BENEFITS OPEN ENROLLMENT 2018 YOUR HEALTH & WELLNESS STARTS WITH YOU

Transcription

1 BENEFITS OPEN ENROLLMENT 2018 YOUR HEALTH & WELLNESS STARTS WITH YOU

2 A MESSAGE FROM THE INTERIM PRESIDENT/CEO, Beverly Capasso Dear Broward Health Valued Employees, Broward Health strives to provide robust health benefits and wellness programs for our employees. In that spirit, we are excited to announce our newest wellness initiative that will begin during Open Enrollment. For the first time in several years you will see a reduction in your health insurance premium compared to last year if you take part in the initiative. Did you know that the influenza vaccination recently prevented an estimated 5.1 million illnesses in the US according to the Centers for Disease Control and Prevention (CDC)? By working together to increase our Broward Health vaccination rates, we can prevent even more illnesses this flu season. To show our dedication to this effort, Broward Health is offering reduced premiums for employees covered under our medical plan who comply with Broward Health s Flu Vaccine Guidelines and are attested non-tobacco users. Saving money and staying healthy has never been easier! Employees not covered by our health plan are also strongly encouraged to get a flu shot. Read through this booklet for more information regarding this exciting new wellness initiative and for more details about Open Enrollment. Thank you all for your dedication and commitment to our patients and our community. Open Enrollment Highlights Broward Health s 2018 annual benefits open enrollment will take place from November 6, 2017 through November 17, Representatives from the Benefits Department will be onsite at the following facilities during the week of November 6, 2017 to answer questions. Please see schedule below. Facility Location Date Time BHMC Cafeteria Monday 11/6 12pm 3pm BHN Cafeteria Tuesday 11/7 12pm 3pm BHIP Cafeteria Wednesday 11/8 12pm 3pm BHCS Cafeteria Thursday 11/9 12pm 3pm In this Issue Page Wellness Incentive Page 2 Open Enrollment Basics and HRA Wellness Incentive Page 3 5 Wellness Programs Page 4 Medical Plans Page 7 Dental Plans Page 9 Vision Plan Page 101 Voluntary Short/Long Term Disability Voluntary Supplemental Term Life Insurance Tuition Reimbursement Page 11 Flexible Spending Accounts Health Savings Account Page 122 Benefit Enrollment and Navigation Process Page 133 Notices Corporate Spectrum 1800 Friday 11/10 12pm 3pm Conference Room 1040

3 2018 WELLNESS INCENTIVE Why get the flu vaccine? The flu can be a serious disease that can lead to hospitalization and sometimes even death. Anyone can get very sick from the flu, including people who are otherwise healthy. Encouraging an annual flu vaccine demonstrates our commitment to protect the safety and health of our patients, many of whom already have weakened immune systems, as well as visitors, co-workers and our families. All employees, including those that don t provide direct patient care, might be exposed to the flu virus. If you get the flu, you can spread it to others even if you don t feel sick. By getting vaccinated, you help protect yourself, your family at home, and our patients. This year, Broward Health is strongly encouraging all employees to comply with Broward Health s Flu Vaccine Guidelines, and is adding a new wellness incentive for employees covered under our health plan who comply. What s the new wellness incentive? Employees who participate in the flu vaccine program and are non-tobacco users will receive a premium discount of $28.85 per pay period ($750 annually), which is an increase over the $600 annual incentive in 2017 for being a non-tobacco user. To qualify, employees must receive the flu vaccine by 11/30/17. Employees who qualify and are covering a spouse/domestic partner who does not use tobacco will receive a premium discount of $51.92 per pay period ($1350 annually). Employees who do not receive the flu vaccine by 11/30/17, and those who are tobacco users (or covering a spouse/domestic partner who uses tobacco), will not be eligible for the premium discount effective January 1, Where can I get the flu vaccine? The flu vaccine is available free of charge to our employees at the regional Employee Health Departments. Employees may also receive the vaccine at CVS and other network providers under both Best Choice Plus and Aetna, upon presentation of member ID card. If you receive the vaccine at one of these other locations, be sure to provide the documentation to your Employee Health Department by 11/30/17. If I m a tobacco user, may I still receive the premium discount for receiving the flu vaccine? All employees, regardless of their tobacco status, are strongly encouraged to receive their flu vaccine this season. However, tobacco users (and/or covered spouses/domestic partners who smoke) will not be eligible to receive the new premium discount. For more information about smoking cessation, please contact the EAP Department at EAP. Are exemptions allowed? You may apply for an exemption from receiving the flu vaccine in accordance with HIPAA, the Americans with Disabilities Act (ADA) and/or the Advisory Committee on Immunization Practices (ACIP) vaccination recommendations. Flu vaccine exemptions must be approved by your Employee Health Department by 11/30/17. You and/or your covered spouse/ domestic partner may apply for an exemption from the non-smoking requirement in accordance with HIPAA and/or the ADA by contacting the EAP department at EAP. Please remember that both the tobacco users designation (or approved exemption) and the flu vaccine completion (or approved exemption) are required for an employee to receive the premium discount. For a covered spouse, only the non-tobacco status (or approved exemption) is required as long as the employee meets both the non-tobacco and flu vaccine criteria (or approved exemptions). 1

