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Open Enrollment Plan Year 2008 1 Today’s Agenda Open Enrollment Health Care Web Enrollment :Health Health Contributions Employee Resources Wellness Dental.

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Presentation on theme: "Open Enrollment Plan Year 2008 1 Today’s Agenda Open Enrollment Health Care Web Enrollment :Health Health Contributions Employee Resources Wellness Dental."— Presentation transcript:

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2 Open Enrollment Plan Year 2008 1

3 Today’s Agenda Open Enrollment Health Care Web Enrollment :Health Health Contributions Employee Resources Wellness Dental Flexible Spending Account (FSA) Health Reimbursement Account (HRA) FSA vs. HRA Web Enrollment: FSA/HRA $50 Benefit Allowance 2

4 2008 Open Enrollment 2007 Health Insurance Open Enrollment- October 15 th -26 th Passive enrollment –KCTCS employees MUST enroll if they: Wish to change their current coverage Wish to add or drop dependents –KCTCS Employees should have already received a letter at home with State Benefit Fair information Employee ID & Password for web enrollment 3

5 2008 Open Enrollment KCTCS Open Enrollment –KCTCS employees MUST enroll if they: Wish to enroll in Flexible Spending Account (FSA) Wish to enroll in the Health Reimbursement Account (HRA) for health waivers Wish to enroll in the $50 Benefit Allowance Wish to change their Dental coverage including adding or dropping dependents 4

6 2008 Open Enrollment There are no health benefit changes for Plan Year 2008 Same four plans available: –Please see the 2008 Plan year KEHP Handbook for further details All 4 plans contain the same covered services, exclusions and limitations –Benefit payment levels and premiums will differ 5

7 Health Insurance Plan Selections The Kentucky Employees Health Plan (KEHP) contains the same 3 Preferred Provider Organization (PPO) Options and a High Deductible Health Plan (HDHP) with an embedded HRA that are currently offered in 2007 Commonwealth Essential (PPO) Commonwealth Enhanced (PPO) Commonwealth Premier (PPO) Commonwealth Select (HDHP) 6

8 UCR/Eligible Expense Expenses used to satisfy the deductible and co-insurance limit for Preferred Provider Organizations (PPO), including the Commonwealth Select Plan, are the UCR and/or eligible expenses for that particular service Usual, Customary and Reasonable (UCR)/Eligible Expense –A providers’ fee which Is the provider’s usual charge for a given service under the covered plan Is within the range of fees charged by providers of similar training and experience for the same or similar service or supply within the same or similar limited geographical area Does not exceed the fee schedule developed by the insurance carrier or TPA (Humana) 7

9 2008 Open Enrollment Employees hired during or after OE: –MUST complete two health applications, UNLESS they want their “New Employee” elections to roll to the 2008 Plan Year –MUST complete HRA applications for the remainder of 2007 and a new one for 2008 if they waive health coverage or enroll in a FSA 2007 and wish to enroll in a FSA for PY 2008 8

10 2008 Open Enrollment NOT Plan Year 2008 will NOT be a total health re- enrollment. Employees wishing to make changes may – Web enroll, or – Complete paper application – Paper applications will be included in the handbook or available on the DEI web-site DO NOT NEED TO RE-ENROLLEmployees wishing to keep same coverage and elections for health coverage and/or waiver, DO NOT NEED TO RE-ENROLL 9

11 2008 Open Enrollment October 15-26, 2007Open Enrollment is October 15-26, 2007 For Active employees, COBRA participants and Early Retirees (under age 65) October 5, 2007Employee must be in GHI ( group health insurance) system by October 5, 2007 to be eligible to web enroll, if not they must complete paper application 10/26/07Paper application must be signed by 10/26/07 web confirmationPaper application or web confirmation must be turned into college Human Resources Department 10

