2. 2012 Open Enrollment
Benefit Enrollment Timeline
November 7-23: Open Enrollment
Nov 8 – Benefit and Wellness Fair
Riverside Lobby from 11:00 am to 5:00 pm
Nov 14 – Benefit and Wellness Mini Fair
to coincide with the Midnight Meal 10pm to Midn.
Nov 7-17: Benefit meetings and Q&A sessions
Nov 23: Enrollment period ends
Dec 2: Confirmation of benefit elections will be
mailed to employees’ homes
3. 2012 Open Enrollment
Employees should confirm their benefit elections and
make any necessary changes.
It’s important to confirm your enrollment if you…
would like to make changes to your existing elections
have NEW dependents to add to your plan(s) (you will need to
submit proof of eligible status)
Opt Out of health insurance (you must supply proof of insurance each
year)
want to continue your Flexible Spending Account (the IRS
prohibits the automatic rollover of FSA elections from year to year)
want to avoid the spousal surcharge (if your spouse is not eligible
for benefits with their employer, you must complete the exemption form)
want to avoid the tobacco surcharge (if you are enrolled in health
insurance, you must indicate your tobacco status for yourself and each dependent
enrolled in your plan)
4. Enrollment Process
Log on to the BenefitsTalk™ website at
www.benefitstalk.com/riverside
Review online plan information
Review your current elections
Process your enrollment for 2012
Benefit Call Center representatives are
available toll free at (866) 932-6851
Monday through Friday from 7AM-11PM and
from 7AM-NOON on Saturday.
5. Benefits are part of Total Compensation
Riverside’s goal is to provide employees with a
competitive and affordable health insurance
program.
Riverside receives a discount in plan expenses by
participating with MCHC
Riverside pays 80% of the total cost of healthcare
coverage for employees
After enrollment, employees will receive a
confirmation statement that details employee’s total
compensation including Riverside’s contributions to
benefits costs.
6. Riverside’s costs anticipated to increase
To continue managing costs in 2012 while
providing competitive benefits, premium
adjustments have occurred for health
insurance.
Rates can be viewed online during enrollment
at www.benefitstalk.com or by calling the
Benefit Call Center.
There is no increase in dental, vision, life
insurance, or long term disability rates
7. Medical Insurance Premium Discounts
Earn Medical Insurance Premium Discounts by
participating in the REACH Employee Wellness
Program
If you are enrolled in Riverside's group medical
insurance, you can earn a $20 premium discount
each pay period.
To earn the discount you must…
meet with your Wellness Coach
complete your annual wellness screening
get your annual flu shot
and for women over 40, get your annual
mammography
8. Medical Insurance Premium Discounts
If you Opt Out of medical insurance, you must
participate in the REACH program to receive your full
opt out credit.
Full Time Employees who Opt Out must participate in
the REACH wellness program to receive the full $45
opt out credit. If you do not participate, you will receive
a partial opt out credit of $25.
Part Time Employees who Opt Out must participate in
the REACH wellness program to receive the full $20
opt out credit. If you choose not to participate you will
not receive an opt out credit.
9. REACH Employee Wellness Program
REACH is a FREE comprehensive wellness program offered to
ALL Riverside employees. This unique and special benefit
provides person to person coaching and mentoring, usually over
the course of several months, to improve and/or make progress in
your lifestyle habits. For most participants, this results in a
healthier, happier you!
The mission of the REACH program is to provide opportunities for
all employees to create and maintain healthy and active lifestyles.
By improving employees' physical and mental wellbeing, the
employee wellness program reflects Riverside's mission: "Life is a
remarkable journey. Health impacts every step..."
For complete details, go to the REACH website at
www.riversidemc.net/reach
10. 100% Coverage for Well-Care Services
Beginning January 1, 2012, all Well-Care Services
will be covered at 100% at the home hospital and
BCBS PPO levels.
This change reflects Riverside’s commitment to create a culture
that places the health of its employees among the highest
priorities.
Well-Care Services include immunizations, routine
physical exams, routine labs, mammos, etc…
anything your doctor orders that is preventative or
wellness related.
Keep in mind that once a well-care service becomes a
diagnostic code, the coverage level changes to the Diagnostic
Test level, which is subject to deductible and covered at 90% at
the home hospital level or 70% at the PPO level.
11. Plan Design Changes
FASTCARE Co-Pay only $10
Available immediately (you don’t have to wait for January 1, 2012 to take
advantage of this new benefit
Premium Medical Plan no longer available
If you are currently enrolled in the Premium Plan, you must elect another plan. If you
fail to elect another plan, you will be defaulted into the Preferred Plus Plan.
