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Benefits

2015 Open Enrollment

Open Enrollment

Medical Insurance Plan Information

Dental Insurance Plan Information

Vision Insurance Plan Information

Flexible Spending Accounts

Voluntary Short Term Disabiltiy (STD) Insurance

Voluntary Supplemental Term Life Insurance

Human Resources Benefits Contacts

Open Enrolllment Forms and Documents

During the Open Enrollment period as a benefit eligible employee, you have the opportunity to evaluate your insurance needs and make changes in your benefit coverage for the following plan year.

The 2015 Open Enrollment period will be October 29th, 2014, through November 12th, 2014. During this period you may:

  • Enroll in, drop or change coverage in the medical, dental or vision insurance plans,including adding or dropping dependents.
  • Change your current medical insurance plan.
  • 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 a CDHP/HSA health option) and make an election for 2015. Note: You must resubmit the HSA Election Form annually.
  • Enroll in, drop or change coverage in the voluntary supplemental life insurance program, subject to Evidence of Insurability (EOI) if you are a late enrollee.
  • Enroll in, drop or change coverage in the voluntary short-term disability plan, subject to Evidence of Insurability (EOI) if you are a late enrollee.

It is very important that you take time to review the enclosed information closely as you make your health care choices for 2015.

OPEN ENROLLMENT INFORMATION

The Open Enrollment period will kick-off with a Benefits Bash. Representatives from the following insurance providers will be available to discuss benefit options and decisions with you.

  • Anthem (medical, Rx)
  • HRI (dental)
  • Nyhart (flexible benefit plans)
  • Sun Life (short-term and long-term disability)
  • Anthem Blue View Vision PERF (retirement savings)
  • Prudential (life insurance)
  • Deaconess CONCERN Employee Assistance Program (EAP) with Work-Life resources

The Benefits Bash will be held on:

Wednesday, October 29, 2014
9:00 a.m. to 3:30 p.m.
University Center East
Rooms 2217/2218

A benefits meeting for 2nd and 3rd shift employees is also scheduled for Tuesday, November 4, at 10:00 p.m. in Human Resources – Training Room, FA 164.


Forms will be available at the Benefits Bash on October 29, 2014, online, or may be obtained from the Human Resources Department in the Wright Administration Building, Room FA 166.

The Open Enrollment period 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 2015 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 Benefits staff of that change within 30 days of the event. Benefit enrollment forms must be completed and submitted to the Human Resources Department no later than November 12, 2014, to ensure coverage effective January 1, 2015.

Your current medical, dental and vision insurance coverage will be continued unless you complete a form to change your coverage.

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MEDICAL INSURANCE PLAN CHANGES FOR 2015

ANTHEM BLUE ACCESS CORE PPO PLAN

  • Employee contributions increase by 6.3%, which equates to just under 5% net of taxes. Refer to 2015 Active Employee Rates for specific rates.
  • Deductible - In-network from $600
  • single and $1,200 family to $750 single and $1,500 family; non-network from $1,200 single and $2,400 family to $1,500 single and $3,000 family.
  • Out-of-pocket maximums (OOP) – In-network from $4,000 single and $8,000 family to $4,500 single and $9,000 family; non-network from $8,000 single and $16,000 family to $9,000 single and $18,000 family. Beginning in 2015, prescription drug co-pays will count towards the OOP maximums.
  • 4th tier specialty prescription drug co-pay – from $80 to $150 co-pay.
  • Emergency room co-pay – from $100 to $250 co-pay, waived if admitted.

LUMENOS CONSUMER-DRIVEN HIGH DEDUCTIBLE HEALTH PLAN #1 WITH HEALTH SAVINGS ACCOUNT (CDHP/HSA)

  • Employee contributions increase by 6.3%, which equates to just under 5% net of taxes. Refer to 2015 Active Employee Rates for specific rates.
  • Out-of-pocket maximums (OOP) – In-network from $4,000 single and $8,000 family to $5,000 single and $10,000 family; non-network from $8,000 single and $16,000 family to $10,000 single and $20,000 family.
  • University contributions to your Health Savings Account (HSA) remain the same:
    • For single members, initial
    • funding of $210 and a regular contribution of $390 paid over 12 months, for a total of $600 in annual funding in 2015
    • For all levels of family membership,
    • initial funding of $420 and a regular contribution of $780 paid over 12 months for a total of $1,200 in annual funding in 2015
  • Bariatric surgery is now a covered benefit under this plan.

LUMENOS CONSUMER-DRIVEN HIGH DEDUCTIBLE HEALTH PLAN #2 WITH HEALTH SAVINGS ACCOUNT (CDHP/HSA)

  • Employee contributions increase by 6.3%, which equates to just under 5% net of taxes. Refer to 2015 Active Employee Rates for specific rates.
  • Out-of-pocket maximums (OOP) – In-network from $5,000 single and $10,000 family to $6,000 single and $12,000 family; non-network from $10,000 single and $20,000 family to $12,000 single and $24,000 family.
  • University contributions to your Health Savings Account (HSA) remain the same:
    • For single members, initial funding of $282 and a regular contribution of $468 paid over 12 months, for a total of $750 in annual funding in 2015
    • For all levels of family membership, initial funding of $525 and a regular contribution of $975 paid over 12 months for a total of $1,500 in annual funding in 2015
  • Bariatric surgery is now a covered benefit under this plan.

