2017 Open Enrollment. ARCHDIOCESE OF ST. LOUIS Guide HEALTH INSURANCE AND FLEXIBLE SPENDING ACCOUNT DECISIONS

Transcription

1 2017 Open Enrollment ARCHDIOCESE OF ST. LOUIS Guide HEALTH INSURANCE AND FLEXIBLE SPENDING ACCOUNT DECISIONS May 1 - May 15, 2017

2 OUR MISSION STATEMENT As Catholics in the Archdiocese of St. Louis, in communion with the Bishop of Rome we are called by our Lord Jesus Christ to be His Church and live His Gospel. With joy, we strive to fulfill our Baptismal calling by prayer and worship, teaching and sharing our faith, serving others, and fostering unity in diversity, guided by the Holy Spirit. We commit ourselves to the responsible stewardship of all God s gifts. 2

3 Cardinal Rigali Center 20 Archbishop May Drive St. Louis, Missouri p) f) archstl.org Archdiocese of St. Louis Office of the Archbishop April 2017 Dear Employee of the Archdiocese of St. Louis, As an important member of this Archdiocese, I value your personal development, your spiritual growth, as well as your physical and mental wellbeing. The purpose of this Open Enrollment Benefit Guide is to further your understanding of the health insurance plan and flexible spending account plans, along with presenting the available options for you during this Open Enrollment Period. It is important that you take the time to review your annual choices, especially the important information explaining the health insurance plan s new spousal surcharge. The Archdiocese provides you with many employee benefits to assist your wellbeing. As a benefit eligible employee, you are offered a quality health insurance plan, which consists of medical, prescription, and dental benefits. You are also offered a retirement plan, flexible spending accounts, long term disability, an employee assistance program, an adoption assistance program, employer-paid life insurance, and voluntary life insurance. I am grateful for the faithful service of the Archdiocesan Benefits Committee for their work with the employee benefits plan. Wellness is important to me. It has a place and importance in your daily life and also in the workplace. As some of you may know, this is a very personal issue for me, as preventive testing is what saved my life when I had cancer. Thankfully, I am still cancer free. The Archdiocesan health insurance plan offers many preventative services, including coverage for an annual physical checkup. The Archdiocese also provides employees preventative services such as health risk assessments, mammogram screenings and annual flu vaccines. We promote the importance of having an annual physical/wellness exam with your personal physician and we offer the option for an Archdiocesan-paid health screening by a nurse with H&H Health Associates. Please see more information regarding your wellness benefits within this Open Enrollment Benefit Guide. May God bless you, your family and your service to the Archdiocese of St. Louis. Sincerely yours in Christ, Most Reverend Robert J. Carlson Archbishop of St. Louis

4 TABLE OF CONTENTS Welcome to 2017 Open Enrollment Your Benefits Open Enrollment Is Here Benefits Change, Effective July 1, Eligibility and Enrollment... 7 What You Can Do During Open Enrollment Employees... 8 Dependents Spousal Surcharge Policy Spousal Surcharge Definition Why a Spousal Surcharge Effective Dates of the Spousal Surcharge Spousal Surcharge Exemption Form Cost of the Spousal Surcharge Spouse s Employment Status and Employer s Medical Coverage Your Monthly Cost for Coverage Effective July 1, Medical Coverage Comparison of the UHC Standard and Premier Plans How to Find a UHC Physician Mercy Mammography Screenings UnitedHealthcare Wellness Programs Real Appeal Program Virtual Visits Natural Family Planning Dental Coverage Dental Benefits with Delta Dental of Missouri Flexible Spending Accounts Lower Your Taxes with the Flexible Spending Accounts Employee Wellness Incentive Program H&H Health Associates Wellness Screenings Frequently Asked Questions How to Enroll, If Applicable Getting Started Online Enrollment Frequently Asked Questions UnitedHealthcare (UHC) Choice Plus Medical Plan Summaries The Standard Plan Summary of Benefits The Premier Plan Summary of Benefits Exclusions - Applicable to Premier and Standard UHC Plans Women s Health and Cancer Rights Act of Newborns and Mothers Health Protection Act Medicaid and the Children s Health Insurance Program (CHIP) Offer Free or Low-Cost Health Coverage to Children and Families Health Insurance Portability and Accountability Act (HIPAA) Privacy Notice Annual Rights and Resource Disclosure Benefit Questions?

5 WE LCOME T O OPEN E NR O LLM E NT YOUR BENEFITS OPEN ENROLLMENT IS HERE Open Enrollment is an important time to review some of your benefits, which go into effect on July 1, The Open Enrollment Period allows late enrollees to come into the health insurance plan or the Flexible Spending Accounts without a qualifying event. Late enrollees are employees, dependents, and/or spouses who did not enroll for coverage within 31 days from the time they were first eligible. The Open Enrollment Period is also a time to read about your the Employee Wellness Incentive on pages and an opportunity for an Archdiocesan paid mammogram in June. This benefit guide will explain in greater detail the benefits offered to you and how to enroll with Employee Self-Service. What do you need to do for Open Enrollment? Due to health care reform, you must either be enrolled in the health insurance plan or waive coverage. 5

6 KEY DATES FOR OPEN ENROLLMENT When is the Open Enrollment period? The Open Enrollment period begins May 1 and ends May 15, To help you make the best choices for you and your family, please read this Benefit Guide. If you need additional assistance, you can contact the Archdiocesan Office of Human Resources at or benefits@archstl.org. You can also attend a Question and Answer meeting at Sacred Heart Parish - Crystal City, the Cardinal Rigali Center or at St. Monica Parish. DATE TIME LOCATION Wednesday, May 3, :00 p.m. Sacred Heart Parish - Crystal City Rectory Meeting Room 555 Bailey Rd Crystal City, MO Thursday, May 4, :00 p.m. Cardinal Rigali Center Sr Ebo Room 20 Archbishop May Drive Saint Louis, MO Thursday, May 11, :00 p.m. St. Monica Parish Parish Hall Olive Blvd St. Louis, MO For additional benefit information on the health insurance plan effective July 1, 2017, go to archstl.org/openenrollment2017 and click on Benefit Plan Information. Key dates to remember WHAT HAPPENS WHEN Open enrollment begins May 1, 2017 Employee Open Enrollment question and answer meeting at 7:00 p.m. at Sacred Heart - Crystal City May 3, 2017 Employee Open Enrollment question and answer meeting at 7:00 p.m. at Cardinal Rigali Center May 4, 2017 Employee Open Enrollment question and answer meeting at 7:00 p.m. at St. Monica Parish May 11, 2017 Open enrollment ends May 15, 2017 Mammography van at Cardinal Rigali Center parking lot June 7, 2017 and June 29, 2017 New benefit elections go into effect July 1, 2017 BENEFIT CHANGE, EFFECTIVE JULY 1, 2017 The Health Insurance Plan will be implementing a spousal surcharge, whereby employees will pay an additional cost to cover a spouse who is eligible for health insurance coverage through his/her own employer. The spousal surcharge of $125 per month is in addition to the usual employee contribution cost. There are some exemptions to the spousal surcharge. To assist in understanding the spousal surcharge and whether it applies to you, please see the Spousal Surcharge Frequently Asked Questions document on page 10. 6