12 Reminder Dependent Coverage: Dependents Turning 24 during 2008 –Not eligible to be enrolled for 2008 –Enrollment will end 12/31/07 –Applicable dependents will be eligible for continuation through COBRA; will automatically receive notice –If dependent drop results in eligibility for single coverage, coverage will be changed automatically Any new forms required ($50 benefit, FSA) from this change must be completed 11

13 Web Enrollment: Health Insurance Web Enrollment What is it? Using the internet to make health insurance elections –May enroll from work or from public access Web-site for health insurance access: –www.openenroll.ky.gov/www.openenroll.ky.gov/ 12

14 Web Enrollment: Health Insurance Web Enrollment Who can enroll on the internet? –Anyone who is a plan-holder in the GHI system by October 5, 2007 Employees not eligible to enroll on the internet are: –New hires –KRS, KTRS and KCTCS 403(b) retirees –Employee cross-referencing with KRS or KTRS retiree –Spouse or children of retirees who are not actually the retiree –Cross-referenced employees who want to switch primary plan-holders for 2008 13

15 Web Enrollment: Health Insurance Web Enrollment – Cross Reference If you are currently cross-referenced and do not wish to change your plan, level of coverage or primary policyholder, you will not need to web enroll. Your coverage will remain the same You cannot change the primary policy holder through the web, you will have to complete a paper application If you wish to begin cross reference, you may do so on the web as long as you have your password and your spouse’s password 14

16 Web Enrollment: Health Insurance Your KEHP Online Access will be available for fast, accurate and secure enrollment! Employees will need EmpID & Password to log in –EmpIDs were mailed during the first week of September –Passwords were mailed during the last week of September 15

17 Web Enrollment: Health Insurance Web Enrollment Confirmation Process: –Confirmation number will be provided at the end of a correct enrollment You will have clicked on “enrollment complete” You will have reviewed your elections You will have hit the “Accept” button –Print confirmation statement and give to your college Human Resources Department 16

18 Web Enrollment: Health Insurance Waivers –If you currently waive you Do NOT Need to Re-Enroll, election will roll-over –If newly waiving for 2008 Click on “waive” on the main menu You will NOT elect the HRAYou will NOT elect the HRA –HRA Selection will be through Chard-Snyder Print confirmationPrint confirmation and give to your college Human Resources Department DO NOT MARK HRA BOX!For paper applications, complete section I, Section V, section VIII and give to your college Human Resources Department. DO NOT MARK HRA BOX! 17

19 Waiving Coverage HRA –Employees in either the 18A/151B or the KCTCS personnel system who waive their health insurance will receive an employer contribution of $175 per month to direct to a Health Reimbursement Account administered by Chard-Snyder 18

20 KCTCS Health Insurance Employee Contributions 2008 Employee Contributions 18A/151B employees will use the state established employee contributions based upon smoker or non- smoker status. There is an incentive for non- smoking KCTCS will offer only one employee contribution schedule which is based upon a 25% reduction of the lower state non-smoking schedule 19

21 Employee Health Contributions: KCTCS personnel system PlanSingleParent Plus CoupleFamilyCross- Ref. Common. Essential Not Offered $46.24$218.14$269.10$0.00 Common. Enhanced $0.00$95.82$300.68$360.82$8.18 Common. Premier $15.30$143.20$335.10$399.06$27.82 Common. Select $0.00$73.70$226.58$271.04$6.14 20

22 Employee Health Contributions: 18A/151B Non-Smoker PlanSingleParent Plus CoupleFamilyCross- Ref. Common. Essential Not Offered $61.64$290.84$358.80$0.00 Common. Enhanced $0.00$127.76$400.90$481.10$10.90 Common. Premier $20.40$190.94$446.80$532.08$37.08 Common. Select $0.00$98.26$302.10$361.38$8.18 21

23 Employee Health Contributions: 18A/151B -Smoker PlanSingleParent Plus CoupleFamilyCross- Ref. Common. Essential Not Offered $95.26$324.48$392.42$16.80 Common. Enhanced $16.80$161.38$434.52$514.72$27.70 Common. Premier $37.20$224.56$480.42$565.70$53.88 Common. Select $13.22$124.12$327.44$386.66$20.88 22

24 Health Insurance: Cross- Referencing Cross-referencing will continue to be an option for married employees who are eligible to participate in the Kentucky Employees Health Plan (KEHP) For two 18A/151B employees covered under one family health benefit plan, they each will pay the family cross reference rate reflected in the contribution schedule for state employees 23

25 Health Insurance: Cross- Referencing For two KCTCS employees covered under one family health benefit plan, they each will pay the family cross reference rate reflected in the contribution schedule for the KCTCS Personnel System For a KCTCS employee who cross-references with their spouse employed by another state agency, they each will pay the family cross reference rate reflected in their respective contribution schedule 24

26 Reminder: Double Dipping KRS 18A.225 (13) not be eligible –“Any employee who is eligible for and elects to participate in the state health insurance program as a retiree, or the spouse or beneficiary of a retiree, under any one (1) of the state-sponsored retirement systems shall not be eligible to receive the state health insurance contribution toward health care coverage as a result of any other employment for which there is a public employer contribution. This does not preclude a retiree and an active employee spouse from using both contributions to the extent needed for purchase of one (1) state sponsored health insurance policy for that plan year.” 25

27 Reminder: Double Dipping KTRS Retiree MUSTKTRS Retirees that have returned to active employment MUST select coverage through the active employer (KCTCS) KERS Retiree eitherKRS retirees that have returned to active employment have the option to select coverage either through KRS or the active employer (KCTCS) 26

28 Major Considerations for Health Plan Selection Employee and dependents projected medical expenses –Plan deductibles –Out-of-pocket maximums –Prescription Drugs Employee Premium contribution –Pre-tax consideration You can go on your “MyHumana” web-site and use their Decision Tools 27

29 Employee Resources: MyHumana MyHumana helps you find information you need, 24 hours a day, 7 days a week Contains a myriad of resources Easy access through kyhealthplan.humana.com 28

30 KEHP Wellness Programs A variety of programs exist for participants in the KEHP Smoking Cessation Cooper Clayton Kentucky Tobacco Quit Line Maternity Program Personal Health Assessment (PHA) Why Weight Kentucky Informed Care Management Further information can be found in the KEHP 2008 booklet, on the Humana KEHP web-site (www.kyhealthplan.humana.com) and on the KEHP web- site http://www.personnel.ky.gov/benefits/dei/08planyear/www.kyhealthplan.humana.comhttp://www.personnel.ky.gov/benefits/dei/08planyear/ 29

31 Dental Open Enrollment Dental open enrollment is October 15- October 26, 2007 Dental choices: –Dental Care Plus –Delta Dental –Compdent –HealthResources Dental coverage will “rollover” from 2007 to 2008 If you wish to add or drop family members or change carriers you will need to complete a new dental application To cancel dental coverage, employee must fill out dental application and write “Cancel Coverage Effective 1-1-08” 30

32 Dental Open Enrollment Reminder: If your covered dependent is over age 19, you will need to submit a proof of student status to the dental carrier before claims are paid. Dependents are not covered over the age of 23. They will automatically be dropped from the plan. You will need to notify your college Human Resources Office when this occurs. 31

33 Flexible Spending Accounts (FSA) Federal regulations require that employees that wish to enroll in a FSA do so every year Re-enrollment is necessary to participate in a FSA account either with employee contributions or employer contributions due to the $50 Benefit The carrier for 2008 will continue to be Chard Snyder and Associates There are two kinds of FSA’s –Health Care Spending Account for medical expenses: Minimum $ 5 per paycheck( including $50 benefit); total annual maximum : $ 5,004 ($208.50 per paycheck) –Dependent Day Care Account for Dependent care expenses Minimum $ 5 per paycheck; total annual maximum $4,992 Please refer to the FSA booklet for further information 32

