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Health. It s all about your. Benefits Table of contents

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page } back search Benefits 2013 Enroll in ProvConnect by your deadline It s all about your Health Table of contents Welcome to Providence benefits You re here for Providence. Find out how Providence
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page } back search Benefits 2013 Enroll in ProvConnect by your deadline It s all about your Health Table of contents Welcome to Providence benefits You re here for Providence. Find out how Providence is here for you in this guide and at benefits.providence.org. Your to-do list Your enrollment timeline health incentives Enrolling dependents Medical Premium Assistance Program Employee Assistance Program Benefit options Medical Flexible Spending Accounts Dental Vision Medical, dental and vision premiums Life, accident and disability insurance Voluntary benefits Glossary WA1 Welcome to Providence benefits We know that you bring value to Providence. Let us show you the value of Providence benefits. In joining Providence, we want you to get the most from your experience with us. We hope you find carrying out our Mission to be rewarding and fulfilling, but we also know that the benefits we provide are essential to your security and well-being. We re here to support your health and well-being by providing you and your family with a strong benefits package, as well as incentives and resources to help you stay happy and healthy body, mind and spirit. One of the most valuable benefits Providence offers is medical coverage. Our medical plans help you stay well by covering preventive care 100 percent in-network. Providence medical plans also offer incentives for you to use care efficiently and take charge of your health. We believe that you are in the best position to make health care choices for yourself and your family. Our 2013 benefits include the choice of two account-based medical plans, the Health Reimbursement Medical Plan and the Health Savings Medical Plan. The accounts associated with the plans are used to help pay your out-of-pocket medical costs. Your benefits resource: benefits.providence.org You have a website to help you understand your benefits and make the best enrollment choices for you and your family. Check out benefits.providence.org. The site offers simplified summaries of your benefits along with comparison tables and examples. All you need is your employee ID number to log in. As a new employee, use one of the log-in codes listed below until your employee ID is processed: If you are a Providence Senior and Community Services (PSCS) employee: BenefitsPSCS. If you are a Southeast Washington (Walla Walla area) employee: BenefitsSoutheast. If you are a Southwest Washington (Olympia/Centralia area) employee: BenefitsSouthwest. These plans offer low premiums and give you an opportunity to save for future health care expenses. You can also earn up to $1,400 by completing activities proven to drive health awareness. See 2013 Health Incentives on page four to learn more. You may also have the choice of an HMO from Group Health. See page eight to see how your options compare. Review this guide and decide which benefits you d like for you and your family. If you need help, visit benefits.providence.org or call the HR Service Center at Then go online and enroll in ProvConnect within 31 days of your hire date or date you become eligible. Welcome to Providence and thank you for joining us in our Mission! 2 page home page } back search Your to-do list Your enrollment timeline Review this guide to learn about your benefit options for Visit benefits.providence.org if you would like more help deciding which options work best for you and your family. Use the log-in listed on page two until your employee ID is processed. Enroll online in ProvConnect Employee Self-Service (ESS) within 31 days of your hire date or date you become eligible. Using ProvConnect ESS ProvConnect Employee Self-Service (ESS) is your one stop shop for employee information, including enrolling in benefits. Access ProvConnect from work at or from home at https://provconnect.providence.org. You can only connect on a Windows PC running Internet Explorer. To log into ProvConnect, you will need your user name and password. If you are a new employee, your manager will receive your user ID and password and forward it to you. Once logged in to ProvConnect, to enroll in benefits as a new hire, click on the Employee Self-Service menu (on the left-hand side of the screen), then click New Hire and select New Hire Enrollment. Once you submit your choices, you will not be able to make changes. So be sure to carefully review your selections before you finalize your enrollment. Medical cost calculator You can use the medical cost calculator tool in ProvConnect to calculate your out-of-pocket medical costs, including premiums, to help you choose the right option. If you are a manager, click on the Enhanced ESS tab at the top of the home page. You ll see a link to the