2015 Annual Benefits Enrollment Guide
North Texas (NTX)
BSWH Benefits Enrollment Guide (NTX)
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Table of Contents
Enrollment Overview
What’s New in 2015?
Enrollment Checklist
Enrollment Eligibility
Enrollment Process
Medical Overview
How the Medical Plans Work
Selecting a Medical Plan
Quality Alliance/Preferred Network
Health Accounts
Making Plan Choices? Ask Alex
Dental
Vision
Prescription Drugs Overview
Baylor Pharmacy Discounts
Medical Management of Prescription Drugs
More about Prescription Drugs
Flexible Spending Accounts Overview
How FSAs Work
How FSAs Save You Money
FSA Rules
Protection Overview
Life Insurance
Accidental Death & Dismemberment
Disability
401(k)
Life Benefit Specialists
Time Away from Work
Work/Life
Tuition Reimbursement
Employee Discounts
Legal Services
Resources
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It’s time to enroll in your 2015 benefits.
We know you work hard to make us the best place to give and receive safe, quality, compassionate care.
So it’s important to us to be able to provide high-quality benefits to you and your family. As you know
all too well, the cost of health care and other benefits continue to rise. We worked hard to create a
benefits program that offers the coverage you need at an affordable price while remaining consistent
with our mission.
Use this website to understand the changes coming in 2015 and make the benefits selections that work
best for you and your family.
Get started by reviewing the information below:
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Enrollment Checklist
What’s new in 2015?
Eligibility
Enrollment Process
Quality Alliance and Preferred Network
Need Help?
At any point if you need help with enrollment, contact the HR Center at 877-44MYJOB (877-446-9562)
Monday through Friday, 8 a.m. to 5 p.m.
For information on your 2014 benefits, please visit benefits.mybaylor.com/2014.
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What’s New in 2015?
Over the last year, we’ve made progress toward integrating some of our Baylor and Scott & White
Health benefits. You’ll see some of those changes in this enrollment season. Next year and into 2016,
we will continue our benefits integration, including developing a common medical plan. We will keep
you up to date on any changes as we progress.
What's different in 2015?
What stays the same for 2015?
Eligibility for benefits
Long-Term Disability
Medical
Short-Term Disability
Dental
Life and AD&D insurance
Vision
Discount Program
FSA/HSA vendor
Thrive Wellness Program
Employee Assistance Program
Legal Services
Eligibility
We’ve changed our benefits eligibility. If you are scheduled to work 60 hours or more each pay period
(previously 64 hours), you are now eligible for full-time employee benefits. We will continue to offer
benefits to part-time employees (those who work 40 to less than 60 hours per pay period).
Medical Plan Costs
Our Preferred Network has helped us control cost over the last year. In fact, by using the Preferred
Network and making smart choices, such as getting preventive care, using generic drugs when possible,
and establishing a relationship with a primary care physician in the Preferred Network, has helped us
keep our medical cost increase significantly below many other companies. Your medical insurance rates
will increase 4% in 2015, significantly less than the average industry trend of 8%.
When you use Preferred Network providers, you’ll continue to pay the lowest copays and coinsurance
no matter which medical plan you select. The Preferred Network is made up of BSWH facilities,
providers in the Baylor Scott & White Quality Alliance (BSWQA), as well as certain Aetna network
pediatricians.
To ensure you are using the Preferred Network, visit the Aetna DocFind at
aetna.com/docfind/custom/baylor. This site is customized for Baylor Scott & White employees.
Bookmark it to use any time you need to locate doctors and facilities in the Preferred Network.
Medical Copays and Coinsurance
For the Gold, Silver and HSA medical plans, the coinsurance will remain at only 10% of the cost for
Preferred Network providers and facilities. However, if you choose to use a provider or facility outside
of the Preferred Network, your share of the cost will increase to 50% for Aetna providers. Out of
network care will remain at the highest cost of 70% coinsurance.
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Copays for the PPO plan option will also remain at the lowest levels for Preferred Network providers
and facilities. The copay cost will increase for Non-Preferred Network providers.
Regardless of the plan you choose, emergency care at a Non-Preferred Network facility is not increasing
and will remain at 35%.
To conform to Affordable Care Act (ACA) guidelines, the out-of-pocket limits will increase slightly for
some levels of coverage. However, there will be no increase in out-of-pocket limits at the Preferred
Network level.
Flexible Spending Account (FSA) and Health Savings Account (HSA)
We are changing our FSA and HSA partner to WageWorks. If you enroll in one or both of these
accounts, you will receive a new debit card from WageWorks for your 2015 expenses. In addition to
pharmacy costs, you’ll now be able to use your debit card for eligible medical, dental, and vision
expenses.
Dental Plan
Through some plan efficiencies, we are able to provide a slight premium reduction to all the dental
plans. We will also be adding adult orthodontia to the PPO Plus dental plan option.
Vision
Rates for vision care will increase slightly in 2015. Some of this increase is necessary to cover the taxes
associated with the Affordable Care Act. Eye exam copays will also increase to $20.
Time Off
PTO levels remain the same for 2015; however Baylor Scott & White Health will no longer offer the
option to use future PTO time to help pay for health insurance costs during annual enrollment.
Remember, if you are a full-time employee earning less $12/hour, your medical rates are significantly
lower than those whose earnings are more than $12/hour.
Employee Assistance Program
We’re improving our Employee Assistance Program (EAP) by increasing the number of face-to-face
sessions to six per year.
Legal Services
Beginning in 2015, you can now elect coverage through Hyatt Legal Services, which provides access to
the country’s largest network of legal benefit providers for a relatively low cost to you. If elected, you
can get professional legal assistance with issues like:
• Creating a will or living will
• Buying, selling or refinancing houses
• Reviewing important paperwork
• Losing a spouse or parent
Wellness Credit
We want to reward you for getting and staying healthy. In 2015, employees can now earn a $30 credit
per pay period through the Thrive wellness program if you are enrolled in a medical plan and complete
the steps below.
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1. Submit the 2015 Health Screening Form by November 30. The date of service with your
physician visit can be anytime from December 1, 2013 thru November 30, 2014.
2. You must complete the Online Wellness Assessment at thriveforwellness.com by November 30
(even if taken earlier in the year).
