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2021 FSG Open Enrollment Guide Flipbook PDF
2021 FSG Open Enrollment Guide
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Highlights for 2 0 2 1 C o nt e nt s
C L I C K TO G O TO A TOPIC: Enrollment…......................................................................3 Eligibility ...........................................................................4 When You Can Change Benefits ......................................5 Medical Benefits .............................................................6 Choosing the Plan That’s Right for You............................7 Prescription Drug Coverage ...........................................8
TOBACCO PREMIUMS
Terms You Need to Know ...............................................9 Medical Resources.........................................................10
FSG is dedicated to encouraging and ensuring a healthy environment and lifestyle for all of its employees. Therefore, you will pay a $75 per month health plan surcharge if you or your covered dependents have used tobacco-products within the 30 days prior to open enrollment.
Comparing the Medical Plans .......................................11 Medical Plan Rates ........................................................12 Choosing the Right Healthcare Setting..........................13 Health Savings Account …………………………………………….14 Flexible Spending Account…………………….……………….….16 Health Advocate............................................................17
In order to avoid a tobacco surcharge you must complete an affidavit during Open Enrollment, attesting that you and your dependents are tobacco free.
Dental Benefits..............................................................19 Vision Benefits …………………………………………………….……20 Life Insurance ……………………………………………………..…….22 Disability Insurance …………………………………………….....…23
If tobacco users would like the opportunity to eliminate the $75 per month surcharge, they must register and successfully complete the QUITEPOWER program through UnitedHealthcare. Otherwise you and your covered dependents will be imposed the surcharge for all of .
FMLA/Absence Management …………………………..….……24 Employee Assistance Program …………........................…25 401(k) Retirement Plan .................................................27 How to Enroll …………………………………………………………….28 Important Contacts........................................................29 Important Notices..........................................................30
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Enrollment C h e c k l i s t
QUITPOWER Smoking Cessation Program: Up to eight weeks of the patch or gum, your own personal coach to guide you through each step of the quitting process, motivation and inspiration to keep you on track for success and at NO extra cost — the program is already part of your benefits. Call to enroll today: 1-877-784-8797
S t e p 1: R e a d this entire guide to understand your benefits. S t e p 2 : Collect neces s a ry documentation, s uch a s So cia l Security numbers a n d d a t e s of •birth for all eligible dependents you want to cover.
Access your Paycom Self-Service account at www.paycom.com and click the enrollment link under My Benefits.
S t e p 3 : Follow the s t e p s on page 4 . 2
Enrollment Overview
S t a r t here!
R e a d a b o u t the enrollment p r o c e s s below.
ACTION REQUIRED A s a benefit-eligible Employee, you automatically receive a b a s i c life insurance policy provided b y Facility Solutions Group a t no c o s t to you, but you m u s t indicate who you want to b e the beneficiary of your policy. If you waive benefits, b e sure to d e s i g n a te your beneficiaries for your Facility Solutions Group-paid life insurance, even if you are declining other coverage. To update your beneficiary, log in at www.paycom.com and click on Benefits >> Dependents and Beneficiaries.
Who is Eligible to Enroll? If you work 30 or more hours a week, you and your eligible dependents are eligible to enroll in the benefits described in this guide. Qualifying new hires will become eligible for benefits on the 1st of the month following 60 days of employment.
How Do I Enroll? The first step is to review your benefits and evaluate your needs for the year, then login Paycom Self-Service account at www.paycom.com click the enrollment link under My Benefits and complete your enrollment for 2021.
Can I Make Changes After I Enroll? This enrollment period is the only time you may make benefit decisions for the upcoming calendar year. Once you have enrolled in the plans you cannot cancel coverage unless you have a life event (i.e. birth, adoption, marriage, divorce, death or loss of other coverage). If you have a life event in 2021, you can change your pre-tax benefits by logging into Paycom SelfService to make your “life-event” benefits change request and by contacting HR within 30 days of the qualifying event. If you do not make your request within 30 days, you will be unable to make any changes until open enrollment or if you experience an additional event in 2021.
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Eligibility
E m p l oy e e s
Verification of Eligible D e p e n d e nt s
All regular, full-time E m p l o ye e s working 3 0 or more hours per week are eligible for benefits on the first of the month following 6 0 d a y s of employment. (Eligibility for client-paid life a n d disability benefits varies.)
