2014 Open Enrollment for
Health Benefits
and
Flexible Spending Accounts
All handouts are available online!
• Please take only what you need
• Please don’t throw handouts away on your way out
• Please return what you don’t use
What’s New for 2014-2015?
• Premiums increase for most plans
• COVA Care prescription copays increase for tiers 2-4
• 2 more “do-right” options for COVA HealthAware members
• Residential treatment for behavioral health now covered in all
COVA Care, COVA HealthAware and COVA HDHP plans
• New Asthma/COPD and hypertension incentive programs
added to MyActiveHealth
• FSA claims filing period extended for accounts that end
during the plan year
Flexible Spending
• All current flexible spending accounts end June 30, 2014
and are not renewed. Final payroll deduction July 1, 2014.
• To participate effective July 1, 2014 you must enroll during
open enrollment.
• If you do not enroll during open enrollment, you will not
have another opportunity to enroll unless you experience a
qualifying mid-year event.
Flexible Spending
• $2,500 maximum for medical account
• $5,000 household maximum for dependent care account:
Flexible Spending
• Elections are made in per-pay-period amounts. There are
24 pay periods in the plan year
• Elections must be made in even dollar amounts (no cents)
• Minimum election to participate is $10 per pay period for
either type of account (medical or dependent care)
• Monthly participation fee deducted from your paycheck
Flexible Spending
• Flexible spending administrator is Anthem
• New medical FSA participants receive a Blue Cross Blue
Shield FSA debit card. Previous participants receive new
balance on existing card.
• Dependent Care FSA participants
file for reimbursement
Flexible Spending
• Current participants have until September, 2014 to submit
claims to Anthem/Conexis for expenses incurred on or prior
to June 30, 2014.
• NEW! If you have an FSA for only part of the plan year,
you may file FSA claims for up to 3 months after your
coverage period ends.
Flexible Spending
• All part-time and full-time faculty and classified staff are
eligible for flexible spending
• No health plan participation is required
2014 Open Enrollment – Plans Offered
•
•
•
•
•
COVA HealthAware (Aetna)
COVA Care (Anthem)
COVA High Deductible Health Plan (Anthem)
Kaiser Permanente (NoVA, MD, DC, Fredericksburg only)
TRICARE Supplement Plan
COVA HealthAware
• Health Reimbursement Arrangement (HRA) for medical,
behavioral health and prescriptions:
– Employee: $600 / Employee + Spouse: $1,200
• Receive more HRA funds by completing one or more “do
right” activities
– Up to $150 additional for employee
– Up to $150 additional for spouse
• Unused HRA funds may carry forward into future benefit
periods. HRA pays before FSA.
“Do Rights”
• $50 added to your HRA when you or your covered spouse
completes up to 3 of these:
•Annual physical
•NEW! Routine vision exam
•Routine dental exam
•Annual flu shot
•NEW! MyActiveHealth
coaching module completion
•MyActiveHealth Health
Tracker usage (3 x month for
each month in a quarter)
• Maximum $150 extra each for you and your spouse
COVA HealthAware
• Most services covered in-network at 80% after deductible
• Out of network included but higher deductible applies and
most services covered at 60%
• Expanded Dental and Vision options
• All services administered by Aetna
• One customer service number for everything
COVA HealthAware
How it works….
1. Your HRA pays medical, behavioral health and
prescription expenses first, automatically.
2. If you have more expenses, you and/or your health FSA
pay all expenses until you reach the deductible.
COVA HealthAware
How it works (continued)….
3. Once you satisfy the deductible, the plan pays 80% of
covered expenses in-network (60% out of network) and
you and/or your health FSA pay 20% (40% out of network)
until you reach the out-of-pocket maximum. Expanded
Dental benefits are separate and have a separate
deductible.
COVA HealthAware
How it works (continued)….
4. When you reach the out-of-pocket maximum, the plan
begins paying 100% of covered expenses for the rest of
the plan year – except dental. Expanded Dental
expenses do not count toward the out-of-pocket
maximum.
COVA HealthAware
Remember:
Although out-of-network coverage is included, your
deductible, coinsurance and out-of-pocket maximum are
higher when you use out-of-network providers.
