Open Enrollment 2016 Benefits
Open Enrollment Enroll via www.benefitsolver.com – user name and password needed to log in Open Enrollment Guides are available online at www.healthysteps4u.org https://vimeopro.com/user12542591/healthysteps/video/144444668 Confidential – For Discussion Purposes Only 2
BENEFITSOLVER PASSWORD RESET Confidential – For Discussion Purposes Only 3
2016 Health Plan Highlights What’s New for 2016 − Aetna is the new medical plan provider/administrator for the PPO Plan − PPO Plan is now called “Aetna Choice POS II Plan” − CVS/caremark is the new pharmacy provider for the Aetna Choice POS II Plan − Aetna is the new medical and pharmacy provider/administrator for the SHCA Plan − Dental and Vision plan enhancements − Keas is the new platform for HealthySteps to Wellness program − Increased contribution limit for Health Savings Account (HSA) (Some changes may not be applicable to CRONA) Confidential – For Discussion Purposes Only 4
Medical Plans Key Features: SHCA Same medical plan design as 2015 SHCA medical and prescription administered by Aetna Expanding network No increase or nominal employee contributions (see Guide for details) Expect to receive new medical card from Aetna in late December Same contact information for SHCA Plan Member Care Specialist Confidential – For Discussion Purposes Only 5
Medical Plans Key Features: Aetna Choice POS II Same medical plan design as 2015 Medical administered by Aetna − Most current providers & facilities within UMR network are also part of the Aetna Choice POS II network but as we make this transition, it’s important for you to confirm your current provider is within the Aetna network by logging onto www.aetna.com Prescription administered by CVS/caremark No increase or nominal employee contributions (see Guide for details) Expect to receive new cards in late December − Medical Aetna − Pharmacy CVS/caremark Aetna Concierge services HSA Eligibility Confidential – For Discussion Purposes Only 6
Medical Plans Key Features: Kaiser HMO Same medical plan design as 2015 No increase or nominal employee contributions (see Guide for details) Confidential – For Discussion Purposes Only 7
Dental Three dental plans available and enhancements made for 2016: Services Delta Dental Delta Dental DeltaCare USA Basic PPO Plan Buy-Up PPO Plan DHMO Plan Annual Deductible $50/ $150 $25/ $75 No annual (Individual/ Family) deductible Annual Benefits $2,000 $2,500 Refer to DHMO Max plan documents Choice of Provider of choice Provider of choice Must use a Providers provider within the DHMO network Diagnostic and 100% 100% Most services Preventive Services covered at 100% Basic Services 80% 90% Refer to DHMO plan documents Major Services 50% 60% Orthodontics 50% 50% (new for 2016: coverage for all adults and children) Orthodontic Max $1,500 $2,000 50% Implants 60% (new for 2016) Confidential – For Discussion Purposes Only 8
Vision Vision enhancements made in 2016: 1. Frames - $150 allowance (increased from $130 in 2015) 2. Contacts - $150 allowance (increased from $105 in 2015) 3. Progressive Lenses - $40 Copay (from $50 Standard, $80-$90 Premium, $120-$160 Custom) 4. Anti-Reflective Lenses - $40 Copay (new in 2016) 5. Retinal Screening - $20 Copay (new in 2016) Confidential – For Discussion Purposes Only 9
Wellness Vendor change to Keas in 2016, was Limeade in 2015 Incentives not changing – HSA and HIA remains Payout of incentives changing to calendar year quarterly: − Quarter 1 – January through March: $100/$200 max − Quarter 2 – April through June: $200/$400 max − Quarter 3 – July through September: $200/$400 max Biometric Screenings − Starting November 1 st , you are able to register for Biometric Screening appointments in 2016 − Appointments and walk-ins will be offered January 4-March 31, 2016 at the Stanford Hospital Atrium and other locations Confidential – For Discussion Purposes Only 10
Savings & Reimbursement Accounts Health Savings Account (HSA) - available for employees enrolled in the Aetna Choice POS II Plan – includes wellness incentive dollars earned by participating in HealthySteps to Wellness − Up to $2,850 employee only − Up to $5,750 employee plus one or more covered dependents Healthcare Flexible Spending Account (Healthcare FSA) – available for employees enrolled in SHCA or Kaiser HMO – contribute up to $2,500 in 2016 Dependent Daycare Care Flexible Spending Account (Dep Daycare FSA) – available for employees who have dependent children under 13 and any dependent parents under age 65 eligible for social security – contribute up to $5,000 in 2016 Other Reimbursement Account (Employer-sponsored account) − Health Incentive Account (HIA) – available for employee enrolled in SHCA or Kaiser HMO – wellness incentive dollars earned by participating in HealthySteps to Wellness Confidential – For Discussion Purposes Only 11
Additional Benefit Programs Legal available during open enrollment − Now part of enrollment process in Benefitsolver Accidental Death and Dismemberment (AD&D) – enroll at anytime Optional Life and Supplemental Long Term Disability – Evidence of Insurability (EOI) needed if outside Period of Initial Eligibility Confidential – For Discussion Purposes Only 12
Don’t Forget! Use funds in your Health Incentive Account (HIA) or Flexible Spending Accounts (FSA) by December 31, 2015 − All claims incurred during 2015 must be submitted by March 15, 2016 − Any money remaining in your HIA or FSA at the end of the year will be forfeited and claims submitted after March 15, 2016 will be denied Re-elect HSA or FSA employee contributions for 2016 Recertify for Working Spouse/Eligible Domestic Partner Access Fee Confidential – For Discussion Purposes Only 13
Next Steps and OE Resources Review 2016 Open Enrollment Guide for additional details at www.healthysteps4u.org For general benefit inquiries or enrollment assistance, call the Benefitsolver Team at 855.327.5025 To assist with determining which plan is best for you and/or your family situation, consult with CareCounsel at 888.227.3334 Enroll in your 2016 benefits at www.benefitsolver.com no later than November 20 , 2015, 10pm Pacific time Confidential – For Discussion Purposes Only 14
QUESTIONS? Confidential – For Discussion Purposes Only 15
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