Open Enrollment
Presentation
January 2010
Agenda
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Changes to BigBand’s Benefit Programs
Overview of Plans
What You Need to Do
Important Paperwork
Life Changes
Overview of Benefits Programs
 The following slides are condensed
overview of BigBand’s benefits
 For details, please consult providers’ plan
documents
Filice Insurance Services/Resources
 Dedicated Account Management team
 Eric Pogue – 925-299-7212; epogue@filice.com
 Chris Kelly – 925-299-7216; ckelly@filice.com
 Alaina Kelly – 925-299-7213; akelly@filice.com
 Assistance with claims, eligibility, forms, carrier issues,
etc.
 Customized benefits website:
www.filice.com/benefits/bigband
Blue Shield HMO Plan Design
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Blue Shield HMO

Deductible (facility deductible)
$1,500 per member

Co-payment maximum
$2,000 per member

Primary Care Physician Visits
$15 (deductible does not apply)
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Routine physicals / well-child
$15 (deductible does not apply)

No cost for vision / hearing screenings or medically necessary immunizations
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Emergency
$100 (Waived, if admitted)

Outpatient Surgery
Facility deductible, then $100 / surgery
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Hospitalization
Facility deductible, then 10%

Prescription (Mail Order = 2 times these co-pays for up to a 90-day supply)

Generic
$10 (deductible does not apply)
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Brand Formulary
*** $25 (deductible does not apply)

Non-Formulary
*** $40 (deductible does not apply)
*** $250 Calenday-year Brand-name Drug Deductible
What is a deductible reimbursement plan? (Commonly
referred to as a Health Reimbursement Account)
 A company-sponsored deductible reimbursement plan.
 Reimburses employees and their dependents for any
allowable medical expenses under the company
sponsored plan
 Set up in accordance with IRS Code Section 105: medical
reimbursements to employees are not considered taxable
income to the employees or their dependents.
Kaiser HMO (HRA) Plan Design
 Kaiser HMO (HRA)
 Deductible
$2,000 self only & one member in a family of 2, or more
 Deducbile
$4,000 for an entire family of 2, or more members
 Co-payment maximum
$4,000 self only & one member in a family of 2, or more
 Co-payment maximum
$8,000 for an entire family of 2, or more members
 Primary Care Physician Visits
$20 (after deductible)
 Routine physicals
$20 (deductible does not apply)
 Well-child
$10 (deductible does not apply)
 Emergency
20% (after deductible)
 Outpatient Surgery
20% (after deductible)
 Hospitalization
20% (after deductible)
 Prescription (Mail Order varies)
 Generic
$10 (deductible does not apply)
 Brand Formulary
$30 (deductible does not apply)
Blue Shield PPO Plan Design (HRA)
 Blue Shield (Shield Spectrum PPO Savings Plus 2250 Deductible Plan
 Deductible:
$2,250 / individual - $4,500 / family (in or out-of-network combined)
 Out-of-Pocket Max.
$3,000 / individual - $5,500 / family (in or out-of-network combined)
 Co-Insurance
80% in-network – 50% out-of-network
 Office Visit
20% in-network (after deductible) – 50% out (after deductible)
 Preventive / well-child No charge (deductible does not apply) – Not covered out-of-network
 Other covered non-preventive services subject to the deductible
 Emergency
20% (after deductible) – in or out-of-network
 Outpatient Surgery
20% in-network (after deductible) – 20% out (after deductible)
 Hospitalization
20% in-network (after deductible) – 50% of $600 + excess
 Prescription
(Mail Order = 2 times these co-pays for up to a 90-day supply)
 Generic
$10 (you must meet your deductible before co-pays begin)
 Brand Formulary $25 (you must meet your deductible before co-pays begin)
 Non-Formulary
$40 (you must meet your deductible before co-pays begin)
The BigBand Health Reimbursement Arrangement and
the Comparative Costs
SINGLE EMPLOYEE
 Monthly premium costs:
 $42.10 for the Blue Shield HMO
 $60.11 for Kaiser (HRA)
 $79.89 for the Blue Shield PPO (HRA)
 Annual deductible exposure:
 $1,500 facility deductible for Blue Shield HMO
 $1,000 for Kaiser HRA (BigBand will fund up to the first $1,000 via the HRA)
 $1,000 for Blue Shield PPO (BigBand will fund up to the first $1,250 via the HRA)
 Office Visits
 $15 (no deductible) for the Blue Shield HMO
 20% for Blue Shield PPO (after deductible) BigBand funds $1,250 via HRA
 $20 for Kaiser (after deductible) BigBand funds $1,000 via HRA
 Inpatient care exposure:
 $1,500 for the HMO
 $1,000 for Kaiser ($2,000 - $1,000 HRA funding)
 $1,750 for Blue Shield ($3,000 - $1,250 HRA funding)
The BigBand Health Reimbursement Arrangement and
the Comparative Costs (for a family)
FAMILY
 Monthly premium costs:
 $201.17 for Blue Shield HMO
 $180.32 for Kaiser (HRA)
 $228.84 for Blue Shield PPO (HRA)
 Annual deductible exposure:
 $1,500 facility deductible (per member) for Blue Shield HMO
 $2,000 for Kaiser HRA (BigBand will fund up to the first $2,000 via the HRA)
 $2,000 for Blue Shield PPO (BigBand will fund up to the first $2,500 via the HRA)
 Office Visits
 $15 (no deductible) for the Blue Shield HMO
 20% for Blue Shield PPO (after deductible) BigBand funds $2,500 via HRA
 $20 for Kaiser (after deductible) BigBand funds $2,000 via HRA
 Inpatient care exposure:
 $1,500 for the HMO
 $2,000 for Kaiser ($4,000 - $2,000 HRA funding)
 $3,000 for Blue Shield ($5,500 - $2,500 HRA funding)
Dental Plan Design
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Delta Dental PPO

