what if i forget to enroll in kehp
Page Content 1. When is Open Enrollment for plan year 2016? October 12-26, 2015 two. Do I have to enroll? Do you take to enroll? Yes, if yous want to: Do you accept to enroll? NO, if you lot: Alter your health insurance plan Elect or proceed the employer-funded General Purpose Waiver Wellness Reimbursement Arrangement (HRA) Elect a Healthcare FSA Elect a Dependent Care FSA Notation: If you did not complete your LivingWell Promise for 2015: You must enroll online and select either the Standard PPO or CDHP. If you do non, yous will exist automatically defaulted to the Standard CDHP, single coverage level for 2016. Want to continue your current health insurance plan option Currently accept and want to keep your employer-funded Waiver Dental/Vision HRA Are a KRS, KTRS, or Legislative/Judicial return-to-work retiree, under age 65 and want to keep your current health insurance plan with your active bureau 3. How exercise I enroll if I need to brand changes to my plan, elect the Waiver Full general Purpose HRA, or an FSA? Online KHRIS ESS: Active employees, KTRS retirees, JRP/LRP and KCTCS retirees may enroll online at openenrolllment.ky.gov. Paper Application: If yous are beginning or ending a cantankerous-reference payment option, adding a disabled dependent covered on your plan, or are a KRS retiree who needs to make changes to your plan, yous must complete a paper application and submit it through your insurance coordinator or 60 minutes department. Click here for more 2016 how to enroll details. Note: If you take the Waiver Full general Purpose HRA in 2015 and don't elect to waive coverage or elect a plan in 2016, y'all volition be automatically defaulted to the Standard CDHP, single coverage level for 2016. iv. Who do I call for assistance? Outside Frankfort 888-581-8834 844-402-KEHP (5347) 866-601-6934 877-430-5519 855-478-1623 855-869-2133 502-564-5310 859-256-3100 800-928-4646 502-696-8800 800-618-1687 502-848-8500 v. What are the Open up Enrollment customer service hours? Oct. 12-xvi/Monday - Friday: 8 a.k. to 6 p.m. ET six. When and where are the KEHP Benefit Fairs? Benefit fairs volition exist held at xiv locations from Oct. 1 through Oct. 20 with representatives available from KEHP, Anthem, CVS Caremark, WageWorks, HumanaVitality® and Vitals SmartShopper. Costless flu shots are available starting time-come, first-served ground at Franklin, Fayette and Jefferson canton do good fairs. All locations volition have online enrollment assistance available for active employees and KTRS retirees under age 65. Click hither for a complete list of do good fairs. 7. What plan option are bachelor? • LivingWell CDHP • LivingWell PPO • Standard CDHP • Standard PPO The LivingWell CDHP and the LivingWell PPO require the planholder to fulfill the LivingWell Promise 8. What changes tin can I make during Open Enrollment? You may enroll yourself and your children and/or spouse in a wellness plan or waive coverage. You may too enroll in a Healthcare or Dependent Care Flexible Spending Account (FSA). You tin also modify your tobacco use status. NOTE: You lot may not remove a dependent from your program if the kid is enrolled per an administrative order, including National Medical Support Orders. nine. Who can I encompass on my health plan? You may cover your legal spouse or dependent child under age 26. 10. Can children under age 26 exist covered as dependents on their parent's program if they are eligible for their own coverage (e.g., at another job)? Yes, KEHP has expanded dependent eligibility to include dependents under age 26 who may be eligible for wellness insurance coverage through their full-time employer. This includes children who are eligible for KEHP equally an employee. 11. Can disabled dependents be covered across age 26? A dependent child who is totally and permanently disabled may be covered by KEHP beyond the end of the month in which he/she turns 26, provided the disability (a) started before his/her 26th birthday and (b) is medically-certified in writing by a medico. A dependent child who is not already covered by KEHP at the time of his/her 26th birthday may not afterward be enrolled in KEHP on grounds of full and permanent disability unless and until he/she sustains a loss of other insurance coverage. In such a case, a request to enroll a dependent child in KEHP on grounds of total and permanent disability must be made no afterwards than 35 calendar days following the loss of other insurance coverage. Canticle volition make all dependent child disability determinations. If a dependent child is approved for coverage in KEHP on grounds of total and permanent disability, the planholder will periodically be required to produce written proof of the continuing nature(s) of the kid'due south dependency and/or disability in order to maintain the child'southward KEHP coverage. 12. Tin can I waive coverage and not elect a KEHP health program? Yep, yous may waive coverage. When waiving coverage, you take three options: • Waive coverage and elect the Waiver Health Reimbursement Account (HRA). With this option you will receive $175 per month upward to $2,100 annually to pay for qualified medical expenses. NOTE: This choice is not available to retirees. If y'all or your spouse or dependent is contributing funds to a Wellness Savings Account (HSA), you should consult a tax advisor prior to establishing an HRA or FSA. • Waive coverage and elect the Dental/Vision But HRA. With this option you volition receive $175 per month upwards to $2,100 annually to pay for qualified dental and vision only expenses. NOTE: This selection is not bachelor to retirees. • Waive coverage with no HRA. With this selection yous do not receive any employer funds. 13. What is the cross-reference payment option? The cross-reference payment choice is a legislatively mandated payment option that offers lower employee premiums which are deducted from both employees' paychecks. Employees must satisfy all requirements to elect the cross-reference payment pick. Requirements: • The employees must exist legally married with at least i eligible dependent; • The employees must be eligible employees or retirees* of a grouping participating in KEHP; • The employees must elect the same coverage option. Failure to meet any one of the higher up requirements will brand the employees ineligible for the cross-reference payment choice. *Per the Judicial and Legislators Retirement System, retirees of the Judicial Retirement Plan (JRP) and the Legislators' Retirement Plan (LRP) are not eligible to elect the cross-reference payment pick. xiv. May I drop a dependent from coverage in the middle of the plan year? Coverage may simply exist dropped during the annual open enrollment period or if a member has a qualifying event. A list of qualifying events is included on the KEHP Enrollment or Modify Coverage website one. What is a LivingWell Hope program? The two LivingWell programme options available in 2016 are a function of KEHP's overall wellness program. By completing the steps of the LivingWell Hope, you can brainstorm to: • Access the best benefit options; • Larn about your wellness status and history; • Larn about and empathise your health risks; and • Take action to get and stay salubrious. 