Open Enrollment Presentation Classified Staff Benefit Period: - - PowerPoint PPT Presentation

Benefit Period: October 1, 2015 – September 30, 2016

Open Enrollment Presentation

Classified Staff

Benefit Period: October 1, 2017 – September 30, 2018

ENROLLMENT INFORMATION

PL AN YEAR:

October 1, 2017 to September 30, 2018

O ne - O n- O ne MEET ING S:

June 28th & June 29th

F O RMS DUE:

July 31, 2017

2

EMPLOYEE BENEFIT GUIDE

3

ELIGIBILITY INFORMATION

Who May E nro ll

If you are a .50 FTE or above, you and your eligible dependents may participate in SLOCOE’s benefit program . If you are a .90 FTE or above, you are required to enroll. Your eligible dependents include:

• Legally married spouse
• Registered domestic partner
• Children under the age of 26, regardless of student or marital status

Whe n Yo u Can E nro ll

As an eligible employee, you may enroll at the following times:

• You may participate in SLOCOE’s benefits program on the first day of the month following your date
• f hire. If you are hired on the first of a month, you may start coverage that day.
• Each year, during open enrollment
• Within 30 days of a qualifying event as defined by the IRS

Qualifying E ve nts I nc lude

• Marriage, divorce, legal separation or annulment
• Birth or adoption of a child
• A qualified medical child support order
• Death of a spouse or child
• Loss of coverage from another health plan

4

ACA ‐ INDIVIDUAL MANDATE

The Affordable Care Act (ACA) requires employees to have coverage: If you are without coverage as of March 31, you may face a penalty

• n your 2017 tax return. The fine

will be $695 per adult and $347.50 per child or 2.5 percent

• f your household income,

whichever is greater. Employees will receive the 1095‐C form in 2018 for their 2017 tax filing.

5

WHAT’S NEW?

• There are no changes to the following plan designs:
• Anthem Blue Cross ‐ Medical PPOs
• Delta Dental ‐ Dental PPOs
• Mutual of Omaha – Life Insurance
• VSP ‐ Vision
• Our rate structure is now 3‐tiered (single, 2‐party, or family).
• Advance Medical has replaced Grand Rounds and will provide expert second
• pinions, case management and care advocate services.
• SISC FSA Medical Maximum has been increased from $2,550 to $2,600

6

MEDICAL

7

MEDICAL

8

O ption 1 O ption 2 O ption 3 O ption 4 O ption 5 O ption 6

PPO 100% D PPO 90% C PPO 90% G PPO 80% G PPO 80% M Anc ho r Bro nze

In‐ Network In‐ Network In‐ Network In‐ Network In‐ Network In‐ Network He alth Be ne fits Lifetime Maximum Unlimited Unlimited Unlimited Unlimited Unlimited Unlimited Deductible Ind/Fam $300 / $600 $200 / $500 $500 / $1,000 $500 / $1,000 $3,000 / $6,000 $5,000 / $10,000 Out of Pocket Maximum $1,000 / $3,000 $1,000 / $3,000 $1,000 / $3,000 $2,000 / $4,000 $4,000 / $8,000 $6,350 / $12,700 Co‐Insurance (Plan Pays) 100% 90% after Ded 90% after Ded 80% after Ded 80% after Ded 70% after Ded Office Visit Copay $20 Copay $30 Copay $20 Copay $30 Copay $40 Copay $60 Copay Hospitalization 100% after Ded 90% after Ded 90% after Ded 80% after Ded 80% after Ded 70% after Ded Lab and X‐Ray 100% after Ded 90% after Ded 90% after Ded 80% after Ded 80% after Ded 70% after Ded Emergency Services $100 + 100% after Ded $100 + 90% after Ded $100 + 90% after Ded $100 + 80% after Ded $100 + 80% after Ded $100 + 70% after Ded Retail Pharmacy ‐ Generic Formulary $9 Copay $10 Copay $9 Copay $10 Copay $15 Copay $9 Copay ‐ Brand Name $35 Copay $35 Copay $35 Copay $35 Copay $50 Copay $35 Copay

