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Confidential – For Discussion Purposes Only
Health & Welfare and Retirement Benefits for HOUSE STAFF 2015 - - PowerPoint PPT Presentation
Health & Welfare and Retirement Benefits for HOUSE STAFF 2015 - - PowerPoint PPT Presentation
Health & Welfare and Retirement Benefits for HOUSE STAFF 2015 Benefits Overview (6/1/2015) AGENDA Benefits Enrollment Benefits Overview Benefits Enrollment Checklist Tools and Resources New Employee benefits
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HEALTHYSTEPS: Benefits Website Home Page www.healthysteps4u.org
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ELIGIBILITY
Eligibility
− Regular Employees appointed to work 50% or more are eligible for full benefits − Relief, Temporary, or Contract Employees are not eligible for full benefits
Eligible Dependents (Dependent Verification)
− Spouse: Same- or Opposite-Sex − Eligible Domestic Partner: Same-Sex or Opposite-Sex if you or your partner is age 62+ and eligible for Social Security − Eligible Children up to age 26 / age 23 for Child Life Insurance
Dual Coverage : Spouse, Domestic Partner, or Child(ren) is also an SHC/LPCH/PCHA EE Reference: HealthySteps > HELP & CONTACTS > Benefits Handbook > SPD Booklets – Booklet A
Allow ed Not Allow ed Enroll as an Employee OR as a Dependent Enroll as an Employee AND as a Dependent Only 1 Parent may cover Dependent Children for Medical/ Vision and Child Life Insurance Both Parents cover Dependent Children for Medical/ Vision and Child Life Insurance Both Parents may enroll Dependent Children in Dental Plan Employee should not be a Dependent on Spouse’s Dental Plan Employee must w aive Spouse Life Insurance Employee must w aive Child Life Insurance
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BENEFIT PREMIUMS
Cost
− SHC has a generous benefits package and covers most of the healthcare premiums − Some medical and dental Employee + Child(ren) coverage are provided to you at no cost − Nominal fee is added for Spouse coverage (Working Spouse Access Fee) − Benefits coverage elections are taken out of 24 paycheck deductions − Retirement Savings Plan account contributions and Voluntary Benefits elections through Mercer are taken out of 26 paycheck deductions Reference: HealthySteps > HELP & CONTACTS > Benefits Handbook > SPD Booklets – Booklet A
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SUMMARY OF BENEFITS
Medical/Vision Dental Employee Assistance Program (EAP) HealthySteps to Wellness Program Flexible Spending Accounts (FSA): Health Care and Dependent Daycare FSAs Life and Accidental Death & Dismemberment Insurance Disability Insurance (provided through GME Office)* Business Travel Accident (BTA) Insurance Voluntary Benefits via Mercer: Legal, Pet, Homeowners/Renters, Auto, Identity Theft, Purchasing Program, Online Discount Marketplace* Back-Up Care Advantage Program* Travel Assistance* Retirement Savings Plan (RSP)* * Elections or registration must be done directly with benefits vendor
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BENEFITS ENROLLMENT
Enrollment Period: 31 DAYS starting on your Date of Hire (DOH) to enroll or waive coverage, add Dependents, add Beneficiaries Effective Date: Medical/Vision, Dental, EAP, and BTA is effective on Date of Hire and all
- ther benefits effective 1st day of the month after Date of Hire
Change Benefit Elections: elections are effective through the end of the plan year; the next opportunity to change elections is Annual Open Enrollment in October or if you experience a mid-year Qualifying Life Event (QLE) such as Birth, Marriage, etc. QLE Special Enrollment Period: 31 DAYS starting on QLE Date and must submit supporting documents within 60 days of QLE Date Default Coverage: If NO ACTION is taken, you are assigned the into Employee-Only coverage for the Medical PPO Plan and Delta Dental PPO Plan Auto-Enroll: system auto-enrolls you in the Default Coverage but gets updated after Medical & Dental elections are made in Benefitsolver Dependent Verification: submit required eligibility documents within 60 DAYS of DOH or QLE – Dependents will not have coverage until Dependent Verification is processed by Benefitsolver!
