Select a topic to view information:
Additional Accidental Death & Dismemberment (AD&D) Insurance
BJC Dental Plan
Changing Benefit Elections
Flexible Spending Accounts (FSAs)
Long-Term Disability Insurance
Tobacco-User Surcharge
What Happens if I Don’t Enroll?
Working-Spouse Surcharge
Additional Accidental Death & Dismemberment (AD&D) Insurance
BJC provides Accidental Death & Disability (AD&D) insurance free of charge to full-time and eligible part-time employees under the Basic Life and AD&D Insurance plan. Coverage under this plan is automatic; you do not have to enroll, though you need to name a beneficiary (or beneficiaries). Coverage pays one times the annual base salary of full-time employees. Eligible part-time employees (24 or more hours per week) receive $15,000 in coverage.
During 2020 annual benefits enrollment (October 30 to November 13, 2019), you will have two opportunities to purchase additional AD&D insurance:
- 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. For more information, including cost of coverage, see "Life Insurance" under “Benefits” on the BJC Total Rewards website.
Q. Do I need additional AD&D coverage?
A. Understanding what AD&D insurance covers might help you decide whether you need to elect Additional AD&D coverage:
AD&D insurance pays a death benefit (the amount of coverage elected) to the designated beneficiary (or beneficiaries) should the insured die because of an accident (covered by the insurance). “Accidental” in this regard means the death of the insured cannot have been caused by illness or physical condition.
By the way, you are automatically the beneficiary of the coverage you purchase on your dependents.
AD&D insurance also pays part or the full face value of the policy benefit for accidental dismemberment. For example, if the insured were to lose a limb, the policy would pay half of the coverage elected; if two limbs the full amount. Accidental loss of vision and hearing is also covered.
For details on what’s covered and to what extent, see “Summary Plan Descriptions & Legal Resources” under Benefit>Resources on the BJC Total Rewards website.
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BJC Dental Plan
If you are enrolled in the BJC Dental Plan for 2019 be aware that there are a number of preventive dental care services that are covered at 100 percent (no deductible) if provided by a dentist within Delta Dental of Missouri’s Premier or PPO (preferred provider organization) Network. Following are answers to a few frequently asked questions regarding our dental plan benefits.
Q. How many preventive dental exams per year am I entitled to as a BJC Dental Plan participant?
A. You are entitled to two preventive oral examinations per plan year. This includes an evaluation of your bite and gum tissue, and any evidence of tooth decay, in addition to dental cleaning, scaling and polishing to remove plaque and tartar build-up. Preventive dental exam x-rays are also covered. Two additional cleanings (for a total of four) are covered per plan year for patients who are pregnant, diabetic, have a suppressed immune system or have a history of periodontal (gum) issues. Please note that the Annual Maximum Benefit coverage under the two dental plan options (High and Low) may impact the number of preventive dental exams covered at 100 percent.
Q. What is the difference between Delta Dental’s PPO and Premier Network?
A. Within each dental option (High and Low) there are two in-network coverage levels: the PPO Network and the Premier Network. 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. This is true for both the High and Low dental plan options. Delta Dental’s PPO Network includes nearly 50 percent of all dentists nationwide. Its Premier Network features more than 80 percent of dentists nationwide. All dentists who participate in Delta Dental’s PPO Network are also in Delta Dental’s Premier Network. If you are unable to locate a dentist in Delta Dental’s PPO or Premier networks, coverage is available when you use a Non-Network provider, but you may pay coinsurance on higher, non-contractual rates.
Q. What is 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. Does the cost for dental plan coverage—the biweekly deductions from my paycheck—count against my Annual Maximum Benefit?
A. No. Only the cost of deductibles and coinsurance count against the Annual Maximum Benefit and that’s on an individual plan member basis.
Q. Do the costs for orthodontia services count against the Annual Maximum Benefit?
A. No. Orthodontia benefits (payable only under the High option) are subject to a separate Lifetime Maximum benefit for each covered individual. The Annual Maximum Benefit reflects the maximum benefit payable for all covered charges except orthodontia, per plan year for each covered individual.
For more information, or to find a Delta Dental network provider, go to www.deltadentalmo.com or call toll-free 800.335.8266..
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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 their circumstances (loss/gain of employment)
- Change in job status (e.g. part-time to full-time)
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
Q. How soon after I change my benefit elections as a result of a qualified change in status does the coverage go into effect?
A. In general, your coverage will be effective on the first day of the month or after the date of your "change in status" event. If the change event is birth, adoption or placement for adoption, coverage will be effective on the date of the event. If you marry, coverage for your spouse will begin on the first day of the month on or after your marriage date. For job status changes, coverage will be effective on the first day of the month following the change in status.
