AU MEDICAL CENTER BENEFITS ENROLLMENT GUIDE

Transcription

1 AU MEDICAL CENTER BENEFITS ENROLLMENT GUIDE

2 AU Medical Center has been designated as an American Heart Association Fit-Friendly Worksite and is accredited through the CEO Cancer Gold Standard. We were the first hospital in the C.S.R.A. to receive both designations. The AHA recognizes employers as Fit-Friendly Worksites for creating a culture of wellness in the workplace and providing progressive leadership in employing healthy practices in the workplace. The CEO Roundtable on Cancer has accredited AU Medical Center with the CEO Cancer Gold Standard recognizing the hospital s efforts to reduce cancer risk for employees and covered family members

3 Susan Norton Vice President, Human Resources Welcome to the AU Medical Center s Open Enrollment Guide for the January 1, through December 31, 2017 plan year. Whether you re just starting your career or you ve been with us for years, the information in this guide will help you become a more informed benefits consumer and enhance your understanding of the true value of your total benefits package. Open Enrollment season begins Monday, October 3 and ends Sunday, October 16. We are pleased to continue to offer a very competitive benefits plan, while also introducing the following additions or changes to our plan options for 2017: Group Health Plan - Diabetes Management Program We are excited to introduce a pilot diabetes management program through a partnership with Cerner and Livongo. The first 50 employees to enroll will have access to this program at no cost, including glucometer, annual testing supplies, coaching, education, and monitoring. Health Savings Accounts 2017 will offer an increase in the Employee HSA annual maximum contribution limit of $50. From $3,350 to $3,400. No change to the Family HSA annual maximum. Dental To provide employees with another two year benefit without an increase in premiums, we have updated our out of network reimbursement rate from the 90 th percentile to the 80 th percentile. To reduce your out of pocket costs, it will benefit you to seek services of an in-network dentist. Vision EyeMed members now have access to a hearing care discount from Amplifon Hearing Health Care. Members receive a 40% discount off of hearing exams and a low price guarantee on set, discounted pricing of hearing aids. The Hearing Care Discount is offered to valued clients and enrolled EyeMed members at no additional cost. Please note the hearing care discount is not insurance. We encourage you to read through the enrollment guide carefully to understand your options and responsibilities before making any benefit decisions. Additional information can be found at the Human Resources website at: Sincerely, Susan Norton 3

4 Table of Contents Your benefits. Your way...6 Your Benefits at a Glance...7 Your Coverage Category...8 Your Medical Options...11 Your Dental Options...23 Your Vision Options...24 Your Life and AD&D Insurance Options...25 Your Disability Options...27 Your Voluntary Benefit Options...28 How to Enroll for Your Benefits...32 Your Wellness Benefits...35 Legal Reminders...40 Important Contacts

5 Your benefits. Your way. Your benefits are an important part of your total compensation at AU Medical Center. You have a range of benefit options, including health care, life insurance, disability and financial planning options. We are introducing exciting improvements to your 2017 benefits. Each is outlined on the following pages, and all appear in the 2017 Benefits at a Glance chart on the next page. We offer competitive benefits plans that fit the needs of you and your family. Our commitment is to provide superior benefits unrivaled by our competitors as we become the Employer of Choice. The benefits we are offering in 2017 continue to improve our total benefits package because they: Provide newly redesigned plans, Let you design a benefit plan that fits the needs of you and your family, Give you more control over how you spend Your benefit dollars, Offer affordable comprehensive coverage, and Help both you and AU Medical Center manage health care costs. We re in This Together AU Medical Center does its part by continually reviewing our benefits program to ensure that you have a wide range of choices that meet your diverse needs. We also ensure that the benefits program is affordable for both you and your employer. You have a key role to play as well. You make choices such as living a healthy lifestyle and using the health care resources available to you. These choices affect your health, but they also affect your health care costs. Because AU Medical Center s benefits are self-funded, they affect your co-workers health care costs, too. If you are enrolling in the AU Medical Center-sponsored medical plan, you may think that an insurance company is paying for your health care expenses. But who really pays for your medical care? AU Medical Center and you. Self-Insured Health Plan The AU Medical Center medical plan is not fully insured, but instead it is self-funded. This means that, instead of paying premiums to an insurance carrier who assumes the financial risk of paying for claims, AU Medical Center has set up a plan to pay the health claims of its employees, and AU Medical Center assumes the financial risk. AU Medical Center puts aside funds to cover employee health care costs and pays those claims from the organization s assets and employee contributions. This means that the expense of employees medical claims directly affects the cost of your health coverage. Keeping Costs Down To help keep your and AU Medical Center s costs down, participate in AU Medical Center s wellness and disease management programs to learn healthy behaviors and improve your overall health. Also, seek early treatment for health problems so they don t lead to serious conditions. Not only will you feel better, but you ll also help keep the cost of health care affordable for yourself and your co-workers. 5

6 Your 2017 Benefits at a Glance AU Medical Center PLAN BENEFITS Coverage Levels Choose from four coverage levels for medical, dental & vision Employee Only Employee + Spouse Employee + Child(ren) Family Medical Plan Medical Choice (HDHP) with option to elect HSA; Medical Select Plan (PPO); Medical Base Plan (PPO) Default plan Dental Plans Core Dental plan with $50/$150 annual deductibles; 20% basic/20% - Core Plan periodontics/50% major & orthodontic coinsurances; $1,350 annual - Value Plan maximum benefit Value Dental plan with $50/$150 annual deductibles; 20% basic/50% periodontics/50% major coinsurances; no Orthodontia benefit, and $1,000 annual maximum benefit Vision Plan Vision Value Plan and Vision Elite Plan Life Insurance Choose from a benefit amount of $25,000 or 1,2,3 or 4 times your base annual salary in coverage Disability Short-Term (STD) options 50% employer paid; 60% - employee pays difference Long-Term (LTD) options - 50% employer paid; 60% - employee pays difference Flexible Spending Accounts (FSAs) Health Saving Accounts (HSAs) Annually, you may contribute between $100 and $2,600 of your pretax income to the: Traditional Health Care FSA (or Limited Purpose Health Care FSA if you are enrolling in the Medical Choice Plan) Annually, you may contribute between $100 and $5,000 of your pretax income to the: Dependent Care FSA For 2017, the federal combined employee/employer annual contribution limit is $3,400/individual or $6,750/family. If you are age 55 or older, you may make annual catch-up contributions of up to $1,000. Voluntary Benefits Long Term Care Insurance Retirement Savings Plan 529 College Savings Plan Group Auto Insurance Group Home Insurance Legal Assistance Pet Insurance Accident, Critical Care and Hospitalization Insurance 6

7 Your Coverage Category Before you select your benefits, think carefully about whether you want coverage for your spouse and/or dependent children. Your coverage category options include: Employee Only If you are covering yourself only Employee + Spouse If you are covering yourself and your legally married spouse Employee + Child(ren) If you are covering one or more children Family If you are covering your legally married spouse plus one or more children Eligibility You are eligible for AU Medical Center benefits coverage if you are employed for at least 20 hours per week (at a.5 work commitment) on a regular basis. You may enroll your eligible dependent children for benefits during Open Enrollment October 3 October 16, Children include: Children or step-children up to the age of 26, whether or not they are married, and regardless of whether or not they have access to other employer coverage. Dependent children of any age who are physically or mentally disabled and who depend on you for support, if the disability occurred before age 19; and Children or step-children meeting the age requirements above for whom you have been designated as legal guardian, whether or not they are married. Coverage will be effective on January 1, This eligibility applies to medical, dental, vision and life benefits. Eligible Dependents Not only does AU Medical Center provide you with benefits, but your legal spouse and eligible dependent children may be enrolled in some plans as well. If you are married, and/or if you have dependent children, consider who you want to cover under your AU Medical Center group health benefits. Does your spouse have coverage options through their employer? If so, compare your spouse s plan to the AU Medical Center plan in terms of premiums, deductibles and covered expenses. Enrolling yourself and your spouse and/or children in the AU Medical Center plan may not be the best choice for you in terms of out-of-pocket dollars, but you have options: You can enroll as Employee Only in the AU Medical Center plan, and your spouse and children can enroll in his/her employer s plan. If your spouse remains on our plan an additional $100 per month will be added to your premium. You can enroll as Employee + Child(ren) in the AU Medical Center plan, while your spouse enrolls in his/her employer s plan. You can select No Coverage and your spouse can enroll you (and your children, if applicable) in his/her employer s plan. Note that you will have to provide proof of other health coverage. The choice is yours. 7

