It is time again for open enrollment in the Kentucky Employees’ Health Plan for state employees, public school employees, and other active employees who are eligible for state-sponsored health insurance.
This year’s open enrollment is again a “passive” enrollment, meaning an enrollee doesn’t need to do anything if he or she isn’t making changes to their health insurance plan. For those who want to change their plan or contribute to a health care or dependent care Flexible Spending Account (FSA), active enrollment is necessary and takes place this Monday, Oct. 8 through Friday, Oct. 26.
Here is a brief primer on the 2013 plan options, which have not changed: The Commonwealth Standard PPO is the basic, value plan; the Commonwealth Maximum Choice plan includes a state funded Health Reimbursement Account (HRA) totaling $1,000 for single coverage, $1,500 for parent plus and couple coverage and $2,000 for family coverage that can be used to reduce your deductible; the Commonwealth Capitol Choice plan provides a $500 per family member allowance that can be used to pay many in-network services before payment toward your deductible, and; the Commonwealth Optimum PPO, which is a traditional PPO plan featuring larger payroll deductions in exchange for lower out-of-pocket costs, along with fixed copays for certain services.
One bit of information to keep in mind as we enter open enrollment is a change in FSA rules effective Jan. 1, 2013. The maximum contribution that can be made to a health care FSA annually has been reduced to $2,500 under federal law. As a result, the state health plan is advising enrollees to set aside only that amount that the enrollee expects to use through Dec. 31 since the funds do not roll over to the next year. As the KEHP says, “Use it or lose it!”
Let’s look at the monthly premiums for calendar year 2013 for the lowest cost plan for each plan option. The following premiums will be for non-smokers (Smokers will pay more; if you smoke, please see your plan materials to find your exact premium): The lowest cost premium for the Commonwealth Standard PPO option is offered at no cost to the employee, while premiums for the parent plus, couple, and family plans are lower than for the other plan options; the lowest cost premium for the Commonwealth Maximum Choice option is $30.88; the lowest cost premium for the Commonwealth Capitol Choice option is $37.28, and; the lowest cost premium for the Commonwealth Optimum PPO option is $62.76. Cross referencing for married employees in the same family is available under all four plan options.
Specific data about lifetime maximums, annual deductibles, out of pocket maximums, coinsurance, prescription coverage, dependent eligibility, and all benefits under each plan option can be found in plan materials provided to you by your agency or school HR office, or found online at kehp.ky.gov.
So, let’s do a wrap-up: If you are an active employee and need to make changes to your insurance plan, you should do so during this open enrollment period with either a paper application found in the plan materials provided by your HR office, or online via the KHRIS Employee Self Service system. You should have already received a letter in the mail that explains how to enroll through KHRIS. If you do not need to make changes to your plan or contribute to an FSA, you do not need to do anything.
Please remember that if you are a retiree, you must contact your retirement system for an application, rates, contributions and information about online enrollment. Commonwealth Maximum Choice is not available for retirees.
If you are not sure whether or not you need to make changes to your plan, or if you need more information, there are plenty of places to find answers. Contact phone numbers and 2013 open enrollment assistance hours are listed in your plan materials and online at kehp.ky.gov. You may also contact your agency’s HR office for local, personalized assistance.
Speaking of local (or, at least, regional), benefit fairs will be held again throughout the open enrollment period at different locations across the state beginning on Monday, Oct. 8. Fair locations can be found in the plan materials or online at kehp.ky.gov. For East Kentucky, a fair is scheduled for Tuesday, Oct. 9 at the GC Garland Administration Building on the London Elementary School campus in London from 2-6 p.m. A benefit fair will also be held in Lexington from 4-8 p.m. on Wednesday, Oct. 10 at the Dunbar High School cafeteria (that location will include a health fair). Enrollment kiosks and flu shots will be available at each fair location.
Have a good week!