BENEFITS OPEN ENROLLMENT - INDIANA UNIVERSITY - NOVEMBER 11-22, 2019 - IU Human ...
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INDIANA UNIVERSITY BENEFITS OPEN ENROLLMENT NOVEMBER 11-22, 2019
Open Enrollment Resources
GO.IU.EDU
Plan Changes
Open Enrollment Guide
Plan Summaries
Enrollment Instructions
More!
Employee Center – one.iu.edu
Benefits Center – Start your Open Enrollment
Benefits Center – Change HSA Mid-Year
askhr@iu.edu (812) 856-1234 Enrollment Help Benefits Questions Any HR-related Questions
HDHP & HSA
Two Parts – HDHP & HSA
Health Savings Account
Tax-free Bank Account:
• Medical
• Prescriptions
• Dental
• Vision
High Deductible Health Plan
Comprehensive Medical Coverage:
• Office Visits
• Hospital
• Mental Health
• Prescriptions
• Transplants
High Deductible Health Plans
(HDHPs)
What is an HDHP
• Defined by the IRS
• Medical plan with a deductible at least $1,350 for
an individual and $2,700 for a family.
• Benefits of an HDHP
• Lower monthly premiums
• Pre-negotiated Discounted Rates
• Non-traditional deductible and OOPM structure
• Medical and Rx accumulate together
• Can be paired with a Health Savings AccountHDHP - Lower Premiums
Employee-Only Coverage
$35,000-$59,999 Salary Band
The Lower
the Premium
IU Health HDHP - $2,600 Anthem PPO $500 - $175.16
Anthem PPO HDHP - $1,600 Anthem PPO HDHP - $55.26
Anthem PPO - $500 IU Health HDHP - $46.58
The Higher
the DeductibleHDHP – Pre-Negotiated Discounted Rates
Average Office Visit
With NO Insurance
Average Office Visit
WITH Insurance
$115
$105
Abdomen X-Ray
at hospital
With NO Insurance Abdomen X-Ray
at hospital
$573 WITH Insurance
$372HDHP – Non-traditional Deductible & OOPM Structure
Traditional Plan - Family (employee & spouse, employee & child(ren), family)
• Each person has an individual deductible
Employee Only • Deductible & OOPM only include covered medical services (not Rx)
Only one deductible
HDHP - Family (employee & spouse, employee & child(ren), family)
$1,600 • Only one deductible - combines all family members’ expenses
• Deductible & OOPM Include medical services and prescriptions
$3,200 $0 $1,000 $1,200
OR
$0 $0 $0 $300 $0 $700
Using Anthem HDHP Deductibles = $3,200 = $3,200High Deductible Health Plans
In-Network Medical Benefits IU Health Anthem
Deductible employee-only $2,600 $1,600
all other coverage levels $5,200 $3,200
Coinsurance after the deductible 20% 20%
Out-of-Pocket employee-only $3,200 $3,200
Maximum all other coverage levels $6,400 $6,400
Deductible and OOPM apply to all covered medical services &
prescriptions except:
• preventive medical services
• preventive prescriptionsPrescriptions for the HDHP Plans
In-Network Prescription Benefits
Retail (up to 30-day supply)
100% during deductible phase
Retail at CVS Pharmacies (up to 90-day supply)
20% during coinsurance phase
Mail Order (up to 90-day supply)
0% after OOPM
Specialty Drugs (up to 30-day supply)
• Rx subject to deductible and out-of-pocket maximum (OOPM).
