Re: Open Enrollment for 2011 Health Insurance Benefits November 1 through November 21

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Claud McCoy
5 years ago
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1 Date: October 29, 2010 To: Full Time Faculty and Staff From: Jo Ellen Pinkham, AVP for Human Resources Re: Open Enrollment for 2011 Health Insurance Benefits November 1 through November 21 During Open Enrollment, you have the opportunity to review your health care needs and enroll for benefits for the following year. Open enrollment for 2011 benefits will be held from Monday, November 1 through Sunday, November 21, Medical Insurance Options Basic: Blue Healthy Choices with Generic Only Rx coverage (plan change to Rx benefit) The only change to this plan for 2011 is to the prescription drug benefit. Due to federal health reform legislation, annual limits on essential services, including prescription drug coverage, are no longer permitted. Therefore, Excellus will no longer offer riders with prescription drug coverage caps or limits. In 2011, the plan will cover only generic drugs with a $7 co-pay, but with no annual limit. (Some pharmacies may charge less than $7 for a generic drug.) You will still be able to fill brand name prescriptions, but you will pay 100% of the cost. Moderate: SimplyBlue (new plan offering) SimplyBlue is a preferred provider organization plan which allows you to obtain medical care in and out-of-network without a referral. Co-pays apply to PCP and specialist office visits, x-rays, emergency room services, etc., whereas a deductible and coinsurance with an out-of-pocket maximum apply to in-patient hospital services, skilled nursing facility, and out-patient surgery. Both generic and brand name prescription drugs are covered with $5/$35/$70 co-pays. Enhanced: EPO K (current plan, no changes) Offers both generic and brand name prescription drug coverage with $10/$30/$50 co-pays. EPO J will not be offered for Very Important! Everyone will need to actively enroll for If you do not make an election for 2011, you will default to no medical coverage for 2011.

2 Vision Plan (current plan, no changes) Excellus 20/20 Vision will continue to be offered in 2011 at the single and family levels. Dental Plan Name change and new plan option available Excellus dental plan is changing from Smile Saver to Dental Blue Options. Nazareth will offer Dental Blue Options low option dental plan (similar to the current Smile Saver plan), with a $1,000 annual plan maximum per person and a $750 lifetime orthodontia benefit for each child under age 19. The annual deductible will be $50 per person/$150 per family and covers both basic and major restorative work at 50%. Nazareth is pleased to introduce Excellus Dental Blue Options high option dental plan, which offers a $1,500 annual plan maximum per person and $1,500 lifetime orthodontia benefit for each child under age 19. The annual deductible will be $25 per person/$75 per family and covers basic restorative work at 80% and major restorative work at 50%. It is important to note that basic restorative, major restorative and orthodontia benefits may be subject to a 12 month waiting period if you have not had dental insurance (with any carrier) within 63 days of the January 1, 2011 effective date. Open Enrollment Instructions Attached are instructions to access and complete your on-line enrollment form The secure website will be open from Monday, November 1 at 12:01 a.m. through Sunday, November 21 at 11:59 p.m. Rates for each plan and coverage level are on the website You may review or change your selections as many times as you choose during Open Enrollment. The last selections you make during the Open Enrollment period will be recorded as your benefit elections for Remember: If you wish to elect medical benefits through Nazareth College, you must actively select your plan choice or you will default to no medical coverage for Once Open Enrollment closes at 11:59 p.m. on Sunday, November 21, you will not be able to change your benefits for 2011 unless you experience a qualifying life changing event. Please refer to the enclosed HIPAA Special Enrollment Information sheet for details. As an alternative to obtaining health insurance through Nazareth, New York State offers two comprehensive, low cost health plans, Child Health Plus and Family Health Plus. Child Health Plus is available for children under the age of 19. The monthly cost depends on the number of family members and gross monthly income. Family Health Plus is available to single adults, couples without children, and parents with limited income who are residents of New York State. Information is available online at: or If you have any questions, please contact Cecile O Brien, Senior Benefits Analyst at Extension Enclosures

