Open Enrollment 2021 Hackensack Meridian Health - October 26 - November 20 - TeamHMH
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Hackensack Meridian Health
Open Enrollment 2021
October 26 – November 20
Open Enrollment 2021
WELCOME
Ø Welcome to our 2021 Benefits Open Enrollment Webinar!
Ø All Hackensack Meridian Health Benefit Fairs will be held virtually this year. To view the Benefits
Webinar schedule, please visit our TeamHMH Open enrollment website -
https://teamhmh.com/OpenEnrollment
Ø Benefits Open Enrollment is your annual opportunity to make changes to your healthcare benefits,
add or drop eligible dependents from coverage, and setting up or changing flexible spending
accounts.
Ø Even if you aren’t making any changes to your benefits, open enrollment is a great time to get to
know what’s in your new plan such as the new Omnia 4-Tier plan so you’ll be prepared when you
need to use it.
Ø It is also a great time to add, drop or update any dependent and/or beneficiaries as well as
confirming your tobacco and spousal surcharge.
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Open Enrollment 2021
AGENDA
Ø What you need to know – Important Highlights
Ø What actions will need to be taken – moving into a plan or remaining in a plan
Ø Overview of our Health plans
• Medical plans
• Dental plans
• Vision plans
• Spending Accounts
• Life/AD&D
Ø Voluntary Benefits through Farmington
Ø Where and how to enroll
Ø Important highlights
Ø Questions
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Open Enrollment 2021
What You Need to Know
Ø A new health plan being offered this year is the OMNIA Health plan from Horizon Blue Cross Blue Shield
of New Jersey
Ø The new OMNIA 4-tier plan will be offered in place of the Premium Plus and Premium Plans.
Ø The Basic/High Deductible Plan will continue to be offered with no changes from last year’s plan.
Ø The Out-of-Area plan (originally called Out of NJ plan), will continue to be offered with minimal
changes. This plan will now include certain zip codes throughout NJ.
Ø No plan design changes to dental, vision, life, LTD, and voluntary benefits through Farmington
Ø Premiums are based on 26 pay periods
Ø Your current benefits will automatically be enrolled in the one closest to their current 2020
plan. The only exception is flexible spending accounts, which require a new election every
year.
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Open Enrollment 2021
Do I Need to Enroll?
Ø Even if you aren’t making any changes to your benefits, open enrollment is a great
time to get to know what’s in your new plan such as the new Omnia 4-Tier plan
Ø If team members do not make a plan selection on their own, they will
automatically be enrolled in the one closest to their current 2020 plan.
YOUR CURRENT PLAN:
Premium Plus plan Premium plan Basic/High Deductible plan Out of NJ plan
YOU WILL MOVE TO:
OMNIA 4-Tier plan OMNIA 4-Tier plan Basic/High Deductible plan Out-of-Area plan
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Open Enrollment 2021
Medical Plans at a Glance
Ø OMNIA 4-Tier Health Plan
• Access to leading doctors
• Low copays and deductibles
• No copays or deductibles with Inner Circle Prime facilities, doctors and other health care professionals
• BlueCard for access to doctors when you travel
Ø Basic/High Deductible Plan
• Consumer Directed Health Plan
• 100% coverage after you’ve met your deductible when you use Inner Circle facilities, doctors and other
health care professionals
• Pair with a health savings account
• BlueCard for access to doctors when you travel
Ø Out-of-Area Plan
• For non-NJ residents and residents in remote NJ counties
• Low copays through the Horizon PPO Network
• BlueCard for access to doctors when you travel
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Open Enrollment 2021
Medical/Quick Side-by-Side Comparison
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Open Enrollment 2021
Medical/OMNIA Health Plan-Inner Circle Prime
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Open Enrollment 2021
Medical/OMNIA Health Plan - Inner Circle
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Open Enrollment 2021
Medical /OMNIA Health Plan - Tier 1
10Open Enrollment 2021
Medical/OMNIA Health Plan - Tier 2
11Open Enrollment 2021
Medical/Basic-High Deductible Plan
12Open Enrollment 2021
Medical/Out-Of-Area Plan
13Open Enrollment 2021
Medical/Preventive Health Care
Ø Why do you need Preventive Care?
