IBEW Local 459 Members

Open Enrollment
for 2016 Benefits
For IBEW Local 459 Members
General Information
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Open enrollment is Oct. 19 – Nov. 2
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Enrollment closes at 5 p.m. on Nov. 2
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You must take action if you are:
– Adding or deleting dependents
– Increasing or decreasing life insurance elections
– Contributing to an HSA or FSA
– Changing any plan elections
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Enroll online at www.MyFirstRewards.com
– You will create a password, then log-in using your SAP number and the
password you created. If you forget your password, you can reset it
yourself.
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Key Points
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If you do nothing, your benefit coverage will remain the same
(except for HSA and FSA)
Mandatory enrollment for health savings accounts (HSA) and
flexible spending accounts (FSA) each year
Review your benefits confirmation statement immediately after
you enroll and print the information if you’re able
Coverage is effective Jan. 1, 2016
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The Process
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You will receive 2016 benefits information via:
– Email
– Total Rewards eNewsletter
– Postcard
– Web based training
– Portal articles
– Open Enrollment tool (personalized worksheet and enrollment guide)
– FirstRewards website (www.MyFirstRewards.com)
– OE tab includes OE tools and resources
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Making your 2016 elections
– You will receive an email the week of Oct. 19 with the details needed to make your elections
on www.MyFirstRewards.com
– You have access to enroll from work or home
– The Open Enrollment tool lets you review information and enroll from home or work
– After you enroll, print and review your confirmation statement
– If your elections do not appear correct on the confirmation statement, go back into
the Open Enrollment tool to make any necessary changes before the enrollment
deadline of Nov. 2 or contact the HR Service Center immediately at 1-800-543-4654
Open Enrollment for 2016 Benefits
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Open Enrollment Resources
Located on the Open Enrollment tab on MyFirstRewards.com
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Employee Benefit Meetings Schedule
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Open Enrollment Presentation
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Web-based Presentation with voiceover
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Medical (Anthem)
– Anthem Coverage Advisor- Online interactive tool to assist you in making an informed decision on which
medical option is best for you
– Basics of Health Insurance eTutorial
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Prescription Drug (CVS Caremark)
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CVS Caremark Check Drug Cost Tool
Health Savings Account (BenefitWallet)
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How to open an HSA
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HSA FAQs
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HSA Goal Calculator
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HSA Resource Center
Flexible Spending Accounts (WageWorks)
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FSA Savings Calculator
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Video explaining mobile app
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Enrolling Dependents
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In the Open Enrollment tool:
– Be sure to use the check boxes to select which dependents you want
covered on which plans
– If the check boxes are not marked, your dependent will not be covered
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You are required to call the HR Service Center if you are adding a
dependent
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Confirmation Statement
Remember to print and review your
confirmation statement from the Open
Enrollment tool prior to the benefits open
enrollment deadline on Nov. 2 at 5 p.m.
If any changes are required, go back into the Open Enrollment
tool and make those changes prior to the deadline.
We encourage you not to wait until the last minute to enroll.
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Eligibility
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Who is Eligible
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Spouse
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Domestic Partner
– Call the HR Service Center for more information
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Your children up to age 26, including adopted children, step-children,
children for which you have legal custody and foster children
Your unmarried children age 26 and older who are incapable of selfsupport due to a disability
– Proof of disability and financial dependency is required
– Contact Anthem for details
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Spouse/Domestic Partner Premium
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$200 monthly premium, if:
– You elect coverage for spouse/domestic partner who is eligible for
subsidized medical and prescription drug coverage with their employer
– Spouse/domestic partner must be working at least 32 hours per week
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Does not apply if spouse/domestic partner is employed by FirstEnergy
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You will be asked to verify this information through a dependent audit
– Dependent audit will be conducted this fall
– Additional information will be sent out soon
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What’s New
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Enhanced HDHP Family Deductible and Out-of-Pocket
Maximum
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Enhanced HDHP has a true deductible and embedded out-of-pocket
maximum
– If you elect a coverage level other than individual with the Enhanced HDHP, no claims for
any family member will pay at 80% coinsurance until the entire family deductible of $2,600
has been met
– Any combination of family members can satisfy the out-of-pocket maximum but one family
member would never need to satisfy more than their own individual out-of-pocket
maximum amount
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Health Savings Account (HSA)
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HSA annual limit for two-person/family coverage is increasing from
$6650 to $6750
Flexible Spending Accounts (FSA)
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Health care FSA & Limited FSA annual limit increasing from $2500 to
$2550
Part time employees will be eligible for all FSA’s
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Life Resources Program (EAP)
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Effective Sept 1, 2015
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This program is designed to help you navigate through life
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Who is eligible?
