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Longleaf Hospice Benefits Presentation

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Title: Longleaf Hospice Benefits Presentation


1
2015-2016 Elections Deadline30 Days Prior
to the Effective Date Presented By Brenda
Sanford, PHR, CHRS Director of Client
Management Rodney Rich Company
2
  • IRS Qualifying Events to Make Changes
  • Notification within 30 Days Required
  • Birth
  • Adoption
  • Marriage
  • Divorce
  • Loss of Job
  • Reduction of Hours
  • Death

3
  • Employee Benefit Package

Aetna ? 2 Plan Options FlexCare ?
TeleMedicine MetLife ? Dental ? Vision ?
Basic Life (Employer Paid) ? Short-Term
Disability (Employer Paid) ? Voluntary Life No
New Elections/Increases ? Voluntary Long-Term
Disability AFLAC ? Cancer ? Hospital
Indemnity ? Critical Care ? Accident ?
Short-Term Disability
4
HealthCare Reform You
Names for the Law Patient Protection and Affordable Care Act -- PPACA Affordable Care Act HealthCare Reform Obamacare
Employer Impact Reinsurance Fees - 5.25 Per Covered Member Per Month Dental, Medical, Vision, PCORI Fees - 2.00 Per Covered Member Limits on Deductibles, Pre-existing Removed, Minimum Essential Added Mineral Plan Options
Employee Impact Individual Mandate Credible Coverage Employer Coverage, Spouse Coverage, TriCare, Medicare, Veterans Coverage, Healthy Kids Tax Penalty for Uninsured Per Uninsured Person Exchanges, Subsidies, Medicaid
5
Benefit Summary
  Aetna OAMC 3000 Choice Plan Aetna OAMC 3000 Choice Plan Aetna OAMC 4000 EQHD Plan Aetna OAMC 4000 EQHD Plan
Services In-Network Benefits Below In-Network Benefits Below In-Network Benefits Below In-Network Benefits Below
Physician Visit Specialist Visit Urgent Care Visit 30 Copay Deductible 60 Co-pay Deductible 75 Co-pay 30 Copay Deductible 60 Co-pay Deductible 75 Co-pay Deductible 25 Co-pay Deductible 50 Co-pay Deductible 75 Co-pay Deductible 25 Co-pay Deductible 50 Co-pay Deductible 75 Co-pay
Preventive Care Covered 100 Covered 100 Covered 100 Covered 100
Emergency Room Deductible 500 Co-pay Deductible 500 Co-pay Deductible 300 Co-pay Deductible 300 Co-pay
Hospitalization Hospitalization Hospitalization Hospitalization Hospitalization
Inpatient Outpatient Deductible 250 Co-pay Deductible 250 Co-pay Deductible 250 Co-pay Deductible 250 Co-pay Deductible Deductible Deductible Deductible
Diagnostics Independent Testing Center Diagnostics Independent Testing Center Diagnostics Independent Testing Center Diagnostics Independent Testing Center Diagnostics Independent Testing Center
X-rays Advanced Imaging Lab   Deductible 60 Co-pay Deductible 250 Co-pay 60 Co-pay   Deductible 60 Co-pay Deductible 250 Co-pay 60 Co-pay   Deductible Deductible 50 Co-pay Deductible Deductible Deductible 50 Co-pay Deductible
Financial Features Deductible Out-of-Pocket Max Deductible Out-of-Pocket Max
Individual Family 3,000 6000 6,500 13,000 4,000 8,000 6,450 12,900
Coinsurance 0 0 0 0
Prescription Coverage Prescription Coverage Prescription Coverage Prescription Coverage Prescription Coverage
-Generic -Brand Name -Non Preferred -Specialty 3 / 15 Deductible 45 Deductible 75 Deductible 30 Coinsurance to 250 Max 3 / 15 Deductible 45 Deductible 75 Deductible 30 Coinsurance to 250 Max Deductible 3 / 15 Deductible 35 Deductible 65 Deductible 30 Coinsurance to 250 Max Deductible 3 / 15 Deductible 35 Deductible 65 Deductible 30 Coinsurance to 250 Max
Cost Per Pay Period Cost Per Pay Period Cost Per Pay Period Cost Per Pay Period Cost Per Pay Period
Employee 61.32 61.32 54.00 54.00
Employee Spouse/Partner 232.03 232.03 215.13 215.13
Employee Child(ren) 187.34 187.34 173.26 173.26
Family 316.64 316.64 294.12 294.12
6
Teladoc Telehealth Solutions
 
