AGENDA Registration (Wellness Nurses Available)…………………………………………………………..…… 8:00 AM Welcome…………………………………………………………………………………………………..…… 9:00 AM I. SEIB and Healthcare Reform Overview (Page 3)..…………………………………………………… 9:15 AM SEIB II. Deferred Comp Plan Options………………………………………………………………………….. 10:15 AM Great West Retirement Solutions Break (Wellness Nurses Available)………………………………………………………………..…….. 10:25 AM III. Alabama Retired State Employees’ Association (ARSEA)……………………………………….10:45 AM IV. Supplemental and Southland (Page 24)……………………….…………………………………... .10:50 AM SEIB V. Wellness (Page 42).……………………………………………………………………………..…….....11:20 AM SEIB VI. SEIB Wellness Center & Pharmacy (Millbrook Only)……………………………………………..11:40 AM Lunch (On your own)…………………………………………………………………………….…….. ….12:10 PM VII. Retirement Benefits Overview…….……………………………………………………...…………...1:25 PM Retirement Systems of Alabama VIII. SEHIP Online Enrollment……………………………………………………………….………….. …2:05 PM SEIB IX. Deferred Comp Plan Options………………………………………………………..………………. .2:35 PM Retirement Systems of Alabama Break…………………………………………………………………………………………………..……. ….2:45 PM X. Alabama State Employees’ Association (ASEA)…………………………………….……………… 3:05 PM XI. Retirees (Page 53).……………………………………………………………………………………….3:10 PM SEIB XII. Flexible Benefits Plan (Page 68).………………………………….………………...………………..3:40 PM SEIB Program Concludes………………………………………………………………………...………………..4:20 PM State Employees’ Insurance Board 2013 Benefits Conference 1
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AGENDARegistration (Wellness Nurses Available)…………………………………………………………..…… 8:00 AMWelcome…………………………………………………………………………………………………..…… 9:00 AMI. SEIB and Healthcare Reform Overview (Page 3)..…………………………………………………… 9:15 AM SEIBII. Deferred Comp Plan Options…………………………………………………………………………..10:15 AM Great West Retirement SolutionsBreak (Wellness Nurses Available)………………………………………………………………..…….. 10:25 AMIII. Alabama Retired State Employees’ Association (ARSEA)……………………………………….10:45 AMIV. Supplemental and Southland (Page 24)……………………….…………………………………... .10:50 AM SEIB V. Wellness (Page 42).……………………………………………………………………………..…….....11:20 AM SEIBVI. SEIB Wellness Center & Pharmacy (Millbrook Only)……………………………………………..11:40 AMLunch (On your own)…………………………………………………………………………….…….. ….12:10 PMVII. Retirement Benefits Overview…….……………………………………………………...…………...1:25 PM Retirement Systems of AlabamaVIII. SEHIP Online Enrollment……………………………………………………………….………….. …2:05 PM SEIBIX. Deferred Comp Plan Options………………………………………………………..………………. .2:35 PM Retirement Systems of AlabamaBreak…………………………………………………………………………………………………..……. ….2:45 PMX. Alabama State Employees’ Association (ASEA)…………………………………….……………… 3:05 PMXI. Retirees (Page 53).……………………………………………………………………………………….3:10 PM SEIBXII. Flexible Benefits Plan (Page 68).………………………………….………………...………………..3:40 PM SEIBProgram Concludes………………………………………………………………………...………………..4:20 PM
State Employees’ Insurance Board2013 Benefits Conference
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NEW ADDITIONS
A LIST OF INSURANCE COMPANIES ELIGIBLE FOR PAYROLL DEDUCTION
A LIST OF PAYROLL DEDUCTION CODES ADMINISTERED BY THE SEIB
A LIST OF NEARBY RESTAURANTS
A CERTIFICATE OF COMPLETION
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STATE EMPLOYEES’ INSURANCE BOARD
BOARD MEMBERS AND COMMITTEES
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SEIB BOARD MEMBERSAppointed By Position/ Name TermGovernor Personnel Board Member
Elected Active Employee RepresentativeRobert Wagstaff
4 year term
Elected Active Employee RepresentativePaige Hebson
4 year term
Elected Retiree RepresentativeWilliam Mellown
4 year term
Elected Retiree RepresentativeRobert Pickett
4 year term
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Premium and Benefit Committee
Acting Finance DirectorBill Newton
Active Employee RepresentativePaige Hebson
Retired Employee RepresentativeRobert Pickett
This committee recommends benefit and premium changes to the SEIB.
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STATE EMPLOYEES’ HEALTH INSURANCE PLAN
PLAN OVERVIEW
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2005 Legislative Changes
State authorizes Board to offer supplemental coverage in lieu of the basic medical plan.
State requires retirees to take other-employee coverage, if offered.
State extends supplemental and optional coverages and provides a sliding premium
scale to retirees, based on years of service.
State requires Board to provide discounted coverage for low income active and retired
employees and their dependents.
State approves non-tobacco user discounts.
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2008
Increased Dental maximum from $1000 to $1500 per covered member.
Medicare retirees enrolled in Medicare Advantage Plan.
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2009
Wellness Participation Discount Program adopted. All active employees screened
during 2009 received the Wellness Participation Discount of $25 per month in
2010.
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2010
Effective October 1, 2010, timing of the State's premium payments
changed.
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2011Plan Changes
Implemented annual wellness screenings for all active employees to receive the Wellness Participation Discount.
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2012 Legislative Changes
Board can adjust premiums for spouse’s eligibility for other coverage.
Retirees must have at least 10 years of creditable coverage to be eligible for retiree health coverage.
Cancellation of coverage for fraudulent claims.
FPL discount increased to 300%.
Retiree premiums increased 1% per year for every year prior to Medicare age.
Sliding scale adjusted to charge a 4% per year penalty for less than 25 years of creditable coverage.
Contribution for non-Medicare retirees cannot exceed contribution for active employees by October 1, 2016.
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SEIB Premium Rate HistoryYEAR STATE
SHARE**INDIVIDUAL
PREMIUMDEPENDENT PREMIUM
1975 15.70 0.00 30.75
1980 32.43 0.00 51.77
1985 100.00 0.00 82.50
1990 195.00 0.00 141.00
1995 255.00 0.00 164.00
2000 357.00 0.00 164.00
2005 650.00 0.00 164.00
2010 805.00 15.00* 205.00*
2012 805.00** 15.00* 205.00*
2013 825.00 15.00* 205.00* *Premium shown includes non-tobacco user’s discount and wellness discount. **State share does not reflect credits returned to agencies.***Premiums do not include dental coverage.
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2014 Premium ChangesActive Employee
Single Increase $5Family Increase $5
Early RetireeSingle Increase $15Family Increase $25
The BCBS Supplemental coverage supplements primary health insurance plans
by covering the copay, coinsurance, deductible
that the primary insurance plan does not pay at 100%.
The primary coverage’s deductible cannot exceed $1,250 for individual coverage or
$2,500 for family coverage.
What Is The BCBS Supplemental?
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Enrollment Requirement for the BCBS Supplemental
To be eligible, members must be able toenroll in another health insurance plan
through a spouse, other, or previous employer.
Primary plans NOT eligible:SEHIP (Group 13000)
Local Government Health Insurance Plan (Group 30000)Public Education Employees’ Health Insurance Plan (Group 14000)
TricareMedicare
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Cost of the BCBS Supplemental
Individual Coverage - $0*Family Coverage - $0*
*The tobacco user premium will be waived and the annual wellness check
is not mandatory.
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ExampleA married state employee has a spouse employed
with an auto manufacturer. The spouse elects family health insurance coverage offered through
his employer.
With the primary health insurance now provided through the auto manufacturer, the state
employee can enroll in the BCBS Supplemental, on the first day of the following month.
The BCBS Supplemental will eliminate copays, coinsurance, and deductible (up to a maximum) not covered at 100% by the auto manufacturer’s
coverage.
Remember, the BCBS supplemental is free for individual and family coverage.
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Advantages to enrolling in the BCBS Supplemental
The coverage is free of charge for individual and family coverage.
If the primary insurance does not provide dental coverage, members are eligible to enroll in the individual dental plan ($3) or the family dental plan ($8) offered through BCBS of AL or Southland National
BCBS Supplemental will pay health and pharmacy copays, coinsurance, and deductibles (up to a maximum) that the primary plan does not pay at 100%.
The member can move back to the BCBS basic medical plan on the first day of any month.
Everyone covered under the supplemental is eligible for benefits offered through the SEIB Wellness Program.
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PharmacyPharmacy:
To receive reimbursement on pharmacy benefits, the member should complete a BCBS Medical Expense Claim form (available at www.alseib.org) and attach pharmacy receipt(s).
Pharmacy claims may also be filed online at www.bcbsal.org with reimbursements eligible to bedirect deposited into the member’s personal checking or savings account.