7 ELIGIBILITY AND ENROLLMENT WHAT YOU CAN DO DURING OPEN ENROLLMENT During the May 1 through May 15 Open Enrollment period, you can go online to Employee Self-Service to do any of the following: Enroll or waive the health insurance coverage. Enroll for participation in the flexible spending accounts (FSAs). Decline pre-tax health insurance contributions if you enroll in one of the UnitedHealthcare Premier or Standard plans and would prefer to pay for your health insurance with after-tax dollars. (An after-tax election allows you the freedom to drop your coverage and your dependents coverage during the year. However, you may save money with a pre-tax election.) Change your beneficiary information. Changing Coverage during the Year Don t miss the opportunity to choose the best coverage for you and your family during the Open Enrollment period. You will not have another chance to make changes to your health insurance coverage and flexible spending account participation until next year s Open Enrollment period, unless you have a qualifying event or you are enrolled in the after-tax employee contribution plan. Any changes you make to your coverage must be made within 31 days of the qualifying event. You may attempt to make a change to your voluntary life insurance anytime through out the year. Hartford Life is not offering an Open Enrollment period for the voluntary life insurance this year; however, to make a change you may contact your Benefits Administrator to complete and submit paper forms for Hartford s approval. Making Changes Your benefit elections will stay in place until the next Open Enrollment period unless you have a qualifying event as defined by the IRS. Examples of qualifying events are: Marriage Legal separation Divorce Birth or adoption of a child Change in eligibility of a child Death of a dependent Change in your/your spouse s employment status You or your spouse attains age 65 and is covered by Medicare You must notify your Benefits Administrator within 31 days of the qualifying event to change a benefit election. 7

8 ELIGIBILITY AND ENROLLMENT WHO IS ELIGIBLE FOR HEALTH INSURANCE BENEFITS Benefits Eligibility Please see the table below for your benefits eligibility. WHO IS ELIGIBLE FOR BENEFITS? Active employee working > 1,000 hours annually HEALTH INSURANCE FLEXIBLE SPENDING ACCOUNT VOLUNTARY LIFE INSURANCE Half-time or more Educator Religious on Official Assignment 4 Kenrick Glennon Seminarian 4 Permanent Deacon non employee 4 Former Employees on Early Retiree or Continuation of Coverage Plan 4 Employees You are eligible for health insurance benefits if you are: 1. An active employee working at least 1,000 hours per year; 2. A teacher with a half-time or more contract; 3. A religious employee on official assignment to the Archdiocese, excluding Archdiocesan priests; 4. A Kenrick-Glennon Seminarian, studying for the Archdiocese of St. Louis priesthood; 5. A Permanent Deacon who is: an employee working less than 1,000 hours annually for any Archdiocesan parish/organization employer; a non-paid Permanent Deacon who is providing service to any Archdiocesan parish/organization; The Permanent Deacon pays 100% of the premium for coverage under the plan. 6. A former employee enrolled in the Early Retiree or Continuation of Coverage health insurance plan, according to Plan guidelines. Dependents Your eligible dependents may include the following: Your spouse to whom you are married as recognized by the laws of the Catholic Church or the laws of the State of Missouri. It is always understood for this purpose that the spouse is of the opposite sex. If you choose to cover your spouse in the Archdiocesan plan, a spousal surcharge may be applicable to you. Your child who is married or unmarried, without respect to student or dependency status, until the child s 26th birthday. It is the responsibility of the employee/participant to monitor dependent s eligibility. Your unmarried dependent child older than age 26 who is mentally or physically disabled and depends on you for support and care. (Approval from UnitedHealthcare required.) 8

9 SPOUSAL SURCHARGE POLICY Beginning July 1, 2017, the health insurance plan will be implementing a spousal surcharge, whereby employees will pay an additional cost to cover a spouse who is eligible for health insurance coverage through their own employer. Spousal surcharges are common among employers and assist in managing health plan costs. The Archdiocese Employee Benefit Plan is self-insured and helps pay the cost of each member s healthcare coverage and actual claims. If the employee s spouse moves to his/her employer s plan, it places the costs of those claims with the spouse s employer, thus saving the Archdiocese the cost of those claims. The Archdiocese establishes its premiums based on the actual cost of the claims. If you cover your spouse, a monthly spousal surcharge of $125 will automatically deducted from your pay check withholding unless you qualify for an exemption and submit the online Employee Spousal Exemption Form no later than May 15th. The Spousal Surcharge Exemption Form can be accessed online at You will want to consider how the additional cost may impact your coverage choice during this Open Enrollment There are some exemptions to the spousal surcharge. To assist in understanding the spousal surcharge, please read the following Spousal Surcharge Frequently Asked Questions. 9

10 SPOUSAL SURCHARGE FREQUENTLY ASKED QUESTIONS Please read all of the following questions and answers. They help you to be informed of the full Spousal Surcharge Policy in the event of your spouse s enrollment in the health insurance plan. Spousal Surcharge Definition 1. What is a spousal surcharge? A spousal surcharge is an extra charge that an Archdiocesan employee pays for electing to insure a spouse who has subsidized health insurance coverage available to them through his/her own employer. The spousal surcharge is an added charge of $125 per month to the usual employee contribution for health insurance. 2. When is the spousal surcharge applicable? The spousal surcharge is applicable when your employed spouse is eligible for subsidized health insurance coverage (meaning their employer contributes to the cost of the coverage) through his/her employer and he/she is covered as a participant of the Archdiocesan health insurance plan. The effective date of the new spousal surcharge policy is July 1, During each year s benefit Open Enrollment between May 1 and May 15th, the employee seeking a spousal surcharge exemption will need to submit the annual Spousal Surcharge Exemption Form. 3. What are the exemptions to the spousal surcharge? In general, the spousal surcharge would not be added if the Spousal Surcharge Exemption Form was submitted on time and the enrolled spouse is one of the following: My spouse is not employed. My spouse is self-employed, without employer-subsidized health insurance coverage, and is not eligible for employer-subsidized health insurance. My spouse is employed with an Archdiocese of St. Louis parish, agency, or school. My spouse is employed and is not eligible for his/her employer s health insurance coverage. My spouse is employed and my spouse s employer does not offer health insurance coverage. My spouse is employed and is eligible for his/her health insurance coverage but the full premium cost is paid by the employee. There is NO employer contribution toward the cost of the health insurance. 4. What happens if I enroll my spouse in the Archdiocesan plan even though my spouse is eligible or covered through his/her employer? The $125 monthly spousal surcharge is added to your health insurance cost. Why a Spousal Surcharge? 5. Why did the Archdiocese of St. Louis implement a spousal surcharge policy? The spousal surcharge encourages those who have medical coverage available through their employer to take advantage of that coverage. The Archdiocese Employee Benefit Plan is self-insured and helps pay the cost of each member s healthcare coverage and actual claims. If the employee s spouse moves to his/her employer s plan and uses that benefit instead, it saves the Archdiocese the cost of the claims and will help keep our medical plans more affordable. The Archdiocese establishes its premiums on the basis of the cost of the actual claims which ultimately makes the plan more affordable to the employee. 10

