Open Enrollment

Plan Year 2008

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Today’s Agenda

• Open Enrollment• Health Care• Web Enrollment :Health• Health Contributions• Employee Resources• Wellness• Dental

• Flexible Spending Account (FSA)

• Health Reimbursement Account (HRA)

• FSA vs. HRA• Web Enrollment:

FSA/HRA• $50 Benefit Allowance

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2008 Open Enrollment

• 2007 Health Insurance Open Enrollment- October 15th-26th

• Passive enrollment– KCTCS employees MUST enroll if they:

• Wish to change their current coverage• Wish to add or drop dependents

– KCTCS Employees should have already received a letter at home with

• State Benefit Fair information• Employee ID & Password for web enrollment

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2008 Open Enrollment• KCTCS Open Enrollment

– KCTCS employees MUST enroll if they:• Wish to enroll in Flexible Spending Account

(FSA)• Wish to enroll in the Health Reimbursement

Account (HRA) for health waivers• Wish to enroll in the $50 Benefit Allowance• Wish to change their Dental coverage

including adding or dropping dependents

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2008 Open Enrollment

• There are no health benefit changes for Plan Year 2008

• Same four plans available: – Please see the 2008 Plan year KEHP Handbook for further

details

• All 4 plans contain the same covered services, exclusions and limitations– Benefit payment levels and premiums will differ

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Health Insurance Plan Selections

• The Kentucky Employees Health Plan (KEHP) contains the same 3 Preferred Provider Organization (PPO) Options and a High Deductible Health Plan (HDHP) with an embedded HRA that are currently offered in 2007

• Commonwealth Essential (PPO)• Commonwealth Enhanced (PPO)• Commonwealth Premier (PPO)• Commonwealth Select (HDHP)

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UCR/Eligible Expense• Expenses used to satisfy the deductible and co-insurance

limit for Preferred Provider Organizations (PPO), including the Commonwealth Select Plan, are the UCR and/or eligible expenses for that particular service

• Usual, Customary and Reasonable (UCR)/Eligible Expense– A providers’ fee which

• Is the provider’s usual charge for a given service under the covered plan

• Is within the range of fees charged by providers of similar training and experience for the same or similar service or supply within the same or similar limited geographical area

• Does not exceed the fee schedule developed by the insurance carrier or TPA (Humana)

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2008 Open Enrollment

• Employees hired during or after OE:– MUST complete two health applications, UNLESS

they want their “New Employee” elections to roll to the 2008 Plan Year

– MUST complete HRA applications for the remainder of 2007 and a new one for 2008 if they waive health coverage or enroll in a FSA 2007 and wish to enroll in a FSA for PY 2008

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2008 Open EnrollmentPlan Year 2008 will NOTNOT be a total health

re-enrollment. • Employees wishing to make changes

may – Web enroll, or– Complete paper application– Paper applications will be included

in the handbook or available on the DEI web-site

• Employees wishing to keep same coverage and elections for health coverage and/or waiver, DO NOT DO NOT NEED TO RE-ENROLLNEED TO RE-ENROLL

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2008 Open Enrollment• Open Enrollment is October 15-26, 2007October 15-26, 2007

• For Active employees, COBRA participants and Early Retirees (under age 65)

• Employee must be in GHI ( group health insurance) system by October 5, 2007 October 5, 2007 to be eligible to web enroll, if not they must complete paper application

• Paper application must be signed by 10/26/0710/26/07• Paper application or web confirmation web confirmation must be

turned into college Human Resources Department

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ReminderDependent Coverage: • Dependents Turning 24 during 2008

– Not eligible to be enrolled for 2008 – Enrollment will end 12/31/07– Applicable dependents will be eligible for

continuation through COBRA; will automatically receive notice

– If dependent drop results in eligibility for single coverage, coverage will be changed automatically

• Any new forms required ($50 benefit, FSA) from this change must be completed

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Web Enrollment: Health Insurance

Web EnrollmentWhat is it?• Using the internet to make health

insurance elections– May enroll from work or from public

access

• Web-site for health insurance access:– www.openenroll.ky.gov/

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Web Enrollment: Health Insurance

Web Enrollment• Who can enroll on the internet?

