2016 Faculty & Exempt Open

Enrollment

Monday, November 2, 2015 - Wednesday, November 25, 2015

What’s New in 2016

Four Medical Plans to chose from4 Tiered Premium Rates for Medical,

Dental and VisionNew Vision VendorNew Flexible Spending Account Vendor

CHEIBA Tiered Premium Structure

Employee OnlyEmployee + SpouseEmployee + Child(ren)Employee + Family

Anthem Blue Cross Blue ShieldMedical Plans

Blue Advantage HMO/Point of Service

Prime Blue Priority PPOBlue Priority HMOLumenos HDHP

Anthem Blue Cross Blue ShieldMedical Plans

Blue Advantage HMO/POS

This is an existing plan with no changes other than the addition of the annual eye exam.

Blue Advantage Point of Service POS/HMO

PCP Required Yes

Individual /Family Deductible $0/$0

Out-of-Pocket Max Individual/ Family

$2,000/$4,000

Preventative Care Visits 100% Covered

Primary Care Office Visits $20 Copayment

Specialist Office Visits $20 Copayment

Emergency Room $100 Copayment

Inpatient Hospital $400 Copayment per admission

Outpatient Ambulatory surgery $60 Copayment

Anthem Blue Cross Blue ShieldMedical PlanPrime Blue Priority PPO Formerly known as the Prime Plan.

Plan option has been modified to include an additional tier of coverage.

If you or a family member utilize a Designated Primary Care Physician (PCP) or Specialist, your out-of-pocket cost will be lower.

Designated Provider are located in the following counties: Adams , Arapahoe, Boulder (including Longmont), Broomfield, Denver, Douglas, Elbert, El Paso, Fremont, Jefferson, La Plata, Montezuma, Pueblo, Summit and Teller.

If you do not reside in these counties, you can access these providers while traveling.

Prime Blue Priority PPOTier 1 (limited

Network)Tier 2 Out of Network

PCP Required Yes Yes Yes

Individual /Family Deductible

$400/$800 $400/$800 $960/$1,920

Out-of-Pocket Max Individual/ Family

$750/$1,500 $750/$1,500 $2,000/$6,000

Preventative Care Visits 100% covered 100% covered 100% covered

Primary Care Office Visits $10 Copay 15% After Ded 35% After Ded

Specialist Office Visits $10 Copay 15% After Ded 35% After Ded

Emergency Room 15% After Ded 15% After Ded 15% After Ded

Inpatient Hospital 15% After Ded 15% After Ded 35% After Ded

Outpatient Ambulatory surgery

10% After Ded 10% After Ded 35% After Ded

CHEIBA Tiered Premium Structure

Blue Advantage Point of Service Plan (HMO/POS) & Blue Prime PPO Plan & Custom Plus Health Plan

TOTAL COST YOUR MONTHLY COST

Employee Only $637.52 $147.00

Employee + Spouse $1,528.84 $352.00

Employee + Child(ren) $1,401.84 $323.00

Employee and Family $1,759.13 $405.00

Anthem Blue Cross Blue ShieldMedical Plans Lumenos HDHP HDHP = High Deductible Health Plan

Features a plan year deductible that applies to medical or prescription drug benefits

Health Savings Account eligible plan.

Health Savings Account (HSA)is an account that allows you to pay for qualified out-of-pocket medical expenses.

HSA is a personal, portable account and remains in your control regardless of your employment.

Contact your financial institution for more information about setting up a HSA.

Lumenos HDHP

PCP Required No

Individual /Family Deductible $2,500/$5,000

Out-of-Pocket Max Individual/ Family $2,5000/$5,000

Preventative Care Visits 100% covered

Primary Care Office Visits $0 After Ded

Specialist Office Visits $0 After Ded

Emergency Room $0 After Ded

Inpatient Hospital $0 After Ded

Outpatient Ambulatory surgery $0 After Ded

CHEIBA Tiered Premium Structure

Lumenos 2500 HDHP

Total Cost Your Monthly Cost

Employee Only $573.52 $132.00

Employee + Spouse $1,376.84 $317.00

Employee + Child(ren) $1,261.84 $291.00

Employee and Family $1,584.13 $365.00

Anthem Blue Cross Blue ShieldMedical Plans Blue Priority HMO (Limited Network)

NEW Plan for 2016.

In-Network Only Plan.

Network is limited to providers in Denver metro area, which includes Adams, Arapahoe, Boulder, Broomfield, Denver, Douglas, and Jefferson, counties as well as Elbert, El Paso, Teller, Fremont, La Plata, Montezuma, Pueblo, and Summit counties.

Most ASU employees are not eligible unless you live in the counties listed.

Your PCP will coordinate your care within the Blue Priority HMO Network.

Referrals are required.

CHEIBA Tiered Premium Structure

Blue Priority HMO Plan(Limited Network)

Total Cost Your Monthly Cost

Employee Only $586.52 $137.00

Employee + Spouse $1,406.84 $325.00

Employee + Child(ren) $1,289.84 $298.00

Employee and Family $1,619.13 $374.00

Finding / Selecting Providers (Primary Care Providers = PCP)1. Go to anthem.com

2. Select Find a Doctor

3. Select type of care – Search as a member

4. Select State – Colorado

5. Select Plan/Network (i.e. Prime Blue Priority PPO)

6. Select type of physician

7. Select specialty

8. Select location

9. Click Search

Visit HR website for more information and instructions on selecting a PCP.

