PPTX - State Employees` Insurance Board

Report
1
State Employees’ Insurance Board
2013 Benefits Conference
AGENDA
Registration (Wellness Nurses Available)…………………………………………………………..……8:00 AM
Welcome…………………………………………………………………………………………………..……9:00 AM
I. SEIB and Healthcare Reform Overview (Page 3)..……………………………………………………9:15 AM
SEIB
II. Deferred Comp Plan Options…………………………………………………………………………..10:15 AM
Great West Retirement Solutions
Break (Wellness Nurses Available)………………………………………………………………..……..10:25 AM
III. Alabama Retired State Employees’ Association (ARSEA)……………………………………….10:45 AM
IV. Supplemental and Southland (Page 24)……………………….…………………………………....10:50 AM
SEIB
V. Wellness (Page 42).……………………………………………………………………………..…….....11:20 AM
SEIB
VI. SEIB Wellness Center & Pharmacy (Millbrook Only)……………………………………………..11:40 AM
Lunch (On your own)…………………………………………………………………………….……..….12:10 PM
VII. Retirement Benefits Overview…….……………………………………………………...…………...1:25 PM
Retirement Systems of Alabama
VIII. SEHIP Online Enrollment……………………………………………………………….…………..…2:05 PM
SEIB
IX. Deferred Comp Plan Options………………………………………………………..………………..2:35 PM
Retirement Systems of Alabama
Break…………………………………………………………………………………………………..…….….2:45 PM
X. Alabama State Employees’ Association (ASEA)…………………………………….………………3:05 PM
XI. Retirees (Page 53).……………………………………………………………………………………….3:10 PM
SEIB
XII. Flexible Benefits Plan (Page 68).………………………………….………………...………………..3:40 PM
SEIB
Program Concludes………………………………………………………………………...………………..4:20 PM
A LIST OF INSURANCE
COMPANIES
ELIGIBLE FOR PAYROLL DEDUCTION
NEW ADDITIONS
A LIST OF PAYROLL DEDUCTION
CODES ADMINISTERED BY THE SEIB
A LIST OF NEARBY
A CERTIFICATE
2
RESTAURANTS
OF COMPLETION
STATE EMPLOYEES’
INSURANCE BOARD
BOARD MEMBERS AND
COMMITTEES
3
4
SEIB BOARD MEMBERS
Appointed By
Position/ Name
Term
Governor
Personnel Board Member
John Carroll
6 year term
Governor
Personnel Board Member
Joe N. Dickson
6 year term
Lt. Governor
Personnel Board Member
Joanne Randolph
6 year term
House Speaker
Personnel Board Member
Jon Bargainer
6 year term
Ex Officio
RSA Executive Secretary
David Bronner
Finance Director
Bill Newton
Indefinite
Elected
Personnel Board Member
Faye Nelson
6 year term
Elected
Active Employee Representative
Robert Wagstaff
4 year term
Elected
Active Employee Representative
Paige Hebson
Retiree Representative
William Mellown
4 year term
Retiree Representative
Robert Pickett
4 year term
Ex Officio
Elected
Elected
Indefinite
4 year term
5
Premium and Benefit
Committee
Acting Finance Director
Bill Newton
Active Employee Representative
Paige Hebson
Retired Employee Representative
Robert Pickett
This committee recommends benefit and premium
changes to the SEIB.
STATE
EMPLOYEES’
HEALTH
INSURANCE
PLAN
PLAN OVERVIEW
6
7
2005 Legislative Changes
State authorizes Board to offer supplemental
coverage in lieu of the basic medical plan.
State requires retirees to take other-employee
coverage, if offered.
State extends supplemental and optional
coverages and provides a sliding premium
scale to retirees, based on years of service.
State requires Board to provide discounted
coverage for low income active and retired
employees and their dependents.
State approves non-tobacco user discounts.
8
2008
Increased Dental maximum from $1000 to $1500 per
covered member.
Medicare retirees enrolled in Medicare Advantage
Plan.
9
2009
Wellness Participation Discount Program adopted.
All active employees screened during 2009
received the Wellness Participation Discount of $25
per month in 2010.
10
2010
Effective October 1, 2010, timing of the
