1. 2015 Benefits open enrollment review
City of Marietta
2015 Benefits open enrollment review

2. ShawHankins Service Center- can answer questions on all benefits
Available 8:00 am – 5:00 pm during open enrollment
Available until 7pm until November 14th
Benefit Resource Center- shawhankinsbenefits.net/cityofmarietta

3. Changes for 2015 BCBS POS Plan BCBS PPO Plan
Change in copays, deductible and out of pocket maximum
BCBS PPO Plan
Change in deductible and out of pocket maximum
New Medical Plan offering with Piedmont/Wellstar
Out of pocket maximum on all plans will now include prescription costs
New Pharmacy Benefit Manager-PharmAvail
Everyone will receive new ID cards from BCBS with PharmAvail information
Optional Vision Plan-Avesis

4. Open Enrollment Open Enrollment is November 3rd- November 21st
Benefits Fair will be November 3rd – November 7th
HR and ShawHankins will be available to answer questions and assist with online enrollment
Open Enrollment is your opportunity to make elections for 2015
Only time you can make a change to those elections is if you experience a qualifying event:
Marriage, divorce
Birth or adoption
Change in your or your spouse’s work status that affects benefits
Spouse’s annual open enrollment period
Change in dependent eligibility status
Change in eligibility for Medicaid or Medicare
Death of dependent
Court order

5. Bswift Online Enrollment
Will make elections through Bswift enrollment portal
Username: first letter of first name, last name, and last 4 digits of SSN
Example: JSmith0563
Password: last 4 digits of your SSN
Example: 0563
If you do not make elections through the enrollment portal, your coverage will roll over for the 2015 plan year. You will not be permitted to make changes after the open enrollment period ends, unless you experience a qualifying event.
FSA elections must be made with Colonial representative. Must make new election for 2015.

6. Benefits Fair Fire Department Conference Rooms B & C- 112 Haynes St
Monday November 3rd
Tuesday November 4th
Wednesday November 5th
Thursday November 6th
Friday November 7th
9:00 am-12:00 pm
1:30 pm-4:00 pm

7. Medical and Prescription Coverage

9. PPO Plan-Grandfathered Employees
PPO Plan-Grandfathered Employees
Key Benefit
In-Network
Out of Network
Lifetime Maximum
Unlimited
Deductible
Coinsurance
$800 per person
$2,400 per family
$1,200 per person
$3,600 per family
80% plan / 20% member
70% plan / 30% member
Maximum Annual
Out-of-Pocket Limit
$6,600 per person
$13,200 per family
No maximum
Out of Pocket Maximum includes deductible, coinsurance and all copays – Office Visit, Urgent Care, Emergency Room and Prescriptions
Office Visits
Primary Care Physician
Specialty Care Physician
Urgent Care Facilities
Plan pays 80% after deductible
Plan pays 70% after deductible
Routine Preventive Care
No charge
Inpatient Hospital Facility Services, Physician’s Visits/Consultations, Professional Services
$300 per admit , then plan pays 70% after deductible
Outpatient Facility Services, Professional Services
Hospital Emergency Room

11. Prescription Benefit Changes
Step Therapy-Require prior authorization and will be subject to step therapy
Brand name only cholesterol-lowering agents (statins)
Advicor, Altoprev, Crestor, Lescol XL, Livalo, Simcor, Vytorin
Brand name only COX-2 NSAID (Celebrex)
Brand name only Anti-Migraine Medication (Triptans)
Axert, Relpax, Frova, Sumavel, Treximet
Select brand name only Fibromyalgia Agents (Lyrica)
Brand name only ACE Inhibitors & ACE Inhibitor Anit-Hypertensive Agents
Diovan, Edarbi, Benicar, Tekturna

12. Prescription Benefit Changes
Coverage Change
OTC Proton Pump Inhibitor-Nexium 24HR will be covered, Brand-name Rx Nexium will not be covered
Brand name only drugs with therapeutic generic equivalents
Will exclude coverage for brand name drugs with therapeutic generic equivalents
Adoxa, Doryx, Monodox, Oracea, Arestin, Dynacin, Solodyn, Moxatag, Duexis, Vimovo
Andogel, Testim, Fortesta, Axiron, Androderm, Striant

13. Prescription Benefit Changes
Additions to Non-Preferred Formulary Tiers- 3rd tier copays apply
Azor, Coreg CR, Crestor, Janumet, Januvia, Lovanza, Modafinil, Pexeva, Pristiq, Provigil, Patanase, Pataday, Vilibryd
Specialty Medication Coverage- Prior authorization required and copayment change
Member share will be 10% of total prescription cost up to maximum of $200 per prescription
Examples: Simponi, Avonex, Stelara, Orencia, Humira, Enbrel, Cimzia