calculator on the right. Your benefits become effective the first of the month coincident with or following your date of hire or the date you become eligible for benefits. For example, if you are hired on Feb. 1, and enroll the same day, your benefits are effective that day. If you are hired on Feb. 5, your benefits are effective on March 1 if you enroll by that date. The sooner you enroll, the better for you. If you wait until after the first of the month following your hire date, your benefits will not become effective until the first of the next month. If you don t enroll If you don t enroll within 31 days of your hire date (or the date you become benefit-eligible), you will have the employee-only coverage listed below (no family members will be covered). Health Reimbursement Medical Plan, Delta Dental PPO 1500 Plan, Basic Life and AD&D Insurance (see page 12 for your coverage amount), and Long-Term Disability (see a description of the core benefit in ProvConnect Enhanced ESS). If this is not the coverage you want, you will need to enroll in ProvConnect. If you intend to waive/opt-out of medical and dental benefits, you will need to take action in ProvConnect to make this election. Key facts to know about benefits 2013 You and Providence share in the cost of coverage. The amount you pay for your 2013 medical, dental and vision options is shown on page 12. Premiums for 2013 additional life and disability insurance options are available in ProvConnect. Your benefits will go into effect on the first of the month coincident with or following your date of hire or eligibility, and generally remain in effect for the remainder of You can change your benefits only if you have a change in family status (such as a birth, death, marriage, divorce, etc.) or other qualifying life event by contacting the HR Service Center to request the change within 31 days (60 days for birth/adoption) of the event. Questions? Contact the HR Service Center at or 3 page home page } back search 2013 health incentives You and your enrolled spouse/adult benefit recipient (ABR) can each earn up to $700 in health incentives for 2013, for a total of $1,400. See the chart below. Coverage If you enroll in the Health Reimbursement or Health Savings Medical Plan, earn up to... Employee only $700 $400 Employee + child(ren) $1,400 $400 Employee + spouse/abr $1,400 $800 Employee + family $1,400 $800 If you enroll in the Group Health HMO (where offered), earn up to... Earning your 2013 health incentive You must be enrolled in a Providence medical plan to qualify for a health incentive. If you become benefits-eligible between Jan. 1 and June 30, 2013 To earn your 2013 health incentive, you (and your spouse/abr if enrolled) will need to complete a confidential biometric screening to learn your key health numbers, including your height, weight, blood pressure and cholesterol and glucose levels. You can complete your biometric screening one of two ways: At a free on-site event, where available. Your biometrics are automatically entered in your Healthyroads profile once you register at healthyroads.com. With your own provider. Register at healthyroads.com, download the Provider Form and submit it to Healthyroads. You won t be able to register for an account at healthyroads.com until your medical plan becomes effective. If needed, you can download the Provider Form at benefits.providence.org. Under the Health Incentives tab, choose the Earning Your 2013 Health Incentive page. To sign up for an on-site biometric screening before your medical plan is effective, go to registerformyevent.com/phs. If you choose to use your own provider, the biometric screening may be covered at 100 percent for you and all enrolled family members age 18 and older as part of your preventive care benefit when received through an in-network provider. Your biometrics must be received by Healthyroads no later than July 31, 2013 to earn the health incentive. Learn more at benefits.providence.org. Click on the Health Incentives tab. If you become eligible for 2013 benefits between July 1 and Dec. 31, 2013 You will automatically receive 50 percent of the 2013 health incentive and you do not need to complete a biometric screening, although we highly recommend you still do so. You ll receive information about the 2014 health incentive program in late summer or early fall. How health incentives are paid If you earn a health incentive, it will be paid to the account associated with your medical plan. Your health incentive will be made in a single lump-sum payment to either your Health Reimbursement Account (HRA) or Health Savings Account (HSA). See page seven to learn more about the accounts. If you enroll in an HMO, your incentive will be in the form of reduced premiums (the amount you pay for coverage). You will receive your payment as taxable pay in your paycheck, up to a maximum of $100 per calendar quarter. Timing of health incentive payments Payments will take approximately four weeks from the date your biometric information is recorded with Healthyroads. The later you complete your biometric