Sealaska 2017 Employee Benefits Benefit Year: January 1, 2017 - December 31, 2017 1
Open Enrollment 2017 Open Enrollment is Your Opportunity: To review Sealaska s 2017 benefits package To enroll in benefits or make changes to your current elections (add or remove a dependent, change plans, elect or change beneficiary) in BenefitElect If you do not wish to make any changes, your plan elections will map over to for the 2016-17 plan year. However, you must make your FSA and HSA election each year due to IRS regulations Open Enrollment is from: Wednesday, November 9 th Friday, December 2 nd
Who is Eligible for Benefits at Sealaska? All full time employees who work 25 hours or more per week are eligible for benefits at Sealaska and its subsidiary companies*. If you are a new hire, and meet the hours per week, you are eligible on the first of the month following or coinciding with your date of hire. Spouses and Domestic Partners (domestic partners must complete an affidavit of Domestic Partnership in BenefitElect) Children up to age 26 regardless of student, dependent or marital status. * Sealaska subsidiaries include: Managed Business Solutions, EcoData Analytics, Sealaska Constructors, Sealaska Construction Solutions, Sealaska Environmental Services, Sealaska Technical Services, Alaska Coastal Aggregates, HAA AANI, Sealaska Timber, and Sealaska Government Services 3
What Affects Your Benefits Cost? Unhealthy lifestyle choices Plan designs High utilization of benefits New drugs, technology & treatments State & Federal regulations Aging population 4
What Can I Do as an Informed Healthcare Consumer? Utilize carrier discounts See innetwork providers Use generic Rx Use urgent care clinic vs. ER Get annual medical & dental check ups Go for Preventive Screenings Use your benefits wisely! Take a Health Risk Assessment 5
Sealaska Benefits Mobile App Keeps You Informed Access all your benefit policy details and contact information while on the go! For iphone users: Scan the QR code directly into the Passbook application. For Android, Windows Mobile and Blackberry users: Download the PassWallet application. Scan and save the mobile carrier contact card into the application. Or send directly to your phone at: http://bit.ly/1k5wp8e 6
2017 Benefits Plan Highlights Benefit Medical (Two PPO Plan Options with an HRA: Base or Buy-Up) Dental (Two PPO Plan Options: Base or Buy-Up) Vision Flexible Spending Account & Health Reimbursement Arrangement Administrator Employee Assistance Program Voluntary Life/AD&D and Critical Illness & Accident Employer Paid Life/AD&D, Short & Long Term Disability Provider WebTPA (with Aetna Signature Administrators Network - ASA) Diversified Benefit Solutions (DBS) Unum (with Unum s WorkLife Balance EAP program) 7
Medical Benefits WebTPA For Alaska & Non-Alaska Employees In-Network Aetna Signature Administrators Calendar Year Deductible Health Reimbursement Account- funded by Sealaska Coinsurance Calendar Year Out of Pocket Maximum Includes deductibles, copays & coinsurance Preventive Care Base PPO Medical Plan with HRA $1,500 per individual $3,000 max family Plan pays 80% You pay 20% $6,000 per person $12,000 max per family $250 per employee $500 for employee plus family Covered at 100% deductible waived Buy Up PPO Medical Plan with HRA $750 per individual $1,500 max for family Plan pays 80% You pay 20% $3,250 per person $6,500 max per family Office Visit (Primary Care & Specialist) $30 copay deductible waived $20 copay deductible waived Outpatient Rehabilitation Services 60 combined visits per year You pay deductible then 20% 8
Medical Benefits WebTPA For Alaska & Non-Alaska Employees In-Network Aetna Signature Administrators Base PPO Medical Plan with HRA Buy Up PPO Medical Plan with HRA Diagnostic Lab & X-Ray You pay deductible then 20% Inpatient Hospital Services You pay deductible then 20% Outpatient Surgery You pay deductible then 20% Emergency Room $100 copay (copay waived if admitted into hospital) then you pay 20% Urgent Care $50 copay deductible waived $20 copay deductible waived Outpatient Mental Health $30 copay deductible waived $20 copay deductible waived Inpatient Mental Health You pay deductible then 20% 9
