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Open Enrollment FAQs


FAQs by category:

 

 

 

Also, see the Retirement, Long-Term Disability and Life Insurance pages for information about those benefits, which you can make changes to anytime, including during Open Enrollment.

Visit the Benefits home page for additional FAQs.

About Open Enrollment

Open Enrollment is your annual opportunity to update or choose the benefit options that best meet your needs for 2019.

Fully benefits-eligible faculty/staff can use My VU Benefits to elect, make changes to, or waive:

  • Health, dental and vision insurance
  • Accidental death & dismemberment (AD&D) insurance
  • A 2019 health care flexible spending account (HC-FSA), a pre-tax spending account that reimburses medical expenses for you and your eligible dependents, available to you if you enroll in the Select PPO
  • A 2019 dependent care flex spending account (DC-FSA), a pre-tax spending account that reimburses certain childcare and other dependent care service expenses for your eligible dependents
  • A Health Savings Account (HSA), a tax-advantaged savings account allows you to save for and reimburse yourself for qualified medical expenses, available to you if you enroll in the CDHP

Partially benefits-eligible faculty/staff can use My VU Benefits to elect, or waive:

  • Health plan coverage in the Choice CDHP with HSA for 2019

October 17-31, 2018. Enrollment for the 2019 plan year begins at 8 a.m. on October 17 and ends at 11:59 p.m. on October 31.  Extensions beyond that time are not permitted. 

All fully benefits-eligible faculty and staff must make an active health plan election during October Open Enrollment for 2019 coverage. Employees will not automatically default into their current plan if no action is taken.

In addition to making new elections, you can also:

  • Attest to working spouse coverage - If you carry coverage for your spouse who has access to health insurance through another employer—including Vanderbilt University Medical Center (VUMC)—you’ll pay a spousal fee of $100 per month
  • Attest to whether you and your covered family members use tobacco. -- you’ll save $20 per month on premiums if you and your covered family members are committed to being tobacco-free
  • Confirm/add/remove your eligible dependents and your beneficiaries
  • Add eligible family members as dependents in your My VU Benefits profile if you wish to enroll (or remain enrolled) in the family coverage of AD&D insurance

After the plan year starts on Jan. 1, 2019, you can only make coverage changes if you have a qualifying life event (as defined under federal regulations). Consider your choices carefully; changes and corrections are not permitted except during Open Enrollment or within 30 days of a qualifying event (like getting married or having a baby).

  • For 2019, fully benefits-eligible faculty/staff may choose from two health plans: the Select PPO (Preferred Provider Organization) and the Choice CDHP (Consumer-Driven Health Plan). While the two plans are quite different, they share several important common features, like:

  • Both plans will use the existing Tier 1 VHAN (Vanderbilt Health Affiliated Network) and Tier 2 Aetna provider networks
  • Preventive care is covered at 100 percent 
  • Monthly premium for both plans will be based on a three-tier salary band structure established in 2018 – premiums are adjusted for salary level, and higher-paid employees have higher premiums

 

Partially benefits-eligible faculty/staff may enroll in the Choice CDHP, or may waive coverage

Fully and partially benefits-eligible faculty and staff members who waived coverage in 2018 will continue to be waived for 2019 unless they make an election during Open Enrollment. Partially benefits-eligible employees may enroll only in the Choice CDHP or waive coverage.

To compare the two plans, view the Plan Comparison chart here

  • Fully benefits-eligible faculty/staff can make changes to certain benefit programs anytime, including during Open Enrollment. These include:
    • Health Savings Account (HSA) -- if you enroll in the CDHP
      • You can increase or decrease your voluntary contribution amounts during the year through My VU Benefits
      • You can change how your HSA funds are invested, and make beneficiary changes through Fidelity NetBenefits®
    • Supplemental life insurance (through My VU Benefits)
    • Long-term disability insurance (through My VU Benefits)
    • Short-term disability insurance (staff only, through My VU Benefits)
    • Retirement plan contributions and investments (through Fidelity NetBenefits®)
    • Discounted pet, auto and home insurance, directly through the providers
  • Partially benefits-eligible faculty/staff can elect, or make changes to:
    • Retirement plan contributions and investments, anytime (through Fidelity NetBenefits®)
    • Discounted pet, auto and home insurance anytime through the providers.
Benefit What you'll have in 2019 if you don't act during Open Enrollment
Health Plan 

 

  • Aetna Choice CDHP – the health care plan with the lowest premiums, at the same coverage tier you have now (e.g., individual, family), with the ability to establish an HSA account
  • You miss out on a $20/month credit toward premiums if you and your covered family members are committed to being tobacco-free
  • You pay a $100/month spousal coverage fee, if your spouse is on the Vanderbilt Health Plan. If your spouse does not have access to another employer’s health plan, or works for Vanderbilt University, you must elect this every year to avoid the fee.
Dental Plan*

You'll have the same coverage at the same tier you have in 2018

Vision Plan* You'll have the same coverage at the same tier you have in 2018

Flexible Spending Accounts*

No money will be deposited in your health care and/or dependent care flexible spending accounts unless you re-enroll every year
Accidental Death & Dismemberment*

The same coverage you have in 2018

*fully benefits-eligible staff only.

Elections for health care, dental and vision insurance, accidental death & dismemberment (AD&D) insurance, health care and dependent care flexible spending accounts (FSAs), are effective January 1, 2019.

Changes made to other benefits may become effective within one or two pay periods following your submission. Please read your enrollment and confirmation statements carefully for the correct effective date.

