2017 Open Enrollment - University of the Pacific...Open Enrollment for 2017 will be held from...
Transcript of 2017 Open Enrollment - University of the Pacific...Open Enrollment for 2017 will be held from...
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Open Enrollment
2017
2017 EMPLOYEE BENEFIT ENROLLMENT GUIDE
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Welcome to your Benefits Guide As a valued University of the Pacific employee, you are eligible for group and voluntary benefit plans aimed at providing you access to a variety of healthy care services, at an affordable cost, and promoting your protection and financial security against uncertain events in your life and the life of your family members.
This benefits guide provides an overview of the benefit options available and is meant to assist you in selecting plans that meet your individual and family needs. Please take a moment to review this information as well as visit our online resource, University Benefits, an area dedicated to all information regarding benefits at Pacific.
Your 2017 Benefits Pacific provides a full range of benefits that address your needs now and in the future.
To Your Health • 5 Medical Plan Options • 2 Dental Insurance Options • Vision Insurance • Prescription Drug Benefits • Health Savings Account • Employee Assistance Plan • Chiropractic Care
To Your Wealth
• Life Insurance • Accident Insurance • Retirement Plans • Short Term Disability • Long Term Disability
Current Employees During Open Enrollment
Open Enrollment for 2017 will be held from November 1 through December 2, 2016. You must enroll by December 2, 2016 for benefit elections to be effective January 1, 2017. You must complete an enrollment change form each year during Open Enrollment to enroll in the Medical Flexible Spending Account and/or Dependent Flexible Spending Account. If you would like your other benefits to remain the same, there is no action for you to take.
You only need to enroll if you: 1. You wish to change your existing coverage.
2. Add or drop dependents and/or provide updated dependent information. 3. Want to participate in Flexible Spending Accounts in 2017. According to IRS rules, you
must enroll in the Health Care Spending Account and/or Dependent Care Spending Account to participate each year. All other benefits and options that you have in 2016 will continue through 2017 if you do not make changes before the Open Enrollment deadline.
1. READ through the plan summaries and attend our Benefit Fairs.
2. THINK about what your needs are in relation to benefits.
3. DECIDE which benefits and options are right for you and your dependents.
4. ENROLL by completing the enrollment form.
5. SUBMIT your signed enrollment form to Human Resources.
OPEN ENROLLMENT DEADLINE: DECEMBER 2, 2016
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Who is Eligible Eligible Employees To be eligible for benefits you must be employed by the University of the Pacific and scheduled to work 20 or more hours a week for a minimum of 9 months.
After hire, you become eligible for benefits and must enroll within 31 days of your date of hire. If you do not enroll within the 31 day period, you must wait for the next Open Enrollment in November/ December of 2017.
Dependent Eligibility Your eligible dependents may include: • Your legal spouse/registered domestic partner (same or opposite sex) • Your unmarried children until the age 26 (biological, stepchild, adopted child, legal guardianship,
qualified medical child support order) • Grandchildren are eligible for coverage on the Kaiser HMO plan only and must meet the Kaiser plan
requirements. Refer to the group health plan documents for eligibility • Your adult children of any age who are/become mentally or physically disabled before age 26 and are
dependent on you for support
Only those dependents meeting the eligibility requirements can enroll for coverage. Check your Plan documents for more information regarding the dependent eligibility.
Pacific will continue to apply the Working Spouse Rate Option. Employees covering their spouse/domestic partner, that have insurance benefits available to them at their place of employment, must check the information under 2017 Medical Rates on page 10 to determine their contribution.
Changing or Adding Coverage Changes in coverage or dependents are limited to Open Enrollment or the occurrence of a Qualified Life Event (which must be consistent with IRS Section 125 regulations regarding a Qualifying Event).
If you experience any of the following life events, you are eligible for a special enrollment period: • A change in your marital status such as marriage or divorce • Birth/adoption/death of a dependent • A change in your employment status, such as: termination, lay-off, reduction in hours,
Retirement, return from an unpaid leave of absence • Entitlement to Medicare/Medicaid for you or your dependents • Dependents no longer meeting eligibility requirements • Legal judgments or orders resulting from a divorce, legal separation or change in legal custody
such as a Qualified Medical Child Support Order (QMCSO)
If you experience a Qualified Life Event, you must notify and enroll at [email protected] within 31 days of the event and, in some cases, provide supporting documentation. If you do not provide the required enrollment materials within 31 days, you will have to wait until the next annual Open Enrollment period to make changes to your benefit plans.
