2020 benefits open enrollment - scripps research€¦ · please note: the information contained in...

2020 BenefitsOpen Enrollment

Enrollment Dates: October 28 – November 8, 2019

Changes Effective: January 1, 2020

California Employees

Scripps Research 2020 Benefits Open Enrollment

2.

Open Enrollment

What are my Responsibilities During Open Enrollment

• To add, change or remove dependents from your coverage

• To enroll, change or waive coverage

• To elect / increase voluntary life insurance

• To update beneficiary information (allowed any time)

• Enroll in the Flexible Spending and Health Savings Accounts, if eligible

Enrollment will be completed in bSwift and elections must be made no later than:

November 8, 2019

All benefit changes become effective: January 1, 2020

PLEASE NOTE: The information contained in this presentation is only a summary. For detailed, comprehensive

benefit information, please refer to your carrier plan documents.


3.

Who is Eligible to Enroll?

• Employees: Staff who are regularly scheduled to work at least 20 hours a week

• New Employees: Benefit eligibility begins date of hire

• Eligible Dependents:

– Spouse

– California Registered Domestic Partner (1)

– Dependent children and step-children:

▪ Medical / vision: to age 26

▪ Dental: up to age 19; up to age 25 if full-time student

▪ Children of any age who are incapable of self-support due to a physical or mental disability may potentially

be covered

(1) Premiums for state registered / unregistered domestic partners who do not meet the tax dependent definition of IRC section 152 for the employee, may be considered

taxable income (unregistered domestic partners will not meet the relationship test under IRC section 152). Premiums for children / registered Domestic Partners step-

children under age 26 are not taxable. Premiums for children / stepchildren over age 26 are taxable if not an IRC section 152 tax dependent.


4.

Can I Make Changes During the Year?

• Your healthcare elections will be effective from January 1, 2020, to December 31, 2020, and changes can only

be made mid-year if you have a Change in Status

• Some examples of a Change in Status:

– Marriage / divorce

– Birth / adoption

– Death of a dependent

– Loss or gain of benefits

– Loss or gain of dependent eligibility

– Change in residence affecting eligibility or access

• Changes must be made within 31 days of the qualifying event

• Please contact Benefits Administration immediately if you have a Change in Status. You will be required to

provide documentation of your change in status.


5.

Benefit Plan Review

Additional

Benefits

MetLife

Critical Illness

Hospital

Accident

Medical

Aetna

HDHP Choice POS II

HSA/HRA

Dental

Delta Dental

DPPO

Vision

MES Vision

PPO

FSA

PayFlex

Health Care

Dependent Care

Medical

Aetna

Comprehensive

Choice POS II

Prudential

Life / AD&D

Vol. Life / AD&D

STD / LTD

Life / AD&D /

Disability

Medical

Anthem

Select HMO

Medical

Aetna

Graduate Student

Choice POS II


6.

What’s New Effective Jan 1, 2020?

• Employee Contributions

– Employees enrolled under the Comprehensive Choice PPO plan

will see slight increase in employee premiums.

• Mental Health / Substance Abuse

– Employees enrolled under the Comprehensive Choice PPO,

Graduate Student PPO & HSA/HRA HDHP PPO plans will have a

new carrier for mental health services. Mental health will transition

from Optum Behavioral to Aetna Behavioral Health.

• Compass Pro Health

– Starting January 1, 2020, Compass will be called Alight. Your

Health Pro will remain the same. However, the email address will

now be [email protected].

mailto:[email protected]


7.

Open Enrollment TimelineDates Action

Monday, October 28th – Friday, November 8th

Open Enrollment Period

• Review 2020 Benefits Guide

• Attend informational meeting

• Review/make changes/enroll in benefits through bSwift at: http://scripps.bswift.com

Tuesday, October 29th

Open Enrollment Meeting

Calibr Boardroom

10:00am – 11:00am

Tuesday, October 29th


Keck Amphitheater

2:00pm – 3:00pm

Wednesday, October 30th

Benefits Fair

Immunology Galleria / Breezeway

10:00am – 1:00pm

Friday, November 1st


MB Committee Lecture Hall

11:00am – 12:00pm

Monday, November 4th


HR Training Room

1:00pm – 2:00pm

Friday, November 8th at 5pm PST Open Enrollment system closes

January 1, 2020 Benefits become effective

January 3, 2020 Any changes to payroll deductions will be seen in paycheck

http://scripps.bswift.com/


8.

