Thank you for joining the presentation.
Today we're going to speak
to updates to the medical benefits for calendar year 2025.
This year we'll be introducing new medical plans.
So it is important to understand your options as you're making the decision
that's best for you and your family.
Today
we'll go over active open enrollment and what that means.
We'll introduce the new medical plan options as well as review our current plan
B. So we're all speaking the same language.
New coverage options.
Options.
A closer look at each option.
Talk about some considerations.
So you're making the best decision.
And additional resources and support.
This year
we will be holding an active open enrollment.
Open enrollment will be November 6th, 27th.
And this year everyone must make elections for their benefits.
And active open enrollment means you need to review your choices,
even if you're already enrolled and do not wish to make any other changes.
And open enrollment will be for medical insurance.
That includes whether you're opting in or waiting until insurance
can short term disability
increases or decreases to long term disability and life
insurance, and flexible spending cuts.
If you do not take action,
you will not receive benefits in 2025.
In an effort to support folks, we will be holding our annual Employee
Benefits and Wellness Fair and that will be on November 6th from 8
to 330 at the data center.
Let's now
look at different medical coverage options,
which include new ones, as well as the one
we've had in place for over ten years.
Why are we making changes?
It's no secret that insurance costs have been rising each year.
In 2023, the UVM medical insurance plan went up
19 13.9% 15% in 2024.
And this year will increase by 19.3%.
For the current plan that is offered.
Our goal is to give employees
the power to choose what works best for them.
Also, switching to active open
enrollment will make sure that employees
are looking at their options and making the choice from year to year
for what will be best for them and their family.
This also aligns more with what other organizations are doing.
It is not uncommon for organizations to offer more than one plan
for employees to choose from.
Making.
So as we discuss the different coverage options, we want to make sure
we're talking in the same terms and that we have a common understanding.
So the coverage options. Are.
Will all be within the same Blue Cross Blue Shield provider network.
But there will be four different designs
from which to choose from that have different cost associated.
The premium that is the monthly amount you pay for your coverage.
It's split between you and UVM and that's what you see deducted from your paycheck.
A deductible is an out-of-pocket cost before insurance starts
paying for services.
A copay is a fixed amount paid for services, and co-insurance
is the percentage that is shared between the insurance company and the employee.
After meeting the deductible, and the out-of-pocket
maximum is the most that you would pay in a calendar year.
After that, insurance would pay 100% of the costs.
Our coverage plans
fall into two categories Preferred Provider
Organization called PPO or High
Deductible Health Plan, also called h h p.
Under a PPO plan, you do pay
higher premiums, but then you have lower out-of-pocket costs.
When you utilize services.
Our long standing plan at the university is a PPO plan.
Introduced this year will be high deductible health plans.
That means 1st May pay a lower premium
with higher upfront costs when you use the services.
However, to balance
that, a high deductible health plan includes a health
savings account component, which is also known as an HSA.
And those HSA do receive up contributions.
Regardless of the option you choose.
There are some similarities.
100% of preventative
care accessed within the network is covered at the full cost.
That includes an annual physical exam
and regular screenings such as mammograms
and colonoscopy.
Each of the coverage options
are within the Blue Cross Blue Shield network.
Prescription drug coverages are all through the Optum program,
and then
on all of them have an out-of-pocket maximum.
And if you meet that threshold, then there is no additional cost
to you for that cap per year.
So let's take a look at each
of the options that are available.
The first option
where we will review we are calling PPO one.
This essentially is the UVM traditional offering
that has not changed for this calendar year.
It provides extensive coverage with very low copayments,
but it also has the highest monthly premium,
which is the amount that comes out of your paycheck.
So for in-network coverage, there is no deductible that you need to meet.
It immediately goes into a copay structure.
And it it has a prescription drug deductible.
When and the lowest out-of-pocket maximum or prescription
coverage.
What you pay for this plan is adjusted based on your salary.
And it is that salary cost share.
Great that you are used to seeing
that has the band and rates for about every $10,000
in 2025, premium rates for
you employee's will increase 19.3%
for this plan.
In addition to this plan, we will offer three new plans.
The first one we will review is called PPO two.
