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Annual Enrollment for Plan Year 2018
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2018 Annual Enrollment Georgia Breeze Website: Opens: Monday, October 16th 12:00AM Closes: Friday, November 3rd 11:59PM
* Benefits elected are effective January 1, 2018
Annual Enrollment for Plan Year 2018 2018 Annual Enrollment Georgia - - PowerPoint PPT Presentation
Annual Enrollment for Plan Year 2018 2018 Annual Enrollment Georgia - - PowerPoint PPT Presentation
Annual Enrollment for Plan Year 2018 2018 Annual Enrollment Georgia Breeze Website: Opens: Monday, October 16 th 12:00AM Closes: Friday, November 3 rd 11:59PM * Benefits elected are effective January 1, 2018 February 2010 2 APRIL 2010 Summary
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Summary of Plan Changes for 2018
- BlueCross BlueShield-BlueVision
- Select Plan: 25% increase; no plan changes
- Select Plus Plan: increase of co-pays by tiers for
progressive lens & transitional lens; the contact allowance changed to $150
- Aflac Critical Illness Insurance
- 8% rate increase
- Plan change at the 12 month interval and a 50%
benefit for the 2nd occurrence
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Summary of Plan Changes for 2018
- Unum-Long Term Care
- Rates will increase by 9.9%
- ADP Flexible Spending Account
- WageWorks: New name, same website
www.myspendingaccount.adp
- Limit increase to $2,560
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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 Eyeglass Lens enhancements may be added $20 Copayment
$0 Copayment
Reimbursed up to $40 Reimbursed up to $60 Reimbursed up to $80 Reimbursed up to $80 No reimbursement on enhancements Frames Limited to one set of frames per Member every 24 Months. Allowable Amount up to $130 retail allowance, 20% off remaining balance $45 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.) $105 plan allowance on conventional, 15% off any remaining balance. $105 plan allowance on 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.
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COVERED SERVICES COPAYMENTS/MAXIMUMS Network Providers Non-Network Providers Eye Exam Limited to one exam per Member every Calendar Year. $20 Copayment Reimbursed up to $40 Prescription Lenses Limited to one set of lenses per Member every Calendar Year. Basic Lenses in Standard Plastic (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 (for a child under age 19) Transitions Photochromic lenses (for a child under age 19)
$25 Copayment $0 Copayment
Reimbursed up to $40 Reimbursed up to $60 Reimbursed up to $80 Reimbursed up to $80 No allowance on lens enhancements 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.) Reimbursed up to $150, 15% off any remaining balance on Conventional Lenses Reimbursed up to $150 on Disposable Lenses Reimbursed up to $150 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
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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
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BCBS of Georgia – Select Plan Premiums
– You Only $5.50 – You + Spouse $11.69 – You + Child $12.23 – You + Family $16.54
BCBS of Georgia – Select Plus Plan Premiums
– You Only $9.49 – You + Spouse $20.83 – You + Child $21.79 – You + Family $29.70
Vision Premiums - 2018
Admin fee is included in amount
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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. Child coverage at no additional cost.
AFLAC Specified Critical Illness 2018
8% rate increase
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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. 12-month interval with 50% benefit for 2nd
- ccurrence.
Cancer 12-month treatment-free re-occurrence
- interval. 50% benefit for 2nd occurrence.
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 2018
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%)
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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 2018
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
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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 - 2018
Employees can go to the website: unuminfo.com/sog
- r contact Unum at
1 800-227-4165 for additional information
9.9% Rate Increase
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Flexible Healthcare Spending Account – 2018 Website Update
New Name for FSA:
- ADP site not changing
- 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.
- New cards issued to new
users and existing users with expiring ADP cards.
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Flexible Healthcare Spending Account – 2018 Plan cont’d
- FSA Healthcare limit will increase to $2,560 ( $50 from PY2017)
- Minimum annual contribution remains $120
- Contributions must be re-elected each year, they do not
rollover.
- Once you enroll in a FSA you may not cancel during the plan
year.
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Healthcare Spending Account - WageWorks – Set aside pre-tax money to use for healthcare expenses. – Maximum amount $2,560 ($213.33/month) can be set aside per year. – Money is “Use or Lose”
> You have until March 15, 2019 to use money placed in your 2018
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
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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
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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, 2018 to use money placed in your
2018 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
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APRIL 2010
CIGNA Dental HMO
- Cigna Dental (DHMO) Dental Network
has expanded beyond the Metro Atlanta Area.
- Now serving following counties: Lowndes,
Houston, Baldwin, Spalding, Troup, Richmond, Bibb (Macon), Dougherty, Muscogee, Chatham (Savannah), Clarke, Barrow, Dawson, Floyd, Bartow, and Catoosa, Whitfield, Dawson.
- Provider Network frequently changes
- No late entrant penalties or waiting periods.
- No plan or rate changes for PY 2018
Cigna DHMO Rates You $22.58 You + Spouse $41.15 You + Child(ren) $51.03 Family $60.86
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The following plans have no changes to coverage for 2018
MetLife Life Insurance MetLife AD&D Hyatt Legal Delta Dental Dependent Care Spending Short Term/Long Term Disability
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- No rate increases in PY 2018
Life Insurance – Met Life 2018
Employee Life, Spouse, and Child Life Employee 1x to 10x Benefit Salary; Max Coverage $2,000,000 Based on age, salary, & coverage selection Spouse $6,000, $12,000, $30,000, $60,000, $100,000, $150,000, $200,000, $250,000 Based on employee’s age, salary, and coverage selection. Child $3,000 (0.92), $6,000 (1.14), $10,000 (1.44), $15,000 (1.81), $20,000 (2.18)
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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
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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
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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…
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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
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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
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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
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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 - 2018
Admin fee is included in amount.
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Hyatt Legal Plans 2018
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
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Hyatt Legal Plans – 2018 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
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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.
The Standard’s Disability Plans-2018
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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
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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 3rd will be yours for all of 2018! 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
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