Questions ? Call 1-800-765-6003

Provider Directory = www.deltadentalins.com
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Services
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Deductible *
$50 / individual - $150 / family
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Annual Maximum
$1,500
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Co-Insurance
In
Out (Subject to Usual, Customary & Reasonable)

Preventive
-
100%
100%
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Basic
-
90%
80%
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Major
-
60%
50%
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Orthodontics (child only)
50%
50% ($1,000 Lifetime Maximum)
Pre-determination Review (Recommended for services > $300)
Dental Plan Design (Buy-up Option)
 Delta Dental PPO
 Questions ? Call 1-800-765-6003
 Provider Directory = www.deltadentalins.com
 Services
 Deductible *
$50 / individual - $150 / family
 Annual Maximum
$2,000 in-network / $1,500 out-of-network
 Co-Insurance
In
Out (Subject to Usual, Customary & Reasonable)
 Preventive
-
100%
100%
 Basic
-
90%
80%
 Major
-
60%
50%
50%
50% ($1,500 Lifetime In & $1,000 Lifetime Out))
 Orthodontics (adult & child)
 Pre-determination Review (Recommended for services > $300)
Vision Plan Design
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Vision Service Plan

Questions ? Call 1-800-877-7195
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Provider Directory = www.vsp.com
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Services
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Co-pay
$25 (does not apply to contacts)
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Exams:
Once every 12 months
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Lenses:
Once every 12 months
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Frames ($120 allowance)
Once every 24 months

Contact Lenses ($120 allowance) Once every 12 months
*** Laser Vision Correction Discounts ***
* See fee schedule for out-of-network benefits
Life/AD&D and Disability
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Sun Life
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Questions ? Call 1-800-247-6875