Health Reimbursement Account (HRA) - WebTPA This plan includes an integrated Health Reimbursement Account (HRA) funded by Sealaska Sealaska contributes $250 per employee and $500 for employee plus family per year The HRA will only apply towards your medical deductible expenses If you do not incur medical deductible expenses in 2017, the unused dollars will be credited to 2017 to use toward that year s deductible. 10
Prescription Drugs - WebTPA For Both the Base & Buy Up Medical Plan In Network & Out of Network Mail Order Program (through MiRX) Preferred Generic (Tier 1 ) $15 copay $30 copay Preferred Brand (Tier 2) $35 copay $70 copay Non-Preferred Brand (Tier 3) $50 copay $100 copay Maximum Day Supply Up to 30 days Up to 90 days To save money, you are encouraged to use Generic drugs If you have a maintenance drug, one you take every day, week or month, take advantage of the Mail Order Program through MiRx Pharmacy and save trips to the pharmacy! 11
BridgeHealth BridgeHealth is a surgery benefit program that is offered as part of your health plan at no additional cost! BridgeHealth tools, services and dedicated Care Coordinators are available to help you when considering a planned surgery (orthopedic, spine, women s health, general surgery and/or cardiac surgery). If you are considering surgery, that s when to contact BridgeHealth. Gain access to unbiased decision support tools, a second opinion process to make sure surgery is your best option, information on alternative, less invasive treatment options, procedure insights, and much more. If you decide to have surgery, you want the best care. Our stringent standards in selecting providers, verified by external data, offer top tier options. BridgeHealth has pre-negotiated agreements with care providers that lower the costs of the actual surgery. These savings can be significant. BridgeHealth provides you with dedicated Care Coordinators who are with you every step of the way and will guide you toward your most informed decision. 12
BridgeHealth Advantages for Sealaska members: You will receive care from a top-rated provider in the BridgeHealth network. Your BridgeHealth benefit pays 100% of eligible expenses. Your deductible and coinsurance are waived. You will receive coverage for certain travel costs for you and a companion; such as transportation, lodging, and meals Contact BridgeHealth at 855.265.2853 M-F 8 am 7 pm CT or webtpa@bridgehealth.com 13
Dental Benefits - WebTPA In Network Aetna Signature Administrators Base PPO Dental Plan Buy-Up PPO Dental Plan Deductible Diagnostic & Preventive Care X-Rays, Cleanings, Exams $50 individual $150 maximum per family Covered at 100% deductible waived Basic & Restorative Care Fillings, Extraction, Root Canals Major Care Crowns, Dentures, Bridge Covered at 80% after deductible Covered at 50% after deductible Covered at 90% after deductible Covered at 60% after deductible Annual Maximum $1,500 per covered member $2,000 per covered member Orthodontia (Adults & Children up to age 26) Not Covered Covered at 50% after deductible up to a $2,000 lifetime maximum (per person) 14
Vision Benefits- WebTPA In Network Benefits Aetna Signature Administrators Eye Exam Covered at 100% after a $20 copay One exam every 12 months Glasses Lenses & Frames: Covered at 100% up to $150 maximum every 12 months Or Contacts in lieu of glasses Covered at 100% after up to a $60 copay Up to $150 maximum every 12 months 15
Employer Paid Life, Accidental Death and Dismemberment Insurance - Unum Benefit Options Life Insurance 2x your annual salary up to $500,000 Accidental Death Insurance May Double the Benefit Amount Dismemberment Insurance Scheduled benefit according to loss Remember to designate your beneficiary. You can update your beneficiary at any time during the year IRS Regulations require taxation of life benefits above $50,000 to the employee. This amount will be deducted automatically through payroll deductions. 16