No. After October 31, 2018 (the end of the Open Enrollment window for 2019), you cannot change your 2019 health election, unless you experience a new “qualifying life event” (such as getting married or having a baby). Consider your choices carefully; changes and corrections are not permitted except during Open Enrollment or within 30 days of a qualifying life event.

For the benefits that are only open for changes during the Open Enrollment window, you can only make changes at any other time of year if you experience a qualifying event, such as getting married or having a baby. Note that you may be audited and required to document your qualifying event – and there are limitations to allowable changes. See the Family Status Change website for more information.

Your child(ren) by birth, marriage or adoption – through age 25 -- can be covered by your health, dental and vision plan, regardless of their access to other health insurance coverage. However, under IRS regulations, a parent’s HSA funds cannot be used to reimburse for a child’s health expenses unless the child is claimed as a dependent on the parent’s tax return.

Yes. Vanderbilt’s benefits plans run on a calendar year (not the fiscal year or academic year). And the plan options in 2019 are different than those that were in place in 2018. So -- even if you have been recently hired, and just elected a health plan -- you will need to make an active healthcare plan election for your 2019 coverage.

Yes. When you enroll, indicate in My VU Benefits that you want to waive healthcare coverage. If you are a fully benefits-eligible employee and you don't waive, you will default into the Choice CDHP.  If you are a partially benefits eligible employee, you will default to waived coverage.

In addition to the loss of health care coverage, you will lose prescription drug coverage and you will not be able to use your Go for the Gold wellness credit for your Vanderbilt Health Plan account, or have it applied toward a membership to the Vanderbilt Recreation and Wellness Center in 2019.

Even if you want to continue to waive in 2019, you still need to sign in to My VU Benefits to review your other benefit elections and to check your Life Insurance and AD&D beneficiaries. Due to Affordable Care Act (ACA) requirements, all employees should verify their legal names & Social Security numbers (their own and their dependents) appear correctly in Vanderbilt’s systems, even if they are not covered in VU’s health plan. The information in HR Systems must match what is listed on Social Security cards.

Benefits are tied to your Annual Salary. There are three salary bands upon which health payroll premiums are based.

  • Band A : $0 - $59,999.99
  • Band B : $60,000.00 - $149,999.99
  • Band C : $150,000.00+
  • Employees with a remaining fund balance after Dec 31 will have those funds placed in a Limited Purpose Health Reimbursement Account (LP-HRA) administered by WageWorks via Fidelity Investments. Depending on the fund balance, you will have a specified period of time to use any remaining funds. If you still have funds in that account at the end of 2018, you will receive an email early in 2019 confirming the remaining fund amounts and how long you have to use the funds.
  • Once transferred, LP-HRA funds can ONLY be used for unreimbursed dental and vision expenses. Funds cannot be used for any other healthcare/medical expense reimbursements.
  • If a staff or faculty member leaves employment at Vanderbilt University, any unused LP-HRA funds will be forfeited.
  • You are encouraged to use all of your available funds before the end of 2018 if possible. To check your current fund balance, log into Aetna’s website (www.aetna.com). Under Coverage & Costs, click on HealthFund HRA.

You may be using an unsupported version of Internet Explorer or other browser. My VU Benefits may not function correctly in Internet Explorer 9 or an earlier version. Try logging into the system in Internet Explorer 10 or higher, Google Chrome, or Mozilla Firefox. If you aren’t able to upgrade or access one of these browsers, come to the Human Resources office, located on the 10th floor of the Baker Building, or an enrollment lab for assistance. For details about locations and times, visit our Event Calendar.

You can make changes to your elections in My VU Benefits as many times as you want during the open enrollment window, as long as you have your final elections in by 11:59 p.m. on Oct.31. Keep in mind that your elections are saved as you go through each step of the process, even if you do not click all the way through to the confirmation page. Your most recent elections are saved as you go – and will replace any previous elections, even if you do not get the way to the confirmation page.

To help employees make informed decisions for themselves and their families, Vanderbilt offers the following additional tools and resources:

  • PLANSelect,” an online decision-support guide, available on the Open Enrollment website (vu.edu/oe). By entering personal scenarios, the tool estimates what your costs and relative plan values might look like under each of the two plans.
  • A comparative plan design chart
  • 2019 health care monthly premiums
  • Benefits Open House - Wednesday, Oct. 24 | 10 a.m. - 4 p.m. | Baker Building, 10th floor
    • Talk with benefit providers and learn more about your options
    • Boost your well-being by finding out the latest from the University's health, wellness, and retirement providers
    • Complete your Open Enrollment at a Benefits Enrollment Lab
  • Open Enrollment Labs – view the calendar here.

Employees can use any computer with Internet access to enroll. If an employee would like help with online enrollment, they are welcome to come to an Enrollment Lab or visit the Human Resources office. Computers will be available for their use, and VU HR staff members will help them through the enrollment process. Please make sure they know their VUnetID and password - and that the ID and passwords are active - before they come to an Enrollment Lab or Human Resources.

Speak with the VU HR Benefits Office before leaving the country, in order to make alternate arrangements. 

If you or a family member is eligible for coverage under COBRA provisions, COBRA enrollment is at the end of November 2018 (exact dates yet to come). Call the Benefit Express Customer Care Center at 877-837-5017 if you do not receive your enrollment form.

COBRA enrollment is at the end of November 2018 (exact dates yet to come). Call the Benefit Express Customer Care Center at 877-837-5017 if you do not receive your enrollment form.

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General Health Plan Questions

You can if your doctor is in the VHAN (Tier 1) or Aetna (Tier 2) provider networks. The plan covers both in- and out-of-network care. Just remember that services from providers outside of the VHAN network will likely cost more, so check to see if your doctor is the plan’s network.

