Unless you have a qualified life event, this is the only time period you can make changes to your health insurance, Flexible Spending Accounts (FSAs), or life insurance. Please use this Enrollment and Change Period as an opportunity to review your benefits.
Highlighted below are benefits updates that affect you.
Iowa Select and Deductible 3 Plus: Increase in the Out-Of-Pocket Maximum. The medical maximum out-of-pocket costs for Iowa Select and Program 3 Plus’s members will increase to:
The medical maximum out-of-pocket costs for Iowa Select and Deductible 3 Plus’s members will increase to:
- $1,000 from $650 for single coverage
- $2,000 from $1,450 for family coverage
Dental Insurance: NOT an Open Enrollment Period. Your 2016 dental coverage will automatically carry forward into 2017. The 2017 Open Enrollment and Change Period does not allow you to make any changes to your dental coverage.
Life Insurance: New Life Insurance Provider. The Standard Life Insurance Company will be the State of Iowa’s life and long-term disability (LTD) insurance carrier effective January 1, 2017. You do not need to re-enroll in life insurance. Your current supplemental life insurance elections will carry over to the new vendor.
If you do not make any changes in your health insurance during the 2017 Enrollment and Change Period, your 2016 health plan and covered dependents will remain the same and carry over to 2017.
To participate in the Health Flexible Spending Account (FSA) and/or the Dependent Care FSA, you must enroll each year in IowaBenefits. Make your benefit elections in IowaBenefits.
You can make the following changes to your benefits during the 2017 Enrollment and Change Period.
- Enroll in a health insurance plan, if not currently enrolled.
- Change health insurance plan.
- Change the contract holder in a double spouse family contract.
- Add or remove eligible family members from health insurance.
- Cancel your health insurance.
Supplemental Life Insurance
- Apply to increase the amount of supplemental life insurance to the maximum per contract status.
- Decrease the amount of your supplemental life insurance.
- Cancel your supplemental life insurance.
Flexible Spending Accounts
- Enroll in the Health Flexible Spending Account (FSA) and elect up to a maximum of $2,550 on an individual basis.
- Enroll in the Dependent Care Flexible Spending Account (FSA) and elect up to $5,000 if married and filing a joint tax return, or $2,500 if married and filing a separate tax return.
- Change whether the premiums for health, dental, and supplemental life insurance are taken pretax (before federal, state, and FICA tax) or post-tax (after federal, state, and FICA tax).
You can choose one of the following health plans for 2017.
- Blue Access
- Iowa Select
- Deductible 3 Plus
A side-by-side summary of the benefits between the health insurance plans is available.
If you have questions about a specific health service, contact Wellmark’s customer service representatives dedicated exclusively to the State at 800.622.0043.
The health plan’s out-of-pocket maximum is the dollar amount you must pay before Wellmark pays 100 percent of the eligible medical claims. The out-of-pocket maximum provides you and your family financial protection against large, catastrophic medical claims.
The out-of-pocket maximum includes:
The out-of-pocket maximum does not include:
- Premiums paid
- Services not covered in the State’s plan
Let’s look at an example …
- Jack is an UE/IUP-covered employee enrolled in Iowa Select, family coverage.
- Jack covers Jill, his wife, and Polly, his daughter.
- The Iowa Select benefit design for UE/IUP-covered employees is:
- Deductible – $250 for single coverage, $500 for family coverage (The deductible applies to both inpatient and outpatient services.)
- Office visit - $15 copay
- Coinsurance – 10 percent (in-network), 20 percent (out-of-network)
- Out-Of-Pocket Maximum (OOP) - $2,000 for family coverage
- Jack and his family went to health care providers belonging to the Wellmark network.
toward OOP Max
Jill has an office visit with her health care provider and lab work ($150) done in the provider’s office. Jill is responsible for the $15 copay for the office visit and 10 percent coinsurance for the lab work.
