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Preview Welcome to Open Enrollment Saint Agnes Medical Center!

Welcome to Open Enrollment Saint Agnes Medical Center! CHETrinityHealthandSaintAgnesMedicalCenterarepleasedtoprovideyouwiththeinformationyouwillneedtoenrollin benefitsfornextyear. Throughouttherestofthiscommunication,youwillseeCHETrinityHealthandSaintAgnesMedicalCenter referredtoassimplyCHETrinityHealth. Ifyouhavemorequestionsafterreviewingthisguide,refertothe“ForMoreInformation” sectiontolearnwhereyoucangetanswers. Who Is Eligible What’s Inside Benefit HoursRequirement Dependents Other Medical, Regularlyscheduledfull-or Dependentchildrenareeligiblefor Newhires What’sNewfor2015 2 dental part-timecolleaguewith40or coveragethroughtheendofthePlan mustsatisfy andvision morebudgetedhoursperpay Yearinwhichtheyturnage26, therequired coverage period regardlessofmaritalstatus,student waitingperiod OtherInformationAbout 3 status,residency,financialdependency Enrolling orotherrequirementsprovidedthey Eligibleadult:Youmaycoveryour meetbothofthefollowingcriteria: spouseorEligibleAdult.AnEligible HealthCareReformUpdate 4 Adultisanadultwhoresidesandhas Theyare: financialinterdependencewiththe (cid:129) Youroryoureligibleadult’snatural MedicalCoverage 5 colleague,andisnotatax-qualified children; dependentorrelatedbyblood, (cid:129) Youroryoureligibleadult’slegally MedicalPlanHighlights 6 adoptionormarriagetothecolleague. adoptedchildrenorchildrenplaced withyouoryoureligibleadultfor adoption;or MoreAbouttheHealth 8 (cid:129) Childrenforwhomyouoryour SavingsPPO eligibleadultarethecourt-appointed legalguardian. Theyarenototherwisecoveredunder TaketheHealth 9 thePlanoranyothergrouphealthplan Assessment offeredbytheEmployer Flexible Regularlyscheduledfull-or Cansubmitclaimsforeligible Newhires DentalCoverage 11 spending part-timecolleaguewith40or dependents mustsatisfy accounts morebudgetedhoursperpay therequired VisionCareCoverage 12 period waitingperiod Life Regularlyscheduledfull-or Canelectcoverageforyourspouseor Newhires FlexibleSpending 13 insurance part-timecolleaguewith40or eligiblechildren mustsatisfy Accounts morebudgetedhoursperpay therequired period waitingperiod Long-term Regularlyscheduledfull-or Notapplicable LifeInsurance 14 disability part-timecolleaguewith40or morebudgetedhoursperpay TimeAwayfromWork 15 period VoluntaryBenefits 16 Verifying your dependents Ifyouaddanewdependent,youmustshowtheappropriatedocumentstoyourHuman ResourcesdepartmentbyNov. 19,2014. Toobtainafulllistofdocumentation HowtoEnroll 17 requirementsandresourcesavailabletoobtainthisdocumentation,visityourbenefits website. ForMoreInformation 18 ImportantReminders 19 SaintAgnesMedicalCenter 1 What’s New for 2015 (cid:129) IfyouenrollintheHealthCareFlexibleSpending Account(HCSA),youwillreceiveanewdebitcard fromWageWorks,calledtheWageWorksHealth Card. WatchforyournewcardinthemailbeforeJan. 