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2014 Enrollment Frequently Asked Questions


1. How do I enroll?                               

Online KHRIS ESS: Active employees, KTRS retirees, and KCTCS retirees may enroll online at khris.ky.gov     

Paper Application: If you are enrolling in or ending a cross-reference payment option, have a disabled dependent covered on your plan, or are a KRS retiree, you must complete a paper application and submit it through your insurance coordinator or HR department.​        

2. As a new employee how long do I have ato enroll into a health plan?

New employees have 35 days from the date of hire to enroll into a health plan or waive coverage.

3. What plan options are available?

Four plans are available for 2014; click on the plan name to see specific information for each.

• LivingWell CDHP                               

• LivingWell PPO                               

• Standard CDHP                               

• Standard PPO                               

The LivingWell CDHP and the LivingWell PPO require the planholder to fulfill the LivingWell Promise                               

4. Who can I cover on my health plan?                               

You may cover your legal spouse or dependent child under age 26. In 2014, KEHP expanded dependent eligibility to include dependents under age 26 who may be eligible for health insurance coverage through their full-time employer.                               

5. Can children under age 26 be covered as dependents on their parent’s plan if they are eligible for their own coverage (e.g., at another job)?                               

Yes, KEHP has expanded dependent eligibility to include dependents under age 26 who may be eligible for health insurance coverage through their full-time employer. This includes children who are eligible for KEHP as an employee.                              

6. Can disabled dependents be covered beyond age 26?                               

A dependent child who is totally and permanently disabled may be covered on your KEHP benefit plan beyond the end of the month in which he/she turns 26, provided the disability (a) started before his/her 26th birthday and (b) is medically-certified by a physician. A disabled child who was not covered on this plan prior to his/her 26th birthday may not be enrolled in KEHP on grounds of total and permanent disability unless and until he/she sustains a loss of other insurance coverage. In such a case, a request to enroll a dependent child in KEHP on grounds of total and permanent disability must be made no later than 35 calendar days following the loss of other insurance coverage. Once a dependent child is approved for coverage in KEHP on grounds of total and permanent disability, the planholder may periodically be required to produce written or other proof of the continuing nature(s) of the child’s dependency and/or disability in order to maintain the child’s KEHP coverage.                              

7. What happens if I do not actively Enrollment into a health plan?                               

If you do not actively enroll in a health plan or waive coverage during open enrollment, you will be automatically enrolled in the Standard CDHP plan with single coverage. This is not a “free” plan. The monthly non-tobacco user premium for this plan is $12.98.                              

8. Can I waive coverage and not elect a KEHP health plan?                              

Yes, you may waive coverage. When waiving coverage, you have three options:                               

• Waive coverage and elect the Waiver Health Reimbursement Account (HRA). With this option you will receive $175 per month up to $2,100 annually to pay for qualified medical expenses.​     

NOTE: This option is not available to retirees. If you or your spouse or dependent is contributing funds to a Health Savings Account (HSA), you should consult a tax advisor prior to establishing an HRA or FSA.                               

• Waive coverage and elect the Dental/Vision Only HRA. With this option you will receive $175 per month up to $2,100 annually to pay for qualified dental and vision only expenses. NOTE: This option is not available to retirees.                               

• Waive coverage with no HRA. With this option you do not receive any employer funds.                               

9. What is the cross-reference payment option?                               

The cross-reference payment option is a legislatively mandated payment option that offers lower employee premiums which are deducted from both employees’ paychecks. Employees must satisfy all requirements to elect the cross-reference payment option.       

Requirements:       

• The employees must be legally married with at least one eligible dependent;                               

• The employees must be eligible employees or retirees* of a group participating in KEHP;                               

• The employees must elect the same coverage option.          

Failure to meet any one of the above requirements will make the employees ineligible for the cross-reference payment option.                               

*Per the Judicial and Legislators Retirement System, retirees of the Judicial Retirement Plan (JRP) and the Legislators’ Retirement Plan (LRP) are not eligible to elect the cross-reference payment option.                              

10. Can I drop a dependent from coverage in the middle of the plan year?                               

Coverage may only be dropped during the annual open enrollment period or if a member has a qualifying event. A list of qualifying events is included on the KEHP Health Insurance Add/Drop Form located at kehp.ky.gov                       .       

11. Who do I call for help?                              

For local, personalized help contact your insurance coordinator or HR department.

1. What is a LivingWell Promise Plan?                             

The two LivingWell plan options available in 2014 are a part of KEHP’s overall wellness program. By completing the steps of the LivingWell Promise, you can begin to:                            

• Access the best benefit options;                            

• Learn about your health status and history;                            

• Learn about and understand your health risks; and                            

• Take action to get and stay healthy.                           

2. What is required for the LivingWell Promise?                             

If you choose one of the two KEHP LivingWell plans, you are making a LivingWell Promise and agree to:                            

• Complete your online HumanaVitality® Health Assessment between January 1, 2014 - May 1, 2014. Click here for ademo of the Health Assessment; and                            

• Keep your contact information (i.e. mailing address, phone number, and email) current in KHRIS or, if a retiree, keep your contact information current with your retirement system.                            

3. If I am a new employee and choose a LivingWell plan after open enrollment, how long do I have to complete the LivingWell Promise?                             

New employees who elect a LivingWell plan after Open Enrollment must complete the Health Assessment within 90 days of the effective date of their coverage.                           