Voluntary Life, Accidental Death and Dismemberment Insurance - Unum Benefit Options Voluntary Life / AD&D Employee Spouse Children Guarantee Issue* $10,000 benefit increments up to $5x earnings to $500,000 max. $5,000 benefit increments to 100% of employee amount up to $500,000 max. Birth to age 19 (26 if full time student): 100% of employee amount up to $10,000 Employee: $130,000 Spouse: $25,000 Children: $10,000 *If you do not enroll when first initially eligible and wish to later enroll, you will be subject to medical underwriting for any amounts elected. 17
Employer Paid Short Term Disability - Unum Benefit Consideration Initiation Income Duration Definition of Disability After a 14 - day elimination period for accident or illness 60% of your covered pre-disability weekly earnings to a maximum of $2,500 per week Up to 13 weeks You are disabled when Unum determines that you are limited from performing the materials and substantial duties of your regular occupation due to sickness or injury. Also, you must have a 20% or more loss in weekly earnings due to the same sickness or injury. You must be under the regular care of a physician in order to be considered disabled. If you have a Cesarean section, you will be considered disabled for a minimum period of 8 weeks beginning on the date of your Cesarean section, unless you return to work prior to the end of the 8 weeks. 18
Employer Paid Long Term Disability - Unum Benefit Consideration Initiation Income Duration Definition of Disability After a 90 - day elimination period for accident or illness 60% of your covered pre-disability monthly earnings to a maximum of $10,000 per month Social Security Normal Retirement Age (SSNRA) You are disabled when Unum determines that you are limited from performing the materials and substantial duties of your regular occupation due to sickness or injury. Also, you must have a 20% or more loss in monthly earnings due to the same sickness or injury. After benefits have been paid for 24 months, you are disabled when Unum determines that due to the same sickness or injury, you are unable to perform the duties of any gainful occupation for which you are reasonably fitted by education, training or experience. You must be under the regular care of a physician in order to be considered disabled. 19
Voluntary Critical Illness & Accident - Unum Benefit Options Employee $5,000 or $10,000 Voluntary Critical Illness Spouse $5,000 Voluntary Life / AD&D Dependent Children Birth to age 26: 25% of Employee Coverage Amount Voluntary Accident Employee, Spouse (age 17 to 64) and dependent children until age 26 Scheduled according to injury. See Unum Benefit Summary or speak with a Benefits Counselor for more details 20
Flexible Spending Accounts (FSA) Flexible Spending Accounts are a great way for you to SAVE MONEY on pre-planned health and day care expenses! Participation is 100% voluntary Account is with WebTPA Savings are TAX FREE, not tax deferred Supported by Section 125 & 129 of the IRS Code Two account options or both! FSA Health Care Spending Account FSA Dependent or Day Care Spending Account 21
FSA for Healthcare Expenses The Health Care Spending Account allows you to reimburse yourself for out-of-pocket healthcare expenses not covered by our Medical, Dental and Vision plans. Annual pledge is available immediately on January 1 st! No waiting for the dollars to be withheld each check. The whole family can use the fund. Even if they have other healthcare coverage! However, your Domestic Partner s expense are not typically eligible unless they are a tax dependent. Set aside up to $2,600 for the 2017 calendar year! 22
FSA for Healthcare Expenses Debit Card Option Use anywhere MasterCard is accepted Swipe & Save at the doctor s office or pharmacy Reduce claim forms No waiting for checks Check balances online Keep your receipts Use for Health Care Spending Account Only! 23
FSA Eligible Health Expenses Eligible Acupuncture Birthing Classes Chiropractic Care Deductibles & Copays Dental & Orthodontia Frames & Contact Lenses Prescription Drugs Physical Therapy Airborne Books Not Eligible Club Memberships Face Lifts & Liposuction Marriage Counseling Premiums for other insurance, inc. COBRA Sonicare Toothbrushes Teeth Bleaching 24
