Open Enrollment Overview and Summary



Employee Benefits OverviewIt is currently open enrollment time. Health Care costs continue to increase, and it is no exception for our group. As a result of these escalating costs, we have spent a significant amount of time analyzing our options in the marketplace and working to negotiate with our current carriers with the help of IFS Benefits, LLC. Below you will find our program options effective June 1, 2013. SUMMARY OF EMPLOYEE BENEFITSMEDICALAetna will continue to be our medical insurance carrier. You will still have three plans to choose from. Highlights of your plans include:HN CS 3.4 (New Plan)HN CS 2.4Primary Care:$30 co-pay$30 co-paySpecialist Care:$50 co-pay$50 co-payInpatient Hospital:$2000 ded then 100% covered$1500 ded then 100% coveredOutpatient Surgery:$2000 ded then 100% covered$1500 ded then 100% coveredEmergency Room:$200 co-pay$200 co-payPrescriptions:$15/$40/$70/$250$15/$40/$70/$250HN H S A 1.4Deductibles: $1500 Individual/ $3000 FamilyPreventive Care: 100% covered Most other services: Deductible, then 90% coveredPrescription copays:Deductible, then $15/$40/$70/$250Please note: the H S A plan allows you to put away monies tax free into a savings account to pay for your deductible. If you do not spend this money you do not lose it – it remains in your tax free savings account earning interest tax free!*Please refer to your packet for a more detailed benefit description* Approximate Medical Payroll Deductions:EmployeeEmployee +SpouseEmployee+Child(ren)FamilyHN CS 3.4$96.00$389.08$278.77$542.31HN CS 2.4$108.00$416.77$300.92$578.31HN H S A 1.4$55.38$295.85$205.38$421.38DENTALDelta Dental will continue to be our dental carrier. We will continue to offer two plans to choose from. Highlights of your plans include:High OptionLow OptionDeductible for Basic & Major Services:$50/$150$50/$150Preventive Care: 100%100%Basic Services: 80% 50%Major Services: 50% 50%Orthodontia: 50% up to $750 max 50% up to $750 max Annual maximum benefit:$1250$1000Approximate Dental Payroll Deductions:EmployeeEmployee +SpouseEmployee+Child(ren)FamilyHigh Option$13.47$27.39$31.06$47.22Low Option$11.55$23.54$27.06$41.10LIFEPeople’s Place will continue to pay for a flat $20,000 life and accidental death and dismemberment policy for every full time benefits eligible employee. This coverage will be through Boston Mutual. You may change your beneficiary at any time.VOLUNTARY SUPPLEMENTAL LIFE & AD&DAll full time employees have the option to purchase extra Life & AD&D insurance from Boston Mutual. See HR for costs.SHORT TERM DISABILITYBoston Mutual will be our Disability Insurance carrier. In the event that you become disabled, the Short Term policy will replace 50% of your weekly income (max. of $800/week) for 24 weeks after a 14 day wait. This policy is provided to you at no cost by People’s Place.LONG TERM DISABILITY Boston Mutual will be our Disability Insurance carrier. In the event that you become disabled, the Long Term policy will replace 60% of your monthly income (max. of $5,000/month) after a 180 day wait. This policy is provided to you at no cost by People’s Place.FLEXIBLE SPENDING ACCOUNT We are pleased to continue this benefit again this year. Ameriflex will remain our FSA provider. This benefit will allow employees to set aside money from their paycheck on a PRE-TAX basis to pay for medical, dental, vision, and dependent care - saving you approximately 25% to 40% on these expenses! Those enrolling in the H S A are not eligible to participate in the FSA. The maximum election amount for medical care is $2500. Everyone must complete a form to re-enroll or decline participation. HEALTH ADVOCATE Health Advocate, Inc. is an advocacy and assistance service company founded to specifically address many of the issues Americans encounter while accessing the healthcare and health insurance systems. Their expertise and relationships in the healthcare industry combined with their in-depth knowledge of health and related insurance policies and procedures, give them the know-how to act on your behalf. This benefit is being provided at no cost to the employees, spouses, dependent children, parents and parents- in-law.VISION VSP will continue to be our Voluntary Vision Provider. Some highlights of the plan are: $ 10 co-pay for exams, $ 25 co-pay for lenses. See benefit sheet for a full description of benefits. Approximate Vision Payroll Deductions:EmployeeEmployee +SpouseEmployee+Child(ren)Family$3.47$5.54$5.66$9.12What do you need to do during the OPEN ENROLLMENT period?Open Enrollment meetings will be held:Tuesday, May 7th at 1pm & 4:30pmMonday, May 13th at 9:30amBelow is a list of items needed for open enrollment:Enrollment forms – These are only required if you are making a plan change.Ameriflex FSA election form – Everyone must complete an Ameriflex FSA election or waiver form. All Forms are due to HR no later than Thursday, May 23rd at noonNOTE: After the Open Enrollment Period, you cannot make changes to your coverage during the year unless you experience a change in family status, such as: Loss or gain of coverage through your spouseLoss of eligibility of a covered dependentDeath of your covered spouse or childBirth or adoption of a childMarriage, divorce, or legal separationSwitch from part-time to full-time You have 30 days from a change in family status to make changes to your current coverage.Health Care Reform RemindersPreventive care covered at100%No lifetime or annual maximum dollar limits (in-network services)Dependents can enroll up to age 26Some over the counter medicines require a written prescription in order to use H S A or FSA fundsWomen’s preventive services covered 100% - including FDA approved contraception methods and contraceptive counselingLegislative UpdatesEffective January 1, 2012, DE law provides that same-sex couples who enter into a civil union will have the same rights, protections and obligations that exist for married couples.Effective January 1, 2013, DE law states insurers must provide coverage for screening, diagnosis & treatment of Autism Spectrum Disorder for children under age 21 as well as coverage for Applied Behavior Analysis therapy.Effective January 1, 2013, DE law states that a member’s out-of-pocket costs for orally administered anticancer medications must be equal to the member’s cost for intravenous or injected anticancer medications. **This is not a contract or a definitive statement of benefits. It is intended solely to provide you with an overview of your benefits. Complete details of benefits, terms and exclusions are governed by your Group Membership Agreement. The Group Membership Agreement may not cover all of your health care expenses. Read your Group Membership Agreement carefully to determine which health care services are covered. ................
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