Health Plan Options Open Enrollment 2020 Health Plan

Health Plan Options Open Enrollment 2020

Health Plan Options: Open Enrollment 2020 • • Open Enrollment Overview Choosing a Plan – Health Plan Overviews Participating in Open Enrollment Making Changes Later 2

Open Enrollment Overview • Make health plan changes • Enroll in Flexible Spending • 2020 Open Enrollment Dates: May 1 -15, 2020 https: //edirect. Virginia. gov • Plan Coverage: July 1, 2020 – June 30, 2021 3

Open Enrollment Overview No Action is Required if You: • Have no health plan-related changes • Are not enrolling in a Flex Spending Account • Do not plan to participate in Premium Rewards 4

Open Enrollment Overview • Make any plan changes • Flexible Spending Account (FSA) – ANNUAL • Continue Premium Rewards - ANNUAL • Dental – Basic/Expanded • Vision – Basic/Expanded 5

Open Enrollment Overview Flexible Spending Accounts (FSAs) – Health FSA – Dependent Care FSA – Must enroll every year 6

Open Enrollment Overview Flexible Spending Accounts (FSAs) - NEW this Year • Limit for FSA = $2, 750 • Reminder – Monthly Flex Fee =$2. 10 – PAYFLEX Master. Card • Locked in Rate for the year 7

COVA Care & Health. Aware Only – Premium Rewards • Earn $17 off monthly premiums ($34 couple) • Complete online assessment • Must be completed during Open Enrollment • www. anthem. com or www. aetna. com 8

OPEN ENROLLMENT 2020 CHOOSING A PLAN 9

Factors in Choosing a Plan • If you have small children • If you or someone on your plan has a chronic illness • If you or someone on your plan take(s) prescription medications • If you tend to be very healthy • If your physicians are in the network 10

Factors in Choosing a Plan • Frequently travel outside of coverage area • Travel internationally • Tight budget • Have experienced increase in out-ofpocket expenses 11

Factors in Choosing a Plan All Plans Include – Wellness • Free Office Visits – Children up to age 6 • Free Annual Check-ups – Children age 7 & older • Free Routine Screenings & Exams – Adults • Free EAP Plans 12

Telemedicine • Anthem Live. Health Online • Aetna COVA Health. Aware Teladoc • Optima Health HMO MDLive 13

COVA Health Plans: Dental Open Enrollment Options • Basic – Diagnostic & Preventative – 2 free cleanings per year • Expanded Dental – Dental work, Orthodontic – Deductible person – Different levels of co-insurance based on procedure 14

Choosing a Plan Health Plan Choices Available COVA Care Statewide and elsewhere COVA Health. Aware Statewide and elsewhere COVA HDHP Statewide and elsewhere Optima Health HMO Regional, mostly in Hampton Roads Kaiser Permanente HMO* Regional, mostly N. Virginia TRICARE Supplement* Eligible Military Retirees *Not covered in this presentation 15

COVA Care Primary Care Specialty Care In Patient Hospital Emergency Room $25 $40 $150 facility $300 per stay PCP- $25 Specialist$40 16

COVA Care Deductible – Per plan year Out of Pocket Max– One Person - $300 Two or More - $600 One Person - $1500 Two or More - $3000 17

COVA Care • International Travel – Blue Cross Blue Shield Global Core • Domestic Travel – Blue. Card PPO Program • Out-of-Network Option 18

COVA Care • Vision Basic – Blue View Vision – Routine exam once per year – $15 co-pay • Vision & Hearing Options – Expanded vision – Routine hearing exams - $40 co-pay – Hearing aids and other services 19

COVA High Deductible Health Plan Primary Care Specialty Care In Patient Hospital Emergency Room 20% after deductible 20

COVA HDHP Deductible – Per plan year Out of Pocket Max– One Person - $1, 750 One Person - $5, 000 Two or More - $3, 500 Two or More $10, 000 21