4 OPEN ENROLLMENT BASICS 2018 Open Enrollment runs from 11/6/17 11/17/17. Your current benefit elections will roll over automatically, with the exception of Flexible Spending Accounts. Please make sure you receive your flu vaccine by 11/30/17 in order to receive the discounted medical premiums in All flu vaccine data will be collected and reported by the Employee Health Departments, so you will not be asked to answer any flu vaccine questions in Lawson employee self-service (ESS). Employees do not need to complete a new tobacco status attestation unless their status has changed or their spouse/domestic partner status has changed. Employees who do not receive the flu vaccine by 11/30/17 and/or are tobacco users will not receive the discounted medical premiums in Requests for exemptions must also be completed by 11/30/17. Your benefit elections are effective 1/1/18 with payroll deductions effective 1/1/18. If you wish to make changes, enroll in a 2018 Flexible Spending Account or update your tobacco status, benefit elections must be made online via Lawson employee self-service (ESS) on the Broward Health Employee Intranet. HEALTH RISK ASSESSMENT (HRA) WELLNESS INCENTIVE What is the HRA? At Broward Health, our goal is to make your health and wellness a priority. For this reason, we are continuing to provide our voluntary, confidential, health risk assessment to assist you in your quest to reach your wellness goals and maintain a healthy lifestyle. An annual health assessment provides employees with a personalized report highlighting their current health status and information that can be shared with their personal healthcare providers. How does the HRA incentive work? For those employees who complete an assessment from 10/1/17 through 3/31/18, Broward Health will provide a $50 wellness incentive payable in June If you completed an HRA this year, please complete it again during the timeframe above to receive the incentive in June Please note, the HRA is voluntary. Are exemptions allowed? You may apply for an exemption from completing the HRA in accordance with HIPAA and the ADA. Please contact the EAP Department at EAP for assistance. Where does the data go? Broward Health does not have access to individual health data. Broward Health will only receive aggregate data from the results of all appraisals combined to understand the overall health trends of our employees and in turn provide enhanced health and wellness services to better meet your health needs. 2

5 How do I access the HRA? To take your health risk assessment, see instructions below. First time users will need to register for an account by creating a user name and password. Please note, due to contractual restrictions, physicians are not eligible to receive the incentive. Aetna: Go to Aetna s homepage at log in, and click the Health Assessment link and follow the prompts. For Technical Support, contact Aetna at Best Choice Plus: Go to log in and click the Health Assessment link and follow the prompts. For Technical Support, contact Care Allies at WELLNESS PROGRAMS NUTRITION RESOURCES WELLNESS CENTERS SEMINARS PREVENTIVE CARE EMPLOYEE HEALTH ONSITE RETAIL PHARMACY EMPLOYEE ASSISTANCE PROGRAM TOBACCO FREE/HEALTHY LIFESTYLE HEALTH RISK ASSESSMENT Regional medical centers offer healthy eating options; nutritional information posted on food choices supports wellness and weight management. Wellness centers on site at BHMC and BHIP offer convenient and affordable access to fitness centers. Seminars and health education are offered by the Employee Assistance Program and Employee Health Services on health and wellness topics including mind-body wellness issues, financial topics, stress management, child and eldercare information. Free preventive care for all employees and covered dependents enrolled in medical coverage. Regional Employee Health Centers offer free vaccines for employees, including the seasonal Influenza vaccine and Tdap (tetanus, diphtheria, and pertussis), health screenings, wellness information and education for healthy living and disease prevention. Our onsite retail pharmacies are fast, convenient and affordable ways to fill and pick up your prescriptions, over-the-counter medicines, vitamins or other health care goods. Confidential assessment, referral and counseling services for all employees and benefit eligible family members. Licensed professional staff offer a broad array of clinical and work-life services including coaching, consultations and wellness resources. Contact EAP for information regarding free sessions at EAP. Wellness program provides discounted premiums for employees and spouses/partners that do not utilize tobacco products. Additionally, smoking cessation programs are available at various locations. For more information, please contact the EAP department. On-line screening tool designed to help identify personal health risks and develop a plan for healthier living. 3

6 MEDICAL PLANS As your employer, Broward Health pays the majority of the annual premium costs associated with many of your benefits. Therefore, your premiums and out-of-pocket expenses are substantially lower. The following rate sheets are the Benefits at a Glance which identify your costs per pay cycle along with plan highlights. The discounted medical premiums below apply to employees who are non-tobacco users and who comply with the Broward Health Flu Vaccine Guidelines. Covered spouses/domestic partners must also be tobacco-free for the discounted premiums to apply. Best Choice Plus (Preferred Provider Organization) PPO with Premium Discount without Premium Discount Employee $54.99 $83.84 Employee & Spouse/Domestic Partner $ $ Employee & Children $91.84 $ Family/Domestic Partner $ $ The Best Choice Plus medical plan uses the services of the Broward Health hospitals and our own Broward Health physician network. See below for plan highlights. For more information, you can also go online to the Broward Health website: employee.browardhealth.org/pages/employee-benefits or call Service In-Network Out-of-Network Inpatient hospital benefits 100% after $100 co-pay 60% after $500 co-pay Outpatient surgery 100% after $50 co-pay 60% after deductible Emergency room (ER) visit* 100% after $75 co-pay 100% after $75 co-pay Lab work $5 co-pay Imaging/Diagnostic $10 co-pay 60% after deductible Rehab (60 visits/year) $5 co-pay Primary care provider (PCP) visit 100% after $20 co-pay 60% after deductible Specialist visit 100% after $25 co-pay 60% after deductible Annual deductible $150/single coverage $150/single coverage $400/family coverage $400/family coverage Out-of-pocket maximum $2,000/single coverage $4,000/family coverage Prescription Drugs Retail: $10/$25/$40/$50 Mail order: Co-pays are 2.5 times the above retail cost. Members who fill their specialty prescription at Broward Health Medical Center s Outpatient Pharmacy will incur a $10 co-pay. 4 *Not covered if non-emergency

7 AETNA Select (Open Access) Exclusive Provider Organization) EPO with Premium Discount without Premium Discount Employee $72.22 $ Employee & Spouse/Domestic Partner $ $ Employee & Children $ $ Family/Domestic Partner $ $ The Aetna Select Open Access medical plan uses the services and physicians in the nationwide Aetna network. Please remember, pre-certification is required for hospital admissions and high tech imaging (MRI, CAT, CT, etc.) procedures. See below for further plan highlights. For more information, you can go to or call Service In-Network Out-of-Network Inpatient hospital benefits 100% after $750 co-pay for Aetna Network Or 100% after $250 co-pay at a Broward Health facility Outpatient surgery 100% after $350 co-pay for Aetna Network Or 100% after $100 co-pay at a Broward Health facility Emergency room (ER) visit* 100% after $150 co-pay 100% after $150 co-pay Lab work 80% after plan deductible for Aetna Network Imaging/Diagnostic 90% after plan deductible at a Broward Health Facility Rehab (60 visits/year) 90% after deductible Primary care provider (PCP) visit 100% after $25 co-pay Specialist visit 100% after $35 co-pay Annual deductible $250/single coverage $750/family coverage Out-of-pocket maximum $3,000/single coverage $6,000/family coverage Prescription Drugs Retail: $10/$30/$50/$75 Mail order: Co-pays are 2.5 times the above retail cost. *Not covered if non-emergency Members who fill their specialty prescription at Broward Health Medical Center s Outpatient Pharmacy will incur a $10 co-pay. 5