2. What are the LivingWell Promise requirements for 2016? The LivingWell plans are very popular and keeping the Hope is piece of cake – more than 97% of planholders completed the LivingWell Promise in 2015! Electing or keeping a LivingWell Promise plan in 2016 means you are required to complete either the HumanaVitality Wellness Assessment (HA) or Vitality Check biometric screening from January ane, 2016 through May 1, 2016. Both screenings only have a few minutes to consummate and give you a improve agreement of your wellness status, access to the best benefit plan options, and information to help you lot stay good for you. If you accept a cross-reference payment option, you lot and your spouse both must complete the HA or the Vitality Cheque biometric screening. If you elect a LivingWell plan selection for 2016 and do not complete the LivingWell Hope, you lot will merely be eligible for the Standard plan options in 2017. If you are unable to fulfill the LivingWell Promise considering of a physical or mental health status, KEHP will work with y'all to develop an culling way to qualify for either LivingWell program choice. 3. If I am a new employee and choose a LivingWell programme afterwards open enrollment, how long practise I have to consummate the LivingWell Hope? New employees who elect a LivingWell plan after open enrollment must complete the Wellness Assessment within xc days of the effective date of their coverage. 4. What is the HumanaVitality® Wellness Cess? More than 137,000 KEHP planholders have already taken their HumanaVitality Health Assessment (HA) as part of their 2016 LivingWell Promise! The Health Assessment (HA) is a series of questions about your current concrete and mental well-beingness, your day-to-day lifestyle, and how you experience about your current health levels. It takes well-nigh ten-xv minutes and will tell you your Vitality Age. Visit LivingWell.ky.gov and click on the HumanaVitality login. First time users Click on "Annals Now" and complete the required fields. You will be issued a HumanaVitality ID card and you volition enter the number found on your HumanaVitality ID bill of fare or enter your social security number. Check the box agreeing to the terms, and click "Continue." Verify the fellow member found is you lot. Create a username and password. After completing the registration process, return to HumanaVitality to sign in using the username and password you lot just created. Returning users Sign in using your username and countersign. Subsequently yous sign in, click on the alert to "Take the Health Cess" or await for the "Health Assessment" link under the "Get Healthy" tab. If you know your medical history and key measurements, take them ready to help y'all complete your HA. If you don't have your cardinal measurements, don't worry, y'all'll still be able to consummate the HA. If you had a Vitality Check (biometric screening) within the last xviii months, you volition see those results have pre-populated into your HA. The results cannot be updated until a new Vitality Check is submitted. To observe a Vitality Cheque location near you lot, visit LivingWell.ky.gov. Receive your Vitality Historic period based on your HA responses. HumanaVitality volition then recommend goals. If you choose, y'all may select goals and discover activities that will allow you to commit to a healthier lifestyle, improve your Vitality Age, and earn Vitality Points™ and rewards along the way. five. What is a Vitality Check (biometric screening)? A Vitality Check is a biometric screening that consists of: lab work to test your cholesterol and claret glucose; a blood pressure bank check; elevation, weight and waist circumference to learn your Body Mass Index (BMI). For more than accurate results, fast for at least nine hours prior to the exam. You volition earn 400 Vitality Points for taking each test (cholesterol, blood glucose, blood pressure). Y'all'll earn more HumanaVitality points for completing a Vitality Check than y'all will by taking only a Health Assessment. If you lot choose, you may take both and earn more points! A Vitality Cheque will requite y'all more than authentic and recent results to apply when populating your Health Assessment. And in plough, you will have a more accurate Vitality Historic period. 6. Where can I get a Vitality Check (biometeric screening)? i. At a KEHP scheduled, select, onsite location-to be announced at a later on date. No cost to the member. 2. Through the local health department No toll to the fellow member. iii. At a retail dispensary (eastward.thou. Kroger Petty Dispensary, Walgreens, Have Care Clinics, Concentra) Go to livingwell.ky.gov Click on the Get a Vitality Check box Cull from the locations listed Print the associated Vitality Check voucher Present the voucher and your HumanaVitality ID card at the retail clinic No price to the member. The retail dispensary location will submit your results to HumanaVitality. 4. At your primary care physician (PCP) Go to livingwell.ky.gov Click on the Get a Vitality Check box Click on the "primary care physician" tab Print a copy of the "PCP Vitality Check Voucher."; Fax the completed course to HumanaVitality at one-877-250-7814 or postal service to P.O. Box 14613, Lexington KY 40512-4613. Preventive Services are at no cost to the member if an in-network provider is used; all the same, there may exist a charge if the provider submits the merits other than as preventive. 7. Who must complete the LivingWell Promise? Merely the planholder is required to complete the LivingWell Promise. Non-employee spouses and dependents covered under your plan will not exist required to complete the Health Cess. If you have the cantankerous-reference payment option, both y'all and your spouse must complete the Health Assessment. eight. Are spouses or adult children (age 18 and up) required to fulfill the LivingWell Promise? No. Only you lot, the planholder, are required to complete the LivingWell Promise. The only exception to this requirement is if you have elected a cantankerous-reference payment selection, in which instance both planholders must fulfill the Promise. ix. When exercise I accept to take the Health Assessment? If you brand the LivingWell Promise during Open up Enrollment you lot must take your Wellness Assessment between January one, 2016 and May one, 2016. New employees who elect a LivingWell plan option after Open up Enrollment must complete the Health Cess within 90 days of the effective date of their coverage. x. What happens with the information nerveless through the Health Assessment? KEHP takes your personal health data seriously and has measures in place to protect this information. All responses to your HA are strictly confidential and protected under HIPAA. KEHP volition not collect, or admission, or retain your personal health information, nor will KEHP share your personal health data with your employer. But HumanaVitality volition have access to and be able to view your HA responses. KEHP may receive amass information from HumanaVitality that does not identify any private in order to design and offer wellness programs aimed at improving the health of KEHP members. xi. Is the data collected through the Health Assessment protected? Yes. KEHP takes your personal wellness information seriously and has measures in place to protect this data. All responses to your HA are strictly confidential and protected under HIPAA. KEHP will non collect, or admission, or retain your personal wellness information, nor will KEHP share your personal health data with your employer. But HumanaVitality volition take access to and be able to view your HA responses. KEHP may receive aggregate information from HumanaVitality that does not identify whatsoever private in social club to design and offering health programs aimed at improving the health of KEHP members. 