Flex

My medical expenses weren't as high for the year as I thought they would be. I have extra money sitting in my flex account and I'm worried I'm not going to use it. Is there anything I can do?
-Healthier Than I Thought

Dear Healthier Than I Thought-
Congratulations on your health! This is a good problem to have. For starters, the cutoff date to incur services that qualify under your flex election is extended to March 15th of the following year. The deadline to turn claim forms in has been extended to June 15th. This extension applies to both dependent care and medical flex accounts. Remember, over-the-counter drugs qualify for reimbursement and you may purchase a reasonable amount.

Prescription Drugs 

Are smoking cessation drugs covered under the Prescription Drug plan?
-Determined to Keep My New Year’s Resolution

Dear Determined to Keep My New Year’s Resolution-
Yes, smoking cessation drugs are covered under the new prescription drug card. A majority of the brand smoking cessation drugs that require a prescription are going to be non-preferred.

Some of the more common drugs are:
Zyban is non-preferred, generic is Bupropion.
Nicoderm CQ is over the counter and available in generic.
Chantix is non-preferred with no generic available.
Nicotrol Inhal is non-preferred with no generic available.
Nicotine Patch is a generic.

There is still a $1,000 lifetime retail cost limit on these drugs.

I was reading through my benefits packet and came across a piece I don’t understand. It says, “If a generic is available and you purchase a brand name, you will pay the brand name copay plus the difference in cost between the brand name and the generic.” Really?
-Confused

Dear Confused-
What you are reading is correct and incorrect. Correct in that if you purchase a drug that has a generic available and you choose not to purchase the generic, you would be charged an additional fee. Incorrect in that you would actually pay the generic copay, not brand name copay, plus the difference in cost of the two drugs. Please note that our plan does allow a doctor to override this requirement. When a doctor writes a prescription to be “dispensed as written” or no generic substitution”, you will be responsible for the applicable preferred or nonpreferred copay only.

When will I be getting my new prescription card?

-Anxiously Waiting

Dear Anxiously Waiting-
The January 1, 2008 prescription drug cards were mailed the week of December 10th to your home address. Please make sure your home address is up-to-date on the Roles site. The prescription drug card is the same card used for medical and/or dental.

Medical Insurance

I only received two medical insurance cards and I need another for my child that is in college. How do I get another one?
-Cardless

Dear Cardless-
First Administrators initially only provides two cards to all participants with family coverage. To request additional cards, simply contact Human Resources, and we can order more. The additional cards will be mailed to your home address.

Do the office copays go towards my deductible? If not, can I reimburse them through the flex plan?

-Planning ahead

Dear Planning Ahead-
Although the $30 office copays do not go toward your deductible, they are reimbursable through Flex.

I went to the doctor for my annual exam and I was billed for the ooffice visit. I thought this was free?

-Staying Healthy

Dear Staying Healthy-
Preventive Care Services are payable at 100% up to $350 a year. If you have not reached the $350 limit, you should not be charged the office visit copay. This is often just a matter of telling the office at the time of your visit that your insurance has a preventive service feature and clarifying that it will be coded properly. If a claim wasn’t coded properly, you simply need to call your doctor’s office and ask them to refile it as a preventive service.

How long do I have to file a medical claim for reimbursement? It’s the end of the year and I haven’t turned in a few prescriptions that I paid for earlier this year.

-Scrambling For New Years

Dear Scrambling For New Years-
You have 12 months from the date of service to turn in a claim for reimbursement, under our medical plan. Remember in 2008, we have a drug card and you no longer have to manually turn in claims for prescriptions to our medical plan.

When do I have to call and precertify for a medical service? I recently called to precertify for a colonscopy and was told on the phone that I didn’t have to.

-Covering All Bases

 Dear Covering All Bases-
Kudos to you for calling just in case, but you no longer have to call and precertify for a colonoscopy. In fact, there are very few times under our current plan that a participant needs to call and precertify. Those two instances include:

1. Inpatient Care-Call in advance of a planned admission or within 2 business days of an emergency admission. If you do not call, your benefits will be reduced by $1,000. This reduction does not apply to maternity stays of less than 48 hours for normal delivery and 96 hours for C-section.
2. Maternity Care-Call within the first 3 months of pregnancy or within 31 days of becoming covered to receive valuable information regarding pregnancy and child development. If you do not call, you will not receive the $350 well child care benefit.

PTO

How do I know how much PTO I have?
-Needing a Vacation

Dear Needing a Vacation-
Simply log onto Roles, Click the “Time Off” icon, click on “Available Time” under the “Check Available Balance” icon. Change the date in the “As of” field to the last day of the prior month. Once you get that balance, then add your accrual for the current month. For example, if it shows 150 hours accrued for the last month and your monthly accrual is 17.33, then your current month’s available balance is 167.33. If payroll is already posted for the current month, then you wouldn’t have to do this additional step.

How many PTO hours can I rollover each year?

-PTO Saver

Dear PTO Saver-
You can have a maximum of 320 hours in your PTO Bank. Once you approach 300, you should seriously start thinking about a vacation.

SimplyWell 

How do I reset my password for SimplyWell?
-Wanting to Log My Wellness

Dear Wanting to Log My Wellness-

1. If you provided SimplyWell with your e-mail address, you can reset your password online by answering two challenge questions. If you answer the challenge questions, the SimplyWell system will send an immediate e-mail with the appropriate information. To answer the challenge questions, go to www.simplywell.com; click log in; click on “forgot your user id and password” and then you can provide the requested information.
2. You can call SimplyWell’s password support line at 1.877.991.9355. Press 2 for the Password Support Line. This service is available 24/7, and if you answer the challenge questions, the call center will reset your password immediately.
3. Finally, you can call SimplyWell at 1.877.991.9355 and press 0 between 8 and 4:30 CST, and their administrator can assist. You’ll need to answer the challenge questions, and then their administrator will reset your password immediately.

Vision Insurance

Does the vision insurance cover an eye exam?
-Needs New Glasses

Dear Needs New Glasses-
No, the vision exam is covered under our medical plan. The vision insurance covers contact lenses and frames. Remember, in 2008 the preventive care limit is increasing to $350 a year, and your vision exam is included in this.

Miscellaneous

I was wondering when I’ll get my W-2 so I can file my taxes?
-Planning Ahead

Dear Planning Ahead-
The deadline for providing employees with their W-2s is January 31st. We, of course, aim to get them out to you as early as we can. Please remember to go into Roles and make sure your address is accurate, as all W-2’s get mailed to your home address that is in the system.