Enroll exclusively online at www.HealthyatTenet.com.
1
Enroll exclusively online at www.HealthyatTenet.com
2011 Benefits—If You Remember Only Five
Things
1. Almost everybody will spend less through the Health &
Savings Plan (formerly HDHP) than under any other
option. You’ll receive an additional contribution if you
choose it in 2011.
2. The Health Savings Account—funded by Tenet and
you—can be used now, next year, OR for retiree
medical coverage.
3. Use Tenet facilities whenever available!
4. Nothing is more important than your health and
wellness. Use the preventive benefits!
5. Tenet spends FOUR times the amount you do to provide
YOUR benefits.
Annual Enrollment – November 8 - 23
2
Enroll exclusively online at www.HealthyatTenet.com
3
Enroll exclusively online at www.HealthyatTenet.com
Health and Welfare Benefits
• Pre-tax benefits
–
–
–
–
Medical
Rx
Health Savings Account
Wellness
• Pre-tax benefits (other)
– Dental
– Vision
– Spending Accounts
4
• After-tax benefits
– Disability
– Basic &
Supplemental Life
– Basic &
Supplemental AD&D
– Long-Term Care
– Hyatt Legal Plan
Enroll exclusively online at www.HealthyatTenet.com
NEW! United Healthcare Network!
• Expanded Network & Minimal Disruption – Almost nobody
will have to change doctors
• “Transition of Care” may be available if your physician is
out of network
– Continue to receive services for specified medical and
behavioral conditions
– For a defined period of time
– With out-of-network health care professionals at network
rates
• You must apply for Transition of Care at enrollment, or no
later than January 30, 2011.
UHC Contact Information
Access UHC provider
directories on
www.HealthyatTenet.com or
by calling UHC Member
Services at 1-877-690-9994.
5
Enroll exclusively online at www.HealthyatTenet.com
2011 Medical Plans
• EPO
–
–
–
–
–
Exclusive Provider Organization
Highest premium (regardless of usage)
No Deductible
Co-pays ($)
Unlimited Co-pays
• PPO
–
–
–
–
–
Preferred Provider Organization
Lower Premiums
Moderate deductible
Coinsurance (%)
Out of pocket max - $4,000 to $12,000
• Health & Savings Plan
–
–
–
–
–
–
–
6
All three plans:
• Have the same physician network
• Cover the same procedures
• Require the same pre-authorization
• “More expensive doesn’t equate to
better care”
High Deductible Health Plan
Lowest Premiums
Highest deductible
Coinsurance (%)
Health Savings Account eligible
Steerage to Tenet facilities
Out of pocket max - $5,200 to $10,400
Enroll exclusively online at www.HealthyatTenet.com
2011 Employee Contributions
2011 Bi-Weekly Medical & Rx Contributions (Full time only)
7
EPO
$800 PPO
HSP
Employee Only
$51.28
$18.77
$12.36
Employee + Child
$109.48
$39.39
$26.39
Employee + Spouse
$187.88
$69.80
$45.28
Employee + Children
$166.36
$59.71
$40.10
Employee + Family
$259.47
$92.83
$62.54
Enroll exclusively online at www.HealthyatTenet.com
Health – How does it work?
Traditional Health Plans
(PPO, EPO):
Emphasize insurance-style
coverage
You

You pay larger
monthly premiums
Medical
Plan
Plan pays
most of cost
when you
need care
Health & Savings Plan:
Balances savings and insurancestyle coverage
You
Medical
You pay smaller
Plan

monthly premiums
You save
money in
an HSA
You can use HSA
for your share of
qualified medical
expenses
HSA
You pay a smaller
amount when you
need care
8
Care
Providers
Plan pays
part of cost
when you
need care
Care
Providers
$ save $
Enroll exclusively online at www.HealthyatTenet.com
Health & Savings Plan
HDHP and HSA = The Health & Savings Plan
Why is this plan the best?
What’s the same compared to
other Tenet Plans?
• Comprehensive coverage for
health care services
• Full coverage for preventive
services
• Highest coverage when using a
Tenet facility
• Financial protection from
catastrophic illness or injury
• Tenet pays a significant share
of the cost
9
What’s different?