8 Open Enrollment: October 3 October 16 You must actively make benefit elections during Open Enrollment. If you do not enroll, you will receive default coverage, which may not suit your needs and for which you will have to pay premiums. Because you will not be able to change your 2017 coverage until the 2018 Open Enrollment period (unless you have a qualifying family status change event), you should carefully consider whether you want default coverage or would like to elect other available options. For details on default coverage, see the How to Enroll for Your Benefits section of this guide. Employees hired during and after the Open Enrollment period will be given detailed instructions from Human Resources about how to enroll for benefits. These details will be provided during the enterprise employee orientation program. Enrolling for Benefits During the Plan Year If you are hired during the plan year or become benefits eligible, you may enroll for coverage within the first 30 days of hire or eligibility. If you do not make benefit elections, you will receive default coverage, which may not suit your needs and for which you may have to pay premiums. You should carefully consider whether you want the default coverage. If you do not want default coverage, you must make your benefit elections during your enrollment period. After your new hire benefits enrollment period has ended, you will not be able to change your coverage until the next Open Enrollment period (unless you have a qualifying family status change event). When Benefits Begin The benefits you select during Open Enrollment will be effective on January 1. If you are a new hire or newly benefits eligible, your health and dental coverage will begin the first of the following month or on your eligibility date; all other benefits begin your date of hire. Note that both Short Term and Long Term Disability benefits are effective after you complete one year and a day of service with AU Medical Center. Changing Your Benefits During the Year During each Open Enrollment period at AU Medical Center, you make benefit choices for the following year. Your benefit elections become effective January 1 and continue through December 31. The Internal Revenue Code strictly limits the circumstances under which you may make election changes outside the Open Enrollment period for most benefit plans. You may make certain election changes for the current year if you have a qualifying family status change event and you contact Benefits, Human Resources within 30 days of the event to establish, change or delete any employee insurance. Your benefit changes must be consistent with your family status change. You also may make changes to current-year elections during special enrollment periods mandated by the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Qualified family status events include: Change in your marital status Birth or adoption of a child Death of a covered dependent Change in employment status for you or your spouse A covered dependent losing eligibility status An unpaid leave of absence Coverage for AU Medical Center Couples 8

9 If both legally married spouses are AU Medical Center employees, they cannot be double covered under AU Medical Center medical, dental, life and vision benefits. Spouses choose either to enroll separately for medical, dental and/or vision coverage, or to have one spouse cover the other as a dependent. Spouses cannot elect Spousal Life coverage. Only one spouse may enroll for Family coverage. Both spouses make their own elections for flexible spending accounts as well as dental, vision, short term disability, long term disability and life insurance coverage. Spouses should make sure they do not contribute too much money to the health savings account and/ or flexible savings accounts. Federal penalties apply if you exceed annual maximums. IRS rules governing health savings accounts and flexible spending accounts can be found in Publication 969 on extension of your Health Benefits Plan coverage under the Consolidated Omnibus Budget Reconciliation Act (COBRA). You will be notified about your continuation rights. This certificate outlines the period for which you were covered under a medical/prescription drug/dental plan with AU Medical Center. Waiving Coverage To decline health care coverage, you must provide proof that you have current health coverage elsewhere. You will be asked to provide the insurance company information, policy number and type of coverage when you are enrolling online during Open Enrollment. If you cannot provide this information, you will not be allowed to waive coverage. Instead, you will be given default coverage, which may not be the best option for you, and for which you must pay. When Coverage Ends Benefits coverage for you and your enrolled family members may continue as long as you are employed by AU Medical Center and meet eligibility requirements. Coverage ends if your employment ends, if you no longer meet eligibility requirements, if the Group Plan ceases, or if you fail to make any required contribution toward the cost of your coverage. In any case, your coverage ends with the period covered by your last contribution. Your dependent child is no longer eligible when he or she reaches age 26. Coverage of an unmarried, handicapped child over age 26 ends if he or she is found to be no longer totally or permanently disabled. Coverage for your spouse ends on the date of divorce or death. Your dependent s coverage under the Plan ends if he or she becomes eligible for coverage under the Plan as an employee. If your coverage ends, you and/or your dependents may be entitled to a temporary 9

10 Your Medical Options AU Medical Center offers three medical plans: Medical Choice Plan A consumer-driven health care plan with/without a Health Savings Account (HSA) Medical Select Plan A Preferred Provider Organization Option (PPO) Medical Base Plan A Preferred Provider Organization Option (PPO)/Default Plan AU Medical Center is both an employer as well as an academic medical center. This allows the group health plan an opportunity to provide some services at a reduced cost to our plan members when the service is performed at our medical center or by a provider that has been deemed a part of our reduced rate program. A plan member who is in need of a service not provided at our medical center or by a provider that has been deemed a part of our reduced rate program may request approval for consideration for the reduced rate to be applied. Requests must be submitted in writing to the HR Benefits office in advance of the initial date of service. The type of service, provider and/or facility name, address, phone/fax numbers and initial date of service, as well as, the reason for the request, must be included in the request. A request for the reduced rate for services outside of our medical center does not guarantee the request will be approved and employees should plan accordingly. The plan member will receive confirmation of the decision on the request in writing. Tier 1 - Domestic and Tier 2 - UHC network physicians can be found at: Click on Network Providers under Quick Links. If you require select services that are not available within our AU Medical Center Domestic network, you must first request approval from Benefits, Human Resources in advance of the date of service. Without this advance approval, this service will not be considered in-network. Enrollment will be effective on January 1, 2017 if you enroll during the Open Enrollment period. How Do You Decide on a Medical Plan? You have a choice of three different medical plans: PPO (Select Plan), PPO (Base plan), and consumer-driven health care (Choice Plan). Which one is right for you? In making your choice, you should consider factors such as: The way you use health care services (such as whether you visit the doctor often or rarely); The out-of-pocket costs that you may pay in each medical plan (such as deductibles, copays, coinsurance and payroll deductions); The maximum amount that you might pay out of your pocket on health care expenses during the plan year; and The way each medical plan covers services that may be important to you (such as preventive care or prescription drugs). 10

11 You may find the following chart helpful. It shows certain decision factors and the medical plans that meet those decision factors. Decision Factors Select Choice Base MEDICAL PLAN USAGE You expect limited need for medical care during the plan year You have chronic or serious health conditions and want to save money in an HSA over the years to assist with future medical costs COSTS You want lower payroll deductions You are willing to pay higher payroll deductions to keep your out-of-pocket expenses low You want your plan to cover the cost of preventive care (physicals, immunizations, etc.) You want the plan to cap how much you can spend out of your pocket on in-network medical expenses CONTROL You want to decide how you spend your health care dollars Your Pharmacy Benefits Members will be able to use the in-house pharmacy or go through retail; however, we do encourage the use of our in-house pharmacy to reduce your out of pocket costs as well as overall plan costs. Going through the AU Medical Center Employee Pharmacy will continue being the lowest cost point of sale available to you! Employees will be able to enjoy the benefits of having quality customer service, dedicated pharmacists, reduced costs, and, convenience. The maximum cost to fill a prescription for members of the Select PPO plan and Base PPO plan will be $450 per fill at retail pharmacies. There is no maximum cost per fill for members of the Choice Plan (HDHP). Annual Deductibles and Out-of-Pocket Maximums o o Select/Base PPO plan members will not be required to meet a medical deductible for medications. Beginning in 2017, both Select/Base PPO plans will require separate Medical and Rx OOP maximums. Choice HDHP plan members will not be required to meet a medical deductible for preventive medications, however, copays/coinsurances for preventive medications will apply to a member s deductible. Non-preventive medications will require meeting of a medical deductible. All copays/coinsurances (preventive/non-preventive) apply toward the Rx out of pocket maximum for the calendar year. Specialty medications must be ordered through the Employee Pharmacy. 11

12 Annual OOP Maximums (includes deductible) OOP Maximums Select PPO (In Network/UHC) Base PPO (In Network/UHC) Choice HDHP (Combined Medical/Rx) (In Network/UHC) Employee $1,500 Rx $4,000 / $5,000 Medical $1,500 Rx $5,000 / $5,100 Medical $4,500 / $6,000 Family $3,000 Rx $8,000 / $10,000 Medical $3,000 Rx $10,000 / $10,200 Medical $9,000 / $12,000 Your Pharmacy Costs In-Network Provider Employee Pharmacy Out-of-Network Provider Employee Pharmacy Retail Pharmacy Days Supply 30 day supply / 90 day supply 30 day supply / 90 day supply 30 day supply Tier 1 $5 / $10 $10 / $20 $ % to a max of $450 Tier 2 $10 / $20 $20 / $40 $ % to a max of $450 Tier 3 Must fill at the Employee $30 / $60 $40 / $80 Pharmacy Specialty Must fill at the Employee $50 (30 day supply) $80 (30 day supply) Pharmacy When you enroll in an AU Medical Center-sponsored medical plan, you automatically receive prescription drug benefits through your pharmacy benefit manager. The type of prescription drug benefit you receive is determined by your medical plan and cannot be changed. You may use any pharmacy, but we encourage use of our employee pharmacy to save you time and money. Drug Tiers Prescription drugs costs are based on their tier. There are three tiers. Generally: Generic drugs are chemically the same or similar to their brand name versions and less costly. Formulary drugs are brand name drugs that are on your pharmacy benefit manager s list of preferred drugs. Non-formulary drugs are the most costly drug tier because they are not on your pharmacy benefit manager s list of preferred drugs. Formulary A formulary is a list of preferred drugs that are covered by the plan. Drugs on this list are less expensive than nonformulary drugs, but more expensive than generics. Generics Generic drugs are typically as effective as brand name drugs because they contain the same active ingredients. Like brand name drugs, they are manufactured according to standards and carry the approval of the Food and Drug Administration (FDA) for safety and effectiveness. Because generics are usually less costly than their brand name versions, using generic drugs will save you money. 12

