2017 Benefits Guide
2017 Benefits
Guide
Take a Fresh Look at Your Benefits and Enroll
WELCOME TO OPEN ENROLLMENT 2017 ........................................................ 5
How to Enroll............................................................................................................................................................. 5
What¡¯s New for 2017 ................................................................................................................................................. 5
- Introducing Castlight! A Personalized Tool for Finding High-Quality, Affordable and
Convenient Medical Care ......................................................................................................................... 6
- Medical ..................................................................................................................................................... 6
- Flexible Spending Accounts (FSAs) ......................................................................................................... 6
- Wellbeing Program ................................................................................................................................... 6
Benefit Options at a Glance ..................................................................................................................................... 7
Medical Option Highlights ....................................................................................................................................... 8
- Choosing a Carrier ................................................................................................................................... 8
- Provider Networks .................................................................................................................................... 9
- Health Care Reform ................................................................................................................................. 9
- Choosing a Health Plan............................................................................................................................ 9
- Switching Between Plan HRA and Plan HSA ........................................................................................ 10
Dental Option Highlights ....................................................................................................................................... 10
Flexible Spending Accounts (FSAs) Highlights .................................................................................................. 10
Flex Vacation Highlights ........................................................................................................................................ 11
Benefits Eligibility................................................................................................................................................... 11
- Domestic Partner Definition.................................................................................................................... 12
How to Enroll........................................................................................................................................................... 12
- Enrollment Reminders ............................................................................................................................ 12
- If You Miss the Enrollment Deadline ...................................................................................................... 13
Paying for Coverage ............................................................................................................................................... 14
- Your Per-Pay Cost ................................................................................................................................. 15
- Pricing Structure for Medical Coverage ................................................................................................. 15
Tools to Help You Choose the Right Health Plan ............................................................................................... 15
Health and Wellbeing ............................................................................................................................................. 16
- Wellbeing Program ................................................................................................................................. 16
- Wellbeing Incentives .............................................................................................................................. 18
- Special Information if You Are Covered by the Kaiser, HMSA Hawaii or Aetna International
Health Plan ............................................................................................................................................. 19
- Manage Your Health through Doctor On Demand ................................................................................. 19
- Get Quality Care Fast with a CVS Health MinuteClinic? ....................................................................... 19
- 2017 IRS Limits Impacting HSA Incentives............................................................................................ 19
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CHANGING COVERAGE .................................................................................. 20
What Is a Qualified Life Event? ............................................................................................................................. 20
How to Report a Qualified Life Event Change ..................................................................................................... 20
What You Can Change ........................................................................................................................................... 21
Special Health Coverage Enrollment .................................................................................................................... 23
- When You Have Other Medical Coverage Available ............................................................................. 23
- Coordination of Medicare and BNY Mellon Medical Coverage .............................................................. 24
If You Leave BNY Mellon ....................................................................................................................................... 24
MEDICAL AND PRESCRIPTION DRUG ............................................................ 25
How the Plans Work ............................................................................................................................................... 26
- The Health Accounts .............................................................................................................................. 26
- You and BNY Mellon Share Costs ......................................................................................................... 27
- Cost of Coverage ................................................................................................................................... 28
- Precertification ........................................................................................................................................ 28
- Coverage Includes Mastectomy Benefits ............................................................................................... 28
- Healthy Pregnancy Programs ................................................................................................................ 29
- Aetna¡¯s Beginning Right Maternity Program .......................................................................................... 29
- UnitedHealthcare Maternity Support Program ....................................................................................... 29
- Infertility Services ................................................................................................................................... 30
- Autism Spectrum Disorder Services....................................................................................................... 30
- Applied Behavior Analysis Therapy........................................................................................................ 30
Comparing the Plans .............................................................................................................................................. 31
2017 Medical Contributions ................................................................................................................................... 33
Prescription Drug Benefits .................................................................................................................................... 35
- Find the Right Help for Serious or Chronic Health Conditions ............................................................... 37
Plan HRA (Health Reimbursement Account) ....................................................................................................... 38