– You and your household members; regardless if you’re enrolled in any
health care plans
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Confidential support, information and referral service
– There are tools and resources designed to help you and your family find
solutions to issues that come your way
– Program offers assistance with issues including but not limited to:
Legal
Financial
Marital
Elder Care
Child Care
Stress
Emotional
Parenting
Balancing work and family
Pet care
Education
Moving and relocation
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Life Resources Program (EAP)
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Resources are available 24 hours a day – 7 days a week
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Up to 5 free professional counselor visits per issue per year
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Assistance is available via phone, in-person, and video (computer or
mobile device)
– Video counseling is unlimited
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Contact info
– Phone: 1-888-745-0714
– Website: www.firstenergycorp.com/liferesources
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Health Care Benefits
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Benefit Carriers
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Medical
– Anthem Blue Cross Blue Shield (Anthem)
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Health Savings Account (HSA)
– BenefitWallet
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Flexible Spending Account
– WageWorks
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Prescription Drug
– CVS Caremark
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Dental
– Delta Dental
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Vision
– VSP
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2016 Medical Plan Options (all plans include Rx)
Consumer HDHP
Enhanced HDHP
Base PPO
$2,600 / $5,200
Combined Medical/Rx deductible
Embedded
$1,300 / $2,600
Combined Medical/Rx deductible
True
$750 / $1,500
Separate Rx deductible
Embedded
80% / 20%
80% / 20%
80% / 20%
$5,500 / $11,000
Combined Medical/Rx OOP Max
Embedded
$4,500 / $9,000
Combined Medical/Rx OOP Max
Embedded
$3,500 / $7,000
Separate Rx OOP Max
Embedded
100%
100%
100%
20% after deductible;
$250 copay if not true
emergency
20% after deductible;
$250 copay if not true
emergency
20% after deductible;
$250 copay if not true
emergency
Yes
Yes
No
$3,350 / $6,750
$3,350 / $6,750
$0
No
$0
No
$0
Yes
$2,550
Yes
$2,550
Yes
$2,550
No
$0
In-Network
Deductible (Single/Family)
Type of Deductible
Coinsurance (FirstEnergy / You)
- After deductible
Out-of-Pocket Maximums (OOP Max)
(includes deductible & coinsurance)
Type of OOP Max
Preventative/Wellness Care
Emergency Room Visit
Other
Eligible for HSA
2016 Maximum HSA Contribution
(Single / Family)
Eligible for Health Care FSA
Maximum Contribution
Eligible for Limited FSA
(dental/vision only)
Maximum Contribution
*Bold items reflect changes for 2016
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How Family Deductible and Out-of-Pocket Max. Work
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Consumer HDHP has an embedded deductible and out-of-pocket maximum
– Family deductible and out-of-pocket maximum amounts can be satisfied by any
combination of family members but one family member would never need to satisfy more
than their own individual deductible or out-of-pocket maximum amount
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Enhanced HDHP has a true deductible and embedded out-of-pocket
maximum
– If you elect a coverage level other than individual with the Enhanced HDHP, no claims for
any family member will pay at 80% coinsurance until the entire family deductible of $2,600
has been met
– Any combination of family members (2 or more) can satisfy the out-of-pocket maximum but
one family member would never need to satisfy more than their own individual OOP
maximum amount
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Base PPO has an embedded deductible and out-of-pocket maximum
– Family deductible and out-of-pocket maximum amounts can be satisfied by any
combination of family members but one family member would never need to satisfy more
than their own individual deductible or out-of-pocket maximum amount
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Ex: How the family deductible and out-of-pocket maximum works
There are 3 family members enrolled in the medical plans. Only Dad incurs
expenses during the year.
Deductible:
Out of Pocket Maximum:
Under the Consumer HDHP:
$2,600/$5,200 (Embedded)
$5,500/$11,000 (Embedded)
Under the Enhanced HDHP:
$1,300/$2,600 (True)
$4,500/$9,000 (Embedded)
In January, Dad gets a Rx total discounted cost is
$500.
Dad pays $500 because the Rx
Dad pays $500 because the Rx
deductible is combined with the medical deductible is combined with the
deductible - which he has not satisfied medical deductible - which he has not
yet.
satisfied yet.
The Rx plan is separate from the
medical plan. So Dad pays the $100
retail Rx deductible and $120 - which
is 30% of the remaining $400.
In March, Dad gets a
preventive physical exam.
The plan pays 100% because this is a
covered preventive exam – no
deductible applies.
The plan pays 100% because this is a
covered preventive exam – no
deductible applies.
