ANNUAL OPEN ENROLLMENT

Transcription

1 ANNUAL OPEN ENROLLMENT ANNUAL OPEN ENROLLMENT UNIVERSITY OF UTAH APRIL 2003 Important information for... NEW Health Plan contribution RATES SPECIAL Open Enrollment Opportunities: Long Term Disability Employee Life Insurance CHANGES in Indemnity & ValueCare Basic PRESCRIPTION drug COVERAGE NEW Plan Year Enrollment Opportunities: Medical and Dental Plans Flexible Spending Accounts: Health and Dependent Care Introducing the Benny Card Convenient MasterCard Access to your Health FSA READ on to learn more... READ on to learn more... Benefits Department Division of Human Resources 420 Wakara Way, Suite 105 Salt Lake City, Utah TEL: FAX:

2 It s time to consider your open enrollment options for the new fiscal Plan Year beginning in July Read this announcement to learn what s happening July 1, even if you don t plan to make any changes. Your personalized Open Enrollment form indicates your health plan elections and the cost of your options for the new plan year. All changes will be effective July 1, The materials included should provide you with the information you need to make informed decisions. If you need more details about your options, attend an open enrollment meeting scheduled in April or call the Benefits Department at ENROLLMENT/ CHANGES are DUE by APRIL 30, 2003! Your Health Care Contributions...The University continues to pay the majority of the cost of your health care coverage. As in the past, you must share in the cost of this coverage so that the University can continue to offer comprehensive health plan options to all eligible employees. Financial assistance from the University and the legislature this year still isn t enough to cover the increasing costs. Your personalized Open Enrollment form provides the new monthly contribution rates effective July 1, SPECIAL LIMITED OPEN ENROLLMENT OPPORTUNITY You and your loved ones need financial protection in the event you suffer an unexpected illness or accident. The University provides very generous sick pay benefits, but sick pay will not be enough to protect you and your family from a prolonged illness or injury. Employees have the option of purchasing Long Term Disability (LTD) and/or additional Life Insurance coverage during their initial enrollment period; however, many employees have not purchased this coverage. Those who later decided they wanted this coverage had to provide evidence of good health before they could enroll... until now. The University is excited to announce that during April 2003, you have a chance to take advantage of a special open enrollment opportunity for LTD and employee Life Insurance coverage. During this special open enrollment, you may be able to enroll without providing evidence of good health. This opportunity is only available if you have not previously applied and been denied coverage under the plan. University employees have never before had this open enrollment opportunity and we can t be sure it will ever be available again. Here is how the limited open enrollment works for the coverage available: Long Term Disability LTD coverage provides some income replacement if you are unable to work due to a disability. Income replacement begins on the later of (1) the date you exhaust all your sick and vacation accruals, or (2) the date you have been continuously disabled for the number of days specified by the plan. If you are not enrolled in the University s LTD Plan (and have not applied for this coverage and been denied by TIAA-CREF or The Standard Insurance Company), you can take advantage of this special opportunity now. Your coverage will become effective July 1, 2003, if you are actively at work on that date; otherwise, your coverage will become effective on the day after you have completed five full consecutive days of active work. The cost of this coverage varies by your employee group and retirement plan. Premiums are higher for members of the TIAA-CREF retirement plans because members also purchase coverage for continued retirement contributions during disability. Members of the Utah Retirement Systems Plan (URS) receive service credit for the period they are disabled without the additional premium. To confirm your enrollment status in LTD, refer to the back of your personalized Open Enrollment form. The University pays a portion of the premium for most employees. The amount the University contributes each month is determined by your benefit program and whether you work full-time (.75 FTE or more) or part-time (.50 FTE to.749 FTE). Post-doctoral Fellows and Housestaff are not eligible for LTD benefits under this program. If you are not familiar with the benefits provided by this plan, visit our web site at attend an open enrollment session, or contact the Benefits Department at To determine your cost for LTD coverage, use the LTD Premium Worksheet on page 2. Don t miss this opportunity to protect your income in the event you become disabled. If you are not currently enrolled, enroll now! Page 1