• Even when you are in the best shape of your life, a serious condition with no symptoms may put your health
at risk. Using these services at the right time can help you stay healthier by
- preventing certain illnesses and health conditions from happening
- detecting health problems at early stages, when they may be easier to treat
Ø What’s Preventive Care?
• Preventive care services are provided when you don’t have any symptoms and haven’t been diagnosed with a
health issue connected with the preventive service. They typically are provided during an annual wellness
exam. You and your doctor will determine what tests and health screenings are needed.
Ø What’s Not Preventive Care?
• When your doctor determines that you have a health issue, the additional screenings and tests after this
diagnosis are no longer considered preventive. These services are covered under your plan’s medical
benefits, not your preventive care benefits and therefore you may be responsible for paying a portion or all of
the cost, depending on your plan’s deductible, copay and coinsurance amounts.
Ø What’s your share of the cost?
• Preventive care services are covered at 100% - when you see a doctor within the network.
• Please remember, even when your appointment is for preventive care, you may receive other services during
that exam that are not preventive.
14Open Enrollment 2021
Medical/Horizon BlueCard
Ø The BlueCard program offers access to more than 600,000 Blue Cross and Blue Shield
doctors and 6,000 hospitals in all 50 states – more than any other health insurer
Ø 95% of in-network doctors nationally
Ø 96% of hospitals in-network nationally
Ø No PCP or referral needed
Ø BlueCard is included in all three plans
15Open Enrollment 2021
Medical/Global® Core
Ø Your health plan offers you access to doctors and hospitals around the
world through Global Core.
Ø With the Blue Cross Blue Shield Global Core Program, your benefits go with
you when you travel.
16Open Enrollment 2021
Horizon Behavioral Health
Ø Horizon Behavioral Health offers a full range of support and services to make sure you get all
the care and support you need.
Covers Treatment for:
• ADHD
• Alcohol and Substance use disorder
• Anxiety
• Autism spectrum disorder
• Depression
• Eating disorders
• Emotional health and wellness
• Family care and education
• Grieving after loss
• Serious mental illness
• Suicide prevention
• And much more
17Open Enrollment 2021
Medical/Experian IdentityWorksSM
Ø You have access to Experian identity protection services as an added feature of your
health plan. For additional protection at no cost to you, you may enroll in Experian
IdentityWorks at any time while you are an eligible Horizon BCSNJ member. When
you do, you’ll have access to:
• Experian credit report at signup
• Credit monitoring
• Internet surveillance of your personal info
• Up to 1 million identify theft insurance
• Lost Wallet
• Child monitoring
• Experian IdentifyWorks ExtendCARE™
• Be prepared to provide engagement number DB14223 as proof of eligibility
18Open Enrollment 2021
Accessing your Information
Ø For easy, on-the-go access, use the Horizon Blue app for:
• Benefits and coverage information
• Check your claim status
• ID Cards, view, print and request additional ID cards
• Locate your Doctors & Care
• To get the app, text GetApp to 422-272
• Download it from the App Store® or Google Play™
19Open Enrollment 2021
Prescription/OPTUM RX
• Our prescription plan is included with your medical, however is administered by
OptumRX.
• Maintenance prescriptions allows 1 fill at retail pharmacy, after it’s on-site
pharmacy or mail order.
• Prescriptions for a 30-day supply of medication can be filled through retail or our
on-site pharmacies.
• Using the on-site pharmacies will provide the lower cost option.
