2020 endowed open enrollment decision guide

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2020

Open Enrollment

Workday Decision/ Enrollment Guide

FOR ENDOWED EMPLOYEES

? Decision worksheets ? What you'll see in Workday ? Actions required

OPENENROLLMENTPERIODNOVEMBER1 -NOVEMBER29, 2019

DEAMDOLNINDEAYE,XDTEECNEDMEBDETRO24, P2M019EST

NEW THIS YEAR

Want dental or vision coverage for 2020? You must enroll in Workday!

Improvements to our dental/vision plan options for 2020 mean you'll need to enroll in a dental and/or vision care plan or you won't have coverage in 2020.

Go to hr.cornell.edu/enroll for complete details.

Important reminder: If you want a Flexible Spending Account (FSA) in 2020, you must re-enroll during Open Enrollment. FSA enrollments do not carry over year to year.

HR Services and Transitions Center

WE'RE HERE TO HELP Have questions about your benefits?

LOOK ONLINE: hr.cornell.edu/enroll

EMAIL US: hrservices@cornell.edu

PHONE US: (607) 255-3936

VISIT US: HR Services & Transitions Center 395 Pine Tree Road East Hill Office Building, Suite 110 Ithaca, New York 14850

HOURS: 8am - 4:30 pm, M-F

Note: Our offices will be closed November 28 & 29; mail and electronic submissions will still be accepted.

CONTENTS

Enrollment Tips3 Dependents Worksheet4 Health Plan Worksheet5 Dental Plan Worksheet6 Vision Plan Worksheet6 Spending Account Worksheets 7-9 HSA Worksheet10 Legal Insurance Info 11 Resources11 Workday Instructions12-22 Change after submitting 24

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FOLLOW THESE TIPS TO MAKE ENROLLMENT EASY

? Complete any necessary worksheets Choose your medical, dental, and vision plans, decide on your coverage level, and calculate your savings account contributions. Worksheets are located on pages 4 -10 of this guide.

? Have documents ready Are you adding dependents? Gather documentation you'll need to submit.

? Find your "Open Enrollment Event" in Workday You should receive an email on November 1 notifying you that your "Open Enrollment Event" is ready. See page 12 for directions on how to get started in Workday.

? Follow step-by-step instructions Screen shots are shown in this booklet along with error alerts. There are also instructions on each screen in Workday. If you get stuck, contact HRSTC!

? Make sure to click "Submit!" You'll receive a confirmation message with a successful submission -- be sure to print a copy for your records. If your enrollment isn't properly submitted by the deadline (4:00 pm EST, November 29), your elections will not be accepted.

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Part A: Decision Worksheets

Add dependents

Do you need to add coverage for your spouse, partner, or dependent children?

Gather the information below for each new person, which you will need to enter into Workday.

IMPORTANT! You will also need to provide documentation to the HR Services & Transitions Center. DO NOT UPLOAD documents to Workday: documentation must be received by the HRSTC before 4:00 pm November 29 or postmarked by November 29, 2019.

Note: Our offices will be closed November 28 & 29; mail and electronic submissions will still be accepted.

Submit documentation to: HR Services & Transitions Center 395 Pine Tree Road East Hill Office Building, Suite 110 Ithaca, New York 14850

Documentation can also be submitted through the Cornell Secure File Transfer Site (DropBox): Call the HRSTC at 607-255-3936 if you need help to upload your files.

? Legal name: ? Social Security Number: ? Date of Birth: ? Gender:

? Legal name: ? Social Security Number: ? Date of Birth: ? Gender:

? Legal name: ? Social Security Number: ? Date of Birth: ? Gender:

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*NOTE: If you're keeping your current plan and have no changes to your dependents, you may skip this step! Go to the Dental & Vision blocks.

*NOTE: If you're keeping your current plan and have no changes to your dependents, you may skip this step! Go to the Dental & Vision blocks.

Choose your Aetna medical plan

Cornell Program for Healthy Living (CPHL) Weill Cornell Medicine PPO (WCM-PPO) Aetna Health Savings Account (HSA) Waive medical coverage

Your contribution rate: Find rates in the rate comparison chart

DUAL ELIGIBILITY:

You can choose dual eligibility coverage if the following requirements apply: 1. You and your spouse/domestic partner are both endowed employees and receiving pay. 2. You and your spouse/domestic partner are both eligible for participation in the endowed health care plan. 3. You have dependent children covered by the plan

Coverage options:

? Employee ? Employee + Spouse ? Employee + Domestic Partner ? Employee + Employee Child(ren) ? Employee + Domestic Partner +

Partner Child(ren) ? Employee + Spouse +Employee

Child(ren) ? Employee + Domestic Partner +

Employee Child(ren) ? Employee + Domestic Partner + Em-

ployee Children + Partner Children ? Dual Eligibility Family ? Dual Eligibility Domestic Partner

Family

Primary Care Physician (PCP)

If you've chosen the Cornell Program for Healthy Living (CPHL), select a physician from the CPHL Directory. Note: It's not necessary to select a PCP to enroll, but doing so will include the PCP on your health plan ID card for convenience.

? Family Member(s): ? PCP Name: ? Provider ID:

? Family Member(s): ? PCP Name: ? Provider ID:

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IMPORTANT: Because there is a new dental plan provider next year, you must enroll yourself and any dependents if you want dental coverage in 2020 -- enrollments WILL NOT CARRY OVER from last year!

Choose your MetLife dental plan

Dental - Standard Plan Dental - Plus Plan Waive dental coverage

Contribution rate: Find rates in the rate comparison chart

Coverage options:

? Employee ? Employee + Spouse ? Employee + Domestic Partner ? Employee + Employee Child(ren) ? Employee + Domestic Partner +

Partner Child(ren) ? Employee + Spouse +Employee

Child(ren) ? Employee + Domestic Partner +

Employee Child(ren) ? Employee + Domestic Partner

+ Employee Children + Partner Children

IMPORTANT: Because there is a new vision plan provider next year, you must enroll yourself and any dependents if you want vision coverage in 2020 -- enrollments WILL NOT CARRY OVER from last year!

Choose Davis vision coverage

Vision Plan Waive vision coverage

Contribution rate: Find rates in the rate comparison chart

Coverage options:

? Employee ? Employee + Spouse ? Employee + Domestic Partner ? Employee + Employee Child(ren) ? Employee + Domestic Partner +

Partner Child(ren) ? Employee + Spouse +Employee

Child(ren) ? Employee + Domestic Partner +

Employee Child(ren) ? Employee + Domestic Partner

+ Employee Children + Partner Children

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