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North Carolina Agricultural and Technical State University 2017 Benefits Open Enrollment October 1 -31, 2016

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North Carolina Agricultural and Technical State University

2017 Benefits Open Enrollment

October 1 -31, 2016

North Carolina Agricultural and Technical State University

www.ncat.edu

Overview of Changes: Enrollment Process

NEW: ALL members and eligible dependents will be moved to the Traditional

70/30 Plan – effective January 1, 2017

»If members want coverage under a different plan, they MUST take action and

enroll in their preferred Plan.

»All passwords will be reset to social security number(without dashes and

spaces) beginning October 1, 2016.

Members MUST enroll electronically through https://ncat.hrintouch.com or

by calling Member Services at 855-859-0966. WRITE DOWN CONFIRMATION

NUMBER!

North Carolina Agricultural and Technical State University

www.ncat.edu

Overview of Health Plan Options

CDHP 85/15 with HRA Enhanced 80/20 Traditional 70/30

• High-deductible medical plan

• HRA offsets the deductible

• 85/15 coinsurance (after

deductible)

• $0 ACA Preventive Services

• $0 ACA Preventive

Medications

• CDHP Preventive Medication

List ($0 deductible)

• Wellness premium credits

reduce the employee premium

• Additional HRA funds for

visiting certain providers or

taking part in the Health

Engagement Program

• PPO plan

• Lower copays& coinsurance

• $0 ACA Preventive Services

• $0 ACA Preventive

Medications

• Wellness Premium Credits

reduce the employee

premium

• Reduced medical copay

opportunities

• PPO plan

• Higher copays, &

coinsurance

• No incentives available

• Copays applied to ACA

Preventive Services

• Applicable copays applied

to Preventive Medications

• $0 premium for employee

only coverage if subscriber

completes tobacco

attestation

North Carolina Agricultural and Technical State University

www.ncat.edu

Change Comparison Charts: Enhanced 80/20 Plan

B.O.D. = Blue Options Designated Provider

2016

In-Network

2017

In-Network

2017

Out-of-Network

Annual Deductible $700 Individual

$2,100 Family

$1,250 Individual

$3,750 Family

$2,500 Individual

$7,500 Family

Coinsurance

20% eligible expenses after

deductible

20% eligible expenses after

deductible

40% of eligible expenses after

deductible and the difference between

the allowed amount and the charge

Medical Coinsurance Max

Medical Out-of-Pocket Max

Pharmacy Out-of-Pocket Max

Total Out-of-Pocket Max

(Includes Deductible)

$3,210 Individual/

$9,630 Family

N/A

$2,500

N/A

N/A

$4,350 Individual

$13,050 Family

$2,500

$6,850 Individual

$14,300 Family

N/A

$8,700 Individual

$26,100 Family

$2,500

$11,200 Individual

$28,600 Family

ACA Preventive Services Covered at 100% Covered at 100% Dependent on Service

Office Visits

Selected PCP

Non-selected PCP

$15

$30

$10

$25

40% after deductible

Office Visits

B.O.D. Specialist.

Non-B.O.D. Specialist

$60

$70

$45

$85

40% after deductible

North Carolina Agricultural and Technical State University

www.ncat.edu

Change Comparison Charts: Enhanced 80/20 Plan

B.O.D. = Blue Options Designated Provider

2016

In-Network

2017

In-Network

2017

Out-of-Network

Urgent Care $87 $70 $70

Emergency Room (Copay waived w/

admission or observation stay)

$233, then 20% after deductible $300, then 20% after deductible $300, then 20% after deductible

Outpatient Hospital 20% after deductible 20% after deductible40% after deductible

Inpatient Hospital

B.O.D.

Non-B.O.D.

$0, then 20% after deductible

$233, then 20% after deductible

$0, then 20% after deductible

$450, then 20% after deductible $450, then 40% after deductible

Therapy Services (Chiro/PT/OT) $52 $52 40% after deductible

DrugsTier 1 (Generic)

Tier 2 (Preferred Brand & High-cost Generic)

Tier 3 (Non-preferred Brand)

Tier 4 (Low-cost/Generic Specialty)

Tier 5 (Preferred Specialty)

Tier 6 (Non-preferred Specialty)

Preferred Diabetic Supplies*

$12

$40

$64

N/A

25% up to $100

25% up to $132

$5

$30

Deductible/Coinsurance

$100

$250

Deductible/Coinsurance

$5

$5

$30

Deductible/Coinsurance

$100

$250

Deductible/Coinsurance

$5

*Non-preferred Diabetic Supplies will be priced at Tier 3.