State's premium payments changed.
11
2011Plan Changes
Implemented annual wellness screenings for all
active employees to receive the Wellness
Participation Discount.
12
2012 Legislative Changes
Board can adjust premiums for spouse’s eligibility for
other coverage.
Retirees must have at least 10 years of creditable
coverage to be eligible for retiree health coverage.
Cancellation of coverage for fraudulent claims.
FPL discount increased to 300%.
Retiree premiums increased 1% per year for every year
prior to Medicare age.
Sliding scale adjusted to charge a 4% per year penalty
for less than 25 years of creditable coverage.
Contribution for non-Medicare retirees cannot exceed
contribution for active employees by October 1, 2016.
13
SEIB Premium Rate History
YEAR
STATE
SHARE**
INDIVIDUAL
PREMIUM
DEPENDENT
PREMIUM
1975
15.70
0.00
30.75
1980
32.43
0.00
51.77
1985
100.00
0.00
82.50
1990
195.00
0.00
141.00
1995
255.00
0.00
164.00
2000
357.00
0.00
164.00
2005
650.00
0.00
164.00
2010
805.00
15.00*
205.00*
2012
805.00**
15.00*
205.00*
2013
825.00
15.00*
205.00*
*Premium shown includes non-tobacco user’s discount and wellness discount.
**State share does not reflect credits returned to agencies.
***Premiums do not include dental coverage.
14
2014 Premium Changes
Active Employee
Single
Family
Early Retiree
Single
Family
Medicare Retiree
Single
Family
Family (non-Medicare)
Surviving Spouse < 65
Single
Family
Medicare Surviving Spouse
Single
Family
Increase $5
Increase $5
Increase $15
Increase $25
Increase $5
Increase $5
Increase $15
Increase $20
Increase $25
Increase $20
Increase $25
Non-Tobacco User Discount
Increase $5 to $50
Dental Premium
Individual $3 Family $8
Implement Monthly Spousal Surcharge
$50
If the spouse’s individual coverage is more than $255 per month, the SEHIP member may qualify for
a waiver.
15
2014 Benefit Changes
Mandated Affordable Care Act (ACA) Benefits
Add some preventive and women’s health
Out of pocket limits
No copay
Individual $6,250
Family $12,500
Dental
Offer dental coverage separate from health (BC/BS or Southland)
Urgent Care Facilities
Increase Copay $35 to $50
Outpatient Surgery
Increase Copay $100 - $150
Emergency Room
Increase Copay $50 - $150
Major Medical Deductible
Increase Deductible $100 - $300
Lab Copays
Lower from $10 - $7.50
Expand Wellness Program
Active employee their covered spouse,
Non-Medicare retiree and their covered spouse are eligible for the
wellness discount
BCBS Supplemental
Limit deductible amount on primary coverage – carve-out dental
Health Reimbursement Account
Provide up to $150 reimbursement to supplement other coverage
premiums
Pharmacy Copays
90-day Supply (Tier I at 1.5 x copay)
Tier II , include high cost generics
Implement Generic First Program (new prescriptions only)
16
Dental Options
Benefits
BC/BS
Southland
Deductible
$25
$25
Diagnostic/Preventive
100% Coverage
100% Coverage
Major/Restorative
50% Coverage up to
$1500 annual ($25
deductible)
Single – 80% Coverage
up to $1250 annual (no
deductible)
Family – 60% Coverage
up to $1000/member
annual ($25 deductible)
Orthodontics
50% Coverage up to
$1,000 lifetime per child
under age 19 ($25
deductible)
No Coverage
NOTE: Opt-out and/or plan change forms will be mailed directly to employees.
STATE EMPLOYEES’
HEALTH INSURANCE
PLAN
HEALTHCARE REFORM
17
18
Summary of Health Care Reform
Patient Protection and Affordable Care Act (PPACA)
 Signed into law on March 23, 2010
 “Grandfathered
Plans”
 Plans
that were in existence on March 23, 2010
 SEHIP will lose grandfathered status on January 1, 2014

