annual enrollment for plan year 2013

Annual Enrollment forPlan Year 2013

February 2010 2APRIL 2010

2013 Annual Enrollment Dates:

Tuesday, October 9th* - Friday, November 9th

* Opens at 1:00 a.m. EST


Plan Changes for AE 2013


Dental Plans – Delta Dental

New! Effective January 1, 2013, Delta Dental will be replacing United Concordia as the State of Georgia’s dental provider

Delta Dental will offer two coverage options to choose from:

– Select Plan

– Select Plus Plan

The four family tier levels will remain the same

Premium rates will remain locked through PY 2015

Plan Design/Premium Changes for AE 2013



Transition from United Concordia to Delta Dental:

– Employees currently with U.C. Regular will be transferred to Delta Dental Select Plus Plan

– Employees currently with U.C. PPO will be transferred to Delta Dental Select Plan

Employees will have the option during Annual Enrollment to change from one plan to another




No orthodontia benefits under the Select Plan

Orthodontia benefit is available for children and adults under the Select Plus Plan

Participants currently receiving orthodontia treatment will be eligible for the balance of the maximum coverage amount



Delta Dental Network

Participants are free to choose any licensed dentist

– Approx. 6,400 dentist locations in Georgia

Network dentists agree to set fees based on Delta Dental’s allowances and cannot balance bill

Delta Dental pays participating dentists directly; participant pays their responsible amount at time of treatment

Network dentists complete all claim forms/paperwork

Network dentists are credentialed



Delta Dental Comparison Chart Select Plan Select Plus Plan

Benefits & Covered Services

In NetworkPPO Dentist

In NetworkPremier* Dentist

Out of Network Non PPO Dentist

In NetworkPPO Dentist

In NetworkPremier* Dentist

Out of Network Non PPO Dentist

Diagnostic & Preventive Services (D&P)Exams, Cleanings, x-rays, sealants

100% 100% 100% 100% 100% 100%

Basic ServicesFillings, simple tooth extractions

80% 80% 80% 90% 90% 90%

Endodontics (root canals)Covered under Basic services

80% 80% 80% 90% 90% 90%

Periodontics (gum treatment)Covered under Basic services

80% 80% 80% 90% 90% 90%

Oral SurgeryCovered under Basic services

80% 80% 80% 90% 90% 90%

Major ServicesCrowns, inlays, onlays, cast restorations, bridges, dentures & TMJ

50% 50% 50% 60% 60% 60%

Orthodontic BenefitsAdults & dependent children

Not Covered

Not Covered

Not Covered

50% 50% 50%

Orthodontic MaximumsLifetime

Not Covered

Not Covered

Not Covered

$2,000 $2,000 $2,000

* Premier Dentists are defined as secondary PPO (in network) dentists. Premier Dentists usually charge somewhat higher contracted fees.


Delta Dental (Payment Example)

In Network versus Out of NetworkHypothetical

ExampleIn Network

PPO DentistIn Network

Premier* DentistOut of Network Non PPO Dentist

Charge for a Crown$1,000 $1,000 $1,000

Plan Payment Allowance

$640 $800 $900

Percentage Paid by Delta Dental

60% 60% 60%

Delta Dental Pays$384 $480 $540

Patient Pays$256

($640 - $384)

$320($800 - $480)

$460($1,000 - $540)

* Premier Dentists are defined as secondary PPO (in network) dentists. Premier Dentists usually charge somewhat higher contracted fees.


Premium Rates

Select Plan

– You Only $24.08

– You + Spouse $46.65

– You + Child $48.89

– You + Family $68.40

Dental (Select Plan)

Admin fee is included in amount


Premium Rates

Select Plus Plan

– You Only $38.45




Dental (Select Plus Plan)



Employee, Spouse, Child Life and AD&D Plans – Minnesota Life

Increase the Employee Life and AD&D maximum coverage from $500,000 to $1 million

Employees capped at $500k can increase coverage to the uncapped amount on a guarantee issue basis

Waiver of premium for permanent/total disability will be removed from the plans

– Reduces the premiums by an average of 13%

– Current participants on active waivers will continue



Disability Plans – The Standard

No change in plan design or premiums for the Short Term Disability

Rate decrease of 5% for LTD premiums

LTD maximum benefit will increase from $4,000 to $5,000 per month

Maximum benefit period will increase from age 65 to age 67

– Coordinate with Social Security Normal Retirement Age

– No change on current employee claims; only claims initiated on or after January 1, 2013



