To:
Benefit Eligible Employees
From:
Jesse Albers – HR
Manager of Compensation and Benefits
Date:
October 1, 2015
Re:
Open Enrollment
Medical, Dental, and Flexible Spending Plans
Every year, eligible employees are given the chance to enroll, change their enrollment level or cancel without an IRS
qualifying event such as a birth, marriage, or change in spouse’s plan. Open Enrollment will be from November 1. 2015
through November 25, 2015. To enroll in either the medical or dental plans or make enrollment changes in these plans,
please complete the appropriate enrollment form and return it to Human Resources before November 25, 2015.
Enrollments or changes will take effect on January 1, 2016. Forms can be picked up in HR or printed off the HR website.
Please note that if you are presently enrolled in the Health or Dental plan and are not making any changes, you do not
need to fill out any forms. However, each year you MUST complete a new form with a new election for the Flexible
Spending Plan. Should you have any questions or need assistance with any of these topics, please call Jesse Albers at
403-3982.
MEDICAL and DRUG PLAN
There will be no changes to the premiums for the Preferred Provider Option (PPO) and High Deductible Health Plan (with
Health Savings Account) for the 2016 calendar year. This is great news having the premiums the same for two years.
There are a few things that will change due to Affordable Care Act mandates that take effect January 1, 2016 and some new
internal programs approved by the College:

The Out-of-Pocket Max for any one person in the Family HDHP is limited to $6,550 for in-network services. The
current language states that any one person in the family plan could pay up to the $8,000 out-of-pocket max. The
ACA is now putting a limit on any one person in a family plan.

Mail Service Saver Program – we sent this info out last spring and we also had Optum Rx on campus to help those
looking to transfer any eligible meds to mail order in advance of this program starting. An announcement letter
from Optum Rx will be sent out in December along with any medications you have that should be transferred to
mail order service. After January 1, 2016, you will receive trigger letters after you complete a retail fill and if you
do not change to mail order within 2 months, the third retail fill will cost you double of the normal copayment.
Here is the OPTUM Rx flyer:
http://www.snc.edu/hr/documents/Medical_Dental_Flexible_Spending/Medical_+_Prescription_Drugs/Prescripti
on_Drug_Forms_and_Communication_Materials/Mail_Order/Mail_Service_Saver_Program_2016.pdf

Plans must cover an expanded list of tobacco cessation products (Rx and OTC) at zero cost for members ages 18
and older. Here is the flyer from OPTUM Rx on this :
http://www.snc.edu/hr/documents/Medical_Dental_Flexible_Spending/Medical_+_Prescription_Drugs/Prescripti
on_Drug_Forms_and_Communication_Materials/Programs/Tobacco_Cessation_Program.pdf

Spousal Surcharge – St. Norbert College’s medical plan implemented a plan change requiring that an employee’s
spouse enroll in at least single medical coverage through his/her employer to serve as their primary insurance
coverage, or pay an additional surcharge to enroll in St. Norbert College’s medical plan as primary coverage. This
additional surcharge is $37.50 twice per month ($900 annually). Remember, you must notify St. Norbert
College’s Human Resources if you have your spouse on your plan and their eligibility for insurance coverage
changes. Please understand that intentional misrepresentation of any information constitutes fraud and is a serious
violation of College policy, which may result in financial consequences and/or disciplinary action. So please keep
your spousal status updated regarding their coverage.
Here is the form:
http://www.snc.edu/hr/documents.html?d=/Medical_Dental_Flexible_Spending/Medical_+_Prescription_Drugs/E
nrollment_and_Change_Forms
If you need to make changes to your plan or dependent status, please complete the following form and return to Human
Resources by November 25, 2015:
http://www.snc.edu/hr/documents/Medical_Dental_Flexible_Spending/Medical_+_Prescription_Drugs/Enrollment_and_C
hange_Forms/2015_Enrollment_Form.pdf
DENTAL PLAN
There will be no changes to the premiums or plan design as we continue to use Delta Dental for our claims processing.
If you need to make changes to your plan or dependent status, please complete the following form and return to Human
Resources by November 25, 2015:
http://www.snc.edu/hr/documents/Medical_Dental_Flexible_Spending/Dental/Forms/Delta_Enrollment_form.pdf
FLEXIBLE SPENDING PLAN
We will continue to use Employee Benefits Corporation (EBC) as our administrator. If you want to participate in the next
plan year (1/1/16 – 12/31/16), you must complete the enrollment form:
http://www.snc.edu/hr/documents/Medical_Dental_Flexible_Spending/Flexible_Spending_Account/2015_EBC_Enrollmen
t_Form.pdf
Rollover Provision - any unused amount (but not more than $500) remaining at the end of a Plan Year in a Participant’s
Flexible Spending Health Care Account will be carried over to (and be available for reimbursements of qualifying Health
Care Expenses incurred in) the following Plan Year with no effect on the run-out period. 2015 Plan year (1/1/15 –
12/31/15) was the first plan year we implemented this.
Please remember that employees who are enrolled in the High Deductible Health Plan and have a Health Savings Account
can’t participate in the normal flexible spending at SNC or their spouses/partner plan, only the limited flexible spending
plan. Those who want to move from the PPO to HDHP with a Health Savings Account will not be eligible to accept the
College’s contribution to the Health Savings Account or deposit your own dollars unless you have completely depleted your
Flex account by December 31 or moved the rollover amount to a Limited Flex Only plan (Vision and Dental expenses only)
Finally, for expenses incurred in 2015, please remember that claims must be submitted by March 31, 2016 like in the past.
OPEN ENROLLMENT GROUP EDUCATION
October 22, 2015 - Fort Howard Theatre
9:00 am – 10:00 am
11:00 am – Noon
November 9, 2015 – Michels Ball Room
10:30 am – 11:30 am
12:30 pm – 1:30 pm
We really hope you can make one of these sessions to discuss any of the plan changes, new programs, or open enrollment
processes that become effective January 1, 2016. We will have prizes and giveaways again including a Fit-Bit as our
grand-prize drawing.
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