Open Enrollment 2015

Employee Benefits

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Faith HitesSenior Account Manager, Group

BenefitsRaffa Financial Services, Inc.

Brady J. FosterBroker, Group BenefitsHMBS Group Insurance, LLC.

Moderator

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Open Enrollment Means… You may enroll in coverage

You may add or drop dependents

You may change benefit plans – Medical, Dental, Vision

You must elect new contributions or decline participation with the Flexible Spending Accounts (FSA) - Medical Expense and Dependent Care Plans by completing the paper enrollment form

You must re-elect your taxation choice on your Short and Long-Term Disability benefits by completing the paper tax election form

Open Enrollment

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Important Information

Open enrollment begins December 10th, 2014

All Open Enrollment elections must be made by December 19th, 2014 – No Exceptions!

Medical, Dental, and Vision Open Enrollment elections are completed online through Benefit Mall. (Instructions to log into Benefit Mall are available in your open enrollment packet)

If no changes are to be made to your Medical, Dental, and Vision benefits, your benefits from 2014 will automatically renew in 2015; however, please log into Benefit Mall to review your current benefits so that you can be sure of the benefits you have!

Paper forms will be provided for the FSA (Medical & Dependent care) election, your HRA Medical Reimbursement Acknowledgement, and your STD / LTD taxation election. These forms must be filled out and returned to Human Resources during Open Enrollment.

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Discussion Topics…

CareFirst Medical Plans (POS & PPO)

HRA Debit Card, Prescription & Vision Plans

Guardian Dental Plans

Guardian Standard Plans (Life & Disability)

Flexible Spending Accounts (Medical & Dependent Care)

Benefit Review

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CareFirst Health Plan options for Local and Out-of-Area Employees…

Option 1: Healthy Blue Advantage POS

Option 2: Blue Preferred PPO

Medical Plan Options and Pricing

Participants (1) Healthy BluePOS

(2) Blue PreferredPPO

Employee $166.40 $270.40

Employee & Child(ren)

$351.00 $512.20

Employee & Spouse

$436.80 $634.40

Family $507.00 $741.00

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• All premiums are shown as monthly employee costs.• To find your bi-monthly premium cost, divide the above amount by 2.

CareFirst Open Access POS – All Employees

Medical Benefit Healthy Blue Advantage POSAll are HRA Plans In - Network Out of Network

Deductible (Individual) $1,000 $2,000

Deductible (Family) $2,000 $4,000

Co-Insurance 100% 100%

Out-Of Pocket Maximum $2,000 / $4,000 $4,000 / $8,000

Maximum Benefit Unlimited Unlimited

Inpatient Hospital Ded then $300 facility Ded -$50 doctor/$500 facility

Outpatient Services Ded -$100 doctor/$300 facility Ded -$50 doctor/$500 facility

Lab & X-Ray 100% Ded then $50 co-pay

Emergency Room $200 copay then 100% $200 co-pay then 100%

Primary Care Physician 100% Ded then $50 copay

Specialist $30 copay then 100% Ded then $50 copay

Preventative Care (PCP) 100% Ded then $50 copay

Child Wellness 100% Ded then 100%

Prescription Drugs $15/$35/$60 $15/$35/$60

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CareFirst Healthy Blue Advantage POS

A Primary Care Physician (PCP) must be selected; however, you DO

NOT need a referral to see a Specialist. Instructions on how to find a

doctor can be found in your open enrollment package.

Your HRA debit card is funded to cover your in-network

deductible only.

All copays are the responsibility of the employee.

Full deductible vs copay costs are detailed in your open enrollment

packet.