3 LTD PREMIUM WORKSHEET Monthly Base Salary: Multiply by premium rate that applies to you: Total: Subtract University Contribution: Total Employee Monthly Premium: Divide by 2: Per Paycheck Premium: $ x $ - $ $ 2 $ PREMIUM RATES: Utah State Retirement Plans: TIAA-CREF Retirement Plans: All HPP Program Participants: School of Medicine LTD Plan: UNIVERSITY CONTRIBUTION: Standard Benefit Program: University contributes $8.00 for faculty and full-time staff or $4.00 for part-time staff [covers all University faculty and staff not enrolled in the Hospital Plan Plus Benefit Program ( HPP )] HPP Program: University contributes $10.00 for full-time or $5.00 for part-time employees (University of Utah Hospitals and Clinics HPP participants ONLY). School of Medicine LTD Plan: No University contribution. Life insurance is also an important part of your financial portfolio. You can take advantage Life Insurance of the premiums that have been negotiated for University employees to provide more protection and security for those left behind after your death. During April 2003, you may enroll in Part II, Part III and Employee Supplemental Term Life without providing evidence of good health if you have not previously been denied coverage by Beneficial Life. Your personalized enrollment form confirms your current coverage. Coverage is effective July 1, 2003, if you are actively at work on that date. Part I provides coverage equal to your annual salary up to a maximum of $25,000. This coverage is automatic for all benefit-eligible employees and is provided by the University at no cost to employees. Part II provides additional coverage equal to the amount of Part I (your annual salary, not to exceed $25,000). If you previously waived this coverage, be sure to take advantage of this enrollment opportunity now. The monthly cost is $.20 per $1,000 of coverage for all employees (except HPP Benefit Program participants). The University pays the remaining cost of this coverage. Effective July 1, 2003, employees in the HPP Benefit Program can purchase this coverage for $.25 per $1,000 of coverage per month. These rates do not increase with age and are not affected by your health status. Part III provides life insurance coverage in the amount of $2,000 for your spouse and each eligible child. The rate is the same regardless of the number of dependents you cover. If you previously waived this coverage, you may enroll your spouse and eligible Coverage under Part NEW! II and Part III will be available July 1, 2003, to all Hospital and Clinic employees participating in the HPP Benefit Program. children without providing evidence of good health for your family members. Employees must enroll in Part II to enroll in Part III. The cost is $.50 per month for all employees (except HPP Benefit Program participants). The University pays the remaining cost of this coverage. Effective July 1, 2003, employees in the HPP Benefit Program can also purchase this coverage for $.76 per month. Supplemental Term Life coverage up to $50,000 is available, without evidence of good health, to active employees in benefit-eligible positions during this limited open enrollment. If you previously waived coverage or Page 2

4 elected less than $50,000, you may enroll or increase your coverage up to a total amount of $50,000 without providing evidence of good health. The cost for this coverage is determined by your age and is priced lower for employees who are not tobacco users. The rates per $1,000 of coverage are as follows: Monthly Premium Rate NON-TOBACCO TOBACCO NON-TOBACCO TOBACCO AGE USER USER AGE USER USER Under 30 $0.04 $ $.73 $ Additional Supplemental Term coverage above $50,000, Universal Life coverage, and/or Supplemental Term coverage for your dependents is available through the regular application process which requires evidence of good health. Contact the Benefits Department if you wish to apply for more coverage. Your personalized 2003 Open Enrollment form provides information confirming your current coverage/enrollment in the LTD and Life Insurance plans. To take advantage of these special open enrollment opportunities, you must send your completed Open Enrollment form to the Benefits Department by APRIL 30, The insurance companies require that this deadline be strictly enforced. Don t miss this chance to obtain vital protection. Page 3

