2013 Open Enrollment
Open Enrollment
Health and Dental Insurance Plan Information
Employee Contributions for Medical Plans
Optional Dental Coverage
Optional Vision Coverage
Flexible Spending Accounts
Voluntary Short Term Disabiltiy (STD) Insurance
Voluntary Supplemental Term Life Insurance
Human Resources Benefits Contacts
Open Enrolllment Forms and Documents
Open Enrollment
It is important that you review this information closely as
you make your health care choices for 2013.
As a benefit-eligible employee, you have the opportunity to evaluate your health
insurance needs during the open enrollment period and make changes in your
health plan coverage for the following plan year. This year, due to multiple
changes in the plans and contribution levels, it is especially critical that you
re-evaluate what medical and dental option will be best for you and your family.
2013 Open Enrollment will be October 30, 2012, through November 13,
2012.
At this time you may:
- Enroll in medical insurance coverage.
- Enroll in dental coverage. (Dental is a separate option this year).
- Change your current medical or dental insurance coverage.
- Add or drop dependents to your medical or dental insurance coverage.
- Enroll in the flexible benefit plan. Note: You must enroll in this plan
annually.
- Enroll in a health savings account (as long as you elect the Lumenos CDHP/HSA health
option) and make an election for 2013. Note: You must resubmit the HSA Election
Form annually.
- Enroll in, drop or change coverage in the voluntary supplemental life insurance
program.
- Enroll in, drop or change coverage in the optional vision plan.
- Enroll in or drop the voluntary short-term disability plan.
In 2013, the University will offer three Anthem medical plans:
Blue Access
Buy-Up Plan; Blue Access Core Plan; and the
Consumer-Driven High Deductible
Health Plan (CDHP) with a Health Savings Account (HSA) called Lumenos CDHP/HSA.
Each of these options includes prescription drug coverage through the medical
provider. See the
Insurance Comparison Overview
which compares the
benefits of the different medical plans and a new Summary of Benefits and
Coverage (SBC) for each medical plan. Because the SBC is required of every
medical plan by the Affordable Care Act, those of you comparing spousal coverage
options
will be able to compare information from both plans in this new, common format.
OPEN ENROLLMENT INFORMATION
As always, the Open Enrollment Fair will have representatives from Anthem
Insurance Companies, Inc. (medical/Rx), Health Resources, Inc. (dental), The
Nyhart Company (flexible benefit plans), The Standard Insurance (short-term
disability), Deaconess CONCERN Employee Assistance Program (EAP) with new
Work-Life resources, TIAA CREF (retirement savings), PERF (retirement savings),
and Prudential (Supplemental Life Insurance) who will be available to discuss
benefit options and decisions with you. The fair will be held on:
-
Tuesday, October 30, 2012
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9:00 a.m. to 3:30 p.m.
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University Center East
-
Rooms UC2217 and UC2218
A benefit meeting for 2nd and 3rd shift employees is also scheduled for
Thursday, November 1, at 10:00 p.m. in Human Resources – Training Room, FA 164.
If you are a current
participant in one of the Anthem plans, you may change your
coverage without providing evidence of insurability. If you previously waived
coverage for yourself and/or your dependents, Anthem requires submission of a
Certificate of Health Coverage to waive the pre-existing condition waiting
period. Enrollment forms will be available at the Open Enrollment Fair on October
30, 2012, or may be obtained from the
Human Resources Department in the Wright Administration Building, Room FA 166.
Open Enrollment will be
your only opportunity to elect or change your medical, dental, vision, or
related Section 125 Flexible Benefit Plan coverage elections and/or enroll or
drop dependents or your own coverage on these plans for the 2013 calendar year.
You may only make changes outside of the open enrollment period if you have a
qualified family status change and notify the Human Resources benefit staff of
that change within 30 days of the change. Enrollment forms must be
completed by November 13, 2012, to ensure coverage effective January 1, 2013.
Your current medical and
dental
insurance coverage will be continued unless you complete a form to change your
coverage. However, if you are enrolled in the Welborn plan, you must complete an
Anthem enrollment form since Welborn is ending all health coverage on December
31, 2012
IMPORTANT NOTE:
Benefits under the USI benefit plan(s) are provided pursuant to insurance
contracts between USI and the insurance companies. If the terms of this
webpage conflict with the terms of the insurance contract, the terms
of the insurance contract will control, unless superseded by applicable law.
