Open Enrollment Planning Guide

Transcription

1 Open Enrollment 2019 Planning Guide Printed for VSBIT Spring Conference, 2018 Original artwork by Ashley Anne Johnson

2 What else will you consider including in your Open Enrollment materials? This Guide is current as of April 2018 and is for planning purposes only. Each employer is responsible for ensuring their Open Enrollment process and materials comply with local Plan documents, policies, actual employee benefits, as well as state and federal laws. This Guide assumes one Open Enrollment period for all employee benefit elections. Employers with a split Open Enrollment or a short plan-year need to modify guidance to meet those conditions. Plan years are determined by the district s Section 125 documents, HRA Plan documents, health and dental Plan documents and other benefit provider s documents. The VEHI health plan out-of-pocket costs accrue on a calendar year: January 1 through December 31. VEHI premiums will increase on July 1, 2018 and remain effective through June 30,

3 I am planning Open Enrollment 2019 for the following district(s): District Section 125 Plan year: January 1 July 1 Other We plan to hold Open Enrollment 2019 in this timeframe: Notes: Don t forget your Open Enrollment process and timeframe is governed by one or more of the following: 1. Section 125 Plan document 2. HRA Plan document 3. Board policy 4. Collective Bargaining Agreement terms 5. Merger considerations 6. Internal Chain of Command Reflection: Are there opportunities for modifications to any of the above documents/processes to improve the Open Enrollment process in the future? If so, consider making suggestions to the appropriate parties, including the context and rationale for your recommendations. This Guide Belongs To: 45 2

4 Open Enrollment 2018 Reflections What worked well; points of pride: Reflection: Why did it work well? 3 44

5 Subject to Change 2018/2019 Open Enrollment 2018 Reflections Lessons Learned: Let s not do THAT again! Reflection: Was the OE experience different for different employee groups? Why or why not?

6 Review of sample Open Enrollment Materials/Best Practices Articles What stands out for you as you review these materials? What questions or concerns do you have? What do the samples have in common? Identify at least three essential components to include in Open Enrollment Materials: Things to consider when developing Open Enrollment Materials: What will be helpful to employees making decisions and taking action? How do I avoid information over-load so people are more likely to read the materials and take action? Do I want to use different approaches for different employee groups? Does the number of employees and/or worksites influence the materials and approach? 5 42

7 Open Enrollment Materials Essential Components Look at the draft list below cross off anything you would not include in your OE materials. Add components you feel are missing. Modify items to make this list more useful or clear for you. 1. Messaging a. This is a once a year opportunity b. What action is needed by employee c. What happens if employee does not do anything 2. Eligibility 3. Deadline 4. Location of documents/materials 5. questions answered for support/get Opportunities who to get in touch with a. Contact information 6. Numbers and dollars- what it will mean specifically for employees 7. Positive 8. Focus on employee needs and perspectives 41 6

8 That s a great idea! What I learned from others so far (consider listing who the idea came from so you can follow up as needed): What I would like to do if I have time (will I ever have time???): 7 40

9 I still have these questions Here is how I will get my questions answered 39 8

10 Evergreen/Automatic Open Enrollment This is an approach to Open Enrollment where employees will be automatically re-enrolled in their same health and/or dental plan on a pre-tax basis unless they take action to make another plan selection or waive coverage. At time of hire and at Open Enrollment each year, employees must be provided adequate written notice explaining the automatic enrollment procedure, including the right to decline or modify coverage, the period of time the coverage will be in effect if they take no action, the procedures for exercising the right to decline or modify coverage, the deadline by which they must exercise these rights, and a description of their existing coverage, including any HRA. Reminder: Check your CBA/local policies to see if there is any applicable language that needs to be considered before implementing this practice. 9 38

11 Sample Campaigns from 2017/2018 These may be updated for 2018/2019 Furthermore, the following situations require an annual action by the employee: 1. Change in health plan election (Platinum to Gold for example) 2. Change in tier of health coverage (Single tier to Family tier for example) 3. Waiver of coverage (including any cash-in-lieu of provision which requires confirmation of other group coverage) 4. Election of Flexible Spending Account (IRS requires annual election) 5. Election of a Dependent Care Account (IRS requires annual election) 6. Election of a Health Savings Account (Requires annual certification of eligibility) 7. Election to receive benefits on a post-tax basis (Employees have the right to request their premium payments toward their health and/or dental plans be taxed. This increases their taxable wage which is often a factor in determining their Social Security and other retirement benefits.) Find a sample Evergreen Communication at vehi.org 37 10