Provide preventative services and women’s health with no
copay
19
Summary of Health Care Reform To Date
Lifetime Coverage Limits Prohibited

SEHIP must eliminate the $1 million lifetime limit on coverage of
essential benefits but can allow certain restrictive annual limits until
2014.
Pre-existing Condition Exclusions Prohibited for Dependents

SEHIP must eliminate pre-existing condition exclusions for children
under the age of 19.
Dependent Coverage Expanded up to Age 26


SEHIP must provide coverage for adult dependent children up to
age 26, if the child is not eligible to enroll in other employer
provided coverage.
SEHIP cannot require qualified young adults to pay more than
similarly situated dependents enrolled in the plan.
Health Care Reimbursement Account


Maximum contribution capped at $2,500 annually
Over-the-Counter drugs must be pre-approved
20
Health Care Reform Changes
Effective October 1, 2013
Open enrollment for Marketplace*
Coverage may become effective as
early as January 1, 2014.
*For more information on the Marketplace, click here.
21
Healthcare Reform Changes
Effective January 1, 2014
Pre-existing condition exclusion for all enrollees prohibited.
 SEHIP currently has a 270 waiting period less credit for
time served under other group coverage.
Coverage Eligibility
 Employees must be offered coverage within 90 days of
employment.
Marketplace Subsidy
 SEHIP members who fall between 100%-400% of the FPL
may qualify to receive credit for participation in the
Marketplace.
Individual Mandate
 Everyone, unless exempted by law, is required to
maintain health insurance.
22
Healthcare Reform Changes
Effective January 1, 2018
Excise tax on “Cadillac” Plans
Cost of coverage exceeds $10,200
on individual and $27,500 on family
coverage
SEHIP cost of coverage is
currently well below these levels.
Have Your New, Existing, and Retiring Employees
Contact Their SEIB Benefit Advisor For Plan and Benefit
Information
Marsha Abbett
866-841-9489
[email protected]
Tonya Campbell
866-841-0978
[email protected]
Connie Grier
877-500-0581
[email protected]
Kerry Schlenker
866-838-5027
[email protected]
Rick Wages
866-841-0980
[email protected]
State Employees’
Insurance Board
BLUE CROSS BLUE
SHIELD (BCBS)
SUPPLEMENTAL PLAN
24
25
What Is The BCBS
Supplemental?
The BCBS Supplemental coverage
supplements primary health insurance plans by
covering the copay, coinsurance, deductible
that the primary
insurance plan does not pay at 100%.
The primary coverage’s deductible cannot
exceed $1,250 for individual coverage or
$2,500 for family coverage.
26
Enrollment Requirement for the
BCBS Supplemental
To be eligible, members must be able to
enroll in another health insurance plan
through a spouse, other, or previous employer.
Primary plans NOT eligible:
SEHIP (Group 13000)
Local Government Health Insurance Plan (Group 30000)
Public Education Employees’ Health Insurance Plan (Group 14000)
Tricare
Medicare
27
Cost of the BCBS Supplemental
Individual Coverage - $0*
Family Coverage - $0*
*The tobacco user premium will be waived
and the annual wellness check is not
mandatory.
28
Example
A married state employee has a spouse employed
with an auto manufacturer. The spouse elects
family health insurance coverage offered through
his employer.
With the primary health insurance now provided
through the auto manufacturer, the state
employee can enroll in the BCBS Supplemental, on
the first day of the following month.
The BCBS Supplemental will eliminate copays,
coinsurance, and deductible (up to a maximum)
not covered at 100% by the auto manufacturer’s
coverage.
Remember, the BCBS supplemental is free for
individual and family coverage.
29
Advantages to enrolling in the BCBS
Supplemental
 The coverage is free of charge for individual and family
coverage.
 If the primary insurance does not provide dental
coverage, members are eligible to enroll in the individual
dental plan ($3) or the family dental plan ($8) offered
through BCBS of AL or Southland National
 BCBS Supplemental will pay health and pharmacy copays,
coinsurance, and deductibles (up to a maximum) that the
primary plan does not pay at 100%.
 The member can move back to the BCBS basic medical
plan on the first day of any month.
 Everyone covered under the supplemental is eligible for
benefits offered through the SEIB Wellness Program.
30
Pharmacy
Pharmacy:
To receive reimbursement on pharmacy benefits, the
member should complete a BCBS Medical Expense
Claim form (available at www.alseib.org) and attach
pharmacy receipt(s).
Pharmacy claims may also be filed online at
www.bcbsal.org with reimbursements eligible to be
direct deposited into the member’s personal checking
or savings account.
State
Employees’
Insurance
Board
Southland
Optional Plan
Dental, Vision, Hospital
31 Indemnity, and Cancer
32
What Is The Southland
Optional Plan?
The Southland Optional Plan provides
Dental and Vision Coverage
Cancer and Hospital Indemnity Coverage
33
Cost for the Southland
Optional Plan
Individual Coverage - $0*
Family Coverage - $0*
*The tobacco user premium will be waived and the
annual wellness check is not mandatory.
34
Enrollment Requirement for the
Southland Optional Plan
The SEHIP member must be eligible for primary
health insurance through a spouse or other
employer.*
*Primary plans not eligible:
SEHIP (Group 13000)
Tricare (SEHIP retirees are the only exception.)
Medicare
35
How is the Southland Optional
Different than the BCBS
Supplemental?
The Southland Optional Plan is not designed to pay
copays/deductibles not covered at 100% by your
primary health insurance.
It does however provide dental, vision, hospital
indemnity, and cancer benefits.
36
The Southland Claims Process
Vision


