Transcript Slide 65

2007 Open Enrollment
For Health and Flexible Benefits
It’s the time you can…
• Enroll in or change your health plan
• Add or remove family members, or
• Enroll in a flexible reimbursement
account
Changes you make during Open
Enrollment are effective
July 1, 2007 – June 30, 2008
What do I need to do?
• Take no action to continue your current
health plan and membership level
• Take action to enroll or make changes
to your health plan and membership
level
• Take action to enroll in or continue a
Medical or Dependent Care Flexible
Reimbursement Account
How can I find out what benefits I
have currently?
• You may visit EmployeeDirect to review your
current benefit elections and you can even
enroll or make changes online
• You may also call or e-mail a member of the
Employee Benefits team:
– Barbara Tonovitz (employees last name beginning
A-J)
– Angela Vann (employees last name beginning
K-Z)
– Beth Lunde
EmployeeDirect
https://edirect.virginia.gov/Application.aspx
Available 24 hours a day
Step 1: Verify your registered e-mail address and date of birth
Contact a member of the Employee Benefits team if your information is incorrect. It will
need to be corrected before you can use EmployeeDirect
Step 2:
Step 3:
Step 4:
Step 5:
Create a password
Sign-up or login
Click and follow prompts
Ask questions if you need help
COVA Care changes effective July
1, 2007
• Routine wellness benefit enhanced
– $500 cap on lab work, shots, and x-rays removed
for routine wellness
• Outpatient prescription drug benefit covers
diabetic blood glucose test strips and
glucometers
– 20% of product cost, no deductible
– Prescription needed
• Medical benefit covers diabetic equipment
and education
Anthem’s new 24/7 NurseLine
• Available to COVA Care and COVA
HDHP members
• 365 days a year/24 hours a day
• 1-800-337-4770
• Registered nurse trained to answer your
medical questions
Flexible Reimbursement Account
changes effective July 1, 2007
• New medical flexible reimbursement account
reimbursement card
– EZ REIMBURSE Mastercard
– You present the card for payment when purchasing eligible
medical services, prescription or over-the-counter drugs
– The expense may not exceed your account balance
– You may be required to provide documentation for certain
expenses. Failure to provide requested documentation may
result in suspension of your card until the next plan year
– Must complete an EZ REIMBURSE card request by June 1st
if you wish to receive the card
• Account statements for both Medical and Dependent
Care FRA will change from quarterly to monthly
Health Insurance Premium
Increase
• 4.5% premium increase on COVA Care
ranges from $2 per month to $10 per month
depending on plan and membership level
• 2.75% of the 4.5% increase is to cover the
wellness benefit enhancements
• 1.75% of the 4.5% increase covers other post
employment benefits
– new accounting rules in 2008 require a special
trust fund for early retiree coverage
• HDHP continues to have $0 premium
Health Insurance – Full-Time Employee Monthly
Premiums 7/1/07 – 6/30/08
Plan
Single
Dual
Family
HDHP
$0
$0
$0
COVA Care
$42
$103
$147
COVA Care + Out-of-Network
$52
$117
$166
COVA Care + Expanded Dental
$55
$128
$185
COVA Care + Out-of-Network +
Expanded Dental
$65
$142
$203
COVA Care + Expanded Dental +
Vision & Hearing
$64
$145
$207
COVA Care + Out-of-Network +
$74
Expanded Dental + Vision & Hearing
$158
$224
When will the new premiums go
into effect?
