brenau university 2016 open enrollment and benefits overview plan year: 2016 862431a 04/15 © 2015...

BRENAU UNIVERSITY

2016 OPEN ENROLLMENT

AND BENEFITS OVERVIEW

Plan year: 2016

862431a 04/15 © 2015 Cigna. Offered by Cigna Health and Life Insurance Company, Connecticut General Life Insurance Company, or their affiliates.

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2

Agenda

• Opening Remarks

• How to Enroll during Open Enrollment • What’s New for 2016

• Lincoln Ancillary Benefits– Life Insurance– Short Term Disability– Long Term Disability– Supplemental Life Insurance

• Cigna Tools & Resources– 24/7 Phone and online help– 24/7 Nurse Line– www.mycigna.com– Mycigna Mobile App

• Cigna Pharmacy– Home Delivery Program– Preventative Drugs

• Preventive Medical Care• Convenience Care• Chronic Condition Management

• Cigna Medical / Dental/ Vision - Benefits Overview

• Cigna Claims Process

• Turner, Wood and Smith

http://www.mycigna.com/

3

How to Enroll for 2016 medical, dental, vision, life & disability insurance coverage:

• Each ¾-time and full-time employee will be required to login to our enrollment system (Selerix) to either enroll-in OR opt-out of each offered benefit.

• It is also important to check your personal information as it appears in the system, update beneficiaries, and add/delete dependents, if applicable.

• If you do not log into to the system, your level of coverage will remain the same for 2016 and you will be unable to make changes until the next open enrollment period (November 2016).

• However, please note that flexible spending accounts will not automatically renew. Therefore, if you plan to enroll in the flexible spending account you must actively enroll. The process is quick and easy and should take no more than 10 minutes.

4

What’s New For 2016 - UPDATE

• Lincoln Financial for Life and Disability• Medical, Rx, dental and vision coverage through Cigna• 24/7 Cigna pre enrollment hotline• 24/7/365 Cigna Customer Service throughout plan service year• 24/7/364 Cigna Nurse Information Line• Your Health First Chronic Care (disease) Management / Coaching• Lifestyle Management Programs (smoking cessation, weight, stress)• www.mycigna.com• Cigna Health Assessment

Thank you for choosing Lincoln Financial and Cigna!.


5

Important Information to Know…..

ID Cards• ID cards will be issued prior to 01/01/2016• Each family member will receive their own medical ID card• After 01/01/2016 members can log on to www.mycigna.com • to print a temporary ID card and order replacement ID cards.

Cigna Open Access Plus Providers • Employees can access Cigna OAP providers by logging onto www.cigna.com

– Step 1: Log onto www.cigna.com– Step 2: Click “Find a Doctor” at the top of the screen– Step 3: Click “ Select a plan for your search”– Step 4: Select the first option “Open Access Plus, OA Plus, Choice Fund OA Plus”– Step 5: Select the type of provider “Primary Care Physician” or “Specialist” and click search– Step 6: A listing of providers will appear for you to view– Step 7: You can select the print/email option to print a pdf copy or email the provider listing


http://www.cigna.com/


6Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2015 Cigna

Lincoln Financial GroupLife Insurance / Disability Insurance

Long Term Disability

Long Term Disability (LTD) available through Lincoln Financial.

The following benefits are provided in the LTD plan:

The benefit percentage is: 60% of totally monthly earnings

The maximum monthly benefit is $10,000

Elimination Period: 90 Days

Benefit Period: To age 65

© 2015 Lincoln National Corporation. For plan sponsor use only. Not for use with plan participants.

EmployeeConnect SM services

8

Services available 24/7 via telephone

and internet

Four face-to-face counseling

sessions included

Unlimited phone access to legal,

financial and work-life services

Financial consultations and

referrals

Work-life services for assistance with child care, finding movers and more

Basic Life Insurance

Brenau University provides each employee 2.5 X salary to a maximum of $500,000 of Group Term Basic Life Insurance and Accidental Death and Dismemberment Coverage through Lincoln Financial.

Basic Dependent Life – Spouse $2,000 and Child(ren) $1,000

Accelerated Death Benefit (AD&D) included under the Basic and Supplemental Life programs.

