2017 Lubbock County Enrollment Guide

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1 2017 Lubbock County Enrollment Guide Choose Well Plan Well Live Well

2 WELCOME This guide is designed to help you understand your benefits. Review this material carefully before making your enrollment decisions. Keep this guide to refer to periodically throughout the year. An electronic copy of this guide, the complete Plan Document for each medical plan, and the ACA Summary of Benefit and Coverage (SBC) is located on the Lubbock County Intranet at Every full time employee must enroll. Coverage and/or participation in County benefits is not automatic. It is important to familiarize yourself with the various options and enroll in those that best meet your needs. If you have any questions or need additional information, the Human Resources Department is here to assist you. Do not hesitate to contact us. Melanie Hall Greg George Benefits Manager Human Resources Director Venessa Carter Human Resources Manager Our Mission Opportunity Training Achievement Fostered by Innovation Caring Respect

3 IMPORTANT CONTACT INFORMATION Medical Insurance Plans TeamChoice HSA To locate participating providers: choice.com Group Name: Lubbock County Customer Service: Aetna HSA To locate participating providers: Plan name: Aetna Choice POS II (Open Access) Customer Service: User Name Password Pharmacy Benefit Management (PBM) Med Impact Customer Service: User Name Password Dental Insurance Plan Aetna To locate participating providers: Plan name: Dental PPO/PDN Customer Service: Vision Insurance Plan Superior Vision Customer Service: Employee Assistance Program (EAP) Interface EAP Customer Service: or (Se Habla Espanol) Login: Lubbock County Password: 842 HSA FSA COBRA CONEXIS Customer Service: User Name Password TCDRS Retirement Customer Service: User Name Password Life Insurance VOYA Customer Service: User Name Password Security Benefits Luke Ford

4 ELIGIBILITY AND ENROLLMENT Eligibility Employees: You are eligible to receive benefits as a full time employee if you work at least 30 hours per 7 day work period Dependents: Eligible dependents are: Your legal spouse Your natural child under 26 years of age Your legally adopted child under 26 years of age Your stepchild under 26 years of age A child for whom you have legal guardianship under 26 years of age DEPENDENT VERIFICATION ELIGIBILITY DOCUMENTATION Required Documentation needed to qualify your dependent(s) for coverage. Must be provided within 30 days of enrollment. Legal or Common Law Marriage Documents State issued Marriage Certificate Affidavit of Common Law Marriage filed with the County Biological Child Documents State issued Birth Certificate Stepchild Documents State issued Birth Certificate with state issued Marriage Certificate or affidavit of Common Law Marriage filed with the County Adopted Child Documents Adoption Certificate or Adoption Placement Agreement Disabled Dependent Documents Medical Certification as disabled and incapable of self sustaining employment and all other appropriate dependent documentation as listed above Grandchild Documents Court papers demonstrating legal guardianship and federal tax return within the last 2 years Legal Guardianship Documents State issued Birth Certificate and court order establishing guardianship

5 ENROLLMENT Get started Visit and login by entering your user name and password. If you are a first time user, click on Register to set up your user name, password and security questions. Our Company Key is LubbockCo (note: it s case sensitive). Forgot your password? 1. Visit and click on the Forgot your password? link. 2. Enter your social security number, company key and date of birth. 3. Answer your security phrase. 4. Enter and confirm your new password, then click Continue to return to this page and login. Begin enrollment Click Start Here and follow the instructions to enroll in your benefits or waive coverage. You must make your elections by the deadline located under the Start Here button. If you miss the deadline you will waive any electable benefit coverage, and have to wait until the next open enrollment period to enroll. Wondering what something means? View the online glossary in the Reference Center. Want to review your current plan? You have year round access to your benefit summary and specific benefit elections at 1. Click on your name in the top right 2. Click Benefits Summary in the Benefits tab. 3. Review your current plan. Scan & Enroll Enroll in your benefits from mobile device. Visit or simply scan this QR code and tap your way through your elections. If you don t already have a QR code reader on your smart phone or tablet, download one from your device s app store.

6 Make your elections Review your options as you walk through the enrollment process. Click Select on the plan(s) you choose. Track your choices along the enrollment bar which updates with your total cost. If you have any questions as you go through enrollment, please call HR. Use the Reference Center tools to help you make elections. Review your elections Review, edit and approve your personal information, elections, dependents and total cost. Approve & Agree Once you have reviewed your elections and they are accurate, click Approve. You must then Agree to your benefit elections. Your enrollment isn t complete until you agree to your benefit elections. Print Print your election information and confirmation number for future reference.

