Open Enrollment Decision Guide - Office Of Human Resources
Open EnrollmentDecision Guide2015 Edition
QUICK START GUIDETo make the best of your Open Enrollment elections, start here.12DECIDEGATHERShould you change any of your benefits? Consider these options:The information you’ll need:Dependents. Do you need to add or change medical, dental, vision,or life insurance coverage for a spouse or child?ooMedical. Choose between lower out-of-pocket expenses (HMO), orthe flexibility of out-of-network providers (PPO): page 11.If adding a spouse or dependent:o His/her full legal nameo His/her Social Security Numbero His/her date of birtho You will also need to presentdocuments to Human Resourcesverifying your dependents’eligibility. See page 4.Network. If you prefer certain doctors or hospitals, see pages 10-11.Dental. Choose between lower rates or more comprehensivecoverage: page 15.Vision. Coverage for eye care or corrective lenses: page 16.Life Insurance. Choose your supplemental coverage: page 17.Your netID and passwordYour election decisionsFlexible Spending Accounts. Set funds aside, tax free, for 2015health care expenses. Note: Re-enrollment is not automatic.Participants must enroll each year. pages 18-19.2015 Open Enrollment Decision GuideIMPORTANT DATESOct. 22 – Nov. 7Sept. 1- Nov. 7Oct. 22 & 23Oct. 22 & 23Nov. 7Late Nov. (TBD)Dec. 5OPEN ENROLLMENTComplete Your HRQ (Health Risk Questionnaire)Irish Health Benefits and Wellness Fair. See page 9.St. Joseph’s Mobile Mammogram Unit (in-network for Select and CHA networks)Last day for open enrollment and Your HRQConfirmation statements available online at http://openenroll.nd.eduLast day to submit enrollment corrections. Contact askHR at (574) 631-5900.FREQUENTLY ASKED QUESTIONSQ: Do I need to enroll? A: Yes. All faculty and staff arerequired to enroll by Nov. 7, 2014. If you do not, you will bedefaulted to your 2014 benefit elections, and you will nothave a Flexible Spending Account in 2015.Q: What if I’m making no changes? A: Even ifyou are making no changes to your coverage, youmust confirm your benefit elections by enrollingonline.Q: How do I enroll? A: Online at http://openenroll.nd.eduanytime day or night, Oct. 22 through Nov. 7.Q: Will I receive confirmation of my changes?Q: When does coverage begin? A: All elections take2effect January 1, 2015.A: Yes. A confirmation statement will be availableonline in late November detailing your benefitelections, even if your coverage did not change.
http://openenroll.nd.eduOct. 22 - Nov. 73ContentsENROLLWhen? Oct. 22 – Nov. 7, 2014.Enrollment closes at 11:59 p.m. on Nov. 7.Where? All enrollment is online. Visit http://openenroll.nd.edu anytime through Nov. 7.How? For help with online enrollment: Consult the enrollment tutorial booklet onlineat http://hr.nd.edu/benefits/Some staff may have the opportunity forproctored online enrollment lab sessions. Checkwith your supervisor.Computers will be available at Irish Health andat various locations throughout campus (netIDand password required).For assistance, call askHR at (574) 631-5900.What’s New?NewLook for the green “New” icons like this one toidentify what has changed since last year. Changesfor 2015 include:Medical Increased out-of-pocket maximum for all plans. Page 11. In HMO plans, copayments for outpatient procedures andemergency room visits have changed. Page 11.Prescription New coverage for breast cancer prevention, bowel preps,and fluoride. Page 14. Changes in drug formulary and compound drug coverage.Page 14.Dental Preventive & diagnostic (P&D) charges will be excludedfrom the annual maximum benefit. Page 15.Quick Start Guide.2What’s New?.3Introduction.4Notre Dame Wellness Center.5Doing Your Part.61. Get Informed.62. Take Charge of Your Health.7 Biometric Health Screenings.7 Your HRQ.7 Irish Health.7 Wellness Coaching.7 Chronic Condition Management.7 Baby Steps.7 Nurse Line.7 Rec Sports.8 Mobile Mammogram Unit.8 Employee Assistance Program.83. Use Resources Wisely.8 Visit ER only in emergencies.8 Consider an urgent care center.8 Avoid unnecessary procedures.8 Stay in-network.8 Choose generic drugs.9 Use Flex Accounts.9Notre Dame’s Contributions.10Medical Benefits .10 Choosing a Plan.10 Choosing a Network.10 2015 Monthly Rates.12-13 Prescription Drug Benefits.14Dental Benefits.15Vision Benefits.16Life Insurance.17Flexible Spending Accounts.18Life Maximum supplemental life insurance increases to 1.5million. Page 17.Additional Information.20Notices.202015 Provider Contacts.inside back cover
