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2017 Annual Enrollment Info for SHBP & FLEX. Presented by: Beth Findlay Beth.Findlay@dnr.state.ga.us. SHBP Annual Enrollment. AGENDA Annual Enrollment Dates and Miscellaneous Info 2017 Plan Options HMO Plan and Rates HRA Plan and Rates HDHP Plan and Rates
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2017 Annual Enrollment Info for SHBP & FLEX Presented by: Beth Findlay Beth.Findlay@dnr.state.ga.us
SHBP Annual Enrollment • AGENDA • Annual Enrollment Dates and Miscellaneous Info • 2017 Plan Options • HMO Plan and Rates • HRA Plan and Rates • HDHP Plan and Rates • Pharmacy Benefits for BCBSGa and UHC • Enhanced Benefits • 2017 Wellness • Tricare Supplement/PeachCare For Kids • Making your 2017 Election • Contact Information
SHBP Annual Enrollment Annual Enrollment dates are October 17, 2016 through November 4, 2016. The SHBP website (www.mySHBPga.adp.com) will open at 12:00 AM on 10/17/16 and close at 11:59 PM on 11/4/16. You will need to make your 2017 elections online. NOTE: You should not wait until the last minute to make your election as there may be heavy traffic.
SHBP Enrollment Portal Your password expires every 45 days. Login to the SHBP Enrollment Portal to set up your new password. • Login using your current password • If it’s been over 45 days since the last time you logged in, you’ll be prompted to create a new password (which will expire every 45 days) • If you do not know your current User Name or Password: • Click the Forgot User ID? or Forgot Password? from the login page • Links are located to the right of the User Name and Password blocks.
SHBP Annual Enrollment • 2017 Active Employee Decision Guide • Will not be printed, available online at www.dch.georgia.gov/shbp. • The Active Employee Decision Guide is also available on the DNR Intranet at http://dnrnet.dnr.state.ga.us/hr/benefits. • Please read the Decision Guide booklet so you will know what is changing and what effect the changes will have on your benefits, options, rates, etc. before making your election for the 2017 Plan Year.
SHBP Annual Enrollment • You should go online to make your HI selection. You will not be allowed to make a change in the coverage until the next Annual Enrollment period unless you have a qualifying event that allows a change. • You may go online as many times as you like – but the last election confirmed at the time AE closes will be your election for the 2017 Plan Year. • You should print and keep a copy of the confirmation page which will contain a confirmation number. Once AE is closed, you will be able to go online at www.mySHBPga.adp.com and view your 2017 election.
SHBP Annual Enrollment • When making your benefit election, you should: • Make sure you have selected the correct option. • Confirm you have added all eligible dependents for coverage. • Confirm you have answered the Surcharge question correctly. • Click “Confirm” and Print the Confirmation page. • NOTE: You must answer the Surcharge question EACH TIME YOU LOG ON TO THE WEBSITE. • NOTE: The last selection made when the website closes at 11:59 PM on 11/4/16 will be the Plan you are placed in for the 2017 Plan Year.
Plan Vendors and Options BlueCrossBlueShield of GA • Health Maintenance Organization (HMO) • Health Reimbursement Arrangement (HRA) United Healthcare • Health Maintenance Organization (HMO) • High Deductible Health Plan (HDHP) Kaiser Permanente • Health Maintenance Organization (HMO) • Metro Atlanta Service Area/In-Network only plan
Statewide Health Maintenance Organization (HMO) A HMO allows you to receive covered medical services from in-network providers only (except for emergency care.) It is important to verify your current provider is in-network when selecting an HMO Plan Option. If you have remaining well-being incentive credits in your current BCBSGaMyIncentive Account (MIA) or UnitedHealthcare Health Incentive Account (HIA), those credits will roll over to the Plan Option and/or vendor you select during AE. This option is available with Blue Cross Blue Shield of Ga (BCBSGa) and UnitedHealthcare. Plan Features • Plan pays 100% of covered services provided by in-network providers that are properly coded as “preventive care.” • Certain services are subject to a deductible and co-insurance • You are not required to obtain referrals to see a Specialist (SPC), but are encouraged to select a Primary Care Physician (PCP) to help coordinate your care. • The medical and pharmacy out-of-pocket maximums are combined • Co-payments count toward your out-of-pocket maximum • Certain drug costs are waived if SHBP is primary and you actively participate in one of the Disease Management Programs for diabetes, asthma and/or coronary artery disease.