20Open Enrollment 2021
Prescription/Optum Rx Plan Overview
21Open Enrollment 2021
Prescription/Optum Rx Plan Overview
22Open Enrollment 2021
Prescription/Optum Rx Plan Overview
23Open Enrollment 2021
In-House Pharmacy Locations
In-House Pharmacy Benefits: Access the best medical support in the state while also benefiting from the
least expensive option for your prescription needs. If you have prescriptions that allow for a 90-day supply,
the single, lower copayment will save you time and money.
ØHackensack University Medical Center
ØJersey Shore University Medical Center
ØJFK Medical Center
ØJohn Theurer Cancer Center
ØMeridian Village Pharmacy at Jackson
ØOcean Medical Center
ØPalisades Medical Center
ØRiverview Medical Center
ØSouthern Ocean Medical Center
COMING SOON:
ØRaritan Bay Medical Center –Old Bridge
ØHMH Specialty Pharmacy in Eatontown providing network level service -1/1/2021
ØMedical School Campus -Q4 2021
24Open Enrollment 2021
Health Savings Account (HSA)
Ø What is an HSA?
• An HSA allows you to save pre-tax money to pay for qualified medical expenses. The idea is to lower your overall
healthcare costs by using the HSA funds for such things as deductibles, co-payments, coinsurance, and other expenses. You
can only contribute to an HSA if you are in enrolled in a High Deductible Health Plan (HDHP) such as the as the
Hackensack Meridian Health Basic Plan/High Deductible plan.
Ø What are the advantages of an HSA?
• HSA funds roll over from year-to-year
• There are tax benefits on contributions, earnings and distributions
• Long-term investment opportunities are available.
• You can use your HSA as an investment strategy for retirement.
• If you change your jobs your money is kept in the account to be used in the future Retirement
• Once you turn 65, you can withdraw HSA funds for non-health care expenses (& pay federal income taxes)
Ø What are the contribution limits for HSAs?
• Individual: $3,600
• Family: $7,200
• Catch Up Contribution for age 55 or older remains $1000
Ø Does HMH contribute any funding towards the HSA?
• HSA Funding Varies By Salary Band And Coverage Tier and funding amounts and salary bands remain the same from 2020.
25Open Enrollment 2021
2021 Full-Time Medical Premiums
26Open Enrollment 2021
2021 Part-Time Medical Premiums
27Open Enrollment 2021
Dental Plans
There are no dental plan design changes for 2021
Three plans to choose from to ensure your pearly whites stay that way for the right price.
Ø Horizon Dental Option Plan – PPO (administered through Horizon)
• Access to more than 200,000 office locations nationwide.
• Out-of-network benefits available
Ø Horizon Dental Choice Plan E – HMO (administered through Horizon)
• Care must be coordinated through the in-network dentist you select as your primary care dentist
• Covers 100% of all eligible preventive and basic services with no co-payments, maximums or
deductibles
Ø Healthplex – HMO (administered through HealthPlex)
• Care must be coordinated through the in-network dentist you select as
your primary care dentist
28Open Enrollment 2021
Dental Plan Summary
29Open Enrollment 2021
2021 Dental Premiums
Full-Time 2021 Rates Part-Time 2021 Rates
30Open Enrollment 2021
Vision Plans
There are no vision plan design changes for 2021
You have two plans to choose from,– with in-network and out-of-network
options.
Ø Horizon Vision Plan - One Pair Option (Basic)
Ø Horizon Vision Plan - Two Pair Option (Buy-Up)
31Open Enrollment 2021
Vision Plan Overview & 2021 Premiums
32Open Enrollment 2021
Flexible Spending Accounts
With FSAs, you set aside a predetermined amount to be deducted from your paycheck throughout the entire year, which is then
deposited into your FSA(s). The amount that you designate is deposited before federal and state income tax withholding is deducted.
This means the funds that you set aside to pay for your health care or dependent care expenses are tax-free…saving you money.
NO AUTOMATIC ENROLLMENT: Team Members must re-enroll each plan year to participate in a Flexible Spending
Account.