Benefits are the same, regardless of
provider.
The provider or the member can file the
claim.
Dental


Any dentist can be used. However, if a
provider in the DentaNet network is used,
the member will save money on expenses
over the allowed amount.
DentaNet is the second largest dental
network in Alabama.
37
The Southland Claims Process
Hospital Indemnity and Cancer



These coverages work as a supplemental
to the member’s income;
The amounts of reimbursement are
determined by the procedure, admission,
diagnosis, etc. The member will file the
claim and reimbursement will be mailed
directly to them;
Payment or coverages of the primary
health insurance do not affect the
reimbursement amount.
38
Advantages to enrolling in the
Southland Optional Plan
 This plan includes dental, vision, hospital indemnity and
cancer coverages, all in one.
 There is no premium for individual or family coverage.
 The dental benefits exceed those offered through the SEHIP
BCBS dental plan.
 Southland is the sole dental provider for the Public Education
Employee Health Insurance Plan (PEEHIP).
 This plan can serve as the primary dental and vision benefits
plan or supplement the out-of-pocket expenses that a
member’s primary dental and vision plans do not cover.
 There are no pre-existing conditions for the hospital indemnity
or cancer coverage. In addition, reimbursements are paid
directly to the insured.
39
Things To Remember
•
A minimum enrollment period of 12
months is required.
•
After the12-month requirement has been
met, the member can return to the SEHIP
during Open Enrollment (November 1-30)
with a January 1 effective date.*
*PEEHIP members are eligible to make
enrollment changes during the PEEHIP Open
Enrollment period (July-August) with a
October 1 effective date.
40
Southland Vision Supplemental



