Frequently Asked Questions About 2016 Annual Enrollment: Group 1 Corporate (Tampa) Hourly, US HQ (Denver) Hourly, and All Salaried Employees

Transcription

1 2016 Plan Year Frequently Asked Questions About 2016 Annual Enrollment: Group 1 Corporate (Tampa) Hourly, US HQ (Denver) Hourly, and All Salaried Employees SYKES BENEFITS

2 SYKES ANNUAL BENEFITS ENROLLMENT 2016 GENERAL QUESTIONS When is Annual Benefits Enrollment? Annual Benefits Enrollment for the 2016 plan year is from October 22, 2015, to November 5, Coverage takes effect on January 1, 2016 for the new plans. If I have questions, who do I ask? If you have questions about SYKES benefit options or to enroll in 2016 benefits, please contact a licensed Mercer Marketplace representative once Annual Benefits Enrollment begins on October 22 at: Phone: Online: mercermarketplace.com/sykes Where do I go to enroll? You will enroll through the Mercer Marketplace at mercermarketplace.com/sykes. What login credentials do I use? Returning Enrollees to Mercer Marketplace: Username: Use the username you created in the past. If you have forgotten your username, please contact Mercer Marketplace at Password: Your password will be reset to your last name and the last four digits of your Social Security number (Example: Jones1234). First-Time Enrollees to Mercer Marketplace: Username and Password: You ll need your Social Security number, last name, and date of birth to identify yourself and then you will be prompted to select a unique username and password that you will use going forward. If you have any issues logging in, you can also click on the Can t access my account link or you may call the Mercer Marketplace Benefit Center at How should an employee who is eligible for company-sponsored benefits enroll? For SYKES-sponsored benefits for the 2016 plan year, employees will need to enroll via the Mercer Marketplace during the SYKES Annual Benefits Enrollment window of October 22 nd through November 5. The website address is More details are available in the Annual Enrollment 2016 presentation deck and in the 2016 Benefits Guide. Licensed Benefits Counselors are available at to walk employees through the plans and to provide valuable assistance with the decision-making process. Even if the employee is not eligible for some coverage, such as medical or dental, they may still be able to enroll in some voluntary plans, like accident or critical illness coverage (via the Mercer Marketplace or the local Aflac representative). 1

3 GENERAL QUESTIONS (Continued) What about an employee who is not eligible for company-sponsored benefits? If the employee is not eligible for SYKES-sponsored benefits, he or she can enroll in benefits the following ways: 1) The Mercer Marketplace individual insurance solution, powered by GetInsured, during a special Open Enrollment window of November 1, 2015 January 31, The website address is: or you may call them at Through the individual insurance solution, finding the right health plan is easy. Licensed benefits counselors will help employees review and enroll in an individual health insurance plan of their choice during the special individual insurance open enrollment period (November 1, 2015 through January 31, 2016). With the tools that are provided, one can: Find out if he or she qualifies for tax credits to help pay for health insurance. Understand what plans are available. Compare plans and determine what plans best meets the individuals needs and budget. Enroll in a plan with confidence. 2) Through the health plan of the employee s spouse or domestic partner, as appropriate. 3) Through government programs such as Medicare or Medicaid. Employees may visit to determine eligibility. Are the SYKES benefits linked? (For example, if you don t take medical, can you elect vision and dental)? SYKES benefits are not linked together. You can elect vision and dental without electing medical coverage. NEW HIRES Do new hires who join SYKES late in the year have a longer period in which to select their benefits? Employees who join SYKES late in the calendar year have some special enrollment timeframes as follows: New employees hired 9/1/15 10/31/15 will need to enroll for both the 2015 and 2016 plan years. New employees hired 11/1/15 12/1/15 will only need to enroll for the 2016 plan year. These employees are given the full 30-day window to enroll and are not limited to the Annual Enrollment window only. WAITING PERIODS 2

4 What are the waiting periods for company-sponsored benefits? The waiting period for all Corporate (Salary & Hourly) and Salaried employees is the first of the month following 30 days. 3

