Consumer Directed Healthselect Participant Presentation

Consumer Directed Healthselect Participant Presentation


and on Consumer Directed HealthSelect
is going to be recorded. With me here today, I have Pat Garcia from UnitedHealthcare
here to talk about the high deductible health plan. I also have Alison Marek here to talk
about the prescription drug coverage and Kristi Nonneman from Optum Bank to talk
about the health savings account. So with that, I will go ahead and turn it
over to Pat who will talk about who will go over the next steps of that
presentation. Good morning everybody. For our agenda today we will review the
plan. There’s two components to the plan and
we will review how each component works. We’ll also review the high deductible
health plan as well as the health savings account, how that works, the important tools and customer service
for your health savings account, and then of course we’ll discuss some important
considerations. And then at the very end will have questions and answers. The Consumer Directed HealthSelect is
a new option that’s available starting September 1, 2016 for employees and
retirees not eligible for Medicare. Two key parts make up the new plan. A high
deductible health plan, also known as an HDHP and health savings account,
known as an HSA. UnitedHealthcare will be administering the HDHP plan. Optum Bank is a
subsidiary of UnitedHealthcare Services Incorporated will be
administering the health savings account. The Consumer Directed HealthSelect plan
is made up of two different parts. Medical coverage through a high
deductible health plan and a health savings account. The medical coverage
will cover and exclude the same services as HealthSelect of Texas. The biggest difference is there is no
bariatric surgery benefit through the Consumer Directed HealthSelect plan.
That particular benefit is only available to HealthSelect of Texas
participants. Coverage in-network for preventive care is covered at a 100% of eligible expenses. You will not need to designate a primary care physician and you
will not need a referral to see a specialist. It will have lower monthly health
insurance premiums for those covering dependent. Because of the high
deductible you could have much higher out-of-pocket costs for not preventive
services and prescriptions than in HealthSelect of Texas and the regional
HMOs. The HSA will help cover your deductible and other out-of-pocket
qualified medical expenses. It will help lower your taxable income
through tax free contributions up to a certain amount each year. You can receive pre-tax contributions
from the state of Texas if you’re an active employee or retiree. You can grow
tax-free and provide tax-free withdrawals for your qualifying health
care expenses. Retirees and participants who pay their
insurance premium directly to ERS can make post tax contributions directly to
their HSA through Optum Bank. The medical claims are processed by
UnitedHealthcare which is also the third party administrator for HealthSelect of
Texas. Your HSA can be used to pay for qualified out-of-pocket expenses not
paid by the health plan is available through Optum Bank and
your you’re eligible for an HSA. You will have
the opportunity to set one up when you enroll in Consumer Directed HealthSelect. First let’s take a look at the high deductible health plan. Your plan
has three parts: your deductible, your coinsurance and your out-of-pocket
maximum. We’ll learn about each of these three part in the coming slides, but
before I move on though I should mention that all of these parts are affected
by whether you use network providers. As you can see in this slide, it pays to stay in the network and the
HealthSelect network includes tens of thousands of doctors and other providers
in Texas alone. A requirement for the high deductible health plan is to have a
deductible for non preventive expenses. The deductible is the amount of money
you must pay before your health plan will pay for eligible health care
expenses. For preventive care services you do not have to pay a deductible or coinsurance. Coverage is at a 100% when you use a network provider.
