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October 29, 2014

Reminder to Employees: Choose Your 2015 Health Care Plan by Nov. 14

Your Benefits packets have arrived at home, and open enrollment is under way. During this period—which ends Friday, Nov. 14—you need to pick one of the University’s two new health care plans.

You must:

  • Elect a health care plan provider (Aetna or Excellus) for 2015, or choose to waive coverage
  • Elect a flexible spending account or health savings account if you wish to contribute in 2015
  • Elect a dependent-care flexible spending account if you wish to have one in 2015
  • Elect or change your dental plan coverage
  • Elect or change optional life insurance coverage (without proof of good health) Right now, you do not need:
  • To select a physician in Accountable Health Partners

Glossary of helpful words and terms

Accountable Health Partners (AHP): Accountable Health Partners is a partnership between University of Rochester hospitals and physicians, and community-based hospitals and physicians. AHP has more than 1,600 physicians in its network, plus six hospitals. AHP is an accountable care network, which is a type of organization designed to bring physicians and hospitals together to provide care that is better coordinated.

Behavioral Health Partners (BHP): Behavioral Health Partners (BHP) is a mental-health resource committed to improving your emotional well-being and mental health. Its mission is to provide high quality, personalized, and accessible mental-health care to eligible employees, retirees, and dependents enrolled in a University health care plan. BHP services include a range of therapies for mental health concerns, including anxiety, stress, and depression. BHP’s clinical team can provide psychotherapy, discuss the possible role of medications and prescribe as needed, or consult with your primary care physician about your medications. BHP clinicians tailor the length of treatment to the mental health concerns of the individual.

Preferred Provider Organization (PPO): A preferred provider organization is a health care benefit plan. It is similar to the current copay plan that allows those covered to receive care by network and non-network providers. The plan generally comes with higher premiums but lower deductibles, so in many cases, those covered will enjoy lower fees charged by the health care provider. The network provider will automatically bill the plan, and employees are not billed for charges higher than the amount allowed by their respective administrators: Aetna or Excellus.

Copay: A fixed dollar amount you must pay your health care provider at the time when care is given. Premium: The monthly amount you pay for health care coverage.

Deductible: The out-of-pocket amount you must pay during the calendar year for health services, before the plan begins to pay for covered services.

Health Savings Account (HSA): A health savings account is a voluntary, tax-advantaged savings account available to eligible individuals enrolled in a high deductible health plan as defined by the IRS. An HSA allows you to save money—the amount is defined by the IRS—through pre-taxed payroll deductions that will be used to pay for current and future out-of-pocket covered medical expenses. An employee will be able in 2015 to contribute to an HSA a maximum of either $3,350 for single coverage, or $6,650 for family coverage, and use HSA funds to pay for qualified medical expenses, including those of a spouse and tax dependents. The funds in an HSA “roll over” from year to year and are also portable, so funds can be saved to pay for future qualified medical expenses, even if the employee leaves the University or changes plans.

Flexible Spending Account (FSA): A flexible spending account is a voluntary, tax-advantaged savings account that allows you to set aside pre-tax dollars (through payroll deductions) to pay for qualified medical expenses (as defined by the IRS) incurred by yourself, a spouse, and tax dependents. FSA funds can be used to reimburse eligible medical, dental, and vision expenses, including copays and payroll deductions. One may choose to have an FSA regardless of the health plan that has been chosen. However, you cannot have an FSA if you are contributing to an HSA. In 2015, the maximum contribution is $2,500. These funds do not roll over, nor are they portable.

Limited-Purpose FSA: This type of FSA may provide reimbursement for qualified dental and vision expenses, but it cannot reimburse out-of-pocket medical or drug expenses accrued before the annual HSA deductible has been met.

Dependent-Care FSA: This type of FSA helps you reduce your tax payments while paying for dependent-care expenses, such as for children under age 13 who are claimed as dependents on your yearly federal tax returns.

Three-tiered structuring: AHP occupies the first “tier,” so choosing a health care provider who is within the AHP panel will mean lower costs. The second tier includes providers within Aetna’s and Excellus’s nationwide network, and the costs associated with these providers are comparable to what an employee is currently paying. Within the third tier are out-of network providers; generally, the costs of care from these providers will be the highest of those within the three tiers. If your current provider is not within the AHP panel, that provider may be referred to the AHP website—ahpnetwork.com—for details about participation.

Duo security: The University now requires employees wishing to remotely access sensitive online information to be enrolled in “two-factor authentication,” which asks for additional identification before permitting access. (Duo is the brand of software being used to enact the two-factor authentication policy.) Enroll at https://www.rochester.edu/it/security/duo/.

Help is available

Visit www.rochester.edu/working/hr/benefits/enroll/open_enroll.html for further details about the open enrollment process and for a list of helpful resources, including a schedule of informational sessions.

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