$15 + ($150 * 10%)
|Jack has an office visit with his health care provider, and he is responsible for a $15 copay.||$15||$45|
Polly had an accident and goes to an Urgent Care Center. The bill for the Urgent Care Center was $750. Jack is responsible for the single deductible of $250, plus 10 percent of the charge.
$250 + ($500 * 10%)
Jack has four visits to the chiropractor, and he is responsible for $15 copays for each visit.
($15 * 4)
As a result of Polly’s accident, she had five outpatient physical therapy visits. The charge for each visit was $300. Jack is responsible for 10 percent of the charge. (Polly has already met the deductible with her visit to the Urgent Care Center.)
$300 per visit * 10% = $30 | $30 * 5 visits = $150
|Jill goes into the hospital. The hospital bill is $20,000. Jill has a $250 deductible plus 10 percent coinsurance up to the $2,000 out-of-pocket maximum. In this case, Jack’s responsibility is $1,445 because this will bring him to the family out-of-pocket maximum of $2,000. The hospital will not bill him for any covered services over this amount.||$1,445||$2,000|
At this point, Wellmark will pick up any future claims for this calendar year for Jack and his family.
Double Spouse Family Insurance Contract
If you and your spouse are both employees of the State of Iowa, you have the option of enrolling in the double spouse family insurance contract. The double spouse family insurance contract is one family health insurance plan. The total premium—made up of the state contribution and the employee contribution—is split between each spouse. One spouse is the contract holder. The other spouse is the dependent under the contract holder’s health insurance plan.
If an UE/IUP-covered employee is the contract holder of the health insurance, the State's contribution to double-spouse family coverage is the total premium.
|Contract Holder||One-half of the total monthly premium minus $20||$0 per month|
|Contributing Spouse||One-half of the total monthly premium||$0 per month|
Contact your Human Resources Associate before making any changes to your double spouse family contract.
Basic Life Insurance
The State pays 100 percent of the premium for basic life and accidental death and dismemberment (AD&D) insurance. The basic amount of coverage is $20,000. (Age reductions apply beginning at age 65.)
Supplemental Life Insurance
In addition to the basic life insurance coverage, you have an opportunity to elect supplemental term life insurance at group rates.
|Purchase in Increments|
|Supplemental Life Insurance*||$5,000||$40,000||$5,000|
* Age reductions apply beginning at age 65.
Supplemental life insurance premiums are based on your age and the amount of coverage you elect. You can pay the premium on a pretax or post-tax basis.
Changing Your Supplemental Life Insurance Election
If you want to increase your supplemental life insurance coverage:
- You can purchase additional life insurance from $5,000 to $40,000 in increments of $5,000. (Evidence of insurability must be provided to and approved by The Standard Life Insurance Company before the increased coverage can go into effect.) After the Enrollment and Change Period is over, The Standard Life Insurance Company will mail you a Personal Health Application. You must complete and mail the Personal Health Application back to them.
- Increases to supplemental life coverage will be effective the first of the month after DAS receives approval from The Standard Life Insurance Company.
If you want to decrease or cancel your supplemental life insurance coverage:
- You can decrease the amount of your supplemental life coverage or cancel your supplemental life insurance coverage. Your election to increase or decrease your supplemental life insurance coverage is made in IowaBenefits and is effective January 1, 2017.
Decreases to supplemental life coverage made during the Enrollment and Change Period will be effective January 1, 2017. Increases to supplemental life coverage will be effective the first of the month after DAS receives The Standard Life Insurance Company approval.
Flexible Spending Accounts (FSAs) allow you to set aside pretax dollars to reimburse you for eligible health or dependent care expenses.
When you enroll in a Flexible Spending Account, you decide how much to contribute to each account for calendar year 2017. The money is then deducted from your paycheck pretax (before federal and state income taxes and FICA taxes are deducted) in equal amounts over the course of the year. After you incur expenses that qualify for reimbursement, you submit claims (reimbursement requests) to ASIFlex (the administrator of the program) to request tax-free withdrawals from your Flexible Spending Account to reimburse yourself for these expenses.