If you go to an out-of-network provider for preventive care services you will be
responsible for paying the out-of-network deductible and
coinsurance. When you have an eligible expense, like a doctor visit that is not
preventive care, the entire cost of the visit will
initially apply to your deductible. You will pay the full cost of your non-
preventive health care expenses including prescriptions until you meet
your deductible. The good news is that these are still
negotiated discounted rates when you are using the UHC network of providers. That’s one way the network saves you
money. The other is that your deductible is lower for in-network services. So the plan could start paying some of
the costs sooner. You can choose to pay for your care from your HSA as long as
you have money in your account to cover it. Unlike with a health care flexible
spending account, you cannot pay for care with money that
isn’t in your HSA yet or you can choose to pay another way, like with cash or a credit card and let
your HSA grow. it’s your money so you decide when to
use it. Once you have met your deductible all qualified medical expenses are then
covered at 80% coinsurance when you use a network provider. You will
only pay 20% of the eligible charges. Coinsurance is a shared
experience between you and the plan. Again, it pays to stay in the network. The plan
will pay only 60% and you’ll pay 40% coinsurance if you go
out-of-network for care. Remember preventive care services are
covered at a 100% when you use a network provider. Like the
deductible you can choose to pay for your care from
your HSA or you can choose to pay another way like with cash or a credit card and let
your HSA grow. But what if you have a sudden or ongoing more serious medical
situation? You’re protected from major expenses with an out-of-pocket limit. The
amount is the most you have to pay each year for covered services. To recap, in one step you would need to first satisfy
your deductible. If you are using a network provider then your deductible
would be $2,100 for individual coverage and $4,200 for family coverage. Once you satisfy the deductible, you would then be responsible for paying
20% coinsurance and the plan would pay 80%. Once you reach the total out-of-pocket
maximum which is $6,450 per individual and
$12,900 per family, the plan will then pay one 100% of remaining covered expenses for the rest of the calendar year. And don’t forget, your out-of-pocket
maximum is lower if you use in-network providers. The new Consumer Directed
HealthSelect plan website features a plan cost estimator that allows you to
enter information about you and your family’s health needs and finances. Check
for the link under medical benefits. The estimator will look at the possible cost
you might incur and add health savings account contributions. You can review what your overall cost
and savings might be under the new Consumer Directed HealthSelect compared
to HealthSelect of Texas. If you use the estimator please keep in
mind that it can give you only an estimate of what your cost and savings
might be but, it won’t predict things like accidents that might lead to
emergency medical costs. Thank you Pat and with that we’re going
to turn it over to Caremark with Alison Marek. Let me switch over to the
next slide and all right, you can go ahead Alison. Thanks Cristina. So now it’s important
to talk about prescription costs. If you’re currently in HealthSelect of Texas
or an HMO you’re probably used to paying a $50 per person annual deductible for prescriptions and then maybe no more
than $75 for a 30 day supply of drugs from a network pharmacy. In
Consumer Directed HealthSelect you could pay much more for some drugs, possibly hundreds of dollars depending
on the drugs until you meet the deductible. After you meet the deductible you’ll pay
coinsurance. 20% of the prescription costs if you use the
network pharmacy not a copay. If you are thinking about enrolling and
Consumer Directed HealthSelect you should consider any prescriptions you
take and learn what the full cost of these prescriptions are. Fortunately
Caremark which will administer prescription benefits for
Consumer Directed HealthSelect has a cost estimator available for you. Knowing
the cost of your medication is important. Here’s an example of what you pay for a
30 day supply of Dexilant a tier 3 maintenance medication under HealthSelect of Texas versus what you’d pay for the same drugs under Consumer Directed
HealthSelect. The full cost of this specific drug is $247.54. Under HealthSlect of Texas and the regional
HMOs you only pay a deductible of $50 per participant per year. The deductible as much higher under
Consumer Directed HealthSelect which could be $2,100 or
$4,200 depending on whether you’ve chosen individual or
family coverage. Before you meet the $50 drug
deductible under HealthSelect of Texas, you pay a total of a $125 for the Dexilant at a network retail pharmacy. Under
Consumer Directed HealthSelect you’d pay $247.54 at a network retail pharmacy until you meet your health and
prescription deductible of $2,100 or $4,200. After you meet the drug deductible under HealthSelect of Texas,
you pay a total $75 which is your tier 3 copay for the drug. And if you meet the