The plan pays 100% because this is a
covered preventive exam – no
deductible applies.
Dad pays $1,000 because the $2,600
Dad pays $1,000 because the $2,600
In May, Dad breaks his leg. embedded deductible has not yet been true deductible has not yet been
satisfied.
satisfied.
Expenses are $1,000.
In November, Dad gets
pneumonia then an
infection. Expenses are
$10,000.
Under the Base PPO:
$750/$1,500 (Embedded)
$3,500/$7,000 (Embedded)
Dad pays $750 of the $1,000 - which
satisfies just his medical deductible
for the year. He then pays $50 as the
20% coinsurance he's responsible for.
Dad pays $1,100 - which satisfies only
his combined medical/Rx embedded
deductible. So the plan will now pay
80% for additional claims for Dad for the Dad pays $1,100 - which satisfies his
remainder of the year. The other family and his entire family combined
members (Mom & Child) will need to medical/Rx true deductible. So the plan
satisfy the other half of the deductible will now pay 80% for additional claims
before the plan will pay coinsurance for for the entire family for the remainder Dad pays his 20% coinsurance of the
them.
of the year.
$10,000 - which is $2,000.
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Find In-Network Physicians and Medical Facilities
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Online:
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By Phone:
1.
Visit www.anthem.com
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Call Anthem at 866-236-4365
2.
Look under Useful Tools
2.
3.
Click Find a Doctor
4.
Select your state
5.
Choose plan name National
PPO (BlueCard PPO)
If you’re not a current
Anthem member, say “I don’t
know” when asked for your
member ID. You will be
transferred to a customer
service representative.
Anthem’s mobile app:
Go to the app store on your smartphone or mobile device.
Search for Anthem Blue Cross and Blue Shield.
Select the app. Start the free download.
To use the mobile application, you must be registered on our secure member site and have a username and
password. If you are an Anthem Blue Cross and Blue Shield member but have not registered for access to the
secure member website, go to anthem.com from your computer and click Register Now.
Open Enrollment for 2016 Benefits
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Anthem Tools and Resources
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www.Anthem.com – register online and click on the Resources tab for
educational videos and much more!
Anthem smartphone app
– Find a doctor, urgent care center, hospital or ER
– Access your Anthem ID card
– Estimate Your Cost tool available
– View your claims information
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LiveHealth Online – Conveniently available 24/7 from a mobile device or
computer with webcam
– If you are required to provide medical documentation for time off work, LiveHealth Online physicians are
not permitted to complete FirstEnergy paperwork
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Cost & Quality – Helps you find higher quality, lower cost imaging services
such as CT scans and MRIs
Estimate Your Cost tool – Compare costs for many medical procedures
among different facilities
Open Enrollment for 2016 Benefits
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Health Care Purchasing Preferences
Buying
Preference
Plan
Consumer
HDHP
• No premium out of your paycheck
• Highest deductible
• Can use HSA to pay out-of-pocket expenses – or save those
HSA dollars for retirement
• Opportunity to save the most if few health care services are
rendered because there is no premium
Risk Tolerant
Enhanced
HDHP
• Middle of the road premium out of your paycheck
• Middle of the road deductible
• Can use HSA to pay out-of-pocket expenses – or save those
HSA dollars for retirement
Moderate
Base PPO
• Highest premium out of your paycheck
• Lowest deductible
• Helps balance premiums and the amount you pay out of
pocket when you access care
Conservative
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Individual with No Claims (Preventive Claims only)
Consumer HDHP
Annual Premium
Enhanced HDHP
Base PPO
$0
$317
$954
-$500
-$500
$0
Employee Medical Spend
$0
$0
$0
Employee Annual Spend
-$500
-$183
$954
FirstEnergy HSA Contribution
This example shows:
-EE who elects single coverage
-EE utilizes preventive services which are paid at 100%. No other claims incurred.
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Individual with Low Claims
Consumer HDHP
Annual Premium
Enhanced HDHP
Base PPO
$0
$317
$954
FirstEnergy HSA Contribution
-$500
-$500
$0
Employee Medical Spend
$1,000
$1,000
$800
Employee Annual Spend
$500
$817
$1,754
This example shows:
-EE who elects single coverage
-Total medical & Rx claims of $1000 for the year
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Family with High Claims
Consumer HDHP
Annual Premium
Enhanced HDHP
Base PPO
$0
$2,225
$4,136
FirstEnergy HSA Contribution
-$1,000
-$1,000
$0
Employee Medical Spend
$8,160
$6,080
$5,200
Employee Annual Spend
$7,160
$7,305
$9,336
This example shows:
-EE elected family coverage
-$20,000 in total medical & Rx claims
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Family with Catastrophic Claims
Consumer HDHP
Enhanced HDHP
Base PPO
$0
$2,225
$4,136
FirstEnergy HSA Contribution
-$1,000
-$1,000
$0
Employee Medical Spend
$11,000
$9,000
$7,000
Employee Annual Spend
$10,000
$10,225
$11,136
Annual Premium
This example shows:
-EE elected family coverage
-Catastrophic claim of $500,000 in total medical & Rx
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What is a HDHP?
