What’s New for 2023?
Check the key dates and instructions for 2023 Annual Enrollment here.
Nemours Children’s Health is committed to providing comprehensive benefits that deliver choice, flexibility and security to all our associates. We’re continuing our multi-year strategy to ensure our benefits plans and programs are sustainable and deliver a combination of high-quality care and services while remaining cost-effective for everyone as well as our organization.
As the needs of our associates are evolving, so are our benefit offerings. This past year there were numerous positive changes made, thanks in large part to associate feedback and input derived from surveys, Associate Resource Groups (ARGs) and other feedback mechanisms. For 2023, we continue to address affordability concerns, leading to additional changes as outlined below.
Plan change highlights for 2023 include (eligibility rules may apply):
- PTO buyback option that allows you to sell up to 100 hours of PTO if eligibility requirements are met. PTO buyback is paid at 80 percent of its value.
- New income-based health reimbursement arrangement (HRA) for associates who qualify based on household income. Eligibility rules apply. Additional information is available here and through the income-based HRA FAQs.
- Lower payroll costs for part-time associates’ medical contributions to align with competitive benchmarks.
- Lower rates for critical illness, hospital indemnity and accident plans and better claim payment integration with the medical plan.
- New specialty drug program requiring certain medications to be accessed through ESI’s specialty pharmacy Accredo Health Group, Inc.
- Enhanced dental benefits that no longer count preventive services toward your annual benefit maximum.
Other plan change highlights during 2022 include: a Public Service Loan Forgiveness guidance program with Tuition.io, expert medical second opinion program, expanded surgical centers of excellence through Carrum, diabetic support through Twin Health, and virtual exercise therapy services offered by Hinge Health.
Health Plan Costs
Annual enrollment offers an opportunity to share updated information about the cost of the Nemours Children’s Health plan. The average annual cost per associate has increased from $15,717 in April 2021 to $16,113 in April 2022 representing an increase of 2.5 percent. Some of the key drivers of cost increases include a rise in the number of high-cost claimants, an increase in the frequency and cost of inpatient admissions, higher specialty pharmacy cost and utilization, and higher prices of treatments such as chemotherapy and autoimmune conditions.
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.
- Consider using new programs like 2nd.MD for second opinions, Carrum for surgical centers of excellence, and condition management programs for Type 2 diabetes (Twin Health) and exercise therapy (Hinge Health).
- Use generics, compare pharmacy pricing, and check eligibility for co-pay assistance under the SaveOn program with Express Scripts.
- Use urgent care or telemedicine instead of the emergency room.
- Take advantage of wellness resources to stay healthy.
- 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).
- If you are eligible, consider the SAVI plan, where all your out-of-pocket expenses up to the ACA maximums are paid at 100 percent.
For full-time associates, changes in associate payroll contributions for the medical/pharmacy plans will increase by 2.1 percent ranging from a $1 to $7 increase per paycheck. Dental and vision plan contributions will remain unchanged. Please see rate sheets for specific details.
Premium costs for all supplemental life plans (associate, spouse and child) and voluntary AD&D will remain unchanged, and most of the rates for voluntary medical benefits such as critical illness, accident and hospital will be lower.
Read on to learn more about 2023 benefits:
Medical and Prescription Drug Plans
There are some important highlights and changes to the medical and prescription drug plans for 2023.
2023 Wellness Program
Nemours Children’s wants to reward you for engaging in healthy activities. That’s why you can earn 20 percent 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, 2023, to earn the discounted insurance premium rate for the 2024 plan year. Please visit the Wellness Program portal for more information.
ARGs are a benefit for all associates. Please consider joining one or more of the ARGs. Learn more here or contact OHEI@nemours.org for more information on any of the ARGs.
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 may be limited or amended mid-year 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 long-term care any time during the year by contacting the insurance company directly (you cannot enroll through the online benefits system).
- Transamerica Retirement plan benefits are NOT part of annual enrollment. You may enroll or make changes to your 403(b), 457(b) or 401(k) 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 are continuing to meet your needs and those of your family. This information focuses on what is changing for 2023. If you need detailed information about each of the plans, refer to the 2023 Benefits Guide and/or the benefit booklets on NemoursBenefits.com (see the Home Page and the Library tab). We also encourage you to review the Summaries of Benefits and Coverage (SBCs) intended to help you compare and understand the health plan options available to you.
- SBC – Red
- SBC – Blue
- SBC – White
- SBC – Green
- SBC – Red HRA (special eligibility rules apply)
- SBC – Blue HRA (special eligibility rules apply)
- SBC – White HRA (special eligibility rules apply)
- SBC – SAVI (special eligibility rules apply)
- 2023 Medical Plan Comparison
Enrollment is Your Responsibility
Benefits are very important. Each associate is responsible for reviewing the information provided by Nemours Children’s 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.
Don’t forget that if you have a status change or qualified life event (QLE) after your 2023 benefits go into effect, you may be able to make changes to your elections mid-year within 30 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 Life Event link on NemoursBenefits.com. For more information, refer to the Life Event Enrollment Guide posted on NemoursNet.
Reminders and Helpful Hints
- Annual enrollment will end Wednesday, Nov. 9, 2022, at 11:59 p.m. CT.
- If you have a status change or life event in the last quarter of 2022 (during or after the annual enrollment period), you will need to make benefits elections for both 2022 and 2023 for your benefits changes to be active in 2022 and for 2023. You may make both elections either through the enrollment portal or by contacting the bswift customer service center for assistance.
- You may make changes to your benefits elections during the enrollment period but be sure to click on “I agree and I’m finished with my enrollment” to complete the enrollment process. If you fail to complete this final step, your changes will NOT be saved for 2023.
- Benefits elected during annual enrollment will be effective Jan. 1, 2023 (except those requiring insurance company approval).
Don’t Forget To “Ask Emma”
Ask Emma is an interactive decision support tool — and so much more!
You’ll see Ask Emma when you start the enrollment process in the medical plan section of the bswift enrollment portal. She can help you make an informed and personalized decision across the range of Nemours Children’s benefits offerings.
- Take the guesswork out of benefits enrollment.
- Explore Emma’s FAQs and cost calculator to find the plans that best fit you and your family.
- Review personalized cost comparisons by health needs.
- Model future health scenarios for the whole family.
- Translate insurance jargon into easy-to-understand explanations.
- Emma also will host the associate-friendly Annual Enrollment video, posted on the Benefits portal home page. She will cover everything you’ll need to know in about 15 minutes
Be sure to check the bswift Annual Enrollment checklist to ensure you’ve completed all the steps for 2023!