State and Higher Education Annual Enrollment Period October 3 - PowerPoint PPT Presentation

State of Tennessee Group Insurance Program State and Higher Education Annual Enrollment Period October 3 – October 14, 2016 Enrollment ends at 4:30 p.m. Central

Agenda • Annual Enrollment Period • What’s Important for 2017 • Using ESS in Edison • Health Benefits Overview • 2017 Partnership Promise • Dental, Vision and Additional Benefits Overview 1 www.partnersforhealthtn.gov

Annual Enrollment Period October 3 to October 14 - ends at 4:30 p.m. Central  Annual Enrollment Period (AEP) is an open enrollment for most programs  Shorter time period this year! Only two business weeks! • You can make the following changes:  Change, enroll or cancel health insurance for yourself or your eligible dependents  Choose or change your health insurance network/carrier  New network option this year – you have the choice of three networks  Enroll in, cancel or transfer between dental options  Enroll in, cancel or transfer between vision coverage options  Enroll in or cancel voluntary accidental death & dismemberment coverage  Apply for, cancel, increase or decrease voluntary term life coverage amounts (if eligible)  Enroll in flexible spending accounts (flexible benefits) 2 www.partnersforhealthtn.gov

Very Important Changes • Premiums, copays, coinsurance and deductibles are changing. You should look closely at all costs in your plan options for 2017. Partnership Promise Change • Due to federal rule changes, all members can enroll in any health option . • If you and your spouse are currently in the Partnership PPO or the Wellness HealthSavings CDHP in 2016 and you do not complete the 2016 Partnership Promise , you can stay in your plan, but you do not qualify for the lower Partnership PPO premium or state health savings account (HSA) money. • This means you will pay a higher premium if you stay in the Partnership PPO. Or, if you stay in the HealthSavings CDHP, the state will not put money in your HSA. • Cost changes take place automatically – you could pay more if you don’t make a change • You can choose a different plan option during annual enrollment 3 www.partnersforhealthtn.gov

What is ALEX? ALEX is a smart, funny benefits expert who explains benefits and may help members choose what’s best for them. Go to www.partnersforhealthtn.gov 4

Annual Enrollment Period If you DO NOT want to make changes … • You will keep your current benefits. This means you will stay in your current options (PPO or CDHP) with your current network (BCBS Network S or Cigna LocalPlus). • Remember, if you are in the Partnership PPO or the Wellness HealthSavings CDHP and you do not complete the 2016 Partnership Promise, you will pay a higher premium in the Partnership PPO in 2017. Or, if in the HealthSavings CDHP, the state will not put funds in your HSA. Cost changes will take place automatically 2017 Partnership Promise Plan Members: • Members and spouses who enroll in or stay in a plan with the Partnership Promise agree to fulfill the 2017 Partnership Promise. Three health insurance networks! • You will have the choice between three different health insurance networks. Check the networks and provider directories carefully! • If you want to change networks - you must make this change 5 www.partnersforhealthtn.gov

Annual Enrollment Period If you DO want to make changes • You must use Employee Self Service (ESS) in Edison • Enroll early! The enrollment period is shorter - submit your changes as early as possible. • Enrollment ends at 4:30 p.m. Central on October 14. • All new dependent verification documents must be received by 4:30 p.m. Central on October 14. • Life Insurance: Use the Minnesota Life website for voluntary term life insurance. • Flexible benefits: • State employees: October 3 to October 14 in ESS • Higher education employees: October 1 – October 31 on PayFlex website 6 www.partnersforhealthtn.gov

Annual Enrollment Period • Changes take effect on January 1, 2017 • Selections remain in effect through December 31, 2017, unless you lose eligibility or have a qualifying event • A qualifying event or family status change is something that results in a person losing coverage under another plan or becoming newly eligible for coverage • Examples include birth, a change in marital status or new employment • Contact your Agency Benefits Coordinator (ABC) if you experience a qualifying event 7 www.partnersforhealthtn.gov