4. What is the HumanaVitality® Health Assessment?                             

The HumanaVitality® Health Assessment gives you important information about your current health and offers a variety of ways to improve your health and the health of your family. The Health Assessment includes a series of questions about you and your health habits that takes approximately 15 minutes to complete. After completion, the assessment will provide you with your Vitality Age and with goals that provide specific steps you can take to improve your health. Click here to learn more about the Health Assessment.                           

5. Who must complete the LivingWell Promise?                             

Only you, the planholder, are required to complete the LivingWell Promise. Spouses and dependents who are not employees and are covered under your plan will not be required to complete the Health Assessment. If you have the cross-reference payment option, both you and your spouse must complete the Health Assessment.                           

6. Are spouses or adult children (age 18 and up) required to fulfill the LivingWell Promise?                             

No. Only you, the planholder, are required to complete the LivingWell Promise. The only exception to this requirement is if you have elected a cross-reference payment option, in which case both planholders must fulfill the Promise.                           

7. When do I have to take the Health Assessment?                             

If you make the LivingWell Promise during Open Enrollment you must take your Health Assessment between January 1, 2014 and May 1, 2014. New employees who elect a LivingWell plan option after Open Enrollment must complete the Health Assessment within 90 days of the effective date of their coverage.                           

8. Once I complete my health assessment, do I also have to meet certain goals?   

No. To fulfill the LivingWell promise, you just have to:   

• Complete your online HumanaVitality® Health Assessment between January 1, 2014 - May 1, 2014. Click here for ademo of the Health Assessment; and

• Keep your contact information (i.e. mailing address, phone number, and email) current in KHRIS or, if a retiree, keep your contact information current with your retirement system.

9. What happens with the information collected through the Health Assessment?

KEHP takes your personal health information seriously and has measures in place to protect this information. KEHP will not collect personal health information from the Health Assessment, and any information disclosed during the assessment will be kept confidential.KEHP will not have access to individual health assessment data and the data will not be shared with members’ employers. KEHP may receive combined data from HumanaVitality® based on the Health Assessments completed by all KEHP HumanaVitality® members.This data will help KEHP develop programs and benefits tailored to meet the needs of KEHP’s membership.

In addition, federal law restricts how health plans like KEHP may use information obtained through health risk assessments. Beginning January 1, 2014, the Patient Protection and Affordable Care Act of 2010 (PPACA) prohibits health plans from imposing any pre-existing condition exclusions on persons eligible for the plan. [See, Public Health Service Act (PHSA) §2704(a), as amended by the PPACA, Pub. L. No. 111-148, §1201 (2010)]. That means KEHP cannot use any information from the Health Assessment to deny services covered under the plan even if you have a condition before you enroll.

9A. Can KEHP use my Health Assessment information to increase my premiums?

No. Although wellness programs like the LivingWell Promise are permitted, the Patient Protection and Affordable Care Act of 2010 (PPACA) prohibits KEHP from discriminating against any person based on a health factor. KEHP cannot charge individuals different premiums or impose different costs based on the presence or absence of a health status-related factor. [See, PHSA §2705 as amended by PPACA, Pub. L. No. 111-148 §1201]. That means that KEHP cannot use information from your Health Assessment to change your premiums; however, PPACA non-discrimination provisions do not prevent a group health plan, such as KEHP, from “establishing premium discounts or rebates or modifying otherwise applicable copayments or deductibles in return for adherence to programs of health promotion and disease prevention.” [See, PHSA §2705 as amended by PPACA, Pub. L. No. 111-148 §1201]. In addition, final federal regulations provide rules governing wellness programs that, if adhered to, ensure that a group health plan’s wellness program does not violate PPACA’s anti-discrimination provisions. [See, 78 FR 33157].

10. Is the information collected through the Health Assessment protected?                             

Yes. KEHP takes member personal health information seriously and has measures in place to protect this information. All responses to the Health Assessment are strictly confidential and protected under Health Insurance Portability and Accountability Act and all associated Privacy and Security Regulations (HIPAA). [See, Pub. L. 104-191 and 45 CFR Parts 160, 162, and 164]. All information gathered through the HumanaVitality Health Assessment is retained by Humana, KEHP’s Business Associate and third party administrator. Both KEHP and its Business Associates must comply with HIPAA. As with all KEHP member data obtained and maintained by Humana, the information from the health assessment is considered protected health information and Humana is bound contractually to KEHP to ensure the data is protected, confidential, and not used or disclosed except in accordance with KEHP’s privacy practices. KEHP’s notice of privacy practices can be found at https://personnel.ky.gov/KEHP/HIPAA%20Privacy%20Notice.pdf                            

11. Can I take the Health Assessment if I don’t choose a LivingWell Plan?                             

Yes, if you participate in one of the four health plans, you are automatically enrolled in HumanaVitality®. Once you log in and activate your account you begin earning Vitality Points toward movie tickets, hotel stays, and other rewards. You can also take the Health Assessment which gives you your Vitality Age and helps you set goals for a healthy lifestyle.                         

12. How do I take the Health Assessment?                             

Follow these steps to take the Health Assessment:                          

• Visit LivingWell.ky.gov and click on the HumanaVitality login.    

First time users   

• Click on “Register Now” and complete the required fields. You will need your Social Security number or 9-digit member ID found on your Humana ID card (for example - H12345678).