Go to Aetna’s DocFind website. You will see two network options: 1) Vanderbilt Health Affiliated Network will include providers that are in Tier 1, such as Vanderbilt Medical Group. This is the preferred in-network tier, with the best benefit. 2) Aetna National Network will include facilities, physicians that are in Tier 2. If you use a Tier 2 provider, you will see cost savings – but not at the same level as a Tier 1 provider. If your doctor is not listed on the DocFind website, he or she will be considered out-of-network, or Tier 3, and your costs may be higher than Tier 1 or Tier 2 providers

In most cases, the Vanderbilt Health Plan will pay first. If you need further assistance, please contact Aetna Member Services at 800-743-0910.
Aetna offers overseas coverage. However, Aetna requires that you pay the provider and then submit a claim form to Aetna. Foreign emergency/urgent care claims are paid at the Tier 2 or Aetna in-network level of coverage (not at the Tier 1 Vanderbilt Health Affiliated Network level). Foreign non-emergency claims are paid at Tier 3 (out-of-network). Aetna representatives will be at the Benefits Open House and can further explain how overseas coverage works. Also see the FAQs for AD&D coverage.

Yes, the Vanderbilt Health Plan covers eligible DME claims, and there are several providers in the Tier 1 network. To locate a Tier 1 DME provider, go to the Aetna DocFind website.

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Choice CDHP with Health Savings Account (HSA)

Choice CDHP features:

  • Lower monthly premiums, with higher deductibles than the Select PPO plan
  • Once the deductible is met, the Choice CDHP provides 80% co-insurance (employee pays 20 %) until the out-of-pocket maximum is reached. Upon reaching out-of-pocket maximums, the plan pays 100 % of qualified expenses (including pharmacy costs) for the remainder of the plan year.
  • 100 % of qualified expenses (including pharmacy prescriptions) are paid by the employee until the deductible is met. Once the deductible is met, the employee will pay 20% co-insurance until the employee out-of-pocket maximum is reached. At that point, the Choice CDHP plan pays 100% of qualified expenses for the remainder of the plan year.
  • Paired with a Health Savings Account (HSA) – an investment account into which the IRS allows contributions (from all sources) of up to a maximum of $3,500 for individuals; $7,000 for families in 2019
    • For 2019, Vanderbilt will make a contribution into each full-time, benefits-eligible faculty and staff member’s HSA. Vanderbilt will contribute $750 for those with single coverage ($375 in January and $375 in July), and $1500 for those with family coverage ($750 in January and $750 in July). Vanderbilt’s contribution counts toward the IRS maximum.
    • Those 55 or older may make an additional $1,000 annual contribution to the HSA
    • Funds that the employee and Vanderbilt contribute to the HSA roll over from year to year if they are not used, and may be used tax-free for qualified medical expenses (as defined by the IRS, see “Medical and Dental Expenses”), either in the same year or in the future
    • HSA funds are “triple-tax advantaged”, meaning any money put into the HSA account is contributed on a pre-tax basis, any earnings on the investments are not taxed, and any funds withdrawn for qualified medical expenses are not taxed. The HSA is an account owned by the employee, and the employee may choose to use HSA funds in the current plan year or roll the account balance forward to let it grow – even into retirement. If an employee leaves Vanderbilt, the HSA goes with them.
      • A child may be covered by a parent’s health care plan per Affordable Care Act (ACA) regulations through age 25, regardless of whether the child is a dependent for tax purposes; however, a parent’s HSA funds cannot be used to reimburse for a child’s health expenses unless the child is claimed as a dependent on the parent’s tax return
      • Note: If an employee is Medicare-eligible, still working, and enrolls in Social Security, they will be automatically enrolled in Medicare Part A. Neither Vanderbilt nor employee can contribute to the HSA after enrolling in any part of Medicare (Part A, B, C or D). For more information, visit the Social Security website.
      • Employees who enroll in the Choice CDHP with the HSA cannot also enroll in a health care Flexible Spending Account (dual enrollment is prohibited by the IRS, since both are tax-advantaged accounts).

A HSA-qualified Consumer Driven Health Plan is a health plan that meets the requirements as specified and published annually by the U.S. Treasury Department.

  • The plan is required to have an annual deductible of at least a specified minimum. The IRS sets the minimum deductibles for employee-only coverage and family coverage. All medical and prescription expenses must be subject to the annual deductible, with the exception of preventative care, which may be covered at 100% with no deductible.
  • Your annual out-of-pocket expenses – such as deductibles, copayments, and other expenses may not exceed IRS maximums for out-of-pocket expenses. The out-of-pocket limit does not include premiums or amounts incurred for non-covered benefits (such as amounts in excess of usual, customary, and reasonable amounts, and financial penalties).

No.  Consumer Driven Health Plans offer high quality care from experienced health care professionals, including generalists and specialists.  The new Choice CDHP gives you access to both Tier 1 VHAN (Vanderbilt Health Affiliated Network) providers and Tier 2 Aetna network providers, just like the Select PPO does.

The deductible for the Choice CDHP is higher than the Select PPO, but, there are important things to consider about the Choice CDHP:

  • CDHPs like Vanderbilt’s are defined specifically as “high deductible” health plans.  The minimum deductible levels are set by the IRS, and Vanderbilt’s CDHP will follow those federal guidelines.    
  • In-Network Preventive Care is covered 100%
  • Unlike the PPO, the CDHP can have an accompanying Health Savings Account (HSA), into which you and your employer can make contributions.  You’ll be able to save that money for the future, or use the money in your HSA to pay for eligible health care expenses, which helps offset the deductible.
  • In 2019, Vanderbilt University will make contributions to your HSA, once in January and again in July. 
  • Our health coverage negotiates favorable rates with in-network service providers. These costs are lower than if you went out-of-network or didn’t have health coverage.
  • Before you reach the deductible, you’ll pay the full negotiated rate for those services, unless it is for In-Network Preventive Care (which is covered at 100% even if you have not yet met the deductible).
  • Once you reach the deductible, co-insurance kicks in. Then you’ll only pay a percentage of the costs.
  • When you reach the out-of-pocket maximum, the plan will pay for eligible medical costs, in full, for the rest of the plan year.

