BRS & AHPs. (Association Health Plans) OCTOBER 8, 2018

Transcription

1 BRS & AHPs (Association Health Plans) OCTOBER 8, 2018

2 Who is BRS? Since 1988, BRS (Business Resource Services) has been an association offering small employers access to a variety of services: COBRA Administration Dental Coverage R&D Tax Credits Flexible Benefit Plans FMLA/VT Family Leave Administration isolved - payroll solutions 401(k) Plans 2

3 Why BRS? Inexpensive annual dues Only Association with a license pending with the state (as of 9/7/18) COBRA administration available BRS Dues: $250/year, any business up to 100 employees Other associations: $300 $1,200/year, depending on number of employees 3

4 Requirements for Employers to Participate in AHPs BRS Membership Proof of Workers Compensation Coverage Willingness to participate in wellness program Be a small group (1-100 Full-Time Employees, per State definition of small group) BOR for each employer group BCBSVT Enrollment Application 1st month of premium Most recent Dept. of Labor Quarterly Wage and Contribution Report 4

5 About the Plan Options EPO PCP Network Nationwide network using BCBS providers participating in the local PPO No out-of-network (except for urgent and emergent care) Members are required to select a PCP upon enrollment Preventive Care covered at 100% National Preferred Formulary Wellness program requirement to help deliver cost savings and improve health and wellness of employees 5

6 Plan A Benefit Cost-share Deduc'ble (stacked) $850 Coinsurance 30% Out-of-pocket maximum (stacked) $4,500 medical, $1,300 prescrip'on Preven've Covered at 100% Office Visits (PCP/Specialist) $30/$50 Emergency Room $500 Urgent Care $40 Ambulance $50 Hospital Services Prescrip'ons Generic: $5 Preferred and Non-Preferred: $100 deduc'ble then $50 preferred and 50% for non-preferred 6

7 Plan B Benefit Cost-share Deduc'ble (aggregate) $2,750/$5,500 Coinsurance 0% Out-of-pocket maximum (aggregate) $2,750/$5,500 Preven've Covered at 100% Office Visits (PCP/Specialist) Emergency Room Urgent Care Ambulance Hospital Services Prescrip'ons Subject to deduc'ble Subject to deduc'ble Subject to deduc'ble Subject to deduc'ble Subject to deduc'ble Subject to deduc'ble then*: Generic: $5 Preferred: 40% Non-preferred: 60% *Wellness drugs are not subject to the deduc'ble first, will process as $5/40%/60% 7

8 Plan C Benefit Cost-share Deduc'ble (aggregate) $2,750/$5,500 Coinsurance 20% Out-of-pocket maximum (aggregate) $6,750/$13,500 ($7,900 individual OOP max) Preven've Covered at 100% Office Visits (PCP/Specialist) Emergency Room Urgent Care Ambulance Hospital Services Prescrip'ons Wellness Rx covered in full 8

9 Plan D Benefit Cost-share Deduc'ble (aggregate) $5,250/$10,500 Coinsurance 50% Out-of-pocket maximum (aggregate) Preven've Covered at 100% Office Visits (PCP/Specialist) Emergency Room Urgent Care Ambulance Hospital Services Prescrip'ons $6,550/$13,100 ($7,900 individual OOP max) Subject to deduc'ble then*: Generic: $12 Preferred: 40% Non-preferred: 60% *wellness drugs are not subject to the deduc'ble first, will process as $12/40%/60% 9

10 Why It Works Wellness component ensures groups are committed to better health, leading to a healthier risk pool Flexibility to design in conjunction with HSAs, FSAs, and HRAs Large groups not included 10

11 Why It Works HSAs & FSAs: Employer Determines HRA Options: 1) 50/50 HRA from First Dollar 2) 100% HRA from First Dollar 3) 50/50 HRA after $1,350 (post-deductible HSA compatible) 4) 100% HRA after $1,350 (post-deductible HSA compatible) 11

12 Plan Comparison BRS Plan B vs. comparable BCBS 2019 HIX Group Size 2019 HIX Annual Premium 2019 BRS Annual Premium Annual Savings with BRS 5 Employees (3 single, 2 families) $64,714 $61,278 $3, Employees (15 single, 10 families) $323,570 $306,389 $17, Employees (40 single, 35 families) $1,038,653 $982,514 $56,140 12

13 Questions? CONTACT: (802) (802)