Annual enrollment is Oct. 30 Nov. 10 Choices as unique as you are It s your chance to change your benefits for 2018. To get started, use the benefits checklist inside. More information will be provided at bswhbenefits.com.
1 Annual Benefits Enrollment Starter Guide What s New in 2018 As a Baylor Scott & White Health employee, you help our patients get and stay healthy. As your employer, we re proud to offer benefits that help you and your family do the same. Take your education a step further. Grow your family and your career. Get quality care at an affordable price. Rest a little easier knowing you and your family are protected when care is needed. No matter what life brings, we ve got you covered. In this brochure, you ll find medical, dental and vision rates. More information about other benefits will be available at bswhbenefits.com. Tier 1 Provider Network: a Better Value Scott and White Health Plan and Baylor Scott & White Quality Alliance (BSWQA) have grown our Tier 1 network by 50% over the past two years. This means expanded access to high-quality providers in more convenient locations. Our exclusive Tier 1 network is always the best value. Tier 1 providers commit to, and are accountable for, providing high-quality, efficient and cost-effective care. Their proven track records are why we can provide enhanced benefits for Tier 1 care. What s Up, Doc? Looking for a Tier 1 provider? The BSWQA Health Access Line is here to help. Call 844-279-7589 to find a physician and schedule an appointment! Stay Connected: Text Alerts Text bswhae2018 to 41487 from your smartphone to access direct links to annual enrollment resources. Text message and data rates apply. Income Bands: Making Care More Affordable Your medical premiums are based on how much you make and who you choose to cover. When you earn more and cover more people, you ll pay more for coverage. It s how we help everyone afford medical coverage. For 2018, our medical premiums include four income bands, up from just two last year. Learn more on page 6. How Copays Help Your HRA Dollars Last Longer BSWH Funding into Your HRA Tier 1 Network Preventive Care Visit Tier 1 Network Primary Care Physician Office Visit Tier 1 Network Specialist Office Visit E-Visits: Quality Care at Your Fingertips Get care when and where you need it. Similar to last year, the costs of E-Visits are waived* for 2018. These email visits help you get basic care when it fits your schedule. *Waived cost for E-Visits doesn t apply until after the deductible is met for HSA plan participants. HRA Plan: Copays Help Your Dollars Last Longer The HRA plan is our most popular medical plan. We ve listened to your feedback, and in 2018 the plan will be easier to use than ever before! We re adding copays for Tier 1 and Tier 2 primary care physician and specialist visits. You can use your HRA dollars for all expenses incurred under the Tier 1 network. Tier 2 and Tier 3 office visits to a primary care physician, specialist and urgent care are not eligible for HRA payment. A rollover maximum equal to two times your annual Tier 1 deductible, will apply, effective Dec. 31, 2018. 2017 2018 $1,000 $1,000 $0 $0 (-$95) (-$25) (-$130) (-$50) HRA Dollars Remaining $775 $925 Changes to All Medical Plans Deductibles Tier 1 deductibles are holding steady for 2018! As a reminder, you always save the most on copayments, coinsurance and out-of-pocket maximums when you receive your care from a Tier 1 provider. Deductibles for Tier 2 and Tier 3 will increase. Tier 2 and Tier 3 providers have limited abilities to coordinate your care as effectively as those in Tier 1 (thanks to the Baylor Scott & White Quality Alliance). Receiving care from a Tier 1 provider always offers the best value. Emergency Room Care It s no surprise emergency room care is costly, both for patients and providers. All individuals needing medical treatment are encouraged to use the proper site of care based on their condition. In 2018, we are adjusting the way these visits are covered: 1. HRA and PPO plans: The first visit to the ER is $250 per insured individual. The cost of each additional visit will count toward your deductible and coinsurance. HRA dollars help cover these expenses. 