Page 24 - The Arc SF RFP 10.18

Filice Insurance RFP Response - 2018

34. What is your approach to process for managing prescription drug costs?

Given your group size, we would not be able to secure the necessary data from Kaiser to do a full
analysis of your current Rx utilization. If we were to secure this data, we would do a deep dive into

your Rx claims and determine the appropriateness of a self-funded model where we could work to

better manage prescription drug costs, evaluating the appropriateness of various Pharmacy Bene-
fit Manager (PBM) partners.

35. What experience do you have with partially self-funded health plans?

Filice was an early-adopter, designing and implementing partially self-funded plans since they were
first introduced over 15 years ago.

Depending on access to data from your current medical carrier, our health informatics team will

also do an analysis of your claims and utilization and predictive modeling to determine the ap-
propriateness of these programs. They will analyze your large claims, and along with the compet-

itive carrier rates, we will be well-positioned to negotiate with your incumbent carrier when your

Kripton PHOTOGRAPHIC Employee Benefits Overview Medical Insurance
Krypton Photographic is committed to providing exception- You need to let us know why you are declining/waiving coverage to ensure that we can report in
al benefits to our employees. Keeping in mind the unique the future as required by the “individual mandate.
and diverse needs of our employees, we have put togeth-
Anthem HMO
er a benefits program that will help protect the personal com/ca and hit the pink Health & Wellness banner for
Must designate and coordinate care through more information.
and financial well being of you and your family. a Primary Care Physician (PCP). Kaiser
For California employees only. Use only Kaiser physicians and facilities.
Upon joining Krypton Photographic, most of your benefits Anthem PPO Must designate and coordinate care through a Prima-
are effective on the date of hire. The plan and dependent You can see a specialist without having a re- ry Care Physician (PCP).
For California employees only.
elections that you make when ferral from a primary physician. Kaiser Wellness
Non-network benefits will be paid according
If you are hired or during annual to the usual and customary rate(s). Members have access to free healthy living, wellness,
Your Eligible Dependents
and productivity programs. For more information,
Anthem Wellness (HMO and PPO)
you work 30
Employee benefits You may cover your depen- are eligible to enroll in open enrollment are effective for Members have access to free healthy living, please visit www.kp.org and hit the “Health & Well-
hours or more, you
the entire calendar year unless
ness” tab at the top of the page.
wellness, and productivity programs. For
more information, please visit www.anthem/
you experience a qualifying event
dents under many of the
Krypton Photographic’s
(marriage, birth, adoption, or loss of
benefit plans as long as they
brochures with are one of the benefit plans. coverage). PLAN Kaiser Anthem Blue Anthem Blue Cross PPO
Cross HMO
following:
HMO
In Network
HMO
Out of Network
specific content for ✻ Your spouse How Do I Enroll in Benefits? Individual Deductible None None None None None None $200 $400 (Individual)
Family Deductible
✻ Your qualified domestic
$600 (Family)
New hires will receive an email following orientation with a
partner
Individual Out-of-
each company ✻ Your child(ren) up to age link to the ADP self-service enrollment system. Login in- Pocket Family Out-of-Pocket $1500 $3000 Unlimited $1500 $3000 Unlimited $2000 $4000 Unlimited $2000 $12,000
structions will be included in the email.
26 regardless of student
Within ADP, you can enroll yourself and eligible depen-
or marital
Unlimited
Maximum Benefits
$20
$10
Office Visit
30%
status
Summary of Employee Benefits ✻ Your handicapped dents in the plans that fit you Need to update your Preventive Care Gross Pay $20 Employee Paid Employer Paid 30% after ded. Commuter Benefits
$2,000.00
No Charge
and your family best.
No Charge
Wages
$ 2,000. 00
No Charge
$6.00
LTD Premium
address or personal
Our commuter benefit program gives working people and their families a way to lower the cost of getting to
will receive a greater benefit in the event of disabil-
No Charge
30%
$2,006.00
Well Baby
Example
No Charge
$2,000.00
No Charge
work. With commuter
ity than if you choose to have the company pay your
child(ren) regardless For more information about information? Lab, X-Ray Federal $10 $250 No Charge* $314.64 $84.57 $29.20 10% $84.32 30% after ded. benefits, an employee can save up to 40 percent off their commute, regardless of how they get to work.
$313.70
Social Security
premium directly, since the benefit will generally not
30% after ded. • The commuter benefit allows you to pay for commuting/parking expenses with pre-tax dollars.
No Charge
10% $29.11
the plans offered, select the
Inpatient Hospital Medicare
January 1, 2017 through December 31, 2017 of age if incapable of “Benefits” tab under quick Please use ADP to Outpatient Hospital Unemployment/Disability No Charge $532.31 $83.78 $20.12 10% $20.06 $83.53 30% after ded. For more information about the commuter benefit program, log into www.wageworks.com or contact the
State
be considered a taxable income.
• Enrollment is done through ADP Portal.
self-sustaining employ-
$100
$530.72
Taxes Withheld
update all personal
ment, and if the hand- links in ADP to review plan information including Emergency LTD Premium $100 (waived if $100 plus 10% ($100 waived if admit- customer service center at 877-924-3967.
$ (6.00)
$50
$1,469.28
Net Pay
$1,467.69
admitted)
ted)
icap began before the designs, required notices, W-4 withholdings and Tier 1 Rx Copay $10 $10 $5 $5 plus 50%
