TM

ANNUAL BENEFIT

ELECTION PERIOD

For the FY2017 benefit year

July 1, 2016 – June 30, 2017

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Spring Tour 2016

Montana University System

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Agenda for Today

Important Changes for FY2017

1. Mid-Year Change Recap

2. Rehabilitation Benefit Changes

3. Wellness reminders

Benefit Changes and your Decisions for FY2017

1. Medical, Dental, and Vision

2. Rates and Fees

Time Frames for Making Benefit Change Decisions

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Important Changes for FY2017

MID-YEAR CHANGE RECAP

BENEFIT DESCRIPTIONBENEFIT THROUGH

DECEMBER 30, 2015

CHANGE AS OF

DECEMBER 31, 2015

Copayments

Office Visits (non-specialty) $15 $25

Specialty Visits $15 $40

Emergency Room Facility

Visits

$125 $250

Urgent Care Visits $50 $75

URx Copays Tier A (retail/mail) $0/$0

Tier B (retail/mail) $15/$30

Tier C (retail/mail) $40/$80

Tier D (retail/mail) 50 %

Tier F (retail/mail) 100%

Tier A (retail/mail) $0/$0

Tier B (retail/mail) $25/$50

Tier C (retail/mail) $60/$120

Tier D (retail/mail) 50 %

Tier F (retail/mail) 100%

URx Specialty Copays Specialty $50/ Specialty $200 Specialty $150/ Specialty $300

Deductible

Increase In-Network

Deductible

$500 (individual)/$1,000 (family) $750 (individual)/ $1,500 (family)

Out-of-Pocket Maximums

Increase In-Network Medical

OOP

$3,500 (individual)/$7,000 (family) $4,000 (individual)/$8,000 (family)

Increase Rx Out-of-Pocket $1,650 (individual)/$3,300 (family) $2,150 (individual)/$4,300 (family)

Other Benefit Adjustments

Infertility Treatment Covered – see Summary Plan

Description for details

Not covered – plan exclusion

Vision Hardware Benefit See full description at

www.choices.mus.edu/Vision.asp

$300 frames and lenses maximum

annual allowance , in lieu of contacts

$150 contacts maximum annual

allowance, in lieu of frames and

lenses

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Important Changes for FY2017

REHABILITATION BENEFIT

CHANGES

Rehabilitative Services will be expanded to

include Acupuncture and Chiropractic Services.

BENEFIT DESCRIPTIONIN-NETWORK

COPAY/COINSURANCE

OUT-OF-NETWORK

COPAY/COINSURANCE

REHABILITATIVE SERVICES

Inpatient Services

(Pre-certification is strongly

recommended)

25% 35%

Max: 30 days per year (all therapies combined)

Outpatient Services$25 copay /visit 35%

Max: 30 visits per year (all therapies combined)

Covered Rehabilitative Services Include:

Physical Therapy

Occupational Therapy

Speech Therapy

Cardiac Rehabilitation

Respiratory Rehabilitation

Pulmonary Rehabilitation

Acupuncture

Chiropractic

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Important Information for FY2017

Selection Of Medical Plan - WE WILL

CONTINUE OFFERING THREE MEDICAL

PLAN OPTIONS IN FY2017

Allegiance Managed Care

Blue Cross and Blue Shield

Managed Care

Pacific Source Managed Care

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Important Information for FY2017 (cont.)

Use In-Network Providers – Be sure to use

In-Network providers to ensure you do not

incur “balance billing” charges.

Network participation by

providers is changing in the

health care market.

Always check - DO NOT assume

participation “….but my doctor has

always been In-Network!”

Check with your medical plan vendor,

MUS Benefits Office, or your campus if

you need help finding In-Network

providers.

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Important Information for FY2017 (cont.)

ELIGIBILITY

Dependents up to age 26 may enroll

annually in medical, dental, and vision

benefits. (Does not include spouses)

Proof of eligibility according to

criteria in the Summary Plan

Description will be required.

Mid-year disenrollment may only

occur with a “qualifying event” or

during a “Special Enrollment Period”.

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Important Changes for FY2017 (cont.)

OPTIONAL

VISION HARDWARE

BENEFIT

Optional Vision Hardware Benefit covers ONLY

hardware.

Eyeglass frames and lenses, in lieu of contacts.

UP TO $300 ANNUAL ALLOWANCE.

Contacts, in lieu of frames and lenses.

UP TO $150 ANNUAL ALLOWANCE

Eye Exam is provided as part of the medical plan.

No need to use a network for purchasing hardware

– simply select a place to purchase the frames,

lenses, or contacts and then submit claims to Blue

Cross and Blue Shield.

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Benefit Changes

and

Your Decisions for FY2017RATES AND FEES

NON-MEDICARE RETIREES –• 14.7% Aggregate Increase• Premium increases are between $104 and $251 per month depending on

which medical plan you select and whether you cover dependents.

MEDICARE RETIREES –• 20.9% Aggregate Increase• Premium changes range from a $68 per month increase to a $170 per month

increase depending on which medical plan you select and whether you cover

dependents.

RETIREE DENTAL –• Retiree rates remain the same as 2016.

• Benefits are unchanged.

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Benefit Changes and

Your Decisions for FY2017

RATES AND FEES (cont.)

VISION HARDWARE PLAN –• Rates increase by 5.2% or $0.37-$1.07 per month.

• Remember – the Medical Benefits cover vision exams!

• Optional Vision Hardware Plan covers eyeglass frames and lenses or

contacts

MEDICARE ADVANTAGE PLAN (MUS MAP) –• Rate changes to $225 beginning July 1, 2016 and continues

through December 31, 2017 (18 month rate guarantee).

• MUS MAP will change to a calendar year plan to align with

Medicare on January 1, 2017.

• Deductible and out-of-pocket accumulators will reset January 1,

2017.

• Changes to certain benefits – contact New West for more

information about the plan offering for July 1, 2016 – December

31, 2017.

• Retreat rights end June 30, 2016.

Health Plans and Networks

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To receive your best benefits,

STAY IN-NETWORK

with your health plan

Allegiance 1-877-778-8600, www.abpmtpa.com/mus

Blue Cross and Blue Shield 1-800-820-1674,

www.bcbsmt.com

PacificSource 1-877-590-1596,

www.PacificSource.com/MUS

MUS MAP 1-888-873-8049, www.newwesthealth.com

Retiree Updates

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Please review your medical plan choices carefully.

1. Review Managed Care Plan choices carefully.

2. If you are a Medicare eligible retiree, consider whether the MUS

Medicare Advantage Plan (MUS MAP) offered through New West

Medicare may be an option for you.

Look for the retiree information and updates that will be mailed

to your home and/or attend a campus presentation.

Contact your Campus benefit staff or the MUS Employee

Benefits Office if you have questions – we are happy to help!

All forms for any changes must be received by May 20, 2016

and submitted to the appropriate address noted on your

enrollment form.

If NO CHANGES are desired, you don’t need to do anything!

If you elect MUS Medicare Advantage Plan (MUS MAP) rates are

guaranteed through December 31, 2017. MUS MAP Benefits are

on a calendar year basis beginning January 1, 2017.

QUESTIONS?

Thank you for your time!

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