2016 EMPLOYEE GUIDEBOOK TO BENEFITS OPEN ENROLLMENT
Start Planning ..................................................................3
Stanfords Approach to Managing Employee Health Care Costs ..............................................................4
Discover: Whats Happening in 2016 ...............................7
Whats Staying the Same ..................................................7
Explore: Five Ways to Tour Open Enrollment Information ........................................10
Benefits Fairs ...................................................................12
Information Sessions ......................................................12
Finding Your Way: Common Questions ........................13
Full Time Medical Contribution Rates 2016 ...................15
Destination: Cardinal at Work .......................................16
THE UNIVERSITY HR SERVICE TEAMWERE HERE TO HELP During Open Enrollment, you may require additional support to help understand your benefits choices. The University HR Service Team, your in-house benefits specialists, receives triple the normal call volume during the Open Enrollment period. Therefore, to ensure continuous high-quality service and fast response times, we have enlisted an off-site service team from Oct. 26 Nov. 13. The auxiliary staff will confidently handle your 2016 benefits questions and process elections over the phone.
Log into My Benefits on the Cardinal at Work website (http://caw.stanford.edu/ my-benefits): Submit an online form or chat live with a specialist.
Or Call: 877-905-2985 or 650-736-2985
Mark your calendar for Open Enrollment, the annual opportunity for you to make health benefits changes and to add or drop coverage for eligible dependents. And, be sure to bookmark the Cardinal at Work website (http://cardinalatwork.stanford.edu), your new online destination for employee-related information!
October 26 through November 13
Even if youre happy with your elections from last year, its always a good practice to review and confirm that youve signed up for the right plan for you and your family. If you choose not to take action, coverage will either roll over or default into a new plan.* So take the time to review your options; otherwise, youll have to wait until the next Open Enrollment period unless you experience a qualified life event (such as getting married, having a baby, changing job status) to make changes.
* The cost of coverage will reflect the 2016 contribution amounts. Also, if you elected the following plans in 2015, youll need to re-enroll as these plans will not roll over:
Health Savings Account (HSA)
Health Care Flexible Spending Account (FSA)
Dependent Day Care Flexible Spending Account (FSA)
Child Care Subsidy Grant (CCSG)
Joe Knox Customer Experience SpecialistStanford Web Services
ATTENTIONThe Blue Shield PPO is being discontinued, so if you do not update your elections, youll be defaulted into the Blue Shield Healthcare + Savings plan.
For more information, see page 8.
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Stanfords Approach to Managing Employee Health Care CostsYour annual Benefits Open Enrollment period will be here soon, from Oct. 26 through Nov. 13, 2015. Given the changing health care landscape, here is some background behind some of the changes you can expect this year, including how we are designing health care benefits and managing the growing costs.
In designing health care benefits, we consider four key principles:
1 Helping you stay healthy. We cover the cost of preventive care for you and your family with no co-pays or deductibles, and also provide you access to recreation facilities and healthy living classes to help you and your family maintain a path to good health.
2 Providing access to excellent care. We are fortunate to be surrounded by several health care providers that provide quality service, including Stanford Health Care, Kaiser, Palo Alto Medical Foundation and others.
3 Managing rising health care costs. We will continue to explore ways to minimize our overall health care costs so that we can continue to offer comprehensive health care benefits.
4 Keeping you informed. We will continue to provide information and perspective to help you and family members keep up with changes so you can make the most of your health care benefits.
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DESIGNING PLANS TO KEEP YOU HEALTHYOver the years, we have proactively helped employees get on a path toward
improved health by implementing a number of strategies:
Increased promotion of wellness and disease prevention. We have enhanced our benefits offerings to focus on health improvement. For example, the BeWell@Stanford wellness program continues to offer cash incentives to participants who are actively making meaningful lifestyle changes to improve their health. In addition to wellness benefits, we subsidize the Stanford Coordinated Care (SCC) program, which helps employees with chronic illnesses improve their quality of life and navigate their health care experiences.
