2018 Plan Changes

  1. Intro to Select Benefits
  2. Consider Your Choices
  3. Summary of Medical Plan Options and Rates
  4. Choosing Your Medical Coverage
  5. Choosing Which Facility
  6. Pharmacy Benefits
  7. Health Flexible Spending Account (HFSA)
  8. Dental Benefits
  9. Vision Benefits (VSP)
  10. Life Insurance
  11. NEW Appeal Process

Introduction to Select AlaskaCare Benefits

The State of Alaska allows you to choose your own Select AlaskaCare Benefits plan, commonly referred to as AlaskaCare. In addition to enrolling when you are first eligible or during annual Open Enrollment, benefits may be changed within 30 days of a qualified change in family or employment status.

Select Benefits allows you to choose your benefit plans. Because you may have different needs than your coworkers and friends, you can create a personal benefit program from a range of benefits and levels of coverage. Best of all, you can spend your dollars for benefits that better meet your needs. Here's how it works:

  • You consider the monthly cost of each option and decide which benefits to purchase.
  • If you make selections that require a monthly employee contribution, that amount will be taken through pretax payroll deductions. This means deductions are withheld from your pay before federal income taxes are applied. The monthly employee contribution amount is divided in half and deducted from your paychecks in equal amounts throughout the benefit year.

The online enrollment system will automatically calculate your monthly employee contribution amount as you make selections, allowing you to change your choices until you are satisfied with the choices and cost.

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Consider Your Choices

You will need to make elections based on the Select Benefit options listed below. Please review these carefully to ensure the options you select are best for you and your family. Follow the links for more details about these important benefits. You may enroll in or change these benefits for the first 30 days after first being hired into an eligible position; following a qualified change in family or employment status or during the Open Enrollment.

Carefully review the different benefit options, discuss your benefit needs with your spouse if applicable, and contact the Division if you have questions. Benefits needs are different for everyone. Make sure the decisions you make during open enrollment will be a good fit for you and your family for the next year. The following available benefit options vary in cost and provide different benefit levels.

Your Select AlaskaCare Benefits choices:
AlaskaCare Health
Voluntary Supplemental Benefits (VSB)

 * You must elect this benefit each Open Enrollment period; it will not automatically continue from one benefit year to the next. Limitations to this plan may apply; refer to the AlaskaCare Select Benefits Information Booklet for greater details about this plan.

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Summary of Medical Plan Options and Rates

AlaskaCare offers a menu of medical plan options so you can find the best fit for you and your family. Beginning in 2018, in addition to AlaskaCare’s traditional Standard and Economy plans, there is a new menu option—the Consumer Choice plan. Get more answers about this new option here on the FAQs page.

  • Glossary of Important Terms
    • Deductible is the amount you pay each benefit year before a portion of your costs are paid by your AlaskaCare medical plan benefits. You pay the full cost of your eligible health expenses until you meet your deductible. The amount you pay for your deductible depends on the plan you select.
    • Coinsurance is the percentage of covered expenses paid by AlaskaCare once you meet your deductible.
    • Out-of-pocket limit is a cap which AlaskaCare has set to protect you from large expenses. If you reach the out-of-pocket limit, AlaskaCare will then pay 100% of your eligible expenses for the rest of the calendar year. A separate out-of-pocket limit applies to medical benefits and pharmacy benefits.
    • Health Reimbursement Arrangement (HRA)** is a tax-free medical reimbursement plan funded by the employer for members enrolled in the Consumer Choice plan. The balance of the HRA is applied towards the Consumer Choice deductible each benefit year until the HRA is exhausted.

    Select Alaska Benefits

    ** HRA only applies to Consumer Choice plan. With the Economy and Standard plans, you pay 100% of the deductible amount.

  • Preventive Care — At No Cost

    All AlaskaCare employee medical plan options will pay covered preventive services in full when received from an network provider. In-network preventive care services are not subject to deductibles or coinsurance.

    See the Preventive Care Coverage Information Flyer [PDF] and the Women’s Preventive Care Coverage Information Flyer [PDF] for additional information on covered preventive services.

    All other covered medical benefits are subject to the deductible and coinsurance.

