Open Enrollment - Frequently Asked Questions
GENERAL INFORMATION
SURCHARGES – Biometric Screening/Risk Assessment & Tobacco Use
GENERAL INFORMATION
Q. When is Open Enrollment?
A. The online system opens October 14 and closes October 30
Q. Will the County use both paper enrollment forms as well as online?
A. No, the County is going GREEN! Open enrollment will be available ONLY via the County’s custom online system. NO PAPER ENROLLMENT FOR 2010!
Q. When will employees receive their OE package and how will they receive it?
A. Your OE package will be delivered to your Payroll Liaisons Monday, October 12 and Tuesday, October 13. They will distribute your package immediately upon receipt.
Q. What will be in these packages?
A. Your package will contain the booklet “Your Benefits & You/ABC’s of Broward County” which includes a summary of the benefits available for 2010 and an open enrollment “highlights” flyer. In addition, you will find brief summaries from VISTA (Health), Humana/CompBenefits (Dental/Vision), Standard (Dental), and Fringe Benefits (TPA for HRA/FSA). Also included in the package will be a “Dependent Documentation” transmittal form which MUST be attached to any required documentation you submit to Employee Benefits so that we can identify to whom the information belongs.
Q. When I submit required documentation what is the best way to do this?
A. Employee Benefits is not responsible for receipt of any lost, late, or mis-directed required documentation. The best way to ensure that your documentation is received is to “hand deliver” it by the deadline (but please don’t wait until the last minute!)
Q. Will the vendor information in the OE package be very detailed?
A. Vendor’s packages will be in a summary form highlighting the benefits they offer as they are also going “green”. For more detailed information, it is recommended you visit each vendor’s website which is listed in the vendor’s summary..
Q. Why is the County and vendors using more online resources instead of printing out all the materials as in the past?
A. Both the County and our vendors are going green. In an effort to not only to protect our environment by using less disposable materials, it also is much more cost effective.
Q. If enrollment and benefit information is online and the employee doesn’t own a computer or know someone with a computer with internet access, where can they go to enroll/access information?
A. In a case where an employee or one of their family members do not own a computer with internet access, the employee can visit Employee Benefit Services for assistance, seek assistance from their Payroll Liaison in locating a computer station, visit any Broward County Library which has public computers, or use computers located in the Wellness Resource Center at the Government Center.
Q. Who do I call if I have trouble logging into the County’s online system?
A. ETS help desk at 954-357-8600
Q. Why is online enrollment better?
A. Every year, Employee Benefits receives hundreds of enrollment forms that are incomplete and/or have errors. The online system has “built-in” prompts that prevent omissions of important information. The system also has “pop-ups” that provide important notices/rules to be aware of, if you elect a specific program.
Q. Can I change my online election?
A. Yes, you can log on and change your selections several times but the last dated submission will become your official 2010 enrollment selection.
Q. Will I receive a confirmation statement?
A. Yes, in November, and it is important to review it to see if the information is correct. Too often, employees do not review this information and they miss the opportunity for correction.
Top of Page SURCHARGES – Biometric Screening/Risk Assessment & Tobacco Use
Biometric Screening/Health Risk Assessment
Q. What is a Biometric Screening?
A. It is a simple finger stick test that measures your cholesterol and glucose (sugar) levels.
Q. Is this screening the same one that employees participated in last year at open enrollment?
A. Yes
Q. Is this screening the same one that has been offered for many years at County health fairs?
A. Yes
Q. What is the Health Risk Assessment?
A. It is a commonly used questionnaire (also given at health fairs) which asks questions that help identify current and/or potential health risks for the group.
Q. Are these employer initiatives prohibited or do they violate an individual’s rights?
A. No. But, employers and vendors do observe strict guidelines regarding confidentiality of any information derived from these screenings and/or assessments.
Q. Do many employers use these same initiatives?
A. Yes, within the last few years it has become more common for employers to use these same or similar initiatives with the same goal of creating a “healthy lifestyle” awareness, and to help keep health insurance premium costs affordable.