13 2017 Medical Plans at a Glance - All dollar amounts and percentages reflect employee responsibility. Medical Plan Features Medical Select Plan (PPO) Medical Choice Plan (HDHP with HSA) Medical Base Plan (PPO) Default Plan In Network/UHC Network/OON In Network/UHC Network/OON In Network/UHC Network/OON Deductible/Individual $500/$750/Not Covered $1,500/$2,000/Not Covered $2,000/$4,000/Not Covered Deductible/Family $1,000/$1,500/Not Covered $3,000/$4,000/Not Covered $6,000/$8,000/Not Covered Preventive visits *$0/*$0 /Not Covered *$0/*$0/Not Covered *$0/*$0/Not Covered Medical Out-of-pocket max (Includes deductible) Individual $4,000/$5,000 /Not Covered $4,500/$6,000/Not Covered Family $8,000/$10,000 / Not Covered (1) $9,000/$12,000/Not Covered Rx Out-of-pocket max (Includes deductible) Individual $1,500 Family $3,000 $5,000/$5,100/Not Covered $10,000/$10,200/Not Covered Combined with Medical OOP Max $1,500 Combined with Medical OOP Max Coinsurance 20%/45%/Not Covered 20%/30%/Not Covered 35%/50%/Not Covered Office visit *$30/45%/Not Covered 20%/30%/Not Covered 35%/50%/Not Covered Inpatient care/surgery; Outpatient Surgery (per admit/surgery) 20%/45%/Not Covered 20%/30%/Not Covered 35%/50%/Not Covered Outpatient lab/x-ray/non-hospital tests *0%/45%/Not Covered 20%/30%/Not Covered 35%/50%/Not Covered Labor & Delivery Observation Stay & 35%/50%/Not Covered any related after hours injections *$125/45%/Not Covered 20%/30%/Not Covered Emergency room *$125/*$125/*$125 20%/20%/20% 35%/35%/35% Urgent Care NA/*$75/Not Covered 20%/30%/Not Covered 35%/50%/Not Covered Convenience Care NA/$50 NA/30%/Not Covered NA/50%/Not Covered Ambulance Services 20%/20%/20% 20%/20%/20% 35%/35%/35% Rehabilitation service *$30/45%/Not Covered 20%/30%/Not Covered 35%/50%/Not Covered Acupuncture / Acupuncture Therapy *$30/NA/NA 20%/NA/NA 35%/NA/NA $3,000 Nursing Services Home health (100 visit limit), hospice, private duty (40 visit limit), skilled nursing care (120 visit limit). 20%/20%/Not Covered 20%/30%/Not Covered 35%/50%/Not Covered Genetic Counseling *$30/45%/Not Covered 20%/30%/Not Covered 35%/50%/Not Covered Mental Health Care/Substance Abuse** Inpatient 20%/20%/Not Covered 20%/30%/Not Covered 35%/50%/Not Covered Outpatient *$0/*$0/Not Covered 20%/30%/Not Covered 35%/50%/Not Covered IVIG Therapy/Home Infusion Therapy 20%/45%/Not Covered 20%/30%/Not Covered 35%/50%/Not Covered Durable Medical Equipments (Some exclusions apply) 20%/30%/Not Covered 20%/25%/Not Covered 35%/50%/Not Covered Chiropractic (limit of 10 visits per year) *$30/45%/Not Covered 20%/30%/Not Covered 35%/50%/Not Covered Radiation Therapy/ Chemotherapy *$30/45%/Not Covered 20%/30%/Not Covered 35%/50%/Not Covered Outpatient Dialysis 20%/45%/Not Covered 20%/30%/Not Covered 35%/50%/Not Covered Hearing Aid (1 per ear per life) *20%/45%/Not Covered 20%/30%/Not Covered 35%/50%/Not Covered Bariatric Surgery (requires 3 year wait *$3,000 copay/not Covered /Not 30%/ Not Covered Not Covered Not Covered period in health plan) Covered (1) The maximum any one individual will pay out of pocket is $6,550 each calendar year in the Choice HDHP, Family option * Deductible does not apply. ** It is our intent to comply with required terms of federal regulations related to health care reform and mental health parity. $ Employee copayment/cost out-of-pocket for this service (in dollars) %Employee coinsurance payment (% of total cost of this service) 13

14 Medical Choice Plan A consumer-driven health care plan with a health savings account (HSA) You may have heard plans like the Medical Choice Plan called consumer-driven. This refers to the shift in decision-making power from the plan administrator to you, the consumer. You take control of your health care, and you decide how you spend your health care dollars. How is it that you get to make these decisions? Your HSA gives you this freedom. The Medical Choice Plan features an HSA you may use to help pay for eligible medical expenses. HSAs can help provide funds for out-of-pocket costs protection for years that you have high costs. But in years when you have lower costs, you may have funds to roll over to use in future years, when you may need them. There are no copayments, and referrals are not required All dollar amounts and percentages reflect employee responsibility. Deductible In-Network Services $1,500 individual/ $3,000 family UHC Network $2,000 individual/ $4,000 family Out-of-Network Services Not Covered Coinsurance 20% 30% Not Covered Physician Office Visits 20% 30% Not Covered Preventive Office Visits for all services inclusive of: Colonoscopies, Mammograms, Well Baby Immunizations, Bone Density Testing Medical/Rx Annual Out-of- Pocket Maximum (1) (includes deductible) $0** $0** Not Covered $4,500 individual/ $9,000 family $6,000 individual/ $12,000 family Not Covered Note: (1) The max any one individual will pay out of pocket is $6,550 each calendar year in the Choice HDHP, Family option ** Deductible does not apply Why Choose the Medical Choice Plan? The Medical Choice Plan offers many advantages over traditional health care plans: You have control. You are empowered to make your own medical care decisions and spend your health care dollars the way you see fit. By keeping yourself and your family healthy, your medical costs and AU Medical Center s can decrease. Smart costs. With the Medical Choice Plan, you pay lower payroll deductions than in the Medical Select Plan, but you have a higher deductible. There are no copayments. Instead, when you meet the annual deductible, the program generally pays 80% of most of your eligible in-network expenses up to the out-ofpocket maximum. Tax advantages. Both you and AU Medical Center can contribute to your HSA on a pre-tax basis. When you incur an eligible medical or prescription drug expense, you may use your HSA dollars to pay for it. You also have the opportunity to lower your taxable income by enrolling in the Limited Purpose Health Care Flexible Spending Account. Use this account to reimburse your eligible dental and vision expenses. Lasting savings vehicle. You own your HSA, so you take it with you when you leave AU Medical Center. You may continue contributing to your HSA (following IRS rules) and use your HSA to pay for eligible medical, pharmacy, dental and vision expenses. 14

15 Health Savings Account Similar to electing health insurance, you will need to elect a Health Savings Account each year. Your HSA is a federally regulated savings account. You own your account and can take it with you when you leave AU Medical Center employment. If you wish, you may open an HSA at a different financial institution. If you enroll in the Medical Choice Plan, you also must enroll in the HSA and elect a contribution amount. Using Your HSA Funds You may use your HSA to pay eligible medical, pharmacy, dental and vision out of pocket expenses incurred by you and dependents you claim on your federal tax return. Contributing to Your Account You choose how much to contribute to your HSA through pre-tax payroll deductions. For 2017, the federal combined employee/employer annual contribution limit is $3,400/individual or $6,750/family. If you are age 55 or older, you may make annual catch-up contributions of up to $1,000. After the first payroll of 2017, AU Medical Center will contribute $500 to your individual HSA, or $875 to your family HSA. AU Medical Center will also contribute up to an additional $500 to your HSA account based on your completion of certain AU Healthy You activities. The employer wellness incentive dollars will be added to your account twice during the calendar year (July and October). TIP: When determining your annual contribution amount, remember to factor in AU Medical Center s contributions so you do not contribute more than the federal maximum. Excess contributions are subject to income tax as well as a 20% penalty. There are several online calculators to assist you in comparing your current plan to an HSA plan and the potential savings in having an HSA (from premiums to tax-advantage savings)