high deductible under Consumer Directed HealthSelect you’d pay $49.51 for Dexilent, which is 20% of
the full cost of the drug. Thank you Alison and with that we are
going to turn it over to the health savings account portion of this
presentation and so Kristi you can go ahead and take it away. Great good morning everyone and thank
you for joining. I’m going to share some information with
you about the health savings account specifically and really a health savings
account is just like a personal bank account that you own that has certain
tax advantages assigned to it. So money that goes into this account can
be used to pay for current health care expenses and can be saved for future
health care expenses even into retirement. Any funds that go into the account are
completely exempt from taxes. Any interest that has earned in the
account or even investment earnings are growing on a tax-free basis and all the
withdrawals from the account are taken from the account on a text-free basis as
long as they’re used to pay for qualified healthcare expenses. As I
mentioned this account is not only for current health care expenses but for
future health care expenses and it allows you to grow your money long term
because once you have over $2,000 in your HSA you can choose to
start moving some funds into mutual funds and investments so that you can
grow your savings for long term use down the road. So the HSA really has
triple tax benefits. Again the money is not taxed when it goes in, it’s not taxed when it grows and it’s not
taxed when the money comes out as long as it’s used for qualified healthcare
expenses. The key here is that this account is a
personal account that you own so you decide when to use funds in the
account, how do you use the funds and if there
are any funds left over at the end of the year they actually carry over to the
next year. So unlike flexible spending account, the money is not lost its yours
to remain throughout the life of when you have the account. So it doesn’t
matter if you switch jobs, you change health plans or go to move into
retirement, any funds that have been deposited in the
account while you’ve had it will always remain yours to spend on qualified
healthcare expenses. The nice thing is that you can use money
as I mentioned tax-free for qualified healthcare expenses and we’ll talk a
little bit later about what those entail. If you choose you also have the
flexibility to use the funds for other reasons, however, it’s kind of like taking
money out of an IRA prematurely. If you choose to use the money in your account
for a non-qualified health care expenses expenses their taxes and penalties that
are associated along with that. So far as this account is concerned it is governed
by the IRS and the IRS does have very specific rules for eligibility. First and foremost are extending a very
rich tax benefit to you, so in order for you to be able to take
advantage of that text benefits they want to make sure that you’re
potentially going to incur additional out-of-pocket costs so first and
foremost they say you need to be covered by a qualified high deductible health
plan. A qualified high deductible health plan is really a plan that
combines the medical and prescription expenses towards one deductible and the
IRS also defines high-deductible plans as having a minimum deductible and they
also set a maximum out-of-pocket contributions. Fortunately the Consumer Directed HealthSelect plan that’s being offered to you qualifies as a high deductible health
plan. In addition to having to be covered by a
qualified high deductible health plan you also cannot be covered by any other
plan that isn’t a qualified high deductible health plan if you want to
open up the HSA. So you need to be careful that when you’re looking at your
benefits that you certainly if your spouse is going through an open
enrollment time want to make sure that you’re not covered by any other health
plans that your spouse may have that would disqualify you from being able to
open up an HSA if that’s something you want to do. Other types of
coverage that could impact your ability to open up an HSA would include Medicare,
coverage under Medicare. Now it’s ok if your spouse is covered by Medicare use
the account holder just cannot be covered by Medicare. In addition to that, you cannot be
covered by Tricare for Tricare for Life because these are all benefit programs
that would pay before your deductible is met. The IRS also stipulates that you
cannot be claimed as a dependent on someone else’s tax return and they also
say that you cannot be covered by an FSA program what we call a full
purpose FSA. However, there’s something referred to as
a limited purpose FSA that pays for only dental and vision expenses that is
considered compatible with an HSA. If you happen to be in the TexFlex health
care account today, and you want to enroll in the Consumer Driven HealthSelect plan, if you currently have a balance between $25 and
$500 after August 31, 2016 ERS will open up one of these limited
purpose flexible spending account on your behalf and those funds going
forward will then be allowed to be used towards dental and vision expenses only.
