The Coming 2021 Plan Year
Open Enrollment for the upcoming 2021 plan year will be held from October 15 – 30, 2020.
We are please to announce that 2021 will be the fifth consecutive benefit renewal where there will be no premium rate increases for faculty and staff! This is great news and says something significant about the health and wellness of our SPU population.
Each year the University actively reviews the various employee benefit plans in order to continue to offer access to excellent plans while also keeping the costs of doing so reasonable. Part of this process also includes periodically reviewing our various plan providers.
Out of this year’s review, the best combination of benefits and cost for the upcoming 2021 plan year will require several changes to benefit providers that will become effective on January 1, 2021. The general structure and design of the actual plan offerings are not changing, only the service providers for some of the plans, including SPU medical coverage.
As a reminder, Open Enrollment is the one time each year where benefit-eligible employees are able join/waive coverage, add/drop dependents to/from coverage, or change plans; simply for the reason of it being Open Enrollment. Whatever your coverage election is at the end of the Open Enrollment period will be locked in for the 2021 plan year unless you experience a Qualifying Life Event (per IRS regulations) and request a change that is consistent with the event in the required timeline.
Please CLICK HERE to review the complete 2021 SPU Benefits Guide.
To review the Summary of Benefits and Coverage (SBC), CLICK HERE.
To review important Your Rights Notices, CLICK HERE.
Table of Contents
Fifth Consecutive Benefit Plan-year with No Increases to Your Monthly Insurance Premiums!
We are very excited that there will be no premium rate increase for the 2021 benefits plan year. This is the case for the fifth consecutive plan-year. Given the state of employer-based benefits nationwide, this is an exceptional feat. This results from the way we all care for ourselves, some good luck (blessings!) in not having as many large claims the last few years, and by maintaining a stable medical plan design. It may not always be this positive in the future, but we will take it where we can get it and thank the Lord for it!
Medical
COVERAGE | Full-time | Part-Time |
|---|---|---|
| Employee Only | $0 | $220 |
Employee + Spouse | $414 | $634 |
| Employee + Child(ren) | $136 | $356 |
| Employee + Family | $640 | $860 |
Dental
COVERAGE | Full-time | Part-time |
|---|---|---|
Employee Only | $0 | $22 |
| Employee + Spouse | $58 | $80 |
| Employee + Child(ren) | $56 | $78 |
| Employee + Family | $114 | $136 |
Vision
COVERAGE | Full-time & Part-time |
|---|---|
Employee Only | $0 |
| Employee + Spouse | $10 |
| Employee + Child(ren) | $12 |
| Employee + Family | $24 |
What is a Deductible?
A deductible is the amount you pay each year for eligible health care expenses before your insurance plan will begin to pay for covered expenses.
For example, if you are enrolled in individual medical coverage, you have a $2,000 annual deductible. You will be responsible to pay for all of your covered health care services until you have paid $2,000 that year.
Once you have paid $2,000, Aetna will start to pay their share of the following costs (this is called 'coinsurance') at a rate of paying 90% if using an In-Network service provider and 60% if you use an Out-of-Network provider until you reach your annual out-of-pocket maximum. After that, the plan will pay for 100% of the covered medical expenses.
If you have family coverage, meaning you cover at least one dependent on your medical plan, then a family deductible of $4,000 applies to everyone taken together.
Why are HSAs So Powerful?
- It's your money! You own it, the HSA is portable; even if you change plans, leave SPU, or retire.
- It's very tax-favored! HSAs enjoy what we call a 'triple tax advantage': the contributions are pre-tax, you can get tax-free growth on those funds while you hold them, and distributions that cover eligible health expenses are also tax-free.
- The HSA funds can grow! Once you have a minimum amount, you can invest in a selection of funds through HSA Bank's investment portfolio. But be cautious, these funds are for your health expenses.
- HSAs are retirement accounts! Because you keep the funds, you can take your HSA into retirement and use the funds tax-free for health expenses. Further, once you are 65, you can withdrawal funds like any other retirement account and only pay regular income tax on it (no penalty is assessed like prior to 65).
- HSA are flexible! You are in control of your funds and can contribute up to IRS limits and spend on health costs for any of your tax-dependents, even if they are not enrolled in the SPU medical plans.
What is an Annual Maximum?
Each year that you are covered on the plan (our 'plan year' follows the calendar year), Aetna will keep track of all the covered medical and prescription expenses you have to pay for. These might be in the form of deductible expenses, coinsurance (where you pay a percentage of costs after the deductible is covered), or prescription costs.
This is very important because it puts a limit on what you could owe if you or a covered family member needs high cost medical care.
If you have Employee Only coverage, your annual out-of-pocket maximum is $3,425 per year. If you cover a family member on your medical plan, the maximum increases to $6,850 with all family members taken together. (There is an exception for those with family coverage that have one person with high costs: a separate limit of $4,000 is applied to that individual's costs so that one person cannot make a family owe the entire family maximum.)
How Does SPU Help Offset Deductible Expenses?
To help with the deductible, which resets back to zero each January, SPU contributes the amounts in the table below into an account based on your plan choice between 1/1/2021 – 12/31/2021. These figures assume that your participate in the plan for all 12 months of 2021 and make employee HSA contributions (from your own payroll deductions) at least enough to trigger the SPU match up the annual cap that would apply to you based on your plan enrollment.
An equivalent annual contribution is made into the Health Reimbursement Account (HRA) for those who choose to enroll in that plan. The HRA allows all of the funds to be available right away but there are no employee contributions allowed, by IRS regulations.