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Where to Get More Information Pacific wants to ensure that you have every opportunity to educate yourself and utilize the resources provided to help you make an informed decision about what plan best suits you and your family’ s needs. Using this guide along with the other informative resources Pacific provides, will help you have a smooth enrollment process.
Online Resource Visit the University Benefits portion of www.pacific.edu by entering “University Benefits” in the search box at the top of any page, click on the top search result.
Pacific Benefit Resource Center Human Resources would like to remind you that Pacific’s Benefit Resource Center is an additional resource for your benefit concerns and questions. Benefits specialists are trained to respond to benefit inquiries for all of Pacific’s benefit plans. Over- the-phone interpretation services are also available. Specialists are available Monday through Friday from 8:00 a.m. to 5:00 p.m. (PST) to provide you with secure and professional assistance with your issue. The Benefit Resource Center can be reached at 1-866-4-OUR-BRC (1-866-468-7272), or via email at [email protected]. (When emailing, please indicate that you are an employee of University of the Pacific.)
The Benefit Resource Center (BRC) is now available as an additional resource for employees to contact regarding any of the following issues:
• Claim processing timeline questions • Claim not paid or paid incorrectly • Claim/service denials • Benefit clarification • Assistance with a claims appeal • Any escalated issue
Benefit Fairs Attend one of our upcoming Benefit Fairs where you can learn more about the options available to you, any changes or additions to the plans and how you and your family will benefit.
Date Location Time 11/03/2016 STOCKTON
The DeRosa University Center Ballrooms 3601 Pacific Avenue Stockton, CA 95211
11 a.m. to
2 p.m.
11/8/2016 SAN FRANCISCO Executive Conference Room 437 155 5th Street San Francisco, CA 94103
10 a.m. to
2 p.m.
11/9/2016 SACRAMENTO Lecture Halls, S2 and S3 3200 Fifth Avenue Sacramento, CA 95817
11 a.m. to
1 p.m.
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Overview of Plan Options Please read over these brief descriptions and visit the University Benefits site for a more in-depth description of each plan.
Medical Benefit Options: Pacific offers its benefit-eligible employees 5 Health Plan options to choose from, these include Health Savings Accounts as well as High Deductible plans.
• Pacific Preferred Provider Organization (PPO)
• Pacific Preferred Provider Organization with High-Deductible and HSA (PPO-HD)
• Pacific Exclusive Provider Organization (EPO)
• Kaiser Health Maintenance Organization (HMO)
• Kaiser Health Maintenance Organization with High-Deductible and HSA (HMO-HD)
If you cover qualified dependents, you all must enroll in the same Medical Plan. All medical plans offer prescription drug benefits. Refer to the Prescription Drug Benefits page on our, University Benefits, site for more specific information.
Health Savings Account (HSA) If you select one of the two High Deductible Health Plans listed above, you are eligible for a tax-free HSA. For 2017, you can contribute $3,400 for single and $6,750 for family. Individuals age 55 or older can contribute an additional amount of $1,000. All contributions belong to you and you can take them and use them for your benefit if you leave Pacific. This is a great way to save for medical expenses in retirement!
In addition to enjoying reduced premiums and 100% preventative care coverage, Pacific also contributes $1,250 for employee only and $2,500 for employee + spouse, employee + child(ren) or employee + family annually to your account. Pacific will pre-fund 3 months in your HSA account the first week of January 2017, and then it will be pro-rated by paycheck beginning April 1, 2017.
Vision Insurance Vision benefits are provided through Vision Service Plan (VSP) for employees who enroll in any of the medical plans listed above. The cost of vision benefits is included in the cost of the medical plan you select.
Dental Insurance Pacific offers 2 dental plan options. You do not have to be enrolled in a medical plan to elect dental benefits and your coverage category may be different from your medical category.
• Delta Dental PPO plan • DeltaCare® USA DHMO (must reside in CA)
403(b) Group Retirement Annuity Plan Building a healthy financial future is just as important as taking care of your health needs today. Putting money aside for your future is easy with the 403(b) plan. With contributions deducted before federal taxes are calculated, it’s less painful to your take home pay than you might think.
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VOLUNTARY OPTIONS Voluntary Life Insurance and Accidental Death and Dismemberment
Pacific offers an opportunity for you to purchase additional Voluntary Term Life and AD&D insurance for you and your family. Employee coverage is available for up to five time’s base salary not to exceed the maximum coverage amount of $1,000,000. Spouse/Domestic Partner coverage is available in increments of $10,000, up to a maximum coverage amount of $50,000. Child(ren) coverage is available for $5,000, $10,000 or $20,000 per child. The premium is the same regardless of the number of eligible children covered. Evidence of insurability is required before Voluntary Life and AD&D new coverage is approved. See Evidence of Insurability form and submit with enrollment change form.