Medical Coverage


9.

Anthem Blue CrossHealth Maintenance Organization (HMO) Select HMO

Tips

• Each family member may select their own Primary Care Physician (PCP)

• Are you new to the HMO? Make sure your desired PCP is accepting new patients!

• With the exception of an OB/GYN, mental health, or chiropractic specialist, your PCP

must refer you to specialists

• Contact Anthem to change your PCP. PCP changes made before the 15th of the

month are effective the 1st of the following month

TIP

Primary Care

PhysicianReferral Specialist

In-Network

USING

AN HMO


10.

Anthem Blue Cross Select HMOPLAN HIGHLIGHTS ANTHEM SELECT HMO

In-Network Only

Annual Calendar Year Deductible Waived for office visits

Individual $100

Family $200

Maximum Calendar Year Out-of-pocket (1)

Individual $2,500

Family $5,000

Professional Services

Primary Care Physician (PCP) $30 Copay

Specialist $40 Copay

Diagnostic Lab No charge

Diagnostic X-ray $40 Copay

Complex Diagnostics (MRI/CT Scan) $150 Copay

Hospital Services

Inpatient 10% after deductible

Outpatient Surgery Hospital: 10%, after deductible

Freestanding: $250 Copay

Emergency Room $100 Copay after deductible

Urgent Care $50 Copay

Other Services

Preventive Care No Charge

Therapy, including Physical, Occupational and Speech $40 Copay

Prescription Drugs

Prescription Calendar Year Deductible (applies to Brand-Formulary &

Non-Formulary Drugs)

$100/person

$200/family

Retail Prescription Drugs (30-day supply)

Generic $10 Copay

Brand Formulary $35 Copay after Rx deductible

Non-Formulary Brand $60 Copay after Rx deductible

http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=-jdJ5d4L82qfsM&tbnid=UXmFBRuS7rIgXM:&ved=0CAUQjRw&url=http://addiandcassi.com/bluecross/&ei=1N__Uc-uDMWXiAKF04Fg&psig=AFQjCNFCXBEnV8QWKFzUVrLK_2t51d6bgw&ust=1375809875052866


11.

Aetna Preferred Provider Organization (PPO) Comprehensive Choice POS II Plan

Tips

• You obtain a higher level of benefit by receiving your services from participating or in-

network doctors, specialists, and facilities

• With the PPO, you have freedom of choice and referrals are not required to see a specialist

• Before the insurance company pays certain medical expenses, you are required to pay the

deductible

• You are responsible for the remaining cost up to the out-of-pocket maximum

TIP

Primary Care

Physician

or

Specialist

In-Network or Out-of-Network

USING

A PPO


12.

Aetna Comprehensive Choice POS II Plan

(1) Out-of-pocket maximum is based on the maximum allowable charge the carrier allows. This does not include any balance billing

that may occur when using an out-of-network provider.

PLAN HIGHLIGHTS AETNA COMPREHENSIVE CHOICE POS II (PPO)

In-network Out-of-network

Annual Calendar Year Deductible

Individual $900 $1,800

Family $2,700 $5,400

Maximum Calendar Year Out-of-Pocket (1)

Individual $2,250 $4,500

Family $4,500 $9,000


Primary Care Physician (PCP) 20% after deductible 40% after deductible

Specialist 20% after deductible 40% after deductible

Preventive Care Exam No charge Cancer screenings only

Diagnostic X-ray and Lab 20% after deductible 40% after deductible

Complex Diagnostics (MRI/CT Scan) 20% after deductible 40% after deductible

Hospital Services


40% after deductible

Additional $200 Copay applies if not

pre-authorized

Outpatient Surgery 20% after deductible 40% after deductible

Emergency Room 20% after deductible 20% after deductible

Urgent Care 20% after deductible 40% after deductible

Mental Health & Substance Abuse Mental Health/Substance Abuse through Aetna Behavioral Health




pre-authorized

Outpatient 20% after deductible 40% after deductible

Prescription Drugs Prescription Coverage through OptumRx

Prescription Drug Calendar Year Deductible $100/person

$200/family

Prescription Calendar Year Out-of-Pocket Maximum $2,000/person

$4,000/family


Generic $10 Copay

Formulary Brand $35 Copay after Rx deductible

Non-Formulary Brand $60 Copay after Rx deductible

New

Carrier


13.

