Transcript ABE - University of Wisconsin System

University of Wisconsin System
Annual Benefit Enrollment
(ABE) Period
October 5 – 30, 2015
http://www.wisconsin.edu/abe
Agenda
o Introduction - LaDonna Steinert
o Communications – Cheryl Sullivan
o Toolkit Update – Cheryl Sullivan
o Plan Changes and Updates – LaDonna Steinert and Cheryl Sullivan
o Questions
o BREAK
o Optional Plans – LaDonna Steinert and Cheryl Sullivan
o Statutory Changes – Steve Gunderson
o Questions
2
ABE Employee
Communications Schedule
3
ABE Employee Communications
Schedule
Communication
Spreadsheets, advance
copy or template sent Email Send Date
to Institutions
ABE Employee Alert
9/22 (template)
By 9/25
Current Standard Plan
Participants
9/30 (template)
By 10/1
Current WEA Participants
affected by county coverage
change
9/30 (template)
By 10/1
Main ABE Enrollment Email
(Regular and Grad)
10/1 (Advance copy)
Staggered send
10/3, 10/4, 10/5
Main ABE Enrollment Email
(Rehired Annuitants)
10/2 (Advance copy)
10/5
ABE Employee Communications
Schedule
Communication
Spreadsheets, advance
copy or template sent Email Send Date
to campuses
Individual and Family Email
10/5 (advance copy)
10/6
Leave of Absence Letter
10/6 (template)
By 10/8
ABE Reminder Email
10/20 (advance copy)
10/21
ABE Employee Communications
Schedule
o Audiences and corresponding communications
will be split between eBenefits enrollment and
non-eBenefits for all communications except:
*ABE Alert email
*Rehired Annuitant email
*Leave of Absence letter
o Campus and home address will be populated on
spreadsheets for any employee who does not have
an email address so institutions may reach out to
these employees with a hard copy of any email
communication if needed.
6
Toolkit Update
o ABE Brochure
o Posters
o ABE Website (will be up by 10/5):
www.wisconsin.edu/abe
o Employee Presentation on ABE Site for
Institution
7
2016 ABE
Plan Changes & Updates
8
Benefit Changes Allowed during ABE
o All changes made during this period are effective January 1, 2016.
o If you do nothing, your existing benefit elections, with the exception
of your FSA, will continue in 2016.
Plan
State Group
Health
EPIC
Benefits+
Dental
Wisconsin
VSP Vision
Individual &
Family Life
Insurance
Flexible
Spending
Accounts
(FSA)
Open
Enrollment
Change
Plan
Add
Dependents
Remove
Dependents
Cancel
Coverage
Yes
Any Health Plan
Yes
Yes
Yes
No
Remove vision
No
Yes
Yes
Yes
PPO
Yes
Yes
Yes
Select
Yes
N/A
Yes
Yes
Yes
No
Increase
current
coverage
No
Any time
Any time
Yes
Must re-enroll
every year
N/A
N/A
N/A
2016 ABE
Health Insurance Changes &
Updates
10
Health Insurance Benefit Changes
o Added deductibles
o New office visit copayments
o Increased out-of-pocket limits
o Changes to pharmacy benefits
o $2,000 Health Insurance Opt-Out
Incentive
o Elect or waive Uniform Dental Benefits
o Increased HSA Employer Contribution
11
State Group Health Options
o For State Group Health, you may take the
following actions during ABE:
o
o
o
o
Enroll
Change health plans
Add or remove eligible dependents
May select health plan with or without Uniform
Dental coverage (default is with dental)
o Cancel coverage for 2016
o Health Insurance Opt-Out Incentive (through
paper application only)
o As always, confirm your current medical and
dental providers will still be available in
2016.
12
Health Insurance Plan Changes
Health Plan
Arise Health
Plan
Arise- Aspirus
Health Plan
Network
Health Plan
What’s New in 2016?
