2019 Benefits Open Enrollment

Transcription

1 2019 Benefits Open Enrollment October 29 November 9, 2018 Changes Effective: January 1, 2019

2 Open Enrollment What are my Responsibilities During Open Enrollment To add, change or remove dependents from your coverage To enroll, change or waive coverage To enroll / increase voluntary life insurance To update beneficiary information (allowed any time) Enroll in the Flexible Spending Accounts Enrollment will be completed in bswift and elections must be made no later than: November 9, 2018 All benefit changes become effective: January 1, 2019 PLEASE NOTE: The information contained in this presentation is only a summary. For detailed, comprehensive benefit information, please refer to your carrier plan documents. Scripps Research 2019 Benefits Open Enrollment 2.

3 Who is Eligible to Enroll? Employees: Staff who are regularly scheduled to work at least 20 hours a week New Employees: Benefit eligibility begins date of hire Eligible Dependents: Legal Spouse California Registered Domestic Partner* Dependent children and step-children: Medical / vision: Up to age 26 Dental: Up to age 19; up to age 25 if full-time student Children of any age who are incapable of self-support due to a physical or mental disability may potentially be covered (1) Premiums for state registered domestic partners who do not meet the tax dependent definition of IRC section 152 for the employee, may be considered taxable income (unregistered domestic partners will not meet the relationship test under IRC section 152). Premiums for children / registered Domestic Partners stepchildren under age 26 are not taxable. Scripps Research 2019 Benefits Open Enrollment 3.

4 Can I Make Changes During the Year? Your healthcare elections will be effective from January 1, 2019, to December 31, 2019, and changes can only be made mid-year if you have a Change in Status Some examples of a Change in Status: Marriage / divorce Birth / adoption Death of a dependent Loss or gain of benefits Loss or gain of dependent eligibility Change in residence affecting eligibility or access Changes must be made within 31 days of the qualifying event Please contact Benefits Administration immediately if you have a Change in Status. You will be required to provide documentation of your change in status. Scripps Research 2019 Benefits Open Enrollment 4.

5 Benefit Plan Review Medical Medical Medical Medical Anthem Aetna Aetna Aetna Select HMO Comprehensive Choice POS II HDHP Choice POS II HSA/HRA Graduate Student Choice POS II Dental Vision Life / AD&D / Disability Additional Benefits FSA Delta Dental MES Vision Prudential MetLife PayFlex DPPO PPO Life / AD&D Vol. Life / AD&D STD / LTD Critical Illness Hospital Accident Health Care Dependent Care New Benefit New Carrier Scripps Research 2019 Benefits Open Enrollment 5.

6 What s New Effective Jan 1, 2019? Online Benefit Enrollment System Scripps Research is introducing a new benefit enrollment system, bswift, where you can make your benefit elections online. Minor changes to employee premiums Scripps Research is introducing Voluntary Benefits through MetLife Critical Illness, Hospital, Accident Enhancements to dental benefits Calendar year maximum will increase from $1,500 to $2,000 per person In-Network benefits for Basic & Major services will increase. In-Network Preventive/Basic/Major coinsurance will increase from 100%/80%/50% to 100%/90%/60% Scripps Research will add adult orthodontia to be covered at 50% up to $1,500 per lifetime. Covered services are for orthodontia which begins on or after January 1, 2019 Enhancement to vision benefits In-Network frame allowance will increase from $110 to $150 (every 24 months) and contact lens allowance will increase from $100 to $150 (every 12 months) New Flexible Spending Account Administrator Scripps Research is transitioning FSA administration from TRI-AD to PayFlex claims will need to be submitted to TRI-AD. Scripps Research 2019 Benefits Open Enrollment 6.