• Look for new health plan premiums and
FRA contributions on your paycheck on
July 16, 2007
• 9 month faculty on 18 pay option will not
see changes until the September 1,
2007 paycheck
Health Insurance
• Premium Conversion
– Health insurance premiums are
automatically deducted pre-tax
Review of Plans
Health Insurance – Membership
Levels
• Single – Employee Only
• Dual – Employee and one dependent
(spouse or child)
• Family – Employee and two or more
eligible dependents
Health Insurance – Eligible
Dependents
• Legally married spouse
• Unmarried biological and legally adopted children
– Living with the employee
– Employee provides over ½ support
– May be covered until the end of the year they turn age 23
• Unmarried stepchildren
– Living full-time with employee
– Parent-child relationship
– Eligible to be claimed on tax return
• Children of whom you have permanent sole custody
• Adult Disabled Children
Health Insurance – Ineligible
Dependents
• Siblings
• Grandchildren (unless you have shared custody with a
minor child living in your home)
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Nieces/Nephews
Parents
Grandparents
Aunts
Uncles
Domestic Partners
Health Insurance – Plan Options
• COVA Care
• COVA HDHP
Health Insurance – COVA Care
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No PCP requirement
No referrals
Blue Card PPO Network
Out-of-network defined by providers not
a geographical region
• Out-of network coverage for true
emergencies
Health Insurance – COVA Care
• Co-payments
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PCP - $25
Specialist - $35
Inpatient hospital - $300
Outpatient hospital and ER - $100
• Deductible
– $200 – individual
– $400 - family
• Co-insurance
• Out-of-pocket expense limit
– $1,500 per person
– $3,000 per family
• Wellness visits covered at 100% - no co-pay
Health Insurance – COVA Care
• Prescription Drug Program
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Mandatory generic
Tier System
Mail Order for Maintenance Rx
Co-pays
• Retail pharmacy – up to 34 day supply
– $15 – Tier 1
– $20 – Tier 2
– $35 – Tier 3
• Mail order – 90 day supply
– $30 – Tier 1
– $40 – Tier 2
– $70 – Tier 3
Health Insurance – COVA Care
• Dental Basic Services
– Diagnostic and preventive services
• Twice a year
• Paid at 100%
– Primary services
• Paid at 80%
• Includes fillings, periodontal, and root canals
– Dental Maximum
• $1,200 annually
Health Insurance – COVA Care
•
Options
– Out-of Network
• Access to providers outside Anthem or Blue Card PPO network
• Plan pays 75% - you pay 25%
– Expanded Dental
• Adds complex restorative service coverage at 50% (crowns, dentures, and
bridgework)
• Adds orthodontic services coverage at 50% up to a $1,200 lifetime maximum
• Provides $1,500 dental maximum annually
– Vision and Hearing
• 1 eye exam every 24 months - $35 co-pay
• Provides allowance for lenses, frames, and contacts every 24 months ($50, $75,
or $100)
• 1 hearing exam every 48 months - $35 co-pay
• Provides hearing aids and other hearing aid related services up to $1,200 every
48 months
Health Insurance – COVA Care
• Vendors
– Anthem
– Delta Dental of Virginia
– Medco Health
– ValueOptions
Health Insurance - HDHP
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$1,200/$2,400 Deductible
80/20% Coinsurance
$5,000/$10,000 Out-of-pocket expense limit
100% wellness coverage
Deductible and co-insurance for prescription drugs
Out-of-network – not available
Blue Card PPO Network
Dental Benefits
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$25/$75 Deductible
100/80/50% Coinsurance
$1,500 Plan year maximum
$1,500 orthodontic lifetime maximum
Claims administrator for all services – Anthem
$0 premium does not mean $0 out-of-pocket expense
Flexible Reimbursement
Accounts (FRA)
• Allows employees to use pre-tax dollars to
pay for certain medical and dependent care
expenses
• Cannot claim these expenses on your taxes
and utilize the FRA
• Medical Reimbursement Account – may claim
expenses not covered by your health benefits
plan
• Dependent Care Reimbursement Account –
may claim expenses for the care of your
eligible dependent
Flexible Reimbursement
Accounts (FRA)
• Funds cannot be transferred between the accounts
• “Use it or Lose it” rule
• May claim reimbursement for expenses incurred during the plan
year (July 1 – June 30)
• Must submit all claims for reimbursement by September 30th of
each year
• Must re-enroll in FRAs each year – your election does not roll
over from one plan year to another
• Availability Rule
– Medical – entire election amount available at the beginning of the
plan year
– Dependent Care – funds must be posted to the account in order to
be claimed (available after payroll deductions)
Flexible Reimbursement
Accounts (FRA)
• Minimum contribution - $10 per pay period
• Maximum contribution
– $5,000 per plan year
– IRS has a calendar year limit for Dependent Care
FRA for the plan year beginning July 1 – see the
Flexible Benefits Program Sourcebook for more
information
• Contributions must be made in whole dollar
increments
Flexible Reimbursement
Accounts (FRA)
• Fringe Benefits Management Company
(FBMC) is the claims administrator
• Fax claims accepted
• 5 day processing guarantee
• Daily reimbursements
• Direct bank deposit available
• EZ REIMBURSE Mastercard available
• Online account access at www.myfbmc.com
Qualifying Mid-Year Events
• Within 31 days of qualifying event
• Allows for consistent changes
• Events include
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Marriage
Birth/Adoption
Divorce
Termination or commencement of spouse’s employment
Death of a dependent
Dependent loses eligibility
Going on or returning from an unpaid leave of absence
Spouse’s open enrollment period
Enrollment Options
• Employee Direct
– Quick, easy, and available 24 hours a day
from any computer with internet access
– Permits review and changes to health
benefits, flexible reimbursement accounts,
and personal information in the
Commonwealth’s Benefits Eligibility
System
• Enrollment Form
Confirmation of Changes
• FRA confirmations will be sent to
employees before July 1
• Please check the confirmation carefully
and report errors immediately
• Health insurance selections can be
confirmed via EmployeeDirect
Links to Open Enrollment information and forms
can be accessed on the TCC Benefits webpage
http://www.tcc.edu//welcome/collegeadmin/administrative/hr/b
enefits/index.htm
Open Enrollment ends May 16, 2007