It's time to choose your benefit options - 2021 Open Enrollment Guide - A quick guide to your annual benefit elections: November 2 - 16, 2020
←
→
Page content transcription
If your browser does not render page correctly, please read the page content below
It’s time to choose
your benefit options
2021 Open Enrollment Guide
A quick guide to your annual benefit elections: November 2 – 16, 2020
Medical & Flexible Spending Disability &
Dental Legal
Prescription Accounts Life
Benefits to support you and your family Our success at AU depends on the contributions and commitment of our faculty and staff. Thank you for your work to move the university forward as it strives to achieve its strategic goals. American University offers options to best meet your health and insurance needs This open enrollment guide will help you understand the medical, prescription, and dental coverage available for you and your family. It also explains the flexible spending accounts, life and accident insurance options, and the legal plan. If you have open enrollment questions, email hrpayrollhelp@american.edu or call (202) 885-3836. American University makes every effort to ensure the accuracy of the information in this guide. However, if there are discrepancies between the guide and the legal documents governing a plan or program (the “plan documents”), the plan documents will always govern. American University reserves the right to amend or terminate any benefit plan at its sole discretion at any time, for any reason. Page 1
Important open enrollment information
Open enrollment benefits are available to full-time faculty and staff and their dependents.
• From November 2 – 16, 2020, you can add, change, or drop coverage to your:
• medical
• dental
• flexible spending accounts (FSA)
• optional life and personal accident insurance
• legal plan
• Open enrollment elections are in effect from January 1, 2021 – December 31, 2021, unless
you have a qualifying life event such as a marriage, divorce, birth, or adoption of a child. You
must notify Human Resources within thirty (30) calendar days of the date of a life event to
change your benefits throughout the year.
• If you do not enroll, you will have the coverage you elected for 2020, except for flexible
spending accounts.
! Health care and dependent care FSAs do not rollover and must be elected each
year.
• Your children are eligible to be covered under your medical and dental plans until age 26. If
your child turns 26 in 2021, they will have coverage until December 31, 2021.
To learn more about the benefits offered in this guide and other benefits provided by the
university, visit www.american.edu/hr/benefits.
Voluntary benefits such as pet insurance or group auto and home, and contributions to AU’s
403(b) retirement plan, can be made at any time throughout the year. For more information
about AU’s other benefits, reference page 13 of this guide or visit the benefits site on
www.american.edu/hr/benefits.
Page 2
Make your 2021 benefit elections
Enroll online
1. Login to the myAU portal
2. From the Work@AU navigation menu, click Benefits: myBenefits
Don’t forget to elect flexible spending accounts (FSAs) for 2021
FSA participation does not continue automatically from year-to-year. You must enroll (or re-enroll)
if you wish to participate in 2021.
• elect to contribute up to $2,750 to the health care FSA
• elect to contribute up to $5,000 to the dependent care FSA ($2,500 if you are married and
filing separate tax returns)
For more information about open enrollment or any of American University’s benefits, visit the
benefits site at www.american.edu/hr/benefits.
Page 3
Your cost for coverage
American University contributes to the total cost of your health care coverage. Your portion of the premium is a pre-tax contribution, meaning that it is deducted
from your pay before taxes are withheld. For more information about open enrollment or any of American University’s benefits, visit the benefits site at
www.american.edu/hr/benefits.
• Medical: the university contributes 80% towards individual coverage and 65% for individual plus one and family coverage. The university contributes 95%
towards individuals under $40,000.
• Dental: the university contributes 25% for individual coverage and 20% for individual plus one and family coverage.
