Confidential 2016 Open Enrollment Benefits Summary and Education Session November 23, 2015 –...
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Transcript of Confidential 2016 Open Enrollment Benefits Summary and Education Session November 23, 2015 –...
Confidential
2016 Open EnrollmentBenefits Summary and Education Session
November 23, 2015 – December 4, 2015
Let’s Rock ENROLL!
Confidential
Open Enrollment November 23 – December 4
Let’s Rock ENROLL!
If you are eligible for benefits you must log in to bSwift and either select or decline coverages for 2016. This includes everyone even if you recently enrolled in 2015’s plan for December.
Confidential3
Open Enrollment – November 23 to December 4
*Spouses that are eligible for medical benefits under their employers are not eligible to participate in Touchstone’s medical plans.
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Confidential4
Increasing Healthcare Costs
• Touchstone’s healthcare costs will increase 22.4% next year.– Based on CIGNA’s actuarial analysis.
• Touchstone’s 2016 medical plan changes and premium increases are a result of the increase.
– Note: Touchstone did not increase employee healthcare costs in 2015
• Touchstone spends over $12,000 per enrolled employee per year for health benefits.
Salary$30,000 66.10%Medical Benefits
$12,383 27.29%
401K$900
1.98%
Taxes$2,100 4.63%
Benefits and Employer’sPortion of Taxes Represents33.9% ($15,383) of Compensation.
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Salaries represent only a portion of employees total compensation. This is an illustration of the total compensation paid to a typical employee making $30,000 in annual salary:
Confidential5
2016 Benefit Summary
Touchstone will continue to offer a market competitive benefits package to its employees:
Medical Benefits – CIGNA Dental Insurance – Delta DentalVision Insurance – CIGNALife and AD&D – CIGNA Disability Insurance – CIGNATelaDoc
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Confidential6
Medical Plans
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-Premium Plan $3,000
-Value Plan $3,000 HSAConsumer Driven Value Plan offering the employer funded HSA of $50 per month through JPMorgan Chase
*Spousal Carve out – Spouses cannot be covered by Touchstone if they have access to creditable insurance under their employer.
There are two medical plans offered!
Confidential7
Medical Plans
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Office Visit Co-PayPrimary Care $35.00 $35.00 20% after Ded 20% after DedSpecialist $50.00 $50.00 20% after Ded 20% after Ded
Hospital/Outpatient Surgery/Imaging 20% after Ded 20% after Ded 20% after Ded 20% after DedEmergency Room $250.00 $250.00 20% after Ded 20% after DedUrgent Care $75.00 $75.00 20% after Ded 20% after DedRetail Pharmacy (30 Day Supply) $10/$60/$90 $10/$60/$90 20% after Ded 20% after DedMail Order Pharmacy (90 Day Supply) $20/$120/$180 $20/$120/$180 20% after Ded 20% after Ded
Premium Plan $3,000 Value Plan $3,000
EmployeeOnly
Employee 1 or more
EmployeeOnly
Employee 1 or more
In-Network Deductible $3,000 $6,000 $3,000 $6,000
In-Network Co-insurance 20.0% 20.0% 20.0% 20.0%
In-Network OOP Max $4,000 $8,000 $5,500 $11,000
OON Deductible $6,000 $12,000 $6,000 $12,000
OON Co-Insurance 40.0% 40.0% 40.0% 40.0%
OON OOP Max Unlimited Unlimited Unlimited Unlimited
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Health Savings Account
Touchstone will contribute $50 per month to your HSA account once your banking application has been submitted and approved by JPMorgan Chase. Your enrollment ID with JPMorgan for your banking applications is: TouchstoneHSA
2016 HSAContribution Limits: Single $3,350Family $6,650
Catch up Contributions (age 55 and older) $1,000
Qualified Medical Expenses for complete information, please refer to the IRS Publication 501 *Medical and Dental Expenses.* available online at www.irs.gov.
SAMPLE MEDICAL EXPENSESAcupuncture Home care Pregnancy tests kitsBandages Lab fees ProsthesesBirth control pills Lasik eye surgery TherapyChiropractor Nursing services WheelchairsCOBRA payments Optometrist X-ray feesEyeglasses/contact Orthodontics
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Confidential9
At a glance: Premium Plan vs. Value Plan?