1,2015. Your2015debitcardwillhavetheCHE TrinityHealthlogoonit. Ifyoumadea2014HCSA contribution,besuretoholdontoyourcurrent WageWorksdebitcardbecauseitwillbethecardyou needtousetoaccessyour2014HCSAthrough March2015. Also,remembertocreateanewonline accountatwww.wageworks.com. (cid:129) CHETrinityHealthisofferingtwonewdentalplan optionsthisyearadministeredbyDeltaDental–the HighPlanandtheStandardPlan. Ifyouarecurrently enrolledintoday’sPreferredHighplan,youwill automaticallybemovedtothe2015Highplan. Ifyou areenrolledintoday’sPreferredStandardplan,you willbemovedtothe2015Standardplan. Youmay electtochangeyourdentalplanduringOpen Enrollment. (cid:129) CHETrinityHealthisofferingtwonewvisionplan optionsthisyearadministeredbyUnitedHealthCare –theHighPlanandtheStandardPlan. Ifyouare currentlyenrolledintoday’sSaintAgnesVisionplan, youwillautomaticallybemovedtothe2015Standard UHCVision. YoumayelecttomovetotheHighUHC VisionplanduringOpenEnrollment. (cid:129) Wearechangingourlifeinsuranceprogramto harmonizeacrossthesystem. Thesechangesinclude anincreaseinthecolleaguesupplementallife election,additionofcolleaguesupplementalAD&D coverageaswellasanewcoverageamountfor spousesupplementallife. 2 SaintAgnesMedicalCenter Other Information About Enrolling If you don’t enroll Ifyoudon’tmakebenefitelectionsonorbeforeNov. 12,2014,youwillautomaticallyreceiveadefaultpackageof benefits,whichincludesthesameelectionsyouhavein2014formedical,lifeinsurance,anddisabilitybenefits. In addition,ifyouarecurrentlyenrolledintoday’sDeltaDentalPreferredHighplan,youwillautomaticallybemovedtothe 2015DeltaDentalHighplan. Ifyouareintoday’sDeltaDentalPreferredStandardplan,youwillbemovedtothe2015 DeltaDentalStandardplan. Ifyouarecurrentlyenrolledintoday’sSaintAgnesVisionplan,youwillautomaticallybe movedtothe2015StandardUHCVision. Yourcurrentelectionforthehealthcareanddependentcareflexible spendingaccountsandVacationcash-outwillnotcarryover. Ifyourwishtoparticipateintheseprogramsnextyear youmustcompleteyourenrollmentbyNov. 12,2014at12midnightEST. Benefit elections are effectivefor the entire year Remember,thebenefitsyouelectduringopenenrollmentwillbeineffectfromJan. 1throughDec. 31,2015. Open enrollmentisyouronlyopportunityduringtheyeartomakeelectionsforyour2015benefitsunlessyouexperiencea qualifiedfamilystatuschange. Ifyouexperienceaqualifiedfamilystatuschangeorcertainemploymentstatuschangesandprovideanyrequired documentationtoyourHumanResourcesrepresentativewithin30daysoftheevent,youwillbeallowedtomakecertain benefitchangesaslongastheyareconsistentwiththestatuschange. Forexample,ifyougetmarriedduringtheplan year,you’llbeabletoaddyourspouse/eligibleadulttoyourcoveragewithin30daysofthemarriage. Formore informationonqualifiedfamilystatuschanges,visithttp://mybenefits.trinity-health.org. Adding family members Ifyou’readdingfamilymemberstoyourbenefitplanforthefirsttimeduringthisyear’sopenenrollment,you’rerequiredto providewrittendocumentation(forexample,marriagecertificateorbirthcertificate)verifyingtheirdependentstatusto HumanResourcesnolaterthanNov. 19,2014. Ifyoudon’tsubmittherequireddocumentationbythedeadline,your dependentswillnotbeenrolledforcoveragefor2015,andyou’llberequiredtowaituntilnextyear’sopenenrollment periodtoaddthemtotheplan–providedtheyremaineligible,andyouprovidewrittendocumentationverifyingtheir dependentstatusatthattime. YouarerequiredtoprovideaSocialSecuritynumberforeachofyourdependentsovertheageofoneinorderforthemto becovered. PleaseprovideanymissingSocialSecuritynumberstoHumanResources. Pleasenote,youhavetheoptiontopurchasecoverageforyourspouse/eligibleadultanddependents. Ifyouandyour spouse/eligibleadultbothworkforCHETrinityHealth,andarebenefitseligible,youcannotelectdualcoverage(enrolled