Welcome to Open Enrollment 2015. Benefits Life Dental Health.

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Presentation transcript:

Welcome to Open Enrollment 2015

Benefits Life Dental Health

Term Life Policy Date of Hire Date of Separation Can convert to Retiree Life if you retire from JCBOE Term Life Policy Date of Hire Date of Separation Can convert to Retiree Life if you retire from JCBOE LifeLife

$25.84 $70.94 First Year Limit: EvaluationCleaning Fluoride Treatment First Year Limit: EvaluationCleaning Fluoride Treatment DentalDental

State Health Benefit Plan (Medical) (Medical)

Making Your 2015 Benefit Election Online ElectionOnline Election  Must have address  Members must make their health election at  Registration code: SHBP-GA  Tools: Medical Cost Calculator, Preference Module, Comparison Module Website Open & Close DatesWebsite Open & Close Dates  Website opens at 12:00 a.m. on October 27, 2014  Website closes at 5:00 p.m. ET on November 14, 2014 Online ElectionOnline Election  Must have address  Members must make their health election at  Registration code: SHBP-GA  Tools: Medical Cost Calculator, Preference Module, Comparison Module Website Open & Close DatesWebsite Open & Close Dates  Website opens at 12:00 a.m. on October 27, 2014  Website closes at 5:00 p.m. ET on November 14, 2014

2015 Open Enrollment Members may go online as many times as they like but the last election confirmed at the time OE closes will be the election for the 2015 Plan YearMembers may go online as many times as they like but the last election confirmed at the time OE closes will be the election for the 2015 Plan Year Members should print and keep a copy of the confirmation page which will contain a confirmation numberMembers should print and keep a copy of the confirmation page which will contain a confirmation number Members may go online as many times as they like but the last election confirmed at the time OE closes will be the election for the 2015 Plan YearMembers may go online as many times as they like but the last election confirmed at the time OE closes will be the election for the 2015 Plan Year Members should print and keep a copy of the confirmation page which will contain a confirmation numberMembers should print and keep a copy of the confirmation page which will contain a confirmation number

2015 Open Enrollment Members who do not make an open enrollment election are defaulted to last year’s plan (w/tobacco if in 2014)Members who do not make an open enrollment election are defaulted to last year’s plan (w/tobacco if in 2014) Members who wish to discontinue in 2015 must go online and elect no coverage or they will be defaulted to Bronze planMembers who wish to discontinue in 2015 must go online and elect no coverage or they will be defaulted to Bronze plan Members with no coverage in 2014 will be defaulted to no coverage in 2015Members with no coverage in 2014 will be defaulted to no coverage in 2015 Members who do not make an open enrollment election are defaulted to last year’s plan (w/tobacco if in 2014)Members who do not make an open enrollment election are defaulted to last year’s plan (w/tobacco if in 2014) Members who wish to discontinue in 2015 must go online and elect no coverage or they will be defaulted to Bronze planMembers who wish to discontinue in 2015 must go online and elect no coverage or they will be defaulted to Bronze plan Members with no coverage in 2014 will be defaulted to no coverage in 2015Members with no coverage in 2014 will be defaulted to no coverage in 2015

Applied Behavior Analysis for AutismApplied Behavior Analysis for Autism  $35,000/year, through age 10 Bariatric PilotBariatric Pilot  1 st 75 non-Medicare Advantage members Hearing AidsHearing Aids  $3,000/5 years, up to age 19 Incentive Accounts for HMO/HDHPIncentive Accounts for HMO/HDHP Applied Behavior Analysis for AutismApplied Behavior Analysis for Autism  $35,000/year, through age 10 Bariatric PilotBariatric Pilot  1 st 75 non-Medicare Advantage members Hearing AidsHearing Aids  $3,000/5 years, up to age 19 Incentive Accounts for HMO/HDHPIncentive Accounts for HMO/HDHP 2015 Benefit and Plan Changes

Plan Vendors Blue Cross and Blue Shield - HRA/HMOBlue Cross and Blue Shield - HRA/HMO UnitedHealthcare – HMO/HDHPUnitedHealthcare – HMO/HDHP Kaiser Permanente – Regional HMOKaiser Permanente – Regional HMO TRICARETRICARE PeachCare for KidsPeachCare for Kids Express Scripts - Pharmacy BenefitExpress Scripts - Pharmacy Benefit Healthways - WellnessHealthways - Wellness Blue Cross and Blue Shield - HRA/HMOBlue Cross and Blue Shield - HRA/HMO UnitedHealthcare – HMO/HDHPUnitedHealthcare – HMO/HDHP Kaiser Permanente – Regional HMOKaiser Permanente – Regional HMO TRICARETRICARE PeachCare for KidsPeachCare for Kids Express Scripts - Pharmacy BenefitExpress Scripts - Pharmacy Benefit Healthways - WellnessHealthways - Wellness