AD&D coverage is equal to 100% of your basic life benefits

AD&D pays for accidental death and dismemberment in addition to your Basic Life benefit.

Additional Life Insurance

Brenau University allows the employees to purchase additional life insurance in addition to the amount provided by the university. This benefit is available on a voluntary basis and paid for by employees.

The coverage is with Lincoln Financial and provides the following benefits:

Employee• Coverage is available in $10,000 increments • Minimum coverage is $20,000• Maximum coverage is $300,000 (or 5x your annual salary)• Evidence of insurability may be required to purchase• Coverage reduces 35% upon the person’s attainment of age 70, an additional 15% of the

original amount at age 75, and will terminate upon retirement.

Spouse• Maximum coverage is $100,000

Children• Maximum coverage is $10,000

Additional Life Rates- Monthly

Age Employee and Spouse

<24 $ .031

25-29 $ .033

30-34 $ .058

35-39 $ .067

40-44 $ .112

45-49 $ .166

50-54 $ .293

55-59 $ .465

60-64 $ .514

65-69 $ .745

70-74 $ 1.383

75+ $ 2.767

The rates are:

• Based on the employee’s current age for both Employee and spouse

• Rates are as a monthly rate per $1000 of Life Insurance coverage

• Rates adjusted once each year on the plan anniversary date

• Child rate is $2.00 per month for $10,000, regardless of the number of children

Additional Life Rates Including Accidental Death & Dismemberment – Monthly

Age Employee Spouse

<24 $ .049 $ .056

25-29 $ .051 $ .058

30-34 $ .076 $ .083

35-39 $ .085 $ .092

40-44 $ .130 $ .137

45-49 $ .184 $ .191

50-54 $ .311 $ .318

55-59 $ .483 $ .490

60-64 $ .532 $ .539

65-69 $ .763 $ .770

70-74 $ 1.401 $ 1.408

75+ $ 2.785 $ 2.792

The rates are:

• Based on the employee’s current age for both Employee and spouse

• Rates are as a monthly rate per $1000 of Life Insurance coverage

• Rates adjusted once each year on the plan anniversary date

• Child rate is $3.40 per month for $10,000, regardless of the number of children


LifeKeys® services

13

EstateGuidance® will preparation

Create your will online — easily and economically. Follow a step-by-step guide through the entire process, and then use online instructions to execute your will.

GuidanceResources® Online

GuidanceResources® Online is the place to go for articles, tutorials, streaming videos and “Ask the Expert” personal responses on a variety of topics.

Identity theft

Identity theft is one of the fastest-growing crimes in the U.S. Be sure you have the information you need to recognize and prevent it. Our online resource can help.

Beneficiary services

A combination totaling six in-person sessions for grief counseling, or legal or financial information and unlimited phone counseling.


TravelConnect SM services

14

Available for business or leisure travel when more than 100 miles from home

Medical and dental referrals

Emergency travel arrangements and funds transfers

Repatriation

Travel and security services and assistance with lost or stolen travel documents


Cigna HealthCareMedical / Dental / VisionCoverage Overview


We’ve got your back.

That’s why we offer coverage tools resources that will work for you.

so you can achieve what matters most..

Together, we can all live healthier lives.


but you don’t need to go it

You go the extra mile to be healthy

alone.

With a Cigna medical, dental and vision plan, we’re with you all the way – in sickness and in health.

HOW WE CAN HELP Cigna’s tools and resources


Pre-Effective Date phone help = call 1-800-564-7642.

• Call anytime day or night – live, 24/7

• Ask questions about transition to Cigna, look up doctors, ask benefit questions specific to the Brenau University Cigna program…etc.

• Pre- Effective Date online = www.cigna.com

• Look up participating doctors and hospitals

• General information about Cigna

We’re here for you:Pre-Effective Date


We’re here for you:Post-Effective Date


• Post-Effective Date phone help = 1-800-Cigna-24

• Call us anytime day or night – live, 24/7 customer service, 365 days a year.

• This will be the # on your ID Card.

• Ask for a Spanish-speaking representative or speak with us in your preferred language – interpreter service is available in over 200 languages

Post-Effective Date online = myCigna.com and myCigna Mobile App• Directory of doctors, hospitals, facilities with cost and quality ratings

• Coverage details (copays, deductibles, out-of-pocket maximums, etc.)

• Claim activity and history

• Temporary ID cards or info on how to order new ones (myCigna.com only)

• Condition and wellness resources. Using our interactive medical library, find information on health conditions, first aid, medical exams, wellness, health assessment and more.

HEALTH INFORMATION LINE PROGRAM OVERVIEW

• 24/7/365 telephone access for customers wanting health and medical information and guidance

• Nurses provide education, recommendations and support to achieve the best possible outcomes by:

– Assisting with navigation through the health care system

– Providing health and medical information

– Triaging and guiding customers to the right setting in the right timeframe

– Providing information on self help and home care

– Suggesting online tools

– Referring to other health care professionals


HEALTH INFORMATION LINE SUPPORT

Skilled, experienced nurses provide confidential and convenient service 24/7 to help customers:


Understand and make decisions about current symptom-based health issues

*Based upon availability

Find the right care in the right setting at the right time

Access health and medical information, including an

audio health

library

Better participate in their personal health care with online tools

Connect with other health care professionals and support programs* including:

• Case Management and Chronic Condition Support

• Health Advocacy Programs

i+

myCigna.com Employee Self Service

Auto-suggest anticipates customer’s search


Simpler

Smarter

Intuitivefoot

• Instant, real-time access to health information on the go

• Store and organize info right on smartphone

• Easy and simple navigation

• Completely personalized

• Available whenever, wherever

myCigna mobile app


Sara Anderson

Access ID card information


• Quickly view ID card information for the entire family

• Easily and securely print, email, or fax

Search claims


• Access and review current and past claims

• Bookmark and group claims for quick and easy reference

Find doctors and services


• Search for a health care professional in Cigna’s national network

• Valuable quality-of-care ratings

• Easily navigate using consumer-friendly language, not jargon

• Access maps for driving directions right from your smartphone

Cigna Pharmacy



Save money by

reviewing the

covered drug list

on Cigna.com or

myCigna.com to

know which drugs

are generic or

preferred and

cost less

How can I get the most out of my pharmacy benefits plan?

1 2 3 4 5

Learn what drugs are covered

Compare prices

Use Cigna Home

Delivery Pharmacy

Get help with specialty

medications

Use the pharmacy

page of myCigna.com

Use the

Prescription Drug

Quote Tool on

myCigna.com to

see what drugs

cost with your

plan, or compare

prices at over

60,000 retail

pharmacies and

Cigna Home

Delivery Pharmacy

Have many of

your regular

medications

delivered right to

your door at no

additional cost –

there may even be

a cost savings

Take advantage of

our TheraCare®

program, which

helps customers

who use injectable

medications for

conditions like

multiple sclerosis,

hepatitis C and

hemophilia

Gives you

24/7/365 access to

pharmacy claim

history, benefit

details, drug and

pharmacy

comparison tools

and a pharmacist

to answer your

questions

31

Understanding CIGNA’s Prescription Drug List

Cigna has a formulary drug list categorizes each class of drug (generic, brand and non-preferred brand). You can utilize our “drug list” via www.Cigna.com or www.myCigna.com to determine which tier your prescription drugs are in.

Things to keep in mind:• Your current drug(s) could fall under a different tier with CIGNA’s formulary verses Aetna’s formulary.• When obtaining a new prescription it may require authorization before coverage is provided:

– PA: Prior Authorization – may be required for different reasons. To determine requirements you can call the pre-enrollment line.

– QL: Quantity Limit – means that you may have coverage for a limited amount of a specific medication.

– AGE: Age Requirement – means that a person must be within a specific age group for a specific medication to be covered.

• Be sure to show your new Cigna ID card when obtaining a prescription for the first time after 1/1/2016


32

Cigna Home Delivery Program – How Does it Work?

– Designed especially for people who take prescription medications on a regular basis.

– Have your medications delivered right to your door for free.– Get up to a 90-day supply of your medications at one time. – Plus, its good to know that people who use CIGNA Home Delivery Pharmacy are

more likely to take their prescriptions exactly as their doctor has prescribed when compared to people who use retail pharmacies alone.

