SLIDE 1
Annual Enrollment for Plan Year 2017
February 2010 2
APRIL 2010
2017 Annual Enrollment Georgia Breeze Website: Opens: Monday, October 17th 12:00AM Closes: Friday, November 4th 11:59PM
* Benefits elected are effective January 1, 2017
Annual Enrollment for Plan Year 2017 2017 Annual Enrollment Georgia - - PowerPoint PPT Presentation
Annual Enrollment for Plan Year 2017 2017 Annual Enrollment Georgia - - PowerPoint PPT Presentation
Annual Enrollment for Plan Year 2017 2017 Annual Enrollment Georgia Breeze Website: Opens: Monday, October 17 th 12:00AM Closes: Friday, November 4 th 11:59PM * Benefits elected are effective January 1, 2017 February 2010 2 APRIL 2010 Summary
SLIDE 2
SLIDE 3
February 2010 3
APRIL 2010
Summary of Plan Changes for 2017
- Spending Accounts – New Website
- CIGNA Dental HMO – Expanded Network
- Met Life – One-time opportunity to increase
coverage without completing Statement of Health
SLIDE 4
February 2010 4
APRIL 2010
Flexible Healthcare Spending Account – 2017 Website Update
New Look for ADP Website
- Effective September 17th, the
ADP website will no longer support Internet Explorer version 8 or lower.
- ADP has added an additional
layer of security for first time web users. New users will be advised that a security code will be emailed to them within 5 minutes.
- The State of Georgia’s
security code is STATEOFGE-10029
- This code is the same for all
users, and will never change.
SLIDE 5
February 2010 5
APRIL 2010
Flexible Healthcare Spending Account – 2017 Plan cont’d
- Maximum annual contribution is $2,510
- Minimum annual contribution remains $120
- Contributions must be re-elected each year, they do not
rollover.
SLIDE 6
February 2010 6
APRIL 2010
Healthcare Spending Account - ADP – Set aside pre-tax money to use for healthcare expenses. – Maximum amount $2,510 ($209/month) can be set aside per year. – Money is “Use or Lose”
> You have until March 15, 2018 to use money placed in your 2017
spending account. – Entire amount is available the first day of the year. – Visa debit card available for purchases, but keep your receipts! – Qualifying expenses include: prescriptions, contact lenses/glasses, eye surgery, procedures/surgeries not covered by insurance, health insurance co-insurance. – Excluded expenses include: over the counter drugs, electrolysis, vitamins/herbal supplements, hair transplants, nicotine patches or gum, teeth whitening.
Flexible Healthcare Spending Account
SLIDE 7
February 2010 7
APRIL 2010
Flexible Healthcare Spending Account
- continued
Spending Accounts – Relation to the Health Saving Account
Employees who enroll in the High Deductible Health Plan AND enroll in a Health Savings Account (HSA) will not be eligible to enroll in a Health Care Spending Account If an employee does enroll in a HCSA in error, it will be necessary for them to contact the Gabreeze Call Center and request an Appeal Form to submit to DOAS – The form will be received/reviewed by DOAS – Gabreeze will be notified of the final determination regarding the Spending Account
SLIDE 8
February 2010 8
APRIL 2010
CIGNA Dental HMO
- Cigna Dental (DHMO) Dental Network is
available primarily to those who work or live in the Metro Atlanta Area.
- There are limited participating providers
in Chatham county.
- Additional counties are being added for
2017, to include Lowndes, Houston, Baldwin, Spalding, Troup, Richmond, Clarke, Barrow, Dawson, Floyd, Bartow, and Catoosa.
- Provider Network frequently changes
- No late entrant penalties or waiting periods.
- Slight rate increase for 2017
Cigna DHMO Rates You $22.58 You + Spouse $41.15 You + Child(ren) $51.03 Family $60.86
SLIDE 9
February 2010 9
APRIL 2010
True “OneUp” Special Enrollment Will allow employees to enroll in a life insurance plan at the first level of coverage; or increase their current coverage up one level without a Statement of Health (SOH).
