ANNUAL BENEFIT ENROLLMENT
October 6 – 31, 2014
The Time is Now...
Evaluate, Enroll,
Make Changes
As a UW System employee, the Annual
Benefit Enrollment (ABE) period is your
only opportunity to make changes to your
benefits unless you have an eligible family
(e.g. marriage, birth, divorce) or employment
change during the year. All changes take effect
on January 1, 2015.
In This Brochure
New for 2015 Page 2
Benefit Changes Allowed Page 2
State Group Health Insurance
Page 3
High Deductible Health Plans Page 4
Health Savings Account Page 6
Flexible Spending Accounts
Page 7
Dental and Vision Options
Page 8
Individual & Family Group Life
Page 9
2015 PremiumsPage 10
www.uwsa.edu/abe
Annual Benefit Enrollment Period for 2015!
What do I need to do during the Annual Benefit
Enrollment (ABE) Period?
How To Enroll
If you do nothing, most of the benefits you have now will continue in 2015.
However, you must re-enroll in the Flexible Spending Account (FSA)
program every year. Health plans may make changes to their provider
networks so you should confirm your current medical and dental providers
are still available in 2015.
How Do I Know What Benefits I Have?
Go to the Benefit Information Box in the MyUW portal (my.wisconsin.edu),
click the “View Benefits Summary Detail” link to see your current benefit
enrollments. You may need to contact your benefits office to confirm your
coverage levels.
Please see www.uwsa.edu/abe/
enroll/ to see whether you use
paper applications or eBenefits
to make your benefit elections.
All employees who enroll in a
Flexible Spending Account or
a Health Savings Account will
enroll online directly with TASC
(the plan administrator). .
What’s New For 2015?
A new kind of health plan will be offered in addition to the Coinsurance Uniform Benefits plans (current health plans).
Most employees, except those eligible for the Graduate Assistant/Short-Term Academic Staff benefits package, may
enroll in a High Deductible Health Plan (HDHP) and Health Savings Account (HSA) for 2015. See page 4 for information
about eligibility, how the plan works and whether it is a good option for you and your family.
Summary Chart of Changes Allowed during ABE
Plan
Open
Enrollment
Change
Plan
Add
Dependents*
Remove
Dependents*
Cancel
Coverage
Yes
Any Health Plan
Yes
Yes
Yes
Yes
Add/remove
vision
Yes
Yes
Yes
Dental Wisconsin
Yes
PPO<->Select
Yes
Yes
Yes
VSP Vision
Yes
N/A
Yes
Yes
Yes
Individual &
Family Life
Insurance
No
Increase current
coverage
No
Any time
Any time
State Group
Health
EPIC Benefits+
Flexible Spending Accounts – Healthcare & Dependent Day Care
Must re-enroll every year. Healthcare FSA is not available if you are enrolling in a State HDHP for 2015.
Limited Purpose Flexible Spending Account (LPFSA)
Available if enrolling in a State HDHP for 2015.
Health Savings Account (HSA)
Required to enroll in HSA if enrolling in a State HDHP for 2015.
*See the Overview of Eligible Dependents to see who you can cover on your plans. www.uwsa.edu/ohrwd/benefits/med/uws25.pdf
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Your needs. Your benefits.
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State Group Health Insurance
Dept. of Employee Trust Funds
State Group Health Insurance
See ETF’s It’s Your Choice website
for detailed information including
important changes, guides, premium
rates and health plan by county map.
Remember:
§§
Plans may expand or reduce their network annually and access
to medical and dental providers can change. Verify your current
providers will still be available in 2015!
§§Your current health plan provider will send you a letter alerting you
to changes for 2015, including a list of medical and dental providers
that will no longer be available.
etf.wi.gov/members/IYC2015/IYC_
State_home.html
Changes for 2015
§§There are no changes to the benefits offered by the Coinsurance Uniform Benefits plans for 2015.
