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Open Enrollment 2021 Benefits My Way Oct. 26 – Nov. 13, 2020 hr.sandia.gov » 505-284-4700
Open Enrollment 2021
Table of Contents
Welcome to Open Enrollment!............................................................................................. 3
Your Sandia Benefits................................................................................................................ 5
Decide Now! Benefits to Enroll in by Nov. 13, 2020..................................................................... 5
Decide Anytime.......................................................................................................................................... 5
Benefits that Are Always There for You...........................................................................................6
What’s New for 2021................................................................................................................................6
Who’s Eligible for Benefits.................................................................................................................... 7
Sandia Medical Benefits ........................................................................................................8
What Is a 3-Tier Network?....................................................................................................................8
Employees in New Mexico....................................................................................................................9
Employees in California.........................................................................................................................11
Employees in Other Locations........................................................................................................... 12
Included with Your Medical Coverage............................................................................. 13
Prescription Drugs.................................................................................................................................. 13
Your Health Reimbursement Account............................................................................................14
Customer Advocates.............................................................................................................................14
Access to Convenient Onsite Care................................................................................................... 15
Dental and Vision Care Programs..................................................................................... 16
Monthly Premiums for Medical, Dental, and Vision................................................... 17
Medical........................................................................................................................................................ 17
Dental Care Program............................................................................................................................. 17
Vision Care Program.............................................................................................................................. 17
Flexible Spending Accounts.....................................................................................................18
Healthcare FSA.........................................................................................................................................18
Dependent Care FSA..............................................................................................................................18
Sandia Extras............................................................................................................................ 19
Sandia Extras Available Only during Open Enrollment........................................................... 19
Who’s Eligible .......................................................................................................................................... 19
How to Enroll ........................................................................................................................................... 19
Sandia Extras Available Anytime .................................................................................................... 19
Vacation Buy Plan................................................................................................................... 19
Legal Notices .......................................................................................................................... 20
Women’s Health and Cancer Rights Act of 1998....................................................................... 20
Health Insurance Portability and Accountability Act (HIPAA)
Special Enrollment Periods................................................................................................................ 20
Medicare Part D Eligible Individuals: Notice of Creditable Coverage............................... 20
COBRA General Notice.......................................................................................................................... 20
Premium Assistance under Medicaid and the Children’s Health Insurance
Program (CHIP)........................................................................................................................................ 20
»2« hr.sandia.gov » 505-284-4700
Welcome to
Open Enrollment!
Open Enrollment (Oct. 26 – Nov. 13, 2020) is your once-a-year
opportunity to make changes to your benefits so they
continue to be a good fit for you and your family. Below
is a quick view of your enrollment options.
Review and update your benefit elections, including medical, dental, vision, and the dependents
you cover
Elect benefits that require you to re-enroll every year:
• Vacation buy plan
• Healthcare flexible spending account
• Dependent care flexible spending account
• Transportation flexible spending account (for California only)
Custom-fit your coverage with voluntary benefits through Sandia Extras. Here’s what’s available to
you during Open Enrollment:
• Are you and your family covered in the event you become disabled and can’t work?
Take a look at the short-term disability benefit and take advantage of a guaranteed coverage level
with no evidence of good health required.
• Could you use extra cash if you became critically ill or had a serious accident?
Critical illness and accident insurance benefits can help.
• Have you drafted your will or might you need other legal help? Sign up for support for legal services.
If you don’t take action:
• You won’t be able to contribute to a healthcare, dependent care, or transportation flexible
spending account.
• You’ll continue to have the same medical, dental, and vision coverage in 2021 as you have in 2020,
covering the same dependents. (Reminder: Dependent children are covered up to age 26.)
• You’ll continue to have the same voluntary benefit elections with Sandia Extras that
you do now — they carry over each year.
• Your 2020 vacation buy election will not automatically carry over into 2021! You must re-elect it
during Open Enrollment.
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How to Enroll
You can enroll in or make changes to your benefits anytime from Oct. 26 Even if you are planning
through Nov. 13, 2020. To enroll, visit HR Solutions and choose HR Self
to stay in the plans you
Service. A CryptoCard, HSPD-12, PIV-C, or mobile credential is required if you
want to make your elections from home or your mobile device. are currently enrolled
The elections you make during Open Enrollment are effective from Jan. 1 in, you should review all
to Dec. 31, 2021. of your benefit options,
as your lifestyle or
Need Help or Resources? We Got You. healthcare needs may
Visit HR Solutions have changed!
From INSIDE, visit HR Solutions, our new HR website with everything you
need to know about all of the benefits and services offered at Sandia. From
the site, you can access all benefits information, send a question to HR, and
access HR Self Service.
Call HR Solutions
We’re also available by phone at 505-284-4700.
Visit the Virtual Benefits Fair!
In lieu of an in-person benefits fair this year, Sandia will host a virtual fair
through HR Solutions. Our benefit administrators will share their benefits
information, including flyers, videos, apps, and more.
Open Enrollment begins Monday, Oct. 26, and your 2021 elections
must be made by 5 p.m. MT (4 p.m. PT) on Friday, Nov. 13.
»4« hr.sandia.gov » 505-284-4700
Your Sandia Benefits
At Sandia, you’re empowered with a wide selection of benefit choices that support you today and help you
build a secure future for yourself and your family.
Decide Now! Benefits to Enroll in by You’ve got two
deadlines!
Nov. 13, 2020
The Open Enrollment
• Medical coverage, including preventive care and prescription drug coverage deadline is Nov. 13, 2020.
(Medical coverage comes with a health reimbursement account, which is And, log in to your Virgin
funded by Sandia when you complete healthy activities.) Pulse program account
and take the online health
• Dental coverage
assessment by 9:59 p.m. MT
• Vision coverage (8:59 p.m. PT) on Dec. 31,
• Healthcare flexible spending account 2020, to earn $250 in HRA
funds for 2021!
• Dependent care flexible spending account
• Transportation flexible spending account – California employees only (if
you’re currently enrolled and have funds you want to roll over into 2021)
• Vacation buy plan Saving for college
• The following Sandia Extras:
just got easier!
As part of the Sandia Extras
• Voluntary short-term disability coverage
voluntary benefits program,
• Critical illness coverage
you can now make direct
• Accident insurance deposits from your paycheck
• Legal services into the tax-advantaged 529
Education Plan and save for
your child’s future.
Enrolling is easy and takes
Decide Anytime less than 15 minutes. You
can open a 529 plan account
• You can increase or decrease your employee-paid life insurance anytime.
with just $1 and contribute
However, proof of good health may be required to increase coverage. Note
as much or as little as you’d
that Open Enrollment is a good time to make sure your beneficiary(ies) are
like. Visit HR Solutions
up to date!
for details and benefits,
• If you live in California, you can enroll in the transportation flexible spending including a video, FAQs, and
account anytime. However, you must re-enroll during Open Enrollment links to resources.
in order for this year’s unused funds to roll over to the new year.
• Plus, you can explore and enroll in these Sandia Extras anytime:
• (New!) The 529 Education Plan
• (New!) Help with finding a rental home or buying your
forever home
• (New!) Roadside assistance
• Home, auto, and pet insurance
• Identity theft protection
• Employee discounts on travel, entertainment,
cellphone service, and electronics (available for free!)
»5« hr.sandia.gov » 505-284-4700
Visit HR Solutions to learn
Benefits that Are Always There for You more about all of your
• 401(k) plan. Open Enrollment is a great time to update your beneficiary(ies) benefits and to enroll.
and review your investment allocation and how much you are saving for We make it easy, really!
retirement. With our matching contributions, Sandia adds 66-2/3 cents
to your account for every dollar that you contribute on a pretax, Roth,
and/or after-tax basis, up to 6% of eligible compensation you contribute
Support resources
each pay period. That’s a maximum company match of 4% of your eligible
compensation. Visit HR Solutions for more details, including the Savings and for COVID-19
Income Plan Summary Plan Description. Go to INSIDE to get the latest
• Adoption assistance updates related to COVID-19,
including information about
• Tuition assistance testing and waived employee
• And much, much more! cost-sharing, flexible work
schedules, and guidelines
and policies for return to
work when allowed.
What’s New for 2021
• Monthly premiums. We’re pleased to announce very small premium
increases to the medical plan ($1 – $4 per month depending on coverage
level), and dental and vision premiums are staying the same for 2021.
See page 17.
• Enhanced provider networks under the Sandia Total Health Plan for
both UnitedHealthcare and Blue Cross Blue Shield. Explore the enhanced
preferred networks, with access to high-quality, lower-cost providers in your
community. See page 8.
• Virtual visits. Your copay for virtual visits will decrease to $10 per visit.
• Automatic Roth in-plan conversion. Effective Sep. 30, 2020, you can
automatically convert new after-tax contributions to Roth in the NTESS 401(k)
Plan. Log in to Fidelity NetBenefits® at 401k.com to set up this feature.
• A few more Sandia Extras. We have added a few more benefits
to your voluntary benefits menu, including the 529 Education Plan,
roadside assistance, and help finding a rental or buying a forever
home. See page 19.
