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Employment Services
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Open Enrollment Frequently Asked Questions2010 Plan Year
General QuestionsQ: If I don’t want to make any changes, do I have to do anything? A: No but any new rates will take effect at the start of the new year (January 1) – with the exception of HSA incentive matching contributions. Please Note: If you are an HSA participant and have an incentive match in 2010 but do not chose a new HSA incentive matching level for 2010, you will be defaulted to the lower incentive matching level -- click here for details Q: When can I add my spouse/domestic partner/child to the plans? A: Only during open enrollment or a qualified 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: 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: 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. Q: If I have further questions beyond the scope of this document, who should I call? A: Employment Services (x6280 - 8am to 4:30pm) or see the online vendor contact links 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: 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: What is the lifetime maximum benefit (2010)? A: Unlimited in network; $1,000,000.00 out of network 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: What are the rates for 2010? A: Q: Where can I get more information about what is covered under the plan? A: Click here (PDF) 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: The money in that account is yours to take with you (usable for qualified medical expenses) 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 plan? A: Click here (PDF) Q: What is the most I can put into my HSA annually? A: In 2010 the TOTAL HSA contribution limits are $3,050 individual / $6,150 employee + 1 or more. The Age 55 “catch up contribution” limit remains at $1,000. Q: What are my new HSA contributions and incentive matching options for 2010? A: In 2010, if you are an HSA participant you will now have three (3) options for your HSA contributions:
Q: Why did we change the HSA incentive matching structure for 2010? A: The HSA incentive matching structure was changed for 3 reasons:
Please note: This last reason addresses a plan dynamic that in effect amounted to an over-subsidized savings account for one group of participants only. Now, under the redesigned HSA Contribution structures, ALL coverage levels will now have almost the same contribution levels relative to each other and will now all enjoy the same relative opportunities for reaching their annual deductible with both the basic contributions paired with the newly revised HSA incentive matching contributions. 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 are limited to dental and vision expense reimbursements only until the health plan deductible is satisfied. Q: What is the deductable for the HSA (2010)? A:
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: Link to coverage sheet (PDF) 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 the dental coverage sheet 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 the dental coverage sheet 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: Who is Benesyst? A: Benesyst is Macalester College’s Flex Spending Account (FSA) third party administrator (TPA). Benesyst is responsible for dispursing all reimbursements for eligible Health Care FSA and Dependent Care FSA plan expenses. Benesyst offers the convenience of direct deposit for reimbursements. 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 Medical or Dependent Care components 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 Medical or Dependent Care components (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. Click on the following for a partial list from Benesyst 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. Q: Are we changing life Insurance carriers to SunLife effective January 01, 2010, and why? A: Yes. Macalester currently purchases all of our life insurance, AD&D and long-term disability plans through an ACTC consortium. The consortium decided that SunLife offered all schools the overall best value of the RFP respondents, including our current carrier Unum. SunLife promises a 30% annual premium savings for each school while maintaining the same benefit levels. This comes with a 3 year rate guarantee and a future true open enrollment for all eligible employees with guarantee issue provisions. Q: What will happen to my all of my life insurance, AD&D and long-term disability plans effective January 01, 2010? A: Nothing. Whatever existing coverage levels you currently have will automatically migrate from Unum to SunLife effective January 01, 2010 with no action necessary from you. Essentially this first step in the migration is only a plan administrative change because your benefits will not be changed or impacted in any way. The second step will be a future true open enrollment period for all eligible employees for the supplemental and dependent life plans, with an added guarantee issue provision. This special open enrollment period will occur in February for changes effective March 01, 2010. Supplemental Life InsuranceQ: Can I change my Supplemental or Dependent Life Insurance coverage during this open enrollment? A: No. In order to ensure a smooth migration to SunLife, no changes will be allowed during this open enrollment period, however there will be a special open enrollment period in February offered, separate from the group migration on January 01, 2010, for all changes to be effective March 01, 2010. Q: Why are we migrating to SunLife in 2 steps, and what are the 2 steps of this migration? In order to ensure a smooth transition to SunLife effective January 01, 2010, the College is performing this migration in 2 steps:
Q: What Supplemental or Dependent Life Insurance coverage can I change during the special open enrollment period in February, and what is the “added guaranteed issue provision”? During the special open enrollment period in February for changes effective March 01, 2010, you will be able to change your current levels of supplemental life and AD&D insurance and your dependent life insurance. This special open enrollment will provide all eligible employees (>/= 0.75 FTE), not just current participants, the opportunity to enroll coverage levels with an “added guaranteed issue provision”.This provision allows enrollment in increments of $10,000 up to $200,000 (or 5 times annual salary, whichever is less) with a guaranteed issue provision, meaning no Evidence of Insurability (EOI, or a medical questionnaire) is required for these amounts. Employees who wish to enroll in amounts elected greater than $200,000 up to the maximum of $500,000 will require an “Evidence of Insurability” (EOI) form to be completed and may require follow up medical tests or evaluation. This EOI determination will also apply to those employees who do not take advantage of this special enrollment period in February. SunLife, like Unum previously will make all EOI determinations. Q: Can I purchase this coverage outside of open enrollment? A: No, if you are an existing employee greater than 30 days of service, you can only purchase it during the special open enrollment period in February for changes effective on March 01, 2010. Employees who miss this opportunity will have to wait for the 2011 Open Enrollment period in November of 2010 and additional enrollment restrictions, such as the EOI determination requirement may apply. 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 coverage levels outside of open enrollment? A: No; also, making changes during qualifying life events does not apply for this benefit Q: How much does supplemental life insurance cost? A: Rates for the new SunLife supplemental and dependent life insurance plans are not yet available. However, they will be published after January 01, 2010 and before the special enrollment period in February, 2010 for changes effective March 01, 2010. Life Insurance BeneficiariesQ: How do I change my beneficiary? A: Complete this form (PDF) and return it to Employment Services. Q. Is my spouse automatically my beneficiary? A: Yes. By statutory regulations, 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 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. Click here for contact information. Q: What does guaranteed issue mean? A: 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 disablity benefit? A: Yes. Even though this plan has guaranteed issue, 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 would be subject to a pre-existing condition exclusion. Employee Assistance Program (EAP)Q: What is Macalester’s Employee Assistance Program (EAP)? A: Effective January 01, 2010 Macalester will offer a newly enhanced EAP program through SunLife for all long-term disability eligible participant, which are all employees with an FTE >/= 0.75 The New EAP program will offer the following resources free to you and your family members:
Q: How do I contact the Employee Assistance Program (EAP)? A: Effective January 01, 2010 Macalester’s EAP program through SunLife 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 (2009)? A:
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