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Benefit Plans & Open Enrollment Frequently Asked Questions2012 Plan Year
Open Enrollment QuestionsQ: How do I make changes during open enrollment? A: All open enrollment changes are made from November 1-30 for changes effective January, 1 st, 2012 by using the Online Open Enrollment System (OE) accessible only via 1600 grand. To access OE do the following:
Q: What can you change only during Open Enrollment (Nov. 1-30) without a “qualified event” during the rest of the year? A: You can change the following during open enrollment:
“Did you know?” You can always drop coverage, or change your retirement plan or HSA contributions any time during the year”. Only switching plans or adding coverage is limited to open enrollment without a qualifying life event (QLE). Q: If I don’t want to make any changes during Open Enrollment, do I have to do anything? A: No but any new rates will take effect at the start of the new year (January 1). In 2012 health plans and their premium rates will remain unchanged; however HSA contributions will increase for most employees. So now may be the time to consider whether the HSA plan is right for you and your loved ones. Q: What are the 2012 medical & dental rates and HSA contributions? A: Please see the home page for the 2012 Benefits Enrollment Guide or 2012 Benefits Summary on the home page of BenefitCentral for all 2012 health plan rates, HSA contributions, and all other significant benefits related changes for 2012. Q: What is a qualified life event (QLE)? A: A QLE allows you to make changes to your health benefit plans outside of open enrollment. Examples of a QLE are Births, Adoption, Deaths, Marriage, Divorce, and Loss of Coverage due to employment status changes, and other major life events. Q: How do I make changes after I’ve completed my open enrollment (before the deadline)? A: Click on the “Reopen Open Enrollment” button ("step 1"). Q: If I have a dependent that no longer needs coverage, how do remove him or her? A: Using dependent features under “step 2” enter an end date as of the end of the year. Q: When can I add my spouse/domestic partner/ or dependent child up to age 26 to my health plans? A: Only during the open enrollment (Nov. 1-30 for changes effective January 1) or only after a qualifying life event (QLE) during any other time. Q: Who is Eflexgroup? A: Eflexgroup is Macalester College’s NEW (for 2012) Flex Spending Account (FSA) third party administrator (TPA). Eflexgroup is responsible for dispersing all reimbursements for eligible Health Care FSA and Dependent Care FSA plan expenses. Eflexgroup will offer the convenience of direct deposit for all reimbursements. FSA – Health Care participants will also automatically be eligible for a free debit card, subject to plan rules. FSA – Dependent Care participants will be able to enroll in a new, convenient recurring reimbursement system. See BenefitCentral FSA tab for more details. Q: What important dates do I need to know about Eflexgroup versus Benesyst FSA plans and claims processing timelines? A: Effective January 1, 2012 Eflexgroup will administer all FSA claims incurred on that day and after. What follows is a brief summary of important dates to know related to this transition: Mid December (2011):
January 1, 2012:
April 10, 2012:
Q: Can I change my Supplemental or Dependent Life Insurance coverage during this open enrollment? A: Yes. If you currently have at least $10,000 in supplemental life insurance, you may now change this amount to any amount between $10,000 to $200,000 in “guaranteed issue” or “no questions asked”. All supplemental life enrollments can be done by completing a “SunLife Supplemental Life & AD&D Enrollment Form” found in the “Voluntary Life” tab of BenefitCentral . If you currently do not have supplemental life insurance, or you wish to enroll in more than $200,000 up to $500,000 or 5 X you annual salary (whichever is less) you will be required to complete an evidence of insurability form available on the “Optional Life” tab on BenefitCentral . SunLife will make all EOI determinations. If you wish to newly enroll in Dependent Life Insurance, the open enrollment period is the time to do so. For a flat premium deduction rate of $4.50 per month, you can cover your spouse/domestic partner for a flat amount of $25,000 and/or any number of dependent children over age 6 months in the amount of $10,000 each. Dependent Life enrollments can be made on the “SunLife Life and Long Term