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Annual Enrollment for
Plan Year 2017
February 2010 2APRIL 2010
2017 Annual Enrollment Georgia Breeze Website:
Opens: Monday, October 17th 12:00AM
Closes: Friday, November 4th 11:59PM
* Benefits elected are effective January 1, 2017
February 2010 3APRIL 2010
Summary of Plan Changes for 2017
• Spending Accounts – New Website
• CIGNA Dental HMO – Expanded Network
• Met Life – One-time opportunity to increase coverage without completing Statement of Health
February 2010 4APRIL 2010
Flexible Healthcare Spending Account –
2017 Website Update
New Look for ADP Website
• Effective September 17th, the ADP website will no longer support Internet Explorer version 8 or lower.
• ADP has added an additional layer of security for first timeweb users. New users will be advised that a security code will be emailed to them within 5 minutes.
• The State of Georgia’s security code is STATEOFGE-10029
• This code is the same for all users, and will never change.
February 2010 5APRIL 2010
Flexible Healthcare Spending Account –
2017 Plan cont’d
• Maximum annual contribution is $2,510
• Minimum annual contribution remains $120
• Contributions must be re-elected each year, they do notrollover.
February 2010 6APRIL 2010
Healthcare Spending Account - ADP
– Set aside pre-tax money to use for healthcare expenses.
– Maximum amount $2,510 ($209/month) can be set aside per year.
– Money is “Use or Lose”
> You have until March 15, 2018 to use money placed in your 2017 spending account.
– Entire amount is available the first day of the year.
– Visa debit card available for purchases, but keep your receipts!
– Qualifying expenses include: prescriptions, contact lenses/glasses, eye surgery, procedures/surgeries not covered by insurance, health insurance co-insurance.
– Excluded expenses include: over the counter drugs, electrolysis, vitamins/herbal supplements, hair transplants, nicotine patches or gum, teeth whitening.
Flexible Healthcare Spending Account
February 2010 7APRIL 2010
Flexible Healthcare Spending Account
- continued
Spending Accounts – Relation to the Health Saving Account
Employees who enroll in the High Deductible Health Plan AND enroll in a Health Savings Account (HSA) will not be eligible to enroll in a Health Care Spending Account
If an employee does enroll in a HCSA in error, it will be necessary for them to contact the Gabreeze Call Center and request an Appeal Form to submit to DOAS
– The form will be received/reviewed by DOAS
– Gabreeze will be notified of the final determination regarding the Spending Account
February 2010 8APRIL 2010
CIGNA Dental HMO
• Cigna Dental (DHMO) Dental Network is available primarily to those who work or live in the Metro Atlanta Area.
• There are limited participating providers in Chatham county.
• Additional counties are being added for 2017, to include Lowndes, Houston, Baldwin, Spalding, Troup, Richmond, Clarke, Barrow, Dawson, Floyd, Bartow, and Catoosa.
• Provider Network frequently changes
• No late entrant penalties or waiting periods.
• Slight rate increase for 2017
Cigna DHMO Rates
You $22.58
You +
Spouse
$41.15
You +
Child(ren)
$51.03
Family $60.86
February 2010 9APRIL 2010
True “OneUp” Special EnrollmentWill allow employees to enroll in a life insurance plan at the first level of coverage; or increase their current coverage up one level without a Statement of Health (SOH).
• The opportunity to “OneUp” will onlybe available for the 2017 plan year.
• Employees that do not have coverage can enroll without a SOH.
• Currently covered emplyees can move up one salary level without a SOH.
Life Insurance – Met Life
2017 One-Up Opportunity
February 2010 10APRIL 2010
Life Plans – MetLife
MetLife offers:
– Up to 10x employee’s salary for Employee Life coverage, up to $2 Million
Current employees wishing to increase their current level of coverage beyond one level will be required to complete the online Statement of Health (SOH)
Employees wishing to enroll in Spouse Life or increase the current level of spouse coverage will be required to complete the online Statement of Health (SOH)
– Employees are required to pre-register their spouse on the Gabreeze website before the Statement of Health form will be available online.
Life Insurance – Met Life
February 2010 11APRIL 2010
Life Plans – MetLife
Waiver of Premium to the Employee Life product for permanent or total disability
– Employee must initiate the process after meeting the 180 day qualifying period
– Copy of the form available on the GABreeze, DOAS, and Team Georgia web sites
Additional Life Insurance benefits:
– Will Preparation
– Estate Planning
NOTE: These benefits are offered by Metlife in partnership with Hyatt Legal Services. This service is separate from the benefits provided under the Hyatt Legal Plan
Life Insurance – Met Life cont’d
February 2010 12APRIL 2010
Beneficiaries are managed online.