34 Flexible Spending Account “Grace Period” Use left over money from 2007 plan year until March 15, 2008 –(applies to KCTCS personnel system employees only) Will also apply to 2008 Plan Year (2 ½ monthly grace period will be January 1 – March 15, 2009) –Will apply to all enrolled employees regardless of personnel system 33

35 Flexible Spending Account “Grace Period” Illustration Jan 1 – March 15 continue to incur claims during this period (may choose bucket of money) 34 January 1, 2007 Allocated $1,200 for Healthcare Spending Account October 16 – October 27, 2007 Allocated $1,000 for 2008 Plan Year Healthcare Spending Account December 31, 2007 $300 remaining in Healthcare Spending Account for 2007 January 1, 2008 Total of $1,300 in Healthcare Spending Account for 2008 ($300 must be used by March 15) March. 15, 2008

36 Flexible Spending Account “Grace Period” Reminder –You may use your FSA Benny Prepaid Benefits card for grace period expenses. The Reimbursements will automatically be applied to the correct year –Or, you may also pay for these expenses and then file for reimbursement from Chard-Snyder by mail or fax 35

37 HRA Two Separate Health Reimbursement Accounts Embedded HRA –Offered in conjunction with Commonwealth Select –Funded with employer money only –Administered by Humana and the DEI Stand alone HRA –Available only to employees who waive health insurance –Funded with employer money only –Administered by Chard-Snyder (PCA) (Humana materials may refer to an HRA as a Personal Care Account (PCA) 36

38 FSA vs. HRA FSAHRA (for waivers only) Commonwealth Select (High Deductible Health Plan with HRA) Can be Funded by Employee and Employer Money Funded by Employer Only Money ($175 per month) Employer Funds HRA Single - $1,000 Couple - $1,500 Parent Plus - $1,500 Family - $2,000 Dental and Vision Reimbursed Dental and Vision Reimbursed (does not count toward deductible or out-of-pocket maximum) Use it or Lose it- Balance is forfeited Carry Over if you remain in the same plan 37

39 FSA vs. HRA In addition to the HRA, an employee may fund a Health Care FSA to reimburse unpaid qualified medical expenses ( ex: Deductible, Copays, Co-insurance, Dental, Vision, etc.) –May fund with employee contributions –If waiving or have single health coverage, may use all or part of the $50 Benefit for funding only plan covered expensesFor Commonwealth Select plan participants, when using your HRA, only plan covered expenses will count towards the plan deductible and out-of- pocket maximum ( Excludes: Dental, Vision, Over the Counter Medications) 38

40 FSA vs. HRA If you have both a Health Care Flexible Spending Account (FSA) and a Health Reimbursement Account (HRA), reimbursement will come from your FSA account balance first. –The FSA balance is forfeited at the end of the plan year (12/31/07) and 2 ½ month grace period (3/15/08). –The HRA balance will roll-over from year to year as long as you remain a waiver or enrolled in the Commonwealth Select plan. Will not roll-over if you change your plan selection. NOTE: If you use the Benny PrePaid Benefits Card from Chard-Snyder, reimbursements will automatically be from your FSA first until that annual election amount is depleted. Then, reimbursement will be from your HRA NOTE: If you use the Benny PrePaid Benefits Card from Chard-Snyder, reimbursements will automatically be from your FSA first until that annual election amount is depleted. Then, reimbursement will be from your HRA. 39

41 Using Benny PrePaid Benefits Card for HRA at Pharmacies – “Waivers” Only If employee is covered under spouse’s health plan, they would use that health insurance card first. Employee would then use Chard- Snyder Benny card for any copay or coinsurance amounts due 40