Combining service area
Offering new service area
Offering new service area in southeast part of
the state
Will NOT be providing coverage in following
service areas:
East: Florence, Fond du Lac, Forest, Jefferson,
Kenosha, Langlade, Lincoln, Marinette, Oneida,
WEA Trust
Price, Racine, Taylor, Vilas
PPO (all)
• Northwest Chippewa Valley: Burnett,
Sawyer, Trempealeau
• Northwest Mayo Clinic Health System:
Buffalo
Access Health Uniform Dental benefits will be included with
(Standard)
health coverage automatically. This was not
included in prior years.
Plan
13
Action Needed during ABE
All Arise participants should
confirm provider network for
2016.
None.
Select new health plan if you
will be affected.
May select plan with or
without the Uniform Dental
benefit.
2016 Health Insurance Added Benefits
• Habilitative Services are now available. These
help people gain and maintain a function they
weren’t born with, such as an older child
learning how to speak or walk.
• Health plans must offer Advance Care Planning
and/or Palliative Care Consultation. These
services help people who are diagnosed with a
serious illness.
14
2016 Health Insurance Name Changes
New Name for 2016
Health Plan/IYC Health Plan
Previous Name
Coinsurance Uniform Benefits
(HMO/Regional PPO Uniform
Benefits)
High Deductible Health Plan (HDHP)/ High Deductible Health Plan
IYC High Deductible Health Plan
(HDHP)
Access Health Plan/IYC Access
Standard Plan
Health Plan
Access HDHP/IYC Access HDHP
HDHP Standard Plan
It’s Your Choice (IYC) Medicare
Medicare Advantage
Advantage
It’s Your Choice (IYC) Medicare Plus Medicare Plus
15
Terminology for 2016
Cost Sharing
•Premium
•Deductibles
•Copayments
•Coinsurance
•Out-of-pocket limits (OOPL)
•Maximum Out-of-pocket (MOOP)
Preventative Health
Services
State Group Health OptOut Incentive
Uniform Dental
16
Waive/Elect
Office Visit Copayments
Visit Type
l
Emergency Room
General Physician l Pediatrician
OB/GYN l Nurse Practitioner
l
Chiropractor
$15
Yes
Specialty Providers l Urgent Care
Vision Exam in an office visit setting
$25
Yes
$75 (waived if
admitted)
Yes
Includes
Primary Care
Office Visit
Specialty Office
Visit
Copayment
Counts Toward
Out-of-Pocket
Limit?
l
•
•
Emergency Room
Q: What is a Copayment (copay)?
A: A copay is a fixed amount you pay for certain covered health care services or
prescription drugs, usually due at the time you receive the service.
New for 2016: Copays will be applied to primary care and specialty care office
visits as well as Pharmacy
• Health Plan Copays will not count toward the deductible, but will count toward
the out-of-pocket limit.
• HSHP Plan copays are applied after the deductible is met.
• Additional services billed as part of the office visit (labs/x-ray)are subject to
deductible and/or coinsurance.
17 • Preventive services are covered 100% and are not subject to copays.
Deductibles
Health Plan
Deductible
HDHP
Single
Family
Single
Family
$250
$5001
$1,500
$3,0002
Access Health
Plan
(In-Network)
Single
Family
$250
$5001
Access Health
Plan HDHP
(In-Network)
Single
Family
$1,700
$3,4002
Q: What is a deductible?
A: A deductible is the amount you must pay out of pocket for the full cost of certain health care
services before your health plan begins to pay.
Certain preventive health services are covered 100% and are not subject to the
deductible.
New for 2016: New annual deductible for the Health Plan. Increased deductible for the Access
Health Plan. No change to HDHP plan.
o
The deductible will count toward the annual out-of-pocket limit (OOPL). For HDHP plans, the deductible
includes prescription drugs. Copays for the Health Plan do not count toward the deductible, but do count
toward the OOPL. Dental expenses are not subject to a deductible.
_______________________________________________
18
1
After an individual within a family plan meets the $250 deductible, medical services will be covered for that individual.
2
The full family deductible must be met before any medical services are covered.
Coinsurance
Q: What is coinsurance?
