PEBB Benefits Public Employees Benefits Board PEBB Program

PEBB Benefits Public Employees Benefits Board (PEBB) Program Outreach & Training September 2019

Agenda • Benefits • Medical Plans • Dental Plans • Life insurance • LTD insurance • Auto/home insurance • Smart. Health – wellness program • Dependents • Dependent verification • Premium surcharge attestations • Enrollment • Deadlines • Default Plans • Waiving medical • Dual enrollment • Defaulting • Making changes • Maintaining eligibility

Benefits: Overview

PEBB Benefits package: Voluntary benefits: Medical Dental Life Insurance Long-Term Disability Auto & Home Smart Health

PEBB Medical Plans

PEBB Medical Plans Plan options include: Managed-care plans Kaiser Permanente WA Preferred Provider Organization (PPO) Uniform Medical Plan • Classic • Consumer-directed health plan (CDHP/HSA) • Sound. Choice • UMP Plus PSHVN • Value • UMP Plus UW Medicine CAN Available based on the county you live Administered by Regence Blue Shield, available nationwide and worldwide

PEBB Medical Plans All medical plans offer similar services: • Preventive care • Vision • Prescription drug coverage • Hearing • Hospital • Doctor visits

PEBB Medical Plans – CDHP/HSA Consumer-Directed Health Plan (CDHP w/ HSA) • Kaiser Permanente WA CDHP • Uniform Medical Plan CDHP Larger deductible than non-CDHP plans • $1, 400 Single subscriber • $2, 800 Employee and one or more dependents

Consumer Directed Health Plan Health Savings Account (HSA) • Tax-free health savings account • Pay for IRS-qualified “out-of-pocket” medical expenses: • Deductibles, Copays, Coinsurance, etc… (See IRS publication 969)

Health Savings Account Employer contribution • $700. 08 per year single subscriber ($58. 34 per month) • $1, 400. 04 per year for employee and one or more dependents ($116. 67 per month) • $125 Smart. Health wellness incentive • If you earned the incentive

Health Savings Account (HSA) • Employee can also contribute • • Up to $3, 550 (single), $7, 100 (family) • Max includes employer contribution, employee contributions & wellness incentive • Pretax payroll deductions, or • Direct deposits to Health. Equity Not a “use it or lose it” benefit • Unlike a Medical Flexible Spending Arrangement (FSA) • Cannot enroll in a CDHP w/HSA plan if enrolled in a Medical FSA

Medical Coverage • Plans are available based on your county of residence • Call the plans directly or use the plan’s provider search to ask about provider availability • Dependents • • Must enroll in same plan as the employee They can see different providers • Online medical benefit comparison tool • PEBB Website

Dental Insurance

PEBB Dental Plans Managed Care Plans • Delta. Care • Administered by Delta Dental of Washington • Willamette Dental Preferred-Provider Organization • Uniform Dental Plan (UDP) • Administered by Delta Dental of Washington

PEBB Dental Plans All dental plans offer similar services: • Two preventive care visits per year • Orthodontia • Oral surgery • Dentures • Restorative crown • Periodontal services

PEBB Dental Plans You may not waive dental • There is no cost to add dependents to dental • Dependents do not have to enroll in dental

Life and Accidental Death & Dismemberment Insurance

Life Insurance Employee Basic Life and Basic Accidental Death and Dismemberment (AD&D) • $35, 000 basic life and $5, 000 Basic (AD&D) • Employer paid • May not waive Supplemental Life and AD&D • Employee paid additional coverage for: • Employee • Spouse/state-registered domestic partner • Children

Employee Supplemental Life insurance coverage • Up to $1 million with evidence of insurability • Purchase in $10, 000 increments Guaranteed Issue • Up to $500, 000 • If applying when first enrolling in PEBB benefits

Spouse/Partner Supplemental Life insurance coverage • You must enroll in supplemental coverage to purchase spouse/partner coverage • Cannot exceed 50% of your optional coverage • Up to $500, 000 with evidence of insurability • Purchase in $5, 000 increments Guaranteed Issue • Up to $100, 000 • If applying when first enrolling in PEBB benefits

