BELLARMINE
EMPLOYEES’
OPEN
ENROLLMENT
2012
OPEN ENROLLEMENT 2013
Presented By: Laura Kuczenski
925-385-5305; laura@filice.com
BENEFITS
• Medical
• Blue Shield of California
• Kaiser
•
•
•
•
•
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Dental – Assurant
Vision – VSP
Life/Disability – Sun Life
Long Term Care – Unum
FSA – Pension Dynamics
HSA – Sterling
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OPEN ENROLLMENT
WHAT IS OPEN ENROLLMENT?
Open Enrollment is a once-a-year
opportunity to make election changes
 Change plans
 Add or drop coverage for yourself
 Add or drop coverage for your dependents
3
OPEN ENROLLMENT
MID-YEAR QUALIFYING EVENTS
What changes can I make
outside of Open Enrollment?


The only time you can make an election or enrollment
change outside of your open enrollment period is if
you experience an eligible qualifying event as defined
by the IRS.
Common examples of qualifying events include, but
are not limited to, the following :
Marriage
Divorce or legal separation
Birth or adoption
Gain or loss of coverage
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OPEN ENROLLMENT
IMPORTANT DATES
MEDICAL COVERAGE
• 11/12/12 to 12/17/12 - Open enrollment
• 1/1/2013 – Your plan changes become effective
• 1/1/13 – 12/31/13 – The “Plan Year”
IMPORTANT FACTS
• Deductibles and out of pocket maximums are the Plan
Year (aka Calendar Year)
• Dependent children covered up to age 26
• They are then COBRA eligible
• Opt-out medical incentive: $166.67 per month
• With proof of other medical coverage
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• Largest nationwide
network
• Not-for-profit
organization
• 24/7 nurse line
• Access to free programs
including MyHealth
Coach, Future Moms,
and more
• Can choose any doctor;
however, in-network
doctors will provide
greater savings
• Email your doctor,
online lab results
• Access to free
programs including
health management,
weight loss support,
quitting smoking
• Doctor must be in
Kaiser community
• All Kaiser doctors have
access to your medical
records
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MEDICAL RENEWAL
• No plan changes; however, some carriermandated benefit changes
• Carriers required certain changes to plan designs
across the board for all fully insured clients.
• Bellarmine did not have any say in the changes
• Selected Carrier Mandated changes highlighted in
red
• This presentation is an overview. Complete “Benefit
Modification” summaries can be found on the website
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M E D I C AL P L AN D E S I G N S
BLUE SHIELD – PREMIER PPO
Plan Features
In-Network
Non-Network
$0
$0
$500
Maximum of 3
$1,000
$3,000
$3,000
$9,000
$0
Not covered
Office / Specialist Visits
$10 / $10
30%
Diagnostic Lab & X-ray
$10
30%
Coinsurance
10%
30%
$200/day for 5 days
30%
Deductible
Per Member
Per Family
Out of Pocket Max
Per Member
Per Family
Preventive Care
Routine exam, screenings
Hospital Services
Emergency Services
Prescription Medication
Tier 1
Tier 2
Tier 3
Tier 4
$100 copay + 10%
$10
$20
$35
30%
25% of billed amount plus
copays
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M E D I C AL P L AN D E S I G N S
BLUE SHIELD – SPECTRUM PPO
Plan Features
In-Network
Deductible
Per Member
Per Family
Out of Pocket Max
Per Member
Per Family
Non-Network
$500
$1,500
$2,000
$6,000
$5,000
$15,000
Preventive Care
Routine exam, screenings
$0
Not Covered
Office Visits
$15
30%
Diagnostic Lab & X-ray
$15
30%
Hospital Services
10%
30%
Emergency Services
$100 + 10% after deductible
Prescription Medication
$10
$20
$35
30%
Tier 1
Tier 2
Tier 3
Tier 4
25% of billed amounts
plus copays
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M E D I C AL P L AN D E S I G N S
BLUE SHIELD – 2250/4500 HSA
Plan Features
In-Network
Deductible
Per Member
Per Family
Out of Pocket Max
Per Member
Per Family
Non-Network
$2,250
$4,500
$3,000
$6,000
$6,000
$12,000
$0
Not Covered
Office Visits
20% after deductible
50% after deductible
Diagnostic Lab & X-ray
20% after deductible
50% after deductible
Preventive Care
Routine exam, screenings
Hospital Services
$100 + 20% after
deductible
Emergency Services
Prescription Medication
Tier 1
Tier 2
Tier 3
Tier 4
50% after deductible
$100 + 20% after deductible
After deductible
$10
$25
$40
30%
After deductible
25% of billed amounts
plus copays
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HSA BASICS
 W H AT I S A N H SA?

