2018 employee benefits YOUR GUIDE.

Transcription

1 2018 employee benefits YOUR GUIDE.

2 2018 employee benefits 2 TABLE OF CONTENTS Benefits Overview... 2 Benefit Plans Offered... 2 Eligibility... 2 New in Medical Benefits... 4 Dental Benefits... 6 Voluntary Vision Insurance... 7 Your coverage from an Anthem doctor... 7 Life and Accidental Death & Dismemberment Insurance (AD&D) Basic Life & AD&D Insurance... 8 Voluntary Life and AD&D Insurance... 8 FSA... 9 Long Term Disability... 9 Business Travel Accident... 9 Participant Advocate Link Contact Information BENEFITS OVERVIEW The CHEIBA Trust is proud to offer a comprehensive benefits package that helps meet the individual and family needs of its members. The complete benefits package is briefly summarized in this booklet. Benefit Plans Offered Medical Dental Vision Basic Life and Accidental Death & Dismemberment (AD&D) Voluntary Life Voluntary AD&D Flexible Spending Account (FSA) Long-Term Disability Business Travel Accident Eligibility You and your dependents are eligible for the CHEIBA Trust benefits. Employee definition will be defined by each State college, university and institution who participates in the CHEIBA Trust. Please see the eligibility document for your campus/institution. Eligible dependents are your legal spouse, partner in a civil union, married or unmarried children (natural or biological, child of a partner in a civil union, step-child, legally adopted child, child under legal guardianship) under age 26, disabled dependents of any age, or other eligible dependents as defined by the CHEIBA Trust. Elections made now will remain until the next open enrollment unless you or your family members experience a qualifying event. If you experience a qualifying event, you must contact HR within 31 days. This document is an outline of the coverage proposed by the carrier(s), based on information provided by your employer. It does not include all of the terms, coverage, exclusions, limitations, and conditions of the actual contract language. The policies and contracts themselves must be read for those details. Policy forms for your reference will be made available upon request. The intent of this document is to provide you with general information regarding the status of, and/or potential concerns related to, your current employee benefits environment. It does not necessarily fully address all of your specific issues. It should not be construed as, nor is it intended to provide, legal advice. Questions regarding specific issues should be addressed by your general counsel or an attorney who specializes in this practice area.

3 2018 employee benefits 3 What s New for 2018? Annual enrollment is your opportunity to review your current benefits and make changes for the upcoming plan year. Your new benefit elections will be effective on January 1, Changes for the 2018 plan year are summarized below. Be sure to take a fresh look at all of the benefit options available to you for the year ahead -- and use the communication materials provided to you to help you make your decisions. Medical Plan Changes Prime Blue Priority PPO Changes to the individual and family deductible for in-network and out-of-network services and individual and family out-of-pocket maximum for in-network and out-of-network services. High Deductible Health Plan (HDHP) Changes to the individual and family out-of-pocket maximum for in-network and out-of-network services and change in coinsurance levels. All of your 2018 medical plan options BlueAdvantage HMO/POS, Prime BluePriority PPO, Blue Priority HMO and the HDHP- PPO now include an adult hearing aid benefit. Effective January 1, 2018, you will have a hearing aid benefit allowance of $4,000 every 3 years. Dental Plan Changes PPO and PPO Plus Child orthodontia lifetime maximum has been increased to $1,500 on both dental plans. Basic Life Plan Changes Age reduction provision has been broadened to: Under age 67 Two times annual base salary to a maximum of $500,000 Age 67 through 69 Two times annual base salary to a maximum of $50,000 Age 70+ $10,000 Voluntary Life Plan Changes Voluntary Life rates have been reduced significantly beginning with the January 1, 2018 renewal. Employee maximum election will increase to $500,000, not to exceed 5x annual salary. Employee Guaranteed Issue amount increased to $60,000 Child Life election changed from a flat $5,000 to $5,000 increments to a maximum of $25,000 Voluntary Life benefit enhancements have a one-time Open Enrollment opportunity effective January 1, The information provided in this communication provides a high level summary of the benefit changes for the 2018 Plan Year. For more detailed information, please refer to the 2018 CHEIBA Trust Employee Benefit Plan Booklet and Multi-Option Benefit Summary.