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High-deductible health plan (HDHP) – health care plan that provides
medical and prescription drug coverage in one combined plan
Offers a small or zero premium
Has a high deductible which qualifies for offering a health savings
account (HSA)
Two HDHPs are available in 2016
– Consumer HDHP
– Enhanced HDHP
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What is an HSA?
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Health savings account (HSA) – allows you to set aside pre-tax
dollars to pay for your out-of-pocket health care expenses
– Interest-bearing health savings account like a 401(k) for health care-related
expenses
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HSAs are portable
– Individual account in your name – you can take it when you retire or leave
the company
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No “use it or lose it” rule
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HSA can be used:
– For qualified expenses including medical, prescription drug, dental and vision
– For you, your spouse or any dependent claimed on your tax return
– Now or later (great vehicle for retiree health care)
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For more information on HSAs, visit IRS Publication 502 and 969
Open Enrollment for 2016 Benefits
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HSA Eligibility Requirements
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Must elect FirstEnergy’s Consumer HDHP or Enhanced HDHP
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You cannot:
– Have other medical coverage, such as
– Medicare
– TRICARE
– Health Care FSA
– A spouse’s health plan (unless the coverage is a HDHP)
– Be claimed as a dependent on someone else’s tax return
– Have received veterans’ benefits within the last 3 months
– Have a balance in your Health Care FSA on Dec. 15, 2015
– If you still have money in your 2015 Health Care FSA on Dec. 15, 2015, you are
not permitted to make contributions into your HSA until Apr. 1, 2016
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You are permitted to elect a Limited FSA for dental & vision expenses
Open Enrollment for 2016 Benefits
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Use an HSA for Retiree Health Care
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BenefitWallet - Anthem’s HSA custodian – has
tools available to help you plan for retiree
healthcare by offering a goal calculator. This can
help you determine what your estimated
contributions should be each year to help you
plan for health care in retirement
BenefitWallet
According to a
recent Fidelity
study, the average
couple should
expect to spend
more than
$220,000 in health
care expenses over
the course of
retirement.
Phone: 866-686-4798
Website: www.mybenefitwallet.com
Mobile App: BenefitWallet
HSA FAQs: https://www.mybenefitwallet.com/CMS/portal/default/faq.html
HSA Goal Calculator: https://member.mybenefitwallet.com/portal/calculators/hsagoal/
HSA Resource Center: https://mybenefitwallet.com/resource-center.html
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Establishing an HSA
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Elect an HDHP medical plan and an HSA during open enrollment
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Open an HSA with BenefitWallet – Anthem’s HSA custodian
– Activate your HSA by completing the questions at this link –
https://mybenefitwallet.com/HSA/anthem.adv
– This step can be done now
– This is the recommended approach – much quicker
– If you already have an HSA with BenefitWallet, you do not need to open another
HSA; your existing HSA will continue for you
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Information will be mailed to you from BenefitWallet after you
enroll in an Anthem HDHP medical plan for the first time
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HSA Employee Contributions
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Employee HSA contributions (on a per pay basis)
– Pre-tax contributions through payroll deduction
– Post-tax contributions directly into the HSA bank account
– Receive the tax benefit when you file your taxes
– May take up to 2 business days for check deposits
– May take 7-10 business days to set up the 1st online deposit
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Can change contribution amount at any time
If you are 55 or older (or turning 55 in 2016) you’re able to contribute an
additional $1,000 into your HSA
Your annual HSA contribution amount is not all available on Jan. 1 like an
FSA
2016 Annual contribution maximums:
– Individual coverage $3,350
– Two person / Family $6,750
*these amounts includes EE and ER contributions
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Flexible Spending Accounts
Health Care Flexible Spending Account
Limited Flexible Spending Account
Dependent Care Flexible Spending Account
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Flexible Spending Account (FSA)
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WageWorks contact info
– Phone: (877) WAGEWORKS or (877) 924-3967
– Website: www.wageworks.com
– Mobile app: EZ Receipts
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Types of FSA
– HealthCare FSA
– Limited HealthCare FSA
– Dependent Care FSA
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Can receive reimbursement by:
– Using mobile app (use camera to take picture of documentation & submit)
– Using FSA card
– Visiting vendor website – www.wageworks.com
– Submitting paper claim form to WageWorks
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Flexible Spending Account (FSA)
What’s the benefit of enrolling in a FSA?