A: Coinsurance is the member’s share of the costs of a covered
health care service or prescription drug, calculated as a percent
of the amount for the service or cost of the drug.
o Coinsurance amounts are percentages, so they change based on the total
cost of a drug or service.
o For the Health Plan and In-Network HDHP, once the deductible is met, a 10%
coinsurance will be charged for all non-copayment-related services beyond the
charge for the office visit. Exception: A 20% coinsurance applies to covered
durable and disposable medical equipment, certain hearing aids, and cochlear
implants.
o Federally preventive services are not subject to a deductible, copays, or
coinsurance.
o Medical coinsurance amounts count towards the OOPL.
o Pharmacy Coinsurance applies to level 2,3 and some level 4 drugs.
o Pharmacy level 3 coinsurance does not apply toward the OOPL, only the
federal MOOP
19
Pharmacy Benefits
New for 2016: Costs for Levels 2, 3 and 4 prescriptions will change from copay to
coinsurance, up to a specified maximum. Increased pharmacy out-of-pocket limits.
2016 Prescription Copays, Coinsurance, and Out-of-Pocket Limits
(It’s Your Choice Health Plan)
Prescription Drug Level
Member Costs
Annual RX OOPL*
Level 1
$5 per fill
$600 individual / $1,200 family
Level 2
20% ($50
maximum per fill)
$600 individual / $1,200 family
Level 3
40% ($150
maximum per fill)
Does not apply to Rx OOPL. Only applies to
Federal maximum out-of-pocket limits
(MOOP): $6,850 individual / $13,700 family
Level 4 Preferred Specialty Drug
• Filled at a Preferred Specialty
$50 per fill
Pharmacy (e.g. Diplomat Specialty
Pharmacy)
•
Filled at any other pharmacy
$1,200 individual / $2,400 family
40% ($200
maximum per fill)
*HDHP Plans: Members are responsible for the full cost of prescriptions until their annual
deductible has been met. Once the deductible is met, the member costs in the table above
will apply. See the HDHP Combined OOPL amount for each plan at www.Wisconsin.edu/abe
20
Out-of-Pocket Limits (OOPL)
Q: What is an out-of-pocket limit?
A: An out-of-pocket limit (OOPL) is a plan provision that limits the member’s
cost-sharing. It is the maximum amount that a member will pay for in-network,
covered services during a plan year.
Once the OOPL is met, coinsurance and copayments no longer apply for health.
o
Reminder: There are separate medical and prescription out-of-pocket limits (except for
HDHP plans).
Increased Medical OOPL for Health Plans and Access Health Plan
in 2016; No change to HDHP plans.
2016
OOPL
Single
Family
Single
Family
Access
Health Plan
(In-Network)
Single
Family
$1,250
$2,5001
$2,500
$5,0002
$1,000
Health Plans
HDHP Health Plans
$2,0001
Access HDHP
Health Plan
(In-Network)
Single
Family
$3,500
_______________________________________________
1 After an individual within a family plan meets the single OOPL, medical services will
be covered at 100%.
2 The full family OOPL must be met before medical services will be covered at 100%.
21
$7,0002
Maximum Out-of-Pocket Limits (MOOP)
Q: What is the maximum out-of-pocket limit?
A: For medical and prescription drug out-of-pocket costs that do not stop at the
plan’s out-of-pocket limit, the federal maximum out-of-pocket limit provides a safety
net that does not allow you to incur any out-of-pocket expenses more than
$6,850/single or $13,700 family.
For the State Group Health plan, level 3 prescription drugs do not count toward the
OOPL but will count toward the MOOP.
What does this mean?
A participant would no longer pay expenses beyond the OOPL for medical and the
OOPL for pharmacy. The pharmacy OOPL does not include Level 3 drugs, so the
medical OOPL + pharmacy OOPL + Level 3 drug out-of-pocket costs would reach
the MOOP.
2016 Federal Maximum Out-of-Pocket Limits
22
Single
Family
$6,850
$13,700
Member Medical Costs Overview
Person pays for
medical costs until
they reach their
deductible.
