Welcome to Mid-Year Medical Renewal 2012!
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- Claribel Lee Dickerson
- 5 years ago
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1 Inside this issue: Your Current 0 Premiums Dental and Flex Spending Open Enrollment Information Basic Life and AD&D Insurance Humana Supplemental Products Lincoln Financial Ancillary Products FAQs (Medical, Pharmacy, Vision) Anthem Medical Plan Information Anthem Care Comparison Health Savings Account Details On-line Enrollment Instructions Qualifying Events Crosspoint Boulevard Indianapolis, IN 4656 Phone: Fax: Like us on Welcome to Mid-Year Medical Renewal 0! Renewal for medical is here! This is your opportunity to review your medical election and make a new selection for August 0 December 0. The renewal period is July 9 July 7, 0. Changes made during this time will have an effective date of August, 0. New medical payroll deductions will begin with your first payroll in August. After July 7, all changes requested for 0 medical coverage will be restricted to Qualifying Events (see back page for details). IMPORTANT!!! This renewal period does NOT include dental insurance and flexible spending account election changes. Your current dental election and flexible spending account(s) will remain the same until December 3, 0. We are pleased to announce that our partnership with Anthem will continue! Anthem is the provider for Medical and Vision Insurance. Please review this mailer for details of the 0 Mid-Year Medical Renewal. This outlines important rate and plan information. Everyone with a current medical plan election MUST complete an enrollment, as all medical plan options are changing. Important Facts: Renewal, for medical insurance only, is July 9 July 7. The medical renewal period is for the rest of 0: August, 0 December 3, 0. You will receive a new Member ID card for your August medi- Paperless Enrollment via DarwiNet WorkSmart Systems will once again have online enrollment. It is easy and simple to use. The online enrollment will be administered through our payroll system, DarwiNet. Please go to darwinet to access your 0 Medical Renewal. Your User ID is your Work- Smart Systems employee identification number. This is the ninedigit number printed below your name and address on the back page of this document. Your password is your social security number, without the dashes. If you currently use DarwiNet to access your pay information and have a password different from your social security number, continue using your unique password. If you do not remember your unique password, select the Forgot Password option on the DarwiNet log-in screen. Please see pages 8 and 9 for instructions on how to complete your 0 medical enrollment through DarwiNet. Your online enrollment will provide instant confirmation of your elections. Be sure to print the confirmation page for your records. If you are unable to enroll online, you may obtain the appropriate forms via or fax. cal plan, with a new Member ID number and new Group number. Your deductible and out-ofpocket run on a calendar year, so they do not start over August. Employees will receive deductible credit. All of your medical plan options are new. Please review the information carefully and select the best plan for your needs. If you have Renewal questions, please check the FAQs on page 3 and/or on the WorkSmart Syst e m s w e b s i t e ( westport). Contact WorkSmart Systems at to request a form. Enrollment closes at midnight on July 7, 0. All enrollment decisions, whether via online enrollment or manual form, must be in the WorkSmart Systems office by July 7 in order to make your changes for August, 0. Outside of this enrollment period, changes to medical enrollment are restricted to qualifying event reasons. We are ready to answer your questions (check the FAQs on our website first), and we look forward to receiving your 0 medical election. Thank you for your prompt attention.