Disability Enrollment Form” found on the “Life” tab on BenefitCentral. You can also update your life insurance beneficiaries on the beneficiary form found on the “Life” tab on BenefitCentral. Q: How do I finalize my open enrollment changes? A: IMPORTANT - To finalize your benefit selections, YOU MUST click on the “Complete” button. If you do forget this step, any changes you made will not “write” into Macalester’s Banner ERP and may not be recognized until an audit is performed. General Health Plans QuestionsQ: Who is eligible to be covered under Macalester’s health plans? A: Any regular or limited Macalester employee with a .5 full time equivalent (FTE) or higher Q: Who can I add to my health plan? A:
Q: Can I now cover a dependent in my Macalester health plans up to age 26? A: Yes. Under recent provisions found in the Health Care Reform Act you will now be able to cover dependents on your Macalester health plans up until the last day of the month in which they turn age 26. Additionally, it does not matter whether or not they are a full time student, nor does it matter whether or not they are married. After they turn age 26, they will be eligible for COBRA continuation of coverage. Q: What is the difference between “in network” and “out of network” providers/doctors? A: “In network” coverage typically provides the full benefit allowed under the plan. “Out of network” coverage allows you to see any provider/doctor of your choosing, however at a lower benefit level (higher cost to you). Q: How do I find providers/doctors? How do I know if my favorite provider/doctor is in network? To find a medical provider or a clinic:
To find a dental provider or a clinic:
Medical Plans QuestionsQ: Does Macalester’s medical plan have a lifetime maximum benefit (2012)? A: Under provisions found in the Health Care Reform Act, there are no lifetime limits on the dollar value of your health plan benefits. Q: What is the “Healthy Discounts Program”? A: It’s an additional benefit for all PPO and HSA participants that provides discounts on eyewear, health clubs, exercise equipment – see http://www.healthpartners.com/ , click on “Health Resources” then “Healthy Discounts” to check out details. PPO Open Access PlanQ: What does PPO stand for? A: “Preferred Provider Organization” Q: Where can I get more information about what is covered under the PPO medical plan? A: Please see the Medical tab on BenefitCentral for all for 2012 plan information. For questions about specific medical procedure coverage, please call Health Partners’ Member Services at 1-800-883-2177 and reference group #3100. Empower Health Savings Account (HSA) PlanQ: What is a Health Savings Account? A: A HSA plan is a high deductable health insurance plan that is linked to a savings account that is available to be used for out of pocket, qualified health expenses. Contributions from Macalester and the employee are made on a “pre-tax” basis. Two parts exist for this plan and a participant cannot have one without the other:
Q: How is an HSA like an FSA, and what are the differences between them? A: Similarities Include:
Key Differences Include:
Q: Do I lose the contributions in the account at the end of the year? A: No, unlike the Flex Spending Account, the HSA is a true savings account (usable for qualified medical expenses) that grows from year to year. Q: What happens to my HSA if I leave Macalester? A: You own an HSA account. It is a true asset, so any HSA money you may have in that account is yours to take with you, and usable for qualified medical expenses per IRS guidelines. Q: What is a qualified medical expense? What can I use the HSA for? A: The IRS determines this, see IRS Publication 502 . Q: Can I use my HSA to pay for my heath premiums deducted by Macalester? A: No, because health premiums are already deducted on a “pre-tax” basis from your paycheck. Q: Where can I get more information about what is covered under the HSA medical plan? A: Please see the Medical tab on BenefitCentral for all for 2012 plan information. For questions about specific medical procedure coverage, please call Health Partners’ Member Services at 1-800-883-2177 and reference group #3100. Q: What is the most I can put into my HSA annually? A: In 2012 the TOTAL HSA contribution limits are$3,100 individual / $6,250 employee + 1 or more. This includes both Macalester’s and your contributions. The Age 55 “catch up contribution” limit remains at $1,000. Q: What are my new HSA contributions and incentive matching options for 2012? A: In 2012, if you are an HSA participant you will continue to have three (3) options for your HSA contributions:
Q: Why did we change the HSA basic incentive and matching contribution structure for 2012? A: The HSA incentive matching structure was changed for 3 reasons:
Q: Can I have a HSA and Flexible Spending Account (FSA)? A: Yes, though there is a limitation on how it can be used. Per IRS rules, HSA Plan members can participate in eflexgroup’s “limited FSA plan” and are limited to dental and vision expense reimbursements only until the HSA health plan deductible is satisfied. Q: What is the deductable for the HSA plan in 2012? A: Unchanged
Q: How many HSA accounts can I have at one time? A: One per account holder (though a family must be under IRS annual limits for all accounts) Q: How do I enroll in the HSA? A:
Dental Plans (Basic and Supplemental)Q: Is there any dental coverage in my PPO or HSA plan? A: Yes. Both the PPO and HSA medical plans have a basic embedded dental benefit. This limited benefit allows participants 2 “free” examinations and cleanings per calendar year. Q: What procedures are covered under the supplemental dental plan? A: See BenefitCentral --> Dental section for more information. Q: Can I choose my own dentist? A: Yes. Similar to the medical plans, you can choose any dentist you would like. However under the dental plans, benefit levels are determined by tiers, i.e. “tier 1, tier 2, tier 3” levels of coverage. See dentist directory to find a dentist and which tier they are classified. – see http://www.healthpartners.com/ , click on “Group Dental Plans” then “HealthPartners Distinctions SM Dental Network” to find a dentist or dental clinic. Q: What is tier 1, tier 2, tier 3? A: The tier level drives your benefit amount. For example, seeing a tier 1 dentist would give you the highest benefit, whereas a tier 3 or “Out of Network” dentist would have the lowest benefit level. See BenefitCentral --> Dental section for more information. Q: Is there a maximum annual benefit? A: Yes. Depending on the tier level, but the maximum annual benefit for any dentist or dental work will never exceed $1000 per covered person. See BenefitCentral --> Dental section for more information. Flex Spending Account (FSA)Q: What are the annual limits for the Health FSA? A: Medical Expense Reimbursement: Elections from $120 up to $5,000 per year for a Health Care FSA Q: What are the annual limits for the Dependent FSA? A: Dependent Care Reimbursement: Elections from $120 up to $5,000 per year for a Dependent Care FSA Q: How is an FSA like an HSA, and what are the differences between them? A: Similarities Include:
Key Differences Include:
Q: Can I make changes after open enrollment? A: No, unless you have a qualifying life event (QLE) Q: What is a qualified life event (QLE)? A: Births, Adoption, Deaths, Marriage, Divorce, Loss of Coverage due to employment status changes, and other major life events Q: Do I lose money if I don’t use it by the end of the year? A: Funds left in the FSA – Health Care or Dependent Care plans at the end of the plan year will be forfeited according to IRS regulations. Q: Do I lose money if I leave Macalester’s employment? A: Funds left in the FSA – Health Care or Dependent Care plans (if you leave Macalester) can only be accessed to reimburse expenses incurred prior to the official termination date, or if the employee elects COBRA continuation of coverage to continue to make regularly scheduled FSA contributions. In the event the employee elections COBRA, the account will remain “active” and new expenses incurred could be reimbursed. Any funds forfeited will be according to IRS regulations. Q: What is a qualified expense? What can I use the FSA for? A: The IRS ultimately determines what qualifies as an eligible expense for reimbursement. Also, click on the following for a summary (PDF): Q: Can I have a FSA with a Health Savings Account? A: Yes, however the IRS only allows for a “limited” flex plan (FSA) for HSA participants. See the following HSA FAQ for more information Life InsuranceQ: What is the basic life insurance benefit offered by Macalester? A: The College provides all benefit eligible employees a “basic” life insurance benefit. This benefit amount is 1X your annual salary, rounded up to the nearest $1000. Supplemental Life InsuranceQ: Can I purchase SunLife’s life insurance coverage outside of open enrollment? A: No, if you are an existing employee with greater than 30 days of service, you can only purchase it during