14. Piedmont/Wellstar HMO In-Network
Key Benefit
Piedmont/Wellstar HMO
In-Network
Lifetime Maximum
Unlimited
Deductible
Coinsurance
$750 per person
$2,250 per family 
80% plan / 20% member
Maximum Annual
Out-of-Pocket Limit
$6,600 per person
$13,200 per family
Out of Pocket Maximum includes deductible, coinsurance and all copays – Office Visit, Urgent Care, Emergency Room and Prescriptions
Office Visits
Primary Care Physician
Specialty Care Physician
Urgent Care Facilities 
 $25
$40
$100
Routine Preventive Care
No Charge
Inpatient Hospital Facility Services, Physician’s Visits/Consultations, Professional Services
Plan pays 80% after deductible
Outpatient Facility Services, Professional Services
Hospital Emergency Room
$200
Prescription Drugs
Rx Deductible
Tier 1
Tier 2
Tier 3
Tier 4
Mail Order- 90 day supply
None
$10
$65
10% to $200 max
2.5 x copay

16. City of Marietta Employee Medical Center:
Location
268 Lawrence Street, Marietta, GA 30060
Hours of Operation
Mondays: am – 5 pm
Tuesdays: am- 1pm
Wednesdays: 8 am – 2pm
Thursdays: am – 2 pm
Fridays: am – 1pm
Saturday: am – 12 pm
Available Services
Primary, urgent and preventive care
Laboratory testing
Flu shots
Treatment for chronic health conditions
Medications
What are the benefits to you?
No more long stays in the waiting room
No out of pocket expense
Increased convenience and access
More one-on-one time with the doctor

17. Dental Coverage Will remain with BCBSGA No change to plan design
PPO plan option allows you to see any dentist. However, you can see less out of pocket expense if you stay in the BCBSGA dental network.
Locate participating providers at bcbsga.com
BCBS Dental
In-network
Out-of-network
Annual maximum
$1,000 per person
Deductible (Single/Family)
$25/$75
Diagnostic/preventive services*
100%
Basic benefit services
80%
Major benefit services
50%

18. Flexible Spending Accounts
Two separate accounts- Medical Spending Account and Dependent Care Spending Account
Allows you to set aside pre-tax dollars to spend on qualified expenses, saving on your taxable income
Must make new elections for 2015-See Colonial rep

19. Flexible Spending Accounts
Medical Spending Account
Maximum contribution of $2,500
Some eligible expenses- Deductibles, copayments, dental expense, vision services and materials
Dependent Care Spending Account
$5,000 for married couple filing joint income tax returns, $2,500 if unmarried or married and filing separate income taxes
Some eligible expenses- any care of a dependent that allows you and your spouse to work: day care, after school program, in-home care, camps
Use funds by end of plan year or lose remaining amounts

20. Basic Life and AD&D
City of Marietta provides basic life and AD&D benefit at no cost to you
Provided through MetLife
City Council Employees: $150,000
Closed Group of Public Safety Employees: $40,000
All Other Employees: 3 x your annual earnings, maximum $180,000

21. Optional Life Insurance
Purchase coverage for yourself in increments of 1 x your annual earnings up to a max of 4 x earnings or $420,000
Elect coverage for your spouse in increments of $10,000 up to $100,000
Coverage for your children of $5,000 or $10,000
Includes Will Preparation Service and Legal services through Hyatt Legal
If you have declined this coverage in the past and wish to add coverage during this open enrollment, you must complete an evidence of insurability form and be approved for all amounts of coverage

22. Long Term Disability Coverage
Pays a benefit after you are disabled for 180 days
Covers 50% of your earnings up to a maximum of $5,300 per month.
Continues to pay until you can return to work or reach SSNRA
Elect coverage with Colonial representative Nov 3-7
If you have declined this coverage in the past and wish to add at this time, you must complete an evidence of insurability form and be approved for coverage

23. Optional Vision Coverage
Coverage for 2015 provided through Avesis
You may receive an exam and new lenses every 12 months, new frames every 24 months
Avesis Vision
In-network
Out-of- network reimburseme nt
Exam
$10 copay
$35
Standard lens
$25 copay
$25 single, $40 bifocal, $50 trifocal
Frames
$50 wholesale allowance
$45
Contact lenses
$130 allowance
$130
Medically necessary contact lenses
Paid in full
$250
Laser vision correction
$150 one time

24. Colonial Benefit Options
Disability Insurance
Accident Insurance
Cancer Insurance
Critical Illness Insurance
Life Insurance

25. MetLaw Telephone and Office Consultations Legal Representation
Estate Planning-Wills, Powers of Attorney
Financial Matters-Bankruptcy, Foreclosure, Tax Collection
Real Estate Matters-Sale, Purchase, or Refinance, Eviction, Zoning
Elder Law Matters- Medicare, Deeds, Wills, Nursing Home Agreements
Family Law- Adoption, Guardianship, Prenuptial Agreement
Traffic Offenses- excludes DUI
Document Preparation- Deeds, Mortgages, Affidavits

26. Employee Assistance Program
Provided through LifeWorks
Assistance with questions regarding handling stress, relationships, challenges at work, parenting, caring for an older relative, or health issues.
Available 365 days a year
Provided at no cost to you

27. Questions?