INTRODUCTIONThe healthcare landscape is changing. Costs are rising, andnew laws have been passed. While the University continuesits commitment to providing you and your family with acomprehensive and affordable benefits package, it’s alsoimportant that our entire community work together tomanage costs and promote a healthier Notre Dame so thatcompetitive benefits may be offered for years to come.lifestyle and making other informed choices, you will be doingyour part to lower healthcare costs and stay healthy in the firstplace.This Open Enrollment Decision Guide explains the benefitsprovided by the University. It also highlights additionalprograms and services available to help you do your part bybeing an informed healthcare consumer and taking charge ofyour well-being.Eligibility for Medical and Prescription BenefitsStaff - Regular, full time exempt or non-exempt staff.Faculty - Regular, full time faculty as defined in the University’sAcademic Articles.Dependents - If you are an eligible faculty or staff member,these dependents are also eligible: Your spouse (per Indiana law), unless legally separated; Your children up to age 26 regardless of marital status,student status or whether there is access to other coveragethrough your child’s employer; Your children who become handicapped prior to age 26and are dependent on you for support.N otre Dame’s contributionsYou will see two main sections in this booklet. Thesecond section beginning on page 10 explainsyour benefits–Notre Dame’s contributions to your benefitspackage–and the various choices you may make among them.These benefit programs include:2015 Open Enrollment Decision GuideUniversity benefits are available to Notre Dame faculty, staffand their dependents who meet the eligibility criteria below.Eligibility for Dental and Vision BenefitsFaculty and Staff: All faculty and staff who are eligible formedical/prescription benefits (see above).Dependents - If you are an eligible faculty or staff member,these dependents are also eligible: Your spouse (per Indiana law) unless legally separated; Your unmarried children up to age 19, or to age 25 if aYou have many options. Not only will you choose your 2015full-time student (minimum of 12 credit hours).benefits during Open Enrollment, you will also decide whenand how to use healthcare services during the year. The Who is a Dependent? Dependent ‘children’ include: Biologicalchoices you make will have a direct impact on the costs you children, stepchildren, legally adopted child or other recognizedand the University pay to provide these benefits. This section children for whom you are the legal guardian.will help you make the most cost-effective and appropriatecoverage decisions for you and your family. 4EligibilityMedical and Prescription Drug BenefitsDental BenefitsVision BenefitNotre Dame Wellness CenterBasic and Supplemental Life InsuranceFlexible Spending AccountsDoing your partDependent VerificationThe first section of this booklet, beginning on page6, goes beyond the medical, dental, vision, and otherbenefits that Notre Dame provides to describe additionalprograms to help you take charge of your health and well-being.For example, the Wellness Coaching and Chronic ConditionManagement programs from the Notre Dame Wellness Centeroffer professional and confidential counseling to help youidentify and address health issues.When enrolling a spouse or dependent in University benefits,documentation must be provided to verify the spouse ordependent’s relationship to the benefit-eligible faculty or staffmember.This section also provides additional information to help yoube informed and use resources wisely throughout 2015. Byvisiting in-network providers, choosing generic drugs whenappropriate, avoiding unnecessary care, maintaining a healthyFor more information on the required documentation, seehttp://hr.nd.edu/benefits/.If you are adding a spouse or dependent during the OpenEnrollment period, documentation of eligibility must beprovided no later than December 12. If documentation is notreceived by the deadline, the spouse or dependent will not beenrolled.