• Pharmacy Network includes most retail chain pharmacies and
many independent pharmacies (e.g. CVS, Meijer, Kroger,
Costco, Sam’s). Walgreens is NOT in-network.Prescriptions for the HDHP Plans
In-Network Prescription Benefits
0% for ACA Preventive Medications
• Birth control pills
• Aspirin 81mg for heart health
• Folic Acid supplement
• Tobacco cessation products
20% for drugs on HDHP Preventive Rx List
(No Deductible Applies)
• Diabetic Medications
• Mental Health medications View Preventive Drug Lists at
• Blood Pressure medications
• Cholesterol medications
hr.iu.edu/benefits/rx.html
• Asthma medicationsMEDICAL PLANS Total Out-of-Pocket Costs
Medical Plan Costs
Annual Out-of-Pocket MaximumAnnual Costs – Employee Only Example
Premiums Deductible Co-Insurance
TOTAL:
IU Health HDHP $117 $2,600 $600
$3,317
TOTAL:
Anthem HDHP $195 $1,600 $1,600
$3,395
TOTAL:
Anthem $500 $1,439 $500 $1,900 $3,839
plus Rx
Assumes:
• Employee-only coverage
• Salary of Below $35,000
• Tobacco-Free Affidavit Reduction (-$25/mo) appliedAnnual Costs – Employee Only Example
Premiums Deductible Co-Insurance
TOTAL:
IU Health HDHP $120 $1,000 $600 $1,720
$300 TOTAL:
Anthem HDHP $1,600
$2,100
$200
TOTAL:
Anthem $500 $1,453 $500 $1,900 $3,853
plus Rx
Assumes:
• Employee-only coverage
• Salary of Below $35,000
• Tobacco-Free Affidavit Reduction (-$25/mo) applied
• Used IU Contribution toward Deductible expensesAnnual Costs – Family Example
Premiums Deductible Co-Insurance
TOTAL:
IU Health HDHP $1,189 $5,200 $1,200
$7,589
TOTAL:
Anthem HDHP $1,522 $3,200 $3,200
$7,922
TOTAL:
Anthem $500 $6,126 $1,500 $5,700 $13,326
plus Rx
Assumes:
• Family coverage
• Salary of $35,000-$59,999
• Tobacco-Free Affidavit Reductions (-$50/mo) appliedAnnual Costs – Family Example
Premiums Deductible Co-Insurance
TOTAL:
IU Health HDHP $1,189 $2,000 $1,200
$4,389
TOTAL:
Anthem HDHP $1,522 $600 $3,200
$5,322
TOTAL:
Anthem $500 $6,126 $1,500 $5,700 $13,326
plus Rx
Assumes:
• Family coverage
• Salary of $35,000-$59,999
• Tobacco-Free Affidavit Reductions (-$50/mo) applied
• Used IU Contribution toward Deductible expensesPharmacy
CVS Caremark
Login to your account to:
View the drug formulary list
(drugs covered by our plan)
View the preventive drug lists
(no cost and 20% cost drugs)
Find lower cost alternatives
(generic drugs)
Look up prior Rx claims
Manage your mail order
prescriptions
Check drug interactions
Find a participating pharmacy
App also
available!
Speak with a pharmacistNew Plan Addition Diabetes Management Program • Partnership with Livongo and CVS Caremark • Free unlimited supplies (test strips, lancets) • Free cellular-connected glucose meter • 24x7x365 support, including live interventions from diabetic educators • Two free Minute Clinic visits per year • Can sign up after January 1, 2020
Health Savings Account
Health Savings Account (HSA) Paired with an HDHP A Savings Account For Healthcare Expenses Offers Triple Tax Savings o No taxes on contributions o No taxes on interest/earnings o No taxes on distributions
Tax Advantage #1
No Taxes on Contributions
• No Federal Income Taxes
• No State Income Taxes
• No Local Income Taxes
• No Social Security Taxes (OASDI)
1
• No Medicare Taxes (FICA)Tax Savings Example
Paycheck:
$600
Contribution to HSA: Contribution to HSA:
$0 $450
Remaining Taxable Income: Remaining Taxable Income:
$600 $150
Income Tax (25%): Income Tax (25%):
$150 $37.50
Take Home Pay: Take Home Pay:
$450 $112.50
Purchase Glasses: Pay for Glasses from HSA
$450 $450
Net Balance: Net Balance:
$0 $112.50Your HSA Contributions
• Minimum: $300
• Maximum: IRS limit – IU’s Contribution
IRS Contribution Maximums For 2020
Employee Only $3,550
Family $7,100
(Employee + Spouse, Employee + Child(ren), or Family)
Age 55+ “Catch-Up” $1,000
• Maximums include contributions from all sources (IU contributions,
employee contributions, spouse’s contribution to their HSA, & any
Archer MSA contributions)
• Maximums may be prorated by the IRS when HDHP enrollment is less
than 12 months or when coverage levels change mid-yearIU’s HSA Contribution IU Health HDHP Participants: • $1,600 for employee-only coverage level • $3,200 for all other coverage levels Anthem PPO HDHP Participants: • $1,300 for employee-only coverage level • $2,600 for all other coverage levels IU’s Contribution is deposited into HSA accounts with the second paycheck in January: • Bi-Weekly: January 24, 2020 • Monthly: January 31, 2020
Tax Advantage #2
No Taxes on Interest or Earnings
• Cash Account earns savings interest
• Open an Investment Account:
$1,000 cash account balance minimum
Transfer any amount above the min
Set up one time or recurring transfers
Manage investments online (FREE)
2
Speak with a Nyhart registered investment
representative (FREE)Nyhart Investments
Make your HSA work
harder for you by
investing
Investment Education
• Fund performance information
(prospectus and fact sheets)
• Guidance Tool
• FAQs
Manage Investments
• One-time transfers
• Auto transfers
• Update fund allocationsTax Advantage #3
No Taxes on Withdrawals when Used for
IRS-Approved Health Expenses
• Medical
• Prescriptions
• Dental
• Vision
• Hearing Aids
•
•
Acupuncture
COBRA premiums
3
• Medicare premiums
List of HSA eligible expenses at hr.iu.edu/benefits/hsa.htmlHealthcare Expense Eligibility Table
Access list
• From login page; under Forms
& Resources
• From Welcome page; under
Tools & Support
Searchable List
• Qualifying expense
• Potentially qualifying expense
• Not a qualifying expense
• Additional details and special
notesHow to Pay For Your Healthcare
Insurance sends
Go to your Your provider
you an Explanation
Doctor sends you a bill
of Benefits (EOB)
Show Insurance pays Check that
your ID what it owes your EOB and
Card to your provider bill match
Your provider Insurance determines
Pay provider from HSA
sends a claim to the allowed cost
of the visit - Online bill pay
Insurance
- With debit/Visa cardMake an HSA Transaction Flexibility of Access Use debit/Visa card at healthcare providers (physician offices, pharmacies, dental, vision providers) Use online tools to pay bills directly Use online tools to transfer money Download the mobile app
More Advantages • Can change your contribution amount at any time • Can use for the health expenses of any tax dependent (spouse, child(ren), dependent relative, etc.) • Balance rolls over year after year • Unused funds are always yours to keep, even when: you retire; you leave IU employment; you are no longer eligible to make contributions; and you pass away, your funds can pass to your beneficiaries.
HSA Features
Can use funds to reimburse yourself for:
• Current health expenses paid out-of-
pocket
• Past health expenses incurred all the way
back to the date the account was opened
• Future healthcare expenses anticipated in
retirement including Medicare PremiumsNyhart
iu.nyhart.com
Login to your account to:
View account activity
Find common forms
IRS Qualified Expense List
Use the Expense Tracker function
Transfer funds online to/from a
personal bank account
Pay your healthcare expenses
directly from account
Manage investment accountHEALTH SAVINGS ACCOUNT IRS Rules
HSA Restrictions
• Must meet eligibility requirements to be eligible to
make tax-free contributions
• Under Age 65, must use ONLY for IRS qualified
healthcare expenses, otherwise IRS imposes:
‒ 20% penalty
‒ Income taxes
• Age 65+, can use account for non-healthcare
expenses:
– NO penalty
– Income taxesEligibility Rules
You must have a valid Social Security Number.
You cannot be claimed as a dependent on someone else’s tax return.
You must be covered under an HDHP.
You must have NO other medical coverage.
• Coverage by a federal government program, e.g., Medicare A & B or D, Tricare,
or VA medical
• Coverage by a spouse’s medical plan unless it is also an HDHP
• Coverage by a spouse’s:
o Flexible spending account (FSA)
o Health Reimbursement Arrangement (HRA)
o IU’s TSB Healthcare Reimbursement Account (TSB)Ineligible to Make Tax-free Contributions
You can enroll in HDHP plan and waive the HSA
• No HSA account will be opened; No IU contribution
• No taxes or penalties to worry about
• Can still enroll in the TSB Healthcare Reimbursement
Account
If you are ineligible and still enroll in the HSA
• You will be required to contribute the $300 minimum to
receive the IU Contribution to your account
• You are responsible for:
o Filing an “Excess Contribution” form with Nyhart
o Reporting all contributions (University and Employee
contributions) as taxable income on your annual tax return
o Paying any taxes or penalties assessed by the IRS.
• Recommend consulting a tax advisorHEALTH SAVINGS ACCOUNTS Reporting Requirements
HSA Reporting Requirements
Receipts are not sent to the IRS.
What to Retain:
Keep receipts and records for
Copy of Receipt use if audited by the IRS
Copy of EOB
Doctor’s Prescription or Note
• Show expense is primarily for medical care
• Recommended for treatment of a specific
medical condition
How Long to Keep Records:
3 Years after filing income tax return
As long as you maintain the accountNyhart Expense Tracker
Attach an image of the
receipt to expense. Jane Doe
Add details to each
expense.
• Expense category
• Who the expense was for
Jane Doe
• Notes and expense
details Jane Doe
Jane Doe
Download a report of
all expenses. Jane Doe
Jane DoeHSA Tax Reporting Requirements
Tax Forms: Receipts are not sent to the IRS.