16 Wellness Incentives Throughout 2017, employees in the high deductible health plan (Choice plan) will be given opportunities to earn up to an additional maximum of $500 employer HSA contributions based on completion of wellness activities. The employer contributions will be added to HSA s twice during the calendar year (July and October). Both the Biometric Screening and Health Risk Assessments are required in order to obtain the incentives. Maximum Annual AU Healthy You Incentives 500 Screening/Assessment required to participate in the incentive program BOTH MUST BE COMPLETED BETWEEN NOVEMBER 2016 AND MAY Complete Biometric Screening - (Includes blood pressure screening, weight, lab testing for cholesterol and glucose screening) - Screening obtained in Employee Health & Wellness clinic Complete Health Risk Assessment - HRA completed online Education Attend no less than 3 nutritional weight-loss classes 50 Complete approved Diabetes Management Educational Series (limit 1 time per year) 50 Complete wellness-related education classes (limit of 5 per year) 10 Complete the AU Cancer Center Tobacco Cessation Program (limit 1 time per year) 100 Complete a class presented by the Employee Assistance Program (limit 3 per year) 10 Healthy Lifestyles Exercise Log (30 minutes per day, 3 days/week) for 3 consecutive months 50 Participate in community-based weight loss event (1 time per year) 50 Participate in community-based runs, walks, etc. (up to 4 per year) 25 Complete results-based wellness events (up to 3 coaching sessions per event) 50 Preventive Care Obtain Annual Preventive Exam o Routine Physical 100 o Mammogram for women o PAP screening for women o Colorectal cancer screening over age o PSA/Prostate Screening (for men age 40+) 100 o Coronary Artery Calcium Screening (Age 55 to 75 for men, age for women) 50 o Preventive Dental Screening 25 o Vision Screening 25 o Hearing Screening 25 o Prenatal and/or well-baby care 25 Other Donate Blood at AU Medical Center - (limit of 2 donations per program year) 25 Employees in any Medical Center health plan will have an opportunity to complete a Health Risk Assessment and biometric screening at no cost to the employee and participate in other wellness program activities, however Select and Base plan members are not eligible for HSA incentive dollars tied to each activity. 16

17 Medical Select Plan The Medical Select Plan is a preferred provider organization (PPO) plan. This means that: You pay a co-insurance for Inpatient care/surgery and Outpatient surgeries/procedures. You pay a copay or coinsurance for doctor s office visits with the Medical Select Plan. For some services, you pay a percentage of the cost (coinsurance). You have annual deductibles to meet for various networks (Domestic or UHC network services). Both network out of pocket expenses apply to both out-of-pocket maximums. You can receive care from a UHC Network Services provider, but if you visit Domestic network providers, your benefit level generally is higher and you typically pay less out of pocket. Out of network coverage is not provided, unless emergency services are provided. All dollar amounts and percentages reflect employee responsibility. Deductible In-Network Services $500 individual/ $1,000 family UHC Network Services $750 individual/ $1,500 family Out-of-Network Services Not Covered Coinsurance 20% 45% Not Covered Physician Office Visits $30 45% Not Covered Preventive Care for all services inclusive of: $0** $0** Not Covered Colonoscopies, Mammograms, Well Baby Immunizations and Bone Density Testing coverage Medical Annual Out-of-Pocket Maximum (includes deductible) ** Deductible does not apply $4,000 individual/ $8,000 family $5,000 individual/ $10,000 family Not Covered Medical Base Plan A preferred provider option (PPO). The Medical Base Plan is a preferred provider organization (PPO) plan. You pay a coinsurance for doctor s office visits with the Medical Base Plan. For all services (with preventive services being the exception), you pay a percentage of the cost (coinsurance) after you meet your deductible. You have annual deductibles to meet for various networks (Domestic or UHC network services). Both network out of pocket expenses apply to both out-of-pocket maximums. You can receive care from a UHC Network Services provider, but if you visit Domestic network providers, your benefit level generally is higher and you typically pay less out of pocket. 17

18 All dollar amounts and percentages reflect employee responsibility. In-Network Services UHC Network Services Out-of-Network Services Deductible $2,000 individual/ $6,000 family $4,000 individual/ $8,000 family Not Covered Coinsurance 35% 50% Not Covered Physician Office Visits 35% 50% Not Covered Preventive Care for all services, including: Colonoscopies, Mammograms, Well Baby Immunizations and Bone Density Testing coverage Medical Annual Out-of-Pocket Maximum (includes deductible) $0** $0** Not Covered $5,000 individual/ $10,000 family $5,100 individual/ $10,200 family Not Covered ** Deductible does not apply Your Flexible Spending Accounts You may reduce your tax burden by using AU Medical Center s flexible spending accounts (FSAs) to pay for health care expenses not covered by another benefit plan or dependent care expenses not covered by another benefit plan. You may enroll in a Health Care FSA and/or a Dependent Care FSA. Both are administered by Bank of America. Each year during Open Enrollment, you decide how much of your pretax income you want to put into your FSA. You may contribute: Between $100 and $2,600 into your Health Care FSA (traditional or Limited Purpose), and Between $100 and $5,000 into your Dependent Care FSA. AU Medical Center deducts that amount from your paycheck, in equal installments, over the course of the year. Because this money is deducted before taxes are taken, your taxable income is reduced, which lowers your taxes. How the Health Care FSAs Work You can use the Health Care FSA to pay for eligible health care expenses for yourself and your eligible dependents. There are two kinds of Health Care FSAs: Traditional and Limited Purpose. 18

19 The traditional Health Care FSA enables you to reimburse yourself for eligible medical, pharmacy, dental, vision and prescription drug expenses. You may enroll in this FSA if you are electing the Medical Select Plan, Medical Base Plan, or waiving medical coverage. Note: Over-the-counter drugs are no longer eligible expenses under the traditional Health Care FSA. The Limited Purpose Health Care FSA enables you to reimburse yourself for eligible dental and vision expenses. You may only enroll in this FSA if you are electing the Medical Choice Plan. Note: Over-the-counter drugs are no longer eligible expenses under the Limited Purpose Health Care FSA. Use It or Lose It Rule Carefully decide how much money to set aside in your Health Care or Dependent Care FSA for Once you elect an amount, you cannot change it until enrollment for 2018 benefits unless you have a family status change event. You should be careful in what you elect, because some of your FSA funds may not roll over from year to year. They may be subject to the IRS use it or lose it rule. Carryover Provision Up to $500 of remaining Health Care FSA dollars can be carried over from year to year. There are special rules where this applies. For example, the participant must be an active member on the last day of the plan year and will be electing for the new plan year; and, if the participant doesn t elect a Health Care FSA in the upcoming plan year, a manual election will be set up and balances will only be available via manual claim submission. Spending Account Type Deadline To Incur FSA-Eligible Expenses Postmark Deadline For Reimbursement Of 2017 Expenses Health Care FSA December 31, 2017* March 31, 2018 (Traditional and Limited Purpose) Dependent Care FSA December 31, 2017* March 31, 2018 * The federal use it or lose it rule applies to each of the FSAs. Funds above the carry over amount of up to $500 will be forfeited. How to Determine Your Health Care FSA Contribution How do you decide the right amount to contribute to your Health Care FSA? The FSA works like a household budget. But instead of deciding how much money you will need for food, clothing and utilities, you decide how much to budget for these health care expenses: Traditional Health Care FSA Medical and dental deductibles Medical, dental and vision copayments, and out-of-pocket expenses Prescription drugs, co-payments and out-of-pocket expenses (excludes over-the-counter drugs) Medically required equipment, co-payments and out-ofpocket expenses Limited Purpose Health Care FSA Dental deductibles, copayments and out-of pocket expenses Vision copayments and out-of-pocket expenses 19

20 Track your current health care spending so you ll have an idea of your future expenses. Look at your checkbook, bank statements and receipts to see how much you ve spent since January 1. And from now on, every time you incur an eligible expense, write it down. Then think about next year: Are you enrolling in an HSA? If so, you may want to set aside a smaller amount of your income into your Limited Purpose FSA. Are you enrolling in a new type of medical plan with more out-of-pocket expenses or fewer? Are you expecting to have one or more major eligible expense in the coming year(s)? Once you estimate your 2017 expenses, you may want to use a free online FSA calculator like the one at to determine how much in tax savings an FSA can provide, and visit a site such as to make an initial determination of what you may want to set aside in a flexible spending account. Visa Debit Card When you enroll in the Health Care FSA, paying for eligible expenses is a lot easier! You will be able to pay your eligible expenses with a convenient Visa debit card from Bank of America with the Health Care FSA. A few weeks after you enroll, you will receive your debit card at your home address. Your card will be loaded with the full amount of your health care FSA contribution. Simply use your FSA debit card when you incur an eligible health care expense, and the money will be deducted from your account. Claims do require substantiation, so save your receipts to submit to Bank of America. If you do not substantiate your claims, your account could be placed on hold until receipts are submitted. You may login to your account at If you are enrolled in the Health Savings Account as well as the Limited Purpose Health Care FSA, you will have access to both of these accounts through your debit card. Simply use your card to pay eligible expenses select credit at the register (no PIN is necessary), and the card will automatically deduct your expense from the correct account. To order extra cards, call the customer service number listed in your welcome letter from Bank of America. Expenses Eligible for the Traditional Health Care FSA For further information about additional eligible expenses, see IRS Publication 502, Medical and Dental Expenses. It is available on the Internet at from your local public library or by calling TAX FORM. How the Dependent Care FSA Works You can use the Dependent Care FSA to reimburse yourself for eligible child or elder day care expenses that you have in a plan year, if the expenses are necessary to allow you and your spouse if you are married to work. 20