the special open enrollment period November 1-30 for changes effective on January 01 of the following year. New employees will have 30 days from date of hire to enroll, however during open enrollment ALL employees have the opportunity to enroll in our supplemental life insurance plans. Q: Can I change SunLife life insurance coverage levels outside of open enrollment? A: No, making changes during qualifying life events does not apply for this benefit. Q: How much does supplemental life insurance cost? A: Rates for the SunLife supplemental life insurance plan can be found in the “Optional Life” tab of BenefitCentral. Life Insurance BeneficiariesQ: How do I change my beneficiary? A: You can also update your life insurance beneficiaries on the beneficiary form found on the “Basic Life” tab on BenefitCentral . Please complete this form and return it to Employment Services. Q. Is my spouse automatically my beneficiary? A: Yes. By statutory law in MN, a legal spouse would always be the primary beneficiary unless he or she waived this right in writing. However to ensure that there would exist no confusion on your intended beneficiaries, it is highly recommended that you have a current beneficiary form on file with Employment Services. Q: When can I make changes to my Beneficiaries? A: Changes to Beneficiaries can be made anytime and are not limited to the Open Enrollment Period. Simply complete the beneficiary form found on the “Life” tab on BenefitCentral and return to it Employment Services. Short Term Disability (Staff Employees Only)Q: What is short term disability (STD)? A: Short term disability (STD) is a voluntary (employee paid) income protection benefit in case you sustain an injury or illness that would incapacitate you and affect your ability to work for less than 90 days. This benefit is provided through Colonial Life. Q: How much does it cost? A: Rates are based on cost per $100 of income replacement protection and are age banded for ages 1-49 and for ages 50+. Once you are enrolled, however, you will always pay the same rate as when you first enrolled, regardless of age. This benefit is voluntary and portable, meaning you could take it with you if you ever left Macalester. Q: How do I enroll? A: Please contact a Colonial Life Insurance representative directly. Contact information can be found on the “Short-term Disability” tab found on BenefitCentral . Q: What does guaranteed issue mean? A: If eligible, Colonial Life will guarantee that they will issue you a policy without any health history or questionnaires. Q: Do “pre-existing conditions” apply to the short term disability benefit? A: Yes. Even though this plan has guaranteed issue options, there is a 12 month pre-existing condition clause. Please contact Colonial Life for any further questions .Long Term DisabilityQ: What is long term disability (LTD)? A: Long term disability is an income protection benefit in case you sustain an injury or illness that would incapacitate you and affect your ability to work greater than 90 days. The benefit pays between 60 – 66 2/3% of your gross monthly income and it is taxable. Q: How much does it cost? A: Nothing, it is benefit provided by Macalester, free of charge to all employees with an FTE > 0.75. Q: Do “pre-existing conditions” apply to LTD? A: Yes. If you are disabled by a condition that was treated within the last 3 months, or caused a prior disability within the last 12 months, it may be subject to a pre-existing condition exclusion. Employee Assistance Program (EAP)Q: What is Macalester’s Employee Assistance Program (EAP)? A: Macalester offers an enhanced EAP plan through ComPsych / GuidanceResources for all benefits eligible participants. The EAP plan offers the following resources free to you and your entire household:
Q: How do I contact the Employee Assistance Program (EAP)? A: Macalester’s EAP program through ComPsych / GuidanceResources offers resources that can be accessed either by phone or on the internet. The following resources can be accessed by Phone: (877) 327-4753
The following resources can be accessed on the internet: www.guidanceresources.com (Company ID: ZB3042Q)
RetirementQ: What is the maximum amount I can contribute annually to my supplemental retirement 403b account in 2012? A:
More InformationQ: If I have any further benefits related questions beyond the scope of this document, who should I call? A: Employment Services (x6280 - 8am to 4:30pm) or see BenefitsCentral. |
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