Choose HELLO, ENROLLMENT. your benefits Oct. 5 Nov. 8
ARE YOU READY? IT S TIME TO ENROLL! It s important to review your choices and determine what coverage makes sense for you and your family. Take a look at this guide for the information you need to make sure you make the best choice. CHANGES WHAT S NEW Here s a quick look at what s new: 3 WE ARE CHANGING BENEFIT ADMINISTRATORS. Effective this enrollment period, we are changing the administrator for our benefits (from Mercer to Alight). This means there will be a new enrollment process this year. If you re a BNSF Railway employee, you ll need to go to the Employee tab of the portal and click on 09 Health Plan Elections under the Benefits and Well-Being section to enroll. If you re a BNSF Logistics employee, go to the Logistics intranet and click on the Annual Enrollment graphic to choose your benefits. Even if you don t want to make any changes to your benefits for 09, please register on the site and verify that all of your information transferred over correctly. If you find an error, call the BNSF Benefits Center at 833-77-805. THE CIGNA LOCALPLUS NETWORK IS AVAILABLE FOR OPTION. In 08, we introduced a new medical network for participants in Option who live in certain ZIP codes in and around the Dallas/Fort Worth area. For 09, we re extending the network to participants in Option. What does it mean for you? If you are in the DFW area and enroll for BNSF medical coverage, you ll have a choice between Blue Cross Blue Shield (BCBS) or Cigna for your network. If you choose Cigna, a narrower, cost-effective network that does not sacrifice quality, BNSF will share the savings by adding more money to your Health Savings Account (HSA) for 09 than if you choose BCBS. CONTRIBUTIONS FOR SOME BENEFITS ARE INCREASING. Contributions for both medical options are increasing slightly. We re also adding a new contributions tier to more fairly distribute costs among employees at all income levels, and to help smooth transitions for promotions and salary increases. HEALTH SAVINGS ACCOUNT (HSA) AND HEALTH CARE FLEXIBLE SPENDING ACCOUNT (FSA) MAXIMUM CONTRIBUTION AMOUNTS ARE INCREASING. For the HSA, the maximum contribution (yours + BNSF s) for You Only coverage is increasing to $3,500 and for all other coverage levels is increasing to $7,000. For the Health Care FSA, your maximum contribution is increasing to $,650. Go to enroll.mybnsf.com for all your enrollment information!
NROLLING CHOOSE YOUR BENEFITS Make sure you get the benefits you want. Here s what you need to do: REVIEW YOUR OPTIONS AT ENROLL.MYBNSF.COM. USE THE TOOLS TO HELP YOU CHOOSE. enroll.mybnsf.com 3 KNOW IF YOU NEED TO ENROLL. You must take action if you want to: Contribute to a Health Care FSA and/or Dependent Care Reimbursement Account (DCRA). Make any other changes to your benefits and/or covered dependents. If you do not enroll: Your current benefit elections will roll over, including medical option and network, and HSA contributions from your paycheck and/or ICP award. You won t be able to contribute to a Health Care FSA or DCRA. You won t be able to enroll or make changes during the year unless you experience a qualifying family status event, such as marriage, or birth or adoption of a child. You must notify the BNSF Benefits Center within 3 days of the event to make any changes. Go to enroll.mybnsf.com to review your plan options, health care paycheck contributions and more. Plus, your spouse can also review your options on this site. BNSF Benefits Center The BNSF Benefits Center can answer questions about your plan options, eligibility, the enrollment process and more. Call 833-77-805 Monday Friday from 7 a.m. to 7 p.m., Central time. ENROLL ONLINE BEFORE MIDNIGHT CENTRAL TIME THURSDAY, NOV. 8. To enroll, go to the Employee tab of the intranet and click on 09 Health Plan Elections under the Benefits NEW THIS YEAR and Well-Being section. If you are a BNSF Logistics employee, go to the Logistics intranet and click on the Annual Enrollment graphic to choose your benefits. If your medical coverage includes an HSA, your Health Care FSA becomes Limited Purpose and can be used only for eligible dental and vision expenses. 3
