2015 Annual Enrollment E

My Benefits. My Choices.
FOCUS ON
2015 ANNUAL
ENROLLMENT!
October 2014
See what’s new!
u
u
u
u
new health plan lineup
new dental option
new vision plan
new way to enroll
Get
started!
DON’T LOSE SIGHT OF THIS!
everyone…including YOU…
must enroll to avoid waiving coverage.
2015 Annual Enrollment
November 17 – December 2, 2014
For benefit-eligible Harris pre-age 65 retirees.
READ ABOUT THE TOPICS
THAT INTEREST YOU!
p. 3
NEWs and what’s NEW for 2015
p. 4
Medical and pharmacy options — new line-up for 2015
p. 8
Dental Plan — new second option added
p. 9
Vision Care Plan — new plan design and administrator
p. 11
Health plan pricing for 2015
p. 12
Enrollment
p. 14
Reminders, resources, notices
p. 16
You have things TO DO
Medical
Plan
Pricing
•
Medical option premiums for the
Harris pre-age 65 retiree group
will increase next year for each
level of coverage.
•
You have the choice of electing
Harris group coverage or opting
out of Harris coverage and
purchasing coverage from the
healthcare marketplace through
OneExchange. Please explore the
pricing and choices available in
the open marketplace.
Pricing on page 11.
EVERYONE!
A Harris Medical Plan election is required or you will default
to no coverage, effective January 1, 2015.
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NEWS AND WHAT’S NEW FOR 2015
Annual enrollment for Harris pre-age 65 retiree healthcare benefits will begin on November 17
and extend through December 2, 2014. Since your retiree healthcare benefits were effective prior to
January 1, 2015, you can choose to enroll in Harris group healthcare plans until you are Medicare eligible
or, if earlier, such time that these plans are no longer offered. Your pre-Medicare dependents can also
continue to be covered by Harris plans as long as they were enrolled prior to January 1, 2015.
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You also have the option of exploring and
purchasing coverage in the healthcare marketplace.
Harris has arranged for OneExchange to assist you,
should you wish; however, you are free to select
coverage through another source. You can also place
your dependents’ coverage through OneExchange.
OneExchange — Harris has arranged for our
eligible retirees and enrolled dependents to use
the services of this large healthcare marketplace to
find individual policies that suit personal needs and
preferences. Harris will pay OneExchange for these
services. See page 14 for contact information.
2015 enrollment for non-Medicare retirees and
non-Medicare dependents — If you do not actively
enroll in the Harris Medical Plan, you will default to
no coverage and you cannot enroll in the Harris plan
again. An active election is also required for either
dental or vision. However, if you want either Harris
dental or vision coverage, you must be enrolled in
the Harris Medical Plan.
If you remain in the Harris Medical Plan, you’ll want
to know about these enhancements:
•A second dental option provides a new coverage
alternative at a lower cost
•A new vision plan provides enhanced benefits and
•New radiology options in Brevard County, FL, offer
more consumer choice. (See the retiree website,
http://harris.com/retiree, for details.)
Medicare-eligible dependents — Harris group
healthcare benefits will be discontinued for
Medicare-eligible individuals as of January 1, 2015.
You can enroll your Medicare-eligible dependents
in individual coverage, if you wish, through
OneExchange.
Learn more about 2015 Harris healthcare benefits
on the pages that follow.
MEDICAL AND PHARMACY OPTIONS
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You must actively enroll
in Harris medical and
pharmacy coverage or
you will not be covered by
Harris’ group benefits.
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OAP 1 will be eliminated.
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The pharmacy options will
add a $5,000 pharmacy
family out-of-pocket
maximum.
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You’ll have the opportunity to create your Harris Medical Plan for 2015 by selecting
one medical option (from three choices) and one pharmacy option (from three
choices).
Medical options — You will have three plans
from which to choose. As of January 1, 2015,
OAP 1 will be eliminated but OAPs 2, 3 and 4
will remain the same.
Pharmacy options — A $5,000 family out-ofpocket limit will apply, providing protection in
years when a family experiences extremely high
prescription drug expenditures. Also in 2015,
there will be changes to the prescription drug
formulary. Details on page 7.
All options provide innetwork care through the
Cigna Open Access Plus
(OAP) network.
The prescription drug
formulary (list of covered
drugs) will change in 2015.
