At a Glance Your 2017 Benefits JPS Health Network / Acclaim Physician Group offers a comprehensive benefits package designed to meet the needs of you and your family. Use this guide to help you make your benefits decisions for 2017. Your Stories Your Benefits I m determined to get to a place of healthy living and be whole. JPS ENLIVEN has helped me do that. Lamonica Miles, Data Liaison Health Center for Women and 2016 Biggest Loser Champion All moms at JPS should participate in the Great Beginnings Program. It was a phenomenally rewarding experience to deliver my first baby at JPS. Danielle Bollinger, HR Data Specialist, and Jonathan Redfield with daughter Kinsey Redfield, born at JPS on April 24, 2016
Welcome to Your Benefits at a Glance Your Benefits Summary...3 Your Medical, Dental and Vision...4 Your Prescription Drug Plan...6 Your Additional Resources... 7 This benefits summary highlights the important choices you will make. We have designed a benefits package with the flexibility to meet your unique needs. We encourage you to review your options carefully and select the health, dental, vision and other benefits plans that will best help you and your family to stay healthy and live better in 2017. You must enroll or provide proof of medical coverage during the election period, or you will be enrolled automatically into the Choice Medical Plan, and your dependents will not be covered for the 2017 plan year. Provide dependent verification and or proof of other medical coverage within 31 days of employment or from the life event date. How to Enroll STEP 1 STEP 2 STEP 3 From the JPS intranet Select Staff Resources and then Computer Apps A Z. Select OnPoint Employees and Leaders. Log in using your normal JPS login information. Click on Employee icon. Select To Do. Click Pay and Benefits. Click 2017 Benefits Enrollment. Use the prompts on the screen to follow each step of the enrollment process. In making your elections, select the plan option of your choice, and then select Continue after you ve made each election until you reach the confirmation page. Once you complete all coverage elections, you will land on the Confirmation Statement. Click the Save button at the bottom of the page to complete your enrollment process. You may print and email yourself a copy of your confirmation statement for your records. 2 Have a question? Call (817) 702-2976 or contact HRTotalRewards@jpshealth.org
Your Benefits Summary Your Family In addition to providing dependent access to health care insurance, JPS offers several family-friendly benefits. Great Beginnings Program Receive rewards for taking steps to ensure a healthy pregnancy Convenient Care Options -- TeleHealth Solutions offers convenient access to telephone consultations with local care providers. Dependent Day Care FSA You can save tax-free for day care, after school care or summer day camps. Retirement JPS offers two retirement options as you plan for your financial future. JPS Pension Plan JPS contributes to the plan, which provides a monthly benefit for your lifetime upon retirement. 403(b) Savings Plan JPS will match 50% of your pre-tax contribution up to 4% of your salary. 457 Deferred Compensation Plan You can defer additional federal income tax by contributing to this account. Life Insurance You receive 2 times your annual salary and can purchase Basic Life, Supplemental Life, Universal Life, Critical Illness and Accident Insurance. Income Protection Short-Term Disability You pay on an after-tax basis; pays up to 60% of your base salary or up to $52,000. Long-Term Disability JPS provides this benefit with coverage of up to 60% of your salary Health Insurance You have multiple options that leverage the JPS Health Network. Choice plan Select plan You can also save pre-tax for your medical, dental and vision expenses with a Flexible Spending Account. Dental Insurance PPO Plan -- You can go to any dentist you choose, although you might