Premium is $24 per month, regardless of number of dependents.
New employees may enroll within 60 days from date of employment. Existing
employees should enroll during Open Enrollment (November 1-30) with a
January 1 effective date. Contract will remain in place unless cancelled by
member during Open Enrollment.
This benefit will coordinate with the SEIB Discount Routine Vision Care Network.
Examination
40.00
Frames
Single Vision
Bifocals
Trifocals
Lenticular
60.00
50.00
75.00
100.00
125.00
Contacts
100.00
Note: Plan provides either contact or lenses with frames, but not both in any plan year.
Have Your New, Existing, and Retiring Employees
Contact Their SEIB Benefit Advisor For Plan and Benefit
Information
Marsha Abbett
866-841-9489
[email protected]
Tonya Campbell
866-841-0978
[email protected]
Connie Grier
877-500-0581
[email protected]
Kerry Schlenker
866-838-5027
[email protected]
Rick Wages
866-841-0980
[email protected]
SEIB WELLNESS
PROGRAM
WELLNESS PREMIUM
DISCOUNT
42
43
Wellness Premium Discount
Members are screened for the following risk factors
Blood pressure
At risk if systolic reading is 160 or higher
or your diastolic reading is 100 or higher
Cholesterol
At risk if 250 or higher
Glucose
At risk if 200 or higher
Body mass index
At risk if 35 or higher
44
At-Risk Members
If determined at-risk, the member will receive a copay waiver and
physician referral form for follow-up. The member may receive the
monthly discount by doing one of the following:

Submit an office referral form indicating that you have been counseled
by a healthcare provider for your identified risk(s), or

Submit a completed physician certification form. It’s a good idea to
have your physician complete and sign your form while you are in for an
office visit. Then you can mail or fax to us and have the peace of mind
knowing that your discount is in place, or

Submit proof of participation in an approved exercise facility or SEIB
approved program. Provide dates and location of participation, or

Provide proof that you are self-managing and have made improvement
in your identified risk(s). You must provide documentation of your
improvement.
45
Approved SEIB Wellness
Program Exercise Facilities
No contract agreement
Monthly dues are payroll deducted
No signing fee
All memberships should be executed directly with the facility.
The enrollment and payroll deduction information will be
forwarded from the facility to the SEIB monthly.
For location and rate information, visit our website at
www.alseib.org or click here.
46
Just a Few Things You Need To
Know To Receive The Wellness
Discount