Child(ren) Supplemental Life insurance coverage • You must enroll in supplemental coverage to purchase child coverage • Up to $20, 000 • Purchase in $5, 000 increments • All children covered for the same premium amount

Supplemental AD&D Employee Coverage • Up to $250, 000 • Purchase in $10, 000 increments Spouse/state-registered domestic partner • Up to $250, 000 • Purchase in $10, 000 increments Children • Up to $25, 000 • Purchase in $5, 000 increments

Life / AD&D Premiums Life insurance premium is based on: • Coverage amount • Employee’s age for employee and spouse/SRDP • Tobacco use Children have their own rate AD&D premium is based on: • Coverage amount Separates for employee/spouse & child

Life Insurance Additional Benefits • Funeral planning • Grief counseling • Survivor assistance • Travel assistance • Will preparation • Estate planning services Met. Life Advantages

Long-term Disability Insurance

Long-term Disability Insurance • Basic LTD • Employer paid • 90 day benefit waiting period • Supplemental LTD • Employee paid • You may select a 90, 120, 180, 240, 300, or 360 day waiting period

Supplemental LTD Coverage • Evidence of insurability is required • When enrolling after initial enrollment period, or • Decreasing benefit waiting period • Evidence of insurability is not required • When enrolling during the initial enrollment period, or • Increasing benefit waiting period

Auto/Home Insurance

Auto/Home Insurance • May receive a discount up to 12% off Liberty Mutual’s auto insurance and up to 5% off Liberty Mutual’s home insurance rates • Liberty Mutual also offers: • Discounts based on driving record, age, auto safety features, and more • 12 -month rate guarantee • Convenient payment options • Prompt claims service

Wellness Programs

Wellness Programs • Smart. Health • Diabetes Prevention Program • Living Tobacco Free PEBB website

• A $25 Amazon gift card • Awarded for completing the Well-Being Assessment • Between January 1, 2020 and December 31, 2020 • Email will be sent to you to claim the gift card • The gift card is considered taxable income • $25 is reported on your W-2

• A $125 incentive • Awarded for earning 2, 000 points • Points earned by completing wellness activities • Applied the following plan year to: • PEBB medical deductible, or • Deposited in HSA • Only if enrolled in high deductible plan Deadline to Earn the Incentive November 30, 2020

Dependents & Dependent Verification

Eligible Dependents • Lawful spouse • State-registered domestic partner • • Defined in RCW 26. 60. 020 (1) Substantially equivalent legal unions from other jurisdictions (RCW 26. 60. 090) • Children up to age 26: • Biological, step children, legally adopted children, etc… • Extended Dependents • Grandchild, niece, nephew, etc… court order showing legal responsibility • Disabled dependents • • Children age 26 or older Condition occurred before age 26

Required Forms & Dependent Verification • Dependent verification (DV) is needed for: • Spouse / State-registered domestic partner • Children up to age 26 • Biological, step children, legally adopted children, etc… • In addition, certification form is needed for: • Extended Dependents • Court order required • Disabled dependents (Children age 26 or older) Verification documents are required – dependents are not enrolled until verified

Required Forms & Dependent Verification Submit DV with enrollment form: • Dependent is enrolled once DV documents are approved • If employee fails to submit DV timely • Dependents may be enrolled during: • Annual Open Enrollment (OE) (Nov 1 -30/ effective January 1) • Special Open Enrollment event (SOE) (60 day window)

Premium Surcharge Attestations

Tobacco Use Premium Surcharges Monthly $25 per account surcharge if: • You or any dependent (age 13 or older) • Enrolled in PEBB medical • Used tobacco products in the last 2 months • Attest on the: • Employee Enrollment/Change form • Surcharge is employee paid, in addition to your medical premium

Tobacco Use Premium Surcharge What is tobacco use? • Use of tobacco products within the past 2 months What are tobacco products? • Products made with or derived from tobacco • Examples: cigars, cigarettes, pipe tobacco, chewing tobacco, snuff… • Excluded: E-cigarettes, nicotine gum, and nicotine patches…