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Who’s Eligible for Benefits
Having a life event?
Generally, Sandia benefits offered during Open Enrollment are available to all
regular employees, year-round student interns, post-doctoral appointees, and Getting married, having a child,
limited-term employees. Eligibility information for specific voluntary benefits or getting divorced allows
appears on page 19. you to change your benefits
mid-year. Visit HR Solutions for
details on dependent eligibility
Dependent Eligibility
and when you can enroll and
When you enroll in benefits, you can also enroll your family members: disenroll dependents.
• Your spouse
• Children up to age 26, including biological children, adopted children, children
placed for adoption, legal guardianship, stepchildren, and children covered
under a qualified medical child support order (note that Sandia automatically
disenrolls children who turn age 26, but they are eligible for COBRA)
• Disabled children age 26 or older
Proof of dependent eligibility is required. Complete eligibility requirements
are in the NTESS Health Benefits Plan for Active Employees Summary Plan
Description (SPD).
All employees are responsible for determining whether their dependents meet
the eligibility requirements of the Sandia Total Health Plan.
Making Changes to Your Benefits
If you have a qualifying life event during the year (marriage, birth/adoption of
a child, divorce, etc.), you will have 31 days to make changes to your benefit
elections. If you don’t make your changes by the 31-day deadline, you will
have to wait until the next Open Enrollment period to make changes, and
those changes won’t become effective until the next Jan. 1.
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Sandia Medical Benefits
The Sandia Total Health Program focuses on you and gives
you the choices you need to get the best care for you and
your family. When you enroll in the program, you choose What Is a 3-Tier Network?
the benefit administrator that best fits your needs:
With a tiered network, your out-of-pocket costs
• Blue Cross Blue Shield of New Mexico (BCBSNM) are determined by which tier your doctor or
• UnitedHealthcare (UHC) provider is in — Tier 1, Tier 2, or Tier 3.
• Kaiser Permanente (California employees only) • Tier 1 is made up of a select network of doctors
and facilities that meet both carriers’ standards
The medical services covered by our benefit for high-quality and cost-efficient care, so you
administrators are the same, including preventive save the most with Tier 1. You have the lowest
care covered at 100% in-network. The only difference deductible with this option, and you pay only
is the provider networks offered by each benefit 10% coinsurance for covered services once you
administrator. meet the deductible.
NEW! BCBSNM and UHC are expanding their provider • Tier 2 doctors and facilities are affiliated with
networks, giving you greater choice for high-quality, local, regional, and nationwide PPO networks
lower-cost providers beginning Jan. 1, 2021. offered with our plans today. With Tier 2, your
deductible will be higher than with Tier 1, and
• BCBSNM is replacing the Sandia Health Provider you will pay 20% coinsurance for covered
Network (SHPN) in New Mexico with the Blue services once you meet the deductible.
Preferred Plus Provider Network. The Blue
Preferred Plus Provider Network is also called Tier 1 • Tier 3 doctors and facilities are out-of-network
and is your lowest-cost option for receiving care. providers. You will pay the highest cost when
you go out-of-network for care. You will have
• UnitedHealthcare will also offer a new, lower-cost the highest deductible, and you will pay 40%
network called the UnitedHealthcare Choice Plus coinsurance for covered services once you meet
Premier Provider Network. It is available to all the deductible. Note: There are no balance-
employees, except California residents (due to state billing protections when you use out-of-network
regulations). The Choice Plus Premier Provider providers and facilities.
Network is also called Tier 1 and is your lowest-cost
option for receiving care.
When you use a provider in the Tier 1 network, you
maximize your out-of-pocket savings, though you still
have the option to use an in-network (Tier 2) provider or
an out-of-network (Tier 3) provider. The highlighted box
to the right explains further how 3-tier coverage works.
The tables beginning on page 9 show plan coverage and
network availability for where you live.
»8« hr.sandia.gov » 505-284-4700
Employees in New Mexico
If you live in New Mexico, you will have the choice between UHC and BCBSNM as benefit administrators; both plan
carriers will feature the 3-tier network in 2021.