12. Tin I take the Health Assessment or VitalityCheck biometric screening if I don't cull a LivingWell program? Yes, if you participate in one of the four health program options, yous are automatically enrolled in HumanaVitality®. One time you log in and activate your account you begin earning Vitality Points toward picture tickets, hotel stays, and other advantage. You can too take the Health Assessment which gives you your Vitality Historic period and helps you prepare goals for a healthy lifestyle. 13. If I tin can't take the Health Assessment due to medical or mental health weather, can I still choose a LivingWell plan? Yep, if it is unreasonably difficult because of a medical or mental health status for you to consummate the Wellness Assessment you as well have the option of completing the Vitality Check (biometric screening). If it is unreasonably difficult for yous to consummate either one, call client service at 855-478-1623, and we will piece of work with you to develop an alternative solution. 14. If I do not fulfill the LivingWell Promise, will my wellness insurance claims still be paid? Yes. The program will continue to pay eligible claims for the plan year, fifty-fifty if you practise not fulfill the LivingWell Promise. All the same, you will non be able to elect a LivingWell programme selection for 2017 if you practise not fulfill your 2016 LivingWell Promise. The Standard plans will still exist available to you. 15. What happens if I fail to complete the LivingWell Promise from Jan ane through May 1, 2016? If you elect a LivingWell plan choice and neglect to fulfill the LivingWell Promise, you lot will non be eligible to participate in the LivingWell Promise and cull a LivingWell program selection for the next program year (2017). Stated another way, if you fail to fulfill the LivingWell Promise, you will only be eligible for the Standard plan options the next plan year. 16. If I choose a LivingWell plan selection and take the Health Assessment or VitalityCheck may I change my plan option mid-year? Mid-twelvemonth plan changes tin only be made if yous experience a life outcome referred to equally a qualifying event. If you experience a qualifying event that allows you to change your plan, you lot can elect another LivingWell programme option or a Standard plan selection. If you take the Health Assessment or VitalityCheck from January 1 through May 1, 2016, and consummate your original LivingWell Promise, you tin enroll in a LivingWell program option for 2017. If you experience a qualifying upshot during the 2016 plan yr and elect a LivingWell program option for the outset time as a result of the qualifying event y'all have 90 days from the effective date of the LivingWell plan to complete the LivingWell Hope. The primary rule for completion of the LivingWell Promise is that the first, or original, election of the LivingWell plan option is the controlling factor for whether you are eligible for a LivingWell programme choice the following plan year. If you modify plans during the 2016 plan year, whether that modify is because of retirement, a qualifying event or a break in service, the starting time, or original, ballot of the LivingWell programme follows yous throughout the plan year. The same rule would apply to newly eligible members. For example, at open enrollment you elect a LivingWell programme option. You experience a qualifying effect in June and change to a Standard program option. Your election of the LivingWell plan option, and whether yous completed your LivingWell Promise, will exist tracked regardless of the mid-year change to a Standard plan pick. If you did not complete the LivingWell Promise from Jan. 1 through May 1, 2016, you will not be eligible for a LivingWell plan option for 2017. 17. How does the LivingWell Promise utilize to new hires eligible for KEHP coverage? New employees who elect a LivingWell plan option after Open up Enrollment must consummate the Health Assessment within xc days of the effective date of their coverage. 18. How does electing a LivingWell plan selection for 2016 and making the LivingWell Promise impact my program selections for future years? Please review the following for specific information: What happens if I terminate employment and am hired at some other KEHP participating agency three months later? The get-go/original election of a LivingWell program option will follow yous throughout the program year. The first/original election of a plan requiring the LivingWell Promise is the decision-making element. Y'all don't have to complete the promise twice in the outcome of a qualifying result, termination, re-hire, etc. What happens if I elect a LivingWell program option at Open Enrollment, fulfill the LivingWell Promise, then retire or take a qualifying consequence in 2016 and go on with my LivingWell plan – do I take to fulfill the LivingWell Promise again to exist eligible for a LivingWell programme in 2017? Because you completed the LivingWell Promise with your commencement/original election of a LivingWell programme selection in 2016, you are eligible for a LivingWell plan option in 2017. You lot practice not have to take the Health Assessment once more in the same program year to meet the LivingWell Hope requirement. Would I be able to elect a LivingWell programme choice during Open Enrollment, NOT fulfill my LivingWell Promise from January ane through May 1, then retire (or accept a qualifying event) after May i, 2016 and go on to elect a LivingWell plan option when I retire? Aye. Despite not completing the Health Assessment, you lot could elect a LivingWell plan option upon retirement or with a qualifying outcome, during the same plan year. The fact that you didn't consummate the Health Cess or VitalityCheck will effect in losing the ability to elect a LivingWell plan option and only having Standard plan options in 2017. Once again, the first/original election requiring the LivingWell Hope was not fulfilled and impacts the next programme twelvemonth. Would I be able to elect the LivingWell plan option during Open Enrollment, retire or have qualifying event, and change to a Standard program at retirement and and so elect a LivingWell program option the side by side plan yr? Yes. So long as you fulfilled the hope from the original LivingWell plan election you would be able to choose from all plan options in 2017. Switching to a Standard program pick mid-year wouldn't penalize you lot for 2017. xix. If I didn't choose a LivingWell program option for 2015, will I exist able to choose a LivingWell plan pick in 2016? Yeah. If you selected a Standard plan option in 2015 yous will be able to select a Standard or LivingWell program selection for 2016. The LivingWell plan options besides require a LivingWell Hope in 2016. 