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Open Enrollment Plan Year 2014 November 11 th – 22nd, 2013.

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Presentation on theme: "Open Enrollment Plan Year 2014 November 11 th – 22nd, 2013."— Presentation transcript:

1 Open Enrollment Plan Year 2014 November 11 th – 22nd, 2013

2 Agenda Positive Enrollment, Dates, & Method Tobacco Certification & Medical Plan Changes Voluntary Benefits Platform – Dental – Vision – Life Insurance Options – Disability (Short & Long) – FSA, HSA & new limited use FSA Sick leave pool Questions

3 Positive Enrollment, Dates & Method November 11 th – November 22 nd, 2013 Benefit plans are now uniform among USG – KSU specific dental, vision, etc. no longer available All employees must confirm or decline choices in new plans Active employees must make elections via the ADP portal under the My Benefits tab

4 Tobacco Certification All employees currently in or electing a medical plan for 2014 will be required to certify the tobacco status of all covered individuals age 18 and over. Certification will include examples of tobacco usage (cigarettes, cigars, chewing tobacco, electronic cigarettes, etc.) A surcharge of $50 per person per month will be added to the premium amount for your coverage.

5 Tobacco Certification

6

7 Tobacco Surcharge Increased clarification of penalties and fines for not answering truthfully and not updating your status if it changes If your tobacco status changes after 1/1/14 and you notify HR, the premium differences will take affect the first of the month following. HR and the Wellness Center will be offering increased resources for smoking cessation. Contact KSUs Wellness Coordinator, Farrah Spellman, for details.

8 Medical Plans Good News! 2014 Premium Rates – No increase for any BCBS plan – Small increase (4.3%) for Kaiser participants

9 Plan Changes Open Access POS Increase Emergency Room co-pay from $50 to $150 Prescription drug changes/programs: –Increase Preferred Brand Name prescription co-pay from $30 to $35 – Remember to ask for generic! $10 for 30 day supply – Maintenance medications now have an option to use mail order Rx Out-of-network deductible increase ($400 to $500 for individual and from $1,200 to $1,500 for family) Out-of-network annual maximums increase ($2,000 to $3,000 for individual and $4,000 to $5,000 for family) Co-payments for office visits and emergency room will be included in out-of-pocket maximum No premium increases Remember to think about an FSA

10 Plan Changes HSA Open Access POS (HDHP) Increase of co-insurance from 10% to 15% Separate out-of-network deductible of $2,500 for individual and $5,000 for family Maintenance medications will now have a mail order option No premium increases Remember to activate your HSA for your matching seed money

11 Plan Changes – Blue Choice HMO Increase in PCP co-pay from $15 to $20 Maintenance medications will now have mail order option Now has an annual out-of-pocket maximum of $6,350 for individual and $12,700 for family No premium increases Remember to think about an FSA

12 Plan Changes – Kaiser HMO Increase in PCP co-pay from $15 to $20 Now has an annual out-of-pocket maximum of $6,350 for individual and $12,700 for family Premium increase of 4.3% Remember to think about an FSA

13 Medical ID Cards All covered members will receive a new medical ID cards for Make sure that your address is correct within the ADP portal.

14 Voluntary Benefits Platform With the exception of basic life insurance coverage, all premiums are employee paid. New premium tier for dental and vision will be employee + children.

15 Delta Dental Two plan options Diagnostic & preventive does not count towards annual maximums, only restorative services will. No waiting on orthodontia; available for children and adults No waiting on replacement crowns and implants (with some limitations) Covers implants and mouth guards

16 Delta Dental Network PPO Network – Highest savings as providers have agreed to fee schedule Premier Network – Moderate savings as providers have agreed to a discount All other dental providers. No additional savings; will be balance billed 208,500 providers 294,000 providers A network within a network

17 Delta Dental *Preventive services dont count toward the deductible **Benefit limits on replacement dentures or crowns apply Coverage Tier Base Plan High Plan Employee $24.82 $30.66 Employee + Spouse $49.62 $61.30 Employee & Child(ren) $47.12 $58.24 Family $79.38 $98.10 In-network benefits for PPO network result in lowest cost. In-network benefits for Premier network result in moderate savings. Out-of-network will result in balance billing.