You can if your doctor is in the VHAN or Aetna provider networks.  The plan covers both in- and out-of-network care. Just remember that services from providers outside of the VHAN network will likely cost more, so check to see if your doctor is the plan’s network.

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Health Savings Account (HSA)

A Health Savings Account (HSA) is a personal investment account that you own. You can use it to save money, federal income-tax–free, to pay for qualified medical expenses. When you have medical expenses, including those that may apply to your deductible, you can choose to pay for them using the money in your HSA. Or, you can save the money for a future need – even into retirement.

1. Triple Tax Advantage:

                a). Contributions that both you and your employer make to the HSA can be tax-free for you.

                b). Interest and investment earnings on your HSA balance are not taxed.

                c). Withdrawals used to pay for qualified medical expenses are not taxed.

2. The HSA that accompanies the CDHP plan allows you to save for current and future medical expenses, meaning the funds are held in the account year over year and are available when needed for current qualified medical expenses or future expenses.

3. The CDHP premiums are usually lower than other types of plans, so you might choose to use those savings to fund the HSA.

If one or more of the following are true, you may want to select the CDHP with an HSA:

  • You are paying for insurance you are not using
  • You want an option to save for current and future medical expenses
  • You want to save on monthly premiums
  • You anticipate major health expenses that would exceed the out-of-pocket maximum of the CDHP

An “eligible individual” may establish an HSA. To be an eligible individual, you must be:

  • Covered under a CDHP as of the first day of the month
  • Not also covered by any other health plan that is not a CDHP
  • Not enrolled in Medicare benefits 
  • Not claimed as a dependent on another person’s tax return

The simplest way to contribute to the HSA is through before-tax payroll contributions, but you may also write a check or transfer money from your bank account to make a lump-sum contribution to your HSA. If the money comes from your bank account instead of through payroll contributions, you may deduct the amount contributed on your federal taxes using IRS Form 8889, since those contributions would be made with after-tax money.

An HSA may receive contributions from you or any other person, including an employer or family member, on your behalf. Contributions other than employer contributions or an employee’s before-tax payroll contributions are deductible on your federal tax return whether or not you itemize deductions or whether you or anyone else other than your employer makes a contribution. Contributions from all sources are aggregated for the purpose of applying the maximum annual contribution limit.

With an HSA, the money rolls over year after year and the account is yours to keep, even if you leave the University or retire.

No. If you are enrolled in a health care FSA, federal tax law does not permit you to be eligible for an HSA. If you are married, you may not make contributions to an HSA while covered by your spouse’s FSA.

The main difference between an FSA and an HSA is that the FSA is a spending account and the HSA is a savings account. The IRS makes that distinction because you are expected to spend the money you have set aside in an FSA within the plan year (plus an optional two and a half month grace period) or you forfeit any funds not spent. By contrast, an HSA rules allow you to save your money until you need it, even if that isn’t until many years later. Unlike an FSA. Un-used HSA funds are not forfeited at the end of the year, but remain available to you year after year.

No, the IRS specifies that HSAs must be individual accounts. Each spouse who is an eligible individual who wants to open an HSA must open a separate HSA. However, funds from either spouse’s HSA can be used to pay for the expenses of another spouse if you both meet eligibility guidelines. The combined annual contributions cannot exceed the annual family maximum. 

When you open your Fidelity HSA, a brokerage account, your contributions will initially be invested in the core position through which all your HSA contributions are made and from which all distributions are taken. You can choose to invest in a wide variety of investment options depending on your investment objective, time horizon, and risk tolerance — including more than 10,000 mutual funds, individual stocks and bonds, Treasuries, CDs, and more. Contact Fidelity for more information about your HSA investment options.

Yes. The HSA is a personal savings account in the account holder’s name. Similar to a checking account, the funds must be in the account before it is available to be used to pay for any expense.

The funds belong to you for life. Once funds are deposited into the HSA, the account can be used to pay for qualified medical expenses tax-free, even if you no longer have CDHP coverage or are no longer eligible for some other reason. The funds remain in the account automatically each year and indefinitely until used. There is no time limit on using the funds. Once CDHP coverage is discontinued and/or another type of healthcare coverage is obtained, the IRS no longer allows new contributions, but the funds are not lost and may still be used tax-free for qualified medical expenses.  If you withdraw funds for nonqualified expenses, however, you would be subject to taxes and possible penalties.

No. Contributions cannot be applied to a future tax year.

Once Vanderbilt makes a contribution to your HSA, it is legally owned by you, and you can do whatever you want with the funds.

If you have an HSA, but your spouse has separate health coverage, the following special married couple rules apply:

  • If your spouse has non-qualifying family coverage that includes you, it makes you an “ineligible individual” and you may not contribute to an HSA.
  • If your spouse has an individual HSA-qualifying plan, you would have to subtract your spouse’s contribution from the maximum that you could otherwise contribute.
  • If your spouse has coverage other than an HSA-qualifying plan and you are not covered under the plan, there is no effect on your or your ability to contribute to your HSA.