pay more for an out-ofnetwork dentist MAKE THE MOST OF YOUR JPS BENEFITS & WELLNESS PROGRAM Workers Compensation JPS pays for this coverage. Your Well-Being Employee Assistance Program (EAP) Free, confidential counseling is available for personal concerns and legal issues. JPS ENLIVEN Wellness Program -- You can earn rewards while getting healthy. Time Away from Work JPS provides Paid Time Off (PTO), which includes holiday, vacation and sick time. Dental HMO You must use an innetwork dentists for coverage. Vision Insurance Signature Plus Plan Your VSP coverage includes exams and two pairs of glasses. Choice Plan Your VSP coverage includes exams, and one pair of glasses Access Plan At no cost to you, receive a 20% discount on exams, frames and lens. See your 2017 Benefits Decision Guide on the JPS intranet for additional information. Your Stories Your Benefits My son was born at 33 weeks old, and I chose to deliver at JPS. All the doctors and nurses in the NICU are amazing, and we re all still friends today. I always recommend that people come (to JPS) for care. All the care I ve received has been exceptional and personable. Elizabeth Price, Manager of Trauma Advanced Practice, and JPS medical insurance holder Have a question? Call (817) 702-2976 or contact HRTotalRewards@jpshealth.org 3
Your Medical Plan Options Choice plan: Same coverage as the Select plan but offers you greater control over health care spending. This plan has a lower premium up front but higher copays and deductibles. Select plan: Pay a higher premium up front and have lower out-ofpocket costs. The plan has lower copays and deductibles if you use in- network providers. You will receive the highest possible level of coverage for both plans at the lowest cost if you use JPS Health Network/Tier 1 providers. To find a JPS Provider, visit www.mycigna.com or call (800) 244-6224. JPS Network Member ID: 3332385. Plan Name Calendar Year Deductible (Individual/Family) Office Visit Copay JPS Health Network (Tier 1) CHOICE Cigna Open Access (Tier 2) Out-of-Network (Tier 3) $1,500/3,000 $2,500/5,000 $4,000/8,000 $20 $30 50% after deductible Coinsurance* 90% 70% 50% Out-of-Pocket Max (Individual/Family) Plan Name Calendar Year Deductible (Individual/Family) Office Visit Copay $3,000/6,000 $5,000/10,000 Unlimited JPS Health Network (Tier 1) SELECT Cigna Open Access (Tier 2) Out-of-Network (Tier 3) $250/500 $500/1,000 $1,000/2,000 $15 $25 50% after deductible Coinsurance* 90% 70% 50% Out-of-Pocket Max (Individual/Family) $2,250/4,500 $4,500/9,000 Unlimited * Amount paid by the plan after you reach your deductible for most services that don t have a copay. See the 2017 Benefits Guide on the JPS intranet for additional medical plan details. Medical Plan Premiums (Per Pay Period) Under $36.5K Choice Medical Select Medical Team Member Only $2.31 $20.77 Team Member + Spouse $9.23 $76.15 Team Member + Children $11.54 $48.46 Team Member + Family $23.08 $101.54 Team Member + 1 Child $6.92 $34.62 $36.5K to $50K Choice Medical Select Medical Team Member Only $11.54 $34.62 Team Member + Spouse $32.31 $113.08 Team Member + Children $30.00 $85.85 Team Member + Family $46.15 $152.31 Team Member + 1 Child $25.38 $60.00 $50K to $75K Choice Medical Select Medical Team Member Only $16.15 $48.46 Team Member + Spouse $64.62 $147.69 Team Member + Children $57.69 $120.00 Team Member + Family $78.46 $198.46 Team Member + 1 Child $53.08 $78.46 $75K to $100K Choice Medical Select Medical Team Member Only $23.08 $57.69 Team Member + Spouse $92.31 $180.00 Team Member + Children $80.77 $154.62 Team Member + Family $124.62 $244.62 Team Member + 1 Child $62.31 $103.85 $100K + Choice Medical Select Medical Team Member Only $30.00 $69.23 Team Member + Spouse $113.08 $212.31 Team Member + Children $85.38 $180.00 Team Member + Family $173.08 $281.54 Team Member + 1 Child $69.23 $122.31 Your Stories Your Benefits Being enrolled in JPS Health Insurance allows many options for my family s healthcare. It s affordable, and that s important to me. Donna Young-Bob, Senior Staff Coordinator House Operations (JPS medical insurance holder since 1988) and her children Veronica Johnson and Von Young, Trauma Registrars 4 Have a question? Call (817) 702-2976 or contact HRTotalRewards@jpshealth.org