4 2018 employee benefits 4 MEDICAL BENEFITS Insured by Anthem Blue Cross and Blue Shield Comprehensive and preventive healthcare coverage is important in protecting you and your family from the financial risks of unexpected illness and injury. A little prevention goes a long way especially in healthcare. Routine exams and regular preventive care provide an inexpensive review of your health. Small problems can potentially develop into large expenses. By identifying the problems early, they can often be treated at little cost. Comprehensive healthcare also provides peace of mind. In case of an illness or injury, you and your family are covered with an excellent medical plan through the CHEIBA Trust. The CHEIBA Trust offers you a choice of four medical plans - Blue Advantage HMO/POS, Blue Priority Prime PPO, Blue Priority HMO, and 2500 HDHP/HSA. With the PPO plans, you may select where you receive your medical services. If you use in-network providers, your costs will be less. With the Blue Priority HMO and BlueAdvantage HMO/POS plans, you must select a primary care physician (PCP) for yourself and each covered dependent. For children, you may designate a pediatrician as the primary care provider. With the Blue Priority HMO plan, members are required to obtain a referral from their PCP to see an in-network specialist. BlueAdvantage HMO/POS Blue Priority Prime PPO Blue Priority HMO 2500 HDHP/HSA In-Network (HMO) In-Network In-Network In-Network $0 Individual $500 Individual $2,000 Individual $2,500 Individual Annual Deductible $0 Family $1,000 Family $6,000 Family $5,000 Family $2,000 Individual Annual Out-of-Pocket $3,000 Individual $4,000 Individual $3,500 Individual $4,000 Family $6,000 Family $10,000 Family $7,000 Family Maximum (All Copayments included) (Ded, Copays & Coins. Included) (Ded, Copays & Coins. Included) (Ded. & Coins. included) Coinsurance Copays apply 15% Copays apply 15% Doctor s Office Primary Office Visit Specialist Office Visit Preventive Care (routine exams, immunizations, well baby care and mammograms) Diagnostic Laboratory & X-Ray MRI, nuclear medicine, and other high-tech services $20 copay $40 copay Designated Providers: $10 per visit Participating Providers: 15% after deductible Designated Providers: $10 per visit Participating Providers: 15% after deductible $20 15% after deductible $60 15% after deductible 100% covered 100% covered 100% covered 100% covered 100% covered $60 copay at a freestanding $120 copay at a hospital based- 10% after deductible at freestanding 15% after deductible at a hospital-based 10% after deductible at freestanding 15% after deductible at a hospital-based Lab: 100% covered at freestanding X-Ray: $60 at free-standing Lab & X-Ray: $250 then 20% after deductible at a hospitalbased $250 copay at free-standing $250 then 20% after deductible at a hospital-based 15% after deductible 15% after deductible

5 2018 employee benefits 5 Hospital Services Emergency Room *Same for In-Network and Outof-Network BlueAdvantage HMO/POS PRIME Blue Priority PPO Blue Priority HMO Lumenos HDHP-PPO In-Network (HMO) In-Network In-Network In-Network $150 copay/visit 15% after deductible $250 copay/visit 15% after deductible Inpatient $600 copay/admission 15% after deductible Outpatient Surgery Ambulance Service *Same for In-Network and Outof-Network Prescription Drugs $60 copay at a freestanding $125 copay at a hospitalbased 10% after deductible at a freestanding 15% after deductible at a hospital-based $250 copay/admission plus 20% after deductible $250 copay at free-standing $250 copay then 20% after deductible at hospital-based 15% after deductible 15% after deductible $100 copay/trip 15% after deductible 20% after deductible 15% after deductible Retail (30-day supply) $200 Ind./$400 Fam. Ded. for Tiers 2 & 3 Tier 1 prescription drugs $10 $10 $15 15% after deductible Tier 2 prescription drugs $40 $40 $40 15% after deductible Tier 3 prescription drugs $60 $60 $60 15% after deductible Tier 4 prescription drugs* 30% coinsurance to max $125 30% coinsurance to max $125 30% coinsurance to max $250 15% after deductible Mail Order (90-day supply) 2x Retail Copay *Specialty (only available through The Pharmacy Benefit Manager; mail order is not available). *Not all specialty drugs on Tier 4 are subject to the Tier 4 coinsurance. Certain specialty drugs may be subject to the Tier 1, 2 or 3 copayment. Out-of-Network Annual Deductible Annual Out-of-Pocket Maximum $500 Individual $1,000 Family Individual deductible plus $2,500. Family deductible plus $5,000 $1,200 Individual $2,400 Family $6,000 Individual $12,000 Family Coinsurance 30% 35% Out-of-Network care not covered Out-of-Network care not covered Out-of-Network care not covered $2,500 Individual $5,000 Family $7,000 Individual $14,000 Family 35% after deductible