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HEALTH BENEFITS: Medical Plans
2 Medical Plan Options: https://healthysteps4u.org/health-life-benefits/medical/
− House Staff PPO and Kaiser Permanente HMO − Preventive Care covered at 100% − When applicable, you are responsible for all medical expenses each year until you reach your Annual Deductible amount − Once Annual Deductible is reached, you pay for coinsurance or copays for covered expenses until you reach your Out-of-Pocket Maximum for the year − When you reach your out-of-pocket maximum, you will pay nothing for the rest of the year for covered services Reference: HealthySteps > Health & Welfare Benefits > Medical
Stanford Coordinated Care (SCC): https://stanfordhealthcare.org/medical-
clinics/coordinated-care.html − For people with chronic conditions or serious illnesses − Program available to PPO Plan participants Reference: HealthySteps > Health & Welfare Benefits > Medical > Special Programs (SCC)
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Confidential – For Discussion Purposes Only
HEALTH BENEFITS: Medical Plans
House Staff PPO: https://healthysteps4u.org/health-life-benefits/medical/ppo-plan/
− Administered by UMR 800.430.2176 | www.umr.com − Mental Health Care and Substance Abuse provided through Optum 866.374.6060 | www.livenadworkwell.com − Prescription provided through Express Scripts 866.456.4315 | www.express- scripts.com − House Staff PPO is a low-deductible health plan with 3 Tiers of coverage giving you the flexibility of going in and out of network − Using Tier 1, SHC & Stanford Children’s Health providers and facilities, services are covered at 100% − 2 Cards per Member: 1 Medical (UMR) Card + 1 Prescription (Express Scripts) Card − No need to select a PCP and no referral needed when seeing a Specialist − Access to a Health Care Flexible Spending Account (FSA) − Wellness incentive funds earned deposited into a Health Incentive Accout (HIA) Reference: HealthySteps > Health & Welfare Benefits > Medical > PPO Plan
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HEALTH BENEFITS: Medical Plans
Kaiser Permanente HMO Plan: https://healthysteps4u.org/health-life-
benefits/medical/kaiser-hmo/ − Administered by Kaiser Permanente 800.464.4000 | http://my.kp.org/ca/stanfordmed − Kaiser HMO Plan allows you receive care only within the Kaiser Permanente network − Northern California coverage − Emergency Care services covered outside of network if you contact Kaiser within 48 hours of receiving care and follow-up care must come from Kaiser MDs − Copays and coinsurance apply − Provides 1 Medical Card per Member − No need to select a PCP − Optional Health Care Flexible Spending Account (FSA) − Wellness incentive funds earned deposited in a Health Incentive Account (HIA) Reference: HealthySteps > Health & Welfare Benefits > Medical > Kaiser HMO
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Confidential – For Discussion Purposes Only
HEALTH BENEFITS: Choosing a Medical Plan
COMPARI NG MEDI CAL PLAN
FEATURES
House Staff PPO Kaiser Perm anente HMO See any provider you’d like, I n-
- r Out-of-Netw ork
Must use in-netw ork providers and facilities
Access to 3 tiers of providers and facilities
Set Copays established for services
Free Preventive Care
W ellness incentive funds deposited into Health I ncentive Account ( HI A)
Out-of-State Dependents
Em ergency Services Only
Annual Deductible $EE / $EE+ +
$300 / $750 (In-Network) $750 / $1,875 (Out-of-Network) $400 / $1,000
Annual Out-of-Pocket Max
$1,300 / $3,250 (In-Network) $3,250 / $9,375 (Out-of-Network) $1,800 / $3,600
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Confidential – For Discussion Purposes Only
HEALTH BENEFITS: Vision Plan
Vision Plan: https://healthysteps4u.org/health-life-benefits/vision/
− Provided and administered by VSP 800.877.7198 | www.vsp.com − Medical plans are bundled with vision care coverage − Enrolling in a medical plan automatically provides you and your covered dependents vision care coverage at no additional cost − If you waive medical coverage, no option to only enroll in vision care coverage − Copays apply − No Vision Card issued, member SSN is used as the ID Reference: HealthySteps > Health & Welfare Benefits > Vision
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HEALTH BENEFITS: Dental Plans
2 Dental Plan Options: https://healthysteps4u.org/health-life-benefits/dental/
− Administered by Delta Dental www.deltadentalins.com
Delta Dental PPO 800.765.6003
− No Dental Card issued, SSN is used as the ID − Flexibility of going in and out of network − Diagnostic & Preventive services covered at 100% (exams, cleanings, x-rays) − $13.50 Semi-monthly premium when covering Spouse or Family − Ortho covers adults to age 26 for Employees and Dependent Children only
DeltaCare USA DHMO 800.422.4234
− 2 Dental Cards per Family − Select a Primary Care Dentist from DeltaCare USA network − Most Diagnostic & Preventive Services covered at 100%, others Copay − No semi-monthly premiums − Covers Adult Orthodontia Reference: HealthySteps > Health & Welfare Benefits > Dental
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HEALTH BENEFITS: Flexible Spending Accounts (FSA)
Flexible Spending Accounts (FSA): https://healthysteps4u.org/health-life-
benefits/hsa-fsa/ − Health Care FSA and Dependent Daycare FSA − Administered by HealthEquity 877.395.6548 | www.myhealthequity.com − Tax-advantaged accounts allows you to use pre-tax $ to help pay for IRS-qualified healthcare and/or dependent daycare expenses − IRS sets Annual Maximum Contribution Limits − When FSA is opened with HealthEquity, you will be sent a Welcome Packet − Register online with HealthEquity to view account balance, transactions, and submit claims for reimbursement Reference: HealthySteps > Health & Welfare Benefits > FSA/HIA
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Confidential – For Discussion Purposes Only
HEALTH BENEFITS: Health Care FSA
Health Care FSA Features
− 2015 IRS Maximum Limit: $2,500 − Use it or Lose it plan − Contributions may be updated when you experience a Qualifying Life Event − Must enroll annually during Open Enrollment − Issued a Debit Card by HealthEquity to pay for IRS-qualified health care expenses − Health care expenses must be incurred by 12/31/2015 and claims must be submitted to HealthEquity by 3/15/2016 − can be used to pay for out-of-pocket medical, vision, and dental costs − IRS Publication 502: Medical & Dental Expenses http://www.irs.gov/pub/irs- pdf/p502.pdf
Health Care FSA upon Termination
− If you terminate employment before the plan year ends, healthcare expenses must be incurred before termination date and you must submit claims to HealthEquity no later than 90 days from termination date
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HEALTH BENEFITS: Dependent Daycare FSA
Dependent Daycare FSA Features
− 2015 IRS Maximum Limit: $5,000 per household − Use it or Lose it plan − Contributions may be updated when you experience a Qualifying Life Event − Must enroll annually during Open Enrollment − Not issued a Debit Card; claims reimbursement must be submitted to HealthEquity − Dependent Daycare expenses must be incurred by 12/31/2015 and claims must be submitted to HealthEquity by 3/15/2016 − can be used to pay for out-of-pocket child or elder care expenses while you are at work − IRS Publication 503: Child and Dependent Care Expenses http://www.irs.gov/pub/irs- pdf/p503.pdf
Dependent Daycare FSA upon Termination
− If you terminate employment before the plan year ends, dependent care expenses must be incurred by 12/31/2015 and claims must be submitted to HealthEquity by 3/15/2016
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OTHER HEALTH BENEFITS: Wellness, EAP, CareCounsel
HealtySteps to Wellness Program – Administered by Stanford Wellness Team
− Promotes the improvement and maintenance of health and well-being − Potential to earn incentive dollars by completing wellness activities and challenges Reference: HealthySteps > Wellness & Self Care
