2012 Open Enrollment

2012 Open Enrollment

Carleton College

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Open Enrollment Period

Our 2012 Open Enrollment period begins October 31, 2011 and concludes December 5, 2011.

Employees will access the on-line tool (benefitsCONNECT) on the Human Resources website.

Be sure to review the refresher regarding your username and password; passwords will remain the same for 2012 as they are in 2011.

This is a “passive” enrollment year, which means that unless you request a plan change, your current medical, dental, voluntary life, and long-term disability plans in 2011 (along with your corresponding dependents) will remain active for 2012.

If you want a health care or dependent care flexible spending account in 2012, you will need to enter your annual election through our on-line tool (benefitsCONNECT). We recommend this be done during the Open Enrollment period.

http://www.benefitsconnect.net/carleton

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2012 Benefit Plan Highlights/Changes

There are very minimal benefit plan changes for 2012.

The following initial screens in this presentation will detail the highlights/changes for our plans:

• Health Care Reform Update• TASC• TIAA-CREF• The Hartford• Delta Dental• Blue Cross and Blue Shield of Minnesota

Employees who would like an overview/refresher on how our plans work, please stay for full presentation.

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Health Care Reform UpdateThere are minimal health care reform changes effective in 2012. Listed below are the highlights for 2012, which include requirements that may become effective within the calendar year 2012.

Health Plan SummariesUser-friendly benefits summaries that will help individuals to more easily understand their health plan and its key provisions must be presented in a four-page document prepared by insurance carriers (for fully-insured plans) or by employers of self-funded health plans. These plan summaries are to be presented to participants on/after March 23, 2012 (at the earliest).

W-2 ReportingLarge employers (who issued at least 250 W-2s in the previous year) will need to include the value of employer provided health coverage on employees’ W-2s for the 2012 tax year.

Encouraging Integrated Health SystemsThe new law provides incentives for physicians to join together to form “Accountable Care Organizations”. These groups allow doctors to better coordinate patient care and improve the quality, help prevent disease and illness, and reduce unnecessary hospital admissions.

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Health Care Reform Update (Cont.)Encouraging Integrated Health Systems (Cont.)If Accountable Care Organizations provide high quality care and reduce costs to the health care system, they can keep some of the money that they have helped save.

Linking Payment to Quality OutcomesThe law establishes a hospital Value-Based Purchasing program (VBP) in Traditional Medicare. This program offers financial incentives to hospitals to improve the quality of care. Hospital performance is required to be publicly reported, beginning with measures relating to heart attacks, heart failure, pneumonia, surgical care, health-care associated infections, and patients’ perceptions of care. (Effective on/after October 1, 2012.)

Reducing Paperwork and Administrative CostsHealth care remains one of the few industries that relies on paper records. This new law will institute a series of changes to standardize billing and requires health plans to begin adopting and implementing rules for the secure, confidential, electronic exchange of health information. Using electronic health records will reduce paperwork and administrative burdens, cut costs, reduce medical errors, and most importantly, improve the quality of care. (First regulation is effective October 1, 2012.)

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Health Care Reform Update (Cont.)Understanding and Fighting Health DisparitiesTo help understand and reduce persistent health disparities, the law requires any ongoing or new federal health program to collect and report racial, ethnic and language data. The Secretary of Health and Human Services will use this data to help identify and reduce disparities. (Effective March, 2012.)

CLASS ProgramThe law creates a voluntary long-term care insurance program (called CLASS) to provide cash benefits to adults who become disabled. (A benefit plan is to be designated no later than October 1,2012.) Please Note: HHS announced 10/14/11 that it will halt implementation of the CLASS Act under PPACA.)

Please view more information on health care reform on the Human Resources website (Benefits/Health Care Reform).

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TASC: Flex Spending

Here is an overview of the TASC features. There are new enhancements coming in 2012!

TASC Card• Streamlines the reimbursement of out-of-pocket expenses. It qualifies and pays eligible medical

expenses on the spot, ensuring the correct use of funds and helps monitor your healthcare spending.

• Removes the hassles of paperwork. It eliminates the need to send receipts and track medical expenses and eliminates requests for reimbursements.

• Offers convenience and choice. It provides easy access to reimbursement funds and lets you make transactions without merchant restrictions on general spending.

MyBenefits:• Provides easy reimbursement for eligible healthcare expenses with the swipe of the card.• Auto-substantiates eligible expenses, eliminating requests for reimbursement.• Gives your dependents (spouse, adult child, etc.) the ability to draw funds from your benefit

account.• Lets you easily track expenses and reimbursements online.

MyCash (New in 2012!)TASC card holders who do not use their TASC card to pay for an eligible expense may submit a request for reimbursement via fax, mail, or online. Unless you have already chosen the direct deposit option, your reimbursement will be deposited directly to your MyCash account.

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TASC: Flex Spending (Cont.)

MyCash (Cont.)

Benefits of the MyCash account include:• Out-of-pocket expenses are deposited directly into this account on your TASC card; no more waiting

for reimbursement checks to arrive by mail.• Provides a convenient online site for cardholders to track card activity.• Ensures control over spending. Funds can be spent any way, anywhere – just like cash at any

retailer that accepts VISA.• Cardholders can transfer funds to a personal checking or savings account, or withdraw at an ATM

with a PIN.

