North Carolina Agricultural and Technical State University
2017 Benefits Open Enrollment
October 1 -31, 2016
North Carolina Agricultural and Technical State University
www.ncat.edu
Overview of Changes: Enrollment Process
NEW: ALL members and eligible dependents will be moved to the Traditional
70/30 Plan – effective January 1, 2017
»If members want coverage under a different plan, they MUST take action and
enroll in their preferred Plan.
»All passwords will be reset to social security number(without dashes and
spaces) beginning October 1, 2016.
Members MUST enroll electronically through https://ncat.hrintouch.com or
by calling Member Services at 855-859-0966. WRITE DOWN CONFIRMATION
NUMBER!
North Carolina Agricultural and Technical State University
www.ncat.edu
Overview of Health Plan Options
CDHP 85/15 with HRA Enhanced 80/20 Traditional 70/30
• High-deductible medical plan
• HRA offsets the deductible
• 85/15 coinsurance (after
deductible)
• $0 ACA Preventive Services
• $0 ACA Preventive
Medications
• CDHP Preventive Medication
List ($0 deductible)
• Wellness premium credits
reduce the employee premium
• Additional HRA funds for
visiting certain providers or
taking part in the Health
Engagement Program
• PPO plan
• Lower copays& coinsurance
• $0 ACA Preventive Services
• $0 ACA Preventive
Medications
• Wellness Premium Credits
reduce the employee
premium
• Reduced medical copay
opportunities
• PPO plan
• Higher copays, &
coinsurance
• No incentives available
• Copays applied to ACA
Preventive Services
• Applicable copays applied
to Preventive Medications
• $0 premium for employee
only coverage if subscriber
completes tobacco
attestation
North Carolina Agricultural and Technical State University
www.ncat.edu
Change Comparison Charts: Enhanced 80/20 Plan
B.O.D. = Blue Options Designated Provider
2016
In-Network
2017
In-Network
2017
Out-of-Network
Annual Deductible $700 Individual
$2,100 Family
$1,250 Individual
$3,750 Family
$2,500 Individual
$7,500 Family
Coinsurance
20% eligible expenses after
deductible
20% eligible expenses after
deductible
40% of eligible expenses after
deductible and the difference between
the allowed amount and the charge
Medical Coinsurance Max
Medical Out-of-Pocket Max
Pharmacy Out-of-Pocket Max
Total Out-of-Pocket Max
(Includes Deductible)
$3,210 Individual/
$9,630 Family
N/A
$2,500
N/A
N/A
$4,350 Individual
$13,050 Family
$2,500
$6,850 Individual
$14,300 Family
N/A
$8,700 Individual
$26,100 Family
$2,500
$11,200 Individual
$28,600 Family
ACA Preventive Services Covered at 100% Covered at 100% Dependent on Service
Office Visits
Selected PCP
Non-selected PCP
$15
$30
$10
$25
40% after deductible
Office Visits
B.O.D. Specialist.
Non-B.O.D. Specialist
$60
$70
$45
$85
40% after deductible
North Carolina Agricultural and Technical State University
www.ncat.edu
Change Comparison Charts: Enhanced 80/20 Plan
B.O.D. = Blue Options Designated Provider
2016
In-Network
2017
In-Network
2017
Out-of-Network
Urgent Care $87 $70 $70
Emergency Room (Copay waived w/
admission or observation stay)
$233, then 20% after deductible $300, then 20% after deductible $300, then 20% after deductible
Outpatient Hospital 20% after deductible 20% after deductible40% after deductible
Inpatient Hospital
B.O.D.
Non-B.O.D.
$0, then 20% after deductible
$233, then 20% after deductible
$0, then 20% after deductible
$450, then 20% after deductible $450, then 40% after deductible
Therapy Services (Chiro/PT/OT) $52 $52 40% after deductible
DrugsTier 1 (Generic)
Tier 2 (Preferred Brand & High-cost Generic)
Tier 3 (Non-preferred Brand)
Tier 4 (Low-cost/Generic Specialty)
Tier 5 (Preferred Specialty)
Tier 6 (Non-preferred Specialty)
Preferred Diabetic Supplies*
$12
$40
$64
N/A
25% up to $100
25% up to $132
$5
$30
Deductible/Coinsurance
$100
$250
Deductible/Coinsurance
$5
$5
$30
Deductible/Coinsurance
$100
$250
Deductible/Coinsurance
$5
*Non-preferred Diabetic Supplies will be priced at Tier 3.
North Carolina Agricultural and Technical State University
www.ncat.edu
Change Comparison Charts: CDHP 85/15 (No Change)2016
In-Network
2017
In-Network
2017
Out-of-Network
HRA Starting Balance $600 Employee
$1,200 Employee + 1
$1,800 Employee + 2 or more
$600 Employee
$1,200 Employee + 1
$1,800 Employee + 2 or more
$600 Employee
$1,200 Employee + 1
$1,800 Employee + 2 or more
Annual Deductible $1,500 Individual
$4,500 Family
$1,500 Individual
$4,500 Family
$3,000 Individual
$9,000 Family
Coinsurance 15% of eligible expenses after
deductible
15% of eligible expenses after
deductible
35% of eligible expenses after
deductible and the difference
between the allowed amount and the
charge
Coinsurance Maximum N/A N/A N/A
Out-of-Pocket Maximum
(Combined Medical and
Pharmacy)
Includes Deductible
$3,500 Individual
$10,500 Family
$3,500 Individual
$10,500 Family
$7,000 Individual
$21,000 Family
ACA Preventive Services Covered at 100%Covered at 100% 65% after deductible
Office Visits
Selected PCP
Non-selected PCP
15% after deductible+$25 HRA
credit
15% after deductible+$20 HRA
credit if a B.O.D provider
15% after deductible+$25 HRA
credit
15% after deductible+$20 HRA
credit if a B.O.D provider
35% after deductible
B.O.D. = Blue Options Designated Provider
North Carolina Agricultural and Technical State University
www.ncat.edu
Change Comparison Charts: CDHP 85/15 (No Change)
B.O.D. = Blue Options Designated Provider
2016
In-Network
2017
In-Network
2017
Out-of-Network
Office Visits
B.O.D. Specialist
Non-B.O.D. Specialist
15% after deductible+$20 HRA
credit (for B.O.D.specialists.
15% after deductible
15% after deductible+$20 HRA
credit (for B.O.D.specialists.
15% after deductible
35% after deductible
Urgent Care 15% after deductible 15% after deductible 15% after deductible
Emergency Room 15% after deductible 15% after deductible 15% after deductible
Outpatient Hospital 15% after deductible 15% after deductible 35% after deductible
Inpatient Hospital
B.O.D.
Non-B.O.D.
15% after deductible. + $200
HRA Credit for B.O.D. Hospitals
15% after deductible
15% after deductible. + $200
HRA Credit for B.O.D. Hospitals
15% after deductible
35% after deductible
Therapy Services (Chiro/PT/OT)15% after deductible 15% after deductible 35% after deductible
Drugs
15% after deductible
CDHP Maintenance Medications
are deductible exempt
15% after deductible
CDHP Maintenance Medications
are deductible exempt
35% after deductible
CDHP Maintenance Medications
are deductible exempt
North Carolina Agricultural and Technical State University
www.ncat.edu
Health Engagement Program for CDHP Members The Health Engagement Program offers additional Health Reimbursement Account funds for
CDHP members who engage to help offset their health care expenses. There are two
components:
»The Healthy Lifestyles Program is an incentive-based program designed to encourage all
CDHP members to engage in healthy behaviors
»Positive Pursuits offers CDHP members with certain conditions an opportunity to earn
even more in the HRA for actively managing their condition
New for 2017!
Members will have more activities in which to earn
incentives with RivalHealth! RivalHealth is a fitness-
based wellness platform that engages members with
daily exercise and nutrition activities as well as social
interaction and challenges.
Currently it’s available to CDHP members and qualifying
Wellness Champions worksites. In 2017, CDHP members
can earn HRA funds through completed activities.