Age Employee & Spouse Age Employee & Spouse Under age 30 $.035 55-59 $.225
30-34 $.038 60-64 $.285 35-39 $.048 65-69 $.510 40-44 $.060 70-74 $.885 45-49 $.085 75-79 $1.040 50-54 $.125
Whole Life Insurance Pacific offers Whole Life Insurance for you to purchase for yourself, your spouse/domestic partner and your children. There are no physical exams required to apply for coverage, your coverage is portable and your rates are fixed. See Voluntary Whole Life and Accident webpage for more information.
Employee Coverage up to $70,000 for ages 15-80 in $10K increments Spouse/Domestic Partner Coverage up to $30,000 for ages 15-80 in $10K increments Child(ren) Coverage up to $10,000 for all children in $1K increments
Accident Insurance
Pacific offers Accident Insurance that can pay lump-sum benefits based on the injury you receive and the treatment you need, including emergency-room care and related surgery. The benefit can help offset the out-of-pocket expenses that medical insurance does not pay, including deductibles and copays. This benefit can cover hospitalization, physical therapy, transportation and lodging for family. Benefits are paid for accidents that occur off-the-job. You can elect to cover your spouse and children and there are no health questions or physical exams required. The plan is also portable.
Employee Employee & Spouse Employee & Child Employee, Spouse & Child $8.45 $14.44 $16.67 $22.97
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Flexible Spending Accounts The Plan year runs from January 1 through December 31. The amount you choose is deducted on a pre-tax basis from your paycheck in equal amounts throughout the year. You decide how much you want to set aside to pay for eligible health care and/or dependent day care expenses. Plan wisely for your contributions, as you can only “roll-over” unused amounts up to $500 from a Health Care Spending Account to use for the next year. See Flexible Spending webpage for more information.
Health Care Spending Account Dependent Day Care Spending Account $2,600 annual maximum $5,000 annual maximum
Transportation Management Program Participation in the Transportation Management Program allows you to set aside pre-tax dollars in a Parking Flexible Spending Account (FSA) to pay for eligible parking expenses, and/or a Transit Flexible Spending Account (FSA) to pay for eligible transit passes or vanpooling expenses. This plan is flexible as you are able to start and stop or make adjustments to the amount you use per year. Also, unused funds can be rolled into the next year provided you continue to participate.
Eligible Pre-tax Limits Transit/Vanpool FSA Parking FSA Monthly maximum $130 Monthly maximum $250
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Health Savings Account Highlights Pacific offers two high-deductible plans with much lower or no-cost premium options. With these plans, you pay a deductible first before the plan pays medical and prescription benefits. HSA Preventative care is covered at 100% with no deductible and can be accessed before the deductible is satisfied.
The plan limits the maximum amount of expenses you pay in any year. After your expenses reach that amount, you do not have to pay for any other covered health care expenses. This is called the calendar year out of pocket maximum.
These plans have the unique feature of a Health Savings Account and lower per-paycheck costs. All of your HSA preventative care, screenings and immunizations are paid 100% by the plan. HSA contributions, earnings and withdrawals for qualified health expenses are tax free, which means you are not taxed on the money you contribute, and the HSA is only available if you choose one of our qualified high deductible plans (contributions and earned interest to an HSA are taxable income in California). Unused balances in your HSA roll over from year to year. After turning 65, HSA dollars may be withdrawn for any purpose, paying only normal income taxes with no penalties.
For 2017, you can contribute $3400 for single and $6750 for family. In addition, Pacific also contributes $1250 for employee only and $2500 for employee plus spouse, employee plus dependent or employee plus family annually to your account. If you are 55 or older, you can contribute an additional $1000 in catch up contributions each year.
New for 2017 – Pacific will pre-fund 3 months into your HSA account effective the first week of January 2017, and then it will be pro-rated by paycheck beginning April 1, 2017.
All contributions belong to you and you can take them with you if you leave Pacific to use for IRS qualified health related expenses. Pacific contributes to your HSA, but the account is owned by you. This is also a great way to save for medical expenses in retirement.
To be eligible for an HSA, you must be enrolled in a qualified high-deductible plan. You cannot be enrolled in Medicare (including Part A), receiving social security benefits or claimed as a dependent. You also cannot be enrolled in an HMO plan or enrolled in a spouse’s health plan that is not a qualified high deductible plan. You cannot have an FSA and an HSA. A limited FSA may be available. Please see HR regarding these rules.
