State of Colorado Benefits

1
State of Colorado Benefits

• Coverage Dates
• July 1, 2015 June 30, 2016

2
Open Enrollment Dates

• April 14, 2015 May 14, 2015

3
Topics for Discussion

• Mandatory Enrollment
• Eligibility
• Premiums
• Medical Plan Overview and Changes
• Dental Plan Overview
• Basic Life Insurance
• Optional Life Insurance
• Short- and Long-Term Disability
• Health Savings Accounts
• Flexible Spending Accounts
• Voluntary Retirement Plans

4
On-line Enrollment

• MANDATORY PARTICIPATION!
• You may add/drop/change plans, add/drop
  dependent(s), or enroll in or continue a flexible
  spending plan(s) or make changes to Optional Life
• If you do not wish to participate in one or more
  plans you still must Waive Coverage in
  Benefitsolver
• All enrollments/changes must be done through the
  States online benefits administration system
  www.benefitsolver.com
• Please take this opportunity to review your
  plans, qualified dependents, and beneficiaries!
• Access is available from work, home, or HR if
  assistance is needed

5
Qualifying Events

• A qualifying event is an IRS approved change in
  status which allows a change in benefits outside
  the open enrollment period
• Typical qualifying events are birth of a child,
  marriage, divorce, and loss of coverage
• The change in definition of a dependent will mean
  that qualifying events will be very limited.
  (2011)
• Marriage of a child will no longer be a
  qualifying event
• Change in the childs financial dependence will
  no longer be a qualifying event
• Change in residence will no longer be a
  qualifying event
• Qualifying events must be processed in
  Benefitsolver within 31 days of the event.
  Contact HR for assistance

6
EligibilityDependents

• Requirements as of 07/01/2011
• Spouse (same or opposite sex), common-law spouse,
  SGDP or civil union partner
• An employees, spouses, SGDP or civil union
  partners children through the month in which
  they turn 26
• Marital status, financial status, dependent
  status, or place of residence do not affect
  childrens eligibility

7
EligibilitySame Gender Domestic Partners

• Effective July 1, 2010, same gender domestic
  partners and dependents of same gender domestic
  partners are eligible for Medical and Dental
  Insurance, Optional Life Insurance, Health Care
  Flexible Spending, and Dependent Care Flexible
  Spending.
• Definition-Same Gender Domestic Partner (SGDP)
• Must be at least 18 years of age
• Same gender as the employee
• Shared an exclusive relationship with the
  employee for a minimum of one year with the
  intent for the relationship to last indefinitely.
• Not married to another person
• Check with the Benefits Office for documentation
  requirements

8
EligibilityCivil Union Partners

• Civil Union Partners and dependents of civil
  union partners are eligible for Medical and
  Dental Insurance, Optional Life Insurance, Health
  Care Flexible Spending, and Dependent Care
  Flexible Spending.

9
Documentation Requirement

• Proper documentation will be required for any
  spouses, common-law spouses, SGDPs, or dependents
  added during open enrollment.
• Documents include signed affidavits with
  supporting documentation for common law marriage
  and Same Gender Domestic Partnerships
• Spouses and dependents will require birth and
  marriage certificates
• Proof of marital status is also required
• A full listing of requirements is available on
  the States benefits web page
• Documentation must be provided to the CSM HR
  Office or DPA Benefits Office

10
Patient Protection andAffordable Care Act

• The State of Colorado medical plans meet the
  minimum essential coverage and affordability
  standards set by the ACA
• Remember, most individuals will need to have
  health insurance in 2015 or face a possible
  financial penalty.
• For more information www.healthcare.gov

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PlanDefinitions

• HMO means Health Maintenance Organization (Closed
  Network)
• HDHP means High Deductible Health Plan
• PPO is a Preferred Provider Organization
• HSA is a Health Savings Account
• FSA is a Medical or Dependent Care Flexible
  Spending Account
• Deductible is the amount paid out-of-pocket
  before benefits become payable. However, you may
  have access to co-payment based services without
  satisfying the deductible
• EOI is Evidence of Insurability (Medical
  Questionnaire)
• UHC is United Healthcare