PLEASE NOTE: Currently the TASC Card does not work for MyCash (non-FSA) purchases at CVS Pharmacy, Walmart, and Shopko or for pay-at-the pump purchases.

IMPORTANT MyCASH Information:When your MyCash account is activated, all your benefit account reimbursements (where the TASC Card was not used) will automatically be made to your MyCash account. If you prefer, you may elect direct deposit and your reimbursements will automatically be made to a bank account of your choice.

Once MyCash is activated in 2012, paper reimbursement checks will be issued on a limited basis and only upon request.

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MyWay (New in 2012!)• Protects against embarrassing declines. If funds are unavailable in the MyBenefits account,

payment will be withdrawn from the MyCash account if there are sufficient funds.• Pays for healthcare and general expenses in one transaction. With one swipe of the card, eligible

expenses are automatically withdrawn from MyBenefits, while non-eligible items are paid from the available funds in MyCash.

• Allows dependents to access accounts. You can give your dependents access to your benefit account(s) and cash account. In the future, cardholders will be able to elect the specific accounts dependents can access.

• Lets you transfer cash from MyCash to your personal accounts. Funds can be moved to a personal savings or checking account.

• Provides an easy way to save money. Reimbursements can accumulate in your MyCash account. The “special stash” is a great way to save for a vacation or a shopping spree!!

• Gives you control in general spending. Spend your money anyhow, anywhere, any way, at any retailer that accepts VISA, or withdraw funds at an ATM.

MyTASC Mobile App (New in 2012!)This new application allows participating employees the ability to access their account from anywhere at any time using their mobile device. You’ll be able to check your account balances, submit a request for reimbursement, submit substantiation via camera images and view account transactions. The TASC Mobile app offers text messaging and email notification. **This feature is provided at no charge for participants who possess a mobile device (phone or tablet) with an Apple® or Android™ operating system.

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Annual elections are required for both the health care and dependent care spending accounts.

Please enter your 2012 elections during our Open Enrollment period (October 31 – December 5, 2011) via the on-line tool (benefitsCONNECT).

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TIAA-CREFEffective January 1, 2012, all voluntary (403b) contributions toward your retirement must be made through a group supplemental retirement annuity (GSRA).

Employees with contributions made through the additional pension deferred option, as well as those employees that retained the additional 1% contribution (resulting from the change in employee mandatory contribution from 3% to 2% that occurred on July 1, 2009) will be required to:

• Review investment options for your GSRA account (Lifecycle Funds or Build Your Own Investment Mix).

• Go online with TIAA-CREF to set up your GSRA account.• Complete the Agreement for Salary Reduction form and submit to Human Resources.

The benefits for this change include better customer service and reporting/tracking capabilities for audit requirements.

Please contact Human Resources for support. We will help you in knowing what set ups you may be required to complete and will assist you in the online enrollment process.

As a reminder, anyone 21 or older may open a voluntary (403b) plan via a Group Supplemental Retirement Annuity (GSRA), regardless of your benefit eligibility status.

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The Hartford: Voluntary Life Insurance

Carleton College is pleased to announce that our rates for our group-term Voluntary Life Insurance benefit will remain stable (no rate increases) for 2012. Employees that move into a different (higher) age category will see an increase in premiums, however.

For newly hired benefit eligible non-union employees, The Hartford offers the opportunity to purchase voluntary group term life insurance; the guaranteed issue of this coverage is $150,000 (without requiring medical underwriting). The maximum benefit allowed is $500,000, however, coverage between $150,000-$500,000 will require completion of a Personal Health Application and a medical underwriting process. Coverage can be purchased in increments of $10,000.

For existing benefit eligible, non-union employees that either do not have existing coverage or would like to increase their coverage, the completion of a Personal Health Application and medical underwriting will be required.

In order to request or increase your coverage, you will need to indicate the change on benefitsCONNECT.

For specifics regarding the Voluntary Group-Term Life Insurance plan, please visit the Human Resources website.

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The Hartford: Long-Term Disability

Carleton College is pleased to announce that our rates for our Long-Term Disability benefit will remain stable (no rate increases) for 2012.

Newly hired benefit eligible non-union employees can elect to purchase long-term disability coverage through The Hartford at time of hire without the need for medical underwriting.

For existing benefit eligible, non-union employees without existing coverage, the completion of the Personal Health Application and medical underwriting will be required.

In order to request coverage, you will need to indicate your election on benefitsCONNECT.

For specifics regarding the Long-Term Disability benefit, please visit the Human Resources website.

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2012 Dental Insurance Options

• Value Plan

• Comprehensive Premier Plan

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2012 Dental Insurance

Our renewal rates for Delta Dental for 2012 are flat…there are no increases in premium!

There are no plan design changes with either of our Delta Dental plans for 2012!

Both of our plans are voluntary and are totally employee paid. There is no contribution made by the College towards these premiums.

