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2015 Open Enrollment Non-Represented. SunMonTueWedThuFriSat 15161718 19202122232425 2627282930311 2345678 910111213Nov 14 START END 5:00pm Open Enrollment.

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Presentation on theme: "2015 Open Enrollment Non-Represented. SunMonTueWedThuFriSat 15161718 19202122232425 2627282930311 2345678 910111213Nov 14 START END 5:00pm Open Enrollment."— Presentation transcript:

1 2015 Open Enrollment Non-Represented

2 SunMonTueWedThuFriSat 15161718 19202122232425 2627282930311 2345678 910111213Nov 14 START END 5:00pm Open Enrollment Enroll or make changes October 15 – November 14 2

3 What’s New in 2015? Non-Represented employees to pay 3% of premium 3 EBMSKaiser Permanente Employee Only$20.00$17.99 Employee + Spouse$39.97$35.95 Employee + Child(ren)$37.97$34.14 Employee + Family$57.94$52.10 Maximum employee monthly cost for medical, vision, and dental coverage.

4 What’s New in 2015? $250 vision plan changes to $500 vision plan 4  $500 benefit per enrolled family member every two calendar years.  May use $500 benefit all at once or spread it across two calendar years (e.g. $250 in year 1 and $250 in year 2)  $500 benefit renews every other January 1st (1/1/2017)

5 What’s New in 2015? Kaiser Permanente Vision Plan Discontinued 5 $500 vision plan with Kaiser Permanente discontinued  Kaiser continues to provide routine eye exam with a $15 co-pay.  You may elect the $500 vision plan through EBMS to have coverage for glasses and contacts.  You may elect to waive vision coverage. If you waive vision coverage, you will still have coverage for routine eye exams through the Kaiser medical plan.

6 What’s New in 2015? Option to Waive Vision or Dental Coverage 6 Vision You may elect vision coverage for all family members or waive vision coverage for all family members. Dental You may elect dental coverage for all family members or waive dental coverage for all family members.

7 What’s New in 2015? Prescription Drug Annual Out-of-Pocket Maximum 7 Protects you from unlimited prescription drug costs. Kaiser Permanente Prescription drug costs applied to medical annual out-of-pocket maximum ($1,250 / $3,750) EBMS  $2,000 annual out-of-pocket maximum per individual  $6,000 annual out-of-pocket maximum per family of 3 or more  Does not apply to the annual medical out-of- pocket maximum EBMS  $2,000 annual out-of-pocket maximum per individual  $6,000 annual out-of-pocket maximum per family of 3 or more  Does not apply to the annual medical out-of- pocket maximum

8 What’s New in 2015? Health Care FSA - $500 Carry-Over 8  IRS now allows up to $500 of unused Health Care FSA dollars to be carried over for use in the following calendar year.  Only applies to Health Care FSA, not Dependent Care FSA.  2014 carry-over funds will be available for use after all 2014 reimbursement requests submitted during the 90-day run-out period have been processed (expected availability is April/May 2015). $500

9 Open Enrollment What can you change and when? Open Enrollment Changes  Medical plan selection  Vision plan selection (some exclusions apply)  Dental plan selection (some exclusions apply)  Add or cancel dependent coverage  If you have waived coverage in the past, you may enroll in the health insurance plan. Open Enrollment Changes  Medical plan selection  Vision plan selection (some exclusions apply)  Dental plan selection (some exclusions apply)  Add or cancel dependent coverage  If you have waived coverage in the past, you may enroll in the health insurance plan. Changes Due to Qualifying Events  Birth or adoption of a child  Marriage or divorce  Dependent’s loss of eligibility  Change in spouse’s employment  Loss of other health coverage Changes Due to Qualifying Events  Birth or adoption of a child  Marriage or divorce  Dependent’s loss of eligibility  Change in spouse’s employment  Loss of other health coverage 9

10 Dependent Eligibility Who can you enroll on the health plan?  Your legal spouse  Your same-sex domestic partner  Your legal spouse  Your same-sex domestic partner Dependent children - Up to age 26  Natural child  Step-child  Child of your same-sex domestic partner  Legally adopted child  Child under your legal guardianship  Child over age 26 who is medically certified as disabled and incapable of self-support. Dependent children - Up to age 26  Natural child  Step-child  Child of your same-sex domestic partner  Legally adopted child  Child under your legal guardianship  Child over age 26 who is medically certified as disabled and incapable of self-support. Proof of relationship is required. 10

