annual enrollment for plan year 2018 · 2018 annual enrollment georgia breeze website: opens: ......

Annual Enrollment for

Plan Year 2018

February 2010 2APRIL 2010

2018 Annual Enrollment Georgia Breeze Website:

Opens: Monday, October 16th 12:00AM

Closes: Friday, November 3rd 11:59PM

* Benefits elected are effective January 1, 2018


Summary of Plan Changes for 2018

• BlueCross BlueShield-BlueVision

Select Plan: 25% increase; no plan changes

Select Plus Plan: increase of co-pays by tiers for progressive lens & transitional lens; the contact allowance changed to $150

• Aflac Critical Illness Insurance

8% rate increase

Plan change at the 12 month interval and a 50% benefit for the 2nd occurrence


Summary of Plan Changes for 2018

• Unum-Long Term Care

Rates will increase by 9.9%

• ADP Flexible Spending Account

WageWorks: New name, same website www.myspendingaccount.adp

Limit increase to $2,560

http://www.myspendingaccount.adp/


Vision – Blue Cross/Blue Shield of Georgia – Select Plan

COVERED SERVICES COPAYMENTS/MAXIMUMSNetwork Providers Non-Network Providers

Eye ExamLimited to one exam per Member every Calendar Year. $10 Copayment Reimbursed up to $40

Prescription LensesLimited to one set of lenses per Member every Calendar Year.

Basic Lenses (Pair) Single Vision lenses Lined Bifocal lenses Lined Trifocal lenses Lenticular lenses

Eyeglass Lens enhancements may be added

$20 Copayment

$0 Copayment

Reimbursed up to $40Reimbursed up to $60Reimbursed up to $80Reimbursed up to $80

No reimbursement on enhancementsFramesLimited to one set of frames per Member every 24 Months. Allowable Amount up to $130 retail

allowance, 20% off remaining balance $45

Prescription Contact Lenses Every 12 months in place of eyeglasses(traditional or disposable)

Non-Elective Contact Lenses(Availability once every Calendar Year.)

$20 Copayment

Covered in full

Reimbursed up to $105


Elective Contact Lenses(Availability once every Calendar Year.)

$105 plan allowance on conventional, 15% off any remaining balance.

$105 plan allowance on disposables up to 4 boxes.


Note: If you chose covered Non-Elective Contact Lenses or Elective Contact Lenses, no benefits will be available for covered eyeglass lensesin that period.


COVERED SERVICES COPAYMENTS/MAXIMUMSNetwork Providers Non-Network Providers

Eye ExamLimited to one exam per Member every Calendar Year. $20 Copayment Reimbursed up to $40Prescription LensesLimited to one set of lenses per Member every Calendar Year.

Basic Lenses in Standard Plastic (Pair) Single Vision lenses Lined Bifocal lenses Lined Trifocal lenses Lenticular lenses

Includes the following Lens options Factory scratch coating Tint (Solid & Gradient) Polycarbonate lenses (for a child under age 19) Transitions Photochromic lenses (for a child under age 19)

$25 Copayment

$0 Copayment

Reimbursed up to $40Reimbursed up to $60Reimbursed up to $80Reimbursed up to $80

No allowance on lens enhancements

FramesLimited to one set of frames per Member every Calendar Year. No Copayment

Allowable Amount up to $150 retail allowance


Prescription Contact Lenses (traditional or disposable)

Non-Elective Contact Lenses(Availability once every Calendar Year.)

No Copayment

Covered in full Reimbursed up to $210

Elective Contact Lenses(Availability once every Calendar Year.)

Reimbursed up to $150, 15% off any remaining balance on Conventional Lenses

Reimbursed up to $150 on Disposable Lenses


Note: If you chose covered Non-Elective Contact Lenses or Elective Contact Lenses, no benefits will be available for covered eyeglass lenses in that period.

Vision – Blue Cross/Blue Shield of Georgia - Select Plus Plan


Most Walmart/Sam’s Club are out-of-network providers; completion and submission of the claim form below is required to receive the in-network benefit

Important Note RE: Wal-mart/Sam’s Club providers


BCBS of Georgia – Select Plan Premiums

– You Only $5.50

– You + Spouse $11.69

– You + Child $12.23

– You + Family $16.54

BCBS of Georgia – Select Plus Plan Premiums

– You Only $9.49




Vision Premiums - 2018

Admin fee is included in amount


Specified / Critical Illness Plan DesignSelect Plan = Illness Coverage

Select Plus Plan = Illness + Accident Coverage

Benefits included under the Accident Coverage (Select Plus Plan)– Medical Fees (Physician Charges, X-Rays, Emergency Room Services and Supplies)

– Hospital Fees (Hospital Admission, Daily Hospital Confinement and Intensive Care)

– Accidental Injuries (Fractures/Dislocations, Lacerations, Tendons/Ligaments, Ruptured Disk, Torn Knee Cartilage, Burns, Eye Injuries)

– Accident Follow-up Benefits (Physical Therapy, In-patient Rehab, Follow-up treatments)

– Additional Benefits (Family Lodging, Transportation, Gunshot Wound, Paralysis, Prosthesis)

A complete list of benefits and descriptions is available in the summary plan description.Coverage available up to $50,000; no medical underwriting for <$30,000.Rates are based on employee/spouse age and coverage level. Child coverage at no additional cost.

AFLAC Specified Critical Illness 2018

8% rate increase


Specified Critical Illness– Lump Sum Benefit paid following diagnosis.

– Child coverage at no additional cost, up to age 26. 50% of benefit is payable for children.

12-month interval with 50% benefit for 2nd

occurrence.

Cancer 12-month treatment-free re-occurrence interval. 50% benefit for 2nd occurrence.

Reminder: Coverage for Spouse Specified Illness cannot exceed coverage level for Employee Specified Illness and cannot be of a different plan (e.g. Employee Select and Spouse Select Plus)


Covered Diagnoses:Heart Attack Stroke

Major Organ Transplant

End-StageRenal Failure

Internal Cancer

Coma

Severe Burns

Paralysis

Loss of Sight,Hearing or Speech

Alzheimer’s (25%)

Caricnomain situ (25%)

CoronaryArtery (25%)


Specified / Critical Illness Plans Design Continues…Health Screening Benefits

– Receive a maximum $100 ($160 for Select Plus) for completion of any one covered screening test per calendar year.

– Payable to employee and spouse, (as long as both take test) regardless of results


Examples of Covered Tests Include:Stress Test (Bicycle or Treadmill) Blood Triglycerides

Fasting Blood Glucose Serum Cholesterol Bone Marrow Testing Breast UltrasoundChest X-Ray MammographyColonoscopy Pap SmearFlexible Sigmoidoscopy Blood Tests for breast,

ovarian, prostate, colon cancer, or myleomia


Long Term Care Insurance – Unum Insurance

– Nursing Facility/Nursing-Home Insurance, covers some in-home care.

– Must require continual assistance with at least three activities of daily living to be considered disabled and qualifying for benefits.

– 90-day wait period after disability before benefits are payable.

– Plans offered for employees, spouses, parents, in-laws, includes adoptive or step-parents.

– Only employee premiums taken through payroll deductions. All other premiums direct billed by Unum.

– Medical Underwriting required for covered spouse, parents, or in-laws.

– Medical Underwriting required for employees electing coverage for the first time, after a break in coverage, or electing a higher level of coverage.

Long Term Care Insurance - 2018

Employees can go to the website: unuminfo.com/sogor contact Unum at

1 800-227-4165 for additional information

9.9% Rate Increase


Flexible Healthcare Spending Account –2018 Website Update

New Name for FSA:

• ADP site not changing

• New users will be advised that a security code will be emailed to them within 5 minutes. The State of Georgia’s security code is STATEOFGE-10029

• This code is the same for all users, and will never change.

• New cards issued to new users and existing users with expiring ADP cards.


Flexible Healthcare Spending Account –2018 Plan cont’d

• FSA Healthcare limit will increase to $2,560 ( $50 from PY2017)

• Minimum annual contribution remains $120

• Contributions must be re-elected each year, they do notrollover.

• Once you enroll in a FSA you may not cancel during the plan year.


Healthcare Spending Account - WageWorks

– Set aside pre-tax money to use for healthcare expenses.

– Maximum amount $2,560 ($213.33/month) can be set aside per year.

– Money is “Use or Lose”

> You have until March 15, 2019 to use money placed in your 2018 spending account.

– Entire amount is available the first day of the year.

– Visa debit card available for purchases, but keep your receipts!

– Qualifying expenses include: prescriptions, contact lenses/glasses, eye surgery, procedures/surgeries not covered by insurance, health insurance co-insurance.

– Excluded expenses include: over the counter drugs, electrolysis, vitamins/herbal supplements, hair transplants, nicotine patches or gum, teeth whitening.

Flexible Healthcare Spending Account


Flexible Healthcare Spending Account - continued

Spending Accounts – Relation to the Health Saving Account

Employees who enroll in the High Deductible Health Plan AND enroll in a Health Savings Account (HSA) will not be eligible to enroll in a Health Care Spending Account

If an employee does enroll in a HCSA in error, it will be necessary for them to contact the GaBreeze Call Center and request an Appeal Form to submit to DOAS

– The form will be received/reviewed by DOAS

– Gabreeze will be notified of the final determination regarding the Spending Account


Dependent Care Spending Account - ADP

– Set aside pre-tax money to use for child care expenses for your children under age 13.

> Expenses for care of a dependent of any age, who is unable to care for themselves due to a physical or mental handicap also qualify.

– Maximum family amount $4,992 can be set aside per year under IRS rules.

– Money is “Use or Lose”

> You have until December 31, 2018 to use money placed in your 2018 dependent care spending account.

– Both the employee and spouse must be working full time or enrolled in school full time to utilize this benefit.

– Eligible expenses include: preschool, nursery school, after school care.

– Ineligible expenses include: activity fees, field trips, clothing, food, entertainment, Kindergarten, overnight camps, sports lessons, transportation, or private school tuition.

Flexible Dependent Care Spending Account


CIGNA Dental HMO

• Cigna Dental (DHMO) Dental Network has expanded beyond the Metro Atlanta Area.

• Now serving following counties: Lowndes, Houston, Baldwin, Spalding, Troup, Richmond, Bibb (Macon), Dougherty, Muscogee, Chatham (Savannah), Clarke, Barrow, Dawson, Floyd, Bartow, and Catoosa, Whitfield, Dawson.

• Provider Network frequently changes

• No late entrant penalties or waiting periods.

• No plan or rate changes for PY 2018

Cigna DHMO RatesYou $22.58You + Spouse

$41.15

You + Child(ren)

$51.03

Family $60.86


The following plans have no changes

to coverage for 2018MetLife Life Insurance MetLife AD&D

Hyatt Legal Delta Dental

Dependent Care Spending

Short Term/Long Term Disability


• No rate increases in PY 2018

Life Insurance – Met Life 2018

Employee Life, Spouse, and Child LifeEmployee 1x to 10x Benefit Salary; Max Coverage

$2,000,000Based on age, salary, & coverage selection

Spouse $6,000, $12,000, $30,000, $60,000, $100,000, $150,000, $200,000, $250,000Based on employee’s age, salary, and coverage selection.

Child $3,000 (0.92), $6,000 (1.14), $10,000 (1.44), $15,000 (1.81), $20,000 (2.18)


Life Plans – MetLifeMetLife offers:

– Up to 10x employee’s salary for Employee Life coverage, up to $2 Million

Current employees wishing to increase their current level of coverage beyond one level will be required to complete the online Statement of Health (SOH)

Employees wishing to enroll in Spouse Life or increase the current level of spouse coverage will be required to complete the online Statement of Health (SOH)

– Employees are required to pre-register their spouse on the Gabreeze website before the Statement of Health form will be available online.

Life Insurance – Met Life

https://www.metlife.com/individual/insurance/life-insurance/life-insurance-needs-calculator/lic.html?WT.ac=PRO_Pro1_LIfeCalculatorSnoopy_5-21563_T3619-IN-individual&oc_id=PRO_Pro1_LIfeCalculatorSnoopy_5-21563_T3619-IN-individual

https://www.metlife.com/individual/insurance/life-insurance/life-insurance-needs-calculator/lic.html?WT.ac=PRO_Pro1_LIfeCalculatorSnoopy_5-21563_T3619-IN-individual&oc_id=PRO_Pro1_LIfeCalculatorSnoopy_5-21563_T3619-IN-individual


Life Plans – MetLifeWaiver of Premium to the Employee Life product for permanent or total disability– Employee must initiate the process after meeting the 180 day qualifying period

– Copy of the form available on the GABreeze, DOAS, and Team Georgia web sites

Additional Life Insurance benefits:– Will Preparation

– Estate Planning

NOTE: These benefits are offered by MetLife in partnership with Hyatt Legal Services. This service is separate from the benefits provided under the Hyatt Legal Plan

Life Insurance – Met Life cont’d

https://www.metlife.com/individual/employee-benefits/group-disability/index.html?WT.ac=PRO_PRO_Disability_5-105629_T4303-IN-employee-benefits&oc_id=PRO_PRO_Disability_5-105629_T4303-IN-employee-benefits

https://www.metlife.com/individual/employee-benefits/group-disability/index.html?WT.ac=PRO_PRO_Disability_5-105629_T4303-IN-employee-benefits&oc_id=PRO_PRO_Disability_5-105629_T4303-IN-employee-benefits


Beneficiaries are managed online.

– Remember to review and update your beneficiaries.

An employee must carry Employee Life if they wish to elect Spouse Life coverage.

– Spouse Life coverage cannot exceed Employee Life coverage.

Child life covers an employee’s children under 26, without medical underwriting.

– Child Life coverage cannot exceed Employee Life Coverage

– Disabled children can continue coverage after age 26.

– Child Live coverage starts at live birth.

Premiums are based on employee age and salary.

More About Life Insurance…


Delta Dental Select Plan$50 In-Network Deductible, per person (or) $150 In-Network Family Deductible per calendar year.

$50 Out-of-Network Deductible, per person (or) $150 Out-of-Network Family deductible per calendar year.

$500 maximum coverage per person each calendar year.

100% Coverage for Diagnostic/Preventive services. (Cleanings, xrays, etc.)

80% Coverage for Basic Services (fillings, extractions), Endodontics (root canals), Periodontics (gum treatments), and Oral Surgery.

50% Coverage for Major Services (crowns, inlays, restorations, bridges, dentures, TMJ, surgical periodontics.)

Dental Insurance – Delta Dental


Delta Dental Select Plus Plan

$50 In-Network Deductible, per person (or) $150 In-Network Family Deductible per calendar year.

$50 Out-of-Network Deductible, per person (or) $150 Out-of-Network Family deductible per calendar year.

$2,000 maximum coverage per person each calendar year.

100% Coverage for Diagnostic/Preventive services. (Cleanings, xrays, etc.)

90% Coverage for Basic Services (fillings, extractions), Endodontics (root canals), Periodontics (gum treatments), and Oral Surgery.

60% Coverage for Major Services (crowns, inlays, restorations, bridges, dentures, TMJ, surgical periodontics.)

50% Coverage for Orthodontia Services, up to $2,000 lifetime maximum orthodontia benefit per person.

Dental Insurance – Delta Dental


Late Entrant Penalties – Delta Dental:

• If an employee does not carry dental insurance in the previous plan year, or cannot prove that they have had continuous dental insurance coverage, they are subject to “late entrant penalties.”

• Under Delta Dental, the penalties are as follows:

• Six month wait for:

• major services (crowns, inlays, restorations, bridges, dentures, TMJ, surgical periodontics.)

• Orthodontia (Select Plus Plan Only)

Delta Dental Plans –Late Entrant Penalties


Delta Dental –

Select Plan Premiums

– You Only $26.20




Delta Dental –

Select Plus Plan Premiums

– You Only $42.01




Delta Dental Premiums - 2018

Admin fee is included in amount.


Hyatt Legal Plans 2018Select Plan Covers:

Powers of AttorneyOffice Advice/ConsultationsWills/Living WillsTraffic Matters (Except DUIs)Document PreparationReal Estate Matters for Primary Residence

Elder Law Matters Home Equity Loan AssistanceDebt Collection Defense

Identity Theft Defense

Select Plus Plan Also Covers:

Consumer Protection MattersEnforcement/Change to Support OrdersEviction/Tenant DefenseGuardianship/ConservatorshipAdoptionImmigration AssistanceTax AuditsDivorceReal Estate Matters for Additional ResidencesIncompetency Civil Litigation Defense


Hyatt Legal Plans – 2018 Rates

Legal Plans – Hyatt Network of attorneys with 14,000 nationally, and over 450 attorneys within the State of Georgia

Select Select PlusEmployee $6.37 $8.00Family $8.00 $10.30


Short Term Disability– 7-Day Wait or 30-Day Wait (from date of disability, until payment issued)– Covers disability up to 6 months. – 60% of pay, up to $1,000 per week.– Consider Sick/Annual Leave Balances.– Late Entrant Penalty

> 60 Day wait for disability due to disease, mental disorder, or pregnancy within first 12 months of coverage.

Long Term Disability– Covers disability after 6 months.– 60% of pay, up to $5,000 per month. – Benefits are paid after-tax, not taxable income when on LTD.– Benefits generally are payable until end of disability

or Social Security Retirement Age.> For some conditions, benefits are only payable for two years. (Mental Disability, substance abuse, etc.)

*Rates are based on employee age and salary.

The Standard’s Disability Plans-2018


Accidental Death & Dismemberment Plan – MetLifeMetLife AD&D offers :– Up to 10x AD&D coverage, up to $2 million

– If you are age 75 but less than 80, the value of your coverage is reduced to 50%

Accidental Death & Dismemberment

– Payable on death or injury due to a covered accident.

– Be sure to designate your beneficiaries!

Premiums are based on employee’s age and salary

AD&D – Met Life


Annual EnrollmentVisit www.gabreeze.ga.gov to enroll in your benefits today!

For assistance with the Georgia Breeze website or flexible benefits enrollment, contact the Georgia Breeze call center at 1-877-342-7339.

Print your confirmation page when you have completed your elections!– You may change your elections as many times as you wish during open

enrollment.

– The choices remaining in the system on November 3rd will be yours for all of 2018!

If you complete your enrollment verbally with a Georgia Breeze associate, document the name of the representative, date, and time of the call.

Flexible Benefits Enrollment thru Georgia Breeze

http://www.gabreeze.ga.gov/


Thank

You!

annual enrollment for plan year 2018 · 2018 annual enrollment georgia breeze website: opens: ......

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