2015 Annual Enrollment Guide

Transcription

1 2015 Annual Enrollment Guide For Active Employees Enroll in Your Benefits WHEN: Between 8 a.m. Central Standard Time on Monday, November 3, 2014, and midnight Central Standard Time on Friday, November 14, You can make changes throughout the Annual Enrollment period. Elections saved as of the close of the enrollment period will take effect January 1, 2015 and continue through December 31, WHERE: HOW: Log in to or call BaxHR4U ( ) and follow the prompts to speak with a Baxter Employee Benefit Center (BEBC) representative. Service representatives are available to take your call Monday through Friday from 8 a.m. to 5 p.m. Central Standard Time Annual Enrollment Begins: Monday, November 3, 2014, at 8 a.m. Central Standard Time Ends: Friday, November 14, 2014, at midnight Central Standard Time Enroll online at

2 Inside This Guide 2015 Benefit Changes... 4 Medical Plan Options... 6 Prescription Drug Coverage for the PPO and BTO Plans... 8 Dental Plan Options... 9 Other Benefits You Can Elect...10 Notices About Your Benefits Coverage and Rights...11 Enrollment Deadline After November 14, 2014, you can change elections only if you have a qualified change in status such as marriage, adoption or birth of a child, divorce, death of a covered dependent, or a change in your spouse s or domestic partner s employment status. Changes due to a qualified change in status must be made within 31 days of the event. 2

3 At Baxter, we have a longstanding commitment to provide market competitive benefits. Both New Bax and New Bio share this commitment and at the time of Baxter s separation, both new companies will continue your existing benefit plans. After separation, New Bax and New Bio will continue to review and modify their programs over time to ensure they remain competitive and continue to meet the needs of employees and the individual companies. Your Baxter benefits are a valuable portion of your total compensation. Each year during Annual Enrollment, you have the opportunity to review your benefit elections and make changes to meet your needs and the needs of your dependents. This Enrollment Guide will help you make decisions on the following benefits for 2015: Medical Coverage Dental Coverage Flexible Spending Accounts Long-Term Disability Plus Insurance Supplemental Life Insurance Personal Accident Insurance Long-Term Care Insurance As communicated in July, your 2015 benefit elections will continue at New Bax and New Bio after the separation. 3

4 2015 Benefit Changes Consistent with our goal to align our benefits with the marketplace, Baxter has made the following changes for the upcoming year: Benefit Medical Plans (PPO, BTO, BCO) HMOs Basic Life, Supplemental Life and Personal Accident Insurance Healthcare Contribution Rates What s Changing Residential Treatment Center (RTC) for the treatment of Substance Abuse and Mental Health conditions is now covered subject to medical review. Pre-certification is required. HMO offerings may have plan design changes. Visit for details. The Hartford will be the new provider of Life and Personal Accident benefits. A temporary rate reduction has been in place over the past few years for Employee Supplemental Life contribution rates. For 2015, the rate reduction will no longer apply and rates will be restored to levels consistent with the marketplace for similar group plans. You will see an increase in rates if you enroll in Employee Supplemental Life. Both you and Baxter will see an increase in contribution rates in 2015 consistent with marketplace trends. The new employee contribution rates for your benefits can be found online at beginning November 3. Please note that your costs depend on the plan you choose and the number of eligible dependents you cover. Summary of Benefits and Coverage A summary of each medical plan offered is available to help you understand and evaluate your medical insurance choices. The summaries can be found online at Additionally, you may request a paper copy by calling the Baxter HR Center at BaxHR4U ( ) and following the prompts to the BEBC. If You Are on Leave of Absence During Annual Enrollment, you can only make changes to your medical and dental coverage. When you return to active work, you can complete your other benefit elections, if eligible. Changes can be made by logging in to within 31 days of your return to active work. 4