Employee Cost per Pay Period 4.15
7
Flexible Spending Account (MEDFSA, DEPFSA)
Longleaf Hospice will continue to provide you the
opportunity to pay for out-of-pocket medical,
dental, vision, and dependent care expenses with
pre-tax dollars through the Flexible Spending
Account. You can save approximately 25 of each
dollar spent on the expenses when you participate
in the FSA. Health Reimbursement Account
(MEDFSA) expenses are limited to 2,500 per plan
year Dependent Care Reimbursement Account
(DEPFSA) expenses are limited to 5,000 per plan
year. Beginning January 1, 2016, you will be
able to fund 2,500 in MEDFSA. You must
re-enroll in the plan January 1, 2016. Longleaf
Hospice will again pay the 12 annual fee for you
to utilize the take care card.
8
Dental Coverage
  The Deductible and Calendar Year Max are from January 1 December 31 The Deductible and Calendar Year Max are from January 1 December 31
Benefit Maximum 1,750 In-Network and Out-of-Network Calendar Year Benefit Per Covered Member 1,750 In-Network and Out-of-Network Calendar Year Benefit Per Covered Member
Deductible 50 Individual / 150 Family Maximum Basic and Major services only In and Out-of-Network 50 Individual / 150 Family Maximum Basic and Major services only In and Out-of-Network
Preventive 100 In-Network / 100 Out-of-Network Exams Cleanings X-Rays Fluoride Treatment (to age 19) Sealants (to age 16) 100 In-Network / 100 Out-of-Network Exams Cleanings X-Rays Fluoride Treatment (to age 19) Sealants (to age 16)
Basic Restorative 80 In-Network / 80 Out-of-Network Perio Maintenance Procedure Space Maintainers Oral Cancer Screenings Fillings General Anesthesia Root Canal Perio Surgery Scaling Root Planing Simple Complex Extractions 80 In-Network / 80 Out-of-Network Perio Maintenance Procedure Space Maintainers Oral Cancer Screenings Fillings General Anesthesia Root Canal Perio Surgery Scaling Root Planing Simple Complex Extractions
Major Restorative 50 In-Network / 50 Out-of-Network Bridges Dentures Implants Single Crowns Inlays/Onlays Veneers 50 In-Network / 50 Out-of-Network Bridges Dentures Implants Single Crowns Inlays/Onlays Veneers
Orthodontia 50 In-Network / 50 Out-of-Network 1,000 Lifetime Maximum for children (less than age 19) 50 In-Network / 50 Out-of-Network 1,000 Lifetime Maximum for children (less than age 19)
Cost Per Pay Period (26) Employee Only 6.77 Employee Child(ren) 15.37
Cost Per Pay Period (26) Employee Spouse/Partner 12.95 Family 23.31


9
Vision Coverage
Services Frequencies The Benefits Are Based on a 12 Month Cycle from your initial service. The Benefits Are Based on a 12 Month Cycle from your initial service.
Maximum Allowances In-Network (Member Costs) Non-Network (Member Reimbursement)
   Eye Exam 10 Copay Up to 45
   Lenses (every 12 months)    Lenses (every 12 months)    Lenses (every 12 months)
        Single 25 Copay Up to 30
        Bifocal 25 Copay Up to 50
        Trifocal 25 Copay Up to 65
        Lenticular 25 Copay Up to 100
        Standard Progressive Lens 55 Copay Up to 50
Contact Lenses (every 12 months)  Contact Lenses (every 12 months)  Contact Lenses (every 12 months) 
      Medically Necessary Paid in full after 25 Copay Up to 200
      Elective 130 Allowance Up to 105
    Frames (every 24 months) 130 Allowance, 20 off balance over 140 Up to 70
Cost Per Pay Period (26) Employee 1.26 Employee Child(ren) 2.99
Cost Per Pay Period (26) Employee Spouse/Partner 3.53 Family 4.93
10
Basic Life InsuranceEmployer Paid
Employee Life Insurance with ADD Employee Life Insurance with ADD
Employee Class Definition Benefit Amount
Employees under Age 65 (1X) your basic salary up to a maximum of 100,000
Employee 65 - 69 35 benefit reduction
Employees 70 An additional 15 benefit reduction
11
Voluntary Life Insurance
Voluntary Life Insurance New Elections or Increases Require Medical Underwriting Voluntary Life Insurance New Elections or Increases Require Medical Underwriting Voluntary Life Insurance New Elections or Increases Require Medical Underwriting Voluntary Life Insurance New Elections or Increases Require Medical Underwriting
  Employee Spouse/Partner Child(ren)
Minimum Coverage 10,000 5,000 1,000
Maximum Coverage 500,000 100,000Not to exceed 50 of employee benefit 10,000 Not to exceed 50 of employee benefit
Guarantee Issue New Hires Only 100,000 25,000 10,000
12
Disability Benefits
  Short-Term Disability Long-Term Disability
Elimination Period 14 Days 90 Days
Benefits Duration 11 Weeks 24 Months Own Occupation/Age 65 Any Occupation
Benefit Percentage 50 50
Maximum Benefit 1,500 Weekly 5,000 Monthly
Pre-Existing Conditions Apply None 6 months prior / 12 months insured
Cost 100 Employer Paid 25 Employer Paid
13
AFLAC
AFLAC Benefits Available AFLAC Benefits Available
Key Advantages Benefits are paid directly to you to be spent any way you choose. Pays in addition to any other coverage you may have. Fast and accurate claims services contact the local office. Coverage is portable should you terminate employment. There is an annual wellness benefit on most benefits per covered member.
Cancer First Occurrence Benefit, Hospital Confinement Benefit, Cancer Screening, Wellness Benefit
Accident Emergency Treatment Benefit, Accidental Death Benefit, Initial Hospitalization Benefit
Critical Care Annual Hospitalization Benefit, Diagnostics, outpatient and surgical
Hospital Indemnity Annual Hospitalization Confinement Benefit for Sickness and Injury Daily Hospital Confinement Benefit, Waiver of Premium Benefit
Short-Term Disability Income Replacement begins day one for off the job accidents and day 7 on the sickness side.
14
 
15
Questions Comments
Thank you for your valuable time!
16
Questions, Concerns, or Claim Issues
  • Who do I contact at our Brokers Office for any
    questions or claims that I want to discuss?
  • Chad Rich, Vice President
  • Chad Stacy, Account Executive
  • Brenda Sanford, Director of Client Management
  • Rodney L. Rich Company
  • 300 N. Tarragona Street
  • Pensacola, FL 32501
  • (850) 439-5561 direct
  • (850) 434-5323 fax
  • bsanford_at_rodneyrichco.com e-mail
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