 Hello and welcome to Open Enrollment 2024. This presentation is the long program for active employees. I will cover all of our benefits through this presentation. Open Enrollment will begin October 9th and will end October 27th 2023. We will be using our online system CFWBenefits.com to enroll. The enrollment deadline for all plans is October 27th at 11.59 p.m. I do not recommend you wait until the last possible minute as the window will close at 11.59 p.m. All changes you make will be effective January 1st 2024. First, some insurance terms that I will be using during this presentation. First is co-payment. Co-payment is the flat dollar amount you will pay at the provider's office. On the health center plan, this is the amount you would pay at your primary care doctor's office if you are not visiting a health center or at a specialist's office. This also applies to the DHMO plan where all dental visits are covered by the copay. Second is deductible. This is just like your car insurance deductible. This is the amount of money you pay before the insurance kicks in. If you are on the consumer choice plan, all services apply to the deductible before the insurance pays. If you are on the health center plan, the deductible only applies when doing surgeries or things like complex imaging. Third is co-insurance. Once you've met your deductible, then you pay co-insurance. This is a percentage of the bill you are responsible for. Both our health center and consumer choice plans are 80-20 plans, which means you pay 20% of the bill and the city pays 80% of the bill. Finally, all of this wraps together to be the total out-of-pocket maximum. Once you've reached your total out-of-pocket maximum, you no longer pay for services at providers' offices or pharmacies. We will be offering the same two plans for 2024, the health center plan and the consumer choice plan. The health center plan has the free primary care at the health centers and copays for specialists and providers who are not at the health centers. They have lower deductibles and lower out-of-pocket maximums. We have a national network and there are positions available nationwide. The consumer choice plan is our high deductible health plan. You must meet the deductible before the insurance will pay for your medical services. There is a health savings account that goes with the consumer choice plan and you are able to use the health centers at a discounted rate. Preventive care on both plans is covered 100%, so getting your annual well adult exam, well child exam, and a well woman exam are all covered on both plans. However, one thing to be aware of is on the consumer choice plan. If you talk about an issue you are having or if your doctor orders additional tests, those will have a charge. For example, my provider requests that I get a vitamin D test done. This is a diagnostic test and not a preventive test. And if I were on the consumer choice plan, I would pay for that test. On the health center plan, you can go to the health centers for free. Otherwise, all other primary care providers including pediatricians and OBGYNs are covered with a $30 copay. Specialists such as dermatologists, cardiologists, etc. are covered with a $50 copay. This is a reduction in copays from 2023. We do use the et net choice point of service to open access network. And there is no coverage for out of network providers except in emergencies or certain surgery situations. Those on both plans can use our health centers. For those on our health center plan, all visits at the health centers are covered at 100%. We currently have three primary centers supported by five satellite locations. One of the biggest benefits of the health centers is same day or next day appointments. The health centers are not walk in or drop in clinics. These are health centers staffed with physicians and nurse practitioners. For those on the consumer choice plan, you can still go to the health centers, but the cost is a $60 contracted rate if you're going for an illness or injury visit, or else 100% for your well adult visit. The five satellite locations are around the Fort Worth area, including Keller, Burlison and Bedford. The costs are still covered at 100% for those on the health center plan and $60 contracted rate for those on the consumer choice plan. One thing to note is that some satellite providers offices have services that are not covered by our contract, such as Keller has an x-ray machine. If you're on the consumer choice plan and they do an x-ray, you will be charged the contracted rate of an x-ray. The satellite locations may or may not have same day or next day appointments available. They do not hold open appointments for City of Fort Worth employees. 2023 saw the retirement of two long term health center providers, Dr. Reeve and Sherry Pierce. Both were Hugley providers. We now have Patricia Benavides-Nyep working at Hugley. We moved from the Moncree location in June of 2023 and the downtown Fort Worth Health Center is now called Magnolia and is located at 1320 Hamp Health Street, Suite 350. Starting in November, Dr. Courtney Campbell will be the primary care provider there. We are also opening a new health center at the Police Officers Association Building at 100 North Forest Park Boulevard Suite 120. This is across Forest Park from the new City Hall. This facility will open in November and Dr. Mario Mejia will be the provider there. As I mentioned, the consumer choice plan has that high deductible. For 2024, the individual deductible has increased to $3,200 to comply with IRS regulations. The family deductible is remaining at $5,400. You do have to meet the deductible before the insurance starts to pay for claims, which includes pharmacy claims. With the consumer choice plan, you get the health savings account. The city continues to seed the HSA for you. We will contribute $540 for an individual or $1,000 for the family. The maximum you