Insurance Open Enrollment

2017 Health Insurance Open Enrollment 

Open Enrollment dates: Oct 24 -Nov. 4 2016
Open Enrollment CLOSES at 5 p.m. Nov. 4, 2016
All changes will take effect January 1, 2017


All Benefit Eligible Employees are required to sign into the enrollment tool and confirm their elections, whether it is to enroll or decline coverage for the 2016 plan year.

EnrollmentButton


If you need additional assistance please contact the Insurance Office at 801-826-5428.

Benefits Fair:

To help you to get to know our new carriers we will be having a benefit fair during the enrollment window. We strongly encourage you to attend, talk with the carriers, ask questions and become familiar with the insurance options and carriers.  pdfBenefits Fair Info

Oct. 27, 2016
Professional Development Center (PDC)
CAB-East Building
9361 S. 300 East
Sandy, Utah 84070
4 to 7 p.m.

Enrollment Clinics will be held for those who need assistance at the following location and times:

CSSC, Computer Training Lab, room 252:
  • Oct 24th 3:30 – 5:30
  • Oct 25th 3:30 – 5:30
  • Oct 27th 3:30 – 5:30
  • Nov 2rd 3:30 – 5:30
  • Nov 3rd 3:30 – 5:30

Benefits Information (rates, benefits booklet, etc):

Benefit Changes Effective Jan. 1, 2017

Changes to our Health Plans are made out of necessity. The School District has a self-funded plan, which means that our health insurance premiums are used exclusively to pay for our own health insurance claims. Despite making changes in recent years to mitigate rising health care costs, our claims have continued to outpace the premiums we collect. In recent months our experience shows that for every $1.00 we collected in premiums, we paid out approximately $1.20 in claims.  

There are simple steps that all employees can take to help keep premiums from increasing.  Requesting generic medications whenever possible and reserving use of the emergency room for true emergencies are two relatively effortless ways to keep costs in check.  For preventive care, routine check-ups and minor complaints, such as a cold or sinus infection, it’s best to visit a primary care physician. Many family doctors offer extended office hours in the evenings and on weekends, and many urgent care facilities are open 24 hours a day, seven days a week. One of the best ways to reduce claims is for us to strive to live active, healthy lifestyles by exercising, eating a healthy balanced diet, getting plenty of sleep, practicing good hygiene, and encouraging our family members to do the same.  

We will all benefit if we strive to live healthy, and make good healthcare decisions. pdfBenefit Changes 2017

Rate Change:

The rates for all plans and levels of coverage will increase by 7 percent in 2017.  The District will multiply the current total monthly rate by 7 percent and then allocate half to the employees’ portion and half to the District’s portion.  pdfRate Sheet

Traditional Plan Design Changes: 

· Change In deductible from $500/$1,500 to $750/$2,250

· Change in out-of-pocket max from $2,500/$5,000 to $3,000/$6,000

· Change the Emergency Room copay from $100 AD to $150 AD

· Inpatient copays are changing to 20% after deductible.


Qualified High Deductible Plan Design Changes:
 

The only change to the Qualified High Deductible Plan (QHDP) will be the increase to the premium.  The District will offer the same dollar-for-dollar match ($500 for employee only, $800 for employee, plus one dependent, $1,200 for family) to the Health Savings Account (HSA) for those who choose to enroll in the QHDP and the HSA.   


Benefit Booklet
pdfBenefit Guide 2017


Frequently Asked Questions (FAQs)
The answers to many of your insurance questions can be found here. We have attempted to provide answers to the most common questions. If you have any questions that aren't addressed here, please contact the CSD Insurance Department.

Additional Carrier Information:


