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AGENDA Registration (Wellness Nurses Available)…………………………………………………………..…… 8:00 AM Welcome…………………………………………………………………………………………………..…… 9:00 AM I. SEIB and Healthcare Reform Overview (Page 3)..…………………………………………………… 9:15 AM SEIB II. Deferred Comp Plan Options………………………………………………………………………….. 10:15 AM Great West Retirement Solutions Break (Wellness Nurses Available)………………………………………………………………..…….. 10:25 AM III. Alabama Retired State Employees’ Association (ARSEA)……………………………………….10:45 AM IV. Supplemental and Southland (Page 24)……………………….…………………………………... .10:50 AM SEIB V. Wellness (Page 42).……………………………………………………………………………..…….....11:20 AM SEIB VI. SEIB Wellness Center & Pharmacy (Millbrook Only)……………………………………………..11:40 AM Lunch (On your own)…………………………………………………………………………….…….. ….12:10 PM VII. Retirement Benefits Overview…….……………………………………………………...…………...1:25 PM Retirement Systems of Alabama VIII. SEHIP Online Enrollment……………………………………………………………….………….. …2:05 PM SEIB IX. Deferred Comp Plan Options………………………………………………………..………………. .2:35 PM Retirement Systems of Alabama Break…………………………………………………………………………………………………..……. ….2:45 PM X. Alabama State Employees’ Association (ASEA)…………………………………….……………… 3:05 PM XI. Retirees (Page 53).……………………………………………………………………………………….3:10 PM SEIB XII. Flexible Benefits Plan (Page 68).………………………………….………………...………………..3:40 PM SEIB Program Concludes………………………………………………………………………...………………..4:20 PM State Employees’ Insurance Board 2013 Benefits Conference 1
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AGENDA Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM...

Dec 14, 2015

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Page 1: AGENDA Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM Welcome…………………………………………………………………………………………………..……9:00

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AGENDARegistration (Wellness Nurses Available)…………………………………………………………..…… 8:00 AMWelcome…………………………………………………………………………………………………..…… 9:00 AMI. SEIB and Healthcare Reform Overview (Page 3)..…………………………………………………… 9:15 AM SEIBII. Deferred Comp Plan Options…………………………………………………………………………..10:15 AM Great West Retirement SolutionsBreak (Wellness Nurses Available)………………………………………………………………..…….. 10:25 AMIII. Alabama Retired State Employees’ Association (ARSEA)……………………………………….10:45 AMIV. Supplemental and Southland (Page 24)……………………….…………………………………... .10:50 AM SEIB V. Wellness (Page 42).……………………………………………………………………………..…….....11:20 AM SEIBVI. SEIB Wellness Center & Pharmacy (Millbrook Only)……………………………………………..11:40 AMLunch (On your own)…………………………………………………………………………….…….. ….12:10 PMVII. Retirement Benefits Overview…….……………………………………………………...…………...1:25 PM Retirement Systems of AlabamaVIII. SEHIP Online Enrollment……………………………………………………………….………….. …2:05 PM SEIBIX. Deferred Comp Plan Options………………………………………………………..………………. .2:35 PM Retirement Systems of AlabamaBreak…………………………………………………………………………………………………..……. ….2:45 PMX. Alabama State Employees’ Association (ASEA)…………………………………….……………… 3:05 PMXI. Retirees (Page 53).……………………………………………………………………………………….3:10 PM SEIBXII. Flexible Benefits Plan (Page 68).………………………………….………………...………………..3:40 PM SEIBProgram Concludes………………………………………………………………………...………………..4:20 PM

State Employees’ Insurance Board2013 Benefits Conference

Page 2: AGENDA Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM Welcome…………………………………………………………………………………………………..……9:00

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NEW ADDITIONS

A LIST OF INSURANCE COMPANIES ELIGIBLE FOR PAYROLL DEDUCTION

A LIST OF PAYROLL DEDUCTION CODES ADMINISTERED BY THE SEIB

A LIST OF NEARBY RESTAURANTS

A CERTIFICATE OF COMPLETION

Page 3: AGENDA Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM Welcome…………………………………………………………………………………………………..……9:00

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STATE EMPLOYEES’ INSURANCE BOARD

BOARD MEMBERS AND COMMITTEES

Page 4: AGENDA Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM Welcome…………………………………………………………………………………………………..……9:00

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SEIB BOARD MEMBERSAppointed By Position/ Name TermGovernor Personnel Board Member