Ø Health Care
• Health Care FSAs are used to reimburse health care expenses, including any insurance deductibles, as well as medical and
prescription copayments that are not covered by your medical plan.
• Contribution limit for 2021 is $2,750
• You will need to review your potential healthcare expenses for 2021 since funds you pledge for the year are not reimbursed if
you do not use within 2021 with the exception of the annual FSA roll over
• Annual FSA Roll-Over is $550
• If you enroll in the Basic/High Deductible plan, you will only be allowed to enroll in the Limited HCFSA, which
will only cover eligible dental and vision expenses.
Ø Dependent Care
• Dependent Care Accounts are used to reimburse expenses associated with the care of a dependent child or adult while you
continue working. Child care costs are eligible for reimbursement if a child is younger than 13 years and you claim the child
as a dependent on your federal income tax return.
• Costs of care for an adult dependent, including a spouse or a parent, if the adult is physically or mentally disabled.
• A DCFSA election can be reduced or terminated mid-year due to a change in day care needs.
• Contribution limit for 2021 is $5,000
33Open Enrollment 2021
Life Insurance Plans
Ø Your family is part of the HMH family too and our life insurance plan gives you the coverage
you need to protect your loved ones.
Ø Life insurance plans and rates remain the same from 2020
Plan Details
Basic Life 1.5x Basic Annual Earnings to $500k max
Basic Accidental Death & Dismemberment Life (AD&D) 1.5x Basic Annual Earnings to $500k max
Guaranteed Issue Amount (GI) for Basic $500k
Supplemental Life – Employee 1x-5x Basic Annual Earnings max up to a $1M
Supplemental Life AD&D – Employee 1x-5x Basic Annual Earnings max up to a $1M
Supplemental Spouse Life* Coverage in increments of $5k to a max of $250k
Supplemental Dependent Life* $5k or $10k options
Guaranteed Issue Amount (GI) for Supplemental** Lesser of $200k or 2x BAE Supplemental
If elected within 31 days of initial eligibility
*TM must be enrolled in Employee Supplemental Life
34Open Enrollment 2021
Life Insurance GI & EOI
Ø What is a “Guaranteed Issue" amount?
§ A plan's guaranteed issue (GI) is the amount of life insurance available to an employee
without having to provide Evidence of Insurability (EOI).
ü Basic Life & AD&D: $500k
ü Supplemental Life & AD&D: $200k or 2x BAE Supplemental, (If elected within 31
days of initial eligibility)
ü Spouse Life: $30k
Ø When is Evidence of Insurability required?
§ EOI is generally required for coverage in excess of any applicable guarantee-issue amount,
late entrants, and re-applications for previously-declined coverage.
35Open Enrollment 2021
Life Insurance Beneficiaries
Open Enrollment is a great time to check and confirm that you listed your beneficiaries
for all your Life and AD&D insurance plans. It’s important to keep your beneficiary
designations up-to-date as people move in and out of your life.
Ø A beneficiary is the person or entity that would receive the death benefit from your life insurance
coverage if you were to die. There are two types of beneficiaries: primary and contingent.
§ A primary beneficiary is the person (or persons) first in line to receive the death benefit from
your life insurance policy – typically your spouse, children or other family members.
§ In the event your primary beneficiary dies before or at the same time as you, you are
allowed to name at least one backup beneficiary, called a “secondary” or “contingent”
beneficiary. If the primary beneficiaries are all deceased, the secondary beneficiaries receive
the death benefit.
36Open Enrollment 2021
Employee Assistance Program (EAP)
• Team members and their families can take advantage of five (5) no cost (free) counseling sessions to help
address stress, relationship and other personal issues they may face including:
Ø EAP is staffed by highly trained masters level clinicians who will listen to your concerns and refer you to
in-person counseling and other extended care resources such as
Ø Relationship troubles
Ø Parenting and family issues
Ø Workplace problems or conflicts
Ø Stress and anxiety
Ø Child and eldercare support
Ø Living with chronic conditions
Ø Legal, financial and mediation services
• Accessing your EAP is easy and available 24 hours a day, seven days a week.
