KCTCS OPEN ENROLLMENT OCTOBER 10 24, 2016 HEALTH CARE REFORM The Affordable Care Act The Kentucky Employee Health Plan (KEHP) meets all requirements of the Affordable Care Act (ACA). The PLAN provides affordable health care insurance that is offered to all employees. Employees may shop kynect (the state marketplace) for coverage.
Purchasing coverage through kynect will disqualify the employee and dependents from receiving potential tax credits. KCTCS PERSONNEL SYSTEM The Contribution Strategy The state non-tobacco user contribution rate is reduced by 25% to the employee. KCTCS personnel system employees pay reduced out-of-pocket monthly contributions. KCTCS picks up that additional 25% for the employee. The $50 Benefit Allowance is available to eligible employees to offset
benefit expenses. 2017 PLAN YEAR HIGHLIGHTS Whats new? Whats changing? The four health plan options remain the same 1% increase in premiums for Standard PPO and Standard CDHP plans Some changes to annual deductible and outof-pocket maximums NEW LivingWell Promise deadline moved
to July 1 NEW In CDHP plans, preventive drug prescriptions will bypass the deductible NEW LiveHealth Online begins offering psychology services 1/1/2017 NEW Default plan is now the Standard PPO NEW HumanaVitality will have a fresh new name beginning 1/1/2017 Go-365. THE LIVINGWELL PROMISE Requires member to do one of two things: Promise to take the Go365 Health Assessment (HA) between January 1
and July 1, 2017, OR Complete a Biometric Screening between January 1 and July 1, 2017. You may do both and earn Go 365 points for both! Both members of a LivingWell cross-reference payment plan must complete the Promise. Dependents MAY complete the Promise, but are not required to do so. THE LIVINGWELL PROMISE What if I dont complete the Promise? If you are enrolled in a LivingWell plan for 2016 and did not fulfill your
Promise for 2016, you will not receive the $40/month premium discount on your health insurance plan for 2017. You may select from any of the four plans for 2017. If you do not complete your Promise between January 1 and July 1, 2017, you will not receive the $40/month premium discount on your health insurance plan for 2018. If you have a cross-reference payment option, both spouses must complete the Promise. The premium will be discounted by $40 for each planholder completing the Promise. DO I NEED TO ENROLL FOR 2017? YES! EVERYONE MUST ENROLL FOR 2017
NO EXCEPTIONS! DO I NEED TO ENROLL FOR 2017? In PeopleSoft Self-Service You MUST enroll in PeopleSoft Self-Service if you want to: Keep or change your health insurance plan, coverage level or dependents in any way; Enroll in a new General Purpose or Dental/Vision
Only health insurance waiver; Keep your current health insurance waiver; Enroll in a healthcare or dependent care Flexible Spending Account (FSA) for 2017; Enroll or change your current dental insurance plan, coverage level or dependents in any way; Drop your current dental insurance plan entirely; Enroll in the $50 Benefit Allowance, if eligible. DO I NEED TO ENROLL FOR 2017? In KHRIS
You MUST enroll in KHRIS if you want to: Re-enroll or change your health insurance plan, coverage level or dependents in any way; Enroll in a new health insurance waiver; Re-enroll for your current health insurance waiver. WHERE CAN I GET INFO? Where can I find more detailed instructions? KCTCS has been emailing info and instructions to your KCTCS email address.
CHECK YOUR KCTCS EMAIL!!! This is how we communicate with you! Information, forms and the 2017 DEI Benefits Selection Guide are available on the KCTCS website: https://employees.kctcs.edu/info-center/hr/open-enrollment Department of Employee Insurance (DEI) has information on their website: https://personnel.ky.gov/Pages/KEHP-OE THE PLANS LivingWell Consumer Driven Health Plan (CDHP) LivingWell Preferred Provide Organization (PPO) Standard PPO Standard CDHP Refer to your 2017 KEHP Benefits Selection Guide for details on the plan
options. LIVINGWELL CDHP Whats new? NEW LivingWell Promise is required to be eligible for discounted premium NEW Out-of-Pocket Maximums have been increased NEW Medications on the preventive therapy drug benefit list bypass the deductible Member pays only the co-insurance amount for these drugs NEW dependents must be on the plan to use the HRA funds NEW $7500 or less in HRA will rollover to 2018
LIVINGWELL PPO Whats new? NEW LivingWell Promise is required to be eligible for discounted premium NEW Annual Deductibles and Out-of-Pocket Maximums have increased Medical and Rx co-pays do NOT accumulate toward Annual Deductibles or Out-of-Pocket Maximums STANDARD PPO Whats new?