Plan coverage at a glance
Tier 1 Tier 2 Tier 3
Annual deductible1 (excludes prescription drug costs)
Employee only $500 $750 $2,000
Employee + spouse or $1,000 $1,500 $4,000
child(ren) ($500 per person) ($750 per person) ($2,000 per person)
Employee + spouse and $1,500 $2,250 $6,000
child(ren) (family) ($500 per person) ($750 per person) ($2,000 per person)
Coinsurance You pay 10% You pay 20% You pay 40%
Annual calendar-year out-of-pocket maximum2
Employee only $2,000 $2,750 $6,500
Employee + spouse or $4,000 $5,500 $13,000
child(ren) ($2,000 per person) ($2,750 per person) ($6,500 per person)
Employee + spouse and $6,000 $8,250 $19,500
child(ren) (family) ($2,000 per person) ($2,750 per person) ($6,500 per person)
Preventive care 100% covered 100% covered 60% covered after
(not subject to deductible) (not subject to deductible) deductible (plus you pay
any amount your provider
charges over the benefit
administrator’s allowed
amount)
Telemedicine $10 copay
(not subject to deductible)
1
Annual deductible does not include prescription drug costs. In- and out-of-network deductibles do not apply toward each other; each deductible must be met
separately for eligible expenses. Tier 1 and Tier 2 deductibles do apply toward each other.
2
Annual calendar-year out-of-pocket maximum does not include prescription drug costs. All limits include deductible amount. In- and out-of-network out-of-
pocket maximums do not apply toward each other; each maximum must be met separately. Tier 1 and Tier 2 out-of-pocket maximums do apply toward each other.
Here’s how to find providers in Tier 1:
UnitedHealthcare BCBSNM
Go to welcometouhc.com/tieredbenefits > Benefits > Find Go to bcbsnm.com/sandia > Search our Provider Finder
a Doctor or Facility Tier 1 providers are listed as Blue Preferred Plus. Be sure
Tier 1 providers are flagged with a blue dot that says “Tier 1” to note the change to our provider network name. You’ll no
and are also referred to as Choice Plus Premier Providers. longer use the term “Sandia Health Provider Network.”
»9« hr.sandia.gov » 505-284-4700
Example: How Tiers Save You Money
This example assumes employee-only coverage and deductible has been met: Tier 1, $500 deductible, with 10%
coinsurance; Tier 2, $750 deductible, with 20% coinsurance; and Tier 3, $2,000 deductible, with 40% coinsurance.
Tier 1 Tier 2 Tier 3
Lowest out-of-pocket cost Higher out-of-pocket cost Highest out-of-pocket cost
Doctor visit You pay $20 You pay $40 You pay $80
Cost: $200
2-day inpatient You pay $500 You pay $1,000 You pay $2,000
hospital stay
Cost: $5,000
Before receiving care, go online or call the number on the back of your medical ID card to verify your
provider is in Tier 1. This will ensure you get the most from your benefits at the lowest cost!
» 10 « hr.sandia.gov » 505-284-4700Employees in California
Your current benefit administrators — Blue Cross Blue Shield, UnitedHealthcare, and Kaiser Permanente — will continue
with no changes to the network structure. When you visit in-network providers, you can anticipate lower out-of-pocket
costs, and you’ll have access to regional and nationwide networks of providers and facilities. As soon as California
state restrictions are lifted, California employees will have access to UnitedHealthcare’s 3-tier plan.
Plan coverage at a glance
Benefit Administrators BCBSNM, UHC, Kaiser Permanente
In-Network Out-of-Network
Annual deductible1 (excludes prescription drug costs)
Employee only $750 $2,000
Employee + spouse or child(ren) $1,500 $4,000
($750 per person) ($2,000 per person)
Employee + spouse and child(ren) $2,250 $6,000
(family) ($750 per person) ($2,000 per person)
Maximum HRA funds you can earn Employee only: $500
Employee + children: $750
Employee + spouse: $1,000
Employee + family: $1,250
Coinsurance You pay 20% You pay 40%
Annual calendar-year out-of-pocket maximum2
Employee only $2,750 $6,500
Employee + spouse or child(ren) $5,500 $13,000
($2,750 per person) ($6,500 per person)
Employee + spouse and child(ren) $8,250 $19,500
(family) ($2,750 per person) ($6,500 per person)
Preventive care 100% covered 60% covered after deductible
(not subject to deductible) (plus you pay any amount your
provider charges over the benefit
administrator’s allowed amount)
Telemedicine BCBS and UHC: $10 copay
(not subject to deductible) Kaiser: $0 copay
1
Annual deductible does not include prescription drug costs. In- and out-of-network deductibles do not apply toward each other; each deductible must be met
separately for eligible expenses.
2
Annual calendar-year out-of-pocket maximum does not include prescription drug costs. All limits include deductible amount. In- and out-of-network out-of-
pocket maximums do not apply toward each other; each maximum must be met separately.
