Bearence

Comprehensive training and testing on Bearence employee benefits.

Bearence Overview

Page 1


BEARENCE Management Group is a brokerage firm that will be selling our HealthJoy subscription to their clients.  

In addition, BEARENCE will be offering the HealthJoy Groups app to their employees. The HealthJoy Group subscription is offered at no charge to the employees. HCCs need to recognize when a member has a HealthJoy Group plan and be able to assist based on their membership benefits.


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Bearence has 3 office locations in the United States:

1) West Des Moines, Iowa (Corporate Headquarters)

1045 76th Street, Suite 4000

West Des Moines, IA 50266

515.327.8450 (phone)


2) Mendota Heights, Minnesota

2010 Centre Pointe Blvd.

Mendota Heights, MN 55120

651.379.7800 (phone)


3) Overland Park, Kansas

11020 King Street, Suite 350

Overland Park, KS 66210

913.317.8420 (phone)


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Bearence has roughly 85 employees who will all have our HealthJoy Groups app.  We will service these ~85 employees PLUS their families.

  • These are VIP customers. Be sure you are doing everything you can to provide the best excellent service in helping our members save money on healthcare.
  • If possible, collect insurance Member ID numbers for Medical and Dental upfront! 
  • Bearence employer health plan options (3 different health insurance options) are offered to eligible employees, but customers may opt out and have a health insurance plan outside of the company.
  • Bearence employees have their open enrollment between November 21st and December 9th.  During this time, they can choose if they would like to enroll in one of the three medical insurance plans offered.  They will also choose if they would like the offered vision and dental insurance plans, and if they would like to enroll into the offered F.S.A. or H.S.A.

Bearence Employee Health Insurance

Overview

Bearence offers their employees the option between 3 different health insurance plans.  Bearence employer health plan options are offered to eligible employees, but customers may opt out and have a health insurance plan outside of the company.

All three plans utilize the same plan name and network as well as prescription provider. 

Plan Name: Alliance Select

Plan Network: Wellmark Blue PPO (or  Blue Cross and/or Blue Shield PPO network outside of Iowa)

Prescriptions: Caremark

Plan 1 - Alliance Select Primary

Plan 1:  Alliance Select Primary


Summary of Benefits

Plan Type = PPO

Deductible = $1,000 individual / $3,000 family

Prescription Deductible = $100 individual / $200 family (does not include generics)

Max Out of Pocket = $2,000 individual / $6,000 family

PCP Copay = $25

Specialist Copay = $50

Generic Meds = $8

Preferred Brand Drugs = $35

Non Preferred Brand Drugs = $50


This plan is FSA eligible

A healthcare FSA is another type of reimbursement account offered by employers. It allows you to set aside money from your paycheck before taxes to pay for many of your family's healthcare costs during the year. You decide how much to set aside in your FSA. Because you’re spending pre-tax money on healthcare, you’ll pay fewer taxes and end up with a higher portion of your salary to spend on other things.

Plan 2: Alliance Select Primary

Plan 2:  Alliance Select Primary


Summary of Benefits

Plan Type = PPO

Deductible = $3,000 individual / $9,000 family

Prescription Deductible = $100 individual / $200 family (does not include generics)

Max Out of Pocket = $6,000 individual / $12,000 family

PCP Copay = $35

Specialist Copay = $70

Generic Meds = $8

Preferred Brand Drugs = $35

Non Preferred Brand Drugs = $50


This plan is FSA eligible

A healthcare FSA is another type of reimbursement account offered by employers. It allows you to set aside money from your paycheck before taxes to pay for many of your family's healthcare costs during the year. You decide how much to set aside in your FSA. Because you’re spending pre-tax money on healthcare, you’ll pay fewer taxes and end up with a higher portion of your salary to spend on other things.