5 ELIGIBILITY Who is eligible for company-sponsored benefits? Employees who are salaried or Corporate (Tampa and Denver-based) hourly are eligible for companysponsored benefits, as well as their spouse or domestic partner, and dependent children up to age 26. MEDICAL What is a deductible? A deductible is the amount of money you pay before your health plan will pay its share. For example, if you have a health plan with an $800 deductible, you must reach that amount before your health plan begins paying. Your deductible can be found on your medical plan Benefit Summary. Please contact the Mercer Marketplace at if you need more information. Do I have to meet my medical plan deductible annually? Yes. Medical plan deductibles are reset to $0.00 at the start of every plan year (January 1st). How can I tell if I ve met my medical plan deductible? Your Explanation of Benefits (EOB), which you will receive approximately two weeks after service, states how much you have paid toward your deductible. You may also contact the medical carrier directly at any time for this information. What are the co-pays for the medical plans? All plans offered by BCBSFL and UHC are offered on a co-insurance basis and no longer have co-pays in their plan designs. This means that you must first satisfy the annual deductible for the plan you select before the plan begins covering expenses at the co-insurance percentage. For example, in the CDHP $1,500 deductible plan, you must first satisfy your deductible of $1,500 ($3,000 if two or more people are enrolled) and then the plan will cover eligible expenses at 80%, leaving the 20% balance to be paid by you. How do the deductibles vary between the $800 PPO and the $1,500 or $2,500 CDHP? There are two ways the $800 PPO medical plan will begin to pay benefits for a particular individual within the family: 1. If an individual meets his/her individual deductible, the health insurance benefits will begin and pay the co-insurance for that individual only, but not for the other family members. Example: Mike and Molly are on the EE + Spouse $800 PPO plan. Mike has met his $800 individual deductible, so the plan will begin to pay its co-insurance of his health care expenses. Molly is still responsible for all of her health care expenses. 2. If the family deductible is met by an individual participant or a combination of participants on the plan, the health insurance benefits for every member will begin. Example: Mike & Molly now have a son, Ben. They are enrolled in the $800 PPO under family coverage. Mike has $1,600 in personal medical expenses; therefore, he has met his $800 4

6 individual deductible and the plan will pay 80% of the next $800 in his expenses. Molly then incurs $500 in medical expenses and Ben has $300 in medical expenses. Even though neither Molly nor Ben has reached their individual deductibles, the family has satisfied the $1,600 family deductible ($800 for Mike, $500 for Molly and $300 for Ben). Now that the family deductible has been met, all future expenses for Molly and Ben will be paid at 80% by the plan. The deductible within the $1,500 or $2,500 CDHP medical plans operate differently (by law): 1. The deductible is tied to the number of people enrolled into the plan. In the case of a single person enrolling, the individual deductible applies; however, when two or more people enroll, the family deductible becomes the deductible to be satisfied before the plan will begin paying benefits. Example: Mike, Molly, and Ben are on the EE + Family $1,500 PPO plan. Even though Mike had enough personal medical heath care expenses ($1,600) in our example above to satisfy the $1,500 individual deductible, the plan will not begin paying any benefits until the family deductible of $3,000 is met. Had he been enrolled in employee-only coverage, the plan would have started paying claims once he satisfied the $1,500 deductible, but since he is enrolled in family coverage, the only deductible that applies is the $3,000 family deductible. Can I add a family member to my medical plan? You can add a family member during the SYKES Annual Benefits Enrollment period (October 22 through November 5, 2015) or when you experience a qualifying life event as defined by IRS Section 125 regulations such as marriage, divorce, birth or adoption of a child, loss of coverage, etc. Will there be a state listing of the available medical carriers prior to Annual Enrollment? Employees are only shown the plans and vendors for which they are eligible when they log into the Mercer Marketplace. Will there be a large increase in employee benefit costs this year? Costs change each year and total cost depends on the plan selected, with the $800 PPO being the most expensive and the $2,500 CDHP being the least expensive. We strongly recommend that you review your past use of medical benefits and select the plan that offers you the coverage required for the amount of payroll deduction you wish to pay. When both BCBSFL and UHC plans are offered, what the differences, besides price? Both the UHC and the BCBS plans were set up the same for deductibles and co-insurance. That is where the plans are identical. There may be a difference in what you pay out-of-pocket when you see a provider on one plan versus the other because of the contracted rate between the healthcare plan and the provider. Those rates are not decided upon by SYKES; they are contracted rates between the doctor and the insurance company. SYKES does not have access to those contracted rates. The network of doctors can also vary between UHC and BCBS; again, these are contracts between the providers and the insurance company. UHC and BCBS both have extensive provider networks, but there 5

