Benefit Changes Effective January 1, 2016

Transcription

1 Benefit Changes Effective January 1, 2016

2 Open Enrollment Highlights Changes made during open enrollment will be effective January 1, Premiums for medical, dental and vision insurance, as well as pre-paid legal, will be collected beginning in December Flexible spending contributions will begin in January Health insurance premiums for active and pre-medicare retirees increased by 9.9%, on average, with plan design changes and converting to self insurance. Dental insurance premiums increased 3.5% across all tiers with no plan design changes. Vision insurance, flexible spending and legal benefit plans are not changing for 2016.

3 Plan Change Highlights Current Options Options Effective January 1, 2016 HMO POS PPO HMO POS PPO Annual Deductible Individual/Family Coinsurance $400/800 $300/600 $750/$1,500 $600/$1,200 $500/$1,000 $750/1,500 85% 90% 80% 80% 85% 75% Specialist/Urgent Care Copay $70 copay $50 copay $50 copay $70 copay $50 copay $70 copay Medical Out of Pocket Maximum Individual/Family Pharmacy Out of Pocket Maximum Individual/Family $3,500/$7,000 $4,000/$8,000 $4,000/$8,000 $3,000/$6,000 $3,100/$6,200 $2,600/$5,200 Combined with Medical Out of Pocket Maximum

4 Medical Rates Employee Contributions 2015 HMO POS PPO Employee Only $38.96 $52.60 $ Spouse Child Children $ $ $ $89.28 $ $ $ $ $ Family $ $ $ HMO POS PPO Employee Only $41.08 $62.20 $ Spouse Child Children $ $ $ $95.16 $ $ $ $ $ Family $ $ $929.24

5 Dental Plan Design Annual Deductible $50/$150 Annual Benefit Maximum $1,500 Orthodontic Lifetime Maximum (eligible dependent children) Diagnostic and Preventative Care (including sealants for dependents under age 16) Basic Dental Care - Fillings, simple extractions Major Dental Care Bridges, crowns Amount/Percentage $1,500 Covered at 100% Covered at 80% after deductible Covered at 50% after deductible

6 Dental Rates 2015 Total Employer Employee Employee Only $26.84 $14.04 $12.80 Spouse Child Children $53.68 $32.16 $21.52 $59.04 $35.44 $23.60 $67.12 $40.32 $26.80 Family $93.12 $56.32 $ Total Employer Employee Employee Only $27.80 $14.56 $13.24 Spouse Child Children $55.56 $33.28 $22.28 $61.12 $36.92 $24.20 $69.48 $41.60 $27.88 Family $97.24 $58.32 $38.92

7 Vision RATES PLAN DESIGN Monthly Premium Employee Only $3.96 Spouse $6.96 Child $6.96 Children $7.92 Family $11.52 Service Routine eye exam (once every calendar year Eyeglass frames In-Network Cost $15 copay $140 allowance then 20% off remaining balance Eyeglass lenses $15 copay + Standard contact fitting Fitting and follow up visits up to $55

8 Flexible Spending Medical Can contribute up to $2,550 per year. $500 carryover from calendar year to calendar year. Funds are available on the first day of the plan year WageWorks EZ Receipts mobile app has new functionality user friendly claims submissions and services to pay providers on the go. For more information, visit Dependent care Can contribute up to $5,000 per year.

9 Legal Resource Protect yourself and your family Legal Resources provides an affordable way for you and your family to have legal representation whenever you need it. Pay no attorney fees for the most common legal services everyday & unexpected Work directly with local law firm Annual cost less than one hour of attorney s time Only $17.00 per month for you and all eligible dependents

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11 How the plan works Enroll online with your other benefits as a new hire or at open enrollment Receive a welcome kit with member cards and provider contact information Call you law firm when you need services and say I am a Legal Resources member Use the Plan as often as needed throughout the year Additional questions call Member Services at

12 Online Enrollment The City will be using a new site for online enrollment this year. Employees will enroll through Employee Self Service (ESS), Employees in the Active Directory will use their computer user name and password to access ESS Employees not in the Active Directory (e.g. libraries, CIBH) will use their employee number and last four of their SSN to access ESS. Visit the City of Chesapeake s dedicated benefits website, for detailed information about benefits offered.

