2019 Health Insurance Benefits Memo | St. Lawrence University

2019 Health Insurance Benefits Memo

November 1, 2018

It’s the time of year when we communicate important employee benefit information to faculty and staff for the upcoming calendar year.  We realize there is an enormous amount of employee benefit information contained in this email. However, we hope you take the time to read through carefully to ensure that you make informed employee benefit decisions that may affect you and your family.

This memo will cover the following:

  • Online Benefit Portal for Open Enrollment Period
  • Open Enrollment Meetings on Campus
  • Health4EDU Update
  • Health Insurance Updates -Premiums for 2019 & Health Insurance Plan Design Changes 
  • Dental Insurance  & Vision Insurance
  • Change to MyIgniteHealth Wellness Program Reimbursement Schedule
  • Annual Maximum Contributions Limits for 2019
    • TIAA-CREF Retirement Plan
    • Flexible Spending Plans (FSA)
    • Health Savings Account (HSA)
  • Employee Benefit Reminders

Online Benefit Portal for Open Enrollment: November 5 thru November 21, 2018

Open enrollment is your annual opportunity to make changes to your benefit plans which will become effective January 2019.  If you would like to make changes to your benefits (e.g. add a dependent to your health plan, enroll in dental insurance coverage, terminate coverage, enroll in voluntary life insurance coverage, etc.) you may do so beginning November 5 thru November 21 via the online benefit portal at www.enrollingiseasy.com. REMINDER: you must re-enroll for a flexible spending plan each year….participation in calendar year 2018 does not auto enroll you for a flexible spending plan in 2019. There was some confusion last year where employees thought because they participated in a flexible spending plan in 2017, their enrollment would automatically continue into 2018.  That is not the case…..employees must enroll in new flexible spending plan each calendar year.

Open Enrollment Meetings on Campus

We invite you to attend one of six open enrollment meetings offered by the Human Resources staff in collaboration with the University’s benefits consultant, Relph Benefit Advisors, to review changes to your benefits, outlined in this email.  It’s also a perfect time to ask questions and reacquaint yourself with your employee benefit package.  All meetings will be held in Griffiths 123 on the following dates and times:

November 8, 2018                 November 9, 2018  

8:00 am                                   9:00 am

1:00 pm                                   Noon

4:30 pm                                   3:00 pm

Open enrollment meetings will last approximately one hour depending on audience questions. Facilitators are happy to stay late to answer any individual personal benefit related questions.

Health4EDU Update

St. Lawrence is concluding its fifth year in the self-insured Health4EDU healthcare consortium arrangement with Excellus BlueCross and BlueShield as the third party administrator. The consortium is pleased to report growth in membership in 2018. In addition to Colgate University, Hamilton College, Hobart and William Smith Colleges, Le Moyne College, and St. Lawrence University, new members joining in 2018 include Clarkson University, Alfred University, and Vassar College. 

The intent of the consortium and the health plan design changes, to both the Copay & Deductible (Hybrid) and High Deductible plans noted below, is to stabilize health plan costs and reduce inflationary trends over time.  The plan changes also achieve a better balance of actuarial or plan value and keep premium increases at a minimum for calendar year 2019, both of which are University goals this renewal.

Health Insurance Updates

Health Insurance Plan Design Changes for 2019

Hybrid Plan- The annual medical out-of-pocket maximum (OPM) limits the amount of expenses incurred by members of the plan and includes copays, deductibles and coinsurance paid by members for their medical services.  In 2019, the OPM for in-network medical services will increase from $1,500 to $1,750 for single, $3,000 to $3,500 for a policy with two people enrolled and $4,500 to $5,250 for policy with three or more enrolled.

All copays, deductibles and coinsurance percentages will stay the same from 2018 to 2019.

Example 1:  Susan is enrolled for family coverage. Susan is scheduled for outpatient surgery in January 2019 at CPH (an in-network provider). The hospital charge will be $9,000 for the procedure.  Susan pays the first $500 for a deductible. Susan also pays 20% of the remaining charge; $8,500 x 20% is $1,700 coinsurance. Because $500 + $1,700 exceeds the OPM, Susan pays just $1,750 and the plan pays $7,250.  Additionally, the plan will pay 100% of the in-network medical charges for the remainder of the calendar year as Susan has met her OPM for the plan year after paying the hospital bill. Once Susan and two more members of her family each reach the OPM, the plan will pay 100% of medical expenses for the entire family.

HDHP- There are two changes to the high deductible plan for 2019.  First, members that meet the deductible will now pay 10% coinsurance for in-network medical services after the deductible.  Second, the out-of-pocket maximum (OPM) that limits the amount of expenses incurred by members for in-network medical services and pharmacy through Excellus is decreasing from $5,500 to $4,600 on single and from $11,000 to $9,200 on all tiers with employee plus dependent(s).  Continued from 2018, members that exceed the deductible will also pay prescription copays of $5/$35/$70 after the deductible.  If a member reaches the OPM, the plan will pay all prescription and in-network medical expenses for the remainder of the year.