21 These services may be provided inside or outside your home by baby-sitters, companions or eligible day care centers. Services may not be provided by someone you claim as a dependent on your tax return. Your day care expenses must be for a: Dependent child who is under age 13 for whom you are eligible to claim an exemption on your tax return, Disabled spouse, or Disabled dependent including a child, parent, grandchild, sibling, niece/nephew, aunt/uncle, in-law or stepchild who is physically or mentally incapable of caring for him or herself. Contributing to Your Dependent Care FSA In the case of a divorce, only one parent can contribute to a Dependent Care FSA. Contribution Amounts If You Are Married If This Is Your Your Maximum Annual Situation... Contribution Is: Your spouse also participates in a Up to $5,000 combined for both accounts Dependent Care FSA You file separate federal income tax returns Up to $2,500 through the AU Medical Center Dependent Care FSA Your spouse is a full-time student for at Up to $2,400 if you have one dependent least five months of the year or is totally Up to $4,800 if you have two or more dependents disabled Eligible Dependent Care Expenses You can be reimbursed through the Dependent Care FSA for the costs of: Care provided inside or outside your home by someone over age 19 who is not your dependent, Day care centers qualified under state or local law that provide care for at least six individuals not normally living at the center, FICA and other taxes you may pay for eligible providers, Preschool or summer program tuition, and Before and after school care expenses, for children up to age 13. The Dependent Care FSA is for child and elder day care expenses. It is not for medical expenses for your dependents. Ineligible Dependent Care Expenses Expenses that cannot be reimbursed through the Dependent Care FSA include: Care or services provided by your spouse, children under age 19 or anyone you could claim as a legal dependent for federal income tax purposes, Expenses for overnight camps, Expenses reimbursed by another spending account plan, Expenses you claim as a credit on a federal tax return, Expenses you had before or after you were an FSA participant, Food, clothing or entertainment for a dependent, General baby-sitting other than during work hours, Nursing home expenses, unless the dependent spends at least eight hours a day in your household, 21

22 Child support payments, Health care expenses for you and your dependents, Private school tuition, Kindergarten tuition, and transportation to or from the dependent care location. Tax Considerations You may prefer to use your day care expenses to claim a child care credit when you file your federal tax return. The child care credit means that you use a special formula to determine the amount of any credit for which you qualify. The credit is then subtracted from any tax you owe. The Dependent Care FSA is an alternative way to save taxes if you choose not to file for the child care credit. You may or may not be better off using the child care credit instead of the FSA. A tax advisor can help you figure out which option is better for you. You cannot transfer money between a Health Care FSA and a Dependent Care FSA. IRS regulations require that the administrator of the plan ensures that the expenses incurred through the Flexible Spending Account are qualified IRS eligible medical expenses. Bank of America may request you provide substantiation in order to prove a debit card transaction is a qualified expense. Some merchants have auto substantiation capabilities. In this case, you are not required to provide the receipts or the Explanation of Benefit from your insurance company. If you are required to provide substantiation, Bank of America will reach out to you via post card or depending on your communication preferences to let you know what is needed to substantiate the transaction. 22

23 Your Dental Plans The Core and Value Dental plans have a preventive incentive that will pay benefits for routine exams, cleanings, full mouth and bitewing x-rays, as well as fluoride treatments, without applying those paid benefits towards your annual maximum benefit. No late enrollee provision! In order to provide the best dental coverage possible to our employees and their families, we are waiving the late enrollee provision and will provide full dental coverage for an employee and their dependents if they enroll for dental coverage for the first time during the new hire enrollment period, the Open Enrollment period, or within 30 days of a family status change or qualifying event. Full dental coverage includes preventive, basic, major and orthodontia services. Dental plan enhancements: No late entry provision Choice of either a value or core plan option Delta Dental Vision discount program through EyeMed Vision Care (However, this plan cannot be combined or used in conjunction with any other vision care plans). You can visit any dentist, but your expenses will be less and your benefits will go further if you use a dentist in the Delta Dental PPO Network or their Premier Network. Dentists within the Premier Network agree to accept what Delta Dental deems to be usual, reasonable and customary (UCR) and cannot balance bill you for any amount over UCR. Delta Dental s PPO Dentists agree to accept a negotiated discounted fee resulting in the most savings and helping to stretch your benefit dollars. Out of Network dentists will be paid at the 80 th percentile of the UCR, therefore, your dentist may balance bill you for services rendered. Annual deductible Coinsurance Annual maximum Orthodontia lifetime maximum Note: Periodontics are under Basic Services. Annual deductible Coinsurance Annual maximum Orthodontia Note: Periodontics are under Major Services. Core Dental Plan Features (Delta Dental PPO Network) $50 individual/$150 family 0% preventive / 20% basic / 50% major and orthodontic $1,350 per member $1,500 per member Value Dental Plan Features (Delta Dental PPO Network) $50 individual/$150 family 0% preventive / 20% basic / 50% major $1,000 per member Not provided by the Value Dental Plan * Benefits paid for routine exams, cleanings, bitewing X-rays and fluoride treatments, as well as orthodontia, do not apply to the annual maximum. 23

24 Your Vision Options Vision care is an important part of any comprehensive benefits program. If you want coverage for eyeglasses, eyeglass frames, contact lenses and laser vision correction, you should consider enrolling in this materials-only Vision Plan. Eye examinations are not covered by this plan. You have two Vision plan options. The plans are administered by EyeMed Vision Care: Vision Value Plan or the Vision Elite Plan - The following chart shows your vision options and coverage levels. Vision Plan Features Eyeglass frames Eyeglass lenses Contacts Frequency Eye Exam (and dilation) Vision Value Plan (In Network) $120 retail benefit, plus 20% off balance over $120 Vision Elite Plan (In Network) $200 retail benefit, plus 20% off balance over $200 $10 copay for standard plastic $10 copay for standard plastic lenses lenses $120 retail benefit; 15% discount $250 retail benefit; 15% discount off off balance over $120 for balance over $250 for conventional conventional lenses lenses Once per year for eyeglass lenses or contacts; once per year for eyeglass frames No benefit provided; this is covered under AU Medical Center s medical coverage The EyeMed Vision Care Network To receive the plan benefit, you must get care from a provider in the EyeMed Vision Care Network. The network consists of optometrists, ophthalmologists and opticians in private practice, as well as retailers such as LensCrafters, Target Optical and most Pearle Vision and Sears Optical locations. To find a network provider near you, call or visit EyeMed members now have access to a hearing care discount from Amplifon Hearing Health Care. Members receive a 40% discount off of hearing exams and a low price guarantee on set, discounted pricing of hearing aids. The Hearing Care Discount is offered to valued clients and enrolled EyeMed members at no additional cost. Please note the hearing care discount is not insurance. 24

25 Your Life and AD&D Insurance Options Life and accident insurance can mean peace of mind to you and your family. Because accidents can happen at any time, you should have a plan for coping with them. If a serious accident were to severely injure or kill you, Accidental Death and Dismemberment Insurance (AD&D) could provide your family with financial protection. After your death, your Life Insurance benefit can provide financial protection for your dependents. AU Medical Center s Life and AD&D Insurance plans are administered by The Standard. Evidence of insurability might apply. See Evidence of Insurability (EOI) on the next page for details. You may elect to increase your Basic Life/ADD benefit by one level, and you will not be required to submit any Evidence of Insurability. Life and AD&D Insurance AU Medical Center will provide you with up to 1 times your annual base salary in coverage at no cost, with a minimum value of $25,000. Your options for Life Insurance and AD&D coverage include: $25,000 1 times your base salary* 2 times your base salary* 3 times your base salary* 4 times your base salary* * Minimum of $25,000 and maximum of $525,000. Basic Life/ADD premium rates are based on age and salary. Premiums are grouped by age categories. The year in which an employee moves to a new age category their premium will increase at the beginning of that plan year. How Much Life Insurance Do You Need? If you have a family member that is dependent on your income, then you need life insurance. How much? Smart Money offers a free online life insurance calculator available at Insurance You can also contact The Standard at , or visit to review Life and AD&D Insurance options. 25