• How you pay for coverage
– Premium costs are different
– Deductible and copay/coinsurance amounts are
different
• Health & Savings Plan includes a
savings component
– For 2011 - Tenet provides an
HIGHER annual contribution to
your HSA of $950 employee only,
$1,900 family
– Wellness Incentives are higher on
the HSP
Enroll exclusively online at www.HealthyatTenet.com
EXAMPLE: Family Coverage in Health &
Savings Plan
PLAN PAYS 100%
OF COVERED CHARGES
after you reach your annual out-of-pocket maximum
YOUR COINSURANCE
PREVENTIVE
CARE
10%-50% (In-Network)
60% (Out-of-Network)
2
Many services covered
at 100% without copayment or using HSA
ANNUAL OUT-OF-POCKET MAXIMUM
$10,400 (In-Network)
Your share of the out-of-pocket maximum = $8,000
ANNUAL DEDUCTIBLE
1
10
$2,400 (Family)
Enroll exclusively online at www.HealthyatTenet.com
HEALTH
SAVINGS
ACCOUNT
Employee
Contributions
Up to $6,150 per year
(Includes
$1,900-$2,400
HSA
funded by
Tenet)
Medical: 2011 HSP w/HSA
Pay for expenses Now OR Save to Pay For Retiree Medical
• Health Savings Account (HSA) advantages
– Tenet contributes to your account
– Earn 2010 Wellness incentive $250 employee & $250
spouse
– Carry over remaining money year to year
– Money in your HSA is yours to keep
– Earnings on your account grow tax-free*
– Eligible distributions are never taxed.
– You may contribute through pre-tax deductions*
• Up to $3,050 for employee-only coverage
• Up to $6,150 for coverage that includes dependents
• Catch-up contributions if age 55 or older (maximum) – add
$1,000 to above
*State taxes may or may not apply. See your tax advisor for more information on the state tax implications on HSAs.
11
Enroll exclusively online at www.HealthyatTenet.com
Medical: 2011 HSP w/HSA
• Health & Savings Plan (HSP) considerations
– Certain preventive coverage paid entirely by plan
• Not subject to the deductible
– Certain preventive prescriptions not subject to the
deductible
– For other services, must meet deductible before plan begins
This is your Retiree
paying
• $1,200 individual, OR
Medical Benefit!!!
• $2,400 family
– Non-preventive Rx is applied to the deductible
12
Enroll exclusively online at www.HealthyatTenet.com
Potential Health Savings Account Growth
Hypothetical Annual Account Contribution
Account
growth
$1,000
$2,000
$3,000
After 1
year
$1,020
$2,040
$3,085
After 5
years
$5,562
$11,621
$17,741
After 10
years
$13,236
$27,886
$42,624
After 20
years
$39,093
$82,696
$126,471
Hypothetical example assumes annual contribution amounts as stated above made on Jan. 1 each year until
1, 5, 10 and 20 year periods. Assumes tax-deferred you receive 2% investment growth on funds in the default
account and that once the balance in this account reaches $2,500, excess funds will earn 7%. Assumes
compounding in an HSA. Final balances prior to any eligible medical expenses and taxes may be due on
distribution. Actual returns will be based on actual returns within the HSA.
Source - Fidelity
13
Enroll exclusively online at www.HealthyatTenet.com
Deductible covered in 2011
Employee Only
Deductible
2011
$1,200
HSA Seed
Sign-on
Ongoing
$450
$500
*Wellness
Opportunity
$250
Remaining
Deductible
$0- $250
Family
Deductible
2011
$2,400
HSA Seed
Sign-on
Ongoing
*Wellness
Opportunity
$900
$1,000
$500
*2010 Wellness incentive opportunity; funded to HSA in January 2011
14
Enroll exclusively online at www.HealthyatTenet.com
Remaining
Deductible
$0 - $500
What is the 2011 employee financial model?
Employer Contributions to the HSA* (A)
Plan
HSP with HSA
$800 PPO
EPO
Employee Only
$950
$0
$0
Employee and Family
$1,900
$0
$0
Employee Premiums (B)
Plan
HSP with HSA
$800 PPO
EPO
Employee Only
$321
$488
$1,333
Employee and Family
$1,626
$2,414
$6,746
Average Employee Out of Pocket Expenses (C)
Plan
Employee Only
Employee and Family
HSP with HSA
$800 PPO
EPO
$750
$900
$400
$1,200
$1,600
$1,200
Plan
HSP with HSA
$800 PPO
EPO
Employee Only
$121
$1,388
$1,733
Average Employee Net Cost (B) +(C) – (A)
* Doesn’t include added value of wellness incentive
15
Enroll exclusively online at www.HealthyatTenet.com
Employee and Family
$926
$7K savings
$4,014
$7,946
2011 Wellness Incentives
Wellness Incentives – 2011 Plan
Participation Level
– Wellness Credits
Health Plan
HSP
Other (including opt-out)
Employee Spouse(1) Employee
Spouse(1)
Bronze – 50 (a)
$150
$150
$100
$50
Silver – 100
$250
$250
$200
$100
Gold – 150 (b)
$350
$350
$250
$150
Platinum - 200
$450
$450
$300
$250
Incentive Type
Contribution to HSA
Taxable cash
(a) Health Assessment required to achieve bronze level and above
(b) Annual physical required to earn gold level and above
(1)
Only spouses that are covered under one of Tenet’s medical plans are eligible to receive the wellness incentive.
