2015 IBM Benefits Enrollment Guide for IBM Active Employees IBM Benefits Enrollment Guide
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1 2015 IBM Benefits Enrollment Guide for IBM Active Employees 2014 IBM Benefits Enrollment Guide October 2014 Dear IBMer, Each fall, we ask you to make healthcare benefit elections for you and your family. As part of our commitment to provide high-quality, cost-effective benefits, this year IBM is adding a valuable health plan option for you to consider a second Health Savings Account (HSA) plan, the IBM PPO Plus with HSA. Whatever plan option you choose, IBM s Commit to Health strategy is to give you the right tools and information, at the right time, to make the right health decisions for you and your family. We continue to offer the traditional PPO and HMO medical plan options, so to help you consider the array of plan options, we re making resources available in two stages to give you time to educate yourselves before you make your enrollment decisions. We recommend you follow these simple steps before you make your health plan decisions: STEP ONE: Review your benefits Learn what s new We believe HSAs are a commonsense approach to helping you better manage your healthcare dollars. Every IBMer should know how they work, so we also are offering you a way to earn money by completing one of several educational programs. Review the At a Glance summary of 2015 changes on page 3. You ll find more details throughout this guide and on netbenefits.com/ibm. You will be able to find your personal information on NetBenefits on November 12, when you make your enrollment decisions. STEP TWO: Consider your needs Look for the right health plans and disability coverage to protect your family. Be sure your covered dependents are still eligible for coverage. STEP THREE: Complete Consumer Education and Earn Incentives Every IBMer should have greater insight into their healthcare, so we are offering an opportunity to earn money through a Consumer Education Incentive, no matter which plan option you choose; even if you choose not to enroll in a medical plan through IBM. Learn more on page 15 of this enrollment guide. (Note: Supplemental employees who enroll in an HSA-eligible health plan option for 2015 will be eligible for incentive payments.) FINALLY STEP FOUR: Choose your benefits online Go to netbenefits.com/ibm between November 12 and December 11 to select your coverage for IBM continues to partner with health plans and the healthcare community to advance the health and well-being of every IBMer and their family members. We will continue to offer high-value, low- to no-cost programs like telemedicine, Employee Assistance Program and the Integrated Health Services Program. For now, be sure to review this annual enrollment guide carefully so you can select the 2015 plan option that s best for you and your family. Sincerely, Kyu Rhee, M.D., MPP Chief Health Director, IBM 1
2 Guide to 2015 IBM Benefits Enrollment for Active Employees Enrollment Period: Wednesday, November 12 Thursday, December 11, 2014 In addition to information in this guide, details and resources you ll need to research and select your coverage for 2015 are available to you online 24/7 via NetBenefits at netbenefits.com/ibm. We also encourage you to view the resources in the IBM Connections Community. If you have questions or need assistance, call the IBM Employee Services Center at (TTY: ) on business days (excluding holidays recognized by the New York Stock Exchange) between 8:30 a.m. and 8:30 p.m. Eastern time to speak with a service representative. WHAT S INSIDE At a glance: summary of changes for What s new for 2015 and important reminders Medical... Tobacco surcharge... Prescription drug coverage... Dental... Vision... Healthy Living Incentives... Health Savings Account... Health Care Spending Account... Disability protection... When you re ready to enroll... Information about Medicare coverage
3 At a glance: summary of changes for 2015 New Health Savings Account-eligible (HSA) health plan option available For 2015, IBM will introduce a new medical plan option, the IBM PPO Plus with HSA, giving you two HSAeligible health plan options. See page 5 for details. Updates to annual deductible and out-of-pocket maximums Annual deductibles and out-of-pocket maximums will increase in response to the increased cost of healthcare. For 2015, your costs for prescription drugs will apply toward the medical out-of-pocket maximum under the IBM PPO, IBM PPO Plus and IBM EPO. Turn to page 6 to review changes to coverage that will be effective as of January 1, Tobacco surcharge for medical coverage Effective January 1, 2015, a $50 per month surcharge will apply for IBMers and their enrolled spouses/domestic partners who use tobacco products. Instituting a tobacco surcharge is intended to help offset the additional healthcare costs typically incurred by tobacco users. However, you will have an opportunity for these surcharges to be refunded if you complete your health plan s tobacco cessation program. Information about this surcharge begins on page 6. Consult ALEX before selecting your medical plan option ALEX is the host of a unique online experience that will help you understand and make decisions about your medical and dental plan options during annual enrollment. Learn more about ALEX on page 9. Contribution-free medical coverage remains available through the IBM PPO with HSA In 2015, IBM will continue to pay the full cost of coverage for eligible full-time employees (contributions are required for dependents) who enroll in the IBM PPO with HSA (formerly referred to as the IBM High Deductible PPO with HSA). See page 9 for more information. Changes for the IBM Managed Pharmacy Program Beginning January 1, 2015, under the IBM PPO with HSA and IBM PPO Plus with HSA, the coinsurance percentage for generic prescription drugs will decrease, and it will increase for brand name formulary drugs. Per prescription maximums under these medical options will be $150 for a 30-day supply and $450 for a 90-day supply of generic, brand name formulary, and brand name non-formulary drugs. View the 2015 plan provisions for the HSA-eligible health plan options on page 12. Under the IBM PPO, IBM PPO Plus and IBM EPO, there will be no changes to the per prescription maximums for generic, brand name formulary, or brand name non-formulary drugs for Under these medical options, your costs for prescription drugs will count toward the medical out-of-pocket maximum. View the 2015 plan provisions for these options on page 13. Slight increase in contributions for dental coverage Your cost for dental coverage will increase slightly for 2015, as IBM continues to shift its subsidies toward the cost of coverage from dental to medical. See page 14 for more information. Earn between $300 and $1,100 through the expanded Healthy Living Incentives IBM will build upon its commitment to healthy living by offering additional opportunities in 2015 to learn about and take charge of your personal health and healthcare expenses. The program choices and incentive amounts available to you will depend on the medical plan option and level of coverage you select for Learn more about this new opportunity on page 15. New HSA recordkeeper for 2015 Beginning January 1, 2015, Fidelity Investments will be the recordkeeper for health savings accounts opened in conjunction with enrollment in the IBM PPO with HSA or the IBM PPO Plus with HSA. Find out more, including how to open a Fidelity HSA, on page 18. 3
4 IBM will contribute $500 to HSAs in January 2015 For 2015, IBM will contribute $500 to an HSA for active employees who enroll in the IBM PPO with HSA or the IBM PPO Plus with HSA. IBM s full $500 contribution will be deposited into your HSA in January 2015, giving you access to the full value of these funds early in the year. See page 19 for more information. Note: IBM s HSA contributions and any incentive payments you earn are based your enrollment in an HSAeligible health plan option as of January 1, If you are not enrolled in an HSA-eligible health plan on that date, you will be required to refund IBM the amount paid to you in your account. Contribution changes for long-term disability coverage in 2015 Contributions for some long-term disability plans will decrease in For more information and details about the disability coverage IBM offers, see page 21. Take Advantage of Online Tools IBM encourages you to explore the wide variety of information offered on your health plan administrator s Web site. You ll find interactive tools to help you estimate your costs for medical tests and services based on your specific benefit plan. See page 11 for more information. 4
