Dependent Child Only up to age 19
Calendar Year Deductible Individual / Family Individual / Family
In-Network $50/$150 $50/$150
Out-of-Network $50/$150 $50/$150
Annual Maximum Benefit
In-Network & Out-of-Network $1,000 Combined $2,000 Combined
*R&C = Reasonable and Customary: the amount that your health plan determines is the normal range of payment for a specific service within a given
geographic area
** Important: When using an out-of-network provider, you may be balanced billed for amounts over the reasonable and customary charges
17Vision Benefits
Guardian is the provider for vision insurance, using the Davis Vision network.
Please visit www.davisvision.com to look up a provider in the network.
Vision Insurance - Guardian Life Insurance Company
Choice Plan
Benefit Details
You Pay:
Benefit Frequency
Exams Once every 12 months
Lenses Once every 12 months
Frames Once every 24 months
Exam Co-pays
In-Network $10 Co-pay
Out-of-Network Up to $50 Allowance
Lenses Co-pay
Single Vision: In-Network $25 Co-pay
Out-of-Network Up to $48 Allowance
Bifocal: In-Network $25 Co-pay
Out-of-Network Up to $67 Allowance
Trifocal: In-Network $25 Co-pay
Out-of-Network Up to $86 Allowance
Lenticular: In-Network $25 Co-pay
Out-of-Network Up to $86 Allowance
Frames
In-Network $130 Allowance
Out-of-Network Up to $48 Allowance
Contact Lenses
Conventional: In-Network Up to $130 Allowance
Out-of-Network Up to $105 Allowance
Medically Necessary: In-Network $25 Co-pay
Out-of-Network Up to $210 Allowance
18Employee Life and AD&D Insurance
Exp provides all full-time employees with Basic Term Life Insurance
with Accidental Death & Dismemberment (AD&D.)
The benefit amount is two times your annual earnings to a maximum
of $200,000.
Supplemental Employee Coverage
AD&D Coverage included at no additional cost.
Elect coverage in units of $10,000.
Maximum is the lesser of $500,000 or 5 times basic annual earnings.
During your initial enrollment period: Guarantee Issue amount is the lesser
of 3 times basic annual earnings or $150,000.
If you are already enrolled in EE Supplemental Life, the amount of your life
insurance will automatically increase 5% each year, up to 5 years, with
premium remaining at the lower elected amount. You do not need to do
anything in order for the automatic increase to take effect.
If you would like increase the amount of Spouse coverage you currently
have OR enroll for the first time, you will need to fill out an Evidence Of
Insurability form (available during the enrollment process).
19Dependent Life Insurance Supplemental Spouse Coverage If you elect Employee Supplemental Life and AD&D Insurance for yourself, you may choose to purchase Spouse Supplemental Life and AD&D Insurance in increments of $5,000, $5,000 minimum to a maximum of $100,000. You may only elect up to 50% of the employee’s election for spouse life insurance. For example, if you elect 100k on yourself, you can only elect up to 50k on your spouses. Spouses’ rate are based on Employee's age bracket. If you would like increase the amount of Spouse coverage you currently have OR enroll for the first time, you will need to fill out an Evidence Of Insurability form (available during the enrollment process). Children Coverage If you elect Supplemental Life and AD&D Insurance for yourself, you may choose to purchase Child(ren) Supplemental Life and AD&D Insurance in increments of $2,000, $2,000 minimum to a maximum of $10,000 for each child. Eligible Child(ren) are from age 15 days to 26 years. 20
Disability Insurance
In the event you are out of work due to a short term medical
condition, exp provides all eligible employees a Short-Term
Disability program through Guardian.
This benefit will pay up to 60% of your weekly earnings to up
to a maximum amount for up to 13 weeks.
The company also provides Long-Term Disability at no cost
to the employees.
This benefit covers up to 60% of your basic monthly earnings
up to a maximum should you be unable to work due to non-
work related illness or injury.
21Voluntary Benefits
Voluntary benefits provide you with supplemental coverage
that strengthens your overall benefits package.
