2025 Open Enrollment

October 29, 2024 –  Open Enrollment Presentation. Register to attend the presentation. The video will be made available for on-demand viewing.

November 1, 2024 – Open Enrollment Begins: Visit the benefits portal to review your current elections and make changes.

November 15, 2024 – Open Enrollment Closes at 11:59pm

After 11:59pm on November 15, 2024 – No more changes can be made for Open Enrollment. Only changes for a qualified life event are able to be made for 2025 benefits.

January 1, 2025 – New benefit elections will take effect.

Health Insurance Premiums & Tier Structure Changes for 2025

Health Insurance costs for 2025 are projected to increase by 18.25% due to high claims costs and high pharmacy spending for our covered employees and their dependents.

Macalester is self-funded, which means that Macalester is responsible for the costs associated with the claims that our employees and families incur.  As a result, premiums will increase substantially.

We will also move from a 3-tier to a 4-tier structure for our health plan. This will change the employee + 1 tier into employee + child(ren) and employee + spouse/domestic partner. Updating our tier structure allows our premiums to better reflect actual utilization of our plan and claims experience.

Health Insurance premiums will:

• Increase by 18.25% for employee only and family coverage.
• Increase by 36% for employee + spouse/domestic partner coverage.
• Decrease by 12.3% for employee + child(ren) coverage.

Full-Time Premiums (0.75 FTE and above)

Rates below are shown on a monthly basis.

2024

	High Deductible		PPO
Tier Level	Employee Cost	Mac Cost	Employee Cost	Mac Cost
Employee Only	$123.61	$494.43	$186.58	$746.32
Employee + 1	$372.68	$881.26	$567.65	$1,336.18
Employee + 2+	$542.65	$1,277.86	$829.33	$1,946.78

2025

	High Deductible		PPO
Tier Level	Employee Cost	Mac Cost	Employee Cost	Mac Cost
Employee Only	$146.17	$584.68	$220.63	$882.52
Employee + Child(ren)	$326.68	$762.24	$497.40	$1,160.60
Employee + Spouse/Domestic Partner	$507.18	$1,183.42	$774.17	$1,806.39
Employee + Family	$641.68	$1,497.26	$980.68	$2,288.26

Part-Time Premiums (0.50 – 0.74 FTE)

Rates below are shown on a monthly basis.

2024

	High Deductible		PPO
Tier Level	Employee Cost	Mac Cost	Employee Cost	Mac Cost
Employee Only	$242.21	$375.82	$368.16	$564.74
Employee + 1	$616.47	$637.47	$941.41	$962.41
Employee + 2+	$899.76	$920.76	$1,377.56	$1,398.56

2025

	High Deductible		PPO
Tier Level	Employee Cost	Mac Cost	Employee Cost	Mac Cost
Employee Only	$292.34	$438.51	$441.26	$661.89
Employee + Child(ren)	$544.46	$544.46	$829.00	$829.00
Employee + Spouse/Domestic Partner	$845.30	$845.30	$1,290.28	$1,290.28
Employee + Family	$1,069.47	$1,069.47	$1,634.47	$1,634.47

Health Savings Account (HSA) Limits

The HSA limits for 2025 will be increasing to the following amounts:

• Individual: $4,300
• Family: $8,550

Participants 55 and older can still contribute an extra $1,000 to their HSA.

Nice Healthcare Updates

Due to legislative changes, HDHP participants will be required to pay a nominal fee for Nice Healthcare services. The Consolidated Appropriations Act of 2022 included a provision that allowed individuals with high deductible health plans (HDHP/HSA) to not pay a fee for services prior to meeting their minimum deductible while remaining eligible to make HSA contributions. This provision will end December 31, 2024. What this now means is that those on Macalester’s high deductible plan will have to pay a small fee of $10 per visit for Nice Healthcare services. You will be able to use your HSA funds to pay this fee.

Dental Insurance Premiums for 2025

Dental Insurance premiums are increasing by 4%. Rates below are shown on a monthly basis.