2 Page WorkSmart Systems, Inc. Your Current Premiums: Medical ($,000 HIA; $3,000 HDHP; $5,000 HDHP) You Pay: $xxx.xx/mo. Your Employer Pays: $xxx.xx/mo. Dental (Gold; Silver) You Pay: $xxx.xx/mo. Your Employer Pays: $xxx.xx/mo. Flexible Spending Account (Health Care) monthly election: $xxx.xx Flexible Spending Account (Dependent Care) monthly election: $xxx.xx Health Savings Account : (Yes/No) New Medical Premiums (Effective ): 0 Renewal Medical Premiums $,000 PPO HRA Employee Only $86.3 $60.6 HDHP $9.34 $5,000 PPO $79.7 Employee + Spouse $878. $77.0 Employee + Child (ren) $ $ Family $,68.4 $,00.64 $58. $57.94 $ $643. $ $ These are your monthly premiums. The company s contribution has already been calculated and is reflected in the above rates. 0 Dental and Flexible Spending Enrollments Your current dental and flexible spending account elections will continue through December 3, 0. You will be able to make changes to these elections during our regular Open Enrollment this fall, for benefits effective January, 03. Basic Life and AD&D Insurance Lincoln Financial All benefit eligible employees will have a $5,000 Life and AD&D insurance policy through Lincoln Financial. Basic Life with Lincoln Financial is in addition to any Voluntary Group Term Life Insurance policy you currently have through Lincoln Financial. Humana Supplemental Insurance Products WorkSmart Systems offers Supplemental Insurance products through Humana. The three voluntary plans (Accident Plus, Supplemental Health and Critical Illness Advantage Plus) are not subject to open enrollment, thus enrollment is ongoing throughout the year. All three plan options provide benefits regardless of other in-force coverage, including medical insurance, so there is no coordination of benefits. Each product offering is independent of the others. You can elect any or all plans that are applicable to you and your family. For specific coverage information or to enroll in any of these products, go to supplemental. Lincoln Financial Ancillary Products (Disability and Voluntary Life Insurance) Ancillary products include short-term disability (STD), long-term disability (LTD) and voluntary group term life and AD&D insurance, which are not affected by renewal. Your coverage will continue without interruption unless you notify WorkSmart Systems in writing that you wish to cancel your coverage. These products are not subject to renewal, nor open enrollment, thus enrollment is ongoing throughout the year. If you are not currently enrolled in STD, LTD, Employee Life, Spouse Life or Child Life (available only with Employee or Spouse Life), but wish to elect the coverage, you may apply for these benefits at any time throughout the year. You need to complete the Evidence of Insurability form required by Lincoln Financial for consideration. This form is available on the WorkSmart Systems website ( westport). Simply complete the form and send it to us at humanresources@worksmartpeo.com, or fax it to us at
3 Open Enrollment 0 Page 3 Medical Insurance and Vision Discount Anthem Anthem will continue as the provider for medical insurance, pharmacy benefits and vision benefits for 0. MEDICAL INSURANCE FAQs Q. Does my deductible start over August? A. No. Your 0 deductible and out-of-pocket run on a calendar year, so they will not start over August. Employees will receive credit for 0 deductible paid to date, even if they change plans. Q. What happens if I do not complete an enrollment at this time? A. If you do not complete an enrollment, your existing medical participation will be mapped as follows: Waive/Basic Life Waive/ Basic Life; $,000 HIA $3,000/$6,000 HRA; $3,000 HDHP $3,500 HDHP; $5,000 HDHP $3,500 HDHP. Q. Will I get a new medical insurance card? A. Yes. If you will have medical coverage as of August, 0, you will receive a new medical ID card at your home address. Your new card will be effective August, 0, for medical, pharmacy and vision benefits. Q. How do I find an In-Network provider? A. Log in to your MyAnthem web page (Member Log In at and you will have easy access to participating network providers. Q. How do I contact Anthem if I have an issue with a claim or another customer service question? A. You can contact Anthem customer service through the number on the back of your member ID card. You will have access to your information via your online account at You may also contact WorkSmart Systems at with your questions. Q. What tools, cost containment and otherwise, are available to me with Anthem? A. Anthem provides many robust and cutting edge web tools on their website at Once you become a member, you will have access to Anthem s 360 health program. This includes Future Moms, 4/7 nurse line programs and MyAnthem your personalized benefits site. PHARMACY FAQs Q. How do I find out if my pharmacy is In-Network? A. You can find In-Network pharmacies at Use the Member Log In feature to find a pharmacy near you. Q. What is the name of the drug card? A. Anthem Pharmacy Manager administered through Express Scripts. Your medical card will also service as your prescription card. Q. What is the name of the mail-order program and how do I begin this process? A. Anthem Pharmacy Manager/NextRx. A form is available on the WorkSmart website ( or you can access the form via your MyAnthem. Q. Does Anthem require prior authorization for certain drugs? A. Yes, Anthem does require prior authorization and step therapy for certain prescriptions. Anthem uses Specialty Pharmacy Solutions for specialty medications. VISION FAQs Q. Is Vision included in my medical plan? A. Yes, vision is included in your medical plan. The vision benefit provides you with one routine eye exam every months at a $5 copay with discounts available for lenses and frames. Q. Who is the vision plan carrier and how do I find providers? A. Anthem Blue View Vision. You can access network information at Log in to your MyAnthem web page (Member Log In at and you will have easy access to participating network providers.