– Anyone who is a plan-holder in the GHI system by October 5, 2007

• Employees not eligible to enroll on the internet are:– New hires– KRS, KTRS and KCTCS 403(b) retirees– Employee cross-referencing with KRS or KTRS retiree– Spouse or children of retirees who are not actually the

retiree– Cross-referenced employees who want to switch

primary plan-holders for 2008

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Web Enrollment: Health Insurance

Web Enrollment – Cross Reference

• If you are currently cross-referenced and do not wish to change your plan, level of coverage or primary policyholder, you will not need to web enroll. Your coverage will remain the same

• You cannot change the primary policy holder through the web, you will have to complete a paper application

• If you wish to begin cross reference, you may do so on the web as long as you have your password and your spouse’s password

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Web Enrollment: Health Insurance

• Your KEHP Online Access will be available for fast, accurate and secure enrollment!

• Employees will need EmpID & Password to log in – EmpIDs were mailed during the first week of

September

– Passwords were mailed during the last week of

September

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Web Enrollment: Health Insurance

Web EnrollmentConfirmation Process:

– Confirmation number will be provided at the end of a correct enrollment

• You will have clicked on “enrollment complete” • You will have reviewed your elections• You will have hit the “Accept” button

– Print confirmation statement and Print confirmation statement and give to your college Human give to your college Human Resources DepartmentResources Department

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Web Enrollment: Health Insurance

• Waivers– If you currently waive you Do NOT Need to Re-If you currently waive you Do NOT Need to Re-

Enroll, election will roll-overEnroll, election will roll-over– If newly waiving for 2008

• Click on “waive” on the main menu• You will You will NOTNOT elect the HRA elect the HRA

– HRA Selection will be through Chard-Snyder

• Print confirmation Print confirmation and give to your college Human Resources Department

• For paper applications, complete section I, Section V, section VIII and give to your college Human Resources Department. DO NOT MARK HRA BOX!DO NOT MARK HRA BOX!

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Waiving Coverage• HRA

– Employees in either the 18A/151B or the KCTCS personnel system who waive their health insurance will receive an employer contribution of $175 per month to direct to a Health Reimbursement Account administered by Chard-Snyder

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KCTCS Health Insurance Employee Contributions

2008 Employee Contributions2008 Employee Contributions

• 18A/151B employees will use the state established employee contributions based upon smoker or non-smoker status. There is an incentive for non-smoking

• KCTCS will offer only one employee contribution schedule which is based upon a 25% reduction of the lower state non-smoking schedule

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Employee Health Contributions: KCTCS personnel system

Plan Single Parent Plus

Couple Family Cross-Ref.

Common. Essential

Not Offered

$46.24 $218.14 $269.10 $0.00

Common. Enhanced

$0.00 $95.82 $300.68 $360.82 $8.18

Common. Premier

$15.30 $143.20 $335.10 $399.06 $27.82

Common.Select

$0.00 $73.70 $226.58 $271.04 $6.14

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Employee Health Contributions: 18A/151B Non-Smoker

Plan Single Parent Plus

Couple Family Cross-Ref.

Common. Essential

Not Offered

$61.64 $290.84 $358.80 $0.00

Common. Enhanced

$0.00 $127.76 $400.90 $481.10 $10.90

Common. Premier

$20.40 $190.94 $446.80 $532.08 $37.08

Common.Select

$0.00 $98.26 $302.10 $361.38 $8.18

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Employee Health Contributions: 18A/151B -Smoker

Plan Single Parent Plus

Couple Family Cross-Ref.