7 MID YEAR CHANGES Most benefits are paid for on a pre tax basis; therefore, Federal law limits your ability to make changes during the year. This means you may only change your elections during open enrollment unless you experience a Qualifying Event. Benefit elections made during open enrollment are effective at the beginning of the plan year. QUALIFYING EVENT The benefit elections you make will remain in effect until the end of the plan year, unless you are affected by one of these life changing events: Getting married or divorced, A change in job status (for you or an enrolled dependent), or Having a baby or adopting a child. If you experience any of these qualifying events, you must provide the required supporting documentation and make changes within 30 days of the event. After the 30 days have passed, open enrollment is the only time that you can make changes. 1. Login to 2. Click on the Start Here button to change your benefits or your basic information. 3. Select the life event button and make your changes. Required Documentation for Qualifying Event Adding yourself and/or dependents to coverage: Marriage State issued Marriage Certificate or Affidavit of Common Law Marriage filed with the County Birth State issued Birth Certificate Loss of Other Coverage Letter indicating the loss of coverage which includes the name of the insured, specific coverage(s) that were lost, and date that coverage(s) were lost Removing yourself and/or dependents from coverage: Divorce state issued divorce decree showing date of divorce Gain of Other Coverage Letter indicating the gain of coverage which includes the name of the insured, specific coverage(s) that were lost, and date that coverage(s) were lost Death of Dependent State issued death certificate

8 2017 Employee Premium Rates Medical TeamChoice EPO Your Bi Weekly Cost Aetna PPO Your Bi Weekly Cost Employee Only $10.00 Employee Only $75.00 Employee Child(ren) $90.00 Employee Child(ren) $ Employee Spouse $ Employee Family $ Employee Spouse $ Employee Family $ Dental Aetna Dental Your Bi Weekly Cost Employee Only $0 Employee Child(ren) $10.00 Employee Spouse $15.00 Employee Family $20.00 Vision Vision Plan Your Bi Weekly Cost Employee only $3.42 Employee + 1 $5.83 Employee + Family $8.58

9 MEDICAL INSURANCE Summary of Medical Plans PLAN TEAMCHOICE EPO AETNA PPO BENEFITS IN NETWORK ONLY IN NETWORK NON NETWORK Deductible $1,600 $2,500 $5,000 Co Insurance 20% 20% 40% Max Out of Pocket $4,000 $5,000 UNLIMITED Family Deductible $3,200 $5,000 $10,000 Family Max Out of Pocket $8,000 $10,000 UNLIMITED Routine Annual Exam $0 100% every 12 months $0 100% every 12 months THEN 40% Physician Visit THEN 40% Specialist Visit THEN 40% Emergency Room THEN 40% Urgent Care THEN 40% Prescription Drugs of allowable of allowable THEN 40% Complex Imaging THEN 40% Outpatient Services THEN 40% Inpatient / Hospitalization THEN 40% Lifetime Maximum UNLIMITED UNLIMITED UNLIMITED Network Team Choice Aetna Non Network Benefits presented are only a summary. Please refer to the Plan Document and ACA summaries for the complete details of coverage at

10 AETNA Register at to: Print a medical and/or dental ID card or download the app to view on smartphone, and show to a medical and/or dental provider. View claims, deductibles and maximum out of pocket amounts. Payment Estimator compare cost estimates for health care services. TEAMCHOICE Visit choice.com to locate in network physicians and/or facilities. Enter Lubbock County as your employer, your city and agree to terms then click search. PRESCRIPTION DRUGS

11 Get Started Register at 1. Click on Member 2. If you do not have an account click on Register Now. 3. If you have an account login by using your Username and Password. Benefits of using the MedImpact website: Drug Price Check Compare drug prices and view most commonly dispensed drugs, which may show a lower cost option than the drug you were prescribed. Claims Review View your current prescription drug claims. Locate an In Network Pharmacy Locate a pharmacy in your area and/or one that prescribes a 90 day supply.