screening, the later you will receive your health incentive. Healthyroads Healthyroads is our health management partner. Visit healthyroads.com to register for your biometric screening, track progress toward your personal health goals and find resources to help you improve your health. Healthyroads will also be the record keeper for health incentive activities. Register at healthyroads.com to get started. Click on the orange Sign Up button on the right, accept the terms and conditions and you ll be taken to the registration page. Just enter your name and date of birth and you ll be able to create a user name and password. You and your spouse/abr will not be able to create a personal profile on healthyroads.com until the date your medical coverage becomes effective. You can then register, create a profile and monitor progress on completing the health incentive. It may take up to five weeks after your screening for the results to display in your Healthyroads profile. To ensure you receive your health incentive on time, we encourage everyone to complete their biometric screening as soon as possible. 4 Enrolling dependents Eligible dependents include your legal spouse or adult benefit recipient (ABR) and your children up to age 26. An ABR is someone who has been and will continue to be part of your family, whether legally related or not. Your ABR: Is someone with whom you share a committed, close personal relationship of mutual caring, Must be age 18 or older, and not be your employee or child under age 26, Must rely on you for financial support, Must have lived with you for at least 12 months prior to enrollment and will continue to do so for the upcoming year, and Must not have access to other medical coverage. Your eligible dependent children under age 26 include your: Biological child. Stepchild. Adopted child (including a child placed for adoption). Foster child. Child for whom you are the legal guardian. Working spouse surcharge If your spouse has access to a medical plan through his or her employer, but waives that coverage and instead enrolls in a Providence medical plan, a $150 monthly surcharge will apply. The surcharge will be deducted from your pay on a pre-tax basis in $75 increments twice a month. If you cover your spouse, the surcharge will not apply if he or she: Only has access to employer-provided medical coverage with an annual in-network out-ofpocket maximum greater than $6,250 for employee-only coverage and $12,500 if covering dependents. Is enrolled in his or her employer s plan and a Providence plan (as secondary coverage). Is enrolled in Medicare, Medicaid, Tricare or Tribal health insurance (and it is their only other coverage). Is a Providence benefits-eligible employee. If you cover your spouse on a Providence medical plan in 2013, you can confirm in ProvConnect when you enroll that the surcharge applies to you. If you do not, ConSova will mail you a declaration requiring you to attest whether the surcharge is applicable to you. If your spouse gains or loses employer coverage mid-year, the change should be reported to the HR Service Center within 31 days so the surcharge can be adjusted as necessary. Determining if the working spouse surcharge applies Do you want to cover your spouse on a Providence medical plan? A child more than 26 years old who is incapable of self-support because of a disability may remain eligible for coverage if the disability occurred before the child s 26 th birthday and he or she is your Section 152 tax dependent. When you enroll an eligible dependent for the first time, either during your initial enrollment, during open enrollment or during the year due to a change in family status, you will need to provide documentation showing that your dependent satisfies the eligibility requirement. Dependent eligibility will be verified by ConSova, our dependent eligibility administrator, or the HR Service Center. You will be contacted by ConSova if any proof of eligibility is required. More information about dependent eligibility including ABRs can be found at benefits.providence.org. Yes Is your spouse eligible for medical coverage through an employer other than Providence, but waives that coverage? Yes You will pay the $150 monthly pre-tax working spouse surcharge.* No You are not subject to the working spouse surcharge. You must certify that your spouse does not have other coverage when you enroll. No No action is required. You are not subject to the working spouse surcharge. *You are exempt from the surcharge if your spouse s employer coverage has an annual in-network out-ofpocket maximum greater than $6,250 (employee only) and $12,500 (if covering dependents). 