4 Page 4 Traditional PPO $,000 Deductible: Individual $,000 Family $4,000 IN-NETWORK COVERAGE Coinsurance: 80% covered by insurance / 0% by member after deductible Out-of-Pocket Maximum: Individual $4,000 Family $8,000 Wellness: Adult wellness / immunizations 00% by insurance Child wellness exams / immunizations 00% by insurance Routine mammogram 00% covered by insurance Routine eye exam (every months) $5 copay Office Visits: Primary Care $5 copay Specialty Care $50 copay Pharmacy: Tier (Generic) $5 copay Tier (Formulary) $35 copay Tier 3 (Non-formulary) $50 copay Diagnostic Lab and X-Ray: 00% covered at LabCore, Quest Diagnostics/Mid America (Other In-Network) Physician Services: Other Medical Services (Therapy**, Maternity, Hospital): Mental Health, Chemical & Alcohol Dependency: Inpatient/Outpatient 80% covered by insurance after deductible Office Visit $5 copay Emergency Medical Care: Urgent Care $75 copay Emergency Room $50 copay + 0% coinsurance (ER copay is waived if patient is admitted) 0 WorkSmart Health Reimbursement Account IN-NETWORK COVERAGE Deductible: Individual $,500 after $500 Health Reimbursement Account (HRA) Family $5,000 after $,000 Health Reimbursement Account (HRA) (Family deductible must be met before coinsurance applies) Coinsurance: 90% covered by insurance / 0% by member after deductible Out-of-Pocket Maximum: Individual $4,500 after $500 HRA Family $9,000 after $,000 HRA (Family out-of-pocket max must be met before 00% applies) Wellness: Adult wellness / immunizations 00% by insurance Child wellness exams / immunizations 00% by insurance Routine mammogram 00% covered by insurance Routine eye exam (every months) $5 copay Office Visits: Primary Care 90% after deductible Specialty Care 90% after deductible Pharmacy: Tier (Generic) $5 copay after deductible Tier (Formulary) $35 copay after deductible Tier 3 (Non-formulary) $50 copay after deductible Diagnostic Lab and X-Ray: 90% covered by insurance after deductible Physician Services: 90% covered by insurance after deductible Other Medical Services (Therapy**, Maternity, Hospital): 90% covered by insurance after deductible Mental Health, Chemical & Alcohol Dependency: 90% covered by insurance after deductible Emergency Medical Care: Urgent Care 90% covered by insurance after deductible Emergency Room 90% covered by insurance after deductible **Therapy coverage is subject to plan limits. This is a plan summary and is not a complete description of the plans. The Summary Plan Description provides a more complete explanation of terms of coverage, limitations and exclusions, and will supersede if there is a difference between the two.
5 Anthem Medical Plans High Deductible Health Plan* Deductible: Individual $3,500 Family $7,000 IN-NETWORK COVERAGE Coinsurance: 80% covered by insurance / 0% by member after deductible Out-of-Pocket Maximum: Individual $5,800 Family $,600 Wellness: Adult wellness / immunizations 00% by insurance Child wellness exams / immunizations 00% by insurance Routine mammogram 00% covered by insurance Routine eye exam (every months) $5 copay Office Visits: Primary Care 80% covered by insurance after deductible Specialty Care 80% covered by insurance after deductible Pharmacy: Tier (Generic) $0 copay after deductible Tier (Formulary) $40 copay after deductible Tier 3 (Non-formulary) $70 copay after deductible Diagnostic Lab and X-Ray: Physician Services: Other Medical Services (Therapy**, Maternity, Hospital): Mental Health, Chemical & Alcohol Dependency: Emergency Medical Care: Urgent Care 80% covered by insurance after deductible Emergency Room 80% covered by insurance after deductible * HSA COMPATIBLE PLAN Traditional PPO $5,000 Deductible: Individual $5,000 Family $0,000 IN-NETWORK COVERAGE Page 5 Coinsurance: 80% covered by insurance / 0% by member after deductible Out-of-Pocket Maximum: Individual $7,500 Family $5,000 Wellness: Adult wellness / immunizations 00% by insurance Child wellness exams / immunizations 00% by insurance Routine mammogram 00% covered by insurance Routine eye exam (every months) $5 copay Office Visits: Primary Care $5 copay Specialty Care $50 copay Pharmacy: Tier (Generic) $0 copay Tier (Formulary) $40 copay Tier 3 (Non-formulary) $70 copay Diagnostic Lab and X-Ray: 00% covered at LabCore, Quest Diagnostics/Mid America (Other In-Network) Physician Services: Other Medical Services (Therapy**, Maternity, Hospital): Mental Health, Chemical & Alcohol Dependency: Inpatient/Outpatient 80% covered by insurance after deductible Office Visit $5 copay Emergency Medical Care: Urgent Care $75 copay Emergency Room $50 copay + 0% coinsurance (ER copay is waived if patient is admitted)
6 Page 6 Anthem Care Comparison Anthem Care Comparison is an innovative tool to help take some of the mystery out of healthcare. You can see real price ranges for common services at different facilities and providers in your area. You can compare quality factors, too, to help you evaluate experience and expertise. Try the Anthem Care Comparison today: Log in at Go to your Account Summary page Select Compare Facility Cost and Quality