§§Each health plan will now offer a High Deductible Health Plan (HDHP) in addition to the Coinsurance Uniform
Benefits plans.
Other State Group Health Insurance Changes for 2015 - Plan Specific
Health Plan
What’s New in 2015?
Action Needed during ABE
Arise Health
Plan - SE
New Plan
Offered in Kenosha, Milwaukee, Ozaukee, Racine,
Walworth, Washington and Waukesha counties.
Offering two distinct health plans in the
Northwest region of Wisconsin. One of the
following plans must be elected:
WEA Trust NW -Chippewa Valley or
WEA Trust NW -Mayo Health System
Current members who wish to enroll in the other
offered network must submit a new application.
For example, if you are a current WEA Trust NW
member and have previously selected the Chippewa
Valley network, you will be automatically enrolled in
WEA Trust NW - Chippewa Valley for 2015. If this is
the plan you want for 2015, no action is necessary.
WEA Trust PPO
Northwest
WPS Metro Choice
NW & SE
Plans will no longer be available.
If in either plan, MUST select a new health plan for
2015. If no health plan selected, health insurance coverage
will end on December 31, 2014.
Your feedback is important!
Please take our short survey. Your suggestions will help improve
next year’s process! www.uwsa.edu/abe/survey/
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Your needs. Your benefits.
www.uwsa.edu/abe
State Group Health Insurance — High Deductible
Health Plan (HDHP)
What is a High Deductible Health Plan and Who is Eligible?
§§
A high deductible health plan (HDHP) is a health plan that, under federal law, has a minimum annual deductible and
a maximum annual out-of-pocket limit.
§§
An HDHP begins to pay for health care costs after the annual deductible has been met.
§§
All employees covered by the Wisconsin Retirement System (WRS) are eligible to enroll in the HDHP for 2015 unless
one of the following applies:
§§The employee or any covered dependents are enrolled in any part of Medicare, TRICARE or another health plan
that is not considered an HDHP; or
§§The employee or any covered dependents enroll in the Healthcare Flexible Spending Account (FSA) plan for 2015
or carry over any remaining Healthcare FSA funds from 2014 into 2015; or
§§The employee is a dependent of another person for tax purposes; or
§§The employee is eligible for the Graduate Assistant/Short-Term Academic Staff benefits program.
How is the HDHP different from Coinsurance Uniform Benefits (current health plans)?
The High Deductible Health Plan has:
§§
A lower monthly premium
§§
An annual deductible that must be met by the member(s) before any benefits are payable. The deductible is $1,500
for Single coverage /$3,000 for Family coverage.
§§
Once you enroll in the HDHP, you are required to enroll in the state-sponsored Health Savings Account (HSA). You
may only enroll in the HSA if you are enrolled in the HDHP.
§§
If you enroll in the HDHP, you are not eligible to enroll in the Healthcare Flexible Spending Account (FSA). You may
still participate in the Dependent Day Care FSA and a Limited Purpose FSA that offers reimbursement for vision,
dental and post-deductible medical expenses.
Before enrolling in an HDHP and HSA be sure that you understand the potential for higher out-of-pocket costs, as well as
the possible tax advantages as you build your HSA.
Coinsurance Uniform Benefits vs. HDHP
Deductible and Out-of-Pocket Limit Comparison
Once you meet the annual deductible under the HDHP, you will pay 10% coinsurance on covered medical services,
applicable coinsurance on dental benefits and prescription copays, up to the annual-out-of-pocket limit (OOPL). The
annual deductible is counted towards the annual OOPL.
Coverage Type
Annual
Deductible
Annual Out-ofPocket Limit –
Medical Services
Annual Out-ofPocket Limit
– Level 1 and 2
Prescription Drugs
Single
Level of Coverage
Single
Family
Single
Family
HDHP
$1,500
$3,000
$2,500
$5,000
Coinsurance
Uniform Benefits
$0
$0
$500
$1,000
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Your needs. Your benefits.