Notre Dame Wellness CenterThe Notre Dame Wellness Center is a state-of-the-art full-service health care facility toserve full-time, benefits-eligible faculty and staff and their dependents.Focus on Primary Care. We bring thefamily doctor in-house. Services include: Routine Primary Care Urgent Care Pediatric Care Physical Exams and Lab Services Specialty Infusion Services Vaccinations and Allergy Management Physical Therapy and Wellness Coaching90-day refills. At the Wellness Center drive-thru pharmacy, eligible faculty, staff and dependents may receive90-day refills penalty-free under Notre Dame’s prescription benefits plan – an alternative to mail-order.In-network. The Wellness Center is in-network for all Notre Dame medical benefits networks. Using the NotreDame Wellness Center can be cost-effective for all eligible faculty, staff, and dependents – and for the University.Benefit-eligible faculty and staff who waive University healthcare coveragemay still utilize the Wellness Center, which is credentialed with many thirdparty insurance plans. Verify with your plan whether the Wellness Center isin your network. Wellness Center co-pays, fees, deductibles, co-insurance,and out-of-pocket costs are dependent on your particular healthcare plan (i.e.whether you have a Notre Dame-sponsored HMO or PPO plan or anotherhealthcare plan). Eligibility of your spouse or dependents must be verified(see page 4).Notre Dame Wellness Center ProgramsThe Notre Dame Wellness Center offers much more than just primary care. Here are few of the manywellness services available:Chronic Condition Management. This program helps patients learn how to manage such ongoingconditions as diabetes, cancer or others. A specialist in chronic condition management can help patientsunderstand their condition, make lifestyle changes, and create a plan to combat setbacks. If you needsupport in dealing with a chronic condition, this program may be right for you.Wellness Coaching. A Wellness Coach is a certified coaching professional whospecializes in behavior change theory and process. The Notre Dame WellnessCenter’s Wellness Coaching program is designed to help participants achieve alasting lifestyle change in the areas of weight, stress, nutrition, exercise, smokingcessation, work/life balance, and life satisfaction.Medication Well-Check. Make a free appointment with a Wellness Centerpharmacist who will review all of your prescriptions and over-the-countermedications to ensure that your current therapy is safe and effective.FREEWellness Centerprograms areavailable tobenefit-eligiblefaculty and staffand dependentsat no cost.For more information on Wellness Center programs or to make an appointment,visit http://wellnesscenter.nd.edu or call (574) 634-WELL (9355).For appointments, hours, services, and more, visit http://wellnesscenter.nd.edu
DOING YOUR PARTFor competitive benefits to be offered for years to come, it’s important that our entire communitywork together. You can reduce healthcare costs and promote a healthier Notre Dame by becomingmore informed, taking charge of your health, and using resources wisely.1 2015 Open Enrollment Decision Guide1GET INFORMEDReview your Open EnrollmentDecision GuideEvaluate plans and networksEngage in wellness programsContact askHRAsk a Health AdvocateAsk your provider questions2Take advantage of: Biometric health screenings Your HRQ Irish Health Wellness coaching Chronic Condition Management Baby Steps Nurse Line Rec Sports Mobile Mammogram Unit Employee Assistance ProgramGET INFORMEDDecisions about your health - and your family’s - are some ofthe most important you’ll ever make. Make the right ones bytaking time to learn about your options and discussing themwith your spouse or family.Review this Open Enrollment Decision GuideThe Decision Guide outlines your benefit options and highlightsother programs and services available to you. Review the guideto find out how you can use your benefit plans and programs toachieve better health control costs. For additional informationabout your benefits and University wellness programs, visitwww.hr.nd.edu/.Evaluate plans and networksYour network determines which providers are available toyou at a lower cost than other out-of-network providers.Determine whether the providers in your network will meetyour needs, or if you will need out-of-network coverage.Engage in wellness programsThe University and the Notre Dame Wellness Center offersa variety of programs to help you get informed about your63TAKE CHARGE OFYOUR HEALTH USE RESOURCESWISELYVisit emergency room only in anemergencyConsider an urgent care centerAvoid unnecessary proceduresStay in-networkChoose generic drugsUse Flexible Spending Accountshealth and well-being. Look for programs that will help youmeet your wellness goals.Contact askHRFor answers to questions about University benefits andwellness programs, contact askHR: call (574) 631-5900, sendan email to askhr@nd.edu, or visit the Office of HumanResources at 200 Grace Hall. The Office of Human Resourcesalso provides Open Enrollment information sessions. Ask yoursupervisor to request one for your department.Ask a Health AdvocateHealth Advocate is the nation’s leading healthcare advocacyand assistance company. The service is a benefit paid for bythe University to help you navigate the healthcare system andmaximize your benefits. With just a phone call anytime day ornight, a personal Health Advocate can help you find the rightproviders or hospitals, navigate your insurance plan, untanglemedical bills, locate elder care or other support services,secure second opinions, or explain conditions or treatments.Health Advocates are typically registered nurses, supportedby medical directors and benefits and claims specialists. Forhelp from an Advocate, visit www.healthadvocate.com or call1-866.695.8622. Calls are confidential.