Compare the Plan Premiums JPS Health Network offers you quality care and helps save you and your family money. For example, if you need to receive home health care services that require you to pay toward your deductible, below is an example of the costs you may expect to pay: Choice plan JPS Network (Tier 1) Cigna Open Access Plus Network (Tier 2) Actual cost for services $3,000 $3,000 You pay the individual deductible $1,500 $2,500 Plan pays co-insurance on remainder JPS pays 90% of remaining $1,500 ($1,350) JPS pays 70% of remaining $500 ($350) You pay co-insurance on remainder You pay 10% ($150) You pay 30% ($150) Your total out-of-pocket costs $1,650 $2,650 Select plan JPS Network (Tier 1) Cigna Open Access Plus Network (Tier 2) Actual cost for services $1,000 $1,000 You pay the individual deductible $250 $500 Plan pays co-insurance on remainder JPS pays 90% of remaining $750 (JPS pays $675) JPS pays 70% of remaining $500 (JPS pays $350) You pay co-insurance on remainder You pay 10% ($75) You pay 30% ($150) Your total out-of-pocket costs $325 $650 Reduce Your Medical and Dependent Care Costs with an FSA A flexible spending account (FSA) allows you to pay for certain health, dental, vision and dependent care expenses with pre-tax dollars, reducing your taxable income and saving you money. You must designate how much you want to contribute to your FSA during your enrollment period, and the amount cannot be changed during the year unless you have a qualifying life event. Determining How Much to Contribute to Your FSA To estimate how much you should contribute to your FSA, use the CONEXIS FSA calculator at http://www. conexismarketing.com/employees/tools/fsa-calculator. The annual limit for a personal FSA is $2,550; for a dependent s FSA the limit is $5,000. Keep in mind your FSA account is use it or lose it, and any unused funds will be forfeited at the end of the plan year. Your Stories Your Benefits JPS is tobacco-free, and so am I Thanks to JPS for saving my life and adding years to it. Because it s a no-smoking campus, I quit cold turkey after 50 years of smoking. If it hadn t been for JPS, I would still be smoking. Robert Pribble, Police Communications Dispatch, tobacco-free since August 4, 2014 This brochure highlights some of the features of the JPS Health Network employee benefits program. It does not include all plan rules, details, limitations and exclusions. The terms of your benefit plans are governed by legal documents, including insurance contracts. Should there be an inconsistency between this brochure and the legal plan documents, the plan documents are the final authority. JPS Health Network reserves the right to change or discontinue its employee benefit plans at any time. Have a question? Call (817) 702-2976 or contact HRTotalRewards@jpshealth.org 5
2017 Prescription Drug Costs JPS offers several pharmacy options designed to meet your needs and keep your costs as low as possible. Greatest Value Have your prescription written by a JPS Health Network provider and filled at any JPS pharmacy. Choice and Great Value Have your prescription written by a non-jps provider and filled at the JPS Main Campus pharmacy or mailed to your home. Good Value Have your prescription written by either a JPS or non-jps provider and filled at any CVS pharmacy. Tier 1: Generic and Some Brands Tier 2: Preferred Brands* Tier 3: Non-Preferred Brands* BEST VALUE: JPS Pharmacy (JPS provider or non-jps provider with JPS documented referral) GREAT VALUE: JPS Main Campus Pharmacy or Mail Order (non-jps provider) GOOD VALUE: CVS Pharmacy (JPS provider or non-jps provider) 