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HEALTH and DENTAL INSURANCE PLAN INFORMATION
ANTHEM BLUE ACCESS BUY-UP PLAN (Please notice that
urgent care and emergency room copayments have changed)
-
100% preventative care coverage
-
In-network deductible – $300 individual and $600 family
-
Non-network deductible – $600 individual and $1,200 family
-
In–network out-of-pocket maximum – $1,500 individual and $3,000 family
-
Non–network out-of-pocket maximum – $3,000 individual and $6,000 family
-
In-network co-insurance – 80%/20% and non-network co-insurance
60%/40%
-
Prescription-retail co-payments $10/24/40/70; mail order co-payments $20/48/80
(90 day supply)
-
Office visit copy is $20
-
Urgent care copay is $50
-
Emergency room copay is $100
ANTHEM BLUE ACCESS CORE PLAN (Please notice that
the deductible, out-of pocket maximum, office visit, urgent care and emergency
room copayments have changed)
- 100% preventative care coverage
- In-network deductible – $600 individual and $1,200 family
- Non-network deductible $1,200 individual and $2,400 family
- In-network out-of-pocket maximum – $3,000 individual and $6,000 family
- Non-network out-of-pocket maximum – $6,000 individual and $12,000 family
- In-network co-insurance – 80%/20% and non-network co-insurance –
60%/40%
- Prescription retail co-payments $10/40/60/80; mail order co-payments $20/80/120
(90 day supply)
- Office visit copay is $30
- Urgent care copay is $75
- Emergency room copay is $150
LUMENOS CONSUMER-DRIVEN HIGH DEDUCTIBLE HEALTH PLAN WITH HEALTH SAVINGS ACCOUNT
(CDHP/HSA)
- No Plan Design Changes for 2013
- This plan offers 100% preventative care coverage and extra wellness benefits
- Deductible – $1,500 for single coverage and $3,000 for any level of family
coverage (employee plus child; employee-spouse or family) in-network and
out-of-network combined for this non-embedded deductible
- Out-of-pocket maximum – $3,000 for single coverage and $6,000 for any level of
family coverage (employee plus child; employee-spouse, or family); $6,000 for
single coverage and $12,000 for any level of family coverage out-of-network
- Co-insurance – after deductible, 90%/10% co-insurance in-network or
70%/30% co-insurance non-network, until maximum out-of-pocket is reached
- Prescription drugs – subject to deductible and co-insurance: in-network Rx
retail and mail order co-insurance is 10% after deductible; non-network Rx
retail & mail order co-insurance is 30% after deductible
- Enhanced wellness incentives with rewards include: Health Risk Assessments,
MyHealth Coach, Healthy Lifestyles, ComplexCare, and Comprehensive Medical
Management
- On-line consumer tools, including comparative prescription drug shopping
- A Health Savings Account (HSA) that allows both employer and employee to make
tax-free contributions for use toward qualified healthcare expenses in 2012 and
beyond
- University Contributions to your Health Savings Account (HSA) are as follows:
- For single members, initial funding of $250 and a regular contribution of $450
paid over 12 months, for a total of $700 in annual funding in 2013
- For all levels of family membership, initial funding of $450 and a regular
contribution of $950 paid 12 months for a total of $1,400 in annual funding in
2013
- Newly eligible participants entering after January 1 will receive initial
funding plus pro-rated regular contributions for the period in the plan
Wellness Initiatives for All Anthem Plans
Wellness initiatives will continue with the Anthem Blue Access Plans as steps
toward controlling claims expense. These programs include:
- 24/7 NurseLine: Access to a 24/7 NurseLine in which experienced registered
nurses provide information concerning general health questions and guidance with
critical health issues.
- Future Moms: Support from trained obstetrical nurses to provide maternity
management to help expectant parents have a healthy pregnancy and delivery.
- ConditionCare: Assistance from registered nurses for members to better manage
and improve chronic health conditions.
- MyHealthAdvantage: Utilizes integrated information systems and data analytics to
enhance early detection of potential health issues for participants. MyHealth
Advantage provides members and their doctors with information about
evidence-based standards that can facilitate better health care choices.
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MONTHLY EMPLOYEE
CONTRIBUTIONS
FOR ANTHEM MEDICAL:
Salary $38,000 ($3,166.67/mo, 19.49/hr.) and above
Click on the Individual Health Plan Links below for Bi-weekly Rates
MONTHLY EMPLOYEE
CONTRIBUTIONS
FOR ANTHEM MEDICAL:
Salary below $38,000 ($3,166.67/mo, 19.49/hr.)
Click on the Individual Health Plan Links below for Bi-weekly Rates
For Retiree and COBRA Rates, contact Brandy Smith
OPTIONAL
DENTAL COVERAGE
This coverage is no longer bundled with medical. Beginning in 2013, dental will
be offered as a stand-alone plan. Preventative services are coverage at 100% and
most basic services are covered at 50%. The monthly rates have decreased to the
following:
|
Employee
|
$4.78
|
|
Employee + Child(ren)
|
$11.70
|
|
Employee + Spouse
|
$9.92
|
|
Family
|
$17.10
|
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OPTIONAL
VISION COVERAGE
This is a stand-alone vision plan that is separate from your medical coverage.
There are no changes to the plan design, and the rates did not increase for
2013. While the plan allows participant choice of facility/provider in or
outside the network, and retail and private practices are both included, there
are maximum limitations on reimbursement. The maximum benefit is received by
going to a network facility/provider to ensure contracted discounts. You do not
have to participate in the University medical insurance plan to enroll in the
optional vision plan. The monthly rates are as follows:
Click Here for Bi-weekly Rates
|
Employee
|
$7.40
|
|
Employee + Child(ren)
|
$14.08
|
|
Employee + Spouse
|
$12.96
|
|
Family
|
$21.50
|
You can access the vision provider network at
www.anthem.com by selecting Find a
Doctor; then View National Vision Provider Directory; and then selecting the
plan Blue View Vision.