* The Thrive wellness credit will start with the second paycheck of 2015 in mid-January when medical plan deductions
start.
All employees and spouses are eligible to earn the Thrive rewards related to the wellness
challenges. Employees and spouses will need to complete the steps above to earn your rewards
in 2015.
Tobacco Surcharge
You must validate tobacco use for both you and your dependents on the benefits enrollment site. There
is a $30 per pay period tobacco surcharge for tobacco users.
* The tobacco surcharge will start with the second paycheck of 2015 in mid-January when medical plan deductions start.
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Enrollment Checklist
Before Annual Benefits Enrollment:
• Review this website and the Enrollment Brochure you received at home
• Mark your calendar. The enrollment period is Nov. 3-14.
Enrollment Access, Timeline, and Resources:
• Enroll between Nov. 3-14
• To enroll, go to the “Your Benefits” tab in HRWorkWays at myBaylor.com or
YBR.com/benefits/baylor (for Medco employees) to enroll
• Use the “Making Plan Choices? Ask Alex” tool to help with benefits decisions. This tool can
help you with all benefits, not only medical.
• Use Aetna’s DocFind tool customized for our employees to see if you physician is in the
Preferred Network
• Meet the deadline. If you do not enroll by Nov. 14, you will default to the same coverage you
had in 2014. You will not be able to enroll again until the next Annual Enrollment – unless you
have a qualifying event.
Review and Update all 2015 Benefit Options:
To ensure you have reviewed all of your benefit options and selected the coverage you need, go through
the checklist below. Be sure to review the options, changes and costs. Also, don’t forget to update your
beneficiary information at this time.
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Medical
Dental
Vision
Flexible Spending Accounts
Basic Life and AD&D Insurance
Employee Paid Short-Term Disability
Long-Term Disability
Additional Life and AD&D Insurance
Hyatt Legal Services
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Enrollment Eligibility
Who’s eligible for benefits?
You, if you are:
• a full-time employee regularly scheduled to work at least 60 hours per pay period,
• a Two-Day Alternative (TDA) employee, or
• a part-time employee regularly scheduled to work 40 to less than 60 hours per pay period (with a
full-time equivalent of .5 or greater).
Your spouse or common-law spouse
• You must be legally married as defined by Texas law.
• If you and your spouse or dependent both work for Baylor Scott & White, only one may be
covered as a dependent — neither can be covered as both an employee and a dependent on the
same plan.
Your children
• Dependent eligibility varies between the Baylor Scott & White benefit offerings. The chart below
shows the definitions and eligibility for our Medical, Dental, Vision, Life and Accidental Death
& Dismemberment (AD&D) offerings.
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Things to Remember:
Documentation for Dependents
If you add a new dependent, you will be asked to provide documentation at a later date to verify that he
or she is eligible for coverage under Baylor Scott & White’s plan guidelines.
Enrollment Deadline
Remember to complete and submit your elections during Nov. 3-14. If you don’t complete enrollment
within that time, your benefits selections from 2014 will automatically renew for 2015. If you don’t
currently have Baylor Scott & White benefits and don’t complete enrollment, you won’t have benefits
through Baylor Scott & White in 2015, with the exception of Basic Life and AD&D, Short-Term
Disability, and Long-Term Disability, in which you will be automatically enrolled. You won’t have
another opportunity to elect to participate in the Baylor Scott & White benefits plan until annual
enrollment in the Fall of 2015, unless you have a qualifying event — such as spouse job loss, marriage,
birth or adoption of a child, death of a dependent, etc.
Changing Your Benefits Outside of Enrollment Period
If you have a qualifying life event during the year, this may allow you to enroll or change your benefits
outside of the annual benefits enrollment period. You must notify Baylor Scott & White within 31 days
of the qualifying life event to enroll or make changes to your benefits. Benefits will begin or end on the
qualifying event date. Examples of qualifying events include marriage, divorce, birth, or adoption of a
child, death of a dependent. Learn more about qualifying life events on the Your Benefits tab in
HRWorkWays at myBaylor.com.
Other Benefits
Check out the More Benefits section to find information about benefits you automatically receive and
Baylor Scott & White’s 401(k) plan, which has a separate enrollment process.
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Enrollment Process
Enrollment is easy through HRWorkWays. Just follow the steps below!
All employees (except Medco and those on leave of absence*):
1. Log on to HRWorkWays from myBaylor.com.
2. Click the Enroll in Your 2015 Health & Insurance Benefits link.
3. Click on Enroll Now! Review your options and use the tools to find the benefits that are right
for you.
4. You’ll be taken to the Wellness Program page. Click the Take the Wellness
Assessment button to take the Wellness Assessment. Or, click Continue.
5. Add your dependent information, if necessary.
6. Select your 2015 benefits.
7. Save your choices by clicking on Complete Enrollment. You’ll still be able to make changes at
any time during Nov. 3-14.
8. Click on the print icon to print Your Benefit Choices and your Confirmation Number for
your records before exiting the system.
*Medco employees and those on leave of absence: Go to www.ybr.com/benefits/baylor
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Medical Overview
You have four medical plans to choose from:
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a Preferred Provider Organization (PPO),
two Consumer Driven Health Plans (CDHPs) with Health Reimbursement Accounts (HRAs),
and
one CDHP with a Health Savings Account (HSA)
All four plans are administered by Aetna and cover the same services. The big difference between the
plans is how you pay for expenses before and after you meet your deductible. See How the Medical
Plans Work for more information.
Remember when you use a Preferred Network provider for your care; your office visit copays,
coinsurance and out-of-pocket costs will be lower. The Preferred Network includes all Baylor Scott &
White Facilities and providers who participate in both the Aetna Network and the Baylor Scott & White
Quality Alliance (BSWQA) and is supplemented with Aetna pediatricians with admitting privileges at
Baylor facilities, Children’s Health™ Children’s Medical Center Dallas, Children’s Health™ Children’s
Medical Center Plano, or Cook Children’s Health Care System facilities.
To ensure you are using the Preferred Network, visit the Aetna DocFind at
aetna.com/docfind/custom/baylor. This site is customized for Baylor Scott & White employees.
Bookmark it to use any time you need to locate doctors and facilities in the Preferred Network.
