Annual Enrollment Newsletter

Reminders & Helpful Hints

  • Annual enrollment ends Thursday, Oct. 31, 2024, at 11:59 p.m. ET.
  • If you don’t go through the enrollment process, your 2024 elections will carry over into 2025, except for the following situations:
    • You will need to make a new flexible spending account (FSA) pledge to continue the benefit for 2025 (health care, limited purpose, dependent care, parking or transportation).
    • If you have an HSA in 2024 and continue to be enrolled in the Green plan, you will continue to have an HSA, but you will need to re-elect a contribution amount for 2025.
    • If you are enrolled in the SAVI plan, you need to verify your continued eligibility on the enrollment site.
    • If you are enrolled in the income-based health reimbursement arrangement (HRA), you will have to reapply using the one-page application and your prior year’s tax return(s).
  • If you are a new hire, have a status change or experience a Qualified Life Event (QLE) in the last quarter of 2024 (during or after the annual enrollment period), you will need to make benefits elections for both 2024 and 2025 for your benefits changes to be active for both years.
  • You may make changes to your benefits elections during the enrollment period but be sure to click on “SUBMIT MY ELECTIONS,” then click on the ACCEPT button to complete the enrollment process. If you fail to complete this final step, your changes will NOT be saved for 2025.
  • Benefits selected during annual enrollment will be effective Jan. 1, 2025 (except those requiring insurance company approval).
  • If you are adding a dependent to the Nemours benefits plans for the first time, you will be asked to provide documentation such as a birth or marriage certificate to verify his/her/their eligibility. When you complete your enrollment, you will be able to upload your applicable documents to the Empyrean benefits portal. You don’t need to add these when you enroll, but keep in mind that your dependent(s) will not be enrolled with the carriers until the required documentation is supplied and eligibility approved. The deadline to submit documentation to the benefits portal is Dec. 31, 2024.

What’s new for 2025?

Check the key dates and log-in instructions for 2025 annual enrollment here.

Health Plan Costs

Consistent with other employers in the United States, Nemours faces the challenges of high inflation, increasing costs of pharmaceuticals and medical services, and ongoing labor shortages, resulting in rising healthcare prices and other benefits. Remember, taking an active role in your health care can help keep costs down for the future.

Remember, taking an active role in your own health care can help keep costs down:

  • Ask about the price of services and talk with your doctor about treatment options.
  • Reach out to Quantum Health for coordination of benefits. They are your one-stop shop for all things benefits-related.
  • Consider using programs like 2nd.MD for second opinions, Carrum Health for surgical centers of excellence, and condition management programs for Type 2 diabetes (Twin Health) and exercise therapy (Hinge Health). You should also take advantage of our maternity and parenting planning support program (Cleo).
  • Regarding prescriptions, try generic medications, compare pharmacy pricing, and check eligibility for co-pay assistance under the SaveOn program with Express Scripts.
  • Use telemedicine or urgent care instead of the emergency room.
  • Take advantage of wellness resources to stay healthy and participate in the Wellness Incentive Program to earn points for healthy activities to enjoy a discount for your medical premiums.
  • If you are comfortable with a high deductible, consider the Green plan, where you have lower premiums and get the triple tax advantages of a health savings account (HSA). Plus, Nemours will contribute funds to your health savings account (HSA)!
  • If you are eligible and enrolled in an applicable non-Nemours insurance plan, consider the SAVI plan, where all your out-of-pocket expenses up to the ACA maximums are paid at 100%.

Payroll Contributions

Associate payroll contributions for the medical/pharmacy and visions plans will not increase in 2025. Dental rates will increase by $0.10 to $1.21 twice-monthly, pre-tax ,depending on the plan and who is covered. Please see the rate sheets for specific details.

Premium and plan design features for voluntary life plans (associate, spouse and child) and voluntary AD&D plans are improved with Lincoln Financial Group. 

    Read On To Learn More About 2025 Benefits:

    PTO Buyback

    We are offering a PTO buyback option again this year. This allows you to sell up to 100 hours of PTO if eligibility requirements are met. PTO buyback is paid at 80% of its value. You must have a minimum of 88 hours to participate. Enrollment in this program is only available during annual enrollment.  