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FLEXIBLE BENEFIT SPENDING ACCOUNTS
Flexible Benefit Spending Accounts allow you to set aside pre-tax dollars to pay
for certain un-reimbursed medical and dental expenses, and dependent care
expenses. The spending account limit for the un-reimbursed medical and dental
expense reimbursement plan decreases in 2013 to $2,500 per year as a
requirement of the Affordable Care Act. The dependent care plan
remains at the federal maximum allowance of $5,000 per year. Summary plan
descriptions are available in the Human Resources Department.
Examples of reimbursable medical expenses include eyeglasses, contact lenses,
co-payments for doctor’s visits, deductibles, and other costs (health, dental,
or vision) not covered by co-insurance. In January of
2011, the IRS ruled that over-the-counter (OTC) drugs are
no longer an allowable
expense. Some OTC items can be claimed like vitamins and certain medication if
you obtain a prescription from your doctor stating these are medically
necessary. However, a few non-medical OTC items that remain reimbursable are
contact lens solution, bandages, and other first aid items. Please keep this in
mind when determining the annual election for 2013. Examples of reimbursable
medical expenses include eyeglasses, contact lenses, co-payments for doctor’s
visits, deductibles, and other costs (health, dental, or vision) not covered by
co-insurance.
Employees may use 2012 funds remaining in their medical flexible spending
accounts at the calendar year end for expenses through March 15, 2013. Any
remaining 2012 balances not exhausted by March 15, 2013 will be forfeited.
Additionally, employees may use 2013 funds remaining in their flexible spending
accounts at the calendar year end for purchases through March 15, 2014. The
grace period/carry-over of account balances will only apply to un-reimbursed
medical and dental expenses. The dependent care flexible spending account must
be exhausted within the particular calendar year for which those expenses were
elected.
Please note that if you enroll in the Lumenos CDHP/HSA you are NOT eligible to
participate in the Medical Flexible Spending Account. Instead, you may defer
tax-free funds into your Health Savings Account.
CURRENT FLEXIBLE SPENDING ACCOUNT PARTICIPANTS
Employees currently enrolled in flexible benefit spending accounts need to
complete a new
Flexible Benefit Plan Election Salary Reduction Form, even if allocation amounts
remain unchanged for calendar year 2013. These enrollment forms should be
completed and returned to the Human Resources Department, FA166, by November 13,
2012.
Benefit elections for current participants in the Flexible Benefit
Premium Only
Plan for pre-tax premium contributions will continue, unless you choose to
change your election.
NEW FLEXIBLE SPENDING ACCOUNT ENROLLEES
Employees interested in establishing a Flexible Benefit Spending Account for
2013 will need to complete
various forms in the
Flexible
Spending Account Information Packet and a
Flexible Benefit Plan Election Salary Reduction
Form. Enrollment forms should be completed and returned to the Human Resources
Department, Wright Administration Building, FA166, by November 13, 2012.
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VOLUNTARY SHORT-TERM DISABILITY (STD)
INSURANCE
Short Term Disability insurance helps
provide a partial income replacement for temporarily disabled benefit eligible
employees. This benefit is a supplement to the University’s sick pay benefit
that will be of special interest to those (like short-service faculty and staff)
with limited sick banks.
If you did not enroll in this benefit upon initial eligibility,
you will be considered a late enrollee who
will not receive benefits for the first 60 days of a claim during the first 12
months of coverage. You do not need to complete an Evidence of Insurability
(EOI) form for this benefit.
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VOLUNTARY SUPPLEMENTAL TERM LIFE INSURANCE
Voluntary Supplemental Term Life Insurance offers you the option to purchase
additional term life insurance at group rates on a payroll deduction basis for
yourself, your spouse, and/or dependent children. You may be eligible to
purchase up to $500,000 or eight times annual earnings, whichever is less, for
yourself and up to half that amount for your spouse. There are four levels of
coverage for dependent children. The life insurance program is offered through
Prudential Life Insurance Company. Please note that this insurance plan is
strictly voluntary and is offered as a supplement to the University-provided
life insurance. An
Evidence of Insurability (EOI) form must be completed when
applying at any other time than upon hire.
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HUMAN RESOURCES BENEFITS CONTACTS
Employees should contact the benefit representatives in the Human Resources
Department with any questions concerning the 2013 Open Enrollment. The Human
Resources Department is in the Wright Administration Building, Room FA166.
PLEASE REMEMBER
THAT ALL OPEN ENROLLMENT FORMS MUST BE COMPLETED AND RECEIVED IN HUMAN RESOURCES
NO LATER THAN NOVEMBER 13, 2012, TO BE EFFECTIVE JANUARY 1, 2013.
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Open Enrollment
Forms and Documents
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