11 SPOUSAL SURCHARGE FREQUENTLY ASKED QUESTIONS Effective Dates of the Spousal Surcharge 6. When does the spousal surcharge policy go into effect? The effective date of this policy is July 1st, When is the Archdiocese of St. Louis Open Enrollment? May 1st May 15th. If you elect to cover your spouse, you will need to determine your spouse s surcharge eligibility every Open Enrollment period (May 1st May 15th). If applicable, you will need to submit annually the Spousal Surcharge Exemption Form. Throughout the year, if your spouse experiences a qualified event change in insurance eligibility at his/her employment, you will be able to change your exemption status. Changes during the annual Open Enrollment are effective July When does the spousal surcharge go into effect as a new hire? If you are a new hire, not exempt from the surcharge, and you and your spouse enroll in the Archdiocese Health Insurance plan, the effective date of the surcharge would be the same as the effective date of your health insurance coverage. For your payroll deduction, the rule for the spousal surcharge would be the same as the rule for the employee contribution to the health insurance premium: If the effective date of your health insurance enrollment is prior to the 16th of any given month, you owe the full health premium and spousal surcharge for that month. If the effective date of your health insurance enrollment is on or after the 16th of any given month, you do not owe any health insurance premium or spousal surcharge for that month. There is no prorating of the health insurance premium or the surcharge. The Archdiocese will not be retroactively reimbursing anyone for surcharge amounts already paid. 9. When is the spousal surcharge effective for a health insurance qualifying event? If you have a qualifying event for your Archdiocesan health insurance coverage, the effective date of the employee spousal surcharge would be the date of the qualifying event. A few of the more common qualified events include: marriage, divorce, birth of a baby, change in status such as part-time to full-time, etc. (For example, marriage is a qualifying event where the effective date of the surcharge is the date of the marriage.) The surcharge payroll deduction rules listed above in question #8 would apply. Spousal Surcharge Exemption Form 10. Who must complete the Spousal Surcharge Exemption Form? If you are an employee who is enrolling in the Archdiocesan health insurance plan, will be covering your spouse on or after July 1, 2017, and are eligible to be exempt from the spousal surcharge, then you should complete the exemption form. 11. When is the Spousal Surcharge Exemption Form due? May 15, Also, the Spousal Surcharge Exemption Form will be required each Open Enrollment plan year. 12. What do I need to do to get ready for this change? You should start by obtaining information about your spouse s employer group medical plan. Determine when their employer s annual enrollment period occurs. Read the Employee Spousal Surcharge Exemption Form to determine if you are exempt from the surcharge. If applicable, complete and submit the Spousal Surcharge Exemption Form to the Archdiocese of St. Louis Office of Human Resources. 11

12 SPOUSAL SURCHARGE FREQUENTLY ASKED QUESTIONS 13. Where can I find the Spousal Surcharge Exemption Form and how do I submit the Spousal Surcharge Exemption Form? You can access the Spousal Surcharge Exemption Form on the Archdiocese website at Completing the new online exemption form requires four quick and simple steps for submission. Step 1: In your web browser, type in and press enter for the form to appear. Step 2: Type in your information and make your selections as requested on the form. Step 3: Read the Employee Acknowledgement section of the form and select the Agree to Terms and Conditions box, enter the date the form is being completed, and type in your name in the Employee Signature text box to sign the form. Step 4: Click on the SUBMIT button at the bottom of the page. You will also be given the opportunity to print the form after submitting it. A confirmation will automatically be sent to the address you listed on the form. If you do not have internet or online access, the exemption form can be mailed to you by contacting your benefits administrator or the Office of Human Resources at Once you print the form and complete the requested fields, your signed form can be submitted by mail or fax to: Archdiocese of St. Louis Office of Human Resources 20 Archbishop May Drive St. Louis, MO Fax: or benefits@archstl.org 14. If I am canceling my spouse s coverage on the Archdiocese health insurance plan during Open Enrollment, do I need to submit a Spousal Surcharge Exemption Form by May 15th? No exemption form is required if you are removing your spouse from your health insurance plan effective 7/1/ What happens if I fail to submit the Spousal Surcharge Exemption Form? Your payroll deduction automatically includes the $125 monthly spousal surcharge for your spouse s Archdiocesan health care plan coverage. Additionally, in the event an employee does not complete the form accurately, their coverage under the plan could be terminated or they may be subject to other disciplinary actions up to and including termination. Cost of the Spousal Surcharge 16. Is the $125 employee payroll deduction pre-tax or after-tax? The surcharge would be deducted on a pre-tax basis unless you have elected an after-tax election for your health insurance premium. If you have a pre-tax election for your health insurance contribution, you will have a pre-tax spousal surcharge. If you have an after-tax election for your health insurance contribution, you will have an after-tax spousal surcharge. 17. Excluding the $125 monthly spousal surcharge, what is the monthly cost of health insurance for a full-time employee? Please see page 15 for more detailed premium information. 18. What if I submit documentation later in the plan year that shows my spouse was exempt? The Archdiocese will not be retroactively reimbursing for surcharge amounts already paid. You will be exempt from the surcharge after receipt of the Spousal Surcharge Exemption Form and according to the payroll deduction rules outlined in question #8 of this document. 12

13 SPOUSAL SURCHARGE FREQUENTLY ASKED QUESTIONS Spouse s Employment Status and Employer s Medical Coverage 19. My spouse is currently between jobs. Can I enroll my spouse while they are job searching? Yes, you can enroll your spouse in the Archdiocesan health plan without a spousal surcharge while he/she is unemployed. However, if at any time your spouse becomes eligible for coverage through a new employer, you must notify the Office of Human Resources at or via an to benefits@archstl.org within 31 days of their eligibility on their new employer s plan. 20. What happens if my spouse finds a new job and I forget to notify the Office of Human Resources and he/she remains enrolled in the Archdiocese Plan with the spousal surcharge exemption? In addition to the points in question, you owe your employer the cost of the spousal surcharge for however many months your spouse was enrolled while he/she was eligible for insurance through his/her own employer. It is the responsibility of each parish/school/agency to resolve issues such as these. 21. What if my spouse is going to school and is eligible for a student health plan from the school? The spousal surcharge only applies to spouses who are actively employed and eligible for group medical coverage through their employer. If your spouse is eligible for coverage as a student, they would be eligible for the Archdiocesan health care plan and exempt from the surcharge. 22. What if my spouse and I are both Archdiocesan employees? If you are married to a benefit eligible Archdiocesan employee, you are exempt from the spousal surcharge if you submit the Spousal Surcharge Exemption Form. 23. What if my spouse works for a non-archdiocesan private Catholic employer or I work for a non-archdiocesan private Catholic employer and my spouse works for the Archdiocese of St. Louis? In either employee situation if your spouse is eligible or covered for employer subsidized health insurance and your private Catholic employer participates in our Archdiocese of St. Louis UnitedHealthcare health insurance plan, you are exempt from the monthly spousal surcharge, if you submit the Spousal Surcharge Exemption Form. 24. What if my spouse has to pay 100% of his insurance where he/she works? You are exempt from the surcharge if you submit the Spousal Surcharge Exemption Form. You will only have to pay the $125 monthly spousal surcharge if your spouse has access to employer-subsidized coverage, where the employer is paying part or all of the insurance plan costs. To find out if your spouse s employer is paying part of the plan cost, your spouse should ask his or her HR/benefits representative. 13

14 SPOUSAL SURCHARGE FREQUENTLY ASKED QUESTIONS 25. Is my spouse required to enroll other family members into his/her employer sponsored group medical coverage? No. Dependent children up to the age of 26 years old are still eligible to enroll in the Archdiocesan health insurance plan without the additional surcharge. 26. Whose health insurance plan will cover my children, the Archdiocesan plan or my spouse s employer s plan? If your spouse s employer provides coverage for children and your children meet the eligibility requirements for both plans, you and your spouse will need to decide as to which plan(s) to enroll in. We recommend comparing the key features of both plans, to help with your decision. 27. My spouse s employer holds open enrollment at a different time of the year. What should we do? The Archdiocese of St. Louis Open Enrollment may be a qualifying life event for your spouse to enroll in his/her employer s health insurance plan. Your spouse should ask his/her employer s HR/Benefits representative if he/she can enroll due to the Archdiocesan Open Enrollment or due to this significant cost change, effective July 1, You may contact the Archdiocese Office of Human Resources by calling or ing benefits@archstl.org for assistance. 28. What happens if my working spouse s group medical coverage is terminated because he/she loses their job? Does my spouse have to elect and exhaust COBRA/Continuation of Coverage before being eligible for enrollment in the Archdiocesan health plan? A spouse is not required to elect COBRA/Continuation of Coverage. If a spouse loses other coverage due to losing his/her job, that qualifies as a life event, and the spouse can be enrolled in the Archdiocesan plan. To enroll and be exempt from the surcharge the employee must submit the Employee Health Insurance Enrollment/Change Form along with the Spousal Surcharge Exemption Form to his/her employer benefits administrator within 31 days of the spouse losing coverage. 29. Does my spouse s Medicare coverage have any bearing on the Spousal Surcharge? No, Medicare eligibility or coverage is neither a reason for a spousal surcharge exemption nor a cause for the surcharge fee. Medicare has no bearing on the Spousal Surcharge Policy. 30. If I am in the Archdiocesan Early Retiree Plan or the Continuation of Coverage Plan, am I subject to the Spousal Surcharge? A Spousal Surcharge Exemption Form is not required. You are exempt from the spousal surcharge since you pay the full premium. Questions? Contact the benefits administrator at your parish/school/agency or the Archdiocese Office of Human Resources: benefits@archstl.org Phone: You can access the Spousal Surcharge Exemption Form on the Archdiocese website at 14

