y XX%May 7 - May 18

Changes Effective July 1st

2018 - 2019 Open Enrollment

OverviewOpen Enrollment is May 7 - May 18 / Changes effective July 1st

❖ Enroll or waive medical coverage

❖ Confirm/Update dependents and beneficiary information

❖ Social Security Numbers and Dates of Birth

❖ Update your address

❖ Everyone will receive new BCBS ID cards

Medical plans options:❖ Base Plan

❖ Base Plus Plan

No Changes after Open Enrollment unless a Qualifying Life Event occurs

ENROLLMENT INFORMATION

❖ Active Enrollment - Everyone must enroll to renew/change or waive coverage. (no automatic rollover of current coverage)

❖ If you don’t elect or waive coverage, you will default to Base Plan with Wellness - Employee only coverage➢ Your Spouse and dependents will not have coverage➢ Your next opportunity to elect coverage will be during the next

annual enrollment period

Dependent Documentation If not already provided, the documentation listed is needed.Spouse:

❖ Spouse Eligibility Form

❖ Marriage Certificate & Social Security Card OR

1040 Page 1 showing same information

Children:

❖ Birth Certificate & Social Security Card OR

1040 Page 1 showing same information

New address? YES... remember to update your contact information in ESS!

Make sure your address is current!

Self-InsuredHow is our health care paid for?❖ Healthcare insurance works like other types of insurance. The more you use the medical plans and incur

higher cost claims, the more it will cost you out-of-pocket – and the more your premiums will rise. See, the City is self-funded for its benefits plans. This means that as the employer, the City assumes the financial risk for providing health care benefits to its employees. Since the City is self-insured, the more claims we have, the more it costs the City to provide coverage.

❖ Each year, your HR team reviews the City’s plan, looking for opportunities to limit the cost increase while maintaining high quality coverage. Our goal is to continue to provide affordable healthcare to our employees and their families. By working together, we can accomplish this goal.

What to Expect:❖ Medical Plan Overview❖ Diagnostic Services change❖ New EAP Provider

Know Your Costs❖ Deductible: The amount you pay for covered health care

services before your insurance plan starts to pay.

❖ Coinsurance: The percentage of costs of a covered health care service you pay after you've paid your deductible.

❖ Out-of-Pocket Maximum: The most you will have to pay for covered medical expenses in a plan year through deductible and coinsurance before your insurance plan begins to pay 100% of covered medical expenses.

Plan Features

FeatureBase Plan - HRA Base Plan Plus

In-Network Out-of-Network In-Network Out-of-Network

Deductible $1,500 ind/$4,500 fam $3,000 ind/$6,000 fam $1,500 ind/$4,500 fam $4,500 ind/$10,500 fam

Coinsurance Max $3,000 ind/$6,000 fam $6,000 ind/$12,000 fam $3,000 ind/$6,000 fam $7,500 ind/$15,000 fam

Out-of-Pocket Max $4,500 ind/$10,500 fam $9,000 ind/$18,000 fam $4,500 ind/$10,500 fam $12,000 ind/$25,500 fam

Preventive Care 100% 50% after deductible 100% 50% after deductible

Wellness Screening 100% 100% 100% 100%

Individual Coverage: You are subject to individual deductible and coinsurance.

Family Coverage (2 or more people): You are subject to either individual deductible and coinsurance or family deductible and coinsurance, depending on previous claims for the plan year.

Coinsurance: One you meet the in-network deductible, employer pays 80% of claims and you pay 20%.

Premiums for FY 18-19 Full-time

Base Plan Employee Contribution W / Wellness

Employee Contribution W / O Wellness

COA Contribution

Employee Only $0.58 $24.25 $233.90

Employee Child $56.49 $81.56 $459.14

Employee + Spouse $73.10 $122.24 $539.99

Employee+Children $84.25 $110.69 $557.80

Employee+Family $130.87 $181.46 $852.48

Full-time

Base Plan Plus Employee Contribution W / Wellness

Employee Contribution W / O Wellness

COA Contribution

Employee Only $19.39 $43.81 $233.90

Employee Child $89.93 $115.03 $459.14

Employee + Spouse $124.26 $173.91 $539.99

Employee+Children $131.03 $156.52 $557.80

Employee+Family $224.12 $273.68 $852.48

Employee Contributions shown as per pay period amounts

Part-time 25 - 29 hours

Employee Contribution W/Wellness

Employee Contribution W/O Wellness

COA Contribution

Base Plan

Employee Only $70.28 $93.90 $161.88

Employee Child $162.24 $187.11 $234.67

Employee + Spouse $197.54 $246.38 $272.41

Employee+Children $209.36 $235.53 $245.26

Employee+Family $313.34 $363.49 $389.65

Base Plus Plan

Employee Only $97.95 $122.37 $154.87

Employee Child $221.40 $246.50 $224.02

Employee + Spouse $280.97 $330.63 $259.90

Employee+Children $250.39 $275.89 $235.05

Employee+Family $454.91 $504.48 $371.28

Part-time 20 - 24 hours

Employee Contribution W/Wellness

Employee Contribution W/O Wellness

COA Contribution

Base Plan

Employee Only $93.40 $117.01 $137.94

Employee Child $197.28 $222.15 $198.33

Employee + Spouse $238.74 $287.58 $229.65

Employee+Children $229.21 $255.38 $224.54

Employee+Family $373.76 $423.90 $326.95

Base Plus Plan

Employee Only $124.25 $148.67 $128.47

Employee Child $248.86 $273.96 $184.14

Employee + Spouse $311.26 $360.92 $212.96

Employee+Children $271.82 $297.31 $199.76

Employee+Family $498.36 $547.92 $302.47

Diagnostic ServicesEffective July 1, 2018:

❖ Diagnostic services billed with a wellness diagnosis will be denied.