12
PlanDefinitions

• Co-insurance is a percentage amount paid for
  services. For instance if your co-insurance is
  10 the insurance company pays 90 of the bill
  and you pay 10. Co-insurance payments normally
  count toward your deductible
• Co-pay is a flat dollar amount paid for services
  regardless of the cost of those services. For
  instance 30 co-pay for an office visit.
  Co-payments do not usually apply to the
  deductible
• Out-of-Pocket Maximum (OPM) The most you will pay
  for covered services. Once you reach the OPM the
  plan will pick up 100 of the costs

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Premiums

• Employee contributions for medical have increased
  or decreased depending on the plan.
• The State contributions towards medical insurance
  has increased
• Employee and State contributions for dental
  insurance have remained the same
• Optional Life insurance rates remain the same
• Long Term Disability rates have changed

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Co-Pay PlansRules of the Road

• The State of Colorado has two co-pay based plans.
  The Co-Pay Choice Plus (UHC) and the Kaiser DHMO
• Deductibles can be met on an individual basis
• You do not need to meet the deductible to use the
  co-pay based services such as office visits or
  pharmacy services
• Co-pays do not count toward meeting your
  deductible
• Some services under these plans require
  co-insurance
• Co-insurance generally does count toward your
  deductible
• Most co-pays and co-insurance count toward your
  OPM

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State of Colorado PPO (UHC)Co-pay Choice Plus
In-Network Out-of-Network
Deductibles Employee Family 1,500 3,000 3,000 6,000
Out-of Pocket Max Employee Family 5,000 10,000 10,000 20,000
Preventive Care 0 50
Primary Care Office 30 50
Specialist Office 50 50
Emergency Room 500 500
Out-Patient Surgery 20 Deductible 50
In-Patient Hospital 1,000 co-pay 20 No Deductible 50
Pharmacy 30 Day 10/30/50 10/30/50
Mail Order 90 Day 25/75/125 Not Covered
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KaiserDHMO
In-Network Out-of-Network
Deductibles Employee Family 750 1,500 n/a
Out-of Pocket Max Employee Family 2,000 4,000 n/a
Preventive Care 0 Not Covered
Primary Care Office 30 10 (services) Not Covered
Specialist Office 50 10 (services) Not Covered
Emergency Room 500 500
Out-Patient Surgery 10 Deductible Not Covered
In-Patient Hospital 10 Deductible Not Covered
Pharmacy 30 Day 10/30 Not Covered
Mail Order 90 Day 20/60 Not Covered
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High Deductible Health PlansRules of the Road

• The State offers two HDHP plans one administered
  through UHC and one insured through Kaiser
• You must satisfy the entire deductible before the
  plan pays for any services including pharmacy
• Services with the exception of pharmacy are based
  on co-insurance
• Co-insurance generally counts toward your
  deductible
• Most co-pays and co-insurance count toward your
  OPM

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State of Colorado (UHC)High Deductible Health
Plan
In-Network Out-of-Network
Deductibles Employee Family 1,500 3,000 4,500 9,000
Out-of Pocket Max Employee Family 3,000 6,000 9,000 18,000
Preventive Care 0 50
Primary Care Office 20 Deductible 50
Specialist Office 20 Deductible 50
Emergency Room 20 Deductible 500
Out-Patient Surgery 20 Deductible 50
In-Patient Hospital 20 Deductible 50
Pharmacy 30 Day 10/30/50 Deductible 10/30/50 Deductible
Mail Order 90 Day 25/75/125 Deductible Not Covered
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KaiserHigh Deductible Health Plan
In-Network Out-of-Network
Deductibles Employee Family 1,500 3,000 3,000 6,000
Out-of Pocket Max Employee Family 2,000 4,000 4,000 8,000
Preventive Care 0 Not Covered
Primary Care Office 10 Deductible Not Covered
Specialist Office 10 Deductible Not Covered
Emergency Room 10 Deductible 10 Deductible
Out-Patient Surgery 10 Deductible Not Covered
In-Patient Hospital 10 Deductible Not Covered
Pharmacy 30 Day 10/30 Deductible Not Covered
Mail Order 90 Day 25/75 Deductible Not Covered
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United Healthcare andPaladina Health