2012 Dental Premiums

Dental Insurance Total Annual Premium Monthly Premium Bi-Weekly Premium

Value

Employee $400.80 $33.40 $15.42

Employee + Spouse $804.60 $67.05 $30.95

Employee + Child(ren) $757.20 $63.10 $29.12

Family $1,301.40 $108.45 $50.05

Comprehensive Premier

Employee $508.80 $42.40 $19.57

Employee + Spouse $1,022.40 $85.20 $39.32

Employee + Child(ren) $961.20 $80.10 $36.97

Family $1,651.80 $137.65 $63.53

2012 Medical Insurance Options

• Options Blue (Aware)

• Aware PPO

• Accord HRA

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2012 Medical Insurance Renewal Rates

Aware PPOThe 2012 renewal rates for the Aware PPO plan had a decrease of slightly over 1.5%.

Options Blue and Accord HRAThe 2012 renewal rates for both the Options Blue and Accord HRA plans reflect an average increase of 0.3%.

Ultimately, this reflects a 0% increase in our overall yearly renewal rates for 2012.

2012 Employee Medical Premiums

Medical Insurance Monthly Premium Bi-Weekly Premium

Aware PPO

Employee $120.72 $55.72

Employee +1 $255.02 $117.70

Family $402.72 $185.87

Options Blue (Aware Network)

Employee $84.48 $38.99

Employee +1 $172.98 $79.84

Family $261.39 $120.64

Accord HRA

Employee $74.93 $34.58

Employee +1 $152.79 $70.52

Family $230.70 $106.48

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2012 Renewal Bulletin and Plan Design Changes

Chiropractic Services:Chiropractic office visits can no longer accumulate to the annual service limits for out-of-network providers. Services for therapies and manipulations will continue to accumulate to the service limit.

Prenatal and Well Child Care:Health care reform requires that prenatal and well child care are covered at 100% of billed charge for out-of-network providers.

Non-Participating Provider Pricing:To provide greater transparency when members utilize non-participating providers, the allowed amount will be determined based upon Medicare’s allowed amount.

This change does not impact the non-participating pricing for emergency services. Allowed amounts for emergency services provided at an emergency department or a hospital and by non-participating providers are based on billed charge.

Creditable Coverage Disclosure for Pharmacy Benefits:There are two disclosures relating to creditable coverage: 1) disclosure to Medicare-eligible members; and 2) disclosure to Centers for Medicare and Medicaid Services (CMS).

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2012 Renewal Bulletin and Plan Design Changes (Cont.)

Creditable Coverage Disclosure for Pharmacy Benefits (Cont.):Member notification of creditable coverage status is due each year on October 15, upon member request, upon plan design change, or upon termination of coverage. Member notification is the employer’s responsibility.

Employers must also disclose creditable coverage status to CMS, which includes information relating to the prior disclosure to members. The CMS disclosure must be provided within 60 days after the beginning date of the plan year for which the entity is providing the disclosure to CMS.

Massachusetts Creditable Coverage Service Option:Massachusetts (MA) law requires that residents age 18 and older have health insurance. To avoid monetary penalties, adults must have health insurance that meets minimum creditable coverage requirements. Several employer and employee notification and filing obligations accompany this creditable coverage requirement. Blue Cross and Blue Shield of Minnesota offers services to assist employees and employers with this compliance issue. (See the full 2012 Renewal Bulletin for specifics.)

Master Group Contract Update:Language has been added to the master group contract under Article XIX-Health Care Reform, section 5. Rebates. This change is related to rebates that would be required if

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Master Group Contract Update (Cont.):Blue Cross or Blue Plus does not meet thresholds for medical Loss Ratio (MLR).(See the full 2012 Renewal Bulletin for specifics.)

Prescription Drug Terminology Change:Blue Cross is changing terminology of prescription drugs from formulary/non-formulary to preferred/non-preferred. This is a terminology change; the benefits will remain the same.

Pain Medication Quantity Limits:Blue Cross and Blue Shield of Minnesota recently reviewed narcotic analgesic and combination paid medications, considering safety and usage details, as well as FDA-approved product labeling.

As a result of their findings, effective October 1, 2011, quantity limits will be implemented for narcotic analgesics and combination pain medications for both of their formularies (Carleton’s formulary is FlexRx).

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Pain Medication Quantity Limits (Cont.):Providers will receive letters with the names of their patients who were prescribed a quantity over the limit for their medication. Member letters notifying that they were prescribed pain medication exceeding the quantity limits will also be sent. Providers will work with members to reevaluate their medication.

Please visit the Human Resources to access the 2012 Group Renewal Bulletin in detail.

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2012 Benefit Plan Overview/Refresher

Employees who wish to have a refresher on our benefit plans for BCBS, Delta Dental, The Hartford, TASC, and TIAA-CREF may wish to stay for the remainder of this presentation.

Individual appointments may also be scheduled with Andrea (x5989) or Kerstin (x4068).

Options Blue-Aware

HEALTH PLAN In-network Out-of-network

Deductible Individual $1,000 $1,0002-Party/Family $1,500/$2,000 $1,500/$2,000

Out-of-pocket maximum

Individual $1,900 $1,9002-Party/Family $2,550/$3,800 $2,550/$3,800

Coinsurance 80% 80%Lifetime maximum Unlimited UnlimitedHRA Contribution $500 Individual,

$750 2-Party, $1000 Family

$500 Individual, $750 2-Party, $1000 Family

RolloverCovered expenses

Health Plan Eligible Expenses

Health Plan Eligible Expenses

Options Blue-Aware (Cont’d.)