You may elect to have your reimbursement placed directly into your checking or savings account by adding direct deposit information into IowaBenefits when you enroll.
With the Health FSA, certain health care expenses for you and your eligible family members can be reimbursed. Medical expenses eligible for reimbursement include most medically necessary health care expenses that are not paid through medical or dental insurance plans. Your share of health and dental insurance premiums are not eligible to be reimbursed from the Health FSA. Premiums are already made with pretax dollars.
Maximum Annual Health FSA Election
The maximum annual Health FSA contribution is $2,550 per employee per plan year.
No more use it or lose it!
Up to $500 of unused health FSA amounts remaining at the end of 2017 can be carried over to reimburse medical expenses incurred during the entire calendar year of 2018.
The carryover will not reduce your 2018 election. The carryover of up to $500 is in addition to the State’s plan limit of $2,550. You can carry over up to $500 of unused funds for a total of $3,050 to be used for calendar year 2018 expenses.
A great provision is that you do not have to enroll in the next year in order to use the $500 carryover. You do have to be employed in 2018, but you do not have to enroll in the health flex plan to use your carryover dollars.
Dependent Care FSA
The Dependent Care FSA reimburses you for qualified dependent care expenses necessary for you to work, or if you are married, for you and your spouse to work. Expenses eligible for reimbursement up to the annual maximum limit include:
- Care of dependent children under age 13
- Care of adult disabled dependents
Maximum Annual FSA Elections
The maximum annual Dependent Care FSA contribution is $5,000 per household ($2,500 if you are married and file a separate tax return).
The grace period for the Dependent Care FSA allows you to incur eligible expenses in the year after the plan year ends, through March 15 of the second year. For instance, if your 2017 Dependent Care FSA is $5,000 and you incur claims totaling $4,400 in 2017, you can incur claims for $600 from January 1, 2018 – March 15, 2018, and be reimbursed from your 2017 Dependent Care FSA.
Enrolling in Flexible Spending Accounts
You must enroll each year in IowaBenefits to participate in either or both of the Flexible Spending Accounts.
If you are currently enrolled and are enrolling for 2017, please check your existing deposit information in IowaBenefits for accuracy. The State of Iowa encourages you to “go green” by receiving reimbursements via direct deposit and paperless notifications from ASIFlex for the form to “go green.”
The year 2017 is not an open enrollment period for dental.
You cannot enroll, add any dependents, or cancel your coverage during this Enrollment and Change Period. You will have to wait until the next open enrollment period to make changes to your dental insurance.
The only exception is if you have a qualified life event that would allow you to add or remove dependents on your dental plan during 2017.
If you work at least 1,040 hours per year, you have the option to pay your share of health, dental, and supplemental term life insurance premiums with pretax* dollars. Participating in the Premium Conversion Plan helps you:
- Decrease taxes
- Increase net take-home pay
All employees are enrolled in the Premium Conversion Plan at the time they are hired. Unless you have previously opted out, your enrollment will carry into 2017.
If you do not wish to participate in 2017, complete the Premium Conversion (Pretax) Plan election form and forward it to your Human Resources Associate. You may not re-enroll until the 2018 Enrollment and Change Period, unless you have a qualifying life event.
|* The term pretax, for purposes of the Premium Conversion Plan, means "before federal, state and FICA taxes". Your pretax premium amount will reduce the amount of wages reported to social security. The effect on your social security benefit will be proportional to the amount of total pretax premiums you pay.|
If you have questions or need additional information about the 2017 Enrollment and Change Period:
- Contact your Human Resources Associate
- Attend one of the onsite meetings on the Capitol Complex or through a Benefit Education webcast
- Send an email to firstname.lastname@example.org
Your benefit package is a significant component of the total compensation you receive as a State of Iowa employee. Use the Enrollment and Change Period as an opportunity to review your benefits, so that the State’s benefits meet your needs and your family’s needs.