Also it’s important to know that you can’t be covered under your spouse’s FSA
either so when we talk about having other coverages not only can you not be covered under
spouses non-qualified health plan but you also can’t be covered under spouses
FSA. So if you’re thinking of moving to the HSA make sure that you’re not
covered under spouses FSA so they may want to that the defer on that type of
coverage. Dependent care FSA is have no impact on HSA so day care related
expenses are not impactful. You’re probably
wondering who Optum Bank is. Optum Bank is a subsidiary of UnitedHealthcare
Services and we will be the custodian of your health savings account. We are dedicated solely to healthcare
banking. This is all we do so we don’t do retail banking and we are actually the
leader in health savings account across the country. Well it says here that we have two
million account holders that’s actually just recently grown to close to three
million account holders. And some of the benefits of Optum Bank being owned by UnitedHealthcare is that you will have very easy access to your account
information. it’s the same places that you go to view
medical information so you’ll be able to actually access your account through myuhc.com/HS where you go for regular health care information. You’ll have
single sign on to Optum Bank. You’ll be able to get access easily to
your account information including balance, all your transactions, things like online bill pay. In addition
to that you’ll be sent reimbursement options. We have a debit card that you’ll
be sending access account information or account dollars. They also have the chance online to
invest in mutual funds once your account exceeds a certain dollar amount. So in order to start using the benefits
of the health savings account you actually have to go and open up a health
savings account. You can do that during the summer enrollment by completing the
application that is going to be provided to you in a link in your ERS account
online. So you click on that link, complete the application. Once that
application is complete Optum Bank is going to send you a welcome kit
typically comes within 7-10 days. It will include information on how to
access your account, eligible expenses, some banking disclosure information and
in addition to that you’re also going to receive a second mailing that contains
your debit card. Please be on the lookout for this mailing as it will come in a
plain white envelope for security purposes. So make sure that you don’t toss it
accidentally. In the event that you do lose your card or you need additional
cards they’re easy to order online or through customer service. There’s no charge for additional cards.
Something important to know is with the HSA, the effective date of when you’ll be
opening up this account for someone who has not had made to say previously is
September 1, 2016. That data is important because it means that that’s
the date going forward for which you can reimburse yourself for eligible health
care expenses on the tax free basis. So really what that means is that if you
are incurring expenses over the summer before September 1, those expenses
cannot be paid tax-free out of your HSA unless in the event that you actually
have an HSA today perhaps from another employer. So now that you’ve got your account open
you’re probably wondering how do I go about getting funds in my account, how
can I contribute, who can put money into my account. If you’re an active employee
you can make contributions to your account via regular payroll deductions. You also have the ability to make a
direct contribution to the account via check, via an online ACH from your
personal bank account over to your Optum HSA account or a rollover from a
prior HSA or an IRA. If you happen to be a retiree or a COBRA
participant those contributions since you don’t have payroll deductions your
contributions will made be made on a direct basis. Again, through the same
mechanisms check their online or roll over to the account. Keep in mind that even if you’re unable
to make a contribution through a pre-tax payroll deduction you can still get the tax benefits as
you claim any contributions you make to the account on your tax return at the
end of the year as above the line item deduction. So the tax benefits still remains. The
State of Texas is actually also going to be contributing to your account if
you’re an active employee or retiring not enrolled in Medicare. The States going to
contribute $45 per month for those of you who elect single coverage that
equates to $540 annually to help offset your deductible.
If you elect family coverage that will equate to $90 for a month or
$1,080 annually. It’s important to note that these
contributions in addition to any pre-tax payroll deductions or after tax deposits
that you make to your account all count towards the maximum contribution that
the IRS allows during the year. So it’s important that you know that its your
responsibility to make sure that your total deposits do not exceed the IRS
limits and we have some tools that will help support you in keeping track of
that. Speaking of contribution limits every
year the IRS sets a limit as far as how much you can contribute to the account
based upon what type of health insurance coverage you’ve selected. So what level
of health insurance whether you take the single or higher levels of covered. So
anything above an individual coverage is considered family. So for 2016 those limits are $3,350 an
individual for family $6,750. We just recently got the 2017 indexed
amounts and for individuals that limit is increasing $50 to $3,400 and the IRS is maintaining the family limit at the $6,750
where it was previously. So again, keep in mind this is inclusive of your
contributions and any contributions the state makes on your behalf. Also for those of you who are aged 55
and above you can actually make something we call a catch-up
contribution to your account. That catch-up contribution can be up to a
$1.000 and can be made annually for anyone 55 and above to help
you grow your account balances faster. I want to a real quick
go back I just wanted to make a comment this came back up and one of our
previous calls. I understand there’s a lot of
individuals that work for the state that have their spouses working for the state
as well. In that event while you could open up one account and use it for both
parties it’s in your best interest for each both
the both the individuals the employee and the spouse to open up and I guess
they’re both employees but to each open up their own account because that will
allow you to maximize the contribution that the state will be providing to you. So far as contributions are in and how
these contributions can be spent the IRS have a list of qualified expenses that
are eligible for tax free reimbursement. And probably to make this easier for
anyone who participated in health care flexible spending account in the past
this list mimics for the most part what you can reimburse yourself for from a
health care flexible spending account. So really it’s all the types of expenses
that your health plans don’t fully cover or perhaps don’t cover thought that
would include in expenses that are related to the subject to deductible or
that you pay coinsurance towards and then you know what encompass office
visits, specialist visits, emergency rooms, lab
and x-ray expenses. So all the medical expenses that are going to be you know
least partially covered by your health plan. In addition to that the HSA will also
reimburse you for dental and vision related expenses. So contact lenses,
glasses, orthodontics. Those are all considered eligible
expenses. Contact lens solutions and prescription
drugs are certainly eligible for reimbursement tax-free through your HSA.