7 Page 7 Health Savings Account (Available ONLY with the HDHP) If you enroll in the $3,500 HDHP Plan, you may be eligible to open and contribute to a Health Savings Account (HSA). If you enroll in either of the Traditional Plans or the HRA Plan, or if you have 0 Health Care Flexible Spending, you are not eligible for an HSA this year. In order to contribute to a Health Savings Account You must be enrolled in an HDHP The HDHP must be your only health care coverage. If you have or your spouse has a Flexible Spending Account that covers medical expenses, you are not eligible for an HSA You must not be enrolled in Medicare You must not be claimed as a dependent on another person s taxes (except for spouse) The Health Savings Account allows you to have choice and control You decide how much money to put into the account You decide to save the account for future expenses or pay current health care expenses You decide which health care expenses to pay from the account You decide which bank will hold the account You decide to invest some of your money in the account and what investments to make Funding the Account Contributions to your HSA can be made by you, your employer or both Contributions can be done via payroll deduction You may change the amount funded during the year The maximum funding for 0: $3,00 for Individual $6,50 for + People $,000 additional funding catch-up contributions if over age 55 Ownership The account belongs to you as the account holder Funds remain in the account from year to year and gain interest tax-free, just like an IRA. Unused amounts remain available for later years (unlike the forfeiture rule for Flexible Spending Accounts) SelectAccount WorkSmart sponsors SelectAccount for HSA accounts with pre-tax funding. You can, however, utilize any bank of your choice. Be aware that funding an HSA with a bank other than SelectAccount will be as a post-tax direct deposit. You are responsible for providing all bank and account information to WorkSmart Systems. Money is funded on a pre-tax basis with SelectAccount and will show in your HSA on the Friday following your pay date Interest bearing account that grows tax-free Once your account has reached a $,000 balance, you can elect to invest in Mutual Funds As long as your money is used for qualified expenses, you will not pay taxes on these dollars Access your money by check or via the optional HSA Debit Card Reimbursement There is no time limit when reimbursement can occur Expenses must be incurred after your enrollment in the HDHP/HSA Always spend your HSA money on qualified expenses. If you use the funds for ineligible items, you are subject to a 0% penalty, plus taxes on the amount you spent. You should keep your records for this account the same period of time you keep your income tax returns. Portability Accounts are completely portable, meaning you can keep your HSA even if you: Change jobs Change your medical coverage Become unemployed (you can pay COBRA premiums with your HSA money) Move to another state
8 Page 8 Step : Go to to log in Step-by-Step Instructions Step : Select the Open Enrollment Link to begin 3 NOTE: You will need Internet Explorer to properly view/use DarwiNet.. Your User ID is the nine-digit employee number, located below your name and address on the back page of this mailer.. Your Password is your social security number, without the dashes. If you currently use DarwiNet, you may have a different password. Use that unique password. If you don t remember your password, select the red Forgot Password button. 3. Select the Log In button, which will take you to a new screen where you will select Yes in the Security Information pop-up box. Step 3: Begin your enrollment. Select the Enrollment > Open Enrollment link. Step 4: Review your dependent information (if applicable) 3 4. To begin your online enrollment process, select Click Here to begin Enrollment, which will take you to the next screen where you can view the dependent information WorkSmart Systems has on file.. You do not need to edit the dependent information to include Lives with EE, Full Time Student or Disabled.. To edit current dependent information, click on the name to go to the next screen. From that screen, select the Edit button to go to the screen where you can make the changes. Be sure to select the Save button before you select the Exit button. To delete a dependent, select the name, enter Delete Dependent in the Comment section and select Save before you select the Exit button. 3. To add a dependent, select the Add button and enter the information. Select Save before you select the Exit button. 4. After all dependent information has been reviewed, you will select the Back button from the VIEW Dependent Info screen, then select Click to continue Enrollment. 5. If you have used DarwiNet for Open Enrollment in the past, you should see a screen that allows you to review previous elections, or continue. Select Continue. Step 5: Select your medical plan for 0 Step 6: Review the medical premium information. Scroll up/down to see all of your medical plan options. Select the radio button for the appropriate plan and level of coverage you are electing. If you do not wish to enroll in the medical insurance plan for 0, select WAIVED. After making your selection, scroll up and select the Next>> button.. This shows the plan you selected. It shows your Deduction Start Date (the payroll period start date, which will correspond to your first payroll in July); the Benefits Effective date (August, 0); Your Monthly Cost; your Pay Period Cost; and the Employer Monthly Cost. If you need to check the cost of other plan options, select the <<Previous button and follow the instructions in Step 5 for another plan. If you are unsure and want to save your progress, select the Save & Exit button. Once you have decided on a plan, click the radio button under Select.. Select the Next>> button to continue your enrollment.