Dental HMO Plan no longer available
If you are currently enrolled in the DHMO Plan, you must elect another plan. If you fail
to elect another plan, you will be defaulted into Dental PPO Plan B.
$5 increase in office visit co-pay:
Primary $30 / Speciality $40
Prescription Plan Changes:
90-day supply for 1 co-pay Basic Plan
90-day supply for 2 co-pays for Preferred Plus and Preferred Plans
Exclude non-sedating antihistamines because they are OTC
There are no plan design changes for vision, life or dependent life
insurance, or long term disability.
12. FASTCARE
Riverside Employees only pay a $10 Co-Pay starting NOW!!
Riverside's FastCare clinic offers convenient, economical health care for minor
conditions and symptoms such as sore throats, fevers, flu and colds, ear, sinus
and urinary tract infections, pink eye, skin rashes and allergies as well as other
non-emergency illnesses.
FastCare is healthcare from Riverside Medical Center professionals… quality
care provided by a nurse practitioner
Minimal waiting periods—walk-ins only—no appointments necessary
Open 364 days a year, with day and evening hours
Location
Inside Walmart
2080 N. State Route 50
Bourbonnais, IL 60914
(815) 936-6012
Hours
Mon-Fri: 9:00 a.m.-8:30 p.m. ~ Saturday: 9:00 a.m.-5:00 p.m. ~Sunday: 10:00
a.m.-5:00 p.m. ~Holidays: 10:00 a.m.-2:00 p.m. (Closed Christmas Day)
Patients must be 18 months or older. Age restrictions exist for select services.
For Details, go to www.riversidemc.net/fastcare
14. Tips on Choosing Benefits
Your elections should take into consideration
your cost, your needs, the features of each
plan, and your tolerance for risk
We suggest comparing the plans based on:
MD office visit co-pay and Prescription co-pay
Deductible and Maximum out of pocket
Bi-weekly premiums
See details for each plan in the Benefit Booklet
available at www.benefitstalk.com/riverside,
on RiverNet, or in OLIE.
15. Decision Worksheet
To help in the decision process, we have
developed a spreadsheet where you may
enter information specific to you and then
compare the costs of each health plan
offered. This spreadsheet is available
online at www.benefitstalk.com/riverside,
on RiverNet, and OLIE
Note: This worksheet is intended to be used only
as a guide in the decision process.
16. Spousal Surcharge
Employees who choose to cover their spouse in Riverside’s
group medical plan and whose spouse is eligible for medical
coverage with their employer will pay a $50 surcharge per pay
period, in addition to the health insurance premium.
The Spousal Surcharge will be waived if:
Your spouse does not have medical coverage available through his/her
employer
Your spouse is unemployed, self employed, or retired
Your spouse is covered by Medicare
Your spouse is also employed by Riverside Medical Center
If your spouse meets one of the criteria above, you must
complete the exemption form electronically at
www.benefitstalk.com/Riverside or complete and return to the
Benefit Center by Fax (866) 932-6838 or mail to WestLake
Financial Group, Inc., 1477 Barclay Boulevard, Buffalo Grove, IL
60089
17. Tobacco Surcharge
The purpose of the Tobacco Surcharge Program is to provide
additional motivation to encourage healthy lifestyles in our
workplace environment. In addition to promoting healthy
lifestyles, the surcharge will help cover additional health plan
expenses generated by smoking and other tobacco related
health problems.
The surcharge applies only to employees enrolled in
health insurance.
$15 per pay period for each covered family member
who uses or has used tobacco products within the
past six months.
To avoid the surcharge, you must enroll online at
www.benefitstalk.com/riverside or contact the Benefit
Call Center at (866) 932-6851 and indicate your
tobacco-free status.
18. Quit Smoking Help
Riverside would like to help make it easier for you to quit by
reimbursing you and your dependents the cost of the following smoking
cessation programs and will also reimburse up to $100 for out-of-
pocket expenses for quit smoking aids, such as medications, gum,
patches, etc. Bring your receipts to Employee Health for
reimbursement.
Freedom From Smoking: Cost $30.00 (refunded to you upon
completion) - American Lung Association program - 8 week series of
weekly sessions at Riverside Medical Center. Sign up by calling 815-
935-7531.
Smoking Consultation: Cost $25.00 (refunded to you upon
completion) - Offered every 3rd Thursday of the month at
Bourbonnais Plaza. Sign up by calling 815-935-7531.