Form 1099-SA Keep receipts and records for
use if audited by the IRS
• Reports distributions from your HSA
• Available on Nyhart site in January
Form 5498-SA
• Reports contributions to your HSA
• Available on Nyhart site in January
Form W-2
• Reports contributions made to your HSA through
payroll deductions (IU’s contribution and Yours)
• Available on the Employee Center in January
Tax Reporting:
Form 8889 (filed annually with income taxes)
• Report contributions to your HSA
• Report distributions from your HSA
• Figure any taxes or penalties for ineligible
contributions and/or distributionsAccount Statements Monthly Account Statements Annual Tax Statements
HEALTH SAVINGS ACCOUNT HSA Beneficiary
Designation Spouse: – HSA transfers to spouse – Can continue to use for their healthcare expenses tax-free Friend or Family Member: – Entire value of account becomes taxable in the year of your death Estate: – Total distribution is included on the deceased HSA owner’s final tax return
Adding a Beneficiary
MY SPOUSEMEDICAL PLANS Where to Go for Care
Your
Where to go What can be treated Hours
Cost
Telemedicine - Flu & cold symptoms 24/7 from your
(LiveHealth Online) - Allergies, sinus infection smartphone, tablet or $
(IU Health Video Visits) - Pink eye computer with a webcam
- Flu & cold symptoms
- Allergies, sinus infection Hours vary, usually best by
Doctor’s office - Chronic health conditions appointment
$$
- Regular health screenings, physicals, & checkups
- Flu & cold symptoms
Most can see you nights
Retail health - Minor allergic reactions
and weekends, and accept $$
clinic - Minor cuts and burns
walk-ins
- Vaccinations
- Non-life or limb threating injuries/illness
Usually open extended
Urgent care - Cold / Flu / Sore Throat / Mild asthma
hours (nights and $$$
center - Bone fractures of wrist, hand, ankle, or foot
weekends)
- Cuts / Wounds that may need stitches
Emergency Never hesitate to use ER care, or dial 9-1-1,
Open 24/7 $$$$
Care when facing a health emergency.MEDICAL PLANS Using your Health Plans
Free Care
All medical plans cover in-network
preventive services at 100%:
• Annual preventive exams
• Immunizations
• Cancer screenings
• Women’s medical contraceptive
services
24-Hour Nurseline
• Trained registered nurses provide
24x7 guidance on non-emergency
health questions and concerns.
Employee Assistance Program
• 24x7 helpline providing professional,
confidential counseling.Free Care
Dental plan covers all in-network
preventive services at 100%:
• 2 free cleanings per year
• Routine bite-wing X-rays
• Additional enhanced care for those with
specific medical conditions
Pharmacy Benefits
• ACA list – covered at 100%
• 180 days of Tobacco Cessation products
• Most birth control pills
Health Savings Account (for HDHPs)
• Pay for your healthcare TAX FREE
• Receive IU’s ContributionHealthy IU
• Your Workplace Wellness Program!
• Resources, programs, and workshops
Free for full-time faculty and staff and their
spouses on an IU-sponsored health plan.
• Free Personalized Nutrition Counseling
E-mail Steven Lalevich, RD, at
askanrd@indiana.edu
• Free Health Screenings
Receive a $100 incentive each fiscal year
Spouses on an IU medical plan eligible too
healthy.iu.eduWork + Life
Work+Life Consultant
• Angela Reese, MSW, LSW anlreese@iu.edu
Lactation Support
• Privacy rooms for nursing mothers located across campus
• IU community lactation support education
Childcare and Parenting Education & Resources
• Webinars/Workshops and Parenting Network
Adult and Elder Care Education & Resources
• Webinars/Workshops and Senior Care Planning
Flexible Work Schedules & Telework Guidance
healthy.iu.edu/worklifeLow Cost Care
Pharmacy Benefits
• Generics – low cost alternatives
• For HDHP plans – Preventive Rx list only
costs 20%
Vision Benefits
• Routine Eye Exam - $10 copay
• Diabetic Eye Exam is free under medical
benefit (does not include refraction Rx)Castlight Health Tool
• Fully funded by IU.
• Online tool to help you make smart healthcare
decisions:
• Estimate personalized costs for services
• Learn about prescription drug alternatives
• Search for a primary care physician
• Compare in-network doctors, facilities, and
medical services
• Look up prior medical and Rx claims
• Know where you stand in your deductible and
out-of-pocket maximum
hr.iu.edu/benefits/castlight.htmlCare.com
• Membership paid by IU for finding pre-
screened caregivers for:
̶ Children: babysitters, special needs, nannies, tutors
̶ Adults: caregivers, home health aides
̶ Other: pet care and home assistants
• Back-up Care
– Up to 15 days per year at a subsidized rate
• Other Resources:
̶ Online Articles and Advice
̶ Make and manage caregiver payments
hr.iu.edu/benefits/care.htmlQUESTIONS?
When you have a question about your benefits, jobs at IU, employee policies, or more – just ask. You have questions. We have answers. askhr@iu.edu 812-856-1234 hr.iu.edu
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