18 EyeMed Vision In- NetworkOut-of -Network Exam benefits$10$40 Exam frequency1 per 12 months Single vision lens$25$40 Lens frequency1 per 12 months Frames benefit$150$58 Frames frequency1 per 12 months Employees who enroll will receive an ID card Coverage Tier Monthly Premium Employee $6.38 Employee + Spouse $14.38 Employee & Child(ren) $12.14 Family $18.84

19 EyeMed Insight Network Private Practitioners Premium Economic Function Fashion

20 EyeMed Vision 40% off on unlimited addition pairs 20% of any item not covered by the plan 20% of any frame balance Lasik discount – 15% of retail pricing or 5% of promotion price at U.S. Laser locations Additional Items Include: Tint (solid or gradient)$15 copay UV Coating$15 copy Polycarbonate (kids under 19)Covered in full Polycarbonate (adults)$40 copay Anti-reflective$45 - $68 copay Transition$75 copay

21 Life Insurance – Minnesota Life Employee basic coverage – No change: employer provided coverage of $25,000 plus matching AD&D Employee supplemental life with matching AD&D – From 1x to 8x with maximum of $2.5 million – Based on age as of 1/1 each plan year – No age reductions – Can increase current election additional 1x without health questions for this open enrollment only

22 Life Insurance – Minnesota Life Spouse life coverage – Coverage options of $10,000 to $500,000 in $10,000 increments – Health questions are required for any increase from current spouse coverage amounts – Special note for those currently enrolled in Cigna $10,000 dependent life coverage (DPLF $4.70 a month) – the system will indicate that EOI (health questionnaire) will be required but that will be removed manually by SSC after the fact.

23 Life Insurance – Minnesota Life Child life coverage – $5,000, $10,000, or $15,000 coverage options – No health questions required AD&D plans – Employee or Family coverage levels with options of $10,000 to $500,000 – No health questions required

24 Short Term Disability - MetLife 14 day elimination period (can use sick and vacation during this time, if available) 60% of salary up to $2,500 per week No pre-existing conditions if you enroll during open enrollment (Nov 2013) Covers for up to 11 weeks of medical disability

25 Long Term Disability - MetLife 90 day elimination period (can use sick, vacation, or short term disability during this time) 60% of salary up to $15,000 per month 12 month delay on eligibility for pre-existing condition diagnosed within the previous 3 months of coverage – Previous coverage under KSU plans will count towards this pre-x delay period

26 Long Term Disability - MetLife Premiums for LTD previously paid by KSU but BOR restrictions now prohibit One time structural salary adjustment for covered plan members as of 10/1/13 to take effect 1/1/14 Premiums will be after tax deductions so that benefits paid out will not be taxable

27 Medical Flexible Spending Account – US Bank For employees enrolled in either HMO or in the Open Access POS Pre-tax account to reimburse yourself for out of pocket expenses such as copays, deductibles, dental charges, & vision expenses $2,500 annual maximum deduction Services must be provided in calendar year 2014; use it or lose it Current FSA elections to do roll over; must be elected each year

28 Health Savings Account – US Bank For employees (under age 65) enrolled in the HSA POS HDHP Pre-tax savings account which allows you to reimburse yourself for out of pocket expenses like an FSA Annual limits are $3,300 for individual & $6,550 for family (inclusive of any employer match) KSU pays dollar for dollar match up to $375 for individual & $750 for family (leaving $2,925 or $5,800 available for employees to contribute) Account balance rolls over each year; deduction amount can be adjusted mid-year Can transition from Credit Union of GA or leave in separate accounts New vendor will allow for investing balances over $1,000

29 Limited Purpose FSA – US Bank For employees enrolled in HSA POS HDHP Up to $2,500 can be set aside for use in conjunction with the HSA plan Specifically for reimbursement of vision and dental expenses; not medical FSA rules apply – Must be elected annually – Must be for services within calendar year 2014 – Account balance does not roll over; use it or lose it

30 Dependent Care FSA – US Bank Pre-tax deductions for reimbursement of dependent care expenses $5,000 annual maximum Services must be provided in calendar year 2014; use it or lose it Current FSA elections to do roll over; must be elected each year

31 US Bank Payment card for direct payment at the point of sale rather than seek reimbursement; anywhere that MasterCard is accepted Initiate online reimbursements if expenses are paid out of pocket Issue online bill pay directly to a provider Mobile apps available 90% of claims can be auto-substantiated

32 Sick Leave Pool Enrollees must donate a minimum of 8 hours of sick time every other year. Must have a minimum of 48 hours of sick time to enroll Participation can bridge the gap to disability coverage or assist when someone does not have disability coverage Paper enrollment form is linked at the bottom of the HR OE webpage; should be completed and faxed or scanned to HR.

33 Questions not answered today? Send an to Check out the HR Open Enrollment website: https://web.kennesaw.edu/hr/content/2014-benefits-open-enrollment Watch the OE site for an update of Q&A that comes from these education sessions


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