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CareFirst Blue Pref. PPO – All Employees

Medical Benefit Blue Preferred PPOAll are HRA Plans In - Network Out of Network

Deductible (Individual) $2,000 $4,000

Deductible (Family) $4,000 $8,000

Co-Insurance 100% 80%

Out-Of Pocket Maximum $6,350 / $12,700 $15,000 / $15,000

Maximum Benefit Unlimited Unlimited

Inpatient Hospital Ded then 100% Ded then 80%

Outpatient Services Ded then 100% Ded then 80%

Lab & X-Ray Ded then 100% Ded then 80%

Emergency Room Ded then 100% Ded then 100%

Primary Care Physician $20 copay then 100% Ded then 80%

Specialist $20 copay then 100% Ded then 80%

Preventative Care (PCP) 100% Ded then 80%

Child Wellness 100% 100%

Prescription Drugs $15/$35/$60 $15/$35/$60

CareFirst – Blue Rewards Program

Blue Rewards can be earned towards the deductible or other out of

pocket costs for both of your medical plans.

4 Steps:

Step 1: Select a PCP who participates in CareFirst’s PCMH

Program

Step 2: Agree to receive wellness related communications

electronically

Step 3: Complete the Online Health assessment

Step 4: Schedule an appointment with your PCP and complete the

health and wellness evaluation form with them

Additional information can be found in your open enrollment packet.

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CareFirst Network Access

Local POS plan is part of the Regional CareFirst Blue Choice

Network (you must use this network locally!) – Local includes DC,

MD, and Northern VA (except for Dahlgren)

Out-of-Area POS plan is part of the National Blue Preferred / Blue

Card Network. All out of area employees may utilize the same

network of doctors for both the POS & PPO plans.

All Local PPO and Out-of-Area PPO employees are eligible to use

the National Blue Preferred / Blue Card Network.

POS Networks

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PPO Networks

CareFirst PPO Health Plan

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The PPO is part of the National Blue Preferred / Blue Card Network. This means you are eligible to use any Blue Cross Blue Shield doctor from their nationwide network without a referral.

Your HRA debit card is funded to cover half of your in-network deductible only.

In-Network Primary Care Physician and Specialist Services require a $20 Copay before services are covered at 100%

Out-of-Network Primary Care Physician and Specialist Services require the deductible to be met before services are covered at 80%

After you meet your deductible, the PPO plan covers all other in-network medical expenses at 100% and out-of-network medical expenses at 80% except for emergency services which are covered 100% after the deductible is met.

Full plan details are included your open enrollment packet.

All CareFirst BCBS Health Plans are HRA plans

CareFirst Health Plans – HRA Debit Card

BCF management elects to cover $,1000 (Individual) / $2,000 (family)

of the In-Network medical deductible expenses through the HRA debit

card. This card is to be used ONLY for In-Network medical deductible

expenses!

$ Amount(s) on the HRA debit card for your Medical, In-Network

Deductible

$1000 for Individual coverage

$2000 for Family coverage

If an employee or eligible dependent enrolls at a time other than open

enrollment the dollar amount on the HRA debit card is pro-rated and begins

accruing the month they become effective for insurance.

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What can the HRA Debit Card be used for?

CareFirst Health Plans – HRA Debit Card

The HRA debit card can ONLY be used to pay for eligible services

that are subject to the In-Network Medical Deductible, this

includes:

Inpatient and Outpatient hospitalization services and surgeries

Emergency Services - PPO only (Ambulance, Emergency Room,

or Urgent Care)

Lab and X-Ray – PPO only

Mental/Nervous or Substance Abuse hospitalizations

* Please note this is not a complete and comprehensive list.

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CareFirst Health Plans – HRA Debit Card

THE HRA DEBIT CARD CANNOT BE USED FOR:

Vision Care Expenses

Dental Expenses

Any PPO or POS Copays

Prescription Drug Copays

Cosmetic Surgery

Any expense related to co-insurance after the deductible has

been met

* Please note this is not a complete and comprehensive list.

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Prescription Drug Plan

Benefit: $15 Generic Drug copay

$35 Preferred Brand prescription or refill copay

Preferred Brand is designated by CareFirst

$60 Non Preferred Brand prescription or refill copay

Injectables – you pay 50% up to a $100 copay

FAQs: If you choose a Non Preferred Brand name drug and a Generic is available, you

will pay the difference in the cost of the drugs in addition to your copay.