No LivingWell Promise is required; no premium discount available NEW 1% increase in monthly premium NEW Annual Out-of-Pocket Maximums have increased Rx co-pays have a separate Out-of-Pocket Maximum to help cap costs Medical and Rx co-pays do NOT accumulate toward Annual Deductibles STANDARD CDHP Whats new? No LivingWell Promise is required; no premium discount available NEW 1% increase in monthly premium
NEW Annual Out-of-Pocket Maximums have increased NEW Medications on the preventive therapy drug benefit list bypass the deductible Member pays only the co-insurance amount for these drugs NEW dependents must be on the plan to use the HRA funds NEW $7500 or less in HRA will rollover to 2018 DIABETES VALUE BENEFIT One of KEHPs highest cost medical conditions more than $1M per year Can often be controlled with regular doctor visits and proper medication adherence See page 27 in the KEHP Benefits Selection Guide for details in each plan For most maintenance diabetic prescriptions and supplies
members will pay reduced co-pays and co-insurance no deductibles on diabetic prescriptions and supplies SELF-SERVICE BENEFITS ENROLLMENT October 10 24 A multi-step process again this year: PeopleSoft Self Service
Review each benefit and costs on the Enrollment Summary page October 10 24 KHRIS system Re-enroll or make any changes to health
insurance or waivers Print and save your confirmation page October 31 November 11 Enroll in $50 Benefit Allowance through PeopleSoft Self-Service, if eligible PEOPLESOFT SELF-SERVICE
Will be used again for 2017 enrollments of these benefits: Health (including waivers), Dental, Flexible Spending Accounts (FSA), Waiver HRAs, and $50 Benefit Allowance Follow the direct link on the KCTCS intranet, or log into PeopleSoft and go to Employee SelfService. KHRIS SELF-SERVICE
First You must re-enroll in health insurance or a waiver. Failure to enroll for health insurance or a waiver will result in automatic enrollment in the Standard PPO plan at the current coverage level.
Remember two things! Second Do NOT enroll for healthcare or childcare Flexible Spending Accounts (FSAs) through KHRIS. Enroll in FSAs through PeopleSoft SelfService.
KHRIS SELF-SERVICE More info Once the online enrollment process is complete, print and save your confirmation page as proof of enrollment. If there is an email address on record for you, a confirmation message will be sent. See page 33 of the DEI Benefits Selection Guide for contact information to answer KHRIS questions. Your local HR representative will be unable to obtain your login ID or password, or answer questions about the KHRIS website.
PAPER APPLICATIONS Who needs to fill one out? All cross-reference plan holders; Employees who are eligible under ACA rules; Plan holders with a disabled dependent; New employees or transfers hired between September 1 and October 31; KRS retirees with KRS-paid coverage who are making changes contact KRS for its paper application. WAIVING HEALTH INSURANCE Per federal law, employees must be enrolled in a group health plan that
provides minimum value. Employees in another group health plan providing minimum value may choose to enroll in the Waiver General Purpose HRA, and Must attest in writing that they have other group health plan coverage that provides minimum value. Note: If you or your spouse or dependent is contributing to a Health Savings Account (HSA), consult a tax advisor prior to enrolling in a HRA or FSA. WAIVING HEALTH INSURANCE (continued)
Employees and/or their dependents having coverage purchased through kynect or other governmental plans such as TRICARE, Medicare or Medicaid are not eligible for the Waiver General Purpose HRA. These employees may enroll in the Waiver Dental/Vision Only HRA or elect to enroll in a KEHP health plan. Members enrolling in the Waiver Dental/Vision Only HRA do not need to attest to enrollment in another plan. Note: If you or your spouse or dependent is contributing to a Health Savings Account (HSA), consult a tax advisor prior to enrolling in a HRA or FSA. FSA VS. HRA In addition to the HRA, an employee may fund a healthcare Flexible
Spending Account (FSA) to cover unpaid qualified medical expenses such as deductibles, co-pays, co-insurance, dental, vision, etc. If you have both a FSA and a General Purpose Waiver HRA, reimbursement will be made from the FSA account balance first. The FSA balance is forfeited after the end of the plan year (12/31/17) and the 2-1/2 month grace period (3/15/18). The Waiver HRA will not roll-over if you elect to enroll in a health plan in 2018. FLEXIBLE SPENDING ACCOUNTS Two types of FSAs are available
Health Care Account (HCA) for medical expenses Minimum $5/paycheck (including $50 Benefit Allowance); maximum annual contribution remains $2,550 for 2017. Per federal regulations, only $500 of employer contributions may be used to fund a FSA. Dependent Care Account (DCA) for dependent day care expenses Minimum $5/paycheck Maximum contribution based upon federal tax filing status, up to $4,992 FLEXIBLE SPENDING ACCOUNTS (continued)
Employees wishing to enroll in a FSA must do so every year an IRS regulation. Enrollment must be made in PeopleSoft Self-Service FSA enrollees may use the Benny card for health expenses, or file a paper claim for health or dependent care expenses Claims for reimbursement can be made for any dependents up to age 26. Save your receipts! Substantiation for a Benny card charge may be required. FLEXIBLE SPENDING ACCOUNTS (continued) Termination date for a FSA (and HRA) is the date employment ends or the
date of retirement. Following termination of the FSA, you have 90 days to file paper claims for reimbursement of expenses incurred through the last date of service. Note: If you or your spouse or dependent is contributing to a Health Savings Account (HSA), consult a tax advisor prior to enrolling in a HRA or FSA. FSA GRACE PERIOD NO FSA carryover of $500 as stated in the DEI Benefits Selection Guide. KCTCS elects to use a grace period method instead of a carryover method to utilize prior years money Any amount of leftover money from 2016 may be used and claimed until 3/15/2017.
You may use your FSA Benny card for grace period expenses. Reimbursements will automatically be applied to the correct year. DEPENDENT CARE FSA Maximum contribution is based on employees tax filing status Check the Chard-Snyder paper enrollment form for maximums Plan maximum is $4,992/year Reimbursement is done only by paper claim form Direct deposits of reimbursements is available Retirees not eligible to participate No grace period on Dependent Care FSA Does allow for a run out period claims for 2016 must be filed within 90 days of December 31, 2016
HEALTH REIMBURSEMENT ACCOUNTS Embedded HRA LivingWell CDHP or Standard CDHP Administered by WageWorks and DEI NEW Funds of $7500 or less will rollover to the 2018 CDHP plan NEW Dependents must be on the plan in order to use embedded HRA funds. WageWorks Healthcare VISA issued for use at local vendors New card will not be issued unless the old one has expired. Any remaining HRA money from the 2016 CDHP plan will rollover to the 2017 CDHP plan in April 2017. If you have 2016 expenses to claim in 2017, you MUST file a paper claim with WageWorks after January 1 for services rendered in 2016.
You cannot use 2017 money to pay for 2016 expenses. HEALTH REIMBURSEMENT ACCOUNTS (continued) General Purpose or Dental/Vision Only HRA Administered by Chard-Snyder Benny MasterCard issued for use at local vendors New cards will not be issued unless the old ones have expired. Any remaining money from a 2016 waiver HRA will rollover to the 2017 waiver HRA in April 2017. If you have 2016 expenses to claim in 2017, you MUST file a paper claim
with Chard-Snyder after January 1 for services rendered in 2016. You cannot use 2017 money to pay for 2016 expenses. HEALTH REIMBURSEMENT ACCOUNTS (continued) HRAs are not available to: A retiree who has gone back to work and elects coverage under a government retirement system; Retirees, or Spouses of a hazardous duty retiree.
Note: If you or your spouse or dependent is contributing to a Health Savings Account (HSA), consult a tax advisor prior to enrolling in a HRA or FSA. HEALTH REIMBURSEMENT ACCOUNTS (continued) Special note to employees having both a FSA and waiver HRA If all of your FSA money has been used for 2016 and you have money left from your 2016 HRA, you MUST file a paper claim after January 1 for services rendered in 2016.
You cannot use 2017 money to pay for 2016 expenses Your Benny card does not know the difference between 2016 and 2017 money. HEALTH REIMBURSEMENT ACCOUNTS (continued) A pharmacy tip for General Purpose waiver HRA users: If you waived because your spouse has health coverage elsewhere, use your spouse health plan card first to pay for prescriptions.