Employee Assistance Program (EAP) – Administered by ValueOptions
855.81.1601 | www.achievesolutions.net/shclpch − SHC-provided at no cost to you, auto-enrolled in Benefitsolver, effective Date of Hire − Work-life resources including legal and financial; 10 free sessions per issue per year Reference: HealthySteps > Health & Welfare Benefits > Employee Assistance Program
CareCounsel 888.227.3334 | www.carecounsel.com
− SHC-provided at no cost to you, effective DOH − healthcare advocacy services such as understanding your health benefits, prescription drug formularies, using your health plans, help with claims resolution, etc. Reference: HealthySteps > Health & Welfare Benefits > Medical > CareCounsel
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LIFE & DISABILITY BENEFITS: Life Benefits
Life Benefits – Administered by Liberty Mutual Insurance 888.787.2129
− Survivor Protection Benefits that protect you or your dependents in the event of a death or an accident − Supplemental elections: Employee Life, Spouse Life, Child Life, and AD&D − Statement of Health (SOH) not required for Guaranteed Issue (GI) amount during New Hire Event − Can update elections during Annual Open Enrollment or a Qualifying Life Event and usually required to complete SOH Reference: HealthySteps > Health & Welfare Benefits > Life & Disability > Life & Accident Insurance
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LIFE & DISABILITY BENEFITS: Life, AD&D, and BTA Insurance
Basic Life Insurance: $50,000 or 1x Annual Salary (whichever is lower)
− SHC provides to you at no cost, auto-enrolled in Benefitsolver
Supplemental Life Insurance: Elect 1x-6x Annual Salary
− New Hire GI Amount: 3x – electing up 3x, SOH not required during New Hire Event − Electing 4x-6x at New Hire, SOH required
Spouse Life Insurance: GI Amount $50,000, SOH not required Child Life Insurance: Coverage $10,000 per child up to Age 23, SOH not required Accidental Death & Dismemberment (AD&D)
− Elect 1x-10x Annual Salary, Employee or Family coverage, SOH not required
Business Travel Accident (BTA) - Administered by Hartford
− 5x Annual Salary up to $500,000 Maximum − SHC provides to you at no cost, auto-enrolled in Benefitsolver
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LIFE & DISABILITY BENEFITS: State Disability Insurance
California State Disability Insurance (SDI)
− income protection benefit in the event of an illness or injury that prevents you from performing regular or customary work − Administered by California EDD (Employment Development Department): www.edd.ca.gov − pays 55% of salary for max 52 weeks up to $1104/week (2015)
Long Term Disability (LTD)
− Provided by the GME Office − Supplemental LTD election available through Guardian − For additional information or inquiries, call the GME Office at 650.723.5948
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LIFE AND DISABILITY BENEFITS: Statement of Health
Statement of Health (SOH) – also known as Evidence of Insurability (EOI)
− Some Life elections require completing a SOH − You have 60 days from election date to complete SOH on pending elections − Elections remain in pending status until Liberty Mutual approves SOH − Active coverage will be within the Guaranteed Issue amount range until approval − Complete SOH online at the Benefitsolver website by clicking on the Logo or by visiting www.MyLibertyConnection.com (for online registration, Company Code: SHCLPCH-ER) − Questions on completing SOH: 888.287.8494 x16555 / Tech Support: 800.431.2958
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VOLUNTARY BENEFITS
Voluntary Benefits – Administered by Mercer Voluntary Benefits 800.689.9314 |
www.shclpchvoluntarybenefits.com − Legal Insurance, Pet Insurance, Homeowners/Renters Insurance, Auto Insurance, Identity Theft, Purchasing Program, Online Discount Marketplace − Enrollment must be done directly with Mercer, no election in Benefitsolver − Can enroll and terminate coverage anytime of the year EXCEPT for Legal Plan − When on Leave of Absence and no longer receiving a paycheck, make sure to make