Please note: As we communicated to you in the
summer, Harris has been heavily subsidizing
our pre-age 65 healthcare benefits due to
dramatic increases in healthcare costs in recent
years. Although Harris is reducing our subsidies
for these plans to better align them with their
original intent — a “retiree-pay-all” group
healthcare plan with no explicit Harris subsidy
— we will still be subsidizing these plans in
2015. Harris will continue to increase the cost of
these plans until they are no longer subsidized,
that is, when retirees in the plan pay enough
premiums to cover the cost of all claims. See
page 11 for plan pricing.
Your Other Choice — OneExchange
In addition to your Harris group healthcare
plan choices, you can also explore individual
policies in the healthcare marketplace with
the assistance of OneExchange. You may find
more choice and lower premiums through the
marketplace. It’s worth taking a look to see
what’s available to you.
OneExchange enrollment will extend from
November 17 through December 15, 2014.
See page 14 for contact information.
Once you opt out of Harris’ group healthcare
plans, you cannot enroll in these plans again.
You are not required to use OneExchange to
find alternate coverage.
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Decision Points
Assess your Medical Plan choices by factoring in these six decision points.
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2
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Premiums and plan use — When you make your medical and
pharmacy elections, you are committing to pay set premiums
for a calendar year. Your premiums must be paid whether or
not you use the Medical Plan.
Out-of-pocket expenses — Under any medical and pharmacy
option, you will have potential out-of-pocket expenses.
Whether a copay, deductible or coinsurance, each represents
money that you must pay. Lower premium plans typically have
higher potential out-of-pocket expenses.
Net costs — Premiums plus out-of-pocket expenses create
your net cost for the year. They go hand-in-hand and you really
can’t assess the true price of an option unless you factor in
both. Your net costs will not necessarily be less under the plan
that provides the highest coverage level (OAP 2) since that
option has the highest premiums. Based on your plan use, one
of the other options may be a better financial decision for you.
Net cost made easy!
Let the Medical Cost Estimator do the math. It’s located
under the Tools & Resources tab on the top of the enrollment
website. Reach the website from
http://benefits.harris.com, beginning November 17.
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Financial risks — Under any medical and pharmacy option, you will
have a level of financial risk. If you are willing to accept more risk
(e.g., higher deductibles and out-of-pocket limits), you can benefit
from lower set premiums and vice versa. In any event, it’s important
to remember that in years when you experience high medical
expenses, all of your plan options have an important financial safety
net — your out-of-pocket limit. After it’s met, subsequent eligible
expenses are covered at 100% for the rest of the calendar year.
Cash flow — When creating your Medical Plan, it’s best to look at
the potential financial risks and assess the level up to which you
can self-insure your care. If you have limited cash flow or financial
reserves, you might be more comfortable in a plan that has higher
premiums and generally lower out-of-pocket costs.
Consumerism and wellness — One way to keep your healthcare
costs in check is to adopt or refine your healthcare consumer skills
(e.g., selecting the best setting for your care, comparing providers’
outcomes and costs for specific services, using consumer tools,
purchasing generic drugs, etc.). Another is to improve your health
by managing chronic conditions, accessing appropriate preventive
care and making sound lifestyle choices. The more you manage your
healthcare and your health plan, the more you can stay in touch with
your health and impact your healthcare costs each year.
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Medical Option Designs
2015 MEDICAL OPTIONS
Plan feature/benefit
OAP 2
OAP 3
OAP 4
Innetwork
Out-ofnetwork
Innetwork
Out-ofnetwork
Innetwork
Out-ofnetwork
Deductible
—Individual
$ 500
$1,000
$ 750
$1,500
$1,000
$2,000
—Family
$1,000
$2,000
$1,500
$3,000
$2,000
$4,000
80%
60%
80%
60%
80%
60%
Out-of-pocket limit
—Individual
$2,500
$5,000
$3,000
$ 6,000
$3,500
$ 7,000
—Family
$5,000
$10,000
$6,000
$12,000
$7,000
$14,000
Hospital inpatient
80%
60%
80%
60%
80%
60%
Outpatient care
80%
60%
80%
60%
80%
60%
Coinsurance
Emergency room
$150 copay
$150 copay
$150 copay
Urgent care
$25 copay
$25 copay
$25 copay
Office visit
—Primary care
—Specialist
Preventive care
Lifetime maximum
Copay:
$25
60%
Copay:
$25
60%
Copay:
$25
60%
$40
60%
$40
60%
$40
60%
100%
Not covered
100%
Not covered
100%
Not covered
None
None
None
IMPORTANT NOTE!
•The annual deductible must be met before benefits begin with these exceptions: Services requiring copays, preventive care and pharmacy benefits are covered before the deductible is met.
