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Open Enrollment 2013

Open Enrollment 2013. Employee Benefits. Moderator. Faith Hites Senior Account Manager, Group Benefits Raffa Financial Services, Inc. Brady J. Foster Broker, Group Benefits HMBS Group Insurance, LLC. Open Enrollment Means…. Open Enrollment. You may enroll in coverage

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Open Enrollment 2013

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  1. Open Enrollment 2013 Employee Benefits

  2. Moderator Faith Hites Senior Account Manager, Group Benefits Raffa Financial Services, Inc. Brady J. Foster Broker, Group Benefits HMBS Group Insurance, LLC.

  3. Open Enrollment Means… Open Enrollment • 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 • You must re-elect your taxation choice on your Short and Long-Term Disability benefits by completing the paper tax election form

  4. Important Information • Open enrollment begins December 3, 2012 • All Open Enrollment elections must be made by December 14, 2012 – 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 2012 will automatically renew in 2013; however, please log into Benefit Mall to review your current benefits. • 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 HR during Open Enrollment.

  5. Discussion Topics… Benefit Review • CareFirst Medical Plans (POS & PPO) • HRA Debit Card, Prescription & Vision Plans • Guardian Dental Plan • Reliance Standard Plans (Life & Disability) • Flexible Spending Accounts (Medical & Dependent Care)

  6. CareFirst Health Plan Options for Local and Out-of-Area Employees… Medical Plan Introduction and Pricing Option 1: Open Access POS Option 2: Blue Preferred PPO • All premiums are shown as monthly employee costs. • To find your bi-monthly premium cost, divide the above amount by 2.

  7. CareFirst Plan Comparison – All Employees

  8. CareFirst Open Access POS Health Plan • A Primary Care Physician (PCP) must be selected. You DO NOT need referrals to see a specialist. Instructions on how to find a doctor can be found in your enrollment package. • POS deductible will be covered by your HRA card up to the in-network deductible $ amount. • After you meet your deductible, a copayment is charged for all medical services which is not covered by your HRA card. • Full plan details are in your enrollment packet POS Networks • Local POS plan is part of the Regional CareFirst Blue Choice Network (you must use this network locally!) • 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.

  9. CareFirst PPO Health Plan • 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 your in-network PPO deductible • After you meet your deductible, the PPO plan covers in-network medical expenses at 100% (no copayment for office visits and most services) and out-of-network is covered at 80% • All Local and Out-of-Area employees are eligible to elect the PPO plan option • Full plan details are in your enrollment packet

  10. All CareFirst BCBS Health Plans are HRA’s… CareFirst Health Plans – HRA Debit Card • BCF management elected to cover all in-network employee medical deductible expenses through the HRA debit card. Employees' HRA debit card is funded 100% on the first day of the plan year. • The $ amount on the HRA debit card is equal to your Medical In-Network deductible. Please note this card is to be used ONLY for medical deductible expenses. • If an employee or eligible dependent enrolls at a time other than open enrollment the dollar amount on the HRA card is pro-rated and begins accruing the month they enroll.

  11. All CareFirst BCBS Health Plans are HRA’s… CareFirst Health Plans – HRA Debit Card • The HRA debit card can ONLY be used to pay for eligible services that are subject to the Medical Deductible, this includes: • Inpatient and Outpatient hospitalization services or surgeries • Emergency Services (Ambulance, Emergency Room, or Urgent Care) • Visits to your Primary Care Doctor or a Specialist • Lab and X-Ray Fees • Mental/Nervous or Substance Abuse hospitalizations or physician visits • * Please note this is not a complete and comprehensive list.

  12. All CareFirst BCBS Health Plans are HRA’s… CareFirst Health Plans – HRA Debit Card • Below are some examples of what the HRA debit card CANNOT BE USED FOR: • Prescription Drug Copayments • Cosmetic Surgery • Vision Care • All Dental Expenses • All POS Copayments (after the deductible is met) • Any expense related to co-insurance after the deductible has been met • * Please note this is not a complete and comprehensive list.

  13. Prescription Drug Plan • Benefit: • $15 Generic Drug copayment • $35 Preferred Brand prescription or refill copayment • Preferred Brand is designated by CareFirst • $60 Non Preferred Brand prescription or refill copayment • Injectables – you pay 50% up to a $100 copayment • FAQs: • If you use a Non Preferred Brand name drug and a Generic is available, you will pay the difference in the cost of the drugs. • All $ amounts are copayments per prescription.  The copay is 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 copayments. Forms and information can be found online at www.carefirst.com

  14. CareFirst Blue Vision Plus Plan • Plan is Administered by CareFirst and Davis Vision • Network = Davis Vision • Providers can be located online at https://idoc.davisvision.com/davis/member/adv_doc_locate_v2.asp • All premiums are shown as monthly employee costs. • To find your bi-monthly premium cost, divide the above amount by 2.

