SPECIAL POINTS OF INTEREST: • Flexible Spending Accounts (FSA) for next year require an Review your covered dependents • Review your current plan enrollments • Opportunity to enroll in Short Term Disability • Open Enrollment ends at 5 p.m. on November 29th • What’s ahead for 2015 medical plans INSIDE: Important Dates 2 Plan Information 3 Medical 4-5 Dental & Vision 6 Flexible Spending Accounts (FSA) 7 Short Term Disability November 15-November 29, 2013 It’s time to make your 2014 elections! Open enrollment is your annual opportunity to make changes to your benefit elections and sign up for flexible spending accounts. Your elections will be for the entire 2014 calendar year (January 1, 2014—December 31, 2014). election • Employee Benefits Open Enrollment 8 Frequently Asked Questions (FAQ) 9 Looking Ahead 10-11 After reviewing your current enrollments and verifying dependents, if you do not want to make changes to your benefit elections or elect a 2014 Flexible Spending Account (FSA), no further action is required. Except FSA, your current enrollments will automatically continue. What’s New & Different Enhanced Medical Plan Coverage • Co-pays and deductibles will apply to out-of-pocket maximums • Expanded women’s preventive care with $0 co-pay Kaiser Rate Changes Non-represented employees and some represented employees electing Kaiser medical will begin paying 5% premium share. Providence Rate Changes Employees electing Providence medical will see a slight rate increase in payroll deductions. Depending on coverage level ~$1—$3. Vision Insurance • ODS name change: Moda Health • Rate increase (7.2%) Defense of Marriage Act Changes for same-sex domestic partners with legally recognized marriages. Short Term Disability Employees wanting added income protection have the opportunity to elect short term disability. Wellness at Washington County Wellness activities completed in 2014 will determine 2015 medical plan benefit levels. How to enroll Step 1: Review materials and your current medical, dental and vision enrollments. Step 2: Decide if you want to make changes to your current benefit elections or elect a 2014 Flexible Spending Account (FSA). It’s as easy as 1, 2, 3... Step 3: To make changes or elect a 2014 FSA, return your enclosed Open Enrollment Form to Human Resources (PSB 270 or MS 11) no later than 5 p.m. on Friday, November 29th. The information in this publication is only a brief description of some Washington County benefits. The controlling provisions of these plans are outlined in the group policies or plan documents, which can be requested by contacting the Benefits Team at 503-846-8686. This is not a guarantee of benefits. PAGE Important Dates 2 Fall Open Enrollment Open Enrollment begins November 15, 2013 and ends at 5 p.m. on November 29, 2013. Open Enrollment is your opportunity to: • Change your medical and dental plans • Add or remove dependents (medical, dental and vision) • Elect a 2014 flexible spending account (health care and dependent care) • Enroll in short term disability If you miss this opportunity to enroll, all of your current benefits (except for flexible spending accounts) will automatically continue for the 2014 calendar year with any corresponding 2014 premium contribution rates. You will not be able to make changes to your health benefits until the next annual enrollment period unless you have a qualified family status change (such as a birth, death, marriage or divorce). Changes made during Open Enrollment will be effective January 1, 2014. Information Sessions Make sure you get all of your questions answered and your Enrollment Form submitted to the HR office by 5 p.m. on Friday, November 29th. Presentation of plan changes and benefit options followed by an opportunity for questions. Date Time Location Tues., Nov. 19 11:30 a.m.— 12:30 p.m. PSB Suite 270 Tues., Nov. 19 3:00 p.m.— 4:00 p.m. Walnut Street Center Wed. Nov. 20 9:30 a.m.— 10:30 a.m. PSB Suite 270 Mon., Nov. 25 2:00 p.m.— 3:00 p.m. Sheriff’s Office Tr. Rm. B Tues., Nov. 26 3:00 p.m.— 4:00 p.m. PSB Suite 270 Additional Help Individual Appointments Employees unable to attend an Information Session are invited to schedule individual appointments or contact the Benefits team: [email protected] / 503-846-8686. Short Term Disability For additional information or to apply for short term disability, contact the Unum Call Center during Open Enrollment at 1-800-817-3291 (Monday-Friday, 8 a.m.