Question 1

Spending Account Balances: What will happen to the HRA and FSA balances we currently have?

Accepted Answer

During the transition to the new health insurance plan, it was communicated that there would be multiple options available regarding rollovers for remaining Health Reimbursement Account (HRA) funds.  Regrettably, it has come to my attention through WEX, the City’s FSA administrators, that the options presented were incorrect and not compliant with IRS regulations.   I am reaching out to clarify the situation and outline the steps being taken to resolve it. First and foremost, I want to be clear that employees will not lose their HRA balances.

As a reminder, the HRA options previously presented which are not IRS compliant include;
 • Transfers into a Health Savings Account (HSA)
 • Transfers into a deferred compensation (457) plan
 • Take a cash-out option

Moving forward, we are working with WEX to implement a solution that ensures:
 • All remaining HRA and FSA balances will carry over in a way that complies with IRS guidelines
 • Employees will retain full access to their funds to be used for qualified medical expenses      without unnecessary tax consequences

While we continue finalizing the details with WEX, we want to share a few key points to help ease the transition for those affected:
 • Remaining balances will be transferred to new HRA accounts with WEX
 • The new accounts can be used for all eligible medical expenses, including vision and dental   
 • Upon retirement, employee accounts will automatically convert to Retiree HRA accounts and      remain with WEX

Question 2

HMO Questions

Accepted Answer

1. If my primary care physician is part of the Aurora network, but I wish to see a specialist within the Northwestern network, will this be covered under the HMO plan?  No, all services must be provided within the same HMO provider group. [Click here to search for HMO provider groups.](insert link)
2. Can each family member select a different provider group under the HMO plan?  Yes, each family member can select their own HMO provider group.
3. If a specific provider is not covered under the HMO plan, can an employee still visit that provider and use their FSA for the expenses?  We are currently verifying, but generally, unreimbursed medical expenses are eligible under FSA.
4. If an employee resides in Wisconsin, are they eligible to enroll in the Illinois HMO plan?  No, employees must reside within the coverage area of the HMO plan to be eligible.

Question 3

PPO Questions

Accepted Answer

1. What is the biggest difference between the two PPO plans? 
   1. Answer: The two PPO plans have identical coverage. The difference is in the premium and deductible amounts.
2. Do both PPO plans have the same network? 
   1. Answer: Yes, both PPO plans utilize the same provider network.
3. Does the City fund a spending account for both PPO plans? 
   1. Answer: No, the City only funds a spending account for the PPO plan that includes an HSA option. The traditional PPO has a lower deductible instead of a spending account.

Question 4

Health Savings Account (HSA) Questions

Accepted Answer

1. Will the HSA work like the current FSA? Will we have a debit card to use for medical expenses?
   1. Yes, the HSA will work similar to FSA, with a debit card that can be used for medical, dental, vision, and other qualified expenses.
2. How much will the City contribute to our HSA? Is it different for single versus family coverage?
   1. The City will contribute $1,000 for single coverage and $2,000 for single+1 and family coverage to the HSA. 
3. Do employees need to do anything to receive the employer contribution to their HSA?
   1. No, funds are deposited into your HSA account in January each year. Funds are available as soon as they are deposited.
4. Can we contribute to our HSA pre-tax, like from our paycheck?
   1. Yes, you can contribute to the HSA pre-tax from your paycheck. Funds are available as soon as they are deposited into your HSA each payroll.
5. When are the funds available for use in an HSA?
   1. City contributions are deposited into HSA accounts in January each year. Employees can contribute to the HSA pre-tax from their paychecks, and funds are available as soon as they are deposited.
6. Who is the administrator for the HSA account?
   1. WEX acts as the HSA Administrator for your account, handling day-to-day HSA account management, customer service, and transactional needs. Charles Schwab functions as the Custodian for investment services, providing investment options for any portion of your HSA funds you choose to invest. From a user’s perspective, you primarily interact with WEX for account activities, while Charles Schwab comes into play when you're interested in investing your HSA funds. 
7. Can you clarify the process we need to follow for HSA transactions that are not auto-approved, such as payment for prescription glasses or out-of-pocket dental expenses?
   1. Use the WEX portal or app to upload a detailed receipt or the Explanation of Benefits (EOB). Many transactions are auto-approved, such as copays and re-occurring payments, such as routine medical visits, prescription medications, and dental cleanings.
8. Can the HSA only be used for medical expenses until age 65 after retirement?
   1. If you use your HSA for non-qualified expenses before age 65, there is a penalty. After age 65, you can use your HSA for non-medical expenses, but it will be taxed like income.

Question 5

Flexible Spending Account (FSA) Questions

Accepted Answer

1. Will FSA be available? If so, what is the limit?
   1. Yes, with the Traditional PPO plan and HMO plan. The limit is $3,300 for 2025.
2. When will we receive the new FSA debit card? What is the age limit for dependents on the plan, and when will we receive the medical card?
   1. All new benefit cards will be available January 1st. Dependents can stay on the plan until age 26.
3. Are both HSA and FSA available for the PPO plans?
   1. The HSA spending account, funded by the employer and tied to the HDHP PPO plan, is not available at the same time as the FSA account. Employees cannot contribute to both accounts simultaneously. If you switch from the HDHP PPO to the Traditional PPO or HMO in the future, you can still use your previous HSA balance to pay for medical expenses.
4. Is there a list of FSA-covered items?
   1. Yes, the list is available on WEX's site.
5. From a family perspective, does everyone get covered under the same FSA?
   1. Yes, you can use your FSA for all dependents. 
6. Will Think Healthy wellness points continue to be put on a debit card? What happens to the current healthy points balance?
   1. Yes, Think Healthy wellness points will continue and can be used in spending accounts such as FSA and HSA.