6 2018 employee benefits 6 Dental Benefits Insured by Anthem Blue Cross and Blue Shield Good oral care enhances overall physical health, appearance and mental well-being. Problems with the teeth and gums are common and easily treated health problems. Keep your teeth healthy and your smile bright with the CHEIBA Trust dental benefit plans. PLAN HIGHLIGHTS Anthem Blue Dental PPO Plus Anthem Blue Dental PPO In Network Out of Network In Network Out of Network Annual Maximum (per member) $2,000 $2,000 $2,000 $2,000 Annual Deductible (individual/family) $25 / $75 $25 / $75 $0 $50 / $150 Plan Pays Plan Pays Diagnostic & Preventive Services (deductible does not apply) ¹ Diagnostic & Preventive services do not accumulate towards annual maximum ¹ Services include: Oral evaluations X-Rays Cleanings (Benefit includes (3) three annual cleanings for adults only) Specified space maintainers Restorative/General Services (deductible applies) Services include: Emergency palliative treatment General anesthesia Amalgam and anterior composite restorations Endodontic Services (deductible applies) Services include: Root canal therapy Oral Surgery Services (deductible applies) Services include: Simple and surgical tooth extractions Periodontal Services (deductible applies) Services include Gingivectomy Osseous surgery Prosthodontic Services (deductible applies) Services include Crowns/onlays Removable or fixed partials or dentures Implants Orthodontic Services Adults Children 100% 100% 100% 80% 80% 80% 80% 60% 80% 80% 80% 60% 80% 80% 80% 60% 80% 80% 80% 60% 50% 50% 50% 40% 50% up to $1,500 ² 50% up to $1,500 ² 50% up to $1,500 ² 50% up to $1,500 ² 50% up to $1,500 ² 50% up to $1,500 ² 40% up to $1,500 ² 40% up to $1,500 ² ¹ Deductible does not apply to diagnostic and preventive services. In addition, diagnostic and preventive services do not accumulate towards the annual benefit maximum. ² Lifetime Maximum: the cumulative dollar amount the plan will pay for orthodontic treatment incurred by an individual enrollee for the life of the plan. For family coverage, each individual covered under the plan is subject to the lifetime maximum.