• When you call, an EAP specialist will listen to your needs and connect you to the appropriate resources. If you
have any questions about services, coverage and more, visit liveandworkwell.com or call 866-407-
5252. company ID: HMHNEAP
37Open Enrollment 2021
Coordinated Care Program
Our Coordinated Care Program provides critical resources and discounts to help people live
with chronic health conditions. Through this program, covered team members and/or
dependents are eligible for the following benefits:
Ø Free prescriptions related to the three most common chronic health conditions as long as
you see participating Hackensack Meridian Health-owned providers; follow/adhere to the
prescribed care regiment and fill your eligible prescriptions at our in-house pharmacies.
§ Diabetes
§ High Blood Pressure/Hypertension
§ High Cholesterol
Ø Access to Coordinated Care Managers – a team of caregivers that can provide knowledge,
tools and self-care techniques to help you improve your health and live with chronic health
conditions.
38Open Enrollment 2021
Convenient Care Now/Tele-Health
Ø Have a Doctor Visit from Anywhere. Convenient Care NOW is Hackensack
Meridian Health’s telemedicine service.
• It offers 24/7 video visit access to board-certified doctors in under 10
minutes from your smartphone, tablet or computer.
• Free of cost for all Hackensack Meridian Health team members and
their dependents.
• Convenient Care cards will be mailed out to all new benefit eligible
team members.
• Please use coupon code CARENOW2020 before each visit.
39Open Enrollment 2021
Voluntary Benefits-Farmington Company
Ø Offered in addition to all other benefits
Ø Employee paid through the convenience of post tax payroll deductions
Ø Portability - May be taken with you should you leave HMH
Ø Coverage available for you, your spouse and eligible family members
Ø Available without medical questions, up to stated limits
Ø Plans offered:
• Hyatt Legal
• MetLife Critical Illness
• MetLife Hospital Indemnity Insurance
• MetLife Home & Auto Insurance
• Unum Accident Insurance
• Unum Whole Life Insurance (with Long Term Care Rider)
• Nationwide Pet Insurance
Ø How to Learn More and Enroll
• Voluntary Benefits are not available through MyWay PeopleSoft
• Offered through Farmington Company by calling 1-844-428-6688 (Mon-Fri, 8am – 5pm)
40Open Enrollment 2021
Eligibility
Ø Full-Time and Part-Time Team Members
Ø Your dependents……..
§ Spouse
§ Children - up to age 26 for medical
§ Children - up to age 19 or 23 (FT Students) for dental & vision
Ø Coverage is effective on date of hire. This is temporary due to COVID-19.
Ø You have 31 days from hire date to enroll in benefits through MyWay Peoplesoft.
Otherwise, you must wait until Annual Enrollment or until you have a Qualifying Life
Event to enroll in or change benefits.
41Open Enrollment 2021
Tobacco Surcharge
In addition to regular medical plan premiums, all tobacco users enrolled in the Hackensack Meridian Health,
medical program are required to pay an additional surcharge per pay period, per household.
• Team members who fail to attest to their tobacco status during enrollment become subject to the Tobacco
Surcharge as an enrollment default.
• Surcharge applies to team member and spouse - $15 per pay (per household)
• Tobacco users can reverse their Tobacco Surcharges by completing a designated HMH approved smoking
cessation program designed to educate and provide support to individuals trying to change tobacco-related
habits.
42Open Enrollment 2021
Spousal Surcharge
• Spousal Surcharge - to help absorb the the cost for healthcare that HMH is incurring instead of your
spouse’s employer.
• To avoid paying the surcharge, your spouse can enroll in his or her employer’s medical plan.
• Spousal Surcharge Applied….
Ø If a working spouse has access to their own health coverage (even Cobra), but elects to be covered on
HMH’s plan
ü $25 per pay
• Spousal Surcharge NOT Applied….