Individual Tax-favored health savings account

You own your account, and funds roll over each year – NO “use it or lose it” rules

FSA has a “use it or lose it” policy
 W H O I S E LIGIBLE FO R A N H SA?

Must be enrolled in qualifying High Deductible Health Plan such as Kaiser and Blue Shield HSA

Not covered under any other health insurance

Not enrolled in Medicare or receiving VA benefits

Not another person’s dependent
 M A X I M UM CO N TRIBU TIONS

2012: $3,100 individuals / $6,250 families

2013: $3,250 individuals / $6,450 families

For Both Years: $1,000 “catch-up” contribution for individuals over 55 years of age
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HSA - STERLING
 STE R L ING H SA

Employees must open an HSA account through Sterling to receive direct contributions from
Bellarmine, and to set aside pre-tax dollars through payroll
 W H AT D O ES TH E CO M PANY CO NTR IBU TE?
NO CHANGE FROM 2012


Blue Shield of CA HSA:

Single: $242

Employee Family: $485
Kaiser HSA:

Single: $900

Family: $1,800
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M E D I C AL P L AN D E S I G N S
KAISER HMO $10
Plan Features
Deductible
Out of Pocket Max
Per Member
Per Family
In-Network Only
none
$1,500
$3,000
Preventive Care
Routine exam, screenings
$0
Office Visits
$10
Specialist Visits
$10
Diagnostic Lab & X-ray
No charge
Hospital Services
No charge
Emergency Services
$50 copay
(waived if admitted)
Prescription Medication
Generic and Brand
$10
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M E D I C AL P L AN D E S I G N S
KAISER – HSA
Plan Features
In-Network Only
Deductible
Per Member
Per Family
$1,500
$3,000
Out of Pocket Max
Per Member
Per Family
$1,500
$3,000
Preventive Care
Routine exam, screenings
$0
Office Visits
0% after deductible
Diagnostic Lab & X-ray
0% after deductible
Hospital Services
0% after deductible
Emergency Services
0% after deductible
Prescription Medication
$0 after deductible
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PREVENTIVE CARE FOR WOMEN
 N E W PR E V ENTIVE C A R E GU I D E L INES FO R WO M EN COV ER TH E
FO LLOWI NG S E RV IC ES ( COV ERED AT 1 0 0 % W ITHO UT CO ST
S H A R I N G)

Well-women visits

Gestational diabetes screening

HPV DNA Testing for women 30 and older

Sexually Transmitted infection counseling; HIV screening and counseling

FDA approved contraception methods and counseling

Breastfeeding support, supplies, and counseling

Domestic Violence support, supplies, and counseling
 FO R A D D ITIO NAL D E TA IL S

www.healthcare.gov/law/provisions/preventive/index.html
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D E N TAL P L AN D E S I G N
DENTAL “ACTIVE” PPO
 DEDUCTIBLE

$50 individual / $150 family
 COVERAGE ( in - n et wo rk /out - of- net work )

Diagnostic and Preventive (deductible waived): 100% / 100%

Basic (ex: Fillings, simple extractions): 90% / 80%

Major (ex: crowns, dentures): 60% / 50%

Orthodontia: 50% (child-only)
 PLAN MAXIMUMS

$1,000 calendar year max. per person

$1,000 orthodontia lifetime max.
BELLARMINE PAID
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V I S I O N P L AN D E S I G N
VISION
 VSP SIGNATURE NETWORK

