The document provides information about the 2014 annual open enrollment period for WKU employees. It outlines important dates for open enrollment, pre-enrollment sessions, and a benefits fair. Key highlights include modest increases to health plan premiums and the introduction of specialist copays. The life and disability carrier is changing to Lincoln Financial, which will offer guaranteed issue periods. The summary provides an overview of open enrollment details for the various benefit plans being offered during this period.
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2014 Open Enrollment Guide
1. 2014 PLAN YEAR
ANNUAL OPEN ENROLLMENT GUIDE
Department of Human Resources
October 2013
2. IMPORTANT OPEN ENROLLMENT DATES
Annual Open Enrollment Election
Period:
Pre-Open Enrollment Educational
Sessions:
NOVEMBER 15TH – 29TH, 2013
TUESDAY, NOVEMBER 5TH
• 9:00 AM - DSU Annex A210
• 10:30 AM – DSU Auditorium (DFM)
• 2:00 PM – WAB Room 227
Benefits Fair:
NOVEMBER
20TH
&
21ST
8:30 AM – 3:30PM
Kentucky Building – KY Room
WEDNESDAY, NOVEMBER 6TH
• 9:00 AM – WAB Room 227
• 2:00 PM – DSU Annex A210
THURSDAY, NOVEMBER 7TH
• 8:00 AM – South Campus 226
• 10:30 AM – DSU Auditorium (DFM)
3. HIGHLIGHTS OF THE 2014 PLAN YEAR
ANNUAL OPEN ENROLLMENT
• There will be NO rate increases in 2014 for the Dental, Life*, and
Disability* plans.
– *NOTE: Individuals moving to a new age bracket will see an increase in life and disability
premiums, based on the age-banded rate structure.
• There will be modest Health Plan increases in employee
premiums and minor benefit plan changes in 2014.
– The University’s Health Plan contribution will increase from $471 to $525 per month, which
helped alleviate more significant benefit plan reductions and employee premium increases
• Employee Assistance Program – Anthem EAP will replace
Compsych/Guidance Resources as WKU’s Employee Assistance Program
provider.
4. BENEFIT ENHANCEMENT FOR 2014
Lincoln Financial will replace Sun Life as WKU’s Life and Disability
provider in 2014.
• This carrier change comes with many advantages for employees who
wish to enroll for the first time or increase the optional employee or
spouse life coverage or elect short term disability.
• During open enrollment, Lincoln Financial will offer a one-time special
guarantee issue period which provides a unique opportunity for
employees to enroll in optional employee life, spouse life, and short
term disability without completing a statement of health subject to
approval.
5. BENEFIT ENHANCEMENT FOR 2014
•
The University provided basic life
insurance policy will increase from
$30,000 to $35,000
•
The maximum spouse life coverage
amount will increase from $80,000 to
$250,000.
•
Because of the carrier change, all
employees will be asked to update life
insurance beneficiary information
during open enrollment this year.
DON’T MISS THIS
UNIQUE
OPPORTUNITY!!!
PROTECT YOU AND
YOUR FAMILY FROM
THE POTENTIAL FOR
INCOME LOSS AND
OTHER FINANCIAL
HARDSHIPS SHOULD
THEY ARISE!