15 MONTHLY COST FOR HEALTH INSURANCE COVERAGE The table below shows your cost and the Archdiocese s cost for your health care coverage, which includes medical, prescription drug and dental coverage: Full-Time Employee: HEALTH INSURANCE PREMIUMS FOR FULL-TIME EMPLOYEES AND EDUCATORS Medical Plan Employee Only Employee + One Dependent Employee + Family UnitedHealthcare (UHC) Standard Plan Employee Contributions Employer Contributions Total Monthly Premium $ (15%) $ (85%) $ $ (25%) $ (75%) $1, $ (25%) $1, (75%) $1, UnitedHealthcare (UHC) Premier Plan Employee Contributions Employer Contributions Total Monthly Premium $ (15%) $ (85%) $ $ (25%) $1, (75%) $1, $ (25%) $1, (75%) $1, Part-Time Employee: HEALTH INSURANCE PREMIUMS FOR PART-TIME EMPLOYEES AND EDUCATORS Medical Plan Employee Only Employee + One Dependent Employee + Family UnitedHealthcare (UHC) Standard Plan Employee Contributions Employer Contributions Total Monthly Premium $ (40%) $ (60%) $ $ (50%) $ (50%) $1, $ (50%) $ (50%) $1, UnitedHealthcare (UHC) Premier Plan Employee Contributions Employer Contributions Total Monthly Premium $ (40%) $ (60%) $ $ (50%) $ (50%) $1, $ (50%) $ (50%) $1, Spousal Surcharge: Employee Only Employee + One Dependent Employee + Family N/A $ $ The $125 monthly surcharge is an additional employee health insurance contribution payroll deduction, if he/she covers a spouse who is eligible for employer-subsidized medical coverage. If an employee is eligible for an exemption and submits a timely Spousal Surcharge Exemption Form, the employee does not pay the monthly surcharge. You can access the Spousal Surcharge Exemption Form on the Archdiocese website at 15

16 MEDICAL COVERAGE STAY HEALTHY WITH MEDICAL COVERAGE Your health and the health of your family are of great importance to your well being. That s why the Archdiocese of St. Louis offers you two UnitedHealthcare (UHC) medical plan choices designed to help you get the care you need. You can choose from the Standard Plan, which has lower premiums but a much higher deductible and slightly higher copayments, and the Premier Plan, which offers increased coverage at a higher premium cost to you. If you enroll in one of the UHC Plans for the first time, you will receive a new ID card by the end of June at your home address. Comparison of the UHC Standard and Premier Plans For an at-a-glance comparison of the Standard and Premier plans, please see the table below: PLAN FEATURES UNITEDHEALTHCARE (UHC) CHOICE PLUS MEDICAL PLAN Group # UHC STANDARD PLAN UHC PREMIER PLAN In-Network Out-of-Network In-Network Out-of-Network Calendar Year Deductible (Individual/Family) Copayments do not apply to the deductible $1,000/$2,000 $1,000 per Covered Person per calendar year, not to exceed $2,000 for all Covered Persons in a family $2,000/$4,000 $2,000 per Covered Person per calendar year, not to exceed $4,000 for all Covered Persons in a family $400/$800 $400 per Covered Person per calendar year, not to exceed $800 for all Covered Persons in a family $600/$1,200 $600 per Covered Person per calendar year, not to exceed $1,200 for all Covered Persons in a family Out-of-Pocket Maximum (Individual/Family) Copayments, Coinsurance and Deductible accumulate toward the Out-of-Pocket Maximum $4,000/$8,000 $4,000 per Covered Person, per calendar year, not to exceed $8,000 for all Covered Persons in a family $8,000/$16,000 $8,000 per Covered Person per calendar year, not to exceed $16,000 for all Covered Persons in a family $1,650/$3,300 $1,650 per Covered Person, per calendar year, not to exceed $3,300 for all Covered Persons in a family $2,100/$4,200 $2,100 per Covered Person, per calendar year, not to exceed $4,200 for all Covered Persons in a family Office Visits $30 copay 40% $20 copay 40% Mental Health and Substance Abuse - Outpatient $30 copay 40% $20 copay 40% For a more detailed summary of the plans, including limitations and exclusions, please read the Summary of Benefits. For all UHC forms, information and the drug formulary, you can access the information on our Web site at archstl.org/hrbenefits. 16

17 MEDICAL COVERAGE AND MAMMOGRAM SCREENINGS How to Find a UHC Physician If you are not yet a UHC member, follow these steps to find a physician, specialist or hospital: 1. Go to 2. Click on Find a Doctor, then click on Find a Physician, Hospital or Health Care Facility located on the right hand side of the screen. Then click on All UnitedHealthcare Plans and then select Choice Plus. You can Search by People to find doctors and other professionals by specialty. 3. Continue to follow the prompts to access the information or doctors you are most interested in searching. Please call UHC customer service at , if you need assistance. You may also ask your doctor/hospital if they are innetwork with UnitedHealthcare Choice Plus. MERCY MAMMOGRAPHY SCREENINGS A mammography van is scheduled to be in the Cardinal Rigali Center parking lot located at 20 Archbishop May Drive, Shrewsbury, MO on Wednesday, June 7, 2017 and Thursday, June 29, 2017 from 9:00 a.m. to 4:30 p.m. To make an appointment, call Mercy Mammography at Regardless if you or your spouse is enrolled in the Archdiocesan health insurance plan, you or your spouse may receive an Archdiocesan paid mammogram. Just bring your medical ID card with you to your appointment, or inform the technician that you are uninsured with the Archdiocese. The Archdiocese of St. Louis will pay the cost for your screening if your insurance does not cover it. Call for Appointment You must contact Mercy Mammography to schedule an appointment. There is limited availability, so call this phone number as soon as possible: The decision of what age to begin screening and the frequency used should be made in consultation with your personal physician. 17