Then, person pays
coinsurance amounts
while their insurance
covers the remainder of
medical care costs.
COPAYS are separate
from the deductible and
apply toward the OOPL
23
Insurance covers
expenses at 100% after
reaching the out-ofpocket limit (OOPL) or,
if applicable, the federal
maximum out of pocket
(MOOP).
Is the HDHP/HSA Right for You?
o There are several things to consider when
deciding to enroll in the HDHP/HSA option
o The HDHP has higher out-of-pocket costs
o The HDHP has a lower monthly premium
o The HSA provides a way to set aside pre-tax
monies into a savings account that can earn
interest
o Your employer will contribute $750 for single or
$1,500 for family coverage to your HSA in 2016
24
2016 Health Insurance Premiums
Premium Tier
Tier 1
Tier 2
(Access
Plan –
out of
state)
Tier 3
(Access
Plan)
Employees Covered
Employees Covered by
Employees Covered by the
by the WRS –
Grad Assistant/ShortWRS –
It’s Your Choice HDHP Term AS (It’s Your Choice
It’s Your Choice Health Plan
Health Plan
Health Plan only)
Single
Family
Single
Family
Single
Family
With
Dental
$86
$217
$32
$81
$44.50
$112.50
Without
Dental
$83
$209
$29
$73
$41.50
$104.50
With
Dental
$136
$341
$82
$205
$69.50
$174.50
Without
Dental
$133
$333
$79
$197
$66.50
$166.50
With
Dental
$253
$632
$199
$496
$128
$320
Without
Dental
$250
$624
$196
$488
$125
$312
Premiums listed do not apply to those who are required to pay the less than half-time
rates or the total premium.
25
Health Plan and HDHP Cost Sharing
Changes 2015 to 2016
Health Insurance Deductible, OOPL and HSA
Contribution
Single
2015
$0
$500
$1,500
$2,500
$170
Health Plan Deductible
Health Plan Out-of-Pocket Limit
HDHP Deductible
HDHP Out-of-Pocket Limit (Medical and Rx)
HSA Employer Contribution (HDHP, only)
Copay and Coinsurance in 2016
Primary Care Physician Office Visits
Specialist Office Visits
2016
$250
$1,250
$1,500
$2,500
$750
2015
10%
Coinsurance*
10%
Coinsurance*
2015
$0
$1,000
$3,000
$5,000
$340
2016
$15 Copay and
Coinsurance
$25 Copay and
Coinsurance
*The Health Plan still has coinsurance amounts, but they do not
apply to these services. Deductible goes towards the OOPL
26
Family
2016
$500
$2,500
$3,000
$5,000
$1,500
Prescription/Pharmacy 2016 Overview
Level 1
$5 per fill
Level 2
Member pays 20% (up to $50 per fill)
Level 3
Member pays 40% (up to $150 per fill) Do not apply to OOPL
Level 4
Preferred Specialty
Pharmacy: $50 per fill
Any Other Pharmacy: 40%
(up to $200 per fill)
• Prescription costs are based on formulary levels
• A “fill” is a 30-day supply.
• Log in to the members section of navitus.com to
view the formulary and determine levels.
27
Pharmacy Benefit 2016 Changes
 Know your benefit options for 2016
 Will you be enrolled in an HDHP plan, which requires you to pay the full
cost of your drugs until the deductible is met?
 Will you be enrolled in a non-HDHP plan where the new coinsurance
levels will apply right away?
 Reference the current prescription drug formulary to
determine coverage level for specific drugs
 The formulary will list the coverage Level for each drug.
 Determine the copay or coinsurance percentage using the benefit plan
design and the formulary coverage Level.