7 Open Enrollment Timeline Dates Monday October 29 November 9 Tuesday, October 30 th Wednesday, October 31 st Thursday, November 1 st Monday November 5 th Wednesday, November 7 th Friday, November 9 th at 5pm PST January 1, 2019 January 4, 2019 Action Open Enrollment Period New Review 2019 Benefits Guide Vendor Attend informational meeting Review/make changes/enroll in benefits using the new benefit online enrollment system at: Open Enrollment Meeting Keck Amphitheater, 2:00pm 3:00pm Benefits Fair Immunology Galleria / Breezeway, 10:00am 1:00pm Open Enrollment Meeting HR Training Room 12:00pm 1:00pm Open Enrollment Meeting MB Committee Lecture Hall 10:00am 11:00am Open Enrollment Meeting IT Training Room 11:00am 12:00pm Open Enrollment system closes Benefits become effective Any changes to payroll deductions will be seen in paycheck Scripps Research 2019 Benefits Open Enrollment 7.

8 Medical Coverage Scripps Research 2019 Benefits Open Enrollment 8.

9 Anthem Blue Cross Health Maintenance Organization (HMO) Select HMO TIP Each family member may select their own Primary Care Physician (PCP) Are you new to the HMO? Make sure your desired PCP is accepting new patients! With the exception of an OB/GYN, mental health, or chiropractic specialist, your PCP must refer you to specialists Contact Anthem to change your PCP. PCP changes made before the 15 th of the month are effective the 1 st of the following month Scripps Research 2019 Benefits Open Enrollment 9.

10 Anthem Blue Cross Select HMO PLAN HIGHLIGHTS ANTHEM SELECT HMO In-Network Only Annual Calendar Year Deductible Waived for office visits Individual $100 Family $200 Maximum Calendar Year Out-of-pocket (1) Individual $2,500 Family $5,000 Professional Services Primary Care Physician (PCP) $30 Copay Specialist $40 Copay Diagnostic Lab No charge Diagnostic X-ray $40 Copay Complex Diagnostics (MRI/CT Scan) $150 Copay Hospital Services Inpatient 10% after deductible Outpatient Surgery Hospital: 10%, after deductible Freestanding: $250 Copay Emergency Room $100 Copay after deductible Ambulance $100 Copay after deductible Other Services Preventive Care No Charge Therapy, including Physical, Occupational and Speech $40 Copay Prescription Drugs Prescription Calendar Year Deductible (applies to Brand-Formulary & Non-Formulary Drugs) $100/person $200/family Prescription Drugs through Anthem Retail $10 / $35 / $60 Mail Order $20 / $70 / $120 Scripps Research 2019 Benefits Open Enrollment 10.

11 Aetna Preferred Provider Organization (PPO) Comprehensive Choice POS II Plan TIP You obtain a higher level of benefit by receiving your services from participating or in-network doctors, specialists, and facilities With the PPO, you have freedom of choice and referrals are not required to see a specialist Before the insurance company pays certain medical expenses, you are required to pay the deductible You are responsible for the remaining cost up to the out-of-pocket maximum Scripps Research 2019 Benefits Open Enrollment 11.

12 Aetna Comprehensive Choice POS II Plan PLAN HIGHLIGHTS AETNA COMPREHENSIVE CHOICE POS II (PPO) In-network Out-of-network Annual Calendar Year Deductible Individual $900 $1,800 Family $2,700 $5,400 Maximum Calendar Year Out-of-Pocket (1) Individual $2,250 $4,500 Family $4,500 $9,000 Coinsurance 20% 40% Professional Services Primary Care Physician (PCP) 20% after deductible 40% after deductible Specialist 20% after deductible 40% after deductible Diagnostic X-ray and Lab 20% after deductible 40% after deductible Complex Diagnostics (MRI/CT Scan) 20% after deductible 40% after deductible Hospital Services Inpatient 20% after deductible 40% after deductible Additional $200 Copay applies if not pre-authorized Outpatient Surgery 20% after deductible 40% after deductible Emergency Room 20% after deductible 20% after deductible Ambulance 20% after deductible 40% after deductible Other Services Preventive Care No Charge Cancer Screenings Only Therapy, including Physical, Occupational and Speech (up to 39 visits per calendar year) 20% after deductible 40% after deductible Prescription Drugs Prescription Coverage through OptumRx Prescription Drug Calendar Year Deductible (Applies to Brand Name Drugs) Prescription Calendar Year Out-of-Pocket Maximum $100/person $200/family $2,000/person $4,000/family Prescription Drugs Retail (30-day Supply) $10 / $35 / $60 Mail Order (90-day Supply) $20 / $70 / $120 Scripps Research 2019 Benefits Open Enrollment 12.