Statewide Health Maintenance Organization (HMO) HRA Prescription costs do not apply to your deductible.
Kaiser Permanente HMO The Kaiser Permanente HMO Plan Option is available to SHBP eligible members who live or work in one of the 27 counties within the defined Metro Atlanta Service Area.* Plan Features • Plan pays 100% of covered services provided by in-network providers that are properly coded as “preventative care.” • KP administers the benefits for medical, pharmacy and wellness • No deductibles • The medical and pharmacy out-of-pocket maximums are combined • Co-payment only option *Metro Atlanta Service Area includes the counties of: Barrow, Bartow, Butts, Carroll, Cherokee, Clayton, Cobb, Coweta, Dawson, DeKalb, Douglas, Fayette, Forsyth, Fulton, Gwinnett, Haralson, Heard, Henry, Lamar, Meriwether, Newton, Paulding, Pickens, Pike, Rockdale, Spalding, Walton
SHBP HMO Rates NOTE: An additional $80.00 will be added to the monthly premium shown above, if you or your covered dependents use Tobacco products.
Health Reimbursement Arrangement (HRA) The HRA provides first-dollar coverage for eligible medical and pharmacy expenses and is funded by SHBP. When going to the doctor, you will not pay a co-payment. Instead, you pay the applicable deductible and co-insurance. If you have remaining credits in your HRA account, those credits will roll over to the Plan Option and/or vendor you select during AE. Plan Features • Plan pays 100% of covered services provided by in-network providers that are properly coded as “preventive care.” You must meet separate in-network and out-of-network deductibles and out-of-pocket maximums. • You are not required to select a Primary Care Physician (PCP) or obtain referrals to a Specialist (SPC) • The credits in your HRA Account are used to help meet your deductibles and out-of-pocket maximums • The medical and pharmacy out-of-pocket maximums are combined • Certain drug costs are waived if SHBP is primary and you actively participate in one of the Disease Management Programs for diabetes, asthma and/or coronary artery disease.
HRA Prescription costs do not apply to your deductible. Pharmacy Benefits are the same across the board regardless of plan option.
SHBP HRA Rates NOTE: An additional $80.00 will be added to the monthly premium shown above, if you or your covered dependents use Tobacco products.
High Deductible Health Plan (HDHP) The HDHP offers in-network and out-of-network benefits and has a low monthly premium. However, you must satisfy a high deductible that applies to all covered medical and pharmacy expenses. (except preventive care.) If you have any dependents, the entire family deductible, does not have to be met before benefits are payable for any family member. Additionally, once the out-of-pocket maximum has been satisfied for that individual family member, all covered medical and pharmacy expenses will be paid at 100% for that family member. Also, you may qualify for a Health Savings Account (HSA) to set aside tax-free dollars to pay for eligible health care expenses. If you have remaining well-being incentive credits in your current HIA wellness account, those credits will roll over to the Plan Option and/or vendor you select during AE. Plan Features • Plan pays 100% of covered services provided by in-network providers that are properly coded as “preventive care.” • Before you can use well-being incentive credits, members must meet a threshold ($1,300 – individual; $2,600 other tiers) • You must meet separate in-network and out-of-network deductibles and out-of-pocket maximums • You pay co-insurance after meeting the deductible for covered medical and pharmacy expenses • The medical and pharmacy out-of-pocket maximums are combined • The HSA cannot be combined with a Flexible Spending Account (FSA) • There are no co-payments
SHBP HDHP Rates NOTE: An additional $80.00 will be added to the monthly premium shown above, if you or your covered dependents use Tobacco products.
