Open Enrollment 2018 Diocese of Lafayette
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Open Enrollment
2018
Diocese of Lafayette
What is the definition of Benefits Eligible? • Employees who are employed at 30 hours/week or greater are eligible for diocesan benefits. • ALL paid employees are eligible to enroll in ancillary benefits with AFLAC, through payroll deduction.
Can I enroll my family members?
You may enroll the following family members:
Your lawful spouse
Your child(ren) up to age 26 - with the
exception of Incapacitated Dependent – see your plan
document for more information
Proof of dependent eligibility
Is required.
Dependent Eligibility Documentation To add dependent(s) to your plan, please provide copy (not original) as follows: Documentation to add spouse: • Copy of Marriage License/Certificate Documentation to add child(ren): • Copy of Birth Certificate(s) • Proof of legal guardianship or custody papers • Qualified medical child support order
Cafeteria Plan for Pre-Tax Premiums • The portion of your premiums paid through payroll deduction are processed on a pre-tax basis, unless you advise otherwise. • Should you receive tax-free benefits under this Plan, the amount of contributions you make to SS as well as your employer’s contribution to SS will be reduced. • Check with your tax advisor for information about your specific situation.
Cafeteria Plan • You must re-enroll in the Cafeteria / Flexible Spending* Plan annually. • Plan year runs January 1 through December 31. • Premiums processed through Cafeteria plan cannot be changed unless there is a Qualifying Life Event. (For example…spouse’s new job offers family coverage and employee elects to drop family from diocesan insurance.) *at participating locations
Pre-Tax Deductions Include • Diocesan health, dental and vision premiums • Aflac premiums (Cancer, Critical Care/SP Health; Accident; Hospital and Intensive Care)
Open Enrollment • Open Enrollment occurs during the months of November & December. • Changes made during open enrollment are effective January 1st. • For Life, LTD and STD, coverage becomes effective once approved by Hartford. • Enrollment/Change Forms must be submitted • Once enrolled, changes are not allowed unless you experience a qualifying life event.
Qualifying Life Events – Change in marital status – Birth or adoption of a child – Death of your spouse or dependent – Change in your spouse’s employment – Dependent child reaches age 26 • Qualifying Life Event changes must be submitted, in writing with proper documentation, to your local Benefits Coordinator within 31 days of the event. The change in coverage must be related to the event.
Health Insurance
Health Insurance
Administered through Blue Cross Blue Shield
• Individual coverage:
»$582.00 - Employer
»$25.00 - Employee
• Family coverage:
»$675.00 - EmployeeBenefits Offered through a PPO Plan • Benefits are offered through a PPO Plan (Preferred Provider Organization). • With a PPO plan, you have access to both in- and out- of- network providers: “in-network” providers (those for whom we have a PPO contract) “out-of-network” providers (no PPO contract). Greater cost savings by using in-network providers. BCBS is the largest healthcare network in the nation.
Deductible and Out of Pocket Max • Annual Deductible - the amount you have to pay for health care services before your health plan coverage kicks in. • Out-of-Pocket Maximum - a limit on the amount you pay out of your pocket towards eligible covered health care expenses each plan year. This protects you from financial exposure due to catastrophic health events. • Plan Year – January through December.
In-Network Providers • You are responsible for all costs up to your annual in- network deductible amount ($650). (January – December) • After you satisfy the deductible, a 20% co-payment is required for eligible benefits (office visits, urgent care, etc.) and the plan pays the remaining 80% of eligible benefits. • When your co-pays for eligible covered expenses reach the annual out-of-pocket maximum ($1,950), the plan pays 100%.
Out-of-Network Providers • You are responsible for all costs up to your annual deductible amount ($650). (January – December) • For eligible covered expenses, after you satisfy the deductible, a 40% co-payment is required for eligible benefits (office visits, urgent care, etc.) and the plan pays the remaining 60% of eligible benefits. • Out-of-network charges DO NOT APPLY toward the out- of-pocket maximum and are NEVER paid at 100%. • Going out-of-network results in higher out-of-pocket costs .
CVS/Caremark Pharmacy Benefits • Pharmacy benefits are included with your medical plan. • More than 66,000 network pharmacies to choose from. • Plan uses a 3-Tier Formulary (in-network pharmacy) and offers options for purchasing a 90-day supply of certain medication.
CVS/Caremark Pharmacy Benefits
Generic Drugs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $10
Brand Name Drugs; Generic Not Available . . . . . . $20
Brand Name Drugs; Generic Available . . . . . . . . . $30
www.MyHealthToolkitLa.comSample BCBS Member ID Card Section 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . Employee Info Section 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Member ID Section 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . Pharmacy Info Section 4 . . . . . . . . . . . . . . . . . . . . . BCBS Member Website
www.MyHealthToolkitLA.com
BENEFITS & CLAIMS
Displays selected member/family deductible and
out-of-pocket payment status
QUICK LINKS
Provides fast access to tools most often used by
members.
FINANCIAL INFO
Status of member/family financial accountsDental & Vision Insurance
Dental & Vision Insurance • There are two benefit levels for the dental and vision plans: base and buy-up. • Eligible employees enrolled in diocesan health insurance are offered diocesan BASE dental and BASE vision coverage as part of their health insurance package, at no cost to the employee. • Employees may purchase, at their expense, additional buy-up benefits.