12 Open Enrollment Tips Then allow yourself Keep a tight timeframe for Open Enrollment. time for follow up after the deadline to do individual reach out as needed. Too much time for employees to take action can lessen the sense of urgency, which may result in materials being misplaced and off the radar. Too little time can lead to stress and poor Think about the right balance for your employees. decision-making. Factor in the support you can provide during Open Enrollment and the capacity you have after the deadline to follow up with See page 23. individuals. For Open Enrollment 2018, VEHI had an early deadline for health plan enrollment due to the transition to new health plans. Going forward VEHI will accept plan enrollment changes as it has historically. See the VEHI Administrator Handbook pages 6-8, located on the VEHI Website

13 Sample Campaigns from 2017/2018 These may be updated for 2018/2019 Open Enrollment Tips If you are going to allow employees to change their elections after the Open Enrollment deadline, but before the elections take effect, document what exceptions will be allowed and apply consistently. Keep exceptions tied to logical processes such as a change in life the employee now has which would new information circumstances, have resulted in a different choice if known at the time of employee not receiving notice due to leave of absence or enrollment, absence, etc. other documented Document and be consistent in your process. Once the Plan year begins, typically January 1, no further changes are allowed under federal law unless there is a qualifying event. Since the State of Vermont no longer requires the Declaration of Coverage form be completed by all employees, do not provide these forms in the Open Enrollment materials. See page 33. Other tips that come to mind or I picked up today: 35 12

14 Sample 2019 Open Enrollment Goals Don t forget about VEHI Website Resources for employers and employees! 1. benefits where possible Auto enroll/evergreen 2. Increase education and increase in enrollment in FSA a. How FSA and HRA work together b. TPA web portal support i. and how when to submit claims for reimbursement has to do it ii. how to check portal to see if a reimbursement been processed c. How to get additional debit cards 3. More in-person support paper work 4. Streamline/simplify VEHI Admin Handbook Check out BlueCross BlueShield of Vermont s Benefit Details page The following pages include information on VEHI s Wellness and Dental Programs available to support you and your employees. Note: These 2017/2018 documents may be modified for the upcoming year. Contact VEHI for more information

15 Vermont Declaration of Coverage Department of Taxes form HC-2 This form must be completed each year by uncovered employees. If an employee s health coverage changes at any time during the year, the employee must complete and submit a new Form HC-2 to their employer. If an employee is not covered by the employer s plan and the employer has no HC-2 on file for them, the law requires the employee be treated as uncovered. for an * This means an employer could end up paying assessment employee that meets an exception simply because the employer failed to obtain an HC-2. is required to assess for uncovered * On audit, the Department employees with no Form HC-2 on file. Employees not covered by the employer s plan must obtain a new HC-2 every year. A person who was under the age of 18 at any point during the calendar quarter is not an employee for the purposes of the HCFCA. This means this person is not required to complete and submit an HC-2. An employer, however, may request employees under age 18 to complete the form for their records. If an employee s health care coverage changes, the employee should complete a new Form HC-2 within a reasonable amount of time. Reporting is conducted using the last declaration on file and employers must obtain new forms annually. Retention: Employers should retain Form HC-2 for their records for three years. Form HC-2 is not required to be submitted to the Department of Taxes. My 2019 Open Enrollment Goals: How I will measure success in meeting these goals? I will feel successful if: Tip: -Add form HC-2 to CIL/Waiver Materials. After Open Enrollment, identify the employees who have not enrolled in coverage who have not yet completed HC-2 and follow up. Highlight the sections(s) of HC-2 they need to complete