7 is no guarantee that if a doctor is participating on one plan, that he or she is a participating provider on the other plan. There are additional plan documents available to you on the Mercer Marketplace website at mercermarketplace.com/sykes. We encourage you to go online to the UHC and BCBS websites to check to see if your doctors are participating in these carrier networks before you make a decision on which plan you would like to choose. Mercer Marketplace can also help you with looking up providers, if you choose. The Mercer Marketplace phone number is Mercer s licensed benefit counselors can assist you with any detailed questions you have and can help you choose a plan to fit your needs. What medical services are covered under preventive? Specific preventive services that must be covered without cost-sharing include: Items or services that have an A or B rating in the recommendations of the U.S. Preventive Services Task Force (USPSTF) Immunizations recommended by the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) Evidence-informed preventive care and screenings for infants, children, and adolescents as per Health Resources and Services Administration (HRSA) guidelines, including the Periodicity Schedule of the Bright Futures Recommendations for Pediatric Health Care Evidence-informed preventive care and screenings for women supported by HRSA This list will be updated on an ongoing basis. The complete and current list of preventive services covered without cost-share under the health reform law can be found at: For additional information, we recommend that you contact the healthcare plan directly. 6

8 CDHP/HEALTH SAVINGS ACCOUNT (HSA) Tell me more about the Consumer-Directed Health Plans (CDHPs) and the Health Savings Account (HSA). During Annual Benefits Enrollment (October 22 through November 5, 2015), you ll have three medical plans to choose from a PPO plan and two consumer-directed health plans (CDHPs). The CDHPs can be paired with a health savings account (HSA), which provides you with a way to contribute pre-tax dollars to pay for your out-of-pocket health care expenses while satisfying your annual deductible. You may wish to switch from the PPO plan to one of the newly CDHPs. In a changing health care market, CDHPs are growing more popular. A CDHP offers the following advantages: Pay lower premiums. Get a triple-tax-advantage. Get a one-time company-paid contribution of $250 when you open an HSA, plus SYKES will match a portion of your future contributions. You get to choose which expenses will be covered by your HSA dollars. You re covered from catastrophic medical care costs with the out-of-pocket maximum in your CHDP. Your HSA belongs to you and you decide how and when to spend it. Best of all, the money is yours and it travels with you even if you decide to leave the company. How do the CDHP deductibles work? You must first satisfy your deductible prior to receiving any benefit coverage. Pharmacy expenses are part of your deductible. After you have satisfied your deductible, the plan will begin covering expenses at the co-insurance rate for the plan you select. Please be aware that in a Consumer-Directed Health Plan (CDHP), if more than one person is enrolled, you must satisfy the FAMILY deductible before the plan begins covering expenses. (For example, in the $1,500 plan, a family has a $3,000 deductible. This means they need to reach $3,000 as a family to start their benefit coverage. The family deductible could be met by one or more family members; it doesn t matter.) What is the difference between a Flexible Spending Account (FSA) and a Health Savings Account (HSA)? Flexible Spending Account (FSA) is good for the current plan year. An employee sets aside money pre-tax and he or she has to use that money during that plan year. In other words: Use it or lose it. HSA is similar in that it is pre-tax money that is set aside, but with an HSA, the money is yours and you can spend it during that plan year or the next year. You can also take the HSA money with you in the event you leave the company. Last, but not least, unlike the FSA, there is no documentation required for HSA. However, we do suggest that you maintain copies in case you are ever audited. If I am enrolling in a CDHP, but I do not elect an HSA, can I elect to have a Healthcare FSA? Yes, a participant in a CDHP can elect a health FSA, but if they have elected the health FSA, they will be ineligible to make contributions to an HSA for the entire plan year. 7