Website = www.sunlife-usa.com
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Life Insurance
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1.5 times basic annual salary to a maximum of $375,000
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Voluntary Life up to 5 times salary (maximum benefit = $500,000)
Disability
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STD = 66 2/3% of weekly earnings to a maximum of $2,309 per week
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7-day elimination period
LTD = 66 2/3% of monthly pay to maximum monthly benefit of $10,000
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90-day elimination period
Employee Assistance Program
 Employee Assistance Program
 Need Assistance ? Call 1-877-327-4753
 Website = www.guidanceresources.com
 Company ID # ZB3042Q
 Assistance with the following:
 Confidential Counseling on Personal Issues
 Legal Information, Resources and Consultation
 Financial Information, Resources and Tools
 Information, Referrals and Resources for Work-Life Needs
 Online Information, Tools and Services
 The Importance of Having a Will
Assist America Travel Assistance)
 Provides medical assistance when traveling more than 100 miles from home
 Need Assistance ? Call 1-800-872-1414 in the United States
 Need Assistance ? Call 301-656-4152 outside of the United States
 Assistance with the following:
 Medical Consultation and Evaluation
 Hospital Admission Guarantee
 Emergency Evacuation
 Critical Care Monitoring
 Medically Supervised Repatriation
 Prescription Assistance
 Care for minor children
 Legal and Interpreter Referrals
 Return Mortal Remains
Pension Dynamics (Flexible Spending)
 Questions ? Call 800-888-1998
 Website = www.pensiondynamics.com
 Medical Expenses
 Medical Reimbursement Limit = $3,000
 Eligible Expenses
 Non-Eligible Expenses
 Over-the-Counter Reimbursements
 Dependent Care
 $5,000 limit
 Educational versus Custodial
 Day Camp versus Overnight Camp
Voluntary Pet Insurance
 VPI Pet Insurance
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Nation’s largest & oldest provider
Plan is completely portable
Discounts (5% core policies / 10% for 2-3 pets)
Low deductible of $50
Vaccination & Routine Care coverage available
Easy Enrollment
 www.petinsurance.com/nbg
 866-332-7620
 Customer Care
 my.petinsurance.com
 800-USA-PETS
Pre-Paid Legal
 Pre-Paid Legal plan
 Telephone Conversations (unlimited)
 Letters/Phone Calls on your behalf (one per subject)
 Unlimited Document Review (10-pages per document)
 Identity Theft Shield (Kroll Background America)
 Detailed Credit Report (Experian / FICO Score / Analysis
 Continuous Credit Monitoring (Daily)
 Safeguard for Minors
 Children under age 18
 Continuous Credit Monitoring
Liberty Mutual Auto & Home
Voluntary Benefits
 Car Insurance
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Liability
Medical Payments / Personal Injury
Uninsured / Underinsured Motorists
Collision
Comprehensive
Mechanical Parts Replacement
Car Windshield Repairs
New Car Replacement
 Homeowners Insurance
 Your Home
 Your Possessions
 Your Liability
Maximizing Health Benefits
 Utilize benefits that provide for preventive coverage
 Semi-annual dental cleanings and exams
 Annual eye exam
 Be a savvy consumer – can save you $$$
 Choose plans that fit your situation best
 Familiarize yourself with spouse’s/partner’s plan
 Question doctor regarding procedures and necessity,
generic prescriptions, billing rates, joining carrier’s innetwork listing, referrals to in-network specialists
Open Enrollment - BeneTrac
 BeneTrac: We will notify you when you can access the system for
enrollment.
 BCBS MA / Delta Dental & VSP – If you are enrolled and you do not
want to make any changes, you do not need to do anything but you
should review your BeneTrac account and click “finalize”.
 Group Life/AD&D and Disability - You are automatically enrolled for
the group benefits.
 Voluntary Life – If electing to increase your Voluntary Life, or enroll for
the first time, please complete an application. If you are adding to
existing coverage, or a new enrollment exceeding the Guarantee
Issue amounts, you will also need to complete an Evidence of
Insurability Form.
 Flexible Spending Accounts for 2010 – If you are enrolling, you must
re-elect your contributions in BeneTrac, even if you were enrolled last
year.
Life Changes
Must be done within 31 days from Qualifying Event
 Birth or adoption of a child or dependent change
 Marriage, divorce, or domestic partner
 Child(ren) – Full-time students between the ages of 19
and 25
 Spouse’s change of employment
 Temporary assignment outside of coverage area