2019 Benefits Open Enrollment

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Your annual benefits open enrollment is Nov. 1-16. It’s time to review your benefits and choose what's best for you! You will be able to enroll in and make changes to your benefits through My Total Access

A Note About My Total Access          

To better protect your personal information, My Total Access is now only available through the Carilion network or apps portal (apps.CarilionClinic.org). If you need to make benefits elections outside of a Carilion facility, work with your manager to get access to the site.

You are encouraged to complete the Open Enrollment checklist using a Carilion computer, in case technical support is needed.

We've highlighted important information, including changes and reminders, below to help you complete your benefits enrollment successfully.

Benefits Changes

Medical Plan

  • Premiums: We are excited to share that base premium costs for medical, dental, pharmacy and life insurance plans are staying the same for 2019. This is the fourth year in a row that most base premiums have not changed! Premiums for the medical plan are based on your hourly rate as of Sept. 28. If your hourly rate changed between Oct. 27, 2017 and Sept. 28, 2018, you may be in a new premium tier. Check the contribution summary to see what tier will apply to you..
  • Medical out-of-pocket costs: Health care costs continue to rise and to adjust to the rising costs, we've made changes to some out-of-pocket costs. It is important to understand your out-of-pocket costs for medical services and what choices you have for seeking care. Refer to the Medical Plan Summary for a summary of medical and pharmacy out-of-pocket costs. Here is a list of specific changes for 2019:
    • Specialist copay will increase from $40 to $50 per visit
    • Level A Urgent Care copay will increase from $20 to $30 per visit
    • Level B coinsurance will increase from 30 to 40 percent
    • The out-of-pocket max for Level B will increase to $5500 individual/$11,000 family
    • The out-of-pocket max for Level C will increase to $8500 individual/$17,000 family

Flexible Spending Account

The Dependent Care FSA maximum for 2019 is $5,000 per year and $2700 for the Health Care FSA. If you would like to participate in an FSA in 2019, be sure to enroll or re-enroll during benefits open enrollment. The FSA benefit does not roll over from year to year.

Life Insurance

Benefit-eligible employees will be able to enroll their Carilion-employed spouse or domestic partner in life insurance. If you elect life insurance on your Carilion-employed spouse or domestic partner, you will be automatically approved up to the guaranteed issued amount of $50,000 when enrolling in the benefit during open enrollment. Any request over $50,000 will need to go through the underwriting process.

More Important Information

Working Spouse/Domestic Partner Premium

The working spouse/domestic partner premium will remain $50 per pay period. That means if your spouse or domestic partner is eligible for other group medical coverage and you choose to cover them under our medical plan, then there will be a $50 premium applied to your pre-tax deductions each pay period.

You will not pay the premium if your spouse or domestic partner is:

  • Not employed or is self-employed
  • Employed by Carilion Clinic and is also eligible for medical coverage as an employee
  • Retired
  • Covered under a private policy, COBRA, Medicare or Tricare
  • Not offered coverage through his or her employer, or is not eligible for coverage offered by his or her employer

If you are covering your spouse or domestic partner on our medical plan, you will need to verify that they do not have access to other group medical coverage by completing the Working Spouse/Domestic Partner Premium Employee Statement/Request for Waiver Form to determine if the premium qualifies to be waived.

 Note: If you were approved for the working spouse premium waiver in 2018, you do not need to complete another waiver in 2019, unless your spouse or domestic partner’s coverage options have changed.

If you are covering your spouse or domestic partner on our medical plan and they have access to other group medical coverage, you will not complete the form, but the premium will be applied each pay period.
The chart below shows examples of when you will or will not need to pay the premium and if a waiver form will need to be completed.

Your spouse or domestic partner…

Working Spouse/Domestic Partner Premium Applies

Request for Waiver Form Needed

Is unemployed or retired and does not have access to other group medical coverage

No

No

Is self-employed and does not have access to other group medical coverage

No

No

Is eligible for coverage in the Carilion Clinic medical plan as an employee, but you choose to cover both of you

No

Yes

Is not offered medical coverage through her employer

No

Yes

Is not covered under your plan and has her own coverage

No

No

Is employed and has access to group medical coverage through her employer, but you choose to cover her under the Carilion Clinic plan

Yes

No

Request for Waiver Form

You must return the Request for Waiver form to HR by Nov. 30 for the premium to be waived or applied by Jan.1, 2019. The completed form can be:

For verification purposes, we reserve the right to request documentation verifying the benefits eligibility of a covered spouse/domestic partner throughout the year.