North Carolina Agricultural and Technical State University

www.ncat.edu

Change Comparison Charts: CDHP 85/15 (No Change)2016

In-Network

2017

In-Network

2017

Out-of-Network

HRA Starting Balance $600 Employee

$1,200 Employee + 1

$1,800 Employee + 2 or more

$600 Employee

$1,200 Employee + 1

$1,800 Employee + 2 or more

$600 Employee

$1,200 Employee + 1

$1,800 Employee + 2 or more

Annual Deductible $1,500 Individual

$4,500 Family

$1,500 Individual

$4,500 Family

$3,000 Individual

$9,000 Family

Coinsurance 15% of eligible expenses after

deductible

15% of eligible expenses after

deductible

35% of eligible expenses after

deductible and the difference

between the allowed amount and the

charge

Coinsurance Maximum N/A N/A N/A

Out-of-Pocket Maximum

(Combined Medical and

Pharmacy)

Includes Deductible

$3,500 Individual

$10,500 Family

$3,500 Individual

$10,500 Family

$7,000 Individual

$21,000 Family

ACA Preventive Services Covered at 100%Covered at 100% 65% after deductible

Office Visits

Selected PCP

Non-selected PCP

15% after deductible+$25 HRA

credit

15% after deductible+$20 HRA

credit if a B.O.D provider

15% after deductible+$25 HRA

credit

15% after deductible+$20 HRA

credit if a B.O.D provider

35% after deductible

B.O.D. = Blue Options Designated Provider

North Carolina Agricultural and Technical State University

www.ncat.edu

Change Comparison Charts: CDHP 85/15 (No Change)

B.O.D. = Blue Options Designated Provider

2016

In-Network

2017

In-Network

2017

Out-of-Network

Office Visits

B.O.D. Specialist

Non-B.O.D. Specialist

15% after deductible+$20 HRA

credit (for B.O.D.specialists.

15% after deductible

15% after deductible+$20 HRA

credit (for B.O.D.specialists.

15% after deductible

35% after deductible

Urgent Care 15% after deductible 15% after deductible 15% after deductible

Emergency Room 15% after deductible 15% after deductible 15% after deductible

Outpatient Hospital 15% after deductible 15% after deductible 35% after deductible

Inpatient Hospital

B.O.D.

Non-B.O.D.

15% after deductible. + $200

HRA Credit for B.O.D. Hospitals

15% after deductible

15% after deductible. + $200

HRA Credit for B.O.D. Hospitals

15% after deductible

35% after deductible

Therapy Services (Chiro/PT/OT)15% after deductible 15% after deductible 35% after deductible

Drugs

15% after deductible

CDHP Maintenance Medications

are deductible exempt

15% after deductible

CDHP Maintenance Medications

are deductible exempt

35% after deductible

CDHP Maintenance Medications

are deductible exempt

North Carolina Agricultural and Technical State University

www.ncat.edu

Health Engagement Program for CDHP Members The Health Engagement Program offers additional Health Reimbursement Account funds for

CDHP members who engage to help offset their health care expenses. There are two

components:

»The Healthy Lifestyles Program is an incentive-based program designed to encourage all

CDHP members to engage in healthy behaviors

»Positive Pursuits offers CDHP members with certain conditions an opportunity to earn

even more in the HRA for actively managing their condition

New for 2017!

Members will have more activities in which to earn

incentives with RivalHealth! RivalHealth is a fitness-

based wellness platform that engages members with

daily exercise and nutrition activities as well as social

interaction and challenges.

Currently it’s available to CDHP members and qualifying

Wellness Champions worksites. In 2017, CDHP members

can earn HRA funds through completed activities.