33

CIGNA Home Delivery “Quick Switch Program”

Have the following information handy when you call, and we’ll do

the rest!

1. Name and CIGNA ID number

2. Prescription medication names (for you and your covered family members)

3. Doctor information (name, phone number)

4. Payment information (American Express, Discover, MasterCard or Visa)

Preventive Drugs

• Preventive medications are used for the prevention of conditions such as:– High blood pressure– High cholesterol– Diabetes– Asthma– Osteoporosis– Heart attack– Stroke– Prenatal nutrient deficiency

• Preventive drugs on the Cigna Preventive Drug List are covered at no deductible, no copay.

• See list on www.informedonreform.com


http://www.informedonreform.com/

Preventive CareConvenience CareChronic Condition Support


36

Understanding Preventive Care

•Includes wellness exams/annual physical and certain immunizations, health screenings (colonoscopy, mammogram, etc.) - covered at 100%

•Services provided when you do not have symptoms and have not been diagnosed with health issues connected with the preventive service

•NOTE: If your doctor determines that you have a medical issue present during a preventive service, the additional screenings and tests become diagnostic and not preventive, which are then applied to your medical benefits.

37

Convenience Care Clinics

– Are available when you need treatment for common ailments and injuries.– They offer high-quality, affordable services for a wide variety of routine medical conditions.– Some examples include:

– Seasonal or chronic allergies– Ear infections– Strep throat– Sinus infections– Immunizations and vaccinations

– No waiting for an appointment, wait time on average is 15 minutes. – You pay your primary care copay for services rendered– Extended hours of operation, available 7 days a week.– For example, CVS Minute Clinic or Walgreens Take Care Clinic

Log onto www.mycigna.com or call the number on the back of your ID card for the

location nearest you.


38

Chronic Condition Support

We’ll help you get what you need for your chronic condition.

Connect with one dedicated contact.A health specialist – trained as a nurse, coach, nutritionist, or clinician – may be calling you to get things started, or you can call us anytime.

• Manage a chronic condition.• Create a personal care plan.• Understand medications or your doctor’s orders.• Identify triggers that affect your condition.• Make educated decisions on your treatment

options.• Know what to expect if you need to spend time in

the hospital.• Improve your lifestyle by coping with stress, quitting

tobacco use, maintaining good eating habits, and managing or losing weight.

Take Charge of your health using online tools.When you’re doing well on your own, we can still help with a variety of self-service resources to help you better understand your condition and overcome barriers to better health.

• A tool to help you understand your condition and make more informed treatment decisions.

• Articles and podcast on hundreds of health tops.• Online programs with email campaigns to help you with

lifestyle issues like stress, weight and tobacco use, depression and anxiety and living with a medical condition.

If you have a chronic health condition, we know there are times when you need extra help. That’s why we’re here. Take advantage of our free health coaching and then, when you’re ready to go at it alone, say the word. We’ll guide you to self service resources and be there when you need us. It’s up to you.

OR

You decide when what we have works for you. 1.800.Cigna24 or www.myCIGNA.com



YOUR OPTIONSoverview of medical, dental and vision plans

Planning for Medical Expenses- Cigna Open Access Plus


In Network Out of Network

Single Family Single Family

Deductible $1,000 $2,000 $2,000 $4,000

Out-of-pocket maximum $6,350 $12,700 $10,000 $20,000

Coinsurance 100% 70%

PCP Office Visit Copay

Specialist Visit Copay

Preventive Services

$25

$50

100%

$25

$50

100%

70% after the deductible


Not Covered



Not covered

In Patient Services 100% after deductible 70% after deductible

Out Patient Services 100% after deductible 70% after deductible

Urgent Care Facility $75 per visit (copay waived if admitted)

Emergency Room $150 per visit (copay waived if admitted)

Prescription Drugs (Retail 30 day supply)

Generic: You pay $10Preferred Brand: You pay $30

Non-Preferred Brand: You pay $50

Prescription Drugs (Cigna mail-order 90 day supply)

Generic: You pay $20Preferred Brand: You pay $60

Non-Preferred Brand: You pay $100

*If you choose to receive care outside of your plan’s network, only covered expenses will be applied to your deductible, subject to your plan’s Maximum Reimbursable Charge provisions. See enrollment materials for more information about costs & details about covered and non-covered services, including plan exclusions and limitations.

