US 2014 Benefits What s New 1 Rev. 10.23.13
US Benefits Open Enrollment Overview The US Benefits Open Enrollment is your annual opportunity to review your current ORACLEflex benefit elections and make changes for the upcoming year. Open Enrollment begins on October 28, 2013 and continues through November 15, 2013, providing you three full weeks to make your elections. After the November deadline, elections are binding and no changes can be made. Open Enrollment Begins Open Enrollment Ends Benefits Effective Date New Payroll Deductions October 28, 2013 November 15, 2013 January 1, 2014 January 15, 2014 Review Your Benefits Although your enrollment in ORACLEflex is generally evergreen with elections automatically rolling over from year to year, we encourage you to review your benefits carefully and make adjustments if needed. Remember in most cases, if you do not make any changes during the designated enrollment period, your current elections will automatically roll over into 2014. This includes your Health and Dependent Care Reimbursement Accounts (FSAs). Exceptions If you are currently enrolled in the POS Medical Plan you are required to make a new election. Additionally, due to Health Savings Account (HSA) regulations, your personal HSA contribution election DOES NOT roll over from year to year. To continue your HSA contribution in 2014 without disruption you must make an active HSA contribution election during Open Enrollment. If you do not make an election, your contributions will be discontinued on January 1, 2014 and you will be required to make a new election in 2014 to resume deductions. Enrollment System - Simple and Secure This year, you may use your Oracle Single Sign-on (SSO) credentials to access the US Benefits Enrollment System from inside and outside of the Oracle firewall. To make your elections, click here or link directly from the Oracle Benefits Website. Health Care Reform Health Care Reform legislation continues to evolve and the Oracle US Benefits Website is a resource to help you understand the new and developing regulations. The information changes as the law develops and policies are established so please check back periodically. Health Care Reform s mandated benefits coupled with required fees and taxes increase Oracle s costs and will require ongoing changes to maintain affordable care. Oracle s intention is to continue offering coverage that is affordable, comprehensive, and competitive within the high tech industry. Visit the Oracle US Benefits Website to review Health Care Reform s mandated benefits for 2014. 2 Rev. 10.23.13
What s New for 2014? Unless otherwise noted, the following changes become effective January 1, 2014. Prices & Credits American Well HSA Medical Plan Changes POS Medical Plan FSA Debit Card MetLife Dental AD&D Defense of Marriage Act Information & Questions 3 Rev. 10.23.13
Prices and Credits for 2014 Oracle will continue to pay the majority of the overall cost of your coverage. The table below provides a snapshot of the new medical plan costs. You may access a complete list of prices and credits by selecting Prices & Credits from the Oracle US Benefits Website. Medical Plans 2014 Per Pay Period Cost (Net of Credits) Employee Employee Employee Family Only Spouse/DP Children Premium PPO $91 $190 $159 $356 EPO $46 $132 $102 $234 Medium PPO $28 $89 $68 $143 HSA Med Plan $12 $46 $33 $74 How do the new 2014 prices compare to the current rates? The per pay period cost increases are shown below. For example the cost increase for employee only Medium PPO Plan is $2 per pay period. Medical Plans Per Pay Period Cost Difference Between 2013 and 2014 Employee Employee Employee Family Only Spouse/DP Children Premium PPO $3 $6 $5 $11 EPO $3 $8 $10 $18 Medium PPO $2 $7 $5 $11 HSA Med Plan $0 $0 $0 $0 The ORACLEflex plans listed below will not incur an increase. Kaiser California Kaiser Mid-Atlantic Kaiser Oregon Dental Plans Vision Plan 1 Life Insurance/AD&D* Long Term Disability*.? Did You Know? Oracle covers the majority of health coverage and in 2014 will cover approximately 85% of the aggregate cost of health care coverage across all plans and election levels. View the COBRA rates to see what your costs would be without Oracle s subsidy *Note: While the insurance rates have not increased for these plans your cost is based on your age and annual benefits compensation. Moving to a different age band and/or increased salary may cause your per pay period cost to increase. The cost of your spouse/domestic partner life insurance is also based on employee age and therefore subject to the same rate increase should you move to a different age band. 4 Rev. 10.23.13
American Well (Telehealth) In this world of mobile devices and the internet why not apply the tools and conveniences you rely on every day to help take care of your health? Oracle Benefits is partnering with American Well in a special pilot program to offer a NEW and innovative way for medical plan members to see a licensed physician via video, phone, or chat. Features include: 24-hour access, 7 days a week (including holidays) No appointment needed HIPAA-compliant and meets all Oracle regulatory privacy and security standards Pilot Period - Services available through December 31, 2014 medical plan members and eligible dependents are eligible to take advantage of telehealth services during the established pilot period. The services are available now through December 31, 2014. At the end of 2014 Oracle will assess the outcomes of this pilot and determine if this offering will continue beyond the pilot period. Who Are The Doctors? Clinical services on American Well are provided by Online Care Group the nation s first and largest primary care group devoted