New employees, and their covered spouse, must
participate in a wellness screening or submit a physician
certification form within 60 days from their date of
employment.
All active employees, their covered spouse, nonMedicare retirees and their covered spouse are
required to have a screening/physician certification on
or before November 30th of each year.
A State employee can participate in a screening
offered by the SEIB, regardless of location.
Refunds will not be given for failure to submit
appropriate information by deadline dates.
47
Verifying Discount
To ensure the discount of $25 per month has
been applied to your contract you can:
 Visit our website at www.alseib.org to
create and view your account
information.
 Call the SEIB Wellness Division at
(866) 838.3059.
48
Tobacco Cessation Program
Members and their covered spouse may
receive a reimbursement of 80% of the cost
of a non-covered tobacco cessation
product up to $150 lifetime maximum.
49
Physician Weight
Management Program
Covered SEHIP members can receive 80%,
up to $150 annually for non-covered weight
management programs that are overseen
by a physician.
50
Hearing Aid Benefit
The $100 reimbursement for hearing aids will
no longer be available beginning
January 1, 2014.
51
Reimbursement Process
To receive reimbursements for both tobacco
cessation and weight management,
receipts should be:
Mailed: PO Box 304900,
Montgomery, AL 36104
Faxed: (334) 517-9980
Be sure to include name, contract number, and date of
birth on all correspondence.
Have Your New, Existing, and Retiring Employees
Contact Their SEIB Benefit Advisor For Plan and Benefit
Information
Marsha Abbett
866-841-9489
[email protected]
Tonya Campbell
866-841-0978
[email protected]
Connie Grier
877-500-0581
[email protected]
Kerry Schlenker
866-838-5027
[email protected]
Rick Wages
866-841-0980
[email protected]
State Employees’
Health Insurance
Plan
RETIREE
INSURANCE
53
54
Enrollment / Continuation
A retiring employee may elect to continue
coverage with SEIB by completing the Form 12 that is
included in the RSA retirement package.
The Form 12 authorizes the RSA to deduct the
monthly insurance premium from your retirement
check.
If a retiree chooses not to continue
coverage at retirement, they MUST
wait until the annual Open Enrollment
(November 1-30 with an effective date of January 1)
period to rejoin.
55
Retiree Premium Determination
A Retiree’s Premium Is Based On:
Sliding Scale
Premium payment is based on the retirees years of
service
Medicare Eligibility
Increase in premium based on years shy of Medicare
eligibility, traditionally age 65
56
2014 Retiree Base Premiums
Premiums below are based on an employee with
exactly 25 years of state service.
Non-Medicare
$226 Individual*
$478 Family*
Medicare Eligible (BlueRx)**
$0 Individual*
$121 Family*
*Premiums shown include the $50 non-tobacco
user’s discount.
**BlueRx copays will increase $5 per prescription
beginning January 1, 2014
57
Retiree Premium Sliding Scale
For every year of service under 25, the retiree share
will be increased by 4%.
For every year of service over 25, the retiree share
will be reduced by 2%.
Years of service (YOS) certified through RSA may
differ from years eligible under SEIB.
Participation in ERS does not necessarily mean your
YOS will count towards your insurance premium.
58
Medicare Eligibility
A retiree will have a 1% increase for every
year they are away from Medicare
eligibility.
Example: A 55 year old retiree will see a 10% increase in
their health insurance premium because they are 10
years away from age 65, or Medicare eligibility.
The percentage will remain the same until the member
reaches Medicare eligibility.
59
To Determine Premium at
Retirement
Visit the SEIB website at www.alseib.org
and use the Retiree Premium Calculator to
estimate premiums at retirement.
Or you can click here to automatically be
directed to the Premium Calculator.
60
Other Employer Coverage CarveOut
State law requires the SEHIP retiree to enroll in
the new employer’s plan if member:
 goes to work for another employer and
 is eligible for coverage with the new
employer and
 the new employer pays 50% or more of
the individual premium.
61
Available For Those Who Have Other
Coverage
Blue Cross Blue Shield Supplemental
Picks up co-pays and deductibles that your primary
insurance does not pay at 100%, subject to a
maximum deductible.
Southland Optional Plan
Provides dental, vision, hospital indemnity and
cancer coverage
Both of these plans are free for the
retiree and their eligible dependents,
regardless of age and/or years of service.
62
Retired State Employees Who Return to
Work With the State of Alabama
Medicare eligible retirees returning to work:
Are classified as a non-Medicare retiree.
The employer is subject to the non-Medicare
premium for the individual.
The member is responsible for the non-Medicare
premium for the dependent.
63
Retirees on Medicare
Retirees should contact their
SEIB Advisor for information on
SEHIP benefits and premiums
and coordination of benefits
with Medicare.
64
Status Changes
After retirement, the retiree
becomes responsible for
notifying the SEIB of any changes
to their health insurance
contract.
65
Surviving Spouse Coverage
When a SEHIP member with dependent
coverage dies:
 SEIB should be notified and the necessary forms
should be submitted within 90 days of the date of
death;
 Surviving spouses, and their covered dependents,
will be eligible to continue coverage if they were
covered at the time of death;
 Eligible spouse should make the appropriate
monthly premium payments to SEIB.
66
Just so you know…
 The Wellness Discount is not applicable to
Medicare eligible retirees and their Medicare
eligible covered dependents. However,
Medicare eligible SEHIP members are eligible to
attend Worksite Wellness Screenings.
 The Southland Vision Supplemental Plan is
available to both active and retired employees.
 Retirees should not opt out of the SEHIP without
speaking with an SEIB advisor about the BCBS
Supplemental or Southland Optional.
Have Your New, Existing, and Retiring Employees
Contact Their SEIB Benefit Advisor For Plan and Benefit
Information
Marsha Abbett
866-841-9489
[email protected]
Tonya Campbell
866-841-0978
[email protected]
Connie Grier
877-500-0581
[email protected]
Kerry Schlenker
866-838-5027
[email protected]
Rick Wages
866-841-0980
[email protected]
STATE
EMPLOYEES’
FLEXIBLE
BENEFITS
Health Care Reimbursement
Account (HCRA)
Dependent Care
Reimbursement Account
(DCRA)
68
HEALTH CARE
REIMBURSEMENT
ACCOUNT
(HCRA)
FLEXIBLE EMPLOYEES’
BENEFITS PLAN
69
70
HCRA – How it Works
 Determine
the amount needed for out-ofpocket medical expenses for the
upcoming year that include:







Physician copays
Prescription copays
Over-the-counter medications (ONLY with
doctor’s written order)
Lasik surgery
Orthodontics
Dental
Glasses/Contacts
71
HCRA – How it Works
 The
total contribution is deducted in
equal pre-tax increments from each pay
period over the next year.


$1,000 / 24 pay periods = $41.67 per pay
period.
The money is deducted pre-tax and placed
into an account to use when you have an
out-of-pocket medical expense not
covered by your health insurance.
72
How Am I Reimbursed?
There are three types of reimbursement
offered under the Flex Plan:
Manual
Traditional (Bump)
Flexible Spending Card
73
Manual Reimbursement

Visit your physician and pay your copay of $35

Complete and HCRA reimbursement form,
available at www.alseib.org, and forward to
BCBS along with receipt/documentation from
doctor visit;

BCBS will reimburse the member $35 by either
mailing a check directly to the member, or if
enrolled, the reimbursement can be direct
deposited into a checking/savings account.
74
Traditional Method (Bump)

Visit your physician and pay your copay of $35

When the claim is processed by BCBS, the HCRA will
automatically issue a reimbursement for the out-ofpocket expenses not covered by your health
insurance.*

BCBS will reimburse the member $35 by either mailing
a check directly to the member, or if enrolled, the
reimbursement can be direct deposited into a
checking/savings account.
*If there is no claim filed with BCBS, the HCRA will not be
alerted to send a reimbursement. Example, if
purchasing glasses/contacts, the request for
reimbursement would need to be filed manually
because these are non-covered benefits under BCBS.
75
Flex Spending Card

You receive a MasterCard pre-loaded with the
amount of money you choose to put into your
account for the upcoming plan year.

You go to the doctor.

You use your Flex Spending card to pay the $35
copay directly from your account.
The money does not have to be in the
account before the charge is incurred.
76
How Does the HCRA Benefit
State Employees?

The Health Care Reimbursement Account (HCRA) is
basically an interest-free, tax-free loan.

The State is advancing you the total amount elected for
the upcoming plan year, and that amount is payroll
deducted from 24 pay periods, beginning January 1.*

Qualifying status changes allow enrollment and
contribution changes outside of the open enrollment
period.
*New employees who start after January 1 of the plan year have 60 days from date of employment
to enroll. Their deductions would be divided by the number of payroll periods left in that plan year.
77
Example of Tax Savings
HCRA
Adjusted Gross Income $20,000 $20,000
7.5% AGI Max Amt
Medical Expenses
Amount allowed as
deduction
Tax Savings (15% tax)
Tax Savings (28% tax)
$1,500
$1,500
N/A
$1,500
$0
N/A
$0
$0
$225
$420
78
What if I Don’t Use All of the
Money I Put Into the HCRA?
 This
program is regulated by the IRS;
therefore, it has a “Use It or Lose It” rule.
 The
HCRA is available from January 1 until
March 15 of each following plan year.
 To
determine the contribution amount, only
add expenses for January through
December.
79
Bonus For Joining HCRA
 An
additional $50 will be added to your
account just for enrolling!
 With
a minimum $120 contribution(only $5
per pay period) you will actually have $170
to spend!
DEPENDENT CARE
REIMBURSEMENT
ACCOUNT
(DCRA)
FLEXIBLE EMPLOYEES’
BENEFITS PLAN
80
81
DCRA – How it Works
 Determine
amount needed to cover
dependent care expenses for the
upcoming year.
 That
amount is deducted pre-tax in equal
increments from each pay period over
the next year.
82
DCRA Example