Preventive care

Routine cancer screening

100% 100%

Routine physical exams

100% 100%

Routine hearing examsLab and x-ray servicesImmunizations

Routine vision examsWell-child care (up to age 6)

100% 100%

Immunizations (up to age 18)

100% 80% after deductible

Options Blue-Aware (Cont’d.)Covered services In-network Out-of-network

Services received Inpatient care Facility services 80% after deductible 80% after deductible Professional

services80% after deductible 80% after deductible

Outpatient care Facility services 80% after deductible 80% after deductible Professional


Lab and x-ray services

80% after deductible 80% after deductible

Physician’s office Office visits for

illness80% after deductible 80% after deductible

In-office surgery 80% after deductible 80% after deductible Allergy-related


Urgent care 80% after deductible 80% after deductible Lab and x-ray


Emergency room care Emergency room 80% after deductible 80% after deductible Physician services 80% after deductible 80% after deductible• Ambulance services 80% after deductible 80% after deductible

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Options Blue-Aware (Cont’d.)Covered services In-network Out-of-networkMaternity Care •Prenatal care 100% 100%

•Facility services for delivery


•Professional services for delivery


Prescription drugs

Generic Feature:If a brand name is selected when a generic is available, the member will pay the higher co-pay plus the difference between the cost of the brand and the generic. The difference amount does not accumulate toward the OOPM. Step Therapy Classes: Antidepressants, Cholesterol Lowering, Diabetic Monitors & Strips, Proton Pump Inhibitors.

•Retail pharmacy (31-day supply)

$15 Generic Drugs$35 Brand Name Preferred Drugs$55 Brand Name Non-Preferred Drugs

Prescription Drug Out-of-pocket maximum:$750 Individual$1,000 Family


Prescription Drug Out-of-pocket maximum:

$750 Individual$1,000 Family

•90-day Rx (retail or mail)





Medical equipment and supplies 80% after deductible 80% after deductible

Behavioral health (mental health and chemical dependency)

•Physician services 80% after deductible 80% after deductible

•Inpatient 80% after deductible 80% after deductible

•Outpatient 80% after deductible 80% after deductible

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Options Blue-Aware (Cont’d.)Covered services In-network Out-of-network

Rehabilitative care (physical, occupational, speech therapy)


($500 maximum for out-of-network PT/OT/ST providers combined)

Chiropractic care 80% after deductible 80% after deductible

($500 maximum for out-of-network Chiropractic providers)

Options Blue-Aware

$1,000 deductible

$1,500 deductible

$2000 deductible

Aware PPO

Covered services In-network benefits Out-of-network benefits

Deductible Individual $500 $1,000

Family $1,000 $2,000


Individual $2,000 $4,000

Family $4,000 $8,000

Lifetime maximum Unlimited Unlimited

Coinsurance 80% 60%

Aware PPO (Cont’d.)Covered services

In-network benefits

Out-of-network benefits

Preventive care

Routine physical exams 100% 60% after deductible

Routine cancer screening 100% 60% after deductible

Routine hearing exams 100% 60% after deductible

Lab and x-ray services 100% 60% after deductible

Immunizations 100% 60% after deductible

Routine vision exams 100% 60% after deductible

Well-child care (up to age 6)

100% 100%



Aware PPO (Cont’d.)Covered services

In-network benefits

Out-of-network benefits

Services received Inpatient care Facility services 80% after deductible 60% after deductible Professional services 80% after deductible 60% after deductibleOutpatient care Facility services 80% after deductible 60% after deductible Professional services 80% after deductible 60% after deductible Lab and x-ray


Physician’s office Office visits for illness 100% after $35 copay 60% after deductible



Urgent care 100% after $35 copay 60% after deductible Lab and x-ray


Emergency room care Emergency room 100% after $75 copay 100% after $75 copay Physician services 100% 100%Ambulance services 80% after deductible 80% after deductible

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Aware PPO (Cont’d.)Covered services In-network benefits Out-of-network

benefitsMaternity care •Prenatal care 100% 100%





Prescription drugs




Prescription Drug Out of Pocket Maximum:$500 Per Person



•90 day Rx (retail or mail)






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Aware PPO (Cont’d.)Covered services In-network benefits Out-of-network

benefitsBehavioral health (mental health and chemical dependency)



•Physician services 100% after $35 co-pay for office visits. All other services 80% after deductible.

60$ after deductible


100% after $35 co-pay for office visits. All other services 80% after deductible.

60% after deductible($500 maximum for out-of network PT/OT/ST providers combined)

Chiropractic care 100% after $35 co-pay for office visits. All other services 80% after deductible.

60% after deductible($500 maximum for out-of network Chiropractic providers)

Aware PPO

Accord HRA

Summary of Providers not included in Accord:• Mayo Clinic Providers

– Mayo Clinic – St. Mary’s Rochester – Rochester Methodist – Kasson Mayo Family Practice (contracted under Mayo Clinic)– Kenyon Mayo Family Practice (contracted under Mayo Clinic)

• Hazelden Providers– Hazelden– Hazelden OP CD Treatment– Youth and Family & extended residential CD treatment– Mental health clinics

Note: All Mayo Health System clinics (Faribault, Northfield, Owatonna, etc.) are in the Accord network

Accord HRA (Cont’d.)


Deductible Individual $1,000 $1,0002-Party/Family $1,500/$2,000 $1,500/$2,000


Individual $1,900 $5,0002-Party/Family $2,550/$3,800 $7,500/$10,000

Coinsurance 80% 60%Lifetime maximum Unlimited UnlimitedHRA Contribution $500 Individual,

$750 2-Party, $1000 Family

$500 Individual, $750 2-Party, $1000 Family

RolloverCovered expenses Health Plan Eligible

ExpensesHealth Plan Eligible Expenses


Covered services In-network Out-of-network

Preventive care

Routine cancer screening

100% 100%

Routine physical exams

100% 100%

Routine hearing examsLab and x-ray servicesImmunizations

Routine vision examsWell-child care (up to age 6)

100% 100%





Covered services In-network Out-of-networkServices received

Inpatient care Facility services 80% after deductible 60% after deductible Professional services 80% after deductible 60% after deductibleOutpatient care Facility services 80% after deductible 60% after deductible Professional services 80% after deductible 60% after deductible Lab and x-ray


Physician’s office Office visits for

illness80% after deductible 60% after deductible



Urgent care 80% after deductible 60% after deductible Lab and x-ray


Emergency room care Emergency room 80% after deductible 60% after deductible Physician services 80% after deductible 60% after deductibleAmbulance services 80% after deductible 60% after deductible


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Accord HRA (Cont’d.)HEALTH PLAN In-network Out-of-network

Maternity Care •Prenatal care 100% 100%





Prescription drugs






Prescription Drug Out-of-pocket maximum:

$750 Individual$1,000 Family

•90-day Rx (retail or mail)






Behavioral health (mental health and chemical dependency)

•Physician services 80% after deductible 60% after deductible



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Accord HRA (Cont’d.)HEALTH PLAN In-network Out-of-network



($500 maximum for out-of-network PT/OT/ST providers combined)

Chiropractic care 80% after deductible 60% after deductible

($500 maximum for out-of-network Chiropractic providers)

Accord HRA

Two-party and family plans are subject to individual deductibes and out-of-pocket maximums. An individual can meet their own deductible and out-of-pocket maximum before other family members . Individuals within the family may have claims processed at different levels of coverage. Total expenses will not exceed plan deductibles and out-of-pocket maximums.

$1,000 deductible

$1,500 deductible

$2000 deductible

Prescription Drug Out of pocket maximum comparison:

Options Blue (Aware)

$750 Individual

$1,000 Family

Accord HRA $750 Individual

$1,000 Family

Aware PPO $500 per person

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2012 Delta Dental Plans

• Value PlanA Snapshot of Your Coverage*

Service & Description Delta Dental PPO Delta Dental Premier®

Non-Participating

Diagnostic & Preventive Services Exams & cleanings, x-rays, fluoride treatments, sealants, space maintainers 100% 100% 100% of maximum

allowable fee**

Basic Services Emergency treatment for relief of pain, amalgam restorations (silver fillings) and composite resin restorations (white fillings)

80% 80% 80% of maximum allowable fee**

Endodontics Pulpotomies on primary teeth for dependent children, root canal therapy on permanent teeth


Periodontics Surgical/Nonsurgical periodontics 80% 80% 80% of maximum

allowable fee**

Oral Surgery Surgical/Nonsurgical extractions, all other oral surgery 80% 80% 80% of maximum

allowable fee**

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2012 Delta Dental Plans (Cont.)

• Value PlanA Snapshot of Your Coverage* (Cont.)

Service & Description Delta Dental PPO

Delta Dental Premier® Non-Participating

Deductible Per person/per family (calendar year)

No deductible for diagnostic and preventive services

$50/$150 $50/$150 $50/$150

Calendar Year Plan MaximumPer person $750 $750 $750

Eligible Dependents Spouse, qualified same sex domestic partner and unmarried dependent children up to age 26.

*This is a summary of benefits only and does not guarantee coverage. For a complete list of covered services and limitations/exclusions, please refer to the Dental Benefit Plan Summary.

**Dentists who have signed a participating network agreement with Delta Dental have agreed to accept the maximum allowable fee as payment in full. Non-participating dentists have not signed an agreement and are not obligated to limit the amount they charge; the member is responsible for paying any difference to the non-participating dentists.

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2012 Delta Dental Plans (Cont.)