HRA PLAN (BCBSGa) No co-paysNo co-pays 100% Preventative care coverage100% Preventative care coverage Separate in/out network (ded/max)Separate in/out network (ded/max) HRA credits pay first dollar coverage, if deductible not metHRA credits pay first dollar coverage, if deductible not met HRA credits apply against deductible and out-of-pocket maximumHRA credits apply against deductible and out-of-pocket maximum Disease Management Program appliesDisease Management Program applies Unused HRA credits rolloverUnused HRA credits rollover No co-paysNo co-pays 100% Preventative care coverage100% Preventative care coverage Separate in/out network (ded/max)Separate in/out network (ded/max) HRA credits pay first dollar coverage, if deductible not metHRA credits pay first dollar coverage, if deductible not met HRA credits apply against deductible and out-of-pocket maximumHRA credits apply against deductible and out-of-pocket maximum Disease Management Program appliesDisease Management Program applies Unused HRA credits rolloverUnused HRA credits rollover

HDHP PLAN (UHC) No co-paysNo co-pays 100% Preventative care coverage100% Preventative care coverage Separate in/out network (ded/max)Separate in/out network (ded/max) Incentive credits after 38% deductible metIncentive credits after 38% deductible met Non-embedded deductibleNon-embedded deductible Health Savings AccountHealth Savings Account  Tax free  Employee owns  No employer contribution No co-paysNo co-pays 100% Preventative care coverage100% Preventative care coverage Separate in/out network (ded/max)Separate in/out network (ded/max) Incentive credits after 38% deductible metIncentive credits after 38% deductible met Non-embedded deductibleNon-embedded deductible Health Savings AccountHealth Savings Account  Tax free  Employee owns  No employer contribution

HMO PLAN (BSBSGa/UHC) In-network only (except emergency)In-network only (except emergency) Set co-pays; offset ded-no/max-yesSet co-pays; offset ded-no/max-yes 100% Preventative care coverage100% Preventative care coverage Certain services subject to ded/maxCertain services subject to ded/max Embedded deductibleEmbedded deductible Incentive credits refund co-pays/pay claims if deductible not metIncentive credits refund co-pays/pay claims if deductible not met Disease Management Program appliesDisease Management Program applies In-network only (except emergency)In-network only (except emergency) Set co-pays; offset ded-no/max-yesSet co-pays; offset ded-no/max-yes 100% Preventative care coverage100% Preventative care coverage Certain services subject to ded/maxCertain services subject to ded/max Embedded deductibleEmbedded deductible Incentive credits refund co-pays/pay claims if deductible not metIncentive credits refund co-pays/pay claims if deductible not met Disease Management Program appliesDisease Management Program applies

HMO PLAN (Kaiser) Live or work in 27 Atlanta metro countiesLive or work in 27 Atlanta metro counties Co-pay onlyCo-pay only No deductibles or co-insuranceNo deductibles or co-insurance 100% Preventative care coverage100% Preventative care coverage Must choose Primary Care ProviderMust choose Primary Care Provider KP facility; Henry, Clayton, RockdaleKP facility; Henry, Clayton, Rockdale Wellness incentive – iPad and Fit BitWellness incentive – iPad and Fit Bit Live or work in 27 Atlanta metro countiesLive or work in 27 Atlanta metro counties Co-pay onlyCo-pay only No deductibles or co-insuranceNo deductibles or co-insurance 100% Preventative care coverage100% Preventative care coverage Must choose Primary Care ProviderMust choose Primary Care Provider KP facility; Henry, Clayton, RockdaleKP facility; Henry, Clayton, Rockdale Wellness incentive – iPad and Fit BitWellness incentive – iPad and Fit Bit

2015 Wellness Incentive Members, and covered spouse, must complete between January 15 and December 15, 2015 between January 15 and December 15, 2015 Earn 240 Incentive Credits Complete an online Healthways Well-being Assessment Complete biometric screening (PCP submits form) Earn 240 Incentive Credits Telephonic pathway coaching Online pathway coaching – 40 each (up to 240) Members, and covered spouse, must complete between January 15 and December 15, 2015 between January 15 and December 15, 2015 Earn 240 Incentive Credits Complete an online Healthways Well-being Assessment Complete biometric screening (PCP submits form) Earn 240 Incentive Credits Telephonic pathway coaching Online pathway coaching – 40 each (up to 240)