COVA HealthAware
www.covahealthaware.com
COVA HealthAware
Use Aetna Navigator secure member web site to:
• Track your HRA balance
• Print a temporary ID card or order a new card
• Track your deductible and out-of-pocket expenses
• Check the price of a drug before you go to the pharmacy
• Access the Member Payment Estimator
COVA HealthAware
Employee Premium Changes for 2014-2015
• No premium increase for single basic coverage
• $1.50 per paycheck increase for dual basic
• $1.50 per paycheck increase for family basic
COVA Care
•All medical, behavioral health, EAP and vision benefits
administered by Anthem
•Prescription benefits administered by Anthem Pharmacy
through Express Scripts
•Dental benefits administered by Delta Dental
COVA Care
•Co-payment for most services
•Co-insurance for laboratory & diagnostic services
•Nationwide coverage through BlueCard program, and
international coverage through BlueCard Worldwide when
traveling
COVA Care
What’s Changing for 2014-2015?
•Tier 2 prescription copay increases from $25 to $30 at retail and from
$50 to $60 for mail order.
•Tier 3 prescription copay increases from $40 to $45 at retail and from
$80 to $90 for mail order
•Tier 4 prescription copay increases from $50 to $55 at retail and from
$100 to $110 for mail order
•Residential treatment added to behavioral health benefits
COVA Care
Employee Premium Changes for 2014-2015
• $1.50 pre paycheck increase for single basic coverage
• $3.50 per paycheck increase for dual basic
• $5.00 per paycheck increase for family basic
COVA High Deductible Health Plan (HDHP)
•No plan changes, except coverage added for residential
treatment to behavioral health benefits
•Premium for basic coverage still $0 for faculty and
classified staff who work 80% full-time or greater
Important Dental Coverage Reminder
•Only preventive dental is included with COVA
HealthAware, COVA Care and COVA HDHP basic plans.
Routine dental services are not included in the basic
plans.
•If you need more than preventive coverage, remember to
add Expanded Dental to your plan during open
enrollment!
Kaiser Permanente HMO
•NEW! Pediatric eyewear benefit added
•Premiums increase $3 for single coverage, $7 for dual
coverage, $10 for family coverage
Service area remains limited to:
•Northern Virginia
•Maryland
•DC
•Fredericksburg
TRICARE Supplement Plan
Available to these employees and their
dependents:
• Military retirees
• Spouses or surviving spouses of military retirees
• Must be eligible for TRICARE military benefits and
ineligible for Medicare
•
No plan design or premium changes
Administered by ASI Insurance
Premium Rewards
Earn a discount on your COVA HealthAware or
COVA Care premium!
Annual premium savings:
•Employee or Spouse - $204 ($17/month)
•Employee and Spouse - $408 ($34/month)
Premium Rewards
•If you and/or your spouse have a premium reward in force
right now (January –June, 2014), the reward will continue
through June, 2015 as long as the person who earned the
reward remains enrolled in COVA Care or COVA HealthAware.
•You can change plans between COVA Care and COVA
HealthAware (or vice versa) and keep your premium reward.
Premium Rewards
•If you have been enrolled in COVA Care or COVA HealthAware
since July 1, 2013 but do not currently have a premium reward, you
can earn one effective July 1, 2014!
•Complete a health assessment and biometric screening no later
than May 31, 2014.
•If you lost your premium reward January 1, 2014, you can earn it
back by completing a biometric screening no later than May 31,
2014.
Premium Rewards
•If you and/or your spouse enrolled in COVA Care or
COVA HealthAware between August 1, 2013 and March 1,
2014, you can each earn a premium reward effective July
1, 2014 by completing a health assessment and biometric
screening no later than May 31, 2014.
Premium Rewards
•If you and/or your spouse enrolled in COVA Care or COVA
HealthAware between April 1, 2014 and June 1, 2014, you can each
earn a premium reward by completing a health assessment and
biometric screening:
•Rewards are effective as follows:
Complete both activities by…
Reward effective…
June 30
July 1
July 31
August 1
August 31 (last chance!)
September 1
Premium Rewards
•If you and/or your spouse are newly enrolling in COVA
Care or COVA HealthAware effective July 1st, you can
each earn a premium reward by completing a health
assessment and a biometric screening:
Complete both activities by…
Reward effective…
July 31
August 1
August 31 (last chance!)
September 1
Premium Rewards
How to Complete the Health Assessment
•Register or log in to www.myactivehealth.com/cova.
•Go to the health assessment link and answer questions.
•Click “Complete and Save” to submit.
•Your spouse needs to register separately to complete the health
assessment.
•If you don’t have Internet access, you may call Active Health at 866938-0349 to complete the health assessment by phone.
Premium Rewards
How to Complete the Biometric Screening
•Register or log in to www.myactivehealth.com/cova. Your spouse
needs to register or log on separately.