9 for On-line Enrollment Step 7: Cover dependents (if applicable) Page 9 Step 8: Consider the Health Savings Account Option. If you are covering dependents, you will need to select COVERED from the dropdown menu for each dependent to be enrolled in the medical plan.. Select the Next>> button to continue your enrollment.. If you are eligible for a Health Savings Account, select Health Savings Account and select Next>> to proceed to the next screen where you will define your election amount.. If you do not wish to enroll in this account, or you are not eligible to fund an HSA at this time, select Waived and then select the Next>> button. Step 9: Define your HSA Amount (if applicable) Step 0: Review elections and confirm enrollment Enter your monthly amount. If the white box is not visible, deselect the radio button to the left and then reselect the radio button. The 0 Employee Only annual maximum is $3,00; Employee+Dependent annual maximum is $6,50; Annual catch-up amount for employees age 55+ is $,000.. Select the Next>> button to continue your enrollment.. Click here to review or change selections will take you through your elections one screen at a time.. Click here to show SUMMARY details will list all of your selections in a table. 3. After confirming your elections are correct, check the box to approve your elections. 4. Confirm your elections by entering your social security number and your login password (same as you used to log in to DarwiNet) in the designated boxes. 5. Select Click to submit Enrollment button. Select the OK button on the pop-up window. Print your 0 Medical Open Enrollment confirmation (see Step ). Step : Print your confirmation Above is a sample of what your confirmation screen will look like. To get to it, follow these instructions:. From the Employee Plans for (Your Name) screen, you will be able to print the page listing your elections and covered dependents. To print your confirmation, select the Preview button and print using your browser print option. DO NOT use the Print button.. If your printed confirmation does not correspond to what you intended to elect, contact WorkSmart Systems by phone at , no later than Tuesday, July 7, 0, or by at humanresources@worksmartpeo.com, no later than Tuesday, July 7, 0.
10 9957 Crosspoint Boulevard Indianapolis, IN 4656 Phone: Fax: Like us on Medical Renewal is July 9 July 7 (For your 0 Medical Insurance) Renewal & E-Learning Tools Check out the e-learning tools on our website ( Our website is available 4/7 and you can utilize the e-learning tools at your convenience. Qualifying Events Outside of Open Enrollment, the only time to make changes to your medical, dental and flex elections during the year is due to a change in family status or a life event. These include: Marriage or divorce Birth*, adoption or placement for adoption of a child Death of your spouse or a dependent Change in your spouse's employment resulting in gain or loss of coverage Change from part-time to fulltime (or vice-versa) by you or your spouse Significant change in coverage by your spouse's employer Changes in entitlement to Medicare or Medicaid Qualification by Plan Administrator of a medical child support order Employee satisfies or ceases to satisfy dependent eligibility requirements on another group plan Your request for a change in enrollment must be clearly related to the life event change, and is limited to adding or dropping a dependent and/or coverage, as applicable. You are responsible for notifying the Human Resources Department at WorkSmart Systems so that changes can be made with the insurance carrier within 30 days of the life event. By law, changes cannot be made after the 30-day period ends. Your request to change coverage must be datestamped in the WorkSmart Systems office within 30 days of the qualifying event. * If your qualifying event is due to birth of a child, you must add the child to the plan within the first 30 days of life.
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