11 Medical Plans Deductible and Out-of-Pocket Maximum EBMS PPO Medical PlanKaiser Permanente 1-PartyFamily1-PartyFamily Deductible$250$750$250$750 Out-of-Pocket In-network $1,250$3,750$1,250$3,750 Out-of-Pocket Out-of-network $2,250$6,750N/A 11

12 Medical Plans Preventive Care EBMS In-Network EBMS Out-of- Network Kaiser Permanente Routine Baby and Child Exams $040%$0 Immunizations$040%$0 Routine GYN$040%$0 Mammograms$040%$0 Preventive Exams and Labs $040%$0 12

13 Medical Plans Provider Services EBMS In-Network EBMS Out-of-Network Kaiser Permanente Office Visits20%40%$15/$25 co-pay Allergy Shots20%40%$5 co-pay In-office Surgery 20%40%$5 co-pay Labs20%40%$10 co-pay X-rays20%40%$10 co-pay Mental Health & Chemical Dependency 20%40%$15 co-pay outpatient; 20% inpatient & residential Maternity fee/provider 20%40%$0 13

14 Medical Plans Inpatient and Outpatient Services EBMS In-Network EBMS Out-of-Network Kaiser Permanente Maternity Hospital20%40%20% Inpatient Hospital20%40%20% Outpatient Surgery20%40%20% Emergency Room$100 co-pay, no deductible $100 co-pay, no deductible 20% Emergency Room (non-emergency) 20% after $100 co-pay, no deductible 40% after $100 co-pay, no deductible 20% Urgent Care$50 co-pay, no deductible 40%$15 co-pay Ambulance20% 14

15 Prescription Drug Benefit EBMS Participating EBMS Non- Participating Kaiser Permanente Annual Out-of-Pocket Maximum $2,000 / $4,000 / $6,000 Accrues to Medical out-of-pocket ($1,250 / $3,750) Retail – 30 day supply Generic$10 co-pay Member must pay pharmacy in full and submit claim for reimbursement $10 co-pay Preferred*30% Min $25; Max $55 $20 co-pay Non-Preferred30% Min $45; Max $75 $20 co-pay Mail Order – Up to 90 day supply Generic$20 co-pay N/A $20 co-pay Preferred*30% Min $50; Max $110 $40 co-pay Non-Preferred30% Min $90; Max $150 $40 co-pay *Preferred list may change without notice. 15

16 Vision Traditional Vision $500 Vision Kaiser Permanente EligibilityClosedOpen to All Routine eye exams covered under Kaiser medical plan. Exam Freq.Once every 12 mo. Exam (<18) 100% in-network $25 out-of-network 100% in-network 60% out-of-network Exam (>18) 100% in-network $25 out-of-network Up to $500 every 2 calendar years for any combination of exam, frames, lenses, or contacts. Frames$40 every 24 mo. Not covered. May enroll in $500 Vision plan. Lenses $89 single $125 bifocal $158 trifocal $50 lenticular Contacts$100 16

17 Dental Willamette DentalTraditionalIncentive EligibilityOpen to All Closed to New Deductible$0 Benefit MaxUnlimited$1,500$1,000 Preventive$10 co-pay100%70%/80%/90%/100% Basic$10-$140 co-pay depending on service 80%70%/80%/90%/100% Major I$150 co-pay60%70%/80%/90%/100% Major II$150-$200 co-pay depending on service 60%50% Orthodontia100% after $1,800 co-pay 50% up to $1,000 50% up to $1,000 17

18 How does the health plan work? Preventive Care (plan pays 100% with no deductible for in-network services) You pay 100% of the cost of your medical care until your expenses reach your deductible. Annual Deductible Use this account to pay for deductibles, co- insurance, and co-pays. 18

19 You must meet your deductible before your co-insurance shares the cost of services Preventive Care (plan pays 100% with no deductible for in-network services) You pay 100% of the cost of your medical care until your expenses reach your deductible. Annual Deductible Use this account to pay for deductibles, co- insurance, and co-pays. Once you meet the deductible of: $250 (Individual) $750 (Family) 19

20 After your deductible is met, co-insurance will pay up to 80% of the cost of medical services Preventive Care (plan pays 100% with no deductible for in-network services) You pay 100% of the cost of your medical care until your expenses reach your deductible. Annual Deductible Use this account to pay for deductibles, co- insurance, and co-pays. Once you meet the deductible of: $250 (Individual) $750 (Family) Co- insurance The plan pays 80% for in-network services and 60% for out-of-network services. 20