Dental & Vision Insurance • Employees enrolled in either the base or buy-up plans have the option of selecting a dentist or eye doctor of his/her choice from either the PPO network or a non- network doctor. • When you receive treatment from a Humana PPO dentist or eye doctor, your costs will be reduced. • Non-network providers can bill you for charges above the amount covered by your plan. Also, the coinsurance level will apply to the maximum allowable fee.
Dental & Vision Insurance
For both, base and buy-up:
• Calendar Year Deductible: $50 (Individual)
$150 (Family)
• Annual Maximum: $1,000
• Orthodontia Services – Members of either plan may be able
to receive up to a 20% discount if they visit an orthodontist
from the Humana Dental PPO Network.
• BASE Plan covers Preventative services at 90%
• BUY-UP Plan covers Preventative services at 100%Dental & Vision Insurance BASE DENTAL PLAN BUY-UP DENTAL PLAN Covers Preventative Covers Preventative services at 90% (no services at 100% (no deductible) deductible) Covers Basic services Covers Basic services at 40% (after deductible) at 50% (after deductible) Major services – may Major services – 25% receive discount (after deductible)
Dental & Vision Insurance • Access to a huge network, including LensCrafters, Pearle Vision, Sears Optical, Target Optical, and JC Penney Optical. • Cost Savings – out of pocket cost is based on wholesale pricing for frames, avoiding high retail markups. • Choice – you have access to exclusive lines of designer frames, such as Ralph Lauren, Oakley, Dolce & Gabana, Ray-Ban. • Coverage levels vary for the base and buy-up plans.
Dental & Vision Insurance BASE VISION PLAN BUY-UP VISION PLAN Exam with Dilation Exam with Dilation $10 copay 100% after $15 copay Lenses Lenses (single/bifocal/ trifocal) (single/bifocal/ trifocal) 20% retail discount 100% after $20 copay Frames Frames 20% retail discount $50 wholesale allowance Contact Lens Contact Lens (evaluation and fitting) (evaluation and fitting) 15% discount 100% Medically Necessary
Dental & Vision Insurance • For additional information on coverage and to view the differences in the base and buy-up plans, view the Humana Dental and Vision brochures provided in your packets. • Once enrolled, you can also visit the following websites to learn more about your plans: – For dental, visit www.mycompbenefits.com – For vision, visit www.HumanaVisionCare.com
Retirement
Retirement Plan
All 30-Hour benefits eligible employees can participate in the
Diocesan Retirement Plan.
Please use this opportunity to visit with our local Investment
advisors, Cornerstone Financial Group, to review your
account.
Location contributes percentage of your gross salary each
pay period. Please see your locations Benefits Coordinator
to find out what percentage your locations currently
contributes to your account.
You have the opportunity to make personal contributions
through payroll deduction, but are NOT required to do so.
Open Enrollment is a great time to update your personal
contribution (or begin contributing) for the new year.Retirement Plan The plan allows you to contribute pre-tax or after-tax (Roth) deductions or a combination of both. The value of your account depends on how much is contributed and how well the investments perform. At retirement, you receive the balance in your account, reflecting the contributions and investment gains or losses. Regularly review your quarterly statements. Meet with a member of our investment team at Cornerstone Financial Group for a free account analysis. Be sure to keep beneficiaries up to date. Open Enrollment is a perfect opportunity to update your beneficiaries.
Retirement Plan
2018 IRS 403(b) Annual Retirement
Contribution Limits
Maximum Limit $18,500
Catch-up (Age 50+) $6,000Retirement Plan Please visit www.diolafretire.org to access/manage your account.
Retirement Plan
Personalized investment advice is available to participants by
contacting our local advisors:
Cornerstone Financial Group, Inc.
213 N. College Road
Lafayette, LA 70506-4230
(337) 233-6066Life, LTD &STD Insurance
Life, Long-Term, and Short-Term Disability • These are optional benefits, with coverage through The Hartford. • Employee is responsible for the premium, through payroll deduction.* • If coverage was waived at hiring, employee has the option to enroll during Open Enrollment but will be considered a “late applicant” and becomes subject to approval based on health questionnaire. * Dependent upon location
Life, Long-Term, and Short-Term Disability • Life Insurance benefit is 1 ½ times annual salary (can be converted to individual policy upon termination). • Long-Term Disability Insurance pays 66 2/3 ($5,000 max monthly), coordinated with social security, etc. (elimination period, 6 months). • Short-Term Disability Insurance pays according to weekly earnings/option (elimination period, 14 days).
Life, Long-Term, and Short-Term Disability
Specific questions regarding these benefits should be
directed to the plan administrator:
Trae Brashear or Kathy Ebey
(337) 247-9717Cancer, Critical Care, Accident & Hospital
Aflac • The following optional benefits are offered through Aflac. Premiums are processed through payroll deduction. – Cancer Care Indemnity Insurance – Critical Care Protection – Accident Only Insurance – Hospital Advantage – Critical Illness Benefit Rider
Aflac
Lisa Newsom at (337) 802-2468
or
Patrick Newsom at (225) 505-2030Open Enrollment Resources • For additional information, please visit the Open Enrollment 2018 webpage via the diocesan website, www.diolaf.org/open-enrollment. • You may also visit the Benefits Overview webpage, www.diolaf.org/benefits-overview for a list of complete benefits offered by the Diocese.* *Please check with your location as they may offer additional benefits not listed on the Benefits Overview webpage.
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