Here’s how to find network providers:
UnitedHealthcare BCBSNM Kaiser Permanente
Go to myuhc.com and select the Go to bcbsnm.com/sandia > Search Go to healthy.kaiserpermanente.org/
Choice Plus plan to do your search our Provider Finder doctors-locations
» 11 « hr.sandia.gov » 505-284-4700Employees in Other Locations
During Open Enrollment, you may want to take a closer look at UHC to benefit from the NEW 3-tier benefit option. The
Choice Plus Premier Provider Network is also called Tier 1 and is your lowest-cost option for receiving care. You still
have the option to use an in-network (Tier 2) provider or an out-of-network (Tier 3) provider.
BCBSNM will continue with no changes to the current 2-tier network structure — PPO in-network and out-of-network.
Tier 1 Tier 2 Tier 3
(Available through UHC In-Network Out-of-Network
Choice Plus Premier
Provider Network only)
Annual deductible1 (excludes prescription drug costs)
Employee only $500 $750 $2,000
Employee + spouse $1,000 $1,500 $4,000
or child(ren) ($500 per person) ($750 per person) ($2,000 per person)
Employee + spouse and $1,500 $2,250 $6,000
child(ren) (family) ($500 per person) ($750 per person) ($2,000 per person)
Coinsurance You pay 10% You pay 20% You pay 40%
Annual calendar-year out-of-pocket maximum2
Employee only $2,000 $2,750 $6,500
Employee + spouse $4,000 $5,500 $13,000
or child(ren) ($2,000 per person) ($2,750 per person) ($6,500 per person)
Employee + spouse and $6,000 $8,250 $19,500
child(ren) (family) ($2,000 per person) ($2,750 per person) ($6,500 per person)
Preventive care 100% covered 100% covered 60% covered after
(not subject to deductible) (not subject to deductible) deductible (plus you pay
any amount your provider
charges over the benefit
administrator’s allowed
amount)
Telemedicine $10 copay
(not subject to deductible)
1
Annual deductible does not include prescription drug costs. In- and out-of-network deductibles do not apply toward each other; each deductible must be met
separately for eligible expenses. Tier 1 and Tier 2 deductibles do apply toward each other.
2
Annual calendar-year out-of-pocket maximum does not include prescription drug costs. All limits include deductible amount. In- and out-of-network out-of-
pocket maximums do not apply toward each other; each maximum must be met separately. Tier 1 and Tier 2 out-of-pocket maximums do apply toward each other.
Here’s how to find network providers:
UnitedHealthcare BCBSNM
Go to welcometouhc.com/tieredbenefits > Benefits > Find a Go to bcbsnm.com/sandia > Search our Provider Finder
Doctor or Facility
Tier 1 providers are flagged with a blue dot that says "Tier 1"
and are also referred to as Choice Plus Premier Providers.
» 12 « hr.sandia.gov » 505-284-4700Included with Your Medical Coverage
Prescription Drugs
Prescription drug coverage is included when you enroll in the Sandia Total Health medical plan. To fill a prescription for
up to 30 days, visit a network pharmacy of your choice.
Get Smart90 for Medications You Take Regularly
For medication you take regularly, the Express Scripts Smart90 program allows you to get a three-month supply at a
lower cost than three one-month supplies.
With Smart90, you can either get your prescriptions filled and delivered by Express Scripts, or you can fill and pick up
your prescription at a Walgreens pharmacy of your choice.
Prescription Coverage
Drug Category In-Network Out-of-Network
Retail Pharmacy (maximum 30-day supply)
Generic You pay 20% You pay 50%
$5 minimum copay; $10 maximum copay
Preferred brand name You pay 30% You pay 50%
$30 minimum copay; $45 maximum copay
Non-preferred You pay 40% You pay 50%
brand name $50 minimum copay; $75 maximum copay
Smart90 Mail Order or at Walgreens (maximum 90-day supply)
Kaiser Mail Order (100-day supply)
Generic You pay 20% N/A
$12.50 minimum copay; $25 maximum copay
Preferred brand name You pay 30% N/A
$75 minimum copay; $112.50 maximum copay
Non-preferred You pay 40% N/A
brand name $125 minimum copay; $187.50 maximum copay
Note: There is an annual out-of-pocket maximum of $1,500 per person (or $5,950 per family) for in-network prescription drugs. There is no out-of-pocket
maximum for out-of-network prescription drugs or Smart90 prescription drugs purchased outside of the program.