2021 Employee 2021 Employee 2021 Employee
Plans 2021 Rates 2020 Rates 2021 AU Share/Month
Share/Month Change/Month Share/Bi-Weekly
CareFirst & Express Scripts Individual under $40K $797.40 $741.08 $757.53 $39.87 $2.82 $18.40
Individual over $40K $797.40 $741.08 $637.93 $159.47 $11.26 $73.60
Individual + 1 $1,593.31 $1,480.77 $1,035.65 $557.66 $39.39 $257.38
Family $2,309.83 $2,146.68 $1,501.39 $808.44 $57.10 $373.13
Kaiser Permanente Individual under $40K $521.86 $499.41 $495.77 $26.09 $1.12 $12.04
Individual over $40K $521.86 $499.41 $417.49 $104.37 $4.49 $48.17
Individual + 1 $1,046.49 $1,001.47 $680.21 $366.28 $15.77 $169.05
Family $1,518.62 $1,453.29 $987.08 $531.54 $22.89 $245.33
Delta Dental Comprehensive Individual $40.53 $40.53 $10.13 $30.40 $0.00 $14.03
Individual + 1 $81.07 $81.07 $16.21 $64.86 $0.00 $29.94
Family $117.51 $117.51 $23.50 $94.01 $0.00 $43.39
Delta Dental Basic Individual $32.21 $32.21 $8.05 $24.16 $0.00 $11.15
Individual + 1 $64.42 $64.42 $12.88 $51.54 $0.00 $23.79
Family $93.38 $93.38 $18.68 $74.70 $0.00 $34.48
Hyatt Legal’s MetLaw Plan Individual $16.50 $16.50 $0.00 $16.50 $0.00 $7.62
Family $16.50 $16.50 $0.00 $16.50 $0.00 $7.62
Flexible Spending Accounts Fee $2.95 $2.95 $1.50 $1.45 $0.00 $0.67
Optional Life Insurance Optional Life Varies Varies
For more information about open enrollment or any of American University’s benefits, visit the benefits site at www.american.edu/hr/benefits.
Page 4
Medical coverage Terms to know
Annual deductible is the amount
American University offers a choice between two medical options: you pay before your insurance begins
covering certain services, such as
• CareFirst BlueChoice Advantage offers the flexibility to choose from BlueChoice and
hospitalization or outpatient surgery.
BluePreferred PPO providers locally and BlueCard PPO providers nationwide for in-network
benefits as well as out-of-network providers.
Coinsurance is the amount you pay as
• Kaiser Permanente HMO utilizes a local network of facilities and providers with over 30 a percentage of the allowed cost of your
locations in the DC, Maryland, and Virginia region. services, after you reach the annual
deductible and until you reach the plan’s
out-of-pocket maximum.
Copayment (copay) is a fixed amount
you pay for a health care service.
Out-of-pocket maximum is the most
you will pay for covered medical services
in a calendar year. Once you meet it, the
plan will pay the full cost of additional
expenses.
Generic drugs meet the same
standard quality and is an ingredient or
therapeutic match to the brand name
equivalent.
Brand name formulary drugs have no
generic equivalent and are included on
Vision Coverage
the plan’s preferred drug list.
Discounts through MetLife VisionAccess are automatically available to you at no cost. Simply
visit a participating VisionAccess provider or center, and confirm that they accept the Vision Brand name non-formulary drugs
Access program discount code: Met2020 before using their service. Once confirmed, use the have no generic equivalent and are not
program code: MET2020 and they will automatically charge you the discounted rate. included on the plan’s preferred drug list.
If you are enrolling in an AU-sponsored medical plan, you also receive vision benefits through
your CareFirst or Kaiser plan.
