Benefits Open Enrollment
Nov. 1 – Dec. 2, 2013
DEBCP Training
HumanResources
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Presentation Overview
• UPlan Benefit Changes for 2014
– Medical & Pharmacy
– Wellness
– Life Insurance
• Open Enrollment Basics
• Open Enrollment Assistance
• Common Questions
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UPlan Benefit Changes for 2014
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UPlan changes due
to Affordable Care Act (ACA)
2011:
• Adult child coverage to age 26 - $2M cost for UPlan
2013:
• Healthcare Flexible Spending Account limited to
$2,500
• Additional preventive benefits
• New appeal processes
• Value of your 2012 tax-exempt medical insurance
shows on W-2
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2014 UPlan changes also due to
Affordable Care Act (ACA)
• 2014 UPlan changes are needed due to an ACA
excise tax that begins in 2018
• Tax applies to high value plans such as the UPlan
• If no changes, we would have a UPlan excise tax
liability of $48 million
• University needs to avoid the excise tax
• Changes need to be made in 2014 to assure we are
ready to avoid excise tax in 2018
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2014 Medical Plan changes
• Out-of-Pocket costs will be increased
• New deductibles on all non-copay items
• $100/$200 on Medica Elect/Essential
• $200/$400 on Medica Insights and Choice
• Primary care and related copays will increase by $10
• Family medicine, internal medicine, OB/GYN, pediatrics
• Also chiropractic, acupuncture, PT, OT, ST & MH/SA
• New higher copays for specialty care
• $10 higher than primary care (+ $10 in ACO plan)
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2014 Medical Plan changes
• Higher out-of-pocket expenses in Health Savings
Account Plan
• $250 / $500 reduction in HSA account
• $500 / $1,000 increase in
out-of-pocket maximum
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2014 Medical Plan Changes – Twin Cities
• A new ACO (Accountable Care Organization) Plan
• High-quality; cost effective; care provided by a single group
of hospitals, doctors, and other medical providers
• Benefits slightly higher than Base Plan
• Costs slightly lower – a “buy down” plan
• Four Twin Cities ACOs within this plan
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Fairview & North Memorial Vantage Plan (with UMP & Boynton)
Inspiration Health by HealthEast
Park Nicollet First (does not include HealthPartners)
Ridgeview Connect
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2014 Medical Plan Changes – Twin Cities
• ACO Plan continued
• Annual Elections - Employee & all family members will
select same ACO for the full year
• Members can see any primary care or specialty provider
within ACO network.
• Referrals outside the ACO are unlikely!
• Travel benefit covers care outside service area
• Emergency, urgent & non-emergency care
• Care within service area, but outside of ACO, is
out of network
• ACO providers will reach out to new members
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2014 Pharmacy Program Changes
• Tier 3 – Non-formulary brand copay increased to $75
• Encourages use of Tier 1 and Tier 2 clinically appropriate,
cost effective medications
• Current Prior Authorization and appeal provisions remain
in effect
• The annual Rx Out-of-Pocket Maximum remains the same:
$750 per person, $1,500 per family (Does not apply to HSA
Plan)
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Administrative Changes
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Administrative Changes
• Spouse/SSDP and Family tiers will be combined over
two years
• Employee + Family costs go down slightly
• Employee + Spouse/SSDP costs increase
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Medical Plan Costs
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2014 UPlan Medical Contributions
• UPlan Standard Medical Plan contributions are:
• Employee only coverage
• University pays 87% - Employees pay 13%
• Family coverage
• University pays 80.5% - Employees pay 19.5%
• UPlan Wellness Achievement Rates are reduced by:
• $300 for employee and employee plus children rates
• $400 for employee plus spouse/SSDP and employee plus
spouse/SSDP and child/children
• See the Guide for UPlan Benefits Enrollment for plan options
and rates
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Help for Lower Paid Employees
to Pay Medical Costs
• 2014 Medical Cost Relief Program for lower income
employees
• Credit based on plan selected and household income
• Credits range from $200-$500
• Credit appears in 2014 paychecks, beginning January
22, 2014
• Final Deadline for Applications: December 17, 2013
• New applications are required – even if you participated
in the past
• See Employee Benefits website at
www.umn.edu/ohr/benefits for an application and
program guidelines
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2014 Wellness Program Changes
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Wellness Assessment
• The Wellness Assessment will be available for a
longer time period
• UPlan members will now be able to take the
assessment between:
October 01, 2013 – March 31, 2014
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Fit Choices
• New points level: earn 125 wellness points for 12 visits
per month for six months
• Current point level: continue to earn 75 points for 8
visits per month for six months
• Fit Choices runs from October 1, 2013, to July 31, 2014
• Both points levels are eligible for $20 reimbursement
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Medication Therapy Management
• Face-to-face consultations with an MTM Pharmacist
for UPlan members taking four or more covered
prescriptions.