• Comprehensive Premier PlanA Snapshot of Your Coverage*

Service & Description Delta Dental PPO Delta Dental Premier® Non-Participating

Diagnostic & Preventive Services Exams & cleanings, x-rays, fluoride treatments, sealants, space maintainers


Basic Services Emergency treatment for relief of pain, amalgam restorations (silver fillings) and composite resin restorations (white fillings)


Endodontics Pulpotomies on primary teeth for dependent children, root canal therapy on permanent teeth


Periodontics Surgical/Nonsurgical periodontics 80% 80% 80% of maximum allowable

fee**

Oral Surgery Surgical/Nonsurgical extractions, all other oral surgery


Major Restorative Crowns 50% 50%

50% of maximum allowable fee**

Prosthetic Repairs and Adjustments Denture adjustments and repairs, bridge repair

80% 80%80% of maximum allowable

fee**

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2012 Delta Dental Plans (Cont.)• Comprehensive Premier Plan

A Snapshot of Your Coverage* (Cont.) Service & Description Delta Dental PPO Delta Dental Premier® Non-Participating

Prosthetics

Dentures (full and partial), bridges 50% 50% 50% of maximum allowable fee**

Orthodontics Treatment for the prevention/ correction of malocclusion, available for dependent children only, age 8 up to age 19


Deductible Per person/per family (calendar year) No deductible for diagnostic and preventive services or orthodontics

$50/$150 $50/$150 $50/$150

Calendar Year Plan Maximum

Per person $1000 $1000 $1000

Lifetime Ortho Maximum

Per eligible child $1000 $1000 $1000

Eligible Dependents Spouse, qualified same sex domestic partner and unmarried dependent children up to age 26.

*This is a summary of benefits only and does not guarantee coverage. For a complete list of covered services and limitations/exclusions, please refer to the Dental Benefit Plan Summary.

**Dentists who have signed a participating network agreement with Delta Dental have agreed to accept the maximum allowable fee as payment in full. Non-participating dentists have not signed an agreement and are not obligated to limit the amount they charge; the member is responsible for paying any difference to the non-participating dentists.

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The Hartford: Long-Term Disability• Voluntary Long-Term Disability Insurance pays you a portion of

your earnings if you cannot work because of a disabling illness or injury.

• You may purchase coverage that pays you a benefit of 60% of your earnings (to the maximum of $16,666.66 per month).

• You must be disabled for the later of 90 days or the date you exhaust your Sick Leave before you are eligible to receive a Voluntary Long-Term Disability Insurance benefit payment.

• Benefit payments will be reduced by other income received (e.g. Social Security Disability Insurance, Workers’ Compensation, Retirement Benefits, etc.).

• Employees without this current benefit can request coverage. A Personal Health Application (PHA) will need to be completed, followed by a medical underwriting process through The Hartford.

• Premium payroll deductions will ensue once confirmation of coverage has been received.

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The Hartford: Voluntary Life Insurance• Newly hired benefit-eligible (non-union) employees may purchase voluntary group-

term life insurance in increments of $10,000. Maximum amount of purchase is $500,000. At the time of hire, employees can receive $150,000 in guaranteed access (without need for medical underwriting).

• Newly hired benefit-eligible (Union) employees may purchase voluntary group-term life insurance in the following increments: $1,000, $2,000, $3,000, $4,000, $5,000, $6,000 or $6,500. (The maximum benefit is $6,500.)

• For existing benefit-eligible (non-union or union) employees without current coverage, you may apply for the benefit; however, it will require the completion of a Personal Health Application (PHA) and a medical underwriting process with The Hartford. Premium payroll deductions will ensue upon confirmation of coverage.

• For existing benefit-eligible (non-union or union) employees with existing coverage that wish to increase their coverage (not to exceed the maximums listed above), the completion of a Personal Health Application (PHA) and a medical underwriting process with The Hartford will be required. Premium payroll deductions will remain the same until authorization for the increase in coverage is received.

• Benefit Reductions: Your benefits will be reduced by 35% at ages 65, 70, 75; and by an additional 25% of the reduced amount at ages 80, 85, 90 and 85. All coverage cancels at retirement.

Medical/Dependent Care Flexible Spending

• Medical Flex Spending Limit= $5,000

• Dependent Care Flex Spending Limit = $5,000

Both accounts have risk of forfeiture.

Please be conservative when making your election.

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OTC Medicines, FSAs & Health Care Reform

Health care reform legislation passed by Congress and signed by President Obama in March, 2010 changed the rules for health care flexible spending account (FSA) benefit plans.

Starting Jan. 1, 2011, you can no longer be reimbursed from an FSA for over-the-counter (OTC) drugs or medicines without a prescription.

Many OTC supplies, such as bandages, will still be eligible for FSA reimbursement without a prescription.

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OTC Medicines, FSAs & Health Care Reform (Cont.)

What this means to you?

• Decide how much to contribute to your health care FSA with this law in mind.

• If you use OTC drugs or medicines recommended by your doctor to treat a medical condition, you may want to ask your doctor for a prescription.

• You will purchase these drugs or medicines by paying for them yourself. Then, you can use your TASC debit card or fax, mail or go online to www.tasconline.com to submit for reimbursement from your FSA.

http://www.tasconline.com/

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OTC Medicines, FSAs & Health Care Reform (Cont.)