Q. Does the County receive an employee’s “personal” information from either the Biometric Screening or the Health Risk Assessment?
A. No. An employee’s individual personal information is kept confidential between the employee and VISTA’s Disease Management Department.
Q. Does the County receive “any” information?
A. Some, but ONLY in an aggregate format with no names or identifying information.
Q. Why then is this information useful if it doesn’t have specific individual information?
A. This de-identified aggregate data provides information about the “general” health state of the County’s employee population which in turn helps the County make important decisions about benefit plan design changes. For example, using this type of aggregate data, the County designed this year’s “pharmacy co-pay waiver program” which provides specific maintenance medication to employees for $0 co-pay. From the aggregate data received, we knew which disease states were prevalent in the group population. From knowing the disease states, we then analyzed which ones had the greatest potential to cause more claims in the future IF employees did not consistently take their maintenance medication which controlled their condition. The result was the implementation of the waiver program which provides an incentive to employees ($0 cost) to consistently take their medication. A savings example would be if a person didn’t take their blood pressure medication they could experience a heart attack. That one heart attack could cost the plan a few hundred thousand dollars. So you see, if you multiply the instances of illness that can be avoided, the cost to the plan becomes less. As this progression of wellness becomes more prevalent the opportunity to successfully mitigate future premium increases becomes greater!
Another example would be how we used aggregate data from the health risk assessment where we determined that there is low utilization by our employee population in obtaining preventive care such as annual physicals, well woman exams, etc. As a result, the County determined it was beneficial to continue to maintain a $0 co pay wellness benefit in all our plans.
So you see, just from these two examples how the County uses this kind of aggregate information to provide additional value to employees. These examples demonstrate direct $$ savings to an employee’s out of pocket expense that is in addition to the generous premium and HRA funding the County provides to employees.
The County’s overriding goal is to develop programs that are of value and are meaningful as well as to create an environment with focus on “health awareness”. Individuals tend to spend more time reviewing and researching how to purchase a car or major electronic device than the time they spend reading and understanding what their health program offers in order to get the best bang for their buck……Hopefully, with encouragement, we can change this statistic!
Q. To avoid the $20 bi-weekly surcharge, do I have to do BOTH the Biometric Screening and the Health Risk Assessment?
A. Yes
Q. Will Biometric Screenings be offered at Open Enrollment sites?
A. No, there is too much activity going on at that time especially since we are providing flu shots during open enrollment. However, in late October worksite locations will be selected around the County for onsite screenings and this information will be distributed.
Q. Where can I get the Biometric Screening?
A. You have two options:
A. At specific worksite locations; or
B. By requesting a return postage paid “at home” test kit (more info to follow)
Q. Where can I get the Health Risk Assessment?
A. It will be available online (website info to come)
Q. What is the cutoff date for completing both the Biometric Screening and Health Risk Assessment?
A. Mid January (more info to come)
Q. Do I have to fast for the screening?
A. No. It is better to fast but if you don’t, you would indicate that when you take your test and the test is adjusted accordingly.
Q. When will the Surcharge become effective if I choose NOT to participate?
A. April 1, 2010
Q. Why April 1st and not January 1st?
A. The goal of the County is to provide as much time and opportunity as possible to complete both the screening and the health risk assessment.
Q. What is the County doing with these surcharge monies?
A. The County just recently approved the 2010 Health Insurance Program. The total cost of this program, which includes health, pharmacy, and your HRA totals approximately $45 million dollars. Of that amount, employees only contribute about $4 million dollars in payroll premiums with the County contributing the remaining $41 million dollars! Any surcharge monies would be applied to offset the County’s substantial funding of the program.
Top of Page Tobacco Use
Tobacco use in any form has been proven to cause or exacerbate many health conditions.
Q. Are these employer initiatives prohibited or do they violate an individual’s rights?
A. No
Q. To whom does this surcharge apply?
A. To you and/or any enrolled dependent (18+) who currently smokes/uses tobacco or who has smoked/used tobacco products within 90 days of the date of enrollment.
