2025 Open Enrollment

Open Enrollment Is October 28 to November 8, 2024

It’s your once-a-year opportunity to enroll in or make changes to your benefits. Here are the main “headlines”:

1. Medical plans will be provided by new insurance carriers. Coverage will generally be the same as today, but there will be other changes to understand.
2. Paycheck deductions will change. Premiums for medical coverage will increase in 2025. Dental and vision plan costs will stay the same.
3. Supplemental medical plans will have a new plan administrator. Coverage will mostly be the same as today. However, some benefits will increase, while others will decrease. In addition, paycheck deductions will change.
4. The savings limits for tax-advantaged accounts will increase. This includes Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA).
5. Employee Assistance Program (EAP) will have a new administrator. If it's been a while since you checked out the EAP, you might be surprised to see all that's offered.

Most of your current elections will carry over to 2025. The exceptions are HSA and FSA elections — you must re-enroll for these benefits every year.

Take some time now to understand your options and costs for the upcoming year.

Enroll by November 8, 2024.

We know how hard our employees work, which is why you deserve the best benefits we can offer. This year, we're making significant changes to improve your experience. While these changes will require some adjustment, we're confident they'll provide access to better service, a wider network of providers, and more robust support for your overall well-being.

Read on for details about the 2025 changes.

Aetna medical plans will be replaced by Blue Shield of California plans on January 1, 2025. Tufts Health Plan will be replaced by Harvard Pilgrim on January 1, 2025.

AETNA PLANS: NOW OFFERED BY BLUE SHIELD IN 2025

Starting in 2025, Aetna will no longer be a medical plan provider. Instead, we’ll offer similar plans through Blue Shield of California.

This plan for 2024…	Will be replaced by this plan in 2025…
Aetna PPO	Blue Shield PPO
Aetna CDHP	Blue Shield PPO Savings (CDHP)
Aetna HMO (CA only)	Blue Shield Access+ HMO

If you’re currently enrolled in an Aetna plan, here’s what you need to know about the transition to Blue Shield:

• You'll be automatically enrolled: On January 1, 2025, you’ll be automatically enrolled in the similar Blue Shield plan (noted above). However, you’ll have the option to change medical plans during Open Enrollment.
• Benefits and services: While most things will stay the same, certain programs and provisions may differ.
• CDHP (Blue Shield PPO Savings): Due to IRS guidelines, the in-network deductible will increase to $1,650/member or $3,300/family.
• Review 2025 plan summaries: Blue Shield PPO | Blue Shield PPO Savings (CDHP) | Blue Shield Access+ HMO
• Review 2025 SBCs: Blue Shield PPO | Blue Shield PPO Savings (CDHP) | Blue Shield Access+ HMO
• ID cards: You’ll receive new ID cards mailed to your home in December. For the PPO and CDHP, two copies of the card will be provided for families. For the HMO, each member of the family will receive an individual card. Please note, your ID card is for medical services, as well as prescription drug expenses.

We anticipate that you may be wondering about some other things. Below is information that may help. Some of it may not apply to your situation.

Network of Providers	Don't let the name fool you! Blue Shield of California provides nationwide coverage, giving you access to in-network providers from coast to coast — no matter where you live or work. Most Aetna providers used today will be in-network providers with Blue Shield of California. However, you should confirm this for your providers. To learn more, go to the Blue Shield microsite. To search for providers outside of California, when it asks for the three letters at the beginning of your member ID number, use SON (for the PPO and CDHP plans) or XEH (for the HMO plan).
Primary Care Provider (PCP Designation)	For the HMO, you should select a PCP through Blue Shield. If you don’t, one will automatically be assigned to you. However, you can change it at any time by calling Blue Shield. A PCP is not required for the PPO and CDHP.
Continuity of Care	If your doctor isn’t an in-network provider with Blue Shield, you may be eligible to continue seeing them for a period of time. Continuity of care is available for qualifying medical conditions (for example, inpatient care and pregnancy care). To learn more, complete the Continuity of Care Request Form and return it to Blue Shield.
Prior Authorizations	Medical services: Prior authorizations will not transfer to Blue Shield. Be sure to provide your doctor with your new Blue Shield insurance information, so they can follow-up with Blue Shield as needed. Prescription drugs: For maintenance medications and select specialty drugs, there will be a 90-day grace where prior authorizations will not be required. If your medications are not on the list, your doctor will need to submit a prior authorization to Blue Shield before you can fill your prescription beginning January 1, 2025.
Prescription Drugs	Your prescription benefits and coverage will be the same as today. Here are some other details you need to know about the transition: Retail pharmacies: Coverage will be provided through the Rx Ultra pharmacy network. Click here to verify that your current pharmacy is in the network. Read about the Rx Ultra pharmacy network. Mail order program: Coverage will be provided through Amazon Pharmacy. If you currently have prescriptions delivered to your home, you’ll have to take action and set up an account with Amazon Pharmacy. To do that, call the Blue Shield Concierge at 855.599.2657 (7 a.m. to 7 p.m. Pacific Time). Read about Amazon Pharmacy highlights. Formulary: The Blue Shield prescription drug formulary may include different medications compared to Aetna. This means that some drugs not covered by Aetna might be with Blue Shield, and vice versa. To see which tier your medication falls into, use the formulary search tool. You can find the actual copay amounts for each tier in the 2025 summary for your plan: Blue Shield PPO | Blue Shield PPO Savings (CDHP) | Blue Shield Access+ HMO
Where to Learn More	Visit the Blue Shield microsite for benefit summaries, forms, and more. To search for providers outside of California, when it asks for the three letters at the beginning of your member ID number, use SON (for the PPO and CDHP plans) or XEH (for the HMO plan). If you need assistance before you receive your ID card, call Member Services at 855.599.2650 (5 a.m. to 7 p.m. Pacific Time) or the Blue Shield Concierge at 855.599.2657 (7 a.m. to 7 p.m. Pacific Time).