Health - Aetna - www.aetna.com - 1-800-337-7224

Health - SelectHealth - www.selecthealth.org - 800-538-5038

VRx (prescription plan) - www.myvrx.com  - 1-877-879-9722

Dental Select - www.dentalselect.com - 801-495-3000

EMI Health - Vision- www.vsp.com - 801-262-7476

Flex Spending Account (FSA)- APA Benefits — 801-561-4980

EAP - Blomquist Hale - www.blomquisthale.com - 800-926-9616

Reliance Standard www.reliancestandard.com - 800-644-1103

Insurance Carrier Information

Ins.Plan Vendor Description Phone
 Health Aetna Icon_External_Link Aetna network facilities include: MountainStar, Iasis, and other non-IHC Facilities 800-337-7224
  Select Health Icon_External_Link Select Health network is affiliated with Intermountain Healthcare (IHC) network of Hospitals and Doctors 800-538-5038
 Rx VRx Icon_External_Link Prescription Medication Services 877-879-9722
 Dental Dental Select Icon_External_Link Dental Provider 801-495-3000
 Vision EMI Health - VSP Vision Icon_External_Link Vision Provider: Fashion Plan, Designer Plan 801-262-7476
 Flex APA BenefitsIcon_External_Link Flex Provider: Flexible Spending Accounts(FSA), Dependent Care Accounts(DCA) 866-656-0227
 EAP Blomquist Hale Icon_External_Link Employee Assistance plan 800-926-9619
 Life Reliance Standard Life Insurance and AD&D 800-351-7500
 Disability Reliance Standard Long Term Disability Insurance 800-351-7500
 Other Carrier Information
 *Supplemental AFLAC Icon_External_Link Supplemental Insurance
Contact: Lee Harmer
801-716-0084
 *Supplemental Washington National (formerly Conseco) Supplemental Insurance
Contact: Todd Louer
954-465-9535
 *Supplemental plans are not part of District group plans.

Open Enrollment FAQs


Q: When is the open enrollment period for the 2016 plan year?

A: Open enrollment will be Oct. 24 -Nov. 4th. The Enrollment window will close at 5:00 PM on Friday, November 4.  All employees who want have health, dental, vision or flexible spending coverage in the 2017 plan year will need to go through the enrollment process. Health, dental, vision and flexible spending benefits will not automatically transfer to the new year. Voluntary plans that are not changing will require participants to confirm their elections.

Q: Will I need to do anything during open enrollment?

A: Yes. Open enrollment for the 2017 plan year is mandatory. All employees who are eligible for insurance in the 2017 plan year, which is Jan. 1-Dec. 31, 2017, must log in and confirm their election, even if you want to decline benefits. This online enrollment must be completed by 5 pm on Nov 4, 2016.

Q: Why do I have to participate in the enrollment process? Why can't I just be enrolled automatically?

A: The selection of a health plan is a personal decision and depends largely on the employee's personal circumstances. Needs and circumstances change from time to time, we encourage employees to examine their benefit needs annually to determine if any changes need to be made. We require that employees confirm their elections annually through the enrollment process.

Q: How do I choose a health plan: Step 1 – Traditional vs Qualified High deductible health plan?

A: The choice between the Traditional plan and the Qualified High Deductible Health Plan is a choice that rests on your personal feeling about security vs control. The traditional plan is more about security, you pay a higher monthly premium but you pay less for the deductibles and out of pocket maximum, but conversely you also pay a higher monthly premium even if you don’t require any medical care during the year. The High Deductible plan is more about having control over your health care dollars. You pay substantially less in premium and in exchange you will be expected to cover more of your upfront costs based on the deductible. To help manage the insecurities associated with this plan, the IRS allows you to set money aside in Health Savings Account (HSA); the funds in this account can be used to cover the costs you may incur. A very risk averse person would likely lean toward the Traditional plan, and person who wants to have more control over how their health care dollars are spent will likely lean toward the High Deductible plan.

Q: How do I choose a health plan: Step 2 – SelectHealth vs Aetna

A:  This choice rests on which network you are more comfortable with. SelectHealth is mainly the Intermountain Health Care (IHC) network, whereas the Aetna network is essentially the Non – IHC affiliated hospitals and clinics.   This would include Mountain Star, Iasis, and University of Utah Health Care clinics and hospitals. Some individuals might have strong opinions toward one carrier or the other, while others don’t really care at all. The plan designs are equivalent and you should receive excellent care through both networks. There is a small advantage with the Aetna plan because you can access a national network outside of the Utah region; but, locally there would be little to no advantage. If you don’t have strong feelings toward one or the other you may want to look at the list of covered hospitals, on page 7 & 8 of the benefit guide, and select the network with the hospital closest to your home.

Q: How do I choose a Health plan: Step 3 – Base vs Buy Up?

A: This is question largely about out-of-network coverage. While the base option has regional network agreements that allow participants to receive emergency services out of the Utah region, they don’t provide any kind of out-of-network benefit. The Buy Up option allows you to have out-of-network coverage. There are two advantages to the buy up:  first, some participants who travel might have concerns about finding a doctor to treat a medical need while traveling, this option allows them to get services almost anywhere.  Second, some people have a specialist that they like to visit that may not be in their preferred network; the buy up allows them to have coverage for this out-of-network specialist. To participants on the SelectHealth plans there is also the advantage that allows them to receive non-emergency services through the regional network agreement providers. The additional cost is substantial, so you will want to consider your projected out-of-network costs carefully before you select this option.