Plan 3: Alliance Select HSA-Qualified (HDHP)

Plan 3:  Alliance Select HSA-Qualified (HDHP)


Summary of Benefits

Plan Type = PPO

Deductible = $2,500 individual / $5,000 family

Prescription Deductible = NONE

Max Out of Pocket = $2,500 individual / $5,000 family

PCP Copay = Subject to deductible

Specialist Copay = Subject to deductible

Generic Meds = Subject to deductible

Preferred Brand Drugs = Subject to deductible

Non Preferred Brand Drugs = Subject to deductible


H.S.A. Eligible Plan

Health Savings Accounts (HSA) are special accounts that provide tax benefits when used to pay for medical expenses that are not covered by health insurance. These HSA plans are used along side high deductible health insurance plans (HDHP), or consumer directed health plans (CDHP), to provide a comprehensive protection plan that focuses the user on being a good shopper for health care needs.

Prescriptions

All three plans utilize the same prescription provider and formulary.

Prescription Provider = Caremark

Bearence Spending Accounts

Flexible Spending Accounts (FSA)

Flexible Spending Accounts

  • A healthcare FSA is another type of reimbursement account offered by employers. It allows you to set aside money from your paycheck before taxes to pay for many of your family's healthcare costs during the year. You decide how much to set aside in your FSA. Because you’re spending pre-tax money on healthcare, you’ll pay fewer taxes and end up with a higher portion of your salary to spend on other things
  • Bearence Plan 1 and Plan 2 both have the FSA option available to the employee.
  • Employee's MUST enroll every year during their Open Enrollment Period (Nov 21 - December 9)
  • FSA plans will not roll over to the next calendar year.  The employer owns the account. Whatever is not used, they lose.

Flexible Spending Accounts

  • Bearence employee's have a $2,600 maximum amount that they are able to deposit into their FSA.
  • Bearence employee's will be mailed a debit card starting 01/10/2017 that they can use for FSA qualified expenses.

Dependent Care FSA

Dependent Care FSA

  • Dependent Care Flexible Spending Account (DCFSA) is a pre-tax benefit account used to pay for dependent care services, such as preschool, summer day camp, before or after school programs, and child or elder daycare. Dependent Care FSA is a smart, simple way to save money while taking care of your loved ones so that you can continue to work.
  • Examples of Dependent Care eligible expenses
  • Bearence employees can have BOTH a regular FSA and a Dependent Care FSA.
  • Maximum allowed for Dependent Care FSA is $5,000 a year.

Health Savings Account (HSA)

Health Savings Account (HSA)

  • A Health Savings Account (HSA) is a tax exempt account set up exclusively for medical, dental, and vision expenses for all members covered under a qualified High Deductible Health Plan (HDHP).  The annual maximum contribution is $3,400 for an individual or $6,750 for a family.
  • The money in an HSA plan can be used to pay for the qualified medical expenses that the insurance plan does not cover, such as deductible costs, office visits, prescriptions, eye care, dental needs, chiropractic visits, and acupuncture.
  • ONLY Available to Bearence employees who enrolled into Plan 3.
  • HSA accounts will roll-over at the end of the year and any un-used contributions will deposit into the new HSA for the new year.
  • Bearence will contribute $350 annually to each employee's HSA account.
  • Examples of HSA qualified expenses

Limited Flex Plan FSA (Limited purpose FSA)

Limited Flex Plan

  • If an employee is enrolled into Plan 3 which is HSA eligible, and they also want to enroll into a FSA, they can only enroll into what is called a Limited Flex Plan, or Limited Purpose FSA.
  • A Limited Flex Plan FSA is much like a regular FSA, except that eligible expenses are limited to qualifying dental and vision expenses for the employee and their family, instead of all medical expenses.
  • This only applies to those enrolled in Plan 3 and that also want a FSA.

Bearence Employee Dental Insurance

Blue Dental PPO

  • Bearence employees have the option to opt into the dental insurance that Bearence offers.
  • This dental insurance is offered by Wellmark Blue Cross and Blue Shield.
  • Plan Name = Blue Dental PPO
  • Network =  Blue Dental (spans Iowa and surrounding counties)  If the employee is outside of the Blue Dental service area, then members can visit dentists or specialists that participate in the Dental GRID Corporation network, one of the nation's largest dental provider networks.
  • Provider Search Tool


