1. Let’s Talk Benefits Summer Enrollment
Presented by your Benefits Team:
Sara Aranda, Benefits Coordinator
Brittany Heim, Benefits Coordinator
Tracy Willis, Benefits Manager
Vickie Del Bello, Director of ER & Benefits

2. Summer
Enrollment
July 9 – July 22, 2017

3. DEPENDENTS DEPENDENT CHILDREN Ongoing DEPENDENT AUDIT
Can be covered until the age of 26 on health insurance – regardless of marital or educational status
If child is married, dental insurance, AD&D and dependent life insurance are not available.
Ongoing
DEPENDENT AUDIT
Employees are required to submit documents to ensure dependents are eligible for coverage.
Examples of Required Documents: Birth Certificates, Marriage License, Tax Returns
Will be contacted by Aon Hewitt for documentation submission.
If you do not provide the requested documentation to Aon Hewitt within the designated timeframe, their coverage will be cancelled.

4. Dental Options After tax deduction PPO Plan Can choose any dentist
HMO Plan
Must use dentist in HMO network
Discount Plan
Not an insurance plan – offers discounts from participating providers
Employee Only
$0.00
+ Spouse
$13.70 (+ $0.38)
$4.80
$1.14
+ Children
$19.18 (+$0.54)
$6.70
$1.60
+ Family
$32.88 (+ $0.94)
$11.50
$2.70
After tax deduction

5. Dependent Life Insurance
Optional Life Insurance
SJC pays premium for 2x annual salary
Evidence of Insurability (EOI) must be completed and approved if elected during summer enrollment.
May elect to pay premium for 3x or 4x
EOI must be completed and approved
Rates are age-banded
Maximum coverage amount of $400,000
Dependent Life Insurance
Voluntary AD&D
$10,000 - $200,000 of coverage
Employee Only
$0.02/$1,000 of coverage
Maximum Premium: $4.00/month
Employee + family
$.04/$1,000 of coverage
Spouse covered at 50%, children at 20%
$5,000 term life policy with AD&D rider
Unlimited number of dependents
EOI required if elected during Summer Enrollment

6. Texas Income Protection Plan Short Term & Long Term Disability
STD
Premium $0.26/$100 of monthly salary (decrease from FY 2017)
30 day waiting period
Pays up to 66% of your monthly salary for up to 5 months
LTD
Premium: $0.63/$100 monthly salary (paid by SJC)
180 day waiting period
Pays up to 60% of your monthly salary
Benefit period depends on age when you become totally disabled
Must exhaust all leave
EOI required if elected during Summer Enrollment

7. State of Texas Vision Administrator – Superior Vision
Superior National Network with over 6000 providers in Texas
In-Network Co-Pays
Routine Eye Exam: $25.00
Contact Lens Fitting: $25.00(standard) $35.00(specialty)
Frames or Contacts Allowance: $150 retail

8. HEALTH PLANS HealthSelect of Texas
Point-of-Service Health Plan
KelseyCare by Community Health Choice
Kelsey Seybold HMO Health Plan
Consumer Directed HealthSelect
High-Deductible Health Plan(HDHP) with a Health Savings Account option(HSA)

9. Health Coverage Rates Employee Only $0.00 + Spouse $178.16 (+$1.32)
$138.50
$ (+1.18)
+ Children
$ (+$0.90)
$92.74
$ (+0.80)
+ Family
$ (+$2.22)
$231.24
$ (+$1.98)

10. All Health Plans Annual in-network out-of-pocket maximums
$6,550 individual, $13,100 for family
Includes copays, coinsurance and pharmacy deductibles
$5,000 Basic Group Life Insurance for employee
Vision Rider
Specialist copay, includes discounts at certain providers for frames, lenses or contacts.

11. Tobacco User Premium
Rate is dependent upon how many tobacco users or non-certified members are covered on health insurance
All employees are required to certify.
Choose To Quit(CTQ) program available to receive refund of tobacco fee each year.
Coverage
Fee
You, Spouse, or Child ONLY
$30
You + Spouse
$60
You + Spouse + Child
$90

12. HealthSelect of Texas Plan
Effective 09/01/ Blue Cross Blue Shield of Texas will be the Plan Administrator
No major benefit plan changes
Point-of-Service (POS) plan with direct access for eye exams, OB/GYN, occupational therapy, physical therapy and mental health care.
A PCP must be selected to receive In-Network benefits.
Referral is required for specialist visits.

