Non State Employee Health Plan Open Enrollment 2017

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Non State Employee Health Plan Open Enrollment 2017 Our Mission: To protect and improve

Non State Employee Health Plan Open Enrollment 2017 Our Mission: To protect and improve the health and environment of all Kansans.

State of the Plan • The A&M Efficiency Report recommends changes to the health

State of the Plan • The A&M Efficiency Report recommends changes to the health plan • Plan reserves are slightly below the target level • Plan expenses must be covered by Plan revenues • Additional funding is needed for 2017 Our Mission: To protect and improve the health and environment of all Kansans.

HCC Decisions • Rate & plan design changes approved to address funding needs of

HCC Decisions • Rate & plan design changes approved to address funding needs of the plan • Employer & employee contributions will increase • Premiums for covering spouses will increase • 2 nd year of a multi year plan to adjust rates • Dental rates will increase • Employee only will have an employee contribution Our Mission: To protect and improve the health and environment of all Kansans.

HCC Plan Changes • Plan A • • Office visit Copays $40/$60 Three (3)

HCC Plan Changes • Plan A • • Office visit Copays $40/$60 Three (3) tiered Deductible $1, 000/$2, 000/$3, 000 Out Of Pocket (OOP) Max $5, 750/$11, 500 Pharmacy Coinsurance: • Tiers are now 20%, 40% and 65% • Special Case Copay $100 per 30 day supply Our Mission: To protect and improve the health and environment of all Kansans.

HCC Plan Changes • Plan C • 20% Coinsurance for medical services • Pharmacy

HCC Plan Changes • Plan C • 20% Coinsurance for medical services • Pharmacy Coinsurance added • Coinsurance tiers: 20%, 40% and 65% • OOP Max is $5, 000/$10, 000 • HSA/HRA Employer Contribution • Reduced $500 for employee & employee/child tier • Reduced $1, 000 for employee/spouse & family tiers Our Mission: To protect and improve the health and environment of all Kansans.

HCC Plan Changes • Health. Quest (HQ) Rewards: • New wellness vendor: Cerner Corporation

HCC Plan Changes • Health. Quest (HQ) Rewards: • New wellness vendor: Cerner Corporation • New weight management program: Naturally Slim by ACAP Health • 40 Credits required to earn premium incentive • Employees & covered spouses now eligible to earn HQ Reward for 2018 • Plan C: Covered employees & spouses can earn up to $500 each toward employee’s HSA/HRA in 2017 Our Mission: To protect and improve the health and environment of all Kansans.

Selecting Your Health Plan • Pick a plan design (A or C) • Which

Selecting Your Health Plan • Pick a plan design (A or C) • Which plan design is right for you? • Premiums, Deductibles, Coinsurance • Review the provider networks • Review plan claim example online: • http: //www. kdheks. gov/hcf/sehp/default. htm Our Mission: To protect and improve the health and environment of all Kansans.

Plan A Network Non Network Medical* Deductible $1, 000/$2, 000/$3, 000 Deductible $1, 200/$3,

Plan A Network Non Network Medical* Deductible $1, 000/$2, 000/$3, 000 Deductible $1, 200/$3, 600 Coinsurance 20% Coinsurance 50% PCP Office Visit $40 Copay Out of Pocket (OOP) Max* Specialist Visit $60 Copay Pharmacy* Coinsurance 20%/40%/65% Special Case $100 /30 day Medical $5, 750/$11, 500 Combined Out of Pocket (OOP) Max* Medical & Pharmacy $5, 750/$11, 500 * Non covered services & discount tier drugs do not count toward Deductible, Coinsurance or OOP Max. Our Mission: To protect and improve the health and environment of all Kansans.

Plan A - Three Tiered Deductible • How it works: • 1 st Person

Plan A - Three Tiered Deductible • How it works: • 1 st Person has a $1, 000 Deductible • 2 nd Person has a $1, 000 Deductible • All remaining covered members combine together toward a 3 rd $1, 000 Deductible • Maximum Deductible on a family with 4 or more members is $3, 000 Our Mission: To protect and improve the health and environment of all Kansans.

Pharmacy Changes • Plans A & C will offer 90 day supplies on most

Pharmacy Changes • Plans A & C will offer 90 day supplies on most medications • Compound drugs will only be covered if purchased from a Network Pharmacy • Plan A Only: Asthma and Diabetes drugs: • Generics 10% to max of $20 per 30 day supply • Preferred brands 20% to a max of $40 per 30 day supply • Non Preferred brands – 65% Coinsurance Our Mission: To protect and improve the health and environment of all Kansans.