Spousal Premium Surcharge Monthly $50 per account surcharge if: • Employee enrolls spouse/partner in PEBB Medical, and • Answers “yes” to all 6 questions • Employee: • Completes the attestation Help Sheet • Attests on the Employee Enrollment/Change form • Surcharge will be paid by the County in addition to your monthly premium

Spousal Plan Calculator Tool To complete Spousal Plan Calculator you will need: • Summary of Benefits and Coverage for each plan available to your spouse or partner If you answered ‘Yes’ to all of the questions, complete the Spousal Plan Calculator for each available plan that • Serves the spouse/state-registered domestic partner’s county of residence, and • Costs less than $108. 31

Spousal Premium Surcharge Employee can only re-attest during specific times of the year: • During a Special Open Enrollment (SOE) event which results in the spouse/partner enrolling in PEBB medical • During Annual Open Enrollment (Nov 1 -30) • When there is a change in the spouse or partner’s employer-based group medical insurance

Premium Surcharge Change Effective Date For both the tobacco and spouse/partner coverage premium surcharge: • If change results in surcharge: • Effective the first day of the month following the status change* • If change results in removal of surcharge: • Effective the first day of the month following receipt of the attestation* * If that day is the first of the month, the change to the surcharge begins on that day.

Enrollment

Enrollment Deadlines Forms that must be received during this initial enrollment period: • Employee Enrollment/Change form (includes the premium surcharge attestations) • Long-term Disability Enrollment/Change form • Life Insurance Enrollment/Change form (send to Met. Life) • Dependent verification (DV) documentation

Default Failure to submit forms results in default enrollment: • You will be enrolled as a single subscriber in: • • • Uniform Medical Plan (UMP) Classic Uniform Dental Plan (UDP) Basic life Basic LTD Tobacco use premium surcharge ($25 per month)

Default If you are defaulted, you: • Cannot enroll your spouse and dependents, or • Make plan changes until: • Annual Open Enrollment Nov 1 -30, effective January 1 • Special Open Enrollment event occurs • Can change your tobacco use premium surcharge attestation

Dual Enrollment, Waiving Coverage, & Returning from Waive

Dual Enrollment Dual enrollment in PEBB benefits is prohibited* • If you and your spouse/state-registered domestic partner or child(ren) are eligible for PEBB benefits • You or your dependents may waive medical to enroll as a dependent on a family members PEBB account • You or your dependents cannot waive dental *WAC 182 -12 -123

Waiving Medical Coverage You may waive medical coverage if you are enrolled in: • Other employer-based group medical insurance • TRICARE • Medicare You may not waive for: • Retiree coverage (except TRICARE), or • Health Benefit Exchange coverage If you waive medical, your dependents cannot enroll in medical

Return from Waive You can return from waive during: • Annual Open Enrollment (OE) • Does not require proof of other employer-based group medical insurance • Special Open Enrollment (SOE) • Requires proof of the qualifying SOE event

Resources

Benefit Fairs PEBB benefits fairs • Plan representatives are available to answer questions Date Location Times October 29 UW Medical Center 10 a. m. to 3 p. m. October 30 UW Harborview – Norm Maleng Bldg 10 a. m. to 3 p. m. October 31 UW – Husky Union Building (HUB) 10 a. m. to 3 p. m. November 4 Clover Park Technical College 9 to 11: 30 a. m. November 8 Tumwater – LNI Building 9 a. m. to 2 p. m.

Resources • PEBB website: www. hca. wa. gov/employee-retiree-benefits/public-employees • Contact the Plans – www. hca. wa. gov/employee-retiree-benefits/publicemployees/contact-plans (phone numbers and websites) • Plan websites: • Provider searches • Formulary price check tool

PEBB Retiree Coverage • Enrollment form must be received by PEBB no later than 60 days after: • Employer-paid coverage, COBRA, or continuation coverage ends • Must meet eligibility and procedural requirements

Questions