All copay $ amounts are per prescription. All copays are not covered by the HRA

debit card.

Maintenance medications are eligible for the Mail Order Program, where you can

get 3 months of medication for only 2 copays. Forms and information can be

found online at www.carefirst.com

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Plan is Administered by CareFirst and Davis Vision Network = Davis Vision To find a providers, call Davis Vision at (800) 783-5602

or go online and login (create a login if you do not have one) to find a provider at: https://idoc.davisvision.com/davis/member/adv_doc_locate_v2.asp

CareFirst Blue Vision Plus Plan

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Participants Vision Plus

Employee $4.78

Employee & Child(ren) $8.82

Employee & Spouse $10.98

Family $13.60

• All premiums are shown as monthly employee costs.• To find your bi-monthly premium cost, divide the above amount by 2.

CareFirst Blue Vision Plus Plan

Vision Benefits Davis Vision Network

Exam Frequency 1 per 12 Months

Lenses Frequency 1 per 12 Months

Frame Frequency 1 per 12 Months

Copayments Davis Vision Provider Other Provider

Vision Exams $0 copay Plan Reimburses $45

Lenses (Single Vision) $0 copay Plan Reimburses $52 - $101

depending on lens type

Lenses (Bifocals) $0 copay

Lenses (Trifocals) $0 copay

Frames

$0 copay for Tower Collection; Plan

Allowance of $45 for Non-Tower Collection

Plan Reimburses $45

Contacts (Medically Necessary)

$0 copay Plan Reimburses $285

Overview of Vision Benefits…

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Your CareFirst Medical plan does have vision coverage that will cover most vision related needs. You will pay a $10 copay at the time of your visit for an eye exam on both the POS and PPO plans. There are discounts for eyeglasses and contacts.

All eye injuries and eye related diseases are covered through your CareFirst medical plan.

The Vision Plus benefit is for those individuals who need extra vision coverage.

All in-network Vision Plus plan participants receive an annual eye exam, frames (Tower Collection), lens, or medically necessary contacts with no copay. All out-of-network participants will receive a plan reimbursement for eligible vision services as illustrated on the previous page.

CareFirst Blue Vision Plus Plan

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Guardian Dental Plan

Network = PPO / Traditional Preferred

TX and GA employees have state mandated benefits and must enroll in the NAP plan if electing dental benefits

Orthodontia is not covered under either dental plan; however, you may receive a discount if you use an in-network orthodontist

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Participants Guardian Dental

Employee $17.07

Employee & Child(ren)

$39.36

Employee & Spouse $33.24

Family $55.53

• All premiums are shown as monthly employee costs.• To find your bi-monthly premium cost, divide the above amount by 2.

Overview of Dental Benefits…

Guardian Dental Plan – Non TX or GA

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Guardian Guardian PPO VALUE Plan

In - Network Out-of-Network

Deductible (Individual) $50 Combined

Deductible (Family) $150 Combined

Preventive Care100% (No Deductible)

100% (No Deductible)

Basic Services100% After Deductible

100% After Deductible

Major Services 60% After Deductible 60% After Deductible

Annual Maximum $2,500 with Rollover

Overview of Dental Benefits…

Guardian Dental Plan – TX and GA

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Guardian Guardian PPO NAP Plan (90% UCR)

In-Network Out-of-Network

Deductible (Individual) $50 Combined

Deductible (Family) $150 Combined

Preventive Care 100% (No Deductible) 100% (No Deductible)

Basic Services 80% After Deductible 80% After Deductible

Major Services 50% After Deductible 50% After Deductible

Annual Maximum $2,500 with Rollover

*Due to state mandates all TX and GA employees must enroll in this plan if electing dental benefits*

Ancillary Benefits (Employer Paid)…

• Group Short-Term Disability (STD) Insurance

• Group Long-Term Disability (LTD) Insurance

• Group Term Life Insurance

• Employee Assistance Program (refer to the BCF website for additional information