SISC VALUE‐ADDED BENEFITS

9

Value Adde d Be ne fits

• MDLive
• Available to SISC members 24/7/365
• On‐demand access to a national network of board‐certified doctors and

pediatricians

• Providers can diagnose, recommend treatment and prescribe medication
• Get the care you need, when you need it
• $5.00 per medical consultation
• Office Visit Copay for behavioral health consultation

SISC VALUE‐ADDED BENEFITS

10

Value Adde d Be ne fits

• Advance Medical
• Complex, rare, serious medical conditions
• Another opinion for surgery or other treatment
• Unresolved or undiagnosed medical condition
• Any confusing or unclear medical situation
• Dedicated Case Manager
• Unlimited access to specialists, speak directly with specialists
• High‐touch medical concierge
• Medical record collection
• No travel required for member
• Correspondence of diagnoses, treatment plans
• Access to private member portal

SISC VALUE‐ADDED BENEFITS

11

Value Adde d Be ne fits

• Anthem Employee Assistance Program (EAP)
• Counseling Services—Call EAP to schedule an in‐person visit with a

local provider

• Confidential—Privacy is protected
• Convenient—24/7 access, holidays included
• Free of charge—No extra cost and no paperwork

SISC VALUE‐ADDED BENEFITS

12

Value Adde d Be ne fits

• Costco Free Generic Drug
• Generic medications at Costco and through Costco Mail Order

(excludes certain pain and cough medications).

• Members take prescriptions to Costco pharmacy.
• No need to be a Costco member.

DENTAL

13

DENTAL

14

Optio n 1 De lta De ntal Pre mie r De ntal Optio n 2 De lta De ntal PPO De ntal (w/ Ortho ) Network Network Non‐Network Network Non‐Network De ntal Be ne fits Calendar Year Maximum Unlimited* $1,000 Unlimited* $1,000 Deductible (Annual) ‐ Individual ‐ Family None None $25 $75 Preventive (Plan Pays) Exams, X‐Rays, Cleanings 70%‐100% 70%‐100% (UCR) 100% 50% Basic Services (Plan Pays) Fillings, Oral Surgery, Endodontics, Periodontics 70%‐100% 70%‐100% (UCR) 100% 50% Major Services (Plan Pays) Crowns, Prosthetics 70%‐100% 50% Prosthetics 70%‐100% (UCR) 50% Prosthetics (UCR) 100% 60% Prosthetics 50% Orthodontia ‐ Covered Members ‐ Coinsurance ‐ Lifetime Benefit Maximum Not Covered Children Only 50% $2,000

VISION

15

VISION

16

VSP PPO Plan B $15/ $25 Network Network Non‐Network Visio n Be ne fits Copay ‐ Examination ‐ Materials $15 Copay $25 Copay N/A N/A Examination 100% $35 Reimbursement Lenses ‐ Single Vision ‐ Bifocal ‐ Trifocal 100% 100% 100% $25 Reimbursement $40 Reimbursement $50 Reimbursement Frames $150 Benefit $30 Reimbursement Contact Lenses $105 Allowance In Lieu of Frames and Lenses $90 Allowance In Lieu of Frames and Lenses Laser Vision Correction Discounts Apply Not Covered Frequency ‐ Examination ‐ Lenses ‐ Frames ‐ Contact Lenses 12 Months 12 Months 24 Months 12 Months

BASIC LIFE AND AD&D

17

BASIC LIFE AND AD&D

18

Be ne fits

Life and AD&D Insurance Life insurance protects your family or other beneficiaries in the event of your death while you are still actively employed with the company. SLOCOE pays for coverage, offered through Mutual of Omaha, in the amount of $50,000. If your death is due to a covered accident or injury, your beneficiary will receive an additional amount through Accidental Death and Dismemberment (AD&D) coverage, for a total amount of $100,000.