Family
Applies to
Medical OOPL
$410
$820
Total
Annual
Out-of-Pocket
Limit
Employee Monthly
Premium
(Tier 1 plans)
Single
Family
Single
Family
$2,500
$5,000
$32
$81
$910+
$1,820+
$92
$230
www.uwsa.edu/abe
Coinsurance Uniform Benefits vs. HDHP - Examples
The following examples show how benefits are paid under the HDHP versus the Coinsurance Uniform Benefits plans.
Both plan types offer Uniform Benefits and Uniform Dental Benefits but the HDHP requires that you meet the deductible
before any benefits are payable. Note: Specific federally mandated preventive services are not subject to the deductible
or coinsurance and are covered in full by your health plan.
All examples assume that no charges have been applied to the HDHP annual deductible prior to these services.
Out-of-Pocket Dental Expenses
Out-of-Pocket Medical Expenses
Employee has $10,000 surgery on January 1st. These are the
first charges of the year.
Plan Type
Deductible
(Pay First)
Coinsurance
(Then Pay This)
Member’s
Total Cost
HDHP Single
Plan
$1,500
10% of $8,500
= $850
$2,350
HDHP Family
Plan
$3,000
10% of $7,000
= $700
$3,700
Coinsurance
Uniform
Benefits
Single
$0
10% of
$10,000 =
$1000
Coinsurance
Uniform
Benefits
Family
$0
10% of
$10,000 =
$1000
Member’s Cost
Dental Service
HDHP
Coinsurance
Uniform
Benefits
Cleaning–
$50 - $300
$0
Amalgam
“Silver” Filling
$110 - $200
$0
Full cost –
Not covered under Uniform
Dental
Crowns
$500*
$500*
All health plans offer the Uniform Dental benefits, except
for the Standard Plan and SMP. Supplemental dental
coverage, such as coverage through Dental Wisconsin or
EPIC Benefits+, is not included in this example.
*Annual out-of-pocket limit for Coinsurance Uniform Benefits is $500 for an individual/$1,000 family.
Out-of-Pocket Prescription Expenses
Member’s Cost
Prescription Name
Category of Drug
HDHP*
Coinsurance
Uniform Benefits
Celebrex
Non-steroidal anti-inflammatory
Full Cost
(approx $450)
$15 copay
Cymbalta
Antidepressant
Full Cost
(approx $87 – $223)
$15 copay
Omeprazole
Proton Pump Inhibitor
Full Cost
(approx $13 - $66)
$5 copay
Ortho Tri-Cyclen
Contraceptive
“Preventive” – no cost to member
*Once the annual deductible is met, prescriptions are covered at the Coinsurance Uniform Benefits plan cost.
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Your needs. Your benefits.
www.uwsa.edu/abe
Health Savings Account (HSA)
A Health Savings Account (HSA) is pre-tax savings account used to pay for eligible medical, dental, prescription and
vision expenses (similar to Flex Spending). You may make tax-free contributions through payroll deduction, subject to
annual limits. The UW will also contribute to the HSA. The HSA is administered by TASC.
§§
If you enroll in an HDHP, you are required to establish an
HSA through the State of Wisconsin program. If you are not
Annual Contribution Information for HSA
enrolled for an HDHP, you may not establish an HSA.
§§
The entire employer contribution is deposited to your
Employer
2015 Limit
HDHP
account on the first paycheck of the year.
Contribution
(incl.
ER cont.)
Enrollment
§§
HSAs are owned by the individual, balances roll over from
year to year, and the funds are portable, meaning you keep
$170/year
$3,350*
Single
them if you leave the HDHP plan or state service.
§§
You can also choose to invest a portion of your HSA balance
$340/year
$6,650*
Family
into an HSA investment account with TASC.
§§
You may change your amount of HSA contributions at any
*If you are 55-65 years of age, you may contribute an
time.
additional $1,000 “catch-up” per year to your HSA.
