Annual Enrollment 2013 Webinar Presentation by 8f7sAU

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									Annual Enrollment for
Plan Year 2013
                       Session Purpose

Topics to Discuss
     CSPA Conference 2012
     Annual Enrollment Dates
     Plan Design/Premium Changes for AE 2013
     GaBreeze AE Communications
     Reminders




     February
  APRIL 2010 2010                 2
                         CSPA Conference 2012

Council for State Personnel Administration (CSPA)
     2012 Conference Dates:
         Wednesday, September 26th – Thursday, September 27th
     Flexible Benefits update presentation will be on Wednesday, 26th
    – Registration for the 26th will be 8:00 a.m. till 5:00 p.m.
    – Continental Breakfast will be from 7:30 a.m. till 8:30 a.m.
    – Highlights will include what’s changing under Flexible Benefits for Plan
      Year 2013
    – No charge for attending Day One of the conference
     Conference Location:
         Georgia World Congress Center - Building A
     For questions or assistance contact: glendale@gefa.ga.gov or
     csouthern@georgiatolls.com
     February
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                    2013 Annual Enrollment Dates:


  Tuesday, October 9th* - Friday, November 9th




* Opens at 1:00 a.m. EST
     February
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Plan Changes for AE 2013




    February
 APRIL 2010 2010   5
                         Plan Design/Premium Changes for AE 2013

Dental Plans – Delta Dental
     New! Effective January 1, 2013, Delta Dental will be replacing United
     Concordia as the State of Georgia’s dental provider
     Delta Dental will offer two coverage options to choose from:
    – Select Plan
    – Select Plus Plan
     The four family tier levels will remain the same
     Premium rates will remain locked through PY 2015




     February
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                         Plan Design/Premium Changes for AE 2013

Dental Plans – Delta Dental
         Transition from United Concordia to Delta Dental:
        – Employees currently with U.C. Regular will be transferred to
          Delta Dental Select Plus Plan
        – Employees currently with U.C. PPO will be transferred to Delta
          Dental Select Plan
         Employees will have the option during Annual Enrollment to
         change from one plan to another




    February
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                          Plan Design/Premium Changes for AE 2013

Dental Plans – Delta Dental
         No orthodontia benefits under the Select Plan
         Orthodontia benefit is available for children and adults under the
         Select Plus Plan
         Participants currently receiving orthodontia treatment will be
         eligible for the balance of the maximum coverage amount




    February
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                         Plan Design/Premium Changes for AE 2013

Delta Dental Network
        Participants are free to choose any licensed dentist
       – Approx. 6,400 dentist locations in Georgia
        Network dentists agree to set fees based on Delta Dental’s
        allowances and cannot balance bill
        Delta Dental pays participating dentists directly; participant pays
        their responsible amount at time of treatment
        Network dentists complete all claim forms/paperwork
        Network dentists are credentialed




    February
 APRIL 2010 2010                        9
                                            Delta Dental Comparison Chart
                                                    Select Plan                     Select Plus Plan
                                                                    Out of                                Out of
                                                      In Network                            In Network
                                        In Network                 Network    In Network                 Network
                                                       Premier*                              Premier*
                                        PPO Dentist                Non PPO    PPO Dentist                Non PPO
                                                        Dentist                               Dentist
Benefits & Covered Services                                         Dentist                               Dentist
Diagnostic & Preventive Services
(D&P)                                      100%         100%        100%         100%         100%        100%
Exams, Cleanings, x-rays, sealants

Basic Services                             80%           80%         80%         90%           90%         90%
Fillings, simple tooth extractions

Endodontics (root canals)                  80%           80%         80%         90%           90%         90%
Covered under Basic services

Periodontics (gum treatment)               80%           80%         80%         90%           90%         90%
Covered under Basic services

Oral Surgery                               80%           80%         80%         90%           90%         90%
Covered under Basic services
Major Services
Crowns, inlays, onlays, cast               50%           50%         50%         60%           60%         60%
restorations, bridges, dentures & TMJ

                                            Not          Not         Not
Orthodontic Benefits                                                             50%           50%         50%
                                          Covered      Covered     Covered
Adults & dependent children

                                            Not          Not         Not
Orthodontic Maximums                                                            $2,000        $2,000      $2,000
                                          Covered      Covered     Covered
Lifetime
* Premier Dentists are defined as secondary PPO (in network) dentists. Premier Dentists usually charge
         February
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somewhat higher contracted fees.
                              Delta Dental (Payment Example)

                     In Network versus Out of Network
   Hypothetical            In Network                In Network           Out of Network
    Example                PPO Dentist             Premier* Dentist      Non PPO Dentist

                               $1,000                   $1,000                $1,000
Charge for a Crown
  Plan Payment
                                $640                     $800                  $900
   Allowance
Percentage Paid by
                                60%                      60%                   60%
   Delta Dental

                                $384                     $480                  $540
Delta Dental Pays
                                $256                     $320                  $460
   Patient Pays              ($640 - $384)            ($800 - $480)        ($1,000 - $540)

* Premier Dentists are defined as secondary PPO (in network) dentists.
Premier Dentists usually charge somewhat higher contracted fees.
      February
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                        Dental (Select Plan)

Premium Rates
      Select Plan
     – You Only          $24.08
     – You + Spouse      $46.65
     – You + Child       $48.89
     – You + Family      $68.40




     February
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Admin fee is included in amount
                        Dental (Select Plus Plan)

Premium Rates
      Select Plus Plan
     – You Only          $38.45
     – You + Spouse      $75.01
     – You + Child       $78.66
     – You + Family      $110.27




     February
  APRIL 2010 2010                  13
Admin fee is included in amount
                         Plan Design/Premium Changes for AE 2013

Employee, Spouse, Child Life and AD&D Plans – Minnesota Life
      Increase the Employee Life and AD&D maximum coverage from
      $500,000 to $1 million
      Employees capped at $500k can increase coverage to the uncapped
      amount on a guarantee issue basis
      Waiver of premium for permanent/total disability will be removed from the
      plans
     – Reduces the premiums by an average of 13%
     – Current participants on active waivers will continue




      February
   APRIL 2010 2010                     14
                         Plan Design/Premium Changes for AE 2013

Employee, Spouse, Child Life and AD&D Plans – Minnesota Life
      Rate structure for Employee Life premiums will change to not straddle
      IRS Table 1 rates
     – If the employee selects after-tax, it will eliminate imputed income




      February
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                        Plan Design/Premium Changes for AE 2013

Disability Plans – The Standard
      No change in plan design or premiums for the Short Term Disability
      Rate decrease of 5% for LTD premiums
      LTD maximum benefit will increase from $4,000 to $5,000 per month
      Maximum benefit period will increase from age 65 to age 67
     – Coordinate with Social Security Normal Retirement Age
     – No change on current employee claims; only claims initiated on or
       after January 1, 2013




     February
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                        Plan Design/Premium Changes for AE 2013


Critical Illness Plan – CAIC
      No changes to premiums for the current option
      Name change of the current option – Select Plan
      New! Additional option level – Select Plus Plan
     – Provides same critical illness coverage under the Select Plan
     – Includes Accidental Coverage
      These changes are applicable to both the Employee and Spouse
      Specified Illness benefits
      Additional features of the Accident Coverage
     – 24-Hour coverage
     – No limit on the number of claims

      February
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                          Plan Design/Premium Changes for AE 2013

Critical Illness Plan – CAIC
      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 will be available in the
      Critical Illness Select Plus communication materials
     February
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                              Rate Sheet for Employee Specified Illness
                              (Select Plus Plan)



                Employee Critical Illness & Accident

Age Band            $5,000   $10,000   $20,000   $30,000   $40,000   $50,000

 18-29              $14.29   $16.09    $19.69    $23.29    $26.89    $30.49

 30-39              $15.84   $19.19    $25.89    $32.59    $39.29    $45.99

 40-49              $19.79   $27.09    $41.69    $56.29    $70.89    $85.49

 50-59              $25.39   $38.29    $64.09    $89.89    $115.69   $141.49

 60-69              $33.24   $53.99    $95.49    $136.99   $178.49   $219.99

     February
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Admin fee is included in amount
                               Rate Sheet for Spouse Specified Illness
                               (Select Plus Plan)