18 UNITEDHEALTHCARE WELLNESS PROGRAMS REAL APPEAL PROGRAM YOU AND YOUR LOVED ONES CAN LOSE WEIGHT AND GET HELP TO KEEP IT OFF UnitedHealthcare (UHC) is offering participants and, if applicable, their covered spouse and/or dependents* (over 18 years of age) a healthy weight management program through Real Appeal. Real Appeal uses the secrets to weight loss that may help people lose weight through experts in weight management behavior change. They have proven experience in helping people develop simple weight loss plans that actually work. All Real Appeal claim costs are paid at 100% by the Archdiocesan Employee Benefit Plan with no copay, coinsurance or deductible. To learn more about the Real Appeal Program, go to RealAppeal.com/success or contact a UHC representative at Who can participate? As a UnitedHealthcare participant, you, your covered spouse, and/or your covered dependent child(ren) (from ages 18-26) can participate. *Real Appeal is available to employees, spouses and dependents 18 and older enrolled in our UnitedHealthcare insurance and who have a body mass index (BMI) of 23 or higher. How is Real Appeal different from other weight management programs? Real Appeal uses a highly interactive weekly internet show, with videos and live online coaching to help you make small behavior changes week by week. These tools may help you lose weight and achieve your long team health goals. Using weight-loss research studies, Real Appeal has designed a program to support you through every stage of weight management. Whether you need to lose a lot of weight, are moderately overweight or simply need to lose those extra 10 pounds, this program may work for you. Expert coaching One-on-one coaching with a weight-loss expert Weekly group coaching and live online discussion Personalized support Tools to help support your success based on your needs: Nutrition guides, meal plans, recipes, shopping lists and tips for dining out Video workouts and fitness guides Educational videos Educational videos featuring popular celebrities and experts (recommended operating systems Windows 7, 8, 8.1) Tools and tracking Hands-on tools to help meet your needs Online support tools, including educational website and digital resources Online or mobile tracking tools to help you track your diet and exercise Get started towards a healthier family and a happier you! Enroll in Real Appeal at: 18

19 UNITEDHEALTHCARE WELLNESS PROGRAMS VIRTUAL VISITS Access to a doctor s care online at any time The Archdiocesan Health Insurance plan through UnitedHealthcare is providing participants a virtual doctor visit. When you don t feel well, or your child is sick, the last thing you want to do is leave the comfort of home to sit in a waiting room. Now, you don t have to. A virtual visit lets you see and talk to a doctor from the comfort of your home or office without an appointment. Have a sunburn? Try a Virtual Visit. Have a child catch something at school? Try a Virtual Visit. Have the flu? Try a Virtual Visit. Seasonal allergies bothering you? Try a Virtual Visit. The virtual visit is part of your health benefits administered by UnitedHealthcare. You can expect to pay a portion of the costs according to your medical plan. Your costs may be lower than an in-person appointment with your doctor. All virtual visits will appear in your claim summaries, the same as any other medical claim. Your member cost share amount will vary depending on whether you are in the UHC Standard or Premier Plan. Applicable copays must be paid by you at the time of the virtual visit and will apply toward your deductible and out-ofpocket maximum. You can use a credit or debit card to pay. You can access more information by clicking on the Virtual Visit Frequently Asked Questions. Access virtual visits Login to UnitedHealthcare s website at myuhc.com. Click on the Physician & Facilities tab at the top of the page. There you will find information where you can learn more about virtual visits, and access direct links to provider sites where you can register and receive care. During your visit you will be able to talk to a doctor about your non-emergency health concerns, symptoms and treatment options for conditions including: Bronchitis, Cold/flu, Fever, Pink eye, Rash, Sinus problems, Sore throat, Stomach ache, and more. Per the Archdiocesan employee handbook s Christian Witness Statement, the Archdiocese directs that employee s use of UnitedHealthcare s Virtual Visit and the UnitedHealthcare s secular website at to be in compliance with Catholic Church teaching. 19

20 NATURAL FAMILY PLANNING TEST YOUR NFP IQ When you have the Archdiocese of St. Louis health insurance with United Healthcare, you can learn one of the four methods of Natural Family Planning at 100% coverage! There is no cost to you! There is no co-pay for NFP follow-ups! Does NFP really work? Yes. Modern methods of NFP have effectiveness rates as high as 99.5%. Is NFP morally acceptable? Yes. NFP is in complete compliance with moral teachings of the Catholic Church. Is NFP safe? Yes. NFP is 100% natural and organic. NFP works with a women s body to determine when she is or is not fertile. No harmful chemicals or toxins and no harmful side effects. Is there only one type of NFP? No. There are several methods of NFP taught in the St. Louis area: The Billings Ovulation Method (AWARE) Marquette Method Creighton Model Fertility Care System (CrM FCS) The Sympto-thermal Method (CCL) Are there health benefits to NFP? Yes. The NFP chart also serves as the woman s health record. Doctors who are specially trained in NFP use the information on the chart to help diagnose and treat a variety of woman s health problems such as Endometriosis, premenstrual syndrome, and infertility! Success rates with the treatment of infertility can be higher than in vitro fertilization! WHAT IS NATURAL FAMILY PLANNING (NFP)? Natural Family Planning (NFP) is a system of understanding a couple s combined fertility through observation of natural changes in the woman s body. Couples may then use this information to achieve or avoid pregnancy naturally, without using drugs, surgery or devices. Couples use this method together, creating good communication between them, which promotes a stronger, healthier relationship. This is not the old rhythm method. NOT EVEN CLOSE! Looking for more information on NFP? Archdiocese of St. Louis Office of Natural Family Planning Follow Subscribe to our Newsletter: bit.ly/stlnfpnewsletter

21 DENTAL COVERAGE ENHANCE YOUR SMILE WITH DENTAL COVERAGE Good health includes healthy teeth and gums. Our dental plan, provided through Delta Dental of Missouri, is designed to help you maintain a healthy smile through regular preventive dental care, and to fix any problems as soon as they occur. You are automatically provided with dental coverage, if you are enrolled in the UHC Standard or Premier medical plan through the Archdiocese of St. Louis. Dental only coverage, without the medical plan, is not available. Dental Benefits with Delta Dental of Missouri The Archdiocese has two networks, the Delta Dental Premier network and the Delta Dental PPO network. If you choose to see a Delta Dental PPO dentist, you will save money and stretch your benefits. The Delta Dental PPO network gives you 10% more benefits for Basic and Major services. You and your eligible dependents have the freedom to choose any dentist. Benefits will be based upon your provider and services. You do not enroll in the PPO Network or Premier Network. For example, you may be a patient of a PPO network provider and your dependent may be a patient of a Premier network provider. You are able to change a dentist at any time. To determine if your dentist participates in the Delta Dental PPO or Premier Network: Visit the Delta Dental Web site at and click on Find a Provider and then Find a Dentist on the home page and then click on Delta Dental Premier or the Delta Dental PPO. Complete the fields requested. Call Delta Dental s customer service at: or call your dentist s office to see if they are participating in Delta Dental s PPO or Premier Network. You will receive a Delta Dental ID card at your home address, only if you enroll in the health insurance as a new enrollee or add dependents, effective July 1, When you receive dental care from a Delta Dental participating dentist, simply present your card and the dentist s office will file the claim for you. FEATURES DELTA DENTAL PLAN PPO NETWORK PREMIER NETWORK AND NON-NETWORK A: Preventive Services 100% 100% B: Basic Routine & Restorative Services 90% 80% C: Major Services 60% 50% D: Orthodontics for children up to age 19 50% 50% Annual Deductible (does not apply to A or D benefits) $50 individual/$100 family Maximum Benefit per Year (excluding Ortho) $1,500 individual/$3,000 family Ortho Lifetime Maximum (per dependent child) $1,500 For a more detailed dental benefit summary, read the Delta Dental Benefits Summary on the Archdiocesan benefits Web site at archstl.org/openenrollment2017. Select For the Benefit Plan information and click on the Delta Dental Summary of Benefits. 21

