Employee Benefits
SAINT LOUIS UNIVERSITY
2012 Annual Enrollment
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Benefits Overview—Coverages Offered
 Medical/Pharmacy
 Voluntary Dental
 Flexible Spending Accounts
 Employee Term Life and Accidental Death & Dismemberment (AD&D)
 Voluntary Term Life
 Voluntary AD&D
 Long Term Disability
 Business Travel Accident
Please hold all questions until the conclusion of this presentation.
We will take time to address questions at the end.
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Medical/Pharmacy Benefits
Annual Enrollment 2012
Highlights Effective January 1, 2012
 The Vitality™ Wellness Program
 Save $30 per month on premium
and earn rewards!
 Health screenings are needed to
participate in the Vitality program
 Medical changes
 Primary Plan eliminated
 New qualified High Deductible
Health Plan (HDHP)
 New optional Health Savings
Account (HSA) for the HDHP
 Express Scripts
 Walgreens update
 New copays for Plus Plan
 New 4th tier copay for Plus Plan for
self injectables
 “Preventive” medications under
HDHP covered at 100%
 John Hancock – Long Term Care
 Exiting marketplace for new apps
 Will service existing policyholders
 Applications up until 12/31/11
 No dental plan design changes
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2012 Medical Plan Options
Plus Plan
SLUCare
In-Network
HSA Plan
Out-of-Network
Deductible
SLUCare
In-Network
Out-of-Network
Non-Embedded: (One member can satisfy entire family deductible)
Individual
$0
$250
$750
$1,500
$1,500
$3,000
Family
$0
$500
$1,500
$3,000
$3,000
$6,000
Coinsurance
0%
10%
40%
0%
10%
40%
Out-of-Pocket Maximum (includes deductibles)
Non-Embedded: (One member can satisfy entire family OOP Max)
Individual
$0
$1,250
$4,750
$1,500
$3,000
$6,000
Family
$0
$2,500
$9,500
$3,000
$6,000
$12,000
10% after ded.
40% after ded.
0% after ded.
10% after ded.
40% after ded.
100%
100%
100%
100%
100%
10% after ded.
40% after ded.
10% after ded.
40% after ded.
$100 copay
$100 copay
10% after ded.
40% after ded.
$50 copay
$50 copay
10% after ded.
40% after ded.
Physician Office Visits
Primary Care
$10 copay
Specialist Care
$20 copay
Preventive Care
100%
Inpatient Hospital
Emergency Room
Urgent Care Center
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2012 Pharmacy Plan Options
Plus Plan
HSA Plan
Express Scripts
Express Scripts
Express Scripts
Express Scripts
Retail
Mail Order
Retail
Mail Order
(34-day supply)
(90-day supply)
(34-day supply)
(90-day supply)
Tier 1
$8
$16
Medical Deductible and Coinsurance
Tier 2
$30
$60
Medical Deductible and Coinsurance
Tier 3
$50
$100
Medical Deductible and Coinsurance
Tier 4
20% to $150
Preventive Medications
Priced according to the tier in which they fall
Medical Deductible and Coinsurance
Covered at 100%, no copay or deductible
NEW! Under the proposed HSA plan, certain preventive, or
“maintenance,” medications would be covered at 100%... NO copay
or deductible would need to be satisfied by you or your family!
For a list of these drugs go to www.slu.edu
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What is an HSA?
Health Savings Accounts (HSAs) are designed
to help you save and pay for your health care
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Putting Money INTO an HSA
 #1 Important Lesson:
 Rules when you can put money IN; no rules to pull money OUT
 #2 Important Lesson:
 Need $0.00 in your healthcare FSA before opening an HSA
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HSA Eligibility
You are eligible to open and contribute to an HSA if you:
Are covered by an eligible high deductible health plan
Are not covered by any other health plan that is not a
high deductible plan
Are not enrolled in Medicare, Medicaid, or TRICARE
Have not received VA benefits within the past 3 months
Are not claimed as a dependent on someone else’s tax return
Are not covered by a healthcare FSA
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Putting Money INTO an HSA
 How Much, and When?