8 AETNA Choice (POS II) (High Deductible Health Plan) HDHP with Premium Discount without Premium Discount Employee $8.09 $36.94 Employee & Spouse/Domestic Partner $35.66 $87.59 Employee & Children $20.07 $48.91 Family/Domestic Partner $59.22 $ The Aetna High Deductible medical plan uses the services and physicians in the nationwide Aetna network. This plan allows you to use an in-network provider or an out-of-network provider. Please remember, pre-certification is required for hospital admissions and high tech imaging (MRI, CAT, CT, etc.) procedures. See below for further plan highlights. For more information, you can go to or call Service In-Network Out-of-Network Inpatient hospital benefits 80% after deductible 60% after deductible Outpatient surgery 80% after deductible 60% after deductible Emergency room (ER) visit* 80% after deductible 80% after deductible Lab work 80% after deductible 60% after deductible Imaging/Diagnostic Rehab (60 visits/year) Primary care provider (PCP) visit 80% after deductible 60% after deductible Specialist visit 80% after deductible 60% after deductible Annual deductible $1,500/single coverage $3,000/single coverage $3,000/family coverage $6,000/family coverage Out-of-pocket maximum $5,000/single coverage $10,000/single coverage $7,000/family coverage $20,000/family coverage Prescription Drugs 80% after deductible Covered at 60% after deductible Including Mail Order Mail Order: No benefit *Not covered if non-emergency 6

9 DENTAL PLANS RELIANCE STANDARD DENTAL PPO Employee $5.55 Employee & Spouse/Domestic Partner $11.53 Employee & Children $10.80 Family/Domestic Partner $18.31 The Reliance Standard dental plan offers in-network and out-of-network benefits. See below for plan highlights. For more information, you can go to or Service/Item In-Network Deductible $50 *Maximum annual plan benefit $1,000 Per Person per Calendar Year Pre-existing condition exclusion N/A Oral examinations 100% of Plan Allowance Cleaning 100% of Plan Allowance 1 in 6 months Fillings 80% of Plan Allowance X-rays 100% of Plan Allowance Routine extractions 80% of Plan Allowance Sealants (determined by age) 80% of Plan Allowance Orthodontia (Braces) Up to $1,500 Lifetime Maximum Root canal 50% of Plan Allowance Periodontal treatment 50% of Plan Allowance Space maintainers 50% of Plan Allowance Cosmetic work Not Covered Dentures 50% of Plan Allowance Crowns and bridge work 50% of Plan Allowance Oral surgery 50% of Plan Allowance Dentist You may select any licensed Dentist who meets plan guidelines, however benefits listed above are for in-network providers. *Please note, the annual plan maximum amount for out-of-network providers may differ based on the specific Dentist. 7

10 SAFEGUARD DENTAL HMO Employee $4.28 Employee & Spouse/Domestic Partner $8.12 Employee & Children $7.69 Family/Domestic Partner $9.47 The Safeguard dental plan provides dental coverage for in-network benefits only. See below for plan highlights. For more information, you can go to or call Service/Item Deductible Maximum annual plan benefit Pre-existing condition exclusion Oral examinations Cleaning Fillings X-rays Routine extractions Sealants (determined by age) Orthodontia (Braces) Root canal Periodontal treatment Space maintainers Cosmetic work Dentures Crowns and bridge work Oral surgery Dentist In-Network N/A No maximum N/A N/A Twice a year at no charge Amalgam N/A N/A $5 copay $5 copay per tooth $1,850 copay $110 copay Perio Scaling $50 per quad $65 copay Not Covered $325 $350 copay $245 copay + lab fees 5 copay You may select any dentist from provider directory. There is no out-of-network benefit. 8

11 VISION RELIANCE STANDARD VISION - PPO Employee $0.94 Employee & Spouse/Domestic Partner $1.86 Employee & Children $1.69 Family/Domestic Partner $2.60 The Reliance Standard vision plan offers in-network and out-of-network benefits with access to private practice optometrists and national brand optical retailers. Please be advised, the annual vision exam co-pay will increase in With the Reliance Standard vision plan, you ll utilize the EyeMed Access network. For more information, you can go to or call Service In-Network Out-of-Network Deductible $25 Exam $25 Eye Glass Lenses No deductible Annual eye exam Covered in full Up to $35 Lenses (per pair) Single Vision Covered in full Up to $25 Bifocal Covered in full Up to $40 Trifocal Covered in full Up to $55 Lenticular 20% discount No benefit Progressive See lens options N/A Contacts Fit and follow-up exams Standard Covered in full Up to $40 Premium (allowance) 10% discount + $55 allowance Up to $40 Elective Up to $100 Up to $80 Medically Necessary Covered in full Up to $200 Frames $130 Up to $65 Exam/Lens/Frame (months) 12/12/24 12/12/24 9

12 VOLUNTARY SHORT TERM DISABILITY This benefit provides an opportunity for eligible employees to purchase short-term disability coverage for up to 60% of basic weekly earnings; subject to pre-existing condition limitations. This is a voluntary program offered by Reliance Standard. Program features include: 29 day elimination period, payments up to 22 weeks and $3,000 maximum weekly benefit. The cost per $100 of salary is 86 cents. For an employee earning $25,000 per year, the employee s bi-weekly payroll deduction will be: $8.27. VOLUNTARY LONG TERM DISABILITY This benefit provides an opportunity for eligible employees to purchase long term disability coverage for up to 60% of basic monthly earnings; subject to pre-existing condition limitation. Disability payments start after 180 days and continue until you are able to return to work or up to your Social Security Normal Retirement Age if you remain disabled. This is a Voluntary Program offered by Reliance Standard. The maximum monthly staff benefit is $8,000. Physicians and management are subject to other benefit provisions. Broward Health pays 50% of the cost for this insurance plan; however, ½ of the disability payment will be taxed due to Broward Health s contribution towards this benefit. The cost per $100 of salary is 82 cents. For an employee earning $25,000 per year, the employee s bi-weekly payroll deduction will be: $3.94. VOLUNTARY SUPPLEMENTAL TERM LIFE INSURANCE This benefit provides an opportunity for eligible employees to purchase additional life insurance coverage for themselves, spouses/domestic partners or dependents. This voluntary program is offered by Reliance Standard. Employees are guaranteed coverage of a minimum of $10,000 up to a maximum of $350,000 for themselves and a minimum of $5,000 up to a maximum of $50,000 for a spouse/domestic partner, without answering any medical questions. Dependent children age 14 days to age 26 years can have coverage of $10,000. TUITION REIMBURSEMENT Broward Health provides this benefit to employees to pursue voluntary job related degree and certificate programs at not-for-profit accredited institutions. Approved certificate programs are reimbursed up to $500 on a calendar year basis. Degree programs are reimbursed up to $5,000 on a calendar year basis within the following guidelines: associate s degree is reimbursed up to $105 per credit hour; bachelor s degree up to $200 per credit hour; and master s degree up to $370 per credit hour. 10

13 FLEXIBLE SPENDING ACCOUNTS - (FSA) Health Care FSA This benefit provides an opportunity to set aside pre-tax dollars from your paychecks to pay for out-of-pocket health care expenses that will not be paid by insurance or reimbursed from any other source. The money you set aside in the account is available for your expenses and the expenses of anyone you claim as a dependent on your tax return. You may set aside from $5 to $96 per paycheck, up to a maximum of $2,500 a year for eligible expenses including prescription drug co-pays, and other qualified medical, dental and vision expenses. Non-prescribed items are not eligible for FSA tax-free reimbursement. Dependent Day Care FSA This benefit provides an opportunity to set aside pre-tax dollars from your paychecks for child care expenses you may have for your eligible dependents while you and your spouse work or your spouse goes to school full-time. Your eligible dependents are: 1) Children under age 13 who you claim as dependents on your tax return; or 2) Anyone age 13 or older who lives with you at least eight hours a day and needs supervised care, such as an elderly parent or disabled spouse or dependent. You may set aside up to $5,000 a year. HEALTH SAVINGS ACCOUNT - (HSA) A Health Savings Account is used to set aside pre-tax dollars to pay for medical expenses for you or your dependent(s). To open an HSA and make tax deductible contributions, you must be enrolled in a high-deductible health plan. In 2018 you can contribute up to: $3,450 employee only coverage; $6,900 family coverage and $1,000 additional catch-up if you are age 55 or older in There is an IRS 20% penalty for non-medical distributions. If you have questions about tax savings, you should consult your tax advisor. To participate in a HSA, you must complete a paper enrollment form. The enrollment form can be found in your Human Resources Department. 11