A one-on-one 30 minute consultation to get started and work
independently based on tangible health data of fingerstick lipid profile
and pulmonary function test. A respiratory therapist trained in smoking
cessation will assist in you in your goals for successfully quitting. An
RN will discuss your lipid profile results and benefits of quitting.
19. More help to quit smoking…
Other free smoking cessation programs that are available:
Freedom From Smoking On-line program: FREE!
Sponsored by American Lung Association On-line program to
assist in quitting smoking. www.ffsonline.org
Tobacco Hotline 24 hrs/day: FREE! An option for those that
need to speak to someone periodically in their process of
quitting. Experts are available 24 hours a day at 1-866-QUIT
YES ( 1-866-784-8937)
BCBS Blue Care Connection: FREE to employees enrolled
in BCBS benefits! www.bcbsil.com Go to the Personal Health
Manager and click the Stop Smoking button to enroll in the
online program, or contact customer service.
20. Opt Out Information
If an employee has health insurance coverage
elsewhere, they may OPT OUT of health insurance at
Riverside and receive a benefit credit every pay
period.
To receive this credit, you must…
Provide proof of insurance each year.
Fax or mail a copy of your insurance card to the
Benefit Center (Fax: 866-932-6838)
Please remember to put your name and employee ID
number on anything you send to the benefit center.
Participate in the REACH Employee Wellness Program
to get the full credit.
21. Flexible Spending Accounts (FSA)
FSA’s are a way to save money by paying for certain health and
dependent expenses with before tax dollars.
You must elect your contribution amount each year (the IRS
prohibits the automatic rollover of FSA elections from year to year)
Go to the BenefitsTalk™ website to access balances and view
recent transactions
Grace period extends thru March 15, 2012 to incur expenses.
Deadline to submit 2011 claims is April 15, 2012, to WestLake.
Use-It-Or-Lose-It Rule still applies
Manual claims processed within 48 hours
You will also have the option to use the Debit Card. Approved
expenses are automatically deducted from your pre-tax account.
You may continue to use the same card from last year
22. Dependent Eligibility Verification (DEV)
Employees who are adding new dependents
to their medical, dental, or vision plan, are
required to submit proof of eligible status to
the Benefit Center by December 10.
Documents that are acceptable include, birth
certificates, marriage certificates, tax returns,
etc. A full list of acceptable documents is
available online.
Please remember to put your name and
employee ID number on anything you send to
the benefit center.
23. Riverside In-Network Physicians
For a better level of coverage, employees may
choose from physicians in the Riverside In-Network
Physician List.
$30 co-pay per office visit
$40 co-pay for specialists
90% coverage (after deductible) for inpatient visits
An updated list is available…
online at www.benefitstalk.com/riverside
on RiverNet (in the Benefit Folder under Human Resources)
or from Human Resources
24. Prescription Plan
$10 co-pay for generics
$40 co-pay for formulary brand names
$60 co-pay for brand names and injectibles
Use Riverside Family Pharmacy and get a three
month supply of maintenance drugs for…
TWO co-payments in the Preferred Plus Plan and
Preferred Plan
ONE co-payment in the Basic Plan
25. Prescription Drug Programs
Prescription drugs are getting more expensive every
year. As part of our effort to provide the most healthcare
for our dollars for both employees and our organization,
three prescription programs are in place.
Generic Drug Utilization – This program is to increase generic
drug utilization. A generic medication on average will cost 30%
to 80% less than the equivalent brand-name drug.
Step Therapy Program - This program is all about getting a
proven safe and effective drug for your condition, and getting it
at the lowest possible cost.
Prior Authorization Program - The program monitors certain
prescription drugs and their costs so that you can get the right
drug at the right cost. It works much like a health plan that
approves some medical procedures beforehand, to make sure
you’re getting the tests you need.
26. Riverside Health Fitness Center
Riverside will continue to offer employees monthly
membership at half price with a reduced enrollment
fee of $50 for new employee members.
Riverside will pay 50% of monthly membership for
the first family member (i.e. spouse or dependent)
and the enrollment fee will be $75.
This also applies if the second family member is
enrolling in the Fitness Island Membership
program
To receive discounts, employees must pay through
payroll deduction, commit to a one year
membership, and be a 0.5 FTE or greater
27. Enrollment Process
Log on to the BenefitsTalk™ website at
www.benefitstalk.com/riverside
Review online plan information
Review your current elections
Process your enrollment for 2012 by Nov. 23
Benefit Call Center representatives are
available toll free at (866) 932-6851
Monday through Friday from 7AM-11PM and
from 7AM-NOON on Saturday.