22 FLEXIBLE SPENDING ACCOUNTS LOWER YOUR TAXES WITH THE FLEXIBLE SPENDING ACCOUNTS What is a Flexible Spending Account? Flexible Spending Accounts (FSAs) are a tax-saving way to pay health care and dependent care expenses that you would typically pay out-of-pocket. The FSA can also be a budgeting tool to set money aside for upcoming medical or dependent care expenses. Expenses such as deductibles and copays can quickly add up; and dependent day care or elder care expenses can be even more expensive. The FSAs let you pay these expenses with pre-tax dollars. This means that the money you set aside is not taxed, so you save money. What do I need to do to participate in the FSA? Each year that you would like to participate in the FSAs, you must elect the amount you want to contribute to either or both of the FSAs. Your contributions will be deducted from your paychecks in equal installments throughout the year and deposited into your account(s). You may contribute up to $2,600 to the FSA Medical Reimbursement Account. The FSA Dependent Care Account allows up to $5,000 ($2,500 if you are married and file your taxes separately). Both Carefully Estimate Your Costs For the FSA Medical Reimbursement Account, you have until September 15, 2018 to incur claims for the July 1, 2017 through June 30, 2018 plan year, and you will have until December 15, 2018 to file those claims. For the FSA Dependent Care Account, you will have until September 30, 2018 to file claims for dependent care expenses incurred between July 1, 2017 and June 30, accounts function separately. When you have eligible expenses, you submit a claim for reimbursement from your FSAs. You can access all FSA plan information on our Web site: archstl.org/hrpp/page/flexible-spending-accounts. What are FSA Eligible Expenses? Eligible expenses for the FSA Medical Reimbursement Account include medical, dental, and vision expenses not covered under your health care plans. The FSA Dependent Care Account is not for medical claim expenses for your dependent spouse or child(ren). Eligible dependent care expenses for the FSA Dependent Care Account are those that allow you and your spouse (if you are married) to work or attend school full time. These services generally include day care, babysitters, most day camps, and caregivers for disabled dependents. You can submit claims for reimbursement via paper claim form or on their Tristar FSA website at If you do not have the Tristar User Name and Password, contact Tristar directly at Paper reimbursement claim forms are available on archstl.org/hr/page/forms. What are the rules of the FSA Plan? FSAs may offer tax advantages. The trade-off is that these accounts are subject to strict IRS regulations, including the following: The IRS has a strict use it or lose it rule : If you do not use the full amount in your FSAs by the end of the plan year, including the grace period, you will lose any remaining funds. Once you enroll in the FSAs, you cannot change your contribution amount during the year unless you experience a qualifying event. You cannot transfer funds from one FSA to another. To simplify the online process, insert your pledge amount in the annual box. The system calculates it per pay period for you. If you are unable to estimate your health care and dependent care costs accurately, it is better to be conservative and underestimate rather than overestimate your expenses. 22

23 EMPLOYEE WELLNESS INCENTIVE PROGRAM Maintaining or improving your health with regular preventive care, along with following the advice of your doctor, can help you stay healthy. Routine checkups and screenings can help you avoid serious health problems, allowing you and your doctor to work as a team to manage your overall health, and help you reach your personal health and wellness goals. It is to the benefit of all when an employee identifies health risk factors early and takes steps to minimize those health risks. We encourage you to develop a physician and patient relationship to enhance the quality of your life. DO YOU WANT TO TAKE CARE OF YOUR HEALTH AND RECEIVE AN EXTRA $ IN YOUR RETIREMENT PLAN? Plan Year Beginning July 1, 2017 Benefit eligible employees, with at least one year of service and either working a minimum of 1,000 hours annually or a teacher with a half-time or more contract, may annually complete one of the following in order to receive an Archdiocesan paid, $ contribution to their Archdiocese of St. Louis sponsored 403(b) retirement plan: A. Receive an annual wellness exam with your physician of choice between May 1, 2017 and April 30, 2018 and submit the employee wellness form to H&H Health Associates. The deadline for H&H to receive the wellness form is May 7, OR B. Participate in the Archdiocesan paid, confidential H&H Health Associates health screening between May 1, 2017 and April 30, Important Notes: Participation in the health insurance plan is not a requirement to be eligible to receive the $250 retirement contribution. If you were hired on or before May 1, 2017, and have been working either a minimum of 1,000 hours annually or are a teacher with a half-time or more contract, you have fulfilled the one year of service requirement. Religious sisters, brothers, and priests are not eligible to receive the $250 retirement plan contribution; however, they are eligible for an annual Archdiocesan paid H&H health screening. If you receive an H&H health screening, you do not need to submit the employee wellness form. The $250 retirement plan contribution will be processed on or near June 30, 2018, if you met the above criteria. 23

24 EMPLOYEE WELLNESS INCENTIVE PROGRAM H&H HEALTH ASSOCIATES WELLNESS SCREENINGS The H&H wellness screening involves a venipuncture blood draw (takes about 3-4 minutes total) to scientifically determine one s current health status. The wellness survey is a brief, confidential questionnaire that focuses on lifestyle habits, employee benefits, & general health interests. If you want to participate in an H&H wellness screening, you have two options to make your appointment. You can call H&H directly (M-F, 8:30am-5pm CST) at or register on the H&H Health website. H&H Health Associates Instructions For On-line Registration for an Archdiocese Wellness Screening (September 2017 and March 2018) Simply click on the following link to register. First Time Web Users: Enter Company Code: ARCHDIOCESE to set up your user profile. Once submitted, you will receive an to validate your account. Click on the link within the to activate the account, then log in & choose how you would like to participate. Existing Users: Enter your username ( address) & password. If you forgot your password, simply use the Forgot Password feature to reset it. Then choose to participate at the Archdiocesan Wellness Screening by selecting an appointment time, or choose to participate at an approved clinic (1,600+ nationally). ON-SITE WELLNESS SCREENING PARTICIPANTS: Arrive 5 minutes prior to your appointment. Turn in your completed consent form (& wellness survey, if not already completed on-line) to the on-site examiner at the H&H health screening event. WALK-IN CLINIC PARTICIPANTS: At the time of registration, complete your on-line wellness survey. Take the lab paperwork (received via ) along with a photo ID to the approved clinic. No co-pay or insurance info needed for the blood draw. At the time of registration, complete your on-line wellness survey. If you experience any problems with your on-line registration (Google Chrome is the recommended web browser), or if you prefer to register by phone, please contact H&H Health Associates (M-F, 8:30am-5pm CST) at /

25 EMPLOYEE WELLNESS INCENTIVE FREQUENTLY ASKED QUESTIONS The $250 Retirement Plan Wellness Incentive How do I know if I am an eligible employee for the Wellness Incentive? A benefit eligible employee with at least one year of service, working at least 1,000 hours annually or a teacher with a half-time or more contract, can participate in the Wellness Incentive Program to receive a $250 wellness contribution into his/her Archdiocese of St. Louis sponsored 403(b) employer retirement account. If you were hired on or before May 1, 2017, and have been working either a minimum of 1,000 hours annually or are a teacher with a half-time or more contract, you have fulfilled the one year of service requirement. An eligible employee is not required to be a participant in the Archdiocesan Health Insurance Plan. If an employee has less than one year of service, the employee can still receive an Archdiocesan-paid H&H Health Associate health screening. What is the date range I need to have the wellness exam/screening for the plan year, if I want to receive the $250 retirement plan contribution on or near June 30, 2018? Between May 1, 2017 and April 30, If I complete a wellness exam/screening, how will I receive the $250 retirement plan contribution? $250 will automatically be deposited in your Archdiocese of St. Louis sponsored 403(b) employer retirement account. The contribution is in addition to your normal monthly employer percentage contribution amount. How will the $250 contribution be invested? If you have designated an investment allocation, then the contribution will be invested according to your designated investment election. If you do not have a designated investment allocation, then the contribution will be invested in the default fund. You can adjust your investment funds at any time. If I complete a wellness exam/screening on time, when will I receive the $250 retirement plan contribution? On or near June 30, If I participate in both the voluntary and employer retirement account, can I designate which account to deposit the $250? No. The wellness incentive contribution will be deposited as an employer retirement account contributions. Can I get the $250 contribution in cash instead of being deposited in the lay employer retirement account? No. The incentive can only be received as a contribution to your Archdiocese of St. Louis sponsored 403(b) employer retirement account. Can I opt out of receiving the $250 contribution? No. Will a vesting schedule apply to the $250 contribution? No. As with all contributions to the 403(b) retirement plan, the contribution will be 100% vested immediately. If I terminate my employment and have completed the wellness program, will I still receive the $250 retirement contribution? No. The wellness contribution is for active employees. 25

