1. Faculty Open Enrollment
November 2, 2015 – November 20, 2015
Coverage Effective January 1, 2016

2. Topics for Discussion CHEIBA Trust and Mines Eligibility
Benefits Plan Changes
2016 Rates
Affordable Care Act
Enrollment Process

3. CHEIBA Trust Mines is part of a multi-university benefits trust
The Trust provides comprehensive benefits to all member schools
Mines faculty obtain insurance through the school’s membership in the trust
Health, Dental, LTD, Basic Life and Business Travel (Employer Paid)
Vision, Optional Life and Accidental Death and Dismemberment (Employee Paid)

4. Eligibility
Employee, legal spouse, or partners joined in a Civil Union
Dependent child(ren), civil union partners, qualified step child(ren), or qualified foster child(ren), married or unmarried and regardless of tax status until the end of the month in which they turn 26
Employee’s child(ren) of any age who are medically certified as disabled

5. Domestic Partner Eligibility
No Domestic Partners may be added to trust benefits after December 31, 2015
Existing Domestic Partners enrolled in Trust benefits will be grandfathered for 2016
All Domestic Partner benefits will end December 31, 2016

6. Civil Unions Recognized for insurance purposes January 1, 2014
Requirements
Photocopy of Civil Union Certificate
Joint bill or statement dated within the last 60 days

7. Eligibility Documentation
The CHEIBA Trust requires eligibility documents for all new plan participants including copies of registered marriage certificates and birth certificates
Documentation requirements are posted on the CSM Benefits webpage and available in the Human Resources Office.

8. Health Insurance Five Plan Designs Blue Advantage Point of Service
Blue Priority PPO (Formerly Blue Prime PPO)
Custom Plus (Closed to New Enrollment)
Blue Priority HMO
Lumenos HSA 2500 (High Deductible Health Plan)
The following information is based on in-network benefits only. Some plans have an out-of-network option. Please see the 2016 Benefits Book for details

9. Definitions
Deductible: The amount you pay out of pocket for your health care expenses before the plan makes payments for eligible expenses
Copayment: A flat dollar amount you pay for services regardless of the cost of those services
Co-Insurance: The percentage of the eligible expenses you are responsible for paying

10. Blue Advantage HMO/POS
PCP Requirement
Yes
In-Network Deductible $0
Out of Pocket Maximum
$2,000/$4,000
Preventive Care
No Cost
Primary Care Office Visits
$20 co-pay
Specialist Office Visits
Emergency Room
$100 co-pay
Inpatient Hospital
$400 co-pay
Urgent Care
$50 co-pay
Out-Patient Surgery
$85/$65 co-pay
Retail Rx – 30 Day Supply
$15/$30/$45 co-pay
Mail Order Rx – 90 Day Supply
$15/$60/$90 co-pay
Specialty Pharmacy – 30 Day Supply
30% to a maximum of $125

11. Blue Priority PPO PCP Requirement Yes In-Network Deductible $400/$800
Out of Pocket Maximum
$750/$1,500
Preventive Care
No Cost
Primary Care Office Visits
Tier 1 $10 co-pay Tier 2 15% co-insurance
Specialist Office Visits
Tier 1 $10 co-ay Tier 2 15% co-insurance
Emergency Room
15% co-insurance
Inpatient Hospital
Urgent Care
Out-Patient Surgery
Retail Rx – 30 Day Supply
$15/$30/$45 co-pay
Mail Order Rx – 90 Day Supply
$15/$60/$90 co-pay
Specialty Pharmacy – 30 Day Supply
30% to a maximum of $125

12. Blue Priority PPO Name Change – Formerly Blue Prime PPO
Members must designate a Tier 1 Primary Care Physician (PCP)
Use a Tier 1 PCP or Specialist for a $10 copayment
You still have access to all physicians in the PPO Network including non-Tier 1 PCP’s
Anthem will assign a PCP to members who do not designate one

13. Blue Priority HMO New Option
PCP Requirement
Yes – Limited Network
In-Network Deductible
$2,000/$6,000
Out of Pocket Maximum
$4,000/$10,000
Preventive Care
No Cost
Primary Care Office Visits
$20 co-pay
Specialist Office Visits
$60 co-pay
Emergency Room
$250 co-pay
Inpatient Hospital
$250 co-pay plus 20% after deductible
Urgent Care
Out-Patient Surgery
Retail Rx – 30 Day Supply
$200/$400 (Tier 2 & 3) $15/$40/$60
Mail Order Rx – 90 Day Supply
$200/$400 (Tier 2 & 3) $15/$80/$120
Specialty Pharmacy – 30 Day Supply
30% to a maximum of $250

14. Lumenos 2500 HSA New Option PCP Requirement No In-Network Deductible
$2,500/$5,000
Out of Pocket Maximum
Preventive Care
No Cost
Primary Care Office Visits
$0 after deductible
Specialist Office Visits
Emergency Room
Inpatient Hospital
Urgent Care
Out-Patient Surgery
Retail Rx – 30 Day Supply
Mail Order Rx – 90 Day Supply
Specialty Pharmacy – 30 Day Supply