» 13 « hr.sandia.gov » 505-284-4700Your Health Reimbursement Customer Advocates
Account Dedicated Customer Advocates can help you better
understand how a claim was paid, answer FSA and HRA
When you enroll in a Sandia Total Health medical plan, questions, navigate appeals, find a doctor, and use the
Sandia sets up a health reimbursement account (HRA) cost estimator tool. Because walk-in and onsite services
for you to use to help pay for medical, prescription drug, are currently unavailable due to COVID-19 restrictions,
dental, vision, and other eligible healthcare expenses — you can reach Customer Advocates for your benefit
like your deductible and your share of coinsurance. administrator by phone or email.
Sandia works with our medical benefit administrators BCBSNM Dedicated Customer Advocate
to provide your HRA. Your HRA comes with a debit card, Email: Erica_Lindenmuth@bcbsnm.com
which makes it easy to pay for eligible healthcare expenses, Call: 505-284-8669
like those at the doctor’s office or the pharmacy.
UnitedHealthcare Dedicated Customer Advocate
Email: Kathleen_Mauro@uhc.com
How to Earn HRA Funds
Call: 763-321-3786
There are three ways you can earn HRA funds:
Kaiser Permanente
1. Participate in the Virgin Pulse program.
Dedicated Sandia employee help line: 877-568-0774
2. Log in to Virgin Pulse to take the online health
assessment by Dec. 31, 2020, at 9:59 p.m. MT
(8:59 p.m. PT) to earn $250 for your 2021 HRA.
3. Participate in a Health Action Plan.
Participating in all three will ensure you receive the
maximum annual funding for your HRA, shown below.
Maximum Annual HRA Funding You Can Earn
Employee only: $500
Employee + children: $750
Employee + spouse: $1,000
Employee + family: $1,250
Visit HR Solutions for HRA details.
» 14 « hr.sandia.gov » 505-284-4700Access to Convenient Care
Onsite Sandia Medical Clinic Access a Virtual Visit
The onsite Sandia Medical Clinic provides care to Sandia Be sure to create an account before you need care.
employees in New Mexico and California at no cost for
acute and episodic services for a variety of illnesses and BCBSNM
injuries. Walk in or call to schedule an appointment:
Go to mdlive.com/sandia to get started, or download
New Mexico: 505-844-4237 the MDLIVE mobile app.
California: 925-294-2700
UHC
Sandia’s Behavioral Health Employee
Assistance Program (EAP) Go to myuhc.com to access Amwell, Teladoc, and
Doctor on Demand, or download the UHC mobile
Sandia’s onsite employee assistance program (EAP),
app. You can also call the Nurseline number on the
as well as services available through your medical plan
back of your UHC ID card.
benefit administrator, can connect you with resources
for managing stress, anxiety, family or workplace issues,
Kaiser Permanente
substance abuse, and more. Visit HR Solutions for Sandia
behavioral health contact information in New Mexico and
Go to mydoctor.kp.org/ncal/get-care to schedule
California.
a video visit with your doctor or an e-visit with a
clinician, or call 866-454-8855 to speak with a nurse.
Virtual Physician Visits
Virtual physician visits allow Sandia Total Health members
Help Finding a Primary Doctor
to see and talk with a board-certified doctor from
your smartphone, tablet, or computer — anytime and Open Enrollment is a great time to make sure you and
anywhere, and at a much lower cost than an emergency your family members each have a relationship with a
room or urgent care visit. Use virtual visits for a variety primary doctor. Call one of the phone numbers below
of conditions, including allergies, ear infections, pinkeye, for help finding a provider.
coughs and colds, and COVID-19 symptoms.
BCBSNM and UHC
New for 2021! Beginning Jan. 1, you’ll pay only a $10 Davita Medical Group Ambassador Line
copay for a virtual visit with a BCBSNM or UHC doctor. 505-262-7100
Kaiser will continue to be a $0 copay for virtual visits.
BCBSNM
Lovelace Concierge Line
505-727-2727
UHC
Presbyterian Customer Service Center
505-923-7300
There’s actually a lot more that’s included with your medical coverage than we can list here.
Visit HR Solutions for all the details on what’s available to keep you feeling your best.
» 15 « hr.sandia.gov » 505-284-4700Dental and Vision Care Programs
Dental Care Program Learn more
Find out more about your
Keep your smile healthy with regular cleanings and dental exams that are
potential cost savings with the
covered 100% in-network through the Dental Care Program. You do not have
Delta Dental PPO network.
to enroll in medical coverage to elect dental coverage.
For more information on your
Delta Dental of New Mexico administers the program and gives you a choice dental benefits, see the Dental
of providers and networks: Care Program Summary or visit
deltadentalnm.com.
• Delta Dental PPO Preferred. Dentists in this smaller, preferred network
charge the least for covered services, so your portion of the costs is
also lower.
