Frequently Asked Questions: 2018 Benefits Open Enrollment
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1 Frequently Asked Questions: As of November 27, 2017 Questions about Benefits Open Enrollment Medical Plan Prescription Drug, Dental Plan and Vision Plan Where to Go for More Information Benefits Open Enrollment Q: When is? A: will take place Monday, December 11 Friday, December 15 for team members at Palisades Medical Center. For 2018, team members are required to take action. This includes making benefit choices as well as waiving benefits. Q: What is changing for 2018? A: There are some exciting enhancements to your benefits for Key changes include introducing: Horizon Blue Cross Blue Shield as our network-wide carrier for our medical, dental and vision plans; OptumRx as our network-wide carrier for our prescription drug plan; A new Flexible Spending Account (FSA) administrator; New voluntary benefits; Access to the Employee Assistance Program (EAP); Virtual medical visits for non-urgent issues through TelaHealth; A new online enrollment system; and, The new TeamHMH.com website that provides access to benefits information and enrollment resources. These changes are designed to better serve you and move us toward a more integrated approach to benefits and Total Rewards.
2 Q: What is not changing for 2018? A: There are no changes to our current benefit plan designs for 2018 (co-pays, deductibles, out-of-pocket maximums, etc., will remain unchanged). Additionally, we are pleased to announce that team member medical and dental plan rates (flat dollar amounts) for the 2018 plan year remain unchanged. Rates are available either through the Benefits Counselors or HR team. Q: What do I need to do during enrollment? A: The Benefits Open Enrollment period is your annual opportunity to consider your options and choose the most appropriate benefit plans for you and your eligible dependents, learn about new benefits and review and update your personal, dependent and beneficiary data. You must enroll for benefits this year to ensure you have the coverages that will best meet the needs of you and your family. Please review your highlights bulletin sent in the mail (also available on TeamHMH.com) for additional reminders about what you should do during and after enrollment. A note about voluntary benefits: voluntary benefits are a supplement to Hackensack Meridian Health s core benefit plan offerings. Enrollment in these benefits is not required. However, if a team member would like to enroll in any of the voluntary benefits offered, he/she will pay the full cost of coverage. Q: How do I enroll? A: You have three ways to enroll beginning December 11 (these details are also available on TeamHMH.com): 1. Online Enrollment (Benefits Self-Service) Easy online enrollment 24/7 during the enrollment period, which you can access through the TeamHMH.com website. 2. On-Site Benefits Counselors Meet one-on-one with a Benefits Counselor, who can help you make the best benefit choices for you and your family. Limited appointments are available. Access the appointment website at Palisades Medical Center Frequently Asked Questions Page 2 of 6
3 3. Benefits Enrollment Call Center Speak with a Benefits Counselor to complete your enrollment over the phone at Open Monday Friday, 9:00 a.m. 6:00 p.m. ET. Q: If I am adding a spouse or dependent child to my coverage during Open Enrollment, is any dependent documentation required? A: Documentation is not required. More details are available on the enrollment website. Q: Will I receive new ID cards for 2018? A: Yes. Based on your elections, you can expect to receive new ID cards for the medical, prescription drug, dental, vision and/or FSA plans in January You can also print out ID cards from the carrier websites at TeamHMH.com beginning January 1, The Benefits team will also be on-site in early January to help you access ID cards. Medical Plan Q: What will the change to Horizon Blue Cross Blue Shield mean to me? A: Horizon Blue Cross Blue Shield offers a broad, comprehensive provider network that includes most, but not all, of our current network providers. Be sure to check the provider directory available through HorizonBlue.com/hmh. In the limited case that your current provider is not in the Horizon Blue Cross Blue Shield network, please provide his/her name and address for possible network recruitment to Horizon Blue Cross Blue Shield Member Services at , Monday, Tuesday, Wednesday and Friday, between 8 a.m. and 6 p.m., ET, and Thursday, between 9 a.m. and 6 p.m. ET. Q; What is prior authorization and how do I find out if I need it? How do I get it? A: Prior authorization is the review we provide before you receive certain services. Without precertification, you may have greater out-of-pocket expenses. The review will also ensure that services are eligible under your health plan. When you receive eligible services from an Inner Circle/in-network doctor, health care professional or facility, they are responsible for obtaining prior authorization. If you receive out-ofnetwork services, you are responsible for obtaining prior authorization. For a list of services requiring prior authorization, please call your dedicated Member Services number at Representatives are available to assist Hackensack Palisades Medical Center Frequently Asked Questions Page 3 of 6