—5 p.m. EST) or visit www.unum.com/employees. EMPLOYEE BENEFITS Plan Information PAGE 3 Benefit Eligibility Rules Employees All regular full-time and part-time (20+ hrs/wk) employees are eligible. Dependents* • Legal spouse or registered same-sex domestic partner • Biological children, step-children, and legally adopted children, up to age 26 • Children over age 26 incapable of self-sustaining employment by reason of mental or physical disability • Grandchildren residing with you and whom you claim as tax dependents • Children for whom you are the legal guardian or you support as the result of a valid court order *While some dependents are eligible for coverage under the County plans, their coverage may not be eligible for the pre-tax benefit. For example, the employer cost of providing benefits for registered same-sex domestic partners (who are not legally married in a state or country that recognizes same-sex marriages) is considered ordinary income or “imputed income.” Therefore, the value (i.e. total premium) for any non-tax dependent is subject to taxes, including Federal, FICA (Social Security & Medicare), state and city taxes, where applicable. Imputed income will be calculated and entered upon enrollment. Enrollment and Family Status Changes Your Open Enrollment elections will be effective January 1, 2014. These elections are fixed for the remainder of the plan year, unless you have a qualifying change in family status. After Open Enrollment, if you experience a family status change, you have 30 days from the date of your family status change to submit paperwork to add/remove coverage for any newly eligible/ineligible dependents. For coverage to be effective the 1st of the month following the event, you must submit your form by the 15th of that month. Coverage will be delayed by an additional month for forms received on the 16th or after, but still within the 30 day window. Some family status changes require documentation in addition to completing a request for enrollment. The following are considered “qualifying family status changes:” • • • • • • • • A legal marital status change (marriage, death of spouse, divorce, or annulment) Commencement/Termination of registered same-sex domestic partnership A change in the number of your dependents (birth, death, or adoption) A change in employment status for you, your spouse, your registered same-sex domestic partner or your dependent which results in a change of eligibility for benefits Your dependent ceases to satisfy eligibility requirements due to age You or your dependent becomes entitled to or loses eligibility for Medicare or Medicaid Commencement of or return from an unpaid leave of absence which results in a change of eligibility for benefits Judgment, decree or order resulting from a divorce, annulment or change in legal custody Getting married? ♦ Having a baby? ♦ Don’t forget to notify the Benefits team within 30 days of your family status change. NOVEMBER, 2013 PAGE Medical 4 Kaiser members must utilize a Kaiser facility/provider for the benefit levels below to apply. The County is proud to offer employees two medical plan choices. Choose the plan that best meets your family's needs. Deductible None Office Visit (primary) $15 co-pay X-rays, Lab, Imaging No Charge Rx (Outpatient) up to 30-day supply $15/Rx Generic $30/Rx Brand-name 2 co-pays for 90 day supply Hospital Inpatient No Charge Emergency Visit $75 (waived if admitted) Out-of-pocket maximum $600 / person; $1,200 / family Alternative Care $15 co-pay: Acupuncture, Chiropractic, Naturopathic $25 co-pay: Massage Therapy (max: 12 visits per year) Annual maximum: $1,500 Providence members have the option to use out-of-plan providers, or seek care from in-plan participating providers for lower out-of-pocket costs. In-plan Out-of-plan Deductible $250/person $750/family Office Visit $15 co-pay 40% coinsurance X-rays, Lab, Imaging 20% coinsurance 40%, after deductible Rx (Outpatient) up to 30-day supply Emergency Only Hospital Inpatient $15/Rx Generic $30/Rx Brand-name 2 co-pays for 90 day supply 20%, after deductible 40%, after deductible Emergency Visit $250 co-pay $250 co-pay Out-of-pocket maximum $1,700/person $5,100/family $15/visit: Acupuncture, Spinal Manipulation Alternative Care Not covered Annual maximum: $1,500 Additional benefit plan information is available on the Benefits web page at: www.co.washington.or.us/benefits EMPLOYEE BENEFITS Medical PAGE 5 2014 Medical Plan Changes & Enhancements