EDICAL YOUR OPTIONS Both medical options pay 00% of the cost for in-network preventive care, including some preventive prescription drugs. But before the options pay anything else, you must meet your deductible, which is based on who you cover. You can use money in your HSA to help, including money from BNSF. Here s what you pay when you need care: Deductible Out-of-Pocket Maximum Coinsurance You Only Family You Only Family Option Option In Network Out of Network In Network Out of Network $3,500 $7,000 Office Visits, Urgent Care, Hospital Care, Maternity Care 3 0% after deductible $,500 $3,000 $5,500 $,000 0% 0% after deductible after deductible Note: Family coverage applies for employee + spouse, employee + child(ren) and employee + family coverage. $3,000 $6,000 $5,000 $0,000 $7,000 $,000 0% after deductible Out-of-network expenses are paid based on the allowed charge. You are responsible for any amount above the allowed charge, even after you reach your out-of-pocket maximum. With Family coverage, there is an individual in-network out-of-pocket maximum of $7,900. 3 Some prenatal care is covered 00% as preventive. There are no out-of-network benefits for dialysis. Certain bariatric services are only covered at a Blue Distinction Center, Blue Distinction Center+, a Cigna Center of Excellence or SurgeryPlus provider. Know this! There can be big differences in quality and cost for a procedure, even among in-network facilities. Looking for a network hospital that provides high-quality care for specific procedures? On the administrator s website, search for providers that are recognized: Blue Distinction Centers are facilities and providers recognized for their expertise in delivering specialty care. Blue Distinction Centers+ and Cigna Centers of Excellence are facilities and providers recognized for their expertise and efficiency in delivering specialty care. MEDICAL PRESCRIPTION DRUGS Both medical options include prescription drug coverage, administered by CVS Caremark. Specific Preventive Drugs Retail (up to a 3-day supply) Generic Formulary Brand Non-Formulary Brand Mail Order or CVS Pharmacy (up to a 90-day supply) Generic Formulary Brand Non-Formulary Brand Specialty (Caremark s Specialty Drug List) Up to a 30-Day Supply Up to a 90-Day Supply In Network Option or Option Out of Network No deductible; you pay the copay or coinsurance amount shown below After you meet your medical deductible, you pay: $7.50 (or actual cost, if less) ($30 minimum, $0 maximum) 0% of the cost ($50 minimum, $50 maximum) $5 (or actual cost, if less) ($60 minimum, $0 maximum) 0% of the cost ($00 minimum, $300 maximum) ($75 maximum) ($55 maximum) There are formulary exclusions where you will pay 00% of the cost of the drug. After you meet your medical deductible, you pay: After you meet your medical deductible, you pay: After you meet your medical deductible, you pay the amount below plus any difference between the actual out-of-network charge and the amount that would have been charged by an in-network pharmacy: $7.50 (or actual cost, if less) ($30 minimum, $0 maximum) 0% of the cost ($50 minimum, $50 maximum) MEDICAL CONTRIBUTIONS What you pay each pay period for medical and prescription drug coverage depends on the option you choose, your base salary and who you cover. Annual Base Salary Under $75,000 Option $75,000 $00,000 $00,00 $5,000 Over $5,000 Under $75,000 Option $75,000 $00,000 $00,00 $5,000 Over $5,000 You Only $3.50 $.00 $55.50 $68.50 $9.00 $7.00 $3.00 $.00 You + Spouse $9.50 $7.50 $9.00 $80.00 $56.00 $76.00 $9.50 $3.00 You + Child(ren) $80.00 $99.50 $6.00 $5.50 $8.00 $65.00 $8.00 $96.50 You + Family $38.00 $68.00 $.00 $59.50 $79.50 $08.00 $38.50 $68.50 Don t forget about the surcharges! The tobacco surcharge and the working spouse surcharge may affect your costs. Tobacco surcharge: If you or your spouse uses tobacco products, you will pay an additional $0 per-pay-period surcharge for each tobacco user. You must certify your tobacco status during annual enrollment. Working spouse surcharge: If you cover a working spouse who has group medical coverage available through his or her employer, you will pay a $50 per-pay-period surcharge. 5 6
MEDICAL CHOICES Having choices is important to get exactly what you need for you and your family. Inside you ll find the basics on your medical plan options and prescription drug benefits. Go to enroll.mybnsf.com to see complete details. 6 WHY CHOOSE CIGNA? If you are in the DFW area and enroll in Option or with the Cigna LocalPlus network, your benefits are generally the same and your premiums are identical to the BCBS network. But, there are BIG reasons to consider the Cigna LocalPlus network. +$50 more in your HSA than if you choose BCBS if you enroll in You Only coverage Cigna LocalPlus Network If you choose the Cigna LocalPlus network, you ll see: +$300 more in your HSA than if you choose BCBS if you enroll in any other coverage level MOST major hospital systems in DFW are in network Texas Health Resources (THR) hospitals are in network but THR doctors are not, so to avoid out-of-network physician (such as surgeon, anesthesiologist) charges, THR hospitals should only be used in emergencies. The bottom line: 69% of DFW s Primary Care Physicians (PCPs) are in network LOW out-of-pocket COSTS without sacrificing QUALITY 79% of all DFW physicians are in network A NATIONAL NETWORK covers your dependents outside DFW MEDICAL ACCOUNTS HEALTH SAVINGS When you enroll in a BNSF medical