Blue Cross Blue Shield of GA and United Healthcare Elections Pharmacy Benefits • Express Scripts administers the prescription drug pharmacy benefits for members who choose BCBSGa and UnitedHealthcare. Express Scripts provides benefits for retail prescription drug products, mail order, home delivery and specialty pharmacy services. • Get up to a 90-day supply of your maintenance medication either through Express Scripts home delivery pharmacy services or at a participating 90-day retail pharmacy. • Express Scripts offers several programs for managing your prescriptions: • The My RX Choices Prescription Savings Program lowers out-of-pocket prescription costs • The Worry-Free Fills Program offers automatic refills for long-term medications and will be automatically shipped to you • The Extended Payment Program extends home delivery payments over three installments
Enhanced Benefits • Telemedicine/Virtual Visits • SHBP will continue to provide access to physicians through telemedicine/virtual visits in 2017 • Face-to-face consultations with physicians will be available 24/7, 365 days a year • Services will be available from home, office or on the go from a computer, tablet or smartphone that has a web camera. • There is a Co-Pay for the BCBSGa and UnitedHealthcare HMO Plan Options, Co-Insurance for the HRA-Gold, Silver and Bronze Plan Options, Co-Insurance subject to Deductible for the UnitedHealthcare HDHP and KP is covered at 100% • Wellness Incentive Credits Rollover Expansion • All unused wellness incentive credits will rollover to both the vendor and plan design you select during AE • These credits will be available in April 2017; this allows for processing of any claims submitted at the end of 2016 to apply credits. • Kaiser members’ credits will rollover to a Kaiser Permanente Rollover Account (KPRA); BCBS and UHC member’s credits will continue to be administered by Healthways. • This means that regardless of the SHBP Plan Option and/or vendor you choose to enroll, you can take your credits (includes any unused HRA base credits and previously earned well-being credits) with you. • Children’s Hearing Aids Benefit Increase • The benefit allowance for hearing aids for children (up to age 19) has increased from $3,000 to $6,000 every five (5) years.
Blue Cross Blue Shield of GA and United Healthcare Elections • 2017 Wellness • Healthways will remain the vendor for the wellness vendor • Health actions must be completed between January 1, 2017 and December 15, 2017 in order to earn the well-being incentive credits. • Members will have access to a variety of Healthways’ tools, activities and services such as the Well-Being Assessment, wellness incentives, Well-Being Coaching, Biometric Screenings, and on-site activities. • Members can earn up to 480 well-being incentive credits toward medical expenses, plus an additional 480 for a covered spouse (total of 960 per household)
Kaiser Permanente (KP) Wellness • 2017 Wellness • Members that elect KP will have access to a variety of tools, activities and services such as the Total Health Assessment, Biometric Screenings and Online and On-site Healthy Living Classes • As a part of the KP Wellness Program, if you sign up on kp.org and complete all four health activities (e.g. completing a biometric screening, completing an age/gender appropriate preventive cancer screening, completing one online health education class), you will receive a $500 Visa gift card (up to $1,000 per household for you and your covered spouse). • Health activities must be completed between January 1, 2017 and November 30, 2017 in order to earn the $500 Visa gift card. • For details on the KP Wellness Program, contact Kaiser Permanente at www.my.kp.org/shbp or call 1-855-512-5997.
Other Health Care Options Available to Qualified Employees • TRICARE Coverage • Voluntary, member-pay-all supplemental health benefit. • Available to SHBP eligible individuals who are also eligible for TRICARE, the military health benefit program. • Ends when you turn 65. • Everyone covered under the contract must be in Tricare. • PEACHCARE FOR KIDS • As state or public school employees, you could be eligible to enroll your children in PeachCare for Kids. • Visit www.peachcare.org or call 877-427-3224 for information. Children cannot be enrolled in both SHBP and PeachCare.