– Wellness Points: 100
– Minimum visits: Three
• Provider: MTM Pharmacy Network
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Specialty Therapy Management
• For members using specialty medications for the
following disease states:
• Multiple Sclerosis, Rheumatoid Arthritis,
Hepatitis C, Psoriasis, Psoriatic Arthritis, Crohn’s
Disease, and Cystic Fibrosis.
• Telephone consultations with specialty pharmacy
nurse
• Minimum calls: Three
• Earn 100 Wellness Points
• Provider: Fairview Specialty Pharmacy
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New Reimbursement Programs
• Heart Rate Express – through Twin Cities Rec Center
• Mindfulness in Motion (MiM) – through Center for
Spirituality & Healing
• Virtual Mindfulness Based Stress Reduction – for
coordinate campus employees – through Center for
Spirituality & Healing
• You pay up front; then get reimbursed upon
completion of program
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2014 Life Insurance Changes
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Two Types of Changes
• Changes to simplify human resources processes and
improve efficiency
• Changes due to recent Life Insurance Request for
Proposal (RFP)
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Life Insurance changes: simplify human
resources processes & improve efficiency
• Full-time employee Basic Life benefit increased from 100% to
115%
• Part-time Basic Life benefit changed from full-time to parttime equivalent
• Basic Life maximum benefit capped at $200,000
• Rounding feature changed from next higher $5,000 to next
higher $1,000
• $5,000–$25,000 additional Basic Life benefit for faculty and
P&A eliminated
• One-month U of M death benefit eliminated
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Life Insurance changes: simplify human
resources processes & improve efficiency
• Most employees will benefit from the 2014 Life
Insurance benefit changes
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Life Insurance changes: simplify human
resources processes & improve efficiency
• Those who do not benefit can transfer Basic Life
coverage difference to Additional Life coverage
without the need to provide proof of good health
– Example:
• Employee has $75,000 of Basic Life coverage in 2013
and $58,000 of Basic Life coverage in 2014
• Employee can transfer $17,000 of Basic Life coverage to
Additional Life for 2014
• Additional Life rates are age-rated
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Life Changes due to Request for Proposal
• $10,000 Newborn Child benefit for first child
– Applies prior to enrolling, up to 60 days
• Child Life added to annual open enrollment –
without proof of good health
• New term life portability benefit (in addition to
whole life Conversion policy)
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Open Enrollment Basics
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When and How to Enroll
• Open enrollment dates:
November 1 – December 2, 2013
• You can make changes to your benefits selections
online at http://hrss.umn.edu
• If you (or a dependent) are age 45 or older, you are
required to provide your Social Security Number
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During Open Enrollment,
You Can
• Add or cancel Medical or Dental coverage
• Select a different Medical or Dental plan
• Change your designated dependents
– Verification of dependent eligibility will be requested
following Open Enrollment
• Choose to participate in the Health Care or
Dependent Daycare Flexible Spending Accounts
• Enroll in Child Life
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During Open Enrollment,
You Can:
• Increase your amount of Short-term Disability
coverage up to $200 per month, if you are a current
participant
• Select or change the benefit amount of your
voluntary Long-term Disability Coverage (Civil Service
and Labor Represented employees only)
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Don’t need to go online
unless you want to:
• Set up a Flexible Spending Account for 2014
• Change your Medical or Dental Plan or dependent
coverage
– To change your clinic election only, just call Medica: 952992-1814 or 1-877-252-5558
• Add or increase your Long-term Disability coverage
• Add Child Life
• Note: to increase your Short-term Disability coverage,
you will need to complete a paper application
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Open Enrollment Assistance
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Open Enrollment Assistance
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Phone: 612-624-8647 or 1-800-756-2363
Email: benefits@umn.edu
Employee Health & Benefits Fairs
Computer Lab (Twin Cities): Room 315 Donhowe
Bldg.