2024

	Preventive		Comprehensive
Tier Level	Employee Cost	Mac Cost	Employee Cost	Mac Cost
Employee Only	$4.74	$18.95	$22.66	$22.66
Employee + 1	$13.60	$31.72	$55.62	$37.08
Employee + 2+	$22.87	$53.35	$92.70	$61.80

2025

	Preventive		Comprehensive
Tier Level	Employee Cost	Mac Cost	Employee Cost	Mac Cost
Employee Only	$4.93	$19.72	$23.57	$23.57
Employee + 1	$14.14	$33.00	$57.84	$38.56
Employee + 2+	$23.78	$55.50	$96.41	$64.27

Flexible Spending Accounts (FSA)

In 2025, you are able to contribute up to $3,300 pre-tax dollars to use towards eligible health, dental, and vision expenses. You will be able to rollover $660 unused dollars from your 2025 election into calendar year 2026.

Retirement Limits

The 2025 standard limit is $23,500. Those who are age 50+ are able to contribute up to $31,000.

For reference, the 2024 standard limit is $23,000. Those who are age 50+ are able to contribute up to $30,500.

Employee Voluntary Life

For the 2025 Open Enrollment period, you will be able to elect up to $250,000 worth of coverage without having to complete health questions, otherwise known as Evidence of Insurability. Elections over $250,000 up to $600,000 will require the health questions.

Dependent Voluntary Life

For the 2025 Open Enrollment period, you will be able to elect coverage for a spouse/domestic partner or child(ren) without having to complete health questions, otherwise known as Evidence of Insurability (EOI). Spouses/domestic partners are covered at $25,000 and child(ren) up to age 26 are covered at $10,000

Short-Term Disability

For the 2025 Open Enrollment period, you will be able to elect coverage without having to complete health questions, otherwise known as Evidence of Insurability (EOI).

We have received inquiries and concerns about the 2025 health insurance increase, and we want to provide more details on the context and the actions we took. This wasn’t an easy decision and we recognize the financial impact these updates have to the Macalester community. We explored many options – all with varying impacts. These options were shared with the Benefits Advisory Committee, which is made up of a group of Macalester staff and faculty, and VP of Administration & Finance, Provost and President. Macalester is facing multiple challenges due to the rising costs of healthcare across the country and the number of high cost claims within our group. We will continue to explore options to provide comprehensive health benefits while also trying to reduce costs.

Has Macalester considered becoming fully-insured?

Yes, we approached this conversation with our benefits broker, and we learned that if we switched from self-funded to fully-insured, our premiums would be even higher than our current rates. This is because health insurance companies set premiums at a level that fully reflects the risks associated with our claims history. Our risk, which is a direct reflection of our claims experience, is very high. Over the last few years, our number of high cost claims and total spending on claims has exceeded projections.

What caused our health insurance rates to increase dramatically this year (and over the last 3 years)?

• Healthcare expenses across the country are increasing at a rate that exceeds inflation.
• High number of high-cost claims (claims that exceed $55,000)
• High utilization of pharmaceutical drugs
• New high-cost drugs and new medical treatment innovations
• 50% increase in our stop-loss insurance (Stop loss is insurance that applies when a healthcare claim exceeds $110,000)

What actions did Macalester take in exploring ways to reduce costs associated with our health insurance plan and premium increases?  

Each year, the HR team works with our brokers to explore how we can offer comprehensive plans that are financially sustainable for employees and Macalester. When we learned about the substantial increase in projected claims, we took the following actions:

• Obtained bids from other insurance carriers. Unfortunately, none were lower. Due to our recent claims experience, other insurance carriers were not able to provide lower rates. 
• Attempted to negotiate lower fees from HealthPartners. Because of our claims experience, we did not have much negotiating power with HealthPartners. 
• Modeled adding a smaller provider network option. The impact was negligible as we  would have needed to see more than 60% of the Macalester community switch to a restrictive network to see a nominal decrease.
• Considered increasing co-pays, deductibles and out-of-pocket maximums in order to lower premiums. This was rejected because it would have transferred more costs to employees and likely created a barrier to accessing care.