High Deductible Health Plan (HDHP)

Health Savings Account (HSA)


14.

What is the High Deductible Health Plan (HDHP) + Health Savings Account (HSA) Option?

• You are financially responsible for all eligible expenses, such as doctor’s visits, non-preventive

prescription drugs and lab charges, until the deductible has been met

• If you are enrolled under Employee + 1 or more Dependents, the Family Deductible must be met

before the coinsurance applies

• Similar to traditional PPO plan, you may use the provider of your choice, but the plan will pay more if

you utilize in-network physicians or facilities

• This medical plan can be paired with a Health Savings Account (HSA) to help pay for qualified health

care expenses

• Contribute towards your HSA through convenient payroll deductions by enrolling in an HSA through

PayFlex

TIP


15.

Aetna HDHP Choice POS II Plan

(1) Out-of-pocket maximum is based on the maximum allowable charge the carrier allows. This does not include any balance billing

that may occur when using an out-of-network provider.

PLAN HIGHLIGHTS HDHP AETNA CHOICE POS II (HSA/HRA)

In-network Out-of-network

Annual Calendar Year Deductible Family Deductible applies to all members

Employee Only $2,000 $2,000

Employee & Dependent(s) $6,000 $6,000

Maximum Calendar Year Out-of-Pocket (1) Family OOP applies to all members

Employee Only $4,500 $6,750

Employee & Dependent(s) $6,750 $10,125


Primary Care Physician (PCP) 20% after deductible 40% after deductible

Specialist 20% after deductible 40% after deductible

Preventive Care Exam No charge Cancer Screenings Only

Diagnostic X-ray and Lab 20% after deductible 40% after deductible

Complex Diagnostics (MRI/CT Scan) 20% after deductible 40% after deductible

Hospital Services




pre-authorized

Outpatient Surgery 20% after deductible 40% after deductible

Emergency Room 20% after deductible 20% after deductible

Urgent Care 20% after deductible 40% after deductible

Mental Health & Substance Abuse Mental Health/Substance Abuse through Aetna Behavioral Health




pre-authorized

Outpatient 20% after deductible 40% after deductible

Prescription Drugs Prescription Coverage through OptumRx


Generic $10 Copay

Subject to Medical Plan Deductible (except for Preventive Medications)

Formulary Brand $35 Copay after deductible

Non-Formulary Brand $60 Copay after deductible

New

Carrier


16.

HDHP vs. Traditional PPO Plan

Similarities

• Plans use the same network of doctors,

specialists and hospitals

• Once the plan deductible has been met, you

will receive a higher level of benefit by

receiving services from in-network providers

Differences

• The deductible amount for the HDHP will be

significantly higher than a traditional PPO

• Monthly premiums are usually higher on a

Traditional PPO

• Only the HDHP allows you to use HSA funds to pay

for current and future qualified health care

expenses

• The deductible for a HDHP applies to all services

except Preventive Services and Preventive Generic

Rx

• The family deductible for a HDHP is cumulative,

meaning if you cover a spouse or child(ren), you

must meet the family deductible before your plan

benefits kick in


17.

How do they Compare? HSA vs. HRA

Feature Health SavingsAccount (HSA)

Health Reimbursement Account (HRA)

Account Ownership Employee Owned Employer

Contributions Employer and/or Employee Employer Only

Account Funding May be funded by Employer and/or

Employee contributions

Notional arrangement; Fund reimburses

employees for approved medical care expenses

as they are incurred

Useable for Non-Qualified

Expenses

Yes, but taxable and 20% penalty applies No

Account accrual of Interest or

Investment Earnings

Yes, accrues interest and investment

earnings, which are not federally taxable,

but are taxable for State purposes in some

states

No, the account does not accrue interest or have

investment earnings

Useable for Non-Medical

expenses (Dental & Vision)

Yes, as long as qualified and comply with

Section 213

No, only Medical expenses are paid or

reimbursed by the HRA

Balances for Terminated

Employees

Remains with the Employee Remains with the Employer


18.