26 Dependent Life Insurance You may elect to buy a flat benefit amount of $10,000, $30,000, or $50,000 for your spouse, and/or a flat amount of $10,000 or $15,000 for your dependent child(ren). An amount of $2,000 is available for children between 14 days and six months of age. No Evidence of Insurability is needed for Dependent Life Insurance for your child(ren). Evidence of Insurability for Spousal Life Insurance: You may elect to increase your Spousal Life benefit by one level or add the lowest level as a new benefit, and you will not be required to submit any Evidence of Insurability for your spouse. If you and your spouse are both benefitseligible AU Medical Center employees, neither you, nor your spouse may elect Spousal Life Insurance. If both spouses work for the medical center, but only one is eligible for benefits, the benefitseligible employee may elect Spousal Life Insurance. Child Life - If both parents are employed by the medical center (regardless of marital status), only one parent may elect Child Life Insurance. A $1,000 Dependent (spouse and child/ren) Life Insurance benefit is being provided by AU Medical Center for all benefits-eligible employees, at no cost to the employee, even if you do not elect Dependent Life for your spouse or child(ren). Additional Accidental Death and Dismemberment Insurance You may choose to buy from $10,000 to $500,000 of Additional AD&D Insurance coverage for yourself and your family, in $10,000 increments. No Evidence of Insurability is needed for Additional Accidental Death and Dismemberment Insurance. Evidence of Insurability (EOI) If you elect a benefit amount that requires EOI, you must complete a Medical History Statement (MHS) and be approved by The Standard. If your spouse requires EOI, he or she must complete the MHS. The MHS will be accessible during the entire Annual Enrollment period. You can link to the MHS from the online Annual Enrollment website. If The Standard has not decided your EOI status by January 1, 2017, your coverage level will remain at the current coverage level. The Standard will notify you if your EOI is accepted or denied. If accepted, your coverage level and the premium amount deducted from your pay will increase to the appropriate amount on the first of the month following The Standard s approval. (You must be actively at work on the effective date for the increase in coverage to be made.) If denied, your coverage level will remain at the current coverage amount, and the premiums deducted from your pay will not change. Travel Assistance Services through your Life Insurance Coverage (MEDEX) Travel Assistance provides insured employees and eligible family members access to a comprehensive range of professional, 24-hour medical, legal, and trip assistance information, as well as referral and coordination services. This worldwide assistance service is available to plan participants whenever you are traveling 100 miles or more from home or internationally on trips up to 180 days. This service is offered through FrontierMEDEX. As always, FrontierMEDEX must make all arrangements for the services provided. 26

27 Your Disability Insurance Options Just as routine preventive care can help you prevent future illness, disability coverage can prevent financial hardship if you become disabled and cannot work. Being disabled and unable to provide an income for yourself and your family can threaten your financial security. When you are unable to work due to illness, injury or pregnancy, you may be eligible for AU Medical Center disability benefits. You must complete a year and a day of service with AU Medical Center before you are eligible for STD or LTD benefits. On the day after you complete a year and a day of service, AU Medical Center provides you with both STD (50% benefit) and LTD (50% benefit) coverage. When you complete the online enrollment during the following open enrollment period, you will see all the available STD and LTD options and will be able to elect higher levels of coverage if you so choose. Short Term Disability (STD) STD replaces some of your salary if you cannot work due to an illness or injury for up to 12 weeks. Approved STD benefit payments begin on either the 15 h (50% Benefit Option) or 8 th (60% Benefit Option) calendar day of disability, based on your plan election. Your options are: 50% benefit (up to $1k per week) Employer Paid 60% benefit (up to $1,500 per week) - Employee pays rate difference Long Term Disability (LTD) LTD provides financial protection if illness or injury keeps you out of work for a long period of time. Approved LTD benefit payments begin after 120 days (50% Benefit Option) or 90 days (60% Benefit Option) (based on plan elected) of disability leave and may continue for up to 48 months (50% option) or Social Security Normal Retirement Age (60% option). To help prevent financial hardship if you are out of work for an extended amount of time, AU Medical Center will provide you with 50% of your base salary in coverage at no cost to you (up to $6,000 per month). Your options are: 50% of your base pay (up to $6k/month) Employer Paid 60% of your base pay (up to $6k/month) - Employee pays rate difference AU Medical Center believes you should have access to a program that allows partial replacement of your salary if you are on a Short-Term Disability leave. WHY LTD COVERAGE IS IMPORTANT? Becoming disabled may seem like a remote possibility, but it really isn t. You may not realize how likely you are to become disabled: Six out of ten people between ages 20 and 60 will become disabled. A person age 35 is six times more likely to become disabled than to die before he or she reaches age 65. This is why the organization provides 50% of your Most base people weekly have salary difficulty (up paying to $1,000 their per bills week when they lose their income. For those who face a long-term loss maximum of income benefit) because at of no a cost disability, to you. financial ruin is possible. 27

28 Your Voluntary Benefit Options AU Medical Center is committed to providing you with the best possible total compensation package. We continually monitor our benefits to ensure they provide you with the greatest value. We are proud to continue offering several voluntary benefits that represent the best in their class. Read on to learn how these products can provide peace of mind as well as financial protection for you and your family. To enroll in one of these voluntary benefits, call the name and number of the contact listed under each voluntary benefit option in this section. Home Insurance Contact: Your home is your greatest asset. Whether your home is a house, townhouse, condo or an apartment, you can protect your residence and the precious belongings inside with Travelers Home Insurance. In general, homeowners policies can cover your home and property from theft or damage. Coverage for landlords and renters also is available. Policies can provide: Coverage for theft and property damage from lightning, fire and smoke Coverage for the contents of your home Court fees and liability coverage for lawsuits resulting from injuries that anyone suffers on your property Claim service 24 hours a day, 365 days a week All employees are eligible to apply at any time throughout the year. You are not required to wait until Open Enrollment or your current policies are up for renewal to compare rates and participate in the program. Contact Travelers to request your quote, with special program rates. Auto Insurance Contact: Travelers Auto insurance offers more than basic liability and collision coverage. You can get: Loan lease gap coverage Repair or replacement collision coverage Towing and labor coverages Special program rates and discounts All employees are eligible to apply at any time throughout the year. You are not required to wait until Open Enrollment or your current policies are up for renewal to compare rates and participate in the program. Contact Travelers to request your special program rate quotes. Legal Assistance Contact: Hyatt Legal Plan offers you convenient, affordable access to legal services through any attorney anywhere, anytime. If you stay within the network, covered legal services are provided with no additional attorney fees. Of course, you also have the flexibility to use a non-plan Attorney and get reimbursed for covered services according to a set fee schedule. It s completely your choice! You may choose to work with the attorney any way you want by visiting an attorney s office, by consulting over the phone, or through , fax or mail. 28

29 Pet Insurance Contact: PETS-VPI VPI Pet insurance is an affordable way to give your pet the best medical care possible. VPI Pet Insurance covers well care, the diagnosis and treatment of illnesses (including cancer and hereditary conditions), and the diagnosis and treatment of injuries, including those caused by accidents. Coverage includes: Accidents Illnesses Cancer Vaccinations All employees are eligible to apply at any time throughout the year. You are not required to wait until Open Enrollment to enroll in this program. Contact VPI to request your program rate quotes. Accident Insurance Contact: Colonial Life s guaranteed renewable accident insurance provides lump-sum indemnity benefits for accidents. You can choose coverage for on- and off-the-job accidents. You have a choice of individual or family coverage for yourself, your spouse and/or your dependent children. Coverage is worldwide and policies are portable. Optional riders, such as disability income, are available at an additional cost for you or your spouse. You may want to consider the disability income rider if your spouse does not have disability coverage through his or her employer. Cancer Insurance Contact: Colonial Life s individual Cancer Insurance pays lump sum benefits that can help defray your out-of-pocket cancer treatment expenses. This product also covers annual cancer screening tests and other wellness benefits to encourage you to have regular screenings, which can improve your chance of survival if you develop cancer. You can select from several levels and plan options to meet your needs. Critical Illness Insurance Contact: Colonial Life s Critical Illness Insurance plans complement your major medical coverage by helping pay the direct and indirect costs associated with a specified critical illness. An annual health screening benefit is also available. All employees are eligible to apply at any time throughout the year. You are not required to wait until Open Enrollment to enroll in this program. Contact Colonial Life to request your program rate quotes. Medical (Gap) Insurance Contact: Colonial Life s Medical Bridge 3000 Insurance pays out-of-pocket expenses that occur when you or a family member is hospitalized, has outpatient surgery, or visits a doctor because of a covered accident or sickness. Medical Bridge 3000 covers: Copayments Deductibles Coinsurance Additional expenses not covered by the primary medical plan 29

30 Long Term Care Insurance Contact: Danny Daniel An accident or illness can happen at any time. Long Term Care Insurance can protect you, your parents and your family from the high cost of long term care not covered by health insurance. You can: Cover yourself and/or your spouse Protect your savings and your assets Stay in your home to receive care as long as possible Relieve the burden of future care from your loved ones All employees are eligible to apply at any time throughout the year. You are not required to wait until Open Enrollment to enroll in this program. Contact Genworth Life Insurance Company to request your program rate quotes. The Retirement Savings Plan is a good savings vehicle because it has the potential to build investment income quickly over time. If your investments make money, that money is reinvested and grows your account. This is called compound interest. You invest your plan balance by choosing among the wide variety of funds available. You can change the percentage of base salary that you contribute to the plan once per calendar year quarter; however, the funds in which you are invested, and the percentage of your account that you invest with each fund may be changed at any time. Because you are vested in the plan as soon as you enroll in it, you own both your contributions and AU Medical Center s right away. 529 College Savings Plan Contact: Administered by VALIC, the AU Medical Center 529 College Savings Plan is a tax-advantaged way to save for your children s college education. The plan offers you: Contact: AU Medical Center s Retirement Savings Plan, administered by VALIC, lets you save for the future in a 403(b) and 401(a) retirement plan. You may make pretax contributions through automatic payroll deductions. AU Medical Center provides a 100% match on the first 5% that you contribute to the plan. Because this is like getting free money, you should strongly consider enrolling in the plan and contributing at least 5% of pay so you can get the full employer match. Control over withdrawals: You may change beneficiaries to another family member at any time. You can use the account for tuition, room, board and other qualified expenses at any U.S. college. The account remains in your control even after the beneficiary turns 18. Tax benefits: You pay no federal income taxes while the account is invested and no federal income taxes on your earnings (state taxes may apply) when you withdraw the money to pay for qualified higher education expenses. You can even make taxable withdrawals for non-college expenses. A choice of portfolios: You can choose from four asset allocation options, 10 asset class options or select a combination. 30

31 How to Enroll for Your 2017 Benefits Open Enrollment for 2017 benefits begins at 12:01 a.m. EST on October 3, 2016 and ends at 11:59 p.m. EST on October 16, Enrollment for newly hired employees must occur within 30 days of the date of hire. Active Enrollment You must make benefit elections during Open Enrollment. If you do not, you may receive default coverage, which may not suit your needs, and which may require you to pay payroll deductions. Default Elections If you do not make benefit elections during Open Enrollment or your new hire enrollment period, you will be assigned the default coverage below. You will pay for this coverage through payroll deductions. Benefit Plan Open Enrollment Default Election New Hire Default Election Medical Health Savings Account Flexible Spending Account Dental Vision Life and AD&D Insurance Short Term Disability / Long Term Disability If you currently waive coverage, you must provide proof of other coverage annually. If you do not provide proof of other coverage, you will be enrolled in Employee Only medical coverage with the Medical Base plan. Tobacco Attestation and Spousal Surcharge: There is a non-tobacco attestation and spousal surcharge election requirement for all health plans. If you do not attest or complete the spousal surcharge (if applicable), your premiums will be adjusted. If you are currently enrolled in, or choose to enroll in, the Choice HDHP, you will be auto enrolled in to an HSA, with the ability to decline the HSA during enrollment. An employee contribution must be designated or the employer seed dollars will only apply to your HSA. If you are currently enrolled in an FSA, your coverage will end at the end of the calendar year. You must elect an FSA during open enrollment of each year for the upcoming plan year. If you are currently enrolled in a Dental plan, your coverage will continue. No action on your part will be required, unless you want to change or drop coverage. If you are currently enrolled in a Vision plan, your coverage will continue. No action on your part will be required, unless you want to change or drop coverage. Your Life/AD&D coverage will continue at the same level. No action on your part will be required, unless you want to change coverage. Your disability coverage will continue at the same level. No action on your part will be required, unless you want to change coverage. Medical Base plan (Employee only Coverage) If you waive coverage but do not provide proof of other coverage, you will be enrolled in Employee Only coverage with the Base Medical plan. None None None $25,000 50% benefit after one year of service Remember that you cannot change your coverage until the following Open Enrollment period unless you have a qualifying status change event. This is why you should carefully review the default coverage before you consider not enrolling. 31

32 How to Complete Your Benefit Elections Online HOW TO ACCESS EMPLOYEE SELF SERVICE: Two Options: 1. Go to then click on the HI Employee Self Service button, or, 2. Click on: HELPFUL HINTS: Use Internet Explorer ONLY. The site does not work as well with Mozilla or Firefox. Prior to logging in, click on Tools/Compatibility View Setting. The unicornhro.com website will be seen under Add this website. Click button Add, then close. Go back to Tools, click on pop-up blocker and set this so it reads Turn off pop-up blocker (you actually want the pop-ups to occur this will make your tobacco attestation and spousal surcharge buttons work) HOW TO LOG IN: Username: Enter your employee number as found on the back of your employee badge. The number must be six digits. So, if your employee number on the back of your badge is , drop the 101 and move the 0 at the end to the front of the digits (such that it will look like as ). Password: Your password is the last four digits of your Social Security number followed by the fourdigit year of your birth. For example, if your Social Security number ends in 5678 and you were born in 1965, you would enter Click on Login. You must validate your employee contact and work location information before moving on to First Time Enrollment (or Annual) Enrollment. Click First Time Enrollment (or Annual) Enrollment. The enrollment automatically takes you through steps 1 through 6 - in order. Click next to start the process. Step One: Verify Your Personal Information Check your address and your date of birth. If information is incorrect (and it has a box surrounding it), you can change it. When your review is complete, check Next at the bottom of the screen. Step Two: Add Your Dependent Information Check your dependent information. Is everything correct? To update the information, click Update, enter the correct information, and click Submit. To add a dependent, click Add. Type all of the required information and click Submit. Type in description name of dependent proof (example: birth certificate for dependent child). To upload the documentation, the pop-up blocker must be deactivated. Follow steps 1-3, then click Submit. Add additional dependents if necessary. When completed, click Submit. Note that the system will not allow you to delete listed dependents if they have had coverage in the past, even if they are not currently eligible. Call your HR representative to deactivate a dependent. Step Three: Verify Your Information This screen summarizes you and your dependents personal information. Look it over to make sure your records are complete. If they are not correct, click Back to add the information. If they are correct, click Next. 32

33 Step Four: Review and Elect Benefits This is where you make your benefit elections. Instructions are at the top of the screen. The icon indicates the default benefits that have been assigned to you. If you do not make any changes, you will receive this coverage, which may not suit your needs and for which you will have to pay. Carefully consider whether you want the default coverage. If not, select the options that are best for you and your family. The icon indicates benefits you have selected at an earlier time but not submitted. You may unselect these benefits, but the blue triangle remains until you submit new elections. If a plan appears with a gray background, you do not have the minimum number of dependents required by the plan. To add dependents, click on the dependents box and follow instructions. To change your benefit elections, select a plan by clicking the check box in the Select column. If a plan that is selected that requires you to specify dependents, beneficiaries, a coverage amount or a contribution amount, you will see an icon to the right of the Select check box for the plan such as: Enrollment Symbols details dependents elect all And what they mean This symbol indicates your current elections. It means that you are currently enrolled in that plan at the indicated level of coverage. If you make a benefit change, this symbol will appear, indicating your new election for next year. Click on this icon to see a summary of the benefit coverage and, in some cases, a link to provider websites. Click here to enroll dependents in the benefit plan, one at a time. (To enroll all of your dependents, click on the symbol below.) Click here to enroll all dependents in the benefit plan. If you see one of these icons next to the plan you select, you must click on the icon(s) and make the necessary elections before going to the next step. If you enrolled in dependent coverage for any of the benefit plans, click the Dependents symbol and list them with the plan by checking the box by the name. If you have dependents that you no longer want to enroll in some of your benefit plans, uncheck the box beside the dependents names to delete them from the plans. Certain benefit elections (like Additional AD&D) require you to enter a coverage amount. Click the Coverage symbol and use the drop-down arrow to choose a benefit amount. Then click Next. (Note that the system waits to calculate a rate until the benefit statement portion of the enrollment. The premium will be added to your total benefit costs on the benefit statement.) Tobacco-Free Attestation Form: o Click on the Tobacco-Free Attestation Form box. By clicking on this box, you are providing your electronic signature attesting that you and/or your covered dependents will (or will not) abstain from tobacco use. You must click on either Accept or Decline if you are electing a medical plan. You do not need to provide a hard copy of this statement to the Benefits office. Spousal Surcharge Attestation Form: o Click on the Spousal Surcharge Form box. By clicking on this box, you are providing your electronic signature attesting that your spouse is not eligible for group health plan 33

