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State Personnel Benefits. Benefit Hotline 317-232-1167 Or 877-248-0007 SPDBenefits@spd.in.gov. Self-Service Benefits. Log in to PeopleSoft Verify your personal information Select your insurance coverage Complete the Non-Tobacco Use Agreement
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State Personnel Benefits Benefit Hotline 317-232-1167 Or 877-248-0007 SPDBenefits@spd.in.gov
Self-Service Benefits • Log in to PeopleSoft • Verify your personal information • Select your insurance coverage • Complete the Non-Tobacco Use Agreement • Print a Payroll Authorization Form (AS-47) and return it to your agency payroll • Print out a Self-Service Benefit Statement
Eligible Dependents • Eligibility information can be found in the Employee Benefits Handbook • Spouse • Children – unmarried natural-, step-, foster-, legally adopted – children, or children who reside in the employee’s home for whom the employee or spouse have been appointed legal guardian • Age Limit – end of the calendar year of 19th birthday, unless they are a full-time student or disabled dependent • If they are a full time student, they are covered until the end of the calendar year of their 23rd birthday
Over-age Dependents For Full-Time Students: Mark the dependent as a full-time student in PeopleSoft You may be asked to provide documentation from the school You may be asked to complete Verification of Full Time Student Status Form For Disabled Dependents: Contact the Benefits Hotline Verification of prior insurance coverage Certification of incapacity prior to age 19 Verification of Dependent Disability Form
Health Insurance Definitions • Premium • The bi-weekly amount that is deducted from your paycheck for your elected health insurance plan • Deductible • A set amount that you pay before your health plan begins to pay co-payments • Out-of-Pocket Maximum • The total amount of money you will have to pay in the year before you qualify for 100% coverage • Premiums do no count toward the Out-of-Pocket Maximum, and you must still pay premiums if you have met the Out-of-Pocket Maximum
Health Insurance Options • Anthem High Deductible Health Plan I • Anthem High Deductible Health Plan II • Anthem Traditional II • Welborn HMO
What is a High Deductible Health Plan? • HDHP is a traditional health insurance plan that provides broad coverage for a wide range of services AFTER the deductible has been met. The deductible is considerably higher than the state’s Traditional II plan. • The HDHP requires you to pay little or no premium, but you will have to pay the deductible when you need services. • Once the deductible has been met, the coinsurance begins. Anthem covers 80% and the employee covers 20% of the cost, for in-network services.
Health Savings Account • Health Savings Account- is a special bank account for your health expenses. Contributions to the account remain tax free so long as the money in the account is used only to pay for eligible health expenses. The account- and everything in it- is yours to keep. • The account is exclusive to those enrolled in a High Deductible Health Plan. • The state makes an initial & bi-weekly contribution to your health savings account.
HDHP: How does it work (prior to meeting the deductible) Seeing an in-network physician • As an enrollee you will have an Anthem ID card • Present your Anthem ID card when you go to the doctor • Usually you will not pay at the time of service • Your doctor’s office will file a claim
HDHP: How does it work (prior to meeting the deductible) • You and your doctor both will receive from Anthem a paper called an “Explanation of Benefit” showing your cost- network discounts are applied • Your provider sends you a bill • You pay network cost of service from HSA or other funds.
HDHP: How does it work? Filling a prescription at a pharmacy • Present your Anthem card at network pharmacy • Pay the full network adjusted amount from your HSA or with other funds • Shop around • Ask for generics • If deductible met, pay co-insurance- anywhere from 10% to 40% depending on drug
HDHP: Preventative Services • Preventative services are covered in full before the deductible is met. • Preventative services include immunizations, annual physicals, flu shots, annual pap smears and diagnostic services performed with the annual physical. Well baby visits are also included
Health Savings Account • State Contribution • Pre-funded HSA (Paid to employee on their first HSA eligible check) • HDHP 1 • Single: Initial Contribution - $687.96, $26.46 bi-weekly • Family: Initial Contribution - $1375.14, $52.89 bi-weekly • HDHP 2 • Single: Initial Contribution - $468.00, $18.00 bi-weekly • Family: Initial Contribution - $935.22, $35.97 bi-weekly • Annual Maximum Contribution • Single $3000 • Family $5950 • $1,000 catch-up contribution for employees age 55 and over • Tower Bank • www.towerbank.net
Health Savings Account • Funds rollover from year to year • Employee contribution is optional, not mandatory • Employee contribution can be changed at anytime during the year • Restrictions on who qualifies to have a health savings account • Waiting period before contributions begin
HDHP 1 • Bi-weekly premium • Single $0.00 • Family $0.00 • Deductible • Single $2500 • Family $5000 • Out of Pocket Maximum • Single $4000 • Family $8000
HDHP 2 • Bi-weekly premium • Single $19.32 • Family $47.58 • Deductible • Single $1700 • Family $3400 • Out of Pocket Maximum • Single $2400 • Family $4800