Southland Optional PlanDental, Vision, Hospital Indemnity, and Cancer
State Employees’ InsuranceBoard
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The Southland Optional Plan providesDental and Vision Coverage
Cancer and Hospital Indemnity Coverage
What Is The Southland Optional Plan?
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Cost for the Southland Optional Plan
Individual Coverage - $0*Family Coverage - $0*
*The tobacco user premium will be waived and the annual wellness check is not mandatory.
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Enrollment Requirement for the Southland Optional Plan
The SEHIP member must be eligible for primary health insurance through a spouse or other employer.*
*Primary plans not eligible: SEHIP (Group 13000)
Tricare (SEHIP retirees are the only exception.)Medicare
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The Southland Optional Plan is not designed to pay copays/deductibles not covered at 100% by your primary health insurance.
It does however provide dental, vision, hospital indemnity, and cancer benefits.
How is the Southland Optional Different than the BCBS Supplemental?
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The Southland Claims Process
Vision Benefits are the same, regardless of
provider. The provider or the member can file the
claim.
Dental Any dentist can be used. However, if a
provider in the DentaNet network is used, the member will save money on expenses over the allowed amount.
DentaNet is the second largest dental network in Alabama.
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The Southland Claims Process
Hospital Indemnity and Cancer These coverages work as a supplemental
to the member’s income; The amounts of reimbursement are
determined by the procedure, admission, diagnosis, etc. The member will file the claim and reimbursement will be mailed directly to them;
Payment or coverages of the primary health insurance do not affect the reimbursement amount.
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Advantages to enrolling in the Southland Optional Plan
This plan includes dental, vision, hospital indemnity and cancer coverages, all in one.
There is no premium for individual or family coverage.
The dental benefits exceed those offered through the SEHIP BCBS dental plan.
Southland is the sole dental provider for the Public Education Employee Health Insurance Plan (PEEHIP).
This plan can serve as the primary dental and vision benefits plan or supplement the out-of-pocket expenses that a member’s primary dental and vision plans do not cover.
There are no pre-existing conditions for the hospital indemnity or cancer coverage. In addition, reimbursements are paid directly to the insured.
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Things To Remember
• A minimum enrollment period of 12 months is required.
• After the12-month requirement has
been met, the member can return to the SEHIP during Open Enrollment (November 1-30) with a January 1 effective date.*
*PEEHIP members are eligible to make enrollment changes during the PEEHIP Open Enrollment
period (July-August) with a October 1 effective date.
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Southland Vision Supplemental
Premium is $24 per month, regardless of number of dependents. New employees may enroll within 60 days from date of employment.
Existing employees should enroll during Open Enrollment (November 1-30) with a January 1 effective date. Contract will remain in place unless cancelled by member during Open Enrollment.
This benefit will coordinate with the SEIB Discount Routine Vision Care Network .
Members are screened for the following risk factors
Blood pressure At risk if systolic reading is 160 or higher or your diastolic reading is 100 or higher
CholesterolAt risk if 250 or higher
GlucoseAt risk if 200 or higher
Body mass index At risk if 35 or higher
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At-Risk Members
If determined at-risk, the member will receive a copay waiver and physician referral form for follow-up. The member may receive the
monthly discount by doing one of the following:
Submit an office referral form indicating that you have been counseled by a healthcare provider for your identified risk(s), or
Submit a completed physician certification form. It’s a good idea to
have your physician complete and sign your form while you are in for an office visit. Then you can mail or fax to us and have the peace of mind knowing that your discount is in place, or
Submit proof of participation in an approved exercise facility or SEIB approved program. Provide dates and location of participation, or
Provide proof that you are self-managing and have made improvement in your identified risk(s). You must provide documentation of your improvement.
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Approved SEIB Wellness Program Exercise Facilities
No contract agreementMonthly dues are payroll deducted
No signing fee
All memberships should be executed directly with the facility. The enrollment and payroll deduction information will be forwarded from the facility to the SEIB monthly.
For location and rate information, visit our website at www.alseib.org or click here.
Just a Few Things You Need To Know To Receive The Wellness Discount New employees, and their covered spouse, must
participate in a wellness screening or submit a physician certification form within 60 days from their date of employment.
All active employees, their covered spouse, non-Medicare retirees and their covered spouse are required to have a screening/physician certification on or before November 30th of each year.
A State employee can participate in a screening offered by the SEIB, regardless of location.
Refunds will not be given for failure to submit appropriate information by deadline dates.
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Verifying Discount
To ensure the discount of $25 per month has been applied to your contract you can: Visit our website at www.alseib.org to
create and view your account information.
Call the SEIB Wellness Division at (866) 838.3059.
Members and their covered spouse may receive a reimbursement of 80% of the cost of a non-covered tobacco cessation product up to $150 lifetime maximum.
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Physician Weight Management Program
Covered SEHIP members can receive 80%, up to $150 annually for non-covered
weight management programs that are overseen by a physician.
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Hearing Aid BenefitThe $100 reimbursement for hearing aids
will no longer be available beginning January 1, 2014.
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Reimbursement Process
To receive reimbursements for both tobacco cessation and weight management,
receipts should be:
Mailed: PO Box 304900, Montgomery, AL 36104
Faxed: (334) 517-9980
Be sure to include name, contract number, and date of birth on all correspondence.
Have Your New, Existing, and Retiring Employees Contact Their SEIB Benefit Advisor For Plan and Benefit Information
*Premiums shown include the $50 non-tobacco user’s discount.**BlueRx copays will increase $5 per prescription beginning January 1, 2014
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Retiree Premium Sliding Scale
For every year of service under 25, the retiree share will be increased by 4%.For every year of service over 25, the retiree share will be reduced by 2%.
Years of service (YOS) certified through RSA may differ from years eligible under SEIB.
Participation in ERS does not necessarily mean your YOS will count towards your insurance
premium.
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Medicare Eligibility
A retiree will have a 1% increase for every year they are away from Medicare
eligibility.
Example: A 55 year old retiree will see a 10% increase in their health insurance premium because
they are 10 years away from age 65, or Medicare eligibility.
The percentage will remain the same until the member reaches Medicare eligibility.
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To Determine Premium at Retirement
Visit the SEIB website at www.alseib.org and use the Retiree Premium Calculator to
estimate premiums at retirement. Or you can click here to automatically be
goes to work for another employer and is eligible for coverage with the new
employer and the new employer pays 50% or more of
the individual premium.
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Available For Those Who Have Other Coverage
Blue Cross Blue Shield Supplemental Picks up co-pays and deductibles that your
primary insurance does not pay at 100%, subject to a maximum deductible.
Southland Optional PlanProvides dental, vision, hospital indemnity and cancer coverage
Both of these plans are free for theretiree and their eligible dependents,
regardless of age and/or years of service.
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Retired State Employees Who Return to Work With the State of Alabama
Medicare eligible retirees returning to work:
Are classified as a non-Medicare retiree.
The employer is subject to the non-Medicarepremium for the individual.
The member is responsible for the non-Medicarepremium for the dependent.
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Retirees on Medicare
Retirees should contact theirSEIB Advisor for information onSEHIP benefits and premiumsand coordination of benefits
with Medicare.
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Status Changes
After retirement, the retiree becomes responsible for notifying the SEIB of any
changes to their health insurance
contract.
65Surviving Spouse Coverage
When a SEHIP member with dependent
coverage dies: SEIB should be notified and the necessary forms
should be submitted within 90 days of the date of death;
Surviving spouses, and their covered dependents, will be eligible to continue coverage if they were covered at the time of death;
Eligible spouse should make the appropriate monthly premium payments to SEIB.
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Just so you know…
The Wellness Discount is not applicable to Medicare eligible retirees and their Medicare eligible covered dependents. However, Medicare eligible SEHIP members are eligible to attend Worksite Wellness Screenings.
The Southland Vision Supplemental Plan is available to both active and retired employees.
Retirees should not opt out of the SEHIP without speaking with an SEIB advisor about the BCBS Supplemental or Southland Optional.
Have Your New, Existing, and Retiring Employees Contact Their SEIB Benefit Advisor For Plan and Benefit Information
Determine the amount needed for out-of- pocket medical expenses for the upcoming year that include: Physician copays Prescription copays Over-the-counter medications (ONLY with doctor’s
written order) Lasik surgery Orthodontics Dental Glasses/Contacts
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HCRA – How it Works The total contribution is deducted in
equal pre-tax increments from each pay period over the next year. $1,000 / 24 pay periods = $41.67 per pay
period. The money is deducted pre-tax and
placed into an account to use when you have an out-of-pocket medical expense not covered by your health insurance.
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How Am I Reimbursed?There are three types of reimbursement offered under the Flex Plan:
Manual
Traditional (Bump)
Flexible Spending Card
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Manual Reimbursement Visit your physician and pay your copay of $35
Complete and HCRA reimbursement form, available at www.alseib.org, and forward to BCBS along with receipt/documentation from doctor visit;
BCBS will reimburse the member $35 by either mailing a check directly to the member, or if enrolled, the reimbursement can be direct deposited into a checking/savings account.
Traditional Method (Bump) Visit your physician and pay your copay of $35
When the claim is processed by BCBS, the HCRA will automatically issue a reimbursement for the out-of-pocket expenses not covered by your health insurance.*
BCBS will reimburse the member $35 by either mailing a check directly to the member, or if enrolled, the reimbursement can be direct deposited into a checking/savings account.
*If there is no claim filed with BCBS, the HCRA will not be alerted to send a reimbursement. Example, if purchasing glasses/contacts, the request for reimbursement would need to be filed manually because these are non-covered benefits under BCBS.
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Flex Spending Card You receive a MasterCard pre-loaded with the
amount of money you choose to put into your account for the upcoming plan year.
You go to the doctor.
You use your Flex Spending card to pay the $35 copay directly from your account.
The money does not have to be in theaccount before the charge is incurred.
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How Does the HCRA Benefit State Employees?
The Health Care Reimbursement Account (HCRA) is basically an interest-free, tax-free loan.
The State is advancing you the total amount elected for the upcoming plan year, and that amount is payroll deducted from 24 pay periods, beginning January 1.*
Qualifying status changes allow enrollment and contribution changes outside of the open enrollment period.
*New employees who start after January 1 of the plan year have 60 days from date of employment to enroll. Their deductions would be divided by the number of payroll periods left in that plan year.
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Example of Tax Savings
HCRA
Adjusted Gross Income $20,000 $20,000
7.5% AGI Max Amt $1,500 N/AMedical Expenses $1,500 $1,500
What if I Don’t Use All of the Money I Put Into the HCRA?
This program is regulated by the IRS; therefore, it has a “Use It or Lose It” rule.
The HCRA is available from January 1 until March 15 of each following plan year.
To determine the contribution amount, only add expenses for January through December.
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Bonus For Joining HCRAAn additional $50 will be added to your
account just for enrolling!
With a minimum $120 contribution(only $5 per pay period) you will actually have $170 to spend!
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DEPENDENT CARE REIMBURSEMENT ACCOUNT (DCRA)
FLEXIBLE EMPLOYEES’ BENEFITS PLAN
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DCRA – How it WorksDetermine amount needed to cover dependent care expenses for the upcoming year.
That amount is deducted pre-tax in equal increments from each pay period over the next year.
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DCRA Example
$2,000 / 24 pay periods = $83.34 per pay period.*
The money is placed into an account for you to use when you have a dependent care expense.
*New employees who start after January 1 of the plan year have 60 days from date of employment to enroll. Their deductions would be divided by the number of payroll periods left in that plan year.
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HCRA & DCRA Advantages Allows you to set money aside for
health/dependent care expenses for the upcoming year;
HCRA money can be used for dependents, even if they are not covered under your health insurance;
$50 bonus just for enrolling in the HCRA; Entire amount of election is 100% pre-taxed; Helps to budget health/dependent care
expenses; HCRA money in account after December 31st can
be used until March 15th of the next plan year; Significant tax savings over the course of the
year.
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Benefits of Enrollment in HCRA and DCRA
SEHIP members will pay for their out-of-pocket health and daycare expenses even
if they are not enrolled in the HCRA or DCRA.
So, why not pay with pre-tax money? And receive a $50 bonus just for enrolling in
the HCRA?Encourage your employees to consider
enrolling in the HCRA and DCRA.
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Helpful Links
Visit the SEIB website at to www.alseib.org view last three years of claims history to help determine upcoming years HCRA contribution amount;
Visit the Blue Cross Blue Shield of Alabama website at www.bcbsal.org to view contributions, balances, claims, etc. on both your HCRA and DCRA.
SEHIP Enrollment Form (IB2) After initial enrollment, employee can
communicate directly with their SEIB Advisor for all their health insurance benefit questions, changes, etc.
Non-Tobacco User Discount Application Physician Certification Wellness Discount Form Southland Vision Supplemental Enrollment Form Federal Poverty Level Discount Application Flexible Benefits Plan Enrollment (HCRA and/or
BCBS Medical Expense Claim Form Plan Change Form Membership Status Change Form Non-Tobacco User Discount Form Physician Certification Wellness Discount Form Federal Poverty Level Discount Application Blue Cross Blue Shield Direct Deposit Enrollme
nt Form
Southland National Cancer and Hospital Indemnity Claim Form
Southland National Dental Claim Form Southland National Vision Claim Form