asacolleagueandadependent). Inaddition,onlyoneofyouwillbeabletoelectcoverageforyourchild(ren). Toviewthecompleteeligibilityrulesanddocumentationrequirementsforyouandyourfamilymembers,visit http://mybenefits.trinity-health.org. Choose your Primary Care Physician (PCP) MaintainingarelationshipwithyourPCPisimportantbecausetheyaretrainedtorecognizeanyhealthproblemsyoumay have. APCPisthedoctoryouseeformostservices,includingannualcheck-ups. YourPCPcanalsohelpyouidentify andmeetyourhealthgoalsandhelpyoupreventserious,long-termhealthconditions. And,byfollowingtheirpreventive recommendations,theycanhelpkeepyourhealthcarecostslow. CHETrinityHealthencouragesyoutoselectaPCP anddeveloparelationshipwiththem. Tofindanin-networkphysicianandprovider,visityourbenefitswebsite. SaintAgnesMedicalCenter 3 Update on the Affordable Women’s Preventive Care under the Affordable Care Act Care Act Eachyearduringopenenrollment,CHE PartoftheAffordableCareAct(ACA)(alsoknownashealthcarereform) TrinityHealthgivesanupdateonthe requiresemployerstocovercertainwomen’spreventivecareservices, healthcarereformlaw,officiallycalledthe includingcontraception,underhealthinsurancebenefitsatnocharge. AffordableCareAct(ACA). AsahealthministryoftheCatholicChurch,wehaveengagedinextensive Thelawwasputinplacetomakesure advocacywiththesupportoftheCatholicHealthAssociation,tofindan citizenshaveaccesstohealthinsurance acceptableresolutiontothisissue. theycanafford. SinceJan. 1,2014,the ThefinalrulesfromtheU.S.HealthandHumanServices,Treasuryandthe lawhasrequiredthatmostU.S.citizens DepartmentofLaborgiveanaccommodationtocertainreligiousand andlegalresidentalienshavehealth religiously-affiliatedorganizations,likeCHETrinityHealth,toprovidean insurancewhethertheygetitfroman exemptionfromtherequirementtoprovidecontraceptivecoverageto employer,aprivateinsurancecompanyor employeesaspreventivehealthservices. fromthegovernment. Iftheydonothave Theintentoftherulesistoaccommodatethemoralperspectivesofcertain healthinsurance,theymayhavetopaya religiously-affiliatedemployerswhilealsoprovidingforthepreventivehealth taxpenalty. careneedsoftheiremployeeswhomaynotsharetheemployers’religious AsacolleagueatCHETrinityHealth,here beliefs. ishowthelawmayaffectyou: In2015,yourmedical/pharmacybenefitproviderwillcontinuetoprovide (cid:129) CHETrinityHealthwillcontinuetooffer thesebenefitsasmandatedbytheACA. healthinsuranceforU.S.colleagues whoarebenefitseligible.Duringopen CHETrinityHealthcolleagueswillbeprovidedwithaccesstothesebenefits, enrollment,youcanchoosetheCHE buttheywillnotbepaidforbyCHETrinityHealthoritshealthplans. Contact TrinityHealthmedicalplanthatworks yourmedical/pharmacybenefitproviderforfurtherdetails. bestforyouandyourfamily. (cid:129) EffectiveJan. 1,2015,asaresultofthe More about the Clinically-Integrated Network ACA,employerswillberequiredtooffer AClinically-IntegratedNetwork(CIN)joinslocalphysiciansandhealthcare medicalandprescriptioncoverageto providersthathavemadeadecisiontopartnerwithaRegionalHealth employeeswhoworkmorethan30 Ministry(RHM)todeliverservicesfocusedonhighqualityandcost-efficient hoursaweekormorethan130hours caredesignedtoimprovethehealthofthoseweserve. permonth. Colleagueswhoworkan averageof30hoursaweekovera SeekingcarewithintheCINcanhelpyouandyourphysicianmakehealth rolling12-monthperiodwillbeeligible caredecisionsthatensurethatyouareaccessingtherightcare,attheright formedicalcoveragethroughCHE timeintherightsetting. Inaddition,byutilizingourCINyouwillpaylessout