5 WHAT S NEW FOR 2015 AND IMPORTANT REMINDERS MEDICAL Your medical plan options for 2015 For 2015, IBM will introduce a new medical plan option, giving you even more choice in selecting a plan that is right for you and your family. The following options are available for 2015: IBM PPO IBM PPO Plus IBM EPO IBM PPO with HSA NEW for 2015 IBM PPO Plus with HSA HMOs (if available in your area) Introducing the IBM PPO Plus with HSA Like the currently available IBM PPO with HSA option, the new IBM PPO Plus with HSA features a health savings account with an annual contribution of up to $500 from IBM but this new option offers a lower annual deductible: Individual deductible: $2,000 Family deductible: $4,000 Both HSA-eligible health plan options offer the opportunity to earn tax-free Healthy Living Incentives in 2015 that will be deposited into your health savings account: Individual coverage: up to $300 in lieu of the taxable Healthy Living Rebates Family coverage: up to $300, plus up to an additional $800 when your spouse/domestic partner or family completes the program requirements Turn to page 15 to learn more about the tax-free incentives you can earn in 2015 when you complete the program requirements. Those who enroll in one of the HSA-eligible health plan options will not be eligible for the Healthy Living Rebates in However, the incentives available to you up to $300 for individual coverage or up to $1,100 for family coverage will not be subject to taxes when they are deposited into your HSA or when you withdraw them to pay for eligible healthcare expenses. This allows you to use the full amount of the incentives you earn. Keep in mind that Healthy Living Rebates (available if you enroll in a traditional plan) are subject to applicable federal, state and local taxes when paid to you because they are considered taxable income. HSA quick reference HSAs offer triple tax advantages. You make before-tax contributions to your account investments, earnings can grow tax-free and funds withdrawn to pay for current and future qualified medical expenses are not subject to federal taxes. Unlike a Health Care Spending Account, funds you do not use roll over from year to year, stay in your account and can grow over time. You own the account, so it is yours to keep even if you leave IBM. What s more, interest and investment earning are not subject to federal taxes. You can use an HSA to pay for your share of eligible qualified medical expenses as defined by the IRS (e.g., deductibles, coinsurance and copayments), as well as laser eye surgery, hearing aids and batteries, acupuncture and other qualified medical expenses. Other eligible expenses include long-term care insurance premiums (up to certain limits) and COBRA and Medicare premiums. More information about the HSA-eligible health plan options available to you in 2015 as an IBMer is on the following page. 5
6 Annual deductible and out-of-pocket maximums The table below shows changes to coverage that will be effective as of January 1, Please note: Annual deductible and out-of-pocket maximum amounts apply to medical and mental health/substance abuse services combined. Beginning January 1, 2015, your costs for prescription drugs will also be applied to the annual out-ofpocket maximum under all medical options. Annual deductible Annual out-of-pocket maximum Individual Family Individual Family IBM PPO with HSA* In-Network $6,450 $12,900 $2,550 $5,500*** Out-of-Network $15,600 $23,500 IBM PPO Plus with HSA* In-Network $6,450 $12,900 $2,000 $4,000*** Out-of-Network $15,600 $23,500 IBM PPO** In-Network $1,350 $4,000 $6,600 $13,200 Out-of-Network $2,350 $7,200 $15,000 $27,000 IBM PPO Plus** In-Network $300 $600 $6,100 $9,100 Out-of-Network $2,350 $7,200 $15,000 $27,000 IBM EPO** In-Network $0 $0 $6,600 $13,200 * Medical and prescription drug charges (except for preventive medications) are subject to the annual deductible and apply toward the annual out-of-pocket maximum. ** Prescription drugs are not subject to the annual deductible but do apply toward the annual out-of-pocket maximum. *** If you enroll in Family coverage under an HSA-eligible health plan option, you must meet the Family deductible before the plan begins to pay benefits. Individual deductibles do not apply. Detailed coverage information including medical services, prescription drugs and mental health and substance abuse care services for each of your 2015 medical plan options is available from your Benefits Enrollment page on netbenefits.com/ibm. You may also refer to the Health Benefit Comparison Charts for Active Employees, available in the Reference Library. Tobacco surcharge for medical coverage Effective January 1, 2015, a $50 per month surcharge will apply for IBMers and their enrolled spouses/domestic partners who have used any tobacco products since July 1. This surcharge is being instituted to help offset the additional healthcare costs typically incurred by tobacco users. For purposes of this surcharge, a tobacco product is defined as any product derived from tobacco that is intended for human consumption (U.S. Food and Drug Administration) and includes cigarettes, cigars, pipe tobacco, roll-your-own tobacco, smokeless tobacco and e-cigarettes. You will be asked to indicate whether you and your spouse/domestic partner, if applicable, have used any tobacco products within the last six months when you enroll in your 2015 medical plan coverage. You will select one of the following options for yourself and a separate option for your spouse/domestic partner: Non-Tobacco User: Select this option if you have not used any tobacco products since July 1. Tobacco User: Select this option if you have used any tobacco products since July 1 and do not wish to participate in your health plan administrator s tobacco cessation program. Cessation Program: Select this option if you have used any tobacco products since July 1 but agree to complete your health plan administrator s tobacco cessation program by June 30, (Note: If your healthcare provider advises that participating in a tobacco cessation program is medically inappropriate for you due to a health factor, you should select the Cessation Program option and then contact the IBM Employee Services Center to initiate a medical review of your situation.) 6
7 Tobacco surcharge details The table below provides information about the tobacco surcharge that may be added to your contributions for medical coverage each month, depending on the option you (and your spouse/domestic partner, if applicable) select. Option Result Total monthly surcharge as of January 1, 2015 Non-Tobacco If you and/or your spouse/domestic partner indicate No monthly surcharge will User that you have not used any tobacco products since July 1, the tobacco surcharge(s) will not apply to your contributions for 2015 medical coverage. apply for each individual indicating that they have not used any tobacco products since July 1. Tobacco User Cessation Program If you and/or your spouse/domestic partner indicate that you have used any tobacco products since July 1, the tobacco surcharge(s) will apply to your contributions for 2015 medical coverage. If you and/or your spouse/domestic partner indicate that you have used any tobacco products since July 1, the tobacco surcharge(s) will apply to your contributions for 2015 medical coverage. However, you will have an opportunity to earn a refund of the surcharges you pay if you satisfy the requirements of your health plan administrator s tobacco cessation program. (Note: Although you may choose to participate in other tobacco cessation programs, you will not be eligible to receive a refund unless you complete the program offered by your IBM health plan.) To be eligible for a refund of the tobacco surcharge, you and/or your spouse/domestic partner must meet the health plan s tobacco cessation program requirements and then complete the certification process on by June 30, If you and/or your spouse successfully complete the program s requirements and certify by this date, you will be eligible for a refund of the tobacco surcharges you paid from January through June If you and/or your spouse/domestic partner do not complete the program requirements and/or do not complete the certification process on by June 30, 2015: You will not be eligible for a refund of the tobacco surcharges you have paid in The applicable $50 per month surcharge will continue to apply for your coverage and/or your spouse s/domestic partner s coverage for the remainder of the 2015 plan year. A $50 monthly surcharge will apply for each individual indicating that they have used any tobacco products since July 1 and do not want to participate in their health plan administrator s tobacco cessation program. A $50 monthly surcharge will apply for each individual indicating that they have used any tobacco products since July 1 but agree to complete their health plan administrator s tobacco cessation program. Surcharges will be discontinued and surcharges paid to date will be refunded if individuals complete their health plan s tobacco cessation program and certify their completion on by June 30,