– Remember to review and update your beneficiaries.
An employee must carry Employee Life if they wish to elect Spouse Life coverage.
– Spouse Life coverage cannot exceed Employee Life coverage.
Child life covers an employee’s children under 26, without medical underwriting.
– Child Life coverage cannot exceed Employee Life Coverage
– Disabled children can continue coverage after age 26.
– Child Live coverage starts at live birth.
Premiums are based on employee age and salary.
More About Life Insurance…
February 2010 13APRIL 2010
The following plans have no changes
to coverage for 2017
Delta Dental Blue View Vision
AFLAC Critical Illness Hyatt Legal
Dependent Care Spending MetLife AD&D
Short Term/Long Term Disability
February 2010 14APRIL 2010
Delta Dental Select Plan
$50 In-Network Deductible, per person (or) $150 In-Network Family Deductible per calendar year.
$50 Out-of-Network Deductible, per person (or) $150 Out-of-Network Family deductible per calendar year.
$500 maximum coverage per person each calendar year.
100% Coverage for Diagnostic/Preventive services. (Cleanings, xrays, etc.)
80% Coverage for Basic Services (fillings, extractions), Endodontics (root canals), Periodontics (gum treatments), and Oral Surgery.
50% Coverage for Major Services (crowns, inlays, restorations, bridges, dentures, TMJ, surgical periodontics.)
Dental Insurance – Delta Dental
February 2010 15APRIL 2010
Delta Dental Select Plus Plan
$50 In-Network Deductible, per person (or) $150 In-Network Family Deductible per calendar year.
$50 Out-of-Network Deductible, per person (or) $150 Out-of-Network Family deductible per calendar year.
$2,000 maximum coverage per person each calendar year.
100% Coverage for Diagnostic/Preventive services. (Cleanings, xrays, etc.)
90% Coverage for Basic Services (fillings, extractions), Endodontics (root canals), Periodontics (gum treatments), and Oral Surgery.
60% Coverage for Major Services (crowns, inlays, restorations, bridges, dentures, TMJ, surgical periodontics.)
50% Coverage for Orthodontia Services, up to $2,000 lifetime maximum orthodontia benefit per person.
Dental Insurance – Delta Dental
February 2010 16APRIL 2010
Late Entrant Penalties – Delta Dental:
• If an employee does not carry dental insurance in the previous plan year, or cannot prove that they have had continuous dental insurance coverage, they are subject to “late entrant penalties.”
• Under Delta Dental, the penalties are as follows:
• Six month wait for:
• major services (crowns, inlays, restorations, bridges, dentures, TMJ, surgical periodontics.)
• Orthodontia (Select Plus Plan Only)
Delta Dental Plans –
Late Entrant Penalties
February 2010 17APRIL 2010
Delta Dental –
Select Plan Premiums
– You Only $26.20
– You + Spouse $51.03
– You + Child $53.49
– You + Family $74.95
Delta Dental –
Select Plus Plan Premiums
– You Only $42.01
– You + Spouse $82.22
– You + Child $86.24
– You + Family $121.01
Delta Dental Premiums - 2017
Admin fee is included in amount.
February 2010 18APRIL 2010
Vision – Blue Cross/Blue Shield of Georgia
– Select PlanCOVERED SERVICES COPAYMENTS/MAXIMUMS
Network Providers Non-Network Providers
Eye Exam
Limited to one exam per Member every Calendar Year. $10 Copayment Reimbursed up to $40
Prescription Lenses
Limited to one set of lenses per Member every Calendar Year.
Basic Lenses (Pair)
Single Vision lenses
Lined Bifocal lenses
Lined Trifocal lenses
Lenticular lenses
$20 Copayment
Reimbursed up to $60
Reimbursed up to $80
Reimbursed up to $80
Reimbursed up to $45
Frames
Limited to one set of frames per Member every 24 Months. $ 20 Copayment
Allowable Amount up to $130 retail
allowance
N/A
Prescription Contact Lenses
Every 12 months in place of eyeglasses
(traditional or disposable)
Non-Elective Contact Lenses
(Availability once every Calendar Year.)
$20 Copayment
Covered in full
Reimbursed up to $105
Reimbursed up to $210
Elective Contact Lenses
(Availability once every Calendar Year.) $20 Copayment
$105 plan allowance or disposables up
to 4 boxes.
Reimbursed up to $105
Note: If you chose covered Non-Elective Contact Lenses or Elective Contact Lenses, no benefits will be available for covered eyeglass lenses
in that period.