3 Very Important Notice HIPAA Special Enrollment Information If you decline enrollment in medical benefits for yourself or your eligible dependents because of other health insurance or group health plan coverage, you may be able to enroll yourself and your eligible dependents in the medical benefits provided under this plan if you or your eligible dependent(s) lose(s) eligibility for that other coverage (or if the other employer stops contributing toward your or your dependents other coverage). However, you must request enrollment within 30 days after your or your eligible dependents other coverage ends (or after the other employer stops contributing toward the other coverage). In addition, if you have a new dependent as a result of marriage, birth, adoption or placement for adoption, you may be able to enroll yourself, your spouse and your new eligible dependent children. However, you must request enrollment within 30 days after the marriage, birth, adoption or placement for adoption. If you request a change due to a special enrollment event within the 30 day timeframe, coverage will be effective the date of birth, adoption or placement for adoption. If you request a change for any other eligible reason, coverage will be effective the first of the month following your request for enrollment. Effective April 1, 2009, the Plan must allow a HIPAA special enrollment for employees and dependents who are eligible but not enrolled if they lose Medicaid or CHIP (Child Health Insurance Program) coverage because they are no longer eligible, or they become eligible for a state s premium assistance program. Employees have 60 days from the date of the Medicaid/CHIP event to request enrollment under the Plan. If you request this change and meet eligibility requirements, coverage will be effective the first of the month following your request for enrollment. Specific restrictions may apply, depending on federal and state law. To request a special enrollment or obtain more information, contact the Plan Administrator, Human Resources Department, Nazareth College of Rochester, 4245 East Avenue, Rochester, NY or (585) HIPAA/HIPAA Special Enrollment Information.doc

4 2011 Online Benefit Enrollment Instructions General Instructions From the web browser on any computer, go to the secure site: Enter Nazareth s code: Enter the last 6 digits of your social security number followed by your 4 digit birth year (no dashes or spaces). Click Continue and follow the instructions at the top of each page. Do not use the Back button, as this may disconnect you from the enrollment form. Information already entered will not be saved. Select the plan and the level of coverage you wish for each benefit (single, two person, family, family no spouse or no coverage ), following the instructions at the top of each page. Once you have selected all of your benefits, you will have the opportunity to make changes on the Pre-Confirmation Page by clicking on the Edit buttons. Once you are satisfied with your selections, click the Continue button to formally accept your choices. Please print and keep a copy of your Confirmation Page for your records. You may review or change your selections as many times as you choose during Open Enrollment. The last selections you make during the Open Enrollment period will be recorded as your benefit elections for AFLAC Insurance If you are electing AFLAC for the first time, or switching from AFLAC Gold to AFLAC Platinum, you will need to complete an application (available by online link) and submit it to Human Resources by November 22. Coverage will not be effective until approved by AFLAC. If you are a current AFLAC Gold or Platinum participant and are staying in your current plan, you will not have to complete an application. Dental Benefits No application is required. You may select your plan option, coverage level or disenroll from Dental Blue Options. Vision Benefits No application is required. You may select your plan option, coverage level or disenroll from 20/20 Vision.

5 Flexible Spending Account (FSA) Your current FSA amount is not shown. You will need to indicate the annual amount you wish for 2011 for the Medical/Dental FSA and/or the Dependent/Child Care FSA. If you do not want to contribute to an FSA, enter 0. The minimum annual amount is $100 for either the Medical/Dental or Dependent Care account. The maximum annual amount for the Medical/Dental FSA is $3,000. The maximum annual amount for Dependent/Child Care (daycare, etc.) FSA is $5,000. Employee Life Insurance The College provides you with $10,000 of Basic life insurance. Your additional life insurance options are: $20,000 or $40,000 and 1 x salary or 2 x salary If you increase your $10,000 Basic life insurance to $20,000 or $40,000: Evidence of Insurability is not required. If you select one or two times salary, you must also elect the $40,000 limit. If you are electing one or two times salary for the first time: You may elect up to one times your basic annual earnings, but not more than $50,000 on a Guaranteed Issue basis. Evidence of Insurability (form is available by online link) is required if your selection is more than one times your basic annual salary or $50,000, and should be submitted it to Human Resources by November 22 for processing. Coverage will not be effective until approved by CIGNA. The combined Basic and Optional maximum total life insurance benefit available is $175,000. Dependent Life Insurance You may also select life insurance for your spouse and/or dependent children. The amounts of insurance and premiums are fixed, regardless if you are married and have no children, or if you are not married and have several children. Limits are: $5,000 spouse/$2,000 per child or $10,000 spouse/$4,000 per child. Evidence of Insurability is not required.

6 Long Term Disability Insurance Available to employees with one or more years of full time employment. If you currently have 50% or 70% of pay for LTD coverage, you may continue with your current coverage. If you are increasing your benefit to 70% for the first time, you will need to complete an Evidence of Insurability form (available by online link) and submit it to Human Resources by November 22. Coverage will not be effective until approved by The Standard Insurance Company. *Prior approval from Human Resources is required to cover a domestic partner or eligible dependents of a domestic partner. The Domestic Partner Policy and application form are available from Human Resources.

SPMI Plus Benefits. Open Enrollment 2018! Online Self-Enrollment!

SPMI Plus Benefits. Open Enrollment 2018! Online Self-Enrollment! SPMI Plus Benefits Open Enrollment 2018! Online Self-Enrollment! www.spmiplusbenefits.com Enroll at spmiplusbenefits.com beginning April 2nd. Open Enrollment for 2018 will end April 14th so don t miss