ANNUAL ENROLLMENT: STRAIGHT AHEAD Enroll Oct. Nov. 4, 07
IT S THAT TIME AGAIN. TIME TO ENROLL FOR YOUR BENEFITS. It s important to review your choices and determine what is best for you and your family. We don t want you to spend more than you have to for health care. So, take a look at this guide for the information you need to make sure you get the right benefits. BE READY. LET S GO! CHANGES WHAT S NEW For 08, you ll have the same plan options, but we re making some changes to give you more choices when it comes to your health care. Here s what you need to know: 4 YOU HAVE A NEW NETWORK OPTION. BNSF is working to transform the way health care is delivered. The first step in that direction is to offer you a Cigna network (Cigna LocalPlus), in addition to BCBS. What does that mean for you? If you are in the DFW area and enroll in Option, you ll have a choice between 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 08 than if you choose BCBS. Get more details on this new network and see if it s right for you at enroll.mybnsf.com. YOU MUST ACTIVELY ENROLL TO AVOID UNNECESSARY SURCHARGES. If you don t actively enroll, you will automatically pay surcharges in 08: Tobacco user $0 per pay period each for you and your covered spouse Working spouse (if you cover a spouse) $50 per pay period CONTRIBUTIONS FOR SOME BENEFITS ARE INCREASING. Option will increase up to $5 monthly (depending on your salary) for You Only coverage or up to $8 monthly for Family coverage. Option will increase up to $ monthly (depending on your salary) for You Only coverage or up to $ monthly for Family coverage. Dental and vision contributions will stay the same. Your contributions for buy-up Long-Term Disability (LTD) are also increasing. 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 $,450 and for all other coverage levels is increasing to $6,900. For the Health Care FSA, your maximum contribution is increasing to $,600.
NROLLING CHOOSE YOUR BENEFITS Make sure you get the benefits you want for 08. Here are the steps you need to take: REVIEW YOUR OPTIONS AT ENROLL.MYBNSF.COM. KNOW IF YOU NEED TO ENROLL. You must take action if you want to: Avoid any surcharges. Your current elections for the tobacco user and working spouse surcharges will not carry over from 07. Elect Option medical coverage with the new Cigna LocalPlus network. Contribute to a Health Care and/or Dependent Care FSA. Make any other changes to your benefits and/or covered dependents. If you do not enroll: You will automatically pay the tobacco user surcharge and working spouse surcharge (if you cover a spouse). If you don t take action, your contributions could go up $40 monthly for You Only coverage and as much as $80 monthly if you cover a spouse. Your current benefit elections will roll over, including HSA contributions from your paycheck and/or ICP award. You won t be able to contribute to an FSA. 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 days of the event to make any changes. 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. USE THE TOOLS TO HELP YOU CHOOSE. enroll.mybnsf.com 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 877-45-6 Monday Friday from 8:0 a.m. to 5:0 p.m., Central time. Cigna Check out the Cigna website at cigna.com to help you evaluate the new Cigna LocalPlus network option. Select LocalPlus and search for your providers. Or, call Cigna s OneGuide at 888-806-504. A representative can answer questions you have about the new network option. ENROLL ONLINE BEFORE MIDNIGHT CENTRAL TIME TUESDAY, NOV. 4. Log in to mybnsf.com and click on VIEW, ENROLL OR CHANGE MY BENEFITS on the right side of the home page to make your elections. Be sure to check out after you enroll and confirm your elections. DON T FORGET! You must take action this year to avoid surcharges. 4
EDICAL MEDICAL MEDICAL PRESCRIPTION DRUGS CONTRIBUTIONS 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. Deductible Out-of-Pocket Maximum Coinsurance You Only Family You Only Family Option (Cigna LocalPlus or BCBS network) Option In Network Out of Network In Network Out of Network $,500 $7,000 Office Visits, Urgent Care, Hospital Care, Maternity Care 0% after deductible $,500 $,000 Note: Family coverage applies for employee + spouse and employee + child(ren) coverage $5,500 $,000 40% 0% after deductible 4 after deductible $,000 $6,000 $5,000 $7,000 $0,000 $4,000 40% after deductible 4 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 $7,50. Some prenatal care is covered 00% as preventive. 