Then use your HRA Benny card to pay any remaining co-pay or coinsurance amounts. This saves your HRA money for future use or rollover, instead of paying the bulk of that Rx cost with your HRA money. FSA AND HRA Online enrollment KCTCS employees will NOT Enroll for FSAs through the KHRIS site. If you have a FSA for 2016 and wish to continue it for 2017, you MUST re-enroll through PeopleSoft Self-Service.
For those KCTCS employees who wish to enroll or re-enroll in a waiver HRA for 2017: You MUST enroll through PeopleSoft Self-Service. You MUST enroll through the KHRIS site. FSA AND HRA SAVE YOUR RECEIPTS!!! The IRS requires proof (substantiation) that expenses are qualified under the Plan Save your explanations of benefits (EOBs) from Anthem in case there is a
request to verify an expense If a refund is issued for an expense paid by either a WageWorks or Benny card: The card should be credited by the provider. If the provider refunds the member directly either by cash or check, the member is required to refund the card, per IRS guidelines. If you have the Dental/Vision Only HRA, and want money specifically used from the FSA for dental or vision expenses, a paper claim form must be submitted to Chard-Snyder requesting such. MEDICARE AND HRA If you are enrolled in Medicare and waive your KCTCS health coverage: You are NOT eligible to enroll in the Waiver General Purpose HRA.
You are eligible to enroll in the Waiver Dental/Vision Only HRA. You MUST enroll ALL your dependents who may have claims reimbursed under the Waiver Dental/Vision Only HRA. Federal reporting requirement Must enroll dependents through PeopleSoft Self-Service $50 BENEFIT ALLOWANCE Available to KCTCS personnel system regular, fulltime employees enrolled in single healthcare coverage or waiving healthcare coverage May be used for: health or dental insurance premiums
healthcare FSA (FSA enrollment must be completed in PeopleSoft SelfService), or purchasing voluntary supplemental benefits Per federal regulations, only $500 of employer contributions may be used to fund a healthcare FSA Remaining $100 may be used to purchase another benefit or forfeited $50 BENEFIT ALLOWANCE (continued) May not be used to purchase Group Life Insurance or Supplemental Long Term Disability Preplan your $50 Benefit Allowance (BA) election during Open Enrollment
(October 10 24) If you allocate all or part of the $50 BA to a FSA, you must enroll in the FSA during Open Enrollment from October 10 24. You will NOT be able to go back later to enroll. You will receive an email in early November if eligible to enroll in the $50 Benefit Allowance. Enrollment will be October 31 November 11. DENTAL PLAN ENROLLMENT Same three dental carriers for 2017: Delta Dental Dental Health Options by
Health Resources Humana CompBenefits Verify your coverage as it is currently in PeopleSoft Dental coverage will rollover from 2016 to 2017 unless you make changes in PeopleSoft SelfService. If you wish to add or drop family members, terminate coverage entirely or change carriers, Open Enrollment is the time to do it! Verify your dentists participation in the plan of your choice
2017 INSURANCE/BENEFIT CARDS Will I get new ones? Health Insurance New ID cards will not be issued. New WageWorks HRA VISA card will be issued only if the card has expired. One WageWorks card per household is issued. Dental New cards issued only if coverage is changed. FSA/Waiver HRA Benny cards Issued to new enrollees or if the current card expires 12/31/16.
Same card carries both the FSA and Waiver HRA balances. Remaining 2016 Waiver HRA balances do not rollover until April 2017. SOME MISCELLANEOUS NEED TO KNOW STUFF (SUBTITLED THINGS WE OFTEN GET QUESTIONS ABOUT) PREVENTIVE CARE No cost and in-network All plans cover preventive services by a network provider without charging a co-pay or co-insurance, even if the annual deductible has not been met. Provides for such services as immunizations, preventive screenings, wellchild and well-adult visits.
