Saint Louis University
Employee Benefits 2015 Annual Enrollment
Benefits Overview—Coverages Offered
 Medical/Prescription Drug
New this year! (Non-Union Employees Only)
 Vitality Wellness Program
 Voluntary Vision
 Voluntary Dental
 Voluntary Accident
 Health Savings Account
 Flexible Spending Accounts
 Basic Term Life and AD&D
 Voluntary Term Life
 Voluntary AD&D
 Long Term Disability
 Long Term Care
 Business Travel Accident
Medical/Prescription Drug
Benefits
Annual Enrollment 2015
Highlights Effective January 1, 2015
 Medical - UnitedHealthcare
 Plus Plan: Medical and Prescription drug copays will accumulate towards the
out-of-pocket maximum in the Plus Plan
 QHDHP Plan
 No plan changes
 Health Savings Account
 The Vitality™ Wellness Program
 Participants save on medical premiums and earn rewards!
 Health screenings and HRA completion are needed to receive wellness discount
 If covering your spouse, both must complete requirements
 Deadline: November 30
 Prescription Drug – Express Scripts
 No plan change to prescription drug benefits
 Network continues to include Walgreens and Dierbergs
2015 Medical Plan Options
Plus Plan
SLUCare
In-Network
QHDHP Plan
Out-ofNetwork
SLUCare
In-Network
Out-ofNetwork
Non-Embedded:
(One member can satisfy entire family deductible)
Deductible
Individual
$0
$500
$750
$1,500
$1,500
$3,000
Family
$0
$1,000
$1,500
$3,000
$3,000
$6,000
Coinsurance
0%
10%
40%
0%
10%
40%
Non-Embedded:
(One member can satisfy entire family OOP Max)
Out-of-Pocket Maximum (includes deductibles and all copays)
Individual
$1,500
$1,500
$4,750
$1,500
$3,000
$6,000
Family
$3,000
$3,000
$9,500
$3,000
$6,000
$12,000
10% after ded.
40% after ded.
0% after ded.
10% after ded.
40% after ded.
Physician Office Visits
Primary Care
$10 copay
Specialist Care
$20 copay
Preventive Care
100%
100%
100%
100%
100%
100%
N/A
10% after ded.
40% after ded.
N/A
10% after ded.
40% after ded.
N/A
$100 copay
$100 copay
N/A
10% after ded.
10% after ded.
N/A
$50 copay
$50 copay
N/A
10% after ded.
40% after ded.
Inpatient Hospital
Emergency Room
Urgent Care Center
2015 Pharmacy Plan Options
Plus Plan
QHDHP 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
N/A
Medical Deductible and Coinsurance
Preventive Medications
Priced according to the tier in which they fall
Covered at 100%, no copay or deductible
Under the QHDHP, certain preventive, or “maintenance,” medications are
covered at 100%... No deductible or coinsurance!
2015 Cost Sharing
 No change to rates!!! Premium has remained the same for 3 years!
