The open enrollment period for benefit elections effective January 1, 2016 begins Monday, October 19, 2015 and ends at:
5:00 pm on Friday, November 13, 2015.
1. Election Participation Forms:
Due to new regulations in 2016 related to the Affordable Care Act Reporting
Requirements, the Payroll Manager MUST have a current mailing address on file. If
you moved during 2015, you MUST complete the attached Election Participation Form.
Please click on this link: 2016 ELECTION PARTICIPATION FORM
Complete all sections of the form as it relates to you and your coverage needs for
2016. Forms must be completed and returned to the HR Office
by November 13, 2015.
2. FSA plans have two new changes for 2016:
1. The Health Care allowable contribution has increased to $2,550 (previously $2500).
You still have until March 31st of the following year to submit expenses incurred in the
2. A new option called the "Carry-Over" Rule goes into effect January 1, 2016. If you
participate in the FSA Plan for 2016 and DO NOT use all of the money for expenses
incurred in 2016, up to $500 of your remaining balance will carry over to the next
Please read this attachment "Flexible Spending Account Plan Changes 2016" for
complete details and examples.
Reminder: You MUST complete a new application every year in order to
participate in the FSA.
3. Vision Buy Up Plans:
Effective January 1, 2016, our Vision Provider for the buy-up plan will change
from Davis Vision to Anthem (UniView Vision). There is no change in the premium
cost. Important: If you are currently with Davis Vision and want to keep your
additional coverage you MUST complete a new application with UniView. The
application is attached below under UniView Vision. Important Change: You can
now purchase contact lenses in addition to eyeglass lenses every calendar
year. Frames can be purchased every two years.
4. Anthem Medical Plans:
Benefits will remain the same; however rates have increased. To view the new rates
for 2016 please click on this link: 2016 Insurance Rates.
5. Delta Dental Plans:
Low and High Plan Benefits and Rates will remain the same for 2016.
6. Express Scripts:
Increase in RX copays:
* Retail: from $10/$35/$55 to $10/$40/$60
* Mail Order: from $10/$70/$110 to $10/$80/$120
* Added a 4th tier cover specialty drugs at 20% up to $200 per script
maximum; Mail order - 20% up to $400 per script maximum.
* Standard Preventative Care Medications will no longer have Co-pays.
There will be no charge for these drugs.
* You can view a list of ESI standard preventative care medications below
under Prescription Drug Coverage.
If you want to add/change Medical, Dental or Vision you MUST complete an application
and the 2016 ELECTION PARTICIPATION FORM for the plan(s) you are adding/changing
only. Application forms for each benefit are provided below. You can complete the
application online. It can be saved to your computer. Completed forms should
be sent to:
Debbie Herndon, Benefits Manager, at one of the following:
email@example.com, or fax (434.223.7049), or Campus Box 127, or delivered to the
office on the 2nd Floor, Cabell House.
Forms must be RECEIVED by 5:00 pm on Friday, November 13, 2015.
|Anthem (Medical):||Information Booklet|
|Summary of Benefits and Coverage|
|CHIP (Children's Health Insurance Program)|
|Women's Health & Cancer Rights Act|
|Coverage for Spectrum Disorder|
|HIPAA Special Enrollment Rights|
|HIPAA Privacy Notice|
|Delta (Dental):||Information On Low Option|
|Information on High Option|
|Delta Dental Network Providers|
|UniView (Vision):||Information on High Option|
Prescription Drug Coverage
Express Scripts (Prescriptions): Information On Coverage
ESI Standard Preventative Care Medications
ESI Home Delivery & Mobile App Information
ESI Mobile App Registration Instructions
Flexible Spending Accounts
|LD&B (FSA):||Information Enrollment Packet|
|FSA Plan Changes 2016|
|HIPAA Privacy Notice LD&B|