North Carolina Agricultural and Technical State University
www.ncat.edu
Change Comparison Charts: Traditional 70/30 Plan2016
In-Network
2017
In-Network
2017
Out-of-Network
Annual Deductible $1,054 Individual
$3,162 Family
$1,080 Individual
$3,240 Family
$2,160 Individual
$4,320 Family
Coinsurance 30% of eligible expenses after
deductible
30% of eligible expenses after
deductible
50% of eligible expenses after
deductible and the difference
between the allowed amount and the
charge
Medical Coinsurance Max
Pharmacy Max
Out-of-Pocket Max
(Includes Deductible)
$4,282 Individual/$12,845 Family
$3,294
N/A
$4,388 Individual/
$13,164 Family
$3,360
N/A
$8,776 Individual/
$26,328 Family
$3,360
N/A
ACA Preventive ServicesCost-Sharing Applies ($39 for
Primary Care/$92 for Specialists)
Cost-Sharing Applies
($40 for Primary Care
$94 for Specialists)
Only certain services are covered
Office Visits
PCP Copay$39 $40 50% after deductible
Office Visits
Specialist Copay$92 $94
50% after deductible
North Carolina Agricultural and Technical State University
www.ncat.edu
Change Comparison Charts: Traditional 70/30 Plan2016
In-Network
2017
In-Network
2017
Out-of-Network
Urgent Care $98 $100$100
ER (Copay waived w/ admission or
observation stay)
$329, then 30% deductible $337, then 30% deductible $337, then 30% deductible
Outpatient Hospital 30% after deductible 30% after deductible50% after deductible
Inpatient Hospital $329, then 30% deductible $337, then deductible/30%
coinsurance
$337, then deductible/50%
coinsurance
Therapy Services (Chiro/PT/OT) $72 Copay $72 Copay 50% after deductible
Drugs
Tier 1 (Generic)
Tier 2 (Preferred Brand & High-cost Generic)
Tier 3 (Non-preferred Brand)
Tier 4 (Low-cost/Generic Specialty)
Tier 5 (Preferred Specialty)
Tier 6 (Non-preferred Specialty)
Preferred Diabetic Supplies*
$15
$46
$72
N/A
25% up to $100
25% up to $132
$16
$47
$74
10% up to $100
25% up to $103
25% up to $133
$10
$16
$47
$74
10% up to $100
25% up to $103
25% up to $133
$10
*Non-preferred Diabetic Supplies will be priced at Tier 3.
North Carolina Agricultural and Technical State University
www.ncat.edu
Tobacco Wellness Premium Credit: NEW for 70/30 Plan
ACTIVE members who enroll in the 70/30 Plan MUST do the following in order to
receive coverage premium-free for employee-only coverage in 2017:
Attest to being tobacco-free OR enroll in QuitLineNC by Oct. 31, 2016.
This premium credit only applies to the employee-only premium.
This credit opportunity does not apply to spouses, dependents, non-Medicare or
Medicare-eligible retirees.
North Carolina Agricultural and Technical State University
www.ncat.edu
Wellness Premium Credit Opportunities
Active members have three opportunities to earn Wellness Premium Credits if enrolled in the CDHP
85/15 and 80/20 Plans:
»Attest to being tobacco-free OR enroll in QuitLineNC
»Select Primary Care Provider(PCP) for all covered members
»Complete Health Assessment if not completed on or after MAY 1, 2016
For each of these actions, the member earns reductions on his or her premiums.
Wellness premium credits apply only to the employee-only premium.
New hires MUST re-attest to being tobacco-free during Open Enrollment even though they might
have just enrolled.
This tobacco-free attestation is separate from the tobacco question included in the Health
Assessment. NOTE: Completing the Health Assessment does not count as completing the
attestation.
North Carolina Agricultural and Technical State University
www.ncat.edu
Wellness Premium Credit Amounts for 2017
CDHP 80/20
Plan
70/30
Plan
Attest to being tobacco-free OR enroll
in QuitlineNC
$40 $40 $40
Choose/confirm a Primary Care
Provider (PCP)
$20 $25 N/A
Complete the Health Assessment $20 $25 N/A
TOTAL CREDITS AVAILABLE FOR 2017 $80 $90 $40
North Carolina Agricultural and Technical State University
www.ncat.edu
2017 State Health Plan Premiums
Plan Coverage Level
Traditional
70/30 Plan
Enhanced 80/20
Plan
Consumer-Directed
Health Plan 85/15
Employee $0.00* $15.04* $0.00*
Employee & Child(ren) $218.14* $290.14* $196.32*
Employee & Spouse $562.10* $668.48* $505.90*
Employee & Family $598.70* $708.72* $538.82**If you complete the wellness activities, you pay this lower cost.
North Carolina Agricultural and Technical State University
www.ncat.edu
New Pharmacy Benefit Manager
As of January 1, 2017, the new Pharmacy Benefit Manager will be CVS/Caremark.
Members will receive communication regarding what steps to take.
ALL members WILL RECEIVE a new Pharmacy ID Card. The 2016 card WILL NOT work in 2017–
members MUST use the NEW CVS/Caremark card.
Advantages
Members will have access to the CVS/Caremark online drug lookup tool during Open Enrollment.
This tool enables members to look up and compare the costs of various drugs – especially useful for
those enrolled in the CDHP 85/15.
North Carolina Agricultural and Technical State University
www.ncat.edu
New Pharmacy Tier for Diabetic Testing Supplies
Drugs Traditional 70/30 Plan Enhanced 80/20 PlanConsumer-Directed
Health Plan 85/15
Tier 1 (Generic) $16 $5
Preferred brands fall under
CDHP Preventive List –
deductible is waived
Tier 2 (Preferred Brand & High-cost Generic) $47 $30
Tier 3 (Non-preferred Brand) $74 Deductible/Coinsurance
Tier 4 (Low-cost/Generic Specialty) 10% up to $100 $100
Tier 5 (Preferred Specialty) 25% up to $103 $250
Tier 6 (Non-preferred Specialty) 25% up to $133 Deductible/Coinsurance
Preferred Diabetic Supplies*
(e.g. Test Strips, Lancets, Syringes,
Needles)
$10 $5
*Non-preferred Diabetic Supplies will be priced at Tier 3
• There will be a new tier added for Preferred Diabetic Supplies
• Enhanced 80/20 Preferred Diabetic Tier copay will equal the Tier 1 copay
• Traditional 70/30 Preferred Diabetic Tier copay will remain at $10 (Tier 1 is $16)
North Carolina Agricultural and Technical State University
www.ncat.edu
Dental Plan
New vendor - MetLife
Coverage Level Change: Employee + Child to just Employee + Child(ren)
High Option Annual Max INCREASED to $5,000
New Lower Rates
Employee Only Employee and
Spouse
Employee and
Child(ren)
Family
High Option $36.10 $72.40 $78.20 $123.70
Low Option $21.22 $42.78 $45.94 $ 73.22
North Carolina Agricultural and Technical State University
www.ncat.edu
VISION
No Changes
$20 copay for vision exams; $40 copay for contact lenses fitting
CORE WELLNESS: FREE FOR EMPLOYEES ONLY
Coverage Level Employee Only Employee and Family
Core Wellness Exam $0.00 N/A
Basic Plan $5.56 $15.46
Enhance Plan $8.58 $22.88
North Carolina Agricultural and Technical State University
www.ncat.edu
FLEXIBLE SPENDING ACCOUNT
Healthcare: $120 - $2,550 Annually
»Funds are available on January 1
»Members can use convenience card for medical expenses(deductibles, copays, prescriptions, vision
materials, dental services, etc.)
»Contributions can be used for medical expenses for eligible dependents within same household
(spouse and dependent children).
Dependent Daycare: $120 - $5,000 Annually
» Dependent children 12 and under or adult daycare.
USE IT OR LOSE IT:
»Employees have until March 15, 2018 to incur expenses for his/her 2017 election.
»Claims MUST BE submitted by April 30, 2018
Requires annual enrollment – employees currently enrolled for 2016 plan year MUST RE-
ENROLL
North Carolina Agricultural and Technical State University
www.ncat.edu
CRITICAL ILLNESS
New $25,000 Limit Option
Plan pays lump-sum payment per diagnosis for three categories:
»Heart
»Cancer
»Other – Transplants
Eligible dependent child(ren) – No cost
Employee/Spouse
Age<25 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80+
$15,000 $1.30 1.40 2.60 4.10 7.40 12.00 18.60 27.80 42.60 64.20 84.40 101.40 119.50
$25,000 2.18 2.34 4.34 6.84 12.34 20.00 31.00 46.34 71.00 107.00 140.66 169.00 199.18
North Carolina Agricultural and Technical State University
www.ncat.edu
CANCER & SPECIFIED DISEASES
No Evidence of Insurability(EOI) required
Annual wellness benefit for employee and family
Coverage Level Employee Only Employee and Family
Low Option $6.38 $10.56
High Option $15.18 $25.16
Premium Option $20.28 $33.54
North Carolina Agricultural and Technical State University
www.ncat.edu
Term Life Insurance
Guaranteed Issuance (GI) for employee is $200k
Employees may increase $10k or $20k at annual enrollment without submitting Evidence of
Insurability(EOI) up to GI amount.
Spouse coverage remains the same
»Enroll in $50k without submitting EOI
»Increase $10k during annual enrollment
New Lower Rates
Age 0-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75+
$1,000 $.04 .05 .07 .08 .09 .13 .22 .40 .64 1.27 2.06 2.06
Per Dependent Unit
$5,000
$10,000
$0.68
$1.36
North Carolina Agricultural and Technical State University
www.ncat.edu
ACCIDENTAL DEATH & DISMEMBERMENT• New vendor – Voya
• Voya Travel Assistance if you or family are traveling 100 miles away from your home.
CORE
Remains the same – $10,000 coverage FREE for EMPLOYEE ONLY
VOLUNTARY
New coverage levels in $50k increments
Employees will be moved to next plan level.
New Lower Rates
Coverage Level Employee Only Employee and Family
$50,000.00 $0.85 $1.35
$100,000.00 $1.70 $2.70
$150,000.00 $2.55 $4.05
$200,000.00 $3.40 $5.40
$250,000.00 $4.25 $6.75
$300,000.00 $5.10 $8.10
$350,000.00 $5.95 $9.45
$400,000.00 $6.80 $10.80
$450,000.00 $7.65 $12.15
$500,000.00 $8.50 $13.50
North Carolina Agricultural and Technical State University
www.ncat.edu
TRICARE
Must be enrolled in a TRICARE Standard/Extra, Prime or TRS benefits offered through military
community to be eligible for this plan.
Plan pays a benefit for costs not covered by TRICARE
Both plans work together to maximize your benefits and minimize out-of-pocket expenses.
Coverage Level Total
Employee Only $60.50
Employee and Spouse $119.50
Employee and Children $119.50
Employee and Family $160.50
North Carolina Agricultural and Technical State University
www.ncat.edu
HOW TO ENROLL
Electronically: https://ncat.hrintouch.com
LOGIN by default: First name, First initial of Last Name, Last 4 digits of SS#
Reminder: Passwords will be reset to social security number(no dashes or spaces) effective October 1, 2016.
SAVE YOUR CHANGES – WRITE DOWN CONFIRMATION NUMBER
Member Services: 855-859-0966
Additional Resources:
Health Assessment – www.myactivehealth.com or 800-817-7044
State Health Plan – www.shpnc.org
NCFlex – www.ncflex.org
North Carolina Agricultural and Technical State University
www.ncat.edu
NAVIGATION ASSISTANCE
October 3 8:00-5:00 Wendover Bldg, Computer Lab
October 5 8:00-5:00 General Classroom Bldg, A213
October 7 8:00-5:00 Wendover Bldg, Computer Lab
October 11 8:00-5:00 Wendover Bldg, Computer Lab
October 12 8:00-5:00 General Classroom Bldg, A213
October 14 8:00-5:00 Wendover Bldg, Computer Lab
October 19 8:00-5:00 General Classroom Bldg A213
October 25 10:00-2:00 Wendover Bldg, Computer Lab
October 26 8:00-5:00 General Classroom Bldg, A213
October 27 10:00-2:00 Wendover Bldg, Computer Lab
North Carolina Agricultural and Technical State University
www.ncat.edu
Who To Contact
Jeanette Foulks
Benefits Counselor
336-285-3793
Denika Waters
Benefits Assistant
336-285-3789
LaRita Burks
Benefits Manager
336-285-3788