New for 2016LiveHealth Online

See a doctor 24 / 7 on your computer or mobile device.

No waiting for a callback. Wait time – 2-3 minutes.

Available anywhere you have a computer or mobile device with Internet access.

Access to in-network board-certified Physicians.

Allows doctors to ePrescribe medications.

Members may pay via Visa, MasterCard, American Express and Discover.

Cost is lower than or equal to a doctor’s visit.

More Information or to sign up https://www.livehealthonline.com/

Anthem Blue Cross Blue ShieldDental Plans

Two Dental plans offered

1. Anthem Blue Dental PPO Plus

2. Anthem Blue Dental PPO

No changes to the plans

Anthem Blue Cross Blue ShieldDental Plans

Anthem Blue Dental PPO Plus Anthem Blue Dental PPO

In Network Out of Network In Network Out of Network

Annual Maximum $1,500 $1,500 $1,500 $1,500

Annual Deductible $25/$75 $25/$75 0 $50/$150

Diagnostic & Preventive Services*(No Deductible)

100% 100% 100% 100%

Restorative/General Services (Fillings, Composites,Anesthesia, Emergency, Oral Surgery)

80% 80% 80% 60%

Endodontic Services (root canal therapy, etc.)

80% 80% 80% 60%

Periodontal Services* (gingivectomy, osseous surgery,periodontal scaling & root planing and maintenance)

80% 80% 80% 60%

Major Services (Crowns, Bridges,Dentures, Approved Implants)

50% 50% 50% 40%

Orthodontia Lifetime Maximum for EligibleDependent children to age 19

50% up to $1,000

50% up to $1,000

50% up to $1,000 40% up to $1,000

Anthem Blue Cross Blue ShieldDental Plans – Premium Tier

Anthem Blue Dental PPO Plus or Anthem Blue Dental PPO

TOTAL COST

YOUR MONTHLY COST

Employee Only $39.00 $13.00

Employee + Spouse $90.00 $31.50

Employee + Child(ren) $86.00 $30.00

Employee and Family $102.00 $36.00

Anthem Blue Cross Blue ShieldVision Plans

Anthem Blue View Vision Plan replaces VSP Enrollment in any of the Anthem medical plans will

automatically include an annual eye exam. Access to vast network of both private doctors as

well as retail locations such as: Sears Optical, Pearle Vision, JCPenney Optical, Target optical and LensCrafters. Also local providers Rocky Mountain Eye Center and Abba Eye Center.

Anthem Blue View Vision

Employees enrolled in an Anthem Medical plan & would like to cover material and hardware can elect the

Blue View Vision Materials Only Benefit

Employee Only $6.36

Employee + Spouse $11.92

Employee + Child(ren) $11.92

Employee and Family $17.31

Blue View Vision Materials Only

Description Level of Coverage from an Anthem Provider

Non-Anthem Provider

Eyeglass Frames (once every 12 months)

$130 allowance, the 20% off any remaining balance

Reimbursed up to 70%

Standard plastic single vision lenses

$15 Copay, then covered in full

Reimbursed up to $50

Standard plastic lined bifocal lenses

$15 Copay, then covered in full

Reimbursed up to $75

Standard plastic lined trifocal lenses

$15 Copay, then covered in full

Reimbursed up to $100

Contact Lenses (once every 12 months

$130 allowance, then 15% off any remaining balance

Reimbursed up to $100

Anthem Blue View Vision Employees who are not enrolled in the Anthem medical plans but

would like vision coverage can elect

Voluntary Exam & Materials (Full-Service) Plan

Employee Only $8.80

Employee + Spouse $16.49

Employee + Child(ren) $16.49

Employee and Family $23.95

Supplemental Programs

24 Hour Nurse Line – Reach a RN 24 hours a day, 7 Days a week.

Audio Health Library – More than 300 prerecorded health topics.

Future Moms – Manage a healthy pregnancy.

MyHealth Advantage – Home mailings from Anthem.

Condition Care – Support for Chronic conditions.

Colorado Quitline – Support for helping to quit smoking or tobacco use.

PAL Program – Independent consultant who can help you navigate the Anthem system or claims issues

Health Fairs – Yearly blood draws, flu shots and biometric screenings.

Flexible Spending Account – 24 Hour Flex

24 Hour Flex is replacing PayFlex as new vendor.

Claims for expenses incurred 2015 to PayFlex. (Deadline is April 15, 2016).

I will be in touch with anyone who currently has a Flex that might be impacted by the roll-over

Maximum amount for Health Account is $2,550.00

Maximum amount for Dependent Account is $5,000.00

Pre-tax deductions & pre-retirement. Use it or lose it.

24 Hour Flex Debit Card is available.

Sign up for direct deposit.

Must enroll yearly

ASU CHEIBA Health Fair

Wednesday, November 11, 2015Free blood draws, flu shots and

biometric screens.SUB 309 7:00am until 11:00 am.Vendors from Anthem, 24 Hour Flex,

TIAA-CREF, Valic and Fidelity.

2016 Faculty & Exempt Open Enrollment

For more information or to print forms http://www.hr.adams.edu/administration/hr/benefits.php

Questions….