7. 2014 HEALTH PLAN CHANGES
While Health Plan benefits and premiums have remained unchanged
over the past 3 years (with the exception of several benefit
enhancements), there will be some changes in 2014:
• Modest Increases in Employee Premiums
• The Economy Plan will be the FREE Option for Employee Only
Coverage in 2014
• A Specialist Office Visit Copay will be added to the Health Plan
• A $50 Annual Rx Deductible will be added and applicable to Tier 2
& Tier 3 Prescriptions
8. Cost
WKU Monthly
Contribution
Employee
Monthly
Premiums
$600
$965
$775
$1155
$965
$1155
$525
$525
$525
$525
$1050 (2x$525)
$1050 (2x$525)
$75
$440
$250
$630
$0
$105
2014 HEALTH PLAN
MONTHLY RATES
High Plan
EE Only
EE + Spouse
EE + Child(ren)
Family
Cross Ref Couple
Cross Ref Family
Standard Plan
EE Only
EE + Spouse
EE + Child(ren)
Family
Cross Ref Family
$550
$830
$685
$975
$975
$525
$525
$525
$525
$1050 (2x$525)
$25
$305
$160
$450
$0
Economy Plan
EE Only
EE + Spouse
EE + Child(ren)
Family
$525
$750
$625
$875
$525
$525
$525
$525
$0
$225
$100
$350
•
The University’s Health Plan
contribution will increase
from $471 per month to $525
per month
•
The increase in the
University’s contribution
helped alleviate more
significant benefit plan
reductions and employee
premium increases
9. HEALTH PLAN DESIGN CHANGES FOR 2014
Addition of a Specialist Office Visit
Copay:
High
Standard Economy
Primary Care
Office Visit
Copay
$25
$35
$35
Specialist
Office Visit
Copay
$40
$50
$50
• The average cost to see a
Specialist is nearly double that of a
Primary Care Physician
• Primary Care will include the
following:
– General Practitioners, Family Practice,
Internal Medicine, OB/GYN,
Pediatricians and Geriatrics
• All other types of Office Visits will
fall under Specialists and be
subject to the new copay level
10. PRESCRIPTION BENEFIT CHANGES FOR 2014
Addition of a $50 Annual Rx
Deductible for Tier 2 & Tier 3 Drugs:
• No deductible for Generics!
– Tier 2 and Tier 3 Drugs cost on average
more than 6 times the cost of Tier 1
Generic Drugs!
• Tier 2 & Tier 3 drugs made up over
High
Tier 1
Generic
Tier 2 Brand
Preferred
70% of our total Rx costs in 2013
• Use Generics whenever possible!
Tier 3 Brand
NonPreferred
Standard
Economy
$10
$15
$15
$25
$30
$35
*after $50
annual
deductible
*after $50
annual
deductible
*after $50
annual
deductible
$35
$45
$45
*after $50
annual
deductible
*after $50
annual
deductible
*after $50
annual
deductible
11. HEALTH PLAN COMPARISON CHART
Benefit Highlight (In-Network)
HIGH
STANDARD
ECONOMY
Deductible
• Single
• Family
$400
$800
$750
$1500
$1000
$2000
Out of Pocket Max
• Single
• Family
$1500
$3000
$2000
$4000
$4000
$8000
Coinsurance (after annual deductible)
10%
20%
30%
Preventive Care Services
$0
$0
$0
Office Visit Copay
$25
$35
$35
Specialist Visit Copay
$40
$50
$50
Rx Copay
• Generic
$10
• Brand Preferred (after $50 annual deductible)
$25
• Brand Non Preferred (after $50 annual deductible) $35
$15
$30
$45
$15
$35
$45
12. VISION PLAN
No changes to the vision
coverage for the 2014
Plan Year
Vision coverage is
automatically
included with
participation in the
WKU Health Plan
Benefit
In Network
Non-Network
(Reimbursement)
Exam
(every 12 months)
$10 copay
Up to $42
Prescription lenses and
frames
*lenses every 12
months
*frames every 24
months
$20 copay
Up to $40 - $125
Varies by lens type
Prescription contact
lenses
*once every 12 months
Elective – up to
$130
Non-elective - $20
copay up to $250
Up to $210
13. EMPLOYEE WELLNESS PROGRAM
• We are excited to launch the second year of the
Employee Wellness Program starting in January 2014
• We encourage you to participate in the health
improvement activities to improve your health and
wellbeing and earn incentive rewards
• Additional information is available at
https://wku.livehealthier.com
15. Example of the Tax Savings applicable
to Flexible Spending Accounts
Without an
FSA
With an FSA
Annual Gross
Salary
$30,000
$30,000
Annual
Healthcare
Expenses
$1,000
$1,000
Annual Daycare
Expenses
$2,000
$2,000
Contributions to
an FSA
$0
$3,000
Taxable Income
$30,000
$27,000
Estimated Taxes
$10,695
$9,626
Net Tax Savings
by Using an FSA
$0
$1,069
IMPORTANT
INFORMATION!!
Voluntary Medical and Dependent
Care FSA’s REQUIRE annual reenrollment. You MUST take action
during open enrollment to re-enroll!!
Employees who waive the WKU
Health Plan and receive the $150/mo.
are NOT required to re-enroll
annually. It will automatically
continue unless you elect health
coverage.
All employees enrolled in Flexible
Spending will receive a new FSA Card
for the 2014 Plan Year.