13 High Deductible Health Plan (HDHP) + Health Savings Account (HSA) Scripps Research 2019 Benefits Open Enrollment 13.

14 What is the High Deductible Health Plan (HDHP) + Health Savings Account (HSA) Option? TIP You are financially responsible for all eligible expenses, such as doctor s visits, non-preventive prescription drugs and lab charges, until the deductible has been met If you are enrolled under Employee + 1 or more Dependents, the Family Deductible must be met before the coinsurance applies Similar to traditional PPO plan, you may use the provider of your choice, but the plan will pay more if you utilize in-network physicians or facilities This medical plan can be paired with a Health Savings Account (HSA) to help pay for qualified health care expenses Contribute towards your HSA through convenient payroll deductions by enrolling in an HSA through PayFlex Scripps Research 2019 Benefits Open Enrollment 14.

15 Aetna HDHP Choice POS II Plan PLAN HIGHLIGHTS HDHP AETNA CHOICE POS II (HSA/HRA) In-network Out-of-network Annual Calendar Year Deductible Family Deductible applies to all members Employee Only $2,000 $2,000 Employee & Dependent(s) $6,000 $6,000 Maximum Calendar Year Out-of-Pocket (1) Deductible & Rx expenses apply towards OOP Max. Family OOP applies to all members Employee Only $4,500 $6,750 Employee & Dependent(s) $6,750 $10,125 Coinsurance 20% 40% Professional Services Primary Care Physician (PCP) 20% after deductible 40% after deductible Specialist 20% after deductible 40% after deductible Preventive Care Exam No charge Cancer Screenings Only Diagnostic X-ray and Lab 20% after deductible 40% after deductible Complex Diagnostics (MRI/CT Scan) 20% after deductible 40% after deductible Hospital Services Inpatient 20% after deductible 40% after deductible Additional $200 Copay applies if not pre-authorized Skilled Nursing Facility 20% after deductible 40% after deductible Additional $200 Copay applies if not pre-authorized Emergency Room 20% after deductible 20% after deductible Prescription Drugs Prescription Coverage through OptumRx Prescription Drugs Preventive Medications Retail (30-day Supply) $10 / $35 / $60 Not Subject to Medical Plan Deductible All Other Retail (30-day Supply) $10 / $35 / $60 Copay After Medical Plan Deductible All Other Retail (30-day Supply) $10 / $35 / $60 Copay After Medical Plan Deductible (1) The entire family deductible must be met before benefits are provided for any one member Scripps Research 2019 Benefits Open Enrollment (2) The entire family out-of-pocket must be met before benefits are payable at 100% 15.

16 HDHP vs. Traditional PPO Plan SIMILARITIES Plans use the same network of doctors, specialists and hospitals Once the plan deductible has been met, you will receive a higher level of benefit by receiving services from in-network providers DIFFERENCES Only the HDHP allows you to use a HSA to help pay for current and future qualified health care expenses The deductible for a HDHP applies to all services except Preventive Care Services and Preventive Medications The family deductible for a HDHP is cumulative, meaning if you cover a spouse or child(ren), you must meet the family deductible before your plan benefits kick in Scripps Research 2019 Benefits Open Enrollment 16.

17 Compass Pro Health Services Compass PHS is a patient advocacy firm providing personal concierge available to Aetna HDHP plan members at no cost. Services include: Unlimited access to a health care expert Researching generic or clinical alternative prescription options Unbiased doctor recommendations based on quality and cost Coordinating transfer of medical records Reviewing bills and charges Resolving billing issues with Aetna, hospitals, and provider billing offices Explanation of insurance processes and Scripps Research benefit plans Comparing service costs, cost estimates TIP You can get in touch with Scripps Research s Health Pro via: Phone: answers@compassphs.com Website: Scripps Research 2019 Benefits Open Enrollment 17.