• Enter your name exactly as it appears on your Humana ID card.                          

• Check the box agreeing to the terms, and click “Continue.”                          

• Verify the member found is you. Create a username and password.                          

• After completing the registration process, return to HumanaVitality to sign in using the username and password you just created.   

Returning users:   

• Sign in using your username and password.   

• Once you’re signed in, click on the alert to “Take the Health Assessment” or look for the “Health Assessment” link under the “Get Healthy” tab. If you know your medical history and key measurements, have them ready to help you complete your Health Assessment. If you don’t have your key measurements, don’t worry, you’ll still be able to complete the Health Assessment.

If you had a Vitality Check (biometric screening) within the last 18 months, you will see those results have pre-populated into your Health Assessment. These cannot be updated until a new Vitality Check is submitted. To find a Vitality Check location near you, visit LivingWell.ky.gov.                          

• Receive your Vitality Age based on your Health Assessment responses. HumanaVitality will then recommend goals.                          

• Select the goals you want to work on and discover activities that will allow you to commit to a healthier lifestyle, improve your Vitality Age, and earn Vitality Points™ and rewards along the way.                         

13. Do I have to create an online account?                              

You must log in and activate your HumanaVitality® account before you can complete the Health Assessment. Select this link to register for HumanaVitality®.                         

14. What information do I need to create an online account?                             

You will need your Social Security number or 9-digit member ID found on your Humana ID Card (for example - H12345678).                         

15. If I can’t take the Health Assessment due to medical or mental health conditions, can I still choose a LivingWell plan?

Yes, if it is unreasonably difficult because of a medical or mental health condition for you to complete the Health Assessment, call customer service at 877-597-7474, and we will work with you to develop an alternative solution.

16. How do I keep my address updated?

Open Internet Explorer. Then go to KHRIS.ky.gov and log in to KHRIS ESS.   

​Current KHRIS ESS users   

• Enter your KHRIS user ID and password and click “Log on.” If this is the first time you have used KHRIS this year, read the user agreement, enter your full name and click “I agree.”   

​New KHRIS ESS User​   

• Click the “Forgot/Reset Password or New User” link.                          

• Enter your KHRIS user ID and click “Validate.” For security purposes, you must provide the following information: Last Name, Zip Code, Date of Birth, and Social Security Number. Click “Authenticate.” If your information has been validated, a temporary password displays. Write this down or copy it.                          

• Click “Exit.” Back at the main page KHRIS.ky.gov, type your KHRIS user ID and temporary password.                          

• Click “Log On.” You will now be prompted to change the temporary password. Type your temporary password created above, create a new password, and confirm your new password by typing it again. Click “Change.”                          

• Once logged in, click “Personal Information” in the panel on the left of the screen or the “Addresses” link under Personal Information.                          

• In the Permanent Residence section, click “edit.”                          

• Update your home address, phone number(s) and work/personal e-mail addresses. If these changes are immediate, click the “Valid as of Today” button, otherwise, click the “Valid as of a Future Date” button and enter the effective date of the change.                          

• Once you have completed your entry, click “Review.” If correct, click “Save,” otherwise click “Previous Step” and revise your entries.                          

• Once complete, click “Log off.”                         

17. If I do not fulfill the LivingWell Promise, will my claims still be paid?                             

Yes. The plan will continue to pay eligible claims for the plan year, even if you do not fulfill the LivingWell Promise. However, you will not be able to elect a LivingWell plan for 2015 if you do not fulfill your 2014 LivingWell Promise. The standard plans will still be available to you.                         

18. What happens if I fail to complete the LivingWell Promise between January 1 and May 1, 2014?                         

If you elect a LivingWell plan and fail to fulfill the LivingWell Promise, you will not be eligible to participate in the LivingWell Promise and choose a LivingWell plan for the next plan year (2015). Stated another way, if you fail to fulfill the LivingWell Promise, you will only be eligible for the standard plan the next plan year.                         

19. If I choose a Living Well plan and take the Health Assessment may I change my plan mid-year

Mid-year plan changes can only be made if you experience a life event referred to as a qualifying event. If you experience a qualifying event that allows you to change your plan, you can elect another LivingWell plan or a standard plan. If you take the Health Assessment between January 1 and May 1, 2014, and complete your original LivingWell Promise, you can enroll in a LivingWell plan for 2015.                          

If you experience a qualifying event during the 2014 plan year and elect a LivingWell plan for the first time as a result of the qualifying event, you have 90 days from the effective date of the LivingWell plan to complete the LivingWell Promise. The primary rule for completion of the LivingWell Promise is that the first, or original, election of the LivingWell plan is the controlling factor for whether you are eligible for a LivingWell plan the following plan year. If you change plans during the 2014 plan year, whether that change is because of retirement, a qualifying event or a break in service, the first, or original, election of the LivingWell plan follows you throughout the plan year. The same rule would apply to newly eligible members.          

For example, at open enrollment you elect a LivingWell plan. You experience a qualifying event in June and change to a standard plan option. Your election of the LivingWell plan, and whether you completed your LivingWell Promise, will be tracked regardless of the mid-year change to a standard plan. If you did not complete the LivingWell Promise between Jan. 1 and May 1, 2014, you will not be eligible for a LivingWell plan for 2015.          

20. How does the LivingWell Promise apply to new hires eligible for KEHP coverage?

New employees who elect a LivingWell plan after Open Enrollment must complete the Health Assessment within 90 days of the effective date of their coverage.                       