5 What You Need to Know About Your Health Plan Options This Year Prescription NEW Drug Benefits for Indemnity & ValueCare Basic Plan Members Effective July 1, 2003, members of the Indemnity and ValueCare Basic Plans will no longer be required to pay the full cost for your prescription drugs, submit a claim, and then wait to be reimbursed the amount the health plan will pay. When you present your AdvancePCS Prescription Drug Card at a participating pharmacy, you will pay your co-insurance amount (20% for Indemnity Plan members and 30% for ValueCare Basic Plan members) right at the pharmacy and you re done no more claims to file! AdvancePCS will bill the plan directly for the remainder of the cost. Because all prescription drugs include dispensing and administration fees, a minimum co-insurance of $3.00 will be charged for each prescription filled. But wait, there is more good news, prescription drugs will no longer be subject to the medical plan deductible! Participating pharmacies include all University of Utah pharmacies and pharmacies at Albertsons, Smiths, Rite Aid, and Fred Meyer. Additional participating pharmacies can be found through the Pharmacy Locator on AdvancePCS web site at goto.do?page=home&reset=x&com=universityofutah. In exchange for these benefits, prescription drug costs will no longer count toward your medical out-of-pocket maximum. A separate out-of-pocket maximum will apply to the prescription drug benefits to protect you from catastrophic expense. Once your share of the cost for any one member reaches $500 for Indemnity Plan members or $750 for ValueCare Basic Plan members, the plan will pay 100% of that member s prescription drug expenses for the balance of the Plan Year. The outof-pocket maximum for employees with family coverage is an accumulative maximum. If your share of the cost for prescription drugs for all family members combined reaches $1,500 for Indemnity Plan members or $2,250 for ValueCare Basic Plan members, the plan will pay 100% of all covered family members prescription drug expenses for the remainder of the Plan Year. If you no longer have your AdvancePCS Prescription Drug Card, contact the Benefits Department at and a benefits representative will order a replacement card for you. If you do not use your AdvancePCS card or do not purchase your prescription at a participating pharmacy, you must pay the full retail cost and submit a claim to AdvancePCS for reimbursement of the plan s share of the cost. Prescription drug claims will no longer be processed through the medical plan (BCBS). In addition, reimbursement of these claims will not exceed the amount the Plan would have paid to a participating pharmacy. For all health plan members, coordination of prescription drug benefits to 100% of the cost will only be available when both husband and wife work for the University and BOTH carry health care coverage that covers the other and/or any dependent children. The secondary benefit is available for members of the Indemnity, ValueCare Preferred, and ValueCare Basic plans when you file a claim with AdvancePCS. UUHP members will file a claim with UUHP. For claim forms, contact the Benefits Department or print the form from the Benefits Department web site at forms. Full coordination of benefits for prescription drug expenses will no longer be available for members who have primary coverage provided by another employer s group insurance plan. The new BENNY TM Card can be used at the pharmacy to pay your share of the expense and instantly submit a claim to your Health FSA (if you participate in that plan). Page 4

6 Members of the ValueCare Preferred, ValueCare Basic, and Indemnity Plans may purchase Diabetic Supplies the following diabetic supplies using their AdvancePCS prescription drug card: syringes, lancets, alcohol swabs and test strips. The required co-insurance amount will not change (20% for ValueCare Preferred and Indemnity members and 30% for ValueCare Basic members). You will only need to pay your share of the cost at the pharmacy; AdvancePCS will bill the plan directly for the remainder of the cost. Any deductible previously required under your health plan will no longer apply to these specific diabetic supplies when you use your Advance PCS prescription drug card at the pharmacy. However, in exchange for this convenience, these expenses will no longer apply to your medical out-of-pocket maximum. UUHP members will continue to purchase diabetic supplies using your UUHP card, as you have done in the past. The new BENNY TM Card can also be used at the pharmacy to pay your share of the expense for these supplies and instantly submit a claim to your Health FSA (if you participate in that plan). Fiscal Plan Year OTHER HEALTH PLAN REMINDERS The University s Health Plan will operate on a Fiscal Plan Year beginning July 1, The short plan year (six months) used to make this transition will end on June 30, Your elections made during this open enrollment will be effective for the 12-month Plan Year beginning July 1, Deductible and Other Annual Maximums/Limits Your deductible and co-insurance maximum requirements start over July 1 and apply until June 30 of the following year. Any annual coverage limits on the number of visits or dollars allowed will also start over and be available to you for the full Plan Year that begins July 1, 2003, and ends June 30, Paying with Tax Free Dollars Unless you specifically request that you want more taxes taken out of your paycheck, the University automatically deducts your health care contributions on a pre-tax basis. This makes your take-home pay higher. In exchange for these tax advantages, IRS regulations limit when and why you can change your health care deductions to specific status change events provided you report the event to the Benefits Department within three months of the date of the event. During the Plan Year, you may change your deduction and health plan coverage level only for special status change events, including marriage, divorce, and the birth or placement of a child for adoption. You must make all changes within three months following the date of the event; otherwise, you cannot change your deduction until the next annual open enrollment. If your status change event results in discontinuation of coverage for a family member who no longer qualifies as a dependent, you must notify us within three months of the date they no longer qualify. (However, in order for the dependent to be eligible to continue coverage under COBRA, the COBRA coverage must be requested within 60 days of the status change event. If you wait the full 3 months to notify the Benefits Department, the dependent will not be eligible to continue coverage under COBRA.) Any change in your contribution will occur on the first paycheck after the date you notify us that your dependent is no longer eligible. We cannot make refunds, even if your dependent was ineligible for coverage during earlier payroll periods. To avoid extra expense, contact the Benefits Department at as soon as a dependent no longer qualifies for coverage. Page 5

7 FLEXIBLE SPENDING ACCOUNTS: Health and Dependent Care The University s Flexible Benefit Plan is a valuable benefit that can reduce your taxes and increase your spendable income. Using a flexible spending account ( FSA ) can save you as much as 30% on out-of-pocket health care (medical, dental and/or vision) expenses and dependent care costs. The same IRS rules that allow your health care contributions to be withheld before taxes apply to FSA s. Those rules provide you the opportunity to reduce your current income and taxes by contributing an amount you specify toward a Health and/or Dependent Care FSA. You can then use these pre-tax funds for reimbursement of qualified expenses. The University s Flexible Benefit Plan allows you to make an election to defer up to $6,000 per Plan Year for reimbursement of eligible health care expenses (medical, dental and vision expenses not paid under a health plan) incurred by you and your eligible dependents. In addition, you can elect to defer up to $5,000 for the reimbursement of qualified dependent care expenses annually. The IRS determines the dependent care account limit of $5,000 for each tax year (not fiscal year), which means your contributions cannot exceed $5,000 in the calendar tax year Since your election will be divided equally among your paychecks received through the end of 2003 and the first half of 2004, be careful to estimate the expenses that will be incurred during this Plan Year without exceeding the $5,000 IRS limit for each calendar year. Although these plans are advantageous for many employees, the IRS rules that govern them are complex. CAUTION: Lower tax rates effective in 2002 and liberalization of the dependent care tax credit may make the credit more attractive than a dependent care spending account for a broader range of middle income earners. The dependent care spending account will, however, continue to provide higher income earners superior tax benefits. To participate in the flexible spending accounts, you must make a new election every year during open enrollment. Your participation will not be continued from one year to the next without making a new enrollment election. Use the area provided on your personalized Open Enrollment form to enroll in the Health FSA and/or Dependent Care FSA for the plan year beginning July 1, 2003, and ending June 30, The amount you list on your form will be divided equally among the twenty-four (24) paychecks that are received between July 1, 2003, and June 30, If you elect to participate in the FSA, your deductions will begin on the check you receive on July 7 and only expenses incurred between July 1, 2003, and June 30, 2004 (or the date you terminate participation in the plan, if earlier), will be eligible for reimbursement. For additional information on the University s Flexible Benefit Plan (Health FSA and Dependent Care FSA) visit our web site at attend an open enrollment session, or contact the Benefits Department at INTRODUCING THE BENNY CARD! We are pleased to announce an exciting enhancement to your Health FSA that will make access to your funds much more convenient. The BENNY TM MasterCard provides an easy way to access your Health FSA. The Benny TM Card is a special MasterCard that draws on the value of your annual Health FSA election amount. Each time you incur a qualified health care expense (that will not be reimbursed by your primary or secondary health plans) at a provider that accepts MasterCard, you can present the Benny TM Card for payment. Your qualified expenses will be deducted from your Health FSA automatically, which means you don t have to pay the expense, file a claim, and wait for reimbursement. You can use the Benny TM Card for qualifying expenses, such as covered prescription drug co-pays, doctor and emergency room co-pays, co-insurance amounts, eyeglasses, orthodontics, Lasik surgery, and more, provided they will not be reimbursed by your primary or secondary health coverage. Save your receipt. In some instances you may be asked to provide a receipt to verify that your transaction was for a qualified health care expense. (This special MasterCard will be issued to all Health FSA participants at no charge. Sorry, you cannot use the Benny TM Card at non-health related locations, such as restaurants, gas stations, and bookstores or for Dependent Care FSA transactions.) You ll find additional information about the Benny TM Card in your enrollment materials. We encourage you to become familiar with this new concept and take advantage of the exciting new approach to managing your Health FSA. Page 6

