Benefits Newsletter for Salaried Employees

Welcome to Open Enrollment 2015

Meet BenefitsVendors at Your SiteHEALTHFAIROct 2 - NiagaraOct 3 - Clark

Oct 6 - 500 MWOct 7 - White PlainsOct 10 - B-GOct 14 - STL-FDROct 17 - Flynn

HEALTH TALK FOR YOUR BENEFIT Page 1

Important Changes are ComingAs the Affordable Care Act (ACA) is implemented, changes are occurring throughout the health insurance industry. For salaried employees in 2015, only the NYPA PPO and the NYPA Choice plans will have noticeable changes, since they will no longer be grandfathered and must now cover additional provisions of the ACA. What does this mean?

These two plans will now cover certain in-network preventive care services with

no copay. This is noteworthy since some employees have chosen other plans in the past because they emphasize preventive and wellness care programs. (See page 2 for a description of preventive care items.)

The ACA also requires the NYPA PPO and NYPA Choice plans to implement an “overall in-network out-of-pocket maximum,” which will help control your in-network medical expenses. Once an employee reaches the —continued on page 2

NYPA PPO PLAN CHANGES IN 2015

Prescription Copays Retail (30 day supply)

Prescription Copays Mail Order

(90 day supply)

Preventive Care (In-network)

Out-of-Network Deductible

Overall In-Network Out-of-Pocket

Maximum

Tier 1 - $7

Tier 2 - $25

Tier 3 - $40

Tier 1 - $14

Tier 2 - $50

Tier 3 - $80

Now covered, with no copay

$600 Employee

$1200 Employee +1

$1800 Family

$1800 Employee

$3600 Family

Note—Tier refers to the UHC “prescription tier,” not your Retirement System Tier.

OCT.1-31

Open Enrollment

Open Enrollment is your annual opportunity to reassess your health care needs for the coming plan year. The Open Enrollment period for 2015 begins on Wednesday, October 1, and runs through noon on Friday, October 31. NYPA’s online enrollment vendor continues to be FBMC Benefits Management.

NYPA’s FlexAbility Program provides you with a comprehensive benefits package, allowing you the flexibility to choose the plans that best fit your needs and health care preferences. Use the information provided in this newsletter and in the 2015 Open Enrollment section of

the Powernet to educate yourself on the changes coming next year. Understanding the plans available to you enables you to make more informed decisions about your 2015 benefits.

NYPA CHOICE PLAN CHANGES IN 2015

Physician Copays Preventive Care

(In-network)

Overall In-Network Out-of-Pocket

Maximum

$20 Additional services now covered with no copay

$1800 Employee

$3600 Family

The Powernet provides much more information on these plans as well as the HMOs that NYPA offers, including Summaries of Benefits & Coverages (SBC) and Benefits Plan Summaries. Salaried employees should use these materials to compare their health care options

Did You Know ?Most health care plans use a “tier” system to categorize prescription drugs according to cost. The costs associated with these tiers vary from plan to plan. Tier 1 medications are the lowest-cost option. If your medication is placed in a higher tier, check to see if there is a Tier 1 option available. Many Tier 3 drugs have lower-cost alternatives in Tier 1 or 2.

NOTE: The tier pricing system for prescriptions has no connection with the New York State Retirement System tiers.

October 2014

Inside This IssueMedical Benefits Options Page 2Preventive Care Services Page 2The Power Flex Option Page 3Dependents, Qualifying Events Page 3Open Enrollment Checklist Page 4

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Benefits Newsletter for Salaried Employees

Benefits CreditsNYPA continues to absorb a substantial portion of employee health care costs while providing you with flex credits to subsidize the amount of money you must pay for your benefits. For 2015, single flex credits are $2,750 and family flex credits are $4,650.

Understanding the Overall Out-of-Pocket MaximumHealth care reform requires that all in-network costs (deductibles, copays, co-insurance) will accumulate toward an overall out-of-pocket maximum.

Currently, the NYPA PPO and NYPA Choice plans have no maximum cost for in-network benefits. That means there is no limit to how much you might pay for these services. For 2015, these plans will join our HMOs in setting an in-network out-of-pocket maximum, which can help limit your medical expenses.

The maximum varies by plan, so refer to the SBCs posted in the 2015 Open Enrollment section of the Powernet for details.