AlaskaCare 2018 Active Employee Premiums
Benefit Standard Economy Consumer Choice
Monthly Employee -
Only Contribution
$136 $0 MEBA/IBU/ ACOA/TEAME
$40 All Others
$23
Monthly Employee Contribution for Employee and Family $388 $0 MEBA/IBU/ ACOA/TEAME
$115 All Others
$66
Deductible $400 / Individual
$800 / Family
$600 / Individual
$1,200 / Family
$2,500 / Individual
$5,000 / Family
Coinsurance 1 2 80% of allowable amount 70% of allowable amount 70% of allowable amount; 50% for out-of-network services
Annual Out-of-Pocket Limit (See plan document for to see exclusions) $1,850 individual / $3,700 individual if out-of-network for facility services outside of Alaska or in the Municipality of Anchorage $2,850 individual / $5,700 individual if out-of-network for facility services outside of Alaska or in the Municipality of Anchorage $5,500 individual / $11,000 individual if out-of-network for facility services outside of Alaska or in the Municipality of Anchorage

1 See section 2.1.1 of the plan booklet for a list of coinsurance exceptions, such as 100% for in-network preventive care, or reduced coinsurance levels for receiving services at some out-of-network facilities.
2 Coinsurance will be 30% of covered charges for dependents that are covered by a State employee health trust and that coverage: has been waived, pays less than 70% of covered expenses, or has an individual out-of-pocket maximum, including deductibles, of more than $3,500.

Effective: Jan. 1 - Dec. 31, 2018

 * Under the authority of 2 AAC 39.920, Select Benefits will only pay 30 percent of covered charges for your dependents if your spouse or children are covered by a State employee health trust and that coverage:

  • has been waived,
  • pays less than 70 percent of covered expenses, or
  • has an individual out-of-pocket maximum, including deductible, of more than $3,500

This applies to any dependent covered by Select Benefits where the trust plan would normally pay first if you hadn't reduced or waived coverage. When your spouse or the parent of any of your children selects coverage under a State employee health trust, they must ensure they are electing a plan that covers at least themselves and any dependents for which they have primary responsibility and that coverage provides full family coverage. Failure to do so will result in lower coverage for your dependents in the coming year.

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Choosing your Medical Coverage

The AlaskaCare Employee Health Plan is offering a new medical plan option this year with a higher deductible than medical plans traditionally offered by AlaskaCare, but with a lower premium. This new Consumer Choice plan is a consumer driven health plan with an employer sponsored Health Reimbursement Arrangement (HRA).

Meet the Taylor Family

David and Katie Taylor are in their late 40s with two children Emma (age 10) and Liam (age 14). Katie is in the Supervisory bargaining unit. They have family coverage under AlaskaCare and no other coverage. In this example, the Taylor family would pay less out-of-pocket if they choose the Economy plan.

  • About the Taylors’ Health
    • The Taylors see their family doctor annually to receive preventive care.
    • They are a healthy active family, but had some unexpected health issues during the year. Liam was involved in a snowboarding accident and taken to the emergency room. He was discharged and instructed to begin physical therapy for a neck injury.
    • With his accident Liam met his individual deductible, and the Taylors continued to pay coinsurance for his eligible expenses during the calendar year until he reached the individual out-of-pocket maximum.
    • All services were received in-network.
-- Consumer Choice Economy Standard
Total Annual Premiums $792 $1,824 $4,656
Total Estimated out-of-pocket (OOP) Claim Costs $5,650 $3,000 $2,000
State of Alaska Contribution to HRA ($900) $0 $0
Combined Total OOP Estimated Annual Costs $5,242 $4,824 $6,656
Meet the Clark Family

Andrew and Sophie Clark are in their mid-30s and have one child, 9-year-old Noah. Andrew is a legislative employee. They have family coverage under AlaskaCare and no other coverage. In this example, the Clark family would pay less out-of-pocket if they choose the Consumer Choice plan.

  • About the Clarks’ Health
    • The Clarks see their family doctor annually to receive preventive care.
    • They are a healthy active family, but Sophie has chronic condition that requires monitoring through periodic medical office visits and testing. In addition, Noah had two unanticipated doctor visits, one for a severe sore throat with fever; the other for an earache.
    • Neither Noah or Sophie met the full deductible.
    • All services were received in-network.
-- Consumer Choice Economy Standard
Total Annual Premiums $792 $1,824 $4,656
Total Estimated out-of-pocket (OOP) Claim Costs $3,020 $1,690 $1,300
State of Alaska Contribution to HRA ($1,150) $0 $0
Combined Total OOP Estimated Annual Costs $2,662 $3,514 $5,956
What about you? What will your healthcare needs be in the coming year?