What’s nice about the HSA is while the IRS does consider these individually
owned accounts you can use the money in your account for any of your legal tax
dependents. So it doesn’t matter if your spouse or
your children are covered under your health plan, you can still use the funds in your HSA
to pay for any of their out-of-pocket expenses. We’ll be providing you with a
list of qualified expenses on the Optum Bank website and I
believe there will also be a list that will be provided with your welcome kit. So in addition to be traditional
expenses that you may be used to being reimbursed for from a flexible spending
account, an HSA actually extends that list of qualified expenses to certain
types of premiums. The premiums include if you’re paying for health insurance
while you’re receiving unemployment benefits that’s an allowable expense for
the premiums. You can also pay your COBRA continuation
premium on a tax-free basis through your HSA. Thirdly you can pay for eligible
long-term care expenses and lastly Medicare premiums are considered
eligible for reimbursement. I know I personally in saving up funds
to offset my Medicare premiums when I get to that age. So not only is that your Medicare
premiums certainly any out-of-pocket expenses you might incur while you’re
covered by Medicare same holds true with COBRA. Keep in mind that Medigap or Medicare
supplement policies are not considered eligible for reimbursement on a premium
basis but certainly all your Medicare premiums B, C and D would certainly be
eligible. So now that you have opened up an
account you have funds in your account and know how to spend them, how do you have
access to those funds? We will be issuing to you a UnitedHealthcare savings
account debit Mastercard. This is the debit card that will come in
the mail to you and that plain white envelope. You can use it and point of service with
either a signature or pin number. You’ll actually self select your PIN
number when you activate your debit card. You can request additional cards for a
spouse or for dependents over the age of 18. Maybe have a student child that’s a
student college and you want to send a card to them, it’s as easy as just clicking on a link
which I’ll show you on the website or you can contact customer service and
there’s no additional cost for debit cards or additional cards. The debit
card can be used to point of service that your doctor’s office. It can be used at
an ATM to withdraw cash to reimburse yourself for an out-of-pocket expense. Something I want to point out as
always make sure you process and make sure that your claim has been submitted
to UnitedHealthcare first so that they’re applying any out-of-pocket
expense you have to your deductible and you can take advantage of all the
discounts at United has negotiated for you and then use your debit card to pay
for your expense once you know what your true liability is. While we provided a
debit card, there’s also other ways to access funds
in your account. You can request a check book we send out checkbooks with 25
checks and those are available upon request. We also have a free online bill pay that
you can access online where you can set up one time or recurring payments to a
provider and it stores your data so that if you want to set up a payment to your
orthodontist that payment information will remain in the system until you
choose to remove it. What’s unique about these HSAs is
that they are different from a flexible spending account in as much as the
relationship and responsibility is not between you and a third party. It’s between
you and the IRS. So, Optum Bank is not going to be auditing any requests for reimbursement since the
funds are yours and you make the decision on how to spend them. The only difference is the tax treatment
of those expenses. So if you use money for qualified healthcare expenses you
received the full tax benefits of tax exemption. If you choose to use it for
non qualified expenses you’re subject to taxes and penalties. So the decision
there is between you and the IRS. So you just need to make sure that you keep
your receipt so that the IRS ever audits you, you have the
documentation to prove that the expense was qualified if indeed you remove those
funds on tax-free basis. Somebody asked how long they should keep
the receipt and I always say that the IRS has a seven year threshold and I
would say that would be seven years from the date that you request for be
reimbursement. And that kind of brings up another point is that the nice thing
about an HSA is that you do not have to request for reimbursement in the year
that you’ve actually incurred the expense. Since this account can be used
for current and future health care expenses you can actually reimburse
yourself years down the road for an expense that you would have today or I
should say and expense you have any time after September 1, and you can
reimburse yourself years into the future for that expense. You don’t have to reimburse in the same
year that that expenses incurred. So this is just a snapshot of probably
a view that you’re familiar with,. Going to myUHC.com to check healthcare
information to look up doctors. Well this is where you also access your
HSA. As you can see there’s the bottom box it says Optum
Bank HSA so it’s a tab that you can click on it immediately single signs
you over to Optum Bank where you can view all your account information. From there, without
needing additional passwords, you’ll get into your Optum Bank account. It will
provide basic information for you. Some of the most requested information our
account holders asked. Typically they want to know what their balance is. Not
only what’s available in cash they also want to know what their
investments, that’s right up front. Remember I said that you could order a
debit card if you were interested or additional debit cards and simple to do
there’s a button there right in the middle that says need additional cards?
