In This Episode
Jeremy Stickling, Klay Nafziger, Peg Balducci, & Klay Nafziger answer frequently asked questions about our health insurance plan updates and what it means for you.
Episode Recap
HSA
- “HSA is basically a wealth building tool specifcally for medical payments.” – Klay
- “HSA banks web portal and app is pretty slick.” – Jeremy
- “You can tie this (HSA) into your own bank account. It’s easy to connect it to payroll deduct. The most you can put in is $8,750 for a family and $4,400 for an individual.” – Jeremy
- “Do you get zero health with HSA? No, if you take the HSA. But you do get access to marathon health which is zero to use.” – Peg
- “Does Nussbaum make a contribution to the HSA? Simple answer: no” – Klay
- “How does FSA pair with HSA? No, It doesn’t pair with HSA. You can’t do both. But the child care with FSA does work with HSA. You can easily roll over from FSA into HSA.” – Rick
- “Use your FSA funds by the end of April if you’re switching to the HSA” – Peg
- “We’re indifferent on the FSA to the HSA – we just want to provide options. It depends on what your needs are.” – Jeremy
- “HSA works best with individuals that don’t go to the doctor often or do go to the doctor often. It doesn’t work well with that middle ground background. Do your research before picking a plan.” – Klay
Pharmacy change TruRX to Drexi
- “Who is Drexi? Drexi is a PBM (Pharmacy benefits manager) which has potential for more transparency and cost savings than TruRX. Every year we want to put together a package that makes the most sense for all parties.” – Klay
- “It operates the same if your pharmacy bill is under 750/month.” – Jeremy
- “if your med is over 750/month – you will do paperwork to source it BUT you can find the specific med for the best value. It is $0 cost to the member it is sourced. There is more paperwork but less cost overall. That med will be for free. That’s a huge deal.” – Klay
- “They have an app where you can see the cost at different locations around you.” – Rick
Supplemental Benefits
- “The three supplemental benefits are Accident & Critical illness, Hospital Indemedy. You don’t have to be on the health plan to elect for these coverages. You can look this up in Employee Navigator.” – Klay
- “These are all HSA compatible. And compatible with other insurances like Samaritan.” – Rick
- “What do these supplements do? They help with preventitive care things (dentist, flu shot, annual check) – you can get $50 credit back/individual if they are in the plan.” – Klay
- “This can pay a good chunk of a covered family member’s medical visits.” – Jeremy
Decision Making & Plan Simplification
- “Know your needs. Start with, do you want a regular PPO with network or reference based? Do you want a high deductible with HSA?” – Jeremy
- “The plan is self funded which means we pay costs ourselves. The claims cost went up a lot this last year (15% which equates to roughly 1 million dollars). This nudges us to mention the cost share.” – Jeremy
- “What is a reference based price plan? Medicare is the base line reference and health scope pays 20% above that base. There is no network of provideers – you can go whererver you want. But when that claim is filed you’ll still get your discounts like the UMR plan.” – Peg
- “The pain point of reference based price plan is having to verify the plan with your provider front desk.” – Jeremy
- “EOV (explanation of benefits) – don’t pay any bills till you run it past the EOV.” – Jeremy
- “Reference based can be scary. ELAP is the engine that runs referenced based. They send it to a rep, I sign a HIPPA form, and they get me a legal representation. Your job is to take that info and take it to ELAP.” – Jeremy
- “Can we send all bills to ELAB? Read your explanation benefits and if there is a descrepancy, then send it to ELAB. Peg and Klay are here to talk you through those questions.” – Rick
- “Someone can by yesterday to look if it was a balanced bill. We were able to deduce if it was. Swing by our (Peg & Klay) desks if you have a question..” – Klay
Find Value in the Plan
- “If you’re not using Marathon, Zero Health, or Teledoc. You’re not getting the value out of the plan.” – Jeremy
- “I’ve saved over a thousand dollars by using Marathon.” – Rick
- “Any additional marathon locations? East Peoria, Bloomington (anyone can use these). See other network locations at Network Locations | Marathon Health. Swing by if you’re a driver and once you do that first visit you can use them virtually. We recommend this.” – Klay
- “Teledoc is access to a provider around the clock. They treat common illnesses and they have counseling, dermatology, and more services available. This is $0 to use. It saved us for things like ear infections, pink eye, strep throat for kids. You don’t have to go anywhere. ” – Peg