•Out-of-pocket limits include the deductible.
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continued...
Pharmacy Option Designs
You will pair your choice of option — either Pharmacy 1, 2 or 3 — with your medical option. Please note that even though benefit
levels are the same for each pharmacy option (same copays and coinsurance), there is a difference in the pharmacy networks.
2015 PHARMACY OPTIONS
Plan
Benefit
Pharmacy
access
Annual
pharmacy
out-of-pocket
maximum
Pharmacy 1
Pharmacy 2
Pharmacy 3
Generic: $7
Formulary: 20%, $25 min. and $75 max.
Non-formulary: 50%, $50 min. and $100 max.
Full Express
Scripts
pharmacy
network
Same network
as Pharmacy 1
minus CVS and
Walgreens. You
can go anywhere
in the network
other than CVS
and Walgreens
Same network
as Pharmacy 2
plus maintenance
drugs must
be purchased
through the mailorder program*
Individual: $2,500
Family:
$5,000
* You will be able to purchase up to two fills at your network retail
pharmacy while your mail-order prescription is being activated.
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UPDATE:
PRESCRIPTION DRUG
FORMULARY
Beginning next year, all pharmacy options will
be using the Express Scripts national preferred
formulary, representing a change for some
plan participants. Most drugs on the current
formulary will continue to be covered; however,
some will have a status change (e.g., from
preferred to non-preferred) and others will no
longer be covered. If you are impacted, you
will be contacted by Express Scripts soon and
presented with alternatives to discuss with your
physician.
You can see the new formulary through the
retiree website at http://harris.com/retiree.
Keep in mind, however, formularies are
regularly updated to include new drugs, drugs
that have become generics as well as drugs that
experience a change in coverage status.
DENTAL PLAN
The Harris Dental Plan will offer two options in 2015 —
Dental 1, the current plan, and the new Dental 2. Both
options are administered by MetLife and give you access
to the Preferred Dentist Program (PDP).
These are the three areas where Dental 2 differs from Dental 1:
•Orthodontia is not covered
•Basic restorative care is paid at 50% instead of 80%, and
•The annual maximum is lower at $1,000 instead of $1,500.
These differences allow Harris to charge lower premiums for
Dental 2. Depending on your dental benefit use, Dental 2 might be
a choice worth considering.
2015 DENTAL OPTIONS…QUICK COMPARISON
Features
Dental 1
Dental 2
Preventive care
100%
100%
Basic restorative care (fillings,
root canals)
80%
50%
Major restorative care (crowns, bridges)
50%
50%
Orthodontia for children (limits apply)
50%
0%
Annual deductible (applies to basic and
major restorative care)
•Individual
•Family
$ 50
$100
$ 50
$100
$1,500
$1,000
Annual maximum per person for
preventive and restorative care
You must be enrolled in the Harris group Medical Plan to select
Harris dental benefits. If you do not elect Harris group dental
for 2015, you cannot do so again but you can enroll through the
marketplace with the assistance of OneExchange, if you wish.
✓
✓
✓
✓
✓
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Dental Plan rates on page 11.
You must actively enroll or you will have no dental coverage next year.
Two dental options will be offered for the first time.
You can only enroll in dental if you are enrolled in Harris group medical.
You can only enroll dependents who are already covered by the plan and
who are not Medicare eligible.
You can purchase alternate coverage through OneExchange.
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VISION CARE PLAN
MetLife will replace Davis Vision as the plan administrator, bringing a new network of providers from which to choose. The network
includes thousands of ophthalmologists, optometrists and opticians in private practices as well as retail outlets such as Costco Optical
and Visionworks. Benefits include lenses, frames and contacts as well as new features including retinal imaging and many vision-related
discounts. Check out highlights of the in- and out-of-network benefits on the chart below.
2015 VISION CARE PLAN
Feature
In-Network
Out-of-Network
Frequency
Eye exam
•Standard
•Retinal imaging
•$10 copay
•$39 maximum copay
$45 allowance
Once every
12 months
$55 allowance
Once every
24 months
Frames
Standard corrective
lenses**
•Single vision
•Bifocal
•Trifocal
•Lenticular
Contact lenses**
•Necessary***
•Elective
Page revised: November 14, 2014
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•$10 copay then
•$120 allowance* plus
•20% discount on balance due
•Included with frame purchase
• Included under eye exam copay
•$120 allowance
* $65 allowance at Costco.
** Plan benefits include either corrective lenses or contact lenses
once every 12 months.