Ø If you and your spouse are BOTH employed at HMH and are both covered on the HMH plan under
either you or your spouse coverage
Ø If your spouse has NO access to health coverage
Ø If your spouse is self-employed
Ø If your spouse is covered under Medicare or Tricare
43Open Enrollment 2021
Qualifying Life Events
When you enroll in benefits, typically, you must stay enrolled for the entire plan year. This means that you
cannot make changes to your benefits mid-year. However, there are certain qualifying life events (also
known as qualifying status changes), defined by the IRS, that may allow you to make changes to your
benefits outside of an Open Enrollment period.
Ø Examples of a qualifying life event include:
§ Marriage
§ Divorce
§ Having a baby or adopting a child
§ Death of a dependent
§ Loss of coverage elsewhere
§ Gain of coverage elsewhere
§ A dependent becoming ineligible for coverage
§ Moving from a non-benefit eligible position to a benefit-eligible position
§ Transferring between full-time and part-time status
Ø You must complete your enrollment within 31 days of a qualifying life event. Once your elections have
been finalized, they cannot be changed unless you experience another qualifying life event. If you do
not make your elections within 31 days of the qualifying life event, you will not be permitted to make
any changes until the next open enrollment period.
44Open Enrollment 2021
Important Points to Remember
Ø If you are enrolling in any new plan for Medical, Dental and Vision, ID cards will be
mailed directly to your home listed in PeopleSoft. If you re-enroll for the same plan,
new cards will not be sent and you may use the ID cards you currently have.
Ø Temporary ID cards may be downloaded through the mobile app or the Horizon website
Ø Please verify your mailing address is correct in PeopleSoft.
Ø Please ensure you added and/or updated your beneficiaries for Life/AD&D insurance
Ø Please ensure you have dates of birth and social security numbers for dependents on
your health insurance plans.
Ø Remember, for more in-depth information about the new OMNIA 4-tier health plan,
Basic/High Deductible plan, Out-of-Area plan, behavioral health benefit details, Inner
Circle provider list and more, please visit our TeamHMH Open enrollment website -
https://teamhmh.com/OpenEnrollment
45Open Enrollment 2021
How to Enroll?
You can make your Open Enrollment 2021 benefits elections online by logging into MyWay – PeopleSoft.
Access the MyWay system as follows:
Ø Go to URL, http://www.hmhn.org.
Ø At the top right of the page, click the MyWay link.
Ø Click the Sign In tile.
Ø Enter your User ID and password and click the Sign
In button.
46Open Enrollment 2021
Where to go for Questions?
Ø Benefit programs are complex and can be difficult to understand. That’s why we have engaged outside experts who specialize
in understanding the technical nature of benefits and how to work with our benefit partners on your behalf. The Benefit
Advocate Center can help you with:
Ø Insurance Contact Information
• Have you not received your insurance cards, need replacement cards or need to get in touch with an insurance carrier?
Ø Explanation of Benefits
• Is it unclear to you what your insurance covered on a particular claim and what your responsibility is?
Ø Prescription/Pharmacy Issues
• Is the pharmacy telling you that your medication is not covered or charging you full price? Do you need help getting an
authorization on a medication?
Ø General Policy Questions
• How much PTO am I eligible for? How do I learn more about my 401k? What is my tuition reimbursement opportunity? Am I
eligible for FMLA? I don’t understand my disability benefits.
Ø You may reach the Benefit Advocate Center by calling Team Member Service Center (TMSC) at the number below and listen for
the prompt for the direct connection to the Benefit Advocate Center.
Ø Team Member Service Center
ü 551-996-2877 (Monday-Friday: 8am-6pm) - Email: BAC.TEAMHMH@AJG.COM
47Open Enrollment 2021
TeamHMH Open Enrollment Website
Ø To see team member contributions, FAQs, Decision Guides and additional in-depth information,
please visit Team HMH Open enrollment website at:
https://teamhmh.com/openenrollment/
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