Active Employee Open Enrollment 2019

The Open Enrollment period for Active Employee Health and Life insurance plans will be from April 1 – 30, 2019.  Now is the time when you should stop and think about health coverage for yourself and your family and determine which plans will best meet your needs for the new plan year (July 1, 2019 through June 30, 2020).  Open enrollment is your only opportunity to make changes to your health plan enrollment without experiencing a qualifying event.

During open enrollment, you can:

  • Add a plan, change from one plan to another, or drop a plan
  • Add an eligible dependent or drop a dependent
  • Change coverage tiers such as changing from single to family or family to 2-party

Important Dates

Open Enrollment election period
April 1 – 30, 2019
Rate changes effective
July 1, 2019
New premiums deducted from paycheck
July 15, 2019 through June 30, 2020
(County Employees)
July 20, 2019 through July 5, 2020
(State Employees)
Plan period
July 1, 2019 through June 30, 2020
Deadline to submit EC-1/EC-1H to your employer’s open enrollment designee
April 30, 2019

Plan Changes (effective 7/01/19)

HMSA:

  • For EUTF PPO and HMO plans, improved the Advance Care Planning benefit whether provided during a physician visit or an ER physician visit to 100% coverage for in-network providers (not subject to the 75/25 deductible) and standard plan benefits* for out-of-network providers.
  • For HSTA VB plans, added an Advance Care Planning benefit, covered at 100% for in-network providers and standard plan benefits* for out-of-network providers.
  • For EUTF PPO, HMO, and HSTA VB plans, added coverage for genetic counseling at standard plan benefits* for both in-network and out-of-network providers.
  • For EUTF PPO and HMO plans, replaced the Routine Physical Exam benefit with the Annual Preventive Health Exam benefit, covered at 100% for both in-network and out-of-network providers (not subject to the deductible).
  • For EUTF PPO, HMO, and HSTA VB plans, added benefit for chlamydia and gonorrhea screenings for men, covered at 100% for in-network providers (not subject to the 75/25 deductible) and the same plan benefits as provided for women* for out-of-network providers.
  • HSTA VB members with pre-diabetes, now have access to the Diabetes Prevention Program, covered at 100% from in-network providers and limited to once per lifetime. This program was previously added for the EUTF PPO and HMO plans effective 7/1/2018.
  • For HSTA VB plans, added Dr. Ornish’s Program for Reversing Heart Disease, covered at $20 per session from in-network providers and limited to once per lifetime. This program was previously added for the EUTF PPO and HMO plans effective 1/1/2016.
  • For HSTA VB plans, added a supportive care benefit, covered at 100% from in-network providers and limited to 90 calendar days in a 12-month period. This benefit was previously added for the EUTF PPO and HMO plans effective 7/1/2017.

* For more information about your coinsurance or copayment, see your HMSA Guide to Benefits.

Kaiser:

  • Kaiser Permanente EUTF and HSTA VB active members diagnosed with pre-diabetes have additional resources to help manage your health. Starting July 1, 2019, Kaiser Permanente will be offering a facility-based and digital-based Diabetes Prevention Program at no cost to the member. Contact a Kaiser Permanente lifestyle coach at 808-432-2260 to get started.

CVS/Caremark:

  • Added Two-Trial Step Therapy to EUTF active plans where members will be required to try two generic medications before certain brand-name medications will be covered for the following drug classes: ACE/ARB (treats high blood pressure), COX 2 Inhibitors/NSAIDs (treats pain), Proton Pump Inhibitors (treats acid reflux) and Urinary Antispasmodics (treats urinary incontinence). Existing members in the ACE/ARB and COX 2 Inhibitors/NSAIDs drug classes will not be required to try a second generic.
  • EUTF 75/25 PPO drug plan calendar year maximum out-of-pocket (MOOP) will increase from $2,350/$4,700 (Individual/Family) to $2,900/$5,800.
  • The specialty calendar year MOOP for EUTF active members will increase from $2,000 to $2,500.
  • Added tiered specialty copayments to EUTF active plans where the specialty copayment will change from 20% up to $250 per fill to:
    • Specialty generic: 10% up to $200 per fill
    • Specialty preferred brand: 20% up to $300 per fill
    • Specialty non-preferred brand: 30% up to $400 per fill

HDS Dental:

    • Added benefits designed for prevention: Total Health Plus gives you access to more services and shares the importance of maintaining good oral health care. This supplemental set of benefits is essential to improving your overall health and is designed to prevent oral disease and tooth decay that accompanies certain medical conditions or diseases. Discuss with your dentist to see if you qualify for Total Health Plus benefits.
Medical Condition or Diagnosis
Benefit
Frequency
Diabetes (or history of diabetes)
Cleanings
Two additional per year*
Cancer (or history of cancer or undergoing treatment such as chemotherapy or radiation; not including oral cancer)
Cleanings
Fluoride Treatments
Two additional per year
Two additional per year
Oral Cancer (or history of oral cancer or undergoing treatment for oral cancer)
Cleanings
Fluoride Treatments
Two additional per year
Four additional per year
Sjögren’s Syndrome (or history of Sjögren’s Syndrome)
Cleanings
Fluoride Treatments
Two additional per year
Four additional per year
Stroke (or history of stroke; TIA – Transient Ischemic Attack)
Cleanings
Two additional per year
Heart Attack, Congestive Heart Failure (or history of heart attack; MI – Myocardial Infarction)
Cleanings
Two additional per year
Kidney Failure (or history of renal failure or dialysis)
Cleanings
Two additional per year
Organ Transplants (or history of organ transplants)
Cleanings
Two additional per year
Pregnancy (expectant mothers)
Cleanings
One additional per year*
Medical Risk for Cavities
Fluoride Treatments
Three additional per year

*Previously covered under the EUTF and HSTA VB plans.

VSP Vision

  • Standard progressive lenses (no-line multi-focal lenses) covered at 100% for VSP Providers, excluding any lens option add-ons.
  • Wal-Mart & Sam’s Club have been added to the VSP Network for EUTF.
  • $120 Frame benefit available at all VSP Providers (including Costco, Wal-Mart & Sam’s Club).

Life Insurance

  • Securian Financial (Securian) has been chosen as the new carrier for your Group Life Insurance effective July 1, 2019. Coverage is underwritten by Minnesota Life Insurance Company, an affiliate of Securian Financial.
  • The life insurance benefit provided through Securian Financial will change from $41,116 to $38,505 for active employees under age 65.
  • Benefits will be reduced once you turn age 65 as follows:
    • $25,028 for participants age 65 through 69
    • $17,737 for participants age 70 through 74
    • $11,552 for participants age 75 through 79
    • $7,701 for participants age 80 and over
  • Increased the maximum age at which the portability provision applies from age 65 to 79. Also increased the maximum age at which such coverage will terminate from age 70 to 80. The portability provision allows a terminated participant to continue their life insurance at a group discounted rate instead of an individual rate, if eligible.
  • The accelerated death benefit will change from up to 75% to 100% of your life insurance benefit. The accelerated death benefit allows a terminally ill participant with a life expectancy of 12 months or less to request early payment of their life insurance benefit.

Website Resources

EUTF Active Employee Premium Calculator – Use the Premium Calculator link below to compare 2019 premiums between your current plan and 2 additional plans.
Premium Calculator

EUTF Plan Finder – Use the EUTF Plan Finder tool to determine which Benefit Plans you are currently enrolled in based on the amounts from your pay stub.
EUTF Plan Finder

EUTF Active Employee Rates and Contributions
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