LMC test
Open Enrollment 2021
WELCOME TO OPEN ENROLLMENT 2
WELCOME TO OPEN ENROLLMENT Welcome to Open Enrollment Voluntary Vision ▪ Eligibility ▪ Qualifying Events Life & AD&D ▪ Open Enrollment Period ▪ How to Enroll Disability Benefits Overview Financial Medical ▪ Health Savings Account ▪ Key Terms ▪ Preventative Care Q&A & Disclosures ▪ Base Plan ▪ Buy-Up Plan Account Team ▪ Meet Alex ▪ Telemedicine ▪ Rally Wellness Dental 3
ELIGIBILITY QUALIFYING EVENT All full time employees working 30 hours or Eligible employees may enroll or make more per week are eligible to enroll in the changes to their benefit elections LMC medical, dental, voluntary vision and during open enrollment. These voluntary long-term disability benefit plans. elections will hold for the entire year, Employees working 30 hours per week are unless you have a qualifying event, such automatically enrolled in the life and short- as listed below. term disability plans. ▪ Marriage The following family members are eligible for the medical, dental and vision programs. ▪ Divorce ▪ Spouse ▪ Legal Separation ▪ Dependent Children ▪ Birth of a Child ▪ Dependent Step Children ▪ Adoption ▪ Loss of other coverage 4
OPEN ENROLLMENT PERIOD HOW & WHEN TO ENROLL? Open Enrollment April 19, 2021 – April 23, 2021 Plan Dates May 1, 2021 – April 30, 2022 How to Enroll ISolved Employee Portal 5
BENEFITS OVERVIEW 6
BENEFITS OVERVIEW Coverage Carrier Contact Number Website Medical Oxford/United Healthcare 1-866-414-1959 www.myuhc.com Telemedicine Virtual Visits 1-855-615-8335 www.myuhc.com/virutalvisits Dental United Healthcare 1-866-414-1959 www.myuhc.com Voluntary Vision EyeMed 1-866-939-3633 www.eyemed.com Life Insurance & Short-Term Mutual of Omaha 1-800-228-7104 www.mutualofomaha.com Disability Voluntary Long-Term Disability Mutual of Omaha 1-800-228-7104 www.mutualofomaha.com Health Savings Account HSA Bank 1-800-357-6246 www.hsabank.com 7 7
MEDICAL 8
KEY TERMS Annual Deductible Out-of-Pocket Copays/Coinsurance Maximum The amount you have to pay each year The total amount you can pay These expenses are your share of the before the plan starts paying a portion out of pocket each year before cost paid for covered health care of the medical expenses. the plan pays 100 percent of services. Embedded (E) – Each covered family covered expenses for the rest of Copays – A fixed dollar amount, usually member only needs to satisfy their the year. due at the time you receive care. individual deductible, not the entire Most expenses that meet Coinsurance – A percentage share of family deductible prior to receiving provider network requirements the allowed amount charged for the plan benefits. count toward the annual out-of- service. It is generally billed to you Non-Embedded (A) – The entire family pocket maximum, including after the health insurance company has deductible must be satisfied before expenses paid to the annual reconciled the bill with the provider. copays/coinsurance is applied to any deductible, copays and family member. coinsurance. 9
Examples of Preventative Services: ▪ Routine Physicals PREVENTATIVE CARE ▪ Well Baby & Child Care Visits What is covered? ▪ Well Women Visits ▪ Immunizations Under both LMC medical plans you are eligible to ▪ Routine Bone Density Test receive routine preventative and wellness services ▪ Routine Breast Exam at no cost. ▪ Routine Gynecological Exam No cost means: ▪ Obesity Screening & Counseling ▪ Routine Digital Rectal Exam ▪ No deductibles ▪ Routine Colonoscopy ▪ No copays ▪ Routine Colorectal Cancer Screening ▪ Routine Prostate Test ▪ No coinsurance ▪ Routine Mammograms Preventative Care Flyer ▪ Routine Pap Smear ▪ Health Counseling for STD’s & HIV ▪ Testing for HPV & HIV ▪ Screening & Counseling for Domestic Abuse 10