North Carolina Agricultural and Technical State University

www.ncat.edu

Change Comparison Charts: Traditional 70/30 Plan2016

In-Network

2017

In-Network

2017

Out-of-Network

Annual Deductible $1,054 Individual

$3,162 Family

$1,080 Individual

$3,240 Family

$2,160 Individual

$4,320 Family

Coinsurance 30% of eligible expenses after

deductible

30% of eligible expenses after

deductible

50% of eligible expenses after

deductible and the difference

between the allowed amount and the

charge

Medical Coinsurance Max

Pharmacy Max

Out-of-Pocket Max

(Includes Deductible)

$4,282 Individual/$12,845 Family

$3,294

N/A

$4,388 Individual/

$13,164 Family

$3,360

N/A

$8,776 Individual/

$26,328 Family

$3,360

N/A

ACA Preventive ServicesCost-Sharing Applies ($39 for

Primary Care/$92 for Specialists)

Cost-Sharing Applies

($40 for Primary Care

$94 for Specialists)

Only certain services are covered

Office Visits

PCP Copay$39 $40 50% after deductible

Office Visits

Specialist Copay$92 $94

50% after deductible

North Carolina Agricultural and Technical State University

www.ncat.edu

Change Comparison Charts: Traditional 70/30 Plan2016

In-Network

2017

In-Network

2017

Out-of-Network

Urgent Care $98 $100$100

ER (Copay waived w/ admission or

observation stay)

$329, then 30% deductible $337, then 30% deductible $337, then 30% deductible

Outpatient Hospital 30% after deductible 30% after deductible50% after deductible

Inpatient Hospital $329, then 30% deductible $337, then deductible/30%

coinsurance

$337, then deductible/50%

coinsurance

Therapy Services (Chiro/PT/OT) $72 Copay $72 Copay 50% after deductible

Drugs

Tier 1 (Generic)

Tier 2 (Preferred Brand & High-cost Generic)

Tier 3 (Non-preferred Brand)

Tier 4 (Low-cost/Generic Specialty)

Tier 5 (Preferred Specialty)

Tier 6 (Non-preferred Specialty)

Preferred Diabetic Supplies*

$15

$46

$72

N/A

25% up to $100

25% up to $132

$16

$47

$74

10% up to $100

25% up to $103

25% up to $133

$10

$16

$47

$74

10% up to $100

25% up to $103

25% up to $133

$10

*Non-preferred Diabetic Supplies will be priced at Tier 3.

North Carolina Agricultural and Technical State University

www.ncat.edu

Tobacco Wellness Premium Credit: NEW for 70/30 Plan

ACTIVE members who enroll in the 70/30 Plan MUST do the following in order to

receive coverage premium-free for employee-only coverage in 2017:

Attest to being tobacco-free OR enroll in QuitLineNC by Oct. 31, 2016.

This premium credit only applies to the employee-only premium.

This credit opportunity does not apply to spouses, dependents, non-Medicare or

Medicare-eligible retirees.

North Carolina Agricultural and Technical State University

www.ncat.edu

Wellness Premium Credit Opportunities

Active members have three opportunities to earn Wellness Premium Credits if enrolled in the CDHP

85/15 and 80/20 Plans:

»Attest to being tobacco-free OR enroll in QuitLineNC

»Select Primary Care Provider(PCP) for all covered members

»Complete Health Assessment if not completed on or after MAY 1, 2016

For each of these actions, the member earns reductions on his or her premiums.

Wellness premium credits apply only to the employee-only premium.

New hires MUST re-attest to being tobacco-free during Open Enrollment even though they might

have just enrolled.

This tobacco-free attestation is separate from the tobacco question included in the Health

Assessment. NOTE: Completing the Health Assessment does not count as completing the

attestation.

North Carolina Agricultural and Technical State University

www.ncat.edu

Wellness Premium Credit Amounts for 2017

CDHP 80/20

Plan

70/30

Plan

Attest to being tobacco-free OR enroll

in QuitlineNC

$40 $40 $40

Choose/confirm a Primary Care

Provider (PCP)

$20 $25 N/A

Complete the Health Assessment $20 $25 N/A

TOTAL CREDITS AVAILABLE FOR 2017 $80 $90 $40

North Carolina Agricultural and Technical State University

www.ncat.edu

2017 State Health Plan Premiums

Plan Coverage Level

Traditional

70/30 Plan

Enhanced 80/20

Plan

Consumer-Directed

Health Plan 85/15

Employee $0.00* $15.04* $0.00*

Employee & Child(ren) $218.14* $290.14* $196.32*

Employee & Spouse $562.10* $668.48* $505.90*

Employee & Family $598.70* $708.72* $538.82**If you complete the wellness activities, you pay this lower cost.