When you become eligible for coverage, you must provide supporting documentation and/or sign a n affidavit (if applicable) in order to enroll your dependents and/or domestic partner.
S p o u s e s / D o m e s t i c Pa r t n e r s You c a n enroll your legal sp o u se or s a m e or opposite se x domestic partner (affidavit required).
Children •
Medical – Your natural child or a natural child of your domestic partner, your legally adopted child, st e p child, a child who is your dependent for federal income t a x purposes or whose primary residence is your household a n d whom you are legal guardian or related by blood or marriage a n d dependent upon you for more than half of their support; until the end of the calendar month the child reaches a g e 2 6 .
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Dental/Vision – Your natural or adopted child; your stepchild (including the child of a domestic partner); or a child who resides with a n d is fully supported by you; a n d who, in e a c h case, is under a g e 2 6 a n d unmarried.
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Supplemental Life Insurance – Your unmarried child until they reach a g e 19 ( 2 5 if primarily supported by you).
You are responsible for notifying Facility Solutions Group when you move, acquire new dependents or g e t married or divorced. P l e a s e b e aware that a misrepresentation of eligible dependents on your enrollment record will result in a forfeiture of your right to participate in FSG’s healthcare plans.
W H O D O I C O N TA C T W I T H QUESTIONS?
Disabled Children You m a y cover your dependent child who is beyond the limiting age, a s long a s the disability occurred before the limiting age. Eligible disabled children are incapable of self-sustaining employment by reason of mental or physical handicap, a n d chiefly dependent upon you for support a n d maintenance. Disabled children c a n b e covered to the end of the month in which the they d o not meet the requirements for extended eligibility.
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E m p l oye e s c a n co nta c t the Benefits te a m a t b e n e f i t s @ f s g i . c o m with questions a bout the plan offerings a n d for a s s i sta n c e with eligibility a n d verification.
When You Can Change Benefits
Annual O p e n Enrollment Period
P L E A S E N O T E : E m p l o y e e s m u s t b e already enrolled in Supplemental L ife Insurance a t the time of the Qualifying Event in order to b e able to a d d Supplemental L ife Insurance for their s p o u s e or child(ren).
O n c e a year we conduct a n O p e n Enrollment where you c a n a d d or drop benefit plans a n d a d d or remove dependents from your coverage for the coming plan year.
Qualifying Ev e n t s
MAKING C H A N G E S DUE TO A QUALIFING E V E N T
Outside of the annual O p e n Enrollment period, you m a y only c h a n g e your benefit elections during the year if you experience a Qualifying Event. You must m a k e the c h a n g e s to your benefits within 3 0 d a y s of a Qualifying Event. It is required you s e n d documentation to H u m a n R e s o u r c e s to verify your c h a n g e of status. If this is not done within 3 0 days, your c h a n g e will not g o into effect a n d you will have to wait until the next annual O p e n Enrollment period to m a k e changes.
When you have a Qualifying Event, it is your responsibility to initiate the process to make applicable c h a n g e s to your benefit elections. You have 3 0 d a y s from the dat e of the event to g o online www.paycom.com to enter your election c h a n g e s a n d add/delete your dependent(s). •
Verification is Required: You must also provide the supporting documentation to your Benefits Department within 3 0 d a y s from the d a t e of your qualified c h a n g e in family status.
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Deadline Date: Failure to m a k e c h a n g e s within 3 0 d a y s from the event d a te will result in the inability to m a k e c h a n g e s to a n y of your elections until the next O p e n Enrollment period.
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Payroll Deductions: C h a n g e s to your benefit deductions will b e reflected on the appropriate p a y c h e c k after your revised elections have been processed. Additional premium deductions m a y b e applied b a s e d on the effective d a t e of coverage. N o retroactive refunds will apply.