18 HSA Eligibility Rules For you, the employee, to be eligible to open an HSA, you must: Be enrolled in a qualified high deductible health plan (HDHP) NOT be enrolled in a non-hdhp including a spouse s plan, Medicare, Tricare or prescription drug only plan NOT be claimed as a dependent on another individual s tax return, other than your spouse s NOT have received any health benefits from the Veterans Administration or one of their facilities, including prescription drugs, in the last three months NOT be enrolled in a Health Care Flexible Spending Account (FSA) In order to have deductions from your paycheck, you must be earning a taxable paycheck from TSRI. Scripps Research 2019 Benefits Open Enrollment 18.

19 HSA Contribution Limits Eligible Individuals and the Employer can make Financial Contributions to an HSA Calendar Year Maximum Contribution Employee Only $3,500 Employee & Dependent(s) $7,000 Additional catch-up if 55 or older $1,000 Maximum contribution is reduced pro-rata for partial year enrollment (i.e. 1/12 for each month of HDHP Coverage) Scripps Research contributes towards your HSA with an annual amount of $1,000 for Employee Only and $3,000 for Employee & Dependent(s). Employer contributions will be made on quarterly basis. Your and Scripps Research s contributions count toward the annual contribution maximum Scripps Research 2019 Benefits Open Enrollment 19.

20 Using HSA Funds Your HSA Funds can be used for Qualified Healthcare Expenses Examples: Unreimbursed qualified medical, dental and vision expenses LASIK Orthodontia Prescriptions Medical premiums for COBRA, or health coverage while receiving unemployment compensation, Medicare Parts B & D Certain Long Term Care premiums Medical Supplies The HSA must be established and an initial deposit must be made before you can be reimbursed for eligible expenses or use funds Because you own the HSA, funds can be used towards eligible expenses even after you are no longer covered by an HSA-qualified plan If you use an HSA for non-irs approved medical expenses, you will be subject to pay earned income taxes on the misused funds as well as a 20% excise tax Scripps Research 2019 Benefits Open Enrollment 20.

21 Where are my HSA Funds? Scripps Research has selected PayFlex as the preferred bank to handle Health Savings Accounts. Money is deposited at PayFlex into an interest-bearing account. Like a Medical IRA Owned by Employee; Portable Tax-advantaged personal savings account Employee contributions are tax-free and reduce taxable income* Use today or save for future and retirement health expenses Unused money rolls over year to year PayFlex will administer your HSA account through convenient payroll deductions If you leave Scripps Research or change medical plans, the HSA account still belongs to you. * Taxable for California income tax Scripps Research 2019 Benefits Open Enrollment 21.

22 Why enroll in the HSA? You Keep the Money: When you leave the company or retire, you can take the money with you Build Savings: You have the ability to grow a sizeable account over time Invest: HSA vendors offer a wide array of investment options for you to invest and grow your savings taxfree Tax Savings: Tax-free contributions and distributions (excludes state taxes in CA, AL, NJ) Scripps Research 2019 Benefits Open Enrollment 22.

23 Health Reimbursement Arrangement (HRA) Scripps Research 2019 Benefits Open Enrollment 23.

24 What is a Health Reimbursement Arrangement (HRA)? How to Use Your Health Reimbursement Arrangement TIP Employees who are ineligible for Health Savings Account (HSA) contributions enroll in the Aetna HDHP Choice POS II Health Fund (HRA) plan and will be set up with a Health Reimbursement Arrangement (HRA) through PayFlex. Scripps Research 2019 Benefits Open Enrollment 24.

25 HRA Contributions Scripps Research makes Financial Contributions to toward your HRA Annual Contribution Individual (Employee Only) $1,000 Family (Employee + Dependents(s)) $3,000 If you were hired in the middle of the plan year, contributions will be prorated based on the number of quarters you are enrolled in the HRA Plan Employer HRA Fund contributions are tax free Scripps Research 2019 Benefits Open Enrollment 25.