Expanded access to outpatient mental health providers. In 2015, non-network coverage was enhanced for the Blue Shield EPO and High Deductible Health Plan, as well as Stanford Health Care Alliance (SHCA). This provides you more flexibility in accessing psychologists, therapists, counselors and other mental health services.
Encouraged health care marketplace competition. The introduction of the SHCA in 2014 has meant greater competition, and as a result, we expect to see new and different health care plans and provider partnerships. This means more options for you to choose from.
Maria Eugenia Smith
Director of Finance and Administration
Office of Public Affairs
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STANFORDS APPROACH TO MANAGING EMPLOYEE HEALTH CARE COSTS
MANAGING THE GROWING COST OF HEALTH CAREIn addition to offering health benefits that support the varying lifestyles and well-being of our employees, we must also continue efforts to keep health care costs manageable.
Keeping health care plan costs low for you and the university has been a challenge. National health care spending costs continue to climb and, according to recent reports, are expected to grow 5.8% annually through 2024.
The reasons for this include:
Increased numbers of patients with chronic illnesses;
Increased aging population;
Poor lifestyles and obesity; and
New costly drugs to treat chronic illnesses.
In addition, spending is fueled by the increased use of fee-for-service health plans (when doctors/hospitals get paid for each service performed) versus managed care (HMO-type plans).
Stanford remains one of the few employers in the Bay Area to offer free employee-only coverage. That means we pay 100% of the lowest-price plan for employees who cover themselves only. The cost differential between the lowest-price plan and the more expensive plans are increasing over time, which means the difference in your semi-monthly contributions, will also continue to rise. The lowest-priced plan for 2016 will be the Stanford Health Care Alliance (SHCA).
While many community members might prefer that Stanford simply contribute more, employee health care benefits have been absorbing an increasing share of the universitys operating budget, constraining the funds available for salary increases and other benefits, said Randy Livingston, Vice President Business Affairs & CFO.
WHAT YOU CAN EXPECT One way to slow down rising plan premiums is to increase co-pays, deductibles and out-of-pocket maximums. You can expect increases in these for 2016, and possible increases in 2017 and 2018 if the Affordable Care Acts (ACA) excise Cadillac tax remains unchanged. (See page 15 for more on the Cadillac tax impacts).
Stanford is not the only employer exploring changes to keep health care costs down. In a survey done recently by risk management and human resources consulting agency, Towers Watson, 84% of employers predict moderate to significant changes to their health care benefit programs for full-time employees over the next three years.
Other industries are implementing more aggressive strategies such as implementing an extra surcharge for enrolled spouses, mandatory enrollment in wellness programs, and increasing rates or medical plan premiums based on biometric results.
We want to be transparent about changes to our programs and share information early so that our employees are informed and can make the best decision for their health needs, said Neal Evans, Stanfords Health Benefits Director. Our approach will focus on solutions that allow the university to stay aligned with our core mission while continuing to provide sustainable benefits to our employees within the legislative and financial requirements.
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STANFORDS APPROACH TO MANAGING EMPLOYEE HEALTH CARE COSTS
DISCOVERWhats Happening in 2016
WHATS STAYING THE SAMEHere are the plans and options Stanford will continue to offer in 2016:
Health Plan Options
We know having options is important. In 2016, youll still have several plans to choose from including the Blue Shield EPO, the Blue Shield Healthcare + Savings Plan (formerly the Blue Shield High Deductible Health Plan), as well as the Kaiser HMO and the Stanford Health Care Alliance (SHCA) plan.
Vision and Dental
Good dental and vision care contribute to your overall health and wellness, and both continue to be part of our comprehensive health care benefits.
Mental Health A healthy body also needs a healthy mind. Youll continue to receive expanded access to out-of-network outpatient mental health providers for the Blue Shield EPO, Blue Shield Healthcare + Savings and SHCA plans.
BeWell Incentive ProgramThe BeWell program will continue to offer a monetary incentive and other rewards to encourage healthy lifestyle behaviors.