VOLUNTARY LIFE AND AD&D

19

VOLUNTARY LIFE AND AD&D

20

Be ne fits

• Employee: increments of $10,000 up to $200,000
• Guarantee Issue: $200,000
• Spouse: if you enroll in employee coverage, spouse can elect

increments of $5,000 up to $50,000

• Guarantee Issue: $50,000
• Child(ren): Flat $10,000
• Guarantee Issue: $10,000
• 100% Employee‐paid

CONTRIBUTIONS

21

22

Classified Employee Contributions

0.90 to 1.00 FTE

O ption 1 Anthe m PPO 100% D

w/Premier Dental w/PPO Dental

O ption 2 Anthe m PPO 90% C

w/Premier Dental w/PPO Dental

Employe e Pa ys Employe e Pa ys

Single $404.62 $395.02 Single $349.42 $339.82 2‐Party $759.94 $742.18 2‐Party $655.54 $637.78 Family $901.86 $888.66 Family $759.06 $745.86

O ption 3 Anthe m PPO 90% G

w/Premier Dental w/PPO Dental

O ption 4 Anthe m PPO 80% G

w/Premier Dental w/PPO Dental

Employe e Pa ys Employe e Pa ys

Single $336.22 $326.62 Single $260.62 $251.02 2‐Party $620.74 $602.98 2‐Party $477.94 $460.18 Family $703.86 $690.66 Family $505.86 $492.66

O ption 5 Anthe m PPO 80% M

w/Premier Dental w/PPO Dental

O ption 6 Anthe m Bronze Pla n Employe e Pa ys Employe e Pa ys

Single $116.62 $107.02 Single $0.00 2‐Party $192.34 $174.58 Employee + Child(ren) $0.00 Family $300.26 $287.06

Effective 10/1/2017

O ption 1 Anthe m PPO 100% D

w/Premier Dental w/PPO Dental

O ption 2 Anthe m PPO 90% C

w/Premier Dental w/PPO Dental

Employe e Pa ys Employe e Pa ys

Single $479.62 $470.02 Single $424.42 $414.82 2‐Party $911.44 $893.68 2‐Party $807.04 $789.28 Family $1,138.11 $1,124.91 Family $995.31 $982.11

O ption 3 Anthe m PPO 90% G

w/Premier Dental w/PPO Dental

O ption 4 Anthe m PPO 80% G

w/Premier Dental w/PPO Dental

Employe e Pa ys Employe e Pa ys

Single $411.22 $401.62 Single $335.62 $326.02 2‐Party $772.24 $754.48 2‐Party $629.44 $611.68 Family $940.11 $926.91 Family $742.11 $728.91

O ption 5 Anthe m PPO 80% M

w/Premier Dental w/PPO Dental

O ption 6 Anthe m Bronze Pla n Employe e Pa ys Employe e Pa ys

Single $191.62 $182.02 Single $47.80 2‐Party $343.84 $326.08 Employee + Child(ren) $77.50 Family $506.51 $493.31

23

Classified Employee Contributions

0.75 to 0.89 FTE

Effective 10/1/2017

24

Classified Employee Contributions

0.50 to 0.74 FTE

Effective 10/1/2017

O ption 1 Anthe m PPO 100% D

w/Premier Dental w/PPO Dental

O ption 2 Anthe m PPO 90% C

w/Premier Dental w/PPO Dental

Employe e Pa ys Employe e Pa ys

Single $529.62 $520.02 Single $474.42 $464.82 2‐Party $1,012.44 $994.68 2‐Party $908.04 $890.28 Family $1,295.61 $1,282.41 Family $1,152.81 $1,139.61

O ption 3 Anthe m PPO 90% G

w/Premier Dental w/PPO Dental

O ption 4 Anthe m PPO 80% G

w/Premier Dental w/PPO Dental

Employe e Pa ys Employe e Pa ys

Single $461.22 $451.62 Single $385.62 $376.02 2‐Party $873.24 $855.48 2‐Party $730.44 $712.68 Family $1,097.61 $1,084.41 Family $899.61 $886.41

O ption 5 Anthe m PPO 80% M

w/Premier Dental w/PPO Dental

O ption 6 Anthe m Bronze Pla n Employe e Pa ys Employe e Pa ys

Single $241.62 $232.02 Single $97.80 2‐Party $444.84 $427.08 Employee + Child(ren) $178.50 Family $644.01 $630.81

25

QUESTIONS AND COMMENTS?

F RI E NDL Y RE MI NDE R:

All enrollments are due by July 31, 2017.

• If you are not making any changes, there is nothing you need to

do at this time.

• If you are making a plan change, this can be done online.
• If you are changing dependents, you must complete the

enrollment/change form and submit to Cindy Mauch or Jenni Pong.

26

THANK YOU!

27