Q: I don’t understand the HSA tax dependent rules. Who can I use my HSA dollars for?

A: Because the HSA is governed by the IRS, the HSA regulations follow tax law for dependency. This means that the funds can only be used for medical expenses for either you and your tax dependents. In short if you claim them on your taxes, as a dependent, you can use your HSA dollars for their approved expenses.  If you don’t claim them as a tax dependent, you can’t use your HSA to pay for their expenses. The confusion comes because the Affordable Care Act allows children to stay on a parents health plan until they reach age 26, but dependents who are in there 20’s may, or may not be a tax dependent. Let me give you an example, I have two children one age 22 and one age 24. The 22 year old is a student and living at home, I claim him as a dependent for taxes. The 24 year old has graduated from college, is married and has started a career; I don’t claim her on my taxes. I am however, covering both children on my health insurance. I can use my HSA to cover the medical expenses of the 22 year old because they are still my tax dependent; however, I can’t use my HSA to cover the expenses of the 24 year old because I no longer claim her as a dependent on my taxes.

Q: I am seeing Aetna, not Altius, as a carrier choice. did we change carriers?

A: In 2014 Altius was purchased by Aetna. Since that time Aetna has been working on consolidating the newly acquired clients onto the Aetna infrastructure. This change to the Aetna system for our plans occured on January 1, 2016.  The networks are vary sililar to the old Altius network.  The change is largely in name only.

Q: I am seeing APA benefits as the administrator for the Flex spending and HSA accounts; is this a new Carrier?

A: We have been working with APA benefits for some time now. APA benefits acquired Custom Benefit Solutions our previous flexible spending and COBRA administrator. We transitioned to the APA benefit structure on January 1, 2016. We expanded our contract with APA benefits for them to also administer the HSA. We do not anticipate any adverse impact to the participants. This transition required new, flexible spending debit cards to be issued. All participants who elect to participate in the Flex or the HSA and request a debit card will receive two cards in the participant’s name. An annual $18 debit card fee will be assessed to your account if you elect for the card.

Q: Will my premiums change?

A: The health Insurance premiums for will increase by 7% in the 2017 benefit year.    This increase was determined by multiplying the total premium (employee + employer portion) by 7% then deviding that increased amount in half and allocating half to the District portion and Half to the employee portion.

Q: Will my benefits change?

A: Aside from the 7% rate increase on the total Premium that was divided equally between employees and the District, we needed to make changes to the Traditioanl Plan.  Those Changes are as follows:

 -Change In deductible from $500/$1,500 to $750/$2,250
 -Change in out‐of‐pocket max from $2,500/$5,000 to $3,000/$6,000
 -Change the Emergency Room copay from $100 AD to $150 AD
 -Inpatient copays are changing to 20% after deductible.
There were not any plan design changes to the High deductible plan, other than the rate increase.

Q: Why are Socials Security numbers required for my dependents?

A: The Social Security Number is the unique identifier used by insurance companies to reconcile claims data when more than one carrier is involved. Starting January 2015, the Affordable Care Act requires that pharmacy claims and health insurance claims both count toward the annual out-of-pocket maximum. While this is a small change to the plan design it requires a major change to the administrative process. In order to accumulate claims data toward the annual out-of-pocket maximum, the carriers must communicate and reconcile claims between the pharmacy and health administrators. If dependent Social Security Numbers are not recorded in the enrollment system then the claims incurred will not accumulate toward your out-of-pocket maximum correctly. If you do not have Social Security Numbers for your Dependents, please contact the Insurance Department as soon as possible at 801-826-5428 or send an email to This email address is being protected from spambots. You need JavaScript enabled to view it. and we will assess your situation to determine your options.

Q: Some of the benefits are indicating “Plan Disabled.”

A: When there is an indicator showing “Plan Disable,” this signifies that another step must be completed before the plan is activated.   The enrollment system is designed around a specific procedure.  Some benefits are contingent on other benefits being selected or waived.   For instance, the HSA benefit might show as “disabled” because the health plan election has not been finalized.  If an employee doesn’t enroll in a Qualified High Deductible Plan, they would not be eligible to enroll in the HSA and it consequently would not be an option for them.   When you select the “Next” button, the system will take you to the section of the enrollment tool that is next in the process.