Benefits – Subject Matter Minute Blog

Subject Matter Minute, Episode #71 – Flex Reimbursement Process

The below post is taken from the Video Blog, the Subject Matter Minute. You can view the episode on YouTube if you would like. Find it here: Episode #71 – Flex Reimbursement Process

If YouTube is blocked for you or your agency, you can scroll to the bottom of this post to view it from Google Drive. (I would prefer you view it on YouTube, so I know how many people have watched)

You can also listen to an audio version.

Hello and welcome to the Subject Matter Minute! Glad you could join me… We are waist deep into what they call the Open Enrollment period, so I hope you have watched all the relevant episodes that go over items you can enroll in and/or change during open enrollment. I covered one of these things in the last episode. That was episode #70, and it covered the Flexible Spending Accounts. If you didn’t watch and aren’t sure what I’m talking about… and you haven’t gone through the open enrollment process yet, be sure to watch it. This episode is also about the Flexible Spending Accounts, but today we will be covering more of the process of submitting documentation. So… today we are covering the Flex Reimbursement Process. (music)

Before I get started, I need to give a shout out to this episode’s Subject Matter Experts… Karyn Williams and Karissa Toalson. Thank you for being patient with me and my dozen or so questions!

So, you set up your Flexible Spending Accounts and have money coming out of your check pre-tax for out of pocket medical expenses, daycare and even some over the counter supplies. How do you go about actually getting reimbursed? Well, you are obviously going to need some documentation to prove that you had these expenses. So that is what we are talking about today.

There’s a few ways to submit your documentation. You can do it the old-fashioned way and actually print out and hand over and/or mail the documentation. You can also gather your electronic documents and email them, or you can use the portal to submit them. I gather that the portal is the preferred method as far as EGI is concerned, but there is a caveat with that. I’ll elaborate in a bit.

So, what documents are you going to need? First, you will need the reimbursement claim form. This form is linked in the show notes. You will need to fill this out… I will show you how.

Next, for medical reimbursement, you will need supporting documentation, most of which is EOBs or explanation of benefits. You get that from the Cigna or Delta Dental website. Not to worry, once again 🙂 I’ll show you how.

You may also need receipts if it’s something that doesn’t have an EOB (explanation of benefits) associated with it, like vision or if it’s covered over the counter items.

For Daycare, you’ll either need an itemized receipt or you can have a signature of the provider on the claim form. I’ll show you what I’m talking about.

First… I’m going to show you how to gather all your “stuff,” then I’ll show you how to do it the paper way and then I’ll show you how to do it on the online portal. Ok? Alright, let’s go find our EOBs on the cigna website.

Ok… Here we are at the cigna website. Go ahead and login. If you haven’t before, you will need to click on “register.” You may need your insurance card to register.

Once you are logged in, go to the top menu bar and hover over Claims, and then click on claims. You can see that this is showing only my claims right now. If you have a family and want to see all of the claims, you can click “view all” here.

Side note… please don’t freak out that I’m showing this information. I really don’t care if you know who our doctors are. 🙂

So… I’m viewing all at this point. The other thing that you may need to change is the year you are viewing. If you are doing this during the year you are submitting for, you want to select “year-to-date.” But, if you are doing this in February for the previous year, you will want to select “prior year.”

Now you can see all of the claims for the year. And yes, there are a lot of them. You want to look for the ones where you owe money. Alright? It’s pretty clear. Depending on how much you elected for your medical reimbursement, I find that things are much easier if you use the biggest charges. For instance… If I only had $1500 in my flex account, I can do it all with just one EOB… this one right here for over $1600.

But no matter how you do it, this is how you get your EOBs. Find one where you owe and click on “download EOB.” That will open the EOB in a new window and/or tab. From here, you can either download it or print it… depending on how you are submitting your documents. In my browser, the buttons for this are in the upper right corner. Yours may differ slightly.

Now I’ll show you how to do the same on the Delta Dental Website. Go to deltadentalwy.org and click login. (link is in the show notes) Select subscriber, then login, and then click on claims. Take a look down the “patient pays” column for the services you paid for, and then click “view” in the EOB column. The EOB will open in a new window or tab. The printing and downloading are the same as they were for Cigna.

Now that you have all of your EOBs gathered up, let’s go over how to fill out the reimbursement claim form.

Here is the flexible spending reimbursement claim form. As it says at the top, this is for medical, daycare and over the counter reimbursement.

Top part is pretty straightforward. Fill it out.

The next section is the Medical section. This is where you list all of your EOBs and/or your receipts for medical items. As it says in red, you need to list each service date separately. For you long-timers, this is a bit different. You used to be able to group services from one provider. No longer… Please list them separately. Then fill out the rest of the information, put the amounts and the total.

This is a good spot to pass on something I’ve learned over the years. When filling out the medical reimbursement section, you can avoid that letter you get when the total is more than you elected with your flex account with a simple trick. This letter. (show letter) As long as your total is over the amount you elected for flex, you can just put the “correct” amount as the total. So… for instance… All the providers add up to $1540, but you only elected $1500 for your medical flex. Put the providers in the appropriate way and then put $1500 as both totals. EGI will reimburse the $1500 and you won’t get the letter. Tricky, right?

The next section is the daycare reimbursement area. This is slightly different. For one thing, if you remember from the last episode, you can’t claim money that hasn’t yet been deposited or contributed to your flex account. Also, you need to get the tax ID number or social of the provider and put it with the name of the provider. Then go through and put the date of service, the dependents name and the rest. Same deal… put the amount and the total.

Remember that with daycare reimbursement, you can’t request more reimbursement than is in your daycare flex account. If you do, you will receive a letter that looks like this. (show letter) However, the system will track the claim and reimburse you for that extra as funds come into the account.

Ok… next is the new “over-the-counter” claims section. You can claim certain over the counter medications, but not all, so it’s best to do a little reading in the Flex booklet that’s linked in the show notes. So you fill that out just like the other sections.

Make sure to read the information below that section. It’s important information. Also, before you sign, you should read all the info below the signature line. That’s just good practice when signing your name, right??

Next sign and date here if you have already printed it out and if not, print it and sign and date.

The next step is submitting all of this stuff on the online portal. (or dropping it off to EGI, or sending it to EGI) But, before we go there, I want to warn you that they want all of the documents combined into one document for upload. Also, if you can put the supporting documentation in the order of your claim form, it’s a big help to EGI when processing. If you have a year’s worth of EOBs and they do not match up to your claim form, your claim may be returned to you.

There may be a bunch of you out there that know how to combine and order files in Adobe Acrobat, and that’s great. Just do it.

(VO) For those that don’t have access to Acrobat, or know how to use it, there is a free online tool that can make it happen.

It’s called Merge PDF Files and it’s also by Adobe. Unfortunately, you do have to create a free account to use it, but it’s pretty straightforward. The address is https://www.adobe.com/acrobat/online/merge-pdf.html. The link is in the show notes. Just drop all the EOBs, scanned receipts and the claim form into it, reorder the files, merge the files and download the merged file.

Another option that I’ve heard of is to put the papers in order and xerox to your email on a copier.

In any case, once you have all your files merged, you can go to the portal to do the uploading.

Go to the portal by using your bookmark…. Or by going to the A&I website, then clicking on Employees’ Group Insurance, then scrolling down and clicking on the portal link. On that page you will find helpful videos showing you how to register and how to use the portal during open enrollment. For now, just click on “employee portal access.” Click on “log in.” Then sign in however you have in the past. I use Google personally.

You don’t have to go far to make this happen. In the top section, you will see a tab called “Flex.” Click on that tab. Next, you will click on the “upload flex claims” button. You can refresh your memory about the details by reading the information on this page and when you are ready, click “new upload.” Next, click “select file.” Click “choose file,” select your file, and then click “attach file.” I can’t show you, but don’t forget to click “submit” after attaching, as sometimes folks do and the claim is not actually submitted. I’m not going to be doing that right now. So, I’m going to cancel.

You should see your file in the documents tab, but you might need to “show more items” and scroll down. Once EGI audits the claim, you will see it in this list under the flex tab.

Ok!! I know that’s a lot, but it is what it is. 🙂 Get in there and get reimbursed! I gotta fly… see ya next time.

Subject Matter Minute, Episode #70 – Flexible Benefits Plan

The below post is taken from the Video Blog, the Subject Matter Minute. You can view the episode on YouTube if you would like. Find it here: Episode #70 – Flexible Benefits Plan

If YouTube is blocked for you or your agency, you can scroll to the bottom of this post to view it from Google Drive. (I would prefer you view it on YouTube, so I know how many people have watched)

You can also listen to an audio version.

Hello and welcome to the Subject Matter Minute, I’m Matt Nagy, thanks for joining me! Thought I would celebrate the cowboys first win of the season today with my fancy rugby shirt. Hope you like…

If you have dug through the past Subject Matter Minutes, you will recognize this as a redo. There have been just enough changes, since 2016! to warrant a new episode. I will also be doing a new episode taking you through the process of submitting medical and dependent care reimbursement claims. So… today’s episode on the Flexible Benefit Plan is taking the place of episode #6. Please remember that because some episodes are being replaced, and YouTube doesn’t allow you to simply replace a previous video, the numbering will be inconsistent within the YouTube playlist. However, all of the current topics will be contained in that playlist. You can find the link to the playlist in the show notes.

Ok… today we are covering the Flexible Benefit Plan. (music)

Alright, the Flexible Benefit Plan. I guess this type of account is also known as the cafeteria plan, flexible spending account, or the 125 plan, just in case you’ve heard of those.

Before I get started, though, I want to thank this month’s subject matter expert, or experts…. it’s the folks down at EGI. Specifically Karissa Toalson and Karyn Williams. They got me the information, and hopefully I do it justice. It’s a lot of great information. Thanks Karissa and thanks Karyn, I appreciate it.

Really there are 3 components to this and keep in mind these are all IRS regulated benefits because they are tax sheltered, if you aren’t sure of the implications be sure to research or call EGI before electing them. (ok, first disclaimer out of the way) The first component is to have your health, dental and basic employee life insurance premiums, your monthly premiums, taken out of your pay, pre-tax. Doing so locks you into those benefits for a calendar year, unless you later experience a qualifying event that would permit changes. (you can watch the Qualifying Event video on EGI’s website to see what those are)

The second component is a medical reimbursement account. This is an account that allows you to take money out of your pay, pre-tax, and you can use that money on medical expenses that you incur throughout the year, . Basically, medical expenses that your insurance doesn’t cover. At the time of this recording, you can put up to $3192 a year into that account (per employee), you don’t have to put that much, you can decide, and it’s a monthly deduction. Please know that these numbers can change year to year, so check with EGI. Unless you are watching this at release time, it’s likely a different number.

There’s also a medical reimbursement account for you folks who have a high deductible health plan. This is called a wraparound medical reimbursement account. It’s very similar, but the difference is that you can’t use the money in that account for items that are run through the health insurance plan including your deductibles, co-insurance or prescriptions. . You can only use it for things that are truly not part of the health insurance plan, which is things like vision, dental, orthodontics and some over-the-counter supplies. It’s a bit confusing, so please contact EGI with questions. So those are the folks with a high deductible health plan. That’s still a medical reimbursement account, it’s just that they have a slightly different one.

Ok… so, that’s the medical reimbursement account…

The 3rd component of the flexible benefit plan is dependent daycare reimbursement. You can get reimbursed up to $5000 in a year, (per family) for day care, home care, or child care bills for care of a dependent child under age 13, a disabled child of any age, a disabled spouse or a disabled dependent parent.. Same deal, you’ll sign up for it, they will take the money out monthly, up to $5000 that you can put towards this care. Again, check with EGI for the most recent numbers.

I’ve explained the components of it, and at this point you’re wondering, ok, this is all my money… and then you are putting it in an account…. what’s the point? There’s actually a couple. First of all, all of this money comes out of your check pre-tax. So, it reduces your taxable income. So the less money you make in the government’s eye, the less tax you pay.

Let’s run a little scenario. Let’s pretend I have 2 kids that are still in daycare. If you have 2 kids in daycare, it’s going to easily be over $5000 for the year. So, you do that maximum, and they take out $5000 pre-tax. Then you know that with a family of 4, like I have, we typically have… mental health bills, specialist visits, vision and all these other tidbits… we are easily going to have over $3000 in extra medical expenses. So we max out our medical reimbursement account. That’s $3192. Then I also choose to “take out my health insurance premiums pre-tax.”

So, our monthly cost for health insurance is currently $386, for the family… that’s going to come out pre-tax. So you have the $5000, you have the $3192, and then you have nearly $5000 in health insurance premiums. We are talking about a $13,000 reduction in your taxable income. Now that’s a big deal. And it could even be a bigger deal … I’m not an accountant… but if it was to put you down into a lower tax bracket, you would save even more.

So you are saving on taxes. That’s one reason you want to do this. There’s other reasons. One of them is that with the medical reimbursement account, you can use that money any time during the year. You sign up for it. Let’s say you decide on $1200 for the year. $100 a month. If you decide that you want to get lasik surgery in March, you can go ahead and claim that whole amount, even though you haven’t actually had it taken out of your checks yet, and pay for your lasik surgery. So you can do it at any point.

Now it’s different with the dependent daycare account… You actually have to have the money in your account before you can use it.

There’s a very important piece of this that you need to know and keep in mind when you are signing up and choosing the amounts you want to do. This program, both the medical reimbursement and the daycare reimbursement are “use it or lose it.” That means that if you decide to take out $5000 for your daycare, and you don’t claim the entire amount by the yearly deadline, you forfeit the money. However, reimbursement accounts can be changed with certain qualifying events, so please contact EGI for more information on that.

I know that sounds mean, but on the flip side, if for instance, with your medical reimbursement, you sign up for $100 a month, cause you are going to get lasik in February. So you claim all that money that you haven’t yet taken out of your checks, and then you quit your job in March, the State loses money. So there is risk both ways.

Another important thing to know is that we must re-elect the reimbursement accounts every year. So, during the open enrollment period, which just opened up, you will need to select and choose an amount every year. It’s hard to miss when going through the open enrollment process in the portal… so that’s good.

So you sign up for all this… you get all the appropriate paperwork done… which, like I said earlier, I will have another episode on how to submit all this stuff. You submit it all, you go through the process, “boom,” you’ll get a check from EGI or, of course, you can sign up for direct deposit.

Which brings up another thing. You can do it in any fashion that you want. If you have $2500 in the medical reimbursement account, you can turn in your paperwork monthly and get monthly checks, or, like I do, you can wait until the end of the year, and get a big check. If it’s little things along the year that you are paying for and you can go ahead and do that, it’s kinda like a savings account for you in that if you turn in everything at the end of the year, you will get the total at the end. It’s a chunk of money, it’s nice.