$80.00 Tobacco Surcharge not included

Pharmacy Benefits

PeachCare for Kids Call TRICARETRICARE

JCBOE Contribution Certified employees $ = $11,340.00Certified employees $ = $11, Classified employees $ = $7,154.40Classified employees $ = $7, Certified employees $ = $11,340.00Certified employees $ = $11, Classified employees $ = $7,154.40Classified employees $ = $7,154.40

Affordable Care Act SHBP meets the minimum essential coverage mandateSHBP meets the minimum essential coverage mandate SHBP meets the affordability mandateSHBP meets the affordability mandate Health Insurance Marketplace Notice contains information for inquiryHealth Insurance Marketplace Notice contains information for inquiry SHBP meets the minimum essential coverage mandateSHBP meets the minimum essential coverage mandate SHBP meets the affordability mandateSHBP meets the affordability mandate Health Insurance Marketplace Notice contains information for inquiryHealth Insurance Marketplace Notice contains information for inquiry

Open Enrollment Webpage Decision Guides; At-A-Glance Tables; RatesDecision Guides; At-A-Glance Tables; Rates Individual Plan SummariesIndividual Plan Summaries Pharmacy Guides, AAG, Summaries, WebsitePharmacy Guides, AAG, Summaries, Website Vendor VideosVendor Videos Wellness Incentives SummaryWellness Incentives Summary ADP OE User Login, Guide, AAGADP OE User Login, Guide, AAG Vendor Website LinksVendor Website Links Dental Insurance; Summary, FormDental Insurance; Summary, Form Life Insurance; Summary, FormLife Insurance; Summary, Form Decision Guides; At-A-Glance Tables; RatesDecision Guides; At-A-Glance Tables; Rates Individual Plan SummariesIndividual Plan Summaries Pharmacy Guides, AAG, Summaries, WebsitePharmacy Guides, AAG, Summaries, Website Vendor VideosVendor Videos Wellness Incentives SummaryWellness Incentives Summary ADP OE User Login, Guide, AAGADP OE User Login, Guide, AAG Vendor Website LinksVendor Website Links Dental Insurance; Summary, FormDental Insurance; Summary, Form Life Insurance; Summary, FormLife Insurance; Summary, Form

ADP OE Website Decision Support Tools w/in OE Portal Medical Cost CalculatorMedical Cost Calculator  Which plan option is best for you Preference ModulePreference Module  Which plan features best meet your need Comparison ModuleComparison Module  Match specific need to plan option Decision Support Tools w/in OE Portal Medical Cost CalculatorMedical Cost Calculator  Which plan option is best for you Preference ModulePreference Module  Which plan features best meet your need Comparison ModuleComparison Module  Match specific need to plan option

QuestionsQuestions

Important Notice The information provided in this presentation is a summary of the 2015 Plan Year. It is intended only to highlight principle benefitsThe information provided in this presentation is a summary of the 2015 Plan Year. It is intended only to highlight principle benefits Please refer to the Active Decision Guide and Plan Summaries for more detailsPlease refer to the Active Decision Guide and Plan Summaries for more details The information provided in this presentation is a summary of the 2015 Plan Year. It is intended only to highlight principle benefitsThe information provided in this presentation is a summary of the 2015 Plan Year. It is intended only to highlight principle benefits Please refer to the Active Decision Guide and Plan Summaries for more detailsPlease refer to the Active Decision Guide and Plan Summaries for more details

Questions or Additional Information Blue Cross/Blue Shield – Blue Cross/Blue Shield – www.bcbsga.com/shbp UnitedHealthCare – UnitedHealthCare – www.welcometouhc.com/shbp Kaiser Permanente – Kaiser Permanente – www.kp.org/shbp Healthways – (12/15/13)Healthways – (12/15/13) Express Scripts – Express Scripts – www.dch.georgia.gov/shbp Blue Cross/Blue Shield – Blue Cross/Blue Shield – www.bcbsga.com/shbp UnitedHealthCare – UnitedHealthCare – www.welcometouhc.com/shbp Kaiser Permanente – Kaiser Permanente – www.kp.org/shbp Healthways – (12/15/13)Healthways – (12/15/13) Express Scripts – Express Scripts – www.dch.georgia.gov/shbp

More Information is available on the Personnel/Payroll webpage

Thank you