2015 Open Enrollment

Open Enrollment DatesNovember 10 – November 21

THINGS TO KNOW• TO HAVE COVERAGE IN 2015, YOU ARE REQUIRED TO MEET WITH A

BENEFITS COUNSELOR. • BENEFITS COUNSELORS ARE THROUGH COLONIAL LIFE. THEY WILL

ENROLL YOU FOR ALL BENEFITS MEDICAL,DENTAL, VISION, FLEXIBLE SPENDING ACCOUNTS AND VOLUNTARY BENEFITS.

• ELIGIBILITY FOR MEDICAL & DENTAL HAS NOT CHANGED. IF YOU ARE NOT ELIGIBLE FOR MEDICAL & DENTAL TODAY, YOU ARE STILL NOT ELIGIBLE.

• NEW BENEFIT AVAILABLE- VISION. EVERYONE IS ELIGIBLE FOR VISION AND IT IS A VOLUNTARY PLAN.

• EVERYONE IS ELIGIBLE FOR VOLUNTARY BENEFITS. • 9.9% INCREASE IS ON TOTAL PREMIUM NOT ON PER PAY EMPLOYEE

CONTRIBUTION

MEDICAL

4 PLANS• NPOS $250- $250/$500 DEDUCTIBLE THEN 90%, $2250/$4500 MAX OOP

(INCLUDES DED & COINSURANCE), $15 OV/$30 SP, $200 ER COPAY, $15/$35/$55/25% RX.

• COVERAGE 1ST $1000- $500 PMPY BENEFIT ALLOWANCE, $1000/$2000 DEDUCTIBLE THEN 80%, $3500/$7000 MAX OOP (INCLUDES DED & COINSURANCE), $25 OV/$40 SP, $200 ER COPAY, $15/$35/$55/25% RX

• HDHP $2650- $2650/$5250 DEDUCTIBLE THEN 100%• ***NEW PLAN ***HDHP $5000- $5000/$10000 DEDUCTIBLE THEN 100%

ALL PLANS• PREVENTIVE CARE COVERED AT 100%*• BIRTH CONTROL COVERED AT 100%**• PRESCRIBED SMOKING CESSATION PRODUCTS COVERED AT 100%• DIABETIC SUPPLIES COVERED AT 100%*100% COVERAGE DEPENDS ON DIAGNOSIS CODE PROVIDED ON CLAIM**IUDS/NON ORAL BIRTH CONTROL MAY NOT BE COVERED AT 100%

SHOULD I SWITCH PLANS?THINGS TO CONSIDER….

• HOW YOU UTILIZE BENEFITS. ARE YOU A CASUAL USER OR DO YOU GENERALLY MEET YOUR DEDUCTIBLE AND COINSURANCE.

• TOTAL COSTS = (PER PAY PREMIUM + DED/COPAYS/COINSURANCE) EVALUATE BASED ON IF YOU USE PLAN TO THE FULLEST OR IF YOU ONLY USE PLAN CASUALLY.

• PRESCRIPTION COSTS. IF CONSIDERING MOVING TO THE HDHP YOU WILL WANT TO CHECK WITH YOUR PHARMACIST ON THE COST OF YOUR PRESCRIPTIONS. GENERALLY PRESCRIPTIONS ARE THE MOST EXPENSIVE REOCCURRING COST ON AN HDHP. ON THE HDHP YOUR RX GOES TOWARDS YOUR DEDUCTIBLE AT THE FULL COST LESS ANY DISCOUNTS.

• MEDICARE ELIGIBLE. IF YOU ARE MEDICARE ELIGIBLE (65 OR OLDER) YOU CAN NOT CONTRIBUTE OR HAVE MONEY CONTRIBUTED TO AN H.SA ON YOUR BEHALF. ADDITIONALLY, AN HDHP IS CONSIDERED NON CREDIBLE COVERAGE FOR RX. IF YOU ARE ENROLLED ON AN HDHP, YOU WILL BE PENALIZED 2% FOR EACH MONTH YOU ARE ENROLLED ON AN HDHP AND ARE MEDICARE ELIGIBLE. THIS PENALTY IS FOR THE LIFE OF YOUR ENROLLMENT ON MEDICARE.

2015 H.SA INFO

• 2015 LIMITS. Individual with self-only coverage under a high deductible health plan is $3,350. Individual with family coverage under a high deductible health plan is $6,650. – Employees 55 & older can do an additional $1000 per year as “catch up”

• USES. Can be used for all medical expenses outlined by IRS as qualified medical expenses. Visit www.irs.gov for detailed listing. Dental and Vision qualify as qualified expenses.

• FSA. You can only have an FSA with an H.SA for dental and vision purposes. If you currently have an FSA and move to an HDHP with an H.SA you have to exhaust all your FSA funds before contributing or having a contribution towards an H.SA.

DENTAL

NO CHANGES TO DENTAL BENEFITS. PLAN REMAINS THE SAME.

VISION

COLONIAL LIFE

PRODUCTS OFFERED

• FLEXIBLE SPENDING ACCOUNTS • SHORT TERM DISABILITY• CANCER• CRITICAL CARE• VOLUNTARY LIFE• ACCIDENT

THINGS TO KNOW….• SHORT TERM DISABILITY. IF YOU ARE CURRENTLY ENROLLED, YOUR

COVERAGE WILL BE TAKEN OVER, MEANING YOU WILL BE GIVEN CREDIT FOR HAVING COVERAGE AND PRE-EXISTING WILL NOT APPLY. – DIFFERENCES: SHORTER ELIMINATION PERIOD MOVING FROM 30 DAYS TO

14 DAYS• CANCER. IF YOU ARE CURRENTLY ENROLLED, YOUR COVERAGE WILL

BE TAKEN OVER, MEANING YOU WILL BE GIVEN CREDIT FOR HAVING COVERAGE AND PRE-EXISTING WILL NOT APPLY. IF YOU ARE NOT ENROLLED AND ARE INTERESTED, FOR THIS INITIAL ENROLLMENT IT IS GUARANTEED ISSUE, MEANING THERE ARE NO HEALTH QUESTIONS. – IF YOU ARE ENROLLING FOR THE 1ST TIME, YOU ARE ELIGIBLE TO ENROLL IF

YOU CURRENTLY HAVE OR PREVIOUSLY HAD COVERAGE, HOWEVER, PRE-EXISTING WILL APPLY.

ENROLLMENT PROCESS

• ENROLLMENT BEGINS ON NOV 10 AND WILL END ON NOV 21

• YOU MUST MEET WITH A BENEFITS COUNSELOR TO ENROLL ON COVERAGE OR WAIVE

• BENEFITS COUNSELORS WILL:– ENROLL YOU ON ALL BENEFITS YOU ARE CURRENTLY

ELIGIBLE FOR INCLUDING MEDICAL & DENTAL– BE ABLE TO PROVIDE GUIDANCE FOR YOUR MEDICAL

CHOICES– INPUT BENEFICIARY INFORMATION FOR GROUP

BASIC LIFE

• SIGN UP SHEETS WILL BE AT EACH LOCATION/SCHOOL WITHIN THE WEEK. PLEASE SIGN UP FOR A TIME TO MEET.

• EXPECT TO SPEND 15 MINUTES WITH A BENEFITS COUNSELOR TO REVIEW BENEFITS

QUESTIONS???