to telehealth. Doctors on American Well have an average of 15 years of experience, are US Board Certified, licensed, and credentialed. Note: Telehealth is permissible and available in most states however there are a few states (including Texas) where state law does not allow physicians to practice telehealth. Visit the American Well website to verify state eligibility. If you live in a state that does not allow telehealth you can sign up with American Well to receive state law updates. Cost A doctor visit on American Well saves you money. For most plans, the co-pay is lower than an in-office visit. And for those with an HSA, the full visit cost of $45 is still far lower than an in-office doctor visit which according to the Healthcare Blue Book averages $68 nationally. The table below reflects the subsidized cost for members. Premium PPO EPO Medium PPO Harvard Pilgrim $5 copay $5 copay $5 copay $5 copay HSA Medical Plan Covered at 90% after deductible Once deductible is met the cost per visit is $4.50 While services are not a complete replacement for all of your health care needs this new approach addresses the most common ailments such as colds, flu, fever, rash, pain, sinusitis, and migraines. Once you re connected, your physician can answer your questions and at their discretion diagnose, treat, prescribe medication, and even electronically submit a prescription fill to the pharmacy of your choice*. * Doctors can prescribe medications, as appropriate in states where prescribing following a telehealth consultation is permitted. 5 Rev. 10.23.13
? Examples When to Use American Well I should see a doctor but can t fit it into my schedule I feel too sick to drive Weather is horrible today I don t want to drive in the snow I have children at home and don t want to bring them with me It's difficult for me to get a doctor's appointment I m on business travel and stuck in a hotel room Easy Steps to See a Doctor 1. Download ios or Android App or; 2. Go to https://oracle.amwell.com/home.htm from your computer 3. Enter Enrollment Code: ORACLE Learn More Click here to watch a short video to see how telehealth can completely change the way you access healthcare. You can also visit www.americanwell.com or the Oracle Benefits Website. HSA Medical Plan Changes Annual Contribution Maximum The annual contribution limits have increased slightly for 2014. If you are age 55+ or turning 55 in 2014 you can contribute an additional $1,000. Be reminded - the combined Oracle seed and your own personal contributions cannot exceed the annual maximum. For additional information, visit the HSA Medical Plan Resource Center. Health Savings Account (HSA) 2014 Annual Contribution Maximum Medical Plan Election Tier Maximum Contribution Employee Only $3,300 Employee + Spouse/DP $6,550 Employee + Children $6,550 Family $6,550 Annual Deductible The annual deductible for the EE+Spouse/Domestic Partner and EE+Child(ren) coverage tiers will increase by $250. The deductible for Employee Only and Family coverage tiers will remain the same. Employee Only EE + Spouse/DP EE + Child(ren) Family Network and Non-Network Annual Deductible $1,500 6 Rev. 10.23.13 Network and Non-Network Annual Deductible $2,500 Network and Non-Network Annual Deductible $2,500 Network and Non-Network Annual Deductible $3,000 Acupuncture and Hearing Aids United Healthcare s acupuncture network and physicians and providers that dispense hearing aids across the country are limited. As such, the HSA Medical Plan s acupuncture and hearing aid benefits have been modified to provide an 80% benefit for both network and non-network
services. While this poses a slight coinsurance reduction for network services it increases the benefit when non-network providers are used. United Healthcare () Medical Plan Changes Out of Pocket Maximum Increases Medium PPO and EPO Plans The calendar year out of pocket maximum is increasing in two plans. 2014 Calendar Year Out of Pocket Maximum Network Non-Network Medium PPO Individual: $1,500 Family: $3,000 Individual: $3,750 Family: $7,500 EPO Individual: $1,500 Family: $3,000 Not Applicable Network only plan What is an Out of Pocket Maximum? The out of pocket maximum acts as a financial safety net by placing a cap on the amount you pay out of pocket each year. Once you reach the maximum the medical plan begins to pay 100% of the allowed amount. Most expenses will apply to the out of pocket maximum including: Deductibles and Coinsurance Laboratory/X-Ray Expenses Emergency Room Copayments Network Office Visit Copayments (New for 2014) Network Prescription Drugs (New for 2014) There are certain expenses that do not count towards the out of pocket maximum. These expenses include your per pay period contributions, amounts above Usual, Customary, and Reasonable (UCR), ineligible services, and non-notification penalties. Prescription Drugs All Medical Plans Currently, the dispensing rules allow pharmacies to fill a 34-day supply or 100 units of a prescribed medication. These dispensing rules will be modified slightly to remove the 100 units allowing you to obtain the appropriate 34-day supply quantity prescribed by your physician. Acupuncture Premium PPO, Medium PPO, EPO, and Harvard Pilgrim (HPHC) Plans United Healthcare s acupuncture network is limited and most members seek care from nonnetwork providers as there simply are not enough network providers. The Premium PPO, Medium PPO, EPO, and Harvard Pilgrim (HPHC) Plans will cover acupuncture at 80% for both network and non-network providers with no deductible. Emergency Room Harvard Pilgrim (HPHC) Plan The HPHC emergency room copayment is increasing from $50 to $75 (copay is waived if the patient is admitted into the hospital). 7 Rev. 10.23.13