26 How Will I Receive HRA Funds? Scripps Research has selected PayFlex as the preferred administrator to handle Health Reimbursement Arrangements. If you leave Scripps Research or you have a change in your eligibility, any remaining HRA funds will stay with the company unless you elect COBRA Claims are paid from the HRA for you and your covered dependents only once the incurred expense is approved Unused funds rollover each year Register at to monitor your fund Scripps Research 2019 Benefits Open Enrollment 26.

27 Prescription Drug Coverage The pharmacy administrator for the Comprehensive Choice POS II, HDHP Aetna Choice POS II, and Graduate Student Choice POS II plans continue to be OptumRx. The pharmacy administrator for the Anthem Select HMO will be Express Scripts. There are 3 tiers for prescription drugs: Generic - $10 Copay Brand Formulary - $35 Copay Non-Formulary Brand: $60 Copay Please call OptumRx at for more information on Comprehensive Choice POS II, HDHP Aetna Choice POS II, or Graduate Student Choice POS II Plans or visit Please visit for more information on the Anthem Select HMO Plan Scripps Research 2019 Benefits Open Enrollment 27.

28 Health Care Reform The Covered California State Exchange open enrollment for obtaining your own medical coverage (where you may qualify for tax credits or subsidies to help pay for coverage) is November 1, 2017 January 31, 2018.* Individual Mandate: Every U.S. citizen / legal resident must have Minimum Essential Coverage (MEC) or pay a tax penalty (exemptions may apply). However, the Individual Mandate penalty after December 31, 2018 will be $0. *The plan renewal period is October 2018 to December 15, 2018, so please see for timelines applicable to your plan. Scripps Research 2019 Benefits Open Enrollment 28.

29 Forms Forms Forms The Affordable Care Act requires all individuals to provide proof of health insurance. You will receive the following forms next year to use when you file your taxes B: Provided by your insurance carrier Provides proof that you and your dependents have at least Minimum Essential Coverage 1095 C: Provided by your employer Describes what kind of coverage was made available to you You will get both around the same time as your W2 and need to use them when filing your taxes. For more information, contact your CPA. Scripps Research 2019 Benefits Open Enrollment 29.

30 Tools, Resources, and Discount Programs Scripps Research 2019 Benefits Open Enrollment 30.

31 Aetna: Online or On-the-go! Secure 24/7 Access Look up a claim status Check account balances Find costs of test and doctor visits View tools and educational materials Download a temporary ID Card Plus, Discounts Available! Scripps Research 2019 Benefits Open Enrollment 31.

32 Anthem: Online or On-the-go! Go Green for 24/7 convenience with less paper Access your plan and benefit information Find a doctor or hospital specific to your plan Check on claims and payments Refill a prescription Tap to call Customer Service Download a temporary ID card Plus, Discounts Available! Scripps Research 2019 Benefits Open Enrollment 32.

33 ibenefits: Mobile Benefits App With ibenefits, you can take your Employee Benefits information on the go! View company benefit plans, 24/7 Access group numbers and review detailed plan information when you need it most Quickly contact an insurance company using the tap to call feature Keep up with important benefit plan announcements via push notifications such as Open Enrollment dates, deadlines and more Store ID card images Company Code: scripps2019 Scripps Research 2019 Benefits Open Enrollment 33.

34 Dental DENTAL COVERAGE Scripps Research 2019 Benefits Open Enrollment 34.

35 Delta Dental PPO Plan Overview: Freedom to see a wider network of dentists You don t need to select a Primary Care Dentist and a referral is not necessary to receive specialty services You will pay a higher amount for services from an out-of-network dentist NOTE: If you re planning to have extensive dental work, a Predetermination of Benefits is suggested so you can fully understand your out-of-pocket cost before receiving services. Scripps Research 2019 Benefits Open Enrollment 35.

36 Delta Dental PPO Plan PLAN HIGHLIGHTS DELTA DENTAL PPO PPO Dentist Delta Premier Provider All Other Providers Calendar Year Deductible Individual Family $50 / person* Annual Maximum Individual $2,000 / Calendar Year Dental Services Preventive 100% 80% 80% Deductible waived Basic Services 90% 80% 80% Major Services 60% 50% 50% Orthodontia Services Child up to age 19 50% 50% 50% Adult 50% 50% 50% Lifetime Maximum $1,500 / Person / Lifetime *Deductible does not apply to Orthodontia services. The above information is a summary only. Please refer to your Evidence of Coverage for complete details of Plan benefits, limitations and exclusions. Delta Premier Dentist and All Other Provider network charges are based off of reasonable and customary rates. Scripps Research 2019 Benefits Open Enrollment 36.