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How the Medical Plans Work
Select one of the four plan options below when you enroll. You can also select to receive added savings
at the time you receive care by using the Preferred Network.
All four plans cover eligible preventive care at 100% when using a Preferred Network provider or an
Aetna provider in-network. The plans differ when it comes to how you pay for expenses before and
after you meet your deductible. The other big difference in the plans is that the Consumer Gold and
Silver plans offer health reimbursement account (HRAs), while the Aetna Medical HSA plan offers a
health savings account (HSA). Here's a rundown of how the plans work, starting with how Baylor Scott
& White can help offset your costs.
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Aetna Consumer Gold & Silver Plans Limit Expenses for Families
If you choose the Aetna Consumer Gold or Silver option for you and your family (Employee + Spouse
or Employee + Family coverage) and a family member reaches $1,800 (Gold option) or $2,300 (Silver
option) in expenses, the plan begins paying at the coinsurance rate for expenses incurred by that same
individual — even if the full deductible has not been met. Other family members' expenses must be paid
out of pocket until you meet your full deductible and will apply to your deductible until you reach your
out-of-pocket maximum.
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Selecting a Medical Plan
Everyone likes choices. But, sometimes comparing your choices can be tough. Take a look at the
comparison chart below to help you make your decision.
The Preferred Network
No matter which plan you choose during enrollment, you can always elect to use a Preferred
Network provider when you need care. You’ll receive lower office visit copays, coinsurance and out-of
pocket costs using the Preferred Network.
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Quality Alliance/Preferred Network
Using the Baylor Scott & White Quality Alliance and the Baylor Scott & White Preferred
Network
We work hard to be health care leaders and role models in the communities we serve. This commitment
starts with taking care of ourselves; making good health care choices and using the great resources we
have on our team. The Baylor Scott & White Quality Alliance (BSWQA or Quality Alliance), as part of
our Baylor Scott & White Preferred Network, is a great way to bring these together and help the system
provide even better care year over year.
High Quality Care
The Quality Alliance is an industry-leading network of hospitals, physicians and specialists dedicated to:
Improving the patient experience
Improving the health of populations
Decreasing cost
Increasing efficiency
So how does it work? First, Quality Alliance providers must elect to participate. Once a member of the
Quality Alliance, participating physicians gain access to advanced technologies, support tools and
administrative solutions. But, that’s just the starting point.
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Improving Lives and Communities
For The Lives of Patients
What makes the Quality Alliance special is its commitment to integrated, patient-centered care. The
network encourages creating a strong medical home for patients with coordinated touch points across
all care settings. So, you’re sure the team of Quality Alliance physicians and specialists is working
together to provide the most coordinated care possible.
For The Communities We Serve
What’s more important, Quality Alliance members also look beyond individual health. Alliance members
agree to work together to gain a broader perspective on the health of our community. Their shared
knowledge allows the Quality Alliance to more accurately identify health trends, share treatment
successes and evaluate the most effective outcomes — which ultimately benefits the communities they
serve.
By using the Quality Alliance you are doing more than being responsible with your health care use, you
are helping physicians, specialists and hospitals in our community learn more about our collective health
and provide better treatment to our community as a whole.
Growing Network
The Quality Alliance network started just a few short years ago and continues to grow stronger each
year. The network now includes all Baylor Scott & White facilities as well as more than 2,500 other
physicians and specialists in North Texas. And more providers request to join every day.
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Best Care for the Best Cost
As part of the Baylor Scott & White Preferred Network, the Quality Alliance provides you with the best
care at the best cost. You’ll get the highest level of coverage at the lowest out-of-pocket cost. So, be sure
to see if your provider has joined the Quality Alliance. Just check Aetna’s DocFind customized for
Baylor Scott & White employees at aetna.com/docfind/custom/baylor.
The Preferred Network
What is in-network?
In-network includes a select group of health care providers who have agreed to provide services that
meet our standards for quality and cost. Our basic level of in-network providers is in the Aetna network
– available nationwide.
Taking it to the next level.
Baylor Scott & White has taken in-network service to the next level by combining the Aetna network
providers with those who’ve met the high standards of the Baylor Scott & White Quality Alliance
(Quality Alliance)
*Includes pediatricians with admitting privileges at Baylor facilities, Children’s Health℠ Children’s Medical Center Dallas,
Children’s Health℠ Children’s Medical Center Plano, or Cook Children’s Health Care System facilities.
**50% if hospitalized in a non-Baylor Scott & White facility for non-emergency care. Emergency care at a non-Baylor Scott
& White facility is covered at 65%.
How does it work?
As a medical plan participant, you are free to see any provider within the Aetna network and receive innetwork care. But, you will receive the best care at the lowest cost by using a provider who participates
in both the Aetna network and the Quality Alliance.
To see if your provider is part of the Baylor Scott & White Preferred Network, check Aetna’s DocFind
customized for Baylor Scott & White employees at aetna.com/docfind/custom/baylor.
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Health Accounts
If you enroll in the Aetna Consumer Gold or Silver or the Medical HSA, you'll get money from Baylor
Scott & White to help pay your medical expenses. If you enroll in the Consumer Gold or Consumer
Silver plan, you automatically have a Health Reimbursement Account (HRA) funded by Baylor Scott &
White to help offset your higher deductible.
If you enroll in the Medical HSA Plan, Baylor Scott & White will put money in a Health Savings
Account (HSA) for you. In addition, you can contribute your own tax-free money to the HSA. You
must have a physical mailing address (not a P.O. Box) in HRWorkWays to open an HSA.
Review the chart on the next page to understand how these accounts work.
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“Making Plan Choices? Ask Alex”
Picking the right medical plan can be tough. But, help is just a few clicks away.
Check out Aetna’s medical plan comparison tool - “Making Plan Choices? Ask Alex”
Ask Alex is an interactive tool that acts as a virtual benefits counselor to help you understand and select
benefits in a personalized way. It also helps you determine the financial impact of your benefit choices.
It’s easy and can help you pick the right plan for you and your family!
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Dental
You have three dental plans to choose from: the MetLife PPO Standard, the MetLife PPO Plus, and the
Aetna DMO.