That’s another benefit… at least I consider it one… it’s automatic savings for something that you are going to have to spend money on anyways. I don’t know how you guys are, but for me, it’s really hard… even if I know I’m going to have lasik in October, I can say that I’m going to save for it, but the odds are pretty good that I won’t. And then I’ll have to slap it on a credit card. So this is a way of doing it. They do it automatically, it’s there, you can use it at any point.

On that… the timelines… If you are doing a medical reimbursement for the year 2024, you have until March 31st of 2025 to turn in the paperwork but remember your services have to be incurred in the calendar year (in this case 2024) even though you have until March of the next year to submit for reimbursement. You could, and should probably, do it before that though. The money cannot be carried over for the next year’s services; if you cannot claim it, you forfeit it, so plan accordingly.

So, I talk fast… seems like a lot of information… I hope that you can tell that I think that this is a very good idea. Reducing your taxable income, paying less in taxes, and allowing them to put aside the money for you. Doing it automatically. Being able to pay for things up front. Even when you don’t have the money in the account yet. All these things… Great benefit from the State of Wyoming. Use it if this is something that you are going to spend money on anyways. Unless there is something your accountant says otherwise, definitely get your health insurance premiums taken out pre-tax, reduce your taxable income. That’s my financial advice, I am not a financial advisor, but I did stay at a holiday inn express last night!

If you have more questions, please visit the EGI website, check out the Flexible Benefits book, or contact EGI directly. All of that info is in the show notes. Since open enrollment has just opened, I also included a link to the how-to video for the portal. Don’t forget to go through the process!

Thanks for joining me and I’ll see you next time!

Subject Matter Minute, Episode #69 – Sick Leave Donation

The below post is taken from the Video Blog, the Subject Matter Minute. You can view the episode on YouTube if you would like. Find it here: Episode #69 – Sick Leave Donations

If YouTube is blocked for you or your agency, you can scroll to the bottom of this post to view it from Google Drive. (I would prefer you view it on YouTube, so I know how many people have watched)

You can also listen to an audio version.

Hello and welcome to the 69th episode of the Subject Matter Minute. For those of you who have been along for the entire ride…. Thank you! It’s been over seven years and fittingly, if you were with me for that first episode on Longevity Pay, you have received at least one bump in pay because of it. Go back and check out the first episode if you don’t know what I’m talking about. It’s what started it all.

Sometime in the past, I guess right before covid, I told you all that my generous parents were taking my entire family on an Alaskan cruise. Well, as you can imagine, covid killed that. Well, this is the year we got it back on the schedule. We just finished up a 7 day trip on a Celebrity Cruise!

Apparently we are very lucky travelers. We had cloudless skies and temps in the 70’s for 6 of the 7 days. This is unheard of… It was beautiful and really allowed us to see everything.

While I’m not entirely sold on the cruise type vacation, it was a fabulous way to see and experience Alaska. What an amazing place. We also had a great time with my family. Everything went really well.

The problem with cruises, of course, is the amount of people. Our boat “only” had 2300 people on it. Which is somewhat manageable for doing things on the boat, but when you pull into port at these small Alaskan towns, and there are 2-3 more giant cruise ships there, you really cannot experience anything but people. I’m guessing that over 10,000 people got off in Juneau, a town of only about 30,000.

However, we were lucky enough to score a table at the Alaskan Brewery in Juneau and had a uniquely Alaskan experience… A bear literally ran through the brewery! We heard a commotion and thought somebody was fighting, but then saw a man yelling and chasing a small bear out the far side of the brewery… went right through the brewery! So that was fun!

Oh, and speaking of Covid and too many people… 3 of us, including me, got covid at the end of the trip. I know… surprise right? Unheard of on a cruise ship…. (sarcasm)

And being sick is a perfect segue to today’s topic! Today we are talking about Sick Leave Donation! (music)

First of all, I don’t need any… I’m fine! Having said that…..

Most of you have probably seen the emails that go out about donating sick leave. I’m not sure how it worked with all agencies before, but we now have a statewide sick leave donation policy that has standardized the process for all agencies. (Thank you HRD!) I think this is a fabulous policy. The ability to help our fellow State employees at their greatest time of need makes my heart feel good. I’m guessing that there are some long term employees out there (and maybe a few others) that have been blessed with excellent health and have a few extra hours tucked away. And you can’t take it with you. Literally… the state only allows you to cash out a certain amount when you retire or leave employment.

Just so you know… when you leave employment at the state, you can cash in half of your sick leave, up to 480 hours total. OR, you can put the value of that same number of hours into your 457 retirement plan. Either way, you are only taking 480 hours with you… so to speak.

While it’s true that it would be nice to have as much as possible if you were to get sick or need some sort of ongoing treatment, personally, I think the good Kharma of spreading it around might be a better trade. Obviously, we need to keep a nice pile for ourselves, but hoarding sick leave when we are doing well and others aren’t seems kind of selfish. No judgment! Probably just me dealing with my own issues. But I’ll tell you that it does feel good to donate sick leave. Generally, I do it for those in my agency, but I’ll sometimes go outside my agency if it seems like a position that doesn’t pay much.

Ok, enough guilt trip, let’s get to the meat and potatoes of the policy.

You can find the links to, first of all, the A&I page that has all the links down in the show notes. I’ve also broken out the links to the policy and the process and then the necessary forms… so the sick leave request form and the sick leave donation form.

The bottom line is that any employee in the Executive branch who has exhausted all accrued sick leave, comp time, vacation leave and all other available leave, and who has no documented history of abusing leave, and who has a legitimate medical reason to be absent, may request sick leave donations.

To start the process of asking for donations, we talk to our supervisor. Then our supervisor completes the State of Wyoming Sick Leave Donation Request form (PER-2) and submits it to HR. It’s actually PER dash 2, but being a superfan of MASH, I just wanted to say stroke. If you watch, you’ll understand. 🙂

Next, HR does what they do… a little verification and such. Then HR and the involved supervisor decide the “level of request.” Donation requests can go out to the division only, or the full agency or the entire state.

But before sending out the request, HR obtains approval from the Agency head. If the agency head denies it for any reason, then the HRD admin must approve the denial. The only way it can be denied is if it meets the reasons in the policy and procedures or the personnel rules. Something like documented abuse of leave, or not having a legitimate medical reason to be absent.

After this, the donation request is sent out and you and I have an opportunity to give, give, give. So, if we decide to give, we fill out the sick leave donation form PER-2-A and submit it to our agency HR rep.

Then HR does what they do… a little verification and such. They verify that we have a minimum of 80 hours accrued after the donation amount. They also verify that we are donating within the rules of how much we can donate. We can donate a minimum of 4 hours up to 16 hours of sick leave per calendar year to the same person. Now if the person requesting leave is an immediate family member, we can give as much as we want as long as we still have the 80 hours in our account after giving.

Then, the donation needs to be approved by the Agency Head. Which again, can only be denied if it goes against the requirements listed in the Personnel Rules or there are documented abuses of leave.

Then HR does what they do. Which at this point is quite a few things! You can see the list on the procedures document. And then they take the sick leave out of our accounts and transfer it. If, for some reason it doesn’t get used, they will get it back to us as well.

So… that’s probably way more info than you needed, but if you still need more information, you can take a look at both the policy and the process as I have linked to those documents in the show notes.

As an aside, I once got a thank you note from someone that I donated to, and it really made my day. So, if you are unfortunate enough to need to get sick leave donations, consider contacting HR to find out who the kind souls were and throw them a little thank you.