37 Vision Scripps Research 2019 Benefits Open Enrollment 37.

38 MES Vision PPO PLAN HIGHLIGHTS MES VISION PPO In-Network Out-of-Network Copay $10 Copay / Person $10 Copay / Person Exam Every 12 months Plan pays 100% Up to $40 allowance Lenses Every 12 months Single Plan pays 100% Up to $30 Bifocal Plan pays 100% Up to $50 Trifocal Plan pays 100% Up to $65 Frames Every 24 months Plan pays 100% up to a $150 frame allowance Up to $75 Contacts Every 12 months, in lieu of lenses & frames Medically Necessary Plan pays 100% Up to $250 Cosmetic Plan pays 100% up to $150, plus up to $40 for a contact lens fitting fee Up to $150 allowance, plus up to $40 for a contact lens fitting fee The above information is a summary only. Please refer to your Evidence of Coverage for complete details of Plan benefits, limitations and exclusions. Scripps Research 2019 Benefits Open Enrollment 38.

39 2019 Monthly Medical/Vision Premiums COVERAGE LEVEL EMPLOYEE CONTRIBUTION SCRIPPS RESEARCH CONTRIBUTION TOTAL MONTHLY PREMIUM Comprehensive Choice POS II Plan Employee Only $75 $559 $634 Employee and Spouse / DP $260 $1,007 $1,267 Employee and Child(ren) $200 $858 $1,058 Employee and Family $390 $1,302 $1,692 Anthem Blue Cross Select HMO Plan Employee Only $50 $430 $480 Employee and Spouse / DP $250 $804 $1,054 Employee and Child(ren) $180 $683 $863 Employee and Family $390 $1,095 $1,485 HDHP Aetna Choice POS II Plan Employee Only $0 $540 $540 Employee and Spouse / DP $0 $1,163 $1,163 Employee and Child(ren) $0 $1,014 $1,014 Employee and Family $20 $1,446 $1,466 Scripps Research 2019 Benefits Open Enrollment 39.

40 2019 Monthly Dental Premiums COVERAGE LEVEL EMPLOYEE CONTRIBUTION SCRIPPS RESEARCH CONTRIBUTION TOTAL MONTHLY PREMIUM Delta Dental PPO Plan Employee Only $0 $45 $45 Employee and Spouse / DP $20 $69 $89 Employee and Child(ren) $15 $60 $75 Employee and Family $35 $84 $119 Scripps Research 2019 Benefits Open Enrollment 40.

41 Life Insurance and AD&D Scripps Research 2019 Benefits Open Enrollment 41.

42 Basic Term Life and AD&D* underwritten by Scripps Research offers choice of: $50,000 flat benefit amount, OR 2x your annual salary up to $1,500,000, OR 3x your annual salary (on age-rated basis) up to $1,500,000 You may elect 3x annual salary during this open enrollment Proof of good health is required if your total basic life coverage exceeds $1,000,000 TIP Required! Update your beneficiary information in bswift. In the past, benefit information was completed on paper forms. With the introduction of bswift, Scripps Research allows the information be housed online. Scripps Research encourages you to enter your beneficiary information in the bswift system for ease of tracking. *Postdoctoral Associates/Fellows now eligible for $50,000 Basic Life benefit. Trainees and Graduate Students are not eligible for the basic life plan. Scripps Research 2019 Benefits Open Enrollment

43 Voluntary Life Insurance underwritten by Coverage Level Employee Spouse Description Increments of $10,000 up to $500,000 Premium based on Employee Age All enrollment (except new hires) require Evidence of Insurability (EOI) Guarantee Issue up to $100,000 coverage for 1 st time eligible Increments of $10,000 up to $500,000 Guarantee Issue up to $50,000 coverage for 1 st time eligible Spouse may be enrolled regardless if you enroll yourself Child Increments of $2,500 up to $10,000 TIP Enroll, make changes, or update your beneficiary information in bswift. In the past, benefit information was completed on paper forms. With the introduction of bswift, Scripps Research allows the information be housed online. Scripps Research encourages you to enter your beneficiary information in the bswift system for ease of tracking. Scripps Research 2019 Benefits Open Enrollment 43.