26 EMPLOYEE WELLNESS INCENTIVE FREQUENTLY ASKED QUESTIONS The Health Insurance Plan Can I get the H&H Health Associates wellness screening if I am not in the UnitedHealthcare (UHC) Premier or Standard Plan? Yes. The benefit of the screening is for all benefit eligible employees (not spouse or dependents), even with less than one year of service. Other related questions regarding the Wellness Screening/Exam Can I get the wellness screening any time during the year or just in September and March? For your convenience, you can get the screening anytime between May 1, 2017 and April 30th, The screening must be scheduled through H&H Health Associates ( ). You will be directed to an H&H approved lab close to your home or work. The Archdiocese will sponsor onsite H&H Health screenings at multiple locations during the months of September 2017 and March How can I register for the H&H wellness screening? Simply click on the following link to register or call H&H Health Associates at Refer to page 24 for further website instructions. Will my health results of my exam/screening be sent to the Archdiocese or my employer? No. Individual health data will not be shared with your employer, the Archdiocese, our insurance provider, or any other entity. The alternative health screening is being conducted by H&H Health Associates or an H&H approved lab and will be managed in a completely confidential, HIPAA compliant manner. If you choose to have a wellness exam with your physician, only the Employee Wellness Form will be submitted to H&H Health Associates. If I receive a serious diagnosis, will you terminate my health insurance plan? No. Your health insurance continues, and we have no knowledge of any diagnosis. We only want to encourage you to be engaged in good health practices. Does the physician who conducts my wellness exam have to be my primary care physician? No. Any physician you choose, who meets the definition of a physician under the UHC health plan, can conduct your wellness exam. Does the annual wellness exam at my physician s office require an employee copayment or coinsurance? Maybe. The UHC plan generally covers preventive services, as specified in the health care reform law, at 100% without charging a copayment, coinsurance or deductible, as long as they are received in the UHC health plan s network. UHC covers other routine services, which may require a copayment, coinsurance or deductible. Always refer to your plan documents for your specific coverage. Medical treatment for specific health issues or conditions, ongoing care, laboratory tests or other health screenings necessary to manage or treat an already-identified medical issue or health condition are considered diagnostic care, not preventive care. If I do not complete the wellness exam/screening for the 2018 plan year, do I need to do anything? No. If I get the H&H Health Associates wellness screening, do I need to complete the Employee Wellness Form? No. H&H Health Associates will have a record that you had a wellness screening. H&H Health Associates will inform the Archdiocese Employee Benefit Plan that a screening was completed within the appropriate time period. 26

27 EMPLOYEE WELLNESS INCENTIVE FREQUENTLY ASKED QUESTIONS Can my spouse/child participate in the employer paid H&H wellness screening? No. The H&H screening only applies to you, the employee; however, when your spouse/child sees the physician for a wellness exam, the UHC plan typically covers preventive services. The wellness exam/screening only applies to benefit eligible employees. If I fail to have a wellness exam/screening prior to April 30, 2018, can I ask for extra time to get the exam? No. You had a full year notice, from May 1, 2017 to April 30, 2018 to complete the wellness choice. Extra time allowances will not be offered due to administrative requirements. May I receive both an annual wellness exam from a physician and a health screening from H&H Health Associates? Yes. You may receive both an annual wellness exam and health screening. Should I get an H&H screening in lieu of an annual wellness exam by a physician? While the H&H screening is a good wellness tool, it does not replace the importance of a comprehensive wellness exam, including lab work, by a physician on a regular and long term basis. We encourage you to develop a physician/ patient relationship to enhance your quality of life. Your decision on receiving a screening in lieu of a comprehensive physician wellness exam is your prerogative. IMPORTANT: This guide s Frequently Asked Questions and Description is intended to give you an overview of the Employee Wellness Program options offered by the Archdiocese of St. Louis. Any of the benefit plans offered by the Archdiocese of St. Louis may be amended, revoked, suspended or terminated at the Archdiocese s sole discretion at any time. 27

28 HOW TO ENROLL OPEN ENROLLMENT REVIEW Please use the following checklist to ensure that you take all the necessary steps to enroll for coverage effective July 1, Please note: You must go online to make your elections during the annual Open Enrollment period, which begins on May 1, 2017 and ends on May 15, STEPS q 1. Review your coverage options and your benefit needs. q 2. If you have decided to enroll or waive the health insurance plan, please review this box for your benefit decisions. q 3. Taxes q 4. If you want to enroll in the FSA plan, please review this box for benefits decisions. q 5. Go online to implement your enrollment(s). ACTION Read this Benefit Guide and review your coverage options. Consider your Health Insurance and Flexible Spending Account (FSA) needs. If necessary, obtain additional information on the benefit plan details at the Archdiocesan Benefits Web site at Action Items for 2017 Plan Year: If you choose to participate, you must enroll online for the health insurance plan and/or the FSA accounts for the plan year If you are not currently covered by the Archdiocesan health insurance plan and do not want coverage, you must complete the Employee Health Insurance Waiver Form and submit it to your employer s benefits administrator. If you want to include your spouse as a dependent on your health insurance plan and have determined you are exempt from the spousal surcharge, complete the online Spousal Surcharge Exemption Form and click submit prior to May 15, For the online Exemption Form go to: Understand that your Health Insurance Plan and Flexible Spending Account elections made between May 1 and May 15, 2017 will not be eligible for a change effective from July 1, 2017 through June 30, 2018, unless you have a qualifying event or you made an after-tax election. Health Insurance Plans You may choose one of the following: q UnitedHealthcare Choice Plus Standard Plan q UnitedHealthcare Choice Plus Premier Plan OR q Waive Coverage Taxes Pre-Tax or After-Tax Option for Employee Contributions for Health Insurance If you choose to enroll in the health insurance plan, you would be automatically enrolled in the Pre-tax plan. If you want to change to After-tax, you will need to go online to make the change. A spousal surcharge will be deducted on a pre-tax basis unless you elect an after-tax election for your health insurance premium. Flexible Spending Accounts (FSAs) You may choose one or both of the following: q FSA Medical Reimbursement Account and Online Pledge Amount q FSA Dependent Care Account and Online Pledge Amount With your User Name from your cover letter, go online to Employee Self-Service at archstl.org/openenrollment2017 to make your benefit elections for the annual Open Enrollment period no later than May 15,

29 HOW TO ENROLL Go to archstl.org/openenrollment2017 between May 1 and May 15, and follow the online instructions, which are summarized below. If you have any questions during enrollment, please call or benefits@archstl.org. GETTING STARTED screen to come The next few pages will illustrate a series of computer screen prints to assist you with the process of online Open Enrollment. Please note that we included only a few screen prints due to the space limitations. You can use a few internet browsers: Chrome, Internet Explorer, and Firefox. Not Safari, Microsoft Edge, or mobile devices. When using a Mac computer, use Firefox, not Safari. To start go to archstl. org/openenrollment2017, with your User Name and Password in hand, click on the green button, Employee Self-Service. If you are an employee who is currently using Employee Self-Service for reviewing your paycheck, you would use the same personal User Name and Password to access Employee Self-Service for Open Enrollment. Don t have a User Name or forgot your User Name? If you don t already have a User Name for Employee Self- Service, complete the Employee User Name Form and send the completed form via fax to the Office of Human Resources at If you do not already have an Employee User Name Form, you may find a copy of the form on the Archdiocesan website at If you already have a User Name for Employee Self Service, look on your Open Enrollment Cover Letter at the top right hand corner across from your name and address. This is your User Name (e.g., ss654321). It is not your name or your Social Security Number (SSN). Contact the Office of Human Resources at if you have any User Name problems. Don t have a password or forgot your Password? Click on Password Assistance button, then click on Reset Password. It will ask for your Domain User Name. Enter your ss User Name, click Continue and answer the security questions and other steps to create a new password. Once you have your User Name and Password, click on the green button for Employee Self-Service. You will see the Login screen on the next page. Since the software for Employee Self-Service has been upgraded and/ or you are using a Windows 10 based computer, screens may differ from the following online screen examples. 29