  15. CareFirst Blue Vision Plus Plan Overview of Vision Benefits…

  16. CareFirst Blue Vision Plus Plan • Your CareFirst Medical plan does have vision coverage that will cover most vision related needs. You will have to pay a $10 copayment 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, lens, and contacts with no copayments. All out of network participants are required to pay a portion of their vision services as illustrated on the previous page.

  17. Guardian Dental Plan • Network = PPO / Traditional Preferred • TX and GA employees have state mandated benefits - NAP • Providers can be located online at www.guardiananytime.com/fpapp/FPWeb/home.process • Orthodontia is not covered under either dental plan but you may get a discount if you use an in-network orthodontist • All premiums are shown as monthly employee costs. • To find your bi-monthly premium cost, divide the above amount by 2.

  18. Overview of Dental Benefits… Guardian Dental Plan – Non TX or GA

  19. Overview of Dental Benefits… Guardian Dental Plan – TX and GA *Due to state mandates all TX and GA employees must be on this plan*

  20. Ancillary Benefits (Employer Paid)… Reliance Standard Benefits • Group Short-Term Disability (STD) Insurance • Group Long-Term Disability (LTD) Insurance • Group Term Life Insurance • Employee Assistance Program • Identity Theft Recovery Services (refer to the BCF website for additional information) • On Call Travel Assistance (refer to the BCF website for additional information)

  21. Short-Term Disability (STD) Insurance • Waiting Period (0 Days Accident/7 Days Sickness) • Benefit Percentage (up to 60% of eligible income) • 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

  22. Long-Term Disability Insurance • Waiting Period (90 days) - LTD is continuation of STD benefits. The STD benefit period satisfies this waiting period. • Benefit Percentage (up to 60% of eligible income) • Duration of Benefits to Age 65 / Social Security Normal Retirement Age (SSNRA) • Benefit Monthly Maximum is ($7,500) • 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

  23. Disability Insurance • 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 (found on the BCF Website). • To receive disability benefits, a claim form must be submitted. The Reliance STD Claim Form can be found on the BCF website. Please return this form to HR. • Supervisors will forward the 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.

  24. Group Life Insurance • 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 HR Manager.

  25. 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, job or family related problems. • Your EAP can help you and your dependents identify, resolve and gain control over personal problems that may be interfering with work and daily life. • Dedicated Toll Free Crisis Line: • 24 hours a day – 7 days a week – 365 days a year • 1-800-767-5320

  26. HRA Debit Card vs. FSA 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.

  27. Pre-Tax Contributions for Eligible Out-of-Pocket Medical expenses… FSA – Medical Expenses • Up to $2,500 can be set aside to pay for eligible medical expenses for plan year 2013 • Full amount elected can be accessed immediately • An FSA can be used to pay for eligible medical, dental, vision, or prescription expenses.

  28. 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 2013 • Expenses are reimbursable as contributions become available through your payroll deductions. The reimbursement form is located on the BCF website.

  29. Reminder - Important Information • All Open Enrollment Elections must be made by December 14, 2012 – 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 HR: • 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!

  30. Thank You For Your Participation… Questions Who can I call with Additional Questions? • BCF Human Resources Department • Triad/S4/RedBlack – Sunita Gupta; 703-817-9475; Sgupta@bcfsolutions.net • Defense & Space – Dina Johns; 703-717-9937; Djohns@bcfsolutions.net • Angela Fitzpatrick, Raffa Financial Services BCF’s Dedicated Customer Service Representative 240-403-2546 • Brady J. Foster, HMBS Group Insurance BCF’s Dedicated Insurance Broker 949-630-2523, Bfoster@hmbsinsurance.com

  31. Appendix

  32. CareFirst – How to Find a Doctor PPO POS – Local and Out of Area

  33. 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)

  34. Medical Benefits Terminology Terms Networks • Localincludes 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 • Deductiblethe amount an individual must pay for health care expenses before co-pays & 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. • Copayment a predetermined (flat) fee that an individual pays for health care services. For example, the POS plan requires a $30 copayment for each office visit. • Out-of-Pocket Maximuma predetermined amount that an individual must pay, annually, before health care expenses will be covered at 100% by Blue Cross Blue Shield.

  35. 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) 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

  36. Issues Using HRA Card • If you cannot use your HRA debit card for any reason • 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 you can fax/mail or e-mail/scan the EOB to 125Company for reimbursement. • 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 on the BCF website)

  37. STD/LTD Benefits Terminology Terms Tax Choice Option • 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 • 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.

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