What s New in 2015 Healthy Advantage Option and Health Savings Account The Healthy Advantage Option is a consumer-directed health plan with a Health Savings Account (HSA), which provides a unique way to help you pay for out-of-pocket health care expenses. This plan offers valuable, comprehensive coverage for you and your family at a much lower cost than Core Plus. Each year, the IRS sets guidelines for consumer-directed health plans (like the Healthy Advantage Option) and their accompanying HSAs. To comply with these guidelines, we need to increase the in-network deductibles by $50 for employee-only coverage and $100 for family coverage. 2015 Healthy Advantage Option In-Network Out-of-Network Annual Deductible Employee Only $1,300 $2,600 $2,000 $4,000 Annual Out-of-Pocket Limit (Includes deductible) Individual $4,500 $9,000 $6,000 $12,000 The HSA contribution limits, which are set annually by the IRS, will increase slightly as well to $3,350 for employee-only coverage and $6,650 for family coverage. These limits include your contributions plus any Healthy Living Rewards you earn. If you will be age 55 or older by December 31, 2015, you can make an additional annual catch-up contribution of $1,000.
Core Plus Medical Option PepsiCo will continue to offer the Core Plus Medical Option for 2015. Note: The Core Plus Medical Option is not available to executives in Band 2 and above. We are making the following changes to the Core Plus Medical Option: 1. Increases to in-network deductibles The individual deductible will increase by $100, and the family deductible limit will increase by $200. Here s a summary of the 2015 deductibles. In-Network Out-of-Network 2015 Core Plus Annual Deductible Individual $600 $1,200 $2,000 $4,000 2. Changes to out-of-pocket limits Amounts you pay toward prescription drugs at retail pharmacies and mail order will now count toward the annual out-of-pocket limit. This change is being made to comply with a new rule under the Affordable Care Act (ACA), which requires that all eligible prescription drug expenses count toward the limit. Currently, mail-order prescription drug expenses count toward a separate $1,500 out-of-pocket maximum, which will be eliminated in 2015. In-Network Out-of-Network 2015 Core Plus Annual Out-of-Pocket Limits: Medical and Prescription Drugs Combined (Includes deductibles) Individual $4,000 $8,000 $8,000 $16,000 3. Target Pricing If you are covered under Core Plus, need one of the procedures subject to target pricing and choose a provider that charges more than the target price, any amount above the target price does not count toward your deductible. Starting in 2015, any amount above the target price will not count toward the deductible and the out-of-pocket limit. As a reminder, procedures subject to target pricing include radiology scans, arthroscopies, upper GI endoscopy procedures, non-preventive colonoscopies and bunionectomies. Target pricing does not apply in emergency situations.
4. Emergency Room Copay The Core Plus Option includes a copay for emergency room visits. The $150 emergency room copay will increase to $250 after your first two visits in a calendar year (starting with a third visit). (The $100 emergency room copay for the first two visits remains the same.) For non-emergency situations, you can save money (and time) by using less expensive options such as urgent care facilities, Teladoc or NurseLine. HMOs HMOs will continue to be offered where they provide good value to employees. In 2015: The Kaiser Permanente of Ohio Plan will no longer be available. IHC Select Med (Utah) will be making plan design changes. If you are affected by these HMO changes, you ll receive a separate communication with more details. If your HMO isn t changing, you can still expect to see increases in employee contributions. Use the Health Plan Comparison Charts and Medical Expense Estimator on YBR to make sure an HMO is still the right choice for you and your family. Employee Contributions The changes we put in place for 2014 are helping to keep cost increases in check. If you remain in Healthy Advantage or Core Plus for 2015, there will be no increase in paycheck contributions. However, that doesn t mean health care costs still aren t a challenge. They continue to increase a reminder that we all need to stay diligent in managing our own health and health care. Alternate Coverage Contribution The alternate coverage contribution is the additional amount you pay to cover a spouse/partner who works full-time and has major medical coverage available through his or her employer. (If your spouse/partner is offered a preventive care-only plan, you would not be subject to the alternate coverage contribution.) We set the amount at $600 when we first introduced the alternate coverage contribution in 2011. In 2015, we will be increasing the annual amount to $1,200, which is more in line with what other companies charge. We encourage working spouses/partners to evaluate their own employer s medical coverage before enrolling in PepsiCo s plan. During this fall s annual enrollment, you will be required to re-certify whether the alternate coverage contribution applies. See important note below. Please remember the alternate coverage contribution is subject to audit at any time.
Does your spouse/partner have full-time medical coverage available through another employer outside of PepsiCo? If you answer NO You certify that your spouse/partner: If you answer YES You certify that your spouse/partner: Does not work, works part-time or works for PepsiCo or Is not eligible for medical coverage from his or her employer. Works full-time for an employer other than PepsiCo (including selfemployment) and Can obtain medical coverage from his or her employer. In these cases, the alternate coverage contribution will not apply. In this case, the alternate coverage contribution will apply. If you have a qualifying life event during the year (e.g., your spouse/partner gains or loses other coverage), you will need to update your response by logging onto YBR or calling the HR Service Center. Important Note! If you are currently covering a spouse/partner and you don t actively enroll and re-certify, the alternate coverage contribution of $1,200 will automatically apply starting with your first paycheck in 2015. Care Management Program PepsiCo invests in the Healthy Living wellness program to help you and your family manage a variety of health issues, including ongoing serious illnesses and pregnancy. In 2015, our Care Management Program will be enhanced to provide those enrolled in the Healthy Advantage and Core Plus Options with even more support. The new program will be offered through our medical plan carriers Anthem Blue Cross and Blue Shield and UnitedHealthcare. Having them administer the Care Management Program gives you one place to go for your health care needs and builds on our very successful Health ACE model. The Care Management registered nurses will have real-time access to information on your benefits and claims, so they can provide more effective support, guidance and education. Whether you are facing a planned surgery, navigating at-home recovery after a recent hospitalization, dealing with a serious health condition or preparing to have a baby, the Care Management Program is designed to ensure you have the support you need from a team of qualified professionals.
