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City of Marietta2016 BENEFITS OPEN ENROLLMENT REVIEW

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ShawHankinsService Center- can answer questions on all benefits Available 8:00 am – 5:00 pm during open enrollment 800-994-7429Benefit Resource Center- shawhankinsbenefits.net/cityofmariettaAll elections will be made using the ShawHankins bswift enrollment portal

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Changes for 2016BCBS POS and PPO Plans

No Changes to these Medical PlansPiedmont/Wellstar plan will no longer be offeredDental plan-new buy up optionOptional Vision Plan- new buy up optionLife insurance and VTL will be administered by Lincoln FinancialBasic Life now cover 3 x salary up to $300,000 max VTL now purchased in $10,000 increments instead of salary

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Changes for 2016

Disability coverage will be administered by Lincoln FinancialSTD will now be on a group plan with lower premiums (was Colonial)LTD will increase from coverage of 50% of salary to 60% of salary

Legal coverage vendor changing to ARAGAdditional coverage for divorce, real estate disputes, identity theft

New Benefits through UnumWhole life with Long Term CareAccidentCritical Illness

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Open Enrollment Open Enrollment is October 26-November 13 Enrollment Assistance will be available November 2-6 ShawHankins will be available to answer questions and assist with online enrollment

Open Enrollment is your opportunity to make elections for 2016Only time you can make a change to those elections is if you experience a qualifying event:

Marriage, divorceBirth or adoptionChange in your or your spouse’s work status that affects benefitsSpouse’s annual open enrollment periodChange in dependent eligibility statusChange in eligibility for Medicaid or MedicareDeath of dependentCourt order

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Bswift Online EnrollmentMake all elections through Bswift enrollment portal

www.cityofmarietta.bswift.com Username: first letter of first name, last name, and year of birth

Example: JSmith1972 Password: employee ID number

If you do not make elections through the enrollment portal, your coverage will roll over for the 2016 plan year. You will not be permitted to make changes after the open enrollment period ends, unless you experience a qualifying event.

You must make new FSA elections for 2016 to continue to participate in this plan. You will now be able to enroll in the FSA through bswift.

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Benefits Fair Monday November 2nd

7:00 am-4:00 pm

Custer Park Gym

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Medical and Prescription Coverage

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K ey B e n e fit

BCBS GA POS Plan In-Network

L ife t im e M a x im u m Unlimited

Deductible

C o in s u r a n c e

$750 per person

$2,250 per family

80% plan / 20% member

M a x im u m A n n u a l

O u t-o f-P o c k e t L im it

$6,600 per person $13,200 per family

Out of Pocket Maximum includes deductible, coinsurance and all copays – Office Visit, Urgent

Care, Emergency Room and Prescriptions

O ff ic e V is its

P r im a r y C a r e P h y s ic ia n

S p e c ia lty C a r e P h y s ic ia n

U r g e n t C a r e F a c ilit ie s

$35

$40

$75

Routine Preventive Care No Charge

I n p a t ie n t H o s p ita l F a c ility S e r v ic e s , P h y s ic ia n ’s V is its /C o n s u lta t io n s ,

P r o fe s s io n a l S e r v ic e s

Plan pays 80% after deductible

O u tp a t ie n t F a c i lity S e r v ic e s , P r o fe s s io n a l S e r v ic e s Plan pays 80% after deductible

H o s p ita l E m e r g e n c y R o o m $200 per visit copay, Co-pay waived if admitted

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PPO Plan-Grandfathered Employees

  

Key Benefit In-Network Out of Network

Lifetime Maximum Unlimited 

Deductible  

Coinsurance 

 

$800 per person

$2,400 per family

  

  

$1,200 per person$3,600 per family

 80% plan / 20% member

 

 70% plan / 30% member

  

Maximum Annual Out-of-Pocket Limit

$6,600 per person$13,200 per family

No maximum

Out of Pocket Maximum includes deductible, coinsurance and all copays – Office Visit, Urgent Care, Emergency Room and Prescriptions

Office VisitsPrimary Care PhysicianSpecialty Care Physician

Urgent Care Facilities  

 

Plan pays 80% after deductible

 

Plan pays 70% after deductible

Routine Preventive Care No charge Plan pays 70% after deductible

Inpatient Hospital Facility Services, Physician’s Visits/Consultations, Professional Services

 

Plan pays 80% after deductible$300 per admit , then plan pays 70%

after deductible

Outpatient Facility Services, Professional Services Plan pays 80% after deductible Plan pays 70% after deductible

Hospital Emergency Room Plan pays 80% after deductible

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P h a r m A v a il-P r e sc r ip tio n D r u g s B e n e fit

BCBS POS Plan

BCBS PPO Plan

Rx Calendar Year Deductible

None

$200 per individual/ $600 max for family

Retail Pharmacy 30 Day Supply Tier 1 Tier 2 Tier 3

Tier 4-Specialty Drugs

$10 $40 $65 10% to $200 max

20% 25% 30% 30%

Retail Pharmacy 90 Day Supply Tier 1- Generic Tier 2- Preferred Brand Tier 3- Non-preferred Brand Tier 4- Specialty Drugs

$20

$80 $130 Not Available

Coinsurance applies

Step Therapy required for), Hyper-Liptropics (Crestor), Fibromyalgia Agents (Lyrica), Migraine Treatment Triptan-Class

(Sumavel), Selective Cox-2 Inhibitors (Celebrex), Anti-Hypertensives-ACE & ARB (Diovan) Proton Pump Inhibitors (Nexium) covered OTC if available, instead of prescription version Prior Authorization and Step Therapy is required on all Specialty Medications (i.e. Humira, Enbrel)