Medical Benefits Options The following summary provides a general overview of the types of medical plans available to NYPA salaried employees. Detailed information about each of the plans is available in the 2015 Open Enrollment section of the Powernet.

NYPA PPO Plan• In-network or out-of-network benefits• No referrals are required for specialist care• Certain services, such as hospital

admissions, require pre-approval • You are responsible for the deductible,

co-insurance and charges over the reasonable & customary limit for out-of-network services

• Empire Blue Cross\Blue Shield provides

hospitalization; UnitedHealthcare provides major medical coverage; OptumRx provides prescription benefits

HMOs• Emphasize preventive and wellness care

programs• A primary care physician is generally

responsible for the coordination of your care from specialist referrals to hospital admissions

• Some HMOs may include limited out-of-network benefits

• HMOs available are NYPA Choice, CDPHP, Community Blue, Independent Health, MVP and Oxford

HEALTH TALK FOR YOUR BENEFIT October 2014 Page 2

Preventive Care ServicesUnder the Affordable Care Act, all NYPA salaried employee medical plans will now cover a range of preventive care benefits, at no cost, when provided by in-network physicians. Covered items are specified under health care reform law, and are based on gender, age and other factors. The following are some of the covered items:

Children • Preventive screening • Vision screening • Routine immunizations • Hearing screening

Women • Well woman screening • Mammogram • Pre-natal care • FDA-approved Tier 1 contraceptives

Adults • Yearly wellness visit • Diabetes screening • Routine immunizations • Colorectal cancer screening – age 50+

Changes for 2015 – continued

maximum amount of expenditures on services by in-network providers, they will not incur additional costs for covered services during the rest of the year. (See sidebar for details.)

These changes are particularly important for calculating your Power Flex flexible spending account (FSA) for 2015. Because Power Flex has a “use it or lose it” rule, you may not want to set aside as much money for certain medical expenses, especially for copays, as you’ve done in previous years.

In addition, there will be increases to the prescription copays and the out-of-network deductible for the NYPA PPO Plan. The NYPA Choice Plan will have new costs associated with physician copays as well. All of these changes are outlined in the chart on page 1.

All of NYPA’s salaried medical plans will now comply with ACA coverage requirements. Employees are strongly encouraged to carefully review their 2014 medical expenses and the various health care options being offered in 2015. The choices you make this October will impact your health care costs next year.

Additional information on preventive care services is available from UnitedHealthcare and NYPA’s HMOs. The links below provide specific UnitedHealthcare details.

Preventive Care Age/Gender GuidelinesPreventive Care Highlights

Benefits Newsletter for Salaried EmployeesHEALTH TALK FOR YOUR BENEFIT October 2014 Page 3

Save Money with Power Flex Looking for a way to save on health care and/or child care expenses? Consider participating in the “Power Flex” flexible spending account (FSA) options. You can pay for out-of-pocket health care expenses or dependent care expenses on a pre-tax basis and save money.

Participants can use the health care account (HCA) option for reimbursement of medical and dental copays and deductibles, vision exams, eye glasses, contact lenses and a limited list of over-the-counter items. The dependent care account (DCA) option can be used for eligible dependents’ child care (under age 13) or elder care expenses while you and your spouse are at work. A complete list of eligible expenses is available at http://www.irs.gov/pub/irs-pdf/p969.pdf.

Keep in mind that Power Flex has a “use it or lose it” rule. If you contribute to your HCA or DCA and then do not incur enough eligible expenses during the year, you will lose any remaining balance in your Power Flex account.

Important Note: Keep in mind that preventive care services under ALL salaried medical plans will be covered with no copay starting in 2015. Be sure to calculate your FSA elections carefully!

Qualifying EventsOnce Open Enrollment ends, you may add or delete depen-dents to your health plans only under limited circumstances (known as a “qualifying event”).

The IRS requires you to report changes to Human Resources within 30 days of the qualifying event. Otherwise, you will need to wait until the next Open Enrollment period to add or drop a dependent.

Changes in status are events that cause you, your spouse/domestic partner or a depen-dent to gain or lose eligibility for coverage. They include events such as marriage or divorce, adoption or birth of child, change in the employment status of your spouse/domestic partner or dependent child, or having your dependent reach the maximum eligible age for coverage.

To add or drop dependents under your plan, complete a Change of Status form and return it to your local HR manager with the appropriate documentation.

DAYS30

Benefits Coverage for Dependents

Re-Enrolling DependentsFor dependents who were previously enrolled under the medical, dental or vision plans, access the FBMC website and check the box next to the appropriate dependent’s name for each plan (e.g., medical, dental, vision).

Adding New DependentsIn order to add a new spouse, dependent child(ren) or domestic partner during Open Enrollment, you must complete a Change of Status form, attach the appropriate documentation (i.e. birth certificate, marriage certificate, etc.) and return it to Human Resources by noon on October 31, 2014.

Domestic PartnersIf you are interested in covering a domestic partner for the upcoming year and meet the required criteria, contact Human Resources during Open Enrollment for cost, imputed income and enrollment information.

All employees who wish to continue to cover a domestic partner will need to complete a separate Domestic Partner Recertification form, which HR will distribute in November.

You can cover your eligible dependents under various benefits plans. Eligible dependents are defined as your spouse or domestic partner, children and eligible foster children. Be sure to review your dependent data carefully while completing your 2015 enrollment at www.myFBMC.com. Depending on the coverage, the maximum age for dependent children to be included is 26 for medical; 23 for dental and 25 for vision.

Benefits Newsletter for Salaried EmployeesHEALTH TALK FOR YOUR BENEFIT October 2014 Page 4

Open Enrollment Checklist Read the Open Enrollment newsletter and carefully review the 2015 benefits materials on the Powernet.

Attend the Health Fair at your local site.

Login to www.myFBMC.com, review your benefits elections and make any changes.

“Submit” your benefits online to complete the enrollment process.

Print a confirmation of your 2015 benefits from the myFBMC.com website by noon on October 31, 2014.

Complete your enrollment by noon on October 31, 2014.

Receive new ID cards before the end of 2014 (applicable for all NYPA PPO and NYPA Choice participants; also new enrollees in HMOs).

Start using benefits effective January 1, 2015.

Review benefit deductions on your January 14, 2015, paycheck.

Not Making Any Benefits Changes?If you do not want to make changes to your benefits, your 2014 enrollment elections will carry over to 2015 with the exception of your Power Flex account(s).

If you currently participate in Power Flex and wish to continue in 2015, you MUST re-elect your participation in the plan(s). If you do not make an election during the Open Enrollment period, your 2015 Power Flex contribution will default to $0.

Benefits Questions?Plan to attend your NYPA site’s Health Fair. Representatives from the benefits providers, as well as HR staff, will be available to answer your questions at each of the Health Fairs. You may also contact your local HR manager or the Benefits Hotline at ext. 718-3114.

And Don’t Forget…Besides comprehensive medical coverage, Open Enrollment is also the time to decide additional FlexAbility benefits, including:

• Dental - provided by Delta Dental; diagnostic and preventive services are paid at 100%.

• Vision - choose between the Core Vision Plan, provided by NYPA at no cost, and the Optional Vision Plan, provided by Davis Vision with enhanced vision care coverage.

• Life Insurance - select from 4 levels of coverage.

• Dependent Life Insurance - includes life insurance for your spouse and/or eligible children.

• Long Term Disability - provides income if you are disabled and cannot work after three consecutive months of absence.

• Accidental Death & Dismemberment - offers coverage 24-hours a day, 365 days a year against accidents in the course of business or pleasure.

• Cancer Protection - provided by AFLAC; a specified disease insurance policy designed to supplement your health insurance coverage when certain losses occur as a result of cancer.

• Accident Expense - provided by AFLAC; provides cash benefits directly to you to help with unexpected expenses if an accident occurs.

• Group Legal - provided by Hyatt Legal; a resource for advice and assistance on a range of legal matters which can help you save money on attorney services.

DisclosuresThe material in this newsletter is intended to assist you in the selection of benefits. More specific details are available in the 2015 Open Enrollment section of the Powernet. Final determination of benefits, exact terms and exclusions of coverage for each of the benefits plans will be determined by each insurance carrier.

Providing false or misleading information about eligibility for coverage is considered fraud. At any time during the year, you may be requested to provide proof of dependent eligibility. Failure to do so may jeopardize your family coverage.

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