Alight ServicesAlight is a patient advocacy firm providing personal concierge available

to Aetna HDHP plan members at no cost. Services include:

• Unlimited access to a health care expert

• Researching generic or clinical alternative prescription options

• Unbiased doctor recommendations based on quality and cost

• Coordinating transfer of medical records

• Reviewing bills and charges

• Resolving billing issues with Aetna, hospitals, and provider billing offices

• Explanation of insurance processes and Scripps Research benefit plans

• Comparing service costs, cost estimates

You can get in touch with Scripps Research’s Health Pro

via:

• Phone: 800.513.1667

• Email: [email protected]

• Website: https://member.compassphs.com

TIP


https://member.compassphs.com/


19.

HSA Eligibility Rules

For you, the employee, to be eligible to open an HSA, you must:

• Be enrolled in a qualified high deductible health plan (HDHP)

• NOT be enrolled in a non-HDHP including a spouse’s plan, Medicare, Tricare or prescription

drug only plan

• NOT be claimed as a dependent on another individual’s tax return, other than your spouse’s

• NOT have received any health benefits from the Veterans Administration or one of their

facilities, including prescription drugs, in the last three months

• NOT be enrolled in a Health Care Flexible Spending Account (FSA)

In order to have deductions from your paycheck, you must be earning a taxable paycheck

from Scripps Research


20.

HSA Contribution Limits

Calendar Year Maximum Contribution

2020

Employee Only $3,550

Employee + dependents $7,100

Additional “catch-up” if 55 or older $1,000

• Maximum contribution is reduced pro-rata for partial year enrollment (i.e. 1/12 for each month of HDHP

Coverage)

• The plan / calendar deductible is not pro-rated from the enrollment date like the fund is

• Scripps Research contributes towards your HSA account with an annual amount of $1,000 for Employee

Only and $3,000 for Employee & Dependent(s). Employer contributions will be made on a quarterly basis.

• Your and your Scripps Research’s contributions count toward the annual contribution maximum

Eligible Individuals and the Employer can make Financial Contributions to an HSA.

Any statements concerning actuarial, tax, accounting, investment or legal matters are based solely on our experience as insurance brokers and are not to be relied upon

as actuarial, accounting, tax, investment or legal advice, for which you should consult your own professional advisors.


21.

Using HSA Funds

Your HSA Funds can be used for Qualified Healthcare Expenses

• Examples:

– Unreimbursed qualified medical, dental and vision expenses

– LASIK

– Orthodontia

– Prescriptions

– Medical premiums for COBRA, or health coverage while receiving unemployment compensation,

– Medicare Parts B & D

– Certain Long Term Care premiums

– Medical Supplies

• The HSA must be established and an initial deposit must be made before you can be reimbursed for

eligible expenses or use funds

• Because you own the HSA, funds can be used towards eligible expenses even after you are no longer

covered by an HSA-qualified plan

• If you use an HSA for non-IRS approved medical expenses, you will be subject to pay earned income taxes

on the misused funds as well as a 20% excise tax


22.

Where are my HSA Funds?

Scripps Research has selected PayFlex as the preferred bank to

handle Health Savings Accounts. Money is deposited at PayFlex into

an interest-bearing account.

• Like a Medical IRA

• Owned by Employee; Portable

• Tax-advantaged personal savings account

• Employee contributions are tax-free and reduce taxable income*

• Use today or save for future and retirement health expenses

• Unused money rolls over year to year

• PayFlex will administer your HSA account through convenient payroll

deductions

• If you leave Scripps Research or change medical plans, the HSA

account still belongs to you

* Taxable for California income tax


23.

Advantages of an HSA

CostYou Own the HSA

BuildSavings

Invest Tax Savings

In most instances,

an HSA plan

premium is a less

costly option for you

and your family

When you leave the

company or retire,

you can take the

money with you

Because you and

your employer can

contribute to your

HSA, you have the

ability to grow a

sizeable account

over time

[Vendor / bank]

offers a wide array

of investment

options for you to

invest and grow your

savings tax-free (1)

Contributions are tax

deductible at the

federal level and

earnings grow tax

free (1)

(1) Contributions and earnings to an HSA are taxable income in CA, AL & NJ and earnings are only taxable in NH & TN


24.