44 Voluntary AD&D Insurance Coverage Level Description underwritten by Employee Increments of $50,000 up to $500,000 Spouse Coverage amount equal to 50% of employee amount Child(ren) Coverage amount equal to 15% of employee amount Family Coverage amount for your spouse equal to 40% of employee amount. Coverage amount for child(ren) equal to 10% of employee amount TIP Enroll, make changes, or update your beneficiary information in bswift. In the past, benefit information was completed on paper forms. With the introduction of bswift, Scripps Research allows the information be housed online. Scripps Research encourages you to enter your beneficiary information in the bswift system for ease of tracking. Scripps Research 2019 Benefits Open Enrollment 44.

45 Voluntary Long Term Care Available to Staff, spouses, children (age 18+), parents and grandparents Guarantee Issue Coverage equals: Up to $4,000 Nursing Facility Benefit Amount And a Facility Benefit Duration of 3 or 6 years To elect higher levels of coverage or longer benefit durations, or to enroll in the plan after your initial eligibility period, you must provide Evidence of Insurability To enroll, you must complete the Benefit Election Form available through bswift or by contacting Benefits Administration at or benefits@scripps.edu. Forms are also available through the Benefits website. *Postdoctoral Associates/Fellows, Trainees and Graduate Students are not eligible Scripps Research 2019 Benefits Open Enrollment 45.

46 FLEXIBLE SPENDING ACCOUNT (FSA) Scripps Research 2019 Benefits Open Enrollment 46.

47 What is a Flexible Spending Account (FSA)? An FSA is a pre-tax benefit allowed under IRS Code Section 125, which allows you to set aside a specific pretax dollar amount for unreimbursed medical, dental, vision and dependent care expenses. Plan Administrator moving from TRI-AD to PayFlex Pre-tax benefits (before Federal, State, & FICA taxes apply) FSA Plan Year: January 1, 2019 through December 31, 2019 It is not required that you be enrolled in your company s health plans Depending on the type of FSA you have (Health Care FSA or Dependent Care FSA), you can contribute up to an annual maximum level per plan year You are not permitted to enroll in the Health Care FSA if you enroll in a HSA eligible plan Contribution Limits $2,650 Health Care (minimum $120) $5,000 Dependent Care Scripps Research 2019 Benefits Open Enrollment 47.

48 What is a Flexible Spending Account (FSA)? [continued] Health Care Spending Accounts* $2,650 Annual Maximum Contribution (minimum is $120) Out of pocket expenses for you, your spouse, and your dependents Does not include domestic partner Dependent Care Spending Account** $5,000 maximum per calendar year $2,500 if married, filing separately $5,000 maximum if married, filing jointly *Postdoctoral Associates/Fellows, Trainees and Graduate Students are not eligible for Health Care Spending Account ** Postdoctoral Associates, Trainees, & Graduate Students may be eligible for Dependent Care Spending Account based on status. Please see Human Resources for eligibility Scripps Research 2019 Benefits Open Enrollment 48.

49 Using the Flexible Spending Account (FSA) Scripps Research 2019 Benefits Open Enrollment 49.

50 FSA Eligible Expenses Health Care FSA Applicable for you and any eligible dependent Medical Copays Deductibles Prescriptions Hospital costs Smoking cessation Fertility / family planning Acupuncture Chiropractic OTC medications with physician prescription Dental Deductible Copays Orthodontia Vision Prescription glasses and sunglasses (frames and lenses) Contact lenses and products LASIK, PRK, etc. Physician prescription not required Band Aids Bandages and wraps Braces and supports Physician prescription not required (continued) Sunscreen, SPF 30+ Contact lens supplies Denture adhesives First aid supplies Diabetic supplies Diagnostic tests & monitors Reading glasses Wheelchair, walker, cane Other durable medical equipment Dependent Care FSA Daycare centers In-home day care / Nanny / Au Pair Before or after school programs for children under age 13 Summer day camp Nursery school and Pre-school programs Elder care or dependents not capable of self-care Scripps Research 2019 Benefits Open Enrollment 50.