Out-of-pocket expenses All co-pays and coinsurance will apply to the out-of-pocket maximum. Providence medical plan benefits expanded to include chiropractors, acupuncturists, and naturopaths. Services (e.g. office visits, imaging, labs) by these provider types will now be covered under medical benefits vs. alternative care. Alternative care benefit will continue to cover acupuncture and spinal manipulation. Expanded Women’s Preventive Care The following additional preventive care services for women will now be covered with no cost sharing: • Prenatal office visits • Three screenings for gestational diabetes • Breastfeeding support, supplies, and counseling • HPV DNA testing for women 30 years or older • Sexually-transmitted infection counseling • HIV screening and counseling • Domestic violence screening and counseling • FDA-approved contraception methods and contraceptive counseling Hearing Care Oregon-mandated hearing aid benefit for children; removing the frequency limit of every 4 years. 2014 Medical Premium Contribution Rates Both Providence and Kaiser members will contribute 5% premium share in 2014*. Premium deduction amounts are semi- (2x) monthly on the first and second checks of a month. Kaiser Semi-monthly Rate County Share (95%)* Employee Share (5%)* Employee Only $251.30 $238.74 $12.56 Employee + Spouse $502.61 $477.48 $25.13 Employee + Child(ren) $452.35 $429.74 $22.61 Employee + Family $753.91 $716.22 $37.69 Providence Semi-monthly Rate County Share (95%)* Employee Share (5%)* Employee Only $263.37 $250.21 $13.16 Employee + Spouse $526.76 $500.43 $26.33 Employee + Child(ren) $474.08 $450.38 $23.70 Employee + Family $790.14 $750.64 $39.50 Medical premiums are scheduled to increase next year. Kaiser 9.98% Providence 9.5% *Percentage share amounts are for regular full-time and part-time employees. Job Share employees electing coverage pay 50% of the full insurance rates above. If you are represented by the AFSCME or ONA, the County will pay 95% of the Providence rate and the employee share rates for Kaiser will differ from those listed above. NOVEMBER, 2013 PAGE Dental & Vision 6 Vision Decide if adding dependents to your vision plan makes sense for you. Washington County will continue to provide vision benefits through Moda Health (formerly ODS) with the Moda Health Provider network. ODS Vision Semi-monthly Rate County Share* Employee Share* Employee Only $4.69 $4.69 $0.00 Employee + Spouse $9.38 $4.69 $4.69 Employee + Child(ren) $9.38 $4.69 $4.69 Employee + Family $14.07 $4.69 $9.38 *Percentage share amounts are for regular full-time and part-time employees. See the enclosed Enrollment Form for Job Share rates, if applicable to you. Description Max. amount covered Eye Exam (every calendar year) 100% after $5 co-pay Single Vision Lenses $40/pair* Bifocal Lenses $60/pair* Trifocal Lenses $80/pair* Contacts Lenses $150/pair* Frames (every calendar year) $110 *This coverage does not provide for lenses and contacts in the same calendar year. Note: There is typically no additional benefit to electing “double coverage” for a dependent when this plan is the secondary insurance. Contact the Benefits team for additional Coordination of Benefits (COB) information. Willamette Dental Group Description Co-pay Annual Max Benefit None Office Visit charge $4 co-pay Exam/Cleaning/ X-rays $0 co-pay (No Charge) Fillings No Charge for certain material Crown/Inlay $40 co-pay Root Canal Work $30 co-pay Orthodontia $2,500 co-pay + office charge Dental Providers Willamette Dental Network EMPLOYEE BENEFITS Dental Both dental plans are renewing this year with the same plan design and 100% County-paid premiums for regular employees. See Enrollment Form for Job Share rates, if applicable to you. Moda Health Description Coverage Annual Maximum Benefit $1,500 Preventative & Basic Care (exams/x-rays, cleaning, fillings, endodontics & periodontics) 1st year – 30% coinsurance 2nd year – 20% coinsurance 3rd year – 10% coinsurance 4th year – 0% Major Services (crowns, bridge work, dentures) 50% coinsurance Orthodontia No Coverage Dental Providers Provider of choice Flexible Spending Accounts (FSA) PAGE 7 Health Care & Dependent Care Flexible spending accounts offer you the opportunity to set aside before-tax dollars to pay for certain health-related and dependent care (e.g. day care) expenses. When you have an eligible expense, you are reimbursed from your account tax-free. How the Plans Work The accounts are separate (i.e. you can choose to participate in one FSA or both). Based upon your expected annual eligible expenses, you decide how much money you want to contribute. You can contribute up to $2,500 to the Health Care FSA and up to $5,000 ($2,500 if you’re married filing single) to the Dependent Care FSA. Rules and Risks of the FSA Plans Since FSA plans provide a tax benefit, the IRS imposes several notable rules on these plans. It is important that you keep these in mind when making your election. Be conservative with the amount you elect for your FSA. Once you make your election to participate, you generally cannot change the amount that you contribute for the year. • • • • One election per plan year- Once you make your annual election, that election cannot be changed until the next FSA Open Enrollment unless you experience an IRS qualifying family status change. Date Incurred- Services must be received during the plan year or during the grace period in order for the expense to be eligible for reimbursement. Special rules apply to orthodontia expenses. Use it or lose it- If you over-estimate your expenses for the year or fail to make a timely request for reimbursement, the money left in the account is forfeited. FSA balances do not rollover from year to year; therefore, it is important that you are conservative when estimating your expenses. No double-dipping- Expenses paid through the FSA cannot be taken as an income tax deduction. What Are Considered Eligible Expenses? Dependent Care expenses (child care or elder care) you incur while at work or school may be eligible for reimbursement through this plan. In many cases, this will be more advantageous than the federal tax credit. Health Care expenses that are either not covered or only partially covered by insurance may be eligible for reimbursement through this plan. Examples include: co-pays, deductibles, prescriptions, certain medical supplies, dental expenses, orthodontia, vision care, lenses & frames, acupuncture, chiropractic. See Benefits website for a thorough list of eligible expenses. After Enrollment Beginning with your first paycheck in January, contributions will be deducted from your check on a pre-tax basis. As you incur eligible expenses throughout the plan year (January 1—December 31, 2014) or during the grace period (January 1, 2015—March 15, 2015) you use your health FSA debit card or submit a reimbursement request form, receipts and any required supporting documents to the administrator for reimbursement. The final date for reimbursement for claims incurred during the plan year or during the grace period is June 15, 2015. Reimbursement checks can be mailed to you or can be automatically deposited into your bank account. Tax Savings Example Dollars you contribute to your FSA reduce your reportable and taxable income. No FSA With FSA $1,500 $1,500 Gross Salary Pre-tax expense Adjusted Salary Taxes (30%) Net Salary After-tax expense Take Home Pay 0 -$200 $1,500 $1,300 -$450 -$390 $1,050 $910 -$200 $0 $850 $910 Additional instructions (e.g. claims administrator information) will be mailed to employees after enrollments have been processed. If you have a 2013 FSA debit card and elect a 2014 FSA, do not throw away your card, it will be reloaded with your new year’s election. NOVEMBER, 2013 PAGE Individual Short Term Disability 8 What is Unum’s Short Term Disability Plan? Individual short term disability insurance can pay you a percentage of your gross monthly salary if you become injured or ill due to covered disability or covered pregnancy. You can choose monthly benefit amounts from $400 to $5,000. You can use it in any way you choose. You own this policy so you can keep it even if you leave Washington County or retire. Unum will bill you directly for the same premium amount. Monthly expenses you should consider: mortgage/rent, transportation, utilities, insurance, food & clothing, education, loans/credit card debt, child care/elder care, savings contributions/retirement, medical costs. Who is eligible? This policy is available to all eligible employees ages 17-69 who are actively at work. How do I enroll? For additional information or to apply for short term disability, contact the Unum Call Center during Open Enrollment at 1-800-817-3291 (Monday-Friday, 8 a.m.