commonwealth of virginia 2015 open enrollment health care and flexible spending accounts (fsas) may...
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Commonwealth of Virginia
2015 Open Enrollment
Health Care and Flexible Spending Accounts (FSAs)
May 1- 22, 2015
Choose a plan based on your needs
• Enroll, change or keep your health plan
• Consider buy-up options:• COVA Care• COVA HealthAware • COVA HDHP
• Waive coverage
• Add or remove eligible family members
• Enroll in a Flexible Spending Account (FSA)
April 2015
Plans Offered Administrator Available
COVA HealthAware • Aetna Statewide
COVA Care• Anthem Blue Cross and Blue Shield
• Delta Dental of Virginia Statewide
COVA HDHP• Anthem Blue Cross and Blue Shield
• Delta Dental of VirginiaStatewide
Kaiser Permanente HMO
• Kaiser PermanenteRegional, primarily in Northern Virginia
TRICARE Supplement • Selman Company/ASI Statewide
Your Health Plan Choices
April 2015
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Children and Teens
Administered by Anthem
The basic plans include:• Medical• Behavioral Health• Employee Assistance Program (EAP)• Prescription Drug• Diagnostic and Preventive Dental
April 2015
Changes for 7/1/2015
• New plan year deductible $300 one person/$600 two or more persons
• Prescription drug copayments now count toward out-of-pocket expense limit
• Physical therapy copayment decreases to $15 per visit
• Routine hearing exam under Vision/Hearing option now covered once per plan year
April 2015
Optional Benefits
• Expanded Dental • Routine Vision/Hearing• Out-of-Network
• Expanded Dental
April 2015
Expanded Dental Option
Delta Dental of Virginia administers dental benefits
Expanded Dental option• Primary Care – such as fillings,
extractions, root canals• Complex Restorative - crowns,
dentures, bridges and implants• Orthodontic services
April 2015
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Vision and Hearing Option
Blue View Vision• Eye exam
• Eyeglasses • Contact lenses• Discounts on accessories
Hearing• Routine hearing exam once per
plan year • Hearing aids and related supplies
up to $1,200 every 48 months
April 2015
Out-of-Network Option
• Plan payment reduced by 25%
• Provider may balance bill for amounts the plan doesn’t pay
April 2015
www.AnthemEAP.com
• Mental health• Parenting and child care• Marriage and relationship
concerns• Workplace issues• Finance/Legal
Up to 4 visits per issue each plan year at no cost to member
April 2015
LiveHealth Online
Your Next Doctor’s Appointment Could Be Online • 24/7 access to a doctor from
smartphone, tablet or computer• Download the LiveHealth app
or go to livehealthonline.com
April 2015
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Administered by Aetna
Administered by Aetna
The basic plan includes:• Medical• Behavioral Health• Employee Assistance Program (EAP)• Prescription Drug• Routine Vision & Hearing Exams• Diagnostic and Preventive Dental Services• Health Reimbursement Arrangement (HRA)
April 2015
What is a Health Reimbursement Arrangement (HRA)?
• Account that automatically pays eligible out-of-pocket expenses as long as funds are available• Medical • Behavioral health• Pharmacy
• Funds paid from HRA toward eligible expenses for any covered member
• Unused HRA funds roll over into future plan years with no limit if enrollment in the plan continues
April 2015
• The initial HRA contribution for 7/1/2015:• Employee/Retiree $600• Employee/Retiree + Spouse $1,200
• HRA contribution is prorated for new enrollments or QME changes during the plan year.
• The HRA proration chart may be found at www.COVAHealthAware.com
HRA Contribution
April 2015
How the Plan Works
HRA Contribution
Employee/Retiree Only $600
Employee/Retiree + Spouse
$1,200
In-NetworkOut-of-
Network
Deductible
One person $1,500 $3,000
Two or more persons $3,000 $6,000
Out-of-Pocket Max
One person $3,000 $6,000
Two or more persons $6,000 $12,000
April 2015
HRA “Do Rights”
Employees/Early Retirees and enrolled spouses • Additional $50 HRA contribution for up to three “Do Rights”
• Up to $150 per employee/early retiree • Up to $150 per enrolled spouse
“Do Rights” • Annual routine physical exam• Routine dental exam• Annual routine vision exam • Annual flu shot• Active Health Management Health Tracker• Active Health Management Coaching Module
April 2015
Optional Benefits
• Expanded Dental• Expanded Vision
April 2015
Expanded Dental Option
April 2015
Expanded Dental option• Primary Care – such as fillings,
extractions, root canals• Complex Restorative - crowns,
dentures, bridges and implants• Orthodontic services
Expanded Vision Option
• Eyeglasses • Contact lenses• Discounts for eyewear and
accessories
• Network includes private practice providers plus participating national chains
April 2015
Aetna Resources for LivingSM EAP
• Available to participants and members of their household
• Confidential resource to address and resolve personal and workplace challenges
• Additional legal and financial guidance
Up to 4 visits per issue each plan year at no cost to member
April 2015
www.mylifevalues.com
Your Next Doctor’s Appointment Could Be Online • 24/7 access to a doctor from smartphone, tablet or computer
• Visit www.Teladoc.com or call 855-Teladoc
April 2015
Administered by
MyActiveHealth
• Provides coaching services as part of the COVA health management program
• Available for COVA Care, COVA HealthAware and COVA HDHP
• Partners with Anthem and Aetna to deliver services promoting healthy lifestyles and chronic condition management.