MetLife PPO Standard and MetLife PPO Plus
With both the PPO plans, you can go to any dentist you choose, but you'll save money by going to one
in the MetLife Preferred Dental Program (PDP). You have to meet the same deductible for both PPO
plans ($50 Employee Only/$150 Employee + Spouse or Family) before the plan shares the cost of
dental care with you. Preventative Care is 100% covered; you pay $0.
In the MetLife Standard PPO, you pay a higher coinsurance and the annual maximum is lower. It does
not cover orthodontia.
In the MetLife Plus PPO, you pay a lower coinsurance, and the annual maximum is higher. MetLife Plus
PPO covers orthodontia for adults and dependent children.
Aetna DMO
You must choose a primary dentist in the Aetna network if you enroll in the Aetna DMO. This plan
covers basic and major care and orthodontia, but you don't have to meet a deductible. Instead, you pay
fixed copays depending on the procedure. View Aetna's DMO Benefits Summary to see the schedule of
copays.
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Find a dental provider in your network. For the MetLife Dental PPOs, go to www.MetLife.com and
click on “Find a Dentist.”
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Vision
Baylor Scott & White offers one vision plan administered by Superior Vision Services.
How It Works
The plan covers routine exams, lenses, frames and contacts. You can see any doctor you'd like, but you'll
save more money if you go to a doctor in the Superior Vision Services network.
Go to www.superiorvision.com to find a provider in the Superior Vision Services network.
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Prescription Drugs Overview
What you pay for prescription drugs varies based on the medical plan you choose. All prescription drugs
are administered by Express Scripts. The plans pay better benefits when you use a Baylor pharmacy for
your retail purchase — or buy generic. All mail order and specialty prescriptions are filled through
Baylor pharmacies.
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Baylor Pharmacy Discounts
Just as you can save more by selecting the Preferred Network for your care, you can also save on your
prescriptions if you choose a Baylor pharmacy.
Go to a Baylor pharmacy where an additional 4% to 5% average discount is available to medical plan
participants.
Fill your prescription through Baylor pharmacy mail-order program or at any Baylor pharmacy to get a
three-month supply at a two-month supply price. (Note: Consumer-driven plan participants must
exhaust their HRA and meet their deductible first. Medical HSA Plan participants must meet their
deductible first).
Get a 20% discount on over-the-counter drugs when you show your employee badge at any Baylor
pharmacy.
Best Buy!
If you are enrolled in the PPO or have met your deductible in one of the other plans, you’re eligible for
a great deal at a Baylor pharmacy (mail-order or retail). You can get a three-month supply of
prescription drugs at a two-month price.
Go Generic When Available
If you choose to a fill a prescription with a brand-name drug when a generic is available, you will pay the
difference in cost plus the applicable brand copay or coinsurance.
Which drugs are chronic/preventative?
View the specific list of drugs considered chronic/preventative.
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Medical Management of Prescription Drugs
Baylor Scott & White has implemented several programs to help manage prescription drug costs. When
you're at the doctor's office or filling prescriptions, be aware of the following:
Step Therapy
With almost every health condition, there are usually several different prescription drugs to choose
from. In many cases, the medications are very similar or even identical but may vary substantially in cost.
That's where Step Therapy comes in. Before using certain types of brand name medications, you may be
required to try a lower-cost alternative first.
How Step Therapy Works
When you need a new prescription, for certain types of medications you will be required to try the least
costly drug (usually a generic) for treating your condition. If it isn’t effective for you, you may “step up”
to the next low-cost medication until you find the medication that works best. Keep in mind that when
you step up to a brand-name back-up drug, you will pay more.
Prior Authorization
Some drugs need approval before the plan will cover them. If you receive a prescription for a drug that
requires prior authorization, the pharmacist will contact your doctor. When the medication is approved,
you'll pay the applicable copay or coinsurance. If it's not approved and you still want to take it, you'll pay
the full cost.
Quantity Management
Quantity Management means that for certain prescription drugs Express Scripts will limit the amount
you receive at one time based on the manufacturer's recommended dosages.
How Quantity Management Works
Let’s say your doctor decides to increase your dosage from one 10mg pill to two. Instead, with your
doctor’s approval, you could take just one 20mg pill. Another example is for drugs (like inhalers or nose
sprays) that you might not be able to measure easily. When you submit a prescription for one of these,
you’ll receive the recommended amount, which should last until it’s time for a refill. When you submit a
refill prescription, the pharmacist will discuss your options with you. Options could include talking to
your doctor about changing your prescription to a higher strength or seeing if your medicine can be
covered for larger quantity.
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More about Prescription Drugs
Aetna Consumer Plan Participants
When you shop at a Baylor pharmacy, you will get a discount off of the retail price. Then, if you’ve met
your deductible, your coinsurance amount (10% generic, 20% preferred brand-name, 30% nonpreferred brand-name) will be calculated using the discounted retail price.
In the case of chronic and preventive drugs, the pharmacy offers the discount according to whether the
drug is regularly classified as a generic, preferred brand-name or non-preferred brand-name drug. After
the appropriate discount is applied, you pay a coinsurance of 10%. It is not necessary for you to meet
your deductible to pay this amount. For prescription drugs you take regularly, you can also receive a
three-month supply at a two-month price if you’ve exhausted your HRA and met your deductible.
Medical HSA Participants
When you shop at a Baylor pharmacy, you will get a discount off of the retail price. Then, if you’ve met
your deductible, your coinsurance amount (10% generic, 20% preferred brand-name, 30% nonpreferred brand-name) will be calculated using the discounted retail price.
In the case of chronic and preventive drugs, the pharmacy offers the discount according to whether the
drug is regularly classified as a generic, preferred brand-name or non-preferred brand-name drug. After
the appropriate discount is applied, you pay a coinsurance of 10%.
PPO Participants
The PPO offers a set copay amount for prescription drugs. When purchasing prescriptions from any
Baylor pharmacy, participants in the PPO will pay either the copay amount or the price of the drug,
whichever is lower. So if a prescription drug costs less than your copay, you will receive the same
discount (averaging 4% to 5% depending on whether it is generic or brand-name) that Consumer Plan
participants receive. For prescription drugs you take regularly, you can receive a three-month supply at a
two-month price. You will also receive the 20% discount on over-the-counter drugs.