John Carroll6 year term

Governor Personnel Board MemberJoe N. Dickson

6 year term

Lt. Governor Personnel Board MemberJoanne Randolph

6 year term

House Speaker Personnel Board MemberJon Bargainer

6 year term

Ex Officio RSA Executive SecretaryDavid Bronner

Indefinite

Ex Officio Finance DirectorBill Newton

Indefinite

Elected Personnel Board MemberFaye Nelson

6 year term

Elected Active Employee RepresentativeRobert Wagstaff

4 year term

Elected Active Employee RepresentativePaige Hebson

4 year term

Elected Retiree RepresentativeWilliam Mellown

4 year term

Elected Retiree RepresentativeRobert Pickett

4 year term

Page 5: AGENDA Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM Welcome…………………………………………………………………………………………………..……9:00

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Premium and Benefit Committee

Acting Finance DirectorBill Newton

Active Employee RepresentativePaige Hebson

Retired Employee RepresentativeRobert Pickett

This committee recommends benefit and premium changes to the SEIB.

Page 6: AGENDA Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM Welcome…………………………………………………………………………………………………..……9:00

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STATE EMPLOYEES’ HEALTH INSURANCE PLAN

PLAN OVERVIEW

Page 7: AGENDA Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM Welcome…………………………………………………………………………………………………..……9:00

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2005 Legislative Changes

State authorizes Board to offer supplemental coverage in lieu of the basic medical plan.

State requires retirees to take other-employee coverage, if offered.

State extends supplemental and optional coverages and provides a sliding premium

scale to retirees, based on years of service.

State requires Board to provide discounted coverage for low income active and retired

employees and their dependents.

State approves non-tobacco user discounts.

Page 8: AGENDA Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM Welcome…………………………………………………………………………………………………..……9:00

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2008

Increased Dental maximum from $1000 to $1500 per covered member.

Medicare retirees enrolled in Medicare Advantage Plan.

Page 9: AGENDA Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM Welcome…………………………………………………………………………………………………..……9:00

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2009

Wellness Participation Discount Program adopted. All active employees screened

during 2009 received the Wellness Participation Discount of $25 per month in

2010.

Page 10: AGENDA Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM Welcome…………………………………………………………………………………………………..……9:00

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2010

Effective October 1, 2010, timing of the State's premium payments

changed.

Page 11: AGENDA Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM Welcome…………………………………………………………………………………………………..……9:00

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2011Plan Changes

Implemented annual wellness screenings for all active employees to receive the Wellness Participation Discount.

Page 12: AGENDA Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM Welcome…………………………………………………………………………………………………..……9:00

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2012 Legislative Changes

Board can adjust premiums for spouse’s eligibility for other coverage.

Retirees must have at least 10 years of creditable coverage to be eligible for retiree health coverage.

Cancellation of coverage for fraudulent claims.

FPL discount increased to 300%.

Retiree premiums increased 1% per year for every year prior to Medicare age.

Sliding scale adjusted to charge a 4% per year penalty for less than 25 years of creditable coverage.

Contribution for non-Medicare retirees cannot exceed contribution for active employees by October 1, 2016.

Page 13: AGENDA Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM Welcome…………………………………………………………………………………………………..……9:00

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SEIB Premium Rate HistoryYEAR STATE

SHARE**INDIVIDUAL

PREMIUMDEPENDENT PREMIUM

1975 15.70 0.00 30.75

1980 32.43 0.00 51.77

1985 100.00 0.00 82.50

1990 195.00 0.00 141.00

1995 255.00 0.00 164.00

2000 357.00 0.00 164.00

2005 650.00 0.00 164.00

2010 805.00 15.00* 205.00*

2012 805.00** 15.00* 205.00*

2013 825.00 15.00* 205.00* *Premium shown includes non-tobacco user’s discount and wellness discount. **State share does not reflect credits returned to agencies.***Premiums do not include dental coverage.

Page 14: AGENDA Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM Welcome…………………………………………………………………………………………………..……9:00

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2014 Premium ChangesActive Employee

Single Increase $5Family Increase $5

Early RetireeSingle Increase $15Family Increase $25

Medicare RetireeSingle Increase $5Family Increase $5Family (non-Medicare) Increase $15

Surviving Spouse < 65Single Increase $20Family Increase $25

Medicare Surviving SpouseSingle Increase $20Family Increase $25

Non-Tobacco User Discount Increase $5 to $50

Dental Premium Individual $3 Family $8

Implement Monthly Spousal Surcharge $50 If the spouse’s individual coverage is more than $255 per month, the SEHIP member may qualify for a waiver.