7 2018 employee benefits 7 Vision Benefits Administered by Anthem Blue Cross and Blue Shield Regular eye examinations can not only determine your need for corrective eyewear but also may detect general health problems in their earliest stages. Protection for the eyes should be a major concern to everyone. Description Blue View Vision - Exam Only Frequency: Once every 12 months (included with your medical plan election) Level of Coverage from an Anthem doctor Non-Anthem Doctor or Provider Level of Reimbursement $15 copay, then covered in full Reimbursed up to $50 Blue View Vision - Materials Only (Voluntary) Eyeglass Frames Frequency: Once every 12 months Standard Plastic Lenses Frequency: Once every 12 months (from last date of service) $130 allowance, then 20% off any remaining balance Reimbursed up to $70 One time materials copay of $15 Standard plastic single vision lenses $15 copay, then covered in full Reimbursed up to $50 Standard plastic lined bifocal lenses $15 copay, then covered in full Reimbursed up to $75 Standard plastic lined trifocal lenses $15 copay, then covered in full Reimbursed up to $100 Lenses include factory scratch coating at no additional cost. Polycarbonate and photochromic lenses are covered for dependent children under age 19 with no additional cost. Contact Lenses* Frequency: Once every 12 months (from last date of service) Elective conventional lenses $130 allowance, then 15% off any remaining balance Reimbursed up to $110 Elective disposable lenses $130 allowance Reimbursed up to $110 Non-elective contact lenses Covered in full Reimbursed up to $210 allowance Contact lens exam (Fitting & Evaluation) Copayment up to $55 N/A * Contact lenses are in lieu of lenses and/or frame. Eyeglass lens upgrades When obtaining eyewear from a Blue View Vision Provider, you may choose to upgrade your new eyeglass lenses at a discounted cost. Eyeglass lens copayment applies. Transitions lenses (Adults) Standard Polycarbonate (Adults) UV Coating Progressive Lenses ¹ o Standard o Premium Tier 1 o Premium Tier 2 o Premium Tier 3 Anti-Reflective Coating ² o Standard o Premium Tier 1 o Premium Tier 2 Other Add-ons and Services In-Network Member Cost (after any applicable copay) $75 $40 $15 $65 $85 $95 $110 $45 $57 $68 20% off retail price ¹ Please ask your provider for his/her recommendation as well as the progressive brands by tier. ² Please ask your provider for his/her recommendation as well as the coating brands by tier. Laser vision correction surgery LASIK Refractive Surgery Discount per eye For more information please visit and select vision care. If you see an out-of-network provider, you must pay the cost in full and submit an out-of-network claim form for reimbursement up to the allowed amount. To search for a network providers, please use the Blue View Vision network plan in Anthem s Find a Doctor tool.

8 2018 employee benefits 8 Basic Life and Accidental Death & Dismemberment Insurance Insured by Anthem Life Insurance Company Life Insurance Life insurance provides financial security for the people who depend on you. Your beneficiaries will receive a lump-sum payment if you die while employed. The amount of life insurance benefit for active Employees is calculated on your annual base salary (ask your Human Resources/Benefits Office for specific definitions of base salary). The plan provides the following coverage: Under age 67 Two times annual base salary to a maximum of $500,000 Age 67 through 69 Two times annual base salary to a maximum of $50,000 Age 70+ $10,000 Coverage is rounded up to the nearest $1,000. The plan also provides your spouse, your partner in civil union and your Eligible Dependent children a maximum life benefit of $2,000 per person. Voluntary Life Insured by Anthem Life Insurance Company You may purchase Voluntary Life Insurance in addition to the Basic Life coverage for yourself and for your dependents even if you do not enroll yourself. Employee Spouse Children $10,000 increments to a maximum of $500,000 $10,000 increments to a maximum of $300,000 Ages 6 months to 26 years $5,000 increments to a maximum of $25,000 per child Accidental Death and Dismemberment (AD&D) Insurance Insured by Anthem Life Insurance Company Accidental Death and Dismemberment (AD&D) insurance provides payment to you or your beneficiaries if you lose a limb or die in an accident. This coverage is in addition to your life insurance described above. Anthem Life will pay the amount of insurance specified in the loss Schedule of Indemnities as explained in your Anthem Life brochure. Voluntary Accidental Death and Dismemberment (AD&D) Insurance Insured by Mutual of Omaha Insurance Company You may purchase Voluntary AD&D Insurance in addition to the Basic AD&D coverage for yourself and for your dependents. Employee Spouse Children $10,000 increments to a maximum of $500,000 (not to exceed 10x your annual salary) 50% of the Employee Coverage Amount (60% if there are no children) 10% of the Employee Coverage Amount for a Dependent Child(ren) (20% if there is no spouse)