Page 5Compare medical plans
Prescription Drug Prescription Drug Prescription Drug
Maximum
Choice of Physician Annual Deductible Copayment Coinsurance Retail Home Delivery Out-of-Pocket
Out-of-Pocket
(30-Day Supply) (90-Day Supply) Maximum
CareFirst BlueChoice Advantage
In-network* Use any provider $400 individual $20 primary care 90% paid by health $2,750 individual Express Scripts** Express Scripts or Express Scripts and
in BlueChoice, plan CVS Smart 90† CVS Smart90†
$800 individual + 1 $40 specialty care $5,500 individual + 1 Generic drugs $10
BluePreferred PPO, or Generic drugs $25 $3,850 individual
10% paid by Brand name formulary
BlueCard PPO. $800 family No copayment for: $5,500 family
participant 30% coinsurance to Brand name formulary $7,700 family
No referral required. In-network deductible • preventive care
$30 maximum 30% coinsurance to
applies to non- office visits
$75 maximum
preventive care • women’s preventive Brand name non-
services (preventive health services formulary Brand name non-
care such as annual 50% coinsurance to formulary
physicals and $50 maximum 50% coinsurance to
mammograms are $125 maximum
Excluded drugs‡
not subject to the 100% patient Excluded drugs‡
deductible). responsibility 100% patient
Out-of-network Choose any physician, $1,000 individual None 65% paid by health $4,000 individual responsibility
no network limitations. plan
$2,000 individual + 1 $8,000 individual + 1
No referral required. 35% paid by
$2,000 family $8,000 family
participant
Kaiser Permanente
HMO Must select a primary None $20 primary care None $3,500 individual Kaiser Center Kaiser Home Delivery Included with medical
care physician at one Pharmacy
$40 specialty care $9,400 family Generic drugs $20
of Kaiser Permanente’s Generic drugs $10
medical centers. Does not apply to Brand name formulary
outpatient mental Brand name formulary $40
health and prescription $20 Brand name non-
benefits. Brand name non- formulary $70
No copayment for: formulary $35 Excluded drugs not
• adult and children Excluded drugs not applicable
over age 5 applicable
preventive care Outside Pharmacy
office visits
• primary care Generic drugs $20
physician Brand name formulary
office visits for $40
children under
age 5; specialist Brand name non-
copayment applies formulary $55
for children under Excluded drugs not
age 5 applicable
• women’s preventive
health services
*
Your choice of provider affects your out-of-pocket in the CareFirst plan. Out-of-network deductibles, maximums, and other costs are significantly higher than those in-network. Visit www.carefirst.com to find out if your provider is in-network.
**
After the first three retail prescription fills for maintenance drugs, CareFirst participants pay an additional $10 for each retail fill.
†
CVS Smart90 allows you to fill a maintenance medication at your local CVS store for a 90-day supply.
‡
Excluded drugs do not apply towards out-of-pocket maximums.
For more information about medical options or any of American University’s benefits, visit the Benefits site at www.american.edu/hr/benefits.
Page 6Dental coverage Finding a dentist/confirming your
dentist’s participation
American University offers a choice between two dental plans from Delta Dental: The Basic Plan requires that you choose
a PPO network dentist.
• Delta Dental Basic covers screenings, cleanings, fillings, and periodontics, and is available
for a lower monthly cost. For the Basic Plan you must choose a dentist who is in the Delta The Comprehensive Plan lets you select
Dental PPO network. The Basic Plan does not provide coverage for services from a Premier any licensed dentist, but you can save
or non-participating dental provider. more when you select a dentist who
• Delta Dental Comprehensive helps you pay for most necessary dental services and participates in the Delta Dental PPO or
supplies, including orthodontia, and offers the flexibility to choose from PPO, Premier, and Premier network. Please contact your
out-of-network dentists. However, the dentist you choose determines the level you pay out- dentist’s office to confirm that they
of-pocket. participate in Delta Dental PPO or are a
Reimbursements are based on PPO contracted fees for PPO dentists, PPO contracted Premier provider.
fees for Premier dentists, and PPO contracted fees for non-Delta Dental dentists.
Predetermination of dental
• You pay the least out-of-pocket if you see a dentist in the Delta Dental PPO network; benefits
• You pay a little more out-of-pocket if you see a dentist in the Delta Dental Premier If your dental care will be extensive,
network; and ask your dentist to complete and
• You pay the most out-of-pocket for seeing a dentist who is not affiliated with Delta submit a claim form to Delta Dental for
Dental. a predetermination of benefits. Delta
Dental will advise you exactly which
procedures are covered, the amount that
will be paid towards the treatment, and
your financial responsibility.
Terms to know
Allowed benefit is the maximum amount the plan will pay for a covered service. This is also
known as the “eligible expense,” “payment allowance,” or “negotiated rate.” If you use a
Premier or non-affiliated dentist, and the charges are more than the plan’s allowed benefit
amount, you may have to pay the difference (also called balance billing).