Health Reimbursement Arrangement (HRA)


25.

What is a Health ReimbursementArrangement (HRA)?

Your employer makes

tax-free contributions

to your HRA

Visit In-Network

provider

HRA funds will be used for

payment or

reimbursement

Use HRA debit card or

turn in receipts for

eligible expenses

How to Use Your Health Reimbursement Arrangement

Employee who are ineligible for Health Savings Account (HSA) contributions enroll in the Aetna HDHP

Choice POS II Health Fund (HRA) plan and will be set up with a Health Reimbursement Arrangement

(HRA) through PayFlex.

TIP


26.

HRA Contributions

Annual Contribution

Individual (Employee Only) $1,000

Family (Employee + Dependents(s)) $3,000

• If you were hired in the middle of the plan year, contributions will be pro-rated

based on the number of quarters you are enrolled in the HRA Plan

• Employer HRA Fund contributions are tax free

Scripps Research makes Financial Contributions to toward your HRA

Any statements concerning actuarial, tax, accounting, investment or legal matters are based solely on our experience as insurance brokers and

are not to be relied upon as actuarial, accounting, tax, investment or legal advice, for which you should consult your own professional advisors.


27.

How Will I Receive HRA Funds?

Scripps Research has selected PayFlex as the preferred

administrator to handle Health Reimbursement Arrangements.

• If you leave Scripps Research or you have a change in your eligibility, any

remaining HRA funds will stay with the company unless you elect COBRA

• Claims are paid from the HRA for you and your covered dependents only

once the incurred expense is approved

• Unused funds rollover each year

• Register at www.PayFlex.com to monitor your fund

http://www.payflex.com/


28.

Prescription Drug Coverage

• The pharmacy administrator for the Comprehensive Choice POS II,

HDHP Aetna Choice POS II, and Graduate Student Choice POS II plans

continue to be OptumRx. The pharmacy administrator for the Anthem

Select HMO will be Express Scripts.

• There are 3 tiers for prescription drugs:

• Generic - $10 Copay

• Brand Formulary - $35 Copay

• Non-Formulary Brand: $60 Copay

• Please call OptumRx at 855.395.2022 for more information on

Comprehensive Choice POS II, HDHP Aetna Choice POS II, or Graduate

Student Choice POS II Plans or visit www.optumrx.com.

• Please visit www.anthem.com/ca for more information on the Anthem

Select HMO Plan

http://www.optumrx.com/

http://www.anthem.com/ca


29.

Health Care Reform

Not all Employees are Entitled to a Premium Tax Subsidy in the Health

Marketplace: If an employer offers its full-time employees Minimum Value and

Affordable coverage, those employees may not be entitled to a premium tax

credit in the Health Marketplace/Exchange.

Proof of Coverage: You will receive proof of coverage from your insurance

company and employer describing the coverage made available to you. These

forms are called the 1095-B (from the insurance company) and 1095-C (from

your employer). Expect to receive this in time to file your taxes. (Non-Applicable

Large Employers (Non-ALEs) who have less than 50 FT/FTE employees are not

required to provide Form 1095-C to full-time employees)


30.

Forms Forms Forms

You will receive the following forms next year to use when you file your taxes.

1095 B: Provided by your insurance carrier

• Provides proof that you and your dependents have at least Minimum Essential Coverage

1095 C: Provided by your employer

• Describes what kind of coverage was

made available to you

You will get both around the same

time as your W2 and need to use

them when filing your taxes. For

more information, contact your CPA.


31.

Tools, Resources, and Discount Programs


32.

Aetna: Online or On-the-go!

• Secure 24/7 Access

• Look up a claim status

• Check account balances

• Find costs of test and doctor visits

• View tools and educational materials

• Download a temporary ID Card

Plus, Discounts Available!


33.

Anthem: Online or On-the-go!