21. How does electing a LivingWell plan for 2014 and making the LivingWell Promise impact my plan selections for future years?

Please review the following for specific information:

What happens if I terminate employment and am hired at another KEHP participating agency three months later?

​The first/original election of a LivingWell plan will follow you throughout the plan year. The first/original election of a plan requiring the LivingWell Promise is the controlling element. You don’t have to complete the promise twice in the event of a qualifying event, termination, re-hire, etc.                    

What happens if I elect a LivingWell plan at Open Enrollment, fulfill the LivingWell Promise, then retire or have a qualifying event in 2014 and continue with my LivingWell plan – do I have to fulfill the LivingWell Promise again to be eligible for a LivingWell plan in 2015?

Because you completed the LivingWell Promise with your first/original election of a LivingWell plan in 2014, you are eligible for a LivingWell plan in 2015. You do not have to take the Health Assessment again in the same plan year to meet the LivingWell Promise requirement.          

Would I be able to elect a LivingWell plan during Open Enrollment, NOT fulfill my LivingWell Promise between January 1 and May 1, then retire (or have a qualifying event) after May 1, 2014 and continue to elect a LivingWell plan when I retire?                       

Yes. Despite not completing the Health Assessment, you could elect a LivingWell plan upon retirement or with a qualifying event, during the same plan year. The fact that you didn’t complete the Health Assessment will result in losing the ability to elect a LivingWell plan and only having standard plan options in 2015. The first/original election requiring the LivingWell Promise was not fulfilled and impacts the next plan year.                    

Would I be able to elect the LivingWell plan during Open Enrollment, retire or have a qualifying event, change to a standard plan at retirement, and then elect a LivingWell plan the next plan year?                        

Yes. So long as you fulfilled the promise from the original LivingWell plan election you would be able to choose from all plans in 2015. Switching to a standard plan mid-year wouldn’t penalize you for 2015.          

22. If I don’t choose a LivingWell plan for 2014, will I be able to choose a LivingWell plan in 2015?                          

Yes. If you select a standard plan in 2014 you will be able to select a standard or LivingWell plan for 2015. The LivingWell plan will also require a LivingWell Promise in 2015.                       

23. If I choose a LivingWell plan but fail to fulfill the LivingWell Promise in 2014, and have to take a standard (non-LivingWell) plan in 201​5, when is the next time I can enroll in a LivingWell Promise plan?          

If you do not fulfill the LivingWell Promise, you must wait one full plan year before you are eligible to enroll in a LivingWell plan again. As a result, if you did not fulfill the LivingWell Promise in 2014, you would not be eligible for a LivingWell plan until plan year 2016.                       

24. If I elect a LivingWell plan and agree to the LivingWell Promise, am I required to participate if I’m contacted by a nurse with one of the HumanaHealth Nurse Support Programs?                       

No, electing a LivingWell plan only requires you to complete the HumanaVitality® Health Assessment and keep your contact information current. However, the Nurse Support Programs are free to KEHP members and provide valuable services such as personalized support for reaching healthy living goals or managing complex medical conditions.

25. Issues or concerns completing the Health Assessment?

If you have concerns or issues related to completing the HumanaVitality Health Assessment for your LivingWell Promise, contact customer service at 877-597-7474.

1. How do the medical and pharmacy benefits work for the 2014?                

Click on the plan name to see specific information for each plan.                

• LivingWell CDHP                               

• LivingWell PPO                               

• Standard PPO                               

• Standard CDHP                               

2. What is a Consumer Driven Health Plan (CDHP)?                

CDHPs put you, the consumer, in more control of managing your healthcare expenses. CDHPs feature lower premiums and include an employer-funded, pre-loaded Health Reimbursement Account (HRA) to help reduce your deductible and maximum out-of-pocket expenses. With a higher deductible, the employer-funded HRA, and lower co-insurance amounts, a CDHP engages members in their healthcare decisions and makes them more aware of the cost and utilization of healthcare services. Like a PPO, members in a CDHP have flexibility when choosing healthcare from in-network providers and members must pay more for healthcare from out-of-network providers. Unused dollars in the HRA can accumulate year to year if a member continues to elect a CDHP.                

To learn about about Consumer Driven Health Plans

Watch a video (QuickTime).

Watch a video (Flash player).

3. What is a Preferred Provider Organization Plan (PPO)?                

PPOs are a type of insurance plan with which most people are familiar. Usually PPOs have higher premiums, low deductibles and require you to pay co-pays and co-insurance. The insurance plan is responsible for the remainder. In addition, PPOs allow flexibility when choosing healthcare from in-network providers and members must pay more for healthcare from out-of-network providers.                

4. What providers participate in Humana's provider network?

Sign in or register on myhumana.com, and click on the "Doctors" tab across the top of the screen. You will be directed to a "Provider search" area where you can search for participating providers by specialty or location.

5. What is a deductible?                

A deductible is the amount you have to pay out-of-pocket before the plan begins to pay expenses. Deductibles are generally calculated per calendar year and most plans have individual and family deductible amounts.                

6. What is co-insurance?                

Co-insurance refers to a shared payment between the health plan and you, described in percentages (e.g. 80%/20%).                

7. What is out-of-pocket maximum?                

This is the most money in a plan year that you can expect to pay for covered medical and pharmacy services.                

8. What is a co-pay?                

A co-pay is your portion of the cost for a health care service (e.g. You may pay $25 per office visit or $10 to get a prescription filled.) Your insurance plan pays the difference.                

                

1. What is a Health Reimbursement Account (HRA)?                

An HRA is an employer-funded account that you can use to cover qualified expenses. The KEHP has multiple types of HRAs: embedded HRAs that are part of the CDHP plan options, a Waiver (health) HRA and a Waiver Dental/Vision Only HRA that can be selected when you choose to waive your health coverage. HRA funds can roll over to the next calendar year, as long as you continue to elect a CDHP plan or waive coverage with an HRA.                

Funds in the LivingWell CDHP HRA, Standard CDHP HRA, and the Waiver (health) HRA can be used to pay for:                 

• Medical and prescription deductibles, co-payments and co-insurance                 

• Certain dental fees such as cleanings, fillings and crowns                 

• Orthodontic treatment                 

• Vision fees including contacts, eyeglasses and laser vision correction                 

• Medical supplies such as wheelchairs, crutches and walkers                 

NOTE: If you use your CDHP HRA funds for dental and vision expenses, these funds will not apply to your deductible and out-of-pocket maximum.                

Funds in the Waiver Dental/Vision Only HRA can be used to pay for:                 

• Certain dental fees such as cleanings, fillings and crowns                 

• Orthodontic treatment                 

• Vision fees including contacts, eyeglasses and laser vision correction                

NOTES: a. Retirees are not eligible for either Waiver HRA or the Dental/Vision Only HRA. b. If you or your spouse or dependent is contributing funds to a Health Savings Account (HSA), you should consult a tax advisor prior to establishing an HRA or FSA.                

2. What is a Flexible Spending Account (FSA)?                

FSAs let you set money aside from your paycheck before taxes to pay for certain healthcare and dependent care (child or adult day care services) expenses. This results in you paying less income and Social Security taxes. Make sure to set aside only as much as you will use during the current calendar year. With an FSA, you can use the money only for eligible expenses paid for during the current calendar year – it is a use it or lose it account.                

3. What is a Healthcare Flexible Spending Account (FSA)?                

A Healthcare FSA is an account funded by you for healthcare services such as prescription co-payments, deductibles, and doctor’s office co-payments with pre-tax money. The amount you contribute will be payroll deducted. Make sure to set aside only as much as you will use during the current calendar year – with an FSA, you can use the money only for eligible expenses paid for during the current calendar year. Remember: Use it or lose it. You can use your FSA for eligible expenses incurred by you, your spouse, dependent you claim on your taxes, and your children who are under the age of 27 at the end of the tax year. The 2014 limit for contributions to a Healthcare FSA is $2,500 per employee. FSA funds can be used to pay for:                

• Medical and prescription co-payments and co-insurance                 

• Certain dental fees such as cleanings, fillings and crowns                 

• Orthodontic treatment                 

• Vision fees including contacts, eyeglasses and laser vision correction                 

• Medical supplies such as wheelchairs, crutches and walkers                

4. What is a Dependent Care Flexible Spending Account (FSA)?                

A Dependent Care FSA allows you to pay for dependent care expenses such as a daycare or after-school programs for dependents up to age 13, or an adult day care. The maximum that you can contribute per year is based on your tax filing status: $5,000 for married, filing a joint return; $5,000 filing as head-of-household; or $2,500 married, filing separate returns. Make sure to set aside only as much as you will use. You can use the money only for eligible expenses paid for during the current calendar year. Remember: Use it or lose it.                

5. How do I receive reimbursement for my HRA or FSA account?                

If you have an HRA or Healthcare FSA, you will receive a HumanaAccessSM Visa® Debit Card and your funds will be automatically deducted from your FSA or HRA when you use the card. You can use the debit card anywhere that Visa® is accepted. IRS rules require you to save all your receipts. You can also pay for your claims up front if you prefer, instead of using the debit card and then file for reimbursement. All Dependent Care FSA claims must be requested manually – you cannot use the HumanaAccessSM Visa® Debit Card for Dependent Care FSA expenses. In order to receive reimbursement for the money you pay out of your pocket, you must complete an HRA/FSA Reimbursement Claim Form and submit this form, together with your documentation, to: Humana Spending Account Administration, PO Box 14167, Lexington KY 40512-4167. You can also fax the information to 800-905-1851.                

6. What is substantiation?                

Substantiation is required by the IRS to verify that an HRA or FSA claim is an eligible expense. If you have a health insurance plan with KEHP, as well has a Healthcare FSA, then most of your HRA or FSA expenses paid with your HumanaAccessSM Visa® Debit Card will be verified through Humana’s medical claims system. If you have a Waiver HRA or Waiver Dental/Vision Only HRA, Humana will not have access to your health insurance claims; therefore, you must submit documentation to verify your claim is an eligible expense. Documentation that can be used to verify expenses include an itemized statement from your provider or an explanation of benefits.                

7. Who is eligible for an FSA?                

Employees of state agencies, schools boards, and certain quasi-agencies are eligible. Contact your insurance coordinator or HR department for details.                