$2,000 / 24 pay periods = $83.34 per
pay period.*

The money is placed into an account
for you to use when you have a
dependent care expense.
*New employees who start after January 1 of the plan year have 60 days
from date of employment to enroll. Their deductions would be divided by
the number of payroll periods left in that plan year.
83
HCRA & DCRA Advantages
 Allows
you to set money aside for
health/dependent care expenses for the
upcoming year;
 HCRA money can be used for dependents, even if
they are not covered under your health insurance;
 $50 bonus just for enrolling in the HCRA;
 Entire amount of election is 100% pre-taxed;
 Helps to budget health/dependent care
expenses;
 HCRA money in account after December 31st can
be used until March 15th of the next plan year;
 Significant tax savings over the course of the year.
84
Benefits of Enrollment in HCRA
and DCRA
SEHIP members will pay for their out-ofpocket health and daycare expenses even
if they are not enrolled in the HCRA or
DCRA.
So, why not pay with pre-tax money? And
receive a $50 bonus just for enrolling in the
HCRA?
Encourage your employees to consider
enrolling in the HCRA and DCRA.
85
Helpful Links
Visit the SEIB website at to www.alseib.org
view last three years of claims history to help
determine upcoming years HCRA
contribution amount;
Visit the Blue Cross Blue Shield of Alabama
website at www.bcbsal.org to view
contributions, balances, claims, etc. on
both your HCRA and DCRA.
86
Notes
 Be
sure to use correct plan year
enrollment forms*
 All
payroll deductions in GHRS for both the
HCRA and DCRA are administered by SEIB
* 2014 enrollment forms have been included in your folder
Have Your New, Existing, and Retiring Employees
Contact Their SEIB Benefit Advisor For Plan and Benefit
Information
Marsha Abbett
866-841-9489
[email protected]
Tonya Campbell
866-841-0978
[email protected]
Connie Grier
877-500-0581
[email protected]
Kerry Schlenker
866-838-5027
[email protected]
Rick Wages
866-841-0980
[email protected]
State Payroll
and
Personnel
Officer
Assistance
New and Existing
Employee
Information and
Forms
SEHIP Benefits, Plan Options,
and Programs
 Blue
Cross Blue Shield Basic Medical Plan
 Blue
Cross Blue Shield Supplemental Plan
 Southland
 Federal
National Benefits Plan
Poverty Level Program and
Federal Poverty Level Guidelines
New Employee Forms

SEHIP Enrollment Form (IB2)






After initial enrollment, employee can
communicate directly with their SEIB Advisor for all
their health insurance benefit questions, changes,
etc.
Non-Tobacco User Discount Application
Physician Certification Wellness Discount Form
Southland Vision Supplemental Enrollment Form
Federal Poverty Level Discount Application
Flexible Benefits Plan Enrollment (HCRA and/or
DCRA)
Existing Active Employee
Forms










BCBS Medical Expense Claim Form
Plan Change Form
Membership Status Change Form
Non-Tobacco User Discount Form
Physician Certification Wellness Discount Form
Federal Poverty Level Discount Application
Blue Cross Blue Shield Direct Deposit
Enrollment Form
Southland National Cancer and Hospital
Indemnity Claim Form
Southland National Dental Claim Form
Southland National Vision Claim Form
SEIB Wellness Benefits and
Programs
 Worksite
Wellness Screening Schedule
 Tobacco
Cessation Program
 Physician
Administered Weight
Management Program
 Participating
Exercise Facilities
Have Your New, Existing, and Retiring Employees
Contact Their SEIB Benefit Advisor For Plan and Benefit
Information
Marsha Abbett
866-841-9489
[email protected]
Tonya Campbell
866-841-0978
[email protected]
Connie Grier
877-500-0581
[email protected]
Kerry Schlenker
866-838-5027
[email protected]
Rick Wages
866-841-0980
[email protected]

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