February 2010 19APRIL 2010
COVERED SERVICES COPAYMENTS/MAXIMUMS
Network Providers Non-Network Providers
Eye Exam
Limited to one exam per Member every Calendar Year. $10 Copayment Reimbursed up to $40
Prescription Lenses
Limited to one set of lenses per Member every Calendar Year.
Basic Lenses (Pair)
Single Vision lenses
Lined Bifocal lenses
Lined Trifocal lenses
Lenticular lenses
Includes the following Lens options
Factory scratch coating
Tint (Solid & Gradient)
Polycarbonate lenses
Transitions Photochromic lenses
Standard & Premium Progressive lenses
Standard Anti-Reflective coating (Not
Covered For Non-Network Providers)
$25 Copayment
Reimbursed up to $40
Reimbursed up to $60
Reimbursed up to $80
Reimbursed up to $80
Frames
Limited to one set of frames per Member every Calendar Year. No Copayment
Allowable Amount up to $150 retail
allowance
Reimbursed up to $45
Prescription Contact Lenses
(traditional or disposable)
Non-Elective Contact Lenses
(Availability once every Calendar Year.)
No Copayment
Covered in full Reimbursed up to $210
Elective Contact Lenses
(Availability once every Calendar Year.) No Copayment
$200 plan allowance
Reimbursed up to $200
Note: If you chose covered Non-Elective Contact Lenses or Elective Contact Lenses, no benefits will be available for covered eyeglass lenses in that period.
Vision – Blue Cross/Blue Shield of Georgia
- Select Plus Plan
February 2010 20APRIL 2010
Most Walmart/Sam’s Club are out-of-network providers; completion and submission of the claim form below is required to receive the in-network benefit
Important Note RE: Wal-mart/Sam’s Club
providers
February 2010 21APRIL 2010
Important Note re: Wal-Mart/Sam’s Club
providers
February 2010 22APRIL 2010
BCBS of Georgia – Select Plan Premiums
– You Only $4.54
– You + Spouse $9.49
– You + Child $9.92
– You + Family $13.37
BCBS of Georgia – Select Plus Plan Premiums
– You Only $7.73
– You + Spouse $16.80
– You + Child $17.57
– You + Family $23.90
Vision Premiums - 2017
Admin fee is included in amount
February 2010 23APRIL 2010
Hyatt Legal Plans…
Select Plan Covers:
Powers of Attorney
Office Advice/Consultations
Wills/Living Wills
Traffic Matters (Except DUIs)
Document Preparation
Real Estate Matters for Primary
Residence
Elder Law Matters
Home Equity Loan Assistance
Debt Collection Defense
Identity Theft Defense
Select Plus Plan Also Covers:
Consumer Protection Matters
Enforcement/Change to Support Orders
Eviction/Tenant Defense
Guardianship/Conservatorship
Adoption
Immigration Assistance
Tax Audits
Divorce
Real Estate Matters for Additional
Residences
Incompetency
Civil Litigation Defense
February 2010 24APRIL 2010
Hyatt Legal Plans – 2017 Rates
Legal Plans – Hyatt
Network of attorneys with 14,000 nationally, and over 450 attorneys within the State of Georgia
Select Select Plus
Employee $6.37 $8.00
Family $8.00 $10.30
February 2010 25APRIL 2010
Long Term Care Insurance – Unum Insurance
– Nursing Facility/Nursing-Home Insurance, covers some in-home care.
– Must require continual assistance with at least three activities of daily living to be considered disabled and qualifying for benefits.
– 90-day wait period after disability before benefits are payable.
– Plans offered for employees, spouses, parents, in-laws, includes adoptive or step-parents.
– Only employee premiums taken through payroll deductions. All other premiums direct billed by Unum.
– Medical Underwriting required for covered spouse, parents, or in-laws.
– Medical Underwriting required for employees electing coverage for the first time, after a break in coverage, or electing a higher level of coverage.
Long Term Care Insurance - 2017
Employees can go to the website: unuminfo.com/sogor contact Unum at
1 800-227-4165 for additional information
February 2010 26APRIL 2010
Short Term Disability– 7-Day Wait or 30-Day Wait (from date of disability, until payment issued)
– Covers disability up to 6 months.
– 60% of pay, up to $1,000 per week.
– Consider Sick/Annual Leave Balances.
– Late Entrant Penalty
> 60 Day wait for disability due to disease, mental disorder, or pregnancy within first
12 months of coverage.
Long Term Disability– Covers disability after 6 months.
– 60% of pay, up to $5,000 per month.
– Benefits are paid after-tax, not taxable income when on LTD.
– Benefits generally are payable until end of disability
or Social Security Retirement Age.