Posters, flyers, postcards and email communications provide program information.
MyActiveHealth
April 2015
All eligible adult members may access their
own customized portal
• Complete health assessment
• Get a Physician Results Form to complete
their biometric screening
The portal is enhanced with online coaching
and web tools
• Digital coaching
• Interactive trackers, games and more
Customized Health Portal
www.myactivehealth.com/cova
April 2015
MyActiveHealth Programs
Healthy Lifestyles - Lifestyle Coaching with Five Tracks
• Smoking Cessation • Weight Management • Stress Management • Nutrition• Exercise
Healthy Beginnings - Maternity Care
Healthy Insights - Disease and Chronic Condition Management for Conditions Such As:
• Heart Disease• Diabetes
April 2015
Healthy Insights • Diabetes management • Hypertension • COPD & Asthma
Healthy Beginnings for expectant moms
Incentives for COVA Care and COVA HealthAware
April 2015
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Kaiser Permanente HMOAdministered by Kaiser Permanente
Kaiser Permanente HMO
• Available in Northern Virginia, Fredericksburg and
other cities and counties
• All care coordinated by your primary care physician
April 2015
Administered by Selman Company/ASI (SelmanCo ASI)
April 2015
• Voluntary supplemental health benefit option
• Available to state employees and non-Medicare eligible retirees who are military retirees, or the spouse of a military retiree. They must be eligible for:
• TRICARE, the military health benefits program, and • The state health benefits program
• Eligible employees who enroll in the plan are responsible for 100% of the monthly premium amounts
• Monthly premium payments are made with pre-tax dollars through payroll deduction
April 2015
Premium Rewards
Save Every Month with Premium Rewards
• For employee, retiree and/or spouse enrolled in COVA Care or COVA HealthAware
• Employee/Retiree or spouse can save $17/month
• Together can save $34/month
April 2015
Requirements to Earn a Premium Reward
• Be enrolled in COVA Care or COVA HealthAware
• Complete or update your health assessment at myactivehealth.com/cova by June 30, 2015
• A health assessment completed as early as March 1, 2015 will qualify
• Report biometric screening results• Already submitted? No need to report again• Measurements taken as far back as April 1, 2013 will qualify• Not sure you have submitted? Contact your Benefits Administrator
April 2015
www.myactivehealth.com/cova1-866-938-0349
Earning Premium Rewards After June 30
April 2015
Eligible for a Premium Reward and didn’t meet the requirements by June 30?
Once you complete both a health assessment and biometric screening, your Premium Reward will begin the first day of the following month.
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Flexible Spending AccountsAdministered by Anthem
Health Care FSASet aside up to $2,550 per year, pre-tax, for eligible health expenses
Dependent Care FSASet aside up to $5,000 per year, pre-tax, for dependent care expenses
Flexible Spending Accounts (FSA)
Use the Elite Benefit Card for eligible Health FSA expenses
April 2015
To find information before enrolling:• Go to anthem.com/cova and select Benefits tab, FSA for:
• 2015 FSA Sourcebook• FAQs • Calculators
Once enrolled: • Register online at www.benefitadminsolutions.com/anthem
Important FSA Information and Resources
April 2015
• You must enroll each plan year to participate.
• “Use it or lose it” rule: Use all of your funds and file for reimbursement by the filing deadline or forfeit your FSA funds.
• If you enroll in COVA HealthAware, the HRA pays first.
ALEX is Back!
• Interactive guide to health plan options
• Helps you determine which plan is best for you
www.alexforcova.com
April 2015
Get the Open Enrollment Details
• Spotlight on Your Benefits newsletter or Retiree Notification booklet for:• Comparison of Benefits• Premiums & Premium Rewards• Who to contact for assistance
• Your agency Benefits Administrator• The health plans• www.dhrm.virginia.gov
April 2015
• Log on to Employee Direct at http://edirect.virginia.gov
• Select “Health Benefits Enrollment and Information”
• Or submit an enrollment form to your agency benefits office
Open Enrollment Ends May 22
Make Your Election!