• “Go Green” for 24/7 convenience with less

paper

• Access your plan and benefit information

• Find a doctor or hospital specific to your plan

• Check on claims and payments

• Refill a prescription

• Tap to call Customer Service

• Download a temporary ID card

Plus, Discounts Available!


34.

iBenefits: Mobile Benefits App

With iBenefits, you can take your Employee

Benefits information on the go!

• View company benefit plans, 24/7

• Access group numbers and review detailed plan

information when you need it most

• Quickly contact an insurance company using the

“tap to call” feature

• Keep up with important benefit plan

announcements via “push notifications” such as

Open Enrollment dates, deadlines and more

• Store ID card images

Company Code: scripps2020

https://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwi3h8WK3NPPAhUBVyYKHTKpCwkQjRwIBw&url=https://ting.com/shop/iPhone-5-White-Refurbished&psig=AFQjCNHepbDzNK47MeMA_rX3HUdBj2osgw&ust=1476308548045151


35.

DENTAL COVERAGE

Dental


36.

Delta Dental PPO Plan

Overview:

• Freedom to see a wider network of dentists

• You don’t need to select a Primary Care Dentist and a referral is

not necessary to receive specialty services

• You will pay a higher amount for services from an out-of-network

dentist

NOTE: If you’re planning to have extensive dental work, a Predetermination of Benefits is suggested so

you can fully understand your out-of-pocket cost before receiving services.


37.

PLAN HIGHLIGHTS DELTA DENTAL PPO

PPO Dentist Delta Premier

Provider

All Other Providers

Calendar Year Deductible

Individual ----------------------$50 / person*----------------------

Family

Annual Maximum

Individual ---------------$2,000 / Calendar Year---------------

Dental Services

Preventive 100%

Deductible waived

80% 80%

Basic Services 90% 80% 80%

Major Services 60% 50% 50%

Orthodontia Services

Child up to age 19 50% 50% 50%

Adult 50% 50% 50%

Lifetime Maximum ---------------$1,500 / Person / Lifetime---------------



38.

Vision


39.

MES Vision PPO

PLAN HIGHLIGHTS MES VISION PPO

In-Network Out-of-Network

Copay $10 Copay / Person $10 Copay / Person

Exam – Every 12 months Plan pays 100% Up to $40 allowance

Lenses – Every 12 months

Single Plan pays 100% Up to $30

Bifocal Plan pays 100% Up to $50

Trifocal Plan pays 100% Up to $65

Frames – Every 24 months Plan pays 100% up to a $150

frame allowance Up to $75

Contacts – Every 12 months, in lieu of lenses & frames

Medically Necessary Plan pays 100% Up to $250

Cosmetic

Plan pays 100% up to $150,

plus up to $40 for a contact lens

fitting fee

Up to $150 allowance, plus up

to $40 for a contact lens fitting

fee


40.

2020 Monthly Medical/Vision Premiums

COVERAGE LEVEL

EMPLOYEE

CONTRIBUTION

SCRIPPS RESEARCH

CONTRIBUTION

TOTAL MONTHLY

PREMIUM

Comprehensive Choice POS II Plan

Employee Only $82.50 $674 $756

Employee and Spouse / DP $286 $1,227 $1,513

Employee and Child(ren) $220 $1,043 $1,263

Employee and Family $429 $1,591 $2,020

Anthem Blue Cross Select HMO Plan

Employee Only $50 $430 $480

Employee and Spouse / DP $250 $804 $1,054

Employee and Child(ren) $180 $683 $863


HDHP Aetna Choice POS II Plan


Employee and Spouse / DP $0 $1,332 $1,332

Employee and Child(ren) $0 $1,155 $1,155



41.

2020 Monthly Dental Premiums

COVERAGE LEVEL

EMPLOYEE

CONTRIBUTION

SCRIPPS RESEARCH

CONTRIBUTION

TOTAL MONTHLY

PREMIUM



Employee and Spouse / DP $20 $75 $95

Employee and Child(ren) $15 $64 $79

Employee and Family $35 $92 $127


42.

Life Insurance and AD&D


43.