E x a m p l e s of Qualifying Events include, but are not limited to: •
Marriage, divorce, or legal separation
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D e a t h of sp o u s e or dependent
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Birth, adoption, or placement for adoption
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C h a n g e of employment st a t u s of Employee, spouse, or dependent due to termination or start of employment, L O A , F M L A , or c h a n g e in worksite
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A dependent’s eligibility s t a t u s c h a n g e s due to age, student status, marital status, or employment
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You or your sp o u se experience a c h a n g e in work hours that affect benefit eligibility
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Relocation into or outside of your plan’s service area
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Eligibility for Medicaid or C H I P ( 6 0 - d a y special enrollment)
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L o s s of Medicaid or C H I P ( 6 0 - d a y special enrollment)
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Medical Benefits
UnitedHealthcare clients nationwide are f a c e d with the challenge of rising health car e co st s , a n d Fa c i l i t y S o l u t i o n s G ro u p ( F S G ) is n o exception. T h e great n ews is that we are doing something a b o u t it!
We’re taking the s t e p s n e c e s s a r y to keep our benefits competitive a n d affordable. In 2 0 2 1 , we are proud to b e partnering with UnitedHealthcare a n d introducing two new plan options, which you c a n read a b o ut below a n d on the following p a ge s. T hi s move will help FSG balance the quality of the benefits program with the c o s t of coverage.
U n i t e d H e a l t h c a r e I S H E R E TO WA L K YO U T H R O U G H T H I S C H A N G E ! To learn more a b o u t new pl a n details, look u p d o c to rs , or re s e a rc h the c o s t of prescription dr ug s , w w w. m y u h c . c o m and/or contact information*.
C o n n e c t with your health ca r e resources. When you’re making decisions that impact your health or that of your family, you have a c c e s s to a variety of resources to help you make informed choices s o you c a n feel confident about your care.
L o g in. Re g i s t e r a t www.myuhc.com to a c c e s s your pl a n information anytime.
Talk with them. A representative c a n call you promptly. J u s t alert UnitedHealthcare through www.uhc.com or myuhc.com. Monday through Friday, during business hours. O n the myuhc.com a p p you c a n a l so schedule a callback.
G o mobile. D ownl oa d the my u h c . c o m mobile a p p for o n - t h e - g o a c c e s s to your plan information. A s k a nurse. 2 4 / 7 p h o n e a c c e s s to a registered nurse. S i m p l y call the p h o n e num be r o n your health pl a n I D card.
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Choosing the Right Plan for You
When choosing a medical plan, it is important to look a t your budget, your preferences, a n d the a g e a n d health of you a n d your covered dependents. You should consider the key differences between plan t y p e s a n d choose one that be s t suits you a n d your family. C o s t of coverage (including payroll deductions) a n d how you a n d the plan p a y for services throughout the year should b e considered when selecting a plan.
Ke y Features of the Two P l a n s F o r 2 0 2 1 , y o u c a n c h o o s e b e t w e e n t w o p l a n s from UnitedHealthcare: •
Convenience Care Plan h a s a low deductible a n d out-of-pocket limit along with c o p a y s for office visits, urgent care, a n d prescription drugs. In turn, the plan only covers in-network doctors a n d facilities a n d h a s a n d higher c o s t per paycheck. •
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Premium Designated Providers: O n e great benefit of this plan is that it offers discounted c o p a y s for doctors who are classified a s Premium Designated Providers.
HealthSaver HSA Plan: h a s a higher deductible, includes both i n - a n d out-of-network coverage, a n d c o s t s less per paycheck, but you’ll p a y more out of pocket when you use health care services.
L e t ’ s look a t how the two plans compare when it c o m e s to the features that matter m o s t to you.
PLAN FEATURE
Convenience Care Plan
HealthSaver HSA Plan
C o s t from your p a y c h e c k
$$
$
A n n u a l D e d u c t ible
$
$$
A n n u a l O u t - o f - P o c k e t M a xi mum
$
$$
Medical deductible m u s t b e m e t before prescription c o p a y s a p p l y
No
Yes – except preventive m e d i c a t i o n s which are not s u b j e c t to the deductible
Includes F R E E Virtual V i si t s
✔
✔
Includes o u t - o f - n e t w o r k c o v e r a g e
✔
✔
Includes d i sc o unt for p r e m i u m - d e s i g n a t e d providers
✔
✖
$ 0 c o p a y for children under a g e 19
✔
✖
I n - ne t wor k preventive c a r e covered a t 1 0 0 %
✔
✔
C o v e r s office visits with a flat c o p a y
✔
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N o – you p a y for c a r e o u t of p o c k e t until your d e ductible is met, then you p a y coinsurance.