Here are three great resources to find more information on Health Spending Accounts and if they are right for you!
• Frequently asked questions about Health Savings Account • HSA Bank overview for Pacific PPO’s High Deductible Plan with an HSA • HSA information for Kaiser HMO’s High Deductible Plan with an HSA
Faculty and Staff have shared their experiences with Pacific’s medical plans. See what your fellow co-workers are saying about Pacific’s PPO High Deductible plan with a Health Savings Account and Kaiser High Deductible with a Health Savings Account. “HSA is a great way to build funds over time to pay for my medical needs. Pacific contributes money into my HSA before they deduct taxes from my paycheck. This is similar to a piggy bank. If I decide to leave Pacific, I can take my HSA with me and use it when I need to pay for qualified health expenses. “ Mason Lee, Support Services, Staff (Kaiser HMO HD with HSA)
“I always thought I should go for the plan where I have lowest deductibles. Now that there is a high deductible plan where I get contributions to my HSA, I see the value since I don’t need much health care at this time. Since I know I can switch plans each new enrollment term, I know I can switch plans if my health status changes. This flexibility seems like a great new addition.”
Elaine Mo, Gladys L. Benerd School of Education, Faculty (Kaiser HMO HD with HSA)
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Pa c i f i c S e l f - F u n d e d P l a ns Wor ld -C lass Med ica l Trea tment Over The Phone
You now have access to PlushCare, a telehealth solution that provides the quality medical care you deserve without the unnecessary hassle of visiting a physician’s office. And, it is free to use through your employer’s plan ($49 for HDHP members until deductible is met)!
Call 866.460.6205
E a s y A c c e s s Top Tier Physicians Prescriptions
Enjoy easy, fast service, seven days a week through secure online video
or telephone services .
PlushCare’s physicians are Board Certif ied and trained at the top 25
medical schools.
A PlushCare physician can write prescriptions and have them sent
to your local pharmacy.
H e r e ’ s W h a t I s C o v e r e d :
- Bronchitis - Chickenpox - Ear Infections - Impetigo - Kidney Infections - Lice
- Pink Eye - Pneumonia - Pre-Travel Questions and Prescriptions - Rashes/Dermatitis - Sinus Infection (Sinusitis) - Sore Throat
- STD Testing and Treatment - Strep Throat - The Common Cold and Stomach Flu - Urinary Tract Infection - And More!
WWW.PLUSHCARE.COM
For more information about your University Benefits visit the University Benefits @ https://go.pacific.edu or email [email protected] or call The Benefits Resource Center: 866-468-7272 8am-5pm PST email: [email protected] Delta Health Systems Group #475: 888-212-1231, www.deltahealthsystems.com
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ATTENTION ALL UNIVERSITY OF THE PACIFIC
Pacific Plan Members: DAMERON AMBULATORY CARE CENTER
WELCOMES YOU!
We have listened to needs of the community and have built our state-of-the-art facility to better meet your healthcare needs. Services rendered at the Dameron Ambulatory Care Center are provided with the tremendous advantage of a zero co-pay and zero deductible for services provided within the facility. These services include your office visit, in office procedures, immunizations, basic x-rays and laboratory services.
If you are a participant in the High Deductible/HSA plan, using Dameron Ambulatory Care Center providers can help your HSA dollars go further based on their discounted rates for these same services.
WHAT SERVICES ARE PROVIDED? • Family Practice • Pediatrics – including well-child exams • Preventive Health Services • Women’s Health Services • Wellness Vaccinations • Laboratory Testing • X-Ray services
WHERE IS IT LOCATED? Dameron Ambulatory Care Center 530 West Acacia Street, Suite 1 Stockton, California 95203
HOW DO I MAKE AN APPOINTMENT? Call (209) 944-5410 Same day appointments are available for urgent medical problems, but please call first to minimize your wait time.
NO DEDUCTIBLE NO CO-PAY
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2017 Medical Rates Please use the rates below as a reference. These rates are per pay period.