30 HOW TO ENROLL STEP 1: Enter Your Employee Self-Service User Name and Password and click Login. Your User Name will start with ss followed by your special number not your Social Security number. If you get a message that ONLY the Secure Content is displayed, it is safe to proceed; click on the appropriate answer to deliver ALL content (generally Show All Content or the NO button). This will continue to the website for your enrollment. If you are still uncomfortable, call the Office of Human Resources at or benefits@archstl.org for additional help. For Login problems, please read the following Frequently Asked Questions pages. Your User Name looks like, ss654321, and you may need to use the PASSWORD ASSISTANCE tool to reset your password. Windows 10 Users: Please see the following Frequently Asked Questions pages for further instructions. For MAC computers, use Firefox instead of Safari. Safari will not work for the enrollment process. 30

31 HOW TO ENROLL STEP 2: To access your Employee Self Service Open Enrollment window, click on the Bookmarks link to navigate. Hover over Employee Self-Service, then Benefits to see the drop down menu boxes. Dependent Information: You should add, if applicable, by clicking the Dependents box. This is an important initial step. This section does not automatically enroll a dependent in any of the benefits! STEP 3: Click on Benefits Open Enrollment. You will see the Welcome screen. Click Continue and you will see your Current Benefits as of April Your current benefits and costs are based on employment status and previous elections. Click Continue to proceed. 31

32 HOW TO ENROLL STEP 4: The process will continue to guide you through a series of screens for each benefit plan for Open Enrollment. For each benefit plan, you will see an overview of your current benefit. You will be able to determine your benefits for July 1, If you currently are not in a benefit plan, you will see DECLINED plan selected. If you want to enroll, click on Select a Different Plan. Select the correct option for the action you want to take such as Change The Coverage. Since the vast majority of employees are in the Pre-tax plan, the Pre-tax election is the pre-filled automatic default. If you prefer the after-tax election, please select the circle for After-tax. Click Continue. If you currently are not participating in a benefit plan, you will see the DECLINED plan selected. If you want to enroll, click on Select a Different Plan. Regardless if you cover a spouse or not, you will be required to walk through the Health Spousal Fee plan. Click on the appropriate spousal surcharge coverage; then click Continue. You may enroll in one or both of the Flexible Spending Plans. In order to properly calculate the per pay period pledge amount, insert your total pledge amount in the per Year field box. Do not insert a dollar sign. 32

33 HOW TO ENROLL STEP 5: Be sure to go through the entire enrollment process to record your choices for the new plan year beginning July 1, You may click Save to complete the process in order to implement your enrollment information. Click Make Changes to revise these elections, or click Exit to discard your latest changes and return to the site at another time. You do not complete the process if you don t see the Congratulations screen, then your elections will not be implemented effective July 1, Print your elections for your records. You can return to the enrollment site at any time during the Open Enrollment period to make changes to your elections. Upon the approval of your parish/ office/agency benefits administrator, you will receive a benefits confirmation letter detailing your benefit elections, effective July 1, 2017, in mid-june from the Archdiocesan Office of Human Resources. STEP 6: After clicking Save to save your choices, you must see a Congratulations screen which will let you know you completed the process successfully. You are finished! If you did not see the Congratulations screen, your entries did not take. In order to Sign Out, click your user name/ss# at the top right corner of your screen. You will get a drop down menu, where you click on Sign Out. If you did not see the Congratulations screen, your enrollment will not be implemented on July 1, 2017! 33

34 OPEN ENROLLMENT FREQUENTLY ASKED QUESTIONS Online Enrollment How do I get into the system? Use archstl.org/openenrollment2017 to access the Web site and click on Employee Self-Service. I have Windows 10 with Microsoft Edge and I am having difficulties. How do I proceed? Open your Microsoft Edge browser. Click on the tab in the upper right corner with the little dots. It will give you a drop down message that says Open With Internet Explorer. Click that choice. If you get a white screen with a display at the bottom about Only Secure Content, click on Show All Content. Now you can proceed to the Employee Self- Service website. What is my User Name? Your User Name starts with the ss letters followed by a series of numbers. This is not your Social Security number. If you are a current participant in the health insurance plan, your User Name is printed on the Open Enrollment cover letter dated April If you have misplaced your User Name, please contact your Benefits Administrator or the Office of Human Resources at or benefits@archstl.org. What is my Password? I have my User Name but I do not have my Password. We have a password reset tool that will assist you. To use this tool, click on the link to PASSWORD ASSISTANCE. Click on Reset Password. After resetting your password, you should enter the requested information that can be referenced in the future. When I enter my User Name and Password, the boxes turn yellow. Nothing happens. What do I do? Either your User Name or Password is incorrect. Try entering them again. The password is case sensitive. I enter my User Name and Password, and my computer locks up. What do I do? You might be using a Web browser or a computer that is not compatible with the Self-Service system. Do not use mobile devices, Safari, Mozilla, Opera, or Netscape. Use Internet Explorer, not Microsoft Edge, on a PC computer. On a MAC computer, use Firefox only, not Safari. How do I add a dependent to my health insurance coverage? Before adding a dependent to the health insurance plan, the Employee Self-Service system needs to know your dependent s information. Click on Dependents on the left side of the screen. Click the Add Dependent button at the bottom. Complete the fields and click ADD. Repeat as needed if you have a spouse and/or more than one dependent child. This ADD button does not enroll your dependents in either of the health insurance plans. You will need to proceed to the Benefits Open Enrollment link to enroll dependents in the health insurance plan. My screen is giving me a message about an invalid script. How do I proceed? The Self-Service enrollment process works only with Chrome, Internet Explorer, and Firefox. If using a MAC computer, use Firefox only, not the Safari browser. 34

35 OPEN ENROLLMENT FREQUENTLY ASKED QUESTIONS I received a security message stating there is a problem with a security certificate for the site. Should I use the site? Yes, the site is safe. Click the appropriate link to continue to the website. My screen is not doing anything after I clicked on Benefits Open Enrollment. What is going on? Please check to be sure your pop-up blocker is turned off. How do I turn off pop-up blocker? On the toolbar of your Internet browser, click on Tools. The drop-down menu should show Pop-Up Blocker. Click on it and set the browser to allow for pop-ups, by turning off pop-up blocker. Each Internet Explorer version is a little different but should be easy to follow. If you have downloaded toolbars from other Web companies such as a Google toolbar, they may include their own pop-up blockers that you will need to turn off. You may also include our site as a valid site for pop-ups rather than turning off the pop-up blocker entirely. I still cannot get the enrollment screen to work when I click on Continue. What else can I do? You may also try holding down the Control key (CTRL) and the Alternate (ALT) key at the same time, while clicking on the Continue button and the various choices through the benefit selection process. While tedious, this should allow you to defeat the pop-up blocker and finish your enrollment. I got a Navigation Canceled message or I only have a White Screen displayed. What is wrong? Try clicking the Refresh icon at the top of Internet Explorer. When you are asked about the Content to View/Display, click on the appropriate answer to deliver ALL content (generally Show All Content or the NO Button). This will continue to the website for your enrollment. If you still have problems, call the Office of Human Resources at