20. If I don't choose a LivingWell programme pick for 2016, will I be able to choose a LivingWell program option in 2017? Yep. If yous select a Standard program option in 2016 you will be able to select a Standard or LivingWell programme option for 2017. The LivingWell programme options also crave a LivingWell Promise in 2017. 21. If I chose a LivingWell plan option but failed to fulfill the LivingWell Promise in 2015, and accept to have a Standard (non-LivingWell) plan option in 2016, when is the next time I can enroll in a LivingWell Promise plan selection? If you exercise not fulfill the LivingWell Promise, y'all must wait one full plan year before you lot are eligible to enroll in a LivingWell plan option again. As a result, if yous did non fulfill the LivingWell Promise in 2015, you would not be eligible for a LivingWell plan option until plan yr 2017. 22. If I elect a LivingWell plan option and concord to the LivingWell Promise, am I required to participate if I'm contacted past a nurse with ane of the Anthem Personal Wellness Nurse Programs? No, electing a LivingWell plan option only requires yous to complete the HumanaVitality® Wellness Assessment or the Vitality Cheque (biometric screening). All the same, the Personal Health Nurse Programs are free to KEHP members and provide valuable services such equally personalized support for reaching healthy living goals or managing complex medical weather . i. How practise the medical and pharmacy benefits work for the 2016? Click on the program name to run across specific information for each programme. • LivingWell CDHP • LivingWell PPO • Standard PPO • Standard CDHP 2. What is a Consumer Driven Wellness Plan (CDHP)? CDHPs put you, the consumer, in more than command of managing your healthcare expenses. CDHPs feature lower premiums and include an employer-funded, pre-loaded Wellness Reimbursement Business relationship (HRA) to help reduce your deductible and maximum out-of-pocket expenses. With a higher deductible, the employer-funded HRA, and lower co-insurance amounts, a CDHP engages members in their healthcare decisions and makes them more enlightened of the toll and utilization of healthcare services. Like a PPO, members in a CDHP have flexibility when choosing healthcare from in-network providers and members must pay more for healthcare from out-of-network providers. Unused dollars in the HRA can accrue year to yr if a member continues to elect a CDHP. iii. What is a Preferred Provider System Plan (PPO)? PPOs are a blazon of insurance plan with which nigh people are familiar. Ordinarily PPOs have college premiums, low deductibles and require yous to pay co-pays and co-insurance. The insurance program is responsible for the remainder. In addition, PPOs let flexibility when choosing healthcare from in-network providers and members must pay more for healthcare from out-of-network providers. four. What is a deductible? A deductible is the amount you have to pay out-of-pocket before the plan begins to pay expenses. Deductibles are generally calculated per agenda year and most plans have individual and family unit deductible amounts. 5. What is co-insurance? Co-insurance refers to a shared payment betwixt the health plan and yous, described in percentages (e.chiliad. 80%/20%). 6. What is out-of-pocket maximum? This is the virtually money in a plan yr that you lot can expect to pay for covered medical and pharmacy services. 7. What is a co-pay? A co-pay is your portion of the toll for a wellness care service (due east.g. You may pay $25 per office visit or $ten to go a prescription filled.) Your insurance plan pays the difference. 1. What is a Health Reimbursement Business relationship (HRA)? An HRA is an employer-funded account that you can use to encompass qualified expenses. The KEHP has multiple types of HRAs: embedded HRAs that are part of the CDHP plan options; and a Waiver General Purpose (health) HRA and a Waiver Dental/Vision But HRA that can be selected when you choose to waive your health coverage. HRA funds can roll over to the side by side calendar year, equally long as you proceed to elect the same type of HRA; i.east. CDHP to CDHP, Waiver General Purpose HRA to Waiver Full general Purpose HRA or Waiver Dental/Vision Only HRA to Waiver Dental/Vision Merely HRA. Funds in the LivingWell CDHP HRA, Standard CDHP HRA, and the Waiver (wellness) HRA tin can exist used to pay for: • Medical and prescription deductibles, co-payments and co-insurance • Sure dental fees such equally cleanings, fillings and crowns • Orthodontic treatment • Vision fees including contacts, eyeglasses and laser vision correction • Medical supplies such as wheelchairs, crutches and walkers NOTE: If you utilize your CDHP HRA funds for dental and vision expenses, these funds will not utilize to your deductible and out-of-pocket maximum. Funds in the Waiver Dental/Vision Only HRA can exist used to pay for: • Certain dental fees such as cleanings, fillings and crowns • Orthodontic treatment • Vision fees including contacts, eyeglasses and laser vision correction NOTES: a. Retirees are non eligible for either Waiver HRA or the Dental/Vision Only HRA. b. If you lot or your spouse or dependent is contributing funds to a Health Savings Account (HSA), you should consult a tax advisor prior to establishing an HRA or FSA. two. What is a Flexible Spending Account (FSA)? FSAs let you set money aside from your paycheck before taxes to pay for certain healthcare and dependent intendance (kid or adult mean solar day intendance services) expenses. This results in y'all paying less income and Social Security taxes. Starting in 2015, you can behave over up to $500 of unused funds in your Healthcare FSA to the next calendar year. Note: If you lot take an FSA and carry over funds into a subsequent plan twelvemonth, you will non be eligible to participate in a Health Savings Account (HSA) in the subsequent plan yr. You volition be ineligible to participate in an HSA fifty-fifty if yous do non elect an FSA for the subsequent plan year and even later your FSA deport over funds are spent. You should consult a tax advisor for more information on how an FSA and the FSA comport over impacts your eligibility to participate in an HSA. iii. What is a Healthcare Flexible Spending Account (FSA)? A Healthcare FSA is an account funded by y'all for healthcare services such as prescription co-payments, deductibles, and doctor's office co-payments with pre-tax money. The amount you contribute will exist payroll deducted. Make certain to set aside simply as much as you will use during the electric current calendar year – you tin can bear over up to $500 of unused funds in your Healthcare FSA to the next calendar year, but anything above that