16 Open Enrollment Materials Checklist VEHI Health Benefit Guide Enrollment Notice (if taking this approach) Evergreen/Auto Enrollment Form BCBSVT/VEHI SBC and HRAWrap HRA Wrap update needed? Did the HRA change? requirements. on distribution VEHI website has information Local Cost Sharing per EE Group and Premium share for each health plan from January-June (new rates and possibly new CBA terms) July-December HRA/HSA each health plan including any change for July-December if CBA indicates new terms and CIL Forms, including Waiver Certification Declaration of Coverage form HC-2 FSA Election Forms Dependent Care Election Forms Link to federal IRS limits for FSA, Dependent Care and HSA -remind these limits are all on a calendar year basis Credit Memo when Open Enrollment is effective other than Accumulator January 1, calendar year if electing HSA HSA Eligibility Certification Other benefits Dental LTD Wellness Reminders: The VEHI Health Benefit Guide is available in pdf on the VEHI website. For paper copies, contact Bobby-Jo Salls. Give 2 weeks notice to VEHI/BCBSVT to ensure delivery to meet your timeframe. Don t use Open Enrollment to meet all your annual notice obligations. Focus on the benefit choices employees have and actions they need to take in the near future. Other notice obligations include: *COBRA *Medicare Part D Creditable Coverage *BDD Wrap *HSA Establishment by employer *HSA/Medicare/SS Heads Up *Exchange notice to new hires Changing VEHI Health Plans Mid-Calendar Year Accumulator Credit Reminder There are times when an employee may change benefit plans outside of January. Some districts have fiscal-year Open Enrollments, for example, and every district is subject to changes based on an employee s life events. Additionally, an employee may be in this situation if they move from one VEHI employer to another VEHI employer during the calendar year. When employees change plans mid-year, most ask, What about the that I have already met during this and coinsurance copayments deductibles, calendar year? In most cases, those out of pocket costs will carry over to the new health plan. credit also refers credit. Accumulator BCBSVT refers to this as accumulator care. There are, to visit limits on covered services, such as chiropractic credit is not eligible for carryover. Also, however, times when the accumulator credit is automatic and others when it is there are times when accumulator not. VEHI has developed memos on this issue for both employer and employee. They can be found on the VEHI website: > Health >Employer >Additional Resources > Accumulator Credit for Mid-year Changes Health >Employee>How do I know what to pay? > Employee Mid-year Change Mid-Year Plan Change and New Hires If you have an employee who qualifies for a mid-year plan change or is a new hire from another VEHI member district, please use the Employee Mid-Year Change Memo template to notify employees of how the accumulator credit works to be sure they are aware of their responsibilities in the situations noted above. Document in your records that the memo was provided

17 Open Enrollment Merger Tips 1. Vermont law requires continuation of the CBA terms of the former districts remain in effect until a new CBA is reached. If the former districts share common employee benefits already, this process will be easier to manage. 2. If the former districts have different employee benefit terms, you may have to run more than one system of benefits until the new CBA terms are in effect. My Open Enrollment Materials Checklist These materials are ready: These materials need revisions for the 2019 Open Enrollment: 3. Consider making the new CBA benefit terms effective January 1st, to align with the HRA plan Year, and calendar year out of pocket costs. 4. Work closely with legal counsel, your Board and Superintendent, and the local union to avoid surprises. I will develop these materials: 5. Start early and plan ahead! 6. Don t be overly ambitious as to what you can accomplish year one. 7. The new entity will need to take action to adopt Section 125 Plan and HRA documents- even if all of the terms remain the same. 8. The new entity needs new VEHI Health and/or Dental Program Agreements. FSA, HSA eligibility, Vermont Declaration of Coverage forms 9. CIL certification, etc. all need to be updated for the new entity. 10. The new entity needs to provide an SBC Wrap and BDD Wrap to their employees. for each benefit plan VEHI does not allow 11. Check eligibility requirements employee to choose between two different dental plans, for example. Different employee groups can have different dental benefits, however. 12. Review your employee classifications- be able to justify each employee group. Work with the local union to ensure each employee is properly classified. I will include the following additional information: VEHI PATH Wellness Program NEDD Health and Oral Wellness (HOW) Program Employee Navigation Resources VEHI Website Tip: Highlight the section(s) of each form that an employee needs to complete/sign to reduce the number of submitted forms that are missing information. 13. Pay attention to local waiting periods for benefit eligibility. 14. Communicate, Communicate, Communicate! 31 16

18 Another great idea! What I learned from others so far (consider listing who the idea came from so you can follow up as needed): Write down what you will do on Monday to prepare for Open Enrollment 2019: What I would like to do if I have time (will I ever have time???): Other notes to self on Open Enrollment 2019: 17 30

19 What are the three most useful things you discovered this afternoon? 1. I still have these questions What two things will you commit to for Open Enrollment 2019? Here is how I will get my questions answered Item One: How I will accomplish: Item Two: How I will accomplish: 29 18