How is Macalester planning to address the rising costs of premiums?

Macalester is committed to offering comprehensive health insurance because this is a critical component of employee wellbeing. HR, in partnership with the Benefits Advisory Committee, will explore alternative models to address the high costs.

What can employees do to keep healthcare costs in check?

• Commit to preventive care and take care of your health. Investing in preventive care can catch health issues before they become serious, lower healthcare costs, save money in the long run, and improve overall health and well-being. 
• Use Nice Healthcare. Going through Nice Healthcare for primary care will reduce your costs, as well as reduce claims on Macalester’s group health plan. Nice Healthcare offers over 550 medications at no cost to participants. Check out their Rx and Pharmacy services to see if a medication you are currently taking can be prescribed by Nice. 
• Use in-network providers, rather than out-of-network providers. Typically, you will receive better coverage and pay less when you go to a provider in-network versus out-of-network. Visit the FAQ – 2025 Benefits section below on how to find more information on searching for in-network providers for HealthPartners.
• Be a wise consumer of healthcare. Use the lowest level of care that matches your need (virtual care, medical clinic, urgent care, emergency room)
• Consider the High Deductible Health Plan (HDHP) – Folks who participate in the HDHP are able to enroll in a Health Savings Account. For those who elect Level 3, Macalester contributes 50% of the plan’s deductible over the calendar year to help cover eligible expenses.

Why did Macalester chose to move from a 3-tier to 4-tier health plan structure? 

One of the areas we looked at to help guide our decision making was at our claims trend to help us understand where our spending is coming from. We learned that our highest claims come from our employees, spouses, and domestic partners on our health plans. By understanding this data better, it was then decided to separate out the Employee + 1 tier so that we could assign premiums to better reflect our communities spending and claims experience.

Am I required to complete Open Enrollment?

Macalester observes a passive open enrollment, meaning that we do not require employees to complete the open enrollment process.  Though, we do strongly encourage all employees to review their elections to ensure they are still a good fit. And with the changes to our tier and premium structure to our health plan, it is as important as ever.  As a reminder, Flexible Spending Account (FSA) elections, such as the Healthcare FSA, Limited Healthcare FSA, and Dependent Care FSA do not roll over and require reenrollment each year.

When does Open Enrollment begin and end?

Open Enrollment will begin on Friday, November 1 and will close at 11:59 pm on Friday, November 15.

Where do I go to make my Open Enrollment elections?

You will want to visit our Benefits Portal to make your open enrollment elections. Once you have clicked the link, it will bring you directly into our benefit enrollment system called Bswift. You are also able to access Bswift through 1600grand. In your Employee Dashboard you will see a button labeled Benefits. Click that button and you will be directed to the benefit enrollment system.

What is a premium, co-pay, co-insurance, deductible, and out-of-pocket maximum?

Understanding what each of these mean is important in order to help you use your benefits effectively. Watch this short video to learn more about these key terms.

Macalester offers two different health plan options. What is the difference between PPO and HDHP?

High-deductible health plans (HDHPs) offer lower monthly premiums but higher deductibles, while preferred provider organizations (PPOs) typically have higher monthly premiums but lower deductibles. With HDHPs, you will be responsible for paying all costs associated with health care, such as office visits and prescriptions until you have met your deductible whereas PPO plans, you will pay co-pays for health costs such as office visits and prescriptions. When choosing between an HDHP and a PPO, it is important to consider your health status, expected medical needs, and financial situation.

Watch a short video to learn more about PPO and HDHPs.

What are the Health Savings Account (HSA) limits for 2025?

For individual plans, the limit for 2025 is $4,300. For family plans, the limit for 2025 is $8,550. If you are 55 or older, you are able to contribute an additional $1,000. These limits are both the employee and employer contributions combined.