- ther arrangements with Mercer Voluntary to continue coverage
Reference: HealthySteps > Additional Benefits & Special Programs > Voluntary Benefits
Legal Plan: https://healthysteps4u.org/additional-benefits/legal-assistance/
− As a New Hire, must enroll within 31-day window; otherwise, next opportunity is Annual Open Enrollment − Coverage termination can only be due during Annual Open Enrollment as well Reference: HealthySteps > Additional Benefits & Special Programs > Legal Services
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OTHER BENEFITS
Back-Up Care Advantage Program: https://healthysteps4u.org/additional-
benefits/special-programs-back-up-care/
− Administered by Bright Horizons 877.242.2737 | www.backup.brighthorizons.com
− 80 hours of back-up child or adult/elder care/calendar year; not a replacement for normal daycare arrangements − Copay $4/hour per child for center-based child care, $4/hour for up to 3 people for in- home care − Register online, no election in Benefitsolver
Reference: HealthySteps > Additional Benefits & Special Programs > Back-Up Care
Travel Assistance: https://healthysteps4u.org/additional-benefits/travel-assistance/
− Administered by Hartford 800.243.6108 | http://thehartford.com/employee-coverage/travel- assistance − ID# GLD-09012 Reference: HealthySteps > Additional Benefits & Special Programs > Travel Assistance
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RETIREMENT SAVINGS PLAN (RSP)
Retirement Savings Plan: https://healthysteps4u.org/retirement/retirement-savings-
plan/
− Administered by Transamerica Retirement Solutions 800.755.5801 | http://shclpch.trsretire.com
− SHC offers a 403(b) defined contribution retirement savings plan to help employees save for retirement − You can participate effective Date of Hire − 2015 IRS Maximum Limit: $18,000 (under Age 50) − Age 50+ $6,000 Catch-up Contribution: $24,000 − Contribute 1%-75% (percentage NOT dollar amount) − Dedicated Retirement Planning Consultants: Selina Chan 650.339.9173 | selina.chan@transamerica.com & Javier Ovalles 650.665.0185 | javier.ovalles@transamerica.com Reference: HealthySteps > Retiremen Plans & Benefits > Retirement Savings Plans
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BENEFITSOLVER: Website or Link www.benefitsolver.com
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BENEFITSOLVER: Benefits Enrollment
Benefitsolver – Communicate with Benefitsolver Team by Phone, Email, or Live Chat
− Enroll online at www.benefitsolver.com or by phone at 855.327.5025
− Register online to create a User Name and Password | Company Key: healthysteps Reference: HealthySteps > Health & Welfare Benefits > Benefitsolver
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BENEFITS ENROLLMENT CHECKLIST
Information: Review benefits information in NEO Booklet and HealthySteps at www.healthysteps4u.org. If further guidance is needed in choosing the right plan for you and your family, contact CareCounsel at 888.227.3334. Benefitsolver: Register, Enroll, Print Confirmation
- Register at www.benefitsolver.com.
- Enroll/Waive benefit options, Add eligible dependents, and Add Beneficiaries within the 31-day
New Hire enrollment window.
- Print a confirmation statement. Transaction is complete when given Confirmation #.
Dependent Verification: When adding Dependents, prepare to submit required eligibility documents to Benefitsolver (expect to receive a Letter from Businessolver). Statement of Health: If applicable, complete SOH with Liberty Mutual within 60 days of enrollment at www.MyLibertyConnection.com (Company Code: SHCLPCH-ER) or by clicking on Liberty Mutual logo when in Benefitsolver. Legal Plan: If electing the Legal Plan, enroll with Mercer Voluntary Benefits within 31-day New Hire enrollment window at 800.689.9314 or www.shclpchvoluntarybenefits.com. RSP: Don’t forget to enroll in the Retirement Savings Plan with Transamerica at 800.755.5801 or http://shclpch.trsretire.com.
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