This is essentially a middle of the road approach.
It balances lower monthly premiums and PPO
one with some more up front pocket costs.
So it this plan does
have a deductible associated with it.
You would need to
pay either $500 for employee
only coverage, or $1,000 for family coverage
out of pocket for the insurance plan
would begin to pick up costs
once that deductible is met.
There is what
we now utilize as co-insurance rather than a co-payment.
Co-insurance in this plan,
as 10% of the services you access.
It also includes a slightly different
prescription coverage.
There is no separate prescription deductible and your prescription costs
costs are paid out-of-pocket until your medical deductible
is reached.
For this plan, it is.
The premium is still based on your salary.
However, it is a collapsed salary grid that has four different bands.
The premium rates for this plan
will be 5.9% lower than the PPO.
One A rates.
The university will also offer two different high
deductible health plans and high deductible health plan.
One has more upfront costs, but with an opportunity to save
B, this plan will have a lower total monthly premium.
However, it will be with a higher deductible
and a higher out-of-pocket maximum.
Please keep in mind that these plans also include
a health savings account, in which UVM will contribute to.
This plan is also based
on the deductible and coinsurance structure.
The deductible for an an employee
only plan is $2,000, or $4,000.
If enrolled in a family plan.
You do have to meet that deductible again
for the insurance to start covering costs.
Once the deductible is met, a co-insurance
is that you will pay 20% in the final pay, 80% for the services.
Access.
Again, the prescription deductible is combined with the medical deductible.
Once that deductible is reached, it goes into a copay structure
for prescriptions of $10, $40, or $80.
The out-of-pocket maximum for prescriptions
is $1,650 for employee only coverage,
or $33,300 for family coverage,
out-of-pocket maximum for medical insurance
or medical costs is $4,000 if enrolled in employee
only coverage, or $8,000 if enrolled in family coverage
for the high deductible health plans.
The premium will be the same cost share for everyone.
If you opt into this plan.
Employees pay 20% of the premium cost,
and UVM pays 80% of the premium costs,
regardless of your salary.
The second high deductible health plan option is recommended
for those who have experience in a high deductible health plan,
and may have previous health savings accounts.
With money accessible.
This one does have the lowest total premium
in exchange for the highest deductible and highest out of pocket.
Maximum.
As I previously said, it is recommended for only for employees
who have significant health savings account balances.
In this plan.
The individual deductible is $3500
or $7000 for family coverage.
The coinsurance is also a higher rate than the FDP.
One option.
This coinsurance, the employee pays 30% of the cost of services,
and the insurance plan will pay 70% of the cost.
Again, the prescription
deductible is combined with the medical deductible
and then it after that, deductibles reached is when you will go into the copay
structure of $10, $40, or $80
for a month's worth of prescriptions.
The prescription out-of-pocket max
is $1,650 for employee only coverage,
or $3,300 for family coverage.
The out of pocket Max for this high deductible health plan
two is $6,500 for employee only coverage,
or $13,300 for family coverage.
However, with high deductible health plans,
it comes with the health savings Account component,
and this component it allows for tax
advantaged savings in order to offset court
costs for that deductible amount
that one needs to pay out of pocket.
The University is creating a four tiered
salary plan for made into health savings accounts
for employees
who earn less than $50,000 per calendar year.
The university will contribute $800
if enrolled in employee only coverage, or $1,600
if enrolled in family coverage between 50 and 80,000.
That amount decreases slightly to $600 or $1200.
80,000 to 110,000
would be $400 or $800.
And for employees who make $110,000 or more.
The health savings account contribution will be $200
or $400.
However, in 2025,
if one enrolls in a high deductible
health plan and makes less than $80,000 per year,
UVM will contribute a one time
additional deposit of $1,000.
A health savings account
are tax advantaged account.
There is three ways where they are tax free,
so when money is put into the account, it is a tax free contribution
that includes the employer on that plan.
And if an employee chooses to also contribute to their health savings account
when you withdraw the money,
it is also not taxed.
As long as you are paying for medical eligible medical expenses.
And then also you do have the option if you choose
to invest the funds in your health savings account.
If you do choose that option, any growth or earnings
on those investments are taxed.