•Go to the biometric screening link
•Print either a:
•Biometric Screening Physician Form to take to your doctor, or
•LabCorp authorization to take to a location that is convenient for you
•Be sure to follow all instructions on the form or authorization
Premium Rewards
Need Help?
Call ActiveHealth at 866-938-0349 to:
•Get detailed instructions about completing the activities or for help
with the web site
•Find out whether you are on record as having completed either or
both activities
•Important: ActiveHealth cannot tell you whether you have earned a
premium reward, only whether you have completed activities.
Premium Rewards
Need Help?
Not sure if you’re getting a premium reward?
•Log on to Employee Direct using your health plan ID number at
http://edirect.virginia.gov.
•Contact VCU Benefits to check your reward status
•Important: VCU does not approve or deny premium rewards, but
we can check the reward status in your state health plan record.
Only rewards approved by the state health plan result in lower billing
to your VCU paycheck. VCU cannot see your health activities record
or data.
Premium Rewards
More About Active Health
•The state health plan has safeguards in place to ensure
that your personal information on the MyActiveHealth
portal is not shared with VCU.
•The state health plan confirms that all data from your
health assessment and biometric screening is completely
secure. The data is available to you and also your doctor
at your request.
Premium Rewards
More About Active Health
•ActiveHealth uses health information to identify possible health
issues and to help you and your doctors track and improve your
health. Participation is voluntary.
•You may call ActiveHealth to “opt out” of the program. Just
remember that since ActiveHealth administers the Commonwealth’s
incentive programs, you will be unable to receive any program
incentives in the future, including premium rewards.
MyActiveHealth
Oversight for incentive programs
•Premium Rewards
•Bariatric surgery pre-education program
•Diabetes management
MyActiveHealth
Holistic health management
•Healthy Insights – Disease Management
•Healthy Beginnings – Maternity Management
•Healthy Lifestyles – Coaching
•Incentive programs can include free supplies or
prescriptions for specified conditions, copay waivers, or
HRA contributions.
MyActiveHealth Portal Registration
•Visit www.myactivehealth.com/cova
•Click on “Create Account” and use 00+health plan ID for employee
ID
•Enter your information to create User ID and password
New ActiveHealth Program for 2014-2015
•For members with asthma, COPD and hypertension
•May allow participants to get certain drugs at no cost to
manage these conditions.
•Program criteria must be met to qualify
More MyActiveHealth Services
•Digital coaching
•Interactive trackers, games and more
•Telephone support
Choosing Your COVA Plan
Use the Alex online tool to compare COVA
HealthAware, COVA Care and COVA HDHP.
www.alexforcova.com
The tool helps you project your out-of-pocket
expenses under each plan.
Making Your Open Enrollment Elections
Use the Open Enrollment Checklist, then:
•Make your elections online using Employee Direct
•Submit dependent documents to VCU Benefits if
you are adding dependents to your health plan
Making Open Enrollment Elections
If you use a paper enrollment form instead of
Employee Direct, it must be received by VCU
Benefits by 5pm on May 23rd!
If you use Employee Direct, you must complete
your online transaction by 11:59 pm on May 23rd!
Everyone’s Favorite Question!
If I don’t do anything during open
enrollment, everything stays the
same, right?
…and the answer is
NO!
FSAs are never automatically renewed
If you take no action during open
enrollment…
•Your flexible spending account will end on June 30,
2014! Final contribution on July 1, 2014 pay date.
•You can lose your opportunity to earn a premium reward
if you don’t have one right now
•Your health plan choice and membership will stay the
same
What can you do during Open Enrollment?
•Change your health plan
•Add or drop optional coverage
•Waive health coverage for the next plan year
•Enroll effective July 1 from waived status
•Add or remove eligible family members
•Remember: Documents proving eligibility are required
whenever you add someone to your plan.
•Enroll in flexible spending for the 2014-2015 plan year
Important Steps
•Carefully read all 12 pages of your Spotlight
Newsletter
•Use the VCU Open Enrollment Checklist
•Visit plan web sites
•Be sure your doctors are in the provider network
for the plan you choose
•Check the coverage for your prescription drugs
Final Answer Due May 23!
•Even if you’re on vacation or leave!
•Even if you’re on VSDP!
•Even if you’re a forgetful person!
•Even if your computer or fax machine broke!
•Even if the dog ate your form!
Don’t wait until the end…the state does not allow
VCU to grant extensions!
When Do Open Enrollment
Changes Become Effective?
•Open enrollment election become effective on
July 1, 2014
•Changes are reflected in payroll deductions
beginning on the July 16, 2014 pay date
We’re Here to Help!
VCU Benefits
827-1723
benefits@vcu.edu