> For some conditions, benefits are only payable
for two years. (Mental Disability, substance abuse, etc.)
*Rates are based on employee age and salary.
More About Disability Plans…
February 2010 27APRIL 2010
Specified / Critical Illness Plan Design
Select Plan = Illness Coverage
Select Plus Plan = Illness + Accident Coverage
Benefits included under the Accident Coverage (Select Plus Plan)
– Medical Fees (Physician Charges, X-Rays, Emergency Room Services and Supplies)
– Hospital Fees (Hospital Admission, Daily Hospital Confinement and Intensive Care)
– Accidental Injuries (Fractures/Dislocations, Lacerations, Tendons/Ligaments, Ruptured Disk, Torn
Knee Cartilage, Burns, Eye Injuries)
– Accident Follow-up Benefits (Physical Therapy, In-patient Rehab, Follow-up treatments)
– Additional Benefits (Family Lodging, Transportation, Gunshot Wound, Paralysis, Prosthesis)
A complete list of benefits and descriptions is available in the summary plan
description.
Coverage available up to $50,000; no medical underwriting for > $30,000.
Rates are based on employee/spouse age and coverage level.
AFLAC Specified Critical Illness 2017
February 2010 28APRIL 2010
Specified Critical Illness
– Lump Sum Benefit paid following diagnosis.
– Child coverage at no additional cost, up to age 26. 50% of benefit is payable for children.
90-day re-occurrence interval
Cancer 12-month treatment-free re-occurrence interval
Reminder: Coverage for Spouse Specified Illness cannot exceed coverage level for Employee Specified Illness and cannot be of a different plan (e.g. Employee Select and Spouse Select Plus)
AFLAC Specified Critical Illness 2017
Covered Diagnoses:
Heart Attack Stroke
Major Organ
Transplant
End-Stage
Renal
Failure
Internal
Cancer
Coma
Severe
Burns
Paralysis
Loss of
Sight,
Hearing or
Speech
Alzheimer’s
(25%)
Caricnoma
in situ (25%)
Coronary
Artery (25%)
February 2010 29APRIL 2010
Specified / Critical Illness Plans Design Continues…
Health Screening Benefits
– Receive a maximum $100 ($160 for Select Plus) for completion of any one covered screening test per calendar year.
– Payable to employee and spouse, (as long as both take test) regardless of results
AFLAC Specified Critical Illness 2017
Examples of Covered Tests Include:
Stress Test (Bicycle or Treadmill) Blood Triglycerides
Fasting Blood Glucose Serum Cholesterol
Bone Marrow Testing Breast Ultrasound
Chest X-Ray Mammography
Colonoscopy Pap Smear
Flexible Sigmoidoscopy Blood Tests for breast,
ovarian, prostate, colon
cancer, or myleomia
February 2010 30APRIL 2010
Dependent Care Spending Account - ADP
– Set aside pre-tax money to use for child care expenses for your children under age 13.
> Expenses for care of a dependent of any age, who is unable to care for themselves due to a physical or mental handicap also qualify.
– Maximum family amount $4,992 can be set aside per year under IRS rules.
– Money is “Use or Lose”
> You have until December 31, 2017 to use money placed in your 2017 dependent care spending account.
– Both the employee and spouse must be working full time or enrolled in school full time to utilize this benefit.
– Eligible expenses include: preschool, nursery school, after school care.
– Ineligible expenses include: activity fees, field trips, clothing, food, entertainment, Kindergarten, overnight camps, sports lessons, transportation, or private school tuition.
Flexible Dependent Care Spending
Account
February 2010 31APRIL 2010
Accidental Death & Dismemberment Plan – MetLife
MetLife AD&D offers :
– Up to 10x AD&D coverage, up to $2 million
– If you are age 75 but less than 80, the value of your coverage is reduced to 50%
Accidental Death & Dismemberment
– Payable on death or injury due to a covered accident.
– Be sure to designate your beneficiaries!
Premiums are based on employee’s age and salary
AD&D – Met Life
February 2010 32APRIL 2010
Annual Enrollment
Visit www.gabreeze.ga.gov to enroll in your benefits today!
For assistance with the Georgia Breeze website or flexible benefits enrollment, contact the Georgia Breeze call center at 1-877-342-7339.
Print your confirmation page when you have completed your elections!
– You may change your elections as many times as you wish during open enrollment.
– The choices remaining in the system on November 4th will be yours for all of 2017!
If you complete your enrollment verbally with a Georgia Breeze associate, document the name of the representative, date, and time of the call.
Flexible Benefits Enrollment thru
Georgia Breeze
February 2010 33APRIL 2010
Thank
You!