21 Once you meet the annual maximum, the plan pays the rest! Preventive Care (plan pays 100% with no deductible for in-network services) You pay 100% of the cost of your medical care until your expenses reach your deductible. Annual Deductible Use this account to pay for deductibles, co- insurance, and co-pays. Once you meet the deductible of: $250 (Individual) $750 (Family) Co- insurance The plan pays 80% for in-network services and 60% for out-of-network services. The plan pays 100% of eligible expenses if you have met the annual maximum from your own pocket. Out-of-Pocket Maximum 21

22 Flexible Spending Accounts (FSA) reimburse your out-of-pocket expenses with tax-free dollars Preventive Care (plan pays 100% with no deductible for in-network services) You pay 100% of the cost of your medical care until your expenses reach your deductible. Annual Deductible Use this account to pay for deductibles, co- insurance, and co-pays. Once you meet the deductible of: $250 (Individual) $750 (Family) Co- insurance The plan pays 80% for in-network services and 60% for out-of-network services. The plan pays 100% of eligible expenses if you have met the annual maximum from your own pocket. Out-of-Pocket Maximum Flexible Spending Account Use this account to help pay for or reimburse your deductible, co-insurance, and co-pays. 22

23 Flexible Spending Accounts (FSA) help you pay for health care expenses tax-free!  Deducted from paycheck before taxes  Eligible health care expenses not covered by health insurance can be paid with tax-free dollars:  Deductible, co-pays, co-insurance  Glasses and contacts  Dental care, and more  Benny Card to pay eligible health care expenses directly from your FSA  NEW! $500 Carry-Over  Set aside up to $2,500 per calendar year 23 Benny Card Tips and Tricks  Keep your receipts  Respond to documentation requests  Pre-pay for medical services with caution  Don’t use Benny Card in 2015 to pay for 2014 expenses Benny Card Tips and Tricks  Keep your receipts  Respond to documentation requests  Pre-pay for medical services with caution  Don’t use Benny Card in 2015 to pay for 2014 expenses

24 Flexible Spending Accounts (FSA) help you pay for dependent care expenses tax free!  Deducted from paycheck  Eligible child or elder care expenses paid tax-free  Dependents under age 13, or any age if incapable of self-care  After/Before school care  Day camp  Preschool  Babysitter  Use it or lose it!  Set aside up to $5,000 per calendar year 24

25 Employee Assistance Program (EAP) Available 24/7/365 for free! EAP provides:  Confidential counseling  Legal consultation  Financial consultation  Identity theft recovery assistance  Home ownership program  Wellness coaching  Smoking cessation 25

26 City-paid Basic Life Insurance and AD&D protects your loved ones  Guaranteed protection to your designated beneficiaries  $50,000 life insurance policy  $50,000 accidental death & dismemberment (AD&D) policy  Automatically enrolled as a benefit-eligible employee  You may change your beneficiaries at any time 26

27 Voluntary Life Insurance and AD&D gives you added peace of mind Life insurance (Standard)  $10,000 - $500,000 for yourself and/or your spouse/same-sex domestic partner  $2,000, $5,000, or $10,000 for your children  Apply any time during the year, medical underwriting required AD&D (Hartford)  $25,000 - $300,000 for yourself or yourself and your family  Apply any time during the year  Provides additional protection for you and your family  Premiums are paid after-tax from your paycheck 27

28 Long Term Disability protects a portion of your income if you become disabled  Plan pays if you are disabled and unable to work for more than 120 days  Pays 60% of the first $10,000 of your pre-disability earnings, reduced by deductible income.  Automatically enrolled as a benefit- eligible employee. 28

29 Long Term Care Insurance helps pay for nursing facility or in-home care  Plan helps preserve financial security when you or a covered family member requires long term care in a facility or at home.  Must be unable to perform two or more activities of daily living for more than 60 days.  May apply for a monthly facility benefit of $1,000 to $6,000 for 2 years, 4 years, or unlimited duration.  Apply anytime during the year, medical underwriting is required. 29

30 Deferred Compensation Are you saving enough for retirement?  Set aside (defer) money from your paycheck before taxes  2015 annual deferral limits are:  $18,000, if you are under age 50  $24,000, if you are 50 years or older  $36,000, if you are within 3 years of retirement (restrictions apply)  Pay taxes upon withdrawal of funds in retirement.  Sign up or change your deferral amount any time during the year.  Save for your future retirement and save on taxes today! 30

31 Open Enrollment Forms due by 5:00 p.m., Friday, November 14, 2014 If you are changing medical, vision, or dental plans, or adding or canceling dependent coverage, complete this form: If you or your covered dependents have other health insurance coverage, complete this form: If you would like to participate in flexible spending for 2015, complete this form:

32 Questions?


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