#1FY2024 GROUP HEALTH INSURANCE PERSONNEL & PAYROLL OFFICER MEETING DEPARTMENT OF ADMINISTRATION DIPATTAMENTON ATMENESTRASION SEPTEMBER 6, 2023#2AGENDA I. FY2024 PLAN BENEFITS II. OPEN ENROLLMENT INFORMATION III. ENROLLMENT/CANCELATION PROCEDURES IV. TRANSMITTAL PROCESS V. ACCOUNTING PRESENTATION INVOICE & PAYMENT PROCESS VI. SELECTCARE PRESENTATION VII.NETCARE PRESENTATION VIII. DISCUSSION IX. CONTACT INFORMATION 9/6/2023 PERSONNEL, PAYROLL & ACCOUNTING MEETING 2#39/6/2023 SELF-INSURED HEALTH PLAN Employer Authorizes TPA to pay Claims 3 + Provider Bills go to TPA 1 Third Party Administrator -Provider Payments -Customer Service -Claims Processing TPA Processes Claims 2 PERSONNEL, PAYROLL & ACCOUNTING MEETING Employer 3#4R FY2024 Government of Guam Group Health Self-Funded Insurance SELF-FUNDED EXCLUSIVE MEDICAL, PHARMACY & FOSTER Select Care PPO1500 HSA2000 HEALTH PLANS RETIREE SUPPLEMENTAL PLAN (RSP) SELF-FUNDED EXCLUSIVE DENTAL NetCare Life & Health Insurance DENTAL 1500 9/6/2023 PERSONNEL, PAYROLL, & ACCOUNTING MEETING 4#5R FY2024 OPEN ENROLLMENT INFORMATION I. OE DATES: SEPTEMBER 11, 2023 - SEPTEMBER 26, 2023 II. EFFECTIVE DATE OF COVERAGE OCTOBER 1, 2023 III.FIRST DEDUCTION ACTIVE-PPE: OCTOBER 7, 2023 RETIREES/SURVIVORS- PPE: OCTOBER 15, 2023 9/6/2023 PERSONNEL, PAYROLL, & ACCOUNTING MEETING 5#6FY2024 OPEN ENROLLMENT INFORMATION LOCATION SATELLITE LOCATION GUAM MUSEUM - MULTIPURPOSE ROOM Monday-Friday | 9:00AM - 3:00PM Saturday, Sept. 16, 2023 | 9:00AM - 12:00PM 9/6/2023 PERSONNEL, PAYROLL, & ACCOUNTING PRESENTATION 6#79/6/2023 FY2024 OPEN ENROLLMENT INFORMATION PRESENTATIONS о о TPA PRESENTATIONS GUAM MUSEUM AUDITORIUM- In Person September 11-13, 15-26 | 9am and 1pm | Monday to Friday September 14 | 1pm | Thursday о September 16 | 10am | Saturday VIRTUAL PRESENTATIONS 9am | M-F | Sept. 11-26 10am | Sat Please refer to DOA Circular 2023-031 attached OE Calendar Links will be on the DOA Website PERSONNEL, PAYROLL, & ACCOUNTING PRESENTATION 7#8ENROLLMENT GUIDELINES NO CHANGES -ROLLOVER NEW ENROLLMENT NO ACTION REQUIRED • MEDICAL AND DENTAL INSURANCE BENEFITS WILL CONTINUE WITH THE AWARDED TPA AT THE NEW RATES FOR FY2024 Please have employees verify current coverage and deductions to ensure proper enrollment. ACTION REQUIRED • COMPLETION OF ENROLLMENT FORM REQUIRED CHANGE OF STATUS ACTION REQUIRED ADD/DELETE DEPENDENT NAME CHANGE CHANGE CLASS/PLAN UPDATE INFO COMPLETION OF ENROLLMENT FORM REQUIRED TERMINATION ACTION REQUIRED COMPLETION OF A SC or NC TERMINATION FORM REQUIRED 9/6/2023 PERSONNEL, PAYROLL & ACCOUNTING MEETING 8#9ELIGIBILITY GUIDELINES SUBSCRIBER DEPENDENT 1. Active: Must be working 30 hours or more per week 1. Legal Spouse - MC may be required 2. Domestic Partner (DP) 2. Retiree or Survivor of GovGuam DP Affidavit Required* 3. Must be a resident of Guam 3. Legal children 1. Natural born child/ren - BC may be required if different last name 2. Step Child/ren - MC & BC required* 3. Court Legal guardianship - BC & Court Documents required* 4. Disabled dependents above legal age -documents required* *Supporting documents required *PLEASE ENSURE ALL FORMS SUBMITTED ARE COMPLETE TO INCLUDE SUPPORTING DOCUMENTS TO AVOID DISCREPANCIES. 