Free Employee-Only Coverage We remain one of the few employers in the Bay Area to offer free employee-only coverage. Stanford Health Care Alliance (SHCA) is the lowest-price plan for 2016 that is free for employees who cover themselves only.
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WHATS CHANGINGThe plan changes for 2016 are comparable to previous annual benefit changes, and include increases to health plan costs; deductibles and out-of-pocket maximums; and co-pays for office visits, prescription drugs
and other services. Here are highlights of the changes:
Blue Shield PPO plan is discontinued
The PPO Plan is being discontinued, so current members will have an opportunity to elect a new plan during Open Enrollment.
If you choose to do nothing, youll be defaulted into the Blue Shield Healthcare + Savings Plan (formerly the High Deductible Health Plan).
This plan is no longer the lowest-price plan, which means employee-only coverage is no longer free for Kaiser HMO.
Stanford Health Care Alliance (SHCA)
SHCAs administrator is changing from Blue Shield to Aetna.
Plan members will receive new ID cards by January 1, 2016.
Plan members should check the SHCA website at http://stanfordhealthcarealliance.org for a list of in-network providers.
Blue Shield Healthcare + Savings Plan (formerly the High Deductible Health Plan)
The Blue Shield High Deductible Health Plan(HDHP) is now called the Blue Shield Healthcare + Savings Plan.
The plan design hasnt changed, only the name which better aligns with the Health Savings Account (HSA), an optional savings account that you may elect to help offset eligible health care expenses. With this plan, Stanford will also make a contribution to your HSA.
This plan pays 80% of covered costs in network and 60% out of network, after youve paid the deductible.
Deductibles: $1,750 individual; $3,500 family.
Out-of-pocket maximum expenses: $3,750 individual; $7,500 family.
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DISCOVER: WHATS HAPPENING IN 2016
Health Plans (continued)
Blue Shield ACA Basic High Deductible Health Plan NEW
This is a new plan option that meets the minimum essential coverage requirements under the federal health care reform, Affordable Care Act (ACA).
When compared to the Blue Shield Healthcare + Savings Plan, this plan has higher out-of-pocket costs:
This plan only pays 60% of covered costs in network and only 50% out of network, after youve paid the deductible.
In-Network Deductibles: $3,250 individual; $6,500 family; Out-of-Network Deductibles: $6,500 individual; $13,000 family.
Out-of-pocket maximum expenses for in-network services: $6,500 individual and $13,000 family. Out-of-pocket maximum expenses for non-network services: $13,000 individual and $26,000 family.
You may enroll in a Health Savings Account (HSA) to set aside money to cover eligible out-of-pocket expenses, but unlike the Blue Shield Healthcare + Savings Plan, Stanford will not contribute to your HSA.
Covered Service Charge: Gender Reassignment
Coverage for gender reassignment procedure has been extended to the Blue Shield EPO, Blue Shield Healthcare + Savings and Stanford Health Care Alliance plans. Previously, Kaiser was the only plan to offer this coverage.
Flexible Spending Account (FSA)
The FSA administrator has changed its name to TASC (formerly Benesyst, a TASC company).
The Health Care FSA maximum election is increasing to $2,550.
Health Savings Account (HSA)
The HSA maximum limit for families is increasing to $6,750.
Stanford will only contribute to the HSA when you elect the Blue Shield Healthcare + Savings Plan and when you enroll through HealthEquity, Blue Shields financial partner.
Long-Term Care (LTC) Insurance
Stanfords Long-Term Care provider is changing to Genworth.
If you are currently enrolled through CNA, you may continue coverage or purchase a new policy with Genworth; Genworth will manage all new Long-Term Care enrollees.
For a limited time (10/12 11/13), Genworth is offering active, full-time employees under age 66 a special opportunity to apply for LTC insurance using a brief health questionnaire vs. a full evidence of good health form. To learn more or to apply, visit the Genworth website (www.genworth.com/groupltc) (Enter Group ID: Stanford and Access Code: groupltc), or call (800) 416-3624.
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DISCOVER: WHATS HAPPENING IN 2016
EXPLOREFive Ways to Tour Open Enrollment Information