Medical Insurance

Cigna Weekly Rates Cigna Monthly Rates

Employee Only $25.39 Employee Only $110.00

Employee+ Spouse $168.46 Employee+ Spouse $730.00

Employee+Child(ren) $115.38 Employee+Child(ren) $500.00

Family $255.00 Family $1,105.00

Planning for Dental Expenses – Cigna Dental PPO


Plan DesignTotal Cigna DPPO Out of Network

Calendar Year Maximum(Class I, II, III Expenses)

$1000 Class I Applies $1000 Class I Applies

Calendar Year Deductible*Per IndividualPer Family

$50$150

$50$150

Class I Expenses- Preventive & Diagnostic Care (oral exams, cleanings & x-rays)

100%, No Deductible 100%, No Deductible

Class II Expenses – Basic Restorative Care(fillings, extractions, sealants, endodontics & periodontics)

80%, After Deductible 80%, After Deductible

Class III Expenses- Major Restorative Care(bridges, crowns & dentures)

50%, After Deductible 50%, After Deductible

Class IV Expenses- Orthodontia 50%, No Ortho Deductible$1000

50%, No Ortho Deductible$1000

Dental Plan Reimbursement Levels Based on contracted fees 90th Percentile

*If you choose to receive care outside of your plan’s network, only covered expenses will be applied to your deductible – subject to your plan’s Maximum Reimbursable Charge provisions. See your enrollment materials for more information about costs and details about covered and non-covered services, including plan exclusions and limitations.

Dental Insurance




Employee+ Child(ren) $17.52 Employee+Child(ren) $75.92

Family $27.85 Family $120.69

Note: If the charge for dental treatment is expected to exceed $500, you should ask your dentist to submit a dental treatment plan to the Cigna claims department before treatment begins.

Planning for Vision Expenses – Cigna Vision PPO


Cigna VisionSchedule of Vision Coverage

Exam CopayIn-Network

BenefitOut of Network

BenefitFrequency

Period

Exam Allowance (once per frequency period)

$20 N/A 12 months

Materials CopayCovered 100% after

$20 CopayUp to $45 12 months

Eyeglass Lenses Allowances:(one pair per frequency period)Single VisionLined BifocalLined TrifocalLenticular

Covered 100% after CopayCovered 100% after CopayCovered 100% after CopayCovered 100% after Copay

Up to $32Up to $55Up to $65Up to $80

12 months12 months12 months12 months

Contact Lenses Allowances:(one pair or single purchase per frequency period)ElectiveTherapeutic

$130Covered 100%

Up to $105Up to $210

12 months12 months

Frame Retail Allowance(one per frequency period)

Up to $130

Up to $71

24 months

** Your Frequency Period begins on January 1 (Calendar year basis)

This chart shows the amounts you’ll pay for covered services after your plan deductible has been met. Health benefit plans vary, but in general to be eligible for coverage a drug must be approved by the Food and Drug Administration (FDA), prescribed by a health care professional, purchased from a licensed pharmacy and medically necessary. Refer to your plan documents for costs and complete details of your plan's prescription drug coverage.

.

Routine Vision Insurance




Employee+Child(ren) $2.35 Employee+Child(ren) $10.20

Family $3.46 Family $14.99


HOW IT WORKSthe claims process


The claims process

You get an explanation of benefits, or “EOB,” (your receipt)

from Cigna.

Show Cigna ID card. Pay copay or

coinsurance* as required.

Visit in-network doctor/hospital/

facility.

* If a coinsurance applies, it is not paid at the time of service and is billed to you or charged to an HSA/HRA after the claim is processed and the EOB is issued.


Tracking your claims

Explanation of benefits (EOB)

• Clearly shows how and when claims were paid, and by which plan and/or account(s)

• Available in print or online at myCigna.com

• You choose if you would like EOBs mailed to your home or go paperless and receive email alerts after each claim is processed and posted to myCigna.com

Doctor’s fee

Cigna discount

Amount billed

Amount paid to doctor

What you saved

What you owe


Important Information

This is one of the most important decisions you’ll make this year. This checklist will help you choose wisely:

• Login to our enrollment system (Selerix) to either enroll-in OR opt-out of each offered benefit.