—5 p.m. EST) or visit www.unum.com/employees. Coverage becomes effective January 1, 2014. Deadline to enroll is Friday, November 29th. Policy Provisions Pre-existing condition limitation: If you have a preexisting condition within a 12-month period before your coverage effective date, benefits will not be paid for a disability if it begins during the first 12 months the policy is in force. A pre-existing condition is a condition for which symptoms existed (within 12 months before your coverage effective date) that would cause a person to seek treatment from a physician or for which a person was treated or received medical advice from a physician, or took prescribed medicine. The determination on whether your condition qualifies as pre-existing will be based on the date of disability and the date you notify Unum. Pregnancy: Nine months after coverage becomes effective, pregnancy is considered the same as any other covered illness. The available monthly benefits will be paid upon fulfillment of the elimination period. Benefits will not be paid if the insured individual gives birth within nine months after the coverage becomes effective. However, medical complications of pregnancy may be considered as any other covered sickness, subject to the pre-existing condition limitation. Sample Rates Maximum Monthly Benefit $800 $1,200 $1,600 7 Days Accident / 7 Days Sickness 14 Days Accident / 14 Days Sickness Elimination period / 3 Months Benefit Elimination period / 3 Months Benefit Sickness & Off Job Accident Issue Ages 17-49 Issue Ages 50-69 Issue Ages 17-49 Issue Ages 50-69 $13.50 $16.34 $10.01 $12.05 $20.24 $24.49 $15.02 $18.07 $26.98 $32.66 $20.00 $24.10 Premiums are based on your age on the policy effective date and are deducted from your paycheck semi-monthly (first two checks of the month). Premiums will be after-tax deductions. EMPLOYEE BENEFITS Frequently Asked Questions PAGE 9 Q: Do I have to complete a form? A: This Open Enrollment, forms are only required if you are changing your current elections (e.g. plans or covered dependents) or, if you are electing to participate in a 2014 Flexible Spending Account (FSA). Q: What happens if I do not turn in a form? A: If you do not turn in a form, your current elections (except FSA) and level of coverage will automatically continue. You will not be permitted to change your benefits for the remainder of the plan year unless you have a qualifying family status change (e.g. marriage, birth, adoption). Q: When are forms due? A: Completed Open Enrollment forms must be returned to Human Resources (PSB 270 or MS11) no later than 5 p.m. on November 29, 2013. Q: What happens if I do not re-elect FSA? A: FSA deductions must be re-elected each year according to IRS guidelines. If you do not turn in a form to re-elect deductions, this plan automatically ends each year. Q: Do I have to cover the same dependents on all health plans? A: No. You can specify which dependents you would like to cover on the medical, dental and vision plans that you select as the employee. Q: Can I elect to add additional life insurance or Long Term Disability (LTD) Buy-up coverage now? A: Enrollment changes to life insurance and LTD may be requested at any time during the year by completing an application (including a medical history statement). Coverage is subject to insurance underwriting and approval with Standard Insurance. Contact the Benefits team to request applications (503-846-8686). Q: Can I pay for my medical premiums using my Flexible Spending Account? A: No. Your medical premiums will already be paid on a pre-tax basis. Q: Can I change my Flexible Spending Account election if I need to? A: Generally, changes to your FSA election are not permitted during the year. The IRS rules do permit an election change if you have a qualifying family status change and your election change is consistent with that life event. See page 3 for a list of qualifying family status changes. Q: How do I apply for Individual Short Term Disability (ISTD) with Unum? A: You can contact the Unum Call Center (1-800-817-3291) and apply via phone. ISTD is only available for enrollment during an Open Enrollment period. Q: When is the next opportunity to change my benefit elections? A: The next Open Enrollment will be Fall of 2014 for the 2015 benefit year. Q: Where can I find more Open Enrollment information? A: Additional information can be found in several ways: • Electronic versions of most materials can be found on the Employee Benefits website: www.co.washington.or.us/benefits under the Open Enrollment link. • Open Enrollment materials, forms, policies, and current plan summaries are