Benefits
        Open Enrollment
        May 21 - June 1

 


To enroll, disenroll or make changes to your benefits coverage or your dependent's benefits coverage, click on the Open Enrollment button below. Online submissions must be completed by 7 p.m.  June 1. Paper forms must be submitted by 4 p.m., June 1.


 

For further enrollmenrollment details, click Open Enrollment Instructions below.

All Employees

Important changes for the upcoming benefit year from July 1, 2018, through June 30, 2019: 

  • Vision Plan – Beginning July 1, 2018, the vision plan administrator for exempt employees will change from VSP to EyeMed Vision Care. Exempt employees enrolled in vision coverage will receive a welcome packet from EyeMed in June with two identification cards.
    EyeMed ID cards also can be obtained from the EyeMed website, eyemed.com, or the EyeMed mobile app. The EyeMed ID cards are not required when using the benefit.
  • Employees enrolled in medical coverage will receive an ID card from Optum Behavioral Solutions in June for use with their behavioral health coverage.
  • The third-party administrator for the wellness program (known as Take Charge! Live Well!) is now Sharecare, which acquired Healthways in 2016. The program remains the same and is being administered by the same staff and health coaches.

Benefits Checklist

Check your Benefits Summary: login to myOhio.gov, click the Health and Benefits tab and click the Benefits Summary link.

• Enroll and/or make election changes from May 21 to June 1, 2018.

 

Ensure required proof of eligibility for your newly enrolled dependent(s) is submitted timely. Coverage will not be provided for dependents until the eligibility documentation is received and approved.

• Refer to the Eligibility Requirements Matrix.

June 1 – Deadline for proof of eligibility in order for the newly added dependent(s) to be included on the medical and OptumRx ID cards effective July 1.

            NOTE: Anthem and OptumRx do not include the names of dependents on the card(s)

July 31 – Deadline for proof of eligibility changes; replacement medical ID cards will be generated.

 

Review your confirmation statement when it arrives by mail in late May/early June.

• Contact your human resources office before July 31 if any information on the confirmation letter is not correct.

 

Look for new medical ID cards to arrive by mail near the end of June.

• Contact your agency human resources office if any information on your ID card(s) is not correct.

MyBenefits Guide for 2018-19 Benefit Year

Medical Contributions

Open Enrollment Frequently Asked Questions

ZIP Code Chart

Open Enrollment Instructions

Save Money: Find the Right Care

Where to Get Care 
Right care | Right Place | Right Time


       Click the image to download the chart

Non-Emergency 

  • 24-hour Nurse Advice Line 866-556-2288, option 1
  • Home/local
    • Call your primary doctor.
    • He/she knows you and your health best.
  • After-hours or traveling
    • Call your doctor for advice, if possible.
    • Ask questions and understand your options if he/she isn’t able to see you.
       

Need Surgery? Choose Wisely.

Compare Hospitals

Source: Health Action Council
 

Use Benefits Wisely

All of the State of Ohio’s health plans are self-funded. This means that the cost of your benefits is funded by contributions from you and the State of Ohio. All claims are paid from these contributions. Your third-party administrator does not pay for them. Rather, Aetna, Anthem and Medical Mutual of Ohio are paid an administrative fee to review claims and process payments. When the amount of claim payments is greater than the amount of contributions from you and the State of Ohio, medical costs increase. 

It is up to each of us to use our benefits wisely. We can all do our part by making wellness a priority in our lives, evaluating our options when we need care and avoiding unnecessary visits.

Take advantage of consumer tools provided by our medical third-party administrators that enable you to shop and find lower costs for the services provided (MRIs, labs, surgeries, etc.) by visiting your third-party administrator's website.

The Best Care Starts With You: Things to Know Before You Go

Be a Better Patient

Before you go:

  • Grab a notepad and pen.
  • List and describe symptoms:
    • What? I get a sharp/dull/throbbing pain...
    • Where? In my stomach/knee/neck...
    • When? When I cough/walk...
    • How often? Once in a while/constant...
  • List any prescription or over-the-counter drugs, vitamins and supplements you take.
  • Ask a friend or family member to go with you.
     

Get All the Facts

Know what to ask

  • How will this treatment help me?
  • Are there simpler alternatives?
  • What is this test for?
  • When will I get the results?
  • How many times have you done this procedure?
  • What are the possible complications?
  • What does this drug do? Any side effects?
  • Is this drug offered as a generic or over-the-counter?
  • Will this interact with other medications/supplements I take?
     

Work with Your Doctor

Ask | Listen | Learn

  • Ask your doctor:
    • “What’s causing this?”
    • “What’s next?”
      • Medication?
      • Referrals/tests?
      • Cost?
      • Self-care at home/rehab?
    • “What will this do for me?” 
  • Listen and take notes.
  • Learn by following up.
     

Help is at Your Fingertips

Remember to check your insurance carrier’s website for no-cost tools available to help you in your decision-making process.

Source: Health Action Council

Part-time Permanent Employees

  • Part-time permanent employees’ premium tier will be determined annually rather than semi-annually.
  • The percentage that part-time employees pay toward their premium is based on the average service hours in an active pay status. Average service hours in an active pay status shall be calculated over a 12-month period (Standard Measurement Period), which starts with the first pay period in May through the last pay period in April.
    • All part-time permanent employees working an average of 30 or more hours a week (over a 12-month period) will be eligible for the full-time deduction tier, or 15 percent.
    • All part-time permanent employees working an average of 29.99 or less hours a week (over a 12-month period) will be eligible for the 50 percent tier.
    • All part-time permanent employees working an average of 19.99 or less hours a week (over a 12-month period) will be eligible for the 100 percent tier.
  • All part-time permanent employees will be notified at their mailing address of their eligibility.

Part-time Temporary Employees

 

  • The State of Ohio is required to offer medical care coverage only, per the ACA, to all part-time temporary employees who average at least 30 hours of service per week throughout a twelve-month measurement period (Standard Measurement Period). 
  • Part-time temporary employees are those employees typically hired as interns, intermittent employees, and external interim employees. This does not include Americorps or contingent workers.
    • Existing employees who were hired before April 5, 2014, and who averaged 30 work hours or more will be notified by DAS of their eligibility for medical coverage. Those who elect medical coverage will have coverage from July 1, 2017, through June 30, 2018, or until they terminate their service with the State of Ohio.
    • Employees who are hired with a reasonable expectation of averaging 30 hours or more per week will be eligible to enroll for coverage upon hire. Coverage is effective the first of the month following the hire date and cannot be terminated until the 12 months expires or the employee leaves state service.
    • Employees who are hired with a reasonable expectation of averaging 29 hours or less per week will be not be eligible at the time of hire and will instead be measured over a twelve-month period. The twelve-month measurement period for all newly hired part-time temporary employees is called the initial measurement period.
      • The initial measurement period begins the first full pay period after the first pay period with one or more hours of service credited.
      • After the initial measurement period, if the average service hours are 30 or more per week, the employee will be offered the opportunity to enroll the first of the month following the end of the initial measurement period