§§
You may use the money once it is deposited into your
account.
§§
Employees who are required to pay half the total health
insurance premium, will receive half of the employer
contribution towards their HSA.
§§
Craftsworkers and Rehired Annuitants are NOT eligible for the employer contribution towards their HSA.
Who might be most interested in enrolling in the HDHP/HSA?
§§
Risk Takers. Employees who think that their medical, prescription and dental costs will be low in 2015.
§§
Savers. Employees who can afford to pay the deductible, if necessary and who want to use the HSA as a savings/
investment vehicle.
§§
Spenders. Employees who are attracted to the lower premium cost. This group should consider putting the monthly
premium savings in the their HSA to build up the account in case it is needed to pay expenses that are applied to the
deductible. This group will likely spend the annual HSA contribution for out-of-pocket costs.
Are you eligible for the HSA?
In order to be eligible for the HSA, you must meet the HDHP eligibility
requirements outlined on page 4 and be enrolled in an HDHP.
When Should I Enroll in the HSA?
§§
You should submit your application to enroll in an HDHP before you
enroll in the HSA.
§§
After enrolling in the HDHP, you must enroll for the HSA online through
Enrollment
Enroll online with TASC at
tascparticipant.lh1ondemand.com.
The UW’s Client/Employer ID
number is TAS-WI1368 (must enter
this number during enrollment).
TASC. You must enroll in the HSA by October 31, 2014.
For More Information on HSAs
An HSA Participant Guide that provides detailed instructions about how to set up your HSA with TASC, a list of HSA
eligible expenses and an informational HSA flyer are available at: www.uwsa.edu/abe/hsa/. You may also contact TASC’s
HSA Customer Service at 1-800-350-3778 with your HSA enrollment questions.
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Your needs. Your benefits.
www.uwsa.edu/abe
FlexSystem® Flexible Spending Accounts (FSA)
Healthcare, Dependent Day Care and Limited Purpose FSA
(Formerly known as the Employee Reimbursement Account program)
The FlexSystem® Flexible Spending Accounts (FSA) program allows you to pre-fund your anticipated, eligible medical
and dependent care expenses. You decide how much to set aside and that amount is deducted from each paycheck
before Federal, State and FICA taxes are calculated so you save money on taxes.
All benefit-eligible employees may participate in the FSA program except LTEs, Fellows, Scholars, Graduate Interns/
Trainees, or Post-Doctoral Fellows/Trainees.
If you are enrolling for the HDHP/HSA, you may enroll in the Dependent Day Care FSA. You may not enroll in the
Healthcare FSA but you may enroll in the new Limited Purpose FSA.
§§
A Healthcare FSA is used to pay for eligible medical expenses that aren’t covered by your insurance. These expenses
can be incurred by you, your spouse (including same-sex spouse) and your qualifying child or relative.
§§
A Dependent Day Care FSA is used to pay for eligible dependent care expenses such as after school care, babysitting fees, adult or child daycare and preschool. Eligible dependents include your qualifying child, spouse
(including same-sex spouse) and/or relative.
§§
*NEW* - A Limited Purpose FSA is available to employees who enroll in the HDHP and HSA and is used to pay for
dental and vision expenses and post-deductible expenses that are not covered by insurance.
FSA Carryover
§§
2014 Participants: The 2014 plan year is from January 1, 2014 – March 15, 2015. You have until March 15, 2015 to incur
expenses and until April 15, 2015 to submit claims for the 2014 plan year. Any remaining balance in your account
after April 15, 2015 will be lost.
§§Note: If you enroll in the HDHP/HSA for 2015, all funds in your Healthcare FSA must be exhausted by December
31, 2014.
§§
2015 Participants: The 2015 plan year is from January 1, 2015 - December 31, 2015. If you have unused monies left
in your Healthcare or Limited Purpose FSA on December 31, 2015, up to $500 will carry over to the 2016 plan year.
Anything over $500 will be lost. You will have until April 15,
2016 to file your 2015 claims.