TrinityHealth. ofpocketforthecareyoureceive,becausealloftheCINprovidersareinour (cid:129) ACHETrinityHealthmedicalplanmay Tier1network. beyourbestoptionforcoverage. TheAffordableCareActischangingthewayweprovidecare. Asaresult, Youwillprobablycontinuetohearalot therehavebeenmanychangesdesignedtohelpincreasehealthcarequality aboutthehealthinsurancemarketplace andreducethecostinordertomakeitmoreaffordable.Ourhealthcare thathasbeensetupineachstatetohelp organizationischanginginordertodeliverbettercareatareducedcostand peoplefindhealthinsurancefor2015. If withanimproved,people-centeredcareexperience. youarebenefitseligible,aCHETrinity Therearealotofchangeshappeningonthehealthcarelandscape. We Healthmedicalplanwilllikelybethemore believeputtingtheminplacewillbetterpositionourorganizationtokeepour cost-effectiveoption. colleaguesandtheirfamilieshealthier,fulfillourMission,meetournation’s CHETrinityHealthwillcontinue needsandimprovethehealthofthemillionsofpeopleandthehundredsof communicatingwithyouaboutyour communitiesweserve. benefitscoverageasweremaincommitted Ifyouhavequestionsaboutthesechanges,pleasecontactyourHuman toprovidingyouwiththelatestinformation. Resourcesrepresentative. Inthemeantime,ifyouhavequestions, pleasecontactyourHumanResources representative. 4 SaintAgnesMedicalCenter Medical Coverage Watch the Video CHETrinityHealthisofferingyouthreemedicalplanchoicesfor2015which to Learn More supportsoureffortstoprovideacommonexperienceforallcolleaguesandprovide meaningfulchoices. AllthreeplansareadministeredbyBlueCrossBlueShieldof MichiganwithabenefitincentivetouseaTier1provider. ThethreemedicalplanoptionsaretheTraditionalPPO,theHealthSavingsPPO, andtheEssentialPPO.Eachplanoffersthesethreetierssoyoucanpaylessby receivingcarefromnetworkproviders. (cid:129) Tier1,ortheCHETrinityHealthnetworkproviders,arefacilitiesorphysicians Scanthetagwithyour alignedwithourorganizationthatprovideyouwiththemostcost-effective smartphonetodownload care. andviewavideoabout (cid:129) Tier2includesallotherBlueCrossandBlueShieldProvidersnotlistedunder your2015medicalplan Tier1. Tier2providerscansaveyoumoney,butnotasmuchasusingour choices. Getthefree Tier1network. mobileapplicationat http://gettag.mobi.Ifyou (cid:129) Tier3providersareout-of-networkprovidersandthisTierprovidesthelowest don’thaveasmartphone, levelofcoverage. Youcanusethesefacilitiesandphysiciansforcare,butyou visityourbenefitswebsite willpaythemostoutofyourpocketwhenyoudo. toviewthevideo. How the medical plan works TraditionalPPO IfyouelectcoverageundertheTraditionalPPO,youpayforaportionofthemedicalservicesyoureceive untilyoumeettheannualdeductible. Then,coinsurancebeginsuptotheannualout-of-pocketmaximum. HealthSavingsPPO WiththeHealthSavingsPPO,youpaymuchlessperpayperiodforcoverage–leavingmoremoneyin yourpaycheck–andyouhaveaccesstoaHealthSavingsAccount(HSA)tohelppayforcurrentandfuture medicalexpenses. Here’showitworks: IfyouenrollintheHealthSavings Youpaythefullcostofmedicalandprescription First PPO,youwillautomaticallyhave expensesuntilyoureachtheannualdeductible(Note: anHSA.CHETrinityHealthand preventivecareservicesandcertainpreventive90-day SaintAgnesMedicalCenter genericprescriptionsdonotrequireyoutopaythe contributestoyourHSAtohelp deductible). youpayforexpensestowardyour annualdeductibleand Onceyoumeetthedeductible,youpaycoinsuranceuntil