Patient Protection and Affordable Care Act (ACA) The Department of Community Health which administers the State Health Benefit Plan states that all entities involved in the State Health Benefit Plan may assume that “all options meet the affordability and minimum value requirements of the Patient Protection and Affordable Care Act.” For this reason and others DNR is in compliance with the ACA. Employees of the DNR office of Human Resources (OHR) are not qualified to accurately answer any questions regarding this federal program. Therefore, employees are encouraged to direct their questions regarding the ACA to the federal government website www.Healthcare.gov or call 1-800-318-2596.
Making Your 2017 Benefit Election • Online Election • Employees must make their health election on-line at www.mySHBPga.adp.com • Website Open & Close Dates • Website opens at 12:00 a.m. on October 17, 2016. • Website closes at 11:59 p.m. on November 4, 2016. • Active Employee Health Plan Decision Guide • Available on the website at www.dch.georgia.gov/shbp. • No printed hardcopies.
Employee Responsibilities • Read and make sure you understand the plan materials posted at www.dch.georgia.gov/shbp and other information provided by DNR and take the required actions. • Confirm that you answered the Tobacco Surcharge question appropriately • Check your payroll deduction to verify that the correct deduction amount has been made. If you are not being charged the correct amount, immediately contact HR. • Notify SHBP whenever you have a change in covered dependents (within 31 days of a Qualifying Event.)
What Happens If No Action Is Taken? • Members who do not make an election, either through the web portal or by calling the SHBP Member Services Center, will be defaulted to the same plan option previously selected for 2016. • If you do not make an election and are currently paying the Tobacco Surcharge, your coverage will default and the Tobacco Surcharge you were paying in 2016 will continue to apply. • If you do not make an election and are currently enrolled in TRICARE Supplement in 2016, you will be enrolled in TRICARE Supplement in 2017.
Contact Information Blue Cross Blue Shield of GA - www.bcbsga.com/shbp 855-641-4862 Monday – Friday 8:00am – 8:00pm ET UnitedHealthcare– www.welcometouhc.com/shbp 888-364-6352 Monday – Friday 8:00am – 8:00pm ET Kaiser Permanente– www.my.kp.org/shbp 855-512-5997 Monday – Friday 7:00am – 7:00pm ET Healthways - www.BeWellSHBP.com 888-616-6411 Monday – Friday 8:00am – 8:00pm ET Express Scripts – www.express-scripts.com/georgiaSHBP 877-841-5227 24 hours a day/7 days a week SHBP Member Services– www.mySHBPga.adp.com 800-610-1863 Monday – Friday 8:30am – 5:00pm ET Tricare Supplement – www.selmantricareresource.com/ga_shbp 866-637-9911 PeachCare For Kids – www.peachcare.org 877-427-3224
Important Notice • The information provided in this presentation is a summary of changes for the 2017 Plan Year. It is intended only to highlight principal benefits. • Please refer to the Active Employee Decision Guide for more details.
Qualifying Events that Allow Coverage Changes • Birth/Adoption (90 days to enroll) • Marriage • Divorce • You or your spouse lose coverage through other employment • Dependent loses coverage through Medicare, Medicaid, former spouse loss of coverage • Gain/Loss of coverage due to other employer’s open enrollment • You or your spouse is activated into military service • You or an Enrolled Dependent Turns Age 65 *Employee has 30 days from the date of the event to notify SHBP of change.
How to Declare a Qualifying Event • Log onto the SHBP Web Enrollment Portal • Click Declare a Qualifying Event • Choose type of Qualifying Event • Enter Date of Qualifying Event • Follow the instructions given to complete change. • Email will be sent to employee from SHBP with a cover letter attachment. Cover letter is to accompany all documentation to SHBP. • OHR has no access to cover letter and is unable to send documents to SHBP.