If each is enrolled in their own plan as self-only coverage, the maximum amount that can be contributed to each account is limited to the individual IRS contribution limit. If either spouse has family CDHP coverage, then both spouses are treated as having family CDHP coverage, and the contribution limit is combined for both spouses and is limited to the family IRS contribution limit. If each spouse has family coverage under a separate plan, the contribution limit is combined for both spouses and limited to the family IRS contribution limit.

Federal rules permit “catch-up” contributions to HSAs if you are age 55 or older, allowing you to contribute up to an additional $1,000 per year. You are eligible for this extra contribution if you are 55 years or older at the beginning of the year -- or turning 55 anytime during that year. If your spouse is also turning 55, your spouse cannot contribute their catch-up contribution to your HSA. However, if your spouse meets the eligibility requirements, they can open their own HSA and contribute catch-up contributions to that account.

                For example:

  • 2019 individual coverage contribution limit:
    • $3,500 + $1,000 (age 55+ catch-up) = $4,500
  • 2019 family coverage contribution limit:
    • $7,000 + $1,000 (age 55+ catch-up) = $8,000

Yes, rollover contributions from other HSAs are permitted and limited to one rollover annually. In a rollover, you have direct control (custody) of your funds and you have 60 days to roll the funds over into the new HSA in order to avoid taxes and a penalty. Rollover contributions are not subject to the annual contribution limits. The IRS also allows a onetime (per lifetime) qualified funding distribution from a traditional or Roth IRA to an HSA.

The Internal Revenue Service (IRS) decides which expenses can be paid and reimbursed from an HSA.

Some examples include:

  • Medical plan deductible
  • Dental treatments, exams, or cleaning costs
  • Prescription drug costs
  • Vision expenses, such as contact lenses or glasses
  • Chiropractic care or acupuncture fees
  • Crutches

You can find a complete list of HSA-qualified expenses at: https://www.irs.gov/pub/irs-pdf/p502.pdf

Generally, if you are younger than age 65, and you take an HSA distribution that must be included in your gross income because the funds were not used to pay for qualified medical expenses, the amount of that withdrawal will be subject to an additional 20% penalty as well as the income tax. This 20% penalty tax does not apply to distributions made after the HSA account holder’s death, disability, or attainment of age 65. 

You must keep itemized receipts and explanation of benefits statements (EOBs). This is similar to the way you would keep itemized receipts for charitable donations that you claim as an itemized expense of your personal income tax return. You are subject to IRS audits, so you should keep the receipts for seven years.

Currently, there is no statute of limitation for when funds can be withdrawn to pay for qualified medical expenses, as long as the account holder keeps their itemized receipts. It could be done in a future year as long as the HSA had been established before the expense was incurred.

If you need to pay a medical expense that is more than what you have set aside in your HSA, you can pay the bill out of personal non-HSA funds, and then reimburse yourself in the future as soon as those funds become available in your HSA.

Yes. HSA funds may be used to pay for qualified medical expenses for tax dependent child(ren), even if the child(ren) are not covered by your health insurance plan.

No. It is important to differentiate between a tax dependent and medical dependent. Under federal regulation, children up through age 25 can be covered by their parent’s medical insurance, even if they are not considered dependents for tax purposes. In this case, however, because the child is not a tax dependent, the tax-advantaged HSA funds cannot be used for his or her medical expenses.

The transfer of an HSA to a spouse pursuant to a divorce decree is not considered a taxable transfer. Since HSAs are individual bank accounts, when a transfer request such as this occurs, the former spouse will be treated as the new account holder of the HSA. In order to process the transfer to his or her name, Fidelity must be provided with a certified copy of the divorce decree and property settlement or transfer agreement. The spouse must also sign the appropriate documents to establish the account in their own name.

This situation is referred to as an “erroneous distribution.” You can repay the mistaken distribution by April 15 of the following year with no penalty, if there is reasonable evidence that the original distribution was made in good faith and that it was a qualified medical expense. The repayment is classified as a “re-deposit,” not a contribution. Therefore, it would not count “twice” toward the yearly maximum.

Most people enroll in Medicare when they first become eligible at age 65, to get health coverage and avoid late entrance penalties. Medicare enrollment disqualifies you from making any further HSA contributions, though you can still use any already-accrued funds in your HSA for qualified medical expenses.

If you are Medicare-eligible, still working, and covered by your employer’s CDHP, you may choose to postpone your Medicare enrollment, although you should consider this option carefully before doing so. You should get a letter in the mail from Medicare prior to your 65th birthday explaining the rules to avoid Medicare “late entrance” penalties.  Vanderbilt’s CDHP is considered “creditable” for Medicare Part D (prescription coverage). Even if you decide to postpone your Medicare enrollment until after you quit working, if you enroll in Social Security, you will be automatically enrolled in Medicare Part A.  So, if you decide to postpone Medicare, you would also need to postpone Social Security benefits in order to be eligible for HSA contributions.

Your eligibility to contribute to an HSA is not affected if you choose not to enroll in Medicare but your spouse chooses to enroll in Medicare. Both you and your spouse’s qualified medical expenses can still be paid from an HSA, with the exception of your spouse’s Medicare premiums. No Medicare premiums can be paid from your HSA if you are not enrolled in Medicare.

Your enrollment in any part of Medicare (A, B, C or D) makes you ineligible for further HSA contributions, including employer funding. This is true even though Part A is free for most people. You become ineligible for new HSA contributions the first day of the month your Medicare is effective. During the year you enroll in Medicare, you must prorate your annual maximum contributions, including catch-up contributions. (The total annual contribution maximum is divided by 12 and multiplied by the number of full months you were eligible).