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Convenient, tax effective way to pay for qualified health care and
dependent day-care expenses - can save 25-40% depending on your tax
bracket
To participate, you must make an election each year
– 2015 contributions do NOT automatically continue into 2016
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Can submit expenses for anyone you claim on your taxes
– See IRS publication 969 for more information
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Save your receipts – documentation may be required
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If you don’t use the money by the deadline, you will lose it
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Can submit eligible expenses incurred from
Jan. 1, 2016 through Mar. 15, 2017
Must submit expenses for the above timeframe by Jun. 30, 2017
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Health Care FSA
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Who is eligible to elect a Health Care FSA?
Employees that enroll in Base PPO or those that waive FE medical
– Not eligible if you enroll in the Consumer HDHP or Enhanced HDHP
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Pre-tax deductions through FE payroll
Annual limits: $26 minimum and $2,550 maximum
Eligible expenses include:
Your out-of-pocket expenses for medical, Rx, dental and vision expenses
When is your annual election amount available?
Entire annual amount is available on Jan. 1st
How can I submit claims?
FSA card, mobile app, website or paper claim form
IMPORTANT NOTE :
If you have a 2015 Health Care FSA and elect a HSA in 2016, the balance in this FSA
must be $0 by Dec. 15 or contributions cannot be made to the HSA until Apr. 1, 2016
Open Enrollment for 2016 Benefits
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Limited FSA
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Who is eligible to elect a Limited FSA?
If you enroll in the Consumer HDHP
Enhanced HDHP
Pre-tax deductions through payroll
Annual limits: $26 minimum and $2,550 maximum
Eligible expenses include:
Dental and Vision
When is your annual election amount available?
Entire annual amount is available on Jan. 1
How can I get reimbursed?
FSA card, mobile app, website or paper claim form
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Dependent Care FSA
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Who is eligible to elect a Dependent Care FSA?
All employees who have eligible dependents
Pre-tax deductions through FE payroll
Annual limits: $26 minimum and $5,000 maximum
Eligible expenses include:
Daycare, before and after-school care for children
under age 13 and adult/elder care
When is your annual election amount available?
Account is like a checking account – can only be
reimbursed the amount that has been contributed
year-to-date (deposits made on a per pay basis)
How can I get reimbursed?
Mobile app, website or paper claim form
How much can I save per year?
Up to $2,000 per year in tax savings
– depending on tax bracket
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WageWorks Tools & Resources
WageWorks Contact Information
– Phone: (877) WAGEWORKS or (877) 924-3967
– Website: www.wageworks.com
WageWorks - Tools & Resources
v
Mobile App (EZ Receipts)
Check your balances
Submit Claims
Take photos of receipts Sign up for alerts via email or text
v
FSA Saving Calculator
§ Enter estimated annual expenses by category and see what your
potential tax saving could be - Average savings is 30%!
v
HealthCare Card
§ Use the card to pay for copays, prescriptions and FSA eligible
products at FSA store
v
Website
§ Provides videos on how the plans work, FAQ’s, eligible expenses list
and much more!
Open Enrollment for 2016 Benefits
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Prescription Drug Options
Consumer HDHP
Enhanced HDHP
Rx Base
Yes*
Yes*
Yes*
$2,600 / $5,200
Combined Medical/Rx
deductible
$1,300 / $2,600
Combined Medical/Rx deductible
$100 / $200
Separate Rx deductible
80%/20%
80%/20%
70%/30%
Generic Coinsurance
20%
20%
30% ($5 min)
Primary Coinsurance (if no Generic is available)
20%
20%
30% ($15 min)
Brand Coinsurance**
20%
20%
30% ($30 min)
No maximum
No maximum
$100 per Rx
$2,600 / $5,200
Combined Medical/Rx
deductible
$1,300 / $2,600
Combined Medical/Rx deductible
None
80%/20%
80%/20%
80-75%/20-25%
Generic Coinsurance
20%
20%
20% ($12.50 min)
Primary Coinsurance (if no Generic is available)
20%
20%
25% ($37.50 min)
Brand Coinsurance**
20%
20%
25% ($75 min)
No maximum
No maximum
$200 per prescription
In-Network (Individual / Family)
$5,500 / $11,000
Combined Medical/Rx OOP Max
$4,500 / $9,000
Combined Medical/Rx OOP Max
$3,000 / $6,000
Separate Rx OOP Max
Out-of-Network
$10,000 / $20,000
Combined Medical/Rx OOP Max
$8,500 / $17,000
Combined Medical/Rx OOP Max
No Limit
Generic Drug Rule
Retail (up to 30-day supply with one refill)
Annual deductible (Individual / Family)
Coinsurance (FirstEnergy/Your)
Maximum coinsurance per Rx
Mail Order (up to 90-day supply with three refills)
Annual deductible (Individual / Family)
Coinsurance (FirstEnergy/Your)
Maximum coinsurance per Rx
Annual Out-of-Pocket Maximums (OOP Max)
* In addition to coinsurance, participant will also be responsible for difference in cost between generic & brand drug if the participant does not choose to fill script with
available generic. The brand penalty does not count towards the deductible and out-of-pocket maximum.