Critical Illness Plan – CAIC

No changes to premiums for the current option

Name change of the current option – Select Plan

New! Additional option level – Select Plus Plan

– Provides same critical illness coverage under the Select Plan

– Includes Accidental Coverage

These changes are applicable to both the Employee and Spouse Specified Illness benefits

Additional features of the Accident Coverage

– 24-Hour coverage

– No limit on the number of claims



Critical Illness Plan – CAIC

Benefits included under the Accident Coverage (Select Plus Plan)

– Medical Fees (Physician Charges, X-Rays, Emergency Room Services and Supplies)

– Hospital Fees (Hospital Admission, Daily Hospital Confinement and Intensive Care)

– Accidental Injuries (Fractures/Dislocations, Lacerations, Tendons/Ligaments, Ruptured Disk, Torn Knee Cartilage, Burns, Eye Injuries)

– Accident Follow-up Benefits (Physical Therapy, In-patient Rehab, Follow-up treatments)

– Additional Benefits (Family Lodging, Transportation, Gunshot Wound, Paralysis, Prosthesis)

A complete list of benefits and descriptions will be available in the Critical Illness Select Plus communication materials



Rate Sheet for Employee Specified Illness (Select Plus Plan)

Employee Critical Illness & Accident

Age Band $5,000 $10,000 $20,000 $30,000 $40,000 $50,000

18-29 $14.29 $16.09 $19.69 $23.29 $26.89 $30.49

30-39 $15.84 $19.19 $25.89 $32.59 $39.29 $45.99

40-49 $19.79 $27.09 $41.69 $56.29 $70.89 $85.49

50-59 $25.39 $38.29 $64.09 $89.89 $115.69 $141.49

60-69 $33.24 $53.99 $95.49 $136.99 $178.49 $219.99



Rate Sheet for Spouse Specified Illness (Select Plus Plan)

Spouse Critical Illness & Accident

Age Band $5,000 $10,000

18-29 $14.29 $16.09

30-39 $15.84 $19.19

40-49 $19.79 $27.09

50-59 $25.39 $38.29

60-69 $33.24 $53.99



Spending Accounts – SHPS/ADP

SHPS has become a part of ADP

– ADP branding on future HCSA and DCSA materials

– The customer service phone number, fax number, and mailing address will remain the same

The current URLs will remain active and any changes will be communicated well in advance



Spending Accounts – SHPS/ADP

No increase in admin fees with current plan design

HCSA annual maximum will reduce from $5,040 to $2,460

– Monthly maximum will be $205

– Compliance with Patient Protection and Affordable Care Act (PPACA)

– Note: a monthly administration fee of $3.20 is included in the total contribution amount

Employees who contributed a larger amount in 2012 will be reduced to the new HCSA maximum for 2013



Vision – Spectera

Branding name will change from OptumHealth to Spectera

Select Plus Plan will have the following enhancements:

– Frequency of frames will change to once every 12 months

– Frame allowance of $150 is provided for private practice or retail chain providers

– Standard contact lenses will have a $200 allowance

– Allow up to 8 boxes of standard, disposable lenses

Out-of-network allowance for contact lenses will increase to $200 under the Select Plus Plan



Vision – Spectera

New premium rate structure for the Select Plus Plan

– You Only $8.62







No Plan or Premium Changes

Dental DHMO - Cigna

Legal

Long Term Care



GaBreeze Annual Enrollment Communications & Website Reminder


Annual Enrollment Communications by GaBreeze

COMMUNICATION DATE

Create AE e-mails On GaBreeze (For Actives with preferred e-mail only) October 2 – 3

Mail Enrollment Post Card (Active w/o preferred e-mail, All Retirees, LOA and COBRA)

October 2 – 3

Mail Enrollment Post Card (Active w/o preferred e-mail on file)- Passive e-mail October 2 – 3

Send AE reminder e-mail notifications (Active/Leave/COBRA with preferred e-mail address on file)

October 23

Print Confirmation of Enrollment statements, Beneficiary Confirmation Notices upon enrollment (Notes: ¹GaBreeze Website enrollees will not receive a confirmation of enrollment. ²COE will not show the $3.20 admin fee in the HCSA monthly price tag)

November 15

Mail Confirmation of Enrollment statements, Beneficiary Confirms, Conversion/Portability, COBRA Rights Spouse Notices (if applicable)

November 15


GaBreeze Confirmation Number

Employees will receive a Confirmation Number upon successful completion of their online Annual Enrollment on the completed successfully page on the GaBreeze Website

Additional changes will be permitted online during the remainder of the Annual Enrollment period.