13. HealthSelect of Texas Plan
Effective 09/01/ Blue Cross Blue Shield of Texas will be the Plan Administrator
PCP Office Visit: $25 copay
Specialist Office Visit: $40 copay
Urgent care facility benefits
$50 copay + 20% coinsurance (In-Network)

14. HealthSelect of Texas Plan
Provider Network Changes
Most current providers will continue to be in the HealthSelect network after 09/01/17.
If you are currently receiving treatment from a doctor who will not be in the BCBSTX network after 09/01/17, you may apply to continue treatment with that doctor temporarily.

15. HealthSelect of Texas Plan
Changing PCP
If your current PCP on file with UHC is also in the BCBSTX HealthSelect network, the PCP information will be automatically transferred. NO ACTION IS REQUIRED.
If your current PCP on file with UHC is in the BCBSTX PPO network, but not in the HealthSelect network, the PCP has been approved until an undetermined time, however could be removed by BCBS at any time.

16. HealthSelect of Texas Plan
Changing PCP
If your current PCP on file with UHC is not in the BCBSTX PPO or HealthSelect network, you will be required to select a new PCP to receive in-network benefits.

17. HealthSelect of Texas Plan
Referrals/Prior authorizations
Active referrals/prior authorizations on file with UHC that extend beyond 09/1/17 will be transferred to BCBSTX.
If specialist/provider is in the BCBSTX network, claims will be honored through end date of the original referral/prior authorization.

18. HealthSelect of Texas Plan
Referrals/Prior authorizations
If specialist/provider is not in the BCBSTX network, claims will be paid until 11/30/2017 or the original end date, whichever is sooner.
Specialists need to be in the BCBSTX network, not the HealthSelect network, for the benefits to continue until the original referral end date. After that, a new referral will need to be requested for a specialist in the HealthSelect network.

19. HealthSelect of Texas Plan
Virtual Visit copay changing from $10.00 to $0.00.
Out-of-Area is now called Out-of-State
NO PCP required, but member will still need to use BCBSTX network providers.
No deductible, will have copay for office visits.
Make sure to notify BCBSTX that your dependent is living out-of-state, to be coded in the correct plan.
More information coming soon and will be included in your annual enrollment guide sent by ERS by early July.

20. HealthSelect of Texas Plan
Real Appeal – Will continue to be available
Personalized program and online coaching.
Success kit, online resources and mobile app.
Naturally Slim – new program for BCBSTX
Simple online 10-week program with videos and learning tools.
Includes support and coaching for a full year.
Welcome kit, weekly s and mobile app.
You can participate in both, but cannot enroll in both
plans at the same time.

21. HealthSelect of Texas Plan
New cards will be mailed by BCBSTX in August.
Personal Health Assistant
Dedicated call center for HealthSelect of Texas members.
Line is currently active and agents are accepting calls.
Can answer questions regarding plan benefits, provider information and referral status.
Monday – Friday 7am to 7pm and Saturday 7am to 3pm.
(800)
(available now through August 31st)

22. KelseyCare Plan powered by Community Health Choice
Kelsey Seybold HMO Plan
Benefits similar to HealthSelect plan
Available to the following counties:
Brazoria, Fort Bend, Galveston, Harris and Montgomery
Must use a KelseyCare network doctor
$15 PCP copay
$25 Specialist copay – no referral required
More information at

23. Prescription Drug Plan HealthSelect or KelseyCare
Tier 1
Generic
Tier 2
Preferred
Tier 3
Brand Specific
Deductible
Each participant must pay a $50 annual deductible
Non-maintenance drug bought at a participating retail pharmacy
$10 up to a 30-day supply
$35 up to a 30-day supply
$60 up to a 30-day supply
Maintenance drug bought at a participating retail pharmacy
$20 up to a 30-day supply
$45 up to a 30-day supply
$75 up to a 30-day supply
Maintenance drug bought through a mail order pharmacy
$30 up to a 90-day supply
$105 up to a 90-day supply
$180 up to a 90-day supply
HealthSelect deductible based on calendar year January – December
KelseyCare deductible based on fiscal year September – August

24. Consumer Directed HealthSelect
Blue Cross Blue Shield of Texas – Plan Administrator
No PCP or referrals required.
Must meet deductible before plan pays ANYTHING for health and prescriptions except in-network preventative care.
Deductibles are based on a calendar year. If you switch, the deductibles and out-of pocket maximums will start over on January 1.
Individual
Family
After Deductible Plan Pays
In-Network
$2,100
$4,200
80%
Out-of-Network
$8,400
60%