Q. Will there be a test or screening for this?
A. No. When you use the “online” enrollment process you will be asked to electronically sign an affidavit attesting to use or non-use of tobacco products by you and/or any enrolled dependents. If you do not complete the affidavit, the online enrollment system will not allow you to proceed to complete your open enrollment.
Q. What is the surcharge amount and when does it become effective?
A. The surcharge amount is $20 bi-weekly and it would become effective April 1st.
Q. Why does it become effective April 1st and not January 1st?
A. The County’s goal is not to collect a surcharge, the goal is to assist employees and their family to stop smoking and/or stop their use of tobacco products. TYPICALLY, employers require a tobacco free time frame of at least 12 months. The County is much more sensitive to this issue than many other employers as the County is ONLY looking back 3 months/90 days! The County is providing additional time for individuals to take advantage of smoking/tobacco cessation programs before the surcharge becomes effective.
Q. Will I and/or my dependents have another opportunity in 2010 to remove the surcharge by becoming tobacco free?
A. Yes….absolutely! Because it is the County’s goal to assist and encourage employees and their family in undertaking this important initiative, the County will offer a SECOND & THIRD opportunity in March and September to submit an updated affidavit which will remove the surcharge.
Q. Are there any programs that I and/or my enrolled dependents can participate in to stop/quit the use of smoking/tobacco?
A. YES!!!
Smoking Cessation Prescriptions/Products:
To assist tobacco users with quitting, effective September 7, the County will waive the co-pay for any prescription smoking cessation product(s) or Over-the-Counter (OTC) product(s) (Nicoderm patch, Nicorrette gum, etc). In order to obtain OTC products, you must ask your physician for a script. A script is necessary so that Walgreens can process the claim and bill the County. Note: There is an annual smoking cessation pharmacy benefit limit of $350 per insured person based on the full cost of the prescription(s)/product(s), not the accumulation of co-pays.
Smoking Cessation Programs
VISTA members have access to QuitNet Comprehensive, a program that utilizes online behavioral support to help people quit smoking. In addition, members also have access to the Tobacco Cessation Program offered by PsychCare as part of behavioral health benefits.
Smoking cessation assistance is also available through Tobacco Free Florida at www.tobaccofreeflorida.com, or 1-877-U CAN NOW.
Q. What is the County doing with these surcharge monies?
A. The County just recently approved the 2010 Health Insurance Program. The total cost of this program, which includes health, pharmacy, and your HRA totals approximately $45 million dollars. Of that amount, employees only contribute about $4 million dollars in payroll premiums with the County contributing the remaining $41 million dollars! Any surcharge monies would be applied to offset the County’s substantial funding of the program.
Top of Page Other Benefits
Health/Pharmacy
Q. Why isn’t the HMO being offered in 2010?
A. Unfortunately, the County’s HMO program has been continually experiencing claims in excess of the premium collected. When this happens, the provider must increase the cost of the program to cover the expenses of the plan.
The CDH plans, however, have enjoyed much better claims experience. More employers are replacing HMO programs with Consumer Driven Health Programs because HMO plans are not designed to encourage “consumerism”.
Q. Are the County’s CDH Plans the same as other employer “high deductible” plans?
A. Absolutely not! The County’s CDH plans are VERY UNIQUE. Most CDH plans subject “all” services, including office visits, diagnostic tests, pharmacy, etc., to the deductible and co-insurance and rarely do they include benefits with just a co-pay.
The County’s CDH plans are the complete opposite. Our plans mimic an HMO plan whereby most “all” services are only subject to co-pays! Only services received in a “hospital setting (in/out patient)” are subject to the deductible and co-insurance. THAT IS A BIG DIFFERENCE!
Q. What else makes the County’s CDH plan different/special?
A. The County also provides a fully funded, tax free “Health Reimbursement Account*” to all employees who enroll in the CDH plan.
Employee Only $ 600
Employee + Sp $1,350
Employee + Child(ren) $1,350
Employee + Family $1,600
*Some dependents do not qualify per IRS guidelines, see “Your Benefits & You” OE handbook for more information.
