Open Enrollment

Deductible Copay Example PPO 4
Deductible Copay Example PPO 7

Coordination of Benefits (COB) is how health care carriers coordinated benefits when members or their dependents are covered by more than one health care plan.  Under COB, carriers work together to make sure members receive the maximum benefits available under their health plan.  If an employee or any of their dependents have more than one health insurance plan it is their responsibility to notify BCBS and to complete the Coordination of Benefits Form.

If an employee and their dependents have medical coverage elsewhere, they can choose to waive medical insurance and receive a buy-out of $75 per pay period (up to $1,950 per year).  Proof of coverage must be provided in order to receive the buy-out. Employees and eligible dependents will still be eligible to participate in the flexible spending accounts, dental and vision insurance.

WCRC medical plans include 24/7 online health care through Blue Cross Online Visits™.  With online health care, individuals can see a U.S. board-certified doctor anytime, anywhere.  No appointment needed.  Use a mobile device to log into the BCBSM Online Visits™ app, or a computer to log in to https://www.bcbsmonlinevisits.com/landing.htm.

A Health Care FSA allows employees to use pre-tax dollars for eligible medical expenses not covered by medical and dental plans (i.e., copays, deductibles, orthodontia, etc.), vision care expenses for prescription eyeglasses and contact lenses, as well as prescription medication.

Employees can contribute up to $3,050 annually to a Medical FSA. Medical FSAs are pre-funded, allowing employees access to their annual elections on the first day of participation.  Employees can carry over up to $500 of unused FSA funds remaining at the end the plan over to the next year.  Anything over $610 will be forfeited.  Additionally, changes can be made if the enrolled employee experiences an approved IRA qualifying event.

A Dependent Care FSA allows an employee to set aside pre-tax dollars to pay for eligible dependent care expenses for their qualified dependents. Eligible dependent care expenses are those incurred to work, look for work or attend school as a full-time student. Examples of eligible expenses may include child care facility fees, before-school and after-school care or local day camp.

Employees can contribute up to $5,000 annually, per family, to a Dependent Care FSA.  Unlike the medical FSA, the annual dependent care FSA funds are not available upfront.  Funds are only accessible as they are deposited with each payroll deduction.  Dependent Care FSA funds do not roll over year after year.  You must use your Dependent Care dollars within the plan year or they will be forfeited.

When a qualified expense is incurred, you can use one of the following methods:

• Debit card transactions – Use the HealthEquity FSA debit card at the pharmacy or doctor’s office for instant payment.
• Reimbursement – If paying out-of-pocket for expenses submit a claim for reimbursement directly on the member portal and have funds electronically transferred to a personal bank account.
• Issue payment to provider – From the HealthEquity member portal, employees can issue payments to providers by creating a new claim, or by using existing integrated insurance claims if available.

Coverage Options

For you.  If you are currently enrolled in optional life insurance for an amount less than $150,000, you may elect to increase your coverage by $10,000 annually, up to, but not to exceed, the guarantee issue amount of $150,000 without having to secure medical underwriting approval.

For Your Spouse.  If your spouse is currently enrolled in dependents life insurance for an amount less than $50,000, you may elect to increase coverage by $5,000 annually, up to, but not to exceed, the guarantee issue amount of $50,000 without having to secure medical underwriting approval.

For Your Children.  If your child(ren) is/are currently enrolled in dependents life insurance for an amount less than $10,000, you may elect to increase coverage by $2,000 annually, up to, but not to exceed, the guarantee issue amount of $10,000 without having to secure medical underwriting approval.

If you, your spouse or child(ren) are not currently enrolled, you will have to secure medical underwriting approval by completing the Medical History Statement.

 Guaranteed Issue

Employees may enroll for a certain amount of insurance without answering health questions.  Guaranteed issue amounts are as follows for coverage applied for within 31 days of employment or during a designed open enrollment period:

^{1 The premium paid for child coverage is based on the cost of coverage for one child, regardless of how many children you have.}

Example

Member age 40, choosing $100,000 of coverage: