Commonwealth of Virginia 2019 Open Enrollment Health Care and Flexible Spending Accounts FSAs May 115 2019 2019 Open Enrollment 2 Your Time to Choose Its the annual window for you to make decisions on health plans and flexible spending accounts FSAs ID: 770118
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Commonwealth of Virginia 2019 Open EnrollmentHealth Care and Flexible Spending Accounts (FSAs)May 1-15, 2019
2019 Open Enrollment 2 Your Time to ChooseIt’s the annual window for you to make decisions on health plans and flexible spending accounts (FSAs) Nothing is required if you are: Not changing your health plan or membership, Not enrolling in an FSA, and Not participating in Premium Rewards
2019 Open Enrollment 3 Health PlansEnroll in or change your health planElect or remove optional buy-ups for COVA Care, COVA HDHP and COVA HealthAware Waive coverage Add or remove family members
2019 Open Enrollment 4 Enroll in a Health or Dependent Care FSA or bothYou must submit an enrollment request each year you wish to have an FSA Flexible Spending Accounts (FSAs)
2019 Open Enrollment 5 How to Make ElectionsVisit EmployeeDirect and select Health Benefits Direct or Submit an Enrollment Form to your agency Benefits Administrator The deadline is May 15, 2019
2019 Open Enrollment 6 Visit EmployeeDirect Online Select Health Benefits Direct Review your current health benefits record Update your personal information Enroll or make changes to your health plan and/or membership Enroll in one or both FSAs Submit your elections early and no later than 11:59 p.m., May 15, 2019 h ttps://edirect.virginia.gov
2019 Open Enrollment 7 Complete and Submit an Enrollment FormComplete the fillable form on the DHRM website: www.dhrm.virginia.gov P rint, sign it and submit to your Benefits Administrator No computer access? Request a printed form from your BA Be sure to submit by COB on May 15, 2019
Plans Offered Available COVA HealthAware Statewide COVA Care Statewide COVA HDHP Statewide Kaiser Permanente HMO Regional, Northern Virginia New! Optima Health Vantage HMO Regional, Hampton Roads TRICARE Supplement Statewide Your Health Plan Options 8 April 2018
Open enrollment highlights 9 April 2018See Spotlight…Premium changes New Optima Health Vantage HMO plan offered in Hampton Roads COVA Care, COVA HealthAware and COVA HDHP Anthem will administer the outpatient prescription drug program through IngenioRx Delta Dental will administer dental benefits Medication synchronization program available under pharmacy benefit
Open enrollment highlights 10 April 2018See Spotlight…COVA HealthAware Aetna Health app enhanced Flexible Spending Accounts (FSAs) PayFlex will administer Health and Dependent Care FSAs Health FSA contribution limit increased to $2,700 from $2,600
GET ADVICE FROM ALEX! 11 April 2018April 2018 Review your health plan options with ALEX ALEX will use your input, do the math, and recommend a plan just for you www.myalex.com/cova/2019
Earn premium rewards! 12 April 2018 For employee and/or spouse enrolled in COVA Care or COVA HealthAware Employee or spouse can save $17/month Together can save $34/month
What do I need to do for a premium reward? 13 April 2018Be enrolled in COVA Care or COVA HealthAware For a Reward Starting July 1 Complete or update your health assessment between May 1 and May 15 For a Reward After July 1 Complete a health assessment by the 15 th of any month to receive a reward in six to eight weeks See Premium Reward requirements chart: www.dhrm.virginia.gov/healthcoverage/open-enrollment
Where do I submit my health assessment? 14 If completed between May 1 and June 30 Submit to ActiveHealth as you do now If completed beginning July 1 Visit the COVA Care or COVA HealthAware plan website www.anthem.com/cova or www.covahealthaware.com Questions? Ask your Benefits Administrator www.myactivehealth.com/cova 1-866-938-0349
15 STATEWIDE PLANS Administered by Anthem, Delta Dental a nd Anthem Pharmacy delivered through IngenioRx Administered by Aetna, Delta Dental a nd Anthem Pharmacy delivered through IngenioRx TRICARE SUPPLEMENT http://www.selmantricareresource . com/ cova 1-800-638-2610 , press Option 1 Administered by Selman & Company
The basic plans include: MedicalBehavioral Health Employee Assistance Program (EAP)Prescription Drug Diagnostic and Preventive Dental 16
Optional Benefits COVA Care: COVA HDHP: 17 Expanded Dental Routine Vision/Hearing Out-of-Network Expanded Dental
18 Expanded Dental Option Primary Care – such as fillings, extractions, root canals Complex Restorative - crowns, dentures, bridges and implants Orthodontic services
19 Expanded Vision E y egla ss es C onta c t len s es Includes allowances for non-Blue View provider services Hea r i n g R outine hearing e x am once per plan year H earing aids and related supplies up to $1,200 every 48 months
20 Out-of-Network Plan payment reduced by 25% Provider may balance bill for amounts the plan doesn’t pay
21 New! Engage App Manage Anthem benefits from your smart phone or tablet View your benefits in one place New! Anthem Health Guide Enhanced customer service experience
22 The basic plan includes : Medical Behavioral Health and EAP Prescription Drug Routine Vision and Hearing Exams Preventive and Diagnostic Dental Health Reimbursement Arrangement (HRA) Out-of-Network Coverage