5 Who s Eligible? You and the following family members are eligible for the Baxter benefits* outlined in this guide: Your spouse. Your domestic partner of the same or opposite gender. If you intend to enroll a domestic partner and/ or the children of a domestic partner, call the Baxter HR Center at BaxHR4U ( ) and follow the prompts to the BEBC. What Happens If You Don t Enroll? For medical, dental, life, and personal accident insurance coverage, your children, including the children of your domestic partner, under age 26. * Short- and Long-Term Disability Insurance plans are available only to you. If you are currently enrolled in: If you do not enroll: Medical Coverage Your current election, if available, will continue for If your current election is NOT available, you will default to the PPO (Preferred Provider Option). If the PPO is not available, you will default to the BTO (Baxter Traditional Option). Dental Coverage Your current election, if available, will continue for If your current election is NOT available, you will be enrolled in the Basic Dental Plan. Supplemental Life, Long-Term Disability, Long-Term Care and Personal Accident Insurance Your current elections will continue for Healthcare and Dependent Care FSAs Your current elections will NOT continue for These accounts must be elected each year per IRS rules. Mandatory Medical Coverage Acknowledgement If you waive medical coverage, you must complete the Waiving Medical Coverage survey online at during Annual Enrollment. Dependent Eligibility Audit Baxter conducts dependent eligibility audits on an ongoing basis. This means that if one or more of your dependents are enrolled in Baxter benefits, you are required to provide proof of their eligibility for coverage (such as a birth certificate or a marriage license). Take the time to ensure your covered family members are eligible for coverage and make changes as needed. If you participated in Baxter s Dependent Eligibility Audit in the past and received a confirmation letter, your verification process for those dependents is complete. If you enroll a new dependent, or if you did not previously participate in the audit, you are required to provide the necessary documentation for each dependent shortly after the start of the plan year. Additional information will be mailed to your home after Annual Enrollment. For a complete list of eligible dependents, see the Medical Summary Plan Description (SPD) under Plan Information at New ID Cards If you switch plans or enroll in a plan for the first time, new plan ID cards will be mailed to your home by January 1, Otherwise, you will not receive a new ID card. 5

6 Medical Plan Options The following is a summary of the medical plan options offered. Additional information to help you understand these options are available online at Preferred Provider Option (PPO) The PPO, offered through Blue Cross and Blue Shield of Illinois (BCBSIL), is available to employees who reside in PPO coverage areas. The PPO gives you access to one of the nation s largest networks of doctors, hospitals and other healthcare facilities. While you can see any doctor, you will pay lower out-of-pocket costs when you go to doctors and facilities in the PPO network. To find a doctor in the PPO network, visit and use the Provider Finder tool. If you are prompted to enter an alpha prefix, enter BXE. Key Features of the PPO Plan Plan Feature In-Network Services Out-of-Network Services Annual Deductible Employee $275 $550 Employee + Family $550 $1,100 Annual Out-of-Pocket Maximum (including deductible and copays) Employee $2,500 $5,050 Employee + Family $5,000 $10,100 Preventive Care Routine Preventive Care Plan pays 100% Not covered Mammogram, Colonoscopy, Pap and PSA Tests Office Visits Plan pays 100% Plan pays 60% after you meet the deductible Primary Care Physician Plan pays 100% after $20 copay Plan pays 60% after you meet the deductible Specialist Plan pays 100% after $35 copay Plan pays 60% after you meet the deductible Hospital and Surgery Services Emergency Care Plan pays 80% after you meet the deductible and $55 copay (copay waived if admitted) Plan pays 80% after you meet the in-network deductible and $55 copay (copay waived if admitted); if not a true emergency, plan pays 60% after you meet the out-of-network deductible and copay Inpatient Hospitalization Plan pays 80% after you meet the deductible Plan pays 60% after you meet the deductible Outpatient Surgery Plan pays 80% after you meet the deductible Plan pays 60% after you meet the deductible Diagnostic X-Ray and Laboratory Services Mental Health and Substance Abuse Plan pays 80% Plan pays 60% after you meet the deductible Inpatient Plan pays 80% after you meet the deductible Plan pays 60% after you meet the deductible Outpatient Office Visits Plan pays 100% after $20 copay per visit Plan pays 60% after you meet the deductible Group Therapy: Unlimited Visits Plan pays 100% after $20 copay per visit Plan pays 60% after you meet the deductible 6