 Wellness Incentive remains at $50 for employee only coverage and an additional
$25 for spouse coverage (all or nothing discount)
Plan
Monthly Premium Deductions
With Monthly Wellness Discount
Plus Plan
Employee Only
$143.79
$93.79
Employee and Spouse
$386.97
$311.97
Employee and Child(ren)
$332.25
$282.25
Family
$520.66
$445.66
QHDHP Plan
Employee Only
$79.64
$29.64
Employee and Spouse
$252.24
$177.24
Employee and Child(ren)
$210.36
$160.36
Family
$328.20
$253.20
Plus Plan – Employees earning up to $33,000
Employee Only
$50.00
$0
Employee and Spouse
$293.18
$218.18
Employee and Child(ren)
$238.46
$188.46
Family
$426.87
$351.87
2015 Cost Sharing
 Bi-Weekly Premiums
Plan
Bi-Weekly Premium Deductions
With Bi-Monthly Wellness Discount
Plus Plan
Employee Only
$66.36
$43.28
Employee and Spouse
$178.60
$143.98
Employee and Child(ren)
$153.35
$130.27
Family
$240.30
$205.68
QHDHP Plan
Employee Only
$36.76
$13.68
Employee and Spouse
$116.42
$81.80
$97.09
$74.01
$151.48
$116.86
Employee and Child(ren)
Family
Plus Plan – Employees earning up to $33,000
Employee Only
$23.08
$0
Employee and Spouse
$135.31
$100.70
Employee and Child(ren)
$110.06
$86.98
Family
$197.02
$162.40
Health Savings Account
Annual Enrollment 2015
Health Savings Accounts
 Health Savings Accounts (HSAs) are designed to help you save and pay for
your healthcare now and when you retire
 Triple tax savings:
 Put money in pre-tax
 Grow your savings tax free
 Pay for qualified medical expenses income tax free
 Account is always yours
HSA Eligibility for Account Holders only
 You are eligible to open and contribute to an HSA if you:
Are covered by a Qualified High Deductible Health Plan (QHDHP)
Are not covered by any other health plan that is not a QHDHP
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 Health FSA
(Must have $0 in your Health FSA before contributing to an HSA)
 If you don’t meet one of these eligibility requirements, you can still enroll in the
QHDHP plan, you just cannot open and contribute to a Health Savings Account
HSA Contributions
 2015 Maximum Contribution Limit
2015
IRS Maximum
SLU Seed Money
Individual
$3,350
$250
Family
$6,650
$500
* 2014 Limits: $3,300 for Individual, $6,550 for Family
 IRS maximum reflects a combined employer + employee contribution
 55+ can fund an additional $1,000/year; “catch-up” contribution
 Please note SLU will only put seed money into an OptumHealth administered HSA. If you
choose to go to a financial institution of your choice, then you will not receive the seed
money.
 HSA must be established by November 30 in order to receive seed money on January 1
 Funds must physically be in your account before disbursements can be made
 Any money remaining in the account at the end of the calendar year rolls over into the
next year
Taking Money OUT of an HSA
 Issues in Distributions
 Reimbursement of expenses for employee, spouse and Tax Code dependents are tax free
 Expense must be incurred on or after the date the HSA was established
 Qualified expenses include:
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Health, dental and vision expenses
COBRA premiums
Medicare premiums
Qualified long-term care premiums
Retiree health insurance after age 65, but not Medigap/Supplement plans
 Other withdrawals are taxable
 Income tax, plus…
 Subject to 20% excise tax if withdrawn prior to age 65
 After you turn 65, or enroll in Medicare, you may withdraw money for non medical purposes without a
penalty. The withdrawal is treated as retirement income and is subject to normal income tax.
 It is important to save your receipts in case you are audited by the IRS
 Account is between you and the IRS; OptumHealth bank does not substantiate your claims
HSA & FSA Participation
 IRS guidelines prohibit participants from contributing to a Health Care FSA and
an HSA at the same time
 Spouses are ineligible to participate in their employer’s Health Care FSA
 Ok if a Limited FSA – used for dental and vision expenses only
 In order for you to fund an HSA on January 1, there must be a $0 balance in
your Health Care FSA on December 31
 You can still enroll in the benefit plan, but cannot contribute to an HSA account
Making Deposits
Payroll
Deduction
Arrange for an automatic payroll deduction
into your account
Mail a Check
Make a deposit at any time on OptumHealth
from your checking or savings account
e-Contribute
Arrange a regular electronic transfer from
an account at another financial institution
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
myuhc.com
 Benefit summaries
 Deductible accumulator
 Treatment cost estimator
 Check statements
 Pay bills to health care providers
 Update personal information
 Learn about QHDHPs and HSAs
 HSA calculators
Additional Programs
UnitedHealthcare:
 Diabetes Prevention and Control
 Pre-diabetics work with YMCA lifestyle coaches to prevent the progression
 Diabetics work with Shop N’ Save pharmacists face-to-face to help control and improve
prescription compliance, set goals, and review lab work
 Diabetes Health Plan
 Members incentivized to comply with recommended Medical and Rx guidelines
 Plus Plan: No office visit or pharmacy copays for diabetes-related eligible expenses
 Available only when using SLUCare physicians
Vitality
Annual Enrollment 2015
www.powerofvitality.com
 Earn points by:
 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 Healthy Habits and Preventive Screenings
 Track your workouts using a Vitality-approved fitness device
 Sign up at a Partner Health Club
 Get CPR or first aid certified
 Once you build up your points, go spend them!