Basic Term Life and AD&D*

underwritten byScripps Research offers choice of:

• $50,000 flat benefit amount, OR

• 2x your annual salary up to $1,500,000, OR

• 3x your annual salary (on age-rated basis) up to $1,500,000

You may elect 3x annual salary during this open enrollment

Proof of good health is required if your total basic life coverage

exceeds $1,000,000

Required! Update your beneficiary information in bSwift.

In the past, benefit information was completed on paper forms. Scripps Research allows the

information be housed online. Scripps Research encourages you to enter your beneficiary

information in the bSwift system for ease of tracking.

TIP

*Research Associates now eligible for $50,000 Basic Life benefit. Trainees and Graduate Students are not

eligible for the basic life plan.


44.

Voluntary Term Life100% Employee Paid

underwritten by

Coverage Level

Description

Employee

• Increments of $10,000 up to $500,000

• Premium based on Employee Age

• All enrollment (except new hires) require

Evidence of Insurability (EOI)

• Guarantee Issue up to $100,000 coverage for 1st

time eligible

Spouse

• Increments of $10,000 up to $500,000

• Guarantee Issue up to $50,000 coverage for 1st

time eligible

• Spouse may be enrolled regardless if you enroll

yourself

Child • Increments of $2,500 up to $10,000

Enroll , make changes, or update your beneficiary information in bSwift.

In the past, benefit information was completed on paper forms. Scripps Research now allows the



TIP


45.

Voluntary AD&D Insurance

100% Employee Paid

underwritten by

Coverage Level

Description

Employee • Increments of $50,000 up to $500,000

Spouse• Coverage amount equal to 50% of employee

amount

Child(ren)• Coverage amount equal to 15% of employee

amount

Family

• Coverage amount for your spouse equal to 40%

of employee amount. Coverage amount for

child(ren) equal to 10% of employee amount

Enroll , make changes, or update your beneficiary information in bSwift.

In the past, benefit information was completed on paper forms. Scripps Research now allows the



TIP


46.

Voluntary Long Term Care

• Available to Staff, spouses, children (age 18+), parents and

grandparents

• Guarantee Issue Coverage equals:

• Up to $4,000 Nursing Facility Benefit Amount

• And a Facility Benefit Duration of 3 or 6 years

• To elect higher levels of coverage or longer benefit durations, or

to enroll in the plan after your initial eligibility period, you must

provide Evidence of Insurability

• To enroll, you must complete the Benefit Election Form available

through bSwift or by contacting Benefits Administration at

858.784.8487 or [email protected]. Forms are also available

through the Benefits website.

*Research Associates. Trainees and Graduate Students are not eligible



47.

Flexible SpendingAccount (FSA)


48.

What is a Flexible Spending Account (FSA)?

An FSA is a pre-tax benefit allowed under IRS Code Section 125, which allows you to set aside a

specific pretax dollar amount for unreimbursed medical, dental, vision and dependent care expenses.

• Pre-tax benefits

• FSA Plan Year: January 1, 2020 through December 31, 2020

• It is not required that you be enrolled in your company’s health plans

• Depending on the type of FSA you have (Health Care FSA or

Dependent Care FSA), you can contribute up to an annual maximum

level per plan year

• You are not permitted to enroll in the Health Care FSA if you enroll in a

HSA eligible plan

$5,000Dependent Care

Contribution Limits

$2,700Health Care

Any statements concerning actuarial, tax, accounting, investment or legal matters are based solely on our experience as

insurance brokers and are not to be relied upon as actuarial, accounting, tax, investment or legal advice, for which you

should consult your own professional advisors.


49.

What is a Flexible Spending Account (FSA)? [continued]

Health Care Spending Accounts*

• $2,700 Annual Maximum Contribution (minimum is $120)

• Out of pocket expenses for you, your spouse, and your

dependents

• Does not include domestic partner

Dependent Care Spending Account**

• $5,000 maximum per calendar year

• $2,500 if married, filing separately

• $5,000 maximum if married, filing jointly

*Research Associates. Trainees and Graduate Students are not eligible for Health Care Spending Account

** Research Associates, Trainees, & Graduate Students may be eligible for Dependent Care Spending

Account based on status. Please see Human Resources for eligibility


50.

Using the Flexible Spending Account (FSA)


51.