34 coverage with their employer. You do not need to provide a hard copy of this statement to the Benefits office. Important: If you do not complete all of the required information, the system creates an error message. If you see an error message, click OK. The system will take you back to the screen that needs more information. If you decline medical coverage, you must complete the Attestation of other Medical Coverage box. You do not need to provide a hard copy of your insurance card to Human Resources; however, you must completely fill in this box, then click Accept in order to decline medical coverage. When you are finished electing these benefits, click Next. Step Five: Review Your Elections If your benefits are correct, click Submit. Warning: Until you click Submit, you are not enrolled in the benefits you selected. NOTES Step Six: Benefit Statement No Additional This statement Enrollment lists your Opportunity elected benefits or Opportunity for the plan to year Change along with Elections their per pay period costs. There will not be an additional opportunity for you to enroll, correct or change your enrollment elections outside Print a copy of the of approved this statement enrollment for your periods, records. unless you experience a family status change event. If the information on your statement is not correct, click First Time Enrollment and Verify Dependent(s): In the Verify Dependent Information screen, there is a Delete button that implies you can remove dependents who are ineligible for the benefit plans. The audit provisions of the system prevent you from deleting a dependent with a history of benefit coverage. However, you can: Use the Delete button to delete a dependent that has never been enrolled in a benefit plan. Delete a dependent who has been enrolled in a benefit plan but the coverage is not effective yet. In this case, you must first dis-enroll the dependent from all benefit plans and then select the delete function. Go to the Review and Elect Benefits screen and unclick the box beside the dependent s name. Completely remove a dependent from your benefit record by contacting your HR representative. Proof of dependent eligibility: There is no need to bring proof of dependent eligibility, proof of current/active health insurance, and/or signed Tobacco Attestation Statement to your HR representative. Everything is submitted via the online First Time Enrollment (or Open Enrollment) areas of Employee Self Service. To View / Print: You will need Adobe Acrobat Reader ( to view/print forms. 34

35 Your Wellness Benefits Spend Less, Feel Better, Be Healthier Your health is your greatest asset. That s why it s important to do all you can to protect it. So, in addition to seeing the doctor when you are not feeling well, you should consider getting regular preventive care (such as physicals), eating right, and exercising. Small changes in your behavior can add up to great things: a healthier body, a happier outlook and even a thicker wallet. By taking care of your health proactively, you might be able to prevent major health conditions from developing. But if you do have a serious or chronic condition, programs from AU Medical Center may help. Members of the AU Medical Center health plan will continue to be provided opportunities to receive preventive/routine care benefits to assist in evaluating or assessing your health and well- being for possible detection of unrevealed illness or injury. These may also improve health and extend life expectancy. For example All Members Yearly preventive medical visits (wellness exams) All standard immunizations recommended by the American Committee on Immunization Practices Hearing Exams Eye Exams/Eye Refractions FDA-approved contraceptive methods, sterilization procedures, and patient education and counseling, not including abortifacient drugs Screening services for all members at appropriate ages or risk status Colorectal cancer screening (fecal occult blood testing, sigmoidoscopy, colonoscopy, CT colography) for adults over age 50 Cholesterol and lipids screening Screening and counseling for certain sexually transmitted diseases and HIV High-intensity behavioral counseling to prevent sexually transmitted infections (STIs) for all sexually active plan members and those at increased risk for STIs Alcohol misuse screening and counseling Tobacco use screening, counseling and cessation interventions for those who use tobacco products Substance abuse screening and counseling Nutritional counseling for adults at higher risk for chronic disease High blood pressure screening Diabetes screening Depression screening Screening and counseling for obesity (adults and children) For Women Well-women visits to obtain recommended preventive services for women under 65 Screening mammography 1 time per year for all adult women age 40 or older Counseling and evaluation for genetic testing for BRCA breast cancer gene for all women at higher risk Screening for cervical cancer including Pap smears Screening for gonorrhea and syphilis Screening for chlamydia infection for all pregnant women aged 24 and younger and for older pregnant women who are at increased risk Screening for pregnant women for anemia and iron deficiency, bacteriuria, hepatitis B virus 35

36 Rh Incompatibility screening for all pregnant women and follow-up testing for women at high risk Instructions to promote and help with breast feeding Screening for osteoporosis for those age 60 or older Counseling for those at high risk for breast cancer for chemoprevention Expanded counseling for pregnant tobacco users Screening and counseling for domestic and interpersonal violence for all women High risk HPV DNA testing every three years for women with normal cytology results who are 30 or older For Men: Screening for prostate cancer for those age 40 and older One-time screening for abdominal aortic aneurysm for those ages 65 to 75 who have ever smoked Additional Preventive Practices that are acceptable by the US Preventive Services Task Force and Patient Protection and Affordable Care Act Use of aspirin for men in age 45 to 79 for the Prevention of Cardiovascular Disease Use of aspirin for women age 55 to 79 years Folic Acid supplements for women who may become pregnant Iron supplements for children ages 6 to 12 months at risk for anemia Medical history for all children throughout development Fluoride for prevention of dental cavities for children Gestational diabetes screening for women 24 to 28 weeks pregnant and those at high risk of developing gestational diabetes Autism screening for children at 18 and 24 months For Children: Height, weight and body mass index (BMI) measurements for children Behavioral assessments for children of all ages Screening newborns for hearing, thyroid disease, phenylketonuria, hemoglobinopathies or sickle cell Standard metabolic screening panel for inherited enzyme deficiency diseases Screening for major depressive disorders Vision screening Developmental screening for children under age 3, and surveillance throughout childhood Screening for lead and tuberculosis Oral health risk assessment Gonorrhea preventive medication for the eyes of all newborns Hematocrit or hemoglobin screening for children 36

37 AU Medical Center s Health Management Programs AU Healthy You Wellness Program AU Medical Center s wellness program, AU Healthy You, is designed to help you adopt a healthier lifestyle and take preventative measures to avert the onset of an illness or disease. The AU Healthy You Wellness Program is voluntary and confidential. Your participation will not affect your employment or benefits in any way, be used in any data analysis, or be published in any manner. If you participate, you must first complete the Biometric Screening and Clinical Health Risk Assessment. Both are free of charge to you and will give you the opportunity to earn HSA dollars! Biometric Screening What is Biometric Screening? A biometric screening is a short health examination that determines your risk level for certain diseases and medical conditions. The health check provides several measures including: cholesterol levels for full lipid panel and glucose; blood pressure; blood glucose levels and also includes a measurement of height, weight and body mass index (BMI). Results are confidential, and fall under the same strict privacy guidelines as all other medical records and personal information. The complete biometric screening will only take about 15 minutes Both screening and CHRA must be completed between November, 2016 and May, Lifestyle Classes You can participate in classes on health/fitness, weight management, nutrition, stress management, smoking cessation and workplace safety. Physical Fitness and Activities Create personal goals and take part in fun activities and departmental challenges. If you are interested in joining AU Healthy You please contact Employee Health & Wellness at , for details! What are the benefits of a Biometric Screening? The biometric screening will allow you to learn more about your current health status, and determine your risk for very common and very treatable diseases such as diabetes, heart disease, asthma and other medical conditions. 37

38 Tobacco-Free Incentive Program Reduced Medical Premiums Save on Your Medical Premiums AU Medical Center will reward you for being tobacco-free. If you enroll in the AU Medical Center medical plan and attest that neither you, nor your covered family members, use tobacco products, you will receive a reduction in your medical plan premiums of $41.67/month or $19.23/bi-weekly. All AU Medical Center employees and their dependents that smoke or use tobacco products, including electronic cigarettes, are encouraged to quit. The AU Cancer Center offers an evidence-based tobacco cessation program tailored to meet the individual s unique needs. Cessation services are comprised of two parts: (1) an initial visit and health assessment and (2) cessation classes. Upon completion of the cessation program, AU Medical Center employees/dependents should present their Certificate of Completion of the Augusta University Cancer Center s Cessation Program to the Human Resources Benefits Office in order to update their tobacco-use attestation and qualify for additional health insurance-related benefits. To schedule a tobacco cessation appointment: Call For information, visit Counseling A tobacco cessation benefit is offered to all AU Medical Center covered plan members. The benefit includes: an initial clinic visit, behavioral counseling classes and pharmacotherapy. The medical screening and counseling benefit will be available through the Augusta University Cancer Center. The pharmacy benefit will be available through the AU Medical Center Employee Pharmacy. Once counseling is completed, to receive reduced premiums related to your health plan, bring proof of completion to Benefits, Human Resources. How to Become Eligible for Health Plan Premium Reductions after Annual Enrollment Throughout the calendar year, AU Medical Center health plan members will have the opportunity to become eligible to receive a premium reduction if you attend the approved voluntary smoking cessation program through the AU Cancer Center. Can t Stop Using Tobacco? Opting Out Is Easy! At any time during the year, you may choose to opt out of the conditions of the Tobacco-Free Attestation if you are not able to remain tobacco free. You must send an to AUMCBENEFITS@augusta.edu stating that you are unable to remain tobacco free and you wish to opt out from receiving the tobacco premium reductions. Your premium reduction will be discontinued at the beginning of the next payroll period. You must send the regarding your choice to opt out before you have been notified and selected for random nicotine and metabolites testing. Otherwise, you will be in violation of the terms of this incentive program. AU Medical Center has the authority to terminate your health insurance coverage and/or your employment, as well as require repayment of the incentive amount received during the plan year. 38