- The opportunity to “OneUp” will only
be available for the 2017 plan year.
- Employees that do not have coverage
can enroll without a SOH.
- Currently covered emplyees can move
up one salary level without a SOH.
Life Insurance – Met Life 2017 One-Up Opportunity
SLIDE 10
February 2010 10
APRIL 2010
Life Plans – MetLife
MetLife offers: – Up to 10x employee’s salary for Employee Life coverage, up to $2 Million Current employees wishing to increase their current level of coverage beyond one level will be required to complete the online Statement of Health (SOH) Employees wishing to enroll in Spouse Life or increase the current level of spouse coverage will be required to complete the online Statement of Health (SOH) – Employees are required to pre-register their spouse on the Gabreeze website before the Statement of Health form will be available online.
Life Insurance – Met Life
SLIDE 11
February 2010 11
APRIL 2010
Life Plans – MetLife
Waiver of Premium to the Employee Life product for permanent or total disability
– Employee must initiate the process after meeting the 180 day qualifying period – Copy of the form available on the GABreeze, DOAS, and Team Georgia web sites
Additional Life Insurance benefits:
– Will Preparation – Estate Planning
NOTE: These benefits are offered by Metlife in partnership with Hyatt Legal Services. This service is separate from the benefits provided under the Hyatt Legal Plan
Life Insurance – Met Life cont’d
SLIDE 12
February 2010 12
APRIL 2010
Beneficiaries are managed online.
– Remember to review and update your beneficiaries.
An employee must carry Employee Life if they wish to elect Spouse Life coverage.
– Spouse Life coverage cannot exceed Employee Life coverage.
Child life covers an employee’s children under 26, without medical underwriting.
– Child Life coverage cannot exceed Employee Life Coverage – Disabled children can continue coverage after age 26. – Child Live coverage starts at live birth.
Premiums are based on employee age and salary.
More About Life Insurance…
SLIDE 13
February 2010 13
APRIL 2010
The following plans have no changes to coverage for 2017
Delta Dental Blue View Vision AFLAC Critical Illness Hyatt Legal Dependent Care Spending MetLife AD&D Short Term/Long Term Disability
SLIDE 14
February 2010 14
APRIL 2010
Delta Dental Select Plan
$50 In-Network Deductible, per person (or) $150 In- Network Family Deductible per calendar year. $50 Out-of-Network Deductible, per person (or) $150 Out-of-Network Family deductible per calendar year. $500 maximum coverage per person each calendar year. 100% Coverage for Diagnostic/Preventive services. (Cleanings, xrays, etc.) 80% Coverage for Basic Services (fillings, extractions), Endodontics (root canals), Periodontics (gum treatments), and Oral Surgery. 50% Coverage for Major Services (crowns, inlays, restorations, bridges, dentures, TMJ, surgical periodontics.)
Dental Insurance – Delta Dental
SLIDE 15
February 2010 15
APRIL 2010
Delta Dental Select Plus Plan $50 In-Network Deductible, per person (or) $150 In-Network Family Deductible per calendar year. $50 Out-of-Network Deductible, per person (or) $150 Out-of-Network Family deductible per calendar year. $2,000 maximum coverage per person each calendar year. 100% Coverage for Diagnostic/Preventive services. (Cleanings, xrays, etc.) 90% Coverage for Basic Services (fillings, extractions), Endodontics (root canals), Periodontics (gum treatments), and Oral Surgery. 60% Coverage for Major Services (crowns, inlays, restorations, bridges, dentures, TMJ, surgical periodontics.) 50% Coverage for Orthodontia Services, up to $2,000 lifetime maximum orthodontia benefit per person.