8. Can I have an HRA and a Healthcare FSA?                

Yes, you can elect both. Because HRAs are employer-funded and FSAs are employee-funded, you could choose to have both to cover your out-of-pocket expenses. For example, you elect the LivingWell CDHP, family coverage level, and have $1,000 in an employer-funded HRA that can be used toward your deductible. You could also elect to have $1,500 of your money added to a Healthcare FSA and use those pre-tax dollars to help meet your deductible or to use for vision and dental expenses.                

9. How long do I have to spend FSA and/or HRA money?                

FSA and/or HRA funds may only be used to pay for eligible expenses incurred during the coverage plan year. However, you have until March 31, 2015 to submit reimbursement requests for HRA expenses incurred during your 2014 coverage period.                

                 

                

1. Who is eligible for the Waiver HRA?                

Any active employee of a state agency, school board or certain quasi-agencies who is eligible for state-sponsored health insurance coverage may waive health insurance and enroll in the Waiver HRA. Retirees who have returned to work and who are over age 65 may also waive health insurance and enroll in the Waiver HRA, with the Waiver HRA serving as the primary insurance plan over Medicare.                 

2. Who is not eligible for the Waiver HRA?                

If you are a member of an agency that does not participate in KEHP’s HRA/FSA program, a retiree, or a retiree under age 65 who has gone back to work and elected coverage under the retirement system, then you are not eligible for the Waiver HRA. NOTE: If you or your spouse or dependent is contributing funds to a Health Savings Account (HSA), you should consult a tax advisor prior to establishing an HRA.                

3. Who is eligible for the Waiver Dental/Vision Only HRA?                

Any active employee of a state agency, school board or certain quasi-agencies who is eligible for state-sponsored health insurance coverage may waive health insurance and enroll in the Waiver Dental/Vision Only HRA. Retirees who have returned to work and who are over age 65 may also waive health insurance and enroll in the Waiver Dental/Vision Only HRA.                

4. Who is not eligible for the Waiver Dental/Vision Only HRA?                

If you are a member of an agency that does not participate in KEHP’s HRA/FSA program, a retiree, or a retiree under age 65 who has gone back to work and elected coverage under the retirement system, then you are not eligible for the Waiver Dental/Vision Only HRA.                

                 

                

1. What is the non-tobacco user discount?                

The Commonwealth of Kentucky is committed to fostering and promoting wellness and health in the workforce. As part of the KEHP wellness program, incentives are available for members who do not use tobacco products, including monthly premium discounts for non-tobacco users. You, the primary planholder, are eligible for the monthly non-tobacco user rates if you certify that neither you nor any other person to be covered under your plan has regularly used tobacco within the past six months. Certification of tobacco use or non-use is accomplished by completing a Tobacco Use Declaration Form as part of your application for health insurance coverage through KEHP. Specifically, the question on the Tobacco Use Declaration Form asks: “Within the past six months, have you, or a spouse or dependent to be covered under your insurance plan, used tobacco regularly?  Yes  No.”                

2. What does “used tobacco regularly” mean?

“Regularly” means you (or a spouse or dependent 18 years of age or older) has used tobacco four or more times per week on average excluding religious or ceremonial uses.                

3. What is considered tobacco?                

“Tobacco” means all tobacco products including, but not limited to, cigarettes, pipes, chewing tobacco, snuff, dip, and any other tobacco products regardless of the frequency or method of use. Electronic cigarettes are not considered a form of tobacco.                

4. Who is considered a dependent for the Tobacco Use Declaration?                

“Dependent” means, for the purpose of the Tobacco Use Declaration, only those dependents who are 18 years of age or older and covered under your plan.                

5. When can I qualify for the monthly insurance premium discounts for non-tobacco users?                

All KEHP members or prospective KEHP members have the opportunity to qualify for the monthly premium discounts for non-tobacco users upon application (new hires) for insurance coverage through KEHP and once each year at open enrollment (ongoing employees).                

6. Can I change the tobacco use status during the plan year if I stop smoking?                

Yes, provided all persons covered under your plan are non-tobacco users. KEHP planholders certifying that there is a tobacco user covered under their insurance plan will be eligible for monthly discounted premium contribution rates provided all persons covered under the plan stop using tobacco products regularly (four or more times per week on average) during the plan year. In order to qualify for the monthly discounted rates, the planholder must sign a Tobacco Use Declaration Form certifying that neither the planholder nor their spouse/dependent(s) regularly used tobacco products during the 6 months prior to completion of the Tobacco Use Change Form. To the extent available, proof of completion of a tobacco cessation program or other proof of non-tobacco use will be required (i.e. proof of successful completion of the Cooper-Clayton program). The monthly discounted rates will be applicable on the first of the month following the signature date on the Tobacco Use Change Form.                 

7. Do I continue to get the monthly discounted rates for non-tobacco users if I or a spouse/dependent covered under my insurance plan begin using tobacco during the plan year?                

During the plan year, KEHP planholders must complete a Tobacco Use Change Form if you or a covered dependent experiences any changes in tobacco use. KEHP planholders who certify that there are no regular tobacco users covered under their plan are eligible for the monthly discounted premium rates and are required to notify KEHP if anyone covered becomes a regular tobacco user.                 

8. What is the Tobacco Use Change Form?                

The Tobacco Use Change Form is a form used to advise KEHP of any changes in Members’ tobacco use status that occur during the plan year. A member refers to each person covered under a KEHP insurance plan including employees and retirees and their spouses and dependents. Click this link to access the Tobacco Use Declaration Form.                

