Changing Benefit Elections
BJC Dental Plan
Accidental Death & Dismemberment (AD&D) Insurance
Long-Term Disability
Flexible Spending Accounts (FSAs)
Working-Spouse Surcharge

What Happens if I Don’t Enroll?

Accidental Death & Dismemberment (AD&D) Insurance

In addition to the AD&D coverage that is provided to you at no cost under the Basic Life and AD&D benefit that BJC issues to full-time and eligible part-time employees, you can buy during annual benefits enrollment additional AD&D coverage as part of Supplemental Life and AD&D coverage that you can purchase for yourself, and as Additional AD&D coverage that you can purchase for yourself and/or spouse and children.

Q. What is AD&D coverage?
A.  AD&D insurance pays a death benefit to a designated beneficiary if the cause of death is the result of an accident covered by the insurance. "Accidents" in this regard means the death of the insured cannot have been caused by illness or physical condition.

Q. Why are the Employee Costs for Supplemental Life and AD&D coverage higher than the same amount of coverage under Additional AD&D insurance for employees? 
A. Because Supplemental Life and AD&D coverage have both a death from natural causes provision and a death from accident provision. Additional AD&D only pays due to an accident.

Q. How much AD&D coverage do I need?
A.  That’s a question only you can answer because it could depend on your age, physical and financial health, life-style and whether you’re married and have children, among other factors. Keep in mind that you have AD&D coverage as part of the Basic Life and AD&D plan BJC provides to you at no cost. AD&D plan details can be found in Summary Plan Descriptions & Legal Resources.


Changing Benefit Elections

Q. I understand that BJC employees can change their benefits outside of the annual benefits enrollment period because of certain “life events” that occur. What events are considered “life events”?
A. There are several events that qualify as a “life event”, during which employees will be allowed 31 days to change their benefits:

  • The birth, adoption or the placement of a child for adoption
  • Marriage
  • Divorce
  • Add/drop spouse or dependent from coverage due to change in the spouse's or dependent's circumstances (loss/gain of employment)

For a detailed list of qualified life events, please refer to the Benefits Summary Plan Descriptions (SPD’s) on BJCtotalrewards.org/Benefits/Plan-Information.

Q. When a qualifying life event occurs, how much time do I have to change my benefits?  
A. You have 31 days from the date the qualifying life event occurred.

Q. What steps should I take if I need to change my benefits as a result of a “life-change” event?
A. Follow these steps:

  • Log on to myBJCnet (myHR) with your network ID and password
  • Select myBenefits
  • Select “Enroll Due to Life Events” and follow the instructions


BJC Dental Plan

Q. How do I find a dentist in the Delta Dental of Missouri network? 
A.  Go to the Delta Dental website, select “Find a Provider” and complete the brief “Dental Provider Search” questionnaire. Please note that coverage varies between Delta Dental’s two networks -- PPO and Premier, and the two dental options -- High and Low. Need help?  Call Delta Dental customer service toll-free 800.335.8266.

Q. What’s the difference between Delta Dental’s PPO Network and Premier Network?
A. Within each dental option there are three network coverage levels:  PPO Network, Premier Network and Non-Network.  For both the High and Low dental options, when you use a dentist in the PPO Network, you will pay less out-of-pocket for Basic Care and Major Care dental services, and have a larger annual maximum. Delta Dental’s PPO Network includes nearly 50 percent of all dentists nationwide. Its Premier Network features more than 80 percent of dentist nationwide.  All dentists who participate in Delta Dental’s PPO Network are also in Delta Dental’s Premier Network. 

Q.  What’s the difference between Basic Care and Major Care dental coverage? 
A. Basic Care includes a range of routine dental services, such as fillings, root canals, tooth extractions and treating gum disease.  Major Care involves dental services such as bridges, dentures, crowns, jackets and implants, some of which may be limited to coverage once every five years.

Q. Do you stop receiving coverage for the calendar year when you exceed the Annual Maximum Benefit in the BJC Dental Plan?
A. Yes. The Annual Maximum Benefit is the total cost of care the dental plan will pay on a participant’s behalf in one calendar year.

