2020-2021 Group Benefits Review Newsletter – Anniversary Issue
Cost for most of you won’t change…new tobacco user rates…Blue Cross plans renewed with minimal adjustments. Despite the deep in-network discounts associated with our Blue Cross medical plan, claim costs are rising at an alarming rate. Remember that all of your cost is collected on a pretax basis through our Section 125 Flexible benefit plan so that the net effect on your paycheck is less than the illustrated cost. Now is the time you can change your plan choice so be sure to study the side by side comparison in the newsletter and the detailed plan outlines in your anniversary envelope. Be sure to mark your selection on the benefit election form and if you are enrolling for the first time or changing plans, complete the simplified medical/dental enrollment form.
There are three (3) windows of opportunity for one to join the Acousti Engineering Company Benefit Plans.
- When one is initially eligible (first of the month following three months of continuous full-time employment).
- Enrollment during the 30 days prior to the plan anniversary (currently April 1st).
- Enrollment within 30 days of a change in family status (for example, marriage, birth, death, adoption, etc.)
Tobacco Users will pay a higher cost for medical benefits…
It’s no secret that tobacco use is bad for your health. Higher medical claims related to conditions contributed by tobacco increase our claims and our cost. Beginning with this anniversary, tobacco users will pay 20% more than non-tobacco users. This increase applies just to the individual rate and not the additional charge for dependent coverage. A smoking cessation program is available for members who have registered at www.floridablue.com under the Health & Wellness link and Care Programs. Plus there are many other resources such as tobaccofreeflorida.com.
ALL THREE OF OUR PLANS PROVIDE TERRIFIC IN-NETWORK PREVENTIVE CARE BENEFITS! Our medical plan designs all provide well care benefits. There are no limits on these benefits: adult wellness exams/routine physicals, well woman exams and well child exams and immunizations. Routine mammograms and colonoscopies (subject to age and frequency limitations) are paid at 100%, not subject to the deductible.
CVS removed from pharmacy network… effective with the new Plan year, CVS (including Target) will no longer be a part of our pharmacy network. This change will reduce our cost and affects about 20% of our members. Walgreens and other major chains as well as many independent pharmacies remain in the network and are eager to have your business. To transfer prescriptions from CVS simply have your new pharmacy call CVS for copies of the prescriptions.
NOW HEAR THIS!
It’s ok to ask for help and our medical plans provide an array of Personal Care Services for your use. (All phones are answered by Humans!)
The Nurseline 1-877-789-2583 (24 hours a day) is for General or Urgent Healthcare Questions.
Healthy Additions 1-800-955-7635, Option 6 This is a program designed for pregnant mothers. It is a pre-natal education program in which you have access to nurses who will walk you through the steps of a healthy pregnancy, childbirth and baby. This program is especially important for high risk pregnancies. Members also receive free educational material and even free gifts.
Care Consultants 1-888-476-2227 Planning ahead can save you a lot of money and our Care Consultants can provide you with personalized information based on your healthcare needs. They can provide assistance with coordinating care among multiple providers and they are the go to folks to learn about quality treatment options, costs estimates based on our plan benefits including office visits, medication, imaging and surgical services. They can also link you up with nurses and programs designed to help you manage chronic conditions such as diabetes, COPD, Depression and Behavioral Health. And for specialized care that requires close monitoring: Home Care, Hospice Care, Pain Management and coordination of Complex Medical Issues such as MS, Hepatitis C, Multiple Trauma and more.
Customer Service number is on the back of your ID Card- This is who you would call regarding a specific Claim issue (service already performed).
Remember, you can locate Urgent Care Centers on line on Florida Blue’s website or with the Florida Blue App on your phone.