Anticipated Generic Releases • 4 th Quarter 2016 • Seroquel • Zetia • 1

Anticipated Generic Releases • 4 th Quarter 2016 • Seroquel • Zetia • 1 st Quarter 2017 • Minastrin 24 FE • Vytorin • 2 rd Quarter 2017 • Strattera • Relpax • 4 th Quarter 2017 • Viagra • Viread Our Mission: To protect and improve the health and environment of all Kansans.

Plan C Network Medical & Pharmacy* Deductible $2, 750/$5, 500 Medical Coinsurance 20% Pharmacy

Plan C Network Medical & Pharmacy* Deductible $2, 750/$5, 500 Medical Coinsurance 20% Pharmacy Coinsurance 20%/40%/65% Non Network Medical* Deductible Coinsurance $2, 750/$5, 500 50% Out Of Pocket Max Medical $5, 000/$10, 000 Out of Pocket Max Medical & $5, 000/$10, 000 Pharmacy *Note: Discount tier and non covered items or services do not count toward Deductible or OOP Max. Our Mission: To protect and improve the health and environment of all Kansans.

Plan C - Health Savings Account • Its your bank account for health care!

Plan C - Health Savings Account • Its your bank account for health care! • Use your HSA to pay health care expenses of you & your tax qualified dependents • You can change your HSA contribution during the year Our Mission: To protect and improve the health and environment of all Kansans.

Eligibility for HSA • To qualify for an HSA: • You must enroll in

Eligibility for HSA • To qualify for an HSA: • You must enroll in Plan C • Your medical coverage must be limited to only High Deductible Health Plan(s) like Plan C. • You cannot be enrolled in Medicare or TRICARE • You cannot be claimed as a dependent on someone else’s tax return Our Mission: To protect and improve the health and environment of all Kansans.

Employer HSA & HRA Funding Full Time* Employee HSA/HRA Funding Employee Only Employee plus

Employer HSA & HRA Funding Full Time* Employee HSA/HRA Funding Employee Only Employee plus Spouse Employee plus Children Family Employer (ER) Contribution $83. 34 $104. 17 $145. 84 $104. 17 Annual amount $1, 000 $1, 250 $1, 750 $1, 250 Employers’ HSA & HRA contributions will be made monthly * See Open Enrollment book for part time information Our Mission: To protect and improve the health and environment of all Kansans.

Employee HSA Funding Member Only Member + Child(ren) Member + Spouse or Family plan

Employee HSA Funding Member Only Member + Child(ren) Member + Spouse or Family plan Annual Maximum Allowed HSA Contribution $3, 400 $6, 750 Employer HSA Contribution $1, 000 $1, 750 $1, 250 $600 $1, 000 Minimum Employee $25 Contribution Annually Member over age 55 additional “Catch up” amount • HSA Contributions are based on full time employees with 24 pay period deductions. See Open Enrollment book for part time information. Our Mission: To protect and improve the health and environment of all Kansans.

Health Reimbursement Account (HRA) • For employees not eligible for an HSA • The

Health Reimbursement Account (HRA) • For employees not eligible for an HSA • The HRA is an employer funded account • Same employer contribution as HSA • Employee submits claims for reimbursement • HRA funds are use it or lose it Our Mission: To protect and improve the health and environment of all Kansans.

Preferred Lab: Stormont Vail • Plan A - 100% coverage for eligible outpatient lab

Preferred Lab: Stormont Vail • Plan A - 100% coverage for eligible outpatient lab services • Plan C - Discounts on eligible outpatient lab services until Deductible met, then paid at 100% • Labs drawn at other Cotton-O’Neil locations may be included if by network providers • Show your medical ID Card to access benefit BCBS Members: The local BCBS plan of the physician that ordered the lab test will process the lab claim. If your provider is outside of BCBS of Kansas area, Stormont-Vail may not be a network provider and the claim may be subject to non network benefits. Our Mission: To protect and improve the health and environment of all Kansans.

Preferred Lab: Quest Diagnostics • Plan A - 100% coverage of outpatient lab tests

Preferred Lab: Quest Diagnostics • Plan A - 100% coverage of outpatient lab tests • Plan C - Discounts on eligible outpatient lab services until Deductible met, then paid at 100% • List of collection sites: www. labcard. com • Your doctor can draw the sample and send to Quest BCBS Members: The local BCBS plan of the physician that ordered the lab test will process your lab claim. If your provider is outside of BCBS of Kansas area, Quest may not be a network provider for that BCBS plan and the claim may be subject to non network benefits. Our Mission: To protect and improve the health and environment of all Kansans.

Dental Changes • Employee only dental will now have a contribution • You and

Dental Changes • Employee only dental will now have a contribution • You and your dependents must have medical coverage to buy dental • Changes to dental eligibility: • You may opt out of purchasing dental • You may elect a different coverage tier for dental than medical Our Mission: To protect and improve the health and environment of all Kansans.

