Insurance Open Enrollment

2019 Health Insurance Open Enrollment 

Open Enrollment Dates: Oct 22 - Nov 2, 2018
Open Enrollment CLOSES at 5 p.m. Nov. 2, 2018
All changes will take effect January 1, 2019


Open Enrollment is mandatory.  All Benefit Eligible Employees, including recently hired employees, are required to sign into the enrollment tool and confirm their elections during the enrollment window, regardless of whether you choose to enroll or decline coverage for the 2019 benefit plan year.  There are carrier and rate changes to the benefit structure in 2019, all benefit eligible employees are strongly encouraged to review the 2019 benefit information and consider which plan options will best fit your and your Families needs for the upcoming benefit year.   No changes will be allowed after the open enrollment window closes, unless you have a qualifying life changing event.     

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If you need additional assistance please contact the Insurance Office at 801-826-5428.

Benefits Fair:

To help you to get to know our new carriers we will be having a benefit fair during the enrollment window. We strongly encourage you to attend, talk with the carriers, ask questions and become familiar with the insurance options and carriers.  There will be computers available for participants to complete their enrollment

October 23, 2018
CAB East, PDC
9361 S. 300 E.
Sandy, Utah 84070
4 to 7 p.m.

Summary of Carrier Changes

There are two carrier changes for the 2019 Benefit Year. 

MetLife:

We will be transitioning from Reliance Standard for Life and Accident Insurance coverage to MetLife.   Due to the minimal ongoing service requirements, we anticipate minimal participant disruption with this change. 

Discovery Benefits:

We will be transitioning from APA Benefits to Discovery Benefits.   This will impact the HSA, FSA, Limited FSA, Dependent Care FSA and Cobra participants.   We have taken steps to minimize the impact to employees.   
  • HSA: HSA funds contributed previous to January 1, 2019 will continue to be administered by APA Benefits until the funds are used or transferred to a new HSA account managed by Discovery Benefits.  Contact a member of the Insurance Department for assistance.  After December 31, 2018, APA benefits will charge all active HSA accounts $3.75 per month administrative fee to maintain the account.  
  • FSA: To minimize the impact, APA Benefits will manage the 2018 Grace Period and Claims Run Out period on all FSA accounts.  Debit Cards will still function for these accounts through the Grace Period.   All FSA funds for 2018 will need to be used by March 15, 2019.  
  • COBRA: COBRA Participant’s will receive open enrollment materials from Discovery Benefits for coverage in the 2019 benefit year.   APA will administer COBRA through December 31, 2018.  Effective January 1, 2019, COBRA participants will be administered by Discovery Benefits. 

Summary of Health Plan Changes

As was agreed in the District’s annual negotiation process, there will be a 3% rate increase on the Traditional Health Plan. However, the premiums of the Star Qualified High Deductible plan will remain the same for the 2019 benefit year.  The District Portion of the monthly premiums will also increase by 3%.   The monthly vision premiums will also increase slightly. There are no other notable benefit changes for 2019.     

Insurance Carrier Information

 
             
  2019          
  Insurance Plan  Carrier Network Description Phone Number   
  Health Insurance PEHP Advantage Network  The Advantage Network utilizes prodominetely the Intermountain Healthcare system and its assosciated physicians, hospitals and clinics  (800) 765-7347  
  Health Insurance PEHP Summit Network  The Summit Network Utilizes the University of Utah, Iasis, and Mountain Star heatlhcare systems and their associated physicisans, hospitals and clinics    (800) 765-7347  
  Dental Insurance  EMI HEALTH EMI Health  EMI Health administrers four different plan designs.    (800) 662-5850  
  Vision Insurance EMI HEALTH VSP   EMI health administers two plan designs that Utilize the VSP provider network.    (800) 662-5850  
  Life & Disability Insurance Relaince Standard (2018)    Reliance Standard administers the District's life & disability Insurance coverage.  (800) 351-7500  
  Life & Disability Insurance MetLife (2019)   MetLife administers the District's life & disability Insurance coverage. (800) 929-1492  
  Flexible Spending /HSA APA Benefits (2018)    APA benefits manages the Districts Flexibles Spendings and Health Savings Accounts.  The also administer the District's COBRA benefits.  (801) 561-4980  
  Flexible Spending /HSA Discovery Benefits (2019)    Discovery Benefits manages the Districts Flexibles Spendings and Health Savings Accounts.  The also administer the District's COBRA benefits.  (866) 541-3399  
  Employee Assistance program (EAP) Blomquist Hale    The employee assistance program is a counseling service the assist employee and there families with a variety of counseling needs  (801)262-9619  
             
 
   

Open Enrollment FAQs


Q: When is the open enrollment period for the 2019 plan year?

A: Open enrollment will be Oct. 22 - Nov. 2. The Enrollment window will close at 5:00 PM on Friday, November 2, 2018.  All employees who want to have health, dental, vision, flexible spending or HSA elections in the 2019 plan year will need to go through the enrollment process.  Benefits, particularly flexible spending and HSA benefits, will not automatically transfer to the new year.  Voluntary plans that are not changing will also require participants to confirm their elections.

Q: I don't know what my user name an password is for the enrollment system.

The new enrollment system requires to to set your own User Name and Password by first registering on the website.  This is and upgraded security feature and designed ot give you access to your account and no one else.   To register just click on the "new user registration" link that appears under the Password field.  This registriation process is an easy straight forward process,  just fill in the fields as indicated.  the Company Identifier is "Canyons".  More detailed steps are available in the erollment guide included in the supplemental benefit materials.