28
How to Determine Prescription Costs
Coinsurance is a percentage of total cost (for Level 2, 3 and 4
drugs); the cost of the drug will impact how much you pay.
o Option 1: Contact your pharmacist and ask what the total cost of
your prescription is. If you take this approach, show your pharmacist
your Navitus ID card if necessary and be sure to inform your
pharmacist that:
1. You are a State Group Health insurance program member
2. Navitus Health Solutions is your Pharmacy Benefit Manager
3. You need to know the Navitus discounted cost of the drug– not
the full retail cost.
o Option 2: You may also find the total cost of your prescribed drug on
the documents and/or receipts you receive with your prescription.
o Option 3: If enrolled in SGH for 2015, review your medication history
via the Members portal on Navitus’ website. Log in to the members
section of navitus.com to view the current formulary and determine
levels
29
Calculate Estimated Prescription Cost
1.
ADD the amount your plan paid to the amount that you paid for the
prescription in 2015
2.
Multiply the total from step #1 by the coinsurance percentage found on
your benefit schedule to determine estimated member copay based on
2016 benefit design and formulary coverage Level. Note the Maximum
copay amounts.
EXAMPLE (using 2015 Rx amounts to estimate cost in 2016)
• Formulary coverage Level = 2 (20% with $50 maximum copay). In
example, you would pay $50, not $60.
Plan paid
$285
30
+
You paid
$15
Level 2
Coinsurance
(20%)
Total Drug Cost
=
$300
x 0.20
=
Your
COPAY
$50
($50 maximum)
*NOTE: Drug prices and contracted rates can change daily. All cost calculations will be estimates.
Uniform Dental Benefits
New for 2016: Employees may enroll or waive the
Uniform Dental benefits as part of their State Group
Health Insurance election.
• Employees must be enrolled in State Group Health insurance
coverage in order to be eligible for the Uniform Dental Benefit
plan. Current State Group Health participants- Uniform Dental
benefits will be included automatically (including Access Plan).
• Employees must take action during the ABE period to select a
health plan without the dental option, if they wish to waive
Uniform Dental.
• Coverage level (single/family) must be the same as medical.
• Dental expenses, including those for HDHP plans, are separate
from medical benefits and will not be subject to a deductible and
do not count toward the OOPL.
• Employees should search Delta Dental’s website to determine if
their current providers are included in the coverage network.
31
Uniform Dental Benefits 2016
(in conjunction with any covered service under the UDB)
Make sure your dental provider is in-network before receiving
dental services in 2016. No benefit for out-of-network providers
Search for in-network providers: www.deltadentalwi.com/state-of-wi
Uniform Dental Benefits
Network Access
Delta Dental has two networks – Delta Dental PPO
and Delta Dental Premier.
About 93% of dentists currently seen by State of WI
employees already belong to a Delta Dental
network.
Uniform Dental Benefits
• Administered by Delta Dental of Wi (providers are no longer
determined by health plans)
• Two Delta Dental provider networks:
• Delta Dental PPO – best cost savings
• Delta Dental Premier
• ID Cards for 2016 are expected to be sent out in December,
2015
• Tools and resources at: DeltaDentalWI.com/state-of-wi
34
DeltaDentalWI.com/state-of-wi
35
$2,000 Health Insurance Opt-Out
Incentive
Knowledge as of 09/24/2015
University employees enrolled in State Group Health insurance
(except Craftworkers and Graduate Assistants) in 2015 can opt-out
of coverage for the 2016 plan year and receive a $2,000 Opt-Out
Incentive.
o Must be enrolled (did not waive) for the 2015 year
o May not be covered under the State Group Health insurance program as
a dependent in 2016.
o Must submit a State Group Health insurance PAPER application during
ABE to receive the opt-out incentive for 2016. Not through eBenefits!
o Updated State Group Health application for election.
o How will the incentive be paid out?
o Paid out in installments throughout year
o Incentive will be considered taxable.