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** If you choose a brand that has a formulary equivalent (Primary Drug List), you will pay the brand coinsurance.
Open Enrollment for 2016 Benefits
Generic Drug Mail-Order Example
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Tom elected the Consumer HDHP plan. He is prescribed a 90-day supply of
Singulair (brand drug); however, Montelukast (generic drug) is available.
Scenario #1:
Tom chooses to
purchase the generic
(Montelukast)
Tom pays the full cost of the generic
which will go toward his deductible
$ 51.15
Scenario #2:
Tom chooses to
purchase the brand
(Singulair)
The total cost for the brand Singulair:
The total cost for the generic
Tom pays the difference (Brand Penalty):
Plus his deductible:
Tom’s total out of pocket cost:
$539.92
$51.15
$488.77
$51.15
$539.92
Tom has not yet satisfied the $2,600 deductible in the Consumer HDHP.
The brand penalty does not count toward his $2,600 deductible.
Tom will save $488.77 by purchasing the generic.
Note: Singular is a non-preferred brand drug and prior authorization would be required
Open Enrollment for 2016 Benefits
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Caremark Tools & Resources
n
n
n
Web-based tool to determine prescription costs
Compare prescription costs in a high deductible plan vs. Rx
Base plan
Available on Open Enrollment tab on
www.MyFirstRewards.com
– Select ‘Check Drug Cost’ for appropriate option
Open Enrollment for 2016 Benefits
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Vision Options
n
There are no plan design changes for 2016
n
Basic Vision
– If you enroll in a FirstEnergy medical plan in 2016, you will be automatically enrolled in the
Basic Vision plan at no cost – no enrollment required
– The family members you enroll in your FE medical plan election will also be
enrolled in the Basic Vision plan – unless you elect the Supplemental Vision
n
Supplemental Vision
– Employee will continue to pay the full premium cost
– $25 copay for progressive
– $25 copay for anti-reflective lenses
– $25 copay for all other covered lenses
– Frame allowance $160
– Contact lens allowance $160
NOTE: Your VSP identification number is
the last 4 digits of your SAP number with
leading zeros to make a nine-digit number.
Example: 000002345
Open Enrollment for 2016 Benefits
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Vision Options
Basic Vision
Supplemental Vision
$50 copay
$10 copay
Not covered
Reimbursed up to $45
In-Network
25% discount
$160 retail frame allowance
(all manufacturers)
Out-of-Network
Not covered
Reimburse up to $70
Exam
In-Network
Out-of-Network
Frames
Lens & Lens Options (minimum prescription of .5 diopter for lens coverage – medically necessary)
In-Network
Out-of-Network
Single: $40 copay
Bifocal: $60 copay
Trifocal/Lenticular: $75 copay
$25 copay for progressive lenses
$25 copay for anti-reflective lenses
$25 for all other lens options
Not covered
Single vision - reimburse up to $30
Bifocal lenses - reimburse up to $50
Trifocal lenses - reimburse up to $65
Lenticular Lenses - reimburse up to $100
15% discount on exam only
(no discount on materials)
Elective - $160 allowance
Med necessary - covered in full
(must be pre-approved)
Not covered
Elective - reimburse up to $105
Med necessary - reimburse up to $210
Contacts
In-Network
Out-of-Network
Open Enrollment for 2016 Benefits
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Dental Options
Basic Plan
Plus Plan
In Network
Out of Network
In Network
Out of Network
Deductible
$100 / $300
$200 / $600
$50 / $150
$100 / $300
Annual x-ray, 2
cleanings/exams
(coinsurance only – not
subject to deductible)
100% / 0%
80% / 20%
100% / 0%
80% / 20%
FirstEnergy % / your %
FirstEnergy % / your %
FirstEnergy % / your %
FirstEnergy % / your %
Basic Restorative
50%
70%
20%
40%
Major Restorative
75%
Not Covered
50%
70%
50%
$1,500 lifetime
max
Only children up to
age 19
$2,000 per person
Orthodontia
Benefit %
Benefit $
Eligibility
Not Covered
Not Covered
50%
$1,500 lifetime
max
Only children up to
age 19
Calendar Year Maximum
Benefit Plan Pays
(excludes ortho)
$1,000 per person
$1,000 per person
$2,000 per person
No 2016 dental plan design changes
Open Enrollment for 2016 Benefits
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Delta Dental Tools & Resources
n
n
The Basic Plan and the Plus Plan are administered by Delta Dental
Both the PPO and Premier networks are included.