Page 15: AGENDA Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM Welcome…………………………………………………………………………………………………..……9:00

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2014 Benefit ChangesMandated Affordable Care Act (ACA) Benefits Add some preventive and women’s health No copay

Out of pocket limits Individual $6,250Family $12,500

Dental Offer dental coverage separate from health (BC/BS or Southland)

Urgent Care Facilities Increase Copay $35 to $50

Outpatient Surgery Increase Copay $100 - $150

Emergency Room Increase Copay $50 - $150

Major Medical Deductible Increase Deductible $100 - $300

Lab Copays Lower from $10 - $7.50

Expand Wellness Program Active employee their covered spouse, Non-Medicare retiree and their covered spouse are eligible for the wellness discount

BCBS Supplemental Limit deductible amount on primary coverage – carve-out dental

Health Reimbursement Account Provide up to $150 reimbursement to supplement other coverage premiums

Pharmacy Copays 90-day Supply (Tier I at 1.5 x copay)Tier II , include high cost genericsImplement Generic First Program (new prescriptions only)

Page 16: AGENDA Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM Welcome…………………………………………………………………………………………………..……9:00

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Dental OptionsBenefits

Deductible

Diagnostic/Preventive

Major/Restorative

Orthodontics

BC/BS

$25

100% Coverage

50% Coverage up to $1500 annual ($25 deductible)

50% Coverage up to $1,000 lifetime per child under age 19 ($25 deductible)

Southland

$25

100% Coverage

Single – 80% Coverage up to $1250 annual (no deductible)

Family – 60% Coverage up to $1000/member annual ($25 deductible)

No Coverage

NOTE: Opt-out and/or plan change forms will be mailed directly to employees.

Page 17: AGENDA Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM Welcome…………………………………………………………………………………………………..……9:00

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STATE EMPLOYEES’ HEALTH INSURANCE PLAN

HEALTHCARE REFORM

Page 18: AGENDA Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM Welcome…………………………………………………………………………………………………..……9:00

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Summary of Health Care Reform

Patient Protection and Affordable Care Act (PPACA)

Signed into law on March 23, 2010

“Grandfathered Plans” Plans that were in existence on March 23, 2010 SEHIP will lose grandfathered status on January 1,

2014 Provide preventative services and women’s health with

no copay

Page 19: AGENDA Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM Welcome…………………………………………………………………………………………………..……9:00

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Summary of Health Care Reform To Date

Lifetime Coverage Limits Prohibited SEHIP must eliminate the $1 million lifetime limit on coverage of

essential benefits but can allow certain restrictive annual limits until 2014.

Pre-existing Condition Exclusions Prohibited for Dependents

SEHIP must eliminate pre-existing condition exclusions for children under the age of 19.

Dependent Coverage Expanded up to Age 26 SEHIP must provide coverage for adult dependent children up to

age 26, if the child is not eligible to enroll in other employer provided coverage.

SEHIP cannot require qualified young adults to pay more than similarly situated dependents enrolled in the plan.

Health Care Reimbursement Account Maximum contribution capped at $2,500 annually Over-the-Counter drugs must be pre-approved

Page 20: AGENDA Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM Welcome…………………………………………………………………………………………………..……9:00

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Open enrollment for Marketplace*Coverage may become effective as early as January 1, 2014.

*For more information on the Marketplace, click here.

Health Care Reform ChangesEffective October 1, 2013

Page 21: AGENDA Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM Welcome…………………………………………………………………………………………………..……9:00

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Healthcare Reform ChangesEffective January 1, 2014

Pre-existing condition exclusion for all enrollees prohibited.

SEHIP currently has a 270 waiting period less credit for time served under other group coverage.

Coverage Eligibility Employees must be offered coverage within 90 days

of employment.

Marketplace Subsidy SEHIP members who fall between 100%-400% of the

FPL may qualify to receive credit for participation in the Marketplace.

Individual Mandate Everyone, unless exempted by law, is required to

maintain health insurance.

Page 22: AGENDA Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM Welcome…………………………………………………………………………………………………..……9:00

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Healthcare Reform ChangesEffective January 1, 2018

Excise tax on “Cadillac” Plans Cost of coverage exceeds $10,200 on individual and $27,500 on family coverage

SEHIP cost of coverage is currently well below these levels.

Page 23: AGENDA Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM Welcome…………………………………………………………………………………………………..……9:00

Have Your New, Existing, and Retiring Employees Contact Their SEIB Benefit Advisor For Plan and Benefit Information

Marsha Abbett866-841-9489

[email protected]

Tonya Campbell866-841-0978

[email protected]

Connie Grier877-500-0581

[email protected]

Kerry Schlenker866-838-5027

[email protected]

Rick Wages866-841-0980

[email protected]

Page 24: AGENDA Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM Welcome…………………………………………………………………………………………………..……9:00

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State Employees’ Insurance Board

BLUE CROSS BLUESHIELD (BCBS)SUPPLEMENTAL PLAN

Page 25: AGENDA Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM Welcome…………………………………………………………………………………………………..……9:00

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The BCBS Supplemental coverage supplements primary health insurance plans

by covering the copay, coinsurance, deductible

that the primary insurance plan does not pay at 100%.