Can I use my HSA dollars to pay for expenses for my spouse/domestic partner and child(ren) if they are not on my health plan?

Yes, you can use your HSA dollars to pay for a qualified medical expense for a spouse or tax dependent even if they are covered under another health plan.

Can my spouse/domestic partner who is not on my Macalester health plan still use Nice Healthcare?

Yes! Spouses, domestic partners, and children up to the age of 26 are able to use Nice Healthcare even if they are not covered on your Macalester health plan.

How long can my dependent child be covered on my benefits?

Your child is allowed to be covered by Macalester benefits until the end of the month in which they turn 26.

What happens if my child gets a full-time, benefits eligible job mid-year? Can I drop them from my insurance?

Yes, this would be considered a qualified life event and you would have the opportunity to drop coverage for your child. Human Resources would need to know within 30 days of the life event and would require documentation showing that your child has coverage elsewhere.

Does my FSA rollover happen automatically?

Yes, the rollover will happen automatically and you will be able to rollover up to $640 into 2025 from your 2024 election.

What is the difference between an HSA and an FSA?

An HSA is a type of tax-advantaged savings account where you set aside money through payroll deductions to help pay for medical expenses — like prescription medications, office visits, or other expenses related to diagnosing, treating, or preventing illnesses. HSA funds can roll over at the end of the year and have higher contribution limits.

An FSA is another type of tax-advantaged savings account where you set aside money through payroll deductions to help pay for qualified medical expenses. FSA funds have a “use-it or lose-it” rule and only allow for a small amount to rollover at the end of the year. So, during open enrollment you’ll have to decide how much money you want to set aside for the year, which can be difficult to predict.

The main difference between an HSA and an FSA comes down to flexibility. With an HSA, there are higher contribution limits compared to an FSA, and HSAs are portable, which means you can take the account with you if you were to switch jobs or leave the workforce. You’re also able to roll over your remaining balance from year to year with an HSA, while an FSA doesn’t allow for that same flexibility.

Watch a short video to learn more about the difference between HSA’s and FSA’s

What is a Dependent Care FSA?

A dependent care FSA is a pre-tax account that allows you to set aside money to pay for dependent care expenses. It can be used to pay for childcare for children up to age 13 to allow you and your spouse/domestic partner to work.

Watch a short video to learn more about Dependent Care FSA’s.

What can I use the Employee Assistance Program (EAP) for?

With an Employee Assistance Program, you can get support for everyday issues and life challenges. Macalester’s EAP program, offered through Cigna, is able to connect you with real people who can help you find solutions to life’s challenges. Whether it’s locating a peanut-free preschool, getting legal advice on a speeding ticket or managing workplace stress, EAP will be able to help you get the support you need to achieve a healthy work-life balance.

Our Employee Assistance Program offers services such as:

• Emotional Health: Get referrals to dedicated, licensed counselors. Connect by phone, in virtual session or face-to-face for support on a range of topics such as: Mental Health, Relationships, Management of anxiety, depression and stress, Substance Use.
• Home Life Referral: EAP is able to help with issues that impact your work-life balance including: Child care, Eldercare, Home Repairs, Pet Care.
• Financial and Legal Assistance: Whether you need help with budgeting strategies or will preparation, EAP can connect you with professional assistance for issues like: Student Loan Repayment, Tenant Rights, Power of attorney and living wills.
• Job and Career Support: Connect with EAP for resources and referrals in areas including: Work-related stress, Time Management ,Professional Development.

These services are all confidential and available at no additional cost to you and anyone living in your household. Connect anytime by calling 1-877-622-4327 or visiting their website at mycigna.com. The Employer ID is ‘macalester’ for initial registration.

What is Nice Healthcare?

