Empower your life with smart choices

Transcription

1 Your 2016 Benefits Empower your life with smart choices USG provides you with great benefit choices. Take time to learn about the options USG offers so you can empower yourself to make smart choices for What s new for 2016? In 2016, USG employees with BlueCross BlueShield of Georgia (BCBSGa) healthcare coverage will have access to these new benefits! See a doctor 24/7 with LiveHealth Online In 2016, BCBSGa members can talk face-to-face with a board-certified doctor through a mobile device or computer with a webcam at livehealthonline.com for less than a visit to the doctor s office! LiveHealth Online doctors provide medical advice for common concerns like the flu, colds, allergies, and more. They can also send a prescription directly to a pharmacy. It s faster, easier, and more convenient than a visit to an urgent care center. If you re enrolled in the Comprehensive Care or BlueChoice HMO plan, your copay will be $15. If you re enrolled in the Consumer Choice HSA, this option is often more cost-effective than alternatives like the ER, urgent care, or your primary care physician. USG s benefits website has been refreshed! Visit usg.edu/hr/benefits. You ll even find a schedule of benefit fairs and in-person meetings at institutions across the state! Visit livehealthonline.com to get started. Pay less for care at CVS MinuteClinic BCBSGa members will pay less to visit a CVS MinuteClinic in MinuteClinic walk-in medical clinics are staffed by nurse practitioners who specialize in family healthcare. Always remember to present your BCBSGa ID card when you check in. For Comprehensive Care and BlueChoice HMO plan members, your copay for a MinuteClinic visit is just $15. If you re enrolled in the Consumer Choice HSA, you might find visiting a MinuteClinic to be more affordable than a visit to the doctor s office! Visit minuteclinic.com for a complete list of services and to locate a MinuteClinic near you. University System of Georgia Benefits we provide you decide

2 Shop smarter with Castlight The cost of healthcare varies depending on where you go. Make sure you re getting best value with Castlight a free online tool that helps BCBSGa members compare the cost and quality of healthcare providers and pharmacies. Learn more at mycastlight.com/usg. Better health is its own reward USG is developing a system wide well-being initiative to provide opportunities and resources for the betterment of our institutions, our employees, and their families. For more information, visit usg.edu/wellness. Plus, take advantage of these wellness activities. Know your numbers Activity BCBSGa Kaiser Complete an annual wellness checkup at your physician s office. Check your blood pressure, cholesterol and other health indicators. Get started Complete an online health assessment. It can help you identify lifestyle risks, reinforce healthy habits and learn how to improve your health. Take action Locate an in-network provider at bcbsga.com/usg Visit bcbsga.com/usg, click the Health & Wellness Tab, then select Take my HA now Locate an in-network provider at kp.org Visit kp.org/tha Complete an online wellness education program, or participate in a telephone wellness coaching program. To learn more or get started, call To learn more or get started, call Planning a family? The award-winning Future Moms program helps BCBSGa members have safer pregnancies and healthier babies. To get started, call Has your tobacco status changed? For 2016, you ll continue to see a $75 monthly surcharge on your premiums if you use tobacco. You can make changes to your Tobacco Use Status at any time, and the change will be effective the first of the following month. However, there will be no refunds of the $75 surcharge. 2