The primary coverage’s deductible cannot exceed $1,250 for individual coverage or

$2,500 for family coverage.

What Is The BCBS Supplemental?

Page 26: AGENDA Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM Welcome…………………………………………………………………………………………………..……9:00

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Enrollment Requirement for the BCBS Supplemental

To be eligible, members must be able toenroll in another health insurance plan

through a spouse, other, or previous employer.

Primary plans NOT eligible:SEHIP (Group 13000)

Local Government Health Insurance Plan (Group 30000)Public Education Employees’ Health Insurance Plan (Group 14000)

TricareMedicare

Page 27: AGENDA Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM Welcome…………………………………………………………………………………………………..……9:00

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Cost of the BCBS Supplemental

Individual Coverage - $0*Family Coverage - $0*

*The tobacco user premium will be waived and the annual wellness check

is not mandatory.

Page 28: AGENDA Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM Welcome…………………………………………………………………………………………………..……9:00

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ExampleA married state employee has a spouse employed

with an auto manufacturer. The spouse elects family health insurance coverage offered through

his employer.

With the primary health insurance now provided through the auto manufacturer, the state

employee can enroll in the BCBS Supplemental, on the first day of the following month.

The BCBS Supplemental will eliminate copays, coinsurance, and deductible (up to a maximum) not covered at 100% by the auto manufacturer’s

coverage.

Remember, the BCBS supplemental is free for individual and family coverage.

Page 29: AGENDA Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM Welcome…………………………………………………………………………………………………..……9:00

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Advantages to enrolling in the BCBS Supplemental

The coverage is free of charge for individual and family coverage.

If the primary insurance does not provide dental coverage, members are eligible to enroll in the individual dental plan ($3) or the family dental plan ($8) offered through BCBS of AL or Southland National

BCBS Supplemental will pay health and pharmacy copays, coinsurance, and deductibles (up to a maximum) that the primary plan does not pay at 100%.

The member can move back to the BCBS basic medical plan on the first day of any month.

Everyone covered under the supplemental is eligible for benefits offered through the SEIB Wellness Program.

Page 30: AGENDA Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM Welcome…………………………………………………………………………………………………..……9:00

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PharmacyPharmacy:

To receive reimbursement on pharmacy benefits, the member should complete a BCBS Medical Expense Claim form (available at www.alseib.org) and attach pharmacy receipt(s).

Pharmacy claims may also be filed online at www.bcbsal.org with reimbursements eligible to bedirect deposited into the member’s personal checking or savings account.

Page 31: AGENDA Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM Welcome…………………………………………………………………………………………………..……9:00

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Southland Optional PlanDental, Vision, Hospital Indemnity, and Cancer

State Employees’ InsuranceBoard

Page 32: AGENDA Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM Welcome…………………………………………………………………………………………………..……9:00

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The Southland Optional Plan providesDental and Vision Coverage

Cancer and Hospital Indemnity Coverage

What Is The Southland Optional Plan?

Page 33: AGENDA Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM Welcome…………………………………………………………………………………………………..……9:00

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Cost for the Southland Optional Plan

Individual Coverage - $0*Family Coverage - $0*

*The tobacco user premium will be waived and the annual wellness check is not mandatory.

Page 34: AGENDA Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM Welcome…………………………………………………………………………………………………..……9:00

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Enrollment Requirement for the Southland Optional Plan

The SEHIP member must be eligible for primary health insurance through a spouse or other employer.*

*Primary plans not eligible: SEHIP (Group 13000)

Tricare (SEHIP retirees are the only exception.)Medicare

Page 35: AGENDA Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM Welcome…………………………………………………………………………………………………..……9:00

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The Southland Optional Plan is not designed to pay copays/deductibles not covered at 100% by your primary health insurance.

It does however provide dental, vision, hospital indemnity, and cancer benefits.

How is the Southland Optional Different than the BCBS Supplemental?

Page 36: AGENDA Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM Welcome…………………………………………………………………………………………………..……9:00

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The Southland Claims Process

Vision Benefits are the same, regardless of

provider. The provider or the member can file the

claim.

Dental Any dentist can be used. However, if a

provider in the DentaNet network is used, the member will save money on expenses over the allowed amount.