Plan Coverage Full-Time Employee Part-Time Employee San Francisco Union Full-Time Employee
San Francisco Union Part-Time Employee
Pacific PPO Option 1 Option 2 Option 1 Option 2 Option 1 Option 2 Option 1 Option 2 Employee $211 $309 $90 $187 Employee + 1 $477 $566 $656 $830 $195 $245 $392 $495 Employee + Family $689 $809 $1015 $1196 $275 $315 $558 $642 Pacific PPO w/HD HSA
ER HSA ER HSA ER HSA ER HSA Option 1 Option 2 Option 1 Option 2 Option 1 Option 2 Option 1 Option 2
Employee $23 $47 $23 $47 Employee + 1 $47 $59 $97 $122 $47 $59 $97 $122 Employee + Family $67 $77 $139 $160 $67 $77 $139 $160 Pacific EPO Option 1 Option 2 Option 1 Option 2 Option 1 Option 2 Option 1 Option 2 Employee $84 $170 $60 $119 Employee + 1 $180 $229 $370 $471 $125 $157 $249 $314 Employee + Family $305 $368 $633 $765 $179 $206 $357 $411 Kaiser HMO Option 1 Option 2 Option 1 Option 2 Option 1 Option 2 Option 1 Option 2 Employee $30 $60 $44 $89 Employee + 1 $58 $72 $118 $147 $84 $104 $175 $219 Employee + Family $85 $99 $177 $207 $125 $146 $262 $305 Kaiser HMO w/HD HSA
ER HSA ER HSA ER HSA ER HSA Option 1 Option 2 Option 1 Option 2 Option 1 Option 2 Option 1 Option 2
Employee $0 $0 $42 $0 $0 $38 Employee + 1 $0 $0 $83 $104 $0 $0 $75 $95 Employee + Family $0 $0 $123 $143 $0 $0 $112 $130 Delta Dental PPO Employee $12 $14 $6 $13 Employee + 1 $20 $27 $17 $24 Employee + Family $27 $35 $21 $31 DeltaCare USA DHMO Employee $0 $0 $0 $0 Employee + 1 $0 $0 $0 $0 Employee + Family $0 $0 $0 $0
Enrollment Notes: Pacific will continue to apply the Working Spouse Rate Option. Employees covering their spouse/domestic partner must check the following information to determine their contribution: • Option 1: Employee’s spouse/domestic partner does not have other coverage available. • Option 2: Employee’s spouse/domestic partner is eligible to participate in his/her own employers medical plan but waives coverage
in his/her employer’s medical plan. – If your situation changes regarding a spouse/domestic partner, it is your responsibility to contact Human Resources and
submit an enrollment change form within 31 days of the event so that the correct payroll deductions can be applied. Changes will be applied on a go-forward basis.
– If both you and your spouse/domestic partner work for Pacific and you are enrolled together under the medical plan, Option 1 payroll deductions will apply.
– If you are covering a child or children under the medical plan and your spouse/domestic partner is not enrolled, Option 1 payroll deductions will apply.
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Contacts
University of the Pacific HR Department • [email protected]
BENEFIT CONTACT NUMBER WEBSITE
Pacific Medical
Delta Health 888.212.1231 www.deltahealthsystems.com
Kaiser Medical
Kaiser 800.464.4000 www.kp.org
Pacific HSA Delta Health 888.212.1231 www.deltahealthsystems.com
Pacific Health Savings Account HSA Bank 800.357.6246 www.hsabank.com
Flexible Spending
Delta Health 888.478.7331 www.hrbenefitsdirect.com/delta
Dental - PPO Delta Dental 800.765.6003 www.deltadentalins.com
Dental - DHMO Delta Dental 800.422.4234 www.deltadentalins.com
Vision VSP 800.877.7195 www.vsp.com
Whole Life Unum 866.679.3054 www.unum.com
Accident Insurance Unum 866.679.3054 www.unum.com
Basic Life and
Sun Life Financial 800.862.6266 www.sunlife.com/us
Term Life and AD&D Sun Life Financial 800.862.6266 www.sunlife.com/us
Short-Term Disability Matrix 877.202.0055 www.matrixservices.com
Long-Term Disability Sun Life Financial 800.862.6266 www.sunlife.com/us
Employee Assistance Program
ComPsych
877.595.5281
www.guidanceresources.com Web ID/Login: EAPBusiness Company Code: UNIVE
Retirement TIAA 800.842.2276 www.tiaa.org/pacific
PlushCare Delta TeamCare
866.460.6205 www.plushcare.com
Dameron Ambulatory Care (Dameron Primary Care) 209.944.5410
NOTE: This statement is intended to summarize the benefits you receive from University of the Pacific. The actual determination of your benefits is based solely on the plan documents provided by the carrier of each plan. This summary is not legally binding, is not a contract, and does not alter any original plan documents. For additional information, please contact the Human Resources department.