8 About the cessation program option If you select the cessation program option, you can begin the program through your health plan now. Regardless of when you begin, you must complete the program and certify your completion by June 30, 2015, in order to discontinue the monthly surcharge and receive a refund of surcharges paid to date. Whether you are able to stop using tobacco or not, completing the program and certification process will meet this requirement. The cessation program will include telephonic coaching with a qualified health coach who will help you develop a 12-week cessation or maintenance plan, point you to useful resources to support your efforts and provide follow-up coaching calls. You must complete at least three total calls with the coach in order to qualify for a refund of your Tobacco Surcharge payments. These calls are typically around 30 minutes in length. There is no cost to you or your family members to participate in the program. (Note: If you are hard of hearing and telephonic coaching is not an option for you, please contact the IBM Employee Services Center for an alternative.) To begin the telephone coaching program, call the number for your health plan administrator s tobacco cessation program listed below. After you complete the program requirements, you will need to complete the certification process on by June 30, 2015, in order to receive a refund of the Tobacco Surcharges you have paid. IBM Plan Options Health plan administrator Tobacco cessation program telephone number Aetna (Healthy Lifestyle Coaching Program) Anthem Cigna Global Assignee Health Plan (available after November 1) Health Partners MVP United Healthcare (Optum) HMOs BCBS Blue Care Network (Michigan) BCBS Blue Choice (Georgia) *See below BCBS Excellus (Rochester, NY) Fallon Community Health Plan Health Alliance Plan (Michigan) HIP Prime HMO Illinois Humana (Puerto Rico) *See below Kaiser MVP HMO *See below Oxford Freedom (CT, NJ) *See below United Healthcare of No. & So. California *See below UPMC (PA) *Note: For health plans without a cessation program, you should use the program provided by one of IBM s wellness program vendors, Ceridian. The phone number to access this program is (LifeWorks services). 8
9 Ready to complete the Cessation Program requirements and be eligible for a refund? 1. Find your health plan s program phone number above, and call to begin your coaching program. 2. Complete at least three calls with your coach. 3. Certify that you have completed the program by June 30, You will be able to complete your certification on beginning in January Have you met ALEX? IBM offers a choice of medical plan options. The best option for you depends on your needs and preferences and how you ll use your coverage. To help you figure out which option is right for you, take a few minutes to work with ALEX, your personal benefits expert. ALEX is the host of a unique online experience that will help you understand and make decisions about your medical plan options. Talking with him is easy. He ll ask some basic questions about your personal situation (your answers remain anonymous, of course), crunch some numbers and explain your available options all while making you laugh. ALEX is not only funny, but he also speaks in plain English not insurance talk. He s available from the Health & Insurance section of netbenefits.com/ibm during annual enrollment to help you figure out which medical plan option may best serve your needs. Many people spend more money than they need to in monthly contributions for their healthcare. Don t let that happen to you. Log on to netbenefits.com/ibm and talk to ALEX before selecting your 2015 medical plan option. Important Reminders Contribution-free medical coverage remains available through the IBM PPO with HSA In 2015, IBM will continue to pay the full cost of coverage for eligible full-time employees (contributions are required for dependents) who enroll in the IBM PPO with HSA. The IBM HSA-eligible health plan options enable you to contribute to a tax-advantaged health savings account. For 2015, IBM will contribute $500 to your HSA. You can contribute up to $2,850, if you enroll in self-only coverage (including any Healthy Living Incentives you earn) up to $6,150, if you enroll in family coverage (including any Healthy Living Incentives you earn) an additional $1,000 if you are between the ages of 55 and 65 What s more, if you enroll in an HSA-eligible health plan option for 2015, you will have an opportunity to earn tax-free Healthy Living Incentives that will be deposited into your health savings account; see page 15 for more details. Individual coverage: up to $300 in lieu of the Healthy Living Rebates. Family coverage: up to $300, plus up to an additional $800 when your spouse/domestic partner or family completes the program requirements. You can use the funds in your HSA to save for both current and future healthcare needs, as unused contributions accumulate over time. A brief overview of HSAs is available on page 5; for more details on HSAs, see page 18. Information about the Healthy Living Incentives can be found on page 15. In addition to ALEX, Ayco MoneySmart coaches are available and trained to discuss all IBM plan options. For more information about MoneySmart, see page 23. Credit for No Coverage option if you decline medical coverage Since medical coverage is optional, you can decline coverage from IBM if you choose. If you elect No Coverage as your medical option for 2015, you will receive a $30 credit each month in your paycheck, which will be treated as taxable income. Please note that the credit for the No Coverage option is only available to you while you are actively employed by IBM. If you decline IBM medical coverage, you can enroll again during the next enrollment period, typically held each fall, or if you experience a qualified status change (such as a loss of other coverage) that would allow you to enroll during the year. 9
10 Transition of care If you are selecting a new medical option for 2015 with a different health plan administrator, and you or one of your covered dependents is currently undergoing treatment for certain serious medical conditions or prenatal and maternity care, you may be eligible to continue receiving in-network benefits. The transition period will be for a limited period of time if your doctor does not belong to your new plan network. Contact your new health plan administrator in January 2015 for more information. Medical ID cards You will receive a new medical ID card(s) for 2015 if you select a new medical option or if your health plan administrator is changing. (Note: There is no separate ID card for mental health/substance abuse benefits provided under the IBM Managed Mental Health Program, administered by Optum, by United Behavioral Health. Contact information for Optum is located on the back of your medical plan ID card.) Due to the timing of annual enrollment this year, ID cards will be mailed in late December or early January. If you have questions about ID cards, please contact the health plan administrator directly. If you need to access care before you receive your ID card, many health plan administrators also provide an online option for printing a temporary ID card for their registered users; call your health plan administrator for instructions. If your health plan administrator doesn t provide temporary ID cards, you can print an Enrollment Confirmation Card from the Health & Insurance section of netbenefits.com/ibm. This card will list your 2015 medical option enrollment and can be shown to your medical providers to confirm your coverage. Summary of Benefits and Coverage A Patient Protection and Affordable Care Act (the Affordable Care Act) provision requires that health benefit plan participants be provided with plain English coverage description. This description must be in a standard format so participants can easily compare coverage across plans. This document, referred to as a Summary of Benefits and Coverage, provides information about what each plan covers and what it costs, as well as examples that show what a plan may pay for certain services and how coverage may vary between plans. To assist you in understanding your health plan coverage or plans that you may be eligible for, a Summary of Benefits and Coverage is available on netbenefits.com/ibm. You may also request that a Summary of Benefits and Coverage be mailed to you by contacting the IBM Employee Services Center at between 8:30 a.m. and 8:30 p.m. Eastern time. Note: For a