Nov. 25, 26, 27, and Dec. 2 (8 a.m. – 4:30 p.m.)
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Employee Health & Benefits Fairs
• Duluth: October 31
– Ballroom, Kirby Student Center 10 a.m. to 2:30 p.m.
• Crookston: November 7
– Bede Ballroom, Sargeant Student Center, 12 p.m. to 2 p.m.
• Morris: November 11
– Oyate Hall, UMM Student Center, 11 a.m. to 1 p.m.
• St. Paul: November 12
– North Star Ballroom, Student Center, 10 a.m. to 3:30 p.m.
• Minneapolis: November 13
– Great Hall, Coffman Memorial Union, 10 a.m. to 3:30 p.m.
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Enroll Now
• Open Enrollment: November 1 to December 2, 2013
• Enroll at http://hrss.umn.edu
– See the Guide for UPlan Benefits Enrollment for more
information
• Coverage changes made during Open Enrollment are
effective on January 1, 2014
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Open Enrollment Procedures
and Deadlines
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New Hire Enrollment Procedures
Employees hired and in PeopleSoft by October 29, 2013:
• Will receive Open Enrollment email announcement
• Can participate in Open Enrollment online
• Can view Guide for UPlan Benefits Enrollment online
at www.umn.edu/ohr/benefits/openenroll
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Newly Hired Employees
Enrollment Procedures
Recently hired employees may need to make two elections:
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For remainder of 2013 plan year
For Open Enrollment changes, if desired
Need two elections to participate in FSA for 2013 & 2014
Can make two elections online, but not at the same time:
wait a day or two between enrollments
• Benefits will send email to these employees
• Employees hired on Dec. 1, 2013, or later, can make one
election for 2014
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Termination Dates
• Employees with termination dates prior to January 1,
2014, are not eligible for Open Enrollment
• If employee’s appointment date changes to extend
past January 1, 2014, please refer the employee to the
online Open Enrollment information
• Employee may encounter problems enrolling online
right after appointment changes are made
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Open Enrollment Communications
• Guide for UPlan Benefits Enrollment will be sent to
all employees on Leave of Absence and to those in
job codes who may not have regular computer
access
• One set of medical & dental directories sent to each
department
• Request additional sets for other locations
• Twin Cities UPlan members will receive postcard for
Employee Health & Benefits Fair that can be used as
entry for prize drawings
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Open Enrollment Communications
• Email announcing Open Enrollment will be sent on
November 1 to all benefits-eligible employees
• Email reminding employees that December 2
deadline is approaching will be sent about
November 21
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Benefits Materials for 2014
• 2014 Guide for UPlan Benefits Enrollment will be
available by end of October for new employees
• 2014 COBRA instructions and rates will be updated and
online by end of November
• 2014 Benefits Summaries for prospective employees will
be updated and online by end of November
• 2014 Summary of Benefits for Medical and Dental Plans
will be updated and online before end of December
• Check the Manager’s Toolkit on OHR website:
http://www1.umn.edu/ohr/debcp/index.html
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DEBCP Responsibilities for COBRA
• 2014 COBRA Instructions and Rates will be emailed
at end of November and will be available online
• 2013 COBRA Rates will stay on the website until end
of year
• You must send COBRA notice and application to
terminated employees by U.S. Mail within 10 days of
the employment termination date
• Complete verification form and send, scan, or fax to
Employee Benefits
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DEBCPs: Keep in Touch
• Help to keep the DEBCP email list current: if you are
leaving or changing jobs, and you know who will be
taking over as the DEBCP, please contact Employee
Benefits
• Send updates to benefits@umn.edu
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Thank you for attending and
for your assistance!