9. What happens if I do not accurately declare the tobacco use for persons covered under my KEHP plan?                

KEHP planholders who do not accurately declare the tobacco use for persons covered under their insurance plan will be required to pay the difference between the tobacco-user and the non-tobacco-user premium contribution rates on a retroactive basis for the period during which the planholder falsely certified eligibility for the non-tobacco-user monthly discounted premium contribution rates.                

10. How can I get help to quit using tobacco?                

KEHP has programs available to help you quit using tobacco such as the Cooper Clayton Smoking Cessation program or the Kentucky Tobacco Quit line. Through these programs, KEHP members can get over-the-counter Nicotine Replacement Therapy, without any cost (beginning 1/1/2014), for the life of the program. After the program is complete, members can continue to receive over-the-counter Nicotine Replacement Therapy without any cost if prescribed by a physician. In addition to the Cooper Clayton and the Quit Line programs, KEHP also offers a coaching program that will assist the member with designing a personal plan to decrease dependency on tobacco products and manage withdrawal and cravings that accompany tobacco use cessation.                 

11. How can I receive the non-tobacco use reward if I am unable to meet the non-tobacco use standard?                 

KEHP is committed to helping members achieve their best health. Rewards for participating in a wellness program, including the monthly premium discounts for non-tobacco users, are available to all members. If a member believes they are unable to meet a standard for a reward under this wellness program, they might qualify for an opportunity to earn the same reward by different means. Members who are unable to meet the non-tobacco use standard are required to request and satisfy an alternative standard in order to qualify for each month’s full reward. The member must complete the Tobacco Use Change Form to request an alternative standard.                

12. What are the alternative standards available for those who are unable to meet the non-tobacco use standard?                

Members who request a reasonable alternative standard must complete the HumanaVitality® Health Assessment and enroll in the HumanaHealth Coaching program. Through HumanaHealth Coaching, the member is assigned a “coach” that will assist with designing a personal plan to decrease dependency on tobacco products and manage withdrawal and cravings that accompany tobacco use cessation. The coach will support the member as they go through the steps of ceasing to use tobacco. When the member completes their HumanaVitality® Health Assessment, they will be given a goal and will have access to the HumanaHealth Coaching program. Members who are unable to satisfy or have completed the Health Assessment and Health Coaching alternative standard will be required to enroll in either the Cooper-Clayton smoking cessation program or the Kentucky Tobacco Quit Line program. Members who are unable to satisfy the Cooper-Clayton or Kentucky’s Tobacco Quit Line alternatives must contact DEI for other reasonable alternatives such as the assignment of a personal nurse for support, advice, and information regarding smoking cessation.                 

To the extent feasible and to the extent the member’s physician has joined in the request for a reasonable alternative standard, KEHP will provide the member an opportunity to comply with the recommendations of the personal physician as a reasonable alternative standard to meeting the non-tobacco use standard. In any event, each member seeking a reasonable alternative standard must complete the HumanaVitality® Health Assessment. KEHP will work with you (and, if you wish, with your doctor) to find a wellness program with the same monthly reward that is right for you in light of your health status.                 

                

1. How do I enroll through KHRIS ESS?                

An active employee, you can go to khris.ky.gov to log in and enroll for benefits.

2. What is my KHRIS user ID?                

Your KHRIS user ID is a six-character identification provided to you in the KEHP Open Enrollment packet you should receive in late September. If you do not know your KHRIS ID, you can retrieve it by clicking “Forgot KHRIS User ID?” on the KHRIS login page at khris.ky.gov                

3. How do I find my password?                

You can go to khris.ky.gov and follow these steps:                

• Click the “Forgot/Reset Password or New User” link.                 

• Enter your KHRIS user ID and click “Validate.” For security purposes, you must provide the following information: Last Name, Zip Code, Date of Birth, and Social Security Number. Click “Authenticate.” If your information has been validated, a temporary password displays. Write this down or copy it.                 

• Click “Exit.” Back at the main page khris.ky.gov, type your KHRIS user ID and temporary password.                 

• Click “Log On.” You will now be prompted to change the temporary password. Type your temporary password created above, create a new password, and confirm your new password by typing it again. Click “Change.”                 

4. I’m having trouble with KHRIS ESS after I have logged into the site. What do I need to do?                

You can review the KHRIS technical requirements and make any necessary changes. Keep in mind these tips for accessing the Open Enrollment portion of KHRIS ESS:                

• Best viewed with Microsoft Internet Explorer version 7+                 

• Not recommended for MAC systems or mobile devices (iPads, tablets, etc.)                 

• Disable all pop-up blockers                 

• Screen resolution below 1280x960 may cause some items to not fit on the screen                 

• Install the most recent version of Adobe Reader to correctly view/display forms                 

                

1. Where can I learn more about KEHP’s health and wellness programs?              

Go to LivingWell.ky.gov to learn more about the many programs offered through KEHP or view the KEHP Wellness policy here. You can access information on HumanaVitality®​, Health Coaching, Healthy Kids, Mental and Stress Management, Nurse Support, Quitting Tobacco, Weight Management, Worksite Wellness and other programs.             

2.What is HumanaVitality®?​             

HumanaVitality® ​is KEHP’s incentivized wellness program that allows you to earn points for rewards such as movie tickets, hotel stays, sports equipment and other items. Go to LivingWell.ky.gov for more details.             

3.What are HumanaHealth Nurse support programs?             