7 Baxter Traditional Option (BTO) If you live outside the PPO coverage area, the BTO will be available to you. The BTO gives you the flexibility to go to any doctor, hospital or other provider and pays 80% of your eligible charges once you meet the deductible ($325 individual, $650 family). You are then responsible for any portion of payment not covered by the plan up to the out-of-pocket maximum. For more information on the BTO, visit Baxter Catastrophic Option (BCO) The BCO is available to all employees. This high deductible option, with a low premium cost, provides medical coverage in case you or an eligible family member develops a major illness or suffers a serious accident. Once you meet the plan s deductible limit ($5,000 individual, $10,000 family), the plan pays 100% of eligible medical and prescription drug charges. For more information on the BCO, visit Health Maintenance Organization (HMO) Options Each year, Baxter reviews the HMOs offered at each U.S. location. To find out if an HMO is available in your location or for details on plan design changes for Baxter s HMO offerings, visit If You Live Outside a Plan s Coverage Area If you live outside of a geographic area covered by a medical or dental plan but still wish to enroll in one of these plans, you may request to do so during Annual Enrollment. To enroll online: 1. Select one of the medical or dental plans listed on your enrollment worksheet at Save your elections and print your confirmation statement. This step is necessary because requests for a plan outside a coverage area are subject to approval. 2. Go to Resource Library, print the Opt-In Appeal Form: 2015, complete and return it to the BEBC. Forms must be received no later than November 14, The plan administrator will determine if your request will be approved. If your request is denied, you will be enrolled in the plan(s) you elected in Step 1. Note: If you opted into coverage last year, please review your coverage options carefully as opt-in elections do not carry over from year to year. Pre-Certification and Verification As in the past, if you are covered under Baxter s PPO, BTO or BCO plans, you are required to pre-certify at least one business day before or within 48 hours following an emergency admission for any inpatient admissions, residential treatment center care, skilled nursing care, private duty nursing and home healthcare. In addition, before receiving any services, it is your responsibility to verify medical necessity and understand your benefits. You can request a predetermination review for a recommended procedure to make sure it meets the plan s medical necessity criteria. For more information on your benefit coverage, pre-certification requirements, or predetermination review, call BCBSIL Customer Service at

8 Prescription Drug Coverage for the PPO and BTO Plans The following chart summarizes your prescription drug coverage available through CVS Caremark. Visit the CVS Caremark website at for more information on specific drug costs. No registration or login is required. Key Features of Baxter s Prescription Drug Coverage Type of Prescription Drug Retail Amount You Pay* Mail Order Amount You Pay* Generic $10 $20 Brand name, when a generic equivalent is not available Brand name, when a generic equivalent is available 25% coinsurance ($20 minimum/$60 maximum) $10, plus the difference in cost between the brand name and generic equivalent 20% coinsurance ($40 minimum/$120 maximum) $20, plus the difference in cost between the brand name and generic equivalent * The amount you pay will not exceed the drug cost. Drugs determined as non-formulary based on the prescription claims administrator s current formulary are not covered by the Plan. Additionally, there is a separate prescription drug out of pocket maximum: $2,000 individual/$4,000 family only. BeWell@Baxter One way to get and stay healthy is to receive regular checkups and routine health screenings. Routine, in-network preventive and wellness care are covered at 100% in the PPO and BTO plans. This includes adult physical exams, well-baby and well-child care, mammograms, Pap and PSA tests, and colonoscopies. Through your medical plan, you may have access to fitness center discounts and other programs like smoking cessation and weight management resources that encourage you to stay active and healthy. Check with your medical plan for details. For more information, visit the BeWell@Baxter intranet site by selecting BeWell@Baxter from the Quick Links drop-down menu on the Baxter intranet homepage. Refer to the Taking Action tab. You also have access to the Personal Wellness Profile Tool. Through this tool, you will be able to personally and confidentially review your health status and identify and set goals for improvement. For more information or to access the tool, visit the BeWell@Baxter intranet site by selecting BeWell@Baxter from the Quick Links drop-down menu on the Baxter intranet homepage. Refer to the Staying Well tab or go to Employee Assistance Plan Help when you need it The EAP provides you and your family members with up to three free counseling sessions for help with a wide variety of issues, including marital differences, stress, financial, legal, child or elder care issues and work-related concerns. The EAP network includes more than 50,000 providers nationwide who can offer you the right care in a manner that is comfortable and convenient for you. To talk to someone confidentially about your concerns, call the toll-free number, anytime. You can also visit the EAP website at 8