If you are still working, neither your employer nor your spouse (nor anyone else) can contribute any amount that exceeds your eligible prorated maximum after you enroll in Medicare. However, if you have Medicare and enroll in the Select PPO medical plan that year, you could elect to contribute to a Flexible Spending Account (FSA).

If you’re Medicare-enrolled, you can continue to withdraw funds from your HSA tax-free to pay for personal qualified medical expenses as well as the qualified expenses of your spouse and dependents. This includes your COBRA premiums, as well as Medicare/COBRA premiums for your spouse/dependents.

Note: HSA funds can never be used for Medigap/Medicare supplement premiums.

After you turn 65, the HSA funds can still be withdrawn tax-free for out-of-pocket qualified health expenses, regardless of whether you enroll in Medicare. If the funds are spent for any reason other than for qualified medical expenses, the funds withdrawn will be taxable as income but will not be subject to any other penalties. Normal income taxes will apply if the distribution is not used for unreimbursed medical expenses (i.e., if it is used for expenses that are not covered by the medical plan).

Although the purchase of health insurance is generally not a qualified medical expense that can be paid or reimbursed by an HSA, the IRS code provides an exception for Medicare premiums once an account beneficiary reaches age 65.

  • When you enroll in Medicare, the funds can be used to pay Medicare premiums, deductibles, copays, and coinsurance under any part of Medicare. Premiums for Medicare are usually automatically deducted from Social Security benefit payments. Individuals can use HSA funds to reimburse themselves in an amount equal to the Medicare premium deduction. 

If your spouse is not yet enrolled in Medicare, has CDHP coverage, and meets other HSA eligibility rules, he or she may contribute to an HSA opened in her or her own name. You are not allowed to transfer your HSA to your spouse’s name. However, since contributions to HSAs are tax-deductible and any person may contribute to another person’s HSA, you could contribute to your spouse’s HSA, and the contribution would be an “above the line” tax deduction for your spouse.

If you become disabled and enroll in Medicare, contributions to an HSA must stop as of the first of the month in which you enrolled. However, you can use HSA funds to pay Medicare Part A, B, C, or D premiums. Payment of these Medicare premiums is considered to be a qualified medical expense. 

You have the right at any time to designate one or more beneficiaries to whom distribution of your HSA will be made upon your death. You can contact Fidelity for more information regarding beneficiaries.

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Select PPO Health Plan

The deductibles and out-of-pocket maximums will not increase for 2019. Employee co-payments are $20/visit for primary care physicians and there will be a $35/visit co-payment for specialist visits.

Once the deductible amount is met, the Select PPO plan provides co-insurance at the 90 percent level (employee to pay 10 percent) until the out-of-pocket maximum is reached. Upon reaching out-of-pocket maximums, the Select PPO plan pays 100 percent of qualified expenses for the remainder of the plan year.

Select PPO features:

  • Higher monthly premiums, with lower deductibles than the Choice CDHP
  • The PPO’s deductibles and out-of-pocket maximums are unchanged from 2018
  • Pay only the designated co-insurance and/or co-pay for prescription drugs 
  • Co-pays are $20/visit for primary care physicians and $35/visit for specialist visits
  • Once the deductible ais met, the Select PPO provides 90% co-insurance (employee pays 10 %) until the out-of-pocket maximum is reached. Upon reaching out-of-pocket maximums, the plan pays 100 % of qualified expenses for the remainder of the plan year.
  • The Select PPO may be paired with a health care Flexible Spending Account (FSA) that can be used for qualified medical expenses during the plan year. During Open Enrollment, the employee chooses an amount to contribute in 2019 and then makes voluntary pre-tax contributions up to annual IRS limits. The funds in a health care Flexible Spending Account do not roll over from year to year; if funds are not used, they are forfeited. Vanderbilt does not contribute to health care FSA accounts.
No. The opportunity to participate in the new Health Savings Account (HSA) only accompanies the new CDHP plan. However, if you enroll in the Select PPO, you can still contribute to a healthcare Flexible Spending Account (FSA). To participate in the health care FSA, you must actively enroll each year (even if you are participating in the 2018 healthcare FSA). Vanderbilt does not contribute to healthcare FSA accounts.

Yes. The Select PPO may be paired with a health care Flexible Spending Account (FSA) that can be used for qualified medical expenses during the plan year. During Open Enrollment, the employee chooses an amount to contribute in 2019 and then makes voluntary pre-tax contributions up to annual IRS limits. The funds in a health care Flexible Spending Account do not roll over from year to year; if funds are not used, they are forfeited. Vanderbilt does not contribute to health care FSA accounts.

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Pharmacy Benefits

  • In the Select PPO, the employee covers only the designated co-insurance and/or co-pay.
  • In the CDHP, employees pay 100 percent of qualified expenses (including pharmacy prescriptions) until the deductible is met. Once the deductible is met, the employee will pay co-insurance until the out-of-pocket maximum is reached. At that point, the Choice CDHP plan pays 100 percent of qualified expenses for the remainder of the plan year.

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Tobacco-Free Credit FAQs

Save $20 per month on your health plan premiums if you and your covered family members are committed to being tobacco-free. Just indicate your tobacco usage status when completing enrollment in My VU Benefits.

The credit lowers your health care payroll premium payroll deduction by $20 per month.

No. So when you enroll, if you attest to the fact that you and your family members are tobacco-free, your actual monthly premium cost will be $20 less than the rates shown in the premium rate charts.

Yes, you must indicate your tobacco-free status every year when completing enrollment in My VU Benefits in order to receive the credit.

If you indicate in My VU Benefits that you are committed to trying to quit you will receive the $20 per month credit.

If your dependent uses tobacco and does not plan to quit, you will not receive the $20 per month credit.