You just click on that. If you need to pay a bill, click on that. So some of our most
commonly requested items are pulled right up front. And we talked previously
about the responsibility to keep track of how much you’re contributing to the
account. Optum Bank will actually track a lot of that for you. We will take an information to know
whether you’re covered by an individual policy or family policy in the event of…
regardless of which event that is we will track to the IRS thresholds for
then it for that particular coverage level. And will also take into
consideration your age. You’ll be able to see where you’re tracking to not only
for this year, this coming year, but once you move into the future years you’ll be
able to see the prior year as well so it will help support you in tracking to
account maximums. So there are a lot of tools and resources that we’re going to
provide to you to really help support you in accessing your account
information and understanding the best way to utilize and lever your HSA
not only for current health care expenses but for the future. Today certainly the website provides a
host of information but, you also will have access to your account information
via mobile applications. Anyone using the help for me mobile app
through united healthcare today who elects the HSA we’ll have an additional
tab on their mobile device that says accounts and you’ll be able to look in
and see your account balance at a moment’s notice. You actually can even pay claims from
your HSA through your mobile device. In addition to that, the Optum Bank
website provides a complete mobile experience when accessed on a direct
basis and it’s optimized for the device that you’re on so whether you’re
accessing the site from your tablet or from your iPhone or Android, it’s easy to
use, easy to maneuver and can access account information even investment
information from your mobile device. Some of the tools that United provides
to help you in this making decisions about how you spend your health care dollars include them my
health care cost estimator tool which will help you figure out the cost of a
procedure or course of treatment And what’s nice is every time you utilize
that calculator your HSA account balance will be included in the calculation
information so that you always know how much money you have available to pay for
a particular expense. From a communications perspective we provide a
host of self-guided tours and videos. These are quick tutorials that are
provided online. Some are as short as two minute answers to questions others our
HSA 101 or how to invest and those are available online through my myUCH so that you can actually look at that information at a later point in
time. You can share with your family if they want to learn more about how these
accounts work it’s always there and available for you. I want to point
out a tool down in the lower left-hand corner that I find extremely valuable. It’s called our health savings check up
calculator and is actually accessible from the home screen of Optum Bank. It’s a calculator that helps you
determine how much you’re going to need to save to pay for health care expenses
in retirement. And it’s based on not only when you expect to retire, how much money you currently have in
your HSA, it takes a look at what your health conditions are and also takes
into consideration what Medicare will pay and doesn’t projection as to how
much they feel you’re going to need based on different conditions. It’s a great tool to help you do
planning relative to retirement planning. Because most of your 401k calculators
only take into account living expenses and don’t incorporate health care related
expenses which can certainly be a big cost in retirement. So I encourage you all to take advantage
of that. We talked about the contribution tracker and finally I want to just touch
really quickly on something called our Receipt vault. As I mentioned, it’s your
responsibility to keep track of your expenses and to maintain your receipts
in case you’re ever audited by the IRS. We have a great way to do that. We have
an electronic storage capability where you can either scan or take a picture
with your mobile phone to record a receipt or an explanation of benefits to
show that you’ve had an out-of-pocket expense and you can tuck it away in
various files online. You can decide how you want to organize that information. Is
by type of expenses, is it by member within your family. You can also annotize that list and for
each expense that you import you can say gee I paid it from my HSA or no I
haven’t yet maybe it’s something you’re going to save to reimburse yourself or
in the future. So you can take various notes and
identify who it was for. So it’s a really nice tool to help you