OXFORD 5000/10000 HSA BASE PLAN Services In-Network Benefits Network Annual Deductible Individual - $5,000 (E) ▪ EPO Choice Network Family - $10,000 (E) Out-of-Pocket Maximum Individual - $6,650 (E) Family - $13,300 (E) Plan Primary Care & Specialist Visit 100% Coinsurance after Deductible ▪ 5/1/2021 – 4/30/2022 Urgent Care & Walk-In Visits 100% Coinsurance after Deductible Emergency Room Visit 100% Coinsurance after Deductible Provider Search Labs 100% Coinsurance after Deductible Radiology 100% Coinsurance after Deductible www.myuhc.com High-Cost Diagnostics 100% Coinsurance after Deductible In-Patient Hospitalization 100% Coinsurance after Deductible Additional Information Out-Patient Surgery 100% Coinsurance after Deductible ▪ Benefits Summary Durable Medical Equipment 100% Coinsurance after Deductible Prescription Drugs Deductible Subject to Deductible Tier 1 $5 Tier 2 $25 Tier 3 50% to $250 Max Mail Order 2.5x 11 11
OXFORD 3000/6000 HSA BUY-UP PLAN Services In-Network Benefits Network Annual Deductible Individual - $3,000 (E) ▪ EPO Choice Network Family - $6,000 (E) Out-of-Pocket Maximum Individual - $6,750 (E) Family - $13,500 (E) Plan Primary Care & Specialist Visit 20% Coinsurance after Deductible ▪ 5/1/2021 – 4/30/2022 Urgent Care & Walk-In Visits 20% Coinsurance after Deductible Emergency Room Visit 20% Coinsurance after Deductible Provider Search Labs 20% Coinsurance after Deductible Radiology 20% Coinsurance after Deductible www.myuhc.com High-Cost Diagnostics 20% Coinsurance after Deductible In-Patient Hospitalization 20% Coinsurance after Deductible Additional Information Out-Patient Surgery 20% Coinsurance after Deductible ▪ Benefits Summary Durable Medical Equipment 20% Coinsurance after Deductible Prescription Drugs Deductible Subject to Deductible Tier 1 $5 Tier 2 $25 Tier 3 50% to $250 Max Mail Order 2.5x 12 12
MEET ALEX Interested in reviewing which benefit plans may be best for you and maybe having a little fun? Meet Alex… 13
What are some common issues where I would TELEMEDICINE use Virtual Visits? What is Telemedicine? ▪ Cold United Healthcare members have access to Virtual ▪ Flu Visits with board certified physicians! ▪ Sinus Infection ▪ Allergies Learn more. ▪ Pink Eye ▪ Ear Infections Virtual Visits Psychology ▪ Stress ▪ Anxiety ▪ Depression How Much Does It Cost? The cost of Virtual Visit would typically be less expensive than an urgent care or emergency room visit and likely more convenient 14
RALLY What areas does Rally focus on? ▪ Weight Loss What is Rally? ▪ Smoking Cessation Rally offers United Healthcare members access to a ▪ Fitness variety of wellness and wellbeing programs that ▪ Nutrition are specifically designed to meet your needs. ▪ General Wellbeing Learn more. Getting Started ▪ www.myuhc.com ▪ Quick Health Survey / Find Out Rally Age ▪ Rally will suggest activities for you ▪ Enter challenges as part of a community or individual Perks? You can earn Rally points for chances to win prizes. Track your progress and stay motivated to reach your goals. 15
DENTAL 16
UHC DENTAL PLAN Services UHC High Plan UHC Low Plan Network In-Network Out-of-Network In-Network Out-of-Network ▪ United Healthcare $50 / $150 $50 / $150 $50 / $150 $50 / $150 Deductible (Waived for (Waived for (Waived for (Waived for Plan Preventative) Preventative) Preventative) Preventative) ▪ 5/1/2021 – 4/30/2022 Preventative Services 100% 100% 100% 100% Provider Search www.myuhc.com Basic Services 80% 80% 80% 80% Additional Information ▪ PPO Summary Major Services 50% 50% 0% 0% Annual Maximum $2,000 $2,000 $1,000 $1,000 17 17
