FY2011 Health Benefits Booklet

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ii Table of Contents Dental Benefits............................................................42 Your Choices..........................................................................42 How the Plans Work.........................................................42 For More Information........................................................43 Flexible Spending Accounts .....................................44 What’s New............................................................................44 Your Choices..........................................................................46 How the Plans Work.........................................................45 Getting Reimbursed............................................................47 For More Information........................................................48 Term Life Insurance...................................................50 Life Insurance for Active Employees.........................50 Life Insurance Upon Retirement.................................53 For More Information........................................................53 Accidental Death and Dismemberment ...............54 Your Choices..........................................................................54 How the Plan Works.........................................................54 For More Information........................................................54 Long Term Care Insurance......................................55 Your Choices..........................................................................56 How the Plan Works.........................................................56 For More Information........................................................57 Important Notices and Information.......................58 Employee Fraud and Abuse...........................................58 Notice About Disclosure and Use of Your Social Security Number.......................................58 Leave/Continuation of Coverage/COBRA............58 General COBRA Notice..................................................61 Health Insurance Portability and Accountability Act (HIPAA) ..........................................65 Notice of Privacy Practices.............................................65 Newborns’ and Mothers’ Health Protection Act........................................................................66 Notice of Women’s Health & Cancer Rights Act................................................................67 Medicare and Your State Benefits..........................67 Benefits Appeal Process ...........................................71 Notice of Creditable Prescription Drug Coverage......................................................................72 Definitions....................................................................74 Rates..............................................................................76 Introduction The State of Maryland provides a generous benefit package to eligible Employees and Retirees, with a wide range of benefit options. For more details about each plan, review the sections in this guide or refer to the chart on the inside of the front cover for phone numbers and websites for each of the plans. notice to Employees and their dependents This guide contains several very important Notices for every individual covered through the State Employee and Retiree Health and Welfare Benefits Program. These Notices inform you of your rights under State and Federal Laws on such important topics as Continuation of Coverage (COBRA), the Program’s Privacy Practices, and Creditable Prescription Drug coverage. Please read all the notices carefully.
Maryland State Employees and Retirees 1 What’s New a• NEW! FSA Administrator and Program Enhancements ConnectYourCare becomes the new FSA administrator effective July 1, 2010. Information on the new enhancements to the FSA plans such as debit cards and secure online claims filing can be found in this Benefits Guide on pages 44-49. As with every Open Enrollment, if you are currently enrolled in an FSA and would like FSA coverage in the new plan year, you must re-enroll in an FSA before Open Enrollment ends or you will not have coverage for the 2010-2011 Plan Year. a• NEW! Mental Health Parity Act The Wellstone-Domenici Mental Health Parity and Addiction Equity Act of 2008 requires health benefit plans to cover mental health conditions and substance use disorders, including alcoholism, in the same manner as any other illness. This means that financial requirements, such as co-pays, deductibles and out-of-pocket limitations and any treatment limitations that apply to mental health and substance use benefits may be no more restrictive than the financial requirements and treatment limitations for medical benefits. The State of Maryland is implementing parity for its employees and retirees effective July 1, 2010. For details, see pages 34-36 of this Guide. a• A Word About Program Requirements The State Employee and Retiree Health and Welfare Benefits Program is subject to many federal and State laws and regulations. Complying with these provisions makes it possible for Employees to have pre-tax premium deductions in the Program, to have tax-free State subsidies for Active Employee and Retiree coverage, and to offer benefits like the FSA plans. State regulations and policies provide for treating Employees and State Retirees alike with respect to how certain benefits are administered and to follow certain administration rules. Section 125 of the Internal Revenue Code has strict regulations and guidelines for administering the Program. As a new Employee who is eligible to participate in the State plans, you have 60 days from your hire date to enroll yourself and the eligible dependents you want to cover, and to submit the required documentation. If you do not enroll during this period, you must wait until the annual Open Enrollment period held before the next plan year starts. Once Open Enrollment closes, benefit elections (who is covered, coverage level, and plan) are locked in for the entire plan year. Changes can only be made during Open Enrollment for the next plan year or if you experience a qualified change in status. Qualified status changes include marriage, birth, adoption, divorce, death of a spouse, death of a dependent, moving outside of the health plan network, loss of other coverage, etc. If you experience one of these events and wish to make a change to your benefit elections, you must contact your Agency Benefit Coordinator or the Employee Benefits Division immediately. Your benefit election changes must be consistent with the status change event. For example, if you get married, you may add your spouse to your medical plan. You must make your changes and submit all required documentation within 60 days of the event. Under the regulations, we cannot accept changes received more than 60 days after the event. Please refer to our website for a detailed list of qualified status changes. We must abide by the regulations and cannot allow changes to elections after Open Enrollment closes. Please be sure to make your changes early in the Open Enrollment period in case you need to correct your changes before Open Enrollment ends. WHAT’S NEW
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DEPARTMENT OF BUDGET & MANAGEMENT 3
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