Chemeketa Community College 2017 Open Enrollment

Transcription

1 Chemeketa Community College 2017 Open Enrollment Open Enrollment for Benefits Effective January 1, 2017: This summary provides the following 2017 Plan details: Kaiser Deductible changes New plan rates Action needed if you wish to waive or wish to continue to waive coverage Instructions for making changes Action you must take for 2017 enrollment What s New for 2017? Kaiser Standard Plan The Kaiser Standard Medical Plan now includes a deductible as well as other modest increases: $250 / $750 Deductible The deductible must be met before in-patient hospital or inpatient chemical dependency / behavioral health, outpatient surgeries, emergency room visits, and durable medical equipment will be payable by the plan. $1,250 / $3,750 Out-of-Pocket Maximum This is the maximum amount you will pay including deductibles, co-payments and coinsurance before the plan will pay eligible charges at 100% for the remainder of the year The deductible does not have to be paid before co-payment for office visits, prescriptions, urgent care, physical, speech & occupational therapy, lab, x-ray or high tech imaging such as CT, MRI and Pet Scans, alternative care or vision services. Co-payment changes are as follows: $25 per visit for Specialist Office Visits $25 per visit for Physical, speech and Occupational Therapy $15 for Lab or X-ray per department visit $100 for all High Tech Imaging such at CT, MRI, and Pet Scans. 1

2 2017 Kaiser Standard Deductible HMO Plan Changes are reflected in red type 2017 Kaiser Standard Deductible HMO Plan Deductible $250 individual / $750 Family Out of Pocket $1,250 / $3,750 Preventive Heath 100% Hospital Room & Board Primary Care, Behavioral Health & Chemical Dependency Office Visits Specialist Office Visits $25 co-pay Rx Generic Rx Preferred Brand $30 co-pay Rx Non-Preferred Brand $50 co-pay Rx - Mail Order Maintenance Drugs 90 days for 2 co-pays Urgent care $35 co-pay Outpatient surgery Lab Visits X-rays CT, MRI, Pet Scan $100 co-pay Emergency Care Inpatient Hospital, Behavioral Health & Chemical Dependency Nurse treatment room $10 co-pay Ambulance Services per transport Chemotherapy/radiation therapy visit Durable medical equipment/prosthetic/orthotics Physical, speech, occupational therapy Skilled nursing Alternative care Visit $25 after deductible You pay for the cost of medication 10% coinsurance after deductible $25 co-pay for up to 20 visits per therapy per year for up to 100 days Chiropractic Care: $15 per visit Acupuncture: $15 per visit Naturopathy: $15 per visit Massage Therapy: $25 per visit $1,000 annual maximum for all combined services Vision routine eye exam $15 exam co-pay $150 vision hardware allowance once every 2 years 2

3 New Moda Medical Travel Benefit Network Effective January 1, 2017 Moda is changing their travel benefit network from PHCS Healthy Directions to the First Health Network in order to expand the number of providers that are available to members. If you have family members that live outside of Oregon they will use the First Health Network. If you travel outside of Oregon throughout the US and now Puerto Rico, you will also have access to more than 1,000,000 providers. This compares to the PHCS Healthy Directions network which offered access to only 800,000 providers only in the US. New Moda Medical ID Cards In order to ensure that your ID cards reflect the correct network for travel outside of Oregon, Moda will be issuing new member ID Cards. Your plan ID Number will NOT change. However, it will be important to discard your current ID card and replace it with the new card in order to ensure that you access a covered provider and that charges are billed correctly when you seek urgent care outside of Oregon. Not Changing There are no changes to the coverage of the following Plans: Moda Standard & Wise Consumer Plans Moda Dental Kaiser Dental Kaiser Wise Consumer Plan VSP Vision Life Insurance Short and Long-Term Disability Long-Term Care Limits for Spending and Savings Accounts Increased Maximum s Limits for Health Savings Accounts Effective January 1 December 31, 2017, the IRS has released higher allowed maximum contributions (from all sources) of $3,400 for employee only coverage. The $6,750 limit for employee plus one or more dependent is unchanged. The additional $1,000 that is allowed for an employee who will be 55 or in 2017 is also unchanged. FSA Flexible Spending Account Limits Maximum employee pre-tax deductions remain unchanged for An employee can set aside $2,550 for health expenses and/or $5,000 for dependent care expenses. Funds in both accounts are still use it or lose it. However, up to $500 of funds in the health expense account that are not used in 2017 can be rolled forward into The partial roll-forward provision is not available for dependent care accounts. 3