9 2018 employee benefits 9 Flexible Spending Accounts (FSAs) Administered by 24HourFlex (does not apply to Fort Lewis College) You can save money on your healthcare and/or dependent day care expenses with an FSA. You set aside funds each pay period on a pretax basis and use them tax-free for qualified expenses. You pay no federal income or Social Security taxes on your contributions to an FSA. (That s where the savings comes in.) Your FSA contributions are deducted from your paycheck before taxes are withheld, so you save on income taxes and have more disposable income. Healthcare Spending Limit Dependent Care Spending Limit $2,600 (Annual Individual Limit) $5,000 (Annual Family Limit) Here s How an FSA Works IRS regulations require you to enroll each year during your benefits annual enrollment period if you want to participate in either a Healthcare or Dependent Care FSA. You decide the annual amount (up to $2,600 for the Healthcare Account and $5,000 for the Dependent Care account) you want to contribute to either or both FSAs based on your expected healthcare and/or dependent childcare/eldercare expenses. Important - any contributions to these accounts that are not used for eligible expenses incurred during the Plan Year will be forfeited unless your employer offers the Roll- Over Option. Please contact your Human Resources/Benefits Office for details on the rollover option. You can pay with the Healthcare FSA debit card for eligible healthcare expenses. For dependent care, you pay for eligible expenses when incurred, and then submit a reimbursement claim form or file the claim online. You are reimbursed from your FSA. So, you actually pay your expenses with tax-free dollars. Long-Term Disability Insurance Insured by Standard Insurance Meeting your basic living expenses can be a real challenge if you become disabled. Your options may be limited to personal savings, spousal income and possibly Social Security. Disability insurance provides protection for your most valuable asset your ability to earn an income. LTD coverage provides income when you have been disabled for 90 days or more. Your benefit is 66 2/3% of your pre-disability earnings to a maximum benefit of $7,000 per month or 70% of your pre-disability earnings if you have other deductible sources of income. Benefit payments can continue to age 65, to Social Security Normal Retirement Age, or 3 years and 6 months (whichever is longest) if you are under age 60 at the time of disability. Business Travel Accident Insurance Insured by Chubb Insurance If you are actively employed by a CHEIBA Trust Member employer and have an accident while traveling for employer-approved business, this Travel Accident Insurance Plan protects you with benefit payments to you or your beneficiary. The maximum benefit (Principal Sum) is $100,000 of Accidental Death and Dismemberment. Medical Assistance Services: Medical provider search and referrals to help find hospitals and doctors in a given locale Medial monitoring of treatment Facilitation of medical payment Coordination of medication Medical Evacuation & Repatriation Services: Emergency medical evacuations and medicallynecessary repatriation Coordinate transportation to join a hospitalized family member Dependent children/traveling companion assistance

10 2018 employee benefits 10 Participant Advocate Link (PAL) The PAL Program can help you with claims issues, getting approval for covered services, answering questions about your benefits, and much more. Your PAL representative is available Monday through Friday between 8:00 a.m. 5:00 p.m. MST.

11 2018 employee benefits 11 PLAN CONTACTS 2018 EMPLOYEE BENEFIT INSURANCE Health Insurance Anthem Blue Cross and Blue Shield BlueAdvantage Point of Service Plan (HMO/POS) Blue Priority Prime Plan (PPO) and Custom Plus Health Plan Blue Priority HMO Plan 2500 HDHP/HSA Plan Phone Provider Directories for Health and Dental Future Moms /7 NurseLine LiveHealth Online Prescription Drug Benefit Express Scripts Mail Order Accredo (Specialty Drugs) Dental Insurance Anthem Blue Cross and Blue Shield Anthem Blue Dental PPO Plus Anthem Blue Dental PPO Phone Vision Insurance Anthem Blue Cross and Blue Shield Phone Discount Information Basic Term Life Insurance & Voluntary Term Life Anthem Life Insurance Company Phone Voluntary Accidental Death & Dismemberment Insurance Mutual of Omaha Insurance Company Phone Flexible Benefit Plan 24HourFlex (Except Fort Lewis College See Separate Insert) Phone Participant Website... participant.24hourflex.com Long Term Disability Insurance Standard Insurance Company Phone Colorado State Employee Assistance Program (C-SEAP)... Phone or Toll Free Travel Accident Insurance Chubb Phone Participant Advocate Link (P.A.L.) Arthur J. Gallagher & Co. Phone or Fax COBRA Coverage 24Hour Flex Phone Participant Website...

12 This benefit summary prepared by