9 Dental Plan Options You can choose between two BCBSIL dental options or the CIGNA Dental HMO (DHMO), if it is available in your location. Basic Dental or Basic Plus Dental Under these BCBSIL options, you can use any dentist and receive the same level of benefits whether the dentist is in or out of network. Your costs will likely be less when you use an in-network dentist because BCBSIL negotiates better rates with these providers. DHMO (if available in your location) Under the DHMO, you must select a network dentist. The DHMO covers most dental expenses with no deductible or annual limit. Preventive care, general services and orthodontia are covered according to a schedule of benefits. For details, visit To find a participating dental center, visit and use the Find A Doctor tool. Key Features of the Dental Plan Options Service Basic Dental Basic Dental Plus DHMO Annual Deductible No annual deductible; $5 copay applies to all office visits Employee Employee + Family $150 $300 $125 $250 None None Preventive Plan pays 100% of reasonable and customary charges Plan pays 100% of reasonable and customary charges Plan pays 100% Basic (Endodontics, fillings, oral surgery, periodontics) Plan pays 65% of reasonable and customary charges after deductible Plan pays 80% of reasonable and customary charges after deductible Plan pays 100% Major (Crowns, prosthodontics, implants) Plan pays 50% of reasonable and customary charges after deductible Plan pays 50% of reasonable and customary charges after deductible Plan pays 60% (denture repairs 100%; implants are not covered) Orthodontia No coverage Plan pays 50% of reasonable and customary charges up to $1,500 per person, per lifetime* Plan pays 50% (no maximum benefits) Annual Benefit Maximum, per person $2,000 $2,000 No maximum * Spouses, domestic partners and dependent children over age 19 are not eligible for orthodontia. 9

10 Other Benefits You Can Elect Life, Personal Accident, Disability and Long-Term Care Insurance For details, go to Rates will be shown on your online Annual Enrollment worksheet. Healthcare and Dependent Care Flexible Spending Accounts (FSAs) You can save on taxes using pre-tax money you ve set aside in these accounts to pay for eligible expenses. The maximum amount you can contribute in 2015 to the Healthcare FSA is $2,500 and the maximum amount you can contribute to the Dependent Care FSA is $5,000 (some restrictions may apply if you are married). You can use your Healthcare FSA for eligible healthcare expenses not covered by your medical, dental or vision plans, including deductibles, copays and coinsurance amounts, as well as many common healthcare purchases (e.g., saline solution and first-aid supplies). Over-the-counter medicines (e.g. Claritin, Advil, cough syrups) are not considered eligible expenses unless accompanied by a prescription. Your Dependent Care FSA can be used for child care services for your eligible dependent children under age 13, or for services to care for other qualified dependent family members (e.g., elder care). Note: Both are use it or lose it accounts per IRS guidelines meaning you forfeit any unclaimed funds remaining in your account after the claim deadline. WageWorks, Baxter s FSA vendor, has tools to help you estimate your annual expenses (visit for details). When the current year ends on December 31, 2014, you will have a grace period of 2½ months (until March 15, 2015) to incur eligible claims. For the 2015 calendar year, you can be reimbursed for eligible expenses incurred up to March 15, For a comprehensive list of eligible expenses, see the SPD at com or visit and view IRS Publications 502 (healthcare) and 503 (dependent care). Voluntary Benefits Through YouDecide, an external vendor, you have the opportunity to enroll in the following employee-paid benefits through convenient payroll deductions: 1 Vision Insurance Legal Benefits Auto Insurance Homeowners Insurance Pet Insurance If you would like to enroll in Vision Insurance and/or Legal Benefits, you must do so during Annual Enrollment. Coverage will begin on January 1, If you are currently enrolled in Vision and/or Legal, your election and covered dependents will continue for the benefit year starting January 1, Note: The monthly rate for Legal Benefits will increase starting on January 1, You can enroll in Auto, Homeowners and/or Pet Insurance benefits anytime during the year. For plan and rate information, to enroll, disenroll, or to make any changes to your Voluntary Benefits, visit (Note: This is a separate external site). 1 Baxter does not sponsor, endorse or have any responsibility for these benefits. Baxter s sole involvement with these benefits is to withhold the cost of any benefits that you choose to purchase from your paycheck, on an after-tax basis, and transmit the payments to the applicable provider. Any questions that you have about the benefits must be directed to the provider. For additional information, see the materials from the providers of these benefits. Employee Discounts You and your family have the opportunity to save money on a range of products and services such as electronics, fitness center memberships, movie tickets, flowers, gifts, books and music, through Baxter s employee discount program. Visit for more details and offers. You will be prompted to create a username and password. In addition, you also have access to many other corporate discounts on items such as automobiles, cellular phones and travel-related services. For more details, select Employee Discounts from the HR Links drop-down menu on the Baxter intranet homepage. 10

