GaBreeze Webinar Job Aids Overview WINTER 2012

February APRIL 2010 Session Purpose Topics to Discuss Key Business Processes – COBRA – Employee Eligibility – Evidence of Insurability – LOA Summary Matrix – Qualified Status Change – Retirement General Job Aids – Agency Audits – File Sharing

February APRIL 2010 KEY BUSINESS PROCESSES

February APRIL 2010 Location of Key Business Processes

February APRIL 2010 COBRA

February APRIL 2010 COBRA Job Aid (1) What Is COBRA ?  COBRA is the continuation rights available to employees and their qualified beneficiaries pursuant to the Consolidated Omnibus Budget Reconciliation Act. This act permits former employee and their qualified beneficiaries continue coverage up to 18 months Which Options can be covered by COBRA  Dental  Vision  Health Care Spending Account

February APRIL 2010 COBRA Job Aid (2) Billing Process:  GaBreeze processes COBRA enrollment and sends a monthly invoice directly to participant(s).

February APRIL 2010 ELIGIBILITY PROCESS

February APRIL 2010 Employee Eligibility  A full-time regular employee who works at least thirty hours a week and is expected to work for at least nine months  Public School Professionally Certified Employees working at least 17.5 per week  Public School Non-Certified Employee working at least 20 hours per week & eligible to participate in TRS or its local equivalent.  Public School Non-Certified Employee working at least 15 hours per week & eligible to participate in PSERS or its local equivalent.  County or Regional Library Employees working at least 17.5 per week  In an organization deemed eligible by Federal or Georgia Law. Eligibility Job Aid (1)

February APRIL 2010 Dependent Eligibility:  Legal Spouse  Natural Child, stepchild, adopted child until age 26  Guardianship of child until age 26  Total Disable child age 26 or older if disable child is enrolled before age 26 Dependent Verification: SPA accepts verification done through State Health SPA reserves the right to request dependent documentation Eligibility Job Aid (2)

February APRIL 2010 Coverage Eligibility  Coverage begins the first of the month following a full calendar month worked.  Payroll deductions begin first of the month following newly eligible status effective date  Example: Hired March 8 th ; coverage effective date May 1 st Coverage Termination  Employee terminates before the 16 th of the month Coverage ends last day of the month  Example: Termed June 12 th Coverage ends June 30 th  Employee terminates on or after the 16 th of the month Coverage ends last day of the following month  Example: Termed June 19 th Coverage ends July 31 st STD & LTD coverage ends on the date of termination Eligibility Job Aid (3)

February APRIL 2010 EVIDENCE OF INSURABILITY PROCESS

February APRIL 2010 Evidence of Insurability (EOI):  Series of medical questions: employees may be requested to have a medical exam  Employee continues coverage at the guaranteed issued amount until EOI is approved  EOI is approved with 60 days. Increase becomes effective the 1 st of the month following approval  Employee will receive a prompt to complete the EOI online or if enrolling through Call Center form is mailed Evidence of Insurability Job Aid (1) Plans Requiring EOI:  Employee Life, Spouse Life, Specified Illness, Spouse Specified Illness, LTD & LTC Triggers:  Newly eligible employee enrolling in coverage that exceeds the guaranteed issued amount  Current employee enrolling in coverage for the first time during Annual Enrollment or QSC

February APRIL 2010 Evidence of Insurability Job Aid (2) EOI process is a paper process for LTC & Specified Illness

February APRIL 2010 LEAVE OF ABSENCE (LOA) PROCESS

February LOA Availability Matrix Leave of Absence Job Aid (1)

February What Employees can do when: Leave of Absence Job Aid (2)

February APRIL 2010 QUALIFIED STATUS CHANGE

February APRIL 2010 Qualified Status Change Job Aid (1) What is a Qualifying Status Change?  A personal change, life event change, in status which may allow you to change your benefit elections  Marriage or divorce  Birth or adoption of a child  Death of a spouse or child  Loss of coverage  QSC become effective on the first of the month following the DATE the change is reported regardless of the actual QSC date. Birth/adoption effective on the date of the event.  Example: Employee marry on Feb 7 th, reports status to GaBreeze on Feb. 23 rd changes effective March 1 st (require recoup of the difference in premiums)  Example: Employee marry on Feb 7 th, reports status to GaBreeze on March 5 th changes effective April 1 st (will not recoup of the difference in premiums)

February APRIL 2010 RETIREMENT PROCESS

February APRIL 2010 Retirement Job Aid (1) Coverage Continuation:  Retiree Dental - coverage continues automatically if currently enrolled (no form to complete; Confirmation Kit )  Pension Deduction  Direct Billed  Changes can be made during the annual enrollment period  Vision & *Health Care Spending - continue through COBRA for 18 months  Life, Specified Illness, LTC,*Legal - coverage continuation through Conversion or Portability *Notes benefit options that can only be kept for the duration of the Plan Year in which they end active employment.

February APRIL 2010 Retirement Job Aid (2) Benefits Retiree Coverage Available Through Retirement Plan Benefits Deductions Coverage Can Be Direct Billed By Carrier or Converted to An Individual Policy You Must Decide And complete forms Within Dental Coverage Regular & PPOYesNo DHMO OptionYes 30 days Vision CoverageNo COBRA -60 days Health Care Spending AccountsNo COBRA - 60 days Dependent Care Spending AccountNo Employee/Spouse/Child Life Insurance & AD&DNoYes30 days Specified IllnessNoYes30 days Disability / Coverage Short-TermNo Long-TermNoYes30 days Legal InsuranceNoYes (Through end of the plan year)30 days Long-Term CareNoYes30 days

February APRIL 2010 GENERAL JOB AIDS

February APRIL 2010 Agency Audit & File Share Job Aid Agency Audit:  Allows users to see the reports processed by each Agency user  Smart Forms  Reporting  Files  Agency Information File Share:  Allows file sharing of reports between SPA, GaBreeze and your agency

February APRIL 2010 Final Questions and Follow-ups