4 There are no out-of-network benefits for bariatric services or dialysis. Know this! Both medical plans pay the majority of the cost for care after you meet your deductible. If you have a lot of expenses during the year, you may hit your out-of-pocket maximum, which is the most you ll pay (including your deductible) out of your own pocket for in-network expenses you have during the calendar year. Once you hit the out-of-pocket maximum, the plan pays 00% of eligible expenses. Out-of-network providers may bill you the balance you owe after the plan pays. Both medical options include prescription drug coverage, administered by CVS Caremark. Specific Preventive Drugs Retail (up to a 4-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 0-day supply Up to a 90-day supply Option (Cigna LocalPlus or BCBS network) or Option In Network 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) ($0 minimum, $0 maximum) 40% of the cost ($50 minimum, $50 maximum) $5 (or actual cost, if less) ($60 minimum, $40 maximum) 40% of the cost ($00 minimum, $00 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) ($0 minimum, $0 maximum) 40% of the cost ($50 minimum, $50 maximum) Know this! If you choose a brand-name drug when a generic is available, you will pay the cost difference (unless the brand name is required by your doctor). The difference will not apply to your deductible or out-of-pocket maximum. 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 Less than $75,000 Option (Cigna LocalPlus or BCBS network) $75,000 $00,000 More than $00,000 Less than $75,000 Option $75,000 $00,000 More than $00,000 You Only $0.50 $40.50 $66.00 $8.50 $6.00 $9.50 You + Spouse $9.00 $.00 $7.00 $54.00 $7.00 $08.50 You + Child(ren) $77.00 $95.50 $46.50 $46.00 $6.50 $9.00 You + Family $.50 $6.50 $49.50 $76.50 $04.00 $6.00 Don t pay unnecessary surcharges! Your tobacco user and working spouse status will not roll over for 08. You must take action to avoid surcharges that don t apply to you. The tobacco surcharge and the working spouse surcharge may affect your costs. Tobacco surcharge: If you or your spouse use tobacco products, you will pay an additional $0 per pay period for each tobacco user. You must certify your tobacco status during annual enrollment. If you take no action, you will default into paying this surcharge for you and your covered spouse. 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. If you take no action during enrollment and you cover a spouse, you will default into paying this surcharge. 5 6 7
MEDICAL CHOICES Having choices is important to get exactly what you need for you and your family. WHY CHOOSE CIGNA? Regardless of which network you choose, if you are in the DFW area and enroll in Option, your benefits are generally the same and your premiums are identical. But, there are BIG reasons to consider the new Cigna LocalPlus network. +$50 more than last year in your HSA if you enroll in You Only coverage Option : Cigna LocalPlus Network If you choose the Cigna LocalPlus network, you ll see: +$00 more than last year in your HSA 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 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., 07, BNSF s contributions will be $50 less than what is shown. Option (Cigna LocalPlus network) ($,000 Family Deductible) Option ($,000 Family Deductible) If Your Annual Base Salary is Less than $75,000 Smart tip! If you enroll in Option and choose the Cigna LocalPlus network, BNSF will share the savings by giving you more money in your HSA than if you choose Option and the BCBS network. Option ($6,000 Family Deductible) You Only $850 $700 $950 You + Spouse $,700 $,400 $,900 You + Child(ren) or Family $,00 $,800 $,00 If Your Annual Base Salary is $75,000 or More You Only $650 $500 $750 You + Spouse, Child(ren) or Family $,00 $,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. Inside you ll find the basics on your medical plan options and prescription drug benefits. Go to enroll.mybnsf.com to see complete details. LOW out-of-pocket COSTS without sacrificing QUALITY 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. VISION You have two vision plan options, both administered by EyeMed: the H- Option and the H-4 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 To protect you and your family, 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 (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. (Benefits pay is your base salary plus your target ICP as of Aug. and is frozen for the 08 plan year.) Go to enroll.mybnsf.com for details about these benefits. Everything enrollment is at enroll.mybnsf.com. 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., 08. 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. 0696.078 / ACT-DFW / Oct. 07