2020 In-Network Medical Benefit Comparison
|In-Network Benefits||Green Plan||Blue Plan||Yellow Plan
|Calendar Year Deductible (CYD)||$1,500 per person||$1,000 Single/$3,000 Family||$1,500 Single/$3,000 Family|
|Office Visit Co-pay (PCP/Spc)||$35/CYD then 50% Co Ins||$30/$50||CYD then 20% coinsurance|
|Lab (Quest Labs)||$0||$0||CYD|
|Adv Imaging Services||$300 co-pay||$250 co-pay||CYD then 20% coinsurance|
|Prescription Benefit||$500 ded then $15/50%/50%||$15/$30/$50||CYD then $15/30/50 after CYD to OOP|
|Routine Care/Well Care||Paid at 100%||Paid at 100%||Paid at 100%|
|Hospital Inpatient Care||$2,000/$3,000 (co-pay)||$600/$1,000 (co-pay)||CYD then 20% coinsurance|
|Emergency Room||CYD then 50% coinsurance||$200 co-pay||CYD then 20% coinsurance|
|Surgical Center||CYD then 50% coinsurance||$100 co-pay||CYD then 20% coinsurance|
|Max Out of Pocket (Sng/Fam)||$6,850/$15,000||$7,500/$15,000||$5,000/$10,000|
|Non Tobacco Weekly Cost (Sng/Fam)||$25.00/$79.00||$60.00/$149.00||$33.00/$90.00|
|Non Tobacco Semi Monthly Cost (Sng/Fam)||$54.17/$171.17||$130.00/$322.84||$71.50/$195.00|
|Non Tobacco Monthly Cost (Sng/Fam)||$108.33/$342.33||$260.00/$645.67||$143.00/$390.00|
DENTAL BENEFIT SUMMARY
Standard Dental will continue in 2020. Costs are not increasing and all great benefits remain the same:
- Preventive Max Waiver—Under this benefit, the charges associated with Class I preventive care services (paid at 100%) no longer count towards the calendar year maximum benefit allowance ($1,500)
- The dental plan uses the Ameritas Dental Network. Using the network increases your maximum calendar year benefit from $1,000 to $1,500 and provides a 100% benefit for not only Preventive Services, but many basic services including fillings and root canals.
- The plan even covers up to FOUR CLEANINGS per year (2 Routine, 2 Perio).
- FOUR TIER PRICING significantly reduces costs for those covering only a spouse or only child(ren). The Full Family rate also represents a significant value.
The monthly cost for the 2020-2021 plan year are as follows:
Employee Only: $32.15
Employee + Spouse: $61.59
Employee + Child(ren): $61.93
Employee + Family: $91.37
Note: If you wish to make a change or enroll for the first time, see your Branch Insurance Coordinator for the appropriate form. If you did not enroll when you were initially eligible, you will be subject to “late entrant” penalties.
The dental provider network, Standard Dental Network is quite large. You will be receiving a new Dental ID Card which you MUST provide to your dentist during your next visit. Please go to www.dentalnetworkpartners.ameritas.com to find a dentist.
Group Basic Life and AD&D
All eligible employees receive Basic Life Insurance & Accidental Death coverage equal to your prior year gross earnings with a minimum death benefit of $20,000. Starting 2020, this coverage will be underwritten by The Standard and is paid for entirely by Acousti at no cost to you! See your Branch Insurance Coordinator if you wish to update your beneficiary designation.
SECTION 125 Flexible Payment Plan
Acousti operates a Flexible Benefit (Section 125) Plan which allows participating employees to pay their portion of the cost for medical and dental coverage on a pre-tax basis through payroll deduction. Yellow plan members can also use this plan to make their HSA contributions through payroll on a pretax basis. Simply indicate the amount you wish to contribute to your account each pay period on your 2020 Benefit Election Form. Because of the tax savings associated with this plan, most participants enjoy a savings of 25-35% or more on the cost of these benefits.