available in Human Resources. • Attend one of the Information Sessions. • Contact the Benefits team: [email protected] / 503-846-8686. NOVEMBER, 2013 PAGE Looking Ahead 10 2014 Wellness Activities & 2015 Medical Plans Medical plan options for 2015 will have a focus on wellness. Next year, plan members will have the opportunity to participate in wellness activities which will earn them a better benefit level in their 2015 medical plan (lower deductibles, co-pays and coinsurance). Wellness activities will include items such as obtaining a biometric screening and the completion of an on-line personalized health assessment. Biometric Screenings A screening completed at the doctor’s office or on-site during Employee Health & Wellness Week, which measures blood pressure, body mass index (BMI), cholesterol levels and blood sugar. Personalized Health Assessment An on-line health risk questionnaire that provides a confidential report that outlines health risks and strengths, and offers ideas for healthier living. Health risk questionnaires typically include questions about your diet, sleep and exercise habits, general safety and other topics. Screenings and Assessments are confidential. Individual results are never shared with your employer. Stay tuned! Plan members will receive additional information this Spring. Benefits & Wellness Calendar Wellness is a journey that continues throughout the year. To help you reach your healthy living goals, take advantage of the following resources: • • • Learn more about your own health; have your biometric screening completed at your physician’s office or on-site during Employee Health & Wellness Week Complete a confidential online health assessment Sign up for a free health coach Nov. 2013 Dec. 2013 Nov. 15—Nov. 29: 2014 Open Enrollment EMPLOYEE BENEFITS Jan 1: Coverage effective date Jan.— Dec.2014 Aug. 18—Aug. 22: Health & Wellness Week 2015 Open Enrollment Looking Ahead PAGE 11 From launching a website dedicated to helping employees with their wellness goals to publishing a quarterly Wellness Newsletter, your Wellness Committee has had a very busy and successful year! The Committee’s most recent success was assisting Human Resources with the coordination of the County’s first annual Employee Health & Wellness Week. And what a week it was...with on-site biometric screenings, daily lunch-time information sessions, two fun-filled Employee Health & Wellness Fairs and many prize giveaways, including two iPads from Providence and Kaiser. The following are some highlights from the week. During the week’s event, employees had opportunity to tell us what areas of wellness were important to them. We learned our employees are very motivated about their health status and ready for change. Based on what was shared, the Committee will focus on these areas of wellness over the next year: • Weight management (44% rated top priority) • Nutrition (14% rated top priority) • Depression (13% rated top priority) • Stress management (12% rated top priority) Want more information? • • • Visit the Employee Wellness Website Sign up to receive regular updates of wellness program activities by sending an email to [email protected] with EMAIL BLASTS in the subject line Watch for announcements about future wellness activities via email, on HORIZONS and in the quarterly employee wellness newsletter, Health Matters. NOVEMBER, 2013 Important Phone Numbers & Web Addresses Phone Web / Email Medical—Kaiser Permanente 503-813-2000 www.kp.org Medical—Providence Health Plan 503-574-7500 www.providence.org/healthplans Dental—Moda Health 503-243-3962 www.modahealth.com 1-855-433-6825 www.willamettedental.com 503-243-3962 www.modahealth.com Flexible Spending Accounts (FSA) 1-800-422-7038 psa.pacificsource.com/PSA Short Term Disability—UNUM 1-800-635-5597 www.unum.com/employees Long Term Disability—Standard Contact Benefits [email protected] Life Insurance—Standard Contact Benefits [email protected] EAP—Reliant Behavioral Health 1-866-750-1327 www.myRBH.com 503-598-7377 www.oregon.gov/PERS Retirement—457(b) Great West 1-800-462-9277 www.gwrs.com Retirement—457(b) ICMA 1-866-822-3641 www.icmarc.org 503-846-8686 [email protected] Plan/Program Dental—Willamette Dental Group Vision—Moda Health Retirement—PERS General Benefits Questions Visit the Washington County Employee Benefits Webpage for additional benefit plan details. www.co.washington.or.us/benefits
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