3 Healthcare When it comes to keeping you and your family healthy, we ve got you covered. For 2016, your healthcare options will remain: Consumer Choice HSA Provided by BCBSGa, this is the only healthcare plan that provides you with access to a Health Savings Account (HSA) see more information on page 5. NEW! To comply with the Affordable Care Act, the HSA contribution limit for family coverage will increase in 2016 to $6,750, and the out-of-pocket maximum for in-network coverage will decrease to $6,850. Moving to the Consumer Choice HSA for 2016? If you re moving to the Consumer Choice HSA plan and have an FSA now, make sure your Flexible Spending Account (FSA) balance is zero by December 31, Otherwise, you cannot open an HSA until April 1, Comprehensive Care This BCBSGa plan offers coverage for both in-network and out-of-network providers. BlueChoice HMO You receive benefits when your care is coordinated by your BCBSGa primary care physician (PCP). Which plan is right for you? Wondering which BCBSGa plan is the smartest choice for you for 2016? The Plan Comparison Tool will help you find the option that fits you best. Check it out today at bcbsga.com/usg. Kaiser Permanente (KP) HMO You receive benefits when your care is coordinated by your KP PCP. Your healthcare premiums will increase for Review this guide, so you can empower yourself to make smart choices for you and your family. USG remains committed to providing access and support for healthcare plans for our employees. Your healthcare options Consumer Choice HSA Comprehensive Care BlueChoice HMO Kaiser Permanente HMO In-network In-network In-network only In-network only Deductible (Single/Family) $1,500/$3,000 $500/$1,500 None None Out-of-pocket max (Single/Family) $3,500/$6,850 $1,250/$2,500 $5,500/$9,900 $6,350/$12,700 Primary care physician required No No Yes Yes Preventive care 100% 100% 100% 100% Physician office visit/ Specialist visit 80% after deductible $20 copay/$30 copay $30 copay/$50 copay $20 copay/$25 copay Inpatient hospital services 80% after deductible 90% after deductible $500 copay $250 copay Emergency care 80% after deductible $150 copay, then 90% after deductible $250 copay $250 copay Prescription drugs Retail Generic $10 copay $10 copay Kaiser pharmacies: $10 copay Contracted non-kaiser pharmacies: $20 copay limited to a one-time fill per medication Preferred brand $35 copay $35 copay Kaiser pharmacies: $35 copay 80% after deductible Contracted non-kaiser pharmacies: $45 copay limited to a one-time fill per medication Nonpreferred brand 20% with $45 min 20% with $45 min Not covered and $125 max and $125 max Mail order (90-day supply) Retail Generic $25 copay $25 copay $20 copay Preferred brand $87.50 copay $87.50 copay $70 copay through Kaiser pharmacies only Nonpreferred brand 80% after deductible Bold text in chart above indicates change for % with $ min and $250 max 20% with $ min and $250 max Not covered 3

4 Healthcare change for retirees age 65 and older USG remains committed to providing healthcare benefits to eligible retirees. Beginning in 2016, USG s Medicare-eligible retirees and their Medicare-eligible dependents will receive healthcare coverage in a new way through the Aon Retiree Health Exchange. The exchange enables eligible participants to compare coverage options and enroll in the plans that best fit their needs. Your pharmacy coverage CVS/caremark will continue to be the pharmacy benefit manager for employees enrolled in BCBSGa healthcare plans. Your BCBSGa ID card also includes your CVS/caremark information. Sign up for convenient mail service! Save money on maintenance medications by having a 90-day supply mailed to your home, office, or other location. For more information, visit caremark.com. New for 2016: The Advanced Control Specialty Formulary is an expansion of the current step therapy program for specialty medications. If this benefit applies to you, you will receive additional information. Your dental options USG offers dental options through Delta Dental. Your dental premiums will increase in See the premium chart on page 6. Delta Dental Base Plan In-network Delta Dental High Plan In-network Annual maximum $1,000 per person* $1,500 per person* Deductible (Single/Family) $50/$150 $50/$150 Diagnostic/preventive services* 100% 100% Basic benefit services 80% 80% Major benefit services** 50% 80% Orthodontia (child and adult) No coverage 80% Lifetime orthodontia maximum No coverage $1,000 * Preventive and diagnostic services don t count toward the annual maximum. ** Benefit limits apply on full replacement of existing dentures or crowns. Your vision options USG offers vision coverage through EyeMed, whose provider network includes top national retail chains. Benefits are provided for the following services and supplies once per 12-month period. EyeMed Vision In-network Out-of-network reimbursement Exam $10 copay $40 Single vision lens $25 copay $40 Frames contribution $150 allowance $58 Contact lenses $150 allowance $130 Medically necessary contact lenses Paid in full $210 4