16. FLEXIBLE SPENDING ACCOUNTS
Waiver Funds
(employees who waive WKU
Health Plan)
$150/month
Medical Flexible Spending
Account
Up to $2,500/year
Dependent Care Flexible
Spending Account
Up to $5,000/year
18. DENTAL PLAN COMPARISON CHART
CORE PPO
PREMIER
Deductible
$50 Single/$150 Family
$50 Single/$150 Family
Annual Max
$1000
$1000
Diagnostic/Preventive
Services
100% - no deductible
100% - no deductible
Minor Services
50% - after deductible
80% - after deductible
Major Services
Not covered
50% - after deductible
Orthodontia
Not covered
50% up to $1000
lifetime max for
dependents up to age 19
19. Cost
WKU
Monthly
Contribution
2014 DENTAL PLAN
MONTHLY RATES
Employee
Monthly
Premiums
•
CORE PPO PLAN
There will be no
changes in dental plan
EE Only
$13.06
$13.06
$0
EE + Spouse
$26.06
$13.06
$13.00
rates or benefits for
EE + Child(ren)
$24.94
$13.06
$11.88
2014*
Family
$40.86
$13.06
$27.80
PREMIER PLAN
*Some employees may notice a
$0.01 increase or decrease in the
EE Only
$25.32
$13.06
$12.26
monthly premium as a result of
EE + Spouse
$49.66
$13.06
$36.60
some rounding changes in a few
EE + Child(ren)
$58.90
$13.06
$45.84
Family
$92.36
$13.06
$79.30
coverage levels
20. LIFE AND DISABILITY INSURANCE
Basic, Optional, Spouse, & Dependent Life
Short-term & Long-term Disability
21. LINCOLN FINANCIAL - NEW LIFE &
DISABILITY INSURANCE CARRIER
• During open enrollment, Lincoln Financial will offer a
one-time special guarantee issue period which
provides a unique opportunity for employees to enroll in
optional employee life, spouse life, and short-term
disability without completing a statement of health and
subject to approval.
• Employee Optional Life Guarantee Issue up to $250,000
• Spouse Optional Life Guarantee Issue up to $30,000
23. SHORT-TERM DISABILITY
WKU Employee have the opportunity to
purchase a short-term disability policy through
Lincoln Financial. Short-term disability
provides a weekly benefit of 60% of salary up
to a maximum of $1,250 per week for up to 13
weeks.
Short-term disability is designed to protect
employees from income loss associated with
absence from work due to injury, sickness or
disease.
Important: Short-term disability will be
offered under a special guarantee issue period
during open enrollment this year!!
*No changes to the University provided LongTerm Disability
To compute your short –term disability
monthly premium:
Salary / 52 weeks x 60% x Age Band Rate
Age
Rate
00-25
$.089
25-29
$.090
30-34
$.069
35-39
$.069
40-44
$.066
45-49
$.070
50-54
$.081
55-59
$.104
60-64
$.122
65-69
$.137
70+
$.142
24. IMPORTANT INFORMATION ABOUT ANNUAL OPEN
ENROLLMENT
• You may enroll or make changes during the Open Enrollment
election period between November 15th – 29th
• The choices you make during the Open Enrollment period will be
effective for the plan year beginning January 1, 2014 through
December 31, 2014
• You will not be able to drop or add coverage until the next Open
Enrollment period in November 2014 for the 2015 Plan Year,
unless you have a change in family status or experience a
“qualifying event”
25. MAKING CHANGES THROUGHOUT THE YEAR:
QUALIFYING EVENTS
• If you experience a qualifying event during the 2014 plan year,
you can make mid-year election changes to your benefits
• You must notify the WKU Benefits Team within 31 days of the
qualifying event
• Examples of qualifying events include:
– Birth or adoption
– Marriage or Divorce
– Employment Status (dependent loses/gains other coverage)
– Dependent no longer meets eligibility criteria
– Spouse’s annual enrollment period or change in benefit offerings
26. OPEN ENROLLMENT BEGINS
NOVEMBER 15TH!
NO MORE PAPER!!
•
Additional information will be
shared via email and the HR
Benefits website
•
A new communication and
enrollment portal will be
introduced in the coming weeks
All open enrollment
information will be
communicated
electronically this year
•
Watch for future communication
from WKU Benefits
All open enrollment
changes will be made
in the new enrollment
system