❖ Services included, but not limited to, are: Urinalysis testing, Thyroid function testing, Vitamin D serum testing, EKGs, Testosterone level testing, Vitamin B serum testing, Albumin (urine) testing, Iron level testing, and Chest x-rays.

Diagnostic Mammograms

❖ Base Plan: Member pays 20%; Plan pays 80% (no deductible) ❖ Base Plus Plan: Member pays Co-pay; Plan pays 100% after co-pay❖ Preventive mammograms remain covered at 100%

Pharmacy Benefit❖ Mail Order for Maintenance Medications Required

Members are allowed two refills of a maintenance medication at a retail pharmacy. After the second refill, you will be charged a $20.00 penalty in addition to the cost of your medication.

❖ Getting started: Ask your doctor for a 90 day supply with 3 refills. Send the prescription with your copay to PrimeMail by Walgreens.

❖ To order prescriptions through the mail order, visit www.walgreens.com/primemail. You will need to register with PrimeMail by Walgreens mail service online, by telephone or mail in a completed prescription order form.

❖ Register or refill with PrimeMail by Walgreens online at www.walgreens.com/primemail(You can also access the mail order website from www.bcbsnc.com)

❖ OTC - medications available over-the-counter no longer eligible for prescription coverage

Pharmacy Savings❖ Ask your Doctor about generic medications.❖ Research your medication manufacturer for Special Care Programs - reduced or no cost based

on income; and coupons.❖ Asheville Project - no cost medication(s) for eligible conditions.

Dental Coverage provided by Delta Dental Coverage Standard High Premium

Deductible*Each per benefit year

$50 per person$150 per family

$25 per person$75 per family

$25 per person$75 per family

Preventative(Bi-annual Cleanings)

100% 100% 100%

Basic & Restorative; Endodontic; Periodontics; Denture Repair

80% 80% 80%

Crowns, Caps & Implants & Prosthodontics

50% 50% 80%

Orthodontics - Children N/A 50% up to $1,000 50% up to $2,000

Maximum per benefit year $1,000 $1,500 $2,000

Vision Coverage provided by Community Eye Care

Coverage LevelPer Pay Period

EE Only $3.23

EE/Spouse $6.13

EE/Children $6.45

Family $9.44

Benefit Frequency In-Network

Routine Vision Exam

Once every 12 months

$10 copay, then 100%

Eyewear: can be applied to frames, lenses, contact lenses, special lens options or any combination

Once every 12 months

$140 allowance, then 10% discount on balance

Contact Lenses Fitting or Evaluation

Once every 12 months

$20 co-pay Maximum coverage for contact lens exam is $100 for fittings; and $80 for annual evaluation

Visit www.communityeyecare.net or call 1-888-254-4290(Can use BCBS Medical coverage and Community Eye Care together)

Flexible Spending Accounts

Dollar-for-Dollar Match up to $250 if on Base Plan

Health Care FSA

➢ $2,650 annual maximum➢ Funds available immediately➢ Expenses incurred July 1 - June 30➢ Reimbursement claims can be filed

through Sept 30➢ Up to $500 of remaining balance as of

June 30 can be rolled over to the next year

Dependent Care FSA

➢ $5,000 annual maximum➢ Funds available as contributed➢ Expenses incurred July 1 - June 30➢ Reimbursement claims can be filed

through Sept 30➢ No funds rollover from year to year

Reducing Impact on My Paycheck Employees may choose between two medical plans: Base Plan and Base Plus Plan. Both plans cover the same services and provide you with high quality coverage. The plans differ in the way you pay your portion of the costs. Your portion of the costs is the amount you pay upfront (through payroll deductions) and the amount you pay at the time of care (through deductibles, co-pays and coinsurance).

When deciding which plan is best for you, consider… ➢ Do you or a family member have any special medical conditions that require regular visits to

healthcare providers?

➢ How much do you plan to spend on healthcare expenses next year?

➢ Will you use pre-tax dollars set aside in a Healthcare FSA to cover deductibles and other costs?

… the Base Plan continues to provide a $600 HRA; and a dollar-for-dollar match up to a maximum of $250 if you contribute to a Healthcare Flexible Spending Account.

Employees, covered spouses and retirees will earn 1 point for each of the following activities:➔ Complete a Health Risk Assessment online at www.bcbsnc.com

➔ Complete a Health Screening at Employee Health Services or your Primary Care Physician

➔ Earn additional points online or by participating in activities held by the City!