Dental • Plan pays for 2 exams & cleanings per year Basic Benefit PPO

Dental • Plan pays for 2 exams & cleanings per year Basic Benefit PPO Preventive Services Covered in full Premier Non Network Covered in full Allowed amount covered in full Basic Restorative 50% 50% Major Restorative 60% 70% Enhanced Benefit PPO Preventive Services Covered in full Premier Non Network Covered in full Allowed amount covered in full Basic Restorative 20% 40% Major Restorative 50% 50% Our Mission: To protect and improve the health and environment of all Kansans.

Vision Benefits Enhanced Plan - Covers everything in the Basic Plan PLUS… Basic Plan

Vision Benefits Enhanced Plan - Covers everything in the Basic Plan PLUS… Basic Plan Office Visit Copay $50 Frame Allowance Materials Copay $25 High Index Allowance Up to $116 Frame Allowance $100 Polycarbonate lenses Covered in Full Lenses: single vision, 100% Progressive lenses Allowance Contact lenses Allowance $150 Scratch & UV coating Contact Fitting Fee Copay $35 standard bifocal, trifocal or lenticular $150 Up to $165 Covered in full Our Mission: To protect and improve the health and environment of all Kansans.

Voluntary Plans • New plans available from Colonial Life: • • Accidental Insurance Hospital

Voluntary Plans • New plans available from Colonial Life: • • Accidental Insurance Hospital Indemnity Insurance Cancer Insurance Critical Illness Insurance Our Mission: To protect and improve the health and environment of all Kansans.

Health. Quest (HQ) • New Naturally Slim program by ACAP Health • Interactive web

Health. Quest (HQ) • New Naturally Slim program by ACAP Health • Interactive web based program that promotes healthy eating & weight management • New wellness vendor Cerner • New HQ website and programs • Aligning HQ year to calendar year • New programs start in January 2017 Our Mission: To protect and improve the health and environment of all Kansans.

PY 2018 Health. Quest (HQ) Rewards • HQ Rewards Premium Incentive Discount for PY

PY 2018 Health. Quest (HQ) Rewards • HQ Rewards Premium Incentive Discount for PY 2018 is available to employees & covered spouses that earn 40 credits. • Discount earned by coverage tier: • EE & EE/Children Tiers: • EE can earn the full $480 of the premium incentive • EE/Spouse & EE/Family Tiers: • EE & spouse can each earn $240 of premium incentive discount • The Premium Incentive Discount is earned in PY 2017 and received in PY 2018 Our Mission: To protect and improve the health and environment of all Kansans.

HQ Rewards: Plan C only • Employees & covered spouse can each earn up

HQ Rewards: Plan C only • Employees & covered spouse can each earn up to $500 HSAHRA dollars by completing HQ activities • HSA/HRA funds earned will be paid during 2017 • More information coming soon! • The new HQ programs start January 1, 2017 Our Mission: To protect and improve the health and environment of all Kansans.

Castlight Health Dental services information coming to Castlight in 2017! www. mycastlight. com/sehp Our

Castlight Health Dental services information coming to Castlight in 2017! www. mycastlight. com/sehp Our Mission: To protect and improve the health and environment of all Kansans.

Rx Savings Solutions https: //www. rxsavingssolutions. com Our Mission: To protect and improve the

Rx Savings Solutions https: //www. rxsavingssolutions. com Our Mission: To protect and improve the health and environment of all Kansans.

Identification Cards • BCBS, Caremark, Delta and Surency are sending new cards to all

Identification Cards • BCBS, Caremark, Delta and Surency are sending new cards to all members • Aetna is sending all Plan A members new cards and members who make changes. • Quest is only sending cards to new members or members who make changes in coverage • Optum is only sending new debit card to new members enrolling in the HSA Our Mission: To protect and improve the health and environment of all Kansans.

Open Enrollment Oct. 1 – 31, 2016 • Enroll online: https: //sehp. member. hrissuite.

Open Enrollment Oct. 1 – 31, 2016 • Enroll online: https: //sehp. member. hrissuite. com Our Mission: To protect and improve the health and environment of all Kansans.

Questions Link to Open Enrollment book: www. kdheks. gov/hcf/sehp/default. htm HRA, HSA, Eligibility, &

Questions Link to Open Enrollment book: www. kdheks. gov/hcf/sehp/default. htm HRA, HSA, Eligibility, & Enrollment Portal Questions: SEHPMembership@kdheks. gov Benefit & Plan Questions: Benefits@kdheks. gov Our Mission: To protect and improve the health and environment of all Kansans.

www. kdheks. gov Our Mission: To protect and improve the health and environment of

www. kdheks. gov Our Mission: To protect and improve the health and environment of all Kansans.