No, Vanderbilt considers e-cigarettes to be tobacco products, like regular cigarettes. You should indicate you use tobacco.

Health & Wellness offers a variety of tobacco cessation resources including self-help, medical, and one-on-one coaching services to support you in becoming smoke-free. The Quit RX Smoking Cessation program offers counseling and treatment services, including prescription medication when recommended. Call the Occupational Health Clinic at 615-936- 0955 for an appointment or more information. Licensed counselors at Work/Life Connections-EAP are available to teach relaxation techniques and help you build your stress resilience. Make an appointment by calling 615-936-1327. Contact Health Plus to receive a free tool-kit or to schedule one- on-one coaching. Additional information can be found on the Health & Wellness Tobacco Cessation Resource website.

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Spousal Coverage Fee FAQs

If you choose to cover a spouse who has access to health coverage through an outside employer – including Vanderbilt University Medical Center – you’ll pay a $100 per month spousal coverage fee. The fee will be added to your health care premium payroll deduction. 

Yes, you should indicate whether your spouse has access to insurance through another employer each year or you will be charged the fee.

The fee encourages working spouses to take the coverage offered by their employers. We recognize there are circumstances where the Vanderbilt plan is more attractive – whether for family convenience, providers or cost. In that case, the $100 per month fee would apply. Some organizations do not offer coverage for spouses with other health insurance options. At Vanderbilt, you only have to pay the coverage fee if you cover a spouse with access to health insurance through an outside employer. We compared this cost with other employers and learned that $100 per month is what the majority charge. This amount keeps Vanderbilt aligned with similar-sized organizations and is enough to encourage spouses to consider other available health insurance options with their employer.

Yes. If your spouse’s open enrollment period coincides with Vanderbilt’s, you can easily compare plans and enroll in the best combination to meet your needs. If your spouse’s open enrollment period occurs after Vanderbilt’s, you should still make your elections during our Vanderbilt Open Enrollment period. Then, if you need to make changes to your open enrollment elections after the enrollment period is over, you can do so by declaring a life event in MyVU Benefits and selecting “Gain or Loss of Coverage Elsewhere”. Please note that changing your benefits will prompt you to complete a new Open Enrollment window for all 2019 benefits.

No, the fee applies only to the health plan.

Yes. Your spouse's loss of coverage would be considered a qualifying event. You should declare a life event in My VU Benefits, and indicate your spouse does not have access to coverage to waive the fee when making your new benefit elections. You have 30 days from the last date your spouse is covered in his or her employer’s plan to declare a life event. You may be audited and required to submit documentation proving your qualifying event– and there are limitations in allowable changes. See the Family Status Change website for more information.

Yes, he or she can remain on your Vanderbilt Health Plan, but you will pay the coverage fee. We generally do not recommend carrying secondary coverage.

No, you may cover eligible dependent children on the health plan of your choice – either Vanderbilt's plan or your spouse’s plan, and you will not be charged the coverage fee.

No, the fee only applies to spouses who do not work at Vanderbilt University, but are offered employer-sponsored coverage. The fee will apply if they work for Vanderbilt University Medical Center.

No, Medicare coverage is not considered employer-sponsor coverage, so the fee would not apply.

Yes, because your spouse is eligible for coverage through the other employer, you will pay the spousal coverage fee if you add your spouse to your coverage.

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Go for the Gold FAQs

 

Go for the Gold is Vanderbilt's award-winning health promotion program designed to help faculty and staff lead healthier and more productive lives by identifying health risks and taking action to reduce those risks. Complete the steps by Oct. 31, 2018 to earn wellness credit for 2019. There are three levels:

  • Bronze. Complete Compass Health Assessment to earn a $120 wellness credit.
  • Silver. Complete Compass Health Assessment & Wellness Actions Log to earn a $180 wellness credit.
  • Gold. Complete Compass Health Assessment & Wellness Actions Log & Game Plan for Your Health to earn a $240 wellness credit.

Faculty and staff paying for Vanderbilt Health Plan benefits on Jan. 1, 2018 can earn a Wellness Credit of up to $240 for completing Go for the Gold. Vanderbilt faculty and staff not paying for the health plan can participate in Go for the Gold, but will not be eligible for the Wellness Credit.

If you participate in Go for the Gold and are enrolled in a Vanderbilt Health Plan, you can elect to apply Go for the Gold funds to your Health Plan Account or a Vanderbilt Recreation and Wellness Center membership when completing Open Enrollment in My VU Benefits. If you do not make an election in My VU Benefits, your Go for the Gold will be applied to your Health Plan Account.

The Vanderbilt Health Plan Account will help you pay your deductible and co-insurance (not co-pays). The account is managed by Aetna. When you have an outpatient expense, the bill will be sent to Aetna to process the claim. If you have an amount due, that amount will be paid from your Vanderbilt Health Plan Account first. If you use up your Health Plan Account, you will be responsible for any balance until your deductible is met. Any unused Health Plan Account balance will roll over, up to $1,000.

Yes. If you have a remaining Wellness Credit Health Plan Account balance at the end of 2018, earned for participating in Go for the Gold in 2018, that amount will rollover to 2019. The amount will be placed in a Health Plan Account in whichever Health Plan option you elect. Any Wellness Credit you earn for participating in Go for the Gold this year will be added to that amount, up to a total of $1,000.

No, rollover credits are not eligible to use toward membership to the Vanderbilt Recreation and Wellness Center.

If you complete Go for the Gold, you will earn the Wellness Credit, which will be added to your HealthFund. The account will operate as one total fund.

To find your Health Plan Account balance, log in to the Aetna website (also see step- by-step instructions).