 Rewards in the Vitality Mall:
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Amazon Gift Cards
Hotel discounts to Hyatt
iTunes gift cards
Movie theater ticket vouchers
Fitbits, Fitbugs, Garmin, and Polar devices
Charity
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.
Voluntary Dental Benefits
Annual Enrollment 2015
Voluntary Dental Benefits
 Coverage will remain with Delta Dental
 Choose among two dental plan options
 Both plans include Delta’s PPO and Premier dentists
 Option 1: Flex Plan
 No benefit changes
 Last year the maximum was increased from $1,000 to $1,500
 Option 2: Basic Plus
 No benefit changes
 Combination of previous Basic Plus and Basic Plan
 Both in and out of network benefits
Voluntary Dental Plan—Delta Dental
Flex Option
Basic Plus
PPO Network
Out-of-Network
PPO Network Only
Out-of-Network
Individual
$50
$50
$25
$25
Family
$150
$50
$75
$75
$1,500
$1,500
$1,000
$1,000
0% no deductible
0% no deductible
50% no deductible
30% after deductible
30% after deductible
65% after deductible
40% after deductible
60% after deductible
60% after deductible
80% after deductible
$1,000
$1,000
$1,000
$1,000
50%
For adults and children to
age 26
60%
For adults and children to
age 26
50%
For children to age 19
only
75%
For children to age 19
only
Deductible
Calendar Year Maximum
Per person
Preventive Care (Member Responsibility Shown)
0% no deductible
Basic Restorative Care ( Member Responsibility Shown)
10% after deductible
Major Restorative Services (Member Responsibility Shown)
Orthodontia
Lifetime maximum (per person)
Orthodontia
2015 Dental Contributions
Flex
Basic Plus
Single
$36.01
$21.07
Two-person
$70.49
$40.52
Family
$120.69
$72.60
Single
$16.62
$9.72
Two-person
$32.53
$18.70
Family
$55.70
$33.51
Monthly
Bi-Weekly
Voluntary Vision Benefits
Annual Enrollment 2015
Voluntary Vision Benefits
 New benefit this year! (Non-Union employees only)
 Offered through Vision Service Plan (VSP)
 Plan includes benefits for eye exam, frames, contacts, etc.
 In-Network vs. Out-of-Network
 In-Network = no claim forms to complete
 Out-of-Network = must submit claim form for reimbursement
 VSP.com
 Find a provider
 Network: Choice
 Register and review benefit information
 Discounts available
 Print an ID card (not necessary to use benefits)
 Plan is 100% employee paid
Voluntary Vision Plan—VSP
Vision Plan
In-Network
Out-of-Network
$10 copay
Up to $45 allowance
Single
$10 copay
Up to $30 allowance
Bifocal
$10 copay
Up to $50 allowance
Trifocal
$10 copay
Up to $65 allowance
$150 allowance for a wide selection of
frames; $170 allowance for featured
frame brands; 20% on the amount over
your balance
Up to $70 allowance
$150 allowance for contacts; including
the contact lens exam (fitting and
evaluation)
Up to $105 allowance
Exam
Wellvision Exam
Lenses
Frames
Contacts (in lieu of glasses)
Frequency
Exam/Lenses/Contacts (in lieu of glasses)
Frames
Every calendar year
Every other calendar year
2015 Vision Contributions
Vision Plan
Monthly
Employee Only
$7.02
Employee and Spouse
$12.76
Employee and Child(ren)
$13.38
Family
$20.33
Bi-Weekly
Employee Only
$3.24
Employee and Spouse
$5.89
Employee and Child(ren)
$6.18
Family
$9.54
Voluntary Accident Benefits
Annual Enrollment 2015
Voluntary Accident Benefits
 New benefit this year! (Non-Union employees only)
 Offered through Voya Financial (formerly ING)
 Plan reimburses expenses that occur due to an accident
 Coverage is guarantee issue – no health questions asked
 No “Network”
 When you have an expense, you must submit a claim form; reimbursement
will then be mailed as a check
 24-hour coverage – accidents on or off the job are eligible
 Plan is 100% employee paid
Voluntary Accident Plan—Voya
Below is a sample list of benefits, it does not include all the benefits available under the policy.