• On Call Travel Assistance (refer to the BCF website for additional information)

Guardian Standard Benefits

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Waiting Period (0 Days Accident/7 Days Sickness)

Benefit Percentage (60% of covered weekly earnings)

Duration of Benefits (up to 13 weeks)

Benefit Weekly Maximum ($1,500)

You must re-elect your taxation choice on your Short-Term Disability benefits by completing the paper form

Tax Choice Option – Payment on Premium or Benefit

Short-Term Disability (STD) Insurance

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Waiting Period (90 days) - LTD is continuation of STD benefits. The STD benefit period satisfies this waiting period.

Benefit Percentage (60% of covered monthly earnings)

Benefit Monthly Maximum is ($7,500)

Duration of Benefits to Age 65 / Social Security Normal Retirement Age (SSNRA)

You must re-elect your taxation choice on your Long-Term Disability Benefits by completing the paper form

Tax Choice Option– Payment on Premium or Benefit

Long-Term Disability Insurance

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Procedure

Employees seeking to use BCF’s disability insurance are required to provide notice to their Supervisor of the need to utilize their STD or LTD benefits. Employee requests are submitted via the BCF Leave Request Form (located on the BCF Website).

To receive disability benefits, a claim form must be submitted. The STD Claim Form can be found on the BCF website. Please return this form to Human Resources (HR) as soon as possible.  Supervisors will forward the completed Leave Request Form to HR. If an employee is uncomfortable discussing or providing information on a medical condition, the employee may contact HR directly. In this case, HR will notify the Supervisor and inform them of the request and decision. Every effort will be made to maintain employee privacy regarding the medical condition.

Disability Insurance

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Two (2) Times Annual Salary

Maximum Benefit Without Medical Questionnaire

In the event that something should happen to you, your beneficiary will need to contact your direct manager who will start the claims process with the Human Resources.

Guardian Group Life Insurance

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Class I - Regular Benefit Class II - Tax Relief Benefit

2 x salary up to $200,000 2 x up to $50,000. Employees who elect Class II do so to avoid paying tax on the amount over $50,000

EAP Services are available to all employees!

Employee Assistance Program (EAP)

The EAP is a voluntary and confidential service that provides professional counseling and referral services designed to help you and your family members with personal, work-life or family related challenges.

The EAP can help you and your dependents identify, resolve and gain control over personal issues that may be interfering with work and daily life.

Information on how to access this benefit is included with the open enrollment paperwork.

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HRA Debit Card vs. FSA

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Health Reimbursement Account (HRA Debit Card)

Flexible Spending Account (FSA)

Moneys are contributed by BCF management

Moneys are contributed by employees on a pre-tax basis

Funds are to be used ONLY to cover in-network eligible medical

deductible expenses

Funds can be used to cover any eligible medical, dental, or

vision expense

In the past, there has been confusion regarding the HRA vs. FSA. Please note, these are two different

accounts. The main differences are listed below.

Pre-Tax Contributions for Eligible Out-of-Pocket Medical expenses…

FSA – Medical Expenses

Up to $2,550 can be set aside to pay for eligible medical expenses for plan year 2015

You are allowed to change the $ of your FSA contribution within 30-days of a qualified event

Full amount elected can be accessed immediately

An FSA can be used to pay for eligible medical, dental, vision, or prescription expenses

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Pre-Tax Contributions for Eligible Dependent Care Expenses…

FSA - Dependent Care Account

Up to $5,000 can be set aside to pay for eligible Dependent Care expenses for plan year 2015

Expenses are reimbursable as contributions become available through your payroll deductions. The reimbursement form is located on the BCF website.

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Reminder - Important Information

All Open Enrollment Elections must be made by December 19th, 2014 – No Exceptions!

Medical, Dental, and Vision Open Enrollment Elections are completed online through Benefit Mall. Instructions to log into Benefit Mall are available in your open enrollment packet.

