2018-2019 OpenEnrollment Dixie State University Look inside for an overview of your benefits and what’s new for the 2018-19 plan year. PROUDLY SERVING UTAH PUBLIC EMPLOYEES Introduction Dixie State Open Enrollment April 23-May 31 » This is the time to enroll in or make changes to your benefits and learn more about your options. How to Enroll in Benefits or Make Changes Online Log in to PEHP for Members at www.pehp.org. To create your 1 personal account, you’ll need your PEHP ID number and the last four digits of your Social Security number. Find your PEHP ID number on your benefits card, your EOBs, or call PEHP at 801-366-7555. From the PEHP for Members homepage, find “Online 2 Enrollment” under the “my Benefits” menu. Online Enrollment The Online Enrollment page shows benefits available to you 3 and your enrollment status. Click “Enroll” or “Change.” You may change your selections any time before the end of open enrollment (June 8). Enroll Change 03/28/18 PEHP » Open Enrollment Guide » Page 2 Introduction Enrollment Contents Timeline » Highlights of 2018-19 Plan Year. 4 April 23 » Health Plan Comparison ............. 5 » Your annual open enrollment period begins. It’s the time of » Medical Networks ..................... 6 year you may switch from one medical, » Rates . 7 dental, or vision plan to another. Take this time » Contact Information .................. 8 to review your choices and learn more about the PEHP benefits available to you. Enroll at www.pehp.org. May 18 » Benefit fair: 10a.m.- noon, Gardner Center Ballroom. May 31 » Deadline to enroll or make changes in medical, vision, or FLEX$. 2018-19 Dixie State Benefits Summary You may enroll in AD&D See more details benefits benefits at any time. available to you, including complete benefit grids, in the July 1 Dixie State University Benefits » New plan year begins. Summary. Access it in your Deductibles and Benefits Information Library at out-of-pocket PEHP for Members. Or send an maximums reset. email to [email protected] to request a printed copy. June 30, 2019 » 2018-19 plan year ends. PEHP » Open Enrollment Guide » Page 3 Introduction Highlights: 2018-19 Plan Year The STAR Plan Crisis & Life Assistance The STAR Plan provides a mathematically Counseling higher benefit level than the Traditional You have access to counseling services Plan. See page 5 to help determine which with Blomquist Hale Employee Assistance. plan is best for you. Crisis counseling is also available 24/7 and always confidential. PEHP pays 100% Traditional Plan Copays of the cost. Call 1-800-926-9619 for an Copays remain the same, but some appointment. services are at different copay levels to better reflect comparative costs. Invitro Fertilization Benefit Beginning July 1, 2018, Traditional and Use PEHP Cost Tools STAR Plan members have the option of You can now anticipate where your doctor using a one-time $4,000 benefit for invitro is likely to send your lab and how much it fertilization. Preauthorization is required. may cost. You can also get dollar ratings For more information, call 801-366-7755 or for hospitals and other facilities. Compare 800-753-7754. costs in the Provider Lookup when you log in to PEHP for Members. Looking for Lower Drug Costs? Search for coverage and pricing for Send Secure Messages to PEHP any medication available through your Have a question or can’t find what you’re drug benefit plan. Log in to PEHP for looking for online? Log in to PEHP for Members, go to MyBenefits and click on Members and send us your questions via Express Scripts Personal Account. You’ll the Message Center. From the homepage, see medication prices from different find “Messages” at the top-right. pharmacies. To get the best deal, make sure you use the PEHP Preferred Drug List. Health Benefit Advisors You can call us for help, 801-366-7551 or Need help deciding which plan to choose, 888-366-7551. whether to be covered by more than one plan, or different cost options for a service? Call a PEHP Health Benefit Advisor at 801- 366-7555. E-Care Consult a doctor remotely with Intermountain Connect Care. Available on all PEHP networks. See www. intermountainconnectcare.org for details. PEHP » Open Enrollment Guide » Page 4 Health Plans Plan Comparison Chart MEDICAL PLAN The STAR Plan Traditional (HSA-qualified) (non-HSA) Summary Start by paying medical bills with an HSA This plan has multiple co-pays and This brief comparison is for containing money your employer puts in. deductibles and is NOT eligible for an HSA. It illustrative purposes only. You can also put money in yourself, tax-free. pays benefits sooner with a lower deductible, See your Benefits You pay no premium for The STAR Plan, so but you’ll pay significantly more in premium. Summary for details. you’ll have extra money to save in your HSA. Pays many preventive care services This plan pays benefits when you reach your at 100%, but not as many as The STAR Plan deductible. Covers preventive care services covers. at 100%. All spending goes to the out-of- pocket maximum, protecting