Ok, that’s it for today! Having been floating on the ocean for a week and also dealing with some good old fashioned Covid, I’m way behind on my emails, so I gotta start digging! I’ll see you next time!

Subject Matter Minute, Episode #67 – Submitting a Health Claim on Cigna’s Website

The below post is taken from the Video Blog, the Subject Matter Minute. You can view the episode on YouTube if you would like. Find it here: Episode #67 – Submitting a Health Claim on Cigna’s Website

If YouTube is blocked for you or your agency, you can scroll to the bottom of this post to view it from Google Drive. (I would prefer you view it on YouTube, so I know how many people have watched)

You can also listen to an audio version.

Hello Everybody and welcome to another Subject Matter Minute!

So the last episode was on the Cigna Wyoming on Wellness website that makes it easy to find wellness resources. I hope everyone went out and gave it a look. I decided to give one of the services a go and did a few weeks of therapy through TalkSpace. That’s a service that allows you to get therapy in several ways… Video chat, Live chat and regular chat, where you are just messaging when you have the time. To be honest, the first therapist I was paired with wasn’t responding quickly enough for my taste, so I fired her and was paired with another therapist that is great. It was easy to set up and with our EAP, we get 3 “sessions” for free. This can be 3 video chats, or in my case when you are messaging, you get 3 weeks of chatting back and forth.

So… don’t be scared to get out there and use these services.

I also did an episode recently on the “Ideas Festival.” Well, we seem to have a lot of ideas! At the time of this recording, there have been 225 submissions. And I’ve been told that there are a ton of really good ideas. So… hopefully, these good ideas get implemented and those that submitted them get rewarded! Nice work!

Finally, there has been a big change at the Nagy household, but since I’ve already been rambling on, I’ll save it for next time.

So, typically, when we have health related costs, the provider and our insurance chat and everything gets magically taken care of, right? Well, there are a few reasons why this might not happen, and, thus, we might be required to do the magic ourselves. Today, I’m going to show you how to submit a claim on Cigna’s website. (music)

Before I get started, I want to thank Alice Burron of Cigna for being this month’s episode’s Subject Matter Minute. Thanks Alice.

Like I mentioned, there are a few reasons that we may have to submit our own claims on the Cigna website.

While in-network providers are required to submit our claims, out-of-network providers are not. Some will, but some might not. Another reason we will have to submit ourselves is if we get a blood test beyond the free blood chem test at Wyoming Health Fairs. Also, if you get a Covid vaccine and they don’t submit for you. And finally, if you have emergency care outside the US, you can submit the claim yourself. Also, just so you know… you have 15 months after the expense to submit a claim.

Let’s get to it. So, if you haven’t been there before, you want to start at My.Cigna.com. Either register if it’s your first time or go ahead and login. If it’s your first time in a while, you may need to do the two-step authorization code to your phone thing. Then, you may get an annoying page that asks if you want to invite family members to register. I have just been scrolling down and clicking “skip for now.”

Next, go to “claims” and click on “submit a claim online.” Then you choose the appropriate claim. Mine is a behavioral health claim.

As a side note, you can also submit claims for Covid-19 tests here. You can actually claim up to 8 tests a month. But…. today I’m showing you how to submit a medical or behavioral health claim. So, again, click here.

They give you some instructions here. In my case, it’s a claim from an out-of-network provider, so I’m submitting a superbill. You can see the definition of that here. Otherwise, make sure your digital document has these items on it. Then click the “start a claim” button.

Then you choose the family member that this is for, and click next. There’s a few more steps here. Is this Due to an Auto Accident or Work Related Illness/Injury? I’m going to select “no,” and click next. Is the Patient Covered by Medicare? Again, “no” and next. Does the Patient Have Other Insurance/Coverage for this Claim? One more “no” and next.

If you have different answers for some of those steps, like “if it was an accident” or “covered by medicare,” you will need to have further information. However, you will still end up at the same place where you will upload your claim.

So, click on “choose a file.” Select the file from your computer, and click open. You will see the filename right here. Then click “upload file.” You can add multiple files here as long as all of the steps were answered the same. When you are done uploading the files, click next.

Select who you want the payment to go to. Click the checkbox. Enter a name for the claim. I just leave the person’s name and date as they make it. Then click done. Success! You can read the little “what happens next” text, and you can see that a confirmation message has been sent to you.

So that is the process of uploading claims to Cigna. I’ve done dozens of them and have not had any problems.

If at any point you need help, you can click on this contact us link right here, scroll down, and choose from phone, chat or email. I have made several calls to ask questions about other things, and they have always been very helpful and polite. So don’t hesitate to call.

Alright, that’s it for today! I hope everyone is dealing with the spring weather ups and downs well. And if you need some emotional help to get through it, as soon as you are finished submitting your claim, scroll to the top of the page and click on “mental health support” under the wellness menu item, and set up some time with a therapist. You won’t regret it.

Subject Matter Minute, Episode #66 – Wyoming On Wellness Resources

The below post is taken from the Video Blog, the Subject Matter Minute. You can view the episode on YouTube if you would like. Find it here: Episode #66 – Wyoming on Wellness

If YouTube is blocked for you or your agency, you can scroll to the bottom of this post to view it from Google Drive. (I would prefer you view it on YouTube, so I know how many people have watched)

You can also listen to an audio version.

Hello and welcome to another episode of the Subject Matter Minute! I hope everyone is enjoying winter! Now that it’s getting back to winter!

So, I have a couple updates related to two of the more recent SMM’s. After I did the episode on Pet Insurance, I had a couple state employee friends call me out on not figuring out if the benefit is a good deal. One said that he felt let down, and the other said that I’m just a shill for the man.

But anyways. I did some research into pet insurance, which is an optional voluntary benefit offered by EGI. And I would say that it is “fair to middlin’” price wise. I used a comparison site, used a 5 year old black lab for the pet, and ours came in maybe middle low. There were less expensive plans and considerably more expensive plans. And there are tons of them out there. But, just like with any insurance, different things can be covered, so it’s hard to directly compare. I guess my advice is while it’s a solid choice, everyone may need to do some comparison shopping. (Sorry I can’t be more specific, Bobby!)

The other update is on the employee referral bonus. People have been putting this to use! In the first 6 months of the fiscal year, so July through December, the state (HRD?) paid out $30,500. So, about 122 positions filled with folks that were recommended by you. Last year, they paid a total of $18,500 for the full year. So, I guess a lot of you out there have received a chunk of change for getting someone you know a new job. Nice work! I’m hoping that it was the SMM I did back in August that got you all thinking about it.

Alright… let’s move on. Today I want to talk about our Cigna benefits that are showcased on the website Wyoming on Wellness. (music)

For those of you who were around back in 2019, you may remember that I did an episode that covered some of the wellness benefits that we have through Cigna. Well, that was episode #25, and it still holds up. So give it a watch, if you can. Both for that episode and today’s episode, I was helped along by Alice Burron of Cigna. She is the person that does all the Walkingspree events and the wellness initiatives that regularly spread a bit of money around to many of those that participate. Alice is today’s subject matter expert. Thanks Alice.

So, Wyoming on Wellness is a website that tries to make navigating Cigna’s health and wellness resources easier. There is quite a bit of information on the Cigna website, but wellness is just one of the many items. So, if you are looking for help with your financial wellness, your mental health, maybe you need some coaching, want to catch up on the latest walkingspree initiative, etc… Wyoming on Wellness is where you wanna go.