Second out-of-pocketmaximum. Youcan youreachtheout-of-pocketmaximum. alsocontributetothisaccountto buildsavingsforcurrentand Onceyoureachtheout-of-pocketmaximum,CHETrinity Third futuremedicalexpenses. We Healthpays100%ofallremainingeligibleexpenses encourageyoutoconsultwitha duringtheyear. taxadvisorforIRSrulesandtax TolearnmoreabouttheHealthSavingsPPO,seepage6ofthis implicationsrelatedtoHSAs. enrollmentguide. EssentialPPO TheEssentialPPOworksthesameastheTraditionalPPOwhereyoupayaportionofthemedicalservices youreceiveuntilyoumeettheannualdeductible. Then,coinsurancebegins. IfyouelecttheEssentialPPO, youpaylessinpremiumcontributionsthanintheTraditionalPPO,however,yourout-of-pocketcostsare higher. SaintAgnesMedicalCenter 5 Medical Plan Highlights Formoreinformationaboutyourmedicalplanoptions,visityourbenefitswebsite. MedicalPlan TraditionalPPO HealthSavingsPPO EssentialPPO Highlights Tier1 Tier2 Tier3 Tier1 Tier2 Tier3 Tier1 Tier2 Tier3 CHETrinityHealth- N/A HealthSavingsAccount(HSA) HealthReimbursementAccount(HRA), fundedaccount ifyouqualify Single $650 $750 Family $1,300 $1,500 Annual deductible Individual $250 $750 $1,500 $1,300 $2,500 $3,500 $1,000 $2,500 $4,000 Family $500 $1,500 $3,000 $2,6001 $5,0001 $7,0001 $2,000 $5,000 $8,000 Coinsurance 10%* 20%* 40% 10%* 20%* 40%of 20%* 30%* 40% R&C* R&C* R&C* Preventivecare 0%no 0%no 40% 0%no 0%no 40% 0%no 0%no 40% deductible deductible R&C* deductible deductible R&C* deductible deductible R&C* Officevisit PCP:$20 PCP:$30 40% 10%* 20%* 40% 20%* 30%* 40% Specialist: Specialist: R&C* R&C* R&C* $30 $40 bug Urgentcarevisit 0%after$35copay 10%* 0%after$40copay Emergencyroom 0%after$100copay 10%* 0%after$100copay Inpatient None** $500** $1,000** None** $500** $1,000** None** $750** $1,000** admission Outpatient $50** $100** $200** None** $100** $200** $50** $100** $200** admission Out-of-pocket maximum (includesdeductible, copayments,and coinsurance) Individual $2,500 $4,750 $9,500 $2,600 $5,000 $7,000 $3,500 $5,500 $9,000 Family $5,000 $9,500 $19,000 $5,200 $10,000 $14,000 $7,000 $11,000 $18,000 Prescriptiondrug Retail/In-house pharmacy (34-daysupply) Generic $10 $10 † Brandformulary 20%($30min.,$80max.) 20% ,0%afterout-of-pocketmax. 25%($30min.,$80max.) Brandnon-formulary 40%($60min.,$100max.) (Deductibleandout-of-pocketmax. 50%($60min.,$120max.) basedonTier1) (90-daysupply) Generic Mail$25/In-house$30 Mail$25/In-house$30 Brandformulary 20% 25% † Mail($75min.,$200max.) 20% ,0%afterout-of-pocketmax. Mail($75min.,$200max.) In-house($90min.,$240max.) In-house($90min.,$240max.) Brandnon-formulary 40% 50% Mail($150min.,$250max.) (Deductibleandout-of-pocketmax. Mail($150min.,$300max.) In-house($180min.,$300max.) basedonTier1) In-house($120min.,$360max.) 1Thefullfamilydeductiblemustbemetevenifonlyonepersoninthefamilyisreceivingcare. *Subjecttodeductible. **Subjecttodeductibleandcoinsurance. † Select,genericpreventivedrugsarecoveredat100%andarenotsubjecttotheannualdeductible.SeeMyBenefitsforthe completelistofeligibledrugs. 