Summary of Benefits and Coverage for HMO medical options, please contact the HMO directly. Telephone numbers and Web site addresses are available on netbenefits.com/ibm. Additionally, a Uniform Glossary of healthcare terminology is available at: or you may request that a Uniform Glossary be mailed to you by contacting the IBM Employee Services Center. Notice regarding IBM s grandfathered health plans The Affordable Care Act states all group health plans in effect on March 23, 2010, may be grandfathered plans. A grandfathered plan is exempt from some, but not all, of the requirements under the Affordable Care Act. IBM believes the IBM Special Care for Children Assistance Plan (SCCAP) is a grandfathered health plan under the Affordable Care Act. As permitted by the Affordable Care Act, a grandfathered health plan can preserve certain basic health coverage that was already in effect when the law was enacted. A grandfathered health plan means that the 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 health services without any cost sharing. However, grandfathered health plans must comply with certain other consumer protections in the Affordable Care Act, for example, the elimination of lifetime dollar limits on essential health benefits. If you have questions regarding which protections apply and which protections do not apply to a grandfathered health plan, and what might cause a plan to change from grandfathered health plan status, please contact the 10
11 Health Plan Administrator directly; contact information is available on netbenefits.com/ibm (or on your Health Plan Detail Sheets if you receive print enrollment materials by mail). You may also contact the Employee Benefits Security Administration, U.S. Department of Labor, at or dol.gov/ebsa/healthreform. This Web site has a table summarizing which protections do and do not apply to grandfathered health plans. If you will be enrolling in an HMO and selecting a primary care physician According to a provision of the Affordable Care Act, you have the right to designate any primary care physician who participates in a health plan s network and who is available to accept you or your family members. You may designate a pediatrician as the primary care physician for your child(ren). If you do not designate a primary care physician, or if your designation is no longer valid, the HMO may designate a primary care physician for you. This primary care physician will be assigned to you until you make a designation. You do not need prior authorization from the HMO or from any other person (including a primary care physician) in order to obtain access to obstetrical or gynecological care from a healthcare professional in the network who specializes in obstetrics or gynecology. The healthcare professional, however, may be required to comply with certain procedures, including obtaining prior authorization for certain services, following a pre-approved treatment plan, or procedures for making referrals. For a list of participating healthcare professionals who specialize in obstetrics or gynecology, contact the HMO administrator directly. Health plan Web sites offer helpful resources As costs for medical coverage and medical care continue to rise, health plan administrators are creating consumer-based tools to help you get the most out of your healthcare dollar. There are also tools and resources that can help you optimize your health and get the most for your benefits. IBM encourages you to explore the wide variety of information offered on your health plan administrator s Web site. If your health plan administrator s Web address is not listed below, you can find it on netbenefits.com/ibm (or on your Health Plan Details Sheet if you receive print materials by mail). Aetna: Anthem: MVP: UnitedHealthcare: HealthPartners: When you log on, you ll be able to create a personalized online account, where you can review detailed information on any claims you have incurred and your progress toward satisfying your deductible, and you can also find tools to help you identify network providers. In addition, you ll find interactive tools to help you estimate your costs for medical tests and services based on your specific benefit plan and find useful information on the quality of your providers. Keep in mind that costs for procedures and tests can vary significantly based on where you have them performed. Using the cost quality tools provided through Aetna, Anthem, MVP and UnitedHealthcare can help you make educated decisions about which facility to use based on cost, location, quality, convenience and other factors. 11
12 PRESCRIPTION DRUG COVERAGE Changes for the IBM Managed Pharmacy Program IBM PPO with HSA, IBM PPO Plus with HSA As of January 1, 2015, the coinsurance percentage the amount you pay for generic prescription drugs under the IBM PPO with HSA will decrease, and it will increase for brand name formulary drugs. The same coinsurance percentages and per prescription maximums will apply for both HSA-eligible health plan options. Per prescription maximums refer to the maximum amount you will pay for a 30-day or 90-day supply. For 2015, the per prescription maximums will be $150 for a 30-day supply and $450 for a 90-day supply for generic, brand name formulary and brand name non-formulary drugs. Refer to the chart below for more information. Under both HSA-eligible health plan options, preventive prescription drugs are not subject to the annual deductible. For 2015, additional drugs have been added to the list of preventive prescription drugs. Contact CVS/caremark at or for more information. You will only pay a coinsurance amount for prescription drugs on the preventive drug list; they will not be subject to the annual deductible. Keep in mind that benefits for other eligible prescription drugs under these options are not payable until the applicable annual deductible is met. IBM PPO with HSA, IBM PPO Plus with HSA The chart below shows what you will pay per prescription as of January 1, Please note: Medications on the preventive drug list will not be subject to the deductible. Traditional medications Generic Brand name formulary Brand name non-formulary Specialty medications Generic Brand name formulary Brand name non-formulary Participating pharmacies (up to 30-day supply) 10% of discounted cost after deductible, up to $150 30% of discounted cost after deductible, up to $ % of discounted cost after deductible, up to $ % of discounted cost after deductible, up to $150 30% of discounted cost after deductible, up to $ % of discounted cost after deductible, up to $150 1 Non-participating pharmacies (up to 30-day supply) 30% of actual cost after deductible 40% of actual cost after deductible 55% of actual cost after deductible 30% of actual cost after deductible 40% of actual cost after deductible 55% of actual cost after deductible Mail order (up to 90-day supply) 10% of discounted cost after deductible, up to $450 30% of discounted cost after deductible, up to $ % of discounted cost after deductible, up to $ % of discounted cost after deductible, up to $450 30% of discounted cost after deductible, up to $ % of discounted cost after deductible, up to $ If a generic with the identical active ingredient is available, and you choose the equivalent brand name drug instead, you will pay the generic coinsurance plus the difference between the generic and the applicable brand name drug; per prescription maximums will not apply. 12
13 IBM PPO, IBM PPO Plus, IBM EPO There will be no changes to the per prescription maximums for generic, brand name formulary or brand name non-formulary drugs under these medical options for Per prescription maximums refer to the maximum amount you will pay for a 30-day or 90-day supply. Beginning January 1, 2015, your out-of-pocket costs for prescription drugs will count toward the annual out-ofpocket maximum under the IBM PPO, IBM PPO Plus and IBM EPO plan options. Once you meet the out-ofpocket maximum, the plan pays 100% of the cost for eligible covered expenses, including medical services, mental health/substance abuse care and prescription drugs. The chart below shows what you will pay per prescription as of January 1, Traditional medications Generic Brand name formulary Brand name non-formulary Specialty medications Generic Brand name formulary Brand name non-formulary Participating pharmacies (up to 30-day supply) Non-participating pharmacies (up to 30-day supply) Mail order (up to 90-day supply) 20% of discounted cost, 20% of discounted cost, 30% of actual cost up to $24 up to $26 20% of discounted cost, up to $ % of actual cost 20% of discounted cost, up to $ % of discounted cost, 50% of discounted cost, up to $ % of actual cost up to $ % of discounted cost, 20% of discounted cost, 30% of actual cost up to $31 up to $33 20% of discounted cost, up to $ % of actual cost 20% of discounted cost, up to $ % of discounted cost, up to $ % of actual cost 50% of discounted cost, up to $ If a generic with the identical active ingredient is available, and you choose the equivalent brand name drug instead, you will pay the generic coinsurance plus the difference between the generic and the applicable brand name drug; per prescription maximums will not apply. Generic Step Therapy The CVS/caremark Generic Step Therapy Program will continue to apply in Under this program, for certain therapeutic classes, you may be required to try generic medications before the plan covers more expensive brand name alternatives. Please contact CVS/caremark Customer Care for a complete list of drugs in this program. Drugs requiring prior authorization under the IBM Managed Pharmacy Program The IBM Managed Pharmacy Program, like most other large employer plans, uses a process to ensure that patients are using the best medication to treat their particular condition (right dose, right indication and right patient). This process requires patients to obtain prior authorization from the Pharmacy Benefit Manager, CVS/caremark, before their prescription is filled under the benefit program. In 2015, 46 medications will be added to the prior authorization list. If you are currently taking an affected medication, you will receive a letter from CVS/caremark. For a complete list of the drugs requiring prior authorization in 2015, please refer to the IBM Managed Pharmacy Program List of Medications Requiring Prior Authorization, available in the Reference Library on netbenefits.com/ibm, or contact CVS/caremark Customer Care for more information. 13
14 Compounded Prescriptions Compounding is combining, mixing or altering ingredients to create a medication tailored to the medical needs of a patient. Beginning January 1, 2015, all compound prescriptions (both in- and out-of-network) greater than $500 in cost will require prior authorization costly proprietary topical compounding bases and bulk powders (that have not been proven to have additional benefits) will be excluded from coverage coverage for compounds will be limited to 30-day supplies If the compound ingredients are not covered, you will be responsible for the full cost of the prescription. If the compound ingredients are covered through prior authorization, you will pay your usual cost share. This is particularly important to remember if the compounding pharmacy suggests you pay out-of-pocket for compounded prescriptions, then submit the claim through your benefit plan for reimbursement. Please be aware that these claims also will be subject to review and reimbursement is not guaranteed. If you are currently taking an affected medication, you will receive a letter from CVS/caremark with more information. Prescription Drug ID Cards If your prescription drug benefits are currently provided through the IBM Managed Pharmacy Program, you will not receive a new ID card. Only newly enrolled participants in the IBM Managed Pharmacy Program will receive a new prescription ID card from CVS/caremark in early January. DENTAL Cost for dental coverage As communicated last year, IBM has decided to shift its subsidies toward the cost of coverage from dental to medical in order to keep your medical plan contributions lower than they would have been otherwise. As a result, your cost for dental coverage will increase slightly in If you decide to decline IBM dental coverage for 2015, you can enroll again during the next enrollment period, typically held each fall, or if you experience a qualified status change (such as a loss of other coverage) that would allow you to enroll during the year. Dental ID cards You will only receive a new dental ID card if you enroll with a new dental plan administrator for For information about IBM dental options, refer to About Your Benefits: Health Care (the Summary Plan Description) available in the Reference Library on netbenefits.com/ibm. VISION Vision ID cards You will only receive a new vision ID card or vision discount card if you enroll in a new vision plan option for Employee Assistance Program As a reminder, you and your eligible family members have access to the Employee Assistance Program (EAP), which offers up to eight counseling sessions per situation per year at no cost to you. This benefit is available regardless of your benefits plan, or even if you elect No Coverage through IBM. To access the EAP, call Optum s clinical referral line at (TTY: Dial 771 and enter ), which is available 24/7 and staffed by licensed mental health professionals with clinical experience in treating a range of mental health and substance abuse care needs. 14
15 HEALTHY LIVING INCENTIVES Being an educated healthcare consumer is smart. Knowledge is power; it can help you make wise choices that support your good health as well as informed decisions when spending your healthcare dollars and those that IBM pays for your care. To encourage IBMers to learn about and take charge of their personal health and healthcare expenses, IBM will offer a variety of new educational programs that will reward you with incentive payments when you meet program requirements. (Note: Supplemental employees who enroll in an HSA-eligible health plan option for 2015 will also be eligible for incentive payments.) NEW for 2015: Regardless of the incentives available to you, you will not need to make an election during annual enrollment in order to participate. You can simply access and complete the programs on the program Web sites. The pages that follow the table below provide more information on each incentive. The incentive options available to you and the amount you can earn will depend on your medical plan enrollment for 2015 and whether you choose individual or family coverage, as shown in the table below. If you enroll in the IBM PPO with HSA or IBM PPO Plus with HSA Individual coverage Family coverage How incentives are paid You can earn two $150 incentives when you complete the program requirements. $150 Consumer Education (choose one of the following): o HSA education o ALEX o Better Choices, Better Health $150 Wellness Checkpoint Health Risk Assessment In addition, you ll have access to the Active Track Fitbit Program; see page 17 for more information. You can earn the two $150 incentives above plus two additional $400 incentives when your spouse/domestic partner or family completes the program requirements. $400 Consumer Education (choose one of the following): o HSA education o ALEX o Better Choices, Better Health $400 Wellness Checkpoint Health Risk Assessment Payments will be processed after you certify that you have completed all program requirements and will be deposited in your HSA; payments are not subject to taxes. If you enroll in the IBM PPO, IBM PPO Plus, IBM EPO or an HMO Individual or family coverage How incentives are paid You can earn two $150 incentives* when you complete the program requirements, selecting from the following choices: $150 Consumer Education (choose one of the following): o HSA education o ALEX o Better Choices, Better Health $150 Personal Vitality $150 Children s Health $150 Physical Activity-Nutrition *Note: If you prefer, you may participate in the Active Track Fitbit Program in place of one of the incentives listed above. See page 17 for more information. Payments will be processed after you certify that you have completed all program requirements and will be treated as taxable income in your paycheck. 15
16 A closer look at the Healthy Living Incentives The information below and on the following page provides a brief description of each incentive, as well as when it will be available and where to go to get started. Consumer Education Incentive Options All active employees are eligible to earn an incentive, regardless of medical plan enrollment. You can even participate if you select No Coverage as your medical option for Complete one of the following modules to earn your Consumer Education Incentive. Then, you will need to certify that you have completed the program requirements at incentivecredit.com/ibm. Option Description Available Location HSA education ALEX Better Choices, Better Health Learn more about HSAs in this module by watching a series of brief videos and a narrated online presentation. As the host of a unique online experience, ALEX will help you understand and make decisions about your medical plan options. ALEX was created by the Jellyvision Lab, which specializes in converting complex ideas into interesting interactive experiences. The more you know about your healthcare choices, the more effectively you can use them. This module provides three resources to help improve your health and stretch your dollar. You ll learn more about cost and quality transparency tools, telemedicine services and watch a video that IBM and Consumer Reports have partnered on to help you understand the importance of healthy choices. October 8, 2014 December 1, 2015 October 20, 2014 December 1, 2015 Early 2015 netbenefits.com/ibm netbenefits.com/ibm Welltok s CaféWell Wellness Checkpoint Health Risk Assessment Only active employees who enroll in the IBM PPO with HSA or IBM PPO Plus with HSA are eligible to earn this incentive. The Wellness Checkpoint health risk assessment tool will help you assess your daily health habits, evaluate your health status and identify opportunities for IBM support programs. The tool will help you to assess things like nutrition, stress, health prevention practices and more. You will receive feedback on achievements and suggestions on areas of improvement. You will also be able to learn about IBM programs and other resources which are available to support you and your family. The Health Risk Assessment will be available on wellnessforlifecenter.com, beginning in January