Common. Essential

Not Offered

$95.26 $324.48 $392.42 $16.80

Common. Enhanced

$16.80 $161.38 $434.52 $514.72 $27.70

Common. Premier

$37.20 $224.56 $480.42 $565.70 $53.88

Common.Select

$13.22 $124.12 $327.44 $386.66 $20.88

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Health Insurance: Cross-Referencing

• Cross-referencing will continue to be an option for married employees who are eligible to participate in the Kentucky Employees Health Plan (KEHP)

• For two 18A/151B employees covered under one family health benefit plan, they each will pay the family cross reference rate reflected in the contribution schedule for state employees

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Health Insurance: Cross-Referencing

• For two KCTCS employees covered under one family health benefit plan, they each will pay the family cross reference rate reflected in the contribution schedule for the KCTCS Personnel System

• For a KCTCS employee who cross-references with their spouse employed by another state agency, they each will pay the family cross reference rate reflected in their respective contribution schedule

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Reminder:Double Dipping

• KRS 18A.225 (13)– “Any employee who is eligible for and elects to

participate in the state health insurance program as a retiree, or the spouse or beneficiary of a retiree, under any one (1) of the state-sponsored retirement systems shall not be eligible not be eligible to receive the state health insurance contribution toward health care coverage as a result of any other employment for which there is a public employer contribution. This does not preclude a retiree and an active employee spouse from using both contributions to the extent needed for purchase of one (1) state sponsored health insurance policy for that plan year.”

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Reminder:Double Dipping

KTRS Retiree• KTRS Retirees that have returned to active

employment MUST MUST select coverage through the active employer (KCTCS)

KERS Retiree• KRS retirees that have returned to active

employment have the option to select coverage either either through KRS or the active employer (KCTCS)

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Major Considerations for Health Plan Selection

• Employee and dependents projected medical expenses– Plan deductibles– Out-of-pocket maximums– Prescription Drugs

• Employee Premium contribution– Pre-tax consideration

• You can go on your “MyHumana” web-site and use their Decision Tools

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Employee Resources: MyHumana

• MyHumana helps you find information you need, 24 hours a day, 7 days a week

• Contains a myriad of resources

• Easy access through kyhealthplan.humana.com

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KEHP Wellness Programs

A variety of programs exist for participants in the KEHP• Smoking Cessation

• Cooper Clayton

• Kentucky Tobacco Quit Line

• Maternity Program

• Personal Health Assessment (PHA)

• Why Weight Kentucky

• Informed Care Management

Further information can be found in the KEHP 2008 booklet, on the Humana KEHP web-site (www.kyhealthplan.humana.com) and on the KEHP web-site http://www.personnel.ky.gov/benefits/dei/08planyear/

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Dental Open Enrollment• Dental open enrollment is October 15- October 26, 2007• Dental choices:

– Dental Care Plus – Delta Dental– Compdent– HealthResources

• Dental coverage will “rollover” from 2007 to 2008• If you wish to add or drop family members or change

carriers you will need to complete a new dental application• To cancel dental coverage, employee must fill out dental

application and write “Cancel Coverage Effective 1-1-08”

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Dental Open Enrollment

Reminder:• If your covered dependent is over age 19,

you will need to submit a proof of student status to the dental carrier before claims are paid.

• Dependents are not covered over the age of 23. They will automatically be dropped from the plan. You will need to notify your college Human Resources Office when this occurs.

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Flexible Spending Accounts (FSA)

• Federal regulations require that employees that wish to enroll in a FSA do so every year

• Re-enrollment is necessary to participate in a FSA account either with employee contributions or employer contributions due to the $50 Benefit

• The carrier for 2008 will continue to be Chard Snyder and Associates

• There are two kinds of FSA’s– Health Care Spending Account for medical expenses:

• Minimum $ 5 per paycheck( including $50 benefit); total annual maximum : $ 5,004 ($208.50 per paycheck)

– Dependent Day Care Account for Dependent care expenses

• Minimum $ 5 per paycheck; total annual maximum $4,992Please refer to the FSA booklet for further information

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Flexible Spending Account“Grace Period”

• Use left over money from 2007 plan year until March 15, 2008– (applies to KCTCS personnel system employees only)