I’m going to take you to the website and give you a little tour.

Here is the Wyoming on Wellness .org website. I’m going to take you through the navigation menu here in a minute, but first let’s take a look at the home page. The slider at the top usually has announcements and can be a good place to get started. Just click through them with the arrows. I would suggest you watch any of the videos on the website. They give you good introductory information on all of the aspects of WOW. This one goes through how to make the most of your benefits. And then they map out the 4 steps to get things moving with the Cigna wellness program. The rest of the home page includes links to the events calendar, links to the FAQ, and contact links. We will hit all of that from the top navigation.

I’m going to go through the main menu items here and then finish out with the “wow care navigator.”

So the first menu item is the Cigna steps which you get to by clicking on the main menu item. These are 4 steps to make sure you are making the most of your health plan benefits. And doing this gets you entered to win gift cards if you register for Walkingspree. They give hundreds of $50 gift cards throughout the year. So get your free blood draw at the Wyoming Health Fairs (you get two free screenings a year), register at mycigna.com to fill out your health assessment, then schedule your annual checkup with your doctor and go through those blood work results. Your results will show up automatically in your health assessment.

Ok, if you go down the menu and click on mycigna, you will get information about the registering step. If you go to the health assessment dropdown, you will get information about taking the health assessment.

Ok, let’s move onto events. Here you will see the events calendar, and be able to subscribe to it as well, if you would like. This is where you can find out about walkingspree challenges, webinars, and other special events.

Ok… let’s move on to the programs dropdown. If you click on the main menu item “programs” you will see this page that has the programs shown visually and has some additional info. So you can navigate from this page or the dropdown menu.

So, as you can see the wellness programs include coaching, financial wellness, Mental Health, Omada and Walkingspree. Let’s check out coaching first.

First of all watch the video. It highlights the areas where coaching could help and how we can get it. Then dig through the page to get the details. There are all sorts of areas where coaching could come in handy, like when you’re feeling stressed or would like to work with a coach to improve your health… for example.

Let’s move on to financial wellness. The first thing you should do is take the financial assessment. It’s free and it’s pretty interesting… I took it. Then sign up for the financial webinars that we put on monthly. And, again, we can get help for stress or anxiety related to finances. And who hasn’t had that!?

Next we will head to the mental health page. There are a lot of resources here. They’ve grouped the resources by topic. Building Resilience, Kids Teens and Families, Opioid Use, and Virtual Therapy. Alot of great stuff here. A few that I find interesting right out of the gate include Talkspace where you can get therapy via text messaging or live video. I think I would like text messaging. Also, there are a couple for children and teens that also include help for the parents… Bend Health and Brightline are similar and both provide healthcare and support for the whole family that includes children age 1 to 17. They both offer accessible coaching, therapy and medication management if needed. We can access these services through an app and through virtual sessions. For folks in parts of Wyoming that don’t have pediatric and adolescent mental health providers, or there’s a long waiting list, these services will give you access to Wyoming licensed and in-network providers. You may hear more about Brightline in the future, so keep your eyes open for that.

The next program is Omada. This is a free program for folks that are at risk for type 2 diabetes or heart disease. There’s a video that explains what it is about. It sounds very effective. I guess you get a wireless smart scale for free that monitors and syncs your weight to an online account. You do have to be eligible to enroll. (just click on the button on the Omada page to see if you qualify).

The last of the Program pages talks about the Walkingspree program. Here you can find out how to set up your account, how to earn points, and what you can win. I find the walkingspree challenges to be motivational. Makes me want to get out there and at least walk. And the more points you earn, the higher your chances of winning one of those gift cards!

Ok and finally… they have an FAQ page that has a ton of info on it, a podcast page where there will be monthly podcasts added… including one this month where I talk about benefits with Alice Burron of Cigna… so at least check that one out. 🙂 And then a contact page.

To finish things out let’s take a quick look at the WOW care navigator. This is pretty cool. If you come to the site with a problem but don’t really know where to start, just click here. With a few questions, you can be guided to the information and/or resources you need.

So, that’s a lot of information, I know… and to top it off, we also have another EAP that offers similar services. Look back at episode #41 for information on that.

The bottom line is that we have access to anything we might need in the wellness area. And it’s for our entire family. Do your research and find what you need to improve your situation, or your life.

Subject Matter Minute, Episode #65 – Ideas Festival

The below post is taken from the Video Blog, the Subject Matter Minute. You can view the episode on YouTube if you would like. Find it here: Episode #65 – Ideas Festival

If YouTube is blocked for you or your agency, you can scroll to the bottom of this post to view it from Google Drive. (I would prefer you view it on YouTube, so I know how many people have watched)

You can also listen to an audio version.

Hello, and welcome to another Subject Matter Minute, I’m Matt Nagy, thanks for joining me!

Well, the votes are in, and……. I didn’t listen. I’d say an overwhelming majority of you told me to just shave my head clean. But, apparently, I’m not ready. So…. thanks for your input, and we will see what happens down the road.

You guys mind if I vent for a second? Skip ahead if you don’t have time. I’m guessing a bunch of you went to the University of Wyoming and stayed in several of the finest rentals the town has to offer. I lived in some pretty serious junk back in the day. Well, the slumlord issue certainly hasn’t changed.

My daughters are both renting from the same outfit, but different places. The younger of the two has a place that has a ton of old, original windows. So, in the summer she roasted. I mean roasted. And now in the winter, even with a space heater going all night, she can’t get it past 60 degrees.

My older daughter lives in this tiny house. (not an actual tiny house) You would think it would be nice and cozy…. But it’s not. The heat doesn’t keep the house warm at all. Same deal, can’t even get to 60 degrees. Well… I walked in the door a bit back and found her supplementing her heat with the electric oven. I did the dad thing and told her it was dangerous and would cost her even more, but it reminded me of one of my places in the 90’s.

We had baseboard heat and it was costing around 160 to 170 a month for electricity. Back in the 90’s! Well, we weren’t paying for gas, so we would crank all of the gas burners, put a fan in the doorway and blow the heat into the living room. Talk about dangerous! But, the moral of the story is that nothing has changed. You either gotta have a lot of dough or you have to wear alot of clothes! Thanks for listening….

Alright, on to the goods….

For those of you who were around back in 2020, how many of you remember getting an email about a program designed to get ideas from employees about ways to save the state money, improve processes, etc? I remember it, and I remember being very skeptical. I remember thinking that, you know, it’s always about money. And even though they were offering financial incentives, I figured they would probably be laughably low. The program immediately went off my radar. Well, the state did eventually reward some folks for their ideas. And…… it was more generous than I thought it would be. And… the state is bringing it back, so today I want to talk about the Ideas Festival. (music)

Before I get started, I would like to thank Erin Williams, our HRD Administrator, for getting me all the information. She is today’s subject matter expert. Thanks Erin.

For those of you who have been around forever, you may remember the same program, with a different name back in the late 80’s through the 90’s. In that 11 year span, they gave out just over 10,000 dollars to 31 people. They also gave out 40 days of leave to folks that saved smaller amounts.

Then they revamped the program in 1999. That year alone, they gave out just over $7,000 to 9 people, and 51 days of leave to others.

The program was called STAR back then, for Saving, Tips And Rewards. Like I mentioned earlier, the most recent program is now called the Ideas Festival. The email I remember, back in 2020, garnered 1340 proposals. For this round, they gave out just under $10,000 to 13 people, with one person receiving $3000 by themselves and another getting $1,350.