17 Healthy Living Rebate Incentives The incentive option choices listed below are available to IBMers who enroll in the IBM PPO, IBM PPO Plus, IBM EPO or an HMO. (Note: Supplemental employees are not eligible for these incentives.) Keep in mind if you enroll in one of these medical options, you can earn a total of two $150 incentives either two of the incentives below OR the $150 Consumer Education Incentive plus one of these incentives. Incentive Description Available Location $150 Personal Vitality $150 Children s Health $150 Physical Activity- Nutrition In 2015, Personal Vitality will add experiences to boost cardiovascular conditioning and encourage practical ways to access quality foods in addition to the current modules like Mindfulness, Meaning Uncovered and Nature. Children s Health is designed to optimize your entire family s energy and well-being. This program s real-life activities ( field experiences ) offer age-appropriate, innovative and engaging experiments for inquisitive children and busy parents to enjoy together. There is also a Healthy Pregnancy option, designed to help families experience a healthy pregnancy from pre-conception planning through delivery and post-partum recovery. Physical Activity-Nutrition can help you set personal goals and priorities for eating well and leading a physically active life. You can choose from several options physical activity logging, nutrition or weight management based on what matters to you. Supporting tools and resources are available, and best of all, you can reap the rewards all year long. Early 2015 Early 2015 Early 2015 wellnessforlifecenter.com wellnessforlifecenter.com wellnessforlifecenter.com Active Track Fitbit Program The Active Track Fitbit program uses technology to support your health and fitness efforts. The program provides participants with a Fitbit, a wireless activity device (which syncs with most smartphones) that automatically tracks physical activity and sleep. As steps and sleep are tracked, you will accumulate points that can be redeemed for merchandise or charitable donations. If you enroll in the IBM PPO with HSA or IBM PPO Plus with HSA, you ll have access to the Active Track Fitbit Program, in addition to the incentives available to you. If you enroll in the IBM PPO, IBM PPO Plus, IBM EPO or an HMO, you may select to participate in the Active Track Fitbit Program in place of one of the incentives available to you. 17
18 HEALTH SAVINGS ACCOUNT New recordkeeper for Health Savings Accounts Beginning January 1, 2015, Fidelity Investments will be the recordkeeper for health savings accounts opened in conjunction with enrollment in the IBM PPO with HSA or the IBM PPO Plus with HSA. You will need to open a Fidelity HSA if you wish to receive IBM s contribution for 2015 and to make your own before-tax contributions via payroll deduction. Currently, recordkeepers for HSAs vary based on the administrator of your health plan. If you currently have an HSA with your health plan administrator s recordkeeper, you will have an opportunity to transfer your account balance from that recordkeeper into a Fidelity HSA in early Please note: While you may choose not to transfer your HSA funds, you will be responsible to pay the account maintenance fees for any non-fidelity HSA you have as of February 1, IBM will only pay account maintenance fees for a Fidelity HSA in Opening your Fidelity HSA Opening and managing your HSA with Fidelity is fast and easy. You can do it as part of the enrollment process when you select your 2015 benefits on netbenefits.com/ibm. After electing your coverage for 2015, select the Open Your Health Savings Account (HSA) link on the confirmation screen and follow the online instructions to open your Fidelity HSA. An Open an HSA link will also be available from the home page of netbenefits.com/ibm. NetBenefits will also provide you with information on investment choices and payment options and ongoing support to help you build and manage your savings. If you do not have access to NetBenefits, please contact the IBM Employee Services Center at (TTY: ) to speak with a service representative on business days (excluding holidays recognized by the New York Stock Exchange) between 8:30 a.m. and 8:30 p.m. Eastern time. Fidelity HSA offers convenient payment and reimbursement options With a Fidelity HSA, you ll have multiple ways to access funds in your account to pay or be reimbursed for qualified medical expenses. You will receive a Fidelity HSA debit card to pay for point-of-sale qualified medical expenses, like pharmacy prescriptions. Many providers will also accept it for payment of an invoice you received in the mail. Funds come directly from your HSA, and payment details appear on your account statement. You ll have access to Fidelity BillPay for Health Savings Accounts, an online bill-paying service that enables you to easily schedule and submit payment for qualified medical expenses no stamps, envelopes or checks needed. You ll also be able to write checks using a Fidelity HSA checkbook. Similar to a debit card, funds come directly from the cash available in your HSA and are reported as withdrawals on your account statement. You will receive more information about these features in a separate communication after you open a Fidelity HSA. 18
19 Health Savings Account contributions for 2015 IBM will contribute $500 in January 2015 For 2015, IBM will contribute $500 to an HSA for active employees who enroll in the IBM PPO with HSA or the IBM PPO Plus with HSA. IBM s full $500 contribution will be deposited into your HSA in January 2015, if you open your Fidelity HSA by mid-december, giving you access to the full value of these funds early in the year. Keep in mind you must open a Fidelity HSA and be actively employed in order to receive the $500 contribution from IBM HSA contribution limits In addition to IBM s $500 contribution, you may also choose to contribute to your HSA, as shown in the chart below, up to the annual contribution limit set by the Internal Revenue Service (IRS). Medical plan coverage level IBM s contribution Additional contribution amount per IRS regulations (including any Healthy Living Incentives) Total 2015 contribution limit per IRS regulations Individual $500 Up to $2,850 $3,350* Family $500 Up to $6,150 $6,650* *Note: If you are between the ages of 55 and 65, you can make an additional catch-up contribution of up to $1,000 in IMPORTANT: Keep in mind IBM s contribution and payroll deductions for your before-tax contributions cannot begin until you open your Fidelity HSA. For more information about the HSA, including eligibility for IBM s contributions, select the HSA Learn More link from your Benefits Enrollment page. You may also refer to About Your Benefits: Health Care (the Summary Plan Description) or the 2015 Health Savings Account Participant Information for Active Employees, both available in the Reference Library on netbenefits.com/ibm. Important reminders about Health Savings Accounts You may enroll in either an HSA or the Health Care Spending Account, but not both. If you are enrolled in the Health Care Spending Account for 2014 and want to enroll in an HSA for 2015: If your Health Care Spending Account balance is not exhausted by December 31, 2014, you may not contribute to an HSA until the Health Care Spending Account grace period ends on March 15, IBM s annual $500 contribution will be deposited in your HSA in April You may make contributions to a Health Savings Account during the grace period for the Health Care Spending Account (January 1 March 15, 2015) if your 2014 Health Care Spending Account balance is exhausted by December 31, IMPORTANT: You must call the IBM Employee Services Center by December 12, 2014, if your Health Care Spending Account balance will not be exhausted by December 31, If you don t call, IBM s contribution and your before-tax payroll deduction contributions automatically will begin for the HSA, and you will be subject to income tax and a 10% penalty on all contributions made during the Health Care Spending Account grace period. Please note: All IBM HSA contributions and incentive payments are based on the coverage in which you are enrolled as an active employee on January 1, In the event of an incorrect payment or overpayment, you will be required to refund IBM any amount that was paid to you if your enrollment of record on January 1, 2015, makes you ineligible to receive the IBM HSA contribution and/or incentive previously paid to you. 19