Preventive is defined by the code the doctor uses to submit the billing to Anthem. DEPENDENT ELIGIBILITY Dependents are eligible up to age 26 can be married (coverage does not extend to his/her spouse or children) does not have to reside with the plan holder can remain on the parents plan regardless of eligibility through the dependents employer will be automatically dropped from the KEHP at the end of the month in which the dependent turns age 26 QUALIFYING EVENTS
Changes permitted outside the Open Enrollment period QE applications must be signed within the prescribed QE time frame. QEs for cross-reference payment plans require Insurance Coordinator signatures from BOTH agencies. No exceptions! Supporting documentation must be submitted with the QE application. Coverage will not be activated until applicable documentation is received. Effective date of QE will be subject to federal guidelines; coverage may be activated retroactively TOBACCO USE DECLARATION The Commonwealth is committed to fostering and promoting wellness and
good health practices in its workforce. Focus on tobacco use, not just on smoking Applies to spouses and dependents as well as the planholder KEHP provides support through Tobacco Cessation Programs Cooper Clayton 12-week program Kentucky Quit Line Rx from your physician RETIREES RETURNING TO WORK KTRS retirees MUST select coverage through the active employer (KCTCS) if returning to active employment KRS retirees
MAY be ineligible for KRS coverage when returning to active employment and becoming eligible for KEHP coverage through KCTCS Consult KRS for specific guidance on a case-by-case basis LIFE/AD&D INSURANCE ENROLLMENT No changes in rates for 2017 Paper applications must be completed and returned to your local HR Department. Enrollment is NOT done through PeopleSoft Self-Service or KHRIS Beneficiary information is NOT stored in PeopleSoft; it is stored in a paper file. No proof of insurability is required for an increase of one coverage level (for example, 2x to 3x salary)
Employee must have an existing Optional Life and AD&D plan to increase coverage level Moving from Basic coverage ($20,000) to 1x salary is not considered a one coverage level increase OTHER SUPPLEMENTAL VENDORS Variety of vendors offering a variety of supplemental products AFLAC Colonial Life Insurance Washington National Life Insurance of Alabama Midland National Life AccuFlex/NTA Life
Premiums can be deducted semi-monthly from your paycheck. You may be able to use the $50 Benefit Allowance to purchase Enrollment is NOT through PeopleSoft Self-Service Submit paperwork to your local HR Department DIABETES PREVENTION PROGRAM (DPP) Are you at risk for developing diabetes? Age 45 or older Overweight Family history of Type 2 diabetes
Physically active less than three times/week Had diabetes while pregnant, or given birth to a baby weighing nine or more pounds DIABETES PREVENTION PROGRAM (DPP) Opportunity to attend a program near you to lower your risk 16-week course; once a week for one hour Earn 350 HumanaVitality points Participation is free Receive individual and group support while improving health and reducing risk To find out if you are at risk, take the risk test at www.cdc.gov.
Seven questions no identifiable information required KEHP WELLNESS BENEFITS Several initiatives that can be utilized Go365 wellness program Go365 HealthyFood 5% off Great for You food at Wal-Mart free flu shots, along with preventive care Diabetes Prevention Program (DPP) myStrength to help manage stress and find balance in life HUMANAVITALITY BECOMES GO365 New name, same great program effective 1/1/17
Keep your same member ID from HumanaVitality New Fitness Point Structure 1 point for every 1,000 steps 5 points for every 15 minutes above 60% max heart rate 5 points per 100 calories if burn rate exceeds 20 per hour 10 points per day for checking in at a partner gym NEW No longer a yearly fitness point maximum HUMANAVITALITY BECOMES GO365 (continued) NEW Bonus Bucks for reaching the next level instead of a percentage off
Silver earns 500 Bonus Bucks Gold earns 1,500 Bonus Bucks Platinum earns 5,000 Bonus Bucks Suggestion If you want to make purchases in the HumanaVitality Mall using a percentage off, do it before 12/31/16. TRANSPARENCY PAYS FOR YOU AND FOR THE PLAN Vitals SmartShopper enroll online at vitalssmartshopper.com NOT mandatory YOU CHOOSE to whom or where you go for services Must shop for your procedure prior to the date of the procedure Cash rewards range from $15 to $500, depending on procedure and location The list of eligible procedures and locations changes and is updated
regularly NEED HELP? Heres who you can contact Your first point of contact should be your HR Benefits Representative! (Enter your college contact information here) For assistance with DEI online access, use the contact numbers on page 33 of the 2017 Benefits Selection Guide Information specific to KCTCS, along with forms, are located on the KCTCS intranet site.
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