Endowed Open Enrollment

[Auto-generated.] Hello and welcome to the 2026 endowed. Benefit overview. My name is Emily Brousseau. I'm the associate director for the health and welfare plans at Cornell University.

During the webinar, we will review the 2026 benefit overview and updates specifically to the health care plans and the flexible spending accounts. We'll also discuss open enrollment and how coordination of benefits comes into play. If you have another insurance available to you.

Cornell Endowed Health care offerings are comprised of three components medical, dental, envision. Cornell's medical plans are offered through Aetna Cornell Program for Healthy Living. Weill Cornell Medicine and the High Deductible Health Plan with a health savings account. There are two dental plan offerings through MetLife. The Dental Standard and the Dental Plus plan. And lastly, we have the vision Plan through Davis Vision.

Getting into a little more details on the three offerings through Cornell for the medical plans. The Kffl offers the freedom to choose any doctor in and out of the network, which makes it in almost the most popular plan among the three. In 92% of enrollment among staff and faculty, medical costs are usually lower when you stay in network, and if you live outside of the Ithaca area, this is still a desirable plan. You can receive routine and covered medical services from any participating Aetna provider across the country. Weill Cornell Medicine has our lowest enrollment between the three plans at just under 2%. There are two main factors that contribute to this the network and the premiums.

The network, in addition to a standard network of physicians that can be found in the Kffl plan, also has a specialized network specifically to Weill Cornell Medicine doctors.

And these are the physicians that are located in New York City. Now, not all of while physicians are part of this network. So if you are interested in receiving care at Weill Cornell through one of their physicians, we strongly encourage you to check with Aetna beforehand. The long list that your physician at Weill Cornell to make sure they're accepting this plan.

The premiums for the wild plan are higher than Cornell Kffl and high deductible plans, largely due to health care delivery in New York City being more expensive than in other parts of the country. However, you are getting access to quality care from while physicians. That is the best among the world.

The high deductible plan is Cornell's second most popular plan and offers the lowest payroll deductions among the three endowed plans. There are two components the high deductible medical insurance and then the health savings account. The health savings account can be used to pay your health care costs, or pay those costs out of your own pocket to take advantage of a tax free, investment growth. Or you can turn around and file for those out of your account for reimbursement.

Details on the HSA specifically comparing between 2025 and 2026. So the only changes that we saw for this year were to the deductible and the total HSA contributions. So the deductible for individuals increased by $50 from 1650 to 1700 for 2026.

And then for the family deductible and increased by $100 from 3300 to 3400. Now you will notice that the maximum out-of-pocket did not change. So even though the deductible went up by $50 and then $100 on the family, the maximum out-of-pocket from 2025 to 2026 did not change. Overall. For the HSA portion, we have the employee contribution that went up slightly from 3300 to 3400 for individuals and then for families. It went from 7550 to 7750.

Which increase the contributions overall for the total plan year of 2026 by 100 for individuals and 200 for family.

Now, if you do want to make a contribution to your HSA, Cornell contributes $1,000 when you sign up for your high deductible health plan. Can make your HSA election. If you want to make your own contribution, you do have to take an action in workday during open enrollment and how much you would like deducted from your paycheck.

The endowed employee medical rates will be posted onto Cornell's website on Monday, October 27th. These rate sheets will give you the details on the employee's full share, the coverage type, whether Nonexempt or exempt.

Now we're going to dive into the endowed dental plans. So the main difference between the two that I like to point out on the on this comparison chart between the standard and the plus is the annual maximum benefit. So 1250 per person on the standard plan and then 5000 per person on the plus plan. Another piece that I like to call out is the orthodontic lifetime maximum benefit. So on the standard plan it's $1,000 per child. And this also applies to any two individuals through age 18. Whereas the plus plan is for 2000 per person for you spouse, domestic partner or child through age 18. So if you have a partner or a spouse who's interested in receiving orthodontic services, you would need to elect the plus plan for them to be able to utilize that benefit. If you like the standard plan and they go to seek treatment in the middle of the year, those benefits would not be covered under the standard plan, