Asante Annual Open Enrollment: Your Guide to 2021 Benefits Nov. 1-13, 2020
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Asante Annual Open Enrollment:
Your Guide to 2021 Benefits
Nov. 1–13, 2020
What do employees need to do?
During open enrollment, you will have the opportunity to meet virtually with representatives from Regence/MedSavvy,
MetLife, HealthEquity, Fidelity, VSP, Guild Mortgage, Mercy Flights, Reliant Behavioral Health, Willamette Dental Group,
Asante Physician Partners and Asante Health Network to discuss your benefits-related questions. Spouses are welcome
to attend all events.
Only employees who want to make changes to their current benefits, are enrolling or re-enrolling in a flexible spending
account (FSA) for 2021 or wish to elect earned time off (ETO) cash-out need to participate in open enrollment this year.
If you do nothing, your current benefits elections and covered dependents will automatically roll over into next year,
except for FSA plan participation and ETO cash-out.
What’s new for 2021 (summary of material modifications) Open enrollment events
HEALTH PLANS Virtual benefits fairs Virtual enrollment assistance
■ Benefits Asante’s new virtual fairs enable you to connect with The Asante Benefits team will be available virtually
• Varicose vein treatments were added; medically live representatives from Asante’s benefits vendors via during open enrollment to help you make your
necessary treatments are provided on all Asante
Health Plans. video! Go to myHR during the dates and times listed benefits elections on myHR. The benefits specialists
• Fertility treatments were added; includes limited below, select the Open Enrollment widget on the home will be able to remote in to your computer and help
coverage up to $7,500 per year with a $15,000 page, then click the link titled Virtual Benefit Fair. you with your elections only if you are logged into your
lifetime maximum on all Asante Health Plans. No appointment is necessary. Asante computer, not a personal computer.
• Physical therapy visit limit will increase from 80 to 100.
Monday, Nov. 2 | 7 a.m. to 4 p.m. Need assistance and ready to enroll? Call (541) 789-4551,
• All provider Category 3 deductibles will be reduced
by at least $500 on all Asante Health Plans. Thursday, Nov. 5 | 9 a.m. to 6 p.m. 8 a.m. to 5 p.m., Monday through Friday.
• All provider Category 3 out-of-pocket maximums will be Tuesday, Nov. 10 | 9 a.m. to 2 p.m.
reduced by at least $1,000 on all Asante Health Plans.
■ Provider networks
• Primary care providers, pediatricians and OB/GYNs
in Jackson and Josephine counties who were
processed at the Category 1 network level in 2020 as
part of the transition to the new plan design will be
covered at Category 2 as of Jan. 1, 2021.
■ Rates
• All Asante Health Plans will have a slight increase in
premium rates for 2021 (see rate charts on page 5).
DENTAL PLANS
■ Benefits
• The MetLife dental buy-up plan will cover in-network
basic services at 100% (up from 80% in 2020).
• The MetLife dental buy-up plan’s calendar-year
maximum will increase to $2,250. Eligibility rules
■ Rates
• Both MetLife dental plans will have a slight increase in Only those employees and dependents as Dependents. Your family members (dependents)
premium rates for 2021 (see rate charts on page 5). described below may be covered under the may also be eligible for certain benefits. Eligible
Asante Health Plans. dependents for health, dental, vision and certain
VISION PLANS voluntary benefits include your legal spouse and
All active employees: your children who are:
■ Benefits
• SunCare benefits will be added to both vision plans. Regular | 0.9–1.0 FTE ■ Under age 26, regardless of their marital and
This covers non-prescription sunglasses instead of Scheduled to work at least 72 hours per pay period student status and whether they live with you or
frames/lenses. you provide any of their support; or
• The vision buy-up plan allowance for frames will Regular | 0.7–0.8 FTE
increase from $180 to $200. Scheduled to work at least 56 hours per pay period ■ Physically or mentally incapable of self-support
• The vision buy-up plan will have a slight increase in due to a physical or mental disability that arose
premium for 2021 (see rate chart on page 5) Regular | 0.5–0.6 FTE prior to attaining the limiting age under the plan
Scheduled to work at least 40 hours per pay period and who are financially dependent on you for
HEALTH SAVINGS ACCOUNT Flexible | 0.1–0.4 FTE more than half of their support; or
• Per Internal Revenue Service regulations, the 2021 health Scheduled to work less than 40 hours per pay period ■ Under age 26 and for whom you are required
savings account (HSA) contribution limit will increase to by a Qualified Medical Child Support Order,
allow employees up to age 54 to contribute as much as judgment, decree or order issued by a court or
$3,600 annually for employee-only coverage and $7,200
for employees covering dependents. Employees age 55 through an administrative process established
and older can contribute an additional $1,000. under state law to provide medical coverage.
2 3
2021 annual open enrollment, Nov. 1–13 | How to enroll Medical/Rx
If you are planning to participate in open enrollment Semimonthly amount (taken from the first two pay periods of each month)
this year, you must do so between Nov. 1 and
Asante PPO Health Plan Employee only Employee + spouse Employee + child(ren) Employee + family
Don’t Nov. 13, 2020. Funds for 2020 FSAs must be used by
Dec. 31, 2020, because they do not roll over from year Regular (0.9–1.0 FTE) $37.86 $168.05 $131.16 $217.26
forget to year. All employees who want an FSA for 2021 Regular (0.7–0.8 FTE) $70.61 $205.38 $160.32 $265.49
must re-enroll during this open enrollment period. Regular (0.5 –0.6 FTE) $100.89 $261.40 $204.02 $337.91
The deadline to enroll is 1 p.m. on Nov. 13. Asante Savings Health Plan
Regular (0.9–1.0 FTE) $8.01 $74.15 $62.44 $101.46
Regular (0.7–0.8 FTE) $22.32 $105.38 $88.97 $145.18
Employees are required to participate in open enrollment only if:
Regular (0.5–0.6 FTE) $36.45 $145.16 $113.29 $187.64
■ The employee wants to enroll or re-enroll in an FSA for 2021 Asante Reimbursement Health Plan
■ The employee wants to make changes to current benefits Regular (0.9–1.0 FTE) $16.58 $120.18 $93.79 $155.36
■ The employee wants to add or remove dependents from coverage Regular (0.7–0.8 FTE) $42.64 $146.88 $114.65 $189.86
■ The employee wants to elect ETO cash-out Regular (0.5–0.6 FTE) $60.91 $186.94 $145.89 $241.64
Asante Flexible Workforce Health Plan
Flexible (0.1–0.4 FTE) $300.79 N/A $481.28 N/A
How to enroll Refer to the eligibility rules for definitions of regular and flexible employees.
1. Go to myHR: https://hr.asante
.org and click Continue to Sign
8. Select only the benefits you
plan to change.
Dental
In (if you’re automatically signed Semimonthly amount (taken from the first two pay periods of each month)
9. When finished making
in, skip to step 3).
elections, you will land on Regular employees Employee only Employee + spouse Employee + child(ren) Employee + family
2. You will be asked to sign in: the Review and Submit page, MetLife core plan $5.28 $16.20 $15.80 $24.08
■ If you are completing this or you can scroll to the bottom MetLife buy-up plan $7.94 $21.93 $21.37 $32.58
from home, use your Asante of the menu and click on
Willamette Dental Group $5.07 $15.59 $15.23 $23.15
email address (e.g., john.doe@ Review and Submit.
asante.org) and Asante 10. All of your elections will display
network password.
■ If you are completing this
at the bottom of the Review Vision
and Submit page. To submit
from any Asante network your elections, click the blue Semimonthly amount (taken from the first two pay periods of each month)
workstation, use your Asante Submit button at the top of
Regular employees Employee only Employee + spouse Employee + child(ren) Employee + family
network username and the page.
password. Core vision $0.93 $2.77 $2.89 $6.76
11. Confirm your submission. Buy-up vision $4.49 $8.23 $8.46 $15.75
3. On the myHR home page,
locate the widget titled Open Once you’ve submitted your
elections, a confirmation
Enrollment.
statement will be sent to your Asante Health Plan medical premium assistance
4. Click on My Open Enrollment. Asante email address.
This program is intended to help offset a portion of the 2021 hourly wage
5. If you plan to add new 12. To make changes to elections cost of health plan coverage for lower-wage employees. Health plan category
Health plan comparison chart
Asante PPO Health Plan Asante Savings Health Plan Asante Reimbursement Health Plan
Asante Regence Asante Regence Asante Regence
Medical Preferred Regence Limited Out-of- Preferred Regence Limited Out-of- Preferred Regence Limited Out-of-
Network Network Network network Network Network Network network Network Network Network network
(Category 1) (Category 2) (Category 3) (Category 4) (Category 1) (Category 2) (Category 3) (Category 4) (Category 1) (Category 2) (Category 3) (Category 4)
Deductible — individual $500 $1,500 $2,500 $1,400 $3,000 $4,500 $1,000 $1,500 $2,500 $4,000
Deductible — family $1,000 $3,000 $4,000 $2,800 $6,000 $9,000 $2,000 $3,000 $5,000 $7,000
Out-of-pocket maximum — individual $2,500 $3,500 $6,000 $8,250 $2,000 $3,000 $5,000 $8,000 $2,000 $3,500 $5,500 $8,000
Out-of-pocket maximum — family $5,000 $7,000 $12,000 $16,500 $3,000 $6,000 $10,000 $14,000 $4,000 $7,000 $11,000 $16,000
Office visit — primary care provider $10* $25* N/A 40% 10% 15% N/A 40% $10* $25* N/A 40%
Office visit — specialist $10* $25* $75* 50% 10% 15% 40% 50% $10* $25* $75* 50%
Inpatient/outpatient professional 15% 15% 40% 50% 10% 15% 40% 50% 10% 15% 40% 50%
Inpatient/outpatient facility 15% 30% 40% 50% 10% 30% 40% 50% 10% 30% 40% 50%
Lab/X-ray 15% 30% 40% 50% 10% 30% 40% 50% 10% 30% 40% 50%
Urgent care $10* $25* $75* 50% 10% 30% 40% 50% $10* $25* $75* 50%
Emergency Department $150* (waived if admitted) 15% 15% 15% 15% $150* (waived if admitted)
Acupuncture ($2,000 limit) Not covered N/A 20% 20% 40% N/A $25* $25* 50%
Chiropractic ($2,000 limit) Not covered N/A 20% 20% 40% N/A $25* $25 50%
Wellness program contributions (see page 10 for details)
Asante Health Fund Contributions to HealthEquity HRA Contributions to HealthEquity HSA Contributions to HealthEquity HRA
Annual basic contributions
Only full-time employees enrolled
as of Jan. 1, 2020, are eligible. $0 $300 — Employee-only coverage category $300 — Employee-only coverage category
Contributions will be made in $600 — All other coverage categories $600 — All other coverage categories
January 2021.
Annual wellness activity Up to $75 per enrolled Up to $300 per enrolled Up to $300 per enrolled
employee and spouse employee and spouse employee and spouse
Prescription drug (Rx)
Asante Regence Asante Regence Asante Regence
Preferred Regence Limited Out-of- Preferred Regence Limited Out-of- Preferred Regence Limited Out-of-
Network Network Network network Network Network Network network Network Network Network network
(Category 1) (Category 2) (Category 3) (Category 4) (Category 1) (Category 2) (Category 3) (Category 4) (Category 1) (Category 2) (Category 3) (Category 4)
Rx out-of-pocket maximum Shared with medical Not covered Shared with medical Not covered Shared with medical Not covered
Generic Rx $5* $15 $15 Not covered $5 $15 $15 Not covered $5* $15 $15 Not covered
Brand formulary Rx 25% 35% 35% Not covered 25% 35% 35% Not covered 25% 35% 35% Not covered
Non-brand formulary Rx 30% 40% 40% Not covered 30% 40% 40% Not covered 30% 40% 40% Not covered
* = Deductible waived % = Coinsurance (amount you pay)
6 7
Asante Health Plans 2020
Provider networks explained Basic and supplemental life insurance
You have the freedom to choose your providers on all Asante Health Plans; however, depending on which network your Asante pays for a basic life insurance policy for all regular employees, and you are automatically enrolled on your
provider has chosen to participate in, it will affect your out-of-pocket costs differently. date of hire (or benefits eligibility date). For details about this plan, please refer to myHR. Employees may elect
to purchase additional life insurance for themselves, their spouse or their child(ren). Refer to myHR for rates and
Four categories in each plan biweekly premium amounts. Coverage limitations are as follows.