The cool thing about this program is that it is the state taking advice from those on the ground. Those doing the work. Those getting their hands dirty… either for real or figuratively. All those conversations you have had with your co-workers about, “if only we did it this way,” or “you know… things would run a lot better if…” Those daily conversations could turn into cash in your pocket.

However…. That part is really just about money, right? Pinching pennies, saving the state money, yada, yada, yada. Well, this time they are expanding the program to include awards for people that come up with ideas or projects that simply make the state a better place to work. Kind of a “culture change” award. The awards won’t be based on money saved. And thus, it’s not all about money… it’s about quality of life. This is my favorite program of the 2 for sure. This one makes me feel good. It takes the focus off the money and puts it on happiness.

Don’t get me wrong, I really like them both. Who wouldn’t want some extra cash? And afterall, I am a taxpayer, and would generally like the state to work with less where it makes sense. But… we all have to spend a huge chunk of our lives working, and every attempt to make it less arduous is a plus in my book.

So, the “if you save us money, we’ll give you money” aspect of the challenge rewards people up to either 5% of the total saved, or $5,000, whichever is less. So, $5,000 is the max reward. And they will give out rewards to the chosen projects up to the program budget.

For the culture change part of the program, the rewards will most likely be non-monetary. Admin leave days are on the table for sure, but there may be other rewards. Yet to be determined. There’s no limit on the number of “culture change idea” awards. The state can give out as many as they deem are worthy.

So, if you and your co-workers have had ideas that you thought could never happen, the ideas festival is the time to propose them. Even if it seems like there is a barrier, be it money, time, or bureaucracy, this is the program that could get it pushed through.

Start writing up your plan and keep your eyes open for the announcement. HRD should be sending out the form and instructions very soon.

That’s it for today’s Subject Matter Minute! Hope everyone had a fabulous Christmas and a fun new year. And here’s to an unusually warm winter so my kids can stay comfortable in their own homes.

Subject Matter Minute, Episode #64 – Pet Insurance

The below post is taken from the Video Blog, the Subject Matter Minute. You can view the episode on YouTube if you would like. Find it here: Episode #64 – Pet Insurance

If YouTube is blocked for you or your agency, you can scroll to the bottom of this post to view it from Google Drive. (I would prefer you view it on YouTube, so I know how many people have watched)

You can also listen to an audio version.

Hello, and welcome to another Subject Matter Minute! I hope you enjoyed our beautiful fall weather before it turned on us. It was a great one.

It cracks my wife up, but I still run into you guys out there, you know, where you know me, but I don’t know you? She considers it fame… I keep reminding her that it’s Wyoming fame, so, a pretty small group. But… I was in Cheyenne a week or so ago and ran into a couple fabulous state employees. Wanted to give a shout out to Benoit, who I ran into on the WyDot campus and to Brenda from the Health department who I ran into at the Albany later in the day. Thanks for saying hello, it was great meeting you!

Ok… now it’s time for the serious part of the show. I’ve started getting horrified with my hairline and massive bald spot, and I’m starting to think that it may be time to take it all off…. Down to the skin. I’m curious what you guys think? It’s been a long time since I’ve asked for your input, and this is a very serious matter. A life change if you will. Lemme know what you think in the show comments!

Alright…. Let’s talk about the subject of the subject matter minute now. Today I’m going to talk about a new insurance offering by the state, Pet Insurance. (music)

Before I get started, I want to thank the crew at EGI for looking over my information and making sure I got it right. Like is so often the case, they are the subject matter experts for this episode.

Back when I had dogs, I’m not even sure pet insurance was a thing. And I’m sure I wouldn’t have even considered buying it. However, these days, I think it makes a lot of sense. Pet medical bills are often equal to human medical bills. We have some friends that are currently struggling with the concept of repairing an ACL on their dog for the small sum of $3000. Heck, 20 or so years ago, our dog suddenly lost the use of her back legs. She was paralyzed. So we took her down to Fort Collins and $1500 later, they said there was nothing they could do. She did slowly recover use and regained most of her ability, but that was $1500 back then.

So anyway… the state is now offering pet insurance through Metlife. This is a voluntary benefit, which means that we pay for it out of pocket. It’s also something that can not be payroll deducted. We just have to pay for it on our own…

I honestly have no idea if the rates are better than others out there. It’s a group plan, so they should be lower. But just so you know, I haven’t done any comparisons with individual plans out there. You might want to do so.

So, what do you get?

Insurance plans that can cover the entire pet family with no breed exclusions
Freedom to visit any U.S. veterinarian and reimbursement up to 90% of the cost of services
Family plans covering multiple cats and dogs on one policy
24/7 access to Telehealth Services for immediate assistance
Discounts up to 30% and additional offers on pet care, where available
Optional Preventive Care coverage
Coverage of previously covered pre-existing conditions when switching providers

We control the monthly cost by adjusting 3 components, the amount of coverage, the deductible and the reimbursement percentage. You can have coverage from $500 to unlimited, deductibles from $0 to $2500, and reimbursement percentages from 50% to 90%.

You can see here what’s covered:

The optional preventive care coverage includes things like flea and tick, spay and neuter, heartworm, behavioral training, teeth cleaning and more.

Of course there are some pre-existing conditions that they won’t cover. You can see what these sorts of things are on the Metlife website. The link is in the show notes. https://www.metlifepetinsurance.com/pre-existing-conditions/

Most of the information that you might need about this is linked in the show notes. There are also very clear instructions for how to get a quote and signup. The quote system allows you to add multiple pets, so it seems pretty handy.

We are currently pet free, but I think that if we were to get back into the pet life, we would definitely look into some insurance. Our paralyzed dog that I mentioned earlier had to use a doggy wheelchair for a while and I remember that being hundreds of dollars. The pet industry knows that pets are family and they certainly charge as if they are!

So check out the new coverage, it may be just what you need to reduce one area of financial stress. That’s it for this episode. Thanks for tuning in and I’ll see you next time… with… or without…. hair.

Subject Matter Minute, Episode #63 – Employee Referral Bonus

The below post is taken from the Video Blog, the Subject Matter Minute. You can view the episode on YouTube if you would like. Find it here: Episode #63 – Employee Referral Bonus

If YouTube is blocked for you or your agency, you can scroll to the bottom of this post to view it from Google Drive. (I would prefer you view it on YouTube, so I know how many people have watched)

You can also listen to an audio version.

Hello, fellow State of Wyoming employees! It’s been a while, eh? I was even repeatedly asked why I had quit doing the Subject Matter Minute. Well, good news, I haven’t. I had a subject that just didn’t come together, so after waiting too long, I had to pivot and find a new one. This is a fun one!

Before I get to it, I wanted to say that I hope everyone was reasonably pleased with their raises? Now, if we could just get to the point of yearly cost of living increases, maybe we couldn’t complain about it anymore, right?? Well, we’ll see…

So being mostly Wyoming-ites out there, I’m guessing a large number of you have probably crashed into some big game on the highway. I almost hate to say it, but I have been lucky and have not. But, as we all know, it’s a fairly common occurrence. Well, unfortunately, my parents clobbered a deer at 60 miles an hour last week. They drive a Subaru station wagon and all the airbags deployed. If you have never had airbags deploy, you need to know that they also deploy a bunch of dust or powder. It kinda seems like your car is on fire. It’s probably not, but just so you know. Well, anyway, my dad was driving and he is fine. I don’t think he was even sore. Unfortunately, my mom was reclining a bit and that extra space may have been the difference. She has a compression fracture in her back. She is able to get around but isn’t supposed to in order to allow for healing. My mom is 80 years old, so being sedentary is not good. And, she’s got some fairly serious pain going on. So… send out some good thoughts to my mom. Hopefully, I’ll have good news in a few months.