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Flexible Spending Accounts (FSAs)
During annual enrollment for 2020 benefits (October 30-November 13, 2019), 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 ($2,700) 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 2020. 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 2020. 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 2020. This roll over feature does not apply to dependent day care FSAs.
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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) benefit pays 60 percent of an employee’s earnings up to $2,500 per week for 180 days (if the employee has met the eligibility requirement of having completed six months of service with BJC).
Under BJC’s long-term disability (LTD) benefit, full-time employees, eligible 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 2020 annual benefits enrollment (Oct 30 - Nov 13, 2019) 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.
Following are answers to a few frequently asked questions.
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, what is the elimination period and does it have to occur in the same calendar year?
A. To qualify for LTD, you must satisfy the 180-day elimination period. The elimination period is a period of consecutive days of disability or partial disability for which no LTD benefit is paid. BJC’s short-term disability plan may apply to you during the LTD elimination period. If you return to work for 30 or fewer days during the elimination period and cannot continue to work, Lincoln will count only those days you are disabled or partially disabled to satisfy the LTD elimination period. The LTD elimination period can cross over into a new calendar year.
Q. Will I be required to pay for my benefits while I’m on disability leave?
A. Yes. Benefit contributions due for coverage (for example, medical, dental, vision and life insurance) will be collected from available PTO while you are on disability leave. Once PTO is exhausted, benefit contributions 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.
Q. Where can I find coverage details for short-term and long-term disability?
A. Consult the Summary Plan Descriptions (SPD) and applicable Certificates of Coverage available on the Benefits/Plan Information page on www.BJCtotalrewards.org.
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Tobacco-User Surcharge
During annual benefits enrollment (October 30 – November 13, 2019), employees will be asked to attest to their and their spouse’s use of tobacco. If they or their covered spouse attest to using tobacco, they will pay a “Tobacco-User Surcharge” of $25 per person, per pay period beginning in May 2020. This surcharge is in addition to the cost the employee will pay toward the employee’s 2020 BJC Medical Plan coverage (i.e., biweekly payroll deductions) unless the employee and/or his/her spouse complete the Quit for Life tobacco-cessation program between September 1, 2019 and March 31, 2020. Following are answers to a few frequently asked questions:
Q. What does it cost to participate in the Quit for Life tobacco-cessation program?
A. It doesn’t cost you (or your covered dependents, age 18 and older) anything if you are a BJC Medical Plan participant. Employees and family members who are not Medical Plan participants can enroll in Quit for Life, but due to tax regulations the employee will be taxed on the cost of the cessation program ($365) and the tax will be withheld from the employee’s paycheck. The tax is approximately $55, based on a 15% tax rate.
Q. How long does it take to complete the Quit for Life tobacco-cessation program?
A. Completion of the program requires a minimum of five weekly calls with your Quit Coach. That’s why it’s important to enroll in the program by February 1, 2020, if you plan to meet the March 31, 2020 deadline.
Q. What if I complete the Quit for Life program, but not in time to meet the March 31, 2020 deadline?
A. If you do not meet the March 31, 2020 deadline, you will still have to pay the tobacco-user surcharge from May 2020 through December 2020.
Q. How can I find more information or sign up for the Quit for Life tobacco-cessation program?
A. Call 866.784.8454 or log on to www.quitnow.net/bjc.
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What Happens if I Don't Enroll?
Q. What happens if I don’t enroll in benefits during annual enrollment?
A. Annual enrollment for 2020 benefits will begin on Wednesday, October 30 and continue until midnight Wednesday, November 13, 2019. Even if you want the exact same benefits for 2020 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 2020.
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, 2020, in addition to the costs you will pay toward your 2020 BJC Medical Plan coverage (your biweekly payroll deductions), unless you and/or your spouse complete the Quit For Life tobacco-cessation program between September 1, 2019 and March 31, 2020.
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 2020 and carry over your unused 2019 health care FSA balance, you must actively enroll.
Legal Services: Your current elections with LegalEASE will not carry over to 2020 because BJC is changing to MetLaw/Hyatt Legal services.
If you are currently enrolled in a medical, dental, vision, and supplemental life, additional accidental death and dismemberment and long-term disability insurance option, for 2019, your coverage will remain at the same level in 2020, unless you actively enroll/make changes for 2020.
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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:
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.” If you keep your spouse covered, you will have to pay the $50 per pay period surcharge. Or, you could drop your spouse from BJC Medical Plan coverage,
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.”
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