Healthy Living Rewards To encourage you to take the steps that lead to better health, we are increasing our investment in wellness rewards for 2015. You and your covered spouse/partner will each be able to earn up to $300 in Healthy Living Rewards next year. Here s how: $200 for completing BOTH the PHA and a biometric screening. The combination of your PHA and screening results will give you the comprehensive information you need to determine where you need to focus. That s why we re requiring that you complete both by September 30, 2015 to receive those Healthy Living Rewards. $100 for having at least three out of four biometric screening results within the healthy range and/or moderate health risk range (or, if outside the healthy/moderate health risk range, for completing four telephonic coaching calls). Keep in mind that a spouse/partner must be covered under a PepsiCo medical plan in order to be eligible for Healthy Living Rewards. If you enroll in the Healthy Advantage Option, these rewards will be contributed to your HSA and will be tax-free to you. Please note that you must open your HSA by December 17, 2015 or your rewards will be forfeited. If you enroll in another option or waive coverage through PepsiCo, you will receive a Healthy Living Reward Card, which will be treated as taxable income. Treatment Decision Support Process The treatment decision support process through Best Doctors, introduced in 2013, is designed to educate patients about their treatment options. The goal is to achieve better health outcomes and, when appropriate, avoid unnecessary, more costly inpatient surgical procedures. Through a few simple phone calls, Best Doctors will help you understand the risks, benefits and costs of your various options. Because the process has been so successful in accomplishing its goals and giving patients the confidence to make the best decision for their situation, we will be expanding it. Starting in 2015, we are adding two more procedures: shoulder surgery and carpal tunnel surgery. The table below outlines the procedures that are subject to treatment decision support. If you have an inpatient surgery for one of the procedures without consulting Best Doctors, the first $500 of costs will not be covered. You will be required to pay this amount, and it will not count toward your deductible or out-of-pocket limit. We are recommending you follow the treatment decision support process for any of the surgical procedures performed on an outpatient basis. However, the penalty will not apply.
2015 Procedures Subject to Treatment Decision Support Knee surgery Back surgery Hip surgery Gallstones (non-emergency treatment) Benign uterine condition NEW: Shoulder surgery Bariatric surgery NEW: Carpal tunnel surgery Pre-Certification Requirements There will be a few changes to the pre-certification requirements under the Healthy Advantage and Core Plus Options. Here s a summary of what s changing for 2015: Procedure/Service 2014 2015 Durable Medical Equipment/ Orthotics Required over $500 Required over $1,000 Physical, Occupational, Speech, Vision Therapies Required after 20th visit Not required, but benefit is capped at 100 visits for all therapies combined Home Infusion Therapy Not required Required Diabetic Education Required after four visits Not required, but benefit is capped at four visits For the complete list of pre-certification rules, go to the Plan Details section on the Total Rewards website or call your Health ACE. Company-Provided Life Insurance Company-provided life insurance coverage for all eligible employees will be 1 times eligible pay, regardless of years of service, starting in 2015. This level of coverage is more in line with what other companies offer. If you have 10 or more years of service and are currently receiving 1.5 times eligible pay, you will automatically be enrolled in an additional 1 times eligible pay of Optional Life Insurance, unless you elect otherwise. You will not be required to provide evidence of insurability for this increase. Note that you can decrease your Optional Life Insurance coverage during annual enrollment or at any time during the year. If you are impacted by this change, you will receive a separate communication with more information.
Employee Assistance Program Beginning in 2015, the Employee Assistance Program (EAP) will be administered by Optum. This change will bring several enhancements to PepsiCo employees and their families: Immediate support from clinicians who have a master s degree in one of the main behavioral health disciplines social work, nursing, professional counseling, or marriage and family therapy. They will provide support by telephone or secure video conference for challenges with family and relationships, grief and loss, and workplace issues. A significantly larger network of providers to choose from for in-person counseling. The program will continue to offer up to four visits per year per incident at no cost. Access to online self-help programs and tools, educational information and a professional services directory. These will be available at liveandworkwell.com (password is Pepsi) starting in January. The EAP is available to all eligible employees, regardless of medical plan election. There will be no change to PepsiCo s EAP Private Line Number, which remains 1-800-223-7486. New for You Available Now! YBR Mobile. Make enrollment decisions and enroll right from your smartphone. Go to MyPepsiCo.com and look for the U.S. Benefits link on the main menu. Then you can make your enrollment decisions wherever you are. New & Improved! Discounts & Promotions Program. We re excited to bring you this new and improved program, which is available now. From adventure parks to movie tickets to appliances to retail stores, you can save on everyday purchases, both online and from local businesses. The new website, powered by PerksConnect, is also the new place to comparison-shop for auto, home and other insurance (including boat, motorcycle, renters, condo, etc.) from MetLife, Travelers and Liberty Mutual. Access the site via MyPepsiCo.com > Pay, Benefits and Career > Work/Life > Discounts & Promotions. Or download the PerksConnect app from the Apple or Android store (group code is PepsiCo). PepsiCo does not make any endorsements of or representations regarding any of the discounts or promotions available under this program. Coming Soon! my HealthHub. PepsiCo is creating this online resource to help you and your family members make smart health care decisions. You will find information and tools to help you understand how, when and where to access quality care and get the most value for your health care dollars. Note that this resource will be made available to your family members as well to ensure they have access to the information they need to take charge of their health.