ANTHEM BLUE ACCESS BUY-UP PPO PLAN (Only available to employees currently

  • Employee contributions increase by 6.3%, which equates to just under 5% net of taxes. Refer to 2015 Active Employee Rates for specific rates.
  • Deductible - In-network from $300 single and $600 family to $500 single and $1,000 family; non-network from $600 single and $1,200 family to $1,000 single and $2,000 family.
  • Out-of-pocket maximums (OOP) – In-network from $2,000 single and $4,000 family to $2,500 single and $5,000 family; non–network from $4,000 single and $8,000 family to $5,000 single and $10,000 family. Beginning in 2015, prescription drug co-pays will count towards the OOP maximums.
  • 4th tier specialty prescription drug co-pay – from $70 to $150 co-pay.
  • Emergency room co-pay – from $100 to $250 co-pay, waived if admitted.

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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 answer general health questions and provide 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: Utilizesintegrated information systems and data analytics to enhance early detection of potential health issues for participants. MyHealthAdvantage provides members and their doctors with information about evidence-based standards that can facilitate better health care choices.

DENTAL INSURANCE PLAN CHANGES FOR 2015

Dental benefits are enhanced and rates increase in 2015 as follows:

  • Annual maximum per person increases from $1,200 to $1,350.
  • Orthodontia lifetime maximum per person increases from $1,000 to $1,200.
  • Employee contributions increase by an average of 3.1%.
  • Refer to 2015 Active Employee Rates for specific rates

VISION INSURANCE PLAN CHANGES FOR 2015

Employee contributions increase by 9.1%. Refer to 2015 Active Employee Rates for specific rates. There are no changes to the vision plan design.

FLEXIBLE BENEFIT SPENDING ACCOUNTS

Flexible Benefit Spending Accounts allow you to set aside pre tax dollars to pay for certain un-reimbursed health expenses and dependent care expenses. The spending account limits remain the same in 2015: $2,500 per year for the health and $5,000 per year for the dependent care plan. Temporary status employees are not eligible to participate in the Flexible Spending Account.

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 pre-tax funds into your Health Savings Account. You may participate in the Dependent Care Flexible Spending Account regardless of your medical plan election.

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. Please note that if you did not enroll in this benefit upon initial eligibility, you will be considered a late enrollee and required to complete an Evidence of Insurability (EOI) form with enrollment subject to approval for this benefit. Rates are determined by age and salary as of January 1, 2015, and current enrollees will be automatically continued in the plan (unless you notify us you wish to drop the plan).

VOLUNTARY SUPPLEMENTAL TERM LIFE INSURANCE

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 2015 Open Enrollment. The Human Resources Department is in the Wright Administration Building, Room FA166.

Amy Miller                    812-464-1781         ajmiller3@usi.edu
Connie Schnarre         812-461-5466         csschnarre@usi.edu
Nancy Lumley              812-464-1988         nlumley@usi.edu

PLEASE REMEMBER THAT ALL OPEN ENROLLMENT FORMS MUST BE COMPLETED AND RECEIVED IN HUMAN RESOURCES NO LATER THAN NOVEMBER 12, 2014, TO BE EFFECTIVE JANUARY 1, 2015.

OPEN ENROLLMENT FORMS & INFORMATION

2015 Medical Comparison Overview
2015 Active Employee Rates
Summary of Benefits and Coverage (SBC) - Anthem Buy-Up
Summary of Benefits and Coverage (SBC) - Anthem Core
Summary of Benefits and Coverage (SBC) - Anthem Lumenos #1
Summary of Benefits and Coverage (SBC) - Anthem Lumenos #2
Anthem Medical Enrollment Application
Anthem Employee Change Form
HRI Dental Enrollment Application
Anthem Blue View Vision Enrollment Form
The Nyhart Flexible Benefit Plan Election Salary Reduction Form
The Nyhart Flexible Spending Account Information Packet
Health Savings Account (HSA) Election Form
Short-term Disability (STD) Enrollment Form
Vendor Presentation Schedule  
HRI Dental Pamphlet
HSA: FAQs
HSA: Opening a Health Savings Account
HSA: Investments
HSA: Decision Guide
HSA: Healthy Investing
My HSA
Life Beneficiary Form
Supplemental Life Insurance Booklet
Vision: Summary of Benefits
Medical: Anthem Brochure
Medical: Anthem Provider Search
Retirement: PERF at a Glance
Retirement: TIAA CREF How to Enroll
Retirement: TIAA CREF Voluntary Salary Deferral Form

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Open Enrollment Dates

TIAA-CREF Representative

Lori Matthews of TIAA-CREF will hold individual appointments in the HR Training Room on the below dates. To schedule an appointment, contact 800/732-8353. 

2015 Dates

  • Tuesday, Jan 27
  • Wednesday, Feb 25
  • Thursday, Feb 26
  • Tuesday, Mar 24
  • Wednesday, Apr 22
  • Thursday, Apr 23
  • Tuesday, May 19
  • Wednesday, June 24
  • Thursday, June 25
  • Tuesday, July 21
  • Wednesday, Aug 19
  • Thursday, Aug 20
  • Tuesday, Sep 8
  • Wednesday, Oct 21
  • Thursday, Oct 22
  • Tuesday, Nov 17
  • Wednesday, Dec 9
  • Thursday, Dec 10