11 Notices About Your Benefits Coverage and Rights For more information on these notices, go to and click on Plan Information for the Summary Plan Descriptions. If you have questions, call the Baxter HR Center at BaxHR4U ( ) and follow the prompts to the BEBC. HIPAA Privacy Notice Under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), the Baxter plans are required to provide you with a HIPAA Notice of Privacy Practices ( Notice ) at the time of your enrollment in the plan, and at certain other times. In addition, the plan is required to periodically notify you of the availability of the Notice, and provide you with information on how to obtain a copy of the Notice. You may request a copy of the plan s Notice by visiting and clicking on Plan Information. To the extent that the plan contains benefits other than those covered under HIPAA s privacy rule, this reminder pertains only to those healthcare benefits that are covered under HIPAA s privacy rules. A copy of the latest notice is included in this mailing. Women s Health and Cancer Rights Act of 1998 The Women s Health and Cancer Rights Act of 1998 requires Baxter to advise you annually of the following benefits. Your Baxter medical plan provides for mastectomy-related services, including reconstruction and surgery to achieve symmetry between the breasts. It also provides for mastectomy-related prostheses and provides for services to address complications resulting from a mastectomy, including lymphedema. For more information, consult your medical plan s member services department. Notice of Special Enrollment Rights Children s Health Insurance Program ( CHIP ) Effective April 1, 2010, if you and your eligible dependents are not already enrolled in Baxter s medical plan, you may enroll yourself and your eligible dependents if (1) you or your dependents lose coverage under a state Medicaid or CHIP, or (2) you or your dependents become eligible for premium assistance under the state Medicaid or CHIP, as long as you request enrollment no more than 60 days from the date of the Medicaid/CHIP event. Notice of Grandfathered Plan Status For the 2015 Plan Year, the BTO, BCO, BCBS North Dakota POS, and Bluecare Michigan, Kaiser Permanente California HMO options remain grandfathered health plans under the Patient Protection and Affordable Care Act (the Affordable Care Act). All other options under the Baxter Medical Plan are no longer grandfathered health plans. As permitted by the Affordable Care Act, a grandfathered healthcare plan can preserve certain basic healthcare coverage that was already in effect when that law was enacted. Being a grandfathered healthcare plan means that your plan may not include certain consumer protections of the Affordable Care Act that apply to other plans; for example, the requirement for the provision of preventive healthcare services without any cost sharing. However, grandfathered healthcare plans must comply with certain other consumer protections in the Affordable Care Act; for example, the elimination of lifetime limits on benefits. Questions regarding which protections apply and which protections do not apply to a grandfathered healthcare plan and what might cause a plan to change from grandfathered healthcare plan status can be directed to the plan administrator. You may also contact the Employee Benefits Security Administration, U.S. Department of Labor at or This website has a table summarizing which protections do and do not apply to grandfathered healthcare plans. 11

12 Baxter International Inc. One Baxter Parkway Deerfield, Illinois This guide provides highlights of your Baxter benefits for the 2015 plan year. Please keep this guide with your Summary Plan Descriptions (SPD) and other important papers. This guide is not your SPD. For a copy of your SPD, log in to and click on Plan Information. This guide is based on official plan documents. If there is any discrepancy between this guide and the official documents, the official documents will govern. Nothing in this guide says or implies that participation in the plans described is a guarantee of continued employment with Baxter, nor is it a guarantee that the plans will remain unchanged in the future. Baxter reserves the right to suspend, amend or terminate these plans at any time. For questions about your benefits, call the Baxter HR Center at BaxHR4U ( ) and follow the prompts to the BEBC.