will exist forfeited. You can use your FSA for family members who are considered a tax dependent. The 2016 limit for contributions to a Healthcare FSA is $2,500 per employee. FSA funds tin can be used to pay for: • Medical and prescription co-payments and co-insurance • Certain dental fees such every bit cleanings, fillings and crowns • Orthodontic handling • Vision fees including contacts, eyeglasses and laser vision correction • Medical supplies such as wheelchairs, crutches and walkers 4. What is a Dependent Care Flexible Spending Account (FSA)? A Dependent Care FSA allows you to pay for dependent care expenses such as a daycare or after-school programs for dependents upwards to age 13, or an adult day care. The maximum that you can contribute per year is based on your tax filing status: $5,000 for married, filing a joint render; $five,000 filing as head-of-household; or $ii,500 married, filing separate returns. Brand sure to set aside just as much as you will employ. You can use the money simply for eligible expenses paid for during the current agenda twelvemonth. Call up: Use information technology or lose it. 5. How do I receive reimbursement for my HRA or FSA business relationship? WageWorks offers a variety of methods to pay for and verify your eligible expenses. Swipe and Go: Utilise your WageWorks Healthcare Card, a convenient payment method tied to WageWorks healthcare FSA and HRAs to make healthcare purchases at the doctor'due south office, pharmacy, optician, dentist, and other healthcare providers. You tin not utilize the WageWorks Healthcare Card with Dependent Care FSA services. Online: Reimbursement forms are readily available online. Yous tin can upload your receipt directly to your account. When accessing your account online, yous can besides setup the Pay My Provider service to pay many of your eligible healthcare and dependent care expenses directly from your spending account (similar to online cyberbanking). Mobile App: WageWorks offers a mobile app that allows you to take a flick of your claim receipt or Explanation of Benefits (EOB) and send it to your WageWorks online business relationship. They will use the receipt to validate any receipts needing verification. The mobile app enables y'all to log in to your account and bank check your balances, submit claims, snap photos of receipts, get alerts by text or email — all on the go! Fax/Mail: You can also impress the needed forms from the WageWorks website and submit via fax or mail. Claims Administrator P.O. Box 14053, Lexington, KY 40512 Fax 877-353-9236 half-dozen. What is substantiation? Substantiation is required past the IRS to verify that an HRA or FSA merits is an eligible expense. If y'all accept a health insurance plan with KEHP, as well has a Healthcare FSA, so most of your HRA or FSA expenses paid with WageWorks Healthcare Card will exist verified through Anthem'due south medical claims system. If yous cull a Waiver HRA, your primary health insurance program is non through KEHP. Y'all will need to go along your receipts and submit them for your expenses, even if yous use your WageWorks Healthcare Bill of fare. You tin can submit receipts and verify expenses online or use the EZ Receipts Mobile App. seven. Who is eligible for an FSA? Employees of state agencies, schools boards, and certain quasi-agencies are eligible. Contact your insurance coordinator or Hr section for details. 8. Can I take an HRA and a Healthcare FSA? Yeah, you can elect both. Because HRAs are employer-funded and FSAs are employee-funded, you could choose to have both to cover your out-of-pocket expenses. For example, you elect the LivingWell CDHP, family coverage level, and accept $ane,000 in an employer-funded HRA that tin be used toward your deductible. You could also elect to have $i,500 of your money added to a Healthcare FSA and use those pre-tax dollars to help meet your deductible or to apply for vision and dental expenses. nine. How long do I have to spend FSA and/or HRA money? FSA and/or HRA funds may merely be used to pay for eligible expenses incurred during the coverage plan yr. All the same, y'all have until March 31, 2017 to submit reimbursement requests for HRA expenses incurred during your 2014 coverage period. 1. Who is eligible for the Waiver HRA? • Any active employee of a state agency, school lath, or certain quasi-agencies who is eligible for state-sponsored wellness insurance coverage (see new requirements below) • A retiree who has returned to work Testament of other group health plan coverage required NOTE: Due to changes in federal police force, since 2015, employees who are eligible to waive KEHP health insurance coverage and choose a Waiver (general purpose) HRA may do so only if the employee has other group health plan coverage that provides minimum value and the employee declares, in writing, that the employee has such other coverage. Delight refer to the questions and answers below for more information on whether you are eligible to waive KEHP wellness insurance coverage for 2016 and enroll in a Waiver (general purpose) HRA. What is "other grouping health programme" coverage? "Grouping wellness plan coverage" means coverage under a plan (including a self-insured program) maintained by an employer (including a self-employed person) or labor union to provide health care for current or onetime employees or their families. Group wellness plan coverage does non include Medicaid, KCHIP, TRICARE, Medicare, veteran's health coverage, Peace Corp coverage, any other governmental insurance plan, student policies, state high risk pool coverage, or private market coverage, including individual coverage purchased through the Kentucky Wellness Benefit Exchange (kynect). What is "minimum value"? A group health plan provides "minimum value" if the plan pays at least threescore% of the total allowed cost of covered benefits/services and participants or members in the program are required to pay no more than 40% of the total allowed price of covered benefits/services. What is the divergence between a Waiver (full general purpose) HRA and a Waiver Dental/Vision Only HRA? A Waiver (general purpose) HRA will reimburse the employee or the employee's dependents for sure medical expenses such as medical and prescription drug deductibles, co-payments and co-insurance, certain dental and vision services, and medical supplies. The Waiver Dental/Vision Merely HRA will reimburse the employee or the employee's dependents only for expenses related to vision and dental services. Am I eligible to choose a Waiver (general purpose) HRA if I waive KEHP health insurance coverage? An employee who is eligible for a Waiver HRA may choose a Waiver (general purpose) HRA just if (1) the employee has other group health programme coverage that provides minimum value, and (2) the employee attests or signs a proclamation that the employee has other group health plan coverage. How do I know if my other group health program coverage provides minimum value? The employer or the sponsor of the other group wellness program coverage can tell you if the group health plan provides minimum value. What happens if I lose my other grouping