 $3,100 for an individual; SLU will contribute $250
 $6,250 for a family; SLU will contribute $500
 You must aggregate the employer and employee contributions:
SLU’s Seed Money ($250 or $500)
+ Your contribution
= $3,100 or $6,250
 55+ can fund an additional $1,000/year “catch-up” contribution
 Employee and spouse get one bite at the maximum contribution apple each
year…they may allocate the maximum between their HSAs
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Putting Money INTO an HSA
Must be considered an “Eligible Individual”
 Employee has single coverage under HDHP, but is also covered under spouse’s
non-HDHP plan
 Employee has single coverage under HDHP, but spouse has a traditional FSA
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 Employee has family coverage under HDHP, spouse has employee-only non-HDHP
coverage
 Employee has single coverage under HDHP, spouse has employee + children
coverage under non-HDHP
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HSA Qualified Medical Expenses
Medical plan
deductibles and
coinsurance
Medical, dental and
vision care and
services
Use HSA dollars to pay
for medical expenses
for your spouse or
dependents
Any money you take out of your HSA for
qualified medical expenses is income-tax free
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Taking Money OUT of an HSA
 Issues in Distributions
 Reimbursement of expenses for employee, opposite-sex spouse and Tax Code
“dependents” are tax free…if the expense was incurred on or after the date the HSA
was established
 “Medical expenses” include: SAVE YOUR RECEIPTS!!!
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Section 213 expenses (OTC Rx with prescriptions)
COBRA premiums
Medicare premiums
Qualified long-term care premiums
Retiree health insurance after age 65, but not Medigap/Supplement plans
 Other withdrawals are taxable
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Income tax, plus…
Subject to 20% excise tax if withdrawn prior to age 65
Withdrawal by HSA account holder, who is not yet 65, to pay Medicare premiums for spouse,
who is at least age 65, are taxable and subject to excise tax
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How an HSA Helps You Save
1
2
3
Steve
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Steve puts his money into his HSA pretax
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn income tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
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How You Can Make the Most of Your Coverage
Health Care Consumerism
Make informed choices
Look for ways to lower
health care costs
Own your health care decisions
Understand your medical coverage
Maintain a healthy lifestyle
Use your preventive care coverage
to catch health issues early
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Paying for Non-Qualified Expenses
Any funds used for purposes other than to
pay for qualified medical expenses are:
The tax penalty does
not apply to account
holders age 65 and
older, those who
become disabled or
enroll in Medicare.
Taxable as income
20% tax penalty
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Making Deposits
Payroll
Deduction
Arrange a regular automatic payroll
deduction.
Mail a Check
Mail a deposit at any time to deposit
additional dollars into your account.
e-Contribute
Arrange a regular electronic transfer from
an account at another financial
institution.
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Access Your HSA Funds
Use your UnitedHealthcare
Health Savings Account
Debit MasterCard®
Sign up for automatic bill
pay and online banking
Use HSA checks
Pay with personal funds
and reimburse yourself
from your HSA
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Managing Your HSA with myuhc.com
 Treatment cost estimator
 Check statements
 Check interest rates
 Pay bills to health care providers
 Download forms
 Update personal information
 Arrange for deposits
 Manage investment activities
 Learn about HDHPs and HSAs
 HSA calculators
Investments are not FDIC insured, are not
guaranteed by OptumHealth Bank and may lose
value.