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Weekly

Employee Employee + Spouse

Employee + Children Family

$0.00 $13.59 $10.87 $24.91

Monthly

Employee Employee + Spouse

Employee + Children Family

$0.00 $58.89 $47.10 $107.94

Weekly

Employee Employee + Spouse

Employee + Children Family

$11.28 $25.77 $22.87 $36.19

Monthly

Employee Employee + Spouse

Employee + Children Family

$48.88 $111.67 $99.10 $156.82

Weekly

Employee Employee + Spouse

Employee + Children Family

$0.00 $43.08 $34.46 $85.29

Monthly

Employee Employee + Spouse

Employee + Children Family

$0.00 $186.66 $149.34 $369.61

POS PlanActive EmployeesHired Prior to November 1, 2006

POS PlanActive EmployeesHired November 1, 2006 or Later

PPO PlanActive EmployeesHired Prior to November 14, 1996

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Dental CoverageNo change to current plan design or cost with BCBSGA

New Buy Up Plan option

Locate participating providers at bcbsga.com- Prime and Complete Network CURRENT- BCBS Dental

Base PlanNEW-BCBS Dental

Buy Up Plan In-network Out-of-network In-network Out-of-networkAnnual maximum $1,000 per person $1,500 per person

Deductible (Single/Family) $25/$75 $25/$75 $25/$75 $25/$75

Diagnostic/preventive services* 100% 100% 100% 100%

Basic benefit services 80% 80% 80% 80%

Major benefit services 50% 50% 50% 50%

Orthodontic services Not Covered Not Covered 50% to $1,000 Lifetime Max

50% to $1,000 Lifetime Max

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Flexible Spending AccountsWill be administered by TASC for 2016Participants will receive a new Debit CardTwo separate accounts- Medical Spending Account and Dependent Care Spending AccountAllows you to set aside pre-tax dollars to spend on qualified expenses, saving on your taxable incomeMust make new elections for 2016- via bswift

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Flexible Spending AccountsMedical Spending Account Maximum contribution of $2,500 Some eligible expenses- Deductibles, copayments, dental expense, vision services and

materialsDependent Care Spending Account $5,000 for married couple filing joint income tax returns, $2,500 if unmarried or married and

filing separate income taxes Some eligible expenses- any care of a dependent that allows you and your spouse to work:

day care, after school program, in-home care, camps

May rollover up to $500 left in the Medical Spending Account at the end of the year. Any other unused funds will be forfeited.

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Basic Life and AD&DCity of Marietta provides basic life and AD&D benefit at no cost to youProvided through Lincoln Financial

City Council Employees: $150,000Closed Group of Public Safety Employees: $40,000All Other Employees: 3 x your annual earnings, maximum $300,000*

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Optional Life InsurancePurchase coverage for yourself in $10,000 increments up to a max of 5 x earnings or $420,000Elect coverage for your spouse in increments of $5,000 up to $100,000, or 50% of employee electionCoverage for your children of $10,000

If you are currently enrolled, you may elect to increase current coverage by 2 benefit increments for yourself and your spouse. without submitting evidence of insurability. Employees that have declined this coverage in the past and wish to add coverage at this time may purchase up to $20,000 for themselves and up to $10,000 for their spouse without submitting evidence of insurability.

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Long Term Disability CoverageProvided through Lincoln FinancialPays a benefit after you are disabled for 180 daysCovers 60% of your earnings up to a maximum of $5,300 per month.Continues to pay until you can return to work or reach SSNRAElect coverage through bswift

For 2016, there will be an open enrollment for the Long Term Disability coverage. If you enroll now, you will not be required to submit evidence of insurability to enroll.

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Short Term Disability Coverage

Now have group Short Term Disability coverage through Lincoln Financial-lower premiumsPays after you are disabled for 14 daysCovers 60% of your salary, up to $2,500 per weekPays for up to 24 weeks of disabilityEnroll through bswift

For 2016, there will be an open enrollment for the Long Term Disability coverage. If you enroll now, you will not be required to submit evidence of insurability to enroll.

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Optional Vision CoverageMay choose between current plan (no change in plan or rates) and new Buy Up Plan

Avesis VisionCURRENT –Base Plan

Avesis Vision NEW-Buy Up Plan

In-network

Out-of-network reimbursement

In-network

Out-of-network reimbursement

Exam $10 copay $35 $10 copay $45

Standard lenses $25 copay $25 single, $40 bifocal, $50 trifocal

$15 copay $40 single, $60 bifocal, $80 trifocal

Frames $50 wholesale allowance

$45 $65 wholesale allowance

$75

Contact lenses $130 allowance $130 $150 allowance

$150

Medically necessary contact lenses Paid in full $250 Paid in full $250

Laser vision correction $150 allowance $150 allowance $300 allowance $300

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Legal ServicesWill be available through ARAG for 2016

Access to a nationwide network of attorneys

Work with you in person, over the phone or online on legal issues

Review or prepare documents

Make calls or write letters on your behalf

Represent you in court

Family law, real estate matters, civil damage claims, criminal matters, debt related matters, dispute with a landlord, government benefits, small claims court, tax issues, traffic matters,

Includes ID theft protection-monitoring, restoration, lost wallet service, $1,000,000 in insurance

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Unum Benefit OptionsWhole Life with Long Term Care Rider OptionAccident InsuranceCritical Illness Insurance, with Cancer coverage

Please note: UNUM will provide all worksite products for 2016 (Whole life, Critical Illness, and Group Accident Plans) If you prefer to retain your Colonial coverage, you must decline Unum coverage and pay Colonial directly. Your current Colonial coverage will rollover to the Unum plans if you make no election for 2016.

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Questions?