• Available to employees and family members
  enrolled in the United Healthcare Co-Pay Choice
  Plus or HDHP Plans
• Primary Care Clinics 9 locations including 6 in
  the Denver Metro Area
• Same and next day urgent appointments
• No co-pay charge for Co-Pay Choice Plus members
• No co-insurance for HDHP members once the
  deductible is satisfied
• Many services and labs can be preformed on site
• Certain prescriptions can be filled in office at
  a lower cost than through a pharmacy
• 24/7 access to your personal physician via their
  personal cell phone
• State of Colorado pays the membership fees
• You must register at www.paladeniahealth.com/color
  ado or by calling 1-866-808-6005

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Vision Benefits

• Vision Care Exam
• Vision exams are covered through medical
  insurance and may be subject to deductibles,
  co-pays, or co-insurance. Contact lens exams are
  normally subject to additional charges
• Hardware
• UHC Plans 25 materials co-pay plus 130 frames
  allowance every two years. Contact Lenses 150
  every two year. Must use in-network provider
• Kaiser 150 every two years (Kaiser Optical
  Department)

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United Healthcare

• www.myuhc.com UHC Members Website
• Online Health Assessment
• Health Discount Program
• Allows members to enjoy a 10-50 discount on
  qualifying health and wellness purchases
• 24 Hour NurseLine Services
• Health and Wellness programs including healthy
  pregnancy, weight management, healthy back
  programs, and more
• Online treatment cost estimator
• Quicken Health Expense Tracker
• www.welcometouhc.com/colorado - UHC Non-Member
  website
• Paladina Health www.paladinahealth.com/colorado
  or 1-866-808-6005

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Kaiser

• www.kp.org Kaiser Members Website
• My Health Manager
• Request/View appointments
• Refill prescriptions
• View and learn about test results
• Communicate via secure email with your health
  care providers!
• Complete a personal health assessment
• Estimated service costs
• Online programs for weight-loss, fitness,
  nutrition, and more
• Information about medical conditions and
  prescription drugs

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Making A ChoiceThings to Consider

• What types of services do you normally use?
  Office visits, a couple of E.R. visits a year or
  just preventive care?
• Do you have major surgery planned in the next
  year?
• What is your risk tolerance?
• Remember you have an Out-of-Pocket Maximum. HDHP
  plans may have a lower OPM
• Look at the difference in the cost of premiums.
  Not just for a single month but over the course
  of a year
• Would you have funds available to cover the
  deductible if needed on a HDHP?
• Could you contribute to an HSA or Flex account to
  cover deductibles?
• Consider using United Healthcare and Kaisers
  online tools to estimate expenses for particular
  services. Look at your current EOBs (if
  available) for the cost of frequent services

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BenefitsolverMyChoice

• When you start the Open Enrollment process in
  Benefitsolver you will have an option to click on
  the MyChoice tool
• MyChoice will ask you a series of questions
  related to your health and your family members
  health if applicable
• Using this information it will make plan
  recommendations for you
• You must still select a plan and enroll. You
  dont have to choose the MyChoice recommendation

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Medical InsuranceSupplement Program

• A program designed to offer financial assistance
  in covering medical premium costs for low-income
  state employees with at least one eligible child
• Must have a 2014 calendar year household income
  three time (3x) or less of the federal poverty
  level
• Complete details and tables available on the
  State of Colorados Employee Benefits web page
• All applications must be filed online (States
  website) and completed by May 14th
• Contact Human Resources if you need assistance
  scanning documentation or with the application
  process

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Dental Plan Highlights

• Basic and Basic Plus Plans
• Composite fillings (white fillings) are now
  covered for all teeth (2011)
• Necessary dental implants are now covered (2012)
• Members with certain health conditions are
  eligible for cleanings up to 4 times per year if
  deemed necessary. Conditions include pregnancy,
  cardiovascular disease, diabetes, kidney failure,
  and suppressed immune system. Verification of a
  covered condition from a physician will need to
  be on file with the dental office.