can contribute to your HSA has increased for 2024. As an individual, you can contribute up to $4,150 and $8,300 for family. However, this maximum does include the city's contribution. So the maximum you can contribute from your paycheck will be $3,610 for the individual and $7,300 for family. In big news, we have replaced Acolyte with A-Lite. You may or may not remember that we had Compass three years ago and they changed their name from Compass to A-Lite. We are basically returning to them after three years with Acolyte. They will help you with benefits navigation such as cost estimates and bill of reviews. They can help with clinical decision support and second opinion services. Finally, they can also help you with surgery support, including what to expect before and after a surgery. Throughout the past several years, we have added a number of special programs to the plan. We offer Teladoc, which provides virtual visits. Through Teladoc, you have the option of seeing a provider for an urgent issue or scheduling an appointment in the future. If you decide to use Teladoc for mental health visits, you would receive the same mental health provider each visit. We started offering Hinge Health at the end of last year. Hinge Health is virtual physical therapy, both if you've been prescribed by your physician or just want to work out a minor issue. We've been offering surgery plus for the past several years. They offer a bundled billing for non-emergent surgeries. Their bread and butter are musculoskeletal surgeries. However, they can also see you for a hernia or hysterectomy. They are also our sole provider of bariatric surgeries. Orosti is our soft tissue rehab provider. They do a combination of physical therapy, muscle manipulation, and kinesthetic taping to help you feel better faster after a soft tissue injury. Hello Heart provides blood pressure cups and an app to help you track your blood pressure. You can then provide this information to your doctor on your annual visits to help keep better track of your blood pressure. And they now offer cholesterol support as well. Finally, we have Verda, which we introduced three years ago. Verda helps with diabetes support and reversal as well as weight loss support. Through coaching and diet, they can help you get off your diabetes medications. Optum will continue to be our pharmacy benefits manager in 2024. Under the health center plan, there is a $100 deductible, which begins January 1st. After that costs are on a coinsurance basis with a minimum and maximum. On the consumer choice plan, everything hits the deductible and then coinsurance. For both plans, if you take a maintenance medication, you need to do either mail order or get your three months prescription from Walgreens. There are some medications, opioids, for example, where providers will not allow you to pick up the medication on a 90 day supply. That's fine. And you can continue to pick up your medications on the limited 30 day supply. On the health center plan, medications have a 20% coinsurance with a minimum and maximum cost. This means if you are prescribed a generic medication that is $200, you only pay the maximum of $20. If your generic medication costs less than $10, a ZPAC, for example, you would pay that dollar amount. But for a medication that is $15, you would pay the $10 minimum. The minimums and maximums for mail order or Walgreens are 2.5 of the generic maximum and minimum. So you save a little money with mail order or Walgreens. These are the medical rates for 2024. There was a slight increase in premiums for all plans except the consumer choice plan employee only coverage. For the health center plan employee only coverage, the increase was less than $2 a paycheck. The city continues to offer flexible spending accounts for members. There are two different types, a medical and dependent care FSA. The benefit of the FSA is that you are using pre-tax funds to pay for qualified medical or daycare expenses. A medical FSA is for medical expenses for yourself and your family. In order to participate in the medical FSA, you have to either be on the health center plan or not take the city's insurance at all. You cannot be on the consumer choice plan and use the medical FSA. The medical FSA is like an interest-free credit card. You do have access to the full amount of the funds in January and just pay a remainder back via payroll deduction throughout the year. You can use medical FSA funds for things like copays, deductibles, orthodontia, vision care, etc. If you do not use all of your medical FSA, $570 will roll over into the new year. The rest is use or lose. The dependent care FSA is for daycare for your child up to the age of 13 or an adult who is an adult who is disabled and attends a day program or some sort of dependent care for adults. Dependent care accounts are more like a checking account. You can only get out what you've put in at a time. So if you put in $196 per paycheck but have a $500 bill, you can only get out $196. The dependent care account does not roll over. You must use it in the year or you lose it. For 2024, the contribution limit has not been announced. So we will remain at a maximum of $3,050 for the medical FSA and $5,000 per family for the dependent care FSA. Remember, if you want to participate in the flexible spending accounts in 2024, you must re-enroll during this open enrollment period. The benefit of the health savings account is that it is pre-tax money and as long as you use it for qualified medical expenses, you never pay taxes on the money. You own the HSA. This means if you ever leave the city or change from the consumer choice plan to the health center plan or a spouses plan, any money in the HSA, including the city's contribution is yours. There is no documentation needed when you use HSA money. Health equity will never ask you for receipts regarding your expenses. However, if you were to build up $5,000 in the account and think, ooh, instead of using this for medical expenses, I'm going to buy myself a boat. You can. Health equity will never know. However, Uncle Sam may come knocking at the door to do a tax audit. If you don't have medical receipts to back up the $5,000 claim and sadly, even with a prescription, a boat is not a qualified medical expense. You will have to pay both a penalty on that $5,000 and income taxes, so it isn't advised to use your funds for nonmedical uses. 100% of your money in the account rolls over from year to year, so whatever you don't spend will be there year after year, which will allow you to grow your account. Once you have a minimum of $1,000, you can also start investing your HSA money to increase your account. Once you've reached the age of 65, you can take the funds without a penalty for non-medical expenses, but you would still pay the taxes. To ensure no penalty and no taxes, you need to use it for qualified medical expenses. One other thing to realize about the HSA is that it's more like your checking account. You can only take out what you've put in, so if you have a bill for $700 in January, but all that is in there is the city's $540 contribution, all you would be able to pay would be the $540. You would have to pay the other $160 from your own funds and reimburse yourself later. We still offer the same dental options. We have the DPPO plan with a high and low option. On both options, preventive services are covered at 100% and have a $50 deductible per person. The annual maximum, which on the dental is the maximum the dental insurance will pay, is $1,000 on the low option and $2,000 on the high. Basic restorative care, that's things like your cavities and simple extractions, are covered at 80% on the high option and 50% on the low. Major care, bridges, crowns, inlays and onlays, are covered at 50-50 on both plans. Both plans cover orthodontia and implants. There is a lifetime maximum on orthodontia for the low and high option. On the low option is $1,000 and the high option it's $1,500. We still offer the DHMO plan. This plan has no deductible or annual maximum. You can get all the dental work you need done. However, there is a very limited network and you have to choose a primary care dentist. Everything is paid out on a copay basis, so you know walking into the dentist's office how much these copays are. This plan does cover orthodontia for adults and children, but does not cover implants. Here are the dental rates. They're staying the same for 2024. We have an exciting new offering from IMED for 2024. We are now able to offer a high and a low vision plan option. On the high plan, there's a slightly better contact lens and frame allowances, as well as lower copays for progressive lenses. In addition to the new high option, IMED is offering a better benefit if you go to plus providers. You can identify a plus provider when searching a doctor online. Primarily plus providers will be chain providers such as target optical or lens crafters. When searching for providers online, we are the Insight Network. For life insurance, we will continue to offer you one times your salary for basic life and accidental death and dismemberment. For this open enrollment session and going forward, we are pleased to be able to offer you a new maximum of eight times your annual salary to a new maximum of $600,000. For this year, you can enroll in the first time or increase your life insurance amount by one times your annual salary with no evidence of insurability, EOI requirement. Also new this year is an additional amount of life insurance for your spouse. You can elect up to $150,000 for your spouse coverage. If your spouse is enrolling for the life insurance for the first time, they will have to do EOI. If you are submitting evidence of insurability, you will have to wait for that coverage to be approved before coverage will begin. Finally, we have an additional option for your dependent children. They are now eligible for up to $20,000 of life insurance. There is no evidence of insurability requirement for child life insurance. We continue to offer short and long-term disability through UNIM. Disability covers you in the event that you cannot work due to your own accident or illness. For the short-term disability plan, there are four options, a high and low option with a 60 or 40% pre-disability earnings replacement with a 14-day or 30-day wait period. Within the high and low option, there are two different maximum payout times. If you elect long-term disability as well, they will be set up to dovetail so that when your short-term disability ends, your long-term disability starts. We still offer the same long-term disability plans we've offered for several years. We have a 40 or 60% pre-disability earnings replacement with a 90 or 180-day wait. If you enroll in LTD, you will only be offered the elimination period that matches your short-term disability maximum benefit period. For both short-term disability and long-term disability, if you are enrolling for the first time or increasing plan benefits, going from 40 to 60% for example, you will have to be due in evidence of insurability form and be approved by UNIM before the benefit will start. We still offer TIAA as our 457 plan. TIAA does not require an open enrollment period to enroll. You can do so online at any time by going to TIAA.org. The minimum election is $10 or 1% of salary. The benefit of selecting a percentage is that in the event you get a pay increase, your contribution amount also automatically increases. So with every pay increase, you're always contributing a little more to help you save for your retirement. We do have a pension plan which will pay you, but this is supplemental retirement income. Maybe this is money that pays for an RV to tour around the U.S. or cabin by a lake. There are a variety of funds available to contribute to and you can change