2016 Benefits Open Enrollment

Becky Goins, Human Resources11-9-2015

Nov 1 – Dec 1, 2015

• Log into Employee Self Service (ESS). Link is on HR home page and “Inside UAMS” intranet. https://enterprise.uams.edu/irj/portal

• Select Benefits

• 2 ways to look at your benefits...

First, what benefits do I have now?

• Benefits Participation Overview shows the benefits you have today. Change date to see past or future benefits.

• UAMS Benefits Statement shows all benefits, including ones you don’t have. Use this one so you know what to do during open enrollment. You can print it.

Check out “total compensation” info on 2nd page.

For those without computer access, your department SAP person or Human Resources can print it for you (transaction ZHRESSBENSTMT).

• Now that you know what benefits you currently have, find out what options you have for 2016.

• Guides to be mailed to all benefit-eligible employees via campus mail

• Copy posted at www.hr.uams.edu, click on Open Enrollment

• Medical• Dental• Vision• Flexible Spending Account• Optional Long Term Disability

Forms to make changes posted on our website. Except FSA… must enroll online via ESS.

What does Open Enrollment apply to?

• Make sure you’re only covering your legally married spouse and eligible children. Otherwise subject to disciplinary action (up to termination) and fines. This is the LAST amnesty.

• Eligible children are:– Under age 26– Your biological or adopted child (or court order showing guardianship)– Step-children; you must be married to child’s parent

Check your dependents

• Starts in early 2016• You’ll get a letter from Aon Hewitt• You will send documentation to Aon

Hewitt. Do not send to HR.• Examples of documentation:

• Copies of marriage license + last year’s tax return• Copy of birth certificate

Dependent Audit coming!

• No employee rate increases for January

• However, rates will increase for retirees on the UA health plan and the UnitedHealthcare Medicare Advantage plan. COBRA rates will also increase.

Insurance Premiums

• Deductible – $500 increase• If you come to UAMS SmartCare, from $250 to $750 • If you go elsewhere in-network, from $750 to $1,250

• Out of Pocket Max – $500 increase• If you come to UAMS SmartCare and did wellness - $3,350• If you go elsewhere in-network and did wellness - $3,850• If you DID NOT do wellness (tsk tsk) - increase by $1,400.

These are individual amounts. Double if covering family.

Medical Coverage Changes

• No changes to copays– Tier 1 (mostly generic)… $15– Tier 2 (preferred)… $50– Tier 3 (non-preferred)… $80

• Drug out of pocket max cost remains $1600 per individual. Only covered drugs and lowest priced “reference based priced” drugs count toward this amount.

Prescription drug benefits

• UAMS SmartCare is an incentive for you to come to a UAMS facility for your healthcare

• Applies to UAMS employees and family covered under our medical plan

• Automatically reduces what you pay out of your pocket after insurance pays

• Call SmartCare Concierge at 686-8749 to schedule an appointment or if you have a question about a UAMS bill.

• Smartcare website: http://hr.uams.edu/benefits/smartcare/

Don’t forget about

Let’s review so you can better understand how the University’s plan works.

Medical insurance benefits - 2016

What is your copay for doctor office visit?(No change from current)

If you goin-network

SmartCareSavings

Primary care physician (PCP)

Annual eye exam

Outpatient mental health visits(pre-auth required)

$35 $20 $15

Specialist $50 $35 $15

Office visit copays do not apply for routine pre-natal care, nor annual preventive visit.

What is your cost for procedures at your visit?such as labs, radiology, OT, PT, outpatient surgery

in-networkSmartCare

Savings

Deductible$ 1,250

+ $150 copay for outpatient surgery

$ 750no copay for

outpatient surgery$500 - $650

Coinsurance 30% after deductible

20% after deductible 10%

Out of pocket max* $ 5,250 $ 4,750 $500

* Reduce the out of pocket max by $1400 if you completed the wellness program; new hires with coverage that starts after 8-1-2015 are defaulted to wellness their first year.

What is your cost for a hospital stay?

If you go in-network

SmartCareSavings

Hospital admission copay $ 250 $ 150 $ 100

Deductible $ 1,250 $ 750 $ 500

Coinsurance 30% after deductible

20% after deductible 10%

Out of pocket max * $ 5,250 $ 4,750 $ 500

TIP: If having a baby, reduce your cost by $300 by enrolling in UMR Maternity Management program in your first trimester.

* Reduce by $1400 if you are eligible for the wellness reward

John is 66 and goes to the doctor for his annual physical. The doctor orders blood work, chest x-ray and provides a Shingles vaccine.

– This visit should cost John $0 because annual preventive care visit is covered at 100%. (Shingles vaccine is covered starting at age 60.)

– But if John receives this vaccine by an out-of-network provider, the plan pays $0 and John must cover the full expense.

Benefit Scenario - John

Mary takes her teen daughter to their family doctor for suspected strep throat. The doctor does a throat culture and sends it to the lab.

– IN-NETWORK: This visit would be subject to the PCP copay ($35) and the lab work would be subject to the deductible + coinsurance, as this is a diagnostic service. Average cost of throat culture lab strep test is $23. Member would be responsible for $58.

– UAMS SmartCare: $43 ($15 savings on the PCP copay)

Benefit Scenario - Mary

Sue has diabetes. She sees her Endocrinologist quarterly to ensure her diabetes is controlled. At each visit the doctor orders a basic metabolic panel lab test.

– IN-NETWORK: Sue would be responsible to pay the specialist copay of $50. The diagnostic testing would be subject to deductible + coinsurance. The average cost of this lab test is $24. Sue would be responsible for $74.

– UAMS SmartCare: $59 ($15 savings on the Specialist copay)

Benefit Scenario - Sue

James is on vacation with his spouse in 2016. The spouse has a suspected stroke. The ambulance takes her to the nearest hospital where she is admitted. The hospital bill is $45,000.

– All of the services, regardless of the hospital’s network affiliation (because this was an emergency), are subject to in-network deductible + coinsurance. The member reached her medical Maximum Out of Pocket and is responsible to pay $3,850, the lower amount because James completed wellness (otherwise would have been $5,250).

– UAMS SmartCare: $500 savings not applicable unless they were admitted to UAMS

Benefit Scenario - James

Tim doesn’t feel well and suspects he has the flu. He drives himself to the emergency room. They provide Tim with care instructions and send him home. This is Tim’s 3rd ER visit of the year.

– Tim is responsible to pay $250 ER copay.

– UAMS SmartCare savings do not apply to ER visits.

Benefit Scenario - Tim

David receives a steroid injection in his knee. He sees an in-network specialist for the service.

– IN-NETWORK: David will pay the specialist office copay of $50 + the injection will be subject to deductible and coinsurance. The average cost of this injection is $235. David would be responsible for $285.

– UAMS SmartCare: $270 ($15 savings on the specialist copay)

Benefit Scenario - David

Patty receives allergy shots for her seasonal allergies.

The standard allergy shots are covered at 100% after the office visit copay. Depending on where Patty receives the allergy shot will depend on the copay applied.

OUTLIERS:• Some providers do not charge an office visit copay for allergy shots.• Some injections for allergies may not be the standard allergy shot. If

this is the case, the services may be subject to deductible + coinsurance.

– For example, if a member receives steroid therapy as part of their allergy treatment, that would be subject to deductible + coinsurance.

Benefit Scenario - Patty

Medical insuranceWhat you need to do

• Changes you can make:– Enroll as a new member– Add eligible family members – Drop dependents or drop all coverage

TIP: first make sure other coverage is in place

– Change between Classic and Point of Service• Send forms to Human Resources by Dec 1

Changes take effect 1-1-2016. Forms available at Open Enrollment website and in our office on main campus and at ACH.

Can your spouse get insurance through their job?

• In case you heard the rumor…

• …yes, the University of Arkansas considered adding a “working spouse exclusion” in 2016, similar to State of Arkansas.

• But it’s been delayed.

• For now your working spouse can remain on your UA medical and dental plans.

Everyone must have health insurance It’s the law

You will get Form 1095-C by Feb 1. Shows if you were offered coverage by UAMS and if you and your dependents were enrolled. You’ll refer to it when you do your taxes.

This information will also be reported to the IRS.

Dental insuranceWhat’s new for 2015?

• No changes• Remember that twice a year* check-ups

and cleanings are covered in full. Have you made your appointment?

* Those with diabetes or heart disease, are pregnant, or have a history of periodontal disease may be eligible for up to 4 cleanings a year.

Dental insuranceWhat you need to do

Changes you can make:– Enroll as a new member– Add eligible family members (especially young children you

may not have added when they were born)– Drop dependents or all coverage

Send forms to Human Resources by Dec 1Changes take effect 1-1-2016.

Vision planWhat’s new?

• Coverage and premiums the same• Still have two plans to pick from: Basic or

EnhancedDetails about the two plans on our website and in Open Enrollment Guide

• If you have a vision impairment, this plan helps lower your costs for frames, lenses and contacts

• Best benefit if you go to a provider in the Superior Vision network. UAMS Jones Eye Clinic is in the network. Eye exam will be filed under medical with $20 copay. But if you also have vision coverage, UMR will work with Superior Vision to have the $10 difference in copay reimbursed to you after-the-fact.

Vision plan What you need to do

Changes you can make:– Enroll as a new member– Add eligible family members – Drop dependents or all coverage – Change between Basic and Enhanced plans

Send forms to Human Resources by Dec 1Changes take effect 1-1-2016. Forms available on our website and in our office.

TIP: plan your 2016 healthcare FSA accordingly in regards to eyeglasses and contacts(You can’t double dip; what you run through your FSA has to be your true out-of-pocket cost after insurance pays.)

Section 125 Premium ConversionWhat you need to do

• Already pre-taxing your Medical/Dental/Vision premiums now and you want to keep it that way? Good, will automatically continue into 2016.

• If you want to change to have your premiums deducted on a pre-tax basis, complete the premium conversion form by Dec 1

• Or vice versa --you want to change from pre-tax to post-tax – fill out the same form by Dec 1

• Changes take effect first paycheck of 2016• FYI, most employees elect to pre-tax their premiums to reduce their taxes.

Risk is that you’re locked into that deduction and coverage for the calendar year unless you’re within 30 days of a qualifying event.

• Limited

• Must be within 1 month (31 days max) of a qualifying work/life event, such as:

Marriage Birth of childDivorce DeathSpouse’s job change which affects eligibility

• Check out our website or contact our officehttp://hr.uams.edu/benefits/how-when-to-enroll/

What changes can I make mid-year?

Flexible Spending AccountsWhat’s new?

• Maximum you can put into health care FSA increases from $2500 to $2550.

• No change to $5000 max for dependent care/daycare FSA (reduced to $2500 if you file married/separate)

• Keep your UMR benny card if you’re re-enrolling in a health care FSA for 2016. It will be reloaded with your new elected amount.

Flexible Spending AccountsWhat you need to do

• Consider if you (+ family you claim as tax dependents) will have out-of-pocket medical costs in 2016 to do a health care FSA.

• Consider if you will have daycare costs in 2016 to do a dependent care FSA

• If you’ve never participated in an FSA before or need a refresher, view “How FSA’s Work” on our website, http://hr.uams.edu/benefits/flex-plans/flexible-spending-account/.

• Once you’re comfortable with the FSA claim process, enroll on-line via Employee Self Service by Dec 1

Current participants: be sure to re-enroll if you want to participate next year.

FSA Deadlines

Claims for this year’s 2015 account– Healthcare FSA: expenses must be incurred by Dec 31. But you

have until Mar 31 to send paperwork to UMR. – Dependent care (daycare) FSA: expenses must be incurred by

Mar 15 (75 day grace period applies). Same Mar 31 deadline to send paperwork to UMR.

– IMPORTANT: March 31, 2016 remains the absolute deadline to file claims to UMR on your 2015 FSA money. Any money remaining on 4-1-2015 is forfeited (except for $500 healthcare carry-over).

– Be sure to send in documentation on your benny card purchases if UMR notifies you. IRS rules apply!

$500 Healthcare FSA Carry-Over

• If you have a balance left after the Mar 31 deadline to file claims...

• and it’s $500 or less…• It carries over into your 2016

FSA.

• You don’t lose it!• This only applies to healthcare,

not daycare

• No changes.• UAMS still provides Basic Life coverage equal to 1 x your

salary (up to max $50,000) on your life.• You can buy-up more coverage on your life by applying for

Optional Life. 1x, 2x, 3x or 4x salary up to $500,000.• You can buy-up coverage on your spouse and children by

applying for Dependent Life. $20,000 max on spouse, $10,000 max on children.

• NO open enrollment for Optional or Dependent Life. But can apply to the company through EOI at any time.

Life insurance What’s new?

• No change to Accidental Death & Dismemberment (AD&D) insurance.

• You can add or change this benefit at any time.

TIP: sign up for maximum coverage the month before you take a trip.

Life insurances What you need to do

No action required if you don’t have changes Changes you must make by Dec 1 deadline:

– None. – Can apply for additional coverage at any time of the year. Subject to

approval by the carrier. – Can drop or reduce coverage at any time of the year; takes effect end

of that month, effective end of the month

http://hr.uams.edu/forms/benefits-forms/

• Update your life insurance beneficiary through Human Resources. Form is on our website, http://hr.uams.edu/forms/benefits-forms/. Or visit our front desk on 4C of Central Building.

• Update retirement beneficiary directly with your plan sponsor: TIAA-CREF, Fidelity, APERS

Beneficiary up to date?

• NEW Short Term Disability (STD)• In the works, so look for future

announcement. Tentatively (subject to change)…

• Same 60% salary replacement benefit as Long Term Disability• Kicks in after run out of leave time and you’ve been off work

more than 2 weeks (versus 6 months for LTD). Payable on maternity!

• Through Standard, same insurance company that handles our life and LTD insurance.

• Will replace catastrophic leave

Disability Insurance What’s new?

• 60% salary replacement if you’re going to be off for more than 6 months

• Basic LTD - paid by UAMS on first $20,000 salary

• Optional LTD – employee buys up coverage on salary over $20,000 (up to $100,000 max). Max cost is $31.33 per month.

• Above not applicable to FGP members or Housestaff (they have separate coverage)

LTD (Long Term Disability)

Long Term Disability What you need to do

Changes you can make:– Take advantage of open enrollment!

Buy-up disability coverage on yourself by enrolling in Optional LTD.

– Send forms to Human Resources by Dec 1Changes take effect 1-1-2016. Forms available on our website and in our office.

You can drop LTD coverage at any time of the year, effective end of the month

• You can contact the carrier directly to apply for coverage:

– Liberty Mutual (home/auto)– CNA (long term care – ends Jan 31)– MetLife (critical illness)

http://hr.uams.edu/benefits/insurance-plans/

What about the voluntary insurances?

What about the UA retirement plan?

You can change how much you contribute at any time. Details and forms are on our web site. http://hr.uams.edu/benefits/retirement-plans/retirement-plans/

UAMS matches up to 10%. Try to do 10% so you enjoy the full match. Don’t pass up free money!

You can change your investments or beneficiaries at any time. Contact TIAA-CREF or Fidelity.

Have you considered the Roth option? Make after-tax contributions now, then qualified distribution later would be tax-free, including the earnings.

Other retirement changes?

No change on the IRS limits in 2016:

• Tax-deferred limit remains $18,000Even though Roth contributions are post-tax, they count towards your tax-deferred limit.

• X 2 = $36,000 because our plan is a combo 403(b) and 457(b) plan

• Add in $6,000 (x 2) if age 50 or older by Dec 31

• Means if you are age 50+, you could tax defer up to $48,000.

UAMS employer contribution

• Remains 5% minimum, 10% maximum at this time

• “Comp Limit” is $265,000. UAMS cannot match or contribute for the rest of the year once your salary reaches this amount.

Where to get forms, ask questions

Employee Benefits Fair– Wed, Nov 18, 9am to 3pm, ground floor Ed 2– ACH employees go to Children’s Hall on Thurs, Nov 19 for fair

conducted by UAMS Peds Dept Human Resources – Employee Services

– 4th floor Central Building, C wing– (501) 686-5650 or AskHR@uams.edu – ACH employees: visit the UAMS Pediatrics Office in the Sturgis

Building, 4th floor, Suite 4175 Visit our special Open Enrollment website. Link found on our HR web

site, hr.uams.edu.

• Please mark this date on your calendar• Human Resources must receive your forms by

close of business on Tuesday, December 1. Or if you are enrolling in an FSA, this is the last day you can enroll online.

• Sorry, we can’t accept any forms or late enrollment appeals after this date.

December 1, 2015 is the deadline !

• Try to turn in your enrollment forms as early as possible, before the Thanksgiving holiday.

– If you fax your form, be sure to keep your original copy and fax confirmation as proof.

– If you email your form, keep the original and read receipt. Send through UAMS email so it’s secure.

• Did you know that if you log into Employee Self Service, change the Benefits Participation date to 01-01-2016, you can confirm we have processed your benefit changes?

And lastly…