TUFTS HEALTH PLAN: NOW OFFERED BY HARVARD PILGRIM IN 2025

Starting in 2025, the Tufts Health Plan HMO (available in MA) will be replaced by a similar plan through Harvard Pilgrim.

This plan for 2024…	Will be replaced by this plan in 2025…
Tufts Health Plan HMO	Harvard Pilgrim HMO

If you’re currently enrolled in the Tufts Health Plan HMO, here’s what you need to know about the transition to Harvard Pilgrim:

• You'll be automatically enrolled: On January 1, 2025 you’ll be automatically enrolled in a similar Harvard Pilgrim plan. However, you’ll have the option to change medical plans during Open Enrollment.
• Benefits and services: Most of your benefits will stay the same, but there are a few updates: Fertility services will be 100% covered, some prescription copays will change, and blood glucose monitors will be covered at 100%. For details about these and other changes:
• Review the 2025 summary: Harvard Pilgrim HMO
• Review the 2025 SBC: Harvard Pilgrim HMO
• ID cards: You’ll receive a new ID card to use for medical and prescription drug expenses. These will be mailed to your home in December.

We anticipate that you may be wondering about some other things. Below is information that may help. Some of it may not apply to your situation.

Network of Providers	Most Tufts providers used today will be in-network providers with Harvard Pilgrim. In addition, the Harvard Pilgrim network is broader than the Tufts network. To confirm that your providers are in the network, go to hphc.providerlookuponlinesearch.com/search. Under "Health Plan," select HMO or HMO Open Access.
Primary Care Provider (PCP Designation)	Current PCP designations with Tuft Health Plan will transfer automatically to Harvard Pilgrim. If you’re new to the HMO in 2025, you’ll need to select a PCP. If you don’t, one will be automatically assigned to you. However, you can change it at any time.
Continuity of Care	If your doctor doesn’t participate in the Harvard Pilgrim network, you may be eligible to continue seeing them for a period of time. Continuity of care is available for qualifying medical conditions (for example, inpatient care and pregnancy care). To learn more, contact Harvard Pilgrim’s SmartStart at 866.874.0817 or email smartstart@harvardpilgrim.org.
Prior Authorizations	Any referrals and prior authorizations that you currently have on file with Tufts Health Plan (medical, behavioral health, and pharmacy) will transfer automatically to Harvard Pilgrim. Note: Any pending prior authorizations that haven't been approved by the end of 2024 will not transfer.
Prescription Drugs	For prescription drug coverage, your benefits and coverage will be the same as today. Here are some other details you need to know about the transition: Retail pharmacies: Coverage will be provided through OptumRx. To verify that your current pharmacy is in the network, go to this OptumRx website and click Find a network pharmacy. Under "Plan options," choose 2024 Premium 4-Tier. Mail order program: If you currently have prescriptions delivered to your home through Tufts, your prescriptions will transfer automatically to Harvard Pilgrim. No action is required by you. Formulary: The formulary will generally be the same. To verify how your prescription drugs will be covered, go to www.harvardpilgrim.org/public/prescription-drug-plans. Look for Premium 4-Tier.
Where to Learn More	Review the 2025 plan summary: Harvard Pilgrim HMO. Review the 2025 SBC: Harvard Pilgrim HMO. Check out new member resources: Go to www.harvardpilgrim.org/public/are-you-a-new-member. Search for providers in the network: Go to hphc.providerlookuponlinesearch.com/search. Under "Health Plan," select HMO or HMO Open Access. Check prescription drug coverage and costs: Go to www.harvardpilgrim.org/public/prescription-drug-plans. Look for Premium 4-Tier.

The amount you pay for medical coverage each paycheck will increase in 2025. Dental and vision deductions will remain the same.

Beginning January 1, 2025, Lincoln Financial Group will administer our supplemental medical plans. This applies to our Accident, Critical Illness, and Hospital Indemnity Insurance plans.