Although you may not be able to fully predict the answer this question, consider if you have a chronic condition such as high blood pressure, or are planning a scheduled procedure. You might be able to calculate the expected costs to determine which plan may be the greater value for you or your family. Also, consider what would happen if you experience and unanticipated medical event? Would you and your family be able to absorb these unexpected out-of-pocket costs?

Compare the annual cost of the premiums and out-of-pocket maximums for each plan when deciding which plan may be the best fit for you. Please see our Health Plan Cost Comparison Tool [XLSM] for help comparing the different costs.

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Choosing Which Facility to Use

Network facilities in the Anchorage area have changed and it could impact how much you pay. It is more important than ever to use a preferred facility to avoid costly balance bills and increased cost share.

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Pharmacy Benefits

Prescription drugs are the fastest growing cost in most health plans, including ours. Higher claim costs from prescription drugs, as with any other expense, means higher premium payments to all participants in the plan. There are some important changes to the pharmacy benefit in 2018. To ensure you get the most out of your benefits you should consider switching to mail order where your co-pay goes further. In addition, choosing a lower level drug (generic) when it is appropriate can provide access to necessary medications to stay healthy, at a cost that is more affordable.

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Health Flexible Spending Account (HFSA)

With the Select Benefits Health Flexible Spending Accounts (HFSA), you can set aside money to pay for certain health care expenses on a tax-free basis. You must contribute in whole dollar amounts. The contribution amount you elect will be deducted from your paycheck in equal amounts throughout the year.

2018 Health Flexible Spending Account Rates
Minimum Monthly Amount $20.00
Maximum Monthly Amount $220.00
Effective: Jan. 1 - Dec. 31, 2018

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Dental Benefits

Oral health is an essential part of staying healthy. Studies have linked oral health to several chronic diseases, including diabetes, heart disease and stroke. Pregnant women who have periodontal disease are more likely to have a premature and underweight baby. Lower your risk by keeping up with your preventive services. Both plans cover preventive (Class I) services, such as cleanings and periodic oral exams, at 100% when using a network provider.

There are no changes in the Dental Plan options or coverage for 2018. There are currently two AlaskaCare plans to choose from.

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Vision Benefits (VSP)

Most experts estimate that over 64% of adults need some sort of vision correction. Depending on how often you need new lenses, getting vision insurance may be a good financial fit.

Many hidden medical problems can be detected through an eye exam, so even those with perfect vision should have regular eye exams. If this routine exam is all you need, the vision plan may not be the right financial fit for you.

Review the premiums and the coverage offered under the VSP plan before making a decision if this vision coverage is the right fit for you.

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Life Insurance

The benefits you choose now can make a difference to your family later. Select Benefits lets you customize the amount of life insurance that is right for your situation. The IRS limits the pretax premiums to the cost of group-term life insurance coverage up to $50,000. If you are a member of a bargaining unit that provides $10,000 in Basic Life insurance, this leaves a remainder of $40,000 in coverage that can be purchased with a pretax premium without exceeding the IRS limit of $50,000. If you elect coverage combinations from the pretax life and accidental death and dismemberment (AD&D) options that exceed the $50,000 IRS limit, a portion of the premiums you pay will become imputed income. Only the portion of the premium representing the coverage amount over $50,000 will be taxable.

To determine your monthly premium, find your age as of January 1, 2018, the amount of insurance elected, and the corresponding premium on the chart.

2018 Select Life and AD&D Rates
Age Rate Per $1,000 per month
Under 30 $0.050
30 – 39 $0.060
40 – 44 $0.100
45 – 49 $0.150
50 – 54 $0.230
55 – 59 $0.357
60 – 64 $0.510
65 – 69 $0.740
70 – 74 $1.632
75 & over $2.060
Effective: Jan. 1 - Dec. 31, 2018

There are several plans available to you: (overview)

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NEW Appeal Process

If your health plan denies payment for a treatment that you believe should be covered, you have the right to challenge that decision through the appeal process. AlaskaCare has added a new level to the appeals process for services or supplies received on or after January 1, 2018. Under the new appeal process, if the third party claims administrator or external review organization uphold their original denial of your appeal, you have the right to appeal to the Division of Retirement and Benefits. Should the Division also uphold the denial, you retain the legal right to take the appeal to superior court.

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