2014 Health Benefits Open Enrollment

May 1 – 23, 2014

Highlights for July 1, 2014

April 2014

Commonwealth of Virginia Health Benefits Program

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Customize based on your needs

• Enroll, change or keep your health plan

• Consider buy-up options:• COVA Care, • COVA HealthAware &• COVA HDHP

• Add or remove eligible family members • Waive coverage• Enroll in a Flexible Spending Account

Your Health Plan ChoicesPlans Offered Available Administrator

COVA Care Statewide Anthem Blue Cross and Blue Shield

Delta Dental of Virginia

COVA HealthAware Statewide Aetna

COVA HDHP Statewide Anthem Delta Dental

Kaiser Permanente HMO

Regional, primarily in Northern Virginia

Kaiser Permanente

TRICARE supplement

Statewide Association and Society Insurance Corporation (ASI)

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COVA Care and COVA HDHP

Administered by Anthem and Delta Dental

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Anthem administers:

Medical Behavioral Health

Employee Assistance Program (EAP)

Prescription Drug

Delta Dental partners with Anthem

for Dental

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COVA Care and COVA HDHP Behavioral Health

• Residential Treatment Centers

Approved in-network behavioral health services

Change Effective 7/1/2014

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www.AnthemEAP.com

•Mental health

•Parenting and child care

•Marriage & relationship concerns

•Workplace issues

•Finance/Legal

•Health and Wellness

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• Change for 7/1/2014• Drug copayments increase for tiers 2-4

• $5 retail/$10 mail

COVA Care – Prescription Drugs

TierRetail

Home Delivery

1Generic drugs (no change) $15 $30

2Lower cost preferred brands $30

$603Higher cost brands $45 $90

4High cost Specialty brand $55

$ 60

$110

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Home Delivery

Three month supply foronly two copays

Easy to get startedonline at

anthem.comor by phone Delivered safely to yourdoorstep

◦◦◦

Optional Buy-Ups

Out-of-Network

Expanded Dental (Delta Dental)

Routine Vision/ Hearing

• Expanded Dental (Delta Dental)

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COVA Care – Vision and Hearing

Blue View Vision• Eye exam• Eyeglasses and contact lenses• Frames• Discounts on accessories

Hearing• Routine hearing exam • Hearing aids

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Go to urgent care centers instead of emergencyrooms$25 PCP/$40 Specialist copay for Urgent Care vs. $150 copay the ER

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Call 24/7 NurseLineAccess to a registered nurse day or night

Download the Mobile App on your smartphone Find Doctor &Urgent Care Centers, View ID Card and Estimate Your Costs

Use the “Estimate Your Cost” toolFind cost ranges for services and quality reviews for doctors

Bookmark your dedicated website forCommonwealth employees at anthem.com/cova

Anthem Tips and Resources

More on Dental Benefits Administered by Delta Dental of Virginia

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• Delta Dental of Virginia will continue to administer the dental benefits for COVA Care and COVA HDHP

IMPORTANT PLAN FEATURES:

• Diagnostic & Preventive services are covered at 100% for all members when they see a participating provider.

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• Expanded Dental optional buy-up includes

• Primary Care – such as fillings, extractions, root canals

• Complex Restorative - dentures, bridges and implants

• Orthodontic services

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COVA HealthAware

Administered by Aetna

Plan logo here

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•Benefits and Coverage• Medical• Behavioral Health• Pharmacy• Basic Dental• Routine Vision Exam• Routine Hearing Exam• Includes a Health Reimbursement Account (HRA)

•Expanded Dental and Vision benefits for an additional premium

Comprehensive Plan

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•Residential treatment centers added to behavioral health benefits.

•More healthy activities to choose for “Do Right” contributions to the HRA.

Changes for 7/1/2014

What is a Health Reimbursement Arrangement (HRA)?•Account that automatically pays eligible out-of-pocket expenses as long as funds are available

•Medical •Behavioral health•Pharmacy

•Funds paid automatically from HRA towards eligible expenses for any covered member

•Unused HRA funds roll over into future plan years with no limit if enrollment in the plan continues 19

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COVA HealthAware HRA•The initial HRA contribution for 7/1/2014:

•Employee/Retiree $ 600•Employee/Retiree + Spouse$1,200

• HRA contribution is prorated for new enrollments or QME changes during the plan year.

• The HRA proration chart may be found on www.COVAHealthAware.com

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How the Plan WorksCOVA HealthAware is an open access, point-of-service (POS) plan with a large national network.