COVA HDHP • Pharmacy – Mandatory generic – Retail & Mail Order • Vision • Not Available – Hearing – Out of Network 22

COVA Health. Aware • Consume-driven health plan • Includes a Health Reimbursement Arrangement(HRA) fund – Up to $600 for employee – Up to $1, 200 for employee and spouse 23

COVA Health. Aware Primary Care Specialty Care In Patient Hospital Emergency Room 20% after deductible 24

COVA Health. Aware Deductible Per plan year Out of Pocket Max– One Person - $1, 500 One Person - $3, 000 Two or More - $6, 000 25

COVA Health. Aware Earn HRA funds – Healthy Activities “Do Rights” • $150 maximum • “Do Rights” include: – Routine exams – Use My. Active. Health Tracker – Flu Shot – Completing Coaching Module 26

COVA Health. Aware • Pharmacy – HRA covers pharmacy expenses – Retail and Mail Order – Some free generic and preferred brands • Vision & Hearing – basic • Out-of-Network Coverage 27

OPTIMA HEALTH HMO • Regional – Hampton Roads coverage area • 26, 000 providers • Sentara Quality Care Network & Riverside Health Systems • Referral-less HMO/No Out-of-Network except Children 28

OPTIMA HEALTH HMO – Coverage Area 17 County Service Areas – Chesapeake, Franklin, Gloucester, Hampton, Isle of Wight, James City, Mathews, Newport News, Norfolk, Poquoson, Portsmouth, Southampton, Suffolk, Surry, Virginia Beach, Williamsburg, York 29

OPTIMA HEALTH HMO Primary Care Specialty Care In Patient Hospital $5 – Tier 1 $10 – Tier 1 $25 – Tier 2 $40 – Tier 2 $300 per stay Emergency Room $150 facility 30

OPTIMA HEALTH HMO Deductible – Per plan year Out-of-Pocket Max– One Person - $150 One Person - $1, 500 Two or More - $3, 000 31

OPTIMA HEALTH HMO • Includes Expanded Dental – Dominion National • Includes Vision – Eye. Med 32

OPTIMA Health HMO Network • No out-of-network provided – Except in emergencies over 100 miles away from residence • Coverage only provided in 17 cities and counties • Out of Area Dependent Program provides coverage to dependent children who live outside of service area

OPEN ENROLLMENT 2020 COVA PLANS – SUMMARY OF CHANGES, OPTIONS 34

COVA Care & HDHP – New this Year • Sydney Health Mobile App • Behavioral Health In-Home Services Age limits removed • HDHP Live Health online cost $59 35

COVA Health Plans – New this Year • Informed Rewards • Teladoc now $0 • New ID cards mailed 36

Additional Help • Get Advice from ALEX • State online benefit counselor • www. myalex. com/cova/2020 37

Eligibility Definitions Documents to add dependents need to be sent to HR for online enrollment

Making Changes After open enrollment, when may I make changes to my health benefits plan or FSAs? – During Next Year’s Open Enrollment • Usually occurs May 1 to May 15; effective July 1, 2021 • OR – With a Qualifying Mid-Year Event • Within 60 days of the event with appropriate documentation

Making Changes • • • QUALIFYING STATUS CHANGES INCLUDE: Marriage or Divorce Death of spouse or dependent Birth or adoption of child Loss of dependent eligibility Employment begin/end for spouse Employee or spouse change to/from part-time/full-time employment Loss of other employer plan Eligibility for or loss of government health care Dept. of Social Services Health Care Coverage Order

Other Voluntary Benefits Genworth Long Term Care Any time with Enrollment Website Legal Resources November 1 st to November 22 nd Optional Life Insurance Any time with Enrollment & EOI Forms

Questions? Need more information? William & Mary Office of Human Resources Bell Hall, 109 Cary Street Main HR Phone Number: (757) 221 -3169 Main HR Fax Number: (757) 221 -3156 HR Email: ASKHR@WM. EDU