Page 7Compare dental plans
Delta Dental Basic* Delta Dental Comprehensive**
Delta Dental Premier® and Delta Dental Premier® and
PPO Dentists PPO Dentists
Non-PPO Dentists Non-PPO Dentists
Deductible $50 individual Not applicable $50 individual $50 individual
Waived for diagnostic, preventive, & orthodontics $150 family $150 family $150 family
Plan maximum $1,000 per person Not applicable $1,500 per person $1,500 per person
calendar maximum calendar maximum calendar maximum
$1,000 per person $1,000 per person
orthodontic lifetime maximum orthodontic lifetime maximum
Diagnostic and preventive services† 100% of allowed benefit Not covered 100% of allowed benefit 100% of allowed benefit
Oral exams, cleanings, x-rays, and sealants no deductible no deductible no deductible
Basic services 50% of allowed benefit Not covered 90% of allowed benefit 80% of allowed benefit
Fillings and posterior composites after deductible after deductible after deductible
Endodontics 50% of allowed benefit Not covered 90% of allowed benefit 80% of allowed benefit
Root canals after deductible after deductible after deductible
Periodontics 50% of allowed benefit Not covered 60% of allowed benefit 50% of allowed benefit
Gum treatment after deductible after deductible after deductible
Oral surgery Not covered Not covered 90% of allowed benefit 80% of allowed benefit
Incisions, excisions and surgical removal of tooth after deductible after deductible
Prosthodontics Not covered Not covered 60% of allowed benefit 50% of allowed benefit
Bridges, dentures, and implants after deductible after deductible
Orthodontic services Not covered Not covered 50% of allowed benefit 50% of allowed benefit
Adults and children no deductible no deductible
*
Basic Plan: Fees are based on PPO fees for PPO dentists. Services provided by Premier or non-Delta Dental dentists are not covered.
**
Comprehensive Plan: Reimbursements are based on PPO contracted fees for PPO dentists, PPO contracted fees for Premier dentists, and PPO contracted fees for Non-Delta Dental dentists.
†
Fluoride treatment is covered only for children up to age 19.
Limitations or waiting periods may apply for some benefits; some services may be excluded from your plan. Reimbursement is based on Delta Dental maximum contract allowances and not necessarily each dentist’s submitted fees.
For more information about dental options or any of American University’s benefits, visit the benefits site at www.american.edu/hr/benefits.
Page 8Flexible spending accounts The FSA payment card
FSA participants automatically receive
Lower your taxes with flexible spending accounts a payment card that you can use when
you make eligible health care purchases
You can set aside money in a flexible spending account (FSA) before taxes are deducted from your pay
from merchants who accept credit or
for certain health and dependent care expenses, lowering your taxable income and increasing your take-
debit cards. Because the card deducts
home pay.
funds directly from your FSA account
FSA participation does not continue automatically from year-to-year to pay for services and supplies, it
eliminates the wait for reimbursements.
You must enroll (or re-enroll) in health care and dependent care FSAs if you wish to participate in 2021.
Review the requirements or acceptable
receipts and documentation located on
ConnectYourCare.com.
Health Care FSA Dependent Care FSA
Account use Eligible medical, prescription, dental, and vision expenses Eligible dependent care expenses, such as day care and elder care, The card is offered at no additional
that are not covered or fully reimbursed by your other that enable you (and your spouse, if you are married) to work.
benefit plans such as copayments, coinsurance amounts,
charge to you and is not tied to, or
deductibles, and amounts above benefit maximums. reported against, your credit report.
Maximum $2,750 $5,000 or $2,500 if you are married and filing separate tax returns.
contribution FSA participation does not
continue automatically from
year-to-year
Who is covered You and all dependents that you claim on your federal To be covered through your dependent care FSA, your dependent
tax return – not just your dependents covered under a must meet one of the following criteria: You must enroll (or re-enroll) if you wish
university-sponsored medical plan. • under age 13 for whom you are entitled to a deduction on your to participate in 2021.
federal tax return;
• physically or mentally incapable of caring for oneself; or,
• Elect to contribute up to $2,750 to the
• your spouse who is physically or mentally incapable or caring
for oneself. health care FSA.