6 SaintAgnesMedicalCenter Paying for medical coverage ContributionlevelsforthemedicalplansarebasedontheSocialSecuritytaxablewagebase($117,000for2014,indexed annually)toensureourbenefitplancost-sharingmodelisappropriatelyalignedwithourcolleagues’incomelevels. Theamount youpayformedicalcoverageisbasedonyourannualbasesalary(yourbaserateofpaytimesyourbudgetedhours)andyour participationintheHealthAssessment(HA).Ifatanytimeduringthe2015planyear,youearn$117,000ormore,youwillpaya higherpremiumcontributionperpayperiodforyourmedicalinsurance. TraditionalPPO HealthSavingsPPO EssentialPPO Full-time Part-time Full-time Part-time Full-time Part-time bug Yourperpay With Without With Without With Without With Without With Without With Without periodcost HA HA HA HA HA HA HA HA HA HA HA HA bug Colleagueonly Colleagueplus spouse/eligible adult PleasecontactyourHumanResourcesrepresentativeformedicalplanrates. Colleagueplus child(ren) Colleagueplus family Need help with your health care costs? YoumaybeeligiblefortheEssentialPPOAssistplanifyoumeetcertainincomerequirements. Itisthe sameastheEssentialPPO,butincludesaCHETrinityHealth-fundedHealthReimbursementAccount (HRA),tohelpyoupayforyourhealthcarecostsatthetimeofservice. Youdonotmakecontributionsto theHRAundertheEssentialPPOAssistplan. ToparticipateintheEssentialPPOAssist,youmustapply forandmeetspecificincomeandeligibilityguidelines. Tolearnmoreaboutthequalificationspleasesee theapplicationformonMyBenefits. YoucanapplyfortheEssentialPPOAssistbycompletingan applicationformandsubmittingitwithacopyofyourmostrecentFederalIncomeTaxForm1040or 1040EZtoHumanResourcesbyNov. 19,2014. NOTE:EvenifyouthinkyouqualifyfortheEssentialPPOAssist,youshouldelectthemedicalplanyou thinkwillbebestforyouandyourfamily–whichcouldbetheTraditionalPPO,theHealthSavingsPPO, ortheEssentialPPO.IfyouqualifyfortheEssentialPPOAssistplan,youwillbemovedtotheEssential PPOAssistplan. Otherwise,youwillremainintheplanyouelectedduringopenenrollment. SaintAgnesMedicalCenter 7 More about the How the Health Savings Account (HSA) works Health Savings WhenyouenrollintheHealthSavingsPPOplan,youautomaticallyhaveaHealthSavings Account(HSA)throughHealthEquitytohelpyoupayforcurrentorfuturehealthcarecosts. PPO CHETrinityHealthwillmakeafullcontributiontoyouraccountinJanuarybasedonthe TheHealthSavingsPPO coveragelevelyouelect. Inaddition,youcanalsocontributetothisaccountuptoIRSlimits: isaconsumer-driven CoverageLevel CHETrinityHealth YourVoluntary TotalIRSAllowed healthplanwhichgives SaintAgnesMedicalCenter Contributions*† HSAContributions youtheopportunityto Contributions† participateinaplanwhere Colleagueonly $650 $2,700 $3,350 yourhealthcarecostsare Allothercoveragelevels $1,300 $5,350 $6,650 morecloselydetermined *Ifyouare55orolder,youcancontributeanadditional$1,000incatch-upcontributionstoyourHSA. byyourdecisions. Here †Maybesubjecttostatetaxation. aresomereasonsto Questions about the HSA considerchoosingthe HealthSavingsPPOin HowdoIgetanHSA?TobeeligiblefortheHSA,youmustenrollintheHealthSavings 2015: PPO.Inaddition,youcannothavecoverageunderanyothermedicalplan,suchasMedicare, TRICARE,orcoveragethroughaspouse’shealthplan. “ IlikedthatIsaved WhocanusefundsinmyHSA?Youandyourdependentscanpayformedical,dentaland moneyinpremium visionexpenseswithfundsinyourHSA.Dependentsmustbeclaimedonyourtaxreturn. contributions– spendingmoney WhywouldIcontributetomyHSA?ContributionstotheHSAareagreatwaytosaveon onlywhenIused taxes. WiththeHSA,youdonotpaytaxesontheamountyoucontributethroughpayroll medicalcare.” deductions,theamountyouwithdrawformedicalexpenses,andtheinterestyouearninthe account(uptoamountssetbyfederallaw). Keepinmindthatyoucanchangetheamountyou “ Icanreallysave