2018 benefit summary - arc erie county · 2018-04-17 · employee benefits guide pick the best...

2018 Benefit Summary

EMPLOYEE BENEFITS GUIDE

PICK THE BEST BENEFITS FOR YOU AND YOUR FAMILY.

The Arc Erie County New York strives to provide you and your family with a comprehensive and valuable benefits package. We want to make sure you’re getting the most out of our benefits—that’s why we’ve put together this Open Enrollment Guide.

Open enrollment is the period each year when you can make changes to your benefits. This guide will outline all of the benefits we offer so that you can choose the plans that will be the most beneficial to you and your family. During open enrollment, you can add or remove coverage, make a change in coverage, and add or remove a dependent (adding or changing coverage outside of open enrollment is allowed within 30 days of a qualifying event such as marriage, birth of child, loss of other coverage, etc.)

Elections you make during open enrollment will become effective on January 1, 2018. If you have questions about any of the benefits mentioned in this guide, please do not hesitate to reach out to Human Resources.

TABLE OF CONTENTS Contact Information ............................................................................................................... 3 Health Insurance ................................................................................................................. 4‐5 Health Reimbursement Account……………………………………………………………………………………6‐7 Flexible Spending Accounts ................................................................................................... 8 FitWorks……………………………………………………………………………………………………………………………9 Life and AD&D Insurances……………………………………………………………………………………………….10 Dental Insurance ............................................................................................................. 11‐12 Vision Insurance ................................................................................................................... 13 How to Enroll ........................................................................................................................ 14

This guide is intended for informational purposes only. © 2008‐2017 Zywave, Inc. All rights reserved.

EMPLOYEE BENEFITS GUIDE The Arc Erie County New York

• MEDICAL CONTACT INFORMATION

Independent Health www.independenthealth.com Member Services P: 716.631.8701 Toll Free: 1.800.501.3439

• HEALTH REIMBURSEMENT ACCOUNT (HRA) & FLEXIBLE SPENDING ACCOUNT (FSA):

NOVA www.HRbenefitsdirect.com/ihnova Member Services P: 716.505.8509 Toll Free: 1.800.264.9115

• VISION:

VSP Vision Toll Free: 1.800.877.7195

• DENTAL:

Dental Pay Plus Member Services P: 716.831.8171 Toll Free: 1.888.683.3682

HUMAN RESOURCES CONTACT INFORMATION: • Adriana Argenio, Benefits Administrator [email protected]

101 Oak Street Buffalo, NY 14203 P: 716.856.4204 x 1216 F: 716.332.3047

• Lissa Carroll, HR Director [email protected]

P: 716.856.4204 x 1345 F: 716.332.3047

• Barbara Kaczmarek, Sr. Associate Director of HR [email protected]

P: 716.856.4204 x 1272 F: 716.332.3047

• Rachel Shamp, Benefits/HRIS Specialist [email protected] P: 716.856.4202 x 1275 F: 716.332.3047

The information in this Enrollment Guide is presented for illustrative purposes and is based on information provided by the employer. The text contained in this guide was taken from various summary plan descriptions and benefit information. While every effort was taken to accurately report your benefits, discrepancies or errors are always possible. In case of discrepancy between the guide and actual plan documents, the actual plan documents will prevail. All information is confidential, pursuant to the Health Insurance Portability and Accountability Act of 1996. If you have any questions about the guide, please contact HR.


HEALTH INSURANCE Effective January 1, 2018, employees will no longer be able to enroll in the Encompass Essential Plus E plan unless they are currently enrolled in that plan. Those currently enrolled in the *Encompass Essential Plus E plan may re‐elect the plan or change to the iDirect 2 series plan.

*Encompass Essential Plus iDirect 2 with Limited Use HRA

Services Please refer to your IHA full benefit summary for complete plan details.