o More information to come…
36
Let’s Talk About HSA/FSA/LPFSA
37
FSA Plan Descriptions
FSA Type
Health Care
FSA
Eligible
Expenses
Eligible Dependents
Medical, dental, You, your spouse (same or
vision &
opposite-sex), qualifying
prescription
child or relative
Yearly Contribution
Limits
Min: $100
Max: $2,550
Min: $100
After school care,
Your spouse (same or
adult or child
Dependent
Max: $5,000 —
opposite-sex), qualifying
daycare,
Day Care FSA
dependent on tax filing
child or relative
preschool
status
Limited
Purpose FSA
Dental, vision & You, your spouse (same or
post-deductible opposite-sex), qualifying
expenses
child or relative
Min: $100
Max: $2,550
Health Savings Account (HSA)
New in 2016: Increased employer contribution
Annual Contribution Information for HSA
HDHP Enrollment
Employer
Contribution
(including ER contribution)
Single
$750/year
$3,350*
Family
$1,500/year
$6,750*
2016 Limit
o
*If you are 55-65 years of age, you may contribute an additional $1,000
“catch-up” per year to your HSA.
o
The employer contribution will be paid throughout year.
o If you do not enroll for the HSA, you are not eligible for the HDHP.
o Will follow up prior to processing application for HDHP, to ensure HSA is
accepted.
o
39
Craftsworkers are not eligible to receive the annual employer contribution to
an HSA but must still enroll in the HSA if electing an HDHP. (Grad/Short-term
Academic Staff participants are not eligible for the HDHP)
Flexible Spending Accounts (FSA)
You must re-enroll every year if
you want to continue the
coverage!
o Health Care FSA
o Dependent Day Care FSA
o Limited Purpose FSA
o Eligibility - all benefit-eligible employees except
LTEs, Fellows, Scholars, Graduate Intern/
Trainees, or Post-Doctoral Fellow/Trainees.
o You decide how much to set aside and that
amount is deducted from each paycheck before
your Federal, State, and FICA taxes are
calculated so you save money on taxes.
40
TASC FSA Updates
o Participants will receive a new TASC card in 2016
(new look)
o Do not use 2015 TASC card for expenses in 2016, as of 1/1/2016
o MyCash balance will remain on 2015 TASC card if funds are not
moved to bank account.
o Recommend moving My Cash balance to bank account
o Carryover funds will not be available until after the run-out period
(90 days after plan year ends)
o Can incur expenses during run out period, will have to pay out of
pocket, then submit claims once funds are loaded after run out
period.
41
Health Care and Limited Purpose
FSA Carry-Over
o The plan year is from January 1, 2016 to December
31, 2016.
o Up to $500 remaining in your Health Care or Limited
Purpose FSA can carry over to the following plan
year. Anything over $500 will be forfeited.
o Current Participants: If you have any unused
funds in your 2015 Health Care or Limited
Purpose FSA on December 31, 2015, up to $500
will carry over to 2016.
o You will have until March 30, 2016 to file your
2015 claims.
42
How to Enroll for FSA/HSA with TASC
o New TASC website for members
o Enroll online for the FSA, LPFSAplans
(as of 10/05/2015) at:
https://partners.tasconline.com/ETFEmployee
o All enrollees will receive a new TASC
card in 2016
o More to come…
43
o QUESTIONS????
44
Dental & Vision Insurance Options
o All health plans offer Uniform Dental
benefits. May select health plan without
Uniform Dental benefits.
o Vision exam under health plans are subject
to $25 specialty office visit copay.
o If dental and vision coverage offered by
your health plan doesn’t meet your needs,
consider one of our optional dental or
vision plans. See Comparison charts.
o If elected, you must remain enrolled in the
plan for the entire calendar year.
45
Dental & Vision Insurance Options
o Offering an enrollment opportunity:
o Dental Wisconsin PPO and Select
o VSP Vision
o For these plans, you may take the following
actions during ABE:
o Enroll
o Change plans (if applicable)
o Add or remove eligible dependents
o Cancel coverage for 2016
46
Dental Wisconsin
o Dental Wisconsin offers two plans – the PPO plan
and the Select plan. You may enroll in one of these
two plans. These plans provide partial coverage for:
o Fillings and major dental services (crowns, implants,
etc.) up to the annual $1,000 maximum
o PPO covers annual cleanings and x-rays
o Orthodontic services (up to $1,000 lifetime maximum)
o Vision discount program through Davis Vision
o Waiting periods apply for new enrollees:
o Basic: 3 months (i.e. fillings)
o Major: 3 months (i.e. crowns, implants)
o Orthodontics: 12 months
Waiting periods may be waived if you had prior comparable coverage (no gap in coverage).