Traditional 2 • Bi-weekly premium • Single $62.73 • Family $184.86 • Deductible • Single $500 • Family $500 • Out of Pocket Maximum • Single $2000 • Family $4000
Welborn HMO- available to those who work or live in Daviess, Dubois, Gibson, Knox, Perry, Pike, Posey, Spencer, Vanderburgh, and Warrick counties • Bi-weekly premium • Single $33.03 • Family $91.47 • Deductible • Single $500 • Family $500 • Out of Pocket Maximum • Single $2000 • Family $4000
Dental & Vision • Delta Dental • No employee premium • Diagnostic and Preventative services covered at 100% (includes exams, cleanings and fluoride treatments for children up to age 14) • EyeMed Vision • Premium • Single $0.00 • Family $2.43
Insurance Cards and Information • Anthem • Cards will come in the mail • www.anthem.com • Search for a Provider • Blue Access PPO plan • Welborn • Cards will come in the mail • www.welbornhealthplans.com • Search for a provider
Insurance Cards and Information • Delta Dental • Delta Dental PPO & Delta Dental Premier • www.deltadentalin.com • Eye Med Vision • Cards will come in the mail • Access Network • www.eyemedvisioncare.com
Insurance Cards and Information • Towerbank • Go to http://hsa.towerbank.net • Enter State of Indiana Employer Code • 100366 • Choose to receive a debit card and/or checks • Key Benefit Administrators • Debit Card will come in the mail
Flexible Spending Accounts • Medical Flexible Spending • Money for reimbursable medical expenses • $5000 annual maximum contribution • $2.59 bi-weekly administration fee • Money in Flexible Spending Account cannot be used to help cover deductible expenses • Dependent Care Spending • Dependent day care eligible expenses include expenses necessary for you and your spouse (if married) to be gainfully employed or attend school. • $5000 annual maximum contribution • $2.59 bi-weekly administration fee
How do the Health Savings Account and Flexible Spending Account work together? • If you are enrolled in the Medical Flexible Spending Account and the Health Savings Account then there are restrictions as to what they can be used for. • Limited Scope FSA: • dental • vision • health expenses after your deductible has been met
Basic Life and AD&D Insurance • Insurance coverage is equal to your annual salary rounded up to the next $1000 multiplied by 150% • Make sure to designate at least 1 beneficiary
Supplemental Life Insurance • You must first elect Basic Life Insurance before you can elect Supplemental Life Insurance • You can elect Supplemental Life Insurance in $10,000 increments up to a maximum of $150,000 • Make sure to designate at least 1 beneficiary • If you wish to increase coverage level after the initial enrollment period, you must go through Evidence of Insurability
Dependent Life Insurance • Options • Spouse Only • $5,000, $10,000 & $15,000 • Child Only • $5,000, $10,000 & $15,000 • Spouse and Child • $5,000, $10,000 & $15,000 • You must first elect Basic and Supplemental Life insurance in order to elect Dependent Life Insurance • If you wish to increase coverage level after the initial enrollment period, you must go through Evidence of Insurability
Non-Tobacco Use Agreement • In exchange for a $500 reduction in the Health Plan deductible, the employee agrees to: • Not use any tobacco products during 2009 • Be subject to nicotine testing • Be subject to the full deductible if they fail to honor the agreement • Be subject to discipline, up to and including termination if they fail to honor the agreement
Family Status Changes • Must call and notify the Benefit Hotline of your qualifying event within 30 days of the event • Qualifying events include, but are not limited to: • Marriage, Divorce, Birth, Adoption, Loss of Coverage, and Death of a dependent • Documentation must be submitted within 30 days of notification
Disability Plan • JWF Specialty Company • Third party administrator of State’s Disability Plan • Short term and long term disability • Eligibility • Full time employees with 6 continuous months of employment
Disability Plan • Short term • Benefits are payable the first pay period following a 30 day elimination period for a maximum of 5 months • Long term disability • If continuously disabled for 6 months, an employee may be moved to long term disability.
One Care Street • Voluntary program that functions to help identify existing or potential health concerns and provide the tools necessary to improve how you feel. • Available to all employees who participate in the State sponsored health insurance programs and the employee’s spouse, if covered. • If you are eligible to participate in One Care Street for next year, you will receive a letter that contains information on how to proceed. • Anyone that completes all participation requirements will receive a cash incentive.
EASY-Employee Assistance Program • Voluntary and Confidential • Telephone counseling, crisis assistance, legal and financial referrals and care resources are available 24 hours a day, 365 days a year. • Contact the EASY Program at (800) 223-7723 or visit AnthemEAP.com
COBRA • Initial Cobra Notification • Please sign and date the Acceptance of COBRA Initial Notification • This notice outlines covered participants potential future options and notification obligations should you ever lose your health insurance in the future for certain reasons.
BenefitInformation • Benefit Hotline • 317-232-1167 or toll free at 1-877-248-0007 • Benefit Website • http://www.in.gov/spd/2337.htm • Benefit Email • SPDBenefits@spd.in.gov • Questions????