Need help finding providers?
– Call Delta Dental at 1-800-524-0149
– www.deltadental.com
– Delta Dental Mobile app
n
Learn about oral health
– There is information for every stage of life on Delta’s website
– Check out the Risk Assessment tool
n
Check claims status
n
Review your benefit plan
Open Enrollment for 2016 Benefits
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Wellness Program
Open Enrollment for 2016 Benefits
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Healthy Living Wellness Program
The purpose of the Healthy Living program is to develop a culture
where employees are encouraged and rewarded for improving or
maintaining positive health and well being.
n
ALL employees are eligible to participate
– Even those that do not elect benefits through FirstEnergy
n
Participation is voluntary
n
Provant Health Solutions administers the program
n
Program is confidential
n
FirstEnergy does not receive any personal information or individual results
n
FirstEnergy will only know if an employee qualifies for the Healthy Living
credit
Open Enrollment for 2016 Benefits
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Healthy Living Credit Criteria
Required Activities
Must complete both activities to earn either part of the credit
Participation Activities
Must complete 3 of 9 activities – this is in addition to the Required activities to
earn $25 per month
Results-Based Criteria
Must complete 3 of 7 activities – this is in addition to the required activities to
earn $25 per month
Visit our Healthy Living website for a list of the criteria and activities at:
www.myfirstrewards.com
Up to $600 annual credit available - paid in 2016; deadline for criteria completion is Nov. 13
If you feel that it is unreasonably difficult to meet the program criteria to earn the Healthy Living Credit due to a medical
condition or you would like to appeal your results due to a specific issue that prevents you from being able to meet the criteria as
outlined, call Provant Health at 1-877-239-3557 to initiate an appeal. Alternative standards and waiver opportunities may apply
for all similarly situated employees. Provant Health will work with you and your physician to certify the issue and, if applicable,
develop another way for you to qualify for the credit.
Open Enrollment for 2016 Benefits
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Healthy Living Credit
n
n
n
n
The Healthy Living Credit form and tobacco affidavit are available at
https://firstenergy.provantonline.com
Complete all criteria by the Nov. 13 deadline
The incentive will be divided per pay and will show as a separate line
item on 2016 pay statements
Online health risk assessment and biometric screening are both
required this year to receive either portion of the credit
– health risk assessment can be completed on the Provant website
n
Visit the above website to confirm what you need to do to satisfy the
criteria
Open Enrollment for 2016 Benefits
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Healthy Living – Onsite Health Fairs
n
Health fairs available to:
1. Help you earn your Healthy Living incentive
2. Provide flu vaccines
3. Encourage healthy lifestyles
4. Help you know your numbers (glucose, cholesterol, blood pressure, etc.)
n
n
n
More than 130 Health Fairs offered Sept. through Oct.
Sign up online to attend a Health Fair
Go to www.myfirstrewards.com
Flu Care Cards (flu vaccine) and lab vouchers available by
request for those unable to attend Healthy Living Fair – call
Provant at (877) 239-3557 for more information
Open Enrollment for 2016 Benefits
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Other Benefits
Basic Life Insurance
Supplemental Life Insurance
Dependent Life Insurance
Accidental Death & Dismemberment
Long-Term Disability
Open Enrollment for 2016 Benefits
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Group Life Insurance Plan
n
Basic Life
– 1x annual base pay
– Company paid
n
Supplemental Life
– May elect 1x to 10x annual base pay
– Can increase 1x each open enrollment
– Maximum coverage amount of $5 million
Please note:
The premium for supplemental life insurance will change the pay period when you
reach your birthday for the next premium level or if your salary changes – not the
1st of the following month or year.