• Will also apply to 2008 Plan Year (2 ½ monthly grace period will be January 1 – March 15, 2009)– Will apply to all enrolled employees regardless of

personnel system

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Flexible Spending Account“Grace Period” Illustration

• Jan 1 – March 15 continue to incur claims during this period (may choose bucket of money)

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January 1, 2007

Allocated $1,200 for Healthcare Spending Account

October 16 – October 27, 2007

Allocated $1,000 for 2008 Plan Year Healthcare Spending Account

December 31, 2007

$300 remaining in Healthcare Spending Account for 2007

January 1, 2008

Total of $1,300 in Healthcare Spending Account for 2008 ($300 must be used by March 15)

March. 15, 2008

Flexible Spending Account“Grace Period”

Reminder– You may use your FSA Benny Prepaid Benefits

card for grace period expenses. The Reimbursements will automatically be applied to the correct year

– Or, you may also pay for these expenses and then file for reimbursement from Chard-Snyder by mail or fax

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HRATwo Separate Health Reimbursement

Accounts

• Embedded HRA– Offered in conjunction with Commonwealth Select– Funded with employer money only– Administered by Humana and the DEI

• Stand alone HRA– Available only to employees who waive health insurance– Funded with employer money only– Administered by Chard-Snyder

(Humana materials may refer to an HRA as a Personal Care Account (PCA)(PCA)

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FSA vs. HRAFSA HRA

(for waivers only)Commonwealth Select

(High Deductible Health Plan with HRA)

Can be Funded by Employee and Employer Money

Funded by Employer Only Money ($175 per month)

Employer Funds HRASingle - $1,000Couple - $1,500Parent Plus - $1,500Family - $2,000

Dental and Vision Reimbursed

Dental and Vision Reimbursed

Dental and Vision Reimbursed (does not count toward deductible or out-of-pocket maximum)

Use it or Lose it-Balance is forfeited

Carry Over if you remain in the same plan

Carry Over if you remain in the same plan

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FSA vs. HRA• In addition to the HRA, an employee may fund a

Health Care FSA to reimburse unpaid qualified medical expenses (ex: Deductible, Copays, Co-insurance, Dental, Vision, etc.)– May fund with employee contributions– If waiving or have single health coverage, may use all or part

of the $50 Benefit for funding

• For Commonwealth Select plan participants, when using your HRA, only plan covered only plan covered expenses expenses will count towards the plan deductible and out-of-pocket maximum (Excludes: Dental, Vision, Over the Counter Medications)

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FSA vs. HRA• If you have both a Health Care Flexible Spending Account

(FSA) and a Health Reimbursement Account (HRA), reimbursement will come from your FSA account balance first.– The FSA balance is forfeited at the end of the plan year

(12/31/07) and 2 ½ month grace period (3/15/08).– The HRA balance will roll-over from year to year as long

as you remain a waiver or enrolled in the Commonwealth Select plan.

• Will not roll-over if you change your plan selection.NOTE: If you use the Benny PrePaid Benefits Card from NOTE: If you use the Benny PrePaid Benefits Card from

Chard-Snyder, reimbursements will automatically be Chard-Snyder, reimbursements will automatically be from your FSA first until that annual election amount from your FSA first until that annual election amount is depleted. Then, reimbursement will be from your is depleted. Then, reimbursement will be from your HRAHRA.

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Using Benny PrePaid Benefits Card for HRA at Pharmacies –

“Waivers” Only

• If employee is covered under spouse’s health plan, they would use that health insurance card first.