8 SOME FINAL REMINDERS... 1) IF YOU PREVIOUSLY WAIVED LTD OR LIFE INSURANCE COVERAGE, TAKE ADVANTAGE OF THE LIMITED OPPORTUNITY TO ENROLL NOW WITHOUT PROVIDING EVIDENCE OF GOOD HEALTH. Your completed Open Enrollment form must be returned to the Benefits Department by April 30. Evidence of good health is required if your form is not completed and returned by April 30, ) All changes selected during open enrollment will be effective July 1, ) Review the Health Plan Comparison included in your packet for coverage information about each plan. Member Services telephone numbers and internet addresses for each health plan are provided on the chart and are excellent resources for questions and up-to-date provider directories. Attend an Open Enrollment meeting if you have any questions. Specialists representing the various plans will be available to answer your questions. 4) Be sure to indicate on your personalized Open Enrollment form if you want to add or drop dental coverage. 5) Your personalized Open Enrollment form lists your dependents. Take a moment to make certain the information for each dependent is correct and that all dependents listed are eligible to continue coverage under the Plan. If you need to make a change, simply write the correction on your Open Enrollment form and return it to the Benefits Department. 6) If you want to enroll or make changes, return your completed Open Enrollment form to the Benefits Department by April 30, Your new elections will be effective July 1, 2003, for the Plan Year that ends on June 30, ) If you do not return your completed Open Enrollment form, your current health care, LTD, and Life Insurance coverage, if any, will be continued; and your flexible spending account participation will terminate effective June 30, The University is required by federal Medicare regulations to maintain current and accurate records on the Medicare status of employees and their covered dependents. If you and/or a covered dependent currently have Medicare benefits, you MUST advise the Benefits Department of this coverage to avoid future health claim problems or delays. In addition, please notify us immediately if your Medicare status, or that of your covered dependents, changes for any reason. Call the Benefits Department at or send an to benefits@hr.utah.edu. This announcement contains only a general description of some of the features of the University s Benefit Plans. The exact details of the plans are included in the legal plan documents that govern each plan. If there is any discrepancy between this announcement and the plan documents, the plan documents will govern. REMINDER: Women s Health and Cancer Rights Act Each year we are required to distribute a notice about the Women s Health and Cancer Rights Act, a federal law, which became effective on October 21, This law requires group health plans that provide coverage for mastectomies to also cover re-constructive surgery and prostheses following mastectomies. The University s Health Care Plans have always provided these benefits. Page 7