If you’re currently enrolled in one of these plans, here’s what you need to know:

• No action is required: Your current coverage will automatically transfer to Lincoln Financial on January 1, 2025. However, you'll have the option to update your coverage during Open Enrollment.
• Benefits and coverage: There will be some changes. Some benefits will increase, while others will decrease. Review a 2025 summary for your plan: Accident Insurance - Low Option | Accident Insurance - High Option | Critical Illness Insurance | Hospital Indemnity Insurance
• Paycheck costs: There will be minor changes to your cost.

Not enrolled today? If you’re NOT currently participating in a supplemental medical plan, you can enroll during Open Enrollment. These plans pay cash benefits for covered events.

Important incentive! All plans have a $50 wellness benefit included for each member. You can earn $50 per member each year, which can help offset the cost of this coverage. All you have to do is complete a wellness activity (like a primary care office visit, physical, etc.) and submit information to Lincoln Financial Group.

The following contribution limits will increase for 2025:

• HSA: The annual HSA limits will be $4,300 for employee-coverage and $8,550 for family coverage. If you’re age 55 or older, the annual catch-up contribution will remain unchanged at $1,000. You can contribute to an HSA if you enroll in the Blue Shield PPO Savings (CDHP).
• Health Care FSA/Limited Purpose FSA: The annual limit will increase to $3,200. You can use funds for expenses you incur beginning January 1, 2025, through March 15, 2026.

Learn more about tax-advantaged accounts.

Our Employee Assistance Program (EAP) will change from Resources for Living to SupportLinc.

At some point in our lives, we each face a problem or situation that's difficult to resolve. When that happens, the SupportLinc EAP will be there to help. They can help you deal with life's challenges and the demands that come with balancing home and work. SupportLinc provides professional referrals and up to eight face-to-face or virtual counseling sessions for a wide variety of concerns including anxiety, depression, marriage and relationship problems, grief and loss, substance abuse, anger, stress, financial assistance, legal assistance, and family assistance.

Learn more about the EAP.

YES!	NO
If you want to… Enroll in, change, or cancel coverage. Add or remove dependents. Contribute to an FSA or HSA in 2025. Avoid surprises! If you're enrolled for medical coverage in 2025, you should also check to see if your doctor is part of the new Blue Shield of California or Harvard Pilgrim network.	No action is required if… You want to be enrolled in a similar Blue Shield or Harvard Pilgrim medical plan for 2025. You don’t want to contribute to an FSA or HSA in 2025. You want the same benefits for everything else, and you want to cover the same dependents as you do today.
Do you currently waive health care coverage?
If you don't take action during Open Enrollment, you'll continue to have NO health care coverage in 2025.

Use this checklist to make the most of your enrollment opportunity:

Attend an employee meeting.
• Seattle: Tuesday, October 22
• Virtual: Wednesday, October 23
• Boston and Goleta: Thursday, October 24

Explore these tools to learn about your options:
• Find your new paycheck costs: See sections above for "Employee Premiums" and "Supplemental Medical Plans"
• 2025 medical plan summaries: Blue Shield PPO | Blue Shield PPO Savings (CDHP) | Blue Shield Access+ HMO | Harvard Pilgrim HMO
• 2025 SBCs: Blue Shield PPO | Blue Shield PPO Savings (CDHP) | Blue Shield Access+ HMO | Harvard Pilgrim HMO
• Estimate 2025 costs with ALEX Go
• Schedule a one-on-one session with TouchCare for help selecting your 2025 benefits

Verify your doctors participate in your new medical plan network.
• Blue Shield of California: Blue Shield microsite. To search for providers outside of California, when it asks for the three letters at the beginning of your member ID number, use SON (for the PPO and CDHP plans) or XEH (for the HMO plan).
• Harvard Pilgrim HMO: hphc.providerlookuponlinesearch.com/search. Under "Health Plan," select HMO or HMO Open Access.

Make sure your dependent information is correct, all your dependents are still eligible, and correct coverages are listed.

Enroll in an FSA or HSA, if eligible — current elections do not carry over to next year.

Review your beneficiaries — it’s a good idea to review your beneficiary information for life/AD&D insurance and the 401(k) plan (especially if your personal circumstances have changed) and make updates, as needed. If a beneficiary is not designated for life and AD&D insurances, you’ll be unable to complete the enrollment process.

Complete your enrollment online through Workday by 11:59 p.m. Pacific Time on Friday, November 8, 2024.

Look for new medical ID cards in December. They’ll be mailed to your home.

1. Log on to Workday.
2. In My Tasks, open the Complete Open Enrollment Elections task.
3. Select Let’s Get Started to choose your elections.
4. Select Enroll to elect a benefit, or Manage to view your current elections and make any desired changes. Be sure to follow the prompts, as the enrollment process may take place over multiple pages (for example, selecting your plan, adding dependents, etc.).
5. After you’ve selected benefits for you and your eligible dependents, select Review and Sign. You’ll be able to see a full list of your chosen benefits and the total cost per paycheck.
6. If you’re satisfied with your elections, scroll to the bottom of the page and check the I Agree box. Then, click Submit.
7. Click View Benefits Statement, then Print to download your confirmation statement.