Nice Healthcare is a primary care clinic that offers you and your family unlimited virtual and in-home visits with clinicians.  If you are enrolled in one of Macalester’s health plans, you are automatically enrolled in Nice. Your spouse/domestic partner and children up to age 26 can also use Nice even if they’re not enrolled in a health plan through Macalester.   Macalester covers 100% of the premium so there is no monthly cost to you or your family members when you use Nice! Due to legislative changes though, beginning January 1, 2025, plan participants on the HDHP will pay a fee of $10 per visit for Nice Healthcare services.

Nice Healthcare is a clinic that comes to you! They offer:

• Same-day chat and video visits: Diagnosis, prescriptions, treatment plans, care guidance, referrals, and more – care when you need it from anywhere you happen to be.
• In-Home Visits: Need a blood draw, a rapid test, a physical exam, or any other in-person need? Nice will come to you with 35 free labs and physical tests!
• Full-Service Prescriptions: Nice integrates with nearly every pharmacy in the country and provides white glove support to make your prescription experience simple. Plus, Nice provides 550+ medications for free.
• Virtual Physical Therapy: You’ll get access to licensed physical therapists who are trained to diagnose and treat virtually, allowing you to get better without the hassle of endless in-person visits.
• Virtual Mental Health Therapy: Nice mental health therapists focus on prevention, helping you to self-manage your mild to moderate mental health needs. Don’t wait to start feeling better!
• In-Home X-ray and EKGs: Nice can send a mobile imaging technician right to your home to conduct x-rays, EKGs.

Use the Nice Healthcare app to schedule visits, chat with clinicians, attend video visits, review treatment plans, upload documents, and more.

How do I find in-network providers for health, dental, and vision?

You’ve most likely heard the term “in-network” when it comes to Macalester insurance plans, but what does that mean exactly? When facilities, healthcare providers, pharmacies, and suppliers are in-network that means our insurance company has contracted with them to provide services. Typically, you will receive better coverage and pay less when you go to a provider in-network versus out-of-network. HealthPartners, Delta Dental, and VSP Vision Care make it easy to find providers who are in-network to help you make the best decision for you and your covered family.

HealthPartners:  You can search for doctors and medical practitioners, clinics, hospitals, surgical centers, etc. Be sure to select the plan network called ‘Open Access Network’.

Delta Dental:  You can search for General Dentists, Oral Surgeons, Orthodontists, Periodontists, etc. When selecting the plan network, there are two options: Delta Dental PPO and Delta Dental Premier. As a reminder, the Delta Dental PPO Network will provide you with the best level of coverage.

VSP Vision Care: You can search for eye doctors by location, office, and name.

How much can I contribute to my retirement in 2025?

For 2025, the annual contribution limit per IRS regulations is $23,500. For folks aged 50+, they are able to make an additional $7,500 contribution known as a ‘catch-up contribution, bringing their annual contribution limit to $31,000.

For 2024, the annual contribution limit per IRS regulations is $23,000. For folks aged 50+, they are able to make an additional $7,500 contribution known as a ‘catch-up contribution, bringing their annual contribution limit to $30,500.

Is there anyone I can talk to about my retirement portfolio?

Individual counseling sessions are provided through TIAA representatives and are available to all Macalester staff and faculty. A session with a TIAA Financial consultant can help you create a unique plan for your goals and answer any questions you have about your retirement portfolio. And, it’s at no additional cost as it’s a part of your retirement plan.

To schedule your individual counseling session, visit www.tiaa.org/schedulenow

Am I able to make changes to my benefit elections outside of the Open Enrollment period?

The Open Enrollment period allows you to make changes to your benefit elections without requiring a qualifying event. After the Open Enrollment period, you are only able to make changes if you have a qualified life event (QLE). Common examples of a qualified life event are: marriage, divorce, birth or adoption, a spouse or domestic partner gaining or losing coverage, and death. If you think you have a qualifying life event, please reach out to the HR department within 30 days of the event. We do require documentation in order for the QLE to be made.

It is important to note that a QLE is not needed to make changes to your retirement or HSA contribution elections.

Watch a short video to learn about Qualified Life Events.