HRA ContributionEmployee/ Retiree only

Employee/Retiree + SpouseDo Right HRA Incentives

Employee/ Retiree onlyEmployee/Retiree + Spouse

In-Network Out-of-NetworkDeductible

One person $1,500 $3,000Two or more persons $3,000 $6,000

Out-of-pocket MaxOne person $3,000 $6,000

Two or more persons $6,000 $12,000Coinsurance

Preventive 100% 60%Diagnostic 80% 60%

earn up to $300

$600$1,200

earn up to $150

HRA “Do Rights” • Employees/Retirees and enrolled spouses

• Additional $50 HRA contribution for up to three “Do Rights”

• Up to $150 per employee/retiree • Up to $150 per enrolled spouse

• “Do Rights” include• Annual routine physical exam• Routine dental exam• Annual routine vision exam (new!)• Annual flu shot• Active Health Management Health Tracker• Active Health Management Coaching Module (new!)

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Pharmacy Benefits•Integrated with the medical benefit

Combined deductible and out-of-pocket maximum

•Mandatory Generic plan

•Specialty pharmacy available

•Members can compare drug costs in advance on their member website

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Dental Benefits Diagnostic and preventive dental services

• Included with the basic plan • Covered at 100% in-network

Expanded Dental: Optional Buy-Up

•Primary procedures:•fillings, extractions, root canals

•Complex restorative procedures:•crowns, dentures, bridges, implants

• Orthodontia

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Vision BenefitsRoutine annual vision exam included with

basic plan and covered at 100%

Expanded Vision: Optional Buy-Up• Materials benefit for eyeglasses and contact

lenses• Discounts for eyewear and accessories• Network includes private practice providers

plus participating national chains

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Employee Assistance Program (EAP)Aetna Resources For LivingSM

• Available to participants and members of their household

• Confidential resource to address and resolve personal and workplace challenges

• Provides up to 4 visits per incident per plan year at no cost

• Additional legal and financial guidance

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Member tools and resourcesAetna Navigator

• Secure member website for 24/7 plan access and answers to questions

Member Payment Estimator

• Provides real-time, personalized cost estimates for members based on their specific health plan and balances

iTriage

• Mobile app to help members make better healthcare decisions and improve healthcare delivery

CarePass

• Digital health and wellness tool to combine all leading health, wellness, and nutrition apps in one place

Aetna Mobile• Access to Aetna Navigator from a smartphone

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Finding answers is easy!

•Have a question about any COVA HealthAware Benefit?

• One-stop, concierge-style service: 1-855-414-1901

• Dedicated website: www.COVAHealthAware.com

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MyActiveHealth Total Population Health

Program

ActiveHealth Management:

•Provides coaching services as part of the COVA health management program

•Partners with Anthem and Aetna to deliver services promoting healthy lifestyles and chronic condition management.

Posters, flyers, postcards and email communications provide program information.

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Customized Health Portal

www.myactivehealth.com/cova

• All eligible adult members may access

their own customized portal

• Complete their health assessment

• Schedule biometric screening

• The portal is enhanced with online

coaching and web tools

• Digital coaching

• Interactive trackers, games and more

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Healthy Lifestyles - Lifestyle Coaching with Five Tracks

• Smoking Cessation • Weight Management • Stress Management • Nutrition• Exercise

Healthy Insights - Disease and Chronic Condition Management for Conditions Such As:

• Heart Disease• Diabetes

Healthy Beginnings - Maternity Care

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Incentives - COVA Care and COVA HealthAware

• Healthy Insights • Diabetes management • Hypertension (new July 1, 2014)• COPD & Asthma (new July 1, 2014)• Bariatric Surgery Coaching Program

• Healthy Beginnings for expectant moms

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Kaiser Permanente HMO Administered by Kaiser Permanente

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New for July 1, 2014

•Pediatric Vision Eyewear up to age 19• No cost to members

•One pair of frames per year from select group, and•Certain single vision or bifocal lenses, or•Up to three months supply of contact lenses from selected list

The Power of kp.org

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TRICARE SUPPLEMENT Administered by Association and Society

Insurance Corporation (ASI)

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TRICARE SUPPLEMENT

Voluntary supplemental health benefit option

Available to employees and their dependents who are eligible for: TRICARE, the military health benefit program, and The State Health Benefits Program

Eligible employees who enroll in the plan are responsible for 100% of the monthly premium amounts

Monthly premium payments are made with pre-tax dollars through payroll deduction

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Premium Reward•For employee, retiree and/or enrolled spouse

•Employee/Retiree or spouse can save $17/month

•Together can save $34/month

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Already Earning a Premium Reward?

•Remain in COVA Care or COVA HealthAware

•Reward will continue through June 30, 2015

•No additional actions required

•New! Confirm your reward status on EmployeeDirect

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Earn Premium Rewards – COVA Care and COVA HealthAware

• Eligible members enrolled from July 1, 2013–March 1, 2014•Health assessment and biometric screening must be completed and submitted by May 31, 2014.