Example 1:  Brian is enrolled for single coverage.  He pays 100% of all his prescription drug charges until he meets his $2600 annual deductible.  Once the deductible has been met, he begins to pay co-pays for his medications ($5 tier 1, $35 tier 2 and $70 tier three).  Brian also has an emergency room visit with total charges of $1,500.  Because Brian has met the deductible he must now pay 10% coinsurance, $1,500 x 10% is $150.  Once Brian’s prescription drug co-pays and coinsurance for medical services reach $2,000 in out-of-pocket cost, the Plan will then pay 100% of his prescription and in-network medical for the remainder of the calendar year. In this example, Brian’s total OPM is $4600; a decrease of $900 from 2018.  Brian uses the money in his HSA to pay for his out of pocket medical and prescription drug expenses.

Example 2: Tim is enrolled for family coverage. On January 2, he has an emergency appendectomy at Claxton Hepburn Hospital (an in-network provider). The hospital charge is $12,000.  Tim pays the first $5,200 for a deductible and then 10% coinsurance on the remainder; 12,000 - 5,200 is 6,800 x 10% is $680.  Tim pays $5,880 (5,200+680) total and the plan pays $6,120.  For the remainder of the year, Tim and his family will pay 10% of in-network medical expenses and prescription copays of $5/35/70.  If Tim and his family’s out-of-pocket expenses reach $9,200, all in-network medical and pharmacy expenses will be covered by the plan. Tim uses the money in his HSA to pay for medical and prescription drug expenses incurred by he and his family.

Premiums for 2019

The 2019 premiums for each coverage tier are shown in the tables below.  The rates reflect an overall 1% rate increase for the Co-Pay & Deductible (Hybrid) Plan and a 3% rate increase in the High Deductible Health Plan (HDHP), as recommended by our third-party actuary and benefit advisor and accepted by the University.  The plan design changes (see below for details) were necessary to avoid premium increases of approximately 9%.

2019 Monthly Co-Pay & Deductible (Hybrid) Plan

 

Coverage Tier

Total Cost

Employer Share

Employee Share

OPM (Medical)*

Single

696.72

634.08

62.64

1750.00

Employee + Child(ren)  

1393.52

947.6

445.92

3,500.00/5,250.00 

2 Employees + Child(ren)  

1686.16

1146.65

539.52

5250.00

Employee + Spouse  

1707.04

1160.8

546.24

3500.00

Family  

1881.28

1279.28

602

5250.00

 

*in-network medical services

     

 

2019 Monthly HDHP Plan

 

Coverage Tier

Total Cost

Employer Share

Employee Share

OPM (Medical & Prescription)*

Single  

558.56

508.32

50.24

4600.00

Employee + Child(ren)  

1117.12

759.68

357.44

9200.00

2 Employees + Child(ren)  

1351.76

919.2

432.56

9200.00

Employee + Spouse  

1368.48

930.64

437.84

9200.00

Family

1508.16

1025.6

482.56

9200.00

*in-network medical services and prescription drug expenses                            

Dental Insurance Premiums Remain Unchanged

The Guardian dental plan will have no changes to the cost or coverage levels for 2019.  Two plans are available to choose from, the Base Plan and the Buy-Up Plan.  Benefit summaries are available on the benefits portal and the rates are as follows:

Dental Base (Low) Plan

 

Dental Buy-Up (High) Plan

Tier

Monthly

Cost

 

Tier

Monthly

Cost

Single  

37.64

 

Single  

54.04

Employee & Child(ren)

96.80

 

Employee & Child(ren)

130.74

Employee + Spouse

81.08

 

Employee + Spouse

108.98

Family  

140.16

 

Family  

188.18

Vision Insurance Coverage

The Vision plan was implemented in January 2018. The provider is The Guardian and the network is called the Davis Vision Network.  The University received a two-year rate guarantee last year, therefore, the rates will remain unchanged for 2019. Participants in the plan can receive an eye exam every year for a $10 copayment, lenses for glasses or contacts lenses each year for a $25 copayment and frames every two years. Please consult the vision summary in the Reference Center of the online benefits portal or your optometrist for specific costs.  Premiums are as follows:

Vision Plan

Monthly

Cost

Single

7.20

Employees + Child (ren)

12.34

Employee + Spouse  

12.10

Family  

19.54

Change to MyIgniteHealth Wellness Program Reimbursement Schedule

My IgniteHealth Wellness Program, implemented in January 2018, continues for 2019. Employees and their spouses/partners who are enrolled in the University’s health plan can earn points (each point is worth $1) while participating in the program.  Employees have the potential for earning $400 in a year and spouses/domestic partners can earn up to $200 per calendar year. Participants may earn points by participating in challenges, reporting their own individual fitness activities (e.g. walking, yoga swimming, etc.), participating in any SLU health initiative sponsored by the SLU Health & Wellness Committee (e.g. scheduling a biometric screening, participating in the walking program, etc.).  Points may also be earned by taking the online health risk assessment or scheduling an annual checkup….the list is endless.  Participation in the SLU IgniteHealth Wellness Program is confidential.  Your individual information is not reported to the University.