Open Enrollment for 2016 Benefits
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Group Life Insurance Plan
n
Dependent Life
– Three levels of coverage:
– Standard – $10,000 spouse and
$5,000/child
– High - $20,000 spouse and $10,000/child
– Premier – $40,000 spouse and
$20,000/child
– Can increase one level each year during
open enrollment
– Eligible dependents include children up
to age 19 or 25 if a full-time student
Open Enrollment for 2016 Benefits
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Evidence of Insurability (EOI)
n
Proof that you are eligible before the coverage goes into effect
n
Requires completion of online Statement of Health form
– Details will be provided after Open Enrollment to those who need to
complete it
n
Required for:
– Employees making a first time election for Supplemental life
– Spouses making an election for each level of Dependent life
– Those whose Supplemental life election is greater than $1M
Open Enrollment for 2016 Benefits
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Group Life Insurance Plan
Accidental Death & Dismemberment
Provides coverage if you should die, lose a
limb, or sight as a result of an accident
May elect 1x to 10x Annual Base Pay
– Employee only coverage
– Family coverage
n
Maximum coverage amount of $3M
Open Enrollment for 2016 Benefits
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Beneficiary Designations
n
Person(s) you name to receive the death benefits of a life insurance
policy
– Keep your designations current
– Consider adding a contingent beneficiary
n
Designations can be viewed and updated online anytime at
www.metlife.com/mybenefits
Open Enrollment for 2016 Benefits
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Long-Term Disability (LTD)
*Eligible if hired after 1/1/2005
n
n
The LTD plan protects you and your family if you become disabled by
a work-related or non-work related illness or injury by continuing a
portion of your income until you no longer meet the eligibility
requirements
Basic LTD
– 50% of annual base pay – Company provided benefit
n
Supplemental LTD
– Buy up is 16 2/3 %
– Total benefit of 66 2/3% annual base pay
Open Enrollment for 2016 Benefits
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Long-Term Disability
Plan Details
n
n
n
If electing for the first time, benefits will be limited by any preexisting medical conditions
Payments are offset by primary Social Security and any other
government or Company disability or pension benefit
Payable after 6-month waiting period
– May participate in the Company’s sick pay program during this time
n
n
$100 minimum monthly benefit or 10% of gross monthly
LTD benefit
If you are receiving benefits at the time of your death, your survivors
will receive a lump sum benefit equal to three months of your gross
benefit
Open Enrollment for 2016 Benefits
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Voluntary Benefits
Auto/Home Insurance
Long-Term Care Insurance
Identity Theft Insurance
Pet Insurance
Employee Discount Program
Open Enrollment for 2016 Benefits
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Voluntary Benefits
n
Contact Mercer to enroll
– 866-795-0156 or
www.firstenergyvoluntarybenefits.com
n
Programs include:
–
–
–
–
–
–
–
n
Auto and home insurance
Critical Care Insurance
Long-term care
Accident Insurance
Identity Theft Protection
Pet Insurance
Employee discounts
Why participate in the program?
– Group discounts
– Special offers for FirstEnergy employees
– Convenience of payroll deduction
Open Enrollment for 2016 Benefits
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Where to go for questions
Open Enrollment for 2016 Benefits
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Do You Have a Benefits Question?
If so, you can:
n
Visit the FirstRewards website at
www.MyFirstRewards.com
n
Call the benefit carrier
n
Visit the benefit carrier website
n
Contact the HR Service Center
– 1-800-543-4654
– HRService@firstenergycorp.com
Open Enrollment for 2016 Benefits
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Benefit Carrier
Phone
Website
Provant (Healthy Living Wellness)
(877) 239-3557
www.firstenergy.provantonline.com
Anthem (Medical)
National PPO BlueCard network
(866) 236-4365
www.anthem.com
Anthem 24/7 NurseLine
(800) 700-9184
www.livehealthonline.com
LiveHealth Online
(Virtual Doctor Visit)
CVS Caremark (Rx)
CareChoice network
(888) 202-1654
www.caremark.com
BenefitWallet (HSA)
(866) 686-4798
www.mybenefitwallet.com
Delta Dental (Dental)
Delta Dental PPO & Premier network
(800) 524-0149
www.deltadental.com
VSP (Vision)
Signature Choice network
(800) 877-7195
www.vsp.com
Life Resources
(888)-745-0714
www.firstenergycorp.com/liferesources
MetLife (Life & Long Term Disability)
(866) 492-6983
www.metlife.com/mybenefits
WageWorks (FSA)
(877) WAGEWORKS
www.wageworks.com
Mercer (Voluntary Benefits) Auto/Home,
(866) 795-0156
www.firstenergyvoluntarybenefits.com
FirstEnergy HR Service Center
(800) 543-4654
811-4357 (internal)
www.myfirstrewards.com
HRService@firstenergycorp.com
Long Term Care, Identity Theft Ins, Pet Ins
Open Enrollment for 2016 Benefits
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