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Commonwealth of Virginia 2015 Open Enrollment Health Care and Flexible Spending Accounts (FSAs) May 1- 22, 2015
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Choose a plan based on your needs Enroll, change or keep your health plan Consider buy-up options: COVA Care COVA HealthAware COVA HDHP Waive coverage Add or remove eligible family members Enroll in a Flexible Spending Account (FSA) April 2015
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Plans OfferedAdministratorAvailable COVA HealthAwareAetnaStatewide COVA Care Anthem Blue Cross and Blue Shield Delta Dental of Virginia Statewide COVA HDHP Anthem Blue Cross and Blue Shield Delta Dental of Virginia Statewide Kaiser Permanente HMO Kaiser Permanente Regional, primarily in Northern Virginia TRICARE SupplementSelman Company/ASIStatewide Your Health Plan Choices April 2015
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4 Children and Teens Administered by Anthem
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The basic plans include: Medical Behavioral Health Employee Assistance Program (EAP) Prescription Drug Diagnostic and Preventive Dental April 2015
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Changes for 7/1/2015 New plan year deductible $300 one person/$600 two or more persons Prescription drug copayments now count toward out- of-pocket expense limit Physical therapy copayment decreases to $15 per visit Routine hearing exam under Vision/Hearing option now covered once per plan year April 2015
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Optional Benefits Expanded Dental Routine Vision/Hearing Out-of-Network Expanded Dental April 2015
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Expanded Dental Option Delta Dental of Virginia administers dental benefits Expanded Dental option Primary Care – such as fillings, extractions, root canals Complex Restorative - crowns, dentures, bridges and implants Orthodontic services April 2015
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◦◦◦◦ Vision and Hearing Option Blue View Vision Eye exam Eyeglasses Contact lenses Discounts on accessories Hearing Routine hearing exam once per plan year Hearing aids and related supplies up to $1,200 every 48 months April 2015
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Out-of-Network Option Plan payment reduced by 25% Provider may balance bill for amounts the plan doesn’t pay April 2015
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www.AnthemEAP.com Mental health Parenting and child care Marriage and relationship concerns Workplace issues Finance/Legal Up to 4 visits per issue each plan year at no cost to member April 2015
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LiveHealth Online Your Next Doctor’s Appointment Could Be Online 24/7 access to a doctor from smartphone, tablet or computer Download the LiveHealth app or go to livehealthonline.com April 2015
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13 Administered by Aetna
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The basic plan includes: Medical Behavioral Health Employee Assistance Program (EAP) Prescription Drug Routine Vision & Hearing Exams Diagnostic and Preventive Dental Services Health Reimbursement Arrangement (HRA) April 2015
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What is a Health Reimbursement Arrangement (HRA)? Account that automatically pays eligible out-of-pocket expenses as long as funds are available Medical Behavioral health Pharmacy Funds paid from HRA toward eligible expenses for any covered member Unused HRA funds roll over into future plan years with no limit if enrollment in the plan continues April 2015
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The initial HRA contribution for 7/1/2015: Employee/Retiree$600 Employee/Retiree + Spouse$1,200 HRA contribution is prorated for new enrollments or QME changes during the plan year. The HRA proration chart may be found at www.COVAHealthAware.com HRA Contribution April 2015
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How the Plan Works HRA Contribution Employee/Retiree Only $600 Employee/Retiree + Spouse $1,200 In-Network Out-of- Network Deductible One person $1,500$3,000 Two or more persons $3,000$6,000 Out-of-Pocket Max One person $3,000$6,000 Two or more persons $6,000$12,000 April 2015
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HRA “Do Rights” Employees/Early Retirees and enrolled spouses Additional $50 HRA contribution for up to three “Do Rights” Up to $150 per employee/early retiree Up to $150 per enrolled spouse “Do Rights” Annual routine physical exam Routine dental exam Annual routine vision exam Annual flu shot Active Health Management Health Tracker Active Health Management Coaching Module April 2015
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Optional Benefits Expanded Dental Expanded Vision April 2015
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Expanded Dental Option April 2015 Expanded Dental option Primary Care – such as fillings, extractions, root canals Complex Restorative - crowns, dentures, bridges and implants Orthodontic services
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Expanded Vision Option Eyeglasses Contact lenses Discounts for eyewear and accessories Network includes private practice providers plus participating national chains April 2015
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Aetna Resources for Living SM EAP Available to participants and members of their household Confidential resource to address and resolve personal and workplace challenges Additional legal and financial guidance Up to 4 visits per issue each plan year at no cost to member April 2015 www.mylifevalues.com