health plan coverage during the year? If an employee elects a Waiver (general purpose) HRA and ceases to be covered nether another group health plan that provides minimum value, the employee must notify KEHP within 35 days after the date that the other grouping health programme coverage ends. In this outcome, coverage under the Waiver (general purpose) HRA will be terminated and the employee may elect a KEHP health insurance plan option or the Waiver Dental/Vision But HRA. Any funds remaining in the Waiver (general purpose) HRA after termination may be used to reimburse the employee for eligible expenses incurred prior to termination of the Waiver (general purpose) HRA. The employee is permitted to permanently opt out of and waive future reimbursements from the Waiver HRA at least annually at open enrollment. What happens if I cull a Waiver (general purpose) HRA but do non have other group wellness program coverage that provides minimum value? You are not eligible for coverage nether a Waiver (general purpose) HRA unless you declare, in writing, that yous have other group health plan coverage that provides minimum value. If KEHP determines that you have fabricated a false certification, your coverage nether the Waiver (full general purpose) HRA volition be revoked. Why must the Waiver (general purpose) HRA exist integrated with other "grouping health programme" coverage? The changes regarding the Waiver (general purpose) HRA are the issue of changes in federal law. The Waiver (full general purpose) HRA is considered a "grouping health plan" but it does not comply with certain federal law requirements for group health plans. For instance, the Waiver (full general purpose) HRA does not provide preventive care at zero price sharing for members. Also, the Waiver (general purpose) HRA does not comply with the prohibition against annual limits equally it is express to $2,100 per year. For these reasons, federal law requires the Waiver (general purpose) HRA to exist coupled with other "grouping wellness plan" coverage that meets all the requirements for wellness plans imposed past the federal government. This ensures that individuals have the necessary coverage to comply with the federal individual health insurance mandate. Why isn't TRICARE considered other "group health plan" coverage? The federal police force requiring the upcoming changes for individuals receiving TRICARE benefits with regard to HRA eligibility begins with guidance issued September xiii, 2013, collectively past the US Department of Labor, the US Department of Treasury, and the Us Department of Health and Humana Services. As indicated by the guidance, an HRA, like the Commonwealth'south Waiver (general purpose) HRA, must exist integrated with other group health plan coverage and that coverage must provide minimum value. In order to elect the Waiver (general purpose) HRA, the employee must exist "actually enrolled in a group health plan that provides minimum value." The term "group wellness plan" is specifically defined by federal law. With respect to a "group health plan," the following definition applies: 26 USC 5000(b)(1) - The term "grouping health programme" means a plan (including a self-insured program) of, or contributed to by, an employer (including a cocky-employed person) or employee organization to provide health care (straight or otherwise) to the employees, quondam employees, the employer, others associated or formerly associated with the employer in a business concern human relationship, or their families. TRICARE is a government-sponsored plan and is not an employer-sponsored or employee organization (due east.chiliad. union) – sponsored programme. Equally such, persons with TRICARE are not able to attest or declare that they are enrolled in a "group health plan" that provides minimum value. Can I cull a Waiver Dental/Vision Only HRA if I practice not have other group wellness plan coverage that provides minimum value? Yes. Y'all may waive KEHP health insurance coverage and choose a Waiver Dental/Vision ONLY HRA even if yous do non accept other group health plan coverage that provides minimum value. Y'all are not required to sign a written proclamation if you waive KEHP health insurance coverage and cull a Waiver Dental/Vision Just HRA. You should deport in mind, even so, that you might owe a taxation penalty if you lot do non maintain minimum essential health coverage. 2. Who is not eligible for the Waiver HRA? If you are a fellow member of an agency that does not participate in KEHP's HRA/FSA programme, a retiree, or a retiree under age 65 who has gone back to work and elected coverage under the retirement arrangement, and then you are not eligible for the Waiver HRA. NOTE: If you or your spouse or dependent is contributing funds to a Health Savings Account (HSA), you should consult a taxation counselor prior to establishing an HRA. 3. Who is eligible for the Waiver Dental/Vision Only HRA? Whatsoever active employee of a land bureau, school board or sure quasi-agencies who is eligible for state-sponsored wellness insurance coverage may waive wellness insurance and enroll in the Waiver Dental/Vision But HRA. Retirees who have returned to piece of work and who are over age 65 may also waive health insurance and enroll in the Waiver Dental/Vision Only HRA. 4. Who is non eligible for the Waiver Dental/Vision Only HRA? If you are a fellow member of an agency that does not participate in KEHP's HRA/FSA programme, a retiree, or a retiree under historic period 65 who has gone back to work and elected coverage under the retirement organisation, then you are not eligible for the Waiver Dental/Vision Only HRA. 1. What is the non-tobacco user discount? The Democracy of Kentucky is committed to fostering and promoting wellness and health in the workforce. Every bit role of the KEHP wellness program, incentives are available for members who do not utilise tobacco products, including monthly premium discounts for non-tobacco users. You, the main planholder, are eligible for the monthly non-tobacco user rates if you certify that neither you nor any other person to be covered under your plan has regularly used tobacco within the past six months. Certification of tobacco employ or non-use is accomplished past completing a Tobacco Use Proclamation Course as part of your application for wellness insurance coverage through KEHP. Specifically, the question on the Tobacco Use Proclamation Form asks: "Inside the past six months, have you, or a spouse or dependent to be covered under your insurance plan, used tobacco regularly? Yes No." 2. What does "used tobacco regularly" mean? "Regularly" ways you (or a spouse or dependent 18 years of age or older) has used tobacco 4 or more times per week on boilerplate excluding religious or ceremonial uses. 3. What is considered tobacco? "Tobacco" means all tobacco products including, merely not limited to, cigarettes, pipes, chewing tobacco, snuff, dip, and any other tobacco products regardless of the frequency or method of use. Electronic cigarettes are non considered a form of tobacco. 