VISION 18
EYEMED VOLUNTARY VISION PLAN Services EyeMed Network Frequency Benefit Out-of-Network ▪ EyeMed Well Vision Exam 12 Months $10 Copay Up to $40 Reimbursement Prescription Glasses Plan $130 Allowance + 20% off ▪ 5/1/2021 – 4/30/2022 Eyeglass Frames 12 Months the Balance Up to $91 Reimbursement Eyeglass Lenses Provider Search Single Vision 12 Months $10 Copay Up to $30 Reimbursement www.eyemed.com Bifocal Vision 12 Months $10 Copay Up to $50 Reimbursement Additional Information Trifocal Vision 12 Months $10 Copay Up to $70 Reimbursement ▪ Benefit Summary Contact Lenses Elective 12 Months $130 Allowance + 15% off Up to $130 Reimbursement the Balance Necessary 12 Months Covered in Full Up to $210 Reimbursement Additional Benefits Additional Lens enhancements and eyewear discounts available from EyeMed. 19 19
LIFE & AD&D 20
LIFE INSURANCE ACCIDENTAL DEATH Full-time employees working 30 hours Full-time employees working 30 hours or or more per week are provided group more per week are provided group accidental death and dismemberment life insurance at no cost. insurance at no cost. Employees are covered for 2 x salary up to a Employees are covered for 2 x salary up maximum of $150,000. to a maximum of $150,000. *Please make sure your beneficiary designation is up to date! *Please make sure your beneficiary designation is up to date! 21
DISABILITY 22
DISABILITY Short-Term Disability Voluntary Long-Term Disability LMC provides employees with Short-Term LMC offers employees Voluntary Long-Term Disability coverage at no cost. Disability coverage. Employees would pay the full cost. STD V-LTD th Benefits Start 8 day of Accident & Benefits Start 180th Day of Disability Illness Benefit Duration Up to 26 Weeks Benefit Duration Up to SSNRA Percentage of 60% of earnings Percentage of 60% Income Replaced Income Replaced Benefit Maximum $1,000 Per Week Benefit Maximum $6,000 Per Month ▪ Benefit Summary ▪ Benefit Summary Please note if you have previously waived the LTD plan and would now like to enroll you will be subject to evidence of insurability. You can view coverages amounts and pricing via the ISolved portal 23
FINANCIAL 24
HEALTH SAVINGS ACCOUNT MORE INFORMATION LMC is going to make the following contributions to ▪ You can immediately enroll and contribute to the HSA your HSA account: ▪ Funds are only available as you accrue them ▪ Single: $1,000 annually / contributed monthly ▪ HSA dollars are not ‘use it or lose it’ they rollover from year to year ▪ Family: $2,500 annually / contributed monthly ▪ The account is portable so is yours to keep if you change jobs or retire ▪ You can also fund into the HSA account on a pre- ▪ Your dollars gain interest and can be invested, so they grow tax-free tax basis to pay for eligible medical, Rx, dental and vision expenses ▪ Upon retirement you can roll funds into your 401K or withdraw them ▪ Maximum contribution for 2021 as cash with no penalty ▪ Single - $3,600 ▪ If you are enrolled in Medicare you CANNOT contribute to an HSA ▪ Family - $7,200 account ▪ Aged 55+ can contribute an extra $1,000 per year as a ‘catch-up’ contribution ▪ More Details 25
Q&A + DISCLOSURES 26
Q&A WHAT/WHERE/WHEN? WHAT? ▪ You can enroll, change or waive coverage in the medical, dental, voluntary vision and voluntary LTD plans. WHERE? ▪ ALL employees must submit enrollments via the ISolved portal WHEN? ▪ Complete elections no later than April 23, 2021 NOTICES & DISCLOSURES 27
ACCOUNT TEAM Tom Clements Joe Marino Lead Consultant Account Management 203-339-2735 914-368-1291 [email protected] [email protected] 28
THANK YOU 29