Northern Kentucky University

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Northern Kentucky University Open Enrollment 2010
GCA00CLHH 1008
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Food for thought
What groceries would cost if prices had increased
as fast as healthcare costs since the 1930s

• Apples 6.99 a pound
• Bananas 9.17 a pound
• Coffee 36.67 a pound

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2010 Open Enrollment

• Questions to Ask Yourself at Open Enrollment
• How does your family use healthcare services?
• How much do you spend on your benefits each
  paycheck?
• How much do you pay out of your own pocket?
• Would you rather pay less toward the premium and
  more when you receive care or vice versa?

• Up-Front Costs
• Paycheck contributions
• Pay-as-you-go Costs
• Co-payments
• Deductible
• Coinsurance
• Out of Pocket Maximum

• Once you know the answers, decide by
• Comparing the available plans
• Using the online tools for guidance
• Choosing the plan that meets your healthcare
  needs and budget

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Talking Points

• Are you buying the right amount of coverage for
  you and your family?
• Just because it costs more than other options,
  does not mean that its the best choice for you
• Lets compare what you are currently enrolled in
  versus the next closest option, POS 250 versus
  POS 500 or POS 500 versus Coverage First

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Plan Similarities POS 250 POS 500

• Heres how the two options are similar
• Covered services are the same from option to
  option
• Exception POS 250 90/60 plan includes limited
  coverage for bariatric surgery and infertility
• Prescription drug coverage is the same for both

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Plan Differences

• Heres how the two options differ
• Cost to buy - What you pay to buy the coverage
  (premium)
• Cost to use - What you pay when you use the
  coverage
• Lets look at the cost to buy first

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Medical Plan Comparison POS 250 POS 500
Cost to Buy.
Copayments (In Network)
(Out-of-Network)
2010 Annual Cost by Option and Coverage level
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Plan Differences

• Heres how the two options differ
• Cost to buy - What you pay to buy the coverage
  (premium)
• Cost to use - What you pay when you use the
  coverage
• Lets look at the cost to use now

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Medical Plan Comparison POS 250 POS 500
Cost to Use.
Copayments (In Network)
(Out-of-Network)
Annual maximum coinsurance only
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The Numbers POS 250 POS 500
Copayments (In Network)
(Out-of-Network)

• The annual savings in premium could be used
  towards actual usage costs like office visits
• This allows you to have immediate savings and
  then only pay when you actually use services
  there are always options!

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Plan Similarities POS 500 CoverageFirst

• Heres how the two options are similar
• Covered services are the same from option to
  option
• Prescription drug coverage is the same for both

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Plan Differences

• Heres how the two options differ
• Cost to buy - What you pay to buy the coverage
  (premium)
• Cost to use - What you pay when you use the
  coverage
• Lets look at the cost to buy first

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Medical Plan Comparison NPOS 500 CF
Cost to Buy
Copayments (In Network)
(Out-of-Network)
2010 Annual Cost by Option and Coverage level
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Plan Differences

• Heres how the two options differ
• Cost to buy - What you pay to buy the coverage
  (premium)
• Cost to use - What you pay when you use the
  coverage
• Lets look at the cost to use now

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Medical Plan Comparison POS 500 CF
Cost to Use.
Copayments (In Network)
(Out-of-Network)
Annual maximum coinsurance only Does not
include per person Benefit Allowance - applies
before deductible
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The Numbers POS 500 CoverageFirst
Copayments (In Network)
(Out-of-Network)

• The annual savings in premium could be used
  towards actual usage costs like office visits or
  deductibles
• This allows you to have immediate savings and
  then only paying when you actually use services
  there are always options!

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Stepping into the safe-consumer space
CoverageFirstTM has a unique four-phase design.
An annual allowance 500 per member to cover
medical expenses during the plan year
An annual deductible Starts when the member has
spent the years allowance
Coinsurance Member pays additional medical
expenses until reaching the annual out-of-pocket
maximum
A safety net CoverageFirst pays 100 percent
excluding copayments of covered expenses for
the rest of the plan year
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How CoverageFirst Works
First 500 paid at 100 percent
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Medical Plan Comparison of Usage
Total Hip Replacement
Copayments (In Network)
(Out-of-Network)
Average surgery cost is 23,000 - 33,000, 12
PT visits, 3 PCP office visits for follow up
RX not included in scenario Copayments do not
apply to deductible or OOP Maximum
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Medical Plan Comparison of Usage
Having a Baby
Copayments (In Network)
(Out-of-Network)
Average cost is 9,000 - 14,000, RX not
included in scenario Copayments do not apply
to deductible or OOP Maximum
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Talking Points

• What if I have an unanticipated surgery or
  hospital stay? How would I pay for my deductible
  or out of pocket maximum?
• Remember, doctors and hospitals know that more
  and more patients have health insurance plans
  with higher member responsibility.
• They are willing to work with you - payment
  plans, discounts, etc.

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Coverage thats just right for you!

• Humanas online tools help you
• Compare plans based on expected use
• Estimate costs for procedures
• Estimate healthcare costs
• Find possible cost-saving alternatives to
  medications
• Rx Calculator
• Choose the plan for your needs and budget

Humana's Enrollment Tools
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Benefits Planner Tools Closest to My Current Plan

• Closest to My Current Plan
• visually indicates which plan is most similar to
  users current plan

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Benefits Planner Tools My Estimated Expenses

• My Estimated Expenses - Tool button is
  highlighted.

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Benefits Planner Tools My Estimated Expenses

• Use the calculator to estimate how you and your
  covered dependents might use healthcare services
  in the upcoming year
• Primary Care Physician
• Specialist
• Outpatient Surgeries
• Hospital Admissions
• Prescriptions filled

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Benefits Planner Tools My Estimated Expenses

• My Estimated Expenses
• results for each plan are displayed

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Integrated Tools - Types of Medical Plans

• Types of Medical Plans
• tool is highlighted.

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Integrated Tools - Types of Medical Plans

• Types of Medical Plans pop-up window displays
  summary information about different types of
  plans HMO, PPO and HDHP.

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Integrated Tools - Glossary

• .

Glossary tool is highlighted.
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Integrated Tools - Glossary

• The Glossary pop-up displays definitions of terms
  used in the enrollment process.

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Compare Medical Plans
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Compare Medical Plans
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MyHumana

• MyHumana main page
• Four major sections
• Plans Coverage
• Doctors Rx
• Claims Spending
• Health Wellness

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Points to Remember!

• When? October 19 through October 31
• Where? Benefit Help Centers refer to your
  benefit brochure
• How? http//mynku.nku.edu, Employee Self
  Service, Benefits and Payments, Open
  Enrollment
• Need Help? Open Enrollment Hotline
  1-888-393-6765
• All employees must enroll for coverage effective
  1/1/2010
• If you do not enroll, you will NOT have coverage
• Remember to show your I.D. card to all of your
  providers beginning 1/1/2010.

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GCA00CLHH 0808