4. Who is considered a dependent for the Tobacco Use Proclamation? "Dependent" ways, for the purpose of the Tobacco Use Announcement, only those dependents who are 18 years of historic period or older and covered nether your program. five. When can I qualify for the monthly insurance premium discounts for not-tobacco users? All KEHP members or prospective KEHP members have the opportunity to qualify for the monthly premium discounts for non-tobacco users upon application (new hires) for insurance coverage through KEHP and once each year at open up enrollment (ongoing employees). 6. Can I modify the tobacco use status during the program year if I stop smoking? Yes, provided all persons covered under your programme are not-tobacco users. KEHP Planholders certifying that there is a tobacco user covered under the Planholder'southward insurance program will be eligible for monthly discounted premium contribution rates provided all persons covered under the plan cease using tobacco products regularly (iv or more times per week on boilerplate) during the plan yr. In social club to authorize for the monthly discounted premium contribution rates, the Planholder must sign a Tobacco Utilise Change Class certifying that neither the Planholder nor the Planholder's spouse/dependent(s) regularly used tobacco products during the half-dozen months prior to completion of the Tobacco Use Declaration Form. To the extent available, proof of completion of a tobacco cessation program or other proof of not-tobacco apply will be required (i.e. proof of successful completion of the Cooper-Clayton Smoking Abeyance program). The monthly discounted premium contribution rates will be applicable on the first of the month following the signature appointment on the Tobacco Use Alter Form. See the Answer to Question #10 for more information on the tobacco cessations programs offered through KEHP. 7. What is the Tobacco Utilise Change Form? The Tobacco Use Change Form is a form used to advise KEHP of whatever changes in Members' tobacco use status that occur during the programme year. A member refers to each person covered under a KEHP insurance plan including employees and retirees and their spouses and dependents. Click this link to admission the Tobacco Employ Declaration Form. viii. What happens if I do not accurately declare the tobacco use for persons covered under my KEHP plan? KEHP planholders who do not accurately declare the tobacco utilize for persons covered under their insurance plan will be required to pay the difference between the tobacco-user and the non-tobacco-user premium contribution rates on a retroactive basis for the menses during which the planholder falsely certified eligibility for the non-tobacco-user monthly discounted premium contribution rates. nine. How tin can I get help to quit using tobacco? KEHP has programs available to help yous quit using tobacco such as the Cooper Clayton Smoking Cessation plan or the Kentucky Tobacco Quit line. Through these programs, KEHP members tin can get over-the-counter Nicotine Replacement Therapy, without any cost (beginning 1/one/2014), for the life of the program. After the plan is complete, members can continue to receive over-the-counter Nicotine Replacement Therapy without any cost if prescribed past a physician. In addition to the Cooper Clayton and the Quit Line programs, KEHP also offers a coaching program that volition assist the member with designing a personal plan to decrease dependency on tobacco products and manage withdrawal and cravings that accompany tobacco use cessation. 10. What are the alternative standards available for those who are unable to meet the not-tobacco utilize standard? Members who request a reasonable alternative standard must complete the HumanaVitality® Wellness Assessment and enroll in the HumanaHealth Coaching program. Through HumanaHealth Coaching, the member is assigned a "coach" that volition assist with designing a personal plan to decrease dependency on tobacco products and manage withdrawal and cravings that accompany tobacco employ cessation. The coach will support the member as they go through the steps of ceasing to employ tobacco. When the member completes their HumanaVitality® Wellness Assessment, they will be given a goal and will take access to the HumanaHealth Coaching program. Members who are unable to satisfy or have completed the Health Assessment and Health Coaching alternative standard volition be required to enroll in either the Cooper-Clayton smoking cessation plan or the Kentucky Tobacco Quit Line plan. Members who are unable to satisfy the Cooper-Clayton or Kentucky'south Tobacco Quit Line alternatives must contact DEI for other reasonable alternatives such as the assignment of a personal nurse for support, advice, and information regarding smoking cessation. To the extent feasible and to the extent the member'southward physician has joined in the request for a reasonable alternative standard, KEHP volition provide the member an opportunity to comply with the recommendations of the personal medico equally a reasonable alternative standard to coming together the non-tobacco apply standard. In whatsoever event, each member seeking a reasonable alternative standard must complete the HumanaVitality® Wellness Assessment. KEHP will work with you (and, if you wish, with your medico) to discover a wellness program with the aforementioned monthly reward that is right for you in light of your wellness status. 1. How do I enroll through KHRIS ESS? If you lot are an active employee, a KTRS retiree, or a KCTCS retiree, you can become to khris.ky.gov to log in and enroll for benefits. Click here for a quick KHRIS ESS guide. two. What is my KHRIS user ID? Your KHRIS user ID is a six-character identification provided to y'all in the KEHP Open Enrollment packet you should receive in late September. If you do not know your KHRIS ID, you can call back it by clicking "Forgot KHRIS User ID?" on the KHRIS login folio at khris.ky.gov iii. How do I find my password? You can go to khris.ky.gov and follow these steps: • Click the "Forgot/Reset Countersign or New User" link. • Enter your KHRIS user ID and click "Validate." For security purposes, you must provide the post-obit information: Last Proper name, Zip Code, Date of Nascence, and Social Security Number. Click "Cosign." If your data has been validated, a temporary countersign displays. Write this down or copy information technology. • Click "Exit." Back at the main page khris.ky.gov, type your KHRIS user ID and temporary password. • Click "Log On." You volition now be prompted to change the temporary countersign. Type your temporary password created to a higher place, create a new password, and confirm your new countersign by typing it again. Click "Change." iv. I'thou having trouble with KHRIS ESS later on I accept logged into the site. What practise I need to practice? Y'all can review the KHRIS technical requirements and make any necessary changes. Keep in mind these tips for accessing the Open Enrollment portion of KHRIS ESS: • If your resolution is below 1280 10 960, some items may not fir on the screen • Information technology is not recommended for mobile devices (iPads, tablets, phones etc.) • Install the most recent version of Adobe Reader to correctly view/display forms • Delight disable all pop-up blockers • Please utilise the logout button at the top correct to fully logout before closing the browser window with the X one. Where can I learn more near KEHP'southward health and wellness programs? Get to LivingWell.ky.gov to acquire more than about the many programs offered through KEHP. You lot tin can access information on HumanaVitality®, Health Coaching, Healthy Kids, Mental and Stress Management, Nurse Back up, Quitting Tobacco, Weight Direction, Worksite Wellness and other programs. 