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Dental Plan Highlights

• Basic and Basic Plus Plans
• Delta Premier Dentists are now considered
  In-network (2012)
• No balance billing when using a Premier Dentist
• If you are currently using a Premier Dentist you
  should see your costs decrease
• Premier dentists have a higher contract rate than
  PPO dentists. If co-insurance applies it is still
  usually less expensive to use a Delta PPO Dentist
  

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Dental Plans

• Both the Basic and Basic Plus plans cover
  in-network preventive care twice a year at no
  charge
• Reminder! Preventive care costs will no longer
  count toward the annual maximum benefit!
• Basic
• Maximum 1000 annual benefit per person
• Deductible 50 Employee / 150 Family
• Basic Plus
• Maximum 2000 annual benefit per person
• Additional Orthodontia benefit
• Deductible 50 Employee / 150 Family
• For the greatest cost savings use a Delta PPO
  dentist

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Delta DentalEyeMed Vision Care Discount Program

• Available for employees and dependents enrolled
  in a Delta Dental Plan
• Offers discount exams and hardware through
  designated providers
• www.eyemedvisioncare.com/deltadental
• 1-866-246-9041

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Basic Life

• New! Coverage is 1x base salary or 50,000
  whichever is greater
• Mines will continue to pay this premium
• You are encouraged to check your beneficiaries

32
Optional Life

• Optional Life is available for employees,
  spouses, and same gender domestic partners
  through Minnesota Life
• Employees are eligible for up to 500,000 in
  increments of 10,000
• Spouses and same gender domestic partners are
  eligible for up to 50 of the amount elected by
  the employee
• Different rates for employees and spouses
• Children are eligible for either 5,000 or
  10,000 in coverage
• Employees, spouses, and SGDPs must complete the
  Evidence of Insurability form and submit to
  Minnesota Life.
• Enrollment is now available year round
• Evidence of insurability is required if you are
  increasing your elected amount or enrolling for
  the first time during O.E! Make sure to click on
  the Minnesota Life link during your Benefitsolver
  registration session to complete the EOI
  questionnaire

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Optional LifeChild (Dependent) Life

• Child Life is available for dependent children
  and dependent children of SGDPs
• Employee must be enrolled in Optional Life
• Dependents are only eligible for coverage through
  the month in which they turn 26
• All dependents are covered for one flat rate
• No evidence of insurability is required for
  children
• All children covered under Child Life must be
  listed as dependents in Benefitsolver and
  enrolled under the dependent life plan

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Life InsuranceAdditional Benefits

• Available to employees with Basic Life and/or
  Optional Life insurance through Minnesota Life
• Travel Assistance
• Helps coordinate care during medical emergencies
  if you are more than 100 miles from home.
  Includes locating doctors offices, hospitals,
  replacement of lost/stolen prescriptions,
  eyeglasses, repatriation services, plus much
  more.
• Not a substitution for medical/dental insurance

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Life Insurance Additional Benefits Continued

• Will Preparation and Legal Services
• Free 30 minute consultation with an attorney plus
  legal referrals
• Create legally valid wills, financial power of
  attorney, and living wills online
• Download legal forms
• Legal Information Library
• Financial Counseling for Beneficiaries
• Receive free independent and objective financial
  counseling
• Information on these services is available on the
  Department of Personnel and Administrations
  website

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Short Term Disability

• The State has a new disability insurance carrier,
  Unum
• There are no changes to the Short-Term Disability
  plan (6 month coverage) and Mines continues to
  pay the full premium.