Contribution Minimums & Maximums
New Vendor for 2015
TASC will be the new administrator starting January 1, 2015 for
all Flexible Spending Accounts.
The TASC Card
The TASC Card is a debit card that provides a convenient method
to pay for eligible healthcare, dependent care, and/or transit and
parking expenses.
Health Care & Limited Purpose FSA
Contribution Limits
§§Minimum $100 annually
§§Maximum $2,500 annually
Dependent Day Care FSA Contribution Limits
§§Minimum $100 annually
§§Maximum $2,500 - $5,000 annually (varies by
tax filing status)
How to Enroll
You will enroll online directly with TASC at www1.tasconline.com/enrollment. You are encouraged to enroll online but
you may also submit a paper application. Contact your benefits office for a paper enrollment form.
When you first create your account online, you will need to provide the UW’s Client/Employer ID. This number is 46076190-4348.
For more detailed enrollment information, see www.uwsa.edu/abe/fsa/index.php#enrollment. You may also contact
TASC’s FSA Customer Service at 1-800-745-9202.
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Your needs. Your benefits.
www.uwsa.edu/abe
Dental and Vision Insurance Options
All health plans, except Standard Plan and SMP, offer dental benefits. All health plans, except Standard Plan, offer vision
(eye exam) benefits.
If you want additional vision and/or dental insurance, VSP Vision Insurance, Dental Wisconsin and EPIC Benefits+ are
offering an enrollment. You may enroll, add/remove dependents, change plans (if applicable) and cancel coverage for
2015 for all three plans. These are optional, employee-pay-all plans benefit plans.
VSP Vision Insurance
VSP Vision Insurance provides partial coverage for:
§§
Annual vision exam
§§
Eyeglass lenses every calendar year and eyeglass frames once every other year
§§
Contact lenses every year instead of eyeglasses or eyeglass lenses
§§
Discounts on laser vision correction
§§
KidsCare program (eyeglasses more often for children)
For Premium
Information
See page 10
Dental Wisconsin
Dental Wisconsin offers two plans – the PPO plan and the Select
plan. You may enroll in one of these two plans. These plans
provide coverage for:
§§
Partial coverage for fillings and major dental services
(crowns, implants, etc.) up to the annual $1,000 maximum
§§
The PPO plan also covers annual cleanings and x-rays
§§
Orthodontic services (up to $1,000 lifetime maximum)
§§
Vision discount program through Davis Vision
EPIC Benefits+
EPIC Benefits+ provides coverage for:
§§
Partial coverage for major dental services (crowns, implants,
etc.) up to annual $1,500 maximum
§§
Orthodontic services (up to $1,000 lifetime maximum) - 12
month waiting period
Dental WI Waiting Period
You and your covered dependents must serve
a 3 month waiting period for basic and major
services and a 12 month waiting period for
orthodontic services (unless you have prior
creditable dental coverage).
EPIC Benefits+ Changes for 2015
§§ The AD&D benefit is increasing by 50%.
§§ Hospital/Surgical benefit has been doubled.
§§ Increased benefit for frames and contacts
under the additional vision insurance.
§§
Hospital/Surgical benefit
§§
Accidental Death and Dismemberment (AD&D) benefit.
§§
Vision discount program through Davis Vision.
§§OR you may choose to add EPIC Benefits+ with vision,
which provides you with vision insurance at an additional cost.
EPIC Benefits+ is offering a special enrollment. If you enroll during the special enrollment, your annual dental maximum
will be limited during the first two years of coverage per the following:
Limited Dental Benefit Maximum
§§
2015 - $750
§§
2016 - $1,000
§§
2017 - $1,500 (full benefit)
There is also a 24-month waiting period for orthodontic services. Any dependents added during the special enrollment
will be subject to the limited dental maximums and the extended waiting period.