Prescription Drug Coverage
N o matter which U n i t e d H e a l t h c a r e medical plan you enroll in, prescription drug coverage is included. Through U n i t e d H e a l t h c a r e , you have a c c e s s to t h ousands of independent pharmacies a n d large retail chains.
H E A LT H S AV E R H S A P L A N It’s important to note that if you are enrolled in the HealthSaver HSA plan, you first must meet your medical deductible before you c a n p a y just the c o p a y amount a s listed in the medical comparison chart. T h e only exception is if your prescription is on the 1 0 0 % covered preventive list, in which c a s e you will not have to first meet your deductible.
CONVENIENCECARE P L A N
Prior Authorization / S te p Therapy
T h o s e enrolled in the ConvenienceCare plan d o not have to meet the plan’s deductible before prescription c o p a y s apply; members automatically p a y a flat c o p a y when filling prescriptions. S e e the c h a r t on page 11 for details.
Your prescription benefit program h a s a prior authorization a n d step therapy process for certain medications. It’s a g o o d idea to co nta ct UnitedHealthcare or visit their website at www.myuhc.com to confirm how a certain prescription is covered. • PRIOR AUTHORIZATION is a requirement t h a t your phys icia n obtain a p p r o v a l from your health pla n to prescribe a s p e c i f i c medica tio n for you. • S T E P T H E R A P Y is when your prescription benefit requires you to try a no ther medica tio n prior to s t a r t i n g the medica tio n your phys icia n prescribed.
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Terms you Need to Know
Annual Deductible
O u t - o f - P o c k e t Maximum
E a c h year, you have a deductible, which is the amount that you p a y before the plan s t a r t s paying benefits for your non-preventive doctor’s visits, a n d a n y other medical services. T h e ConvenienceCare plan h a s a much lower deductible of the two plans.
T h e out-of-pocket maximum is the m o s t you could p a y out of your own pocket for covered medical c o s t s in one year. O n c e you reach this amount, the plan p a y s 1 0 0 % of a n y additional coverage c o s t s during the rest of the year. Deductibles, coinsurance, office visits, a n d prescription c o p a y s count toward the out-of- pocket maximum.
Coinsurance O n c e your annual deductible h a s been met, you a n d the plan split the c o s t of your medical care. T h i s is called coinsurance. T h e HealthSaver plan p a y s 8 0 % coinsurance (you p a y 20 % ) once the plan’s deductible h a s been met, whereas the ConvenienceCare plan p a y s 8 0 % coinsurance (you pay 20%) for certain services.
Premium Designated Providers You will s e e this term under the Premium E P O plan in the medical plan comparison chart. If a doctor is designated a s a premium provider by U n i t e d H e a l t h c a r e you will p a y less for e a c h visit. T h e s e doctors are recognized a s providing the b e s t quality care a n d better overall outcomes compared to n o n - premium providers. W h y would you p a y less for higher quality care? B e c a u s e studies show that poor quality care c a n lead to higher complications, repeated surgeries, unnecessary hospitalizations, a n d a higher c h a n c e of a wrong diagnosis – all of which a d d up to greater c o s t s for our c l i e n t down the line. To search for a Tier 1 or Premium C a r e Physician during O p e n Enrollment, g o to www.myuhc.com a n d click on Find a Provider. O u r plans are in the Choice network.
Copays O n e of the main benefits of the C o n v e n i e n c e C a r e plan is that it offers c o p a y s for certain services like doctor’s visits. (It even h a s a $ 0 c o p a y for primary care doctor’s visits for children under a g e 19.) A c o p a y is a flat dollar amount you p a y a t the time of service. After you p a y the copay, the plan p a y s the remaining expenses for that service a t a specified level. Even after you meet your deductible, you will b e required to p a y your c o p a y for e a c h medical visit. If you enroll in the HealthSaver plan, there are no c o p a y s except for prescription drugs. You’ll p a y for services out of pocket until the plan’s deductible is met, then you’ll b e responsible for your coinsurance amount.