Health Savings Accounts (HSA)
If you are enrolled in a Health Savings Account (HSA), SPU will contribute monthly to an HSA setup on your behalf plus a dollar-for-dollar match of your HSA contributions, up to the annual maximum.
| HDHP Coverage Level | SPU Monthly Contributions | SPU Match of Employee HSA Contributions | Total Possible SPU HSA Contributions per Year |
|---|---|---|---|
| Individual | $84 | Up to $400 per plan year* | $1,408 in 2021 |
| Family | $168 | Up to $800 per plan year** | $2,816 in 2021 |
*If you have Individual coverage and contribute by payroll deduction to your HSA during 2021, SPU will match your HSA contributions dollar-for dollar, up to $400 for the year.
**If you have Family coverage and contribute by payroll deduction to your HRA during 2021, SPU will match your HSA contributions dollar-for-dollar, up to $800 for the year.
Tip: For those who participate in the HSA, with SPU’s additional contributions, be sure to review your contribution plan to ensure that all HSA contributions will not exceed the annual IRS maximums. You may change your HSA pre-tax contribution amounts once per pay period. Please take advantage of your personalized HSA Calculator to help you plan appropriately.
HSA funds belong to the account holder and are portable: unused funds do rollover to the next plan year. If you change coverage to the HRA plan or otherwise lose eligibility to this plan, contributions to the HSA are no longer allowed but you do keep current funds in the HSA to be used for qualifying health expenses in the future.
Health Reimbursement Accounts (HRA)
If you are enrolled in a Health Reimbursement Account (HRA), SPU will fund the below amounts to a HRA setup on your behalf, based on your HDHP enrollment.
| Coverage Level | SPU Contributions for 2021 |
|---|---|
| Individual | $1,008 |
| Family | $2,016 |
Eligible reimbursements through the HRA are for the employee and also eligible dependents that are enrolled on the HDHP plan as a dependent under the employee's medical coverage. If an otherwise qualified dependent is not enrolled on the HDHP medical plan, their expenses are not eligible for reimbursement from this HRA plan.
If a participant remain covered on this HRA plan from year-to-year and does not use up all the funds available, the unused HRA funds from the prior year will rollover and be added to the funding available in subsequent plan years.
However, once coverage under this HRA plan is ended, either because of moving over to the HSA plan or because of changing employment or losing benefits eligibility, the funds remaining in the HRA are returned back to the plan at that time. HRA funds are not portable.
HRA contributions are pro-rated on a monthly basis for those with midyear changes.
Flexible Spending Accounts - New Contribution Limits and Deadlines
If you participate in our Flexible Spending Accounts (FSA), please review the contribution limits for 2021 as they have been adjusted for the new plan year. There is a small increase that the IRS announced for the Health FSA, based on cost of living changes (the Dependent Care FSA is, by law, not similarly indexed and continues to remain the same amount). If there are multiple adults in a household with access to a Health FSA, both may use this benefit through their employer in the same tax year; they may be 'stacked'.
If you are considering using the Dependent Care FSA, please note that each household may only use this tax-favored vehicle once per tax year, you cannot have two spouses both using this from their own employer. Further, you may only use the Dependent Care FSA or the Dependent Care tax credit in a given tax year, not both.
FSA Contribution Limits for 2021
Health FSA | Limited-Purpose FSA* (Dental & Vision Only) | Dependent Care FSA |
|---|---|---|
| $2,800 | $2,750 | $5,000 |
*A Limited-purpose FSA is designed to be paired with someone that has a HSA. Remember, if you enroll on a basic Health FSA, that makes you ineligible to make or receive any HSA contributions. But for those on the HSA plan, they are allowed to use the Limited-Purpose FSA without becoming ineligible for HSA contributions. That is because the Limited-Purpose FSA is only allowed to be used for dental and vision expenses. A very common use of the Limited-Purpose FSA is to cover the costs of orthodontia. Orthodontia is a large, known expense and if you want to preserve your HSA funds, you can then use the Limited-Purpose FSA to pay for the orthodontia.
Dates to keep in mind
March 15th: The deadline to incur expenses for FSA reimbursement.
March 31st: All claims must be submitted to HSA Bank for reimbursement.
New Plan Administrators for 2021
Each year the University actively reviews the various employee benefit plans to continue to offer access to excellent plans while also keeping the costs of doing so reasonable. Part of this process also includes periodically reviewing our various plan providers. Out of this year’s review, the best combination of benefits and cost for the upcoming 2021 plan year will require several changes to benefit providers that will become effective on January 1, 2021. The general structure and design of the actual plan offerings are not changing, only the service providers.
What is Changing
Aetna will become the new medical plan service provider on January 1, 2021 for the University’s medical benefit plans, replacing Cigna.
The network for all medical plans will be the “Aetna Choice POS II (Open Access)”. This network is searchable using the Aetna DocFind tool. To search the network CLICK HERE.
The prescription drug formulary (i.e., the list of approved drugs and coverage level) will also move to Aetna. To review the formulary or search for medication coverage, CLICK HERE.
The prescription drug network will become the Aetna/CVS Pharmacy network, titled the “Aetna National Pharmacy Network”. To search the pharmacy network, CLICK HERE and select the “Aetna National Pharmacy Network” in the “Select a Plan” drop-down menu.
HSA Bank will become the administrator for all the following SPU benefit plans: HSAs, HRAs, FSAs, COBRA plans, and Pre-65 retiree plans. These accounts will no longer be accessed through the medical plan provider, but directly through HSA Bank. (HSA Bank is the current administrator for the HSA/HRA plans.)
The Wellness program will also be administered by Aetna.
For further information, please contact in Human Resources at (206) 281-2809 or email hr@spu.edu.