North Carolina Agricultural and Technical State University

www.ncat.edu

New Pharmacy Benefit Manager

As of January 1, 2017, the new Pharmacy Benefit Manager will be CVS/Caremark.

Members will receive communication regarding what steps to take.

ALL members WILL RECEIVE a new Pharmacy ID Card. The 2016 card WILL NOT work in 2017–

members MUST use the NEW CVS/Caremark card.

Advantages

Members will have access to the CVS/Caremark online drug lookup tool during Open Enrollment.

This tool enables members to look up and compare the costs of various drugs – especially useful for

those enrolled in the CDHP 85/15.

North Carolina Agricultural and Technical State University

www.ncat.edu

New Pharmacy Tier for Diabetic Testing Supplies

Drugs Traditional 70/30 Plan Enhanced 80/20 PlanConsumer-Directed

Health Plan 85/15

Tier 1 (Generic) $16 $5

Preferred brands fall under

CDHP Preventive List –

deductible is waived

Tier 2 (Preferred Brand & High-cost Generic) $47 $30

Tier 3 (Non-preferred Brand) $74 Deductible/Coinsurance

Tier 4 (Low-cost/Generic Specialty) 10% up to $100 $100

Tier 5 (Preferred Specialty) 25% up to $103 $250

Tier 6 (Non-preferred Specialty) 25% up to $133 Deductible/Coinsurance

Preferred Diabetic Supplies*

(e.g. Test Strips, Lancets, Syringes,

Needles)

$10 $5

*Non-preferred Diabetic Supplies will be priced at Tier 3

• There will be a new tier added for Preferred Diabetic Supplies

• Enhanced 80/20 Preferred Diabetic Tier copay will equal the Tier 1 copay

• Traditional 70/30 Preferred Diabetic Tier copay will remain at $10 (Tier 1 is $16)

North Carolina Agricultural and Technical State University

www.ncat.edu

Dental Plan

New vendor - MetLife

Coverage Level Change: Employee + Child to just Employee + Child(ren)

High Option Annual Max INCREASED to $5,000

New Lower Rates

Employee Only Employee and

Spouse

Employee and

Child(ren)

Family

High Option $36.10 $72.40 $78.20 $123.70

Low Option $21.22 $42.78 $45.94 $ 73.22

North Carolina Agricultural and Technical State University

www.ncat.edu

VISION

No Changes

$20 copay for vision exams; $40 copay for contact lenses fitting

CORE WELLNESS: FREE FOR EMPLOYEES ONLY

Coverage Level Employee Only Employee and Family

Core Wellness Exam $0.00 N/A

Basic Plan $5.56 $15.46

Enhance Plan $8.58 $22.88

North Carolina Agricultural and Technical State University

www.ncat.edu

FLEXIBLE SPENDING ACCOUNT

Healthcare: $120 - $2,550 Annually

»Funds are available on January 1

»Members can use convenience card for medical expenses(deductibles, copays, prescriptions, vision

materials, dental services, etc.)

»Contributions can be used for medical expenses for eligible dependents within same household

(spouse and dependent children).

Dependent Daycare: $120 - $5,000 Annually

» Dependent children 12 and under or adult daycare.

USE IT OR LOSE IT:

»Employees have until March 15, 2018 to incur expenses for his/her 2017 election.

»Claims MUST BE submitted by April 30, 2018

Requires annual enrollment – employees currently enrolled for 2016 plan year MUST RE-

ENROLL

North Carolina Agricultural and Technical State University

www.ncat.edu

CRITICAL ILLNESS

New $25,000 Limit Option

Plan pays lump-sum payment per diagnosis for three categories:

»Heart

»Cancer

»Other – Transplants

Eligible dependent child(ren) – No cost

Employee/Spouse

Age<25 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80+

$15,000 $1.30 1.40 2.60 4.10 7.40 12.00 18.60 27.80 42.60 64.20 84.40 101.40 119.50