Q. What can I use these HRA monies for?
A. To pay for office visit co-pays, pharmacy co-pays, deductible or co-insurance instead of using your money. Some CDH employees have commented that the HRA removes a burden from them as they now do not have to “lay out” the money out of their pocket to see a doctor for themselves or their children.
Q. If I don’t use all these HRA monies, do I lose it?
A. No. Another great benefit is that unused monies “roll over” and are added to next year’s HRA amount, provided you re-enroll in one of the County’s CDH plans. (Refer to “Your Benefits & You” handbook for more information)
Q. How much can I accumulate in my HRA?
A. Up to $20,000
Q. Do I get to keep these HRA monies if I leave?
A. If you separate from County employment, any “vested” monies will be directed to a tax advantaged account with ICMA in your name. (For vesting info, refer to “Your Benefits & You” handbook)
Q. Are the County’s health insurance premiums affordable compared to other employers?
A. Absolutely. The County’s health insurance program has very affordable premiums (some at no cost to the employee) and provides even further value by the addition of your fully funded tax free HRA!
Q. How many Plan Options are there?
A. Three:
CDH Low (having the higher deductible)*
CDH High
CDH with Out of Network benefits
*The CDH Low Plan is not recommended for “first time” enrollees. It is designed as a more cost effective selection for those employees who have “rolled over/accumulated” additional HRA monies to offset the higher deductible amount)
Q. Why does the County have only one health provider?
A. It is more costly to have more than one vendor as neither of the vendors knows who will enroll in which plan making the risk between the two vendors unknown. This then would cause both vendors to set a premiums much higher in anticipation of this unknown risk.
Q. Why doesn’t the County merge with another large employer, wouldn’t this reduce costs?
A. Yes, if the County’s workforce health risk was low. Unfortunately, the County’s workforce is older than our other public entity neighbors and our claims are much higher as well. The question then is why would an entity having a healthier risk factor want to partner with the County because by doing so it would increase their premium? We have explored these options in the past but until our group health experience gets better, it is not a viable option.
Q. How then can the County reduce/stabilize premiums in the future?
A. Good question…..by helping our employees become healthier!!! The County is continually looking for ways to do this. In 2009, the County rolled out their Wellness Programs which included a new Wellness Resource Center in the Gov’t Center with plans to add more of these sites around the County. In addition, the County also implemented the Biometric Screening/Health Risk Assessment program which also compliments the Pharmacy Disease Management Maintenance Medication Co-Pay Waiver program. In 2010, in addition to the screening, the County will be implementing a robust smoking cessation program.
The above are ALL initiatives designed to help offset future health insurance premium increases as well as increasing other options to consider such a self insurance.
Q. Will the pharmacy co-pays remain as low as they are?
A. Yes, there is NO CHANGE to co-pays next year! Again to encourage wellness, the County is committed to keeping necessary medication co-pays affordable.
Q. Will I be issued a new WHI pharmacy card for 2010?
A. No, please hold onto your current card as only newly enrolled employees will receive a new card.
Q. Will VISTA still offer the free gym membership for 2010?
A. Yes
Q. What if my dependent child attends school outside the VISTA service area?
A. Good News! The County negotiated an enhancement to the health plan to include VISTA’s “Student Passport Program”. Dependent students enrolled in a college or university can take advantage of this program which provides access to the “Coventry” national network. For more information, see VISTA’s information in the OE package.
Q. If I have a problem concerning my health plan who should I call?
A. You have two options: You can always call Employee Benefit Services as we are your liaison to all vendors; or you can call one of two Vista “onsite” representatives who are located within our offices.
Employee Benefit Services 954-357-6700
Minerva Henry 954-765-5170
Marc Dormeus 954-765-5172
Flexible Spending Accounts
Q. What is a Flexible Spending Account?
A. Per IRS guidelines, an employee can set aside monies from their earnings “tax free” in an account to help pay for medical, dental, & vision expenses. Typically, your anticipated expenses should be substantial enough to make participation in the program worthwhile because if you “overestimate” your expenses, per IRS guidelines, you forfeit these unused monies under the “use it or lose it rule”.