The Trustmark Critical Illness Insurance is a benefit that will
pay you a lump sum of money if you are diagnosed with a
critical illness, heart attack or stroke.
The Trustmark Accident insurance is a plan that helps pay
for the unexpected expenses that result from an accident.
The Allstate Cancer Insurance offers a first occurrence
benefits that pay cash to you based upon the severity of the
cancer diagnosis
See the state specific brochure from Allstate and Trustmark
for additional details and rates
22Flexible Spending Account
The FSA allows you to put money aside through payroll
deductions before taxes are withheld to pay the cost of health
care expenses not covered by your medical plan and for the cost
of qualified dependent care.
By doing so, you reduce your taxable income, which increases
your take-home pay.
Healthcare FSA – allows you pay for certain IRS-approved medical
care expenses not covered under your insurance plan with pre-tax
dollars.
Please note that the IRS limit is $2,550 annually.
Dependent Care FSA – allows you use pre-tax dollars towards
qualified dependent care expenses.
Adoption Assistance FSA – provides tax break for adoption
expenses.
Qualified Transportation Plan – allows you to set aside pre-tax
funds to be used for transportation and commuter parking
expenses for travel to and from work.
23Important Information for
Flexible Spending Accounts
You must make an election to enroll in the 2016 FSA programs, as this benefit will not roll
over into the new plan year.
If you have any HealthCare FSA funds from 2015 left over, you may roll up to $500 into the
new plan year. This will automatically occur for you, no action is needed on your end.
For 2015 Healthcare FSA participants: You will have until March 31, 2016 to submit for
reimbursement for FSA Health expenses incurred during the plan year from January 1,
2015 to December 31, 2015. There is no longer a grace period for incurring claims in 2016,
because the plan will allow up to $500 of unused funds to roll over into the 2016 plan year.
Please remember that these accounts have a “use it or lose it” rule, so make sure you use
the money in your account by the deadlines.
2016 Maximum Contributions
Medical FSA $2,550 annually
Dependent Care FSA $5,000 if you are married and filing a joint tax
return, or $2,500 if you are married and file
separate returns
Adoption Assistance FSA $13,460 annually
Transit Account $130 monthly
Parking Account $255 monthly
24MyCafeteriaPlan.com
My Cafeteria Plan manages the FSA/ HRA accounts
You will receive a “Benny Card” in the mail soon after
January 1st. If you are already enrolled, you will keep the
same debit card that you have and money will be added to
this card for the new plan year.
You may go online to check your balances and account
activity at http://myaccount.mycafeteriaplan.com
If you have questions or need assistance, please see Human
Resource Manager, Mary Beth Pfaller, at +1.312.616.7445 or
by email at marybeth.pfaller@exp.com
25Enrollment Process
You will be enrolling via a self-service online enrollment system, EMB
Enroll. The online system can be accessed from any computer with
internet access.
If you are making changes to your current benefits, you will need to
log onto the EMB Enroll site and complete the process. If you do not
enroll, your current benefits will roll over into the same plan you are
already enrolled in (except FSA).
Any amounts up to $500 in your 2015 Healthcare FSA will roll over
into 2016. If you want to enroll into the FSA, you will need to make
an election. Your 2015 Election amounts will not rollover. If you don't
make an election you will have a zero election amount.
Please see your enrollment guide for the instructions on how to log in
and use the online enrollment system to complete your enrollment.
26Next Steps
Please review your benefit guide and carrier summaries.
Please make sure to have the necessary dependent information
(birth date, social security numbers) if you are enrolling dependents
to any of the plans for the first time.
Select your benefits carefully. The only changes that can be made
mid-year are for life events such as marriage, divorce, birth or
adoption, death, or a reduction in hours from full-time to part-time.
Notify Human Resources within 30 days of having a life event in
order to make any changes.
Should you have any questions, do not hesitate to contact exp’s
Human Resource Manager, Mary Beth Pfaller, at +1.312.616.7445
or by email at marybeth.pfaller@exp.com.
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