42 Save your receipts: HRA Reimbursed Expenses It is important to save all itemized receipts –The IRS requires proof (substantiation) that expenses are qualified under your plan’s benefits –For the Commonwealth Select plan -Humana automatically verifies transactions, in most cases, as they occur. However, Humana may ask members to submit receipts for verification of an expense –For Waivers, Chard-Snyder automatically verifies transactions, in most cases, as they occur. However, Chard-Snyder may ask members to submit receipts for verification of an expense –Always save all receipts and explanation of benefits (EOB) in case you are contacted to verify an expense that could not be matched automatically –If a refund is needed: Card should be credited by the provider If providers refund the member directly the member will be required to refund the card (per IRS guidelines) 41

43 Web Enrollment: FSA Flexible Spending Account: FSA Coverage NOT DEI WebsiteKCTCS employees will NOT be able to web- enroll for FSA coverage through the DEI Website –A message will appear that states that KCTCS is non-participating and to contact the Insurance Coordinator 42

44 Web Enrollment: FSA FSA Coverage: FSA Enrollment is a separate process. KCTCS employees will be able to web-enroll for FSA Coverage through the Chard-Snyder Website at www.chard- snyder.comwww.chard- snyder.com –If employees are currently enrolled in FSA, they will use their current password to web-enroll –Detailed instructions will be available in the Chard- Snyder material available for distribution –You will be able to sign up for your employee health care and/or dependent care elections and any $50 Benefit allocations NOTE: If you are signing up for both a FSA and a HRA, you will be able to do both through the same screen 43

45 Web Enrollment: HRA HRA Coverage: HRA Enrollment is a separate process. KCTCS employees will be able to web-enroll for HRA Coverage through the Chard-Snyder Website at www.chard- snyder.comwww.chard- snyder.com –If employees are currently enrolled in FSA, they will use their current password to web-enroll –Detailed instructions will be available in the Chard- Snyder material available for distribution NOTE: If you are signing up for both a FSA and a HRA, you will be able to do both through the same screen 44

46 $50 Benefit Allowance Eligibility is open to KCTCS personnel system regular, full- time employees who are enrolled in single healthcare coverage or who have waived healthcare coverage. You may use the $50 monthly benefit by electing coverage: –To pay for health insurance –To pay for dental insurance –To be placed in Healthcare FSA (FSA form must be completed) –To purchase voluntary supplemental benefit must –You must complete a new $50 Benefit Enrollment Form to participate in 2008 not –You may not use this benefit to purchase Group Life Insurance or Supplemental Long Term Disability 45

47 2008 Insurance/Benefit CARDS Health Insurance and Prescription Drugs If you do not switch coverage, you will continue to use your current Humana ID card If you switch to the Commonwealth Select Plan, you will receive a Health ID card and a HumanaAccess visa card Dental You will only receive a new ID card if you change coverage Waivers You will receive a Chard-Snyder Benny PrePaid Benefits card for your HRA if you are a new enrollee, If you have a 2007 HRA and Benny card, your new 2008 election will be loaded onto it FSA You will only receive a Benny Prepaid if you are a new enrollee If you have a 2007 FSA and Benny card, your new 2008 election will be loaded onto it If you have both a HRA and a FSA, you will use the same Benny card * 46

48 For Active Employees Age 65 and Older  The KCTCS Health Plan is considered primary over Medicare  You do not need to sign up for Medicare Part “B” until you cease employment. You will then enroll for this coverage under a “Special Enrollment Period” NOT  The prescription drug plan offered through the KEHP is considered “Creditable Coverage”. You do NOT need to sign up for a Medicare part “D” plan 47

49 Contacts: KCTCS System Office Employee Benefits 300 North Main Street Versailles, KY 40383 Phone: 859-256-3100 Fax: 859-256-3119 Department for Employee Insurance (DEI) Member Services Phone: 888-581-8834 502-564-6534 HumanaPhone: 877-KYSPIRIT 877-597-7474 Express ScriptsPhone: 800-KYSPIRIT 877-597-7474 48

50 Deadlines Open enrollment: October 15th through October 26th Open Enrollment in Peoplesoft: October 16th through November 2nd All paper applications due by: November 2nd 49


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