Forms to be filled out and submitted to Human Resources:• FSA – Medical and Dependent Care • STD / LTD Taxation Election• HRA Medical Reimbursement Acknowledgement

• These forms MUST be returned even if you are not making changes!

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Thank You For Your Participation…

Questions

Who can I call with Additional Questions?

BCF Human Resources Department Triad/S4/RedBlack – Sunita Gupta; 703-994-4340;

Sgupta@bcfsolutions.com Defense & Space/Special Projects – Dina Johns; 703-994-4537;

Djohns@bcfsolutions.com

Angela Fitzpatrick, Raffa Financial ServicesBCF’s Dedicated Customer Service Representative240-403-2546

Brady J. Foster, HMBS Group InsuranceBCF’s Dedicated Insurance Broker949-244-6421, Bfoster@hmbsinsurance.com

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Appendix

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CareFirst – How to Find a Doctor

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Once on www.carefirst.com Click on “Search for Provider by Plan”

CareFirst – How to Find a Doctor

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PPO

POS – Local and Out of Area

Who is an Eligible Dependent

Medical: • Legal Spouse • Domestic Partner (in accordance with

state law)• Dependent child(ren) up to age 26

(marital & student status not a factor)

Dental & Vision: • Legal Spouse • Domestic Partner (in accordance with

state law)• Dependent child(ren) up to age 26

(unmarried and must live with Employee; student status not a factor)

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Additional HRA Card Information

HRA Website: www.125Company.com

How to use the HRA:• Do not use your card at the time of the service

• After your medical service, wait until you receive an Explanation of Benefits (EOB) from CareFirst indicating that the medical service was applied to your deductible.

• Then you can use your HRA Debit Card to pay the provider the amount that the EOB indicates is your deductible.

Deductible expense verification may be requested by 125 Company.

Proof may be upload at www.125Company.com. EOB and/or deductible

receipts are mailed to you from Blue Cross Blue Shield and can also be

found on the CareFirst website.

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Issues Using HRA Card

If you cannot use your HRA debit card for any reason

1. You may file a manual claim when you get the EOB from Blue Shield

Blue Cross. Complete our HRA online claim form on BCF website

and then fax/mail or e-mail/scan the EOB to 125Company for

reimbursement.

2. If your doctor wants payment at the time of service and will not

accept the HRA card, you can pay for it out of pocket and then

submit a reimbursement claim form (form on the BCF website).

Medical Benefits Terminology

Networks

Local includes employees located in VA (excluding Dalgren), DC, & MD

Out-of-Area includes all other BCF employees

In-Network includes doctors participating in the Blue Cross Blue Shield Network

Out-of-Network includes all doctors not participating in the Blue Cross Blue Shield Network

Terms

Deductible the amount an individual must pay for health care expenses before copays & co-insurance begins to cover your medical costs. BCF covers this expense by issuing you an HRA card.

Co-insurance refers to the percentage of money that an individual is required to pay for services, after a deductible has been paid, up to the annual out of pocket max.

Copay a predetermined (flat) fee that an individual pays for health care services. For example, the PPO plan requires a $20 copay for each office visit.

Out-of-Pocket Maximum a predetermined amount that an individual must pay, annually, before health care expenses will be covered at 100% by Blue Cross Blue Shield.

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STD/LTD Benefits Terminology

Tax Choice Option

Payment on Premium you can opt to pay the initial taxes on the premium payments to avoid paying taxes on your disability income benefits once you are receiving them.

Payment on Benefit you will pay taxes on any disability income benefits you receive.

Terms

Waiting Period or Elimination Period the period of time that must lapse from the onset of a disability, before you are eligible to receive weekly or monthly benefits.

Benefit Percentage the amount payable to you, based on a percentage of the your income prior to disability. The proceeds are limited to an overall maximum amount.

Duration of Benefits the amount of time you are able to collect disability income

Benefit Maximums the maximum amount of disability income you are allowed to receive based on your salary at the time of injury. Amounts are paid weekly for STD and monthly for LTD.

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