Value Plan $3,000 with HSA– Consumer-driven– Lower premiums (e.g. lower bi-weekly cost to employees)– HSA available– Company contributes $600 per year to your HSA
• HSA = Health Savings Account: A savings account that you can put money in pre-tax. Money in this account can only be used to pay health care costs until the age of 65. At age 65 you are able to take this money out of this account and apply it towards other expenses. This will be taxed at a normal income rate at that time.
– There are no co-pays so you will pay ALL medical costs until your deductible is met– Out-of-pocket maximum is higher– Generally, people who don’t expect to use a lot of healthcare choose this type of plan
Premium Plan $3,000– Higher premiums bi-weekly cost to employee– No HSA or company contributions to out of pocket healthcare costs– Co-pays vs. first dollar rather than all costs incurred coming out-of-pocket– Lower out-of-pocket maximums– Generally, people who want minimize the risk of unexpected out-of-pocket healthcare
costs and believe they will consume more healthcare choose this type of plan
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Confidential10
Scenario 1 - Low Volume Healthcare ConsumerThe Value Plan would save this employee over the course of the year
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Patient Healthcare Expectations Premium Plan $3,000 Value Plan $3,000$ # per Year Employee Emp_Spouse Emp_Child Emp_Family Employee Emp_Spouse Emp_Child Emp_Family
Employee OnlyCoverage Elections Emp_SpouseHealty/Average/Sick Healthy Total Cost to Employee Total Cost to Employee
Prescription Drug 10 10 10 10 25 25 25 25Office Visits $90 3 Office Visits 105 105 105 105 270 270 270 270Specialist Visits $150 0 Specialist Visits 0 0 0 0 0 0 0 0Emergency Room Visits $3,000 0 Emergency Room Visits 0 0 0 0 0 0 0 0Urgent Care Visits $200 1 Urgent Care Visits 75 75 75 75 200 200 200 200Hospital Visits $12,000 0 Hospital Visits 0 0 0 0 0 0 0 0Outpatient Surgery $2,500 0 Outpatient Surgery 0 0 0 0 0 0 0 0MRI/CT/PET $800 0 MRI/CT/PET 0 0 0 0 0 0 0 0Other Care Costs $500 0 Other Care Costs 0 0 0 0 500 500 500 500
Emp. Total Claim Cost 190 190 190 190 995 995 995 995Prescription Drug
Tier 1 Rx #1 $25 1 Annual Premium $1,040 $5,590 $4,030 $6,890 $650 $4,160 $2,990 $5,330Tier 1 Rx 2 $30 0 HSA - Company Payment $0 $0 $0 $0 ($600) ($600) ($600) ($600)Tier 1 Rx 3 $30 0 Total Employee Cost 1,230 5,780 4,220 7,080 1,045 4,555 3,385 5,725Tier 2 Rx #1 $75 0Tier 2 Rx #2 $80 0 Total Cost to CompanyTier 2 Rx #3 $85 0 Total Claim Cost $495 $495 $495 $495 $495 $495 $495 $495Tier 3 Rx #1 $300 0 Less: Total Emp. Cost (1,230) (5,780) (4,220) (7,080) (1,045) (4,555) (3,385) (5,725)Tier 3 Rx #2 $350 0 Total Company Cost ($735) ($5,285) ($3,725) ($6,585) ($550) ($4,060) ($2,890) ($5,230)Tier 3 Rx #3 $400 0
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Scenario 2 - High Volume Healthcare ConsumerThe Premium Plan would save this employee over the course of the year
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Patient Healthcare Expectations Premium Plan $3,000 Value Plan $3,000$ # per Year Employee Emp_Spouse Emp_Child Emp_Family Employee Emp_Spouse Emp_Child Emp_Family
Employee OnlyCoverage Elections Emp_SpouseHealty/Average/Sick Healthy Total Cost to Employee Total Cost to Employee
Prescription Drug 370 370 370 370 990 990 990 990Office Visits $90 12 Office Visits 420 420 420 420 1,080 1,080 1,080 1,080Specialist Visits $150 12 Specialist Visits 600 600 600 600 1,800 1,800 1,800 1,800Emergency Room Visits $3,000 0 Emergency Room Visits 0 0 0 0 0 0 0 0Urgent Care Visits $200 1 Urgent Care Visits 75 75 75 75 40 200 200 200Hospital Visits $12,000 1 Hospital Visits 2,535 6,535 6,535 6,535 1,590 6,930 6,930 6,930Outpatient Surgery $2,500 0 Outpatient Surgery 0 0 0 0 0 0 0 0MRI/CT/PET $800 0 MRI/CT/PET 0 0 0 0 0 0 0 0Other Care Costs $500 0 Other Care Costs 0 0 0 0 0 0 0 0