Chronic/Preventive Drugs
If you need one of these drugs, you’ll pay a different amount than shown above. A complete list is
available.
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Flexible Spending Accounts
You have two Flexible Spending Accounts (FSAs) in which you can participate.
Health Care FSAs and Dependent Day Care FSAs let you set aside pre-tax dollars from each paycheck
to pay for out-of-pocket health care and dependent day care expenses. You do not pay federal income
or Social Security taxes on your FSA contributions, which can mean a savings of 15% to 30%,
depending on your tax bracket. If you elect the Medical HSA Plan and set up a Health Savings Account
(HSA), you can still have an FSA, but it will be a Limited Purpose FSA.
Use Online Tools to Estimate Expenses
You'll find tools to help you estimate your FSA expenses at www.wageworks.com.
FSA Debit Card
Participants in all medical plans except the Medical HSA will get an FSA debit card from WageWorks
for all their eligible drug expenses. This WageWorks FSA debit card can be used for prescriptions,
medical copays/coinsurance, vision expenses, and dental expenses.
Over-the-Counter Drug Reminder
Over-the-counter drugs are not covered under the FSA unless prescribed by a physician. Medical
supplies, such as bandages and contact lens solution, will still be covered without a prescription. Keep
this in mind as you estimate your 2015 FSA contributions.
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How FSAs Work
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How FSAs Save You Money
Money you contribute to your FSA comes out of your paycheck on a pre-tax basis. So, if you know you
will incur certain medical or dependent care expenses, putting the money aside each paycheck can save
you money. Here’s an example of how it works.
Marie has a 5 year-old son who attends day care. She contributes $5,000 into her Dependent Day Care
FSA throughout the year. Here’s how much she saves:
Without the FSA
With the FSA
Marie's annual pay
$30,000
$30,000
What Marie put into the FSA
$0
$5,000
Marie's taxable pay
$30,000
$25,000
Taxes (15% federal, 7.65% SS)
$6,795
$5,663
Marie's after-tax day care expense
$5,000
$0
Marie's take-home pay
$18,205
$19,337
Amount Marie saves by using the FSA
$0
$1,132
BSWH Benefits Enrollment Guide (NTX)
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FSA Rules
IRS Rules
Because FSAs have tax advantages, special IRS rules apply:
• No transfers. The Health Care FSA and Dependent Care FSA are separate accounts. You
cannot transfer money between them.
• Meet the deadline. Expenses must be incurred and paid for during the plan year (beginning on
your benefits effective date through Dec. 31, 2015, or by March 15, 2016, for the grace period).
• Use it or lose it. You have until April 30, 2016 to seek reimbursement for 2015 expenses or you
lose the remaining balance. Make sure you estimate carefully.
• No changes. The money you contribute is taken out of your paycheck, in equal amounts, before
taxes. Your contribution amounts cannot be changed during the year, unless you have a
qualifying life event.
Additional FSA Rules
Depending on which medical plan you choose, there are certain limits on how you can use your Health
Care FSA.
If you choose the Aetna PPO plan, you can use your FSA money to pay for eligible expenses.
If you choose the Consumer Gold or Silver Plan:
•
•
•
Eligible expenses are paid using HRA funds first that Baylor Scott & White provides you.
Once you use all the money in your HRA, you can then use your FSA money to pay any
additional eligible medical expenses and help cover the cost of your deductible.
Even before your HRA is empty, you can use your FSA money for eligible expenses not covered
by the medical plan, such as dental and vision expenses.
If you choose the Medical HSA Plan:
•
•
•
•
You are eligible to enroll in a Limited Purpose Health Care FSA. Until you meet your deductible,
you can only use your Limited Purpose FSA for dental and vision expenses or qualified medical
expenses not covered by the medical plan.
Once you meet your deductible, you can use your Limited Purpose FSA for all eligible medical
expenses, too.
You cannot be reimbursed for the same item under your HSA and Limited Purpose FSA.
You are not eligible for the FSA debit card.
BSWH Benefits Enrollment Guide (NTX)
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Protection Overview
Baylor Scott & White Health offers several options to help protect employees and their family members.
This includes Life Insurance, Accidental Death & Dismemberment (AD&D), Short-Term Disability,
and Long-Term Disability.
For Life Insurance, AD&D, and Long-Term Disability, Baylor Scott & White provides employees with
the basic coverage they need. However, you have the option to purchase additional coverage for
yourself or for family members for greater protection in case of unforeseen circumstances.
Review the pages on the left for the various options.
BSWH Benefits Enrollment Guide (NTX)
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Life Insurance
Baylor Scott & White automatically provides you with Basic Life Insurance that pays a benefit to your
beneficiary equal to one times your base pay, up to $50,000. You can choose to purchase additional life
insurance coverage for yourself, your spouse and your children. You can only increase your coverage by
one level during annual enrollment or during a major life event.
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BSWH Benefits Enrollment Guide (NTX)
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Accidental Death & Dismemberment (AD&D)
AD&D benefits are paid if you or a covered family member dies or suffers an injury due to an accident.
Baylor Scott & White automatically provides Basic Employee AD&D insurance equal to one times your
base pay, up to $50,000. You can choose to purchase additional coverage for yourself, your spouse
and/or your children.
BSWH Benefits Enrollment Guide (NTX)
Page 35
Disability
Disability benefits are available to you if you get sick or injured and cannot work for an extended period
of time. Short-Term Disability is voluntary, so you must elect to purchase STD coverage. If you do not
enroll in the STD coverage during your first 30 days of hire, subsequent enrollment will be subject to
Evidence of Insurability and will be effective once approved by the HR Center. Baylor Scott & White
provides you with Basic Long-Term Disability (LTD) Insurance. You can choose to purchase additional
Long-Term Disability coverage.
If you do not enroll in the Voluntary LTD coverage during your first 30 days of hire, subsequent
enrollment will be subject to Evidence of Insurability.
How It Works
• If you elect to pay for Voluntary Short-Term Disability coverage begins after 90 days of
employment. You are eligible for coverage if you elect coverage and are:
• A full-time employee
• A part-time employee regularly scheduled to work 40 to less than 60 hours each pay
period
• If approved, Voluntary Short-Term Disability benefits begin on the 8th calendar day of
disability.