Durable Medical Equipment (DME) Premium PPO and Medium PPO Plans The coverage for Durable Medical Equipment (DME) is being modified in two plans to apply the plan s standard deductible and coinsurance. 2014 Plan Design Durable Medical Equipment Premium PPO Network: 100% after deductible Non-Network: 80% after deductible Medium PPO Network: 90% after deductible Non-Network: 70% after deductible POS Medical Plan Retirement Action Required For POS Plan Members As communicated during last year s Open Enrollment, the POS Medical Plan will wind down and retire at the end of this year. If you are currently enrolled in the POS Plan, you will be required to make an active election to change your medical plan option during this year s Open Enrollment. If you do not make a new election - you will be enrolled in the Medium PPO Plan at your current coverage level. For example if you currently cover your entire family and do not make an election you and your family will be enrolled in the Medium PPO Plan. Your new coverage will take effect January 1, 2014. Information Sessions: Attend one of the scheduled information sessions for current POS Plan members. Learn more about the medical plan options available, tips to help you select a new plan, and participant in Q and A. Click here to access session information on the Benefits Website. Dates: October 29, November 6 and 12 (time for all three sessions is 10 AM 11 AM Pacific) Health/Dependent Care Reimbursement Accounts MasterCard Debit Card Beginning January 1, 2014 you will have a NEW way to pay for eligible General Purpose Healthcare Reimbursement Account and Dependent care Account expenses. You may pay for eligible expenses at point-ofsale or point-of-service using a MasterCard debit card. In addition to the debit card, the current automatic pay and claim submission reimbursement methods will continue giving you more choice and flexibility to access your account(s). The card is not available for the Limited Purpose HCRA that can be used by HSA Medical Plan members. Use the MasterCard debit card to pay for eligible expenses including: Copayments, coinsurance and/or deductibles Prescribed medicines and OTC supplies and equipment Dependent care expenses (where MasterCard is accepted) Substantiation of Claims Reimbursement Accounts are governed by the Internal Revenue Service (IRS) and by law is required to validate all expenses. The majority of debit card purchases will be 8 Rev. 10.23.13
validated at the point of sale or service. However, there may be cases requiring you to submit receipt(s) to. If substantiation is required, you will receive a notice from. Expanded MetLife Dentist Network MetLife has a national network of over 200,000 dentists and in 2014, their network will widen even further giving you access to approximately 15,000 additional participating dentists. Visit www.metlife.com or MyBenefits to find a participating general dentist or specialist. The network type that you should select is PDP Plus. Accidental Death & Dismemberment (AD&D) Enhancements Oracle s Accidental Death and Dismemberment (AD&D) coverage offers benefits if you die or sustain certain serious injuries in an accident. NEW benefits may increase the amounts payable to you and/or help defray expenses that often result from an incident. Some of the additional benefits included are: Air Bag and Seat Belt Benefit Common Carrier Benefit Child Care Center Benefit Spouse and Child Education Benefit Hospitalization Benefit *Please review the MetLife Plan Policy for specific details. Defense of Marriage Act (DOMA) The Defense of Marriage Act (DOMA) Supreme Court ruling confirms that all individuals in legal same-sex marriages will be treated as married for federal tax purposes. Individuals in domestic partnerships, civil unions, or other relationships that are not denominated "marriage" under state law will NOT be treated as married for federal tax purposes. This ruling has implications to your Oracle Benefits. Information, including FAQs, is available on the Benefits website. Should you have any questions or need assistance updating your Benefits, please contact Oracle Benefits. Information and Questions Information sessions are scheduled to assist and support you during Open Enrollment. Each session has a limited number of seats so it is recommended that you dial in early to secure a spot. Click here to view details and access instructions for all sessions listed below. Q & A Session In this audio only teleconference, ask your general open enrollment questions and learn from the questions asked by other Oracle employees. Dates: October 30, November 7 and 13 Time: 10 AM 11 PM Pacific HSA Medical Plan User Group This on-going quarterly session is usually attended by HSA Medical Plan members only. However, for Open Enrollment all employees are invited to join. Learn more about the HSA Medical Plan from a panel of experts and other Oracle employees. Date/Time: November 5 Time: 10 AM 11 PM Pacific 9 Rev. 10.23.13
Information Resources Oracle Benefits Website Oracle Benefits Representatives Notice of Privacy Practices Oracle is committed to protecting the privacy and security of your personal information. The Notice of Privacy Practices ( HIPAA Notice ) satisfies HIPAA s requirement that a group health plan, such as the Oracle Corporation Flexible Benefit Plan (the Plan ), provide notice to individuals whose protected health information ( PHI ) will be used or maintained by the group health plan. The HIPAA Notice has been updated to include the items listed below. The Plan never sells your personal health information (PHI) An individual has a right to be notified when a breach of his or her unsecured PHI has occurred 10 Rev. 10.23.13