2. HSA plan: ER coverage remains the same. You pay 100% of all costs until you meet your deductible. Once your deductible is met, you re responsible for 10% of the cost until the out-of-pocket maximum is reached. You can use your HSA dollars to help pay the cost or save them for other future expenses. Changes to Other Benefits Dental Coverage Great news! Dental rates are lower for all plans through MetLife. Also, the PPO Plus plan now covers implants. New Employee Assistance Program Provider Unum is our new Employee Assistance Program (EAP) administrator. You continue to have access to face-to-face counseling visits, telephonic visits, legal services and so much more. The EAP is available at no cost to all employees. No enrollment is necessary. To learn more, please call 800-854-1446 or visit lifebalance.net (user ID and password: lifebalance). Short-Term Disability Rates Our short-term disability plan remains the same, but rates increase by just 0.08%. Think carefully before you waive your short-term disability coverage. When an illness, injury, new baby or other eligible event requires time away from work, short-term disability will replace part of your pay. If you are not already enrolled in this benefit and would like to add it, you must complete evidence of insurability. Learn more at bswhbenefits.com. This site offers resources for employees and managers on how to manage a Leave of Absence. Annual Benefits Enrollment 2
Medical Coverage Choose the right plan to balance your unique life. Your personal benefits counselor! For more details on each of the plans, please visit bswhbenefits.com. While you re there, ask ALEX to help you choose the right plan for you and your family! Learn more on page 10. All three of our plans the HRA, HSA and PPO include premiums, deductibles, copayments, coinsurance and out-of-pocket maximums. Each plan has the same provider networks, pharmacy formulary and covered services. The main difference is how you pay for care. Remember that with all three plans, you ll get quality care at an affordable price when you stick with our exclusive Tier 1 network of providers. Health Reimbursement Account (HRA) Plan This is a great plan for those who want to take a more active role in managing their care and like getting money from Baylor Scott & White to help. There is a higher deductible, but the HRA dollars help offset certain copays and deductible expenses. The new copays are an added plus! Your HRA helps you meet your deductible and out-of-pocket maximum. Subtract your HRA from the out-of-pocket maximum to see the most you will pay from your own pocket. Health Savings Account (HSA) Plan This plan works well for those who want an added way to defer pretax dollars for future healthcare expenses (including in retirement). It is also a great plan for those who want to take a more active role in managing their healthcare. When you invest your funds and contribute your own dollars, this plan has real value! Employees with high pharmacy costs or those who are not used to managing a high-deductible plan should carefully research this plan before selecting. Preferred Provider Organization (PPO) Plan This plan works well for those who want a lower deductible and the assurance of copays for office visits and most pharmacy costs. Employees who select this plan do not mind a trade-off for higher premiums (paycheck costs). Did you know? The HRA and PPO plans feature embedded deductibles. You receive after-deductible coverage once you have met the individual deductible, even if you haven t met the family deductible. It s one of the best things about these plans. Another way we ve got you covered! The HSA plan does not include embedded deductibles due to Internal Revenue Service requirements. How You Pay for Care: Baylor Scott & White contributes between $1,000 $2,000 to your HRA. This money pays for your care. Once it s gone, you pay from your pocket until you reach your deductible. Keep in mind that you can t contribute your own money to the HRA, but you can set up an FSA to use once your HRA is depleted. Deductible: Lab work, imaging, outpatient procedures, etc., count toward your deductible. The money in your HRA helps offset the cost. Copays: Tier 1 office visit copays are paid from your HRA funds. Tier 2 office visit copays are paid from your pocket with the exception of emergency care. Prescriptions: You pay copays for prescriptions (as low as $3 $5 for generics). Prescription expenses are not paid by your HRA. Unused Dollars: Money left in your HRA carries forward to the following year when you stick with the HRA plan. Unused dollars are forfeited upon retirement or termination. An HRA rollover maximum, equal to two times your annual Tier 1 deductible, will apply, effective Dec. 31, 2018. How You Pay for Care: Baylor Scott & White contributes between $500 $1,000 to help jumpstart your HSA account. You can contribute your own money to your HSA through pretax payroll deductions. Call PeoplePlace at 844-417-5223, any time during the year to increase or decrease your contribution. Deductible: You meet your deductible by paying 100% of the contracted rate for office visits, prescriptions, urgent care visits, lab work, imaging, etc. Copays: Copays are not available with this plan, except for prescriptions after you meet your deductible. Prescriptions: You are responsible for 