Q: Will I need to do anything during open enrollment?

A: Yes. As has been the case with previous years, Open Enrollment for the 2019 plan year is mandatory.  This is for your benefit, if you don't complete the open enrollment, you run the risk of not having your preferred benefit elections in the 2019 benefit year.  All employees who are eligible for insurance in 2019, must log in and confirm their election, even if you want to decline benefits. This online enrollment must be completed by 5 pm on Nov 2, 2018.

Q: Why do I have to participate in the enrollment process? Why can't I just be enrolled automatically?

A: The selection of a health plan is a personal decision and depends largely on the employee's personal circumstances. Needs and circumstances change from time to time, we encourage employees to examine their benefit needs annually to determine if any changes need to be made. This is your only opportunity to make changes without a qualifing event, and we suggest that you consider your options and verify your coverages.

Q: How do I choose a health plan: Step 1 – Traditional vs Qualified High deductible health plan?

A: The choice between the Traditional plan and the Qualified High Deductible Health Plan is a choice that rests on your personal feeling about security vs control. The traditional plan is more about security, you pay a higher monthly premium but you pay less for the deductibles and the out of pocket maximum, but conversely you also pay a higher monthly premium even if you don’t require any medical care during the year. The High Deductible plan is more about having control over your health care dollars. You pay substantially less in premium and in exchange you will be expected to cover more of your upfront costs based on the deductible and out of Pocket Maximum. To help manage the insecurities associated with this plan, the IRS allows you to set money aside in a Health Savings Account (HSA); the funds in this account can be used to cover the costs you may incur. A very risk averse person would likely lean toward the Traditional plan, and person who wants to have more control over how their health care dollars are spent will likely lean toward the High Deductible plan.

Q: How do I choose a health plan: Step 2 – Advantage vs Summit

A:  This choice rests on which network you are more comfortable with. The Advantage network is mainly the Intermountain Health Care (IHC) network, whereas the Summit network is essentially the Non–IHC affiliated hospitals and clinics.   This would include Mountain Star, Iasis, and the University of Utah Health Care clinics and hospitals. Some individuals might have strong opinions toward one network or the other, while others don’t really care at all. The plan designs are equivalent and you should receive excellent care through both networks.  If you don’t have strong feelings toward one or the other you may want to look at the list of covered hospitals, on page 11 & 12 of the benefit guide, and select the network with the hospital closest to your home.

Q: How do I choose a Health plan: Step 3 – Base vs Buy Up?

A: This is question largely about out-of-network coverage. While the base option has regional network agreements that allow participants to receive emergency services out of the Utah region, they don’t provide any kind of out-of-network benefit. The Buy Up option allows you to have out-of-network coverage. There are two advantages to the buy up:  first, some participants who travel might have concerns about finding a doctor to treat a medical need while traveling, this option allows them to get services almost anywhere.  Second, some people might be treated for a condition by a specialist that may not be in their preferred network; the buy up allows them to have coverage for this out-of-network specialist. The additional cost is substantial, so you will want to consider your projected out-of-network costs carefully before selecting this option.

Q: I don’t understand the HSA tax dependent rules. Who can I use my HSA dollars for?

A: Because the HSA is governed by the IRS, the HSA regulations follow tax law for dependency. This means that the funds can only be used for medical expenses for either you and your tax dependents. In short if you claim them on your taxes, as a dependent, you can use your HSA dollars for their approved medical expenses.  If you don’t claim them as a tax dependent, you can’t use your HSA to pay for their expenses. The confusion comes because the Affordable Care Act allows children to stay on a parents health plan until they reach age 26, but dependents who are in there 20’s may, or may not be a tax dependent. Let me give you an example, I have two children one age 22 and one age 24. The 22 year old is a student and living at home, I claim him as a dependent for taxes. The 24 year old has graduated from college, is married and has started a career; I don’t claim her on my taxes. I am however, covering both children on my health insurance. I can use my HSA to cover the medical expenses of the 22 year old because they are still my tax dependent; however, I can’t use my HSA to cover the expenses of the 24 year old because I no longer claim her as a dependent on my taxes.

Q: Will my premiums change?

A: As was agreed in the District's annual negotiation there will be a 3% rate increase on the Traditional plan.  The premiums on the High Deductible Health Plan will remain the same.  The Distirct portion of the monthly premiums will also increase by 3%.

Q: Will my benefits change?

A: There will not be any notable benefit changes for the 2019 benefit year.

Q: Why are Socials Security numbers required for my dependents?

A: The Social Security Number is the unique identifier used by insurance companies to reconcile claims data when more than one carrier is involved. Starting January 2015, the Affordable Care Act requires that pharmacy claims and health insurance claims both count toward the annual out-of-pocket maximum. While this is a small change to the plan design it requires a major change to the administrative process. In order to accumulate claims data toward the annual out-of-pocket maximum, the carriers must communicate and reconcile claims between the pharmacy and health administrators. If dependent Social Security Numbers are not recorded in the enrollment system then the claims incurred may not accumulate toward your out-of-pocket maximum correctly. If you do not have Social Security Numbers for your Dependents, please contact the Insurance Department as soon as possible at 801-826-5428 or send an email to This email address is being protected from spambots. You need JavaScript enabled to view it. and we will assess your situation to determine your options.

What carrier changes will occur in the 2019 benefit year.

In accordance with established state procurement guidlines, MetLife was selected as the District's new Life, Accident and Disability coverage Provider.  Discovery Benefis Was selected to administer the Districts HSA, FSA, Limited FSA, Dependent Care FSA and COBRA benefits.