Following are examples of OTC items that will require a prescription for FSA reimbursement:

• Bengay, Flexall, pain relieving creams or gels• Calamine lotion• Canker/cold sore relievers• Cold medicines• Corn removal• Diaper rash ointment• GasX, baby gas drops• Hemorrhoid creams and treatments• Hydrogen Peroxide or rubbing alcohol• Indigestion or anti-acid relievers• Laxatives• Nicotine patch• Pain relievers (Tylenol, Advil, Aspirin, etc.)• Sinus medicines• Suppositories• Teething gel• Wart removal medication

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Eligible Medical Expenses for a Health Care FSA

• Acupuncture• Artificial limbs• Bandages• Birth control, contraceptive devices• Birthing classes/Lamaze – only the mother’s portion (not the coach/spouse) and

the class must be only for birthing instruction, not child rearing• Blood pressure monitor• Blood sugar test kits/test strips• Chiropractic therapy/exams/adjustments• Contact lens and contact lens solutions• Co-payments• Crutches (purchased or rented)• Deductible and co-insurance• Diabetic supplies• Eye exams• Eyeglasses, contacts, or safety glasses, prescription only (warranties are not

reimbursable)• Flu shots• Hearing aids and hearing aid batteries (warranties are not reimbursable)• Heating pad• Incontinence supplies• Infertility treatments• Insulin

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Eligible Medical Expenses for a Health Care FSA (Cont.)

• Lactation expenses (breast pumps, etc.)• Laser eye surgery; LASIK• Legal sterilization• Medical supplies to treat an injury or illness• Mileage to and from doctor appointments• Nasal strips• Optometrist’s or ophthalmologist’s fees• Orthopedic inserts• Physicals• Physical therapy (as medical treatment)• Physician’s fee and hospital services• Pregnancy test• Prescription drugs and medications• Psychotherapy, psychiatric and psychological service• Reading glasses• Sales tax on eligible expenses• Services connected with donating an organ• Sleep apnea services/products (as prescribed)• Smoking cessation programs• Treatment for alcoholism or drug dependency• Vaccinations• Wrist supports, elastic wraps• X-ray fees

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Eligible Dental Expenses for a Health Care FSA

• Braces and orthodontic services• Cleanings• Crowns• Deductibles, co-insurance• Dental implants• Dentures, adhesives• Fillings

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Eligible Expenses for the Disabled for a Health Care FSA

• Automobile equipment and installation costs for a disabled person in excess of the cost of an ordinary automobile; device for lifting a mobility impaired person into an automobile

• Braille books and magazines in excess of cost of regular editions• Note-Taker, cost of, for a hearing impaired child in school• Seeing eye dog (buying, training and maintaining)• Special devices, such as a tape recorder or typewriter for a visually impaired

person• Visual alert system in the home or other items such as a special phone required

for a hearing impaired person• Wheelchair or autoette (cost of operating/maintaining)

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FSA Healthcare Expenses Requiring Additional Documentation

The following are some expenses eligible only when incurred to treat a diagnosed medical condition. This type of expense requires a Prescription Order Form from your physician to be submitted along with your request for reimbursement that contains the medical necessity of the expense, the diagnosed condition, the onset of the condition and the physician’s signature:

• Ear plugs• Massage treatments• Nursing services for care of a special medical ailment• Orthopedic shoes (excess cost of ordinary shoes)• Oxygen equipment and oxygen• Speech therapy• Support hose• Varicose vein treatment• Veneers• Wigs (for mental health condition of individual who loses hair because of a

disease)

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Eligible Expenses for a Dependent Care FSA

Eligible dependent care expenses must be employment related.

• Day Camp – primary purpose must be custodial care and not educational in nature

• Dependent care expenses that are necessary for you (and your spouse) to work, actively look for work, or attend school full time.

• Dependent care for a child under age 13• FICA/FUTA taxes of day care provider• Late pick-up fees• Nanny expenses attributed to dependent care• Nursery school (Pre-School)• Registration fees – when allocated to dependent care services that have

been provided

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TIAA-CREF

Defined Contribution Plan (Carleton’s Regular Retirement Plan)

Carleton College’s retirement plan is a Defined Contribution plan that operates under Section 403(b) of the Internal Revenue Code (IRC). The plan was established on 9/1/79 and it’s purpose is to provide retirement benefits for participating employees. Benefits are provided through:

A. Teachers Insurance and Annuity Association (TIAA). TIAA provides a traditional annuity and a variable annuity through its real estate account.

B. College Retirement Equities Fund (CREF). CREF is TIAA’s companion organization, providing variable annuities.

Our plan year begins January 1 and ends December 31.

Eligible employees (all benefit-eligible employees, excluding bargaining unit employees) can participate in the Plan. Independent Contractors are ineligible to participate.

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403 (b) Retirement PlansDefined Contribution Plan

(Carleton’s Regular Retirement Plan)(Cont.)

Eligibility: Benefit-eligible employees that are 21 years of age or older.

Contributions: Mandatory Employer: 10%; Mandatory Employee: 2% on compensation earned, excluding overtime pay, bonuses, and other forms of supplemental remuneration. There are limits on contributions; the total amount made on your behalf will not exceed the limits imposed by section 415 and section 403(b) of the IRC. For 2011, the limitation is $49,000.

Vesting: Your contribution to this account will be 100% vested immediately.