We ask that anyone thinking of participating in this program thoroughly read the FBMC booklet in your OE package.
Of additional importance…….employees who enroll in a CDH health plan ALSO receive a Health Reimbursement Account to help pay for health and pharmacy expenses.
Because Dental/Vision expenses are not reimbursable/payable from your HRA, an FSA would be an option for those expenses. However, if you participate in an FSA specifically to pay for out of pocket health expenses, you MUST factor in that all health expenses are paid from your HRA first and the FSA second. Incorrectly estimating your projected annual health expense in excess of your HRA balance may cause you to forfeit FSA monies, so it is advised that you carefully read this information carefully.
Top of Page FBMC VISA Card
Q. Who receives this Visa card?
A. Anyone who is enrolled in a CDH plan or an FSA account will receive two (2) Visa cards. The Visa card will be pre-loaded with your Health Reimbursement Account balance and/or your FSA election.
Q. Does acceptance or use of this Visa card mean that I have opened up a credit card account or have some financial obligation?
A. No, not at all. The myFBMC Visa card is really just like a “gift card” which has an available balance on it to use.
Q. If I currently have a myFBMC Visa card, should I hold onto it or will a new one be issued?
A. Yes, hold onto it, please do not discard. Only new CDH employees will receive a card.
Q. What is the benefit of using this card?
A. Before the County offered this benefit, an employee would have to lay out monies and make a claim to FBMC. With the card, the employee doesn’t have to do this. Many times staff hears that employees do not visit a doctor or pick up medicine because they can’t afford the initial outlay of money; use of the card eliminates this problem.
Q. Do I have to use this card or can I still submit claims via the mail?
A. Both methods are acceptable.
Q. If I use the myFBMC Visa card do I have to submit verifying documentation?
A. Not for services having a set standard co-pay amount; yes, if the service charge is a not a standard set/recognized co-pay amount or if the amount charged is for a deductible or co-insurance expense.
Q. How will I know if I have to submit documentation?
A. You receive a monthly statement from FBMC of your HRA/FSA activity. Any service date appearing in BLUE or RED indicates that documentation is required. The statement provides instructions on how to submit an Explanation of Benefits (EOB) documentation and where to send it.
Q. What happens if I do not send in this verifying documentation?
A. Per IRS rules, the program has several options. If documentation is not submitted, monies paid out or reimbursed for services you receive are considered taxable income. If it turn out that the service cannot be verified with documentation, to avoid this taxable income situation, the member can reimburse the plan (FBMC) these monies; or the member can submit new claims in place of those claims. But, if the member does nothing, the result will be that the plan may issue a W-2 form for these taxable earning or deduct it from future payroll earnings.
Dental
Q. The DHMO is adding 127 new ADA dental procedure codes, why does this add more value to the plan?
A. In 2009, if you have any of the 127 codes performed you would only receive a 25% discount on an unknown fee schedule which varies dentist to dentist. With the addition of the new codes, most all dental procedures will be listed with set co-pays providing you with specific cost information helping you to know what your total treatment cost will be. After three consecutive years of flat premium, this program is being increased by 5%.
Q. Why isn’t the Standard “Schedule” plan being offered in 2010?
A. Just like health insurance, a PPO dental plan is subject to how well the plan performs in relation to its claims expense. The Schedule plan’s claims exceeded the premium collected and this has been the case since 2008. In order to make the plan more affordable, the benefits would have to have been reduced significantly or the premium increase would have been significant. Neither option was deemed acceptable. As a result, the “Schedule” Plan was eliminated and the Standard HI PPO plan was enhanced with a “max builder” benefit that allows some roll-over of your unused annual benefit allowance (per guidelines) AND the County negotiated a 15% reduction in premium. (See Standard’s dental brochure in the OE package for more information)
Vision
Q. Are there any changes to Humana/CompBenefits Vision Plan for 2010?
A. No changes to benefits OR cost!
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