• Basic Long-Term Disability benefits begin to pay after 180 calendar days of disability, if
approved.
Coverage Amount
Voluntary STD Coverage
•
Up to 60% of base weekly pay (based on authorized
Who Pays
You (after Tax)
hours in primary position) up to 180 days
•
Weekly maximum of $3,000
Cost is $0.93 per $100 of base pay.
Basic LTD Coverage
Up to 50% of base weekly pay (based on authorized hours in
Baylor Scott & White
primary position) with a minimum benefit of $100 per month
and a maximum of $15,000 per month
Voluntary LTD Coverage
•
Add 10% of base pay (for a total benefit of 60%) with a
You (after Tax)
maximum of $15,000 per month.* Cost is $0.117 per
$100 of base pay
•
Add 20% of base pay (for a total benefit of 70%) with a
maximum of $15,000 per month.* Cost is $0.411 per
$100 of base pay
*Maximum applies to Basic and Voluntary LTD combined.
How to Apply for Disability Benefits
If you are on an approved Leave of Absence and benefits eligible, you can apply for Voluntary ShortTerm Disability benefits. Call the HR Center at 1-877-446-9562 as soon as you know you will be absent
from work
BSWH Benefits Enrollment Guide (NTX)
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401(k)
The 401(k) plan is designed to help people save money for their retirement years. It’s a special type of
savings plan with features that can help your savings grow and outpace inflation.
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•
•
You choose a percentage of your income to be withdrawn from your paycheck pre-tax and
deposited into a 401(k) account.
Baylor Scott & White matches a portion of the amount you contribute.
The money in your account is invested in the funds of your choice within the Plan, giving your
balance a chance to grow on a tax-deferred basis.
Eligibility
All Baylor Scott & White employees, including PRNs, are eligible to participate immediately (many
employers make you wait six months to one year).
Investor Basics
If you are a first-time investor, visit the 401(k) at Your Benefits tab in HRWorkWays via myBaylor.com.
You’ll find a presentation that explains investing basics, such as the difference between stocks and
bonds.
Company Match
Baylor Scott & White will match your 401(k) contributions dollar for dollar, up to the first 5% of your
eligible pay.
Vesting
Vesting is the amount of company match you get to keep when you leave Baylor Scott & White. See the
chart below for the vesting schedule. The money you contribute is always yours.
Years of Service
Vesting Percentage
New Vesting Percentage
Hired Prior to January 1, 2015 and not
Effective January 1, 2015
working after
January 1, 2015
Less than 2 years
0%
0%
2 but less than 3 years
25%
0%
3 but less than 4 years
50%
100%
4 but less than 5 years
75%
100%
5 or more years
100%
100%
BSWH Benefits Enrollment Guide (NTX)
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If you were hired prior to January 1, 2015 and continue employment after January 1, 2015, the “new”
vesting schedule will apply on and after January 1, 2015, although you will never have a vesting
percentage less than your vesting percentage on December 31, 2014.
Here are a couple of examples:
1. If you begin employment on March 1, 2014, you will be 0% vested until March 1, 2017. On that
date, you will become 100% vested.
2. If your employment began on December 1, 2012, you become 25% vested on December 1, 2014
and 100% vested on December 1, 2015.
Once you are 100% vested, you will always remain 100% vested in the Plan.
Contributions
You may contribute 1%-50% of your eligible pay on a pre-tax and after-tax basis. Baylor Scott & White
matches your contribution, dollar-for-dollar up to a maximum of 5% of your base pay each pay period.
Contribution limits*
• Pre-tax employee contributions are limited to $17,500.
• You can contribute on an after-tax basis only after you have reached the pre-tax limit.
• If you are age 50 or over, you can contribute an additional $5,500 pre-tax.
• Total contributions combined are limited to $52,000 (including Company Match).
• The maximum recognizable compensation is $260,000.
• The definition for a “Highly Compensated” plan participant is a person who earned $115,000 or
more during 2014.
* All limits are based on 2014 guidelines. The online Summary Plan Description will be updated if the Internal Revenue
Service announces new limits.
Loans and Withdrawals
Prior to retirement, you can access your money through loans or withdrawals.
•
Loans:
Limited to one residential and one general purpose loan at any time
Loan repayments are payroll deducted
• Withdrawals can be made under these circumstances:
• Due to hardship (your individual and Baylor Scott & White matching contributions will
also cease for six months)
• From after-tax contributions you made
• From money you rolled over to the Baylor Scott & White plan from another plan
• At age 59 ½
Visit the Your Benefits tab in HRWorkWays via myBaylor.com for full details, including taxes and
penalties for withdrawals.
•
•
Investment Options and Features
Some of the great features of our 401(k) plan include:
•
•
•
A large variety of investment fund options
Self-managed accounts
The ability to view your investments online and make daily investment changes.
BSWH Benefits Enrollment Guide (NTX)
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Target Date Funds
Target Date Funds will allow you to select a fund based on your target retirement date. They are
available in five-year increments. If you expect to retire in the year 2019, you might select the 2020
Fund. The fund automatically redistributes your investments over time.
For example, the fund might invest heavily in stocks early in your career, and then gradually move to
more conservative investments, such as bonds, as you approach retirement.
Rollovers
You may roll money into your Baylor Scott & White 401(k) from another qualified plan without
incurring a tax penalty. More information is available in the Plan's Summary Plan Description.
Financial Engines
Financial Engines offers objective investment advice to employees who participate in retirement plans at
many of America’s largest companies. They do not sell investments and do not receive commissions.
Baylor Scott & White chose Financial Engines to help employees with their retirement planning. You
can take advantage of the service in two ways: the free Financial Engines online advisor or by having
Financial Engines professionally manage your account for a fee. If you want advice over the phone, you
can use the Financial Engines Advisor at 1-800-601-5957. To access Financial Engines, go to the Your
Benefits tab in HRWorkWays via myBaylor.com and click on Manage Your Savings & Retirement
Benefits. From the Welcome Box, select button number 3 and click Get Advice.
