2016 Open Enrollment

Open Enrollment DatesNovember 9 – November 20

THINGS TO KNOW

• TO HAVE COVERAGE IN 2016, YOU ARE REQUIRED TO MEET WITH A BENEFITS COUNSELOR OR GO ON-LINE TO ENROLL.

• BENEFITS COUNSELORS ARE THROUGH COLONIAL LIFE. THEY WILL ENROLL YOU FOR ALL BENEFITS MEDICAL,DENTAL, VISION, FLEXIBLE SPENDING ACCOUNTS AND VOLUNTARY BENEFITS.

• ELIGIBILITY FOR MEDICAL & DENTAL HAS NOT CHANGED. IF YOU ARE NOT ELIGIBLE FOR MEDICAL & DENTAL TODAY, YOU ARE STILL NOT ELIGIBLE.

• EVERYONE IS ELIGIBLE FOR VISION AND IT IS A VOLUNTARY PLAN.

• EVERYONE IS ELIGIBLE FOR VOLUNTARY BENEFITS.

MEDICAL

4 PLANS• ***NEW PLAN***NPOS $500- $500/$1000 DEDUCTIBLE THEN 90%,

$2500/$5000 MAX OOP (INCLUDES DED & COINSURANCE), $20 OV/$40 SP, $200 ER COPAY, $15/$35/$55/25% RX.

• ***NEW PLAN***COVERAGE 1ST $1500- $500 PMPY BENEFIT ALLOWANCE, $1500/$3000 DEDUCTIBLE THEN 80%, $4500/$9000 MAX OOP (INCLUDES DED & COINSURANCE), $30 OV/$50 SP, $200 ER COPAY, $15/$35/$55/25% RX

• HDHP $2650- $2650/$5250 DEDUCTIBLE THEN 100%• HDHP $5000- $5000/$10000 DEDUCTIBLE THEN 100%

ALL PLANS• PREVENTIVE CARE COVERED AT 100%*• BIRTH CONTROL COVERED AT 100%**• PRESCRIBED SMOKING CESSATION PRODUCTS COVERED AT 100%• DIABETIC SUPPLIES COVERED AT 100%*100% COVERAGE DEPENDS ON DIAGNOSIS CODE PROVIDED ON CLAIM**IUDS/NON ORAL BIRTH CONTROL MAY NOT BE COVERED AT 100%

SHOULD I SWITCH PLANS?THINGS TO CONSIDER….

• HOW YOU UTILIZE BENEFITS. ARE YOU A CASUAL USER OR DO YOU GENERALLY MEET YOUR DEDUCTIBLE AND COINSURANCE.

• TOTAL COSTS = (PER PAY PREMIUM + DED/COPAYS/COINSURANCE) EVALUATE BASED ON IF YOU USE PLAN TO THE FULLEST OR IF YOU ONLY USE PLAN CASUALLY.

• PRESCRIPTION COSTS. IF CONSIDERING MOVING TO THE HDHP YOU WILL WANT TO CHECK WITH YOUR PHARMACIST ON THE COST OF YOUR PRESCRIPTIONS. GENERALLY PRESCRIPTIONS ARE THE MOST EXPENSIVE REOCCURRING COST ON AN HDHP. ON THE HDHP YOUR RX GOES TOWARDS YOUR DEDUCTIBLE AT THE FULL COST LESS ANY DISCOUNTS.

• MEDICARE ELIGIBLE. IF YOU ARE MEDICARE ELIGIBLE (65 OR OLDER) YOU CAN NOT CONTRIBUTE OR HAVE MONEY CONTRIBUTED TO AN H.SA ON YOUR BEHALF. ADDITIONALLY, AN HDHP IS CONSIDERED NON CREDIBLE COVERAGE FOR RX. IF YOU ARE ENROLLED ON AN HDHP, YOU WILL BE PENALIZED 2% FOR EACH MONTH YOU ARE ENROLLED ON AN HDHP AND ARE MEDICARE ELIGIBLE. THIS PENALTY IS FOR THE LIFE OF YOUR ENROLLMENT ON MEDICARE.

2016 H.SA INFO

• 2016 LIMITS. Individual with self-only coverage under a high deductible health plan is $3,350. Individual with family coverage under a high deductible health plan is $6,750. – Employees 55 & older can do an additional $1000 per year as “catch up”

• USES. Can be used for all medical expenses outlined by IRS as qualified medical expenses. Visit www.irs.gov for detailed listing. Dental and Vision qualify as qualified expenses.

• FSA. You can only have an FSA with an H.SA for dental and vision purposes. If you currently have an FSA and move to an HDHP with an H.SA you have to exhaust all your FSA funds before contributing or having a contribution towards an H.SA.

• ESTABLISHING AN H.SA. To start an H.SA you have to open an account through Mainsource Bank. You can fill out a paper application with an enroller or by contacting Deena. Or you can go to the Grant Line Rd. Mainsource location and open an account.

2016 Prescription UpdatesHumana released a letter in October that overviewed that there are changes to the 2016 Humana Drug List. If you are currently taking maintenance medications please go online to www.humana.com/druglist to see if there are any changes in 2016 to your prescriptions. • Changes can be from tier, prior authorization, step

therapy, quantity limits or not being covered.

DENTAL

NO CHANGES TO DENTAL BENEFITS. PLAN REMAINS THE SAME.

Only change is, you will see lower per pay premium as NAFCS contribution to dental has increased.

VISION

LIFE & LTD

• Life & LTD will now be deducted on a per pay basis. Eligibility has not changed.

LIFE/AD&D/LTDEffective 1/1/2016

Annual Cost 20 pays 22 pays 26 paysEmployee Only $ 26.00 $ 1.30 $ 1.18 $ 1.00

COLONIAL LIFE

PRODUCTS OFFERED

• FLEXIBLE SPENDING ACCOUNTS • SHORT TERM DISABILITY• CANCER• CRITICAL CARE• VOLUNTARY LIFE• ACCIDENT

ENROLLMENT PROCESS

• ENROLLMENT BEGINS ON NOV 9 AND WILL END ON NOV 20

• YOU MUST MEET WITH A BENEFITS COUNSELOR OR ENROLL ONLINE FOR COVERAGE OR TO WAIVE

• BENEFITS COUNSELORS WILL:– ENROLL YOU ON ALL BENEFITS YOU ARE CURRENTLY

ELIGIBLE FOR INCLUDING MEDICAL & DENTAL– BE ABLE TO PROVIDE GUIDANCE FOR YOUR

MEDICAL CHOICES– INPUT BENEFICIARY INFORMATION FOR GROUP

BASIC LIFE

• SIGN UP SHEETS ARE AT EACH LOCATION.• EXPECT TO SPEND 15 MINUTES WITH A

BENEFITS COUNSELOR TO REVIEW BENEFITS• YOU WILL NEED YOUR SPOUSE & DEPENDENT

SOCIAL SECURITY NUMBERS. IF YOU HAVE RECENTLY SUBMITTED THEM TO HUMANA OR DEENA, THEY MAY NOT BE UPDATED IN THE SELERIX SYSTEM SO YOU WILL MORE THAN LIKELY NEED TO PROVIDE THEM AGAIN.

QUESTIONS???