• Employee would then use Chard-Snyder Benny card for any copay or coinsurance amounts due

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Save your receipts: HRA Reimbursed Expenses

• It is important to save all itemized receipts– The IRS requires proof (substantiation) that expenses are qualified

under your plan’s benefits– For the Commonwealth Select plan -Humana automatically verifies

transactions, in most cases, as they occur. However, Humana may ask members to submit receipts for verification of an expense

– For Waivers, Chard-Snyder automatically verifies transactions, in most cases, as they occur. However, Chard-Snyder may ask members to submit receipts for verification of an expense

– Always save all receipts and explanation of benefits (EOB) in case you are contacted to verify an expense that could not be matched automatically

– If a refund is needed:• Card should be credited by the provider• If providers refund the member directly the member will be

required to refund the card (per IRS guidelines)

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Web Enrollment: FSA

Flexible Spending Account: FSA Coverage

• KCTCS employees will NOTNOT be able to web-enroll for FSA coverage through the DEI DEI WebsiteWebsite– A message will appear that states that KCTCS is

non-participating and to contact the Insurance Coordinator

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Web Enrollment: FSAFSA Coverage:

• FSA Enrollment is a separate process. KCTCS employees will be able to web-enroll for FSA Coverage through the Chard-Snyder Website at www.chard-snyder.com– If employees are currently enrolled in FSA, they

will use their current password to web-enroll– Detailed instructions will be available in the

Chard-Snyder material available for distribution– You will be able to sign up for your employee

health care and/or dependent care elections and any $50 Benefit allocations

NOTE: If you are signing up for both a FSA and a NOTE: If you are signing up for both a FSA and a HRA, you will be able to do both through the same HRA, you will be able to do both through the same screenscreen

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Web Enrollment: HRA

HRA Coverage:• HRA Enrollment is a separate process. KCTCS

employees will be able to web-enroll for HRA Coverage through the Chard-Snyder Website at www.chard-snyder.com– If employees are currently enrolled in FSA, they

will use their current password to web-enroll– Detailed instructions will be available in the

Chard-Snyder material available for distributionNOTE: If you are signing up for both a FSA and a NOTE: If you are signing up for both a FSA and a

HRA, you will be able to do both through the same HRA, you will be able to do both through the same screenscreen

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$50 Benefit Allowance• Eligibility is open to KCTCS personnel system regular, full-

time employees who are enrolled in single healthcare coverage or who have waived healthcare coverage.

• You may use the $50 monthly benefit by electing coverage:– To pay for health insurance– To pay for dental insurance– To be placed in Healthcare FSA (FSA form must be

completed)– To purchase voluntary supplemental benefit– You mustmust complete a new $50 Benefit Enrollment Form

to participate in 2008– You may not not use this benefit to purchase Group Life

Insurance or Supplemental Long Term Disability

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2008 Insurance/Benefit CARDS

Health Insurance and Prescription Drugs• If you do not switch coverage, you will continue to use your current

Humana ID card• If you switch to the Commonwealth Select Plan, you will receive a

Health ID card and a HumanaAccess visa cardDental

• You will only receive a new ID card if you change coverageWaivers

• You will receive a Chard-Snyder Benny PrePaid Benefits card for your HRA if you are a new enrollee,

• If you have a 2007 HRA and Benny card, your new 2008 election will be loaded onto it

FSA• You will only receive a Benny Prepaid if you are a new enrollee• If you have a 2007 FSA and Benny card, your new 2008 election will

be loaded onto it

If you have both a HRA and a FSA, you will use the same Benny card

*

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For Active Employees Age 65 and Older

The KCTCS Health Plan is considered primary over Medicare

You do not need to sign up for Medicare Part “B” until you cease employment. You will then enroll for this coverage under a “Special Enrollment Period”

The prescription drug plan offered through the KEHP is considered “Creditable Coverage”. You do NOTNOT need to sign up for a Medicare part “D” plan

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Contacts:

KCTCS System OfficeEmployee Benefits300 North Main StreetVersailles, KY 40383

Phone: 859-256-3100Fax: 859-256-3119

Department for Employee Insurance (DEI) Member Services

Phone: 888-581-8834 502-564-6534

Humana Phone: 877-KYSPIRIT 877-597-7474

Express Scripts Phone: 800-KYSPIRIT 877-597-7474

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Deadlines•Open enrollment:

October 15th through October 26th

•Open Enrollment in Peoplesoft:

October 16th through November 2nd

•All paper applications due by:

November 2nd

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