What’s Important for 2017 • Health insurance premiums will increase for the Partnership PPO and the HealthSavings CDHP. Premiums will decrease in the Standard PPO plan, but other costs are higher than the Partnership PPO. Your Decision Guide has more information • Change – Health insurance networks : There will be three different network options. You choose one: • New - Cigna Open Access Plus (OAP) : This is a large network. You will have a choice of more doctors and facilities including Baptist Memphis. But you will pay more each month . • BlueCross BlueShield (BCBS) Network S : This network was offered last year. No additional cost for this network. • Cigna LocalPlus : This network was offered last year. Baptist Physician Group has been added. No additional cost for this network. This network is different from Cigna Open Access Plus. You will stay in your current network (BCBS Network S or Cigna LocalPlus) if you do not make a change 8 www.partnersforhealthtn.gov

What’s Important for 2017 • Member cost sharing is changing in all options • Out-of-pocket maximums: (Partnership PPO and Standard PPO): The medical and pharmacy out-of-pocket maximums will be combined. The total out-of-pocket maximums for the PPOs will be less in 2017. • Partnership PPO options: In 2017, the plan benefits (copays, deductible and coinsurance) will be the same for both options. Difference - you will pay lower premiums if you agree to the Partnership Promise. • Standard PPO: The deductible is twice as much as the Partnership PPO, and the copays and coinsurance are higher. But the premiums are lower. • HealthSavings CDHP options: In 2017, the plan benefits (deductibles and coinsurance) will be the same for both CDHP options. Difference - the state will put money in your HSA if you agree to the Partnership Promise. 9 www.partnersforhealthtn.gov

What’s Important for 2017 • Coinsurance for labs, diagnostics and x-ray: Will have coinsurance for all plan options. Preventive services still covered at 100% • Pharmacy copays and coinsurance: Copays in the PPOs will go up slightly (up $2-$15). For specialty drugs in the PPOs, coinsurance will apply with a member minimum ($50) and maximum ($150) out-of-pocket. • Brand Obesity Medications Now Covered: Gives members a less costly, non- surgical option for losing weight. Members must meet certain criteria to qualify. • Change - Partnership Promise - Coaching: Only members in disease management (diabetes, heart failure, coronary artery disease, asthma and COPD) and case management will have to coach. Lifestyle management coaching is not required in 2017 – members can voluntarily participate but will not be contacted 10 www.partnersforhealthtn.gov

What’s Important for 2017 • Change - Optum Health will be the new behavioral health, substance abuse and Employee Assistance Program (EAP) vendor replacing Magellan. Behavioral health and substance abuse doctors may change . Benefits will include a new TeleBehavioral Health service. • Dental and Vision Premiums: • Cigna dental premiums will increase by 3% • MetLife dental premiums will increase by 4% • Vision premiums will not change 11 www.partnersforhealthtn.gov

What’s Important for 2017 • Change - Flexible Spending Accounts (FSA): PayFlex will manage flexible spending accounts (FSA) for state and higher education employees (except for parking/transportation, managed by Benefits Administration for state employees). • You will have a debit card to pay for medical services (Healthcare FSA/limited purpose FSA) or you can submit receipts • Telehealth: You can contact a doctor for minor illnesses such as cold and flu, infections, fever and more. Schedule a visit for you or your covered dependents from anywhere, at any time. Cost is only $15 for all PPOs. CDHP members pay $38 until the deductible is met. 12 www.partnersforhealthtn.gov

Using Edison ESS To make changes, you must use Employee Self Service (ESS) in Edison . To use ESS, log on to Edison at • https://sso.edison.tn.gov/psp/paprd/EMPLOYEE/EMPL/h/?tab=PAPP_G UEST • Health Insurance option names in Edison: • In Edison, the names of four health insurance options are shortened • Check the chart below before making your choice Health insurance options Names as they appear in Edison Partnership Promise PPO Partners Promise PPO No Partnership Promise PPO No Partners Promise PPO Standard PPO Standard PPO Promise HealthSavings CDHP Promise CDHP No Promise HealthSavings CDHP No Promise CDHP 13 www.partnersforhealthtn.gov

Using Edison ESS Designating Life Insurance Beneficiaries: • You can designate beneficiaries in Edison for Basic Term Life, AD&D and voluntary AD&D • If submitting changes during annual enrollment, the beneficiary page will display after submitting changes Flexible Benefits • State: You must also use ESS to enroll in flexible benefits from Oct. 3 - Oct. 14 • Higher ed: Use the PayFlex website to enroll in flexible benefits from Oct. 1 – Oct. 31 • More information about flexible benefits is in your Decision Guide 14 www.partnersforhealthtn.gov