manage your receipts on a long-term basis so you can store those sure beats
the shoebox I’ve been using for years. I’m working through the process
of taking all my receipts and electronically transfer those to a more
permanent storage. So I’m going to at this juncture turn the call back over so
we can talk a little bit about a wrap-up and customer service and make sure
you’re on your way to making your elections and have any information you
need to move forward. Thank you Kristi and we’re going to go
ahead and turn it over to Pat to talk about some of our healthSelect
resources. Thank you. With the Consumer Directed
HealthSelect plan you will still have access to the dedicated customer service
team in San Antonio. To contact the team you would call customer service at
1 (866) 336-9371 or you can also dial tty 711 for the
hearing impaired. It will be staffed with trained health
advisors to assist you with questions or HSA balance and enrollment inquiries. They will also be able to transfer you
to Optum Bank for detailed transaction assistance. The customer service center is available
Monday through Friday from 8 a.m. – 7 p.m. central standard time and Saturdays
from 7 a.m. to 3 p.m. central standard time. The option to call Optum Bank directly you can call 1 (800) 791-9361. The number will be listed on the back of your debit card. We also have two dedicated web sites
available for use as well. www.healthselectiveoftexas.com/CDHS for a general plan information on the Consumer Directed HealthSelect plan
and also your personal account, www.myUHC.com/hs so that you can access your
personal account information as well. Some of the final considerations if
you’re thinking of enrolling in Consumer Directed HealthSelect there’s
a few things to consider. Because Consumer Directed HealthSelect
is comprised of a high deductible health plan your out-of-pocket costs may be
much higher than what you pay under Consumer Directed HealthSelect or an HMO. As with non preventive medical services,
prescription drugs do not have co-payments and will be subject to the
deductible. That means you pay the full cost of
prescription drugs until you meet the deductible. After that you’ll pay 20% of
the full cost at a network pharmacy. You’ll have access only to funds that
are actually in your health savings account. Not any funds that are pledged to be
deposited in the future because the state HSA confirmation will be made in
monthly payments starting on October 1 for your September pay period. It might
be a while before much has accumulated in your account depending on what you contribute when.
You will have access to the same network of providers as with HealthSelect of
Texas. Remember to use network providers to
lower what you have to pay out of pocket. Preventive care services are covered at
a 100% and not subject to the deductable or coinsurance when you use
an in-network provider. If you use a non-network provider for preventive care
services coverages at the out-of-network coinsurance after satisfying that
adjustable. If you enroll in Consumer Directed HealthSelect on Setember 1, 2016, any qualified out-of-pocket cost you’ve paid in HealthSelect of Texas since January 1, 2016 will be carried over to the
new plan and apply to the out-of-pocket maximum and deductible if applicable. However, because of the Consumer Directed HealthSelect plan has a deductible, you will need to satisfy the fully
deductible before the coinsurance applies. This applies to both non preventive
medical costs and prescription drug costs. On January 1, 2017, this
deductable and your out-of-pocket maximum will start over. The deductible
amount will vary depending upon whether you have individual or family coverage.
For individual coverage only the individual deductible amount will apply.
For family coverage only the family deductible will apply. The individual
deductible is not applicable. The family deductible could be satisfied
by one person or several people in your family. Consumer Directed HealthSelect
does not require you to designate a primary care physician and it does not
require you to obtain a referral to see a specialist. If you are eligible for Medicare even if
you haven’t enrolled yet you cannot enroll in the Consumer Directed HealthSelect plan. Thank you Pat and with that we are going
to open it up for questions so if you look on the look on the right hand box
you’ll see a little box for questions. If you just want to enter them in there I
will give you all a couple minutes to do that and then we’ll read the questions
out loud and one of our specialists will answer your question. It looks like
our first question is are prevented cost applied to be deductible? No they would not be applicable to the
deductible because preventive care as long as there are rendered by an
in-network provider would be covered at a 100%.