Wellness Points ★ 6 points required for employee and if applicable, covered spouse

★ Points tracked by Blue Cross Blue Shield

★ Wellness Plan participants load their own activities to earn points; and view point balances on the BCBS website

★ Points reporting & tracking instructions are available on ONE Asheville

Completion Period: July 1, 2018 - April 30, 2019

The Asheville Project

Disease Management Program to help you manage:

❖ Diabetes❖ Asthma❖ Depression❖ High Blood Pressure❖ High Cholesterol

All this… covered at 100%Education Counseling Condition-specific lab testsMedications Routine monitoring Appointments Coaching

*Wellness Program participation not required to enroll in Asheville Project*

Employee Assistance ProgramCity of Asheville employees, and their families, have access to an Employee Assistance Program – at no extra charge.

It features access to licensed and certified counselors who can offer support and referrals to help employees manage

personal concerns. The toll-free phone service is available twenty-four hours a day, seven days a week. No

appointment necessary and calls are completely confidential. When an individual calls, a counselor will listen carefully,

assess the situation and then help the caller take the next steps.

If you need help, call anytime toll-free 1-855-885-0226 (1-800-832-9559 for the hearing impaired) or go online at

bcbsnc.com/eap.

Get support for:

Financial matters Marriage and relationship issues Child care and elder care services Work-related issues

Substance abuse Legal concerns Mental health Stress

EAP counselors can help you manage your personal concerns so you feel your best at home and at work.

Confidential support for everyday challenges.

Voluntary Life Insurance provided by SunLife

Cancer Insurance provided by TransAmerica

Coverage Level Low Option High Option

Individual $5.96 $12.91

Individual & Child(ren)

$7.04 $15.25

Individual & Family $11.16 $24.18

Provides coverage to employees and their dependents diagnosed w/cancer or any of the other specified diseases.

•Maximum 12 month pre-existing condition exclusion

•Coverage will be granted for new hires

•$100 payment each year for each covered person getting annual physical that includes cancer screening even during exclusion period.

Critical Care Insurance provided by TransAmericaTransamerica provides insurance coverage for critical illnesses. This insurance can be purchased for you, your spouse and your child.

This benefit will pay you directly if you suffer from a critical illness. You will receive a lump sum benefit equal to the benefit election multiplied by a percentage designated in the Schedule of Benefits. If the critical illness occurs more than once within a 12 month period, the initial instance is covered based on the schedule and the second is paid at 50%. This insurance covers instances such as a Heart Attack, Stroke, Organ Transplant or Invasive Cancer.

Waiting PeriodThe policy includes a 12-month pre-existing condition limitation. Anyone electing not to enroll at the initial offering can apply for coverage later only if EOI is provided and approved. Critical Illness can be purchased for $10,000, $15,000 or $20,000. The tables to the right show the premiums if $10,000 is elected.

These rates are guaranteed and locked-in at issue date. Your rates do not increase with age.

Credit for Internal Cancer Screening with a PhysicalIf you have critical illness insurance, you and each dependent can receive a $100 reimbursement for having your annual physical as described under Cancer Insurance. You and each covered dependent can receive a check for $100 once per calendar year.

More InformationFor more information, visit the Critical Illness Brochure. For questions, contact 1-888-763-7474 (press option 2) or visit http://customers.transamericaemployeebenefits.com.

Long Term Care

Provides coverage for chronic care that is not covered under the medical insurance plan or Medicare.

•The following are eligible to elect this coverage:•Employees, who work 30+ hours per week, and their spouses or live-in companion•Retirees and spouses•Parent and parent-in laws

For more information contact (828) 210-3803.

Universal Life InsuranceWhole life policy in effect as long as the premiums are paid.

•You can take it with you without a change to cost or coverage.

•Rates are based on tobacco or non-tobacco use. Non-tobacco rates require you to be tobacco free for 12 months or more.

•This benefit must be elected in-person with an insurance representative during open enrollment.

•Rates are guaranteed and locked For more information visit:

http://customers.transamericaemployeebenefits.com

Other Coverage

Sick Leave Sharing BankEmployees are eligible for the Sick Leave Sharing Bank after completing 1 year of service*.

Qualifications:➢ Enroll during open enrollment➢ Contribute 1 day of sick leave based on your accrual rate➢ Must have a balance of at least 2 weeks of sick leave on July 1st of the

benefit year➢ You must enroll each benefit year.

Enrolled employees can draw from the sick leave sharing bank if they have a catastrophic illness and have used all available accrued leave

*Must have 1 year employment between July 1, 2018 - June 30, 2019

ENROLLMENT INFORMATION

❖ Active Enrollment - Everyone must enroll to renew/change or waive coverage (no automatic rollover of current coverage)

❖ If you don’t elect or waive coverage, you will default to Base Plan with Wellness - Employee only coverage➢ Your Spouse and dependents will not have coverage➢ Your next opportunity to elect coverage will be during the next

annual enrollment period

❖ Enrollment will require dependent documentation and social security numbers

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Questions?Open

EnrollmentFY 18-19

Access ONE Asheville from home:

https://one.ashevillenc.gov

Thank you for coming!