Ok, so that wasn’t fun… but the topic today is. I don’t know if you are aware, but the state is having a hard time filling a ton of positions. Well, HR has been trying to figure out ways to attract more people. They are trying to think outside the box. Beyond the marketing tricks… Well, the state, as you may have noticed via an email that went out recently, is now offering a referral bonus for folks who help fill a position.

Before I give you the deets, I want to thank Stefanie Stack of HRD for answering questions about today’s topic. Thanks, Stefanie!

Here are the deets. It’s simple. Check out the available jobs, and let your friends and family know. There will be a place on their application to put your name down. Boom, 250 bucks in your bank account. Ok, so it’s $250 for permanent positions and $100 for temporary positions. Obviously, they need to actually get hired for us to get the bonus.

Honestly, they don’t need to be friends and family for you to get the bonus! Just as long as you can get your name on their application. Can you entrepreneurs out there figure something out?

There are a few things to know about this. First of all, the person being hired must not have worked for the state in any capacity in the last year, or 365 days. Also, temporary employees (AWEC, TP01s) are not eligible for the referral bonus. The only exception is if a TP01 has been continuously employed for 6 months or more. And finally, the referring employee’s name must be listed on the application.

I don’t know, maybe everyone you know is happily employed? But if not, take a look at the available jobs and let them know. I don’t know about you, but an extra $250 is always nice.

I have some links in the show notes. A link to the referral bonus brochure as well as a link to the State of Wyoming jobs page.

Ok, that’s it for this subject matter minute. I’ve been knocking on wood since my opening remarks about never hitting a large animal on the highway. You guys be careful out there.

Subject Matter Minute, Episode #61 – Flexible Work Schedule Policy

The below post is taken from the Video Blog, the Subject Matter Minute. If it’s a little hard to read, it’s because it’s taken from the spoken word. You can view the episode on YouTube if you would like. Find it here: Episode #61 – Flexible Work Schedule Policy

If YouTube is blocked for you or your agency, you can scroll to the bottom of this post to view it from Google Drive. (I would prefer you view it on YouTube, so I know how many people have watched)

You can also listen to an audio version.

Hello! Good to see you all again, I know it’s been a while… There were a couple of possible topics that weren’t quite ready for primetime, and my involvement with the implementation of our new HR software, Neogov, has kept me pretty busy, so, yeah… it’s been a while. Please forgive me. 🙂

If you missed it, the last episode was on our vision benefits, which was a redo since some numbers and coverage had changed since the first recording 5 years ago. Check it out if you haven’t…

I’m curious how many of you out there are early-morning folks? I have definitely become one. I find the morning coffee time to often be the best time of the day. Well, this past winter, a group of friends and I have taken the early morning thing up a notch. It has pushed my quiet coffee time to even earlier, but in the end, it really feels even better. We got up to at least 2-3 days a week of early morning cross-country skiing at Happy Jack. Leaving around 6 and getting back about 7:45. No matter what the weather situation was, we always feel great after the ski. Got to see some amazing sunrises, forests of frost, and snowstorms, and got into some pretty good shape.

And since the interstate was closed so often this year, we also discovered the Wyoming Travel Authorization Program, or W-TAP through WYDOT. This allows you to drive on closed roads in certain situations. It’s fabulous for getting to Happy Jack. You might want to check it out…

Anyways, cheers to all of you early morning people!

Alright, let’s get started on today’s subject… today we are going to talk about the state’s policy on Flexible Work Schedules. (music)

The reason I’m going into it now is because it recently changed. I’m not going to go into the changes because, honestly, who cares! It is what it is now…

So, I’m just going to say upfront that if you are a full-time employee, the policy basically allows any sort of schedule as long as your 40 hours fall within the “official workweek.” The official workweek is Saturday to Friday.

Of course, having said that you know that this, or any change to your schedule, would need to be approved by your supervisor and agency director.

Also, there are a few exceptions to the rule of staying within the “official workweek.” One of which is the ability to do the Phoenix schedule. I had never heard of it before reading this, but a Phoenix schedule is when you work 4- 9 hour days, say Monday through Thursday, and then work an 8-hour Friday every other week. So basically taking every other Friday off. This is allowed even though it falls outside of the “official workweek.” You are still averaging 40 hours a week with this schedule.

There are a few other exemptions to this which you can find in the Compensation Policy, Chapter 5, Section 6.

But again, if you stay within the official workweek, and your supervisor and agency director approves it, the policy allows you to have pretty much any work schedule you can dream up.

Now all employees, non-exempt or exempt, are expected to work the agreed-upon weekly schedule, however, sometimes things come up and hours fluctuate. As mentioned, non-exempt employees can flex time within the same workweek. But they can only flex time within the same workweek because they are eligible for overtime after working 40 hours. However, because exempt employees are paid on a monthly salary, and don’t get paid for overtime, they can flex time outside the workweek within the same month. So, they can work 50 hours one week and 30 the next, for example.

If you go read the policy, which you can find in the show notes, you will see that it goes through all the details. It talks about eligibility and that it’s a case-by-case situation that must work for both the employee and the state.

It defines 5 different types of flexible work schedules. I’m not going to define those for you, because what it ends up meaning is exactly what I’ve described to you. You can do most anything.

So, if you want to use the correct word when you go to your supervisor about this; variable, alternative, extended, compressed, or phoenix, then check out the policy.

And actually, you will need to know the correct term to fill out the Flexible Work Schedule Agreement which you can find on the A&I website on the HRD Policies and Procedures page… or in the show notes. 🙂 So, you will need to get approval and fill out the agreement to make this happen.

I think it goes without saying that flexible work schedules can be canceled at any time by management, although they will give you 14 days notice. Also, any changes to a flexible work schedule must be approved by your supervisor and the agency director. And finally, this can be considered a reasonable accommodation under the ADA.

I think that this new policy is very forward-thinking of the state. Whether it has been kinda forced by a lack of recruitment ability…………. Doesn’t matter. 🙂 It’s still awesome.

So, if you have a schedule that works better for you, works for the state, and works for your supervisor, talk to him or her and give it a go! Who knows, you might be able to squeeze in more activities like xcountry skiing with a different schedule!

Ok, that’s it for this episode! I’m starting to get a little sleepy since I was up at 5:00 this morning. See ya next time.

Subject Matter Minute, Episode #60 – Vision Benefits 2023

If YouTube is blocked for you or your agency, you can scroll to the bottom of this post to view it from Google Drive. (I would prefer you view it on YouTube, so I know how many people have watched)

You can also listen to an audio version.

Hello All, I hope you all had a fabulous holiday and that you got to use some of that hard-earned vacation time! I took on a challenge during the holiday season. A buddy of mine and I installed a new steering rack in my 2004 Toyota Camry. This is no small task. That’s why the shops wanted to charge around $2000 to get it done. Well, I bought the part, and with a little help from our friend, YouTube… we got it done. Quite a feeling of accomplishment! My buddy is a bit more confident in the auto repair arts, so he convinced me that we could make it happen, and by golly, we did. You gotta love YouTube, right?