Ask your provider questionsIt’s important to be informed. The American Board of InternalMedicine (ABIM) Foundation recommends five questions toask your provider before a test or procedure is performed: Is the test or procedure needed? What are the drawbacks? Are there simpler and safer options? What happens if I do nothing? How much does it cost?2TAKE CHARGE OF YOUR HEALTHNotre Dame provides a wealth of programs and tools that youand your family can use year-round to take charge of yourwell-being.Biometric Health ScreeningsA biometric screening is a general health check that canidentify some of the most common health problems. Thisfifteen-minute screening measures standard biometrics suchas blood pressure, height, weight, body mass index (BMI), andscreens for problems such as diabetes and high cholesterol.Screenings are available to all full time, benefit-eligible NotreDame faculty, staff and their spouses who are enrolled inthe University’s medical plan. Screenings are available at theNotre Dame Wellness Center through November 7, or fromMemorial Health & Lifestyle at various locations on campusthrough October 24. Appointments can be made for theND Wellness Center at wellnesscenter.nd.edu or by phoneat (574) 634-WELL (9355). To schedule an appointment forcampus locations, call askHR at (574) 631-5900. For the mostaccurate results, fasting for eight hours prior to the screeningis recommended.Your HRQYour HRQ (Health Risk Questionnaire) is an online assessmentof your wellness and potential risks. Once your screeningresults are entered and you complete a short questionnaire,you will receive a detailed report to help you take chargeand make positive change. It’s confidential, only takes a fewminutes, and can even earn you cash: benefit eligible facultyTo complete Your HRQ, log in to the Wellness Center PatientPortal at wellnesscenter.nd.edu anytime through November 7,2014. Note: Your HRQ is not complete without a screening.Eligibility for prizes requires completion of both a screeningand Your HRQ by the deadline.Irish HealthIrish Health is an annual benefits and wellness fair for NotreDame faculty and staff. The two-day fair features exerciseclasses, wellness workshops and demonstrations, andrepresentatives from over 50 vendors, wellness organizationsand benefits providers. You may even receive your biometricscreening, complete Your HRQ, and make your OpenEnrollment elections online with the assistance of an HRBenefits Specialist at the event. This year’s Irish Health eventis October 22 and 23, 2014. See page 9 for more information,or visit http://hr.nd.edu/benefits.Wellness CoachingA Wellness Coach is a certified coaching professional whospecializes in changing behaviors. Coaching is a powerfulrelationship that enables you to learn more about yourself,and to set and achieve your wellness goals. Your WellnessCoach can help you stop smoking, lose weight, reduce stress,and be happier and healthier. Wellness Coaching is available atthe Notre Dame Wellness Center. See page 5 for more.Chronic Condition ManagementA service of the Notre Dame Wellness Center, ChronicCondition Management helps patients learn how to managesuch ongoing conditions as diabetes, cancer, or others.Specialists in chronic condition management can help patientsunderstand their condition, develop the skills necessary tomake lifestyle changes, and create a plan to combat setbacks.See page 5 for more.Baby StepsBONUS:A service of MeritainHealth, the Baby StepsIf you enroll in the BabyProgram offers guidanceSteps program duringand assistance for expectantthe first trimester, yourmothers. Participants areinpatient deductible willassigned their own personalbe waived!Case Manager – a RegisteredNurse who will monitor progress, provide baby wellnesseducation, and counsel expectant mothers during their specialtime. For more information, visit http://hr.nd.edu/benefits/group-insurance/.2015 Open Enrollment Decision GuideResults from screenings conducted at the Wellness Center oron campus will be automatically entered into Your HRQ.and staff who complete a screening and Your HRQ by Nov. 7will receive an automatic 120 credit, plus entry into a drawingfor one of five 1,000 prizes. Eligible spouses who complete ascreening and Your HRQ by Nov. 7 will receive an additional 60credit. For more information, see http://hr.nd.edu/benefits.Nurse LineWhen you have a health question and you’re not sure whatto do, call the Meritain Health Nurse Line at 1-888-668-6855,24 hours a day, seven days
Wellness Coaching. A Wellness Coach is a certified coaching professional who specializes in behavior change theory and process. The Notre Dame Wellness Center’s Wellness Coaching program is designed to help participants achieve a lasting lifestyle change in the areas of weight, stress, nutrition, exercise, smoking
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Open Enrollment 2022 Dear George Washington University Community, Welcome to the 2022 Benefits Open Enrollment season! Open Enrollment . begins on Monday, October 11, 2021, and closes at 8 p.m. (ET) on Friday, October 29, 2021. Open Enrollment provides an annual opportunity to reflect upon yo
Welcome to the Ensign Services' Workday Employee User Guide - Open Enrollment! You can enroll or make changes to your benefits during Open Enrollment using Workday which you can access from work or home. The Open Enrollment period is from November 29th through December 13th.
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OPEN ENROLLMENT STEP BY STEP USING THE ENROLLMENT PLATFORM Page 9 of 24 In this step, the Enrollment Platform connects to the Marketplace to verify your identity. This is designed to ensure your privacy, so they can verify you are the real person applying. You will be asked to respond to a series of questions to determine your identity. Some .
3. On CityNet under the Pay & Benefits tab obtain FY 16 Open enrollment Information and Costs booklet 4. Review the provider information on CityNet under the Pay & Benefits tab. d. If you have questions about a plan, contact the plan at the number listed in the Open Enrollment Information and Costs booklet (last page) before open enrollment .
accept them (see Step 6) and get confirmation. (fig. 10) To know if you completed enrollment, look for a green check mark and message that says your benefits are confirmed and ready to take effect when Open Enrollment closes. NOTE Remember to log out of the enrollment site in the upper left corner when finished with your enrollment.