30-Day Supply 90-Day Supply 30-Day Supply 90-Day Supply 30-Day Supply 90-Day Supply $10 $20 $15 $37.50 $30 N/A $25 $50 $40 $100 $75 N/A $40 $80 $65 $167.50 $120 N/A Tier 4: Specialty Drugs 30-Day Supply 90-Day Supply 20% of the cost (minimum $50, maximum $150) N/A * If a patient or doctor requests a name brand drug when a generic equivalent exists, the patient will pay the difference between the brand and the generic medication in addition to the applicable brand copay. Your Dental Plan Options JPS offers two optional dental plans: the Cigna Dental PPO and the Cigna Dental DHMO. Both plans have an emphasis on routine preventive care in an effort to prevent small dental problems from becoming more serious. Your Vision Plan Options Plan benefits are provided through Vision Service Plan (VSP), which provides a contact lens CLEX fitting and evaluation allowance in both the Signature Plus and Choice Plans. VSP helps pay the cost of routine eye examinations and the cost of eyeglasses or contact lenses. JPS also offers the free Access Plan, which provides a 20% discount on exams and frames and a 15% discount on professional services for contact lenses. Dental Premiums (Per Pay Period) PPO DENTAL You Pay: DHMO DENTAL You Pay: Vision Premiums (Per Pay Period) VSP CHOICE You Pay: VSP SIGNATURE PLUS You Pay: Team member only $7.73 $3.92 $2.31 $6.75 Team member + spouse $20.92 $10.95 $3.60 $10.53 Team member + 1 child $20.44 $8.95 N/A N/A Team member + children $33.78 $18.59 $3.67 $10.75 Team member + family $48.00 $23.84 $5.93 $17.34 Preventive Care Services The best and lowest-cost medical care is the care you don t need, which is why it s important to keep up with preventive care. JPS Health Network in-network medical plans provide 100% coverage for preventive care, including immunizations; well-baby, well-child, well-woman and wellman exams; mammograms; and other services. Get Well and Save Money Team members participating in JPS ENLIVEN earn points for engaging in wellness activities during the year. The more points you earn, the greater your chances of winning a prize. You can also earn Wellness Credits if you are a Cigna health insurance holder through JPS Health Network. 6 Have a question? Call (817) 702-2976 or contact HRTotalRewards@jpshealth.org
Your Additional Resources Important Numbers and Websites Your HR team stands ready to assist. Below is additional benefit contact information. Plan Vendor/Organization Phone More Information Medical Cigna 800-244-6224 www.mycigna.com Prescription Drugs MaxorPlus 800-687-0707 www.maxorplus.com Dental Cigna 800-244-6224 www.mycigna.com Vision Vision Services Plan (VSP) 800-877-7195 www.vsp.com Flexible Spending Accounts (FSA) CONEXIS 866-279-8385 www.mybenefits.conexis.com Employee Assistance Program (EAP) JPS 817-702-1688 www.jpshealthnet.org/about_ jps/employee_assistance_ program Short-Term Disability Lincoln Financial Group 866-783-2255 www.lfg.com Long-Term Disability Lincoln Financial Group 866-783-2255 www.lfg.com Cancer/Critical Illness Lincoln Financial Group 800-423-2765 www.lfg.com Basic Life & Accidental Death and Dismemberment (AD&D) Lincoln Financial Group 800-423-2765 www.lfg.com Universal Life Lincoln Financial Group 800-423-2765 www.lfg.com 403(b) Retirement Savings Plans 457 Deferred Compensation Plan Voya Financial 800-584-6001 Voya Financial 800-584-6001 www.voyaretirementplans. com/enrollment www.voyaretirementplans. com/enrollment Pension Plan JPS 817-702-1030 HRTotalRewards@jpshealth.org Legal & Identity Theft Legal Shield 800-654-7757 www.legalshield.com Travel Assistance TravelConnect/MEDEX 800-527-0218 www.lincoln4benefits.com LifeKeys Lincoln Financial Group 855-891-3684 www.lincoln4benefits.com Have a question? Call (817) 702-2976 or contact HRTotalRewards@jpshealth.org 7
JPS Health Network 1500 S. Main Street Fort Worth, TX 76104 Notes Have a question? Call (817) 702-2976 or contact HRTotalRewards@jpshealth.org