Only non preventive care such as the flu, some type of office visit or other
than preventive care that would apply to the deductible. Our next question. I’m medicare-eligible
but not yet on medicare so I’m not yet eligible for this plan correct and on
and so for this even if even if you’re
actively employed or if you’re retired, if you’re eligible for Medicare
you’re not eligible for this plan. Pat if you want to speak
more on that? That is correct if you are medicare-eligible even if you have not
enrolled you would not be able to enroll in this particular Consumer Directed HealthSelect plan. Thank you and looks like we don’t have
any other questions. So while we’re waiting for other questions to come
in I just wanted to go ahead and point
out some of our some of the resources that we have on the website. If
you go to healthselectoftexas.com. You can go to Consumer Directed HealthSelect and we mentioned earlier on the presentation that you can
look at the plan cost estimator. If you go under medical benefits of
Consumer Directed HealthSelect on the Unitedhealthcare websites, you can look
at the plan cost estimator. Looks like we have another question. If
preventive care is rendered by a non-network provider than the cost I pay
out of pocket would apply to the deductible, correct? That is correct. If you receive a preventive care
services from a non-network or out-of-network provider, what you pay out of pocket would apply
to the deductible, but please note that the out-of-network deductible is $4,200
for an individual and $8,400 for a family coverage. It is important to note
that there are those separate deductibles there’s one for the out-of-
network and one for in-network. Correct. So if anybody is interested in joining this plan and, I encourage you to use my plan cost estimator that
UnitedHealthcare just put on their website. You’ll be able to enter an
information about your health needs and your
finances and it already factors in the health savings account
contribution. So you can put your your family members
names and ages and any other type of medical conditions that they may have. We have a question. If I declare
for a family do I have can meet the out-of-pocket maximum
amount per family before the plan pays 100%. Yes.
If you have family coverage, you have to meet that whole deductible. So
for an in-network that’s $4,200. So that is the amount
that you have to pay out-of-pocket and the plan wouldn’t pay 100% for in-network services, you will
be responsible for 20% on the health plan will be responsible for
80%. For anything for a preventive care if you just go for your
annual checkup that’s going be covered at a 100% as long as you see an in-network provider. And please note that the
out-of-pocket maximum that you would need to meet for family coverage before
the plan page that a 100% would need to be $12,900 for family. Thank you
for clarifying that Pat. So, yes that’s correct. After you meet that
deductible and the plan starts paying coinsurance and you’ve met that out of
pocket maximum then yes, the plan does pay for 100%. Ok and so while we’re waiting I will
also i also want to show you where we have we have other places on our website
that have they have resources. We’ve recently added… if you go under employees you can even go into retirees, too. Just
go under health benefits and then Consumer Directed HealthSelect. You
can watch a video that on that ERS helped produce. And then you
can also find information about the high deductible health plan and the health
savings account. We also have a number of articles under
employee news that you’re welcome to check out.
There’s fact sheets and also if you’re a retiree or for any other type of
participant you want to look under that appropriate tab I especially for the health savings
account because it works a little differently for retirees and other
participants. I and it looks like we have one more question. What are the
premiums for the plant this plan? I assume they’re found on the website. Yes, they are. So, if you look on the page
that I’m on right now, you go to rates. You have to look on the left-hand
navigation and you can use this. You can use our rates calculator. Just click on
September 1, 2016 and you can kind of navigate through here. Your other option is from sometimes
compatibility settings on your on some people of machines won’t always allow
the calculator to work, so we also have the information in a document format. So
as you can see here just looking on this document you’ll see that for example you
plus spouse on your Consumer Directed HealthSelect is $318.32 and that includes the health savings account contribution and
then just in comparison you can see HealthSelect of Texas for you plus spouse
and it’s $353.68. Ok everyone, I thank you for
joining us this morning. If you have other questions you can always feel free
to send them our way. The wrap-up email that should be sent to you will
give you a reply email you can ask us question there. You can always call
UnitedHealthcare. You can call Caremark. You can also talk
to Optum Bank if you have any specific questions about the plan. I thank you
and have a great day.

Leave a Reply

Your email address will not be published. Required fields are marked *