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Flexible Spending Account FAQs

  • You can contribute up to $2,700 into a Healthcare FSA for eligible health, dental, vision or certain over-the-counter expenses not covered by insurance. These expenses can be for you or your eligible tax dependents, whether or not they are covered on the Vanderbilt Health Plan, but you must re-enroll every year. 
  • You can contribute up to $5,000 (per household) into a Dependent care FSA for child and adult day care expenses for eligible dependent expenses that allow you and, if you are married, your spouse to work, but you must re-enroll every year.
Yes. The Select PPO may be paired with a health care Flexible Spending Account (FSA) that can be used for qualified medical expenses during the plan year. During Open Enrollment, the employee chooses an amount to contribute in 2019 and then makes voluntary pre-tax contributions up to annual IRS limits. The funds in a health care Flexible Spending Account do not roll over from year to year; if funds are not used, they are forfeited. Vanderbilt does not contribute to health care FSA accounts.
No. Since the Choice Plan is already paired with the tax-advantaged HSA, the IRS will not allow enrollees to also take advantage of an additional tax-advantaged plan, like a Health Care FSA.

No. Unless your current card has an expiration date in 2019, you should plan to use your card until it expires.

Putting pre-tax money from your paycheck into a flexible spending account lowers your taxable income, so you pay less income tax. Ask Alex, Vanderbilt’s interactive health plan helper can further explain how FSAs save you money.

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Dental and Vision FAQs

2019 carriers are BlueCross BlueShield DentalBlue PPO and Cigna DHMO. There are no payroll premium increases to the BCBS DentalBlue plan and minimal payroll premium increases to the Cigna DHMO plan.

For Cigna, go to the Cigna website.

1. In the orange bar in the middle of the page, FIND A DOCTOR.
2. Click on FOR PLANS OFFERED THROUGH WORK OR SCHOOL.
3. Choose Find a DENTIST.
4. Under Select a Plan, click on PICK.
5. Under DENTAL PLANS, choose Cigna Dental Care.

Call Cigna Dental Care Customer Service at 1.800.367.1037.

For BlueCross BlueShield DentalBlue, go to the BlueCross BlueShield website.

1. Select Find a DentalBlue Dentist under Consumer Tools & Information.
2. Choose DentalBlue Network as the network for Tennessee.

You can also call the Dental Member Service at 1.800.523.1478 between 8 a.m. and 6 p.m. EST Monday-Friday. 

Superior Vision Services will continue as the carrier for 2019. Superior Vision offers a convenient network of providers, including the Vanderbilt Eye Institute, Walmart, Target and LensCrafters.

Go to the Superior Vision website and click on the Locate a Provider map in the left column. You can also call Superior Vision at 800-507-3800.

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AD&D FAQs

If you purchase $10,000 or more of accidental death & dismemberment insurance, you are eligible for MetLife's Travel Assistance. Participants have access to assistance when faced with an emergency while traveling internationally or domestically more than 100 miles from home. Learn more by reading the MetLife Travel Assistance brochure.

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Benefits Eligibility

Legal spouses (same- or opposite-sex), natural, step-, or adopted children through age 25,and other qualified dependents, such as disabled children age 26 and older, with required documentation.
No. As of 2017, unmarried domestic partners and their children are not eligible for coverage in Vanderbilt benefit plans.

Some part time and temporary employees are considered partially benefits-eligible, which means they and their dependent children are eligible for the Choice CDHP health plan with HSA ( note -- there is no Vanderbilt contribution to the HSA for partially benefits-eligible employees).

Spouses of partially benefits-eligible employees are not eligible for coverage; see the HR website for more details.

Vanderbilt Health Plan coverage for partially benefits-eligible employees is optional and you must enroll to receive coverage. If you are already covered on someone else’s plan or prefer to purchase a plan from the healthcare.gov marketplace, you do not need to take any action.

In 2019, this will include:

  • Regular faculty working part-time schedules less than 30 hours per week (less than .75 FTE)
  • Regular/term exempt professional staff and postdocs working part-time schedules (less than 30 hours per week / less than .75 FTE)
  • Regular and term non-exempt (hourly-paid) staff who are regularly scheduled to work at least 20, but less than 30 hours per week
  • Temporary faculty such as adjunct, adjoint, in-residence who are appointed to work 30 hours per week or more (.75 FTE or more), or whose work vary from academic term to term, but who have worked an average of 30 hours per week across the prior 12-month period
  • Staff such as VTS and flex staff who are appointed to work 30 hours per week or more (.75 FTE or more), or whose hours vary from week to week but who have worked on average, 30 hours per week or more across the prior 12-month period
  • Graduate and professional students, including graduate teaching and graduate research assistants; as well as post-baccalaureate students in the professional schools who are appointed to work 30 hours per week or more, or whose hours vary but who have worked on average 30 hours per week or more during the last a 12-month period  (NOTES:  Advance written Dean and Provost approval is required for any graduate or professional student to exceed 29 hours per week total in all assignments. Students have access to coverage under the Student Healthcare plan, and thus should consider carefully before electing employee healthcare.)  
  • Undergraduate students need advance written Dean and Provost approval to work more than 20 hours total in all assignments. They already have other healthcare coverage as a dependent or through the Student Healthcare plan, and should consider carefully before electing employee healthcare,
    • Family members eligible to be covered by partially benefits-eligible employees:
    • Natural, step-, or adopted children up through age 25
    • Other qualified dependents, such as disabled children over age 25, with required documentation

Partially benefit-eligible employees can enroll in the Choice CDHP (without HSA seed) health plan coverage for themselves and their children or they can choose to waive coverage.

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