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Common Questions with Answers
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Will I receive a paper copy
of the benefits guide?
• Guide for UPlan Benefits Enrollment will be posted
online at www.umn.edu/ohr/benefits/openenroll
• Employees without regular access to a computer and
those on LOA will receive a paper copy of the guide
• All employees will receive a paper copy of the U &
Your Benefits newsletter with enrollment details,
including medical and dental plan rates, in your
campus mailbox
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Who can I cover on my UPlan
Medical and Dental Plans?
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Yourself
Your spouse or registered same-sex domestic partner
Your dependent children up to age 26
For the dependent eligibility definition, visit
www.umn.edu/ohr/benefits/eligibility/index.html
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How do Wellness Points work?
• You accumulate points for participating in wellness points
activities
• You must earn the minimum number of points by August
31, 2014:
– 300 points for employee-only or employee plus children
– 400 points for employees who cover a spouse/same-sex
domestic partner
• Covered spouses/partners can contribute up to 100 of the 400 total
points required
• You will receive either a $300 or $400 reduction in your
2015 UPlan Medical Program rates if you earn the
required number of points
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Will I need a referral to
see a specialist with Medica?
• Some Medica Plans do not require a referral to see
an in-network specialist
– Medica Insights
– Medica Choice National or Regional
– Medica HSA
• Medica Elect/Essential have special guidelines
– No referral needed in your care system
– Referral needed to see an in-network provider who is not
in your care system
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Will I need a referral to
see a specialist with Medica?
• New Medica ACO Plan
– You can see any primary or specialty care provider within
the ACO you select
– Referrals outside of your ACO are unlikely
• For all plans, you’ll need a referral from your care
system and Medica to receive in-network benefits
from an out-of-network provider
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Will I receive new
Medical and Dental ID Cards?
• Members will receive a new Medical ID card from Medica
• Members will receive a new Dental ID card from Delta
Dental and HealthPartners if they make a change
• New enrollees will receive ID cards from Medica and
Prime Therapeutics if they choose a medical plan, and a
dental ID card from Delta Dental or HealthPartners
Dental if they choose a dental plan
• Replacement cards can be obtained from your health or
dental plans
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Will I receive a new FSA debit card?
• No. Current participants will have their new 2014
health care FSA election loaded on their current
debit cards
– Please retain your FSA cards!
• New Health Care FSA enrollees will receive new FSA
debit cards
• Replacement cards can be obtained from ADP
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Will flu shots be available this year?
• Yes, seasonal flu shots will be available at no cost
– On campus
• Walk-in clinics and flu clinics
– On the Twin Cities campus, schedule an appointment
online at www.bhs.umn.edu/public-health/flu.htm
• Employee Health & Benefits Fairs
– Your medical clinic
– Convenience clinics and retail pharmacies (no cost if
pharmacy is in Prime Therapeutics’ network)
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Who is eligible for the Medication
Therapy Management Program?
• You are eligible if you take four or more medications
for chronic conditions
• The program offers:
– UPlan-paid consultations with an MTM pharmacist (HSA
members pay full cost of consultations)
– NEW: earn 100 Wellness Points if you visit your MTM
pharmacist at least three times before August 31, 2014
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How do I contact the Health Plans?
• Medica
– 952-992-1814 or 1-877-252-5558
– www.medica.com/uofm
• Delta Dental
– 651-406-5916 or 1-800-448-3815
– www.deltadentalmn.org/uofm
• HealthPartners Dental
– 952-883-5000 or 1-800-883-2177
– www.healthpartners.com/uofm
• Prime Therapeutics
– 1-800-727-6181
– www.myprime.com/MyPrime/umn
• Fairview Specialty Pharmacy
– 612-672-5289 or 1-877-509-5115
– www.fairviewspecialtyrx.org/uplan
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