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Open Enrollment 2012. 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 2012 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 • You may add or drop dependents • You may change benefit plans – Medical, Dental, Vision • If you are utilizing the Flexible Spending Account (FSA), you Must elect new contributions to your 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 form
Important Information • Open enrollment begins December 5, 2011. • All Open Enrollment Elections Must be Made by December 16, 2011 – No Exceptions! • Medical, Dental, and Vision Open Enrollment Elections are completed online through Benefit Mall. Instructions to log onto Benefit Mall are available in your open enrollment packet. • If no changes are to be made to your Medical, Dental, and Vision benefits, then you do not need to log onto Benefit Mall. Your benefits from 2011 will renew automatically in 2012. • Paper forms will be provided for the FSA (Medical & Dependent care) election, your HRA Acknowledgement, and your STD / LTD taxation election. These forms Must be filled out and submitted during Open Enrollment.
What’s New With Benefits… Introduction • New POS Low Cost Medical Benefit Option for Local (VA, DC, or MD) and Out of Area Employees (all other states). Look for additional details on plan deductibles, co-pays, etc… on the Medical Analysis page in your open enrollment packet. • Both the CareFirst HMO and POS plans from last year have been eliminated in favor of a new Lower Cost POS Plan. • The Dental Plan changed from Humana to Guardian
What’s Not Changing This Year… Introduction • CareFirst PPO plan • Reliance Standard for Life, Short-Term and Long-Term Disability • FSA (Medical & Dependent Care ) and HRA administration with The 125 Company
Discussion Topics… Benefit Review • CareFirst Medical Plans (PPO vs. POS) • HRA Card, Prescription & Vision Plans • Guardian Dental Plan • Reliance Standard Life & Disability Plans • Flexible Spending Accounts (Medical & Dependent Care)
CareFirst Health Plan Options for Local and Out of Area Employees… Medical Plan Introduction and Pricing Option 1: Open Access POS (New!) 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.
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. • Co-pay 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.
CareFirst Open Access POS Health Plan • A Point of Service (POS) Plan is a hybrid between an HMO and PPO plan offering the features of both plan types. • 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. • There is a deductible that needs to be met with coverage. • HRA cards WILL BE used to cover deductible expenses up to the in-network deductible $ amount. • After you meet your deductible, a co-payment is charged for all medical services. • HRA cards DO NOT cover co-payments. 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.
CareFirst PPO Health Plan • The BCF Solutions VA Blue Preferred PPO plan has not changed. • All Local and Out of Area employees are eligible to elect the PPO plan option. • 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. • After you meet your deductible, the PPO plan does not have a co-pay associated with regular doctor visits. • Just as last year, your HRA card will cover your in-network PPO deductible.
CareFirst – How to Find a Doctor Click to find a Provider
CareFirst – How to Find a Doctor PPO POS – Local and Out of Area
All CareFirst BCBS Health Plans are HRA’s… CareFirst Health Plans • The $ amount on the HRA debit card is equal to your In-Network deductible. • BCF management elected to cover all in-network employee medical deductible expenses through the HRA debit card. • The HRA debit card can ONLY be used to pay for 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.
All CareFirst BCBS Health Plans are HRA’s… CareFirst Health Plans • Below are some examples of what the HRA debit card CANNOT BE USED FOR. • Prescription Drug Co-Pays • Cosmetic Surgery • Vision Care • All Dental Expenses • All POS Co-Payments (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.
Additional HRA Information • HRA Website: www.125Company.com • How to use the HRA • Monitor your account • Upload “Explanation of Benefits/Receipts” to the website • Explanation of Benefits are mailed from BCBS and can also be found on the CareFirst website • Don’t pay for your appointment while at the doctor’s office. • The doctor needs to first submit a claim to BCBS and then send you a bill. Wait for the bill to be mailed to you. • If your HRA card is not accepted by the doctor you have two options • You can pay for it out of pocket and then submit a reimbursement claim (form on the BCF website) • You can submit the reimbursement form with your EOB to 125 Company (form on the BCF website) and once you receive the money, pay the bill.
Prescription Drug Plan • Drug Benefit Description • $15 Generic Drugs • $35 Preferred Brand prescription or refill. • Preferred Brand is designated by CareFirst • $60 Non Preferred Brand prescription or refill • 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. • Injectables – you pay 50% up to a $100 Co-pay
Prescription Drug Plan • All $ amounts are co-pays. The co-pay is Not covered by the HRA card. • Maintenance medications are eligible for the Mail Order Program, where you can get 3 months of medication for only 2 co-payments. Forms and information can be found online at www.carefirst.com • If the cost of the drug is less than the listed co-pay, the employee will only have to pay the cost of the drug at the time the prescription is filled.
CareFirst Blue Vision Plus Plan • Plan is Administered by CareFirst and Davis Vision • Network – Davis Vision • Providers Can Be Located On-Line 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.
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 copayment at the time of your visit for an eye exam on both PPO and POS 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 your vision services as illustrated on the next page.
CareFirst Blue Vision Plus Plan Overview of Vision Benefits…
Guardian Dental Plan • Plan is Administered by Guardian Dental • Network – PPO / Traditional Preferred • TX and GA employees have state mandated benefits • Providers can be located online at www.guardiananytime.com/fpapp/FPWeb/home.process • All premiums are shown as monthly employee costs. • To find your bi-monthly premium cost, divide the above amount by 2.
Overview of Dental Benefits… Guardian Dental Plan – Non TX or GA
Overview of Dental Benefits… Guardian Dental Plan – TX and GA *Due to State Mandates al TX and GA employees must be on this plan
Benefits are Staying the Same… Reliance Standard Benefits • Three (3) Employer-Paid Plans • Group Short-Term Disability Insurance • Group Long-Term Disability Insurance • Group Term Life Insurance
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.
Short-Term Disability Insurance • Waiting Period (0 Days Accident/7 Days Sickness) • Benefit Percentage (60%) • Duration of Benefits (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
Long-Term Disability Insurance • Waiting Period (90 days) • Benefit Percentage (60%) • 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
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.
Group Life Insurance • Two (2) Times Annual Salary • Class I: Maximum Benefit of $200,000 • 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.
Pre-Tax Contributions for Eligible Out of Pocket Medical expenses… FSA – Medical Expenses • Up to $3,000 can be set aside to pay for eligible medical expenses for plan year 2012 • Full amount elected can be accessed immediately • An FSA can be used to pay for medical, dental, vision, or prescription expenses.
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 2012 • Expenses are reimbursable as contributions become available through your payroll deductions. Reimbursement form is located on the BCF website
Reminder - Important Information • All Open Enrollment Elections Must be Made by December 16, 2011 – No Exceptions! • Medical, Dental, and Vision Open Enrollment Elections are completed online through Benefit Mall. Instructions to log onto Benefit Mall are available in your open enrollment packet. • There will still be paper forms that must be filled out for the FSA (Medical Expense & Dependent Care) election, HRA Acknowledgement, and your STD / LTD taxation election.
Reminder - Important Information • Forms to be filled out and submitted to HR: • FSA – Medical and Dependent Care • STD / LTD Taxation Election • HRA Acknowledgement • These forms MUST be returned even if you are not making changes!
Thank You For Your Participation… Questions Who can I call with Additional Questions? • BCF Human Resources Department • PMA/S4 – Sunita Gupta; 703-817-9475; Sgupta@bcfsolutions.net • Defense & Space – Dina Johns; 703-717-9937; Djohns@bcfsolutions.net • Triad – Mike Parker; 626-793-7314; Mparker@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, cell 949-244-6421; Bfoster@hmbsinsurance.com