Q. If you elect the High dental option and exceed the Lifetime Maximum of $2,000 for Orthodontia Benefits in the PPO Network, does this mean you would never again be eligible for orthodontia coverage under the BJC Dental Plan?
A. Orthodontia Benefits, which are payable only under the High dental option, are subject to a separate lifetime maximum benefit of $2,000 for each covered participant if the charges are made by a Delta Dental PPO Network provider. Once the $2,000 lifetime maximum is reached, no additional orthodontia benefits will be payable. The same principal applies to the $1,500 Lifetime Maximum for a Premier or Non-Network provider under the High dental plan.

Note: For maximum benefits (annual or lifetime) non-network expenses count toward network maximums, and that network expenses count toward non-network maximums.


Flexible Spending Accounts (FSAs)

During annual enrollment for 2019 benefits (October 31-November 14, 2018), you will have an opportunity to enroll in the tax-saving benefits of a Flexible Spending Account (FSA). BJC offers both a health care and dependent day care FSA.

Q. What are the benefits of a FSA?
A. An FSA reduces your taxable income by allowing you to set aside a portion of your pay, before taxes, to pay for qualified health care or dependent day care expenses throughout the year. This pretax deduction lowers your taxable income, reducing the amount of tax you owe on your bi-weekly paycheck. In addition, FSA participants receive a FSA debit-like card that provides a convenient way to pay for prescription drugs, medical and dental office visits, and both child and adult day care expenses.

Q. Can I change my FSA election after the plan year begins?
A. Certain qualifying events allow you to either increase or decrease your FSA election or begin/cease participation in the FSA program. Common qualifying events include marriage, divorce, birth, death or change in the cost of dependent day care.

Q. Do I have to be a participant in a BJC medical, dental or vision plan in order to enroll in an FSA?
A. No. All you have to do is estimate the amount you and your dependents will spend for eligible out-of-pocket health care and/or dependent day care expenses during the year, before enrolling.

Q. Any advice on how to determine a FSA contribution?
A. First, you need to know the IRS limits on what you can contribute annually to a health care ($2,650) and dependent day care ($5,000) FSA. Next, it’s good to know eligible and ineligible FSA expenses. Go to DiscoveryBenefits.com/employees/eligible-expenses for a detailed listing.

If you are a BJC Medical Plan participant, go to myCigna.com and look at your “Explanation of Benefits” to determine the total amount of out-of-pocket expenses you incurred last year (and so far this year). Based on what you spent in the past, estimate what you might spend out-of-pocket on eligible health care and dependent day care expenses in 2019. For example, how much did you spend last year on medical, dental and prescription drug copayments and deductibles? Do you plan to have laser eye surgery next year? Purchase hearing aids or reading glasses? Enroll a child in nursery or preschool?

Taking past and future expenses into account should help you determine your FSA contributions for 2019. You can also plug into Discovery’s FSA calculator which, based on your salary, tax bracket and potential expenses, can help you determine a contribution amount for next year: DiscoveryBenefits.com/employees/fsa-calculator.

Q. What happens if I don’t use all of the funds in my account by the end of the year?
A. You can roll over $50 to $500 of unused health care FSA funds to the following year, provided you enroll in an FSA for 2019. This roll over feature does not apply to dependent day care FSAs.    


Long-Term Disability (LTD) Insurance

BJC automatically provides to eligible employees both short-term and long-term disability benefits to help replace some of the income they would lose while disabled. BJC’s short-term disability (STD) pays 60 percent of an employee’s earnings up to $2,500 per week for 180 days (after the employee completes six months of service with BJC).

Under BJC’s long-term disability (LTD) benefit, full-time employees, after completing six months of employment with BJC, receive 50 percent of their base pay, up to $8,000 per month, at no cost. Full-time employees who want to increase their LTD benefit will have the option during annual benefits enrollment (October 30-November 14, 2018) to purchase an additional 10 percent in LTD coverage to a maximum of $10,000 per month in coverage. Eligible part-time employees have the option of purchasing 60 percent in coverage to a maximum of $10,000 per month. 