Each plan offers four categories of network coverage.
Supplemental life insurance coverage limitations
Asante Preferred Network (Category 1)
Employee coverage ■ Guarantee issue at initial eligibility: up to $150,000
■ (1) Asante providers, services and facilities and (2) independent providers, services
and facilities aligned with Asante through the Asante Health Network* ■ Guarantee issue increases at open enrollment: $20,000*
■ Maximum coverage with evidence of insurability: $450,000
Best value
Spouse coverage ■ Guarantee issue at initial eligibility: up to $25,000
Regence Network (Category 2) ■ Guarantee issue increases at open enrollment: $10,000*
■ Maximum coverage with evidence of insurability: up to $250,000 (but not more than
■ Providers, services and facilities not in the Asante Preferred Network but part of
employee coverage**)
the Regence-contracted network
More options ■ All primary care providers (general practice, family practice and internal medicine) Child(ren) coverage ■ Guarantee issue at any time: up to $10,000
and OB/GYNs in Jackson and Josephine counties who see adult patients, regardless ■ Coverage options: $2,500, $5,000, $7,500, $10,000
of network status.
■ Independent specialty services not offered in the Asante Preferred Network *Increases above the guarantee issue amount are approved following medical underwriting approval. If you or your covered spouse
reaches an age shown below, the amount of life insurance will be the amount you have, reduced to the following percentage of your
Regence Limited Network (Category 3) benefit: age 70–74: 67%; age 75 and older: 50%. Limitations apply to coverage increases when the covered member is not actively at
work on the coverage effective date.
■ Providers and facilities that are contracted as “specialists” in the Regence
**Employee coverage includes the employee’s supplemental life insurance policy in addition to the basic life insurance policy that
BlueCross BlueShield of Oregon PPO Network that provide services already
Costlier Asante pays for.
offered in the Asante Preferred Network
Out-of-network (Category 4)
Additional benefits options†
■ Providers or facilities that are not contracted with the Regence Blue Cross Blue Shield
of Oregon PPO Network or providers that are not contracted with the national ◼ Accident insurance
Rare BlueCard network are considered non-participating (out of network)
◼ Auto and home insurance
*To check providers in the Asante Health Network go to asantehealthnetwork.org. ◼ Critical illness insurance
You can also visit Regence.com to check provider categories. ◼ Dependent care FSA, health FSA,
limited-purpose FSA
◼ Hyatt legal insurance
Frequently asked questions
◼ Mercy Flights
What if my provider is in the My doctor is not in the Asante What if I want to continue seeing ◼ Short-term disability insurance
Asante Preferred Network Preferred Network. Will an my specialist who is not part of
(Category 1) but refers me Asante provider be available the Asante Preferred Network? †Please refer to myHR or
outside that network for for me? If that provider offers the same clinical asante.org/employee-benefits for
services such as an imaging Asante employees who services as an Asante Preferred detailed benefits information.
scan or laboratory test? choose to establish care with Network specialist, your out-of-pocket
Imaging, lab services and procedures an Asante Physician Partners costs will fall under the Regence
performed outside an Asante primary care provider are Limited Network (Category 3). If the
Preferred Network facility fall under given preferential access. Asante Preferred Network does not
the Regence Limited Network The new-patient access team can offer that specialty service, however,
(Category 3). be reached at (541) 789-1234. that provider would be under the
Regence Network (Category 2).
8 9Asante Health Plan
2021 wellness program Annual required notices
be Well to our health
This document provides you with important notices and information Website: oregon.gov/OHA/healthplan/Pages/index.aspx
about the Asante Health Plan. Address: 500 Summer St. NE E37, Salem, OR 97301-1079
■ Women’s health and cancer rights To request special enrollment or obtain more information, contact the
■ Special enrollment rights Asante Human Resources Department at (541) 789-4551.
■ Newborns’ and mothers’ health protection
■ Premium assistance under Medicaid and the Children’s Health
Notice about newborns’ and mothers’ health protection
Insurance Program (CHIP) Group health plans and health insurance issuers generally may not,
Earn a premium credit through Step 1. Complete a biometric a preventive exam with your under federal law, restrict benefits for any hospital length of stay in
Notice about women’s health and cancer rights in the connection with childbirth for the mother or newborn to less than
Know Your Numbers screening or preventive exam primary care provider if it includes 48 hours following a vaginal delivery or less than 96 hours following
As a regular Asante employee, that includes biometric screening biometric screening. Asante Health Plan a cesarean section. However, federal law generally does not prohibit
The Women’s Health and Cancer Rights Act of 1998 requires group
you and your covered spouse by Dec. 31, 2020. health plans to cover certain expenses relating to a mastectomy. The
the mother’s or newborn’s attending provider, after consulting with the
Complete an on-site biometric Step 2. Complete the Healthy mother, from discharging the mother or her newborn earlier than
have an opportunity to earn a Asante Health Plan complies with this law and covers the following: 48 hours (or 96 hours as applicable). In any case, plans and issuers may
wellness credit toward your 2021 screening at an Asante facility Lifestyle Assessment on MyChart ■ Medical and surgical charges directly related to a mastectomy not, under federal law, require that a provider obtain authorization from
Asante Health Plan premium by Dec. 31. Refer to myHR for by Dec. 31, 2020. ■ Reconstruction of the breast on which the mastectomy has been the plan or the insurance issuer for prescribing a length of stay not in
contributions by participating in appointment times, locations and Sign into your MyChart account, performed excess of 48 hours (or 96 hours).
■ Surgery and reconstruction of the other breast as necessary to provide
a biometric screening and online online scheduling or call Asante or create one, and check your Notice about premium assistance under Medicaid
a symmetrical appearance
health assessment. Health Promotion at (541) 789-5211. messages to access your Healthy ■ Prosthetic devices relating to such breast reconstruction and the Children’s Health Insurance Program
Alternatively, you may complete Lifestyle Assessment. ■ Treatment of physical complications arising from a mastectomy If you or your child(ren) are eligible for Medicaid or CHIP and you are
These benefits will be provided subject to the same deductibles, co-pays eligible for health coverage from your employer, your state may have
Know Your Numbers premium credit and co-insurance provisions applicable to other medical and surgical
benefits provided under the plan.
a premium assistance program that can help pay for coverage, using
funds from its Medicaid or CHIP program. If you or your child(ren)
are not eligible for Medicaid or CHIP, you will not be eligible for these
2021 semimonthly premium credit If you have any questions regarding this law, please contact the Asante
Upon completion of Know Human Resources Department at (541) 789-4551 or Regence at
premium assistance programs but you may be able to buy individual
If employee completes If spouse completes If both complete insurance coverage through the health insurance marketplace. For more
Your Numbers, employees (866) 344-8235. information, visit healthcare.gov.
Health plan Know Your Numbers Know Your Numbers Know Your Numbers
will see the appropriate
Notice about special enrollment rights in the Asante Health Plan If you or your dependents are already enrolled in Medicaid or CHIP
amount semimonthly in the Asante PPO Health Plan and Loss of other coverage. If you declined enrollment for yourself or your and you live in a state listed below, contact your state Medicaid or CHIP
Asante Reimbursement Health Plan $16.25 $10.84 $27.09
earnings section of their dependents (including your spouse) because of other health insurance office to find out if premium assistance is available.
checks, marked “Wellness or group health plan coverage, you may be able to enroll yourself and
Asante Savings Health Plan $13* $8.67 $21.67 your dependents in this plan if you or your dependents lose eligibility
If you or your dependents are not currently enrolled in Medicaid or
Discount.” for that other coverage (or if the employer stops contributing toward
CHIP and you think you or any of your dependents might be eligible
*Regular 0.9–1.0 FTE employees enrolled in the Asante Savings Health Plan who are not covering dependents will for either of these programs, contact your state Medicaid or CHIP
your or your dependents’ other coverage). You do not need to wait for
receive a $2.17 premium credit and a $10.83 semimonthly HSA contribution. office, call (877) KIDS NOW or visit insurekidsnow.gov to find out
the next open enrollment period. You must request enrollment within
how to apply. If you qualify, ask your state if it has a program that
30 days after your or your dependents’ other coverage ends (or after the
might help you pay the premiums for an employer-sponsored plan.
Earn HSA/HRA incentives employer stops contributing toward the other coverage).
New dependent by marriage, birth, adoption or placement for adoption. If you or your dependents are eligible for premium assistance under
If you have a new dependent as a result of marriage, birth, adoption Medicaid or CHIP and are eligible under your employer plan, your
Engage in a few of these activities and maximize your HealthEquity Asante or placement for adoption, you may be able to enroll yourself and employer must allow you to enroll in your employer plan if you aren’t
contribution for 2021! Incentives apply to enrolled employees and their Asante PPO Reimbursement or your dependents without waiting for the next open enrollment period. already enrolled. This is called a “special enrollment” opportunity, and
enrolled spouses; some restrictions apply. Health Plan Savings Health Plan You must request enrollment within 30 days after the marriage, birth, you must request coverage within 60 days of being determined eligible
adoption or placement for adoption. for premium assistance. If you have questions about enrolling in your
employer plan, contact the Department of Labor at askebsa.dol.gov or
Incentive option Who is eligible? Award amount Award amount Individuals who become eligible for state premium assistance subsidy. call (866) 444-EBSA (3272).
If you declined enrollment for yourself or your dependents (including
Complete a preventive exam.* Employee + spouse $50 $100 your spouse), you may enroll yourself or your dependent(s) in this plan if If you live in Oregon, you may be eligible for assistance paying your
employer health plan premiums. If you reside in another state, please
• The family loses its Medicaid or CHIP coverage because its contact Asante Human Resources at (541) 789-4551.
Complete any interactive program employment situation improves; the family can then sign up for
on Regence Empower.** employer-sponsored coverage without having to wait for the open The following is current as of July 31, 2020. Contact your state for more
Employee + spouse $50 $150 information about eligibility.
There are 12 options to choose from enrollment period and experiencing a gap in coverage.
to support you where you are. • A child becomes eligible for Medicaid or CHIP and has access to OREGON — Medicaid
employer-sponsored coverage that the state wishes to subsidize healthcare.oregon.gov • Phone: (800) 699-9075
Engage with Journi by downloading through a premium assistance option; the family may then sign up
the Journi app immediately and does not have to wait for the open enrollment To see if any other states have added a premium assistance program since
Employee + spouse $25 $50 period. Enrollment must be requested within 60 days following the July 31, 2020, or for more information about special enrollment rights,
If already downloaded, you will need to log in date of the eligibility event. contact either of the following:
on or after Jan. 1, 2021, to receive the credit.
For information about eligibility for coverage either through Medicaid U.S. Department of Labor
or Oregon’s CHIP program (typically administered through the Oregon Employee Benefits Security Administration
Total funds available per participant $75 $300 Health Plan), please contact the Department of Human Services: dol.gov/ebsa • (866) 444-EBSA (3272)
Oregon Department of Human Services, U.S. Department of Health and Human Services
*Age-appropriate preventive exams include: adult physical, routine OB/GYN exam, colorectal cancer screening, cervical cancer screening and routine mammogram.
Also included are establish-care visits, preventive dental exams and preventive vision exams. Office of Medical Assistance Programs Centers for Medicare & Medicaid Services
**Interactive programs include: Improving Your Blood Pressure, Managing Your Stress, Improving Your Sleep, Achieving Your Healthy Weight, Maintaining Your Health, Phone: (503) 945-5772 • Toll-free: (800) 527-5772 cms.hhs.gov • (877) 267-2323, menu option 6, ext. 61565
Building Resilience, Enhancing Your Physical Activity, Nutrition for Better Health, Quitting Tobacco, Staying Tobacco-Free, Improving Your Oral Health and Financially Fit. TTY: (800) 375-2863 • Email: dhs.info@state.or.us
10 11Notice regarding Asante Wellness Programs in some cases may also be used to offer you services through the Asante
Asante Wellness Programs are voluntary wellness programs available to Wellness Programs. You also are encouraged to share your results
employees and their spouses participating in one of the Asante medical or concerns with your own doctor.
plan options (“Medical Plan”). The programs are administered according Protections from disclosure of medical information
to federal rules permitting employer-sponsored wellness programs The medical information received as part of the Asante Wellness Programs
that seek to improve employee health or prevent disease, including is subject to the privacy and security rules of HIPAA. We are required
the Americans with Disabilities Act of 1990, the Genetic Information by HIPAA and other applicable laws to maintain the privacy and security
Nondiscrimination Act of 2008 and the Health Insurance Portability of your personally identifiable health information. The Asante Wellness
and Accountability Act (HIPAA), as applicable, among others. Programs and Asante may use aggregate information it collects to design
The three Asante Wellness Programs programs based on identified health risks in the workplace. However,
■ The first Asante Wellness Program gives the employee premium credits the Asante Wellness Programs will never disclose any of your personal
toward the Medical Plan premiums otherwise payable by the employee information either publicly or to your employer, except as necessary to
in the following calendar year. To earn this incentive, you must complete respond to a request from you for a reasonable accommodation needed
two tasks in the current calendar year. to participate in the Asante Wellness Programs or as otherwise expressly
permitted by law. Medical information that is produced through the Asante
For example, to earn the premium credit for 2022, you must complete Wellness Programs and that personally identifies you will not be provided
two tasks in 2021. The first task to complete is a voluntary online to your supervisors or managers and may never be used to make decisions
Healthy Lifestyle Assessment in MyChart that asks a series of questions regarding your employment.
about your health-related activities and behaviors and whether you have
or had certain medical conditions (e.g., cancer, diabetes or heart disease). Your health information will not be sold, exchanged, transferred or otherwise
disclosed except to the extent permitted by law to carry out specific
The second task to complete is an on-site biometric screening — or have activities related to the Asante Wellness Programs. You will not be asked
an off-site preventive medical exam that includes biometric screening for or required to waive the confidentiality of your health information as a
height, weight, waist circumference, blood pressure, total cholesterol and condition of participating in the Asante Wellness Programs or receiving an
HDL cholesterol. If your spouse also completes these two tasks, your incentive. Anyone who receives your information for purposes of providing
premium credits will increase. you services as part of the Asante Wellness Programs will abide by the same
■ The second Asante Wellness Program provides incentives of up to $600 confidentiality requirements. The only individuals who will receive your
in annual contributions to the employee’s health reimbursement account personally identifiable health information are those who will provide you
(HRA) or health savings account (HSA). These incentives are available if with services under the Asante Wellness Programs.
the employee or spouse completes the following tasks:
In addition, all medical information obtained through the Asante Wellness
1. Have one of the following preventive exams: wellness exam, weight Programs will be maintained separately from your personnel records, and
screen, vision or dental exam, colorectal cancer screen, mammogram, no information you provide as part of the Asante Wellness Programs will
women’s health exam, or prostate or skin cancer screen. be used in making any employment decision.
2. Complete one of the interactive programs available on the Empower You may not be discriminated against in employment if you decide not to
section of regence.com. participate one or more aspects of the Asante Wellness Programs or because
3. Download the Journi mobile app and log in. If already downloaded, of the medical information you provide as part of participating in the
you will need to log in on or after Jan. 1, 2021, to receive the credit. Asante Wellness Programs. You will not be subjected to retaliation if you
For employees or spouses participating in the Asante Savings Health Plan choose not to participate.
or the Asante Reimbursement Health Plan, if either the employee or the If you have questions or concerns regarding this notice or about protections
spouse completes the first task, the employee will receive a $100 contribution against discrimination and retaliation, please contact Asante Health
into the employee’s HRA or HSA. If the employee or spouse completes Promotion at (541) 789-4995.
the second task, the employee will receive a $150 contribution into the
employee’s HRA or HSA. If the employee or spouse completes the third Notice of nondiscrimination
task, the employee will receive a $50 contribution into the employee’s HRA ■ Asante complies with applicable federal civil rights laws and does not
or HSA. If both employee and spouse complete all the required tasks, the discriminate on the basis of race, color, national origin, age, disability or
employee will receive a $600 contribution into the employee’s HRA or HSA. gender. Asante does not exclude people or treat them differently because
For employees or spouses participating in the Asante PPO Health Plan, if of race, color, national origin, age, disability or gender.
■ Asante provides free aids and services that allow people with disabilities
either the employee or the spouse completes either the first or the second task,
the employee will receive a $50 contribution into the employee’s HRA. If to communicate effectively with caregivers and others in the
either the employee or the spouse completes the third task, the employee will organization, including:
receive a $25 contribution into the employee’s HRA. If employee and spouse • Qualified sign language interpreters
each complete the first or second task plus the third task, the employee will • Written information in other formats (large print, audio,
receive a $150 contribution into the employee’s HRA. These contributions are accessible electronic formats and other formats)
in addition to any other contribution that Asante makes to these accounts. ■ Asante provides free language services to people whose primary
language is not English, including:
Rules applicable to all three Asante Wellness Programs • Qualified interpreters
You are not required to complete the Healthy Lifestyle Assessment, the Regence • Information written in other languages
Empower health risk assessment or other tasks listed above or to participate
in the blood tests or other parts of the biometric screening or a medical If you need these services, contact Alicia Lorenz at the phone number or
examination. However, only employees and spouses who choose to complete email address listed below.
the required tasks will receive an incentive in the following calendar year. If you believe that Asante has failed to provide these services or
Spouses who participate in the Asante Wellness Programs must complete discriminated in another way on the basis of race, color, national origin,
an authorization form prior to beginning a program. This form is available age, disability or gender, you can file a grievance with:
from Asante Employee Health. Alicia Lorenz, director of employee and labor relations
2635 Siskiyou Blvd., Medford, OR 97504
If you are unable to participate in any of the health-related activities or Phone: (541) 789-4227 • Fax: (541) 789-4509
achieve any of the health outcomes required to earn an incentive under Email: alicia.lorenz@asante.org
any of the Asante Wellness Programs, you may be entitled to a reasonable
accommodation or an alternative standard. If you think you might be You can file a grievance in person or by mail, fax or email. If you need
unable to meet a standard for an incentive, you can earn the incentive help filing a grievance, Alicia Lorenz is available to help. You can also file
by different means. You may request a reasonable accommodation or an a civil rights complaint electronically through the Office for Civil Rights
alternative standard by contacting Asante HR/Benefits at (541) 789-4551. Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf
We will work with you (and, if you wish, your doctor) to find a program or by mail or phone at:
with an incentive that is right for you and your health status. U.S. Department of Health and Human Services
The information from your Healthy Lifestyle Assessment, the Regence 200 Independence Ave., SW, Room 509F, HHH Building
Empower health risk assessment, your biometric screening, medical exams Washington, DC 20201
or any other medical tests that are part of the Asante Wellness Programs Phone: (800) 368-1019 • TDD: (800) 537-7697
will help you understand your current health and potential health risks and Complaint forms are available at hhs.gov/ocr/office/file/index.html.You can also read