Physician Visit Copay $25 ($0 children)

$25 after Deductible

In‐Network Medical Deductible (Individual/Family)

$0 $2,500/$5,000

Inpatient Hospitalization $500 20% after Deductible

Preventive Care $0 $0

Emergency Room Visit (waived if admitted)

$250 20% after Deductible

Prescription Drugs ‐ Retail/Mail Order

‐ Generic ‐ Preferred

‐ Non‐preferred

Tier 1: $5 Tier 2: $35* Tier 3: $70*

*$250/$750 Deductible applies to Tier 2 & Tier 3

Tier 1: $10 Tier 2: $50 Tier 3: $100

Urgent Care Center $75 $75 after Deductible

Laboratory Services $0 $0

Telemedicine $0 $0

Limited Use Health Reimbursement Account (HRA) Funded by The Arc Erie County

New York

Not Available $1,000 Individual $2,000 Family

Out‐of‐pocket Maximum (Individual/Family)

$6,350/$12,700 $5,000/$10,000

YOUR COST IN 2018

EMPLOYEE BIWEEKLY DEDUCTIONS *Encompass Essential Plus E iDirect 2 with HRA

Employee $128.77 $43.96 Family $341.24 $110.04


$0 PREVENTIVE SERVICES These services are covered in full when rendered by an in‐network/participating provider. There may be other services performed in conjunction with the above preventive care services. These other services will be subject to any applicable member liability per your contract. *Does not include procedures, injections, diagnostic services, laboratory and X‐ray services, or any other services not billed as an Evaluations and Management code (E&M code).

• Abdominal Aortic Aneurysm Screening • High Blood Pressure Screening • Alcohol Misuse Screening and Behavioral Counseling Intervention • HIV Screening

• Aspirin Therapy Discussion for Prevention of Cardiovascular Disease • HPV Screening

• Bone Mineral Density Measurement or Tests • Major Depressive Disorder Screening for Children

• Breast and Ovarian Cancer Susceptibility Counseling, Genetic Risk Assessment • Mammography Screening

• Breast Feeding – Primary Care Intervention to Promote Breast Feeding

• Newborn Screening (for hearing, thyroid disease,

• Breast Feeding Supplies, Support and Counseling† phenylketonuria, sickle cell anemia) • Chlamydia Screening • Obesity Counseling and Screening • Colonoscopy and Flexible Sigmoidoscopy Screening • Occult Blood Screening • Contraceptive Methods and Counseling† • Pap Smear Collection and Preparation • Counseling for Interpersonal and Domestic Violence • Periodic Routine Health Examination*

• Depression Screening • Pregnant Women Screening (for anemia, iron deficiency,

• Diabetes Screening lead screening, bacteriuria, hepatitis B virus, • Diet, Behavioral Counseling Rh incompatibility) • Fluoride Treatment Counseling (for children up to 5 years old)

• Prenatal Care* and One (1) Post‐Partum Visit*

• Folic Acid Supplementation Discussion (for all women planning or capable of pregnancy) • Preventive Medicine Visits*

• General Health Panel with Basic Metabolic Panel • Prostate Specific Antigen (PSA) Testing • Gonorrhea – Prophylactic Medication for Newborns • Rubella Screening • Gonorrhea Screening • Sexually Transmitted Infections Counseling • Healthy Diet Counseling • Syphilis Screening

• Hemoglobin and Hematocrit • Tobacco Use and Tobacco Caused Disease Counseling

• Immunizations • Vision Screening (for children younger than 5 years old)

• Lead Screening • Well‐Child Visit* • Lipid Panel • Well‐Woman Visit*†


HEALTH REIMBURSEMENT ACCOUNT (HRA)

Health Reimbursement

Account

• $1,000 single/ $2,000 family • This account is provided by The Arc Erie County New York to

help employees pay for deductibles and copayments. • If you join the plan July 1 through the end of the year. You will

receive half of the HRA: $500 single/$1,000 family

What is it?

The Health Reimbursement Account is money to help employees enrolled in the iDirect 2 Hybrid HDHP health insurance pay their

deductible, coinsurance, and copayments.

How does it work?

• Included only with the iDirect plan • You will receive a NOVA PowerPay debit card pre‐loaded with

dollars to help pay your deductible • Only available while you are an employee and enrolled in the

iDirect plan; not portable • Half of your year‐end balance will be rolled over to a maximum of

$5,000.

iDirect 2 Limited Use Reimbursement Account Examples

At the Doctors:

A Single Member Has a Sick visit at the Doctor’s office. Doctor Bills $84

IHA receives invoice from Doctor. There is a $84 balance due from

member.