25. Health Savings Account (HSA) Available to Consumer Directed HealthSelect Members Only
Administrator – Optum Bank, a subsidiary of United HealthCare Services
Pre-tax contribution to assist with out-of-pocket expenses for HDHP.
Must be setup BEFORE eligible expenses are incurred.
Available to non-Medicare eligible employees

26. Health Savings Account (HSA) Available to Consumer Directed HealthSelect Members Only
Cannot be covered under any other traditional health plan (i.e.. spouse or parents)
Contributions and Limits for Plan Year 2018
Individual Plan
Family Plan
State Contribution
$540 ($45 monthly)
$1,080 ($90 monthly)
Maximum Participant Contribution
$2,810
$5,670

27. Because of the possibility of much higher out-of-pocket costs, you should think carefully before signing up for Consumer Directed HealthSelect.
You need to understand all the costs and benefits, to know if the plan is right for you and your family.
If you cannot afford thousands of dollars in upfront out-of-pocket costs before the plan starts paying for ANY covered health services and prescriptions (except preventative care), you should NOT enroll in Consumer Directed HealthSelect.

28. TexFlex
Pre-Tax Spending Account for HealthSelect and KelseyCare participants
Administrator – ADP
Set up an online account
Website:
Health Care
Copays, prescriptions, coinsurance, eyewear
Minimum annual contribution: $180
Maximum annual contribution: $2,544
Debit Cards will be mailed to ALL participants – No fee
Dependent Care
Daycare, summer camps
Maximum annual contribution: $4,996
No debit card option

29. Limited Flexible Spending Account Available to Consumer Directed HealthSelect Members
Administrator – ADP
Pre-tax contribution for eligible vision and dental care ONLY
Contributions Limits for Plan Year 2018
Same as TexFlex Health
$180 minimum annual contribution ($15 monthly)
$2,544 maximum annual contribution ($212 monthly)

30. Limited Flexible Spending Account Available to Consumer Directed HealthSelect Members
Employees who switch to Consumer Directed HealthSelect that have $25 - $500 remaining in their TexFlex account will automatically be enrolled in the LFSA

31. RATE SHEET
When making elections, please refer to the blue rate sheet to determine what the premium cost will be for you.
Premiums listed on the ERS Summer Enrollment guide that you receive next month do not include the amount that SJC pays for.
DO NOT WAIVE (these benefits are paid by SJC)
Long Term Disability
2x Optional Life Insurance

32. Beneficiaries
ERS Designation of Beneficiaries - Visit to update your beneficiaries. For assistance, please contact ERS directly at
TRS Designation of Beneficiaries - Complete the TRS 15 form that can be found at and submit to TRS at 1000 Red River Street, Austin, TX

33. Additional
BENEFITS

34. Available to All ERS Members
ERS Discount Purchase Program
Available to employees, retirees, and their immediate families
Discounts on many products and services, from computers to theme park passes.
No sign-up fee
Visit today at to start saving!

36. Retirement Savings
All employees can participate in a 403(b) and/or 457 plan.
Maximum annual contributions based on age are set by the IRS.
Current annual maximums:
Under age 50 $18,000
Over age 50 $24,000
10 Board approved vendors to choose from

37. Upcoming events

38. ERS Events Summer Enrollment Sessions
11 webinars scheduled at 11am and 2pm beginning June 21 – July 24
For more information and to register for the ERS sessions, visit

39. Items to Bring to Sessions
SUMMER ENROLLMENT
LAB SESSIONS
District Office
South Campus
North Campus
Central Campus
Monday, July 10
A2.203
9 am – 1 pm
Tuesday, July 11
S8.2058
Wednesday, July 12
N14.102
1 pm – 5 pm
Thursday, July 13
C1.229
Monday July 17
Wednesday, July 19
S1.116c
Thursday, July 20
N2.202
Tuesday, July 18
Items to Bring to Sessions
ERS Online Username and Password
Social Security Numbers and DOB for new dependents
Convenient access for employees wishing to make benefit changes during annual enrollment
Confirmation of elections
HR-Benefits team will be available on campus to assist with questions and offer guidance regarding online benefits enrollment.

40. ?
QUESTIONS