UVM will contribute to all health savings
accounts for employees that are enrolled in the high deductible health plan,
and those contributions will be divided between three equal payments
on January, April and October.
During the calendar year.
Employees may also choose to contribute to their health
savings account, but there are limitations to that.
It is $4,300 for the individual for the calendar year,
or 8550 for family coverage.
Employees who are over 55 and opt into this kind of coverage
can contribute an additional thousand dollars as a contribution.
Those contribution limits are include
both employee and employer contributions.
As you're reviewing whether you want to contribute to the plan.
You may be wondering, what's the difference
between a flexible spending account that the university already offers and a health
savings account, which is part of a high deductible health plan?
For a medical flexible spending account.
You may only enroll in that benefit
if you are not in a high deductible health plan.
For an HSA, you must be enrolled in a high deductible health plan.
The IRS does set contribution limits
to each of these types of accounts every calendar year, and in 2025,
a medical flexible spending account is 3300 per individual.
And for an HSA, it is 4300
for an individual or 8550 for family
coverage with a potential thousand dollars catch up.
As we noted previously, that is both employee and employer contributions.
Employers do not
contribute to the flexible spending.
There are carryover
rules for a medical flexible spending account, so only unused funds up
to $640 are carried over.
If you have more in your account at the end of the eligible period
than that, that amounts forfeited that health savings account.
Unused funds are carried over a year to year without limits.
Medical flexible skimming accounts
are not available to invest.
Therefore, they do not earn interest, nor does the amount to grow.
One can choose to invest their health savings account
in stocks, bonds or other options, allowing for tax free growth.
To access a medical flexible spending account
as soon as the plan year starts, you can access the amount
that you have pledged towards funding that account for.
However, in a health savings account,
you can only access funds that have been contributed
thus far.
These are new options,
so we want to make sure that folks are taking into consideration
their particular circumstances and deciding
which option is best for that.
Here are some questions to ask yourself
Is your premium payment lower and a PPO
or an FDP?
What kind of medical services do you frequently use?
Do you have ongoing medical conditions?
Do you plan on any major medical expenses in the upcoming calendar year?
Perhaps you have a planned or anticipated surgery.
Perhaps you have maternity care upcoming.
You will want to take those into account.
Does your budget allow for you
to manage a higher out-of-pocket costs to save our monthly premiums?
And if
you had an unexpected medical expense arise, would you be able to cover
that out-of-pocket max on a high deductible plan?
These are all personal decisions that you need to think about
when you're making the best choice for you and your family.
Let's look
at some examples comparing the employee 2025 monthly premium costs,
which are the amounts that are deducted from your paycheck.
As you can see on the chart, the different salary bands have different
monthly costs for the PPO one and PPO
two option
on the High deductible
health plan and High Deductible Health Plan two.
Regardless of your salary, the employee pays 20% of the premium
out of their paycheck.
You'll want to make these considerations
based on your salary and medical costs.
As you are looking
for potentially
making a change to your medical coverage.
For a complete list of premiums, they are available on the website.
And as a reminder, premiums are only part of the equation.
You'll also want to factor in contributions
that the university would make towards your health savings account.
We understand this is a change in benefit options.
However, it may not be a change for what you select in order to support you.
We are offering several resources that you can access.
The Employee Benefits and Wellness Fair will be on November 6th between 8 and 330.
We'll have live medical coverage, overview sessions
and staff on hand to help you navigate
any questions.
We encourage you to review
the reference materials that break down more of the specifics.
We have created a quick guide, a 2025 Benefits Guide.
There is lots of information available via the website and three check estimators.
Are to people you trust.
If you have friends or family who help you make these decisions
and you trust their experience, we encourage you to talk to them
and also talk to your HR rep or the HR info team.
We can help you navigate questions, get your answers,
and make sure that you are making fully informed decision.
Again,
as a reminder, you must actively select your benefits
during the open enrollment period in November.
Make sure you're selecting your benefits, including your medical insurance.
Even if you're opting to waive it.
Dental insurance voluntary vision short term disability
increasingly decreases to long term, long term disability and life insurance,
and a flexible spending account.
Thank you for your time.