So, I started making this show 5 years ago. Time flies… And because of that, I decided that I really needed to go through all the episodes to make sure that the information was still correct, and correct anything that wasn’t. So, for some things, that means completely removing, or hiding, the video. For instance… we no longer use Saba Talentspace for our performance evaluations. I had several videos showing the online processes for that software. So, I’ve now hidden those. Some just have small tweaks that I can add a new voiceover with some text or something to highlight the small changes. Others are just going to have too many changes to deal with without completely redoing them.

Well, episode #1, longevity pay is still the same, nothing has changed. We still get $40 per month added to our pay for every 5 years of service. Check out the episode that started it all.

Episode #2 was/is Vision Benefits. As I went through it, I tried hard to come up with ways to patch it up, but besides the changes, the episode just wasn’t all that great at covering the benefit. So… today, I’m going to redo the episode on Vision Benefits. (music)

While I mostly got my information from the VSP brochure, (which is linked below) I did, of course, have Employees’ Group Insurance look things over and make sure I didn’t misspeak or leave anything out. So thanks to this month’s Subject Matter Experts, the whole crew down at EGI.

So, the first thing to know about our vision benefits is that these are voluntary benefits. This means that the state does not pay for them, we do. We don’t have to have them. They are voluntary. So, I hope that I can help you decide if this benefit is for you or not. I will say that just an eye exam at our doctor costs $242.00 without insurance. Right now, at current rates, the most an individual employee, paying for coverage only for him or herself, (not paying for a family) the most they will pay is just a smidge over $100 a year. So, the math works out.

One other thing to know upfront… There is both a waiting and a commitment period. If you don’t select vision when you are first hired, or if you drop it, you have a 1 year waiting period before you can sign up. Also, once you have selected it, you must pay for the coverage for a year.

The covered components with our vision benefits are eye exams, glasses, and contacts. A new addition since I last covered this is something they are calling Essential Medical Eye Care. I’ll go into that as well.

As far as your exams, glasses, and contacts go, there are two different plans to choose from. Cleverly named Plan B and Plan C. It’s anyone’s guess where Plan A went. First I’ll cover what both plans give us and then I’ll cover the differences. Both plans give you a $10 exam every 12 months. Ok? So, it’s a $10 copay. That’s for the basic exam. Both plans also now have what’s called “essential medical eye care.” This covers additional exams and services beyond routine care to treat immediate issues from pink eye to sudden changes in vision or to monitor ongoing conditions such as dry eye, diabetic eye disease, glaucoma, and more. Each exam will require a $20 copay.

Both plans will get you a set of prescription glasses for a $25 copay. Actually, there are 3 different scenarios. If you just want frames, you pay a $25 copay. If you just want lenses, you pay a $25 copay. And again, if you want full glasses (frames and lenses) you pay a $25 copay. It’s always just going to be one copay.

But here is where the two plans split. With Plan B you have a $170 allowance for the cost of the frames. This means that after the $25 copay, VSP will cover up to $170 of the cost. With Plan C, you have a $190 allowance. Then… because frames can be quite expensive, you will get a 20% discount on the amount above the allowance for both plans.

Ok, and here is another difference between the two plans. With Plan B, you can only get new frames every 2 years… so 24 months. With Plan C, you can get them every 12 months. So, if you have a small child that’s good at snapping your frames, you may want Plan C. Or if your style preferences change more than they should, again, get plan C.

Now, this difference is just with the frames. You can get new lenses every 12 months with both plans.

So to sum that up a bit… you pay a little bit less with Plan B, monthly, and you get a little bit less.

Keep in mind that the lenses that are fully covered are fairly simple lenses. There are a whole bunch of “lens enhancements” that are going to cost you more. VSP claims that you get an average of a 30% discount on these, but they can really add up quickly. The best way to deal with this, if you are trying to keep your costs low, is to log in to the vsp website at vsp.com and see how much they cover for things you might want. Might even make sense to bring that list so you know how much each of those add-ons that they are selling you cost. Cause they will ask.

Ok, next is contact lenses. There is no copay for contacts, and the same allowances apply. So for plan B, you get a $170 allowance and for plan C you get a $190 allowance. You can get the allowance every 12 months for both plans.

If you want to, you can also get non-prescription sunglasses instead of glasses … with the same allowances and time periods. So, every 2 years for Plan B and every 1 year for Plan C. So, if you take care of your glasses, and/or your eyes don’t change too much, you can get some nice sunglasses instead.

There are a few other benefits, like discounts for laser corrective surgery and higher allowances for special (ie. expensive) frames that they are partnering with, discounts on additional pairs of glasses, etc…

Like most things insurance, you will need to use an in-network provider. You can find your providers on the VSP website. I’m going to give you a quick tour of that in a minute.

Please keep in mind that this video is being created at the beginning of 2023. Prices and numbers will change. The easiest way to find the current cost of the vision coverage is on the a&i website. You can find that info below.

Once you have vsp coverage, the best way to see what you benefits are, and to see if you are eligible for new glasses, or whatever, is to login to the vsp site. I’m going to show you that now: (quick site tour)

This is the VSP website – vsp.com. First time here you’re probably going to need to create an account otherwise you log in. That brings you to your dashboard. One thing you need to know here is that you can switch members here. Right here it says switch member if you have family coverage you might want to look at somebody else’s coverage. I’m not going to switch but I’m going to show you how… shows you the drop-down of my family. I’m not going to do it I’m going to bag out and I’m going to look at just for me.

There are a lot of things you can see here… your benefits, your most recent doctor, your claim history, you can manage your account, and all that. I’m not going to show you everything but I’m going to show you where you can look at your benefits so you have an idea of what kind of coverage you have, where you are at in the timeline, and all that. I’m going to click “view your benefits” …you can also switch your member in here again, but you’re going to have to “review your benefits” now to get to this area.

This area basically shows you everything I have said in this video. You can go down through here and see where you’re at and what your coverage is. My exam… I’m eligible on February 1st so I’m not quite eligible, my co-pay is only ten dollars all right, frequency every 12 months. This is actually a contact lens exam which I did not mention in the video but that might cost up to sixty dollars to get that done… if you’re already getting contact lenses you won’t have to do that. The retinal screening is also something I didn’t mention but it’s that thing we’ve all dealt with where you can either get a free one by dilating your eyes or you can get the fancy one and that can cost up to $39. Now we’re down here to what I was talking about… the prescription lenses. I’m eligible for my lenses every 12 months, $25 copay.

Here are all the enhancements that I mentioned. It says here you should expect to pay no more than the following costs. This is what I said you might want to print out or write down and take with you because they’re going to ask you “do you want this, do you want that” and you’re going to go “uh uh I don’t know” so bring that along and at least you’ll know how much it’ll cost you if you do. Frames $25 copay for just the frame… I’m in Plan B so it’s every 24 months… I have a 170 dollar allowance for that. You can also click here if you want to get some much more expensive frames… you’ll get a higher allowance for that. If you keep going down you can get contacts instead of glasses, you can see what your coverage is… this is the Essential Medical Eye Care that I mentioned. It says that I’m eligible, the co-pay is twenty dollars per office visit, and then it continues on. Shows you that you can get an average of 15% off of Laser Vision Care and so on. This is a great place to come see if you’re due for an eye exam, if you’re due to get glasses, and to see all the benefits that you have with VSP.

Ok! Hopefully I’ve helped those trying to decide if they want vision or not and also helped some of you out there that need a refresher on our vision coverage. I’m going to keep going through the early Subject Matter Minutes to see what other ones need to be redone, so keep an eye out for the next email. Also… don’t forget that you can learn anything on youtube! Alright, thanks for joining me on the subject matter minute, I’ll see ya next time.