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2012 Cost Sharing
Plus Plan
Monthly Payroll Deductions
Single
Employee and Spouse
Employee and Child(ren)
Family
Monthly Payroll Deductions
Single
Employee and Spouse
Employee and Child(ren)
Family
With Wellness Incentive
$94.34
$313.79
$283.90
$448.26
HSA Qualified Plan
Without Wellness Incentive
$124.34
$343.79
$313.90
$478.26
With Wellness Incentive
Without Wellness Incentive
$29.81
$178.28
$161.30
$254.68
$59.81
$208.28
$191.30
$284.68
 If you enroll in the HSA Qualified Plan for 2012,
SLU will contribute funds to help you build your balance:
 $250 for Single Enrollees
 $500 for Enrollees with Family Members
 Wellness Incentive increased from $20 to $30 for 2012
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2012 Cost Sharing – Biweekly Rates
Plus Plan
Biweekly Payroll Deductions
Single
Employee and Spouse
Employee and Child(ren)
Family
Biweekly Payroll Deductions
Single
Employee and Spouse
Employee and Child(ren)
Family
With Wellness Incentive
$43.54
$144.83
$131.03
$206.89
HSA Qualified Plan
Without Wellness Incentive
$57.39
$158.67
$144.88
$220.74
With Wellness Incentive
Without Wellness Incentive
$13.76
$82.28
$74.45
$117.54
$27.60
$96.13
$88.29
$131.39
 Wellness Incentive increased from $9.23 to $13.85 per biweekly payperiod for
2012
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2012 Cost Sharing
Annual Contribution Difference vs. 2011 Plus Plan
Plus Plan
Annual Difference in Payroll Deductions
With Wellness Incentive
Single
Employee and Spouse
Employee and Child(ren)
Family
$304.44
$181.92
$164.52
$259.80
HSA Qualified Plan
Annual Difference in Payroll Deductions
With Wellness Incentive
Single
Employee and Spouse
Employee and Child(ren)
Family
($469.92)
($1,444.20)
($1,306.68)
($2,063.16)
 If you enroll in the HSA Qualified Plan for 2012,
SLU will contribute funds to help you build your balance:
 $250 for Single Enrollees
 $500 for Enrollees with Family Members
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Dependent Eligibility Audit
•
SLU has a responsibility to:
 Administer the plan as stated in the plan document
 Administer the plan consistently for all employees
 Monitor the costs of the plan
•
SLU will complete a Dependent Eligibility Audit in early 2012
 Employees will be asked to provide verification for enrolled
dependents
 Ineligible dependent will be removed from the plan
 Claims paid for ineligible dependents may be recovered and the
expenses would become the responsibility of the employee
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Eligible Dependents
Definition of an Eligible Dependent:
Legal spouse or dependent child under 26 years of age of the employee or the
employee's spouse. The term child includes any of the following:
 Natural child
 Stepchild
 Legally adopted child
 Child placed for adoption
 Child for whom legal guardianship has been awarded
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Vitality
Annual Enrollment 2012
Vitality Check
 Where do I go?
 SLU provides the opportunity on campus by calling 977-3500 or you can visit your
physician in November
 What’s in it for me?
 To get the $30 monthly reduction in your medical premiums, you must get a Vitality
Check and complete the health risk assessment (HRA) in November
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Other Activities
 Review and activate your personal health goals
 Update or confirm your email contact information
 Complete an online Course to learn about a health topic
 Complete a Vitality Check™ biometric screening with a Vitality partner
 Schedule a preventive screening
 Schedule a Healthy Habit
 Donate blood
 Complete a Fitness Assessment with a Vitality partner
 Track your workouts using a Vitality-approved fitness device
 Sign up at a Partner Health Club
 Sign up for an Athletic Event
 Complete online health tool calculators
 Get CPR or first aid certified
Please note: This list does not cover the program in its entirety. Please refer to the web site for complete
program activities, rules and details.