Humana offers a variety of programs to assist you with your immediate and ongoing health concerns. These programs are free as part of your enrollment in a KEHP plan. Programs offered include:             

• Humana First® Nurse Advice Line – nurses are available around the clock for your immediate medical concerns.              

• Humana Achieve – dedicated, personalized support program to help you reach your weight loss and other healthy living goals.              

• HumanaBeginnings® - offers planning, pregnancy, and parenting resources and an experienced maternity nurse just for you.              

• Case Management and Disease Management – support for complex medical conditions such as diabetes, cancer, COPD, and other areas.              

For more information about these programs, log in to myhumana.com or call 1-800-622-9529.             

             

1. What is the “Marketplace”?               

In an effort to give individuals access to affordable, comprehensive health insurance coverage, the ACA established the Health Benefit Exchange or the “Marketplace.” The Marketplace offers one-stop-shopping for health insurance coverage. Through the Marketplace, individuals can shop, compare, and apply for coverage. They can also apply for premium tax credits that can be used to reduce the cost of coverage.

2. Is there a Marketplace in Kentucky?               

Yes. Each state has a Marketplace. In Kentucky, the Marketplace is called kynect.               

3. How can I contact kynect?               

You may visit kynect ​for more information or contact kynect by phone at 1-855-4kynect.               

4. Will employees eligible for coverage through KEHP be eligible for premium tax credits through the Marketplace?               

No. If an employee has an offer of health coverage from their employer that meets certain affordability and minimum value standards, the employee will not be eligible for a tax credit through the Marketplace. KEHP will ensure that plan(s) available for participating groups will meet the affordability and the minimum value tests. It is likely that not all plans offered through KEHP will meet the test for every employee, but at least one plan that meets both tests will be available for every employee. No employer action is required to ensure the coverage offered through KEHP meets the affordability and minimum value tests, provided the employer does not make any changes to the employer or employee contributions established by KEHP. If an employer group participating in KEHP offers employer or employee contributions different than those established by KEHP, the employer will need to conduct its own analysis to determine if the minimum essential coverage is affordable.               

5. As a KEHP member, are my dependents or spouse eligible for a premium tax credits through the Marketplace?

Your dependents will not be eligible for a premium tax credits through kynect. However, your spouse may be eligible for and receive a premium tax subsidy through kynect.

6. Can I waive health insurance and buy coverage from the Marketplace?

Yes. However, if an employee has an offer of health coverage through KEHP from their employer, the employee will not be eligible for a tax credit through the Marketplace. Also, the employer premium contribution as well as the employee’s premium contribution is excluded from income for federal and state income tax purposes. Payments for coverage through the Marketplace are made on an after-tax basis.               

7. Open enrollment for kynect begins on October 1, 2013 and runs through March 31, 2014, what if I wait until after October 31 to decide whether to elect coverage through kynect?

A. Because the KEHP mandatory open enrollment is October 1 – 31, all employees are required to enroll. Any employee who does not enroll during that time period will be defaulted to the Single Standard Consumer Driven Health Plan.

8. Even if I elect a KEHP option, can I find stand-alone dental and vision plans on the kynect for purchase?

Stand-alone dental plans will be available for purchase through kynect. Although all plans sold through kynect will contain pediatric vision benefits, stand-alone vision plans will not be available for purchase for 2014.

9. What if I opt out of KEHP plans and elect coverage through kynect and later decide I want to go back and choose a KEHP plan. Can I?

No. Open enrollment for state employees ends October 31. Only new members or those who experience a qualifying event following the close of open enrollment will be able to enroll in KEHP after Oct. 31. Examples of a qualifying event are a change in marital status, birth of a child, change in dependents or some other life event, and loss of other coverage.

10. Does KEHP meet the minimum value standard of 60% as defined by the Affordable Care Act (ACA)?

Yes.

11. Are state employees and their families eligible for Medicaid?

Medicaid is expanding to cover more people at higher incomes. Some employees and their families may be eligible for Medicaid coverage through kynect if they meet certain income standards.View kynect and also see Medicaid website for more information.

12. Are children of state employees eligible for KCHIP coverage?

Some children may be eligible for KCHIP through kynect if they meet certain income standards. To see the different levels of income click here and for more information visit kids health.

13. What is preventive care and what is covered under the preventive care benefits?               

Preventive care helps you stay healthy - it includes annual exams for children and adults, immunizations, and screenings such as mammograms and colonoscopies. In 2014, all four KEHP health plans will provide members with extensive preventive care benefits. Coverage for children’s preventive health services will include autism screening, blood pressure screening, developmental screening, hearing and vision screening, immunization vaccines, and many other tests and screenings. For women, preventive services will include contraception, breastfeeding supplies and counseling, well-woman visits, breast cancer mammography screening, and many other tests, counseling, and screening services. For adults, preventive services include cholesterol screening, diabetes screening, depression screening, immunizations, obesity screening, diet counseling, and many other tests and preventive services. For a full listing of preventive services covered under the KEHP plans in 2014, please click here          

14.​ Will I have to pay a co-payment, co-insurance, or deductible for preventive care?               

No, in 2014, preventive care will be paid for under all four KEHP health plans without any member cost sharing. That means KEHP members will be able to get preventive care without paying a co-payment, co-insurance, or a deductible for those services. To take advantage of the preventive care without cost-sharing, in-network providers must provide the preventive services.