In-Network / O u t - o f Network When you review the medical chat on *page 12* you will s e e that both the C o n v e n i e n c e C a r e a n d H e a l t h S a v e r plans includes in-network benefits O N L Y (except for true emergencies). For the b o t h plans, there are different levels of coverage for services in-network a n d out-ofnetwork. T h i s i s b e c a u s e U n itedHealthcare partners with a wide network of providers a n d facilities that offer discounted rates for members. B y using in-network will s a v e money a n d receive a higher level of benefit coverage under the both plans. 9
Medical Resources
Virtual V i sits
H e a l t h A d v o c a te
S E E A DOCTOR WHENEVER, W H E R E V E R , W I T H N O C O PAY !
If you enroll in UnitedHealthcare’s Medical plans, you have a c c e s s to a great resource called Health Advocate.
UnitedHealthcare medical plan members g e t a c c e s s to care 2 4 / 7 with Virtual Visits. A Virtual Visit lets you se e a doctor from your mobile device or computer without a n appointment. G e t help with common issues s u c h as:
H e a l t h A d v o c a t e p r o v ide s s u p p o r t t o help y o u m a k e s e n s e of h e a l t h c a r e a n d t a k e control of your health. T h e y a r e a v a i lable over the phone, online, or t h r oug h their mobile a p p . C o n n e c t with t h e m for help with:
•
• • •
B l a d d e r infection/ Urinary t r a c t infection Bronchitis Cold/ flu Fever
• • • • •
Pinkeye Rash S i n u s problems S o r e throat Stomachache
MEDICAL CARE G e t answers a b o ut medical conditions, find out a b o ut the latest research, a n d connect with the right in-network providers for s e c o n d opinions.
A D M I N I S T R AT I V E I S S U E S N a v i g a t e through issues you are having with eligibility, coverage questions, medical bills, transferring medical records, a n d more.
TIPS FO R REGISTERING: 1 . L o c a t e your member I D number on your w w w . m y u h c . c o m I D card. 2 . H a v e your credit c a r d ready to cover a n y c o s t s not covered by your health plan.
A C C E S S TO INFO ON T H E G O Download the a p p to a c c e s s your Health A d v o c a t e benefits, a s well a s c h e c k the s t a t u s of your c a s e s a n d upload documents.
3 . C h o o s e a p h a rmac y that’s open in c a s e you’re given a prescription.* * Prescription se r vi c e s m a y not b e available in all states.
H e a l t h A d v o c a t e c a n b e a c c e s s e d during normal b u s i n e s s hours Monday–Friday, from 8 a.m. to midnight, E T . S t a f f is available for a s s i s t a n c e a f t e r hours a n d on weekends.
L E A R N MORE ABOUT VIRTUAL VISITS •
G o to www.uhc.com .
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You c a n also g o directly to www.myuhc.com on UnitedHealthcare’s mobile app.
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Virtual Visits are covered under your health plan benefits either way you decide to a c c e s s care.
F o r help... •
Call 8 6 6 - 6 9 5 - 8 6 2 2
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Email answers@ H ea lthA d voc a te.co m
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G o online to members. healthadvocate.com
T h e y a l s o h a v e a mobile a p p available on the A p p S t o r e a n d G o o g l e P l a y for a d d e d convenience. 10
Comparing Medical Plans
IN-NETWORK ONLY
ConvenienceCare
FSG Health Savings Matching Contribution
HealthSaver HSA
FSG will provide 50% of the annual match on 1/1/2021
Per Individual
Not Applicable
Up to $1,000
Per Family
Not Applicable
Up to $2,000
Per Individual
$1,000
$3,500
Family Maximum
$3,000
$7,000
Per Individual
$6,850
$6,550
Family Maximum
$13,700
$13,100
Preventative Care
No Cost
No Cost
Inpatient Hospital
Deductible + 20%
Deductible + 20%
Emergency Room
$400 Copay + 20%
Deductible + 20%
No Cost
Deductible + 20% (average cost $39-$45)
DEDUCTIBLE
OUT-OF-POCKET (OOP) MAXIMUM
MEMBER COSTS
Virtual Visit Primary Care Office Visit
Premium for Children