8
Your needs. Your benefits.
www.uwsa.edu/abe
Individual & Family Life Annual Increase Option
Individual and Family Life Insurance
The Annual Increase Option (AIO) allows employees that have coverage effective
on or before October 1, 2014 to increase their current coverage for 2015. The AIO
period is the same time as the ABE period.
During the AIO period, you may elect to increase coverage by the following
amounts:
§§
Employee: $5,000; $10,000; $15,000 or $20,000
§§
Spouse/Domestic Partner: $5,000 or $10,000
§§
Child(ren): $2,500
Resources
Please see the Individual &
Family page to see resources
such as a premium calculator,
application and plan certificate.
Don’t forget to update your
beneficiary designation!
www.uwsa.edu/abe/life/
Coverage Maximums
§§
Employee: $300,000
§§
Spouse/Domestic Partner: $150,000
§§
Child(ren): $25,000
Spouse/Domestic Partner or Child coverage cannot exceed your total coverage. If you have Child coverage, new dependent
children are covered automatically.
Other Life Insurance Plans
Individual & Family Life Insurance is the only life insurance plan that allows changes during the Annual Benefit Enrollment
Period. There is not an opportunity to enroll in or make changes to State Group Life Insurance or UW Employees Inc. Life
Insurance. You may enroll in or make changes to Accidental Death & Dismemberment Insurance at any time.
Transit and Parking benefit for 2015
TASC will administer the Transit and Parking
benefit for 2015. This is currently referred to
as the Commuter Benefit.
Change for 2015: TASC will administer
separate Transit and Parking benefits in
2015. These are currently combined in the
Commuter Benefit.
You can make changes to your election at any
time during the year.
9
Your needs. Your benefits.
www.uwsa.edu/abe
2015 Monthly Employee Premiums
UW System State Group
Health Monthly Employee
Premiums for 2015*
Employees Covered
by WRS - Coinsurance
Uniform Benefits
Employees Covered
by WRS—HDHP
Employees Covered by Graduate
Assistant/
Short Term Academic
(Coinsurance Uniform Benefits)
Single
Family
Single
Family
Single
Family
Tier 1 (all plans except
Standard Plan)
$92
(+$4)
$230
(+$11)
$32
$81
$46
(+$2)
$115
(+$5.50)
Tier 2 (Standard Plan –
required to work out of state)
$136
(+$7)
$341
(+$17)
$76
$192
$68
(+$3.50)
$170.50
(+$8.50)
Tier 3 (Standard Plan)
$267
(+$28)
$666
(+$70)
$207
$517
$133.50
(+$14)
$333
(+$35)
*Premiums listed do not apply to those who are required to pay less than half-time rates or pay the total premium.
Numbers in ( ) show change in premium from 2014.
Dental and Vision Monthly
Premiums for 2015
Employee
Employee +
Spouse/DP
Employee +
Child(ren)
Family
EPIC Benefits+ Without Vision
$19.77
$39.54
$39.54
$59.31*
EPIC Benefits+ With Vision
$24.02
$47.04
$47.04
$70.34*
Dental WI Select
$20.52
$42.19
$48.68
$71.59
Dental WI PPO
$25.49
(-$2.83)
$53.96
(-$6)
$60.34
(-$6.70)
$91.21
(-$10.13)
VSP
$6.54
(+$0.19)
$13.08
(+$0.38)
$14.73
(+$0.43)
$23.54
(+$0.69)
*Your premium may decrease if you are moved from Family coverage to the new Employee + Child(ren) premium
category (formerly categorized as Employee + Child). This change will be automatic.
Numbers in ( ) show change in premium from 2014.
DISCLAIMER: Every effort has been made to ensure that this information is correct and current.
However, the terms and conditions of UW benefit programs are established by state and federal laws
and regulations, the relevant contracts, and the policies of the Board of Regents. These sources of
authority have control over the information to the extent there are any differences or conflicts.
Revised 10/10/14
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Your needs. Your benefits.
www.uwsa.edu/abe