51 Claim Reimbursement Claims for expenses to PayFlex Online ( Mail Debit Card (NEW!) Request for reimbursement includes: Request form Proper documentation PPO Services Explanation of Benefits (EOB) Other Services itemized bill or receipt showing name of provider, name of patient, date of service, details of the service or product, cost of service or product. OTC items cash register receipt and prescription Orthodontia contract Scripps Research 2019 Benefits Open Enrollment 51.

52 Which carrier should I submit my reimbursement claims to? Claims incurred during the 2018 plan year If you have a remaining balance in your 2018 account, and you incur an eligible expense during the 2 ½ month grace period (January 1, 2019, through March 15, 2019) Any claims incurred in 2019 under the 2019 plan election Scripps Research 2019 Benefits Open Enrollment 52.

53 Voluntary Coverage & Products Scripps Research 2019 Benefits Open Enrollment 53.

54 METLIFE VOLUNTARY BENEFIT PLANS Coverages Offered: Accident Coverage Critical Illness Coverage Hospital Protection New Benefit Contact MetLife at 800.GET.MET8 with any questions. Scripps Research 2019 Benefits Open Enrollment 54.

55 VOLUNTARY GROUP CRITICAL ILLNESS 100% Employee Paid When you or your family is faced with a life-threatening disease or debilitating illness or injury, Critical Illness Coverage offered by MetLife will pay you cash to help with the associated expenses. Critical illness coverage pays a one-time, lump sum payment, dependent on the illness. Some of the covered medical conditions include: Cancer Heart attack Stroke End stage renal failure Major organ transplant Scripps Research 2019 Benefits Open Enrollment 55.

56 VOLUNTARY GROUP ACCIDENT 100% Employee Paid Accidents happen when you least expect them including motor vehicle accidents, sports injuries, and slips and falls! MetLife s policy will pay cash to help families offset the expenses associated with accidents or injuries. Benefits may be paid for: Emergency room treatment Intensive care unit Hospital admissions and confinement Ambulance transportation Travel expenses to distant treatment centers Scripps Research 2019 Benefits Open Enrollment 56.

57 VOLUNTARY GROUP HOSPITAL 100% Employee Paid Having hospital protection through MetLife may help by paying cash to you or your family to offset both medical and nonmedical bills when you re sick, injured or on maternity leave. The cash benefit can be used towards services or expenses other medical plans might not cover, such as: Copayments & Deductibles Transportation expenses Child care Prescriptions Lost income Scripps Research 2019 Benefits Open Enrollment 57.

58 Next Steps Scripps Research 2019 Benefits Open Enrollment 58.

59 Take Action! Time to Enroll! All employees will need to log in to the new benefit enrollment system bswift to: Complete benefit elections or waive for the 2019 plan year, New elections must be made to continue Flexible Spending Accounts and Health Savings Accounts Enter beneficiary information for life insurance coverage To enroll, follow these simple steps: Go to Username: first initial and last name (e.g. John Doe would be jdoe) Password: last 4 digits of SSN Click on Start Your Enrollment to begin making elections Click on Complete Enrollment once finished. You can print or your final confirmation statement once finished. You will be prompted to verify your personal and family information before selecting your benefits. A helpful tool to walk you through the process is Ask Emma. Emma will guide you through your enrollment and help you decide which plans to enroll in if you are unaware. An enrollment guide and instructions will be posted on the Benefits Administration webpages. bswift will open on October 29th and will close on November 9th and all changes will take effect starting January 1, 2019 through December 31, Scripps Research 2019 Benefits Open Enrollment 59.

60 Questions Scripps Research 2019 Benefits Open Enrollment 60.