you from large bills. Your Rates $0 Single: $23.35 Amount you pay Double: $48.16 per pay period Family: $64.29 Employer Single: $38.00 Not applicable (not an HSA-qualified plan by Contribution Double and Family: $76.00 federal standards) Per Pay Period to Your HSA Medical Deductible $1,500 single plan $350 per individual $3,000 double or family plan $700 per family plan Pharmacy Pharmacy expenses apply to the medical Pharmacy expenses do not have Deductible deductible a deductible Out-of-Pocket Medical and Pharmacy: Medical and Pharmacy: Maximum $2,500 single plan $3,000 per individual $5,000 double plan $6,000 per double plan $7,500 family plan $9,000 per family plan Deductible does not apply to out-of-pocket maximum Benefits Pays covered benefits generally at 80% Pays covered benefits generally at 80% (using in-network providers, after deductible). (using in-network providers, after deductible). Eligibility No special eligibility requirements for the plan. No special eligibility requirements. However, you must meet certain requirements If you enroll in Traditional this year, you cannot to open an HSA and to contribute or receive enroll in Utah Basic Plus next open enrollment. contributions to it. Otherwise, your employer contribution will go into an HRA. Figures above based on Advantage & Summit Networks. For more details, see the 2018-2019 Dixie State University Benefits Sumary. Find it at www.pehp.org/openenrollment or email [email protected] PEHP » Open Enrollment Guide » Page 5 Medical Networks Summit Advantage Steward Health*, MountainStar, Intermountain Healthcare (IHC) and University of Utah Health Care providers and facilities. You can also providers and facilities. You can also see see Summit providers on the Advantage Advantage providers on the Summit network, but your benefits will pay less. network, but your benefits will pay less. Participating Hospitals Participating Hospitals Beaver County Salt Lake County (cont.) Beaver Valley Hospital The Orthopedic Specialty Hospital (TOSH) Beaver County Salt Lake County (cont.) Milford Valley Memorial Hospital LDS Hospital Beaver Valley Hospital Jordan Valley Hospital - West Box Elder County Primary Children’s Medical Center Milford Valley Memorial Hospital Lone Peak Hospital Bear River Valley Hospital Riverton Hospital Primary Children’s Medical Center Box Elder County San Juan County Riverton Children’s Unit Cache County Bear River Valley Hospital Blue Mountain Hospital St. Marks Hospital Logan Regional Hospital Brigham City Community Hospital San Juan Hospital Salt Lake Regional Medical Center Carbon County Cache County University of Utah Hospital Castleview Hospital Sanpete County Cache Valley Hospital University Orthopaedic Center Gunnison Valley Hospital Davis County Sanpete Valley Hospital Carbon County San Juan County Davis Hospital Castleview Hospital Blue Mountain Hospital Sevier County San Juan Hospital Duchesne County Sevier Valley Hospital Davis County Uintah Basin Medical Center Lakeview Hospital Sanpete County Summit County Davis Hospital Gunnison Valley Hospital Garfield County Park City Medical Center Sanpete Valley Hospital Garfield Memorial Hospital Duchesne County Tooele County Uintah Basin Medical Center Sevier County Grand County Mountain West Medical Center Sevier Valley Hospital Moab Regional Hospital Garfield County Uintah County Garfield Memorial Hospital Summit County Iron County Ashley Valley Medical Center Park City Medical Center Cedar City Hospital Grand County Utah County Moab Regional Hospital Tooele County Juab County American Fork Hospital Central Valley Medical Center Iron County Mountain West Medical Center Orem Community Hospital Cedar City Hospital Uintah County Kane County Utah Valley Hospital Kane County Hospital Juab County Ashley Valley Medical Center Wasatch County Central Valley Medical Center Utah County Millard County Heber Valley Medical Center Mountain View Hospital Delta Community Hospital Washington County Kane County Fillmore Community Hospital Kane County Hospital Timpanogos Regional Hospital Dixie Regional Medical Center Mountain Point Medical Center Salt Lake County Millard County Weber County Wasatch County Alta View Hospital McKay-Dee Hospital Delta Community Hospital Intermountain Medical Center Fillmore Community Hospital Heber Valley Medical Center Salt Lake County Washington County Huntsman Cancer Hospital Dixie Regional Medical Center Jordan Valley Hospital Weber County Ogden Regional Medical Center No-Pay Providers PEHP doesn’t pay for any services from certain providers, even if you have an out-of-network benefit. See List of No-Pay Providers at www.pehp.org. *Formerly IASIS PEHP » Open Enrollment Guide » Page 6 Rates HEALTH INSURANCE PREMIUMS for Fiscal Year 2018-2019 Below are premiums of the various health benefit options available to DSU benefit eligible employees. Plan summaries are available through the DSU Human Resources Office and on the DSU HR Employee Benefits webpage: http://humanresources.dixie.edu/employee-benefits/.