Funds Your entire contribution amount is available on You will have access to your funds as they accrue January 1, 2021 – • Elect to contribute up to $5,000 to the
availability January 1, 2021 and you can be reimbursed for eligible December 31, 2021. You can only be reimbursed for dependent care dependent care FSA ($2,500 if you
expenses incurred through March 15, 2022. that has already taken place from January 1, 2021 – March 15, 2022.
are married and filing separate tax
returns).
The amount that is deducted from your pay will depend on the contribution amounts you elect and how often you are paid. You also assessed a small monthly fee of $1.45.
For more information about Flexible Spending Accounts or any of American University’s benefits, visit the benefits site at www.american.edu/hr/benefits.
Page 9Life and accident insurance Terms to know
The Statement of Health, also known
Life and accident insurance protects and provides security for your family or other beneficiaries as Evidence of Insurability or proof of
in the event of your terminal illness or death while you are still actively employed at American good health, is a questionnaire to be
University. completed by you and your physician, if
requested. This provides the insurance
Basic coverage company with some basic health
The university automatically provides you with basic life insurance in the amount of one (1) times information that is used in the approval
your annual salary, at no cost to you. process for your request to enroll in,
or increase, the amount of your life
Optional life and personal accident (accidental death & dismemberment) insurance plan. The Statement of Health
insurance options must be approved by the insurance
You can supplement the basic life insurance by purchasing additional voluntary coverage during company before coverage can become
open enrollment. effective.
Check your beneficiaries
What It Is What It Could Provide A primary beneficiary is defined as the
Employee optional life insurance Supplemental life insurance coverage paid Base salary x 1-5 up to a maximum of person, organization, trust, or entity you
on a post-tax basis. A statement of health $1,500,000.
may be required. name to receive any benefits if you die.
Spouse/domestic partner Life insurance coverage on your spouse $10,000 to $100,000 in $10,000 increments. A contingent beneficiary is defined as
optional life insurance or partner paid on a post-tax basis. A the person, organization, trust, or entity
statement of health may be required.
you name to receive any benefits if the
Dependent optional life insurance Life insurance for your eligible dependent $1,000 to $10,000 in $1,000 increments. primary beneficiary is deceased.
children from live birth to age 26.
Personal accident insurance Coverage in the event of death due to an Base salary x 1-10 up to a maximum of
accident or covered disabling injury. $500,000.
Page 10Optional life insurance
Cost of coverage
Optional life insurance for employees and their Optional life insurance for dependent children Optional personal accident insurance
spouses/domestic partners The monthly cost is determined by the amount of Optional personal accident insurance rates are
The cost of optional life coverage is based on how coverage you elect for your dependent child. based on the amount of coverage you select and
much coverage you select and your age. Calculate whether you want individual coverage or family
the monthly cost of coverage for you or your coverage.
spouse/partner by using the chart below:
Age 2021 Rate/$1,000 of Coverage Amount 2021 Cost Coverage Level 2021 Rate/$1,000 of Coverage
29 and under $0.040 $1,000 $0.11 Single $0.015
30-34 $0.045 $2,000 $0.23 Family $0.025
35-39 $0.051 $3,000 $0.34
Sample Calculation
40-44 $0.089 $4,000 $0.46
Clawed Eagle earns a salary of $50,000 and is
$5,000 $0.57 electing optional personal accident coverage of
45-49 $0.149
$100,000 (2 times his salary) for himself. Clawed’s
$6,000 $0.68 rate for insurance is:
50-54 $0.230
$0.015 x 100 = $1.50
55-59 $0.430 $7,000 $0.80 single rate coverage cost per
amount/ month
60-64 $0.660 $8,000 $0.91 $1,000
65+ $1.225 $9,000 $1.03
$10,000 $1.14
Sample Calculation
Clawed Eagle is 36 years old, earns a salary of
$50,000, and is electing optional life coverage of
$100,000 (2 times his salary). Clawed’s rate for
insurance is:
$0.051 x 100 = $5.10
age rate coverage cost per
amount/ month
$1,000
Page 11Legal plan
Hyatt Legal’s MetLaw® Group Legal Coverage provides access to network attorneys who provide
legal services for covered events.