Note: 2011 incentives are earned in 2011 and paid/funded in 2012. The wellness program and incentives are reviewed
and updated annually. All employees can join Wellness challenges, issue their own challenges to co-workers, track
results and have fun living healthy! California union employees can participate in the HealthyatTenet Wellness Program
but are not eligible for the Wellness Incentives.
16
Enroll exclusively online at www.HealthyatTenet.com
Plan Design Changes
• Work Here…Receive Care Here….For your Health,
Family and Future
– Services in a Tenet facility
• HSP / PPO - plan pays 90% (after deductible in HSP)
• EPO - $250 / $500 co-pay
• Improved benefits for CMA physicians (90% instead of 80%)
– New Non-Tenet 2011 Coverage….If you don’t receive care
here but could have.
• Non-Tenet In-Network Services paid at 50% (after deductible)
• Non-Tenet Out-of-Network Services paid at 40% (after
deductible)
– New for 2011 - If you can’t receive care here
• Emergency, if the service isn’t offered at a Tenet
facility, or the facility is further than 45 miles from
your home
• Same coverage as if you received care at a Tenet
facility!
17
Enroll exclusively online at www.HealthyatTenet.com
2011 Rx Plan Simplification
2011 Proposed Plan Design
Retail – 30 Day Supply
Generic
$5
Formulary Brands
35% with $30 min/$100 max
Non-Formulary Brands
50% with $40 min/$150 max
Mail – 90 Day Supply
Generic
$10
Formulary Brands
35% with $75 min/$200 max
Non-Formulary Brands
50% with $100 min/$300 max
– Out-of-pocket costs are applied to HSP deductible
– Prescriptions are qualified HSA and HCSA (FSA) expenses
18
Enroll exclusively online at www.HealthyatTenet.com
Health Care Reform Changes
• Dependent children under age 26 will be eligible for health care
coverage, regardless of student status
– Special enrollment rights apply to:
• A dependent child between the ages of 19 up until 26, who you were previously
unable to cover in the Tenet medical plans due to student status or age
limitations
– Extended enrollment period through December 8
– Enroll online through November 23rd. After November 23rd call My Benefits
Customer Support Center to add eligible individuals during the extended
enrollment period
– Birth certificate required
• Over-the-counter medications must be prescribed by a doctor to
qualify as eligible expenses under the Health Savings Account or
Health Care Spending Account
• Mental Health Parity Act - Mental health & substance abuse claims
will be paid at the same reimbursement level as Tenet Hospitals
19
Enroll exclusively online at www.HealthyatTenet.com
Enrollment Steps
Enrollment Exclusively Online
www.HealthyatTenet.com
Look for the Annual Enrollment Banner
Quick access to:
• What’s New
• Medical Plan Comparison
• Tools—Use the Medical Expense Estimator to see if
the HSP saves you money (it does for employees in
almost any situation).
• HSP Video—Explore the HSP ……AND EARN 5
WELLNESS CREDITS to start off 2011.
• HSA Mythbusters
• FAQs—Find quick answers to your benefits questions
20
Enroll exclusively online at www.HealthyatTenet.com
Tips
• Evaluate your needs for benefits
•
•
•
•
•
•
21
– Planning could save you thousands
Utilize tools available via HealthyAtTenet
– Medical Plan Estimator; Health Savings Account Value Modeler
Use Tenet Hospitals & outpatient centers to lower your out of pocket
expenses
Make healthy living a priority!
– If you or your covered dependent smoke, quit now!
– Preventive benefits: the most underused and potentially valuable
set of benefits we offer
Earn your Wellness Incentive
Enroll by the deadline!
Look for information during the year on SMART PLAN USE
Enroll exclusively online at www.HealthyatTenet.com
Tenet Benefits Strategy
Simply the best medical coverage for a
lifetime
Create a culture of employee health and
wellness…. engage in understanding and
manage your health and your family’s
Promote employee financial health and
savings….for now and the future
22
Enroll exclusively online at www.HealthyatTenet.com