Emp. Total Claim Cost 4,000 8,000 8,000 8,000 5,500 11,000 11,000 11,000Prescription Drug
Tier 1 Rx #1 $25 24 Annual Premium $1,040 $5,590 $4,030 $6,890 $650 $4,160 $2,990 $5,330Tier 1 Rx 2 $30 1 HSA - Company Payment $0 $0 $0 $0 ($600) ($600) ($600) ($600)Tier 1 Rx 3 $30 12 Total Employee Cost 5,040 13,590 12,030 14,890 5,550 14,560 13,390 15,730Tier 2 Rx #1 $75 0Tier 2 Rx #2 $80 0 Total Cost to CompanyTier 2 Rx #3 $85 0 Total Claim Cost $16,070 $16,070 $16,070 $16,070 $16,070 $16,070 $16,070 $16,070Tier 3 Rx #1 $300 0 Less: Total Emp. Cost (5,040) (13,590) (12,030) (14,890) (5,550) (14,560) (13,390) (15,730)Tier 3 Rx #2 $350 0 Total Company Cost $11,030 $2,480 $4,040 $1,180 $10,520 $1,510 $2,680 $340Tier 3 Rx #3 $400 0
Confidential12
TelaDoc
TelaDoc is available for $4.00 per month ($1.85 per pay period)– Same price no matter how many people are in your family– All members of your family can use TelaDoc, including those family members that are
not covered by Touchstone’s benefit plans
Available via phone or mobile phone APP 24/7/365, no matter where you call from
There is no limit to the number of times you can call them!
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TelaDoc recoups its cost if you utilize it; -As a Value Plan 3000 member, in lieu of 1 trip to the doctor- As a Premium Plan member, in lieu of 2 trips to the doctor
TelaDoc is the ultimate in convenience for treating minor healthcare issues. They can also prescribe non-narcotic medications.
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Dental
• Delta Dental remains our provider
• Coverage– Diagnostic/Preventative = 100%– Basic Services = 80%– Major Services = 50%– Orthodontics = 50%
• $50 Deductible per person total per calendar year on major restorative, repair of cast restorations, endodontics, periodontics, tissue conditioning, prosthodontics and implants.
• $100 Deductible per person total per lifetime. Applies to diagnostic and
preventive, basic services, complex oral surgery, sealants and palliative treatment.
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Confidential15
Life and Disability
Life AD&D Insurance• Touchstone provides $50,000 of life
insurance for all full time benefits eligible employees.
• Employees can buy additional life insurance in $10,000 increments up to $500,000 ($100,000 coverage guaranteed).
• Voluntary Policies can be converted to a private policy if employee leaves company.
• AD&D benefit equals your basic life insurance amount.
Voluntary Disability Insurance
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Confidential16
How To Make Changes After Enrollment
Unless you have a qualifying event you cannot make changes to the benefits you elect during your initial enrollment period until the next annual enrollment period.
Qualified events include: marriage, divorce, legal separation, death of spouse, birth or adoption of a child, change in child’s dependent status, change in residence due to an employment transfer, commencement or termination of adoption proceedings, or change in spouse’s benefits or employment status (applicable only to dental and vision). Please login to bSwift using the credentials previously provided to request the processing of a qualified event change to your benefit status. Also note employees have 30 days from a qualifying event to process a change request. After this time period, employees will have to wait until the next annual open enrollment.
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Contact Information and Tools
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www.myCignaplans.com -Medical Cost Calculator Comparison Tool