More Information
Detailed information about the 401(k) plan funds offered and available services can be found on the
Your Benefits tab in HRWorkWays via myBaylor.com or call the HR Center at 1-877-446-9562. The
Summary Plan Description is also available under the Your Benefits tab in HRWorkWays. In the
Savings and Retirement section, select “Manage your Savings Benefits.” Under the Savings and
Retirement menu, select Plan Information and News.
To Enroll
You can enroll in the 401(k) plan at anytime. To get started, go to the Your Benefits tab in
HRWorkWays via myBaylor.com. You may also call the HR Center at 1-877-446-9562.
BSWH Benefits Enrollment Guide (NTX)
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Life Benefit Specialists
If you are enrolled in a Baylor Scott & White life insurance plan, and if you or your dependents lose a
loved one, Baylor Scott & White offers help accessing life insurance, 401(k) and other benefits. This
service will act as a single point of contact for beneficiaries and will answer your questions and file
claims on your behalf. For more information, call the HR Center at 1-877-446-9562.
BSWH Benefits Enrollment Guide (NTX)
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Time Away from Work
In addition to your health care benefits, Baylor Scott & White offers even more benefits to help you
when you need it.
Bereavement Leave
If you are a full-time employee, you may receive up to three paid days off to attend a funeral, depending
on your relationship to the deceased. If you're not a full-time employee, you may request unpaid time off
for a funeral.
Through Everest Funeral Planning, we also offer funeral concierge services:
Provides funeral planning from licensed funeral directors, available 24/7
Offers as much or as little support as the family needs
Gathers pricing information
Negotiates funeral service prices with local funeral homes
Contact the HR Center at 1-877-446-9562 for more information.
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Jury Duty
You can receive jury duty pay for scheduled work hours you miss while serving on a jury. If you appear
in court on behalf of Baylor Scott & White Health Care System, you'll be paid for your time as hours
worked.
To read more about this, visit the Policy and Procedure Library.
Time Off*
At Baylor Scott & White, we know that you need time off from work to rest, renew and recharge. That's
why Baylor Scott & White offers regular full- and part-time employees one combined accrual for time
off, called Paid Time Off (PTO). PTO hours are based on the number of regular hours you work, up to
80 hours per pay period. You begin accruing PTO on your first day of work, but you cannot use PTO
until you complete 90 days of continuous service. PTO hours can be used for holidays, vacations, sick
days and other personal time off.
You can find your PTO balance and a calculator to help you estimate your PTO accrual through the
HRWorkWays home page (left side of the page). The PTO policy is available in the Policies and
Procedures Library.
*Director-level employees and above participate in a separate plan. Contact the HR Center for more information.
BSWH Benefits Enrollment Guide (NTX)
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Work/Life
In addition to your health care benefits, Baylor Scott & White offers even more benefits to help you
when you need it.
Take a look at the following benefits and programs you can use throughout the year.
Child Care Benefits
Save money on child care! Baylor Scott & White has partnered with one local and two national child
care groups that offer our employees a 10% tuition discount for pre-school and school-age children:
•
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Learning Care Group (includes La Petite Academy, Child Time, Tutor Time and Children's
Courtyard}
10% tuition discount for children ages 2-12
KinderCare. 10% tuition discount for children ages 3-12
The Prep School of McKinney – 10% discount, plus $100 on registration for infants through age
12.
Get the Discount
1. If your child isn't already enrolled, contact the child care provider and ask about openings for
enrollment.
2. Tell them you are a Baylor Scott & White employee and are eligible for the 10% tuition discount.
3. You will be asked to show your Baylor Scott & White ID badge or a current pay stub as proof of
employment.
For more information, see Child Care Benefits on Beneplace at www.beneplace.com/baylorhealth.
Backup Child Care
If your regular child care falls through, KinderCare offers a backup child care program for all Baylor
Scott & White employees. A $15 copay per child, per day (plus any fees for field trips, special events,
etc.) is required. For more information, visit Beneplace at www.beneplace.com/baylorhealth.
Employee Assistance
Life is stressful. But Baylor Scott & White's Employee Assistance Program (EAP) is here to help
employees and their dependents during many life-affecting situations, including:
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•
•
•
•
•
Marriage and family conflicts
Work and school conflicts
Loss and grief
Interpersonal conflicts
Stress management
Emotional and spiritual concerns
Anxiety or fear
EAP Work/Life services include:
•
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Financial planning and consultation
Face-to-face legal advice
Child care and elder care referrals
BSWH Benefits Enrollment Guide (NTX)
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Sick and emergency care referrals
Pre- and post-adoption services
Credentialing referral sources
Carpooling referrals
All EAP services are voluntary, confidential and free. You can receive up to six free counseling visits per
year per occurrence. Call the EAP 24 hours a day, seven days a week at 1-866-605-4700.
Long-Term Care Insurance
Baylor Scott & White Health Care System offers you the opportunity to apply for long-term care
insurance directly from Genworth Life Insurance Company (Genworth Life) at group rates. Long-term
care insurance helps reimburse expenses for the kind of help and care you would need if you could no
longer perform two of six everyday activities, including:
Bathing
Dressing
Toileting
Continence
Transferring from a bed to a chair and vice versa
Eating
Premiums are based on your age and the coverage you select. The coverage is portable, which means
your coverage will continue after you leave Baylor Scott & White, as long as you pay the premiums.
Premiums can be paid directly to Genworth Life on a quarterly, semi-annual or annual basis, or
premiums can be electronically transferred each month from your checking or savings account.
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•
For more information about the program, plan details, premiums or to enroll, visit
www.genworth.com/groupltc.
Legal Services – New for 2015
Coverage through Hyatt Legal Services provides access to the country’s largest network of legal benefit
providers for a relatively low cost to you. If elected, you can get professional legal assistance with issues
like:
Creating a will or living will
Buying, selling or refinancing houses
Reviewing important paperwork
Losing a spouse or parent
The cost of coverage is $5.54 per pay period for coverage. You can learn more about Hyatt Legal Plans
at legalplans.com.
•
•
•
•
Travel Assistance
If an emergency occurs when you are 100 miles or more away from home, Baylor Scott & White offers
the Employee Travel Assistance Program to help you. Case managers can provide you with doctor,
dentist and medical facility referrals throughout the world, and you can get information about
immunization requirements, travel advisories and more.