FLEX Annual Enrollment • AGENDA • Annual Enrollment Dates and Miscellaneous Information • 2017 Flexible Benefit Changes • Dental Plan Information • Legal Plan Information • Long Term Care Plan Information • Long Term Disability Plan Information • Spending Account Plan Information • Reminders for AE 2017 • Contact Information
FLEX Annual Enrollment • Annual Enrollment • Dates for Annual Enrollment: • Starts: 12:00 AM on October 17th • Ends: Midnight on November 4th • Two Options to make benefit selections and/or update dependent information for Plan Year 2016: • Accessing the GaBreeze website: www.GaBreeze.ga.gov • Contacting the GaBreeze Benefits Call Center: • 1-877-342-7339 • Employees will be allowed to have multiple confirmations online during the Annual Enrollment period.
Flexible Benefit Changes Dental Plans – Cigna HMO Plan Changes Employee Life Insurance – MetLife Plan Changes Spending Accounts – ADP New Look for ADP Website
Dental Plan Info • Dental Plans – Cigna (DHMO Option) • 13Additional dental offices available throughout Georgia • Many additional providers added in Metro Atlanta • Cigna Dental HMO plan has a 4% rate increase with no plan changes
Employee Life Insurance Info • Employee Life Insurance – MetLife • Employees allowed to enroll in a life insurance plan at the first level of coverage; or increase their current life coverage up one level without a Statement of Health (SOH). • The opportunity to “OneUp” will only be available for the 2017 plan year.
Spending Accounts Plan Info • Spending Accounts – ADP • If an employee has a current contribution for 2016, it will NOT automatically rollover into the new plan year. • Employees MUST make an election to continue contributions in the FSA Plans for 2017 (Dependent Care & Health Care). • Healthcare FSA maximum contribution amount is $2510. • Employees will be required to make an election amount in order to keep their Health Care and/or Dependent Care Spending Account active. • The last deduction for Spending Accounts will be November 30th unless a new election for 2017 is made. • There will still be a grace period to make claims.
Spending Accounts Plan Info • Spending Accounts – ADP • 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 and reviewed by DOAS • GaBreeze will be notified of the final determination regarding the Spending Account • NO REFUNDS WILL BE GIVEN
Spending Accounts Plan Info New Look for ADP Website • Effective September 17, 2016, ADP Flexible Spending Account website will no longer support access using Internet Explorer version 8 or lower. To ensure continued access to the website, please update web browsers. • ADP has added an additional layer of security for first time web users. New participants will be advised that a security code will be emailed to them. This takes approximately 5 minutes. • State of Georgia’s security code is STATEOFGE-10029. This code will never change.
GaBreeze Confirmation • GaBreeze Confirmation Number • Employees will receive a Confirmation Number upon successful completion of their online Annual Enrollment on the Completed Successfully page on the GaBreeze website. • Additional changes will be permitted online during the remainder of the Annual Enrollment period. • - Employees will retain the same Confirmation Number • - Date/Time Stamp will update to reflect the most recent completion • Employees SHOULD PRINT A COPY of the Confirmation Number for their records.
Flex Annual Enrollment • 2017 Enrollment Materials from DOAS/HRA • You Decide! Booklet • Benefits At-a-Glance Brochure • What’s New for 2017? • Information available on-line at: • http://doas.ga.gov/human-resources-administration/employee-benefits-information/flexible-benefits/flexible-benefits-resources • Please read the information provided so you will know what is changing and what effect the changes will have on your benefits, options, rates, etc. before making your election for the 2017 plan year.
Reminders for AE 2015 • Log onto the GaBreeze website to verify and/or update User ID and Password. • Update email addresses on the “Personal Information” section of the “Your Profile” page to ensure quicker response time to receive password updates from GaBreeze. • Link to the DCH Annual Enrollment site will be on GaBreeze.
Contact Information GaBreeze Website: www.GaBreeze.ga.gov Toll Free: 1-877-3GBreez or 1-877-342-7339 GaBreeze Representatives available Monday – Friday, 8:00 am – 5:00 pm ET (excluding holidays)
Contact Information Office of Human Resources Beth Findlay (404) 656-2697 beth.findlay@dnr.state.ga.us