15. Health Savings Account (HSA)
The Lumenos 2500 HSA is a high deductible health plan and HSA qualified
An HSA is a tax-favored savings account that, when paired with a qualified high deductible health plan (HDHP), allows you to pay for qualified medical expenses, or leave funds invested in the account for future medical expenses tax-free
An HSA can be set-up through your local bank or credit union

16. All Health Plans
New!
A routine vision exam for a $15 copayment will be covered under all Mines health plans
Enrollment is automatic you do not need to do anything
Anthem Blue View Vision Network

17. Pharmacy Reminders
All Asthma and Diabetic medications are available at no cost
Use the Express Scripts Mail Order Pharmacy for significant cost savings
A 90 day supply of generic medication is available through the mail order pharmacy for a $15 copayment

18. Dental Plans (Anthem Dental)
Two Plan Options
Dental PPO Plus
Dental PPO
There are no changes for 2016

19. New! Anthem Blue View Vision
A routine vision exam is now covered under your health insurance
Two Plan Options
Materials Only – For members and dependents covered under Mines health insurance
Materials plus Exam – Only for members not covered under Mines health insurance
In order to start or continue vision coverage you must enroll in one of the 2016 coverage options
Coverage under VSP will end December 31, 2015

20. New! Anthem Blue View Vision
In- Network
Eyeglass Frames
$130 Allowance 20% discount on balance
Eyeglass Lenses
Standard plastic single vision
Standard plastic lined bifocal
Standard plastic lined trifocal
$15 co-pay
$15 copay
Contact Lenses (In lieu of eyeglasses)
Once every 12 months
Elective conventional lenses
Elective disposable lenses
Non-elective contact lenses
Contact Lens exam (fitting & evaluation)
$130 allowance 15% discount on balance
$130 allowance
Covered in full
Copayment up to $55

21. New! Anthem Blue View Vision
In-Network (Member Cost)
Eyeglass Lens Upgrades
Transitions (Adults)
Polycarbonate (Adults)
UV Coating
Progressive Lenses
Anti-Reflective Coating
Other Add on Services
$75 co-pay
$40 co-pay
$15 co-pay
$65-$110 co-pay
$45-$68 co-pay
20% off Retail Price
Out-of-network benefits paid on a schedule – See the 2016 Benefits Book
Members are not eligible for glasses and contacts in the same benefits period
Purchase materials through your provider, or retail locations including Lens Crafters, Pearl Vision, Target, JC Penny and Sears
Discounts on Lasik
Low vision benefit

22. New! Anthem Blue View Vision
2016 Premiums Materials Only
Employee Only
$6.36
Employee + Spouse
$11.92
Employee + Children
Employee + Family
$17.31
2016 Premiums Material plus Exam
Employee Only
$8.80
Employee + Spouse
$16.49
Employee + Children
Employee + Family
$23.95

23. Identification Cards
Due to the change in Health plan options and the addition of Anthem Blue View Vision everyone will be issued a new ID card for 2016
Health, Dental, and Vision will all be on one card
If you have moved please drop by Human Resources GH110 to update your information

24. Long Term Disability Insurance
Income replacement in case of a long term disability
90 day waiting period
The Standard Insurance Company
Mines pays all premiums for this plan
No plan changes for 2016

25. Voluntary Accidental Death & Dismemberment (AD&D)
Coverage for Accidental Death or Dismemberment
Mutual of Omaha
No plan changes for 2016

26. Travel Accident Insurance
Provides coordination of care while traveling on school business
Provides an accidental death and dismemberment benefits while traveling on school business
Mines pays all premiums for this plan
No changes for 2016

27. Basic Life Insurance
Employee Coverage: Under age X annual salary; benefit capped at $500,000 Age 65 – X annual salary; benefit capped at $50,000 Age flat amount of benefit of $10,000 Dependent Coverage included at $2000 Employee’s legal spouse under age 70 and any married or unmarried child(ren) regardless of tax status and between 14 days and 26 years of age Mines pays all premiums for this plan Domestic Partners and children of domestic partners are not eligible for Dependent Coverage

28. Optional Life Insurance Anthem Life
Optional employee paid life insurance
Coverage up to $300,00 for employee and/or spouse
An Application including a medical questionnaire is required during open enrollment
Voluntary Dependent Child Coverage - $5,000
Dependents may be insured through the month in which they turn 26
No health screening is required for children

29. 2016 Flexible Spending Account
Healthcare Flexible Spending
Pre-tax deductions for healthcare expenses for you and your qualified dependents to cover items such as co-pays, deductibles, medical supplies, eye glasses/contact lenses, and dental care
Dependent Care Flexible Spending
Pre-tax deductions for day care expenses for qualified dependents. Tuition beyond preschool is not covered.
Participants save anywhere from 15%-30% or more
Expenses must be incurred during the plan year to qualify for reimbursement. Funds not used are forfeited!