    Income-Based Health Reimbursement Arrangement

    For lower-income associates who qualify based on household income, there is an opportunity to apply for the income-based health reimbursement arrangement (HRA). This would provide for assistance with your co-pays, deductible and coinsurance. This benefit is available with our Red, Blue and White plans. You have to complete a one-page application and submit it with your prior year tax returns.  

    If you are currently using the benefit, you will have to reapply for 2025. For additional information on eligibility, contact our Nemours Children’s Benefits Center by calling 888.624.2387 or call the HR Solutions Call Center at 877.458.9699. 

    2025 YOURHealth Wellness Program

    Nemours wants to reward you for engaging in healthy activities. That’s why you can earn 20% off your medical insurance premiums with the Wellness Incentive Program! Save hundreds of dollars on your medical insurance premiums by completing the requirements. Complete the activities by Nov. 30, 2024, to earn the discounted insurance premium rate for the 2025 plan year. Please visit the YOURHealth Wellness Program portal for more information. Please note that any associate who is hired, rehired or has an eligibility change after Sept. 1, 2024, will automatically have access to the with wellness rates for 2025. The discount is included in the rates and is not a separate line item on your payslip.

    ARGs are a benefit for all associates. Please consider joining one or more of the ARGs at Nemours.

    Other Important Benefits Plan Reminders

    As you go through annual enrollment, please keep the following in mind:

    • The dependent care account is for daycare expenses, not for your family’s health care expenses. 
    • If you are highly compensated (as defined by the IRS), contributions to the dependent care account will be limited to $1,700 in 2025 because of federally required non-discrimination testing.
    • If you enroll in the legal plan, you are required to stay in the plan for the entire calendar year unless you terminate or have a status change to a non-benefits-eligible position.
    • You may enroll (subject to insurance company approval) in the Unum long-term care plan at any time during the year by contacting the insurance company directly (you cannot enroll through the online benefits system).
    • Retirement plan benefits are NOT part of annual enrollment. You may enroll or make changes to your 403(b) or 457(b) contributions at any time during the year.

    Review Your Benefits Choices

    Annual enrollment gives you the opportunity to review your benefits to ensure your elections continue to meet your needs and those of your family. This information focuses on what is changing for 2025. We also encourage you to watch our new video that provides a great overview of the various benefits Nemours offers. The Summaries of Benefits and Coverage (SBCs) are also available to help you compare and understand the health plan options available to you. 

    Enrollment is Your Responsibility

    Benefits are very important. Each associate is responsible for reviewing the information provided by Nemours so that you may make an informed decision about your benefits.

    Please review your benefits elections carefully. Upon completion of your online enrollment, a confirmation statement will be provided for you to save or print. In addition, a copy of your confirmation statement will be sent electronically after the enrollment period ends. 

    Status Changes and Qualified Life Reminders

    • Don’t forget that if you have a status change or qualified life event (QLE) after your 2025 benefits go into effect, you may be able to make changes to your elections mid-year within 60 days of the QLE. Examples of a QLE include marriage, divorce, birth or adoption, and loss of coverage.
    • If you have a QLE, you can now change your benefits online from the “CHANGE YOUR CURRENT BENEFITS” link on www.NCHBenefits.org. For more information, refer to the Life Event Enrollment Guide posted to the online benefits guide.

    Precision Benefits – Customized Decision Support

    When you log in to enroll in your benefits, you will notice a new decision support feature called Precision Benefits. The first time you access Precision Benefits, you will need to authorize the use of your health care claims to help give you recommendations by choosing “I authorize the use of my claims data.” This authorization allows the tool to make medical plan recommendations based on your actual claims history through one of the Nemours medical plans. This history can go back three years. If you are a new hire and do not have claims available for the system to use, there is still logic to help guide you through the decision process. You will see a slightly different message explaining why your process may be a little different.  

    This feature is voluntary and you can withdraw your authorization anytime.  

    If you choose not to authorize the use of your claims, you will be taken to the standard enrollment flow. This allows you to continue to use the decision tool. However, you will have to answer questions, and the tool will provide a recommendation based on your answers. 

    Next: Annual Enrollment Compliance Notices