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Your Next Doctor’s Appointment Could Be Online 24/7 access to a doctor from smartphone, tablet or computer Visit www.Teladoc.com or call 855-Teladoc April 2015
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Administered by MyActiveHealth
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Provides coaching services as part of the COVA health management program Available for COVA Care, COVA HealthAware and COVA HDHP Partners with Anthem and Aetna to deliver services promoting healthy lifestyles and chronic condition management. Posters, flyers, postcards and email communications provide program information. MyActiveHealth April 2015
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All eligible adult members may access their own customized portal Complete health assessment Get a Physician Results Form to complete their biometric screening The portal is enhanced with online coaching and web tools Digital coaching Interactive trackers, games and more Customized Health Portal www.myactivehealth.com/cova April 2015
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MyActiveHealth Programs Healthy Lifestyles - Lifestyle Coaching with Five Tracks Smoking Cessation Weight Management Stress Management Nutrition Exercise Healthy Beginnings - Maternity Care Healthy Insights - Disease and Chronic Condition Management for Conditions Such As: Heart Disease Diabetes April 2015
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Healthy Insights Diabetes management Hypertension COPD & Asthma Healthy Beginnings for expectant moms Incentives for COVA Care and COVA HealthAware April 2015
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29 Kaiser Permanente HMO Administered by Kaiser Permanente
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Kaiser Permanente HMO Available in Northern Virginia, Fredericksburg and other cities and counties All care coordinated by your primary care physician April 2015
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Administered by Selman Company/ASI (SelmanCo ASI) April 2015
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Voluntary supplemental health benefit option Available to state employees and non-Medicare eligible retirees who are military retirees, or the spouse of a military retiree. They must be eligible for: TRICARE, the military health benefits program, and The state health benefits program Eligible employees who enroll in the plan are responsible for 100% of the monthly premium amounts Monthly premium payments are made with pre-tax dollars through payroll deduction April 2015
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Premium Rewards
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Save Every Month with Premium Rewards For employee, retiree and/or spouse enrolled in COVA Care or COVA HealthAware Employee/Retiree or spouse can save $17/month Together can save $34/month April 2015
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Requirements to Earn a Premium Reward Be enrolled in COVA Care or COVA HealthAware Complete or update your health assessment at myactivehealth.com/cova by June 30, 2015 A health assessment completed as early as March 1, 2015 will qualify Report biometric screening results Already submitted? No need to report again Measurements taken as far back as April 1, 2013 will qualify Not sure you have submitted? Contact your Benefits Administrator April 2015 www.myactivehealth.com/cova 1-866-938-0349
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Earning Premium Rewards After June 30 April 2015 Eligible for a Premium Reward and didn’t meet the requirements by June 30? Once you complete both a health assessment and biometric screening, your Premium Reward will begin the first day of the following month.
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37 Flexible Spending Accounts Administered by Anthem
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Health Care FSA Set aside up to $2,550 per year, pre-tax, for eligible health expenses Dependent Care FSA Set aside up to $5,000 per year, pre-tax, for dependent care expenses Flexible Spending Accounts (FSA) Use the Elite Benefit Card for eligible Health FSA expenses April 2015
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To find information before enrolling: Go to anthem.com/cova and select Benefits tab, FSA for: 2015 FSA Sourcebook FAQs Calculators Once enrolled: Register online at www.benefitadminsolutions.com/anthem Important FSA Information and Resources April 2015 You must enroll each plan year to participate. “Use it or lose it” rule: Use all of your funds and file for reimbursement by the filing deadline or forfeit your FSA funds. If you enroll in COVA HealthAware, the HRA pays first.
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ALEX is Back! Interactive guide to health plan options Helps you determine which plan is best for you www.alexforcova.com April 2015
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Get the Open Enrollment Details Spotlight on Your Benefits newsletter or Retiree Notification booklet for: Comparison of Benefits Premiums & Premium Rewards Who to contact for assistance Your agency Benefits Administrator The health plans www.dhrm.virginia.gov April 2015
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Log on to Employee Direct at http://edirect.virginia.gov Select “Health Benefits Enrollment and Information” Or submit an enrollment form to your agency benefits office Open Enrollment Ends May 22 Make Your Election!
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