47
2016 Dental Wisconsin Premiums
o No change in premiums from 2015 to 2016
Monthly
Premiums for Employee
2016
48
Employee + Employee +
Spouse/DP Child(ren)
Family
Select
$20.52
$42.19
$48.68
$71.59
PPO
$25.49
$53.96
$60.34
$91.21
VSP Vision
o VSP Vision offers partial coverage for:
o Annual vision exam
o Eyeglass lenses every calendar year and
eyeglass frames every other year
o Contact lenses every year instead of
eyeglasses or eyeglass lenses
o Discounts on laser vision correction
o KidsCare program (eyeglasses more often for
children)
o No benefit changes for 2016.
49
2016 VSP Vision Premiums
o No change in premiums.
Monthly
Premiums for Employee
2016
VSP Vision
50
$6.54
Employee + Employee +
Spouse/DP Child(ren)
$13.08
$14.73
Family
$23.54
Canceling Dental or Vision Plans
If you use eBenefits, you can cancel Dental Wisconsin
or VSP Vision online for 2016
o To remove dependents or reduce coverage for EPIC
Benefits+, you must submit a paper application.
o All applications and brochures are available on
Annual Benefit Enrollment ( ABE) website:
http://www.wisconsin.edu/abe/
o Note: If you turn in an application during the ABE
period to cancel Dental Wisconsin, VSP Vision or
EPIC Benefits+, your coverage will end 12/31/15.
51
Individual & Family Life Insurance–
ANNUAL INCREASE OPTION
o If covered by the Individual and Family Life insurance
plan on October 1st, may increase coverage level by the
following amounts:
o Employee: $5,000; $10,000; $15,000 or $20,000
o Spouse/Domestic Partner: $5,000 or $10,000
o Child(ren): $2,500
o Coverage maximums:
o Employee: $300,000
o Spouse/Domestic Partner: $150,000
o Child(ren): $25,000
NOTE: Spouse/Domestic Partner or Child coverage
cannot exceed employee coverage.
52
Individual & Family Life Insurance
o Coverage INCREASES for Individual and Family
can be made either through:
o eBenefit election, or
o Annual Increase Option form
o AUDITS WILL BE PERFORMED
o An employee MUST complete a paper
application for all decrease or
cancellations of coverage
53
Wisconsin Retirement System (WRS)
2016 Contribution Rates
2015 and 2016 WRS Contribution Rates
General/Teacher
Executives
Protectives w/
Social Security
Employee
Contribution
6.60%
6.60%
6.60%
Employer
Contribution
6.60%
6.60%
9.40%
Total
13.20%
13.20%
16.00%
Category
o This change will occur on the first check payable in 2016
o Monthly – 1/4/16
o Biweekly – 1/7/16
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Didn’t we miss a few plans??
o LIFE AND AD&D
o AD&D – No Change
o UIA – Annual Process 10/1/15
o SGL – Effective/Termination Coverate Date Change
o ICI –
o 20% Premium Increase
o Effective Coverate Date Change
o TSA/WDC – Encourage savings!
o Long-Term Care – Transmerica is a new option in
addition to United of Omaha
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Important Reminders
1. All benefit enrollments or changes made during
the ABE period are effective January 1, 2016.
2. You have until October 30, 2015 at 4:30 p.m. to
submit your paper applications to your institution’s
benefits office or make your elections using
eBenefits.
3. Visit www.wisconsin.edu/abe for detailed Annual
Benefit Enrollment (ABE) information.
4. Contact your institution’s benefits office if you
have any questions or need assistance.
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oQUESTIONS??
