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Welcome to Insurance Coordinator Option Period Training 2015.
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Welcome to Insurance CoordinatorOption Period Training 2015 This publication is issued by the Office of Management and Enterprise Services as authorized by Title 62, Section 34. Copies have not been printed but are available through the agency website. This work is licensed under a Creative Attribution-NonCommercial-NoDerivs 3.0 Unported License. 3153
Agenda • Packet Materials • Important Dates • Option Period Enrollment • Eligibility • Having a Successful Option Period • Plan Information • Plan Changes • HealthChoice Tobacco-Free Attestation • Member Reminders
Option Period Enrollment This is the time when eligible employees can: • Enroll in plans • Change plans or drop coverage • Increase or decrease life insurance coverage • Add or drop eligible family members from coverage
Eligibility An education employee must be: • Currently employed, eligible for Teachers Retirement System, and working at least four hours a day or 20 hours a week A local government employee must be: • Currently employed, regularly scheduled to work 1,000 hours or more per year, and cannot be listed as a temporary or seasonal employee
Eligibility (cont.) • Employers must participate in plans offered through EGID • Employees must be enrolled in a group health plan to enroll in dental and/or life insurance • If one eligible dependent is covered, all eligible dependents must be covered • Employees can exclude their spouse from health and/or dental coverage while covering other dependents; special provisions apply to vision
Resources • The 2015 Employee Benefit Options Guide • The IC Web page at www.sib.ok.gov or www.healthchoiceok.com • The 2015 Option Period Insurance Coordinator Information disc • The 2015 Employee Benefit Options Presentation available on disc and on the IC Web page
Resources • Employee Option Period meetings • The 2015 Web User Option Period Newsletter • EGID Member Services • ICs should contact their Group Management Specialist • Employees and dependents should contact Member Services at 1-405-717-8780 or toll-free 1-800-752-9475 • Note new phone prompts: • Medicare supplement eligibility/pharmacy • Members • Coordinators
IC Responsibilities • Set your Option Period deadline • Communicate with employees • Schedule employee Option Period meetings • Processes for employee enrollment • Notify employees about the link to the Summary of Benefits and Coverage (SBC) • Coordinate with payroll • Generate pre-bill for 2015
What Your Employees Receive From EGID • 2015 Option Period Packet includes • Plan changes • Premiums • Contact information
What Your Employees Receive From EGID • 2015 Option Period Enrollment/Change Form
2015 Option Period Enrollment/Change Form • Enter changes online by the Nov. 14, 2014 deadline • Initial the IC box on the front of the form • If an employee is not making changes, the form does not need to be returned to EGID • If an employee is retiring before Jan. 1, 2015, have them contact EGID • Mail paper forms to EGID by the Oct. 31, 2014, deadline
What Your Employees Receive From EGID • HealthChoicemembers: Tobacco-free Attestation reminder
2015 Confirmation Statement (CS) • Members are mailed a CS when they enroll or make changes • The CS includes • Coverage • Effective Date • Premium Amounts • If there are no changes, employees do not receive a CS from EGID
Confirmation Statement Corrections • Members should verify their coverage • Members should notify you of any errors within 60 days of their election • Corrections reported after 60 days are effective the first of the month following notification
Life Insurance Application • Required for adding/increasing life insurance during Option Period • No Guaranteed Issue (fornew hires only) • Use only the most current version of the Life Insurance Application • Sign and enter Insurance Coordinator information • Employee is responsible for completing and submitting the application by the deadline • You are notified of approval or denial
Member Meetings • On-site meeting requirements • New ICs can request a member meeting • Any size group that has a minimum attendance of 15 employees • Groups with 150 and over employees • Alternative - Personalized webinar
HealthChoiceHigh • HealthChoice High Alternative • HealthChoiceBasic • HealthChoice Basic Alternative • HealthChoice High Deductible Health Plan (HDHP) • HealthChoiceUSA
Plan Changes • HealthChoice Basic and Basic Alternative • Increase in deductible • Decrease in out-of-pocket maximum amounts • Decrease in premiums • HealthChoice High Deductible Health Plan (HDHP) • Name change; formerly HealthChoice S-Account Plan • Decrease in premiums
HealthChoice Tobacco-Free Attestation • Tobacco-free employees • To remain enrolled in the HealthChoice High or Basic Plan, employees must attest that they and their covered dependents are tobacco-free • Due to HealthChoice by Nov. 14, 2014
HealthChoice Tobacco-Free Attestation • Employees should complete the tobacco-free Attestation • www.sib.ok.gov or www.healthchoiceok.com • If the employee cannot access the Attestation online, they can request a paper form be mailed to them by calling Member Services • Paper form must be received by the Nov. 14 deadline
Reasonable Alternatives • If employees cannot complete the Attestation, they can • Enroll in the quit tobacco program AND complete three coaching calls, or • Provide a letter from their doctor indicating it is not medically advisable for them to quit tobacco • Failure to complete the Attestation or one of the Reasonable Alternatives will result in employees being enrolled in the HealthChoice High Alternative or Basic Alternative Plans
Dental Plan Options • Assurant Freedom Preferred • Assurant Heritage Secure Prepaid • Assurant Heritage Plus with SBA Prepaid • Cigna Dental Care Plan Prepaid • Delta Dental PPO • Delta Dental PPO Plus Premier • Delta Dental PPO-Choice • HealthChoice Dental
Covered Services • Toll-free numbers and website addresses are listed in the Employee Benefit Options Guide • All dental plans are available in all Oklahoma ZIP code areas
Vision Plans • Each vision plan has its own provider network • All vision plans have limited coverage for services by out-of-network providers • Toll-free numbers and website addresses are listed in the Employee Benefit Options Guide • Contact each vision plan for specific benefit questions
Member Reminders • Register for (HealthChoice) • Have free comprehensive preventive office visit before the end of the year for all health plans