14 BENEFIT ENROLLMENT & NAVIGATION PROCESS You must enroll through the Lawson employee self-service (ESS) site located on the Broward Health Intranet. You can only access this from a Broward Health computer. Enter your network user name and password to log-in. Once you log into Lawson ESS, you will: 1. Click on the Bookmark link in the upper left-hand side of your screen 2. Hover over the Employee Self-Service menu 3. Then to Benefits 4. Then click on Benefits Open Enrollment We strongly encourage you and your family to carefully review our Open Enrollment options and make designations and modifications during the Open Enrollment period. Employee Self Service also gives you access to your pay check data, current benefit enrollments, dependent information, and can be used to change your address of record. Additional benefit information including the Uniform Summary of Benefits and Coverage and Children s Health Insurance Program (CHIP) may also be found on the HR tab on the intranet. As a reminder, please see below for how to enroll in specific benefits. Benefit: Medical Dental Vision Short-Term Disability Long-Term Disability Flexible Spending Account Voluntary Supplemental Term Life Insurance Tobacco Attestation Health Savings Accounts 403(b) or 457(b) Retirement Plans Tax Treatment Beneficiary Maintenance Flu Exemptions Enrollment Via: Lawson Employee Self-Service (Online) Paper Enrollment (HR Department) See your Employee Health Department 12

15 NOTICES Notice Regarding Medical Plan Updates Affordable Care Act Preventive Services Due to the Affordable Care Act (ACA), several additional preventive services will be covered in-network with no cost sharing. These services include diabetes screening (adults whom are overweight/obese), high blood pressure screening for adults, and tobacco use counseling and interventions. A complete listing of services can be located on the Broward Health employee intranet page under the HR/Benefits tab. ACA New Rule Section Broward Health is committed to providing all eligible employees health care benefits and will never discriminate against any individual regardless of the basis of race, color, national origin, gender, gender identity or gender expression, pregnancy, sexual orientation, religion, age, disability, military status, genetic information or any other characteristic protected under applicable federal or state law. Notice Regarding Wellness Programs Broward Health has a voluntary wellness program available to all employees. The program is administered according to federal rules permitting employer-sponsored wellness programs that seek to improve employee health or prevent disease, including the Americans with Disabilities Act of 1990, the Genetic Information Nondiscrimination Act of 2008, and the Health Insurance Portability and Accountability Act, as applicable, among others. Wellness Programs Reasonable Accommodation for the HRA, Tobacco & Flu Discounts If you are unable to participate in any of these programs under HIPAA, GINA, ADA or the ACIP, you may request a reasonable accommodation or an alternative standard by contacting EAP at EAP. Approved exemptions will be considered as compliant for applicable discounts and/or credits. Protections from Disclosure of Medical Information We are required by law to maintain the privacy and security of your personally identifiable health information. Although the wellness program and Broward Health may use aggregate information it collects to design a program based on identified health risks in the workplace, Broward Health will never disclose any of your personal information either publicly or to the employer, except as necessary to respond to a request from you for a reasonable accommodation needed to participate in the wellness program, or as expressly permitted by law. Medical information that personally identifies you that is provided in connection with the wellness program will not be provided to your supervisors or managers and may never be used to make decisions regarding your employment. Your health information will not be sold, exchanged, transferred, or otherwise disclosed except to the extent permitted by law to carry out specific activities related to the wellness program, and you will not be asked or required to waive the confidentiality of your health information as a condition of participating in the wellness program or receiving an incentive. Anyone who receives your information for purposes of providing you services as part of the wellness program will abide by the same confidentiality requirements. In addition, all medical information obtained through the wellness program will be maintained separate from your personnel records, information stored electronically will be encrypted, and no information you provide as part of the wellness program will be used in making any employment decision. Appropriate precautions will be taken to avoid any data breach, and in the event a data breach occurs involving information you provide in connection with the wellness program, we will notify you immediately. You may not be discriminated against in employment because of the medical information you provide as part of participating in the wellness program, nor may you be subjected to retaliation if you choose not to participate. For additional information regarding these notices, please refer to the Broward Health Employee Benefits page: employee.browardhealth.org/pages/employee-benefits. 13