9 DENTAL Who administers SYKES dental program? Dental benefits are administered by Delta Dental. How can I get a dental card? Dental cards are distributed by the carrier as a courtesy and ARE NOT required to receive service. Tell your dentist s staff that you are covered by Delta Dental and they can verify your coverage directly with Delta Dental. ID cards will be mailed to your home address in late December/early January. Who do I call if I have questions about a dental claim? You can contact Delta Dental s member service number for any questions about a dental claim. You can also see your claims online at the dental carrier's website. Do I have to meet my dental deductible annually? Yes. How can I tell if I ve met my dental plan deductible? Your Explanation of Benefits (EOB) will state how much you have paid toward your deductible or you may check the Delta Dental website or call their customer service department. Can I add a family member to my dental plan? You can add a family member during our Annual Benefits Enrollment period or when you experience a qualifying life event as defined by IRS Section 125 regulations, such as marriage, divorce, birth or adoption of a child, loss of coverage, loss of COBRA, etc. Contact the Mercer Marketplace ( ) for more information. When is Open Enrollment for the dental plan? Open enrollment for the dental plan is part of SYKES Annual Benefits Enrollment (October 22 through November 5, 2015). Does the dental plan cover orthodontia? It depends on the plan; the Enhanced dental plan includes coverage for orthodontia. Does the dental orthodontia cover adults? Yes. VISION Who is SYKES vision provider? Our vision program is administered by EyeMed. What is the eligibility for vision? Vision benefits are for all benefits-eligible employees and their dependents, including children up to age 26. 8

10 VISION (Continued) Do I receive an ID card for vision coverage? No, you will not receive an ID card for EyeMed vision coverage. Just tell your provider you have EyeMed and they will confirm your benefits. PRESCRIPTION/PHARMACY Who is SYKES prescription plan provider? The prescription plan is administered by OptumRx, formerly known as Catamaran. How will prescription drug coverage work in 2016? We are utilizing a stand-alone pharmacy benefit manager, OptumRx, formerly Catamaran, in Once you enroll into either a BCBSFL or UHC medical plan, you are automatically enrolled into pharmacy with OptumRx and you will receive a separate identification card for prescription drugs. This ID card will be mailed to you in late December/early January. Where can I see the full pharmacy formulary list or obtain additional details? You may access the full formulary list and more information at: Are there still co-pays for prescription drugs? In the BCBSFL and UHC $800 plans you have a co-insurance percentage to pay depending on the type of prescription; however, you have a minimum and maximum dollar amount that would not be exceeded for the cost of the prescription. In both the $1,500 and $2,500 plans, you must first satisfy your annual deductible for the plan and then the plan would begin covering prescriptions at the co-insurance percentage amount. There is no minimum or maximum dollar amounts that you could be charged under these plans. Do I have to enroll in prescription coverage separately? No, you do not have to enroll in prescription coverage separately; when you enroll in a medical plan, you are automatically enrolled in prescription/pharmacy. Do I have to pay a separate deductible for medical and pharmacy? No, you only have to pay a single deductible for both medical and pharmacy benefits. For the prescription/pharmacy plan, do we still have mail order? Yes, OptumRx offers mail-order services. 9

11 VOLUNTARY What voluntary options are available for 2016? The voluntary benefits that are available depend on where you are located. These might include some or all of the following: Accident insurance - Provides financial protection for non-work-related accidents or injuries Critical illness insurance - Provides financial protection for critical illnesses, such as cancer Hospital indemnity - Provides coverage for hospital expenses not covered by your medical plan Group legal - Offers discounted legal services Please Note: Not all voluntary benefits will be effective January 1, Some will become available during the first quarter of Not all benefits are available in all states. When will pet insurance be available? Pet insurance is available and you can elect it through the Mercer Marketplace website. If you elect this benefit, you will be direct-billed from the carrier for the coverage; no payroll deductions are taken for pet insurance. BENEFITS CARRIERS/VENDORS Who are the benefits carriers/vendors for 2016? You ll find many details about the SYKES benefit plans on the Mercer Marketplace website. For more information, or to contact a carrier or plan administrator directly, please refer to the Benefits Contacts chart. 10