IMPORTANT: Engagement Incentive to receive County-funded Health Reimbursement Account (HRA) or Health Savings Account (HSA)
Annual preventive services, (provided at no cost in-network), play a key factor in early detection of chronic and life threatening diseases, yet less than 50% of
our enrolled members received a preventive screening last year. To reverse this trend, the County is implementing an Engagement Incentive for 2015. The Engagement
Incentive is to receive the County-funding for your HRA or HSA account in January 2015. All you, and your enrolled spouse/ domestic partner, have to do is receive
a designated preventive screening or complete the HumanaVitality criteria below. Eligible screenings include an annual physical, well-woman exam, mammogram,
prostate exam or colonoscopy.
Employees with verified engagement in 2014 will have their HRA or HSA account funded on 01/09/15. Employees with verified engagement in 2015 will have their HRA
or HSA account funded on the pay period following receipt of verification by Employee Benefit Services.
HumanaVitality wellness program participation:
Enroll in HumanaVitality online wellness program; Complete the HumanaVitality Health Assessment online; and Complete the HumanaVitality finger
stick screening; OR
Complete and submit a 2015 Engagement Incentive Affidavit indicating when you had your preventive screening in 2014. Information will be verified
by a Humana on-site representative; OR
Have your physician complete a 2015 Engagement Incentive Affidavit at time of service and submit to Employee Benefit Services.
Health Plan Premium Increases
The CDH High and CDH Out of Network plans will have a premium increase in 2015. The High Deductible Health Plan (HDHP) and CDH Low will remain the same with no
increase. See the Open Enrollment newsletter for details.
Pharmacy Plan Changes
Our self-insured pharmacy costs have increased from $10.3 million in 2012 to an estimated $13.8 million in 2015. While costs have significantly increased, member
share has gone down from 11% to 7%.
Pharmacy copays for CDH plans increase for first time since 2006
Members in the CDH health plans will incur an increase in copays (HDHP plan subject to deductible and coinsurance):
30/90 Day Supply
30/90 Day Supply
30/90 Day Supply
30 Day Supply Only
||$25 or $40
Dispense As Written (DAW1) prescribed by physician
As the cost of brand drugs has continued to increase, many employers have eliminated or required the member to pay the difference between brand and generic costs
when a generic is available, even when prescribed by the physician as “dispense as written” (also known as DAW1). Rather than eliminate this option or make it
cost prohibitive, the County has created a separate DAW1 tier of coverage for such situations. Accordingly, if your physician prescribes a brand drug with DAW1, you
will have a higher copay of $75 for 30 days and $150 for 90 days in 2015. (Note: if the cost of the drug is less than $75/$150, you will pay the lower cost.)
New Third Party Administrator (TPA) for administration of HRA, HSA and FSA accounts.
Effective January 1, 2015, PayFlex Services USA, Inc. will replace WageWorks as our TPA for administration of all of our reimbursement accounts. For HRA and HSA
accounts, end of year account balances will be transferred to PayFlex. For FSA accounts, employees will have until March 31, 2015 to submit claims for expenses
incurred in 2014.
New coordination rule for FSA and HRA accounts
Effective January 1, 2015, the County is standardizing our coordination of payment rules for employees enrolled in both a Flexible Spending Account (FSA)-Medical
Expense and HRA account. ALL health, pharmacy, dental and vision expenses will be paid out of the FSA-Medical Expense first, and when exhausted, ALL health,
pharmacy, dental and vision expenses will be paid out of the HRA. Not only will this alleviate the confusion of which account pays first, it opens the HRA up to
dental and vision expenses.
New Vendor for Personal Income Protection Plans
Allstate Benefits, Inc. will be replacing AFLAC for Personal Income Protection Plans (Accident, Cancer, Critical Care and Hospitalization). Current AFLAC members
may continue coverage at the same rates through Direct Bill with AFLAC. More details will be distributed during open enrollment.
We recommend attending one of the scheduled presentations or vendor fairs to learn more about the changes for 2015. Schedules and detailed information are
available 24/7 at broward.org/benefits – Open Enrollment 2015.