Q. When a full-time employee goes on long-term disability and receives LTD benefits, is there a limit as to how long the employee will receive 50 percent of his/her base pay up to $8,000 per month? 
A. The maximum benefit period varies based on the age of the employee at the time the employee goes on long-term disability. For example, an employee who goes on LTD at age 62 could continue to receive LTD benefits until age 65, as long as the employee is still deemed disabled.

Q. In order to qualify for LTD, do the 180 days of being out of work have to be consecutive, and do they have to occur in the same calendar year?
A. In order to qualify for LTD, the 180 days must be consecutive. As long as the days are consecutive, they can cross over into a new calendar year.

Q. Will I be required to make biweekly payroll deductions for benefits while I’m on disability leave? 
A. Yes. Deductions for coverage will be collected from available PTO while you are on disability leave. Once PTO is exhausted, benefit deductions that are due will go into arrears and will be collected when you return to active employment. 

Q. Do I need to complete an evidence of insurability (EOI) form to purchase additional LTD insurance?
A. No, you do not.


Working-Spouse Surcharge

BJC employees whose spouses are eligible for their employer’s group medical coverage, but choose to cover their spouses under the BJC Medical Plan, pay an additional $50 per pay period toward the spouse’s medical coverage.* Called the “Working-Spouse Surcharge,” following are answers to a few frequently asked questions:

*Note: Working spouses of Memorial employees are not eligible for BJC medical coverage if they have access to group medical coverage from their employer and, therefore, are not subject to the Working Spouse Surcharge.  

Q. Do I have to pay the Working-Spouse Surcharge if I only elect coverage for my spouse under the dental and vision plans?
A. No. You would not have to pay the Working-Spouse Surcharge. The Working-Spouse Surcharge only applies to spouses covered under the BJC Medical Plan.

Q. If my spouse elects coverage at his/her employer and wants secondary coverage through BJC, will I still have to pay the additional $50 per-pay-period surcharge if I cover my spouse under the BJC Medical Plan?
A. Yes

Q. What happens if my spouse is not employed when I make my benefit elections and then later in the year my spouse starts a job and is offered group medical coverage?
A. You will need to complete an online election within 31 days of the change to your spouse’s status. Log on to myBJCnet, click on myBenefits and complete “Enroll Due to Life Event.”   

Q. If I’m paying the Working-Spouse Surcharge and my spouse loses his/her job and along with it eligibility for group medical insurance, will my surcharge end when my spouse’s eligibility for coverage ends? 
A. Yes. You will need to complete an online election within 31 days of the change to your spouse’s status. Log on to myBJCnet, click on myBenefits and complete “Enroll Due to Life Event.”  


What if I Don't Enroll?

Q. What happens if I don’t enroll in benefits during annual enrollment?
A. Annual enrollment for 2019 benefits will begin on Wednesday, October 31 and continue until midnight Wednesday, November 14, 2018. Even if you want the exact same benefits for 2019 that you have now, it’s important that you actively enroll. Here’s why:

Working-Spouse Surcharge*: If you don’t actively enroll and your spouse is currently a BJC Medical Plan participant, BJC will assume that your spouse has access to group medical coverage from your spouse’s employer and you will begin paying the $50 per-pay-period Working-Spouse Surcharge for your spouse’s coverage under the BJC Medical Plan in 2019. 

*Excludes Memoral employees

Tobacco-User Surcharge: If you don’t actively enroll and you are a BJC Medical Plan participant who had previously designated yourself and/or your spouse as a tobacco user during last fall’s annual enrollment, you will pay an additional $25 per-person, per-pay-period Tobacco-User Surcharge beginning in May, 2019, in addition to the costs you will pay toward your 2019 BJC Medical Plan coverage (your biweekly payroll deductions).

Flexible Spending Account (FSA): If you want to take advantage of the tax-saving benefits of a health care and/or dependent care FSA in 2019, you must actively enroll. Prior year elections do not apply to the next calendar year.

If you are currently enrolled in any of the medical, dental, vision, and supplemental life, additional accidental death and dismemberment and long-term disability insurance options, and legal services for 2018, your coverage will remain at the same level in 2019, unless you actively enroll for 2019.