your fund allocations at any time. For those new to investing or who are unsure, you can enroll in the life cycle funds which allow you to set when you anticipate retiring and the fund will do the correct things for you until you retire. The maximum contribution amount for 2023 is $22,500. Beneplace is our site for some voluntary benefits and discounts like vacation and car rentals. They also have pet insurance, car and home insurance available for discounts. We offer a variety of voluntary benefits available through MetLife. You are able to enroll in them on the CFW benefits website. For healthcare support, we offer a critical illness plan, accident plan, and a hospital indemnity plan. The critical illness plan pays you a lump sum when you experience a critical illness, such as a heart attack, stroke, or cancer diagnosis. They also have a preventive care benefit that will pay you $100 for getting your physical. There are pre-existing condition limits, so for example, if you've already had a heart attack in the past, they wouldn't necessarily cover it on the plan. The accident plan pays in the event you or a covered family members have an accident and seek medical treatment. These can be for things like fractures, burns, concussions, etc. They pay a flat amount based on each situation. And finally, the hospital indemnity plan pays in the event that you are hospitalized. They pay a flat dollar amount per day of hospitalization. There is an additional benefit if admitted to the ICU. The initial admission benefit is limited to one times per year and the maximum number of days the benefit covers is 31. We also offer two legal plans, MetLife Legal and Allstate Identity Protection. With MetLife Legal, you can have access to a lawyer to talk about common legal matters such as estate planning, identity theft, minor civil suits, traffic accidents. The Allstate Identity Theft Protection Service monitors your credit reports and would send you alerts for large purchases or transfers from your accounts. Both are available to enroll on the benefits portal. We still have the wellness program with Virgin Pulse. The premium incentive is still in place. The deadline to complete the three required items to not receive the penalty is August 31 of each year. The three required items are a physician screening form, the member health assessment and the tobacco affidavit. All three of these are available on the Virgin Pulse website or app. The reason we do this is to ensure that you are seeing a primary care doctor and developing a relationship with one. The goal is to find medical conditions before they are a problem. It is always better to find cancer in stage one than stage three or four. To earn the premium incentive, you need to do a member health assessment through Virgin Pulse, a tobacco affidavit, or a tobacco journey if you smoke cigarettes, cigars, a pipe, vape, or use chewing tobacco. Finally, you go to your primary care provider to receive your annual exam. If you cover your spouse, your spouse also has to do the three activities. The deadline for this program is August 31 of each year. If you did not complete your requirements in 2023, 4, 2024, you will see the additional premiums shown here when you log into CFW benefits. If you believe that you have completed the requirements and it is showing on the benefits portal, please contact the benefits office. If you do your three requirements and one additional preventive care screening, you would be eligible to earn points through the Virgin Pulse app for the healthy challenge payout in January. Examples of additional screenings include a dental or vision exam, colonoscopy, various vaccines including the flu, shingles of age appropriate, and initial COVID vaccines. You would then use the app to earn points by doing things like exercising, tracking your sleep, or your eating, attending a wellness sponsored event like the health safety and benefits fair. The city partners with the weight management companies such as Wonder Health and Weight Watchers. Employees and their spouses are eligible to participate in either program if they are on the city's health insurance plan. Weight Watchers can be enrolled in at any time. Wonder Health has periodic enrollment periods. The city sponsors an employee assistance program. They offer six free counseling sessions per issue. They have dedicated staff available 24 hours a day to help you find support. In addition to counseling, resources for living has daily life assistance such as child care or elder care support or help with emergency services. They also offer legal and financial services such as will preparation, budget preparation. They offer 30 minute consultation with a lawyer or a financial planner. The wellness office is here to support your whole well being. They offer exercise classes, workshops, seminars and webinars as well as special events such as periodic blood drives and the heart walk. You can find more information online including information about meetings and more information about the plans. We will be enrolling online through the benefits portal cfwbenefits.com. If you are adding people to the plan who have not been previously covered you will need to upload proof documents to verify relationship. Remember your flexible spending elections do not roll over automatically. If you do not participate in the FSA or do not want to participate in 2024 you do not have to do anything and your coverages will roll over automatically. However if you would like to take advantage of some of our new offerings such as the increased life insurance or the high vision plan or you want to enroll in the FSA you need to go online in a role. The member portal is cfwbenefits.com. If you've never gone online before you would need to click register. If you have any questions you can reach out to the benefits office at 817-392-7782 or come in and see us in the lower level at City Hall.