Question 6

Dependent Care Flex (DCFSA): Is every plan eligible for Dependent Care?

Accepted Answer

Yes, dependent care is not dependent on selecting a specific medical plan. Even if you do not take City insurance, you can still opt into dependent care.

Question 7

Prescription (Rx) Questions

Accepted Answer

1. Who is our prescription vendor?
   1. Our prescription coverage is provided through Express Scripts, Inc. (ESI).
2. Can I use mail-order services for my prescriptions?
   1. Yes, you can use mail-order services for prescription medications. This is often convenient for maintenance medications.
3. Where can I pick up maintenance medications?
   1. You can pick up maintenance medications at Walgreens and CVS, if you do not want them mailed to your home.
4. Are there any restrictions on which pharmacies I can use?
   1. You can use a wide range of [in-network pharmacies] for short-term prescriptions. For maintenance medications, you can only use home delivery, Walgreens, or CVS. 
5. Is mail-order more cost-effective for maintenance medications?
   1. No, maintenance medications are the same cost whether you use mail-order or pick them up at Walgreens or CVS.
6. How do I set up mail-order prescription delivery?
   1. You can set up mail-order prescriptions through the online portal. [insert link to set up instructions]
7. Can I still use my local pharmacy for non-maintenance prescriptions?
   1. Yes, you can use your local pharmacy for non-maintenance or short-term prescriptions, such as antibiotics.

Question 8

Dental Questions

Accepted Answer

1. Does a deductible have to be met before dental cleanings are covered?
   1. No, the dental deductible does not apply to preventative services.
2. How are out-of-network costs covered?
   1. Out-of-network will run as if they were in-network, but there may not be the same level of discounts available.

Question 9

Vision Questions

Accepted Answer

1. Who is our vision coverage provider?
   1. Our vision coverage is provided through VSP.
2. What types of services are covered under our vision plan?
   1. Our vision plan covers routine eye exams, glasses, and contact lenses, as well as discounts on laser vision correction.
3. Can I use out-of-network vision providers?
   1. Yes, you can use out-of-network providers, but your coverage may be reduced compared to using in-network VSP providers. [insert information for out of network]
4. How often can I get an eye exam?
   1. You are eligible for an eye exam once every 12 months.
5. Are glasses and contact lenses both covered?
   1. Yes, both glasses and contact lenses are covered, but you can only choose one option per benefit period.
6. How do I find an in-network vision provider?
   1. You can find an in-network provider by visiting the VSP website or using their provider search tool. [insert link to provider search]
7. Is there coverage for prescription sunglasses?
   1. Yes, prescription sunglasses are covered under the vision plan, subject to the same allowances as regular glasses.
8. Are there discounts available for laser vision correction?
   1. Yes, VSP members can receive discounts on laser vision correction procedures, such as LASIK, through participating providers.
9. What is a featured frame?
   1. Featured frames are brand names.

Question 10

Life Insurance

Accepted Answer

1. Who is eligible for supplemental life insurance during this enrollment period?
   1. This year is considered a transfer year, which means all employees are treated as if they are new hires. As a result, all employees are eligible for supplemental life insurance.
2. Can I make changes to my supplemental life insurance coverage during this enrollment period?
   1. Yes, you can make changes to your supplemental life insurance coverage during this enrollment period, including increasing your coverage or opting into supplemental life insurance for the first time.
3. Will I need to provide evidence of insurability (EOI) for supplemental life insurance?
   1. During this transfer year, you may not need to provide evidence of insurability for certain levels of supplemental life insurance. Please refer to the benefits guide for specific details.
4. What happens to my current supplemental life insurance coverage if I do not make any changes?
   1. If you do not make any changes, your current supplemental life insurance coverage will continue as is.
5. Can I add coverage for my spouse or dependents?
   1. Yes, you can add supplemental life insurance coverage for your spouse and eligible dependents during this enrollment period.
6. How much supplemental life insurance coverage can I elect?
   1. You can elect supplemental life insurance coverage up to a certain multiple of your salary or a specified dollar amount. Please refer to the benefits guide for the available options.
7. How do I designate beneficiaries for my supplemental life insurance?
   1. You can designate beneficiaries by completing the beneficiary designation form. 
8. Will my supplemental life insurance premiums change?
   1. Premiums for supplemental life insurance may change based on your age and the level of coverage you elect. For most age ranges the premiums have reduced significantly. Details regarding premium rates can be found in the benefits guide. 
9. Can you add a spouse to supplemental life insurance right after you get married?
   1. Yes, that is a qualifying event. 
10. Can life insurance be continued after retirement?
   1. Yes, you have the option to convert it to a whole life policy, which will have higher premiums. Alternatively, you can port it to a term policy, which may also have higher rates.