20 Sample Open Enrollment (OE) Communication Plan My Follow Up Survey Questions: 1. a series of weekly s beginning mid- September a. Announce OE, key dates b. Link to VEHI video series- especially cost sharing c. Link to VEHI Navigation Guide How Do I Know What to Pay? section d. FSA focus e. What requires ACTIVE paperwork where to get forms, how to get questions answered f. Upcoming meeting and deadline g. Final reminder 2. School Meetings one per building 3. Drop-ins one per building a week after the on-site meeting 4. Benefit Fair one per SU 5. Website how to distribute (paper, 6. Newsletter electronic, mail, bulletin boards, mailboxes ) with the 7. Piggy-back communications Life Survey VEHI PATH Adventure/Healthy that people pay communications My Follow Up Process Plans: attention to. Tip: Don t forget COBRA participants- this is an Open Enrollment opportunity for them as well! 19 28

21 Ideas for Follow-up Survey Questions a. Did you attend.. (were there too many, too few?) b. Did you take advantage of. c. Did you read the s? Were they helpful? Why or why not? d. Were your questions all answered? If not - what questions do you still have? e. Best methods for you (select all that apply) i. ii. Website iii. Newsletter iv. Meetings v. One-on-one vi. other f. What did you most appreciate about the process? next year g. Ideas for improvement My Communication Plan: Consider doing a survey now, before you finalize plans for Open Enrollment 2019 Follow up can be more informal- such as reaching out to local union leaders and asking for their perspective, or reaching out to key building personnel for their perspectives

22 Sample Open Enrollment Timeline My Documentation Process: Action Item Complete By Date Done! 1. Finalize Open Enrollment dates 2. Finalize materials (See page 15) 3. Website Updated 4. Finalize Communication Plan 5. Finalize logistics for meetings in each building is needed from various entities 6. Identify what information a. BCBSVT/VEHI b. NEDD c. Invest EAP d. TPA for HRA/FSA/HSA e. Other 7. Plan for individual reach out as needed 8. Documentation of process 9. Follow up survey a. Survey developed plan final b. Distribution c. Distribute on d. Collect on e. Review results f. Action plan developed based on results 21 26

23 Sample Documentation of Process Should include an (electronic/paper) file with the following elements: a. Copies of all materials with cover sheet when and how distributed and list of employees who were provided b. Copies of all communications with date and method sent and list of all employees who were provided c. List of all reach out efforts including dates,times and locations d. A confirmation for the record that regular procedures and processes were followed. e. Document your use of automatic OE/Evergreen and how you communicated if applicable. Reflection: -How do you know s are being opened? -Is there broad attendance at meetings? -Is your process different for employees with different work hours (evenings) or often off site (bus drivers)? Your processes have to be reasonable given your specific situation and employee groups. Action Item My Open Enrollment Timeline Complete By Date Done! Consider: Sign-in sheets to document attendance at meetings

24 Sample Individual Reach Out Plan After the Open Enrollment deadline has passed, I will do individual reach out if: a. No FSA elected b. Last year waived and no action this year c. Enrolled in a health plan that does not have maximum employer cost share support d. Dependent Care last year and no election this year e. HSA last year and no action this year f. No paperwork was submitted at all g. Not enrolled in health coverage and do not have new Declaration of Coverage form on file. (See page 33) NOTE: Individual reach out does not need to be in person. May be by or other approach, document your reach out who, what, when. My Individual Reach Out Plan: Additional tips for Ongoing EE Communications Look for VEHI Reminders throughout the year and share information with employees as appropriate. Add these items to your internal HR Annual Calendar: December/January OOP costs reset January 1st. Reminder to employer- If cost sharing changes on January 1st due to CBA terms, need to update BDD Wrap and SBC HRA Wrap and distribute Early February/ and again early March How to read an EOB as first EOBs of new calendar year arrive May Look for federal changes to limits for pre-tax benefit accounts- HSA, FSA, Dependent Care, typically announced in May. Communicate changes to employees as appropriate make necessary changes to prior year documents for next Open Enrollment period. May/June - Accumulator Credits Memo all new EE before they elect a health plan, at Special Enrollments before they elect a new health plan, at Open Enrollment if it takes effect in the middle of a calendar year May/June If cost sharing changes (due to premium rate increase and/or CBA terms) need to update BDD Wrap and SBC HRA Wrap and distribute 23 24