option, you can use money from your Health Savings Account (HSA) to pay for eligible health care expenses. BNSF adds the full company contribution in January each year. The chart below shows the amount BNSF adds to your account. These amounts assume you certified during the Healthy Steps HSA incentive campaign. If you did not certify, or if you were hired after Aug. 3, 08, BNSF s contributions will be $50 less than what is shown. Option ($3,000 Family Deductible) Cigna LocalPlus Option ($6,000 Family Deductible) Option ($3,000 Family Deductible) If Your Annual Base Salary Is Less than $75,000 BCBS Option ($6,000 Family Deductible) You Only $850 $,00 $700 $950 You + Spouse $,700 $,00 $,00 $,900 You + Child(ren) or Family $,00 $,600 $,800 $,300 If Your Annual Base Salary Is $75,000 or More You Only $650 $900 $500 $750 You + Spouse, Child(ren) or Family $,300 $,800 $,000 $,500 Note: If you re enrolled in Medicare or a government-sponsored health care plan for military personnel such as TRICARE, you ve received benefits under the VA in the last three months (except for certain service-connected disabilities), you ve enrolled in Medicaid or you are receiving payments under the BNSF Long-Term Disability Insurance Program, you re automatically enrolled in a Health Reimbursement Account (HRA), rather than an HSA, when electing BNSF medical coverage. Smart tip! If you enroll for BNSF medical coverage and choose the Cigna LocalPlus network, BNSF will share the savings by giving you more money in your HSA than if you choose the BCBS network. 9
XTRAS ADDITIONAL BENEFITS As part of BNSF s commitment to providing you with benefits that help you live well, you also have dental, vision, life insurance, accidental death and dismemberment (AD&D) insurance and disability coverage available to you. DENTAL BNSF offers the Aetna Dental Preferred Provider Organization (PPO). If you live in certain areas, you may have a second dental option: the Aetna Dental Maintenance Organization (DMO). If this option is available to you, you ll see it listed when you enroll. Both plans cover preventive, basic and major dental services. The PPO covers orthodontia for eligible children under age 9 and the DMO covers orthodontia for adults and eligible children. Under the PPO, you can choose any dentist you d like. Under the DMO, you must select a participating primary care dentist to receive coverage. VISION You have two vision plan options, both administered by EyeMed: the H- Option and the H- Option. Both options cover routine exams, lenses, frames and contacts, but there are some differences, like how often you can get eyeglass frames. You can choose any doctor you d like, but you ll receive higher benefits if you go to an in-network provider. enroll.mybnsf.com YOUR ENROLLMENT RESOURCE. Learn more about the changes, get detailed plan comparisons and enroll when you re ready. INCOME PROTECTION BNSF offers life, AD&D and disability coverage. Basic and Optional Life Insurance Life insurance pays a benefit if a covered person dies. BNSF automatically provides you with Basic Life Insurance. You can purchase additional levels of coverage for yourself, your spouse and your children. AD&D AD&D pays a benefit if you or a covered family member dies or suffers an injury in an accident. You can purchase AD&D coverage for yourself, your spouse and your children. Disability Disability benefits replace a portion of your pay if you become sick or injured and are unable to work for an extended period of time. BNSF automatically provides you with Short-Term Disability (STD) and Basic Long-Term Disability (LTD) coverage at no cost to you. Basic LTD replaces 50% of your Benefits Pay. You have the option to purchase additional LTD coverage that replaces up to 66 ² ³% of your Benefits Pay. Disability payments are taxable, so take that into account when deciding whether to purchase additional LTD coverage. Find everything for enrollment at enroll.mybnsf.com. Go to enroll.mybnsf.com for details about these benefits. 0
The information in this brochure provides highlights of certain changes to the Burlington Northern Santa Fe Group Benefits Plan. In addition, this guide serves as a Summary of Material Modifications (SMM) to the Summary Plan Descriptions (SPDs) for various programs included in the Burlington Northern Santa Fe Group Benefits Plan, effective Jan., 09. Complete details of the plans are included in the official plan documents and contracts. If the information in this brochure or other information conflicts with the legal documents or contracts, the documents or contracts will govern in every instance. In addition, BNSF reserves the right to change or terminate the Burlington Northern Santa Fe Group Benefits Plan, individual programs or any provisions of any program at any time. 0696.03 / ACT-DFW / October 08