Dental Insurance – Delta Dental
SLIDE 16
February 2010 16
APRIL 2010
Late Entrant Penalties – Delta Dental:
- If an employee does not carry dental
insurance in the previous plan year, or cannot prove that they have had continuous dental insurance coverage, they are subject to “late entrant penalties.”
- Under Delta Dental, the penalties are as
follows:
- Six month wait for:
- major services (crowns, inlays, restorations,
bridges, dentures, TMJ, surgical periodontics.)
- Orthodontia (Select Plus Plan Only)
Delta Dental Plans – Late Entrant Penalties
SLIDE 17
February 2010 17
APRIL 2010
Delta Dental – Select Plan Premiums
– You Only $26.20 – You + Spouse $51.03 – You + Child $53.49 – You + Family $74.95
Delta Dental – Select Plus Plan Premiums
– You Only $42.01 – You + Spouse $82.22 – You + Child $86.24 – You + Family $121.01
Delta Dental Premiums - 2017
Admin fee is included in amount.
SLIDE 18
February 2010 18
APRIL 2010
Vision – Blue Cross/Blue Shield of Georgia – Select Plan
COVERED SERVICES COPAYMENTS/MAXIMUMS Network Providers Non-Network Providers
Eye Exam Limited to one exam per Member every Calendar Year. $10 Copayment Reimbursed up to $40 Prescription Lenses Limited to one set of lenses per Member every Calendar Year. Basic Lenses (Pair)
Single Vision lenses
Lined Bifocal lenses
Lined Trifocal lenses
Lenticular lenses $20 Copayment Reimbursed up to $60 Reimbursed up to $80 Reimbursed up to $80 Reimbursed up to $45 Frames Limited to one set of frames per Member every 24 Months. $ 20 Copayment Allowable Amount up to $130 retail allowance N/A Prescription Contact Lenses Every 12 months in place of eyeglasses (traditional or disposable)
Non-Elective Contact Lenses (Availability once every Calendar Year.) $20 Copayment Covered in full Reimbursed up to $105 Reimbursed up to $210
Elective Contact Lenses (Availability once every Calendar Year.) $20 Copayment $105 plan allowance or disposables up to 4 boxes. Reimbursed up to $105 Note: If you chose covered Non-Elective Contact Lenses or Elective Contact Lenses, no benefits will be available for covered eyeglass lenses in that period.
SLIDE 19
February 2010 19
APRIL 2010
COVERED SERVICES COPAYMENTS/MAXIMUMS Network Providers Non-Network Providers Eye Exam Limited to one exam per Member every Calendar Year. $10 Copayment Reimbursed up to $40 Prescription Lenses Limited to one set of lenses per Member every Calendar Year. Basic Lenses (Pair) Single Vision lenses Lined Bifocal lenses Lined Trifocal lenses Lenticular lenses Includes the following Lens options Factory scratch coating Tint (Solid & Gradient) Polycarbonate lenses Transitions Photochromic lenses Standard & Premium Progressive lenses Standard Anti-Reflective coating (Not Covered For Non-Network Providers) $25 Copayment Reimbursed up to $40 Reimbursed up to $60 Reimbursed up to $80 Reimbursed up to $80 Frames Limited to one set of frames per Member every Calendar Year. No Copayment Allowable Amount up to $150 retail allowance Reimbursed up to $45 Prescription Contact Lenses (traditional or disposable) Non-Elective Contact Lenses (Availability once every Calendar Year.) No Copayment Covered in full Reimbursed up to $210 Elective Contact Lenses (Availability once every Calendar Year.) No Copayment $200 plan allowance Reimbursed up to $200 Note: If you chose covered Non-Elective Contact Lenses or Elective Contact Lenses, no benefits will be available for covered eyeglass lenses in that period.