• Delta Dental Premium. This is a larger network, and providers charge more
for their services. However, you are not responsible for any amounts over
the Delta Dental maximum approved fee.
• Out-of-network. You can use any provider; however, dentists considered
out-of-network do not discount their fees, and you will be responsible for
any amounts over the Delta Dental maximum approved fee.
Vision Care Program Did you know?
The Sandia Vision Care Program, administered by Davis Vision, helps you see You can find more information
clearly with coverage for routine eye exams, lenses, frames, and contact lenses. about your Davis Vision benefit
You do not have to enroll in medical coverage to elect vision coverage. at davisvision.com.
When you need care, you can go in- or out-of-network. However, when you use
a Davis Vision in-network provider, you will pay less.
Visit HR Solutions for in-network and out-of-network coverage amounts.
Plan Features
• An eye exam every calendar year
• Single-vision, bifocal, trifocal, and lenticular lenses,
or contact lenses every calendar year
• Frames every other calendar year*
• A discount on LASIK surgery
* The exam and lenses benefit resets every Jan. 1, and the
frames benefit resets every other year on Jan. 1.
» 16 « hr.sandia.gov » 505-284-4700Monthly Premiums for Medical, Dental, and Vision Medical The monthly premiums shown below are for the Sandia Total Health Plan (which include prescription drug coverage). Monthly premiums are the same whether you choose coverage through BCBSNM, UHC, or Kaiser Permanente. Your salary tier is based on your salary as of Jan. 1, 2021. Year-round student interns pay the Tier 1 rates. Coverage Level Tier 1 Tier 2 Tier 3 Tier 4 and Salary Tier Less than $50,000 $50,000 to $80,000 $80,001 to $130,000 More than $130,000 Employee only $62 $91 $133 $163 Employee + spouse $132 $193 $279 $343 Employee + $112 $165 $240 $294 child(ren) Employee + spouse $187 $272 $398 $489 and child(ren) Dental Care Program Vision Care Program Coverage Level Monthly Premium Coverage Level Monthly Premium Employee only $9 Employee only $1.65 Employee + 1 dependent $18 Employee + 1 dependent $3.30 Employee + 2 or more $26 Employee + 2 or more $4.40 dependents dependents » 17 « hr.sandia.gov » 505-284-4700
Flexible Spending Accounts
Healthcare FSA
With the healthcare FSA, you can set aside pretax money
Did You Know?
from your paycheck to use for doctor visits, prescriptions, Even if you are not enrolled in a Sandia medical
dental care, vision care, and other eligible healthcare plan, you can still contribute to a healthcare FSA
expenses. Here’s what you need to know: that is administered by PayFlex.
• If you want to participate, you must enroll during
Open Enrollment each year.
• Your contributions go into your account pretax. This Dependent Care FSA
allows you to pay for these expenses with tax-free
dollars and reduces your taxable income. With the dependent care FSA (DCFSA), you set aside
pretax money to help pay for qualified dependent care so
• To participate in the healthcare FSA, you do not need to
you can work. Here’s what you need to know:
enroll in a Sandia medical plan.
• To participate, you must enroll each year.
• In 2021, you can contribute between $100 and $2,750.
• Each plan year, you can contribute $100 up to the annual
• Please keep your debit card from the previous year; your
IRS maximum, which is currently $5,000. (IRS limitations
new funds will be automatically loaded onto your old card.
apply if both you and your spouse have a DCFSA.)
Use It or Lose It • Use your account to pay for eligible dependent care
expenses for your children under age 13 or for older
Be sure to plan carefully so that you will be able to use all of children and family members who need help caring
your annual FSA contributions. If you have a balance at year- for themselves.
end, you need to use it by the March 15 grace period of the
following year. Any remaining balance will be forfeited. Note • Eligible expenses include before-school and after-school
that Sandia will follow federal and IRS guidelines if deadlines programs, day care, day camps, nanny care, preschool
are extended due to the COVID-19 pandemic. However, we tuition, and eldercare expenses.
do not expect that a mid-year FSA enrollment period will be • PayFlex administers the DCFSA. You submit your claims
offered due to COVID-19 during 2021. through the PayFlex app, online, or by using a form.
• You must enroll during Open Enrollment if you want to
How Does an HRA Work with a participate in 2021.
Healthcare FSA? • The grace period runs from Jan. 1 through March 15, 2021.