FSA for Dependent Care Expenses The Dependent Care Flexible Spending Account is an alternative to the Child Care Tax Credit and an opportunity to save TAX FREE dollars on preplanned Dependent expenses. To participate you must be the Custodial Parent You and your spouse must be working full time, be actively looking for work or be a full-time student Tax free dollars are available as they are withheld Set aside up to $5,000 per household per calendar year ($2,500 if you are married and file your taxes separately). 25
FSA for Dependent Care Expenses Rules Definition of Dependent: They must be under the age of 13 They must live with you They must be claimed as a dependent on your tax return An older dependent may be eligible if they cannot physically or mentally take care of themselves. You must submit receipts for reimbursement from your Dependent Care FSA 26
FSA Eligible Dependent Care Expenses Eligible Nursery and Day Care Pre-schools Summer Day Camps After School Care In-Home Day Care Nannies Au Pair Services Not Eligible Tuition for Kindergarten and above Overnight Camp Nursing Home Expenses Meals Transportation Costs Caretakers or Facilities must have a valid Social Security Number or Tax ID Number 27
FSA - Considerations Decision is IRREVOCABLE for the entire plan year! Be conservative! However, adjustments can be made if a qualifying life event (marriage, divorce, death, birth, adoption) occurs. The IRS has a strict Use it or Lose It rule: If you don t use the full amount in your FSA by the end of the plan year, you will lose any remaining funds. Reduces Social Security Benefits What are the Grace & Run Out Periods? If you wish to participate in a FSA for the 2017 plan year, you will have until March 31, 2018 to submit claims to Diversified Benefit Solutions for reimbursement of expenses incurred through March 15, 2018. If you do not use your funds and submit them by the deadline, the remaining balance will be forfeited. For information on the reimbursement process, contact DBS, the Benefit Resource Center or Human Resources. 28
Benefits Resource Center Do you have a claim that is unpaid or was denied? Is your provider or pharmacy showing you are not covered? Did a call to your insurance carriers leave you more confused about your health benefits? Are you just not sure what is covered? Contact the BRC for help! 1-866-468-7272 phone 4ourBRC@usi.com (email or text) 7:00am 6:00pm Pacific Monday through Friday 29
Reasons to Call the BRC Inadequate answer from your insurance provider (e.g. WebTPA, DBS or Unum) Education / Clarification on benefit plan & eligibility Assistance with plan selection at Open Enrollment or when first hired Support finding a provider within the WebTPA network via Aetna Signature Administrators (ASA) Help understanding your Explanation of Benefits ( EOB s) or Bills Filing an appeal to the insurance company General personal questions on your benefits HIPAA Protected 30
Qualifying Events = Midyear Plan Changes Once you make your choices for 2017 Benefit elections are generally FIXED until Open Enrollment in the fall of 2017 for a January 1, 2018 effective date. The exception is if you experience a qualifying life event including: Legal Marriage Divorce or Legal Separation Birth or adoption of an eligible child (60 day window to enroll) Death of your spouse or covered child Change in work status for you, your spouse or your child that affects eligibility for benefits Change in residence or work site that affects your eligibility for benefits Receiving a Qualified Medical Child Support Order (60 day window to enroll) If you have a family status change, you must notify Shelly Quaif or Heather Davis at shelly.quaif@sealaska.com or heather.davis@sealaska.com within 30 days of the event 31
Next Steps and Questions Next steps Review the guidance and messages that you received from Sealaska HR to complete your 2017 benefits elections. To enroll, please visit BenefitElect via https://www2.benefitelect.com/be/sealaska Please make your elections by midnight on Friday, December 2 nd. For additional assistance or questions 1. Contact the Benefits Resource Center (BRC) for help 1-866-468-7272 phone 4ourBRC@usi.com (email or text) (Monday through Friday, 7:00am 6:00pm Pacific) 2. Contact Sealaska Human Resources HR@sealaska.com (Monday through Friday, 8:00am 5:00pm Pacific) 32