DentaNet is the second largest dental network in Alabama.

Page 37: AGENDA Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM Welcome…………………………………………………………………………………………………..……9:00

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The Southland Claims Process

Hospital Indemnity and Cancer These coverages work as a supplemental

to the member’s income; The amounts of reimbursement are

determined by the procedure, admission, diagnosis, etc. The member will file the claim and reimbursement will be mailed directly to them;

Payment or coverages of the primary health insurance do not affect the reimbursement amount.

Page 38: AGENDA Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM Welcome…………………………………………………………………………………………………..……9:00

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Advantages to enrolling in the Southland Optional Plan

This plan includes dental, vision, hospital indemnity and cancer coverages, all in one.

There is no premium for individual or family coverage.

The dental benefits exceed those offered through the SEHIP BCBS dental plan.

Southland is the sole dental provider for the Public Education Employee Health Insurance Plan (PEEHIP).

This plan can serve as the primary dental and vision benefits plan or supplement the out-of-pocket expenses that a member’s primary dental and vision plans do not cover.

There are no pre-existing conditions for the hospital indemnity or cancer coverage. In addition, reimbursements are paid directly to the insured.

Page 39: AGENDA Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM Welcome…………………………………………………………………………………………………..……9:00

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Things To Remember

• A minimum enrollment period of 12 months is required.

• After the12-month requirement has

been met, the member can return to the SEHIP during Open Enrollment (November 1-30) with a January 1 effective date.*

*PEEHIP members are eligible to make enrollment changes during the PEEHIP Open Enrollment

period (July-August) with a October 1 effective date.

Page 40: AGENDA Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM Welcome…………………………………………………………………………………………………..……9:00

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Southland Vision Supplemental

Premium is $24 per month, regardless of number of dependents. New employees may enroll within 60 days from date of employment.

Existing employees should enroll during Open Enrollment (November 1-30) with a January 1 effective date. Contract will remain in place unless cancelled by member during Open Enrollment.

This benefit will coordinate with the SEIB Discount Routine Vision Care Network .

Examination 40.00

Frames 60.00Single Vision 50.00Bifocals 75.00Trifocals 100.00Lenticular 125.00

Contacts 100.00

Note: Plan provides either contact or lenses with frames, but not both in any plan year.

Page 41: AGENDA Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM Welcome…………………………………………………………………………………………………..……9:00

Have Your New, Existing, and Retiring Employees Contact Their SEIB Benefit Advisor For Plan and Benefit Information

Marsha Abbett866-841-9489

[email protected]

Tonya Campbell866-841-0978

[email protected]

Connie Grier877-500-0581

[email protected]

Kerry Schlenker866-838-5027

[email protected]

Rick Wages866-841-0980

[email protected]

Page 42: AGENDA Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM Welcome…………………………………………………………………………………………………..……9:00

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SEIB WELLNESS PROGRAM

WELLNESS PREMIUM DISCOUNT

Page 43: AGENDA Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM Welcome…………………………………………………………………………………………………..……9:00

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Wellness Premium Discount

Members are screened for the following risk factors

Blood pressure At risk if systolic reading is 160 or higher or your diastolic reading is 100 or higher

CholesterolAt risk if 250 or higher

GlucoseAt risk if 200 or higher

Body mass index At risk if 35 or higher

Page 44: AGENDA Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM Welcome…………………………………………………………………………………………………..……9:00

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At-Risk Members

If determined at-risk, the member will receive a copay waiver and physician referral form for follow-up. The member may receive the

monthly discount by doing one of the following:

Submit an office referral form indicating that you have been counseled by a healthcare provider for your identified risk(s), or

Submit a completed physician certification form. It’s a good idea to

have your physician complete and sign your form while you are in for an office visit. Then you can mail or fax to us and have the peace of mind knowing that your discount is in place, or

Submit proof of participation in an approved exercise facility or SEIB approved program. Provide dates and location of participation, or

Provide proof that you are self-managing and have made improvement in your identified risk(s). You must provide documentation of your improvement.

Page 45: AGENDA Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM Welcome…………………………………………………………………………………………………..……9:00

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Approved SEIB Wellness Program Exercise Facilities

No contract agreementMonthly dues are payroll deducted

No signing fee

All memberships should be executed directly with the facility. The enrollment and payroll deduction information will be forwarded from the facility to the SEIB monthly.

For location and rate information, visit our website at www.alseib.org or click here.

Page 46: AGENDA Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM Welcome…………………………………………………………………………………………………..……9:00

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Just a Few Things You Need To Know To Receive The Wellness Discount New employees, and their covered spouse, must

participate in a wellness screening or submit a physician certification form within 60 days from their date of employment.

All active employees, their covered spouse, non-Medicare retirees and their covered spouse are required to have a screening/physician certification on or before November 30th of each year.

A State employee can participate in a screening offered by the SEIB, regardless of location.

Refunds will not be given for failure to submit appropriate information by deadline dates.

Page 47: AGENDA Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM Welcome…………………………………………………………………………………………………..……9:00

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Verifying Discount

To ensure the discount of $25 per month has been applied to your contract you can: Visit our website at www.alseib.org to

create and view your account information.

Call the SEIB Wellness Division at (866) 838.3059.

Page 48: AGENDA Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM Welcome…………………………………………………………………………………………………..……9:00

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Tobacco Cessation Program

Members and their covered spouse may receive a reimbursement of 80% of the cost of a non-covered tobacco cessation product up to $150 lifetime maximum.

Page 49: AGENDA Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM Welcome…………………………………………………………………………………………………..……9:00

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Physician Weight Management Program

Covered SEHIP members can receive 80%, up to $150 annually for non-covered

weight management programs that are overseen by a physician.

Page 50: AGENDA Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM Welcome…………………………………………………………………………………………………..……9:00

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Hearing Aid BenefitThe $100 reimbursement for hearing aids

will no longer be available beginning January 1, 2014.

Page 51: AGENDA Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM Welcome…………………………………………………………………………………………………..……9:00

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Reimbursement Process

To receive reimbursements for both tobacco cessation and weight management,

receipts should be:

Mailed: PO Box 304900, Montgomery, AL 36104

Faxed: (334) 517-9980

Be sure to include name, contract number, and date of birth on all correspondence.

Page 52: AGENDA Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM Welcome…………………………………………………………………………………………………..……9:00

Have Your New, Existing, and Retiring Employees Contact Their SEIB Benefit Advisor For Plan and Benefit Information

Marsha Abbett866-841-9489

[email protected]

Tonya Campbell866-841-0978

[email protected]

Connie Grier877-500-0581

[email protected]

Kerry Schlenker866-838-5027

[email protected]

Rick Wages866-841-0980

[email protected]

Page 53: AGENDA Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM Welcome…………………………………………………………………………………………………..……9:00

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State Employees’ Health Insurance Plan

RETIREE INSURANCE

Page 54: AGENDA Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM Welcome…………………………………………………………………………………………………..……9:00

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Enrollment / Continuation

A retiring employee may elect to continue coverage with SEIB by completing the Form 12

that is included in the RSA retirement package.

The Form 12 authorizes the RSA to deduct the monthly insurance premium from your retirement

check.

If a retiree chooses not to continue coverage at retirement, they MUST

wait until the annual Open Enrollment (November 1-30 with an effective date of January 1)

period to rejoin.

Page 55: AGENDA Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM Welcome…………………………………………………………………………………………………..……9:00

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Retiree Premium Determination

A Retiree’s Premium Is Based On:

Sliding ScalePremium payment is based on the retirees years of service

Medicare EligibilityIncrease in premium based on years shy of Medicare eligibility, traditionally age 65

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2014 Retiree Base Premiums

Premiums below are based on an employee with exactly 25 years of state service.

Non-Medicare$226 Individual*$478 Family*

Medicare Eligible (BlueRx)** $0 Individual*$121 Family*

*Premiums shown include the $50 non-tobacco user’s discount.**BlueRx copays will increase $5 per prescription beginning January 1, 2014

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57

Retiree Premium Sliding Scale

For every year of service under 25, the retiree share will be increased by 4%.For every year of service over 25, the retiree share will be reduced by 2%.

Years of service (YOS) certified through RSA may differ from years eligible under SEIB.

Participation in ERS does not necessarily mean your YOS will count towards your insurance

premium.

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58

Medicare Eligibility

A retiree will have a 1% increase for every year they are away from Medicare

eligibility.

Example: A 55 year old retiree will see a 10% increase in their health insurance premium because

they are 10 years away from age 65, or Medicare eligibility.

The percentage will remain the same until the member reaches Medicare eligibility.

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59

To Determine Premium at Retirement

Visit the SEIB website at www.alseib.org and use the Retiree Premium Calculator to

estimate premiums at retirement. Or you can click here to automatically be

directed to the Premium Calculator.

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60

Other Employer Coverage Carve-Out

State law requires the SEHIP retiree to enroll in

the new employer’s plan if member:

goes to work for another employer and is eligible for coverage with the new

employer and the new employer pays 50% or more of

the individual premium.