– Employees will retain the same Confirmation Number

– Date/Time Stamp will update to reflect the most recent completion

Employees should print a copy of the Confirmation Number page for their records

GaBreeze Website Reminder for AE 2013


Annual Enrollment Reminders


Annual Enrollment Materials from DOAS

You Decide! Booklet

Benefits At-a-Glance Brochure

What’s New for 2013?

NOTE: Annual Enrollment materials will be posted online by Monday, October 1st

– Materials will be available on the GaBreeze and Team Georgia web sites

Reminders for AE 2013


Annual Benefit Base Rate (ABBR) for PY 2013

ABBR Salary entry deadlines

– Dekalb and Clayton BOE should submit to GaBreeze by Friday, September 21st

– Manual agencies should update on the GaBreeze ERWS site by Friday, September 21st

– SAO agencies should submit to GaBreeze by Wednesday, October 3rd




Manual agencies will be required to enter ABBR salary updates into the GaBreeze ERWS site

– Use the “Employee Data Update” Smart Form

– Enter the updated ABBR salary amount; click “Submit” when finished

– Note: if an employee’s salary did not change, no ABBR update is required

If an employee’s ABBR salary changes after September 21st,

– Use “Frozen Annual Benefit Salary Correction” Smart Form

For additional questions, contact HRA assist team




Job aid is available to assist agencies with entering ABBR updates on the DOAS web site: doas.ga.gov

Deadline to complete is Friday, September 21st



GaBreeze Website (Pre-Annual Enrollment)

Employees should be encouraged to go online as soon as possible to verify and/or update their passwords

Employees should add their email address to the Personal Information section of the “Your Profile” page

– Email address can be either work or personal

– Quickens GaBreeze response time for replacement passwords to be issued

Employees should verify accuracy of addresses, zip codes, etc.

Gabreeze will provide a reminder for employees to enroll in Health Benefits

– Link to the DCH Annual Enrollment site will be on GaBreeze



New Hires During Annual Enrollment

Employees, who are hired by November 1, 2012, will be required to enroll in Flexible Benefits for both Plan Year 2012 and 2013

– Current Plan Year for benefits effective December 1st

– New Plan Year for benefits effective January 1st

If the employee fails to enroll for Annual Enrollment, no benefits will carry over for Plan Year 2013

Pending Enrollment Report on ERWS will assist agencies

– New hires who have not completed Annual Enrollment

– Report will be produced daily during the Annual Enrollment period



Employees returning from Leave of Absence

Employees, who go on a Leave of Absence and cross Plan Years, will be given an enrollment opportunity upon return to Active status

– If the employee paid premiums while on LOA, benefits will rollover into the new Plan Year

– If the employee makes no changes during the enrollment period, the benefits will continue for the remainder of the Plan Year

If the employee failed to pay, no coverage will show on GaBreeze. Employee will be given an enrollment opportunity subject to penalties

HR should verify the returning employee paid premiums during the LOA

– “View Flex Plan Coverage History” via the Employer Web Site

– If employee failed to pay premiums, do not reinstate deductions

– If employee makes benefit selections upon return, Gabreeze will report new deductions via the Financial Report



Support Avenues (Employees/Participants)

Benefits Call Center

1-877-3GBreez or 1-877-342-7339

Monday – Friday, 8:00 am – 5:00 pm ETexcluding holidays

GaBreeze Website

www.gabreeze.ga.gov

Link on Team Georgia Flexible Benefits tab


Barbara Heard

– 404 651-6084 or [email protected]

Chris Barfield


Valencia Timmons


Patricia Applewhite


Support Avenues (Agency Contacts)


Final Questions and Follow-ups

annual enrollment for plan year 2013

Documents

premier dentists

billdelta dental

dental plans delta dentalnew

delta dental payment

delta dental comparison

participating dentists

georgianetwork dentists

plan changes