12 DENTAL INSURANCE You can choose to seek treatment from any dentist. If your dentist does not file insurance claims, you will pay up front and then complete a reimbursement form and submit it to Aetna. If you select a dentist in the Aetna network, you will receive guaranteed savings. To find dentist in the Aetna network go to Preventive Services County Pays 100% Basic Services County Pays 80% Major Services County Pays 50% Annual Maximum Benefit $1,500 Orthodontic Lifetime Maximum $1,000 Annual Deductible Individual $25/Family $100* *The deductible applies to basic & major services only. VISION INSURANCE In Network Out of Network Exam Covered in full Up to $40 retail Frames $150 retail allowance Up to $70 retail Lenses (standard) per pair Single Vision Covered in full Up to $40 retail Bifocal Covered in full Up to $60 retail Trifocal Covered in full Up to $80 retail Progressive See description 1 Up to $80 retail Lenticular Covered in full Up to $80 retail Contact Lenses 2 $150 retail allowance Up to $105 retail Medically Necessary Contact Lenses Covered in full Up to $210 retail Laser Vision Correction $250 retail allowance 3 Co pays apply to in network benefits; co pays for out of network visits are deducted from reimbursements 1Covered to provider s in office standard retail lined trifocal amount; member pays difference between progressive and standard retail lined trifocal, plus applicable co pay 2 Contact lenses and related professional services (fitting, evaluation and follow up) are covered in lieu of eyeglass lenses and frames benefit 3 Lasik Vision Correction is in lieu of eyewear benefit, subject to routine regulatory filings and certain exclusions and limitations

13 Benefits of an HSA Contributions are made through a pre tax payroll deduction Unused dollars roll over into the next year Your employer can contribute to the account HEALTH SAVINGS ACCOUNT 2017 Contribution Limits Individual $3,400 Family $6,750 HSA catch up 55+ $1, HSA High Deductible Health Plan minimum Deductible & maximum Out of pocket limits: Deductible Out of Pocket Individual $1,300 Family $2,600 Who can establish an HSA? You must have coverage under a qualifying HDHP (High Deductible Health Plan) You can t participate in another health plan that s not a qualifying HDHP You can t be entitled to Medicare You can t be eligible to be claimed as a dependent on someone else s tax return *IRS guidelines govern HSA eligibility Individual $6,550 Family $13,100 In-network preventive care is 100% covered How Your Consumer Driven Medical Plan & HSA Work Together Lubbock County contributes to Unused HSA your HSA $$ roll over Pay out-of-pocket expenses into next including prescription drugs, year medical, dental & vision cost START OF PLAN YEAR JANUARY 2017 Pay with HSA or other personal funds Meet your deductible You pay 20% Lubbock County Pays 80% Lubbock County Pays 100% END OF PLAN YEAR DECEMBER 2017 Deductible Out-of-pocket Maximum

14 LIFE INSURANCE Lubbock County provides every benefit eligible employee with a $20,000 basic life policy and $20,000 AD&D policy. Supplemental Life Insurance Voluntary Term Life and AD&D coverage options are: Employee: Spouse: Children: One to five times your annual salary rounded. Not to exceed $500,000. NOTE: Coverage over $200,000 will require employee to complete an Evidence of Insurability form. Half employee election. NOTE: Coverage over $50,000 will require the spouse to complete an Evidence of Insurability. Benefit election maximum is $10,000 for children 6 months to 19 years old and full time students less than 23 years old. Benefit election maximum is $1,000 for children birth to 6 months. All life insurance premiums will be deducted from your pay post tax. Term Life Coverage Rates Age Band Life Bi weekly Rate/$1,000 <25 $ $ $ $ $ $ $ $ $ $ $1.436 Life Bi weekly Rate/$10,000 Children 6 months to 19 and full time students less than 23* $0.924 AD&D AD&D Rate/$1,000 Bi weekly Rates Employee $.014 Spouse $.014 Child(ren) $.014 Benefits reduce by 35% at age 65 and further reduce by 50%, of the original amount, at age 70. *For children over 14 days but less than 6 months of age benefit election maximum is $1,000

15 WORK LIFE BALANCE Employee Assistance Program The Employee Assistance Program (EAP) provides cost free professional consultation and referral services for employees that are experiencing work and personal related issues. Immediate family members are also eligible for EAP services. This benefit is confidential. Issues commonly addressed through your EAP benefit include: Stress management Depression/Anxiety General Wellness Family/Parenting Emotional Alcohol/Drug Abuse Legal referrals Financial referrals Employees and their immediate family members will have access to 5 free face to face counseling sessions per problem, per family, per plan year. WELLNESS Lubbock County has teamed up with Wellness Today to keep our employees healthy and fit. If you are looking to reshape your health contact: Michael Fernuik Or Michael.fernuik@wellnesstodaylubbock.com

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17 This guide is provided for informational purposes only and is a general overview of the provisions described in the plan documents. Please see the actual plan documents for the specifics of each of your benefit plans. If any discrepancy exists between this guide and the plan documents, the plan documents will govern.

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