20 HEALTH CARE SPENDING ACCOUNT 2015 contribution limits The Health Care Spending Account lets you use tax-free dollars to pay for unreimbursed eligible healthcare expenses. Your contributions are deducted from your pay on a before-tax basis each pay period. This lowers your taxable income, so you pay less in taxes. Throughout the year, you may submit claims to your account(s) and receive reimbursement without paying taxes on the reimbursement amount. Participation in this account is optional; however, if you want to participate in 2015, you must enroll and choose an annual contribution amount during annual enrollment. The maximum amount you may contribute is $2,500. The limit is set per individual; therefore, each working spouse may enroll in a Health Care Spending Account and contribute up to $2,500. Remember, account balances not used by the end of the year (including the grace period) will be forfeited. As a reminder, if you enroll in an HSA-eligible health plan option for 2015, you may not enroll in the Health Care Spending Account. Important Reminders Grace period for Health Care Spending Account If you are participating in the Health Care Spending Account as of December 31, 2014, you can submit claims for any eligible expenses you incur between January 1, 2014, and March 15, 2015, giving you an additional grace period to incur eligible expenses (January 1, 2015 March 15, 2015). If you will be participating in the Health Care Spending Account again in 2015, you ll need to indicate whether the expenses should be reimbursed from your 2014 contributions or your 2015 contributions on each claim form you submit for expenses incurred during the grace period. Otherwise, your 2015 contributions will be used to reimburse any eligible expenses incurred from January 1 March 15, Keep in mind expenses for over-the-counter medications, except for insulin, are not eligible for reimbursement under the Health Care Spending Account, unless they are purchased with a prescription. Only medications prescribed by a physician or other medical provider are eligible for reimbursement. Health Debit Card If you will be participating in the Health Care Spending Account in 2015, you will receive a Health Debit Card. This card allows you to pay your portion of the cost of prescription drugs through automatic withdrawal from your Health Care Spending Account, eliminating the need to file claims for reimbursement. If you currently have a Health Debit Card, it will be loaded with your 2015 Health Care Spending Account contribution amount in January 2015, and you will not receive a new debit card unless your current card is more than four years old. Coverage for same-gender spouses As a result of the U.S. Supreme Court s Defense of Marriage Act (DOMA) decision, employees may submit eligible out-of-pocket expenses for their same-gender spouse through the Health Care Spending Account. 20
21 DISABILITY PROTECTION Have you ever considered how you would provide for yourself and your family if you suddenly got sick or hurt and weren t able to work? While most people insure their lives and material assets, such as a home or a car, many overlook the need to adequately protect their income in the event of disability. The IBM Long-term Disability (LTD) Plan can help provide you with financial protection if you become disabled due to an accident or illness. A unique form of insurance offered to IBM 401(k) Plus Plan participants, 401(k) Disability Protection can continue your contributions to the IBM 401(k) Plus Plan, further protecting your financial well-being in the event you become totally disabled and qualify for IBM Long-term Disability (LTD) Plan benefits. During annual enrollment, you can choose to purchase or increase your coverage for these two types of disability income protection; however, you may not purchase coverage if you are currently receiving IBM Shortterm Disability benefits. You must be actively at work on your first regularly scheduled day of work in the 2015 calendar year for any new coverage in these plans to be effective. IBM Long-term Disability (LTD) Plan This plan provides income replacement during a period of long-term disability. Your coverage options depend on your date of hire and years of service. When you reach five years of service, IBM will pay long-term disability benefits that provide income at the 50% level of salary at no cost to you. In all cases, you have the option to buy up to the 66 2/3% level of income replacement; evidence of insurability may be required. In 2015, rates for the 50% LTD option for those with less than five years of service will decrease. Rates will also decrease for the 66 2/3% option for those with five or more years of service. Employee contributions are based on rates, as well as salary and age bands, so while most employees will see a decrease in contributions, some may see an increase. For specific cost information, please see your personalized worksheet, available on netbenefits.com/ibm. If you choose to increase your LTD coverage to the 66 2/3% option at the time you reach five years of service, evidence of insurability will not be required. If you do not choose to purchase it at that time, evidence of insurability will be required if you elect this level of coverage in the future. What is evidence of insurability? Evidence of insurability (EOI), also called proof of good health, is proof acceptable to the insurance company that a participant is in good health. Generally, the participant must complete a medical questionnaire, which is then reviewed and approved by the insurance company before coverage becomes effective. Deadline for evidence of insurability requirements If you choose to increase your IBM Long-term Disability (LTD) Plan coverage, you will be required to provide evidence of insurability, also called proof of good health, by February 28, Evidence of insurability is proof acceptable to the insurance company that you are in good health. You will be prompted to complete the evidence of insurability requirement immediately after you complete your enrollment on netbenefits.com/ibm. 1. After you select Save & Submit, a screen indicating you have some follow-up activity to complete will appear. 2. Under Additional Action Required, select the Evidence of Insurability link, where you will have two choices: Select Go to MetLife Online Statement of Health to complete your evidence of insurability requirement online. You will be linked directly to MetLife s Web site, where you will be able to complete an online evidence of insurability form. If you prefer to print a paper statement of health form, select the link that appears for that option. You will need to complete the form and mail it to MetLife at the address on the form. 21
22 You may also contact MetLife to request that a paper form be mailed to you. MetLife will review and must approve your Statement of Health before your new level of coverage becomes effective. If you have any questions about completing your evidence of insurability requirement, please contact MetLife directly. 401(k) Disability Protection In the event you become totally disabled, as defined by the 401(k) Disability Program, the dollar amount you choose to insure through 401(k) Disability Protection will be contributed to your Plan account in monthly installments for as long as your disability continues, up to age 65. (If your disability begins after age 60, payments will continue for five years.) Evidence of insurability is not required for 401(k) Disability Protection coverage. Coverage premiums Premiums are based on your age and on the dollar amount you choose to insure (your previous year s beforetax contributions, IBM s matching contributions and IBM s automatic contributions and/or special savings award, if you are eligible to receive it). The premiums will be deducted from your IBM 401(k) Plus Plan account balance on a monthly basis. You can estimate your 2015 premium on netbenefits.com/ibm during your enrollment by selecting Things to Consider from the 401(k) Disability Protection section of your Benefits Enrollment page. Actual premiums will be calculated in January Disability ID cards You will receive an ID card from MetLife if you are enrolled in No Coverage for 2014 and enroll in the IBM Long-term Disability (LTD) Plan or 401(k) Disability Protection for If you are not making changes to your coverage for 2015, you will not receive a new ID card. 22