2.What is HumanaVitality®? HumanaVitality® is KEHP's incentivized wellness program that allows you to earn points for rewards such equally movie tickets, hotel stays, sports equipment and other items. Get to LivingWell.ky.gov for more details. 1. What is the "Market"? In an effort to give individuals access to affordable, comprehensive health insurance coverage, the ACA established the Health Benefit Substitution or the "Marketplace." The Market place offers i-stop-shopping for health insurance coverage. Through the Market place, individuals can shop, compare, and utilise for coverage. They can also apply for premium tax credits that can be used to reduce the cost of coverage. 2. Is at that place a Market in Kentucky? Yes. Each state has a Market. In Kentucky, the Market is called kynect. 3. How can I contact kynect? You may visit kynect for more than data or contact kynect by phone at 1-855-4kynect. 4. Will employees eligible for coverage through KEHP be eligible for premium revenue enhancement credits through the Marketplace? No. If an employee has an offer of health coverage from their employer that meets certain affordability and minimum value standards, the employee will not be eligible for a taxation credit through the Marketplace. KEHP will ensure that program(s) available for participating groups will meet the affordability and the minimum value tests. It is probable that not all plans offered through KEHP volition meet the test for every employee, but at least one plan that meets both tests will be available for every employee. No employer action is required to ensure the coverage offered through KEHP meets the affordability and minimum value tests, provided the employer does not make whatsoever changes to the employer or employee contributions established past KEHP. If an employer group participating in KEHP offers employer or employee contributions different than those established by KEHP, the employer will need to carry its ain analysis to decide if the minimum essential coverage is affordable. 5. As a KEHP member, are my dependents or spouse eligible for a premium tax credits through the Marketplace? No. If an employee has an offering of health coverage from their employer that meets certain affordability and minimum value standards, the employee's dependents or spouse volition not exist eligible for a premium revenue enhancement credit through the Marketplace. half-dozen. Can I waive health insurance and buy coverage from the Market place? Yes. However, if an employee has an offer of health coverage through KEHP from their employer, the employee will not be eligible for a tax credit through the Market place. Also, the employer premium contribution equally well as the employee's premium contribution is excluded from income for federal and country income revenue enhancement purposes. Payments for coverage through the Marketplace are made on an afterward-tax ground. Additionally, if you determine to waive KEHP coverage and purchase coverage through the Market, you may not be eligible to enroll in the General Purpose Waiver HRA. In gild to enroll in the Full general Purpose Waiver HRA, an employee must be enrolled in a group wellness program that provides minimum value. Individual insurance coverage purchased through kynect is not "grouping health plan" coverage. For more information on your eligibility to enroll in the General Purpose Waiver HRA, please see the FAQs nether "Waiving Health Insurance Coverage." 7. What is preventive care and what is covered nether the preventive care benefits? Preventive care helps you stay healthy - it includes almanac exams for children and adults, immunizations, and screenings such equally mammograms and colonoscopies. In 2016, all iv KEHP health plans will provide members with extensive preventive intendance benefits. Coverage for children's preventive wellness services will include autism screening, blood pressure level screening, developmental screening, hearing and vision screening, immunization vaccines, and many other tests and screenings. For women, preventive services will include contraception, breastfeeding supplies and counseling, well-woman visits, breast cancer mammography screening, and many other tests, counseling, and screening services. For adults, preventive services include cholesterol screening, diabetes screening, depression screening, immunizations, obesity screening, diet counseling, and many other tests and preventive services. For a total listing of preventive services covered under the KEHP plans in 2016, delight click here eight. Will I take to pay a co-payment, co-insurance, or deductible for preventive care? No, in 2016, preventive care will be paid for under all four KEHP wellness program options without any fellow member cost sharing. That means KEHP members will be able to get preventive care without paying a co-payment, co-insurance, or a deductible for those services. To take advantage of the preventive care without cost-sharing, in-network providers must provide the preventive services.2016 Enrollment Often Asked Questions
Full general Open Enrollment and Eligibility Questions
KEHP Open up Enrollment Hotline
In Frankfort 502-564-6534
The KEHP telephone message will prompt you to choose from one of the following
three options:
Choice i
KHRIS User ID, password, computer & technical assistance
Option 2
Do good questions for Canticle, CVS or WageWorks
Option 3
KEHP Member Services and Eligibility
** Telephone service at these numbers is merely valid Oct. 12-26, 2015. Wellness Insurance Benefits
Canticle Customer Service
Prescription Benefits
CVS/caremark Customer Service
FSA & HRA Benefits
WageWorks
Health Data
HumanaVitality
Shopper Discounts
Vitals SmartShopper
LRP & JRP Retiree Questions KCTCS Retiree Questions KRS Retiree Questions
kyret.ky.gov KTRS Retiree Questions
ktrs.ky.gov
Oct. 17 Saturday: 8 a.k. to one p.k. ET
October. xix-23/Monday - Friday: viii a.thou. to 8 p.1000. ET
October. 24 Saturday: 8 a.g. to 1 p.m. ET
Oct. 26/Mon: viii a.m. to 6 p.m. ETLivingWell Hope
Location Cost
The Vitality location volition submit the results to HumanaVitality.
The health department will submit the results to HumanaVitality.
Plan Information
Health Reimbursement and Flexible Spending Accounts
Waiving Wellness Insurance Coverage
Tobacco Employ
KHRIS ESS - Online Enrollment/Employee Self Service
KEHP Health and Health Programs
Affordable Care Human activity, kynect, Preventive Care and other Questions
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Source: https://personnel.ky.gov/Pages/OEFAQs.aspx