Page 5 - NC OE Guide
P. 5
Eligibility and Enrollment
You may enroll in the beneits program if you are a regular full-time employee who is
actively working a minimum of 30 hours per week. As you become eligible for beneits,
so do your eligible dependents. In general, eligible dependents include your legally married
spouse or domestic partner and children up to age 26. Children may include natural,
adopted, stepchildren, or children obtained through court-appointed legal guardianship.
2016 Enrollment Highlights
X No changes to medical, dental, or vision plan insurance carriers
X All medical and pharmacy expenses (deductibles, copays, and coinsurance) will now
apply towards the out-of-pocket maximum
X Medical/Rx combined out-of-pocket limit will increase to $5,000 per individual and
$9,000 per family in-network
X Employees will be responsible for paying the irst $500 for individual coverage and
$1,000 for family coverage before the HRA pays; MG + BW will continue to fund the
HRA at the same level; the HRA will pay $1,000 for individual coverage and $2,500 for
family coverage after the employee share
X MG + BW will be moving our plan year effective date from December 1 to January 1
in 2017; as a result, the medical and dental plan deductible, medical plan out-of-pocket
maximum, and dental plan limits will run from December 1, 2015 to December 31,
2016; it will restart again on January 1, 2017
X The retail generic drug copay will increase from $4 to $10; if the cost of the drug is less
than $10, you will pay the lesser amount
X Mail order copays will move from 3x retail to 2.5x retail; see the summary on page 8 for
a list of the new copays
X You will now receive a debit card if you enroll in the FSA
X New carrier partner for basic life/AD&D and short term disability programs—UNUM
X New voluntary coverage available through UNUM
Z Voluntary long term disability, voluntary term life insurance, voluntary AD&D,
permanent life insurance, and critical illness coverage during the October 12 through
October 31 open enrollment period
X Enrollment will now be online! All employees will be required to log in and
either enroll or decline coverage; employees may also enroll by contacting the
call center at 844.863.5934
5
You may enroll in the beneits program if you are a regular full-time employee who is
actively working a minimum of 30 hours per week. As you become eligible for beneits,
so do your eligible dependents. In general, eligible dependents include your legally married
spouse or domestic partner and children up to age 26. Children may include natural,
adopted, stepchildren, or children obtained through court-appointed legal guardianship.
2016 Enrollment Highlights
X No changes to medical, dental, or vision plan insurance carriers
X All medical and pharmacy expenses (deductibles, copays, and coinsurance) will now
apply towards the out-of-pocket maximum
X Medical/Rx combined out-of-pocket limit will increase to $5,000 per individual and
$9,000 per family in-network
X Employees will be responsible for paying the irst $500 for individual coverage and
$1,000 for family coverage before the HRA pays; MG + BW will continue to fund the
HRA at the same level; the HRA will pay $1,000 for individual coverage and $2,500 for
family coverage after the employee share
X MG + BW will be moving our plan year effective date from December 1 to January 1
in 2017; as a result, the medical and dental plan deductible, medical plan out-of-pocket
maximum, and dental plan limits will run from December 1, 2015 to December 31,
2016; it will restart again on January 1, 2017
X The retail generic drug copay will increase from $4 to $10; if the cost of the drug is less
than $10, you will pay the lesser amount
X Mail order copays will move from 3x retail to 2.5x retail; see the summary on page 8 for
a list of the new copays
X You will now receive a debit card if you enroll in the FSA
X New carrier partner for basic life/AD&D and short term disability programs—UNUM
X New voluntary coverage available through UNUM
Z Voluntary long term disability, voluntary term life insurance, voluntary AD&D,
permanent life insurance, and critical illness coverage during the October 12 through
October 31 open enrollment period
X Enrollment will now be online! All employees will be required to log in and
either enroll or decline coverage; employees may also enroll by contacting the
call center at 844.863.5934
5