Only available to Blue Shield members

Kaiser members have their own vision plan
 COPAYS

$20 exam copay

Lenses: $20 Copay

Frames: Up to $120 + 20% of additional costs

Contact Lenses: Up to $120 for contact and contact lens exam.
 SERVICE FREQUENCIES

Exams: every 12 months

Lenses (for glasses or contacts): every 24 months

Frames: every 24 months
BELLARMINE PAID
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L I F E AN D D I S AB I L I T Y
LIFE AND AD&D INSURANCE

Insured by Sun Life Financial

2x Salary to $200,000

Benefits reduction:

65% at 70 years of age

50% at 74 years for age
BELLARMINE PAID
LONG TERM DISABILITY

Insured by Sun Life Financial

Benefit is 66.67% of pre-disability earning to $8,000 per month

90-day elimination period
BELLARMINE PAID
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LONG-TERM CARE
 BASE PLAN

Insured by Unum

3-year benefit duration

$3,000 monthly facility benefit; 70% Residential Care facility

$36,000 life-time benefit
BELLARMINE PAID
 BUY UP OPTIONS – OUTSIDE OF INITIAL ELIGIBILITY

Open to you and your family

ALL buy-up requires medical questionnaire (See HR for the forms)

Increase monthly benefit amount

Increase lifetime maximum

Increase benefit duration (6 years or unlimited)

Add inflation protection
EMPLOYEE PAID
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FLEXIBLE SPENDING ACCOUNTS (FSA)
 HEA LT H CAR E FSA – U P TO $ 2 , 500 A N N UA LLY
IRS CHANGED THE MAXIUM FROM $10,000 IN 2012 TO $2,500 IN 2013
 L I M I T ED P UR P OS E FSA – U P TO $ 2 , 5 00 A N N UA L LY
IRS CHANGED THE MAXIUM FROM $10,000 IN 2012 TO $2,500 IN 2013
 DEP EN DENT CAR E FSA – U P TO $ 5 , 000 A N N UA LLY

FSAs help you pay eligible healthcare and dependent care expenses on a
pre-tax basis (lowering your overall taxable income).

If you are enrolled In The Anthem HMO, PPO, or Kaiser HMO, then you may
enroll in a full FSA