Voluntary Life Insurance
For 2020, our Voluntary Life Insurance program will be underwritten by The Standard. This will be a true open enrollment for this anniversary. All eligible employees have the opportunity to apply for economical term life insurance up to $120,000 of benefit WITHOUT HEALTH QUESTIONS. Participants who currently have less than $120,000 of coverage can increase their coverage up to the $120,000 limit WITHOUT HEALTH QUESTIONS. Any coverage over the $120,000 will be subject to underwriting (max amount is six times annual income). Those who have existing coverage over the guaranteed issue limits will NOT require health questions if maintaining the current coverage level.
If electing coverage on yourself, you can also apply for spousal and child(ren) coverage within the dependent guaranteed issue limits WITHOUT HEALTH QUESTIONS. Any amounts over the limits, will be subject to underwriting. The cost for this coverage is paid through convenient payroll deduction. Please review the plan information found in your package. Cost for this coverage is not changing unless you have entered into a new 5 year age bracket.
Get the APP in 2020 Florida Blue has an app that works on most any smart phone. The App gives you access to your personal claim files, allows you to look up providers, shop costs for prescriptions or medical procedures and even allows you to take charge of your health with the Florida Blue “Health Tool Kit”.
SA Compatible Yellow Plan offers the Best Value… Do the math and you’ll see that with lower premium cost and the lowest out of pocket maximums among our three plans the Yellow Plan is a great insurance value. Add to this the fact that you can save the premium differential in a tax qualified HSA account and then use those non taxed funds to pay your out of pocket costs (otherwise paid with after tax dollars) and you are way ahead of the game. Don’t be fooled by the convenience of copays – they add substantially to your cost. 2020 single contribution limit is $3450, for those covering dependents the limit is $6,850. Yellow plan members 55 & over can make an additional $1,000 catchup contribution!
Winning Medical Plan Design Acousti provides all eligible employees with the choice of three Blue Cross and Blue Shield medical plans which we call Green Plan, Blue Plan and the Yellow Plan. The Green Plan plan provides a basic level of benefits. Acousti pays the total cost of the Green Plan plan for employees and a major portion of the dependent coverage cost. Those wanting a richer plan of benefits can join the Blue Plan plan which provides lower office visit copays, lower deductible and an enhanced prescription drug card. Those choosing the Blue Plan plan pays a portion of the cost of single coverage and a little more for family coverage. All plans use Blue Cross and Blue Shield’s extensive Blue Options Network Blue network but also allow members to seek care outside of the network at reduced benefit levels. The Insurance Coordinator at your branch can provide you with a brief plan outline.
Nationwide Access To Participating Blue Cross Shield Providers To find the most current Blue Cross and Blue Shield Participating Provider (PPC) listing visit the Blue Cross website for your state:
Handy Phone Numbers
Blue Cross Blue Shield (customer service): 1-877-352-2583
Standard Dental (Ameritas): 1-877-490-9991
John Geer Company: 1-904-296-3990
- Review this brochure and the other materials in your Anniversary Package.
- Complete a 2020 Benefit Election Form marking your benefit elections. If you are not making any changes, simply check the box for Keep Existing Benefit Elections. All employees must complete and return a new Benefit Election Form. If you are making changes, you must also complete the appropriate enrollment or change forms.
- If you wish to enroll for the first time in one of our medical plans, or make changes to your current medical plan elections (add a dependent, change plans, etc), you must contact your Insurance Coordinator for the necessary form.
- If declining medical insurance, you must sign the Employee Refusal of Medical Coverage Form.
- If you wish to enroll in or make a change to your Dental election, please see your Insurance Coordinator for the necessary form.
- If you wish to enroll or change your current Voluntary Life election, complete The Standard Group Additional Life enrollment form. See your Branch Insurance Coordinator for the Medical History Statement if you are applying for coverages over the guaranteed issue limits.
- Return all forms to your Branch Insurance Coordinator no later than Friday March 23rd.
The plans referred to in this newsletter are controlled by various plan documents and insurance contracts. Neither Acousti Engineering Company of Florida nor The John Geer Company has the ability to promise benefits beyond the scope of the documents or contracts. All final benefits interpretation will be controlled by the various insurance carriers.