contributetoyourHSAatanytimeduringtheplanyear. formyhealthcare HowcanIusethemoneyinmyHSA?YoumayusetheHSAtopayforqualifiedmedical expenseswhenI expensesnowandduringretirementforyouandyourqualifieddependents. usetheHSA.” HowdoIpayformedicalexpenseswithmyHSA?Whenyoureceiveeligiblehealthcare “ It’sgreatthatCHE services,youcanpayforthoseserviceswithyourHSAdebitcard,orthroughseveralonline TrinityHealthmakesits andsmartphoneappoptions. You’llreceivemoreinformationaboutyourpaymentoptionsif fullcontributiontomy youenrollintheHealthSavingsPPOwiththeHSA. HSAinJanuary.” WhathappensifIdon’tuseallthemoneyinmyHSAeachyear? Anymoneyyoudo notuseduringtheyeariscarriedover,withoutanylimits. Remember,youownthemoneyin “ Forcertaingeneric yourHSAanditisyourstokeep–evenwhenyouchangejobsorretire. preventivedrugs,I CanIenrollintheHealthCareSpendingAccount(HCSA)ifIhaveanHSA?When didn’thavetopaymy youenrollintheHealthSavingsPPOwhichincludestheHSA,youwillnothaveaccesstothe deductiblebeforethe healthcarespendingaccount(HCSA).However,theHSAmaybeseenashavingmore planstartedpaying advantagesovertheHCSAincluding: thoseexpenses.” (cid:129) Theopportunitytocarryoversavingsfromyeartoyear–youdonotforfeitanyamountin yourHSAattheendoftheplanyear(ifyouarecurrentlyenrolledintheHCSA,youmust How the utilizeyouraccountfundsbyDec. 31,2014); deductible works (cid:129) Contributionsofupto$6,650†intax-freeHSAdollarseachyear(theHCSAmaximumis TheHealthSavings $2,500); PPOPlanincludesa (cid:129) YourHSAdollarsaresavedinabankaccountthatmayearninterest. combineddeductible. HowdoIknowiftheHealthSavingsPPO,includinganHSA,isrightforme? Your Acombined medicalplanchoicedependsonyourpersonalsituation. Ifyouanswer“yes”tosomeofthese deductiblemeansthe questions,theHealthSavingsPPOplanisrightforyou: fullfamilydeductible mustbemetevenif (cid:129) Wouldyouliketohavelowerperpayperiodcontributionsdeductedfromyourpaycheck? ! onlyonepersonin (cid:129) Doyouwanttosaveontaxesbycontributingtothe thefamilyisreceiving HSAforyourhealthcarecosts? care. Coinsurance (cid:129) Doyouneedawaytopayforfuturehealthcarecosts? Formoreinformationaboutthe HealthSavingsPPO,includingthe beginsoncethe (cid:129) CanyouseeyourHSAbalancegrowingasyoukeep HealthSavingsAccount(HSA), combineddeductible visitwww.healthequity.comor makingcontributionseachyear? hasbeenmet. http://mybenefits.trinity-health.org. WeencourageyoutoconsultwithataxadvisorforIRS rulesandtaximplicationsrelatedtoanHSA. 8 SaintAgnesMedicalCenter Take the Health Assessment TheHealthAssessment(HA)asksaboutyourhealthhabitsandlifestyletohelpidentifysomeofyourhealthneeds. Your answersarekeptsecureandconfidential;summarydataisusedtoidentifyareasoffocusforfuturewellnessandprevention programs. Whenyouandyourcoveredspouse/eligibleadulttaketheHAyouwillmaintain your30percentpremiumcontributiondiscount fortherestof2015. ForcurrentBlueCrossBlueShieldusers,youandyourcoveredspouse/eligibleadultcantaketheHAfrom Oct. 1,2014throughJan. 31,2015. Yourcoveredspouse/eligibleadultmustregisterseparatelyusingtheirBlueCross BlueShieldIDcard. NewBlueCrossBlueShielduserswillbeabletotaketheHAfromJan. 1throughJan. 31,2015because yourBlueCrossBlueShieldbenefitwillnotbeavailableuntilJan. 