9/6/2023 PERSONNEL, PAYROLL & ACCOUNTING MEETING 9#10THE FLOW LINE AGENCIES All employees, retirees & survivors to be directed to the Guam Museum or Online to enroll or make changes. TPA will transmit to HR & Payroll copies (Yellow & Pink) to DOA Benefits for processing DOA to confirm eligibility and transmit to payroll AUTONOMOUS AGENCIES HARDCOPY Only completed forms w/attachments as applicable shall be processed Please date and time forms received TRANSMIT DAILY 9/6/2023 Dept to transmit to Payroll & TPA PERSONNEL, PAYROLL, & ACCOUNTING MEETING 10 10#11THE FLOW TPA GUAM MUSEUM-VENUE HARDCOPY ONLY COMPLETED FORMS W/ATTACHMENTS SHALL BE RECEIVED Dept Validates Employment Status & Eligibility HR transmit to Payroll ONLINE ENROLLMENT ONLINE ENROLLMENT TPA to validate complete enrollment forms and print TPA to transmit to HR HR to transmit to Payroll 9/6/2023 PERSONNEL, PAYROLL, & ACCOUNTING MEETING 11#12THE FLOW AUDITS LINE & AUTONOMOUS AGENCIES AUDIT DEDUCTIONS • PPE 10/7/2023- Active IDENTIFY DISCREPANCIES REPORT CORRECTIONS TO PAYROLL & TPA • PPE 10/15/2023 - Ret/Sur **PLEASE ADVISE EMPLOYEES/RETIREES/SURVIVORS TO MONITOR THEIR DEDUCTIONS AND IMMEDIATELY REPORT ANY DISCREPANCIES. 9/6/2023 PERSONNEL, PAYROLL, & ACCOUNTING MEETING 12#13SUBSCRIBER STATUS ACTIVE ACTIVE, RETIREE & SURVIVOR NON-PAYMENT APPROVED LEAVE WITHOUT PAY (LWOP) LEAVE SHARING Emp must pay both GG and Emp Share to maintain coverage. Prior to going on this status. MILITARY LEAVE WITHOUT PAY (MLWOP) GG will pay both shares if employee did not cancel coverage. FAMILY MEDICAL LEAVE ACT (FMLA) GG will remit for their share when Emp share is received for the duration on this status. UNDETERMINE STATUS UNAUTHORIZED LEAVE Termination retro to the last day of payment. Termination retro to the last day of payment. 9/6/2023 PERSONNEL, PAYROLL & ACCOUNTING MEETING 13#14ACCOUNTING PRESENTATION INVOICE & PAYMENT PROCESS BILLING/INVOICE RECEIVED FROM TPA ACCOUNTING TO AUDIT INVOICE AGAINST PREMIUMS PREMIUM REMITTANCE TO DOA WITH DETAIL 9/6/2023 DOA TO REMIT TPA FEES TO CARRIER PERSONNEL, PAYROLL, & ACCOUNTING MEETING 14#15NON-PAYMENT NON-PAYMENT OR NO DEDUCTIONS DEPT TO REMIT FULL PREMIUMS . • (Gov & Emp/Ret Share) DEPT TO COLLECT FROM EMP/RET DEPT TO TERMINATE COVERAGE AFTER 2 TOTAL NON-PAYMENT REPORTINGS DOA CIRCULAR 2023-032 • Departments and agencies must remit payments for all employees/retirees regardless of non-payment or non deduction, i.e LWOP, leave-sharing, etc. Department are responsible to recover premiums for those it advanced payment for. Termination must take effect after an accumulative of 2 episodes of non-payment. Departments are required to track non-payments and terminate accordingly to the last pay period that payment was made. A form must be completed by the department advising the TPA of termination. 9/6/2023 PERSONNEL, PAYROLL, & ACCOUNTING MEETING 15#16CONTACT INFORMATION Select Care HEALTH PLANS NetCare Life & Health Insurance DEPARTMENT OF ADMINISTRATION Benefits Branch 671-475-1296/1121/1179 ITC Bldg Suite 125 Tamuning, Guam 96931 Email:[email protected] Website: doa.guam.gov SELECTCARE (671) 477-9808 115 Chalan Santo Papa P.O. Box FJ Hagåtña, Guam 96932 Mon-Fri: 8:30am - 5:30pm Email: [email protected] Website: www.calvos.net NETCARE (671) 472-3610 424 West O' Brien Drive, Julale Center Suite 200 Hagatna, Guam 96910 Email: Website: www.netcarelifeandhealth.com 08/30/2023 PERSONNEL, PAYROLL & ACCOUNTING MEETING 16#17QUESTIONS