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2012/2013 Benefit Year This only happens once a year!
Decisions you make are generally binding for the entire year.
Qualifying Event Marriage Divorce Birth Adoption
Important Dates to Remember!Enrollment period: April 23rd – May 23rd Deadline for making changes: May 23rd Changes effective : JULY 1, 2012
Benefits:No changes in coverage or cost!Add or delete eligible dependentsChange Beneficiary on Basic or Voluntary
Life
Not making any changes? We need the following:2012/2013 Benefits Open Enrollment Election
formFlex Spending Account (FSA) and/orHealth Savings Account (HSA)
Flexible Spending AccountReduce your taxable income by what you
spend on non-reimbursable medical and dependent care expenses.
Maximums: $2,500 Health and $5,000 dependent care.
VERY IMPORTANTIf you are currently enrolled in the Flexible
Spending Account, you MUST enroll for each plan year. If you do nothing – you will not be able to contribute to Flex next year unless you have a qualifying event.
Plan ABenefit Description In-Network Out-of –Network
Annual Deductible $500/person$1,000/family
$1,500/person$3,000/family
Coinsurance 80% 50%
Out-of-Pocket Maximum
$2,000/person* $6,250/person*
* Deductible is not included in out-of-pocket maximum.
Health Savings AccountContribution limits for 2012:
$3,100 for Single$6,250 for FamilyEmployer contribution will apply to your
maximum contribution allowed.Your contributions will be withdrawn from your
paycheck each pay period.Important Information:
Once you have accumulated at least $2,000 in your HSA, the balance of your account (above $2,000) will automatically be invested in an interest-bearing, FDIC-insured account.
Your allocation can be changed.HSA Investment Account are available online at
www.eflexgroup.com
High DeductibleHealth Plan (HDHP)Benefit Description In-Network Out-of-Network
Annual Deductible$1,500/person$3,000/family
$3,000/person$6,000/family
Coinsurance 85% 60%
Out-of-Pocket Maximum
$3,000/person*$6,000/family**
$8,000/person*$16,000/family**
*IRS regulations require that the family (including any individual in the family) must meet the family deductible before any reimbursement is made for eligible medical expenses (other then preventative care).** Deductibles and copayments will also accumulate to your Out-of-Pocket maximum.
Making Changes in Health Plans?All forms are available in the Human
Resources Department.Complete a new Enrollment Form
indicating additions or deletions.Complete a Deduction Change form.Complete the Election Form.
All employees, whether you have changes or not.
Submit all forms to H.R. no later than May 23rd.
Voluntary Life InsuranceSun Life
Purchase additional Life Insurance through convenient payroll deductions.
Cost is based on age. Employee – up to $100,000. Spouse – 1/2 of employee coverage up to a
maximum of $25,000. Children – up to a maximum of $5,000 for each
child. Your dependents may ONLY be covered if the
employee is covered.
Employee Assistance PlanAETNA EAP
Free, confidential support to help you balance the demands of work counseling, life and personal issues.
Assessment & short term counseling – 10 Visits24 hour crisis intervention line.1-888-238-6232, or visit www.AetnaEAP.com
Reminders!You need to take action if:
You want to switch to the HDHP or Plan AYou have a Flexible Spending Account or
Health Savings Account You must renew it during Open Enrollment
You want to add or drop a dependentYou want to change your beneficiaries
Complete the Election FormEven if you make no changes
Open Enrollment ends 5/23/12All changes are effective July 1, 2012