limiting age evidence of coverage and direct deposit Tier 2 Rx Copay $30 $25 $10 $10 plus 50%
much more. information. Tier 3 Rx Copay N/A $45 $10 $10 plus 50%
Flexible Spending Account (FSA) 401(k)
*$100 per test for CT, MRI, Nuclear Cardiac Scan, PET
This benefits summary is a general outline of the coverage offered. Please see your evidence of coverage or certificate of insurance for plan specifics. • Choose between Traditional 401(k),
An FSA allows you to set aside pre-tax dollars from each paycheck to help pay qualified health ROTH 401(k) or a combination of the
two, through Fidelity
care expenses and dependent care expenses. • Contribute a percentage of your in-
2 KriptonPHOTOGRAPHIC • All enrollees will receive a debit card. Additional debit cards for dependents can be ordered. KriptonPHOTOGRAPHIC 3 come to the IRS maximum of $17,500
for 2017
• Plan your election carefully; any unused money will be forfeited at the end of the plan year.
• Participants 50 years and older may
also make a $5,500 catch-up contribu-
tion for 2017
• Enroll when you are ready
• New participant log-in:
Health Care Spending Account ~Use SSN as user name
~Set up personal pin number
~Deductions will begin the first of the
month following date of hire
Reimbursement for out of pocket medical, dental, and vision expenses for you and your ~You can enroll anytime
eligible dependents
Plan Year Maximum $2500
Covers Essential health care expenses that are not covered, or are partial-
ly covered, by your medical, dental, and vision insurance plans. College Savings
Beyond the Basics Employee Assistance Program You may also use this account to pay for eligible expenses for (Section 529) Plan 225,000 Projected College Costs Through 2024
which you have no coverage at all.
Business Travel Insurance through Chartis Krypton Photographic cares about its employees, and we Grace Period Individuals may incur expenses through March 15 for the previ- A college savings plan provides a flexible and tax-ad- 200,000
understand that life’s pressures and challenges occasionally ous year. Must be submitted for reimbursement by March 31. vantaged way of saving for higher education. Better 175,000 $200,000
require special attention. Therefore, we are committed to
Business travel insurance gives you the ability to providing you with tools and resources that can help you in Health Care Examples Co-pays, Deductibles yet, you have the convenience of making contribu- 150,000 125,000
tions via payroll deduction.
effectively respond to crises that may occur during your time of need. You and your family members have access 100,000
while traveling on behalf of Krypton Photographic: to a free employee assistance program (EAP). The program Dental Services • Federal tax benefits – After tax contributions grow tax 75,000 $100,000
provides confidential support with issues such as: Vision Exams & Materials free if used for college expenses 50,000
• 24/7 Accidental Death & Dismemberment (AD&D) coverage • One Donor (account owner), One Beneficiary – Account 25,000 $34,132
• Benefits are paid in addition to any other benefits received • Parenting and child care Laser Eye Surgery owner maintains control for the life of the account 0 $14,333
• One single point of contact for all travel, medical and security • Financial problems Chiropractic/Acupuncture • Substantial contribution limits – $350,000 per beneficia- 2008-2009 2023-2024
ry
assistance needs • Marital and family problems • No income restrictions or age requirements – Anyone Average Annual Tuition, Room and Board of Public College
• Access to over 400,000 medical facilities and profession- • Alcohol and drug abuse Diabetic Supplies/Insulin can contribute to Average Annual Tuition, Room and Board of Private College
a 529 Plan
• Legal consultations
als and 400 security professionals Hearing Aid and Batteries
• Emotional distress
• Security Evacuation, Kidnap and Ransom • Elder adult services Some of the over-the-counter drugs are not a qualified medical • Flexible – Choose from a variety of 529 programs and source: http://www.collegesavingsfoundation.org/why-save-for-college.html
Benefit • Loss and death investment choices
• Out of Country Accident & Emergency Business travel expense unless prescribed by a physician.
Sickness Medical Benefit
based counseling or by logging on to: www.lifebalance.net.
• Baggage Loss/Personal Effects insurance provides you Utilize the EAP by calling 800.854.1446 for unlimited phone-
Benefit
• Travel Tracker Online Travel with additional AD&D cov- Three face to face visits are available at no charge
Management Tool erage of 2 times your annual 6 KriptonPHOTOGRAPHIC KriptonPHOTOGRAPHIC 7
salary up to a maximum of
$500,000
Perks
Travel Assistance through UNUM Munchis Daily lunches, Pump it up Game on Mini hoops, Beer O’Clock
bagels, and endless Get your exercise on at foosball, ping-pong, and Wind down with a
snacks the on-site gym video games cold one
Whether you’re traveling for business or personal reasons, our
worldwide emergency travel assistance program goes with you.
Services are available for simple to extreme travel emergencies:
• Hospital admission assistance
• Emergency medical evacuation Catch some rays Team fun Killer gear Unlimited time off
• Critical care monitoring
• Care of minor children Beautiful bay views on Giants games, bowling, Top of the line Macs, Re-charge your batteries
• Emergency trauma counseling our open outdoor space oyster shucking, go-karting, huge cinema displays and come back fresh
and more
and a relaxing work-
• Prescription assistance space
• Legal and interpreter referrals
8 KriptonPHOTOGRAPHIC KriptonPHOTOGRAPHIC 9
Benefits Cards - print
or digital, or both
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