• Eligible members enrolled effective April 1–July 1, 2014•Health assessment and biometrics must be completed and submitted by August 31, 2014.

•Health assessment and biometric registration are available at www.MyActiveHealth.com/cova or by telephone at 1-866-938-0349

MONTHLY PREMIUMSEmployee

OnlyEmployee

Plus OneEmployee

Plus Two Or More

Health Care Plan Reward Earner Employee

Employee or

Spouse

Employee and

Spouse

Employee or

Spouse

Employee and Spouse

COVA Care

Employee Premium $75 $171 $171 $230 $230

Rewards -$17 -$17 -$34 -$17 -$34

Employee Premium with Rewards $58 $154 $137 $213 $196

COVAHealthAware

Employee Premium $26 $81 $81 $96 $96

Rewards -$17 -$17 -$34 -$17 -$34

Employee Premium with Rewards $9 $64 $47 $79

$62

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Flexible Spending Accounts

Administered by Anthem

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Health care FSASet aside up to $2,500 per year, pre-tax, for eligible health expenses

Dependent care FSASet aside up to $5,000 per year, pre-tax, for dependent day care expenses

Flexible Spending Accounts

Use the Elite Benefit Card for eligible Health FSA expenses

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•You must file claims within the three months after your coverage period ends

• Including any documentation required to validate an outstanding FSA card transaction.

•For Example, if your coverage period ends on 4/30/15, you must file by July 31, 2015.

FSA Change for 7/1/2014

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All Participants Should Register Online:

Account Balances Direct Deposit

Account Activity Statements Online Payments

Important Information about your FSA:

Participants must enroll each plan year in order to participate.

If you enroll in COVA HealthAware, the HRA pays first.

See Spotlight on Benefits for website and contact information.

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ALEX is back! ALEX is your online interactive assistant. He can advise you on what plan may be best for you. The final decision is still yours. Take a look at www.alexforcova.com

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Get More DetailsFind information:

•Spotlight or Retiree notification booklet

•www.dhrm.virginia.gov

•Your agency Benefits Administrator

•Contact the plans

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Make Your Election!• Visit http://edirect.virginia.gov

• Login and select “Health Benefits Enrollment and Information”

• Or submit an enrollment form to your agency benefits office

Final answer due May 23!

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Remember, It’s Your Call!

Consider what’s best for you and your family

•Choose your health coverage

•Premium reward

•Employees - Flexible Spending Account

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Important Dates

•Last day of Open Enrollment - May 23

•Last Day to Key RC 56 – May 29

•Last Day to Key RC 47 – June 30

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Premium Rewards

Coverage Effective on: Activities Completed by: Premium Reward Begins:

July 1, 2013 May 31, 2014 July 1, 2014

August 1, 2013 - March 1, 2014 May 31, 2014 July 1, 2014

April 1, 2014 – June 1, 2014 June 30, 2014 July 1, 2014

April 1, 2014 - July 1, 2014 July 31, 2014 August 1, 2014

April 1, 2014 – July 1, 2014 August 31, 2014 September 1, 2014

Current Premium Rewards will continue until June 30, 2015 as long as members remain in

COVA Care or COVA HealthAware.No additional action required!

Premium Reward Status

EmployeeDirect: Health Benefits Enrollment and Information Bulletin Board Confirm your premium rewards: Select “View Current Health Benefits Profile”, then look at Section 3: Health Care Coverage Election for “Reward Earned”.

PSBREW – New Premium Reward Activity Screen - • Check the status of the reward activities• Confirm the end date of the Premium Reward• Numbered Memo 14-01

PSB305: EmployeeDirect

No Reward NonePar Only You OnlySpouse Only Spouse OnlyPar&Spouse You and Spouse

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Employee Mailing

•The Spotlight newsletter will be:

• mailed to the employee’s home• provided electronically to all employees with emails in BES

•Summary of Benefits and Coverage(SBC)

• required by the Affordable Care Act (ACA)• If currently enrolled, employees will receive a plan specific SBC• If not currently enrolled, a notice on how to obtain a copy of the

SBCs.

•Annual CHIP notice • required by the Department of Labor

•HIPAA Special Enrollment Notice

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  EmployeeDirect login/password issues or HuRMan access: Email: support@dhrm.virginia.gov

General Open Enrollment questions:Email:

openenrollment@dhrm.virginia.gov

EmployeeDirect Health Benefits and Enrollment issues, keying BES, or content of a BES report:

Email: ohb@dhrm.virginia.gov

Policy and eligibility questions: Email: ohb@dhrm.virginia.gov

Fax: (804) 371-0231

Need Help?