37
Long Term Disability

• You insure your car and your house are you
  insuring your income?
• New carrier, Unum
• During this Open Enrollment period only anyone
  can enroll in LTD coverage. No evidence of
  insurability required!
• 3/12 exclusion period
• Individuals enrolled currently in The Standards
  policy will not have an exclusion period and
  enrollment will transfer to Unum
• Rates have changed many people will pay less
• Reduced rates for vested employees
• More flexible than PERAs definition of
  Disability Retirement including long-term partial
  disability
• Exclusions and limitations apply

38
Health Savings Accounts (HSA)

• Allows you to use pre-tax dollars to pay for
  qualified medical expenses as they occur or to
  save for qualified expenses in the future
• Unused funds roll over from year to year
• To be eligible you must be enrolled in an HSA
  qualified plan
• HDHP with HSA (United Healthcare)
• HMO High Deductible Health Plan (Kaiser)
• Health Savings Accounts can be arranged through
  financial institutions including the Credit Union
  of Colorado
• The School of Mines does not offer salary
  deduction for HSAs however, you may be able to
  direct part of your paycheck to your HSA account
  through direct deposit

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Flexible Spending Accounts

• Healthcare Flexible Spending allows you to deduct
  money on a pre-tax basis from your paycheck to
  pay for unreimbursed medical expenses such as
  deductibles, co-pays, eye glasses, and dental
  care
• Dependent Care Flexible Spending allows you to
  deduct money on a pre-tax basis to pay for
  qualified child care expenses. This account does
  not cover medical expenses for children/dependents
  
• Both plans lower your taxable income by the
  amount contributed to the plans!

40
Flexible Spending Accounts

• The maximum contribution for the Healthcare
  Flexible Spending Account is 2,550
• Remember, if your spouse is eligible for a
  flexible spending account through their employer,
  they may also be able to deduct up to 2,550

41
Flexible Spending Accounts

• Important! You must re-enroll in flexible
  spending accounts each year during open
  enrollment
• Healthcare FSA maximum annual contribution is
  2,550
• Dependent Care FSA (does not cover medical
  expenses) annual contribution is 5,000 per
  family
• Money not used during the plan year is forfeited
  for the Dependent Care FSA and all but 500 for
  the Healthcare FSA (starting June 30, 2015)
• Starting January 1, 2011, over the counter
  medications will not be reimbursable under
  flexible spending without a prescription

42
Flexible Spending Account

• Starting June 30, 2015, you can rollover up to
  500 in unused Healthcare Flex dollars into the
  next plan year
• A Debit Card is available for Healthcare Flexible
  Spending Accounts!
• .50 cent charge per month deducted from your flex
  account balance
• Eliminates the filing of most claim forms
• Does not relieve you of record keeping
  responsibilities Keep your Documentation!

43
Flexible Spending Account Changes

• A Limited Purpose Healthcare Flexible Spending
  Account has been added (2014).
• Allows individuals contributing to a Health
  Savings Account (HSA) to contribute to a
  Healthcare Flexible Spending account to cover
  dental and vision expenses

44
Voluntary Retirement Plans

• It is never too early or late to start saving for
  retirement!
• The School of Mines offers a variety of voluntary
  pre-tax retirement plans including
• The PERA 457 Deferred Compensation Plan
• The PERA 401(k) Plan
• The 403(b) plan which is available through four
  vendors
• Pre-tax contributions do not lower your highest
  average salary as calculated by PERA
• The Roth 403(b) (post-tax) plan which is
  available through three vendors

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Voluntary Retirement Plans

• You may enroll in a voluntary retirement plan at
  any time
• Contact Human Resources for plan information
• Enrollment forms should be sent to the vendor
• Contact Human Resources or Payroll for a salary
  deduction form

46
Enrollment Tips

• All dependents in Benefitsolver will need to have
  a social security number listed as well as the
  tax dependent and full-time student fields filled
  in
• If Benefitsolver is missing any of this
  information for existing dependents you will be
  required to complete it before moving forward
• If you cant remember your Benefitsolver user
  name and/or password click on Forgot Password
  and follow the recovery instructions. You must
  format the information exactly as shown. The
  company key is soc
• You will receive a confirmation number when your
  transaction is complete
• If you are having difficulties with Benefitsolver
  please call the Benefits Office at [phone]
  for assistance

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Resources

• United Health Care
• www.welcometouhc.com/colorado
• 1-877-283-5424
• Kaiser Permanente
• www.kaiserpermanente.org
• 303-338-3800
• Delta Dental
• www.deltadentalco.com
• 1-800-489-7168
• Department of Personnel and Administration
• www.colorado.gov/dpa/dhr/benefits
• CSM Human Resources
• [phone]