Member Pays $0 out of their pocket

Total $84 bill ‐$84 HRA ‐$0 out of pocket

$1,000

You have $1,000 in your HRA PowerPay Card to pay the $84. You can use your PowerPay Card

like a debit card.

At a Retail Pharmacy:

A Single Member picks up a prescription at a retail pharmacy and there is a $50 copayment due

for the tier 2 medication.

You have $1,000 in your HRA account

Use your PowerPay Card to pay the pharmacy.

$1,000

WELCOME TO OPEN ENROLLMENT The Arc Erie County New York

FLEXIBLE SPENDING ACCOUNTS (FSA)

MEDICAL DEPENDENT

CARE

What is it?

This is an account funded with pre‐tax employee dollars. It is used to pay for medical, dental, & vision related expenses.

This is an account funded with pre‐tax employee dollars.

Why do we have it?

This account is for employees to help the employee save tax dollars on medical, dental, & vision expenses.

This account is for employees to help the employee save tax dollars on day care expenses. Please consult your tax advisor to see if the FSA – Dependent Care or a tax credit on your tax return is best for you.

How does it work?

An employee may elect to have some of their salary added into a flexible spending account on a pre‐tax basis. This elected pre‐tax amount is immediately available for use by the employee. The employee must file claims with NOVA (the vendor) to be reimbursed for claims expenses. The card is smart enough to use the HRA funds if there are any before your FSA funds.

NOTE: this account is a use it or lose it; make sure you use all of your money (you can call NOVA to get your available balance)

An employee may elect to have some of their salary added into a dependent care flexible spending account on a pre‐tax basis. This elected amount is available to reimburse employees for qualified day care expenses. NOTE: the dependent care reimbursement is limited to the amount in the account (unlike the medical flexible spending account where the money is immediately available) NOTE: this account is a use it or lose it; make sure you use all of your money (you can call NOVA to get your available balance)

How much can I contribute?

$2,600 per year *Up to $500 can be rollover to the next plan year

The maximum election amount is set by the IRS and is $5,000 or $2,500 if you are married but file taxes separately. During the year cannot exceed your earned income or your spouse's earned income.


AGENCY PAID LIFE AND AD&D INSURANCE The Arc Erie County New York provides eligible employees with a life and accidental death and dismemberment (AD&D) insurance policy through Liberty Mutual.

Benefit:

Class 2:

Based upon your employment status effective January 1st, all active employees with 6 months – 5 years of services.

Coverage is equal to 100% of your annual salary rounded to the next $1,000, up to $100,000.

Class 1:

Based upon your employment status effective January 1st, all active employees with 5 or more years of service: coverage is equal to 200% of your annual salary rounded up to the next $1,000, up to $200,000. Reduction Schedule: Age reduction is based upon your age as of January 1st each year:

Age 65 (as of January 1) – Coverage reduced to 67%

Age 70 (as of January 1) – Coverage reduced to 50%

*Coverage amount is based upon your salary as of January 1st. (If your salary is $25,000 on 1/1, your coverage will be based on that amount for the year).


DENTAL INSURANCE In addition to protecting your smile, dental insurance helps pay for dental care and usually includes regular checkups, cleanings and X‐rays. Several studies suggest that oral diseases, such as periodontitis (gum disease), can affect other areas of your body—including your heart. Receiving regular dental care can protect you and your family from the high cost of dental disease and surgery.

STARTER PLAN

TYPE OF SERVICE IN‐NETWORK OUT‐OF‐NETWORK

Preventive Services Oral Exams

X‐Rays & Diagnostic Teeth Cleaning (one every six months)

Fluoride Treatment Topical Sealant

Emergency Treatment

Covered at 100%

Covered at 80%

Deductible

No Deductible

$50, 3 per family

Minor Restorative Services Fillings

Space Maintainers Oral Surgery Extractions Endodontics Periodontics

Stainless Steel Crowns Recementation Crowns/Inlay

Occlusion Adjustment Local Anesthesia

Covered at 80%

Covered at 60%

Annual Maximum Per person per calendar year $750

Biweekly Payroll Deductions

Employee only—$15.18 Employee & spouse—$24.60

Employee & child(ren)—$29.31 Family—$32.82


LEVEL 1 DENTAL PLAN

TYPE OF SERVICE IN‐NETWORK OUT‐OF‐NETWORK

Preventive Services Oral Exams

X‐Rays & Diagnostic Teeth Cleaning (one every six months)

