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3350 East Paris Ave. SE
Grand Rapids, MI 49512
p. 877.274.8796
f. 616.301.2149
No. 657 - February 1, 2012
To: Member Schools and Participants Covered by Priority Health
From: Howard Van Mersbergen, Executive Secretary-Treasurer
From Howard’s Desk - Working hard to provide cost-savings options. We're stronger together!
Results of “Hold it for the Holidays” and the Wellness Ambassador Drawing - Congratulations to the prize-winners!
September 1 Rates - Premium rates issued early to help with budgeting
New 1% Health Insurance Claims Assessment (HICA) - New Michigan tax
Plans to be Offered in the 2012/2013 Plan Year - Four plans eliminated; Two plans added.
New Basic Life and AD&D Offering - Schools can now offer $50,000 of Basic Life/AD&D
Keeping HSA’s Qualified - New annual HSA contribution limit for 2012
Shared Time Eligibility - New eligibility provision for shared time employees
Terminations/No Rescissions - Handle termination of coverage with care
HSA Deductible: A Word of Caution - Use care if considering self-funding the deductible
More School Choices - Plan design ideas
Contacting CSI for Support - Contact CSI if you have questions or need assistance
The Trustees continue to work diligently to provide member schools with good benefit coverage at a reasonable cost. In this Update, we explain the plan design changes for next year. In addition, we have already finalized next year’s premium rates (except for schools with less than 50 eligible - coming in April) to help schools in preparing next year’s budgets. We, with the help of our consultants at Mercer, have negotiated with our insurance carriers to minimize your cost. We have also looked at how our programs compare to the marketplace from the benefit side and have made some changes to existing plans to make sure our programs are up-to-date and competitive.
We are confident that working together as a community of schools will provide better value at a lower cost than each school can obtain independently.
Results of “Hold it for the Holidays” and the Wellness Ambassador Drawing
The “Hold it for the Holidays” challenge recently ended with great results! The challenge was to hold your weight through the holidays. The results: 83% were winners and maintained or lost weight.
Ambassadors were randomly drawn from schools that had a 90% participation rate or higher. Congratulations to these winners of $100 gift cards:
Stephanie Mc Carthy - Hollandale Christian School - Hollandale, MN
Steve Witter - Providence Christian High School - Fremont, MI
Sharon Scott - Faith Christian School - Belding, MI
We look forward to some friendly competition as we encourage each other in the Healthy Steps program this spring.
New 1% Health Insurance Claims Assessment (HICA)
The State of Michigan has instituted this new tax, which applies to health and dental claims incurred in
Michigan. We have incorporated this new tax in to the September 1, 2012 dental rates. Health
carriers are still deciding how to collect the tax. More details to follow.
Plans to be Offered in the 2012/2013 Plan Year
Trustmark
Trustmark will continue to offer six (6) flexible plan options for schools to offer to faculty/staff. There are four PPO’s and two of the more popular HSA’s. Schools can offer both a PPO and an HSA to staff. Most schools, on their own, would not be able to offer two plans to faculty/staff.
The primary changes to the plans are the lowering of out-of-pocket maximums for the PPO 80 $1,000; PPO 80 $750 and the two HSA plans effective September 1, 2012. Please see the Appendix for details.
For all PPO 80 and PPO 90 plans: the Urgent Care Center co-pay will increase from $35 to $50 effective September 1.
Priority Health
The Trustees have worked with Priority Health to make the options available through the CSI Insurance Plan even more flexible. The menu of plans will change effective September 1, 2012, so that schools can select the plan(s) that best meets the needs of employees while also meeting the school’s budget requirements.
Health By Choice Achievements (HBCA) 1 and 2, HMO 80 Low and HMO 100 High will be eliminated.
Two new plans will be added: Health By Choice Progressions (HBCP) and HMO Value Plan 80. These plans reduce what the member and the school will pay for healthcare. The HBCP plan is designed to motivate members toward some level of improvement of their health. Levels of improvement will be established by the member and their doctor/provider on an individual basis.
Please see the attached Appendix for a general overview of coverages for these new plans.
In addition, a separate Update is being prepared to explain the two new plans in detail.
New Basic Life and AD&D Offering
For the Trustmark HSA 2 the deductibles are changing to correspond with the 2012 HSA Contribution Limits by increasing the individual deductible to $3,100 and the family deductible to $6,250.
Some CSI schools participate in shared time programs with public schools. In typical shared time programs an employee of the CSI school continues to provide services at the CSI school but does so as a public school employee.
In some cases the employee is employed part of the time by the CSI school and part of the time by the public school. Some of these employees do not meet the eligibility requirements of the CSI Insurance Plan nor the public school insurance plan. Effective immediately, shared time employees who are physically working at a participating school 50% or more of full-time (whether employed by the CSI school or a public school) are eligible for the CSI Insurance Plan.
For participation requirements, an opt-out will be allowed if the employee is covered under a public school’s insurance plan.
The CSI Pension Plan definition of Imputed Compensation will be used for coverage level and premium rates for Long Term Disability.
Health Care Reform contains regulations regarding the termination of benefits. Employers may not terminate (rescind) coverage before informing the employee of the termination of coverage. Carriers must be notified of the termination within 30 days of the date coverage ends. If the carrier is notified more than 30 days after the coverage ends, the employer must certify that the employee was notified of the termination of coverage prior to the termination date. Employers will not be able to retroactively adjust eligibility greater than 90 days.
HSA Deductible: A Word of Caution
Several schools have inquired about using our HSA plans and self-funding a portion of the deductible rather than funding the employee’s HSA account (in effect, creating a deductible reimbursement plan). Self-funding occurs when a school reimburses employees directly for certain health care expenses incurred by the employee or dependents. If you are considering self-funding, we encourage your school to seek legal counsel. Your school will need to develop a Plan Document and distribute copies to participants. Your school may be required to file annual reports with the Department of Labor. The plan will be subject to non-discrimination testing and your school will also be required to adhere to privacy regulations.
For more Plan Design ideas, please see the attached Appendix.
If you have questions or need additional information, contact Lois Landheer by phone at 877-274-8796, extension 233 or 616-284-3233 or by e-mail at . The CSI web site also contains information on CSI benefits and past Updates. Go to http://www.CSIonline.org and select Employee Benefits to see the useful items available.