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Available For Those Who Have Other Coverage

Blue Cross Blue Shield Supplemental Picks up co-pays and deductibles that your

primary insurance does not pay at 100%, subject to a maximum deductible.

Southland Optional PlanProvides dental, vision, hospital indemnity and cancer coverage

Both of these plans are free for theretiree and their eligible dependents,

regardless of age and/or years of service.

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Retired State Employees Who Return to Work With the State of Alabama

Medicare eligible retirees returning to work:

Are classified as a non-Medicare retiree.

The employer is subject to the non-Medicarepremium for the individual.

The member is responsible for the non-Medicarepremium for the dependent.

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Retirees on Medicare

Retirees should contact theirSEIB Advisor for information onSEHIP benefits and premiumsand coordination of benefits

with Medicare.

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Status Changes

After retirement, the retiree becomes responsible for notifying the SEIB of any

changes to their health insurance

contract.

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65Surviving Spouse Coverage

When a SEHIP member with dependent

coverage dies: SEIB should be notified and the necessary forms

should be submitted within 90 days of the date of death;

Surviving spouses, and their covered dependents, will be eligible to continue coverage if they were covered at the time of death;

Eligible spouse should make the appropriate monthly premium payments to SEIB.

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Just so you know…

The Wellness Discount is not applicable to Medicare eligible retirees and their Medicare eligible covered dependents. However, Medicare eligible SEHIP members are eligible to attend Worksite Wellness Screenings.

The Southland Vision Supplemental Plan is available to both active and retired employees.

Retirees should not opt out of the SEHIP without speaking with an SEIB advisor about the BCBS Supplemental or Southland Optional.

Page 67: AGENDA Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM Welcome…………………………………………………………………………………………………..……9:00

Have Your New, Existing, and Retiring Employees Contact Their SEIB Benefit Advisor For Plan and Benefit Information

Marsha Abbett866-841-9489

[email protected]

Tonya Campbell866-841-0978

[email protected]

Connie Grier877-500-0581

[email protected]

Kerry Schlenker866-838-5027

[email protected]

Rick Wages866-841-0980

[email protected]

Page 68: AGENDA Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM Welcome…………………………………………………………………………………………………..……9:00

68

STATE EMPLOYEES’ FLEXIBLE BENEFITS

Health Care ReimbursementAccount (HCRA)

Dependent Care Reimbursement Account (DCRA)

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HEALTH CARE REIMBURSEMENT ACCOUNT(HCRA)

FLEXIBLE EMPLOYEES’ BENEFITS PLAN

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HCRA – How it Works

Determine the amount needed for out-of- pocket medical expenses for the upcoming year that include: Physician copays Prescription copays Over-the-counter medications (ONLY with doctor’s

written order) Lasik surgery Orthodontics Dental Glasses/Contacts

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HCRA – How it Works The total contribution is deducted in

equal pre-tax increments from each pay period over the next year. $1,000 / 24 pay periods = $41.67 per pay

period. The money is deducted pre-tax and

placed into an account to use when you have an out-of-pocket medical expense not covered by your health insurance.

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How Am I Reimbursed?There are three types of reimbursement offered under the Flex Plan:

Manual

Traditional (Bump)

Flexible Spending Card

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Manual Reimbursement Visit your physician and pay your copay of $35

Complete and HCRA reimbursement form, available at www.alseib.org, and forward to BCBS along with receipt/documentation from doctor visit;

BCBS will reimburse the member $35 by either mailing a check directly to the member, or if enrolled, the reimbursement can be direct deposited into a checking/savings account.

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Traditional Method (Bump) Visit your physician and pay your copay of $35

When the claim is processed by BCBS, the HCRA will automatically issue a reimbursement for the out-of-pocket expenses not covered by your health insurance.*

BCBS will reimburse the member $35 by either mailing a check directly to the member, or if enrolled, the reimbursement can be direct deposited into a checking/savings account.

*If there is no claim filed with BCBS, the HCRA will not be alerted to send a reimbursement. Example, if purchasing glasses/contacts, the request for reimbursement would need to be filed manually because these are non-covered benefits under BCBS.

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75

Flex Spending Card You receive a MasterCard pre-loaded with the

amount of money you choose to put into your account for the upcoming plan year.

You go to the doctor.

You use your Flex Spending card to pay the $35 copay directly from your account.

The money does not have to be in theaccount before the charge is incurred.

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76

How Does the HCRA Benefit State Employees?

The Health Care Reimbursement Account (HCRA) is basically an interest-free, tax-free loan.