*** Necessary lenses are for conditions that cannot be corrected by eyeglasses.
•$30 allowance
•$50 allowance
•$65 allowance
•$100 allowance
Once every
12 months
•$210 allowance
•$105 allowance
Vision Care Plan rates on page 11.
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You must actively enroll
or you will have no vision
coverage next year.
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You can only enroll in
vision if you are enrolled
in Harris group medical.
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You can only enroll
dependents who are
already covered by the
plan and who are not
Medicare eligible.
✓
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MetLife is the new vision
administrator.
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You can purchase alternate
vision coverage through
OneExchange.
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The two-year lockin provision will be
eliminated.
More Vision Care Options
In addition to these benefits, lens tinting, a scratch-resistant coating and ultraviolet coatings are covered
in full. There is a full range of lens options — oversized lenses, polycarbonate lenses, progressive lenses,
photosensitive lenses and more — available either at a discount or subject to an allowance. You can also
purchase prescription and non-prescription sunglasses as well as LASIK surgery at a discount.
HEALTH PLAN PRICING FOR 2015
PRE-AGE 65 RETIREE HEALTH PLAN MONTHLY RATES FOR 2015*
MEDICAL OPTIONS*
You
Cigna OAP 2
Cigna OAP 3
Cigna OAP 4
$560.88
$546.27
$531.68
PHARMACY OPTIONS*
You
Pharmacy 1
Pharmacy 2
Pharmacy 3
$156.83
$149.33
$141.83
OTHER HEALTHCARE PLANS**
You
MetLife Dental Plan 1
MetLife Dental Plan 2
Metlife Vision Care Plan
$34.63
$25.73
$ 4.39
You +
spouse
You +
child(ren)
You +
family
$1,233.95
$1,201.82
$1,169.67
You +
spouse
$345.02
$328.52
$312.02
You +
spouse
$69.26
$51.46
$ 8.79
$1,065.68
$1,037.93
$1,010.18
You +
child(ren)
$297.96
$283.71
$269.46
You +
child(ren)
$79.66
$59.19
$ 9.22
$1,682.66
$1,638.83
$1,595.01
You +
family
$470.48
$447.98
$425.48
You +
family
$117.75
$ 87.49
$ 13.61
* Your Harris Medical Plan election consists of both a medical option plus a pharmacy option. You must enroll in each!
** You can only elect these benefits if you are enrolled in the Harris Medical Plan.
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ENROLLMENT
Beginning November 17, you can enroll online or on the go in Harris group benefits through the new HarrisEnroll.
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Enter HarrisEnroll
Get started
Review your data
Enroll in your benefits
Confirm
•You must register as a •Click ENROLL NOW! in the
•Read through the
•Review elections and
•Print a summary of
first-time user and create an ID and password before logging on to the
enrollment website. You can reach the website at http://benefits.harris.com.
Enrolling in the
marketplace?
purple box on the upper
right of the enrollment
website.
information that’s on
record for you. Click SAVE and CONTINUE
•Enter any changes needed in personal
information through
Employee Self Service on
the Harris homepage.
enroll for 2015
•Update dependent
information
•Click COMPLETE
ENROLLMENT.
your elections and
•Exit the enrollment
application. That’s
all there is to it!
Need help? — Call the Harris Benefits Service Center at
1.800.225.4343, option 1, or open an online webchat by
clicking the “Chat” button on the enrollment website’s top
navigation bar, beginning November 17.
Contact OneExchange.
See page 14.
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continued...
Changing your elections — You can change your Harris benefit elections at http://benefits.harris.com on or before the close of enrollment.
Enrolling dependents? — Following annual enrollment, expect an eligibility-verification request for each covered dependent (even if you’ve
provided this information before). You should be prepared to submit requested documentation as proof of eligibility. If you fail to fully comply
or enroll a dependent who’s ineligible, the dependent will be dropped from Harris coverage.
OneExchange enrollment — You can make pre-age 65 elections through OneExchange during the same enrollment period as Harris’ 2015
annual enrollment. You can enroll your Medicare dependents with OneExchange through December 31, 2014. Please call a OneExchange
benefit advisor at your earliest convenience for assistance in finding appropriate coverage that meets your needs and preferences. For contact
information, see page 14.
MUST I ENROLL?
Medical and pharmacy — YES, you must
enroll or will not have Harris Medical
Plan coverage for 2015 or thereafter.
(Alternatively, you can choose healthcare
marketplace coverage through OneExchange
through December 15, 2015 or December 31
for Medicare-eligible dependents.)
Harris enrollment ends
December 2, 2014!