4 Meridian Health team members Monday, Tuesday, Wednesday and Friday, between 8 a.m. and 6 p.m., Eastern Time (ET), and Thursday, between 9 a.m. and 6 p.m., ET. Q: Which labs can I use? A: You will receive the highest plan benefit when you use onsite Hackensack Meridian Health labs. You can use resources on HorizonBlue.com/hmh and TeamHMH.com to identify additional in-network labs. In New Jersey, LabCorp is in network. Q: I am or will be receiving care from a doctor or facility that will be out of network when my Horizon BCBSNJ plan becomes effective. What do I do? A: If you are or expect to be receiving treatment for certain medical conditions and that care will continue into 2018 and your provider is not in the Inner Circle or in Horizon BCBSNJ s network, you may be eligible for transition of care benefits. Transition of care benefits let you continue care with an out-of-network provider as if they are in-network for a limited time under certain circumstances. Examples of conditions that may be eligible for transition of care benefits include pregnancy, chemotherapy, dialysis or transplant. You can access a form to request Transition of Care coverage at HorizonBlue.com/hmh or on the Benefits Portal. Q: I have secondary coverage through my spouse s employer sponsored Horizon BCBSNJ plan. How is this handled? A: The HMH plan is primary for the HMH team member and secondary for the spouse. The spouse s coverage is primary for the spouse and secondary for the HMH team member. Q: Am I covered if I travel out of state, or if I have dependents who do not live in New Jersey? A: Through your plan, you and your covered dependents have access to the national BlueCard PPO program. You can search for an in-network doctor or hospital by visiting the National Doctor and Hospital Finder (accessible from HorizonBlue.com/hmh). You can also call your dedicated Member Services number at to find out-of-area doctors and hospitals. Representatives are available to assist Hackensack Meridian Health team members Monday, Tuesday, Wednesday and Friday, between 8 a.m. and 6 p.m., Eastern Time (ET), and Thursday, between 9 a.m. and 6 p.m., ET. Palisades Medical Center Frequently Asked Questions Page 4 of 6
5 Q: What is Primary Nurse Case Management? A: Horizon BCBSNJ and Hackensack Meridian Health are committed to helping you achieve your best level of health. If you have an acute or chronic health condition, our Primary Nurse program may be able to help. Your Primary Nurse is a dedicated Horizon BCBSNJ registered nurse who can assist you and your covered dependents dealing with a health condition, such as asthma, chronic kidney disease, chronic obstructive pulmonary disease, coronary artery disease, diabetes or heart failure. The Horizon BCBSNJ Primary Nurse program is voluntary, free and available to eligible team members. To be connected with your Primary Nurse, call , option 2, between 8 a.m. and 5 p.m., Eastern Time, Monday through Friday. Prescription Drug, Dental Plan and Vision Plan Q: What will the change to OptumRx mean to me? A: Prescription drug coverage is included as part of the medical plan. For 2018, we will adopt the OptumRx formulary (list of covered medications). If you are impacted by the formulary change, you will receive a letter from OptumRx in December. You also can view the OptumRx formulary through TeamHMH.com. If your current medication is not included in the OptumRx formulary, you can speak with your doctor about: Which alternative medications would be appropriate for you The steps necessary to request an exception You can contact one of the following onsite locations for more information: Hackensack UMC Plaza Retail Pharmacy John Theurer Cancer Center Q: How do I find a dentist? A: It s easy to find a dentist, so be sure to select a network dentist to save the most on out-of-pocket costs. Simply visit HorizonBlue.com/hmh. Once there, select Services. Choose Provider Network. Choose Find a Dentist. Select the name of your dental plan and search for a dentist convenient to you. Q: How do I find a vision provider? A: It s easy to find a vision provider. Simply visit HorizonBlue.com/hmh. Once there, select Services. Choose Provider Network. Choose Find a Vision Provider, and you will be directed to a search page. Palisades Medical Center Frequently Asked Questions Page 5 of 6
6 Where to Go for More Information Q: Where can I go to find out more? A: You can attend the Benefits Fair at the Palisades Medical Center Auditorium on Tuesday, December 5; or you can: Medical, dental and vision questions For general benefits questions Visit Horizonblue.com/hmh, or Call Horizon Blue Cross Blue Shield Member Services at , Monday, Tuesday, Wednesday, and Friday, between 8 a.m. and 6 p.m. ET, and Thursday, between 9 a.m. and 6 p.m. ET. Contact the Benefits Enrollment Call Center at , Monday, December 11 through Friday, December 15, between 9:00 a.m. 6:00 p.m. Palisades Medical Center Frequently Asked Questions Page 6 of 6
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