1,2015. Informationcollectedinthisassessmentwillnotaffectyourparticipationintheplanornegativelyimpactyourhealthcarecosts. Itwillbekeptconfidentialandsharedonlywiththosewhowillhelpcolleaguesmakechoicesthatimprovehealthandqualityof life,andmaybeusedtodevelopfuturehealthandwellnessprogramsforcolleagues. Tocontinuereceivingtheperpayperioddiscountedpremiumcontributionsfortheremainderoftheyear,bothyouandyour coveredspouse/eligibleadultwillneedtocompleteanonlineHealthAssessmentatBCBSM.combyJan. 31,2015. NOTE: Remembertoretainproofofcompletionforyourrecords. Here’s how to complete the HA: 1 Logontowww.bcbsm.com. 2 UnderHealthandWellnesstab,clickon“BlueHealthConnection.”NOTE:Youwillreceivea screenthatindicates“youareleavingthiswebsite.”Thisiscorrect,clickOK. 3 Answerthequestionsonthescreensandclick“Continue”oneachscreen.Ifupdatinga currentHA,besuretoupdateatleastonefieldintheassessmentsoitwillreflectthemost recentdate. 4 Onceyouarefinishedansweringthequestions,youwillbeprovidedanoverallriskscore. Thefollowingscreenshaveinformationforyoutotakebettercontrolofyourhealthrisks andlifestylebehaviors. 5 Caution–theassessmentisnotcompleteuntilyouseeyourcertificateonthescreen. Printthisandkeepitforyourrecords. 6 Ifyouhavequestionsregardingyourhealthassessmentorareexperiencingdifficulties loggingintoBCBS,contactBCBSWebsupportat1-888-417-3479. Remember,ifyoudonotcompletetheHAbyJan. 31,2015,yourperpayperiodpremiumcontributionswillincreasebeginning withthefirstpaythatincludesMar. 1,2015,andcontinuethroughtheremainderofthe2015planyear. Youwillnothavethe optiontoloweryourpremiumcontributionsuntilthe2016planyear. SaintAgnesMedicalCenter 9 Be a smart health care consumer Asyouknow,thecostofhigh-qualityhealthcarecontinuestoincreaseeachyear. Beingasmartconsumermeans gettingthebestpriceonsomethingyouneed,whetherit’sanewcarorhealthcare. Beingasmarthealthcareconsumerdoesn’tmeanyoushouldavoidtripstothedoctor–itmeansmakingthebest decisionsaboutwhentogotothedoctor. Regularcheckupscanimproveyourhealthandextendyourlife. Bygetting therecommendedexamsandtests,youincreaseyourchancesofdiscoveringproblemsbeforeanillnesssignificantly affectsyourhealth. Plus,preventivecareisbeneficialnotonlytoyourphysicalwell-being,italsomakessenseforyour financialhealthbecausegenerally,it’scoveredbyyourmedicalplan. Formoreinformationonpreventivecarebenefits, visithttp://mybenefits.trinity-health.org. AneasywaytobeasmarthealthcareconsumeristochooseaCHETrinityHealthTier1providerwhenyouora familymemberneedsmedicalcare. Besidesreceivingexcellentcareatourownfacilities,youreceivethehighestlevel ofbenefitswhilepayingthelowestavailablecopaymentandcoinsuranceamounts. Maintenance Choice program for your maintenance medications Ourprescriptiondrugplanrequiresthatyoureceiveyourmaintenancemedications*in90-daysuppliesthrough the CVSCaremarkMailServicePharmacyoralocalCVSPharmacy. Onceyoureachyourplanlimit(initialfilland2 refills)forfilling30-daysuppliesataretailpharmacy,youwillpaythefullcostofyourmedicationsifyoudonotmove yourprescriptiontooneofthelong-termoptionslistedhere. *Amaintenancemedicationisalong-termmedicationtakenregularlyforchronicconditionsorlong-termtherapy. 10 SaintAgnesMedicalCenter

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CHE Trinity Health and Saint Agnes Medical Center are pleased to provide you with need to use to access your 2014 HCSA through To view the complete eligibility rules and documentation requirements for you and Maintaining a relationship with your PCP is important because they are trained to
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