Fluoride Treatment Topical Sealant

Emergency Treatment

Covered at 100%

Covered at 80%

Deductible

No Deductible

$50, 3 per family

Minor Restorative Services Fillings

Space Maintainers Oral Surgery Extractions

Stainless Steel Crowns Recementation Crowns/Inlay

Occlusion Adjustment Local Anesthesia

Covered at 80%

Covered at 60%

Major Restorative Services Porcelain Crowns Inlays/Onlays

Periodontics Services Endodontic Services Partial & Full Dentures

Fixed Bridgework Repair to Dentures &

Bridgework

Covered at 50%

Covered at 50%

Annual Maximum Per person per calendar year $1,000


Employee only—$18.24 Employee & spouse—$37.45

Employee & child(ren)—$42.64 Family—$48.83


VISION INSURANCE

VSP Vision Benefits Summary

BENEFIT DESCRIPTION COPAY FREQUENCY

Well Vision Exam Focuses on your eyes and overall wellness $10 Every calendar year

Prescription Glasses $20 See frame & lenses

Frame • $130 allowance for a wide selection of frames • $150 allowance for featured frame brands • 20% savings on the amount over allowance

Included in prescription

glasses

Every other calendar

year

Lenses • Single Vision, lined bifocal, and lined trifocal

lenses • Polycarbonate lenses for dependent children

Included in prescription

glasses

Every other calendar

year

Lens Enhancements

• Standard progressive lenses • Premium progressive lenses • Custom progressive lenses • Average savings of 35‐40% on other lens

enhancements

$50 $80 ‐ $90

$120 ‐ $160

Every other calendar year

Contacts (Instead of glasses)

• $130 allowance for contacts and contact lens exam (fitting and evaluation)

• 15% savings on a contact lens (fitting and evaluation)

$0

Every other calendar year

Diabetic Eyecare

Program

Services related to type 1 diabetes. Limitations and coordination with medical coverage may apply. Ask your VSP doctor for details

$20

As needed

Extra Savings

Glasses and Sunglass • Extra $20 to spend on featured frame brands. Go to vsp.com/specialoffers for details • 30% savings on additional glasses and sunglasses, including lens enhancements from the same VSP

provider on the same day as your Well Vision Exam. Or get 20% from any VSP provider within 12 months of your last Well Vision Exam.

Retinal Screening • No more than a $39 copay on routine retinal screening as an enhancement to a Well Vision Exam

Laser Vision Correction • Average 15% off the regular price or 5% off the promotional price; discounts only available from

contracted facilities • After surgery, use your frame allowance (if eligible) for sunglasses from any VSP doctor


Employee only—$4.50 Family—$10.00

WELCOME TO OPEN ENROLLMENT

How do I enroll in my benefits? Prepare for Enrollment Have all beneficiary and dependent information available including addresses, birthdates, and social security numbers.

Getting Started Go to www.arceriecounty.bswift.com

How to Enroll Enter Your Username Your username will be the same as your work email (before the @arceriecounty.org).

Enter your Password Your password is the last four digits of your social security number. To reset your password, click the “Forgot Password” link on the login screen, and follow the instructions.

Start your Enrollment Click on the button “Enroll Now” on the welcome page.

Complete your Selections In order to complete your enrollment, please check the box “I agree, and I’m finished with my enrollment.” Next, click the button “Save My Enrollment”

Your information will now be automatically sent to Human Resources. Your benefits information is available on the next screen. You can print the screen for your records, or request a confirmation statement be sent directly to you via email.

Important Forms Please remember to print, complete, and sign the FSA application if you wish to enroll. Human Resources will require this completed form to set up your FSA account.

After you Enroll You can revisit this site: www.arceriecounty.bswift.com all year long to view your benefits, review documentations, or make changes due to a qualified life event.

If you have questions, please contact Human Resources at 716.856.4202 x 1216

2018 benefit summary - arc erie county · 2018-04-17 · employee benefits guide pick the best...

Documents