13 Open Enrollment October 7-23, 2015 Monday Tuesday Wednesday Thursday Friday 12 Columbus Day Social Services 1 st floor, multi-purpose room 100 Outlaw St. 10:00 11:00 am Central Library 1 st floor meeting room 298 Cedar Road 2:00 3:00 p.m. 14 Sheriff s Office Administrative Building Multi-Purpose room 401 Albemarle Dr. 10:00-11:00 a.m. 15 Streets Maintenance & Cleaning 925 Executive Blvd 7:30 8:30 a.m. CIBH 2 nd floor conference room 224 Great Bridge Blvd 2:00 3:00 p.m. 16 HR Training Room City Hall 4 th floor HR training room 306 Cedar Rd 11:00 am - noon 19 S Norfolk Library 801 Poindexter St 11:00 a.m.- noon 20 HR Training Room City Hall 4 th floor HR training room 306 Cedar Rd 9:00-10:00 am

14 Open Enrollment - Elections Medical, Dental, Legal, Vision oif no changes are made, employees and pre-medicare eligible retirees will maintain enrollment in their current plan/tier. Flexible Spending ore-enrollment is required annually. Employees may rollover up to $500 of unused medical flexible spending balances. Re-enrollment for calendar year 2016 is required in order for unused calendar year 2015 funds to rollover.

15 Pre-Medicare Eligible Retirees oas required by Virginia Code, pre-medicare retirees are eligible for medical insurance through the City until they become eligible for Medicare. othe retiree s covered spouse who is not eligible for Medicare can remain on the pre-medicare plan until he/she becomes eligible, but is responsible for the entire premium of the selected coverage. odependents can stay on the pre-medicare plan until they are no longer eligible to be a dependent on the plan (generally age 26), but are responsible for the entire premium of the selected coverage.

16 Elimination of Medicare Carve-Out Plan On September 15, 2015, City Council voted on a recommendation by the City Manager to discontinue offering medical insurance to Medicare eligible retirees. The City of Chesapeake is is currently the only municipality in South Hampton Roads that offers medical insurance to Medicare eligible retirees. The reasons for the recommendation are highlighted below: Cost There are more cost effective options available in the Medicare supplemental market. In addition, if the City continued to offer a plan which only a small number of retirees elected, the premiums would undoubtedly increase. Pre-existing conditions If the City continued to offer a plan, retirees with pre-existing conditions could be denied coverage or their coverage could be significantly delayed.

17 Transition for Medicare Eligible Retirees The City of Chesapeake has partnered with OneExchange, one of the largest independent health care plan exchanges in the United States, to assist retirees with this transition. OneExchange is not an insurance company, but a resource that provides access to a variety of individual health care plans at no cost to the retiree. OneExchange has successfully helped more than 500,000 Medicare-eligible individuals enroll in Medicare plans, including assisting retirees from other municipalities in the region.

18 Communication Plan Retired by age 64 One month prior to a retiree turning 64 (for those employees whose Medicare eligibility begins at age 65), the City of Chesapeake will provide OneExchange with the retiree s contact information. OneExchange will send communication to the retiree 12 months, 9 months and 6 months prior to their Medicare eligibility.

19 Communication Plan Illustration

20 Communication Plan Retiring after Medicare Eligibility Once the City receives the employee s retirement application and the employee is already Medicare eligible, the City will provide OneExchange with the employee s contact information. The City s Human Resources Department will also provide the retiree with OneExchange s contact information. OneExchange will send communication to the employee 90 days before they are Medicare eligible or as soon as the contact information is received, whichever comes first.

21 Questions?