23 WHEN YOU RE READY TO ENROLL Log on to NetBenefits to get started Beginning November 12, 2014, you can research your options and make your choices for 2015 from anywhere you have Internet access. Just follow the simple steps below. Log on to netbenefits.com/ibm to access your Benefits Enrollment page, where you will review and update your coverage for When you ve completed your elections, select Save & Submit on your Benefits Enrollment page; your elections will not be saved otherwise. The elections listed will be recorded as your new coverage and displayed on a confirmation screen. Save the confirmation number and print the page for your records. If you have questions or need assistance enrolling, you can call the IBM Employee Services Center at (TTY: ) to speak with a service representative on business days (excluding holidays recognized by the New York Stock Exchange) between 8:30 a.m. and 8:30 p.m. Eastern time. Confirmation of Your 2015 Benefits If you enroll or make changes to your benefits for 2015, you will receive an confirming you successfully completed your enrollment. This will include a link to netbenefits.com/ibm, where you can view your elected coverage for If you do not have an address on record, you will receive a confirmation statement in the mail after you complete your enrollment. If you do not enroll or make changes, you will be enrolled automatically in the coverage shown on your Benefits Enrollment page on netbenefits.com/ibm. You will not receive a separate confirmation statement in the mail. Please note: Health Care and Dependent Care Spending Account elections will not carry over from 2014; if you wish to participate in these accounts in 2015, you must make your elections during annual enrollment. MoneySmart An Ayco MoneySmart Coach can help you assess the impact of your IBM benefit decisions on your financial plan. Contact an Ayco MoneySmart coach for help understanding things such as the impact of purchasing disability coverage versus not having this coverage in the event you become disabled; determining if one of the IBM HSA-eligible health plan options is the right choice for you; how much you should put in your Health Care or Dependent Care Spending Account; and many other financial planning needs. For assistance with financial planning, call an Ayco MoneySmart coach at (TTY: ) or send an to [email protected]. If you are eligible for the Pension Credit Formula and would like assistance with retirement planning, call Fidelity MoneySmart at (TTY: ). Note: Ayco and Fidelity Investments are not affiliated. 23
24 IMPORTANT INFORMATION ABOUT IBM MEDICAL COVERAGE AND MEDICARE Please read this information if you are an active IBM employee who is about to be or is already 65 years of age, and you are eligible to retire from IBM. (Contact the IBM Employee Services Center for details on age and service requirements to be eligible to retire from IBM). There are certain actions you must take with regard to health benefits once you decide to retire from active employment at IBM. When you decide to retire is entirely up to you, of course; IBM is not requesting or encouraging you to do so. The information contained in this section is intended to provide useful information regarding your health benefits that will assist you in the event you decide to retire in the foreseeable future. If you are 65 years old or older when you retire, you (and any of your dependents who are Medicare-eligible) may be eligible to enroll in a health plan that is supplemental to Medicare, Towers Watson s OneExchange (formerly Extend Health). IBM has engaged OneExchange, the country s largest private Medicare marketplace, to provide IBM s eligible Medicare-eligible retirees with options for medical, prescription drug, dental and vision coverage. Once you decide to retire, it s very important that you (and any of your dependents who are Medicare-eligible) follow the necessary steps to enroll in Medicare (Part A and Part B) as soon as possible (even if you are still actively employed and covered under the IBM medical plan for active employees) to avoid any delay or gaps in coverage once you retire. You should not wait until your actual date of retirement to enroll in Medicare. You must be enrolled in Medicare on the effective date of any coverage you enroll in through OneExchange. Please also note: Medicare-eligible retirees and their Medicare-eligible dependents will be offered the opportunity to enroll in health coverage (medical, mental health, prescription drug, dental and vision) through OneExchange. Dependents who are not eligible for Medicare will continue to have the opportunity to purchase health benefits coverage by enrolling in the non-medicare-eligible plan options under the IBM plan for retired employees. If this applies to your family situation, you will receive separate enrollment materials from IBM for health benefits for those not yet eligible for Medicare, and from OneExchange for those who are eligible for Medicare. When you become a retiree, you will also be eligible for COBRA under the IBM plan for active employees at the full COBRA rate. Please keep in mind, however, that when you become eligible for Medicare, any COBRA coverage you elect would be secondary to Medicare. 24
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28 This enrollment guide is intended to provide an overview of certain plans and programs in which you may participate. It is not an official Summary Plan Description and does not provide full details. Complete details are found in the formal plan documents, which are the complete and exclusive statement of the company s obligations under the plan. The official plan documents shall govern in the event of a conflict between information contained in these or other documents and statements. The plan administrator retains exclusive authority and discretion to interpret the terms of the benefits plans and programs described herein. The company reserves the right, in its sole discretion, to amend, change, suspend or terminate any benefit or other plan, program, practice or policy of the company at any time. The company does not have any obligation to, and nothing contained in this enrollment guide shall be construed as creating an express or implied obligation or promise on the part of the company to, maintain, continue to offer, or make available such plans, programs, practices or policies. Eligibility to participate in a plan or program or receipt of benefits does not constitute a promise or right of continued employment or render any person an employee of IBM. IBM and its affiliated companies do not endorse any HMO or other provider, or represent or warrant the quality of care they provide. The decision to choose any health plan option or use any provider is the participant s responsibility. Not all of the plans and programs within this enrollment guide pertain to all of IBM s affiliated companies. For more information, contact the IBM Employee Services Center at (TTY for deaf and hard of hearing employees: ). The information about the Fidelity HSA provided in this guide is general in nature. It is not intended, nor should it be construed, as legal or tax advice. Since the administration of an HSA is a taxpayer responsibility, it is strongly encouraged that the account holder consult their tax advisor before establishing an HSA. Tax information is available from the U.S. Department of Treasury, which can be found on the Treasury Web site at Information is also available from the Internal Revenue Service (IRS) for taxpayers, which can be found on the IRS Web site at This includes IRS Publication 969, Health Savings Accounts and Other Tax-Favored Health Plans, and IRS Publication 502, Medical and Dental Expenses (including the Health Coverage Tax Credit), online, or by calling the IRS to request a copy of each at The Fidelity HSA is a brokerage account offered through Fidelity Brokerage Services LLC, Member NYSE, SIPC. Fidelity Brokerage Services, Member NYSE, SIPC 900 Salem Street, Smithfield, RI IM-H-515R.109
2015 IBM Health Benefit Comparison Charts for IBM Active Employees
2015 IBM Health Benefit Comparison Charts for IBM Active Employees These Health Benefit Comparison Charts provide a summary overview of the coverage available for medical, mental health/substance care
2013 IBM Health Benefit Comparison Charts
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