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Statutory Benefit Changes
2015 Wisconsin Act 55 and GIB
HRS Benefits Impact
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Statutory Benefit Changes
o 2015 Wisconsin Act 55, published
7/13/2015, has several provisions that will
directly impact HRS benefit configuration
and modifications
o Prospective implementation date of the
changes is 1/1/2016
o These statutory and administrative changes
are in addition to the prospective Annual
Benefit Enrollment (ABE) changes
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Statutory Benefit Changes
2015 Budget Act 55 Changes
o Removal of ICI/SGL 6 month WRS participation
requirement
o Coverage effective date change to 1st of month
on or following event (instead of application
exception date) Health, Dental, Vision and
Income Continuation.
o Coverage effective date for State Group Life is
the first of the month after 30 days following the
event for new enrollments.
o Employee Opt-out Incentive for State Group
Health Insurance (eligible WRS participants)
o Change ICI Deferred Enrollment period from 30
to 60 days
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Statutory Benefit Changes
Other Pending Non-ABE HRS Benefit
Changes
o Change of the SGL coverage termination
date
o Payment of Insurance premiums to ETF in
the same month as coverage
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Statutory Benefit Changes
Removal of ICI/SGL 6 Month WRS
Participation Requirement
o Business Requirement: Remove the
requirement for a participating WRS
employee to have 6 months of WRS service
before ICI and SGL become effective
o HRS Change: Configuration
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o Institution Impact: With initial rollout, will
need to reach out to WRS employees hired
after 7/2/2015 to notify regarding
prospective 1/1/2016 ICI and SGL effective
date. FA, AS and LI employees will have
different ICI impacts
Statutory Benefit Changes
Coverage Effective Date Change to 1st of
Month On or Following Event
o Business Requirement: The insurance
application received date is no longer used to
establish the coverage effective date if application
is received within the enrollment window
o HRS Change: Configuration and Development
o Institution Impact:
o The variety of Hire events (HC0, HC1, HC2, etc) should be
able to be significantly reduced
o The need to manually create multiple ADM events for
different new hire coverage effective dates should be
reduced
o Life plans will have a 30 day waiting period. Example: 9/2
hire – 11/1 SGL coverage effective date.
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Statutory Benefit Changes
Health Opt-out Incentive for WRS
Participants
o Business Requirement: Employees who
are eligible for but elect not to receive health
insurance will be paid a $2,000 annual
stipend
o Previously addressed in the ABE policy
section
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Statutory Benefit Changes
Change ICI Deferred Enrollment period
from 30 to 60 days
o Business Requirement: Expand the
enrollment window for all ICI deferred
enrollment windows – Both for the annual
ICI process as well as Faculty/Academic
Staff/Limited 12 month deferred enrollment
o HRS Change: Business process
o Institution Impact: More time to notify
employees and for the employees to submit
the ICI deferred enrollment application
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Statutory Benefit Changes
Change of the SGL Coverage Termination Date
o Business Requirement: Update the State
Group Life termination rules to be consistent
with all other benefit plans: Coverage to end at
the end of the Job termination month
o HRS Change: Configuration, Development,
Business process
o Institution Impact:
o Plan consistency will improve counseling
o Significant reduction in the number of
termination (TM*) and retirement (RT*) events
o Eliminates the need to bill retirees to collect an
additional month’s premium at retirement
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Statutory Benefit Changes
Payment of Insurance Premiums to ETF in the
Same Month as Coverage
o Business Requirement: Move the vendor
insurance premium payments schedule from
the beginning of the month of coverage toward
the end of the month of coverage
o HRS Change: Development, Business
process
o Institution Impact: None. The Deduction:
Coverage month schedule will impact the
institution collection of premiums. The UW
Service Center Reconciliation and Reporting
team will be significantly impacted
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HRS Impact Summary
Description
Complexity
Effort
Config
6-month WRS
Removal for
ICI/SGL
Low
Low
X
Cov Date Tied to
Event Date
High
High
X
X
Medium
Medium
X
X
ICI 60-day
Deferred
Enrollment
Low
Low
SGL Coverage
Termination Date
High
High
Medium
High
Health Opt-Out
Insurance
Premium
Payment
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Development
Business
Process
X
X
X
X
X
X
Questions?
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