• Your benefit elections must be submitted by November 23, 2015.

Please Note:

• Think about your health history and health care needs. How much do you spend, on average, for health care? How might that change in the upcoming year?

• Check the online directory on Cigna.com to see if your doctor participates in the Cigna network.

• Review your Summary of Benefits for specific plan details.

• Call the Pre Enrollment Hotline for subsequent questions.

Enrollment checklist.


Customer Service Steps

1. After January 1, 2016, go to www.mycigna.com to set up your personal account.

2. For Lincoln Financial, www.lfg.com to set up your personal account.

3. For Lincoln Financial, you can also call 1-800-423-2765 with any questions.

4. If you are not able to obtain the answers by calling 1-800 CIGNA24, the 24/7/365 customer service line or www.cigna.com, you can call insurance consultant, Turner Wood and Smith or email them at:

• Megan Hulsey678-928-6725

[email protected]• Tiffany Gillespie

[email protected]• Angela [email protected]



http://www.lfg.com/


mailto:[email protected]






Q&Ahow can we help you?

thank you for choosing Cigna and Lincoln Financial!

Rates will vary by plan design including the amount of plan deductibles, coinsurance, and out-of-pocket and lifetime maximums.

All health insurance policies and health benefit plans have exclusions and limitations. For costs and details of coverage, see your enrollment materials. The information in this presentation summarizes the highlights of your plan. For a complete list of both covered and not covered services, including benefits required by your state, see your employer’s group insurance certificate, summary plan description or group service agreement – the official plan documents. If there are any differences between the information in this presentation and the plan documents, the information in the plan documents takes precedence.

“Cigna,” the “Tree of Life” logo, “TheraCare” and “Healthy Rewards” are registered service marks, and “Together, all the way.” and “Cigna Home Delivery Pharmacy” are service marks, of Cigna Intellectual Property, Inc., licensed for use by Cigna Corporation and its operating subsidiaries. All products and services are provided by or through such operating subsidiaries and not by Cigna Corporation. Such operating subsidiaries include Cigna Health and Life Insurance Company (CHLIC), Connecticut General Life Insurance Company (CGLIC), Tel-Drug, Inc., Tel-Drug of Pennsylvania, L.L.C., Cigna Onsite Health, LLC, Cigna Behavioral Health, Inc., Cigna Health Management, Inc., and HMO or service company subsidiaries of Cigna Health Corporation, including Cigna HealthCare of Arizona, Inc., Cigna HealthCare of California, Inc., Cigna HealthCare of Colorado, Inc., Cigna HealthCare of Connecticut, Inc., Cigna HealthCare of Florida, Inc., Cigna HealthCare of Georgia, Inc., Cigna HealthCare of Illinois, Inc. (IL & IN), Cigna HealthCare of Indiana, Inc., Cigna HealthCare of St. Louis, Inc. (MO, KS & IL), Cigna HealthCare of North Carolina, Inc., Cigna HealthCare of New Jersey, Inc., Cigna HealthCare of South Carolina, Inc., Cigna HealthCare of Tennessee, Inc. (TN & MS), and Cigna HealthCare of Texas, Inc. “Cigna Home Delivery Pharmacy” refers to Tel-Drug, Inc. and Tel-Drug of Pennsylvania, L.L.C. In Texas, Open Access Plus and LocalPlus plans are considered Preferred Provider plans with certain managed care features and Open Access Plus IN and LocalPlus IN plans are considered Exclusive Provider plans with certain managed care features. OK Policy Forms: HP-APP-1 et al (CHLIC); GM6000 C1 et al(CGLIC).

06/15 © 2015 Cigna. Some content provided under license.862431a

Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2015 Cigna 53

brenau university 2016 open enrollment and benefits overview plan year: 2016 862431a 04/15 © 2015...

Documents

cigna open access

cigna oap providers

unpublished property

medical id cardafter

open enrollment period

option open access

open enrollment whats

vision coverage