IF YOU HAVE AN HSA Account, you may only enroll in a Limited Purpose FSA
(Dental and vision expenses)
 Dependent Care FSA is not affected by your medical plan
U S E - I T - O R - L O S E - I T R U L E : U N U S E D D O L L A R S A R E N OT R E T U R N E D TO YO U !
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F L E X I B L E S P E N D I N G AC C O U N T S
Examples of Eligible Expenses
Health Care
Limited Purpose
• Hearing services, including hearing aids
and
• Batteries
• Prescription and office visit copays
• Dental and orthodontia
• Dental and Orthodontia
• Hearing services not covered by your
medical plan
• Lasik Surgery
• Other vision expenses
Dependent Care
• The cost of child or adult dependent care (must be tax dependent)
• Nursery schools and preschools (excluding kindergarten)
• The cost for an individual to provide care either in or out of your house
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C O N T R I B U T I O N S T R AT E G Y
EMPLOYEE CONTRIBUTIONS
BLUE SHIELD
Premier PPO
$0/$500
Single
Employee
Employee + 1
Dependent
Employee +
Family (2 or
more)
2012
EE/PP
2013
EE/PP
2012 EE
Cost/Yr
2013 EE
Cost/Yr
$168.22
$177.04
$4,037
$4,249
$463.55
$485.33
$11,125
$11,648
$641.32
$671.91
$15,392
$16,126
Numbers may vary due to rounding
BLUE SHIELD
HSA
$2,250/$4,500
Single
Employee
Employee + 1
Dependent
Employee +
Family (2 or
more)
BLUE SHIELD
Spectrum PPO
$500/$1,000
Single
Employee
Employee + 1
Dependent
Employee +
Family (2 or
more)
2012
EE/PP
2013
EE/PP
2012 EE
Cost/Yr
2013 EE
Cost/Yr
$124.66
$131.87
$2,992
$3,165
$370.76
$389.08
$12,297
$9,338
$508.02
$533.66
$12,192
$12,808
Numbers may vary due to rounding
2012
EE/PP
2013
EE/PP
2012 EE
Cost/Yr
2013 EE
Cost/Yr
2012
Paid by
ER to
HSA
2013
Paid by
ER to
HSA
$22.35
$25.41
$536
$610
$242
$242
$151.57
$161.04
$3,638
$3,865
$485
$485
$184.31
$197.20
$4,423
$4,733
$485
$485
Numbers may vary due to rounding
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C O N T R I B U T I O N S T R AT E G Y
EMPLOYEE CONTRIBUTIONS
KAISER
HMO $0
2012 EE/PP
2013 EE/PP
2012 EE
Cost/Yr
2013 EE
Cost/Yr
Single Employee
$6.26
$6.37
$150
$153
Employee + 1
Dependent
$80.06
$82.16
$1,921
$1,972
Employee + Family (2 or
more)
$77.58
$79.58
$1,862
$1,910
Numbers may vary due to rounding
KAISER HSA
$1,500/$3,000
Single
Employee
Employee + 1
Dependent
Employee +
Family (2 or
more)
2012
EE/PP
2013
EE/PP
2012 EE
Cost/Yr
2013 EE
Cost/Yr
2012
Paid by
ER to
HSA
2013
Paid by
ER to HSA
$14.72
$24.58
$353
$590
$900
$900
$96.97
$118.58
$2,327
$2,846
$1,800
$1,800
$70.39
$99.95
$1,689
$2,399
$1,800
$1,800
Numbers may vary due to rounding
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E M P L O Y E E B E N E F I T S W E B P O R TAL
OUR BROKER – FILICE INSURANCE
 FILICE HAS DESIGNED A CUSTOMIZED WEBSITE THAT
ALLOWS EMPLOYEES AND DEPENDENTS TO ACCESS
INFORMATION AS NEEDED.

Plan Overviews

Physician Directories

Group Numbers and Carrier Contact Information

HR Forms and Required Postings

Account Manager Contact Information
www.filice.com/benefits/bcp
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WHAT NOW?
 All elections will automatically transfer.

No action needed if you are not changing your medical; however: All
medical waivers must be accompanied by a recent copy of your medical
card to HR. Incentive payments will not begin until a copy of the medical
card is received.
 FSA AND HSA BENEFITS MUST BE RENEWED WITH HR

All changes must be made by December 17, 2012.

All changes will go into effect January 1, 2013.
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OPEN ENROLLMENT INSTRUCTIONS
OPEN ENROLLMENT BEGINS
M o n d a y, N o v e m b e r 1 2 , 2 0 1 2 t h r o u g h D e c e m b e r 1 7 , 2 0 1 2
You will be able to access your benefits and change them, if you desire, on the ADP website. Remember to
reenroll in your Flexible Spending and HSA Accounts! To access your account:
1. Go to this URL: https://portal.adp.com
2. Enter your User ID: (your first initial and last name)@ bellarmine
3. Enter the password you created when you registered
If you forgot your password, hit the “Forgot Password” and it will take you through the steps to setup a new
password. If that doesn’t work, please contact Christine Carbone to help you get into the site.
At the top you will see tabs.
1)
Click on the “Benefits” tab
2)
A dropdown menu will appear
3)
Scroll down to “Review/Change Benefits”
4)
You will then be asked to select one of the following:
•
Walk me through the process
•
I know what changes I want to make.
•
Review my benefits coverage.

5) CONGRATULATIONS!! You are now in “Open Enrollment ”. Make your desired changes now.

6) If you have any questions or need help, don’t hesitate to call (x228) or email Christine
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YOUR QUESTIONS?
You can contact your Filice
Account Manager:
?
Laura Kuczenski
laura@filice.com
925-385-5305
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