Changes to your enrollment in the plan can be made only during open enrollment. Once enrolled
in the legal plan, you may not drop coverage until the next open enrollment.
Covered services include, but are not limited to:
• Preparation of wills, living wills, and living trusts
• Purchase, sale, and refinancing primary residence
• Debt collection defense
• LifeStages® Identity Management Services
• Traffic ticket defense (no DUI/DWI)
For a full-listing of covered legal services and exclusions, visit www.american.edu/hr/benefits.
Page 12Other benefits
American University provides you with a comprehensive offering of other benefits that are
available for you throughout the year:
• Defined contribution 403(b) retirement plan
• Education benefits programs including tuition remission and dependent children benefits
• Short term medical leave and long term disability insurance
• AU Faculty Staff Assistance Program (FSAP) counseling resources
• AhealthyU faculty and staff wellness program
• Pre-tax parking and pre-tax commuter benefits
• Bicycle commuter benefits
• Emergency back-up dependent care, family services & resources
• Group auto and home insurance
• Pet insurance
Page 13Contact information
Auto Insurance* Flexible Spending Accounts Medical
MetLife Auto & Home ConnectYourCare CareFirst
Geomara Polanco (877) 292-4040 (800) 628-8549
AU Designated Agent www.connectyourcare.com www.carefirst.com
(703) 216-9675
Health and Wellness Programs for Kaiser Permanente HMO
www.metlife.com/mybenefits
Faculty & Staff* (301) 468-6000
Commuter Benefits* www.kaiserpermanente.org
AhealthyU
ConnectYourCare (202) 885-3742 Pet Insurance*
(877) 292-4040 ahealthyu@american.edu
Nationwide
www.connectyourcare.com
Home Insurance * (844) 208-1108
Counseling Resources* my.petinsurance.com
MetLife Auto & Home
AU Faculty Staff Assistance Program Geomara Polanco Prescription Drug
(202) 885-2593 AU Designated Agent
Express Scripts
FSAP@american.edu (703) 216-9675
(CareFirst Participants)
www.metlife.com/mybenefits
BHS (877) 486-5984
(800) 327-2251 Legal Plan www.express-scripts.com
https://portal.bhsonline.com, username: AU
Hyatt Legal’s MetLaw Plan Kaiser Permanente
Dental (800) 821-6400 (301) 468-6000
www.legalplans.com www.kaiserpermanente.org
Delta Dental
(800) 932-0783 Life and Personal Accident Insurance Retirement Benefits*
www.deltadentalins.com
AU Human Resources Benefits Team Fidelity
Dependent Care, Family Services & (202) 885-3836 (800) 343-0860
Resources* hrpayrollhelp@american.edu www.fidelity.com
Bright Horizons Prudential TIAA
(877) 242-2737 (Evidence of Insurability Application Status) (800) 842-2252
https://clients.brighthorizons.com/au (888) 257-0412 www.tiaa.org
www.prudential.com/mystatus
Education Benefits* Short Term Medical Leave and Long Term
Disability*
AU Human Resources Benefits Team
(202) 885-3836 AU Human Resources Benefits Team
hrpayrollhelp@american.edu (202) 885-3836
hrpayrollhelp@american.edu
Benefits that do not require election at open enrollment or upon new hire enrollment.
*
Page 14American University
Office of Human Resources
(202) 885-3836
hrpayrollhelp@american.edu
Mailing Address Office Location
4400 Massachusetts Ave, NW 3201 New Mexico Ave, NW, Suite 350
Washington, DC 20016-8054 Washington, DC 20016-8054
B-BG-2021You can also read
