2017 Benefits Guide CTX 2017

Transcription

1 2017 Benefits Guide

2 Welcome to your benefits. We offer a full menu of benefits to eligible employees and their families. You have 30 days from your hire date to enroll in plans so be sure to take a close look and make choices before the deadline. Eligibility You re eligible for medical, dental, vision, flexible spending accounts, disability, life and AD&D insurance if you re: A full-time employee regularly scheduled to work at least 60 hours per pay period A two-day alternative employee A part-time employee regularly scheduled to work 40 hours but fewer than 60 hours per pay period. Your spouse and children are eligible too within certain guidelines. You can visit our benefits website bswhbenefits.com for complete information about eligibility and benefits. You can also use the links here to go directly to the benefits you d like to learn more about. 1

3 Baylor Scott & White benefits help you protect your health, your finances and your peace of mind. With so many options, you ll need to do a little homework to find the right fit for your family. We make it easy to get up to speed. You can see how the plans work in real-life scenarios, find plan overviews, watch an entertaining video enrollment meeting, visit Ask Alex, and more on bswhbenefits.com. Have questions or need a hand? Enrollment questions: PeoplePlace at Specific medical plan questions: SWHP at Benefits to choose You have the following benefit options available for yourself and your dependents: Medical Dental Vision Flexible spending accounts Life insurance Accidental death & dismemberment Short-term disability Long-term disability Legal services 2

4 2017 medical plans Meet Olivia She s single and in good health. She chose the Health Savings Account plan. She budgets to cover upfront costs if something happens, and wants to start saving now to pay for her medical care when she retires. See how each plan covers her annual costs on bswhbenefits.com. Meet Carlos He s a single dad. He chose the Health Reimbursement Account plan because he gets $1,750 in his health reimbursement account each year. He also thinks the premium is reasonable. Last year, he and his son didn t need much care. Carlos paid copays for a few prescriptions out of his pocket, plus had $200 left in his HRA to carry forward to the next year. Meet Jessica She s a married mom. Even though the Ask Alex tool recommended the Health Savings Account plan, she chose the Health Reimbursement Account plan. Why? She did some research. She realized the HSA plan deductible has to be met, in full, before the plan will begin to pay for care or prescriptions. The HRA plan deductible works differently. Once a family member has met the individual deductible, the plan begins paying for that person s care even if the family deductible hasn t been met yet. By choosing the HRA, she also gets upfront prescription drug coverage. 3 Visit bswhbenefits.com for more details.

5 Meet Susannah She s a married mom. She chose the Health Reimbursement Account plan because Baylor Scott & White contributes $2,000 to her health reimbursement account, which covers their medical costs for the year. Also, she likes that her family s prescription drugs are covered before she meets the deductible. See how each plan covers her annual costs on bswhbenefits.com. how will you choose? Not sure which medical plan to pick? Sometimes it can help to see how other people make their medical plan decisions. Protect your pay when you need to be away. Baylor Scott & White benefits help you protect your income in case you re sick or injured and can t work, or when you welcome a new child to your family. You have to buy short-term disability coverage to receive maternity, parental and adoption benefits. Your short-term disability premium is deducted from your check after taxes, which means your benefits are tax free. Meet Glenn He s a married dad. He chose the Health Reimbursement Account plan. His wife needs serious care and he expects to reach the out-of-pocket maximum. He did the math and realized that the HRA gives him the best benefit with the lowest total annual costs. See how each plan covers his annual costs on bswhbenefits.com. Meet Alison She s a single mom. She chose the PPO plan because her daughter has a chronic, serious health condition. She knows the premiums and overall costs are higher, but she wants the reliable costs and day one prescription coverage. If you don t enroll as a new hire, you might miss your chance for coverage. If you want coverage later, you ll have to go through medical underwriting to prove you re insurable. Coverage might be denied due to a pre-existing condition, including pregnancy. 4

6 Comparing the plans When you re shopping for medical coverage, sometimes you just want to see them side-by-side. Check out how the plans compare. Make sure you check out our fictional examples and Ask Alex before you make your choice. You can find these helpful resources and much more on bswhbenefits.com. You pay copays for prescriptions, urgent care and emergency care. Meet your deductible with office visits, lab work, imaging, outpatient procedures, etc. Baylor Scott & White provides a health reimbursement account for medical costs. You receive a pro-rated amount based on your date of hire. Any money left in your health reimbursement account rolls forward to the next year when you stay with the HRA. You pay copays for office visits, prescriptions, urgent care and emergency care. Meet your deductible with lab work, imaging, outpatient procedures, etc. There are no Baylor Scott & White account contributions. Meet your deductible with office visits, prescription drugs, urgent care visits, lab work, imaging, etc. To kick off your savings, Baylor Scott & White contributes to your HSA. You receive a pro-rated amount based on your date of hire. After you meet the deductible, you pay copays for prescription drugs. You can contribute through your paycheck. Your health savings account is yours to keep, even if you leave Baylor Scott & White. 5