5 Save money with tax-free accounts A U.S. Bank Health Savings Account (HSA) and/or Flexible Spending Account (FSA) can save you money on healthcare and dependent care expenses. Your contributions to these accounts are tax-free, saving you money on federal and state income taxes and Social Security taxes. Health Savings Account (HSA) For those enrolled in the Consumer Choice HSA healthcare plan Contribute up to $3,350 (individual coverage) or $6,750 (family coverage) Receive dollar-for dollar match from USG until your contributions reach $375 (individual) or $750 (family) Funds roll over from year to year Use these tax-free dollars to pay for eligible medical, prescription drug, dental and vision expenses FSAs To participate, you must enroll every year! Healthcare FSA Maximum annual contribution: $2,550 Use for eligible healthcare, prescription drug, dental or vision expenses Dependent Care FSA Maximum annual contribution: $5,000 (if you file a joint tax return) or $2,500 (if you file a single tax return) Use for eligible daycare expenses for children under age 13 and for eligible elderly parent care Limited Purpose FSA Only for those enrolled in the Consumer Choice HSA healthcare plan Maximum annual contribution: $2,550 Use for eligible dental and vision expenses only Stretch your dollars USG Perks free to USG employees! This free program helps your dollars go further. We leverage group buying power so you can save money on things you already buy and earn extra rewards, too. Sign up for USG Perks at any time by visiting usg.affinityperks.com/login. Protect your income We provide you with coverage to help protect your family s income against the unexpected. Disability coverage Short-term disability (STD) After you ve been disabled for 14 days, this benefit replaces 60% of your weekly salary, up to $2,500 per week. Benefits may last up to 11 weeks. Evidence of Insurability (EOI) is required if you elect this coverage during Open Enrollment. Long-term disability (LTD) After you ve been disabled for 90 days, this benefit replaces 60% of your monthly salary, up to $15,000 per month. No EOI is required. LTD premiums will increase by 15% in Do you have a medical condition? If you purchase LTD insurance, you may not be eligible for LTD benefits for 12 months if you received treatment for that condition within three months of when your disability coverage begins. Life insurance Protect your family s income in the event of a death due to illness or accident. Basic life and AD&D You ll receive life and Accidental Death & Dismemberment (AD&D) insurance equal to $25,000 at no cost to you. Supplemental life insurance You can buy additional life insurance coverage from one to eight times your salary, up to a maximum of $2.5 million. Without having to provide EOI, you can elect up to the limit of the lesser of three times your salary or $500, 000 as a newly eligible employee Dependent coverage You can choose life insurance coverage for your dependents, too: Spouse coverage options of $10,000 to $500,000. EOI is required for amounts over $50,000. Child(ren) coverage options of $5,000, $10,000 or $15,000. No EOI is required. Additional AD&D insurance You can buy additional AD&D insurance in amounts of $10,000 to $500,000. Bonus! When you purchase supplemental life or additional AD&D insurance, you ll also receive beneficiary financial counseling, legacy planning services, legal services, and travel assistance. LifeStyle Benefits Save money without sacrificing quality. LifeStyle Benefits offers discounts on roadside assistance, legal services, tax help, identity theft protection, pet services, and fitness center memberships. Learn more by visiting usg.lifeperx.com. 5

6 Your 2016 premiums Medical monthly premiums Consumer Choice HSA Comprehensive Care BlueChoice HMO Kaiser Permanente HMO Employee Only $74.00 $ $ $ Employee + One Child $ $ $ $ Employee + Spouse $ $ $ $ Family $ $ $ $ A $75 monthly tobacco surcharge applies to all tobacco users age 18 and over covered under a USG healthcare plan. Dental monthly premiums Vision monthly premiums Delta Dental Base Plan Delta Dental High Plan EyeMed Vision Employee Only $31.06 $38.38 Employee + Child(ren) $58.98 $72.90 Employee + Spouse $62.10 $76.72 Family $99.38 $ Employee Only $6.38 Employee + Child(ren) $12.14 Employee + Spouse $14.38 Family $18.84 Short-term disability (STD) premiums $0.291 / $10 of covered benefit STD calculation example monthly payroll Rate: $0.291 / $10 of covered benefit Annual Salary: $56,000 $56,000 / 52 = $1, weekly covered salary $1, x 0.60 = $ weekly benefit $ x / $10 = $18.80 STD weekly benefit maximum: $2,500 Long-term disability (LTD) premiums $0.258 / $100 of covered salary LTD calculation example monthly payroll Rate: $0.258 / $100 of covered salary Annual Salary: $56,000 $56,000 / 12 = $4, monthly covered salary $4, x / $100 = $12.04 LTD weekly benefit maximum: $15,000 Supplemental life and AD&D premiums Age Under and over Rate / $1,000 / month $0.057 $0.066 $0.083 $0.091 $0.109 $0.143 $0.212 $0.384 $0.590 $1.175 $2.026 Spouse Life Age Under and over Rate / $1,000 / month $0.043 $0.052 $0.070 $0.079 $0.087 $0.133 $0.205 $0.385 $0.592 $1.140 $1.850 $3.001 Voluntary AD&D premiums Employee Only Employee + Family $0.016 per $1,000 per month $0.028 per $1,000 per month 6