Bearence Employee Vision Insurance

Avesis Vision

  • Bearence employees may opt into the vision insurance plan they offer.
  • The vision insurance is provided by Wellmark Blue Cross and Blue Shield
  • Plan name = Wellmark Vision Plan
  • Plan network = Avesis
  • Provider Search Tool

B-Healthy Programs

B-Healthy

  • VOLUNTARY Wellness Program
  • Designed to Fit the Individual
  • Employees can receive a continuing $50/month credit towards their health insurance premium as long as they participate in a Health Risk Assessment (HSA) and an Annual Physical.
  • Employees can also earn $200 Well-Bucks Annually if they participate in a Health Risk Assessment (HSA), an Annual Physical, continuing Education, and Behavior Change Activities (Health Coaching).

Test!

How many different health insurance plans does Bearence offer its employees?

  • 3
  • 5
  • 2
  • 1

Fill in the blanks

Bearence is a that will be selling our HealthJoy subscription to their clients.  Their corporate headquarters are located in the state of and they have two other office locations in the United States.

Bearence will also be offering the to their full time employees at no charge.

HCCs should treat Bearence members as and be sure to do everything they can to provide the best excellent service in helping our members save money on healthcare.

True or False

  • Bearence employees are only allowed to get one of the three health insurance plans offered by their employer.

True or False

  • Bearence employee's Open Enrollment is between November 21st and December 9th.
  • Bearence employees can enroll into a FSA at any time throughout the year.

The plan name for all 3 employer offered health insurance plans is...

  • Caremark
  • Wellmark PPO
  • Alliance Select
  • Alliance Blue Cross and Blue Shield

Select the image that shows the benefits of Plan 2.

Match the terms with the best description

  • HSA
    Account that provides tax benefits when used to pay for medical expenses that are not covered by health insurance. These plans are used along side high deductible health insurance plans HDHP to provide comprehensive protection. Available only with Plan 3
  • FSA
    A reimbursement account offered by employers. It allows you to set aside money from your paycheck before taxes to pay for many of your family's healthcare costs during the year. For Bearence it has a maximum of $2,600 per year and comes with a debit card
  • Limited Flex Plan
    Much like a typical, general-purpose health FSA. However, eligible expenses are limited to qualifying dental and vision expenses for you, your spouse, and your eligible dependents. Only available with Plan 3.
  • Dependent Care FSA
    A pre-tax benefit account used to pay for care services, such as preschool, summer day camp, before or after school programs, and child or elder daycare. For Bearence it has a maximum amount of $5,000 per year.

Which plan(s) are FSA eligible?

  • Plan 1
  • Plan 2
  • Plan 3

Select the image that shows the benefits of Plan 1.

Fill in the blanks

is a high deductible health plan (HDHP) and all office visits other than preventive visits are subject to the  so the member will be paying out of pocket.  However, this plan is eligible so the customer can use pre-tax dollars in order to pay for those expenses.

True or False

  • All three Bearence employee health insurance plans use the same prescription provider: Caremark.

Which health insurance plan has all prescriptions subject to the deductible and no copays?

  • Plan 1
  • Plan 2
  • Plan 3

What is the name of the Plan Network for all 3 plans?

  • Wellmark Blue PPO
  • Caremark
  • Bluecare PPO
  • Alliance Select

What are the two different networks you can search to find dental providers for the Bearence employee dental insurance?

  • Blue Dental PPO
  • Dental Care Blue
  • Dental GRID Corporation
  • Wellmark Dental

True or False

  • A Bearence employee who has a Plan 3 with $2,000 in their HSA can use that $2,000 to pay for their out of pocket dental expenses.
  • Diagnostic and preventive services for the Blue Dental PPO are covered at a $25 copay.

True or False

  • Bearence employees may opt in to a vision insurance plan which is through Wellmark Blue Cross and Blue Shield.
  • The name of the vision network is Avesis.

Match the term to how the employee can qualify for it.

  • $50/month premium credit
    Employees can take a Health Risk Assessment and take an Annual Physical to qualify.
  • $200 Well-Bucks
    Employees must take a Health Risk Assessment, continue education, take an Annual Physical, and enroll in Behavior Change Activities (Health Coaching) to qualify.