7 Comparing deductibles Before the plan begins to pay for certain expenses, you must pay a certain amount from your pocket. Since your Baylor Scott & White account contributions count toward your deductible, we ve done some benefits math to help you choose the right fit. Keep in mind that Tier 1 costs apply to the Tier 2 deductible but Tier 2 costs do not apply to the Tier 1 deductible. Also, the account contributions are prorated based on your date of hire. The amounts shown are for the full year. HRA PPO HSA Full deductible Your HRA pays first * Then, you pay You pay the full deductible Full deductible HSA contribution You pay Tier 1 deductibles Employee only $2,000 -$1,000 $1,000 $800 $2,000 -$500 $1,500 Employee + spouse $3,750 -$1,750 $2,000 $1,600 $4,000 -$1,000 $3,000 Employee + child(ren) $3,250 -$1,750 $1,500 $1,200 $4,000 -$1,000 $3,000 Employee + family $4,000 -$2,000 $2,000 $1,600 $4,000 -$1,000 $3,000 Tier 2 deductibles Employee only $2,300 -$1,000 $1,300 $1,200 $2,300 -$500 $1,800 Employee + spouse $4,350 -$1,750 $2,600 $2,400 $4,600 -$1,000 $3,600 Employee + child(ren) $3,700 -$1,750 $1,950 $1,800 $4,600 -$1,000 $3,600 Employee + family $4,600 -$2,000 $2,600 $2,400 $4,600 -$1,000 $3,600 Paying for care and services HRA PPO HSA Your care Tier 1 Tier 2 Tier 1 Tier 2 Tier 1 Tier 2 Preventive care** $0 $0 $0 $0 $0 $0 Emergency care $200 $200 $200 $200 10% after deductible Urgent care $50 $100 $50 $100 Primary care physician $25 $70 office visit Your HRA pays first. Specialist office visit When it s empty, you meet the $40 $100 Lab work, X-rays, rest of the deductible. diagnostic screenings and imaging Physical therapy Inpatient care Then, you pay 10% (Tier 1) or 50% (Tier 2) until you meet the out-of-pocket maximum. You meet your deductible first. Then, you pay 10% (Tier 1) or 50% (Tier 2) until you meet the out-of-pocket maximum. You meet your deductible first. Then, you pay 10% (Tier 1) or 50% (Tier 2) until you meet the out-of-pocket maximum. *Your health reimbursement account pays for both Tier 1 and Tier 2 care. There are not separate health reimbursement accounts for Tier 1 and Tier 2 care. **Services must be coded as preventive care in order to be paid at 100%. Please review the Summary Plan Description for a complete list of preventive care services. Have you heard about flexible spending accounts? Healthcare flexible spending accounts can help you take your budget to the next level. You choose how much you d like to contribute when you enroll. That amount is divided by the number of paydays in the year and subtracted from your check before taxes are withheld. The best part is that your entire healthcare FSA is ready to use as of your effective date. Using a flexible spending account makes budgeting easier and can help you save money on your taxes. Learn more on the benefits website and in the Fashion Forward FSA segment of Benefits Today, our on-demand enrollment meeting. 6

8 Prescription drugs They are the most common form of treatment. Make sure you know how your medicine will be covered. If you choose the HRA and PPO, you pay copays in most cases. If you choose the HSA, you must meet the deductible first, then pay copays and percentages. Baylor Scott & White retail pharmacies Contracted pharmacies Type 30-day fill 90-day fill 30-day fill Preferred generic $3 $6 $5 Preferred brand $35 $70 $50 Chronic and preventive* $10 $20 $20 Non-preferred generic and brand Lesser of $50 or 50% Lesser of $100 or 50% Lesser of $75 or 50% Specialty 20% ($200 max) Not available Not available Non-formulary unless excluded** 50% 50% 50% *To help make some frequently prescribed preferred brand drugs for asthma, diabetes and other chronic conditions more affordable, we ve placed a select group on a special chronic and preventive medication list. Find the complete list on bswh.swhp.org. **Excluded medications include weight loss, cosmetic, over the counter, herbals and others as described in the Summary Plan Description. Certain non-formulary drugs are covered at specific levels at all BSWH and contracted pharmacies: Fertility drugs are covered at 20 percent with a maximum $400 copayment and a $7,500 lifetime maximum pharmacy benefit. Diabetic testing supplies, including meters, test strips and lancets, are covered and subject to copayments and coinsurance. Thirty-day supplies of generic proton pump inhibitors are covered at 50 percent. (Ninety-day supplies are available at BSWH pharmacies.) Protecting your pocket The out-of-pocket maximum acts as your financial protection from medical costs. It shows you the most you will have to pay for network care out of your pocket during the year. Since your Baylor Scott & White account contributions count toward your out-of-pocket maximum, we ve done some benefits math to help you choose the right fit. Keep in mind that Tier 1 costs apply to the Tier 2 out-of-pocket limit but Tier 2 costs do not apply to the Tier 1 limit. Also, the Baylor Scott & White contributions are pro-rated based on your date of hire. The amounts shown are for the full year. HRA PPO HSA Total out-of-pocket maximum Your HRA pays You pay You pay Total out-of-pocket maximum HSA contribution You pay Tier 1 out-of-pocket maximums Employee only $3,425 -$1,000 $2,425 $3,300 $3,275 -$500 $2,775 Employee + spouse $6,850 -$1,750 $5,100 $6,600 $6,550 -$1,000 $5,550 Employee + child(ren) $5,137 -$1,750 $3,387 $4,950 $6,550 -$1,000 $5,550 Employee + family $6,850 -$2,000 $4,850 $6,600 $6,550 -$1,000 $5,550 Tier 2 out-of-pocket maximums Employee only $6,850 -$1,000 $5,850 $6,850 $6,550 -$500 $6,050 Employee + spouse $13,700 -$1,750 $11,950 $13,700 $13,100 -$1,000 $12,100 Employee + child(ren) $10,275 -$1,750 $8,525 $10,275 $13,100 -$1,000 $12,100 7 Employee + family $13,700 -$2,000 $11,700 $13,700 $13,100 -$1,000 $12,100

9 Medical premiums per pay period Full-time employees earning less than $13 an hour Medical plan HRA PPO HSA Full-time employees A full-time employee is regularly scheduled to work at least 60 hours per pay period, including two-day alternative employees. Part-time employees A part-time employee is regularly scheduled to work 40 hours but fewer than 60 hours per pay period. Employee only $43.01 $67.76 $43.01 Employee + spouse $75.26 $ $75.26 Employee + child(ren) $83.07 $ $83.07 Employee + family $ $ $ Full-time employees earning $13 or more an hour Medical plan HRA PPO HSA Employee only $81.23 $ $81.23 Employee + spouse $ $ $ Employee + child(ren) $ $ $ Employee + family $ $ $ You can earn a $30 credit each pay period when you participate in the Thrive wellness program. Learn more at thriveforwellness.com Part-time employees Medical plan HRA PPO HSA Employee only $ $ $ Employee + spouse $ $ $ Employee + child(ren) $ $ $ Employee + family $ $ $ Dental premiums per pay period Dental plan MetLife PPO MetLife PPO Plus Employee only $9.98 $18.45 Employee + spouse $20.00 $35.99 Employee + child(ren) $26.76 $46.32 Employee + family $33.95 $63.86 Vision premiums per pay period Vision plan Employee only $3.20 Employee + spouse $6.35 Employee + child(ren) $6.23 Employee + family $9.46 8

10 Make an informed choice Our benefits website, bswhbenefits.com, has all the information you need to find the right fit for Fully optimized for smartphones Find everything you need on bswhbenefits.com and mobile devices, you can explore your benefits at home, at soccer practice any time you ve got time, bswhbenefits.com is ready for you. Here are a few you ll things find when you visit. Benefits Today, our on-demand enrollment meeting. An entertaining look at 2017 benefits enrollment, less than 30 minutes with our video enrollment meeting can help you make a confident benefits decision. Learn about the plans, get helpful hints about choosing the right medical plan for your family, take a tour of our benefits website and more. Ask Alex. Your virtual benefits helper, Ask Alex, can help you review all your benefit options. Alex CAN explain our medical plans and flexible spending accounts. Spending some time with Alex will help you get closer to finding the right fit for your family. You can find Alex on bswhbenefits.com. Detailed examples. Ready to dive deep? Meet our fictional employees, Susannah, Glenn and Olivia. You ll see how each Baylor Scott & White medical plan works in real-life scenarios. Summaries of benefits and coverage. For each medical plan, this summary makes it easy for you to explore how different services and procedures are covered. Helpful links. Find the enrollment site when you re ready to enroll. Skip the googling you will find links to every plan s website and contact information on the Resources page. 9

11 How to enroll 1. Log in to PeoplePlace at 2. Click on the Benefits section. 3. Click Benefits Enrollment. 4. Add information about your dependents. 5. Select your benefits. 6. Click Submit to save your choices. 7. On the Summary page, click Submit a final time.

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