100% of your prescription costs until you meet your deductible. Once your deductible is met, you pay copays for prescriptions (as low as $3 $5 for generics). Unused Dollars: Money left in your HSA carries forward to the following year even if you change plans. Unused dollars go with you upon retirement or termination. How You Pay for Care: There are no funded accounts from Baylor Scott & White to help pay for your medical expenses. You pay for care from your pocket. Deductible: This plan offers a lower deductible than the other two plans. You meet your deductible with lab work, imaging, outpatient procedures, etc. Copays: You pay copays from your pocket for office visits, prescriptions, urgent care visits and the first visit to the emergency room for you and each of your covered dependents. Prescriptions: You pay copays for prescriptions (as low as $3 $5 for generics). 3 Annual Benefits Enrollment Annual Benefits Enrollment 4
Medical Plan Coverage and Costs Medical Plan HRA HSA PPO Medical Premiums per Pay Period (premiums listed do not reflect $30 Thrive wellness credit) Coverage Level Your Annual Pay HRA HSA PPO Network Tier 1 Preferred Tier 2 National Tier 3 OON Tier 1 Preferred Tier 2 National Tier 3 OON Tier 1 Preferred Baylor Scott & White Contribution to Account Pays for Medical Costs Only Pays Medical and Costs N/A Employee only $1,000 $500 N/A Employee + spouse $1,750 $1,000 N/A Employee + child(ren) $1,750 $1,000 N/A Employee + family $2,000 $1,000 N/A Tier 2 National Deductible Only Medical Costs Apply Medical and Costs Apply Only Medical Costs Apply Tier 3 OON Employee only $2,000 $3,000 $4,000 $2,000 $3,000 $4,000 $800 $1,800 $3,000 Employee + spouse $3,750* $5,750* $8,000* $4,000 $6,000 $8,000 $1,600* $3,600* $6,000* Employee + child(ren) $3,250* $5,250* $8,000* $4,000 $6,000 $8,000 $1,200* $3,200* $6,000* Employee + family $4,000* $6,000* $8,000* $4,000 $6,000 $8,000 $1,600* $3,600* $6,000* Out-of-Pocket Maximum For Medical and Costs For Medical and Costs For Medical and Costs Employee only $3,425 $6,850 No limit $3,275 $6,550 No limit $3,300 $6,850 No limit Employee + spouse $6,850** $13,700** No limit $6,550** $13,100** No limit $6,600** $13,700** No limit Employee + child(ren) $5,137** $10,275** No limit $6,550** $13,100** No limit $4,950** $10,275** No limit Employee + family $6,850** $13,700** No limit $6,550** $13,100** No limit $6,600** $13,700** No limit Your Cost for Care and Services Preventive care $0 $0 Not covered $0 $0 Not covered $0 $0 Not covered Primary care physician office visit $25 $75 70% AD 50% AD 70% AD $25 $70 70% AD Specialist office visit $50 $100 70% AD 50% AD 70% AD $40 $100 70% AD Urgent care office visit $50 $100 $100 50% AD 50% AD $50 $100 $100 Emergency room visit Hospital inpatient/outpatient care 50% AD 70% AD 50% AD 70% AD 50% AD 70% AD Employee only Up to $13/hour $50 $43 $68 Over $13 to $25/hour $77 $65 $89 Over $25 to $48/hour $84 $73 $103 Over $48/hour $100 $90 $125 Employee + spouse Up to $13/hour $92 $83 $130 Over $13 to $25/hour $155 $140 $210 Over $25 to $48/hour $170 $150 $230 Over $48/hour $190 $175 $266 Employee + child(ren) Up to $13/hour $90 $83 $127 Over $13 to $25/hour $139 $118 $175 Over $25 to $48/hour $150 $129 $200 Over $48/hour $168 $148 $227 Employee + family Up to $13/hour $132 $114 $185 Part-Time Employees Medical Plan HRA HSA PPO Employee only $118.62 $118.62 $231.60 Employee + spouse $300.00 $300.00 $403.52 Over $13 to $25/hour $205 $180 $264 Over $25 to $48/hour $215 $200 $305 Over $48/hour $240 $235 $340 Dental Coverage Level MetLife Dental PPO MetLife Dental PPO Plus Employee only $8.50 $16.89 Employee + spouse $17.03 $32.94 Your Cost for Prescription Drugs HRA and Deductibles Don t Apply Cost After You ve Met Deductible Deductibles Don t Apply Employee + child(ren) $220.84 $220.84 $393.97 Employee + child(ren) $22.79 $42.39 BSWH Contracted BSWH Contracted BSWH Preferred generic $3 or $6^ $5 $3 or $6^ AD $5 AD $3 or $6^ $5 Contracted Employee + family $351.23 $351.23 $594.88 Employee + family $28.91 $58.44 Preferred brand $35 or $70^ $50 $35 or $70^ AD $50 AD $35 or $70^ $50 Chronic and preventive $10 or $20^ $20 $10 or $20^ AD $20 AD $10 or $20^ $20 Vision Non-preferred brand and generic Lesser of $50/$100^ or 50% Lesser of $75 or 50% Lesser of $50/$100^ or 50% AD Lesser of $75 or 50% AD Lesser of $50/$100^ or 50% Lesser of $75 or 50% Specialty 20% ($200 max) Not covered 20% ($200 max) AD Not covered 20% ($200 max) Not covered Non-formulary unless excluded^^ 50% 50% 50% AD 50% AD 50% 50% AD means after you ve met your deductible. You can use your HRA dollars for all expenses incurred under the Tier 1 network. Tier 2 and Tier 3 office visits to a primary care physician, specialist and urgent care are not eligible for HRA payment. * These are