23 What is a Health Reimbursement Arrangement (HRA)? Account that automatically pays eligible out-of-pocket expenses as long as funds are available Medical Behavioral health Pharmacy Funds paid from HRA toward eligible expenses for any covered member Unused HRA funds roll over into future plan years with no limit if enrollment in the plan continues
Initial HRA contribution for 7/1/2019: Employee/Retiree - $600Employee/Retiree + Spouse - $1,200 HRA contribution is prorated for new enrollments or QME changes during the plan year. The HRA proration chart may be found at www.COVAHealthAware.com 24 HRA Contribution
25 April 2018 Update Since Spotlight Published Beginning July 1: Aetna will continue to administer the HRA as it does now Automatic reimbursements continue No MasterCard required for HRA More information from Aetna once you enroll
26 HRA “Do Rights” Employees/Early Retirees and enrolled spouses $ 50 HRA contribution for up to three “Do Rights” Up to $150 per employee/early retiree Up to $150 per enrolled spouse Annual routine physical exam Routine dental exam Annual routine vision exam Annual flu shot Physical activity tracker Digital coaching
27 Expanded Dental Primary Care – such as fillings, extractions, root canals Complex Restorative - crowns, dentures, bridges and implants Orthodontic services Expanded Vision Eyeglasses Contact lenses Discounts for eyewear and accessories Network includes private practice providers plus participating national chains
28 ANTHEM PHARMACY DELIVERED BY INGENIO RX Retail, home delivery and specialty benefits Existing prior authorizations and retail prescriptions automatically transfer Current home delivery prescriptions transfer except for controlled substances and compounded medications 833-267-3108 or www.anthem.com
management HEALTH & WELLNESS PROGRAMS 29 Beginning July 1 Your medical plan will now administer your free and confidential health and wellness programs Disease management Medication and health coaching incentives Maternity Management Health Assessment
HEALTH & WELLNESS PROGRAMS 30 Beginning July 1For more information, see individual plan brochures or the Open Enrollment link on the DHRM website www.dhrm.virginia.gov/healthcoverage/open- enrollment After July 1 Look for details from your health plan on transition of programs
31 EMPLOYEE ASSISTANCE PROGRAM (EAP) Up to 4 visits per issue each plan year at no cost to member For participants and members of their household Confidential resource for personal and workplace challenges Legal and financial guidance www.AnthemEAP.com www.mylifevalues.com
32 REGIONAL PLANS New! Optima Health Vantage HMO Kaiser Permanente HMO Available in Hampton Roads zip codes www.optimahealth.com/cova Available primarily in Northern Virginia zip codes m y. kp.org/ commonwealthofvirginia /
33 Introducing the Optima Health Vantage HMO You must live or work in Hampton Roads area zip codes to enroll You choose a primary care physician (PCP) to coordinate your care No referrals required to see a specialist Out-of-area coverage for dependent children No out-of-network coverage except for emergencies
34 Optima Health Vantage HMO Medical, prescription drug, d ental, vision and hearing benefits Preventive care covered at 100 percent 100 percent of hospitals in Hampton Roads are in-network Employee Assistance Program (EAP) Dedicated member services unit More at optimahealth.com/ cova
35 Kaiser Permanente HMO You must live or work in primarily Northern Virginia zip codes to enroll Changes to dental benefits Coinsurance for dental benefits $75 family deductible You pay 50% of the cost for orthodontia for dependents 19 years old and under Changes to vision benefits: Adults pay 75% of the balance for eyeglass frames Special list of contact lenses and frames for children More at my.kp.org/ commonwealthofvirginia /
36 Flexible Spending Accounts (FSAs) Administered by PayFlex for all employees eligible for health benefits He a lth C a re FS A Set aside up to $ 2,700 per year, pre-tax, for eligible health care expenses D e p en d ent C a re FS A S e t as i d e up to $5 ,00 0 per y e a r , p r e -ta x , for eligible expenses for the care of your dependent
37 Flexible Spending Accounts (FSAs) You must enroll each plan year to participate “ Use it or lose it” rule : Use all of your funds by the end of your coverage period File for reimbursement by the filing deadline or forfeit your FSA funds If you enroll in COVA HealthAware : The HRA pays first Use the PayFlex MasterCard for your FSA
38 More Open Enrollment Information Spotlight on Your Benefits newsletter Retiree Notification booklet f or : Comparison of Benefits Premiums & Premium Rewards Open Enrollment page on www.dhrm.Virginia.gov
39 WHO TO CONTACT FOR ASSISTANCE Your Benefits Administrator The health plans Questions on EmployeeDirect registration or login? Email: edirectissues@dhrm.virginia.gov Questions on Health Benefits Direct or Open Enrollment in general? Email: openenrollment@dhrm.virginia.gov
40 SUBMIT YOUR ELECTIONS ON TIME BY MAY 15! Visit EmployeeDirect at https://edirect.virginia.gov OR Submit an enrollment form to your agency benefits office Employee forms must be received by the close of business on May 15 Retiree forms must be postmarked no later than May 15