4 Open Enrollment Actions During Open Enrollment you may: Change, confirm or drop your current medical, dental, vision elections You may add or drop dependents You may drop, enroll or request an increase on the amount of voluntary life insurance, or short-term disability coverage subject to health evidence Enroll, change, or drop voluntary benefits Increases to Supplemental Voluntary Life Insurance If you wish to enroll or increase the amount of your supplemental voluntary life insurance, you can do so at open enrollment, but a health evidence application will be required. The additional premium and coverage will become effective on the first day of the month following the date the application is approved. Making No Changes No action is needed if you have not waived coverage and you want to continue your current Moda or Kaiser Plan and wish to cover the same family members. If you already contribute to a Health Savings Account and are enrolled in one of the Wise Consumer Plans, your current HSA contribution will roll forward unless you make changes. Actions You Must Take for 2017 If you wish to waive coverage for 2017, even if you currently waive your medical coverage you MUST complete a new waived election form for 2017 (this provision does not apply to spouses/partners covered by another Chemeketa employee). If you do not complete a form to continue or begin waived coverage for 2017, IRS regulations require us to enroll you in a default plan. Default coverage will be the Kaiser Standard HMO Deductible Plan with Kaiser Vision and Kaiser Dental. If you wish to contribute to a health and/or dependent care flexible spending account, a new enrollment form is required for Your 2016 election will not roll forward. Up to $500 of unused health care spending account funds in 2016, will automatically carry forward in Important Reminders Please be sure to update your emergency contact information and/or Beneficiary designation if you have had changes. Please see the rates below and visit the Open Enrollment page on Dashboard. 4

5 Medical, Dental, Vision 2017 Fulltime Employee Monthly Rates Plan Options Total Employer Relief Employee Relief Employee Moda Standard Plan Medical Only $1, $1, $30.00 $ $80.00 $ Medical / VSP $1, $1, $30.00 $ $80.00 $ Medical / VSP / Moda Dental $2, $1, $30.00 $ $80.00 $ Medical / Moda Dental $2, $1, $30.00 $ $80.00 $ Medical / VSP / Kaiser Dental $2, $1, $30.00 $ $80.00 $ Medical / Kasier Dental $1, $1, $30.00 $ $80.00 $ Moda Wise Consumer Plan Medical Only $1, $1, $0.00 $0.00 $0.00 $0.00 Medical / VSP $1, $1, $0.00 $0.00 $0.00 $0.00 Medical / VSP / Moda Dental $1, $1, $30.00 $54.34 $80.00 $4.34 Medical / Moda Dental $1, $1, $30.00 $38.07 $68.07 $0.00 Medical / VSP / Kaiser Dental $1, $1, $30.00 $33.23 $63.23 $0.00 Medical / Kasier Dental $1, $1, $30.00 $16.96 $46.96 $0.00 Kaiser Standard Deductible Plan (includes Kaiser Medical Only $1, $1, $9.40 $0.00 $9.40 $0.00 Medical / Kaiser Dental $1, $1, $30.00 $ $80.00 $56.81 Medical / Moda Dental $1, $1, $30.00 $ $80.00 $77.92 Kaiser Wise Consumer Plan (includes Kaiser Vision) Medical Only $1, $1, $0.00 $0.00 $0.00 $0.00 Medical / Kaiser Dental $1, $1, $20.98 $0.00 $20.98 $0.00 Medical / Moda Dental $1, $1, $30.00 $12.09 $42.09 $0.00 Dental Only Moda Dental Only $ $ $0.00 $0.00 $0.00 $0.00 Kaiser Dental Only $ $ $0.00 $0.00 $0.00 $0.00 Vision Only VSP $16.27 $16.27 $0.00 $0.00 $0.00 $0.00 5