embedded deductibles. The plan provides after-deductible coverage once you have met the individual deductible, even if you haven t met the family deductible. ** These are embedded out-of-pocket maximums. Once you have met the individual out-of-pocket maximum, the plan covers 100% of your eligible costs, even if you haven t met the family out-of-pocket maximum. Services must be coded as preventative care to be paid at 100%. Please see bswh.swhp.org for a complete list of covered preventative care services. To help make some frequently prescribed preferred brand drugs for asthma, diabetes and some other chronic conditions more affordable, we ve placed a select group on a special chronic and preventive medication list. Find the complete list on bswh.swhp.org. ^ This is your cost for a 90-day supply. ^^ Excluded medications include cosmetic, over the counter, herbals, and others as described in the Summary Plan Description. Certain non-formulary drugs are covered at specific levels at all BSWH and contracted pharmacies: Fertility drugs are covered at 20% with a maximum $400 copay and a $7,500 lifetime maximum pharmacy benefit. Diabetic testing supplies, including meters, test strips and lancets, are covered and subject to copays and coinsurance. Thirty-day supplies of generic proton pump inhibitors are covered at 50%. (Ninety-day supplies are available at BSWH pharmacies.) Earn Wellness Credits Participate in Thrive to earn a $30 wellness credit each pay period you can use it to reduce the cost of your premium! Learn more at bswhbenefits.com. Coverage Level Superior Employee only $3.20 Employee + spouse $6.35 Employee + child(ren) $6.23 Employee + family $9.46 5 Annual Benefits Enrollment Annual Benefits Enrollment 6
401(k): Invest in Tomorrow While you re reviewing your benefits, it s a good idea to check on your retirement savings. Keep in mind that you can sign up, make changes and adjust your retirement savings account anytime during the year. Participating is simple. You choose a percentage of your salary to save. We subtract that amount each pay period and deposit the funds in your 401(k) retirement account. Because we want your retirement savings to grow, we match your contribution dollar for dollar up to the first 5% of your eligible pay. You become 100% vested in the employer match after three years of employment. Not participating? Sign up for your retirement plan anytime by visiting bswhretirement.com or by clicking Retirement in PeoplePlace. It only takes a few minutes. Seasoned saver? Visit bswhretirement.com or click Retirement in PeoplePlace after you ve made your 2018 elections. Review your current savings to see if you re on track to meet your future needs. The site helps you: See how much income you may have in retirement Make changes to improve your retirement security View your Lifetime Income Score summary Enroll in auto increase to make saving easier Make additional catch-up contributions (if you are 50, or will turn 50 in 2018*) *If you turn 50 in 2018, you can begin your catch-up contribution in January 2018. Oct. 30 Nov. 10 Enroll for your 2018 health and income protection benefits. All Year Long, Anytime Sign up and make changes to your retirement savings plan. Start saving today! To learn more about your retirement plan with Empower Retirement, visit bswhretirement.com or click Retirement in PeoplePlace. To talk with an Empower representative, please call 844-722-2794 between 8 a.m. and 7 p.m. Central. We re here to help! Benefits on the go! The MyBSWHealth app is an easy and convenient way to manage your healthcare and access your health benefits on the go. Find providers, view claims, register for E-Visits and more! Get the latest MyBSWHealth app on the Apple App Store or Google Play today. Find a Tier 1 Provider Baylor Scott & White Quality Alliance Health Access Line Click bswh.swhp.org and click Find a Provider Talk 844-279-7589 App MyBSWHealth App Questions about Pay, Benefits, Paid Time Off, Disability or Leave PeoplePlace Click mypeopleplace.com Talk 844-417-5223 Questions about Medical and Prescription Drug Coverage or Your Personal Claims and Account Information Scott and White Health Plan Click bswh.swhp.org Talk 844-843-3229 (dedicated employee line) App MyBSWHealth App There s an app for that! The new Empower Retirement app currently available on iphone or Apple Watch allows you to view and manage your plan anywhere, anytime. Download the app on the Apple App Store by searching for Empower Retirement.? Questions about Retirement Empower Retirement Click bswhretirement.com Talk 844-722-2794 App Empower Retirement 7 Annual Benefits Enrollment Annual Benefits Enrollment 8