Vision – Blue Cross/Blue Shield of Georgia
- Select Plus Plan
SLIDE 20
February 2010 20
APRIL 2010
Most Walmart/Sam’s Club are out-of-network providers; completion and submission of the claim form below is required to receive the in-network benefit
Important Note RE: Wal-mart/Sam’s Club providers
SLIDE 21
February 2010 21
APRIL 2010
Important Note re: Wal-Mart/Sam’s Club providers
SLIDE 22
February 2010 22
APRIL 2010
BCBS of Georgia – Select Plan Premiums
– You Only $4.54 – You + Spouse $9.49 – You + Child $9.92 – You + Family $13.37
BCBS of Georgia – Select Plus Plan Premiums
– You Only $7.73 – You + Spouse $16.80 – You + Child $17.57 – You + Family $23.90
Vision Premiums - 2017
Admin fee is included in amount
SLIDE 23
February 2010 23
APRIL 2010
Hyatt Legal Plans…
Select Plan Covers: Powers of Attorney Office Advice/Consultations Wills/Living Wills Traffic Matters (Except DUIs) Document Preparation Real Estate Matters for Primary Residence Elder Law Matters Home Equity Loan Assistance Debt Collection Defense Identity Theft Defense Select Plus Plan Also Covers: Consumer Protection Matters Enforcement/Change to Support Orders Eviction/Tenant Defense Guardianship/Conservatorship Adoption Immigration Assistance Tax Audits Divorce Real Estate Matters for Additional Residences Incompetency Civil Litigation Defense
SLIDE 24
February 2010 24
APRIL 2010
Hyatt Legal Plans – 2017 Rates
Legal Plans – Hyatt
Network of attorneys with 14,000 nationally, and over 450 attorneys within the State of Georgia
Select Select Plus Employee $6.37 $8.00 Family $8.00 $10.30
SLIDE 25
February 2010 25
APRIL 2010
Long Term Care Insurance – Unum Insurance
– Nursing Facility/Nursing-Home Insurance, covers some in-home care. – Must require continual assistance with at least three activities of daily living to be considered disabled and qualifying for benefits. – 90-day wait period after disability before benefits are payable. – Plans offered for employees, spouses, parents, in- laws, includes adoptive or step-parents. – Only employee premiums taken through payroll
- deductions. All other premiums direct billed by
Unum. – Medical Underwriting required for covered spouse, parents, or in-laws. – Medical Underwriting required for employees electing coverage for the first time, after a break in coverage, or electing a higher level of coverage.
Long Term Care Insurance - 2017
Employees can go to the website: unuminfo.com/sog
- r contact Unum at
1 800-227-4165 for additional information
SLIDE 26
February 2010 26
APRIL 2010
Short Term Disability
– 7-Day Wait or 30-Day Wait (from date of disability, until payment issued) – Covers disability up to 6 months. – 60% of pay, up to $1,000 per week. – Consider Sick/Annual Leave Balances. – Late Entrant Penalty
> 60 Day wait for disability due to disease, mental disorder, or pregnancy within first
12 months of coverage.
Long Term Disability
– Covers disability after 6 months. – 60% of pay, up to $5,000 per month. – Benefits are paid after-tax, not taxable income when on LTD. – Benefits generally are payable until end of disability
- r Social Security Retirement Age.
> For some conditions, benefits are only payable
for two years. (Mental Disability, substance abuse, etc.) *Rates are based on employee age and salary.
More About Disability Plans…
SLIDE 27
February 2010 27
APRIL 2010
Specified / Critical Illness Plan Design
Select Plan = Illness Coverage Select Plus Plan = Illness + Accident Coverage Benefits included under the Accident Coverage (Select Plus Plan)
– Medical Fees (Physician Charges, X-Rays, Emergency Room Services and Supplies) – Hospital Fees (Hospital Admission, Daily Hospital Confinement and Intensive Care) – Accidental Injuries (Fractures/Dislocations, Lacerations, Tendons/Ligaments, Ruptured Disk, Torn Knee Cartilage, Burns, Eye Injuries) – Accident Follow-up Benefits (Physical Therapy, In-patient Rehab, Follow-up treatments) – Additional Benefits (Family Lodging, Transportation, Gunshot Wound, Paralysis, Prosthesis)
A complete list of benefits and descriptions is available in the summary plan description. Coverage available up to $50,000; no medical underwriting for > $30,000. Rates are based on employee/spouse age and coverage level.