Visit the Working Spouse/Domestic Partner page for more information

Tobacco-Free Incentive

  • We continue to focus on wellness and improving our own health as well as the health of our communities. Once again, we will offer a $50 per pay period incentive in 2019.
  • You can qualify for the incentive if you and the people you cover on your medical plan do not use tobacco. You may also qualify if you take steps to quit using tobacco products or provide a doctor's note. Visit the tobacco-free page for more information.

Affordable Care Act

  • The Affordable Care Act requires us to provide information to the IRS about employees who are offered health care coverage. To help with the reporting requirements, all employees who are offered health care coverage by Carilion need to either enroll or be listed as “waiving coverage.” If you are eligible for health care coverage and take no action to enroll in or select waive coverage during benefits enrollment, your coverage will be shown as "waived" and will be reflected on your confirmation statement. This will not enroll you in a plan and is only for reporting purposes.
  • Due to reporting requirements as of 2015 under the Affordable Care Act (ACA), we are required to collect Social Security Numbers on all dependents covered by the Carilion Clinic medical plan. This information is used by the IRS to verify individual's coverage and administer any applicable tax credits for the Marketplace plans. When completing the Open Enrollment Checklist through My Total Access you will be asked to provide Social Security Numbers for your covered dependents. Please be sure to have this information accessible when completing the checklist.
  • If the Social Security Number(s) is not provided for the covered dependents during Open Enrollment, you will be contacted to collect this information. If you previously provided this information, it will not be necessary to provide it again.
  • Effective Jan. 1, 2019 the Mental Health Parity and Addiction Equity Act will take effect. Some mental health and substance abuse services rendered outside an office visit will be covered at 100 percent starting Jan. 1. The behavioral health services that fall into this category are:
    • ABA
    • Partial hospitalization program (PHP)
    • Intensive outpatient programs (IOP)
    • Applied behavior analysis (ABA) for the treatment of autism spectrum disorder (when covered)
    • Home health care
    • Transcranial magnetic stimulation
    • Electroconvulsive therapy (ECT)
    • Outpatient monitoring of injectable therapy
    • Psychological testing
    • Neuropsychology testing
    • Outpatient detoxification
    • Ambulatory detoxification
    • 23-hour observation

Reminders

  • If you would like to participate in an FSA in 2019, be sure to enroll or re-enroll during benefits open enrollment. Your elections from last year do not carry over.
  • While you're reviewing your benefits in My Total Access, update your home address, beneficiaries, phone numbers, etc. We don't want you to miss important information we send out.
  • We require social security numbers when you are enrolling your dependents.
  • Use the 2019 open enrollment checklist in My Total Access to complete your benefits enrollment, sign up for direct deposit and acknowledge important reminders about your savings plans.
  • Please use a Carilion computer that is connected to the network when updating your benefits. If you have access to the apps.carilionclinic.org site, you may access My Total Access through that site to enroll in benefits. Please contact TSG at 540-224-1599 or 800-354-1599, if you need technical assistance accessing My Total Access.
  • Submit all documentation to Human Resources by Nov. 30.

 The details regarding benefits changes are outlined in a Benefits Changes Flyer. You can use this flyer when making choices regarding your benefits for 2019. You may also view the 2019 Benefits Open Enrollment Presentation on Cornerstone on Demand for more information.

 

Resources
Downloads
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2019 Employee Contribution Summary
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2019 Employee Contribution Summary
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2019 Physician Contrbution Summary
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2019 Physician Contribution Summary
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2019 Medical Resident Contribution Summary
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2019 Medical Resident Contribution Summary
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2019 Medical Plan Summary
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2019 Medical Plan Summary
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2019 Medical Plan Summary Out-of-Area Plan
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2019 Medical Plan Summary Out-of-Area Plan
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Working Spouse/Domestic Partner Premium FAQs
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Working Spouse/Domestic Partner Premium FAQs
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Working Spouse/Domestic Partner Premium Employee Statement/Request for Waiver Form
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Working Spouse/Domestic Partner Premium Employee Statement/Request for Waiver Form
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2019 Benefits Changes Flyer
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2019 Benefits Changes Flyer
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2019 Summary of Benefits and Coverage: Carilion Clinic Medical Plan
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2019 Summary of Benefits and Coverage
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2019 Summary of Benefits Coverage: Out-of-Area Carilion Clinic Medical Plan
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2019 Summary of Benefits Coverage: Out-of-Area Carilion Clinic Medical Plan
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2019 Health Care Flexible Spending Account Tool
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Tool to help calculate how much to elect for FSA funds.
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2019 Dependent Care Flexible Spending Account Tool
Description
Tool to help calculate how much to elect in DFSA for the year.
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