Service
Accident Hospital Care
Surgery (open abdominal, thoracic)
Hospital Confinement
Coma (14 or more days)
Benefit Amount
Common Injuries – Dislocations
$1,200
$250/day up to 365 days
$6,000
Follow-Up Care
Medical Equipment
Service
Benefit Amount
Hip Joint
$2,400/$4,800
Knee
$1,200/$2,400
Shoulder
$360/$720
Common Injuries – Fractures
$120
Hip
$1,800/$3,600
Physical Therapy
$30/treatment (6 max)
Leg
$960/$1,920
Prosthetic Device
$6,000
Emergency Care
Ground Ambulance Transport
$120
Air Ambulance Transport
$600
Emergency Room Treatment
$180
Common Injuries
Burns, Laceration, Torn Knee
Cartilage, Paralysis,
Tendon/Ligament/Rotator Cuff
Varies
Ankle
$360/$720
Kneecap
$360/$720
Nose
$120/$240
Other Benefits
Wellness Benefit
(completion of health screening test)
$100/employee or spouse
$50/child (max of 4)
Sickness Hospital
Confinement Benefit
$100/day for employee or
spouse
$75/day for children
2015 Accident Contributions
Accident Plan
Monthly
Employee Only
$24.74
Employee and Spouse
$41.90
Employee and Child(ren)
$39.62
Family
$56.78
Bi-Weekly
Employee Only
$11.42
Employee and Spouse
$19.34
Employee and Child(ren)
$18.29
Family
$26.21
Flexible Spending Accounts
Annual Enrollment 2015
Flexible Spending and Dependent Care Accounts
 Administration will remain with ConnectYourCare
 You must make a new election for the 2015 plan year; current elections cannot
be carried forward
 Debit card allows direct payment
 Eases payment, but does not substantiate claims – receipts may still be needed!
 Use at authorized vendors (medical facilities, hospitals, pharmacies, etc.)
 Remember if you are electing the QHDHP plan and open an HSA, the IRS
requires your Health FSA balance to be $0.00 on January 1, 2015 before
contributing to an HSA
Flexible Spending and Dependent Care Accounts
 Due to health reform, annual maximum for the Health FSA will be remain at
$2,500
 Annual maximum for the Dependent Care Account will remain at $5,000
($2,500 if married and filing separate returns)
 For the Health FSA
 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
 Use it or lose it rule applies
Eligible Medical FSA Expenses
 Copays, coinsurance and deductibles for medical, prescription and dental plans
 Eye exams, contacts and eyeglasses
 Laser eye surgeries
 Hearing aids
 Over-the-counter medical supplies
 Bandages, splints, contact lens solution, etc.
 Over-the-counter medical medications must be accompanied by a prescription
 Insulin
 Some expenses not covered by your medical plan
Annual Enrollment 2015
2015 Annual Enrollment
 Plan elections are binding for the 2015 plan year, unless you experience a
qualifying life event:
 Marriage
 Birth/adoption
 Divorce
 Death
 Change in employment status
 Change in dependent status
 Life status changes allow you to make benefit election changes
 The Benefits Department must be notified within 31 days of life change
2015 Annual Enrollment
 Enrollment season is November 1 through 30
 If making changes, do so through Banner Self-Service
 Current medical and dental elections will carry forward
 Must actively enroll in vision and accident plans, if interested
 New and existing HSA, Dependent Care and Health FSA participants will need to make
an election for 2015. Current deductions will not carry forward.
 New HSA participants will also need to establish an OptumHealth bank account by
November 30 in order to receive seed money
 Update beneficiary information if necessary
 All enrollment elections must be completed online no later than Sunday,
November 30, 2014
 Benefits Office will be closed Thursday, November 27 and Friday, November 28
 Contact benefits@slu.edu or wellness@slu.edu with questions!
Questions?