AFLAC Specified Critical Illness 2017
SLIDE 28
February 2010 28
APRIL 2010
Specified Critical Illness
– Lump Sum Benefit paid following diagnosis. – Child coverage at no additional cost, up to age 26. 50% of benefit is payable for children. 90-day re-occurrence interval Cancer 12-month treatment-free re-
- ccurrence interval
Reminder: Coverage for Spouse Specified Illness cannot exceed coverage level for Employee Specified Illness and cannot be of a different plan (e.g. Employee Select and Spouse Select Plus)
AFLAC Specified Critical Illness 2017
Covered Diagnoses: Heart Attack Stroke Major Organ Transplant End-Stage Renal Failure Internal Cancer Coma Severe Burns Paralysis Loss of Sight, Hearing or Speech Alzheimer’s (25%) Caricnoma in situ (25%) Coronary Artery (25%)
SLIDE 29
February 2010 29
APRIL 2010
Specified / Critical Illness Plans Design Continues…
Health Screening Benefits – Receive a maximum $100 ($160 for Select Plus) for completion of any
- ne covered screening test per calendar year.
– Payable to employee and spouse, (as long as both take test) regardless of results
AFLAC Specified Critical Illness 2017
Examples of Covered Tests Include: Stress Test (Bicycle or Treadmill) Blood Triglycerides Fasting Blood Glucose Serum Cholesterol Bone Marrow Testing Breast Ultrasound Chest X-Ray Mammography Colonoscopy Pap Smear Flexible Sigmoidoscopy Blood Tests for breast,
- varian, prostate, colon
cancer, or myleomia
SLIDE 30
February 2010 30
APRIL 2010
Dependent Care Spending Account - ADP
– Set aside pre-tax money to use for child care expenses for your children under age 13.
> Expenses for care of a dependent of any age, who is unable to care
for themselves due to a physical or mental handicap also qualify. – Maximum family amount $4,992 can be set aside per year under IRS rules. – Money is “Use or Lose”
> You have until December 31, 2017 to use money placed in your
2017 dependent care spending account. – Both the employee and spouse must be working full time or enrolled in school full time to utilize this benefit. – Eligible expenses include: preschool, nursery school, after school care. – Ineligible expenses include: activity fees, field trips, clothing, food, entertainment, Kindergarten, overnight camps, sports lessons, transportation, or private school tuition.
Flexible Dependent Care Spending Account
SLIDE 31
February 2010 31
APRIL 2010
Accidental Death & Dismemberment Plan – MetLife
MetLife AD&D offers :
– Up to 10x AD&D coverage, up to $2 million – If you are age 75 but less than 80, the value of your coverage is reduced to 50% Accidental Death & Dismemberment – Payable on death or injury due to a covered accident. – Be sure to designate your beneficiaries! Premiums are based on employee’s age and salary
AD&D – Met Life
SLIDE 32
February 2010 32
APRIL 2010
Annual Enrollment
Visit www.gabreeze.ga.gov to enroll in your benefits today! For assistance with the Georgia Breeze website or flexible benefits enrollment, contact the Georgia Breeze call center at 1-877-342-7339. Print your confirmation page when you have completed your elections!
– You may change your elections as many times as you wish during open enrollment. – The choices remaining in the system on November 4th will be yours for all of 2017! If you complete your enrollment verbally with a Georgia Breeze associate, document the name of the representative, date, and time of the call.
Flexible Benefits Enrollment thru Georgia Breeze
SLIDE 33
February 2010 33
APRIL 2010