                    Spouse Critical Illness & Accident
                    Age Band           $5,000           $10,000

                     18-29             $14.29           $16.09

                     30-39             $15.84           $19.19

                     40-49             $19.79           $27.09

                     50-59             $25.39           $38.29

                     60-69             $33.24           $53.99

     February
  APRIL 2010 2010                        20
Admin fee is included in amount
                       Plan Design/Premium Changes for AE 2013


Spending Accounts – SHPS/ADP
     SHPS has become a part of ADP
     – ADP branding on future HCSA and DCSA materials
     – The customer service phone number, fax number, and mailing
       address will remain the same
     The current URLs will remain active and any changes will be
     communicated well in advance




     February
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                        Plan Design/Premium Changes for AE 2013

Spending Accounts – SHPS/ADP
     No increase in admin fees with current plan design
     HCSA annual maximum will reduce from $5,040 to $2,460
     – Monthly maximum will be $205
     – Compliance with Patient Protection and Affordable Care Act (PPACA)
     – Note: a monthly administration fee of $3.20 is included in the total
       contribution amount
     Employees who contributed a larger amount in 2012 will be reduced to
     the new HCSA maximum for 2013




     February
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                       Plan Design/Premium Changes for AE 2013

Vision – Spectera
     Branding name will change from OptumHealth to Spectera
     Select Plus Plan will have the following enhancements:
    – Frequency of frames will change to once every 12 months
    – Frame allowance of $150 is provided for private practice or retail chain
      providers
    – Standard contact lenses will have a $200 allowance
    – Allow up to 8 boxes of standard, disposable lenses
     Out-of-network allowance for contact lenses will increase to $200 under
     the Select Plus Plan



     February
  APRIL 2010 2010                    23
                         Plan Design/Premium Changes for AE 2013

Vision – Spectera
      New premium rate structure for the Select Plus Plan
     – You Only           $8.62
     – You + Spouse       $18.61
     – You + Child        $19.45
     – You + Family       $26.35




      February
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 Admin fee is included in amount
                      Plan Design/Premium Changes for AE 2013


No Plan or Premium Changes
     Dental DHMO - Cigna
     Legal
     Long Term Care




     February
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GaBreeze Annual Enrollment
Communications & Website Reminder




    February
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                                  Annual Enrollment Communications
                                  by GaBreeze

                              COMMUNICATION                                             DATE
Create AE e-mails On GaBreeze (For Actives with preferred e-mail only)               October 2 – 3

Mail Enrollment Post Card (Active w/o preferred e-mail, All Retirees, LOA and
                                                                                     October 2 – 3
COBRA)
Mail Enrollment Post Card (Active w/o preferred e-mail on file)- Passive e-mail      October 2 – 3

Send AE reminder e-mail notifications (Active/Leave/COBRA with preferred e-mail       October 23
address on file)

Print Confirmation of Enrollment statements, Beneficiary Confirmation Notices upon   November 15
enrollment (Notes: ¹GaBreeze Website enrollees will not receive a confirmation of
enrollment. ²COE will not show the $3.20 admin fee in the HCSA monthly price
tag)
Mail Confirmation of Enrollment statements, Beneficiary Confirms,                    November 15
Conversion/Portability, COBRA Rights Spouse Notices (if applicable)




       February
    APRIL 2010 2010                                27
                        GaBreeze Website Reminder for AE 2013


GaBreeze Confirmation Number
     Employees will receive a Confirmation Number upon successful
     completion of their online Annual Enrollment on the completed
     successfully page on the GaBreeze Website
     Additional changes will be permitted online during the remainder of the
     Annual Enrollment period.
    – Employees will retain the same Confirmation Number
    – Date/Time Stamp will update to reflect the most recent completion
     Employees should print a copy of the Confirmation Number page for
     their records




     February
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Annual Enrollment Reminders




    February
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                       Reminders for AE 2013


Annual Enrollment Materials from DOAS
     You Decide! Booklet
     Benefits At-a-Glance Brochure
     What’s New for 2013?


     NOTE: Annual Enrollment materials will be posted online by Monday,
     October 1st
    – Materials will be available on the GaBreeze and Team Georgia web
      sites




     February
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                      Reminders for AE 2013

Annual Benefit Base Rate (ABBR) for PY 2013
     ABBR Salary entry deadlines
    – Dekalb and Clayton BOE should submit to GaBreeze by Friday,
      September 21st
    – Manual agencies should update on the GaBreeze ERWS site by
      Friday, September 21st
    – SAO agencies should submit to GaBreeze by Wednesday, October
      3rd




     February
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                       Reminders for AE 2013

Annual Benefit Base Rate (ABBR) for PY 2013
     Manual agencies will be required to enter ABBR salary updates into the
     GaBreeze ERWS site
    – Use the “Employee Data Update” Smart Form
    – Enter the updated ABBR salary amount; click “Submit” when finished
    – Note: if an employee’s salary did not change, no ABBR update is
      required
     If an employee’s ABBR salary changes after September 21st,
    – Use “Frozen Annual Benefit Salary Correction” Smart Form
     For additional questions, contact HRA assist team




     February
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                        Reminders for AE 2013

Annual Benefit Base Rate (ABBR) for PY 2013
     Job aid is available to assist agencies with entering ABBR updates on
     the DOAS web site: doas.ga.gov
     Deadline to complete is Friday, September 21st




     February
  APRIL 2010 2010                    33
                        Reminders for AE 2013

GaBreeze Website (Pre-Annual Enrollment)
     Employees should be encouraged to go online as soon as possible to
     verify and/or update their passwords
     Employees should add their email address to the Personal Information
     section of the “Your Profile” page
    – Email address can be either work or personal
    – Quickens GaBreeze response time for replacement passwords to be
      issued
     Employees should verify accuracy of addresses, zip codes, etc.
     Gabreeze will provide a reminder for employees to enroll in Health
     Benefits
    – Link to the DCH Annual Enrollment site will be on GaBreeze

     February
  APRIL 2010 2010                    34
                         Reminders for AE 2013

New Hires During Annual Enrollment
     Employees, who are hired by November 1, 2012, will be required to
     enroll in Flexible Benefits for both Plan Year 2012 and 2013
    – Current Plan Year for benefits effective December 1st
    – New Plan Year for benefits effective January 1st
     If the employee fails to enroll for Annual Enrollment, no benefits will carry
     over for Plan Year 2013
     Pending Enrollment Report on ERWS will assist agencies
    – New hires who have not completed Annual Enrollment
    – Report will be produced daily during the Annual Enrollment period



     February
  APRIL 2010 2010                      35
                        Reminders for AE 2013

Employees returning from Leave of Absence
     Employees, who go on a Leave of Absence and cross Plan Years, will
     be given an enrollment opportunity upon return to Active status
    – If the employee paid premiums while on LOA, benefits will rollover into
      the new Plan Year
    – If the employee makes no changes during the enrollment period, the
      benefits will continue for the remainder of the Plan Year
     If the employee failed to pay, no coverage will show on GaBreeze.
     Employee will be given an enrollment opportunity subject to penalties
     HR should verify the returning employee paid premiums during the LOA
    – “View Flex Plan Coverage History” via the Employer Web Site
    – If employee failed to pay premiums, do not reinstate deductions
    – If employee makes benefit selections upon return, Gabreeze will report
      new deductions via the Financial Report
     February
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                         Support Avenues (Employees/Participants)


                          Benefits Call Center

                            1-877-3GBreez
                           or 1-877-342-7339
                   Monday – Friday, 8:00 am – 5:00 pm ET
                            excluding holidays



                           GaBreeze Website

                         www.gabreeze.ga.gov

                  Link on Team Georgia Flexible Benefits tab
   February
APRIL 2010 2010                       37
                    Support Avenues (Agency Contacts)



   Barbara Heard
   – 404 651-6084 or barbara.heard@doas.ga.gov
   Chris Barfield
   – 404 463-2274 or chris.barfield@doas.ga.gov
   Valencia Timmons
   – 404 651-6080 or valencia.timmons@doas.ga.gov
   Patricia Applewhite
   – 404 463-3589 or patricia.applewhite@doas.ga.gov


   February
APRIL 2010 2010               38
Final Questions and Follow-ups




    February
 APRIL 2010 2010   39

								
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