30. 2016 Flexible Spending Account
24Hour Flex – New Plan Administrator January 1, 2016
Healthcare $2,550 per employee annual maximum
Dependent Care $5,000 per family annual maximum
CSM pays the $3.75 administrative fee
File claims online or using by using the 24Hour Flex mobile app
You must enroll during the open enrollment period to start or continue this benefit (IRS regulations)
Claims for expenses incurred in 2015 should be filed with PayFlex!
Participation for Domestic Partners/Civil Unions partners and/or children of Domestic Partners/Civil Union partners is limited to tax qualified dependents

31. 24Hour Flex Visa Card (Benny Card)
You will automatically be issued a Debit Card
Use to pay for co-pays, prescriptions, qualified dental treatments, medical supplies and other qualified expenses
Keep your Documentation! You may be required to provide documentation to 24Hour Flex, or to the IRS in case of an audit
You are not required to use the debit card. You may still file regular electronic claims

32. 2016 Premium Information Health Insurance
Mines pays 100% of your health and dental premiums
Health premiums increased 6.1% this year
New four tier premium structure
HMO/POS, Blue Priority PPO, and Custom Plus
Medical
Premiums
2015
2016
Employee
Only
$601.00
$637.52
Employee +
Spouse
N/A
$1,528.84
Children
$1,401.84
Family +
Family
$1,568.00
$1,759.13

33. 2016 Premium Information Health Insurance
Blue Priority HMO
Lumenos 2500 HSA
2016
Employee Only
$586.52
Employee + Spouse
$1,406.84
Employee + Children
$1,289.84
Employee + Family
$1,619.13
2016
Employee Only
$573.52
Employee + Spouse
$1,376.84
Employee + Children
$1,216.84
Employee + Family
$1,584.13

34. 2016 Premium Information No increase in dental premiums
New four tier premium structure
Dental Premiums
2015
Employee Only
$39.00
Employee + Spouse
$90.00
Employee + Children
$86.00
Employee + Family
$102.00

35. Value Of Your Coverage (Health, Dental, Life, LTD, Travel)
Assume salary of $60,000
Employee only coverage, under age 65
CSM Pays: $8,170
With PERA included, CSM pays: $19,660
Employee with family coverage, under age 65
CSM Pays: $22,385
With PERA included, CSM pays: $33,874
Assume a salary of $100,000
With PERA included, CSM pays: $41,569
2016 Employer (CSM) PERA Contribution rate is 19.15%
(10.15% Employer Contribution plus 9% AED/SAED)

36. Open Enrollment Enrollment is REQUIRED for those who:
Wish to participate in a Flexible Spending Account
Wish to participate in the vision plan
Wish to add, drop, or change coverage
Wish to add or drop dependents. Reminder: Dependents may be insured through the month in which they turn 26 regardless of, student, tax, or marital status
Forms are due in the Human Resources Office no later than Friday November 20th at 5:00pm. Early submission is greatly appreciated!

37. Open Enrollment
You DO NOT need to complete new enrollment forms if you DO NOT wish to:
Enroll in a Flexible Spending Account
Start or continue Vision Coverage
Change dependent coverage
Your benefits will continue unchanged

38. Qualifying Events REMINDER:
Your benefits elections will be in effect for the entire 2016 calendar year unless a “qualifying event” occurs
You must notify, and provide Human Resources with documentation within 31 days of an eligible qualifying event
Examples are marriage, divorce, birth, overage dependents, spouse loses coverage etc.
Failure to do so means that you must wait until the next open enrollment period (IRS regulations)
Reference your Benefits Book or contact HR for further details

39. Voluntary Tax Deferred Options
PERA 401(k) Plan
PERA 457 Deferred Compensation Plan
403(b) Tax-Deferred Annuity Plan
Roth 403(b) Post-Tax
You may enroll in these plans at anytime!
Detailed plan information is available in Human Resources

40. Affordable Care Act (PPACA) Update
Individual Mandate
Most individuals will be required to carry minimum value (60% actuarial value) coverage or face a possible financial penalty
Employer Mandate
Employers are required to provide minimum value coverage to 95% (70% for 2015) of employees working 30 or more hours per week or face a financial penalty
Starting in January of 2016 employers and insurance companies will be reporting offers of coverage and enrollment information to the IRS for calendar year 2015
Many employees will receive a Form 1095-C Form from their employer outlining offers of coverage and enrollment information for calendar year 2015 by January 31, 2016
Stay tuned for more information on this topic

41. Participant Advocate Link
You have a P.A.L.!
The participant advocate is available to assist you with benefits issues such as billing problems, reimbursement issues, and denied services
The participant advocate is an employee of Gallagher Benefits Services and works only for you!
(303) or (800)

42. Questions? Monica Gutierrez (303) 384-2522 mgutierrez@mines.edu
Ann Hix, (303)