Change for 2019: MyIgniteHealth, not the University, will be processing reimbursements twice each year.  For those electing semi-annual reimbursements, you will receive a payment in July for points earned January 1 thru June 30 and in January for points earned July 1 thru December 31. For those electing annual payments you will receive a payment in January for points earned during the year, January 1 – December 31.

The IRS has released the Annual Maximum Contributions Limits for 2019

TIAA-CREF Retirement Plan

The IRS has announced that Plan contribution limits for calendar year 2019 of $19,000, an increase of $500 from calendar year 2018.  The catch-up contribution for individuals age 50 or over remains unchanged at $6,000.  Individuals with 15 or more years of service at St. Lawrence may, in certain circumstances, be able to contribute up to another $3,000 in 2019 under a special catch up provision ($15,000 lifetime cap). Salary Reduction Agreements to change your Supplemental Retirement Annuity contributions are available in the Human Resources Office.

Flexible Spending Plans (FSA)

The IRS has announced that the calendar year 2019 annual maximum pre-tax election amount for medical care reimbursement accounts will increase $50 from $2,650 to $2,700. The annual limit remains at $5,000 for dependent care (childcare) reimbursement accounts.

A reminder to current FSA Participants: you may carry over up to $500 of unused 2018 health FSA election to pay claims incurred in the 2019 plan year.  Additionally, you must re-enroll for a flexible spending plan each year….participation in calendar year 2018 does not auto-enroll you for a flexible spending account in 2019.

Health Savings Account (HSA) for those enrolled in the High Deductible Health Plan (HDHP)

The IRS has announced HSA plan contribution limits for calendar year 2019.  For those enrolled for single coverage the annual limit is increasing from $3,450 to $3,500. For those in family coverage the annual limit is increasing from $6,900 to $7,000.  There is a special “catch up” contribution of $1,000 for those participants who are at least age 55.   

Unlike the Flexible Spending Account (mentioned above), both participation and annual balances do roll over into the next calendar year.  If you are content with your contribution, you do not need to do anything.  However, if you wish to increase or decrease your contribution, you will need to change the election in the benefits portal. Please note that the University’s contribution to your HSA for calendar year 2019 will remain unchanged.

Employee Benefit Reminders

Voluntary Life Insurance Benefits for Employees, Spouses and Dependents

Beginning January 1, 2018 employees had the option of purchasing additional insurance coverage in blocks of $25,000 to be paid through payroll deduction. Employees may also purchase life insurance coverage for a spouse and/or dependent children.  With this benefit, the guaranteed issue coverage is $200,000 for the employee, $50,000 for spouses and $10,000 for children.  Employees electing coverage levels higher than the guarantee issue amount must submit an evidence of insurability form during open enrollment.  If you did not enroll when first eligible for coverage), new elections may require Evidence of Insurability. Premiums are based on the employee’s age and increase every five years. When making your selections in the benefits portal, the contribution amount will be calculated for you automatically.  

Telemedicine

Excellus BlueCross BlueShield partnered with MDLive to provide you with a faster way to receive non-urgent healthcare. You may visit a board-certified doctor by video conference (smartphone, tablet or computer) or phone right from your home, office, or while traveling, for nonemergency medical conditions.  Telemedicine benefits are available 24/7/365.  Common conditions treated via telemedicine are allergies, ear infections, pink eye, sinus infections, rashes, respiratory infections, urinary tract infections, pediatric care and more.  Once a diagnosis has been made the doctor can send the prescription, if any, to your pharmacy. The full cost of the telemedicine visit is $40.00.  For those enrolled in the Hybrid health plan the copayment is $10.00. The cost is $40.00 for those enrolled in the HDHP. Payment is expected at the time of the telemedicine visit by credit/debit, flex or health savings account cards. Learn more by attending one of the open enrollment meetings (see above). 

Benefits Solver: Online Benefits Portal

Changes to your benefits are made online via the University’s online benefits portal at www.enrollingiseasy.com.  Here is the link to an informational sheet to create online credentials in case you’ve never utilized Benefits Solver.  At the very least, you should log on and update your life insurance beneficiary. 

Please feel free to contact Debra Mousaw at x5597 or Terri Burdick at x5833 in the Human Resources Office with any benefit related questions.   

Thank you.

Salary & Benefits Committee Members:

Brian Chezum, Economics
Jim DeFranza, Mathematics 
Colleen Manley, Human Resources
Debra Mousaw, Human Resources
Ivan Ramler, Mathematics, Computer Science, and Statistics
Paula Sturge, Finance
Mike Temkin, Biology