Just call the toll-free emergency assistance line 24 hours a day, seven days a week at 1-877-935-3704 (US
or Canada), or call collect at 1-312-935-3704 from other countries.
BSWH Benefits Enrollment Guide (NTX)
Page 43
Enterhealth Advanced Recovery Support
Enterhealth is an interactive, approachable online recovery program that provides Baylor Scott & White
employees access to tools they can use to enhance their recovery from drug or alcohol addiction.
Enterhealth understands what it’s like to live with the chronic disease of addiction. They recognize the
struggle to maintain a sense of normalcy while managing life at work, family and friends. Enterhealth’s
Advanced Recovery Support offers a real solution to this real problem – and now it’s free, confidential
and available 24/7 to all employees and their families.
Go to www.bhcs-support.com to learn how you can get started or to help a family member or friend
today.
Baylor Scott & White Advocacy Service
Baylor Scott & White wants you to get the most out of your health care benefits! The Baylor Scott &
White Advocacy Service is available to help you resolve any conflicts you may have with your medical,
dental and vision carriers. The service will help you with unresolved health plan access or claims issues.
The advocacy team will research your issue and work with your health plan to resolve it on your behalf.
The advocacy team helps ensure your issue is given the attention it deserves and is considered fairly.
However, contacting the Advocacy Team does not guarantee the resolution you want – the terms of the
plan still apply. The service is available to employees enrolled in medical, (which includes prescription
drug and mental health care) dental and vision plans. All calls are confidential.
Call the HR Center at 1-877-44MYJOB (1-877-446-9562), Monday–Friday, 8 a.m.–5 p.m. CT and ask to
speak with an advocacy associate.
Before you request assistance from the advocacy team, you must make at least one attempt to
resolve the issue directly with your health plan. This attempt should not be in writing. If your issue
is still unresolved after you’ve discussed it with the health plan’s customer service, call the advocacy
team. If you contact the advocacy team before talking to your health plan, you may be directed to
contact your health plan. An advocacy associate will review the issue to determine next steps. If the issue
requires advocacy assistance, an advocate will be assigned to your issue and research the issue through
resolution.
BSWH Benefits Enrollment Guide (NTX)
Page 44
Tuition Reimbursement
If you are a full-time employee and considering going back to school, you can enroll in classes and apply
for tuition reimbursement when you have been with Baylor Scott & White for at least six months before
the class(es) you want to enroll in begins.
Baylor Scott & White will reimburse 100% of your tuition costs up to $5,250 per calendar year if:
You complete the course with a grade of C or better.
You have an annual review rating of 2.2 or better.
You continue working full-time when reimbursed for the course.
Before you enroll, you submit your tuition reimbursement request through HRWorkWays
available on myBaylor.com.
HealthTexas Provider Network employees must have executive committee approval for all courses
approved by their manager. Not all Health Texas clinics participate in the tuition reimbursement
program. Contact your manager for additional information or limitations for your location.
•
•
•
•
See the Policies and Procedures Library for more information on tuition reimbursement.
Employee Discounts
Baylor Scott & White offers an Employee Discount Program. You can save on various products and
services through Beneplace at www.beneplace.com/baylorhealth. This includes discounts on wireless
phone service, insurance, electronics, entertainment, travel, and more. Visit the Beneplace site for
BSWH employees to take advantage of these discounts.
Legal Services
Coverage through Hyatt Legal Services provides access to the country's largest network of legal benefit
providers for a relatively low cost to you. If elected, you can get professional legal assistance with issues
like:
Creating a will or living will
Buying, selling or refinancing houses
Reviewing documents
Losing a spouse or parent
The cost of coverage is $5.54 per pay period for family coverage – which includes your spouse and
dependents. You can learn more about Hyatt Legal Plans at legalplans.com.
•
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BSWH Benefits Enrollment Guide (NTX)
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Resources
To Find Out About...
Benefits enrollment
Qualified events/status changes
Eligibility, General Benefits, Coverage,
401(k) plan, Short-Term Disability and Leaves of Absence,
General HR, PTO
PPO
Consumer Gold and Silver HRA Medical plans
Dental DMO
Life and AD&D Insurance
Contact…*
HR Center
Aetna
By Calling...
1-877-44MYJOB
(1-877-446-9562)
Monday–Friday
8 a.m.–5 p.m. CT
Or Visiting...
myBaylor.com
Medical
1-800-334-9778
Dental
1-877-238-6200
www.aetna.com
Medical/Dental
Group #878752
Claim mailing address:
P.O. Box 981106
El Paso, TX 79998-1106
HSA account information
WageWorks
1-877-924-3967
www.wageworks.com
FSA account information
WageWorks
1-877-924-3967
www.wageworks.com
Dental PPOs
MetLife
1-800-942-0854
www.metlife.com
Group #304088
Prescription Drugs
Express Scripts
1-866-533-7010
www.express-scripts.com
Vision
Superior Vision
1-800-507-3800
www.superiorvision.com
HR Center
1-877-446-9562
www.everestfuneral.com
/aetna
www.aetna.com
Legal Reference™ Program
1-866-605-4700
www.achievesolutions.net/
Services
Everest Funeral Planning Services
Long-Term Disability
EAP
Aetna
ValueOptions
baylor
Thrive wellness
Accountable
1-877-475-3442
www.thriveforwellness.com
Health Solutions
1-866-QUIT-4-LIFE
www.quitnow.net/
1-866-784-8454
baylorhealth
Quit for Life tobacco cessation program
Quit For Life
Advanced Recovery Support
Enterhealth
Advocacy Service
Baylor Scott &
1-877-44MYJOB
White Advocacy
(1-877-446-9562),
Service
Monday–Friday,
www.bhcs-support.com
8 a.m.–5 p.m. CT
Legal Services
Hyatt Legal Plans
1-800-821-6400
Monday–Friday,
8 a.m. – 7 p.m. ET
www.legalplans.com
Making Plan Choices? Ask Alex
http://www.alexforbswh.com
Aetna DocFind customized for Baylor Scott & White
employees
http://www.aetna.com/
docfind/custom/baylor
Health Insurance Marketplace
(ACA Information)
BSWH Benefits Enrollment Guide (NTX)
1-800-318-2596
www.Healthcare.gov
Page 46