Investment Choices: A variety of investment choices from an array of asset classes to help you diversity for your retirement portfolio are available to you. For the TIAA annuity, you have a traditional annuity and real estate account; for the CREF, you have stock, money market, bond, social choice, global equities, growth, equity index and inflation-linked bond accounts available.

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403 (b) Retirement Plans


(Cont.)

Expenses: Expenses vary from investment to investment. Reference the TIAA-CREF website under the “Investment Choices” page; select an asset class and on the name of the investment you would like to learn more about.

Distributions: When it’s time to decide how to take income from your Carleton College Defined Contribution plan, there are a variety of options available. Please visit the TIAA-CREF website for specifics.

Taxation: Contributions are made pre-tax; federal income taxes are deferred until you begin taking withdrawals later on. You can withdraw funds only after termination of employment or age 59-1/2. If you withdraw before age 59-1/2, they are subject to an additional 10% early-withdrawal penalty.

Loans: Our Carleton College Defined Contribution Plan does not offer a loan feature.

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(Cont.)

Retirement income usually begins at normal retirement age (65); you may begin to receive annuity income at any time which may be either earlier or later than the normal retirement age.

Retirement benefits must normally begin no later than April 1 of the calendar year following the year in which you reach age 70-1/2, or, if later, April 1 following the calendar year in which you retire. Failure to begin annuity income by the required beginning date may subject you to a substantial federal tax penalty.

View the SPD for detailed specifics on the Defined Contribution Plan via the Human Resources website.

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403 (b) Retirement PlansTax Deferred Annuity Plan

Carleton’s Voluntary Retirement Plan – Group Supplemental Retirement Annuity (GSRA)

This Plan was originally adopted on 1/1/1995 and runs from January 1 through December 31.

Eligibility: Employees that are 21 years of age or older, regardless of benefit eligibility status.

Contributions: This plan allows for only voluntary employee contributions, not to exceed the maximum annual limits. For 2011, it is $16,500 (which includes contributions made to other deferred plans). The age 50 “catch up” allows for an additional $5,500 in 2011. For employees that have worked here at least 15 years, you can make a special catch-up contribution equal to the smallest of three amounts as listed below:1.$3,0002.$15,000 minus the amount of the Special 403(b) Catch-Up Contributions made in prior years.3.$5,000 times the number of years you have worked for Carleton – minus – the total amount of deferrals made while you worked for Carleton.

If you contribute too much to this plan as a deferral, the excess amount (plus any earnings on the excess) must be taken from the plan by April 15th of the following year the money was contributed. Failure to do so will impose additional taxation.

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Tax Deferred Annuity PlanCarleton’s Voluntary Retirement Plan – Group Supplemental Retirement Annuity (GSRA)

(Cont.)

Employer Matching: There is no Carleton College employer match for this plan.

Vesting: Your contribution to this account will be 100% vested immediately.

Investments: A variety of investment choices from an array of asset classes to help you diversity for your retirement portfolio are available to you (e.g. equities, real estate, fixed income, money market, guaranteed, and multi-asset).

Expenses: Expenses vary from investment to investment. Reference the TIAA-CREF website under the “Investment Choices” page; select an asset class and on the name of the investment you would like to learn more about.

Withdrawing Funds: You may request distribution of deferrals at time of termination, if you become disabled, when you reach 59-1/2, or on account of **hardship (**your hardship event must meet the plan’s qualifications). Before taking a hardship distribution, you must take all other distributions and non-taxable loans available to you under the plan. If taking a hardship loan and you are under 59-1/2, the distribution is subject to a 10% penalty tax (unless you were called to active military duty).

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403 (b) Retirement PlansTax Deferred Annuity Plan

Carleton’s Voluntary Retirement Plan – Group Supplemental Retirement Annuity (GSRA)(Cont.)

Loans: Loans are available from a minimum of $1,000 to a maximum of $50,000; how much you can borrow depends on the amount you currently have in the plan and whether you have other outstanding loans taken within the last year. If there are no outstanding loans in the previous year, the maximum loan cannot be greater than one-half of your vested account balance or $50,000 (whichever is less). There are further loan stipulations, as well. Please reference the SPD for specifics.

Distributions: There are a variety of options available to you when it’s time to begin taking money from your TDA plan. You can withdraw funds from your account (while still employed) once you have reached 59-1/2. Please see the TIAA-CREF website for a more comprehensive overview on distribution options.

Age 70-1/2 Required Distributions: When you reach 70-1/2, you will need to begin taking distribution each year based on your balance in the Plan.

Taxation: These voluntary contributions are made with pre-tax dollars; federal income taxes are deferred on supplemental plans until you begin taking withdrawals. Funds can be withdrawn only after termination of employment or age 59-1/2. If you withdraw funds before age 59-1/2, they would be subject to a 10% early withdrawal penalty. For additional information and guidance, contact your tax advisor.

Resources

• Enrollment resources are available on HR web site

• BlueCross and BlueShield web site – http://www.bluecrossmn.org

• BlueCross and BlueShield Customer Service – (866) 870-0348

• One-on-one appointments can be scheduled with Kerstin or Andrea during the open enrollment period.

http://www.bluecrossmn.org/

2012 Open Enrollment

Documents

Transcript of 2012 Open Enrollment