With the healthcare FSA, you can contribute pretax dollars All 2020 expense claims must be filed by April 15, 2021.
from your paycheck to cover eligible medical, prescription,
dental, and vision expenses. This allows you to save Who’s Eligible
money on your taxes. The HRA, funded by Sandia, does
To be eligible for a DCFSA, you must be a full- or
not affect your tax status.
part-time regular employee, limited-term employee,
The FSA and HRA work together: One debit card lets you or post-doctoral appointee. If you are married, both
access your FSA and HRA funds. The administrator will you and your spouse must be working full- or part-time,
process claims using funds from your FSA first, and then or your spouse must attend school full-time.
from your HRA. This is because HRA funds roll over from
For more details on the DCFSA, visit HR Solutions.
year to year, up to a maximum amount, while FSA funds
are “use it or lose it” for each year.
» 18 « hr.sandia.gov » 505-284-4700Sandia Extras
Sandia Extras Available Only How to Enroll
during Open Enrollment Visit mysandiaextras.com to view your options and
premiums and to enroll. You can also call Corestream at
Get extra peace of mind when you protect yourself and
855-514-8800.
your loved ones with voluntary benefits available only during
Open Enrollment through the Sandia Extras program:
Sandia Extras Available Anytime
• Short-term disability insurance (OPEIU, SPA, and
non-represented employees only) Be sure to check out the variety of voluntary benefits that
are available for you to enroll in anytime through Sandia
• Accident insurance
Extras at mysandiaextras.com or by calling 855-514-8800:
• Critical illness insurance
• (New!) The 529 Education Plan
• Prepaid legal services
• (New!) Help with finding a rental home or buying your
If you enroll in any of the Sandia Extras programs, you forever home in Livermore or Albuquerque
pay for all coverage elections through one convenient
• (New!) Roadside assistance
payroll deduction.
• Home, auto, and pet insurance
Who’s Eligible • Identity theft protection
• Employee discounts (at no cost) on travel, entertainment,
Sandia Extras programs are offered to all benefits-eligible
cellphone service, and electronics
employees. MTC-represented employees are not eligible
for short-term disability benefits. Note that benefits are
not available for conditions that occurred prior to the
coverage effective date.
Vacation Buy Plan
Want more time to enjoy life, or the peace of mind of
having additional leave available at 100% of your salary,
should you need it? Consider enrolling in Sandia’s
vacation buy plan — available only during Open
Enrollment. If you are eligible for the plan, you can
purchase from eight to 80 hours of vacation per
year on a pretax basis.
Visit HR Solutions for more information.
» 19 « hr.sandia.gov » 505-284-4700Legal Notices Women’s Health and Cancer Rights Act of 1998 The Women’s Health and Cancer Rights Act (WHCRA) provides protection for individuals who elect breast reconstruction after a mastectomy. If you have had or are planning to have a mastectomy, you may be entitled to certain benefits under the WHCRA. See the notice at HR Solutions. Health Insurance Portability and Accountability Act (HIPAA) Special Enrollment Periods If you declined enrollment in a Sandia medical program for yourself or your eligible dependents because of other medical coverage, you may be able to enroll yourself and your eligible dependents in a Sandia medical program during the year if you or your eligible dependent(s) lose your other coverage. A notice describing how medical information about you may be used and disclosed and how you can get access to this information is available through HR Solutions. Medicare Part D Eligible Individuals: Notice of Creditable Coverage Each year, Sandia is required to provide this notice to all members enrolled in self-insured medical plans to explain how the prescription drug coverage provided by their medical plans compares to Medicare’s prescription drug coverage. This notice has information about current prescription drug coverage under the self-insured medical plans and prescription drug coverage available for people with Medicare. You are encouraged to read this notice to understand any implications that may apply to you and your covered dependents. Get the notice through HR Solutions. COBRA General Notice Under COBRA, separated employees and their dependents may be eligible to continue health program coverage (including medical, dental, vision, and healthcare flexible spending account) at group rates on an after-tax basis. COBRA is available in certain qualifying events where health benefit program coverage would otherwise end. Get the notice through HR Solutions. Premium Assistance under Medicaid and the Children’s Health Insurance Program (CHIP) If you or your children are eligible for Medicaid or CHIP and are also eligible for health coverage from your employer, your state may have a premium assistance program that can help pay for coverage. These states use funds from their Medicaid or CHIP programs to help people who are eligible for these programs but also have access to health insurance through their employer. Review the full notice through HR Solutions. Sandia National Laboratories is a multimission laboratory managed and operated by National Technology & Engineering Solutions of Sandia, LLC, a wholly owned subsidiary of Honeywell International Inc., for the U.S. Department of Energy’s National Nuclear Security Administration under contract DE-NA0003525. SAND2020-11158 M » 20 « hr.sandia.gov » 505-284-4700
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