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Dental and vision — YES, if you want to
be enrolled next year in Harris dental and
vision — but you must also be enrolled
in the Harris Medical Plan to make either
election. If you do not enroll in these plans,
you will not be given the opportunity again.
You can, however, choose coverage through
OneExchange in the healthcare marketplace.
REMINDERS, RESOURCES, NOTICES
Reminders
Life change event election and effective dates — Most benefit elections you make during
annual enrollment will stay in place for the 2015 calendar year unless you decide to waive
coverage or remove a dependent. Keep these facts in mind:
•You must request the change in your election within 30 days of the event by entering your
new election through http://benefits.harris.com
•Coverage changes (reduce or waive coverage) will be effective at the end of the month in
which the change is requested.
Resources
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FOR…
GO TO…
Benefit plan phone inquiries
The Harris Benefits Service Center, 8:30 a.m. to 5:30
p.m. (ET), business days, at 1.800.225.4343, option 1
HarrisEnroll — employee
benefit website and webchat,
beginning November 17
http://benefits.harris.com; webchat availability is the
same as noted above for the Harris Benefits Service
Center
OneExchange
1.844.256.0913 (pre-Medicare plans) and
1.844.256.0912 (Medicare plans),
8:00 a.m. to 9:00 p.m. (ET), business days
continued...
Notices
Women’s Health and Cancer Rights
Act — Under this legislation, group health
plans covering mastectomies must cover
reconstructive surgery correlated services
following a mastectomy. These services
include reconstruction of the breast upon
which the surgery was performed as well as
reconstruction of the other breast, if needed,
to create a symmetrical appearance. Also
included is the prosthesis and services in
connection with complications resulting from
the mastectomy, including lymphedemas. All
of these services are elective.
COBRA — If you or your dependent becomes
ineligible for Harris healthcare plans at
anytime, you must notify the Harris Benefits
Service Center in writing (e-mail, fax or mail)
within 60 days of the event to be eligible for
COBRA.
Health Insurance Portability and
Accountability Act (HIPAA) — This
legislation regulates the use and/
or disclosure of your personal health
information. HIPAA defines how those
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who have access to it, such as medical
professionals, plan administrators, etc.
must handle your personal health
information. You can see more information
about HIPAA on the retiree website at
http://harris.com/retiree.
Medicaid and the Children’s Health
Insurance Program (CHIP) — If you are
eligible for Harris health coverage but
can’t afford it, you may be able to get
premium assistance from your state
through its Medicaid or CHIP programs.
To see if you or your dependents are
eligible, contact your state Medicaid or
CHIP office. Call 1.877.543.7669 or visit
www.insurekidsnow.gov. If you or your
dependents are eligible for premium
assistance and you wish to enroll in Harris’
health plans, and are eligible to do so, you
will be entitled to a special enrollment
opportunity and must request coverage
within 60 days of the date when eligibility for
premium assistance is determined. You can
see the complete notice through the retiree
website at http://harris.com/retiree.
YOU HAVE THINGS TO DO!
Refer to your information resources
on page 14 as needed.
Enroll beginning November 17, 2014 in order to elect the benefits of
your choice for next year. Complete
enrollment for Harris group
coverage by December 2, 2014 or
healthcare marketplace coverage
by December 15, 2014. You will
default to no coverage without
elections in place.
Elect healthcare marketplace coverage
for your Medicare-eligible dependents
since Harris group coverage will no
longer be available to them starting
in 2015. You can use OneExchange or
other sources for this purchase.
Confirm the eligibility of each
dependent before enrolling them in
Harris group healthcare benefits since
ineligible dependents will be dropped
from coverage. (Go to page 13 to read
about the new verification process!)
Assess your Medical Plan choices to
see which offers you the best net cost
and level of coverage. The Medical
Cost Calculator can help you out.
(Go to the Tools & Resources tab at
the top of the HarrisEnroll website,
beginning November 17.)
This publication contains highlights of changes to benefits for eligible Harris pre-age 65 retirees who
retired having attained at least age 55 and 10 years of service on or before December 31, 2014. The
contents provide a high-level summary of information about certain benefit plans being offered for
the 2015 plan year and in no way replace the plan documents that actually govern the operation of
all benefit plans. If there is ever a discrepancy between the information in this publication and the
plan documents, the latter will always prevail. Harris reserves the right to amend or discontinue
any benefit programs at any time. Receipt of this publication is in no way a guarantee of continued
employment.
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Complete
enrollment
activities by
12/2/2O14!

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