5 Coordination of benefits When employees have double coverage, such as coverage from Providence and their spouse s employer, the two insurance companies will coordinate benefits. Typically, an employee s plan is primary (first to pay) and other coverage is secondary (may help to pay uncovered charges). Providence medical, dental and vision plans use a maintenance of benefits method. This means that if a covered dependent on Providence s plan has other coverage that is primary, he or she will not be able to receive a greater payment from the Providence plan as secondary than what would have been provided if the Providence plan had been primary. For most, having secondary coverage through Providence offers little, if any, advantage. If you and your spouse are both Providence employees, you cannot double-cover each other nor can you double-cover children. Medical Premium Assistance Program Employees having trouble paying the premiums for medical coverage may be eligible for assistance. This program reduces the amount qualified employees pay for medical premiums by 80 percent. To qualify, your total household income must be at or below 200 percent of the federal poverty guidelines. For example, 200 percent of the 2012 federal poverty guidelines are $22,340 for a single-person household and $46,100 for a four-person household. If you are interested in receiving assistance, contact APS Healthcare at , option 5, and complete a confidential application. Program requirements and application instructions are on the Medical Premium Assistance page under the Enroll in Benefits tab at benefits.providence.org. Employee Assistance Program: Confidential Employee Assistance Program (EAP) short-term counseling and referral services are offered at no cost to all Providence employees and their dependents through APS Healthcare. The EAP is available 24 hours a day, seven days a week at or online at (company code: Providence). For more information, go to the EAP page under the Other Benefits tab at benefits.providence.org. 6 Benefit options Medical You have the following options for medical coverage in 2013: Health Reimbursement Medical Plan, Health Savings Medical Plan, and Group Health HMO (not available to employees who work in Walla Walla). The Health Reimbursement Medical Plan and Health Savings Medical Plan are account-based plans. Each comes with a special account that you can use to help pay your share of health care expenses, such as your deductible and coinsurance. The account you receive depends on the plan you choose: Health Reimbursement Medical Plan Health Reimbursement Account (HRA) Health Savings Medical Plan Health Savings Account (HSA) If you earn a health incentive, it will be deposited into the account associated with your plan. If you enroll in the Health Savings Medical Plan, you can also contribute pre-tax dollars from your pay to your HSA. If you enroll in the HMO, your health incentive may offset a portion of your premium (your cost for coverage). Preventive care and preventive drugs covered at 100% Deductible/ Copay Coinsurance Use account funds to pay health care costs tax-free Account Out-of-pocket maximum If the out-of-pocket maximum is reached, the plan begins to cover 100% of eligible expenses. Using an HRA or HSA Use your HRA or HSA to pay your share of eligible health care expenses tax-free. The funds in the accounts roll over each year there is no use-it-or-lose-it feature. You always own the funds in your HSA and will keep your balance when you leave Providence. Your HRA funds belong to you after you have five years of service. Each account comes with a Visa debit card to make it convenient to pay for your health care costs. Just present your Visa card at provider offices, pharmacies or health care facilities and use it to pay your share of the cost, up to the balance you have in your account. After you enroll, you will receive a welcome kit from HealthEquity, the account administrator, with information on how to use your Visa card and your HRA or HSA account. What s in-network? Providence medical plans cover in-network care at a higher rate. The Health Reimbursement Medical Plan and Health Savings Medical Plan are administered by Providence Health Plans (PHP) and use the First Choice Health network in Alaska, Idaho, Montana and Washington. In Oregon, PHP uses the Open Option Network. In all other states, the MultiPlan Network is used. To find in-network facilities and providers, visit phppd.providence.org. If you live in eastern Washington near Spokane, you have even more choices. Find a provider through our partnership with Group Health Cooperative (GHC) at ghc.org/provider. Care from GHC providers will be paid at the in-network level. Need help deciding which medical option is right for you? Review the plan and account comparisons on the next few pages, then check out our benefits website for more information: benefits.providence.org. Use the medical cost calculator in ProvConnect to see the differences between your options and estimate your 2013 out-of-pocket costs under different scenarios. 7 2013 medical plan comparison Percentages indicate what the plan pays. Dollar amounts indicate what you pay. Health Reimbursement Medical Plan Health Savings Medical Plan Group Health HMO (where available) Plan feature In-network Out-of-network In-network Out-of-network In-network only Annual deductible $1,150 per person $2,300 max per family $1,500 employee only $3,000 with dependen
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