- HRA Contributions .................................................................................................................................. 38
- How the HRA Works .............................................................................................................................. 39
- Plan HRA Details .................................................................................................................................... 40
Plan HSA (Health Savings Account) ..................................................................................................................... 41
- Health Savings Account (HSA) Contributions ........................................................................................ 41
- How the HSA Works ............................................................................................................................... 42
- Plan HSA Details .................................................................................................................................... 47
How the Health Accounts Compare...................................................................................................................... 49
- New Health Plan ID Card ....................................................................................................................... 51
Castlight: Make Informed Health Care Choices .................................................................................................. 51
Best Doctors: Get Help with Important Medical Decisions ................................................................................ 51
Illustrated Plan Comparisons ................................................................................................................................ 51
FLEXIBLE SPENDING ACCOUNTS .................................................................. 55
How FSAs Work ...................................................................................................................................................... 55
Health Care FSA Eligible Expenses ...................................................................................................................... 57
Dependent Care FSA Eligible Expenses .............................................................................................................. 58
Health Care FSA During a Leave of Absence ...................................................................................................... 58
Dependent Care FSA During a Leave of Absence .............................................................................................. 58
Important FSA Rules .............................................................................................................................................. 58
Should You Use the Dependent Care FSA or the Dependent Care Tax Credit? .............................................. 59
Limited Purpose FSA ............................................................................................................................................. 59
Things to Think About............................................................................................................................................ 59
2
DENTAL AND VISION ...................................................................................... 60
Dental Coverage ..................................................................................................................................................... 60
- 2017 Dental Contributions ...................................................................................................................... 60
- MetLife Options ...................................................................................................................................... 60
- Aetna DMO ............................................................................................................................................. 62
- Things to Consider ................................................................................................................................. 64
Vision Coverage...................................................................................................................................................... 64
- 2017 Vision Contributions ...................................................................................................................... 64
- How the Plan Works ............................................................................................................................... 65
FINANCIAL PROTECTION ............................................................................... 67
Disability Coverage ................................................................................................................................................ 67
- Short-term Disability (STD) .................................................................................................................... 67
- Long-term Disability (LTD) ..................................................................................................................... 67
Life and Accident Coverage .................................................................................................................................. 68
- Coverage Amounts ................................................................................................................................. 68
- Life and Accident Coverage at a Glance ................................................................................................ 68
- Cost of Coverage ................................................................................................................................... 69
- Evidence of Insurability .......................................................................................................................... 69
- Employee Coverage ............................................................................................................................... 70
- Dependent Coverage ............................................................................................................................. 71
TIME OFF & PERSONAL .................................................................................. 72
Flex Vacation Purchase ......................................................................................................................................... 72
- How Flex Vacation Works ...................................................................................................................... 72
LEGAL NOTICES ............................................................................................. 73
Women¡¯s Health and Cancer Rights Act of 1998 (WHCRA) Notice ...................................................................73
Newborns¡¯ and Mothers¡¯ Notice ............................................................................................................................ 73
Military Leave Under the Uniformed Services Employment and Reemployment Rights Act
(USERRA) ................................................................................................................................................................ 73
Qualified Medical Child Support Orders .............................................................................................................. 74
Premium Assistance Under Medicaid and the Children¡¯s Health Insurance Program (CHIP) ....................... 74
Key Things to Know About the Affordable Care Act (ACA) ............................................................................... 76
Health Insurance Marketplace Coverage Options............................................................................................... 76
- PART A: General Information................................................................................................................. 76
- PART B: Information About Employer-Provided Health Coverage ........................................................ 77
Information Regarding Termination of Health Plan Coverage for Cause ......................................................... 77
Self-Insured Plans .................................................................................................................................................. 78
Medicare Prescription Drug Notice....................................................................................................................... 78
- BNY Mellon Creditable Coverage Plans ................................................................................................ 78
HIPAA Notice........................................................................................................................................................... 81
COBRA Rights Notice ¨C Health and Welfare Benefits ........................................................................................ 87
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