7 Protect those who matter Your USG healthcare, dental, vision, life, and additional AD&D benefits cover your eligible dependents: your legal spouse; your natural, adopted, or stepchild(ren) through the end of the month of their 26th birthday; and your disabled child(ren) with proof of disability. If you are adding new dependents to any coverage, you may be required to provide documentation of your relationship or your child s age. Examples include a marriage certificate, birth certificate, adoption certificate, and income tax returns. If both you and your spouse are eligible University System of Georgia employees, only one may elect to cover the other spouse and/or dependent children. Institution-specific benefits In addition to USG benefits, individual USG institutions offer some additional benefits. For more information, contact your institution s HR/Benefits Office. Institution Albany State University Hyatt Legal Plan, Aflac, Legal Shield Additional Benefits Armstrong State University Bainbridge State College Darton State College East Georgia State College Fort Valley State University Georgia College and State University Georgia Highlands College Georgia Institute of Technology Georgia Perimeter College Georgia Regents University Georgia Southern University Georgia Southwestern State University Georgia State University Gordon State College Kennesaw State University Middle Georgia State College South Georgia State College University of Georgia University of North Georgia University of West Georgia Valdosta State University Colonial Life Cancer and Accident Insurance Hyatt Legal Plan, Aflac Critical Care and Recovery Insurance, Cancer Insurance, Accident Insurance Accident, Cancer, Critical Care and Recovery Insurance Unum Critical Illness Insurance Delta Dental HMO, Identity Theft Protection, Legal Club of America Legal Plan, ARAG Critical Illness Insurance, Unum Whole Life Insurance Epic Hearing Plan, MetLife Whole Life Insurance, MetLife Accident Insurance, MetLife Critical Illness Insurance, MetLife Discounted Home and Auto Insurance, VPI Pet Insurance Aflac Cancer Indemnity Insurance, Personal Accident Indemnity Insurance, Hospital Protection Insurance, VPI Pet Insurance Aflac Hyatt Legal Plan Epic Hearing Plan, MetLife Whole Life Insurance, MetLife Accident Insurance, MetLife Critical Illness Insurance, MetLife Discounted Home & Auto Insurance, VPI Pet Insurance MetLaw Legal Plan through Hyatt Legal Aflac Accident Advantage, Cancer Care, Critical Care Protection Aflac Accident and Cancer Insurance Critical Illness Insurance, Accident Insurance Aflac Accident and Cancer Insurance, Legal Shield, Genworth Long Term Care MetLaw Legal Plan, Aflac Supplemental Insurance 7

8 Get help when you need it Have questions about your benefits? We have answers. Visit usg.edu/hr/benefits or call your institution s HR/Benefits Office. Healthcare BCBSGa Consumer Choice HSA Comprehensive Care BlueChoice HMO bcbsga.com/usg KP HMO (Outside of Atlanta) Pharmacy (BCBSGa plans) CVS/caremark caremark.com Walk-in clinic (BCBSGa plans) CVS MinuteClinic minuteclinic.com Online healthcare (BCBSGa plans) LiveHealth Online livehealthonline.com Healthcare cost & quality (Comprehensive Care and Consumer Choice HSA plans only) Castlight (first-level service support provided by BCBSGa) kp.org mycastlight.com/usg Dental Delta Dental deltadentalins.com/usg Vision EyeMed eyemedvisioncare.com/usg HSA & FSA U.S. Bank mycdh.usbank.com Disability MetLife mybenefits.metlife.com Life and AD&D Minnesota Life lifebenefits.com Discounts on services LifeStyle Benefits mymemberportal.com Online discount purchasing program USG Perks Contact the Help Center via the website usg.affinityperks.com The University System of Georgia Health Plan meets the Affordability requirement under the Affordable Care Act. Therefore, generally, University System of Georgia employees will not be eligible for a tax credit in 2016 through the Health Insurance Marketplace created under the Affordable Care Act. HOOO BENEFITS SUMMARY