FSA Eligible Expenses

Health Care FSA

• Applicable for you and any eligible dependent

• Medical

– Copays

– Deductibles

– Prescriptions

– Hospital costs

– Smoking cessation

– Fertility / family planning

– Acupuncture

– Chiropractic

– OTC medications with physician prescription

• Dental

– Deductible

– Copays

– Orthodontia

• Vision

– Prescription glasses and sunglasses (frames and

lenses)

– Contact lenses and products

– LASIK, PRK, etc.

• Physician prescription not required

– Band Aids

– Bandages and wraps

– Braces and supports

• Physician prescription not required (continued)

– Sunscreen, SPF 30+

– Contact lens supplies

– Denture adhesives

– First aid supplies

– Diabetic supplies

– Diagnostic tests & monitors

– Reading glasses

– Wheelchair, walker, cane

– Other durable medical equipment

Dependent Care FSA

• Daycare centers

• In-home day care / Nanny / Au Pair

• Before or after school programs for children under age

13

• Summer day camp

• Nursery school and Pre-school programs

• Elder care or dependents not capable of self-care


52.

Claim Reimbursement

• Claims for expenses to PayFlex

• Online (www.payflex.com)

• Mail

• Debit Card

• Request for reimbursement includes:

• Request form

• Proper documentation

• PPO Services – Explanation of Benefits (EOB)

• Other Services – itemized bill or receipt showing name of

provider, name of patient, date of service, details of the service

or product, cost of service or product.

• OTC items – cash register receipt and prescription

• Orthodontia contract

http://www.payflex.com/


53.

Voluntary Coverage & Products


54.

METLIFE VOLUNTARY COVERAGE

Coverages Offered:

• Accident Coverage

• Critical Illness Coverage

• Hospital Protection

Contact MetLife at 800.GET.MET8 with any questions.


55.

Voluntary Group Critical Illness Coverage

100% Employee Paid

When you or your family is faced with a life-threatening disease or

debilitating illness or injury, Critical Illness Coverage offered by

MetLife will pay you cash to help with the associated expenses.

Critical illness coverage pays a one-time, lump sum payment,

dependent on the illness.

Some of the medical conditions may include:

• Cancer

• Heart attack

• Stroke

• End stage kidney failure

• Major organ transplant


56.

Voluntary Group Accident Coverage

100% Employee Paid

Accidents happen when you least expect them including motor

vehicle accidents, sports injuries, and slips and falls! MetLife’s

policy will pay cash to help families offset the expenses associated

with accidents or injuries.

Benefits may be paid for:

• Emergency room treatment

• Intensive care unit

• Hospital admissions and confinement

• Ambulance transportation

• Travel expenses to distant treatment centers


57.

Voluntary Group Hospital Protection

100% Employee Paid

Having hospital protection through MetLife may help by paying

cash to you or your family to offset both medical and non-medical

bills when you’re sick, injured or on maternity leave.

The cash benefit can be used towards services or expenses other

medical plans might not cover, such as:

• Copayments & Deductibles

• Transportation expenses

• Child care

• Prescriptions

• Lost income


58.

Next Steps


59.

Take Action! Time to Enroll! All employees will need to log in to bSwift to:

• Complete benefit elections or waive for the 2020 plan year,

• New elections must be made to continue Flexible Spending Accounts and

Health Savings Accounts

• Enter beneficiary information for life insurance coverage

To enroll, follow these simple steps:

• Go to http://scripps.bswift.com

• Username: first initial and last name (e.g. John Doe would be jdoe)

• Enter established password (last 4 digits of Social Security Number for first-

time users)

• Click on “Start Your Enrollment” to begin making elections

• Click on “Complete Enrollment” once finished. You can print or email your

final confirmation statement once finished.

You will be prompted to verify your personal and family information before selecting your benefits. A helpful

tool to walk you through the process is “Ask Emma.” Emma will guide you through your enrollment and help

you decide which plans to enroll in if you are unaware. An enrollment guide and instructions will be posted on

the Benefits Administration webpages.

bSwift will open on October 28th and will close on November 8th and all changes will take effect starting

January 1, 2020 through December 31, 2020.

http://scripps.bswift.com/


60.

Questions

2020 benefits open enrollment - scripps research€¦ · please note: the information contained in...

Documents