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Voluntary Dental Benefits
Annual Enrollment 2012
Voluntary Dental Benefits
 Coverage will continue through Delta Dental
 Choose among three dental plan options
 Benefits will remain the same for 2012
 Contributions increasing 3.2%
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Voluntary Dental Plan—Delta Dental
Flex Option
Basic Plus
Basic
In-Network
Out-of-Network
In-Network
Only
In-Network
Only
Individual
$50
$50
$25
$25
Family
$150
$50
$75
$75
$1,000
$1,000
$1,000
$750
0% no deductible
0% no deductible
10% after deductible
30% after deductible
30% after
deductible
30% after
deductible
40% after deductible
60% after deductible
65% after
deductible
Not covered
$1,000
$1,000
$1,000
Not covered
50%
For adults and
children
60%
For adults and
children
50%
For children only
Not covered
Deductible
Calendar Year Maximum
Per person
Preventive Care
0% no deductible 0% no deductible
Basic Restorative Care
Major Restorative Services
Orthodontia
Lifetime maximum (per person)
Orthodontia
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Dental Payroll Deductions
Flex
Basic Plus
Basic
Single
$32.00
$20.89
$14.91
Two-person
$62.64
$39.46
$28.98
Family
$107.24
$67.45
$51.84
Single
$14.77
$9.64
$6.88
Two-person
$28.91
$18.21
$13.38
Family
$49.50
$31.13
$23.93
Monthly
Bi-Weekly
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Flexible Spending Accounts
Annual Enrollment 2012
Flexible Spending and Dependent Care Accounts
 Administration will remain with ConnectYourCare
 You must make a new election for the 2012 Plan Year; current elections
cannot be carried forward
 Can be used at authorized vendors (medical facilities, hospitals, pharmacies,
etc.)
 Debit card allows direct payment at time of service
 Cards are good for three years – don’t throw yours away!
 Remember if you are electing the HSA plan option, the IRS requires
your current healthcare balance to be $0.00 before opening the HSA
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Flexible Spending and Dependent Care Accounts
 Annual maximum for the health care FSA will remain at $5,000
 Annual maximum for the Dependent Care Account Contribution will remain at
$5,000 ($2,500 if married and filing separate returns)
 For the health care FSA, your total election amount less previous
reimbursements is available at the time of transaction
 For the Dependent Care FSA, only the cash balance in your account is
available at the time of transaction
 You cannot roll over unused balances from one year to the next; carefully
estimate your expenses for the next plan year
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Eligible Traditional Medical FSA Expenses
 Copays, co-insurance and deductibles for medical, prescription and dental
plans
 Eye exams, contacts and eyeglasses
 Laser eye surgeries
 Hearing aids
 Over-the-counter medical supplies (but not medications)
 Bandages, splints, contact lens solution, etc.
 Insulin
 Some expenses not covered by your health care plan
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Advantages of FSAs—Tax Savings Example
Without FSA Pretax
Savings
Annual Base Pay
With FSA Pretax Savings
$25,000
$25,000
Health Care Account Expenses
-$0
-$1,000
Dependent Care Account Expenses
-$0
-$2,000
Annual Taxable Income
$25,000
$22,000
Estimated Federal Income Taxes
-$3,750
-$3,300
After-tax Cost of Expenses
-$3,000
-$0
Annual Net Pay
$18,250
$18,700
Tax Savings
$450
Assumes individual filer w/federal income tax rate of 15%; example does not include
state, city, or other taxes
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Annual Enrollment 2012
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Elections Are Binding For The Plan Year Unless There Is A
Life Status Change
 Marriage
 Birth/adoption
 Divorce
 Death
 Change in employment status
 Change in dependent status
Life status change allows you to make benefit election changes and adjust your
FSA elections
Benefits department must be notified within 31 days of life change
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Final Words
 Enrollment season is November 1st through 30th
 All employees must enroll or make changes through Banner Self-Service
 Update beneficiary information if necessary
 All materials to benefits office no later than Wednesday, November 30, 2011
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Contact Information
 Please email questions or comments to:
benefits@slu.edu
or
wellness@slu.edu
 Your feedback is important!!!
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