The State is advancing you the total amount elected for the upcoming plan year, and that amount is payroll deducted from 24 pay periods, beginning January 1.*

Qualifying status changes allow enrollment and contribution changes outside of the open enrollment period.

*New employees who start after January 1 of the plan year have 60 days from date of employment to enroll. Their deductions would be divided by the number of payroll periods left in that plan year.

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Example of Tax Savings

HCRA

Adjusted Gross Income $20,000 $20,000

7.5% AGI Max Amt $1,500 N/AMedical Expenses $1,500 $1,500

Amount allowed as deduction $0 N/A

Tax Savings (15% tax) $0 $225Tax Savings (28% tax) $0 $420

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What if I Don’t Use All of the Money I Put Into the HCRA?

This program is regulated by the IRS; therefore, it has a “Use It or Lose It” rule.

The HCRA is available from January 1 until March 15 of each following plan year.

To determine the contribution amount, only add expenses for January through December.

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Bonus For Joining HCRAAn additional $50 will be added to your

account just for enrolling!

With a minimum $120 contribution(only $5 per pay period) you will actually have $170 to spend!

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80

DEPENDENT CARE REIMBURSEMENT ACCOUNT (DCRA)

FLEXIBLE EMPLOYEES’ BENEFITS PLAN

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DCRA – How it WorksDetermine amount needed to cover dependent care expenses for the upcoming year.

That amount is deducted pre-tax in equal increments from each pay period over the next year.

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DCRA Example

$2,000 / 24 pay periods = $83.34 per pay period.*

The money is placed into an account for you to use when you have a dependent care expense.

*New employees who start after January 1 of the plan year have 60 days from date of employment to enroll. Their deductions would be divided by the number of payroll periods left in that plan year.

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HCRA & DCRA Advantages Allows you to set money aside for

health/dependent care expenses for the upcoming year;

HCRA money can be used for dependents, even if they are not covered under your health insurance;

$50 bonus just for enrolling in the HCRA; Entire amount of election is 100% pre-taxed; Helps to budget health/dependent care

expenses; HCRA money in account after December 31st can

be used until March 15th of the next plan year; Significant tax savings over the course of the

year.

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Benefits of Enrollment in HCRA and DCRA

SEHIP members will pay for their out-of-pocket health and daycare expenses even

if they are not enrolled in the HCRA or DCRA.

So, why not pay with pre-tax money? And receive a $50 bonus just for enrolling in

the HCRA?Encourage your employees to consider

enrolling in the HCRA and DCRA.

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85

Helpful Links

Visit the SEIB website at to www.alseib.org view last three years of claims history to help determine upcoming years HCRA contribution amount;

Visit the Blue Cross Blue Shield of Alabama website at www.bcbsal.org to view contributions, balances, claims, etc. on both your HCRA and DCRA.

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Notes Be sure to use correct plan year

enrollment forms*

All payroll deductions in GHRS for both the HCRA and DCRA are administered by SEIB

* 2014 enrollment forms have been included in your folder

Page 87: AGENDA Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM Welcome…………………………………………………………………………………………………..……9:00

Have Your New, Existing, and Retiring Employees Contact Their SEIB Benefit Advisor For Plan and Benefit Information

Marsha Abbett866-841-9489

[email protected]

Tonya Campbell866-841-0978

[email protected]

Connie Grier877-500-0581

[email protected]

Kerry Schlenker866-838-5027

[email protected]

Rick Wages866-841-0980

[email protected]

Page 88: AGENDA Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM Welcome…………………………………………………………………………………………………..……9:00

State Payroll and Personnel Officer Assistance

New and Existing Employee Information and Forms

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New Employee Forms

SEHIP Enrollment Form (IB2) After initial enrollment, employee can

communicate directly with their SEIB Advisor for all their health insurance benefit questions, changes, etc.

Non-Tobacco User Discount Application Physician Certification Wellness Discount Form Southland Vision Supplemental Enrollment Form Federal Poverty Level Discount Application Flexible Benefits Plan Enrollment (HCRA and/or

DCRA)

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SEIB Wellness Benefits and Programs

Worksite Wellness Screening Schedule

Tobacco Cessation Program

Physician Administered Weight Management Program

Participating Exercise Facilities

Page 93: AGENDA Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM Welcome…………………………………………………………………………………………………..……9:00

Have Your New, Existing, and Retiring Employees Contact Their SEIB Benefit Advisor For Plan and Benefit Information

Marsha Abbett866-841-9489

[email protected]

Tonya Campbell866-841-0978

[email protected]

Connie Grier877-500-0581

[email protected]

Kerry Schlenker866-838-5027

[email protected]

Rick Wages866-841-0980

[email protected]