$25,000 2.18 2.34 4.34 6.84 12.34 20.00 31.00 46.34 71.00 107.00 140.66 169.00 199.18

North Carolina Agricultural and Technical State University

www.ncat.edu

CANCER & SPECIFIED DISEASES

No Evidence of Insurability(EOI) required

Annual wellness benefit for employee and family

Coverage Level Employee Only Employee and Family

Low Option $6.38 $10.56

High Option $15.18 $25.16

Premium Option $20.28 $33.54

North Carolina Agricultural and Technical State University

www.ncat.edu

Term Life Insurance

Guaranteed Issuance (GI) for employee is $200k

Employees may increase $10k or $20k at annual enrollment without submitting Evidence of

Insurability(EOI) up to GI amount.

Spouse coverage remains the same

»Enroll in $50k without submitting EOI

»Increase $10k during annual enrollment

New Lower Rates

Age 0-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75+

$1,000 $.04 .05 .07 .08 .09 .13 .22 .40 .64 1.27 2.06 2.06

Per Dependent Unit

$5,000

$10,000

$0.68

$1.36

North Carolina Agricultural and Technical State University

www.ncat.edu

ACCIDENTAL DEATH & DISMEMBERMENT• New vendor – Voya

• Voya Travel Assistance if you or family are traveling 100 miles away from your home.

CORE

Remains the same – $10,000 coverage FREE for EMPLOYEE ONLY

VOLUNTARY

New coverage levels in $50k increments

Employees will be moved to next plan level.

New Lower Rates

Coverage Level Employee Only Employee and Family

$50,000.00 $0.85 $1.35

$100,000.00 $1.70 $2.70

$150,000.00 $2.55 $4.05

$200,000.00 $3.40 $5.40

$250,000.00 $4.25 $6.75

$300,000.00 $5.10 $8.10

$350,000.00 $5.95 $9.45

$400,000.00 $6.80 $10.80

$450,000.00 $7.65 $12.15

$500,000.00 $8.50 $13.50

North Carolina Agricultural and Technical State University

www.ncat.edu

TRICARE

Must be enrolled in a TRICARE Standard/Extra, Prime or TRS benefits offered through military

community to be eligible for this plan.

Plan pays a benefit for costs not covered by TRICARE

Both plans work together to maximize your benefits and minimize out-of-pocket expenses.

Coverage Level Total

Employee Only $60.50

Employee and Spouse $119.50

Employee and Children $119.50

Employee and Family $160.50

North Carolina Agricultural and Technical State University

www.ncat.edu

HOW TO ENROLL

Electronically: https://ncat.hrintouch.com

LOGIN by default: First name, First initial of Last Name, Last 4 digits of SS#

Reminder: Passwords will be reset to social security number(no dashes or spaces) effective October 1, 2016.

SAVE YOUR CHANGES – WRITE DOWN CONFIRMATION NUMBER

Member Services: 855-859-0966

Additional Resources:

Health Assessment – www.myactivehealth.com or 800-817-7044

State Health Plan – www.shpnc.org

NCFlex – www.ncflex.org

North Carolina Agricultural and Technical State University

www.ncat.edu

NAVIGATION ASSISTANCE

October 3 8:00-5:00 Wendover Bldg, Computer Lab

October 5 8:00-5:00 General Classroom Bldg, A213

October 7 8:00-5:00 Wendover Bldg, Computer Lab

October 11 8:00-5:00 Wendover Bldg, Computer Lab

October 12 8:00-5:00 General Classroom Bldg, A213

October 14 8:00-5:00 Wendover Bldg, Computer Lab

October 19 8:00-5:00 General Classroom Bldg A213

October 25 10:00-2:00 Wendover Bldg, Computer Lab

October 26 8:00-5:00 General Classroom Bldg, A213

October 27 10:00-2:00 Wendover Bldg, Computer Lab

North Carolina Agricultural and Technical State University

www.ncat.edu

Questions?

North Carolina Agricultural and Technical State University

www.ncat.edu

Who To Contact

Jeanette Foulks

Benefits Counselor

[email protected]

336-285-3793

Denika Waters

Benefits Assistant

[email protected]

336-285-3789

LaRita Burks

Benefits Manager

[email protected]

336-285-3788