Here s a checklist to help you keep track of your benefits decisions. Decision 1: Medical Coverage Choose from the Health Reimbursement Account (HRA) plan, Health Savings Account (HSA) plan or Preferred Provider Organization (PPO) plan. Each plan has the same provider networks, pharmacy formulary and covered services. The main difference is how you pay for care. Decision 2: Dental Coverage Choose from two optional plans to help cover dental costs for you and your family: the MetLife Dental PPO and the MetLife Dental PPO Plus. Decision 3: Vision Coverage We offer an optional vision plan administered by Superior Vision. It covers routine exams, lenses, frames and contacts. You pay less when you stick with the Superior Vision network. Decision 4: Flexible Spending Accounts (FSAs) These accounts let you set aside pretax dollars to pay for eligible expenses. Use the dependent day care FSA to pay for child or elder care. Use the general-purpose FSA to pay your share of medical, dental and vision costs. The general-purpose FSA can accompany the HRA or PPO plans. Use it after your HRA is gone to help pay the rest of your deductible. The limited-purpose FSA can accompany the HSA plan. Use the limited-purpose FSA to pay your share of dental and vision costs until your deductible has been met. After the deductible has been met, use this account to pay for medical costs too. Decision 5: Life Insurance For most employees,* we provide basic life insurance that pays your beneficiary an amount equal to one times your annual base salary ($20,000 minimum; $1 million maximum). If you desire additional coverage, you can purchase voluntary life insurance coverage for you, your spouse and children. Decision 6: AD&D Insurance For most employees,* we provide basic accidental death and dismemberment (AD&D) insurance equal to one times your base pay ($20,000 minimum; $1 million maximum). If you desire additional coverage, you can purchase voluntary AD&D coverage for you, your spouse and children. Decision 7: Short-Term Disability Insurance Short-term disability insurance pays a portion of your salary if you re sick or injured or add a child to your family. Keep in mind that you must purchase short-term disability to receive parental leave benefits. Decision 8: Long-Term Disability Insurance For most employees,* we provide basic long-term disability insurance that pays 60% of your base pay, up to $15,000 a month. You can purchase additional coverage to increase your benefit to 70% of your base salary, up to $15,000 a month. Decision 9: Legal Services You can purchase coverage with Hyatt Legal Services to help with a wide range of personal legal matters. Get access to a network of attorneys to handle real estate sales or purchases, adoptions, creating a will and much more. You can secure coverage for yourself or for yourself and your family. Decision 10: Retirement Contributions Now is a good time to review your retirement contributions. Make sure you re receiving the full 5% match and consider enrolling in auto increase to make saving even easier. If you are currently over 50 or turning 50 in 2018, you can make additional catch-up contributions. Keep in mind that you can make changes to your retirement savings plan at any time. Sign up before time runs out. Annual enrollment is Oct. 30 Nov. 10. Don t miss your chance to sign up or update your benefits. Looking for more? Additional information is available at bswhbenefits.com. You ll find lots of resources there, including videos and a comprehensive digital guide. You ll also be invited to participate in an in-person or virtual benefits information session with members of our HR Benefits Team. Annual enrollment is your chance to adjust your benefits coverage. With so much to consider, sometimes it s nice to have some help. How to Enroll Once you re ready to enroll, just follow these steps: 1. Log in to PeoplePlace. 2. Click Benefit Details. 3. Click Benefits Enrollment. 4. Click Select to choose your 2018 benefits and add or update your dependents and beneficiaries. 5. Click Save and Continue to accept your final choices or I Have No Changes if you prefer to make no election changes. 6. Click Submit to finalize your choices. You can change your elections until midnight on Nov. 10. If you do not go through annual enrollment, your 2017 benefits elections will roll over for 2018. Ask ALEX, your interactive benefits counselor, walks you through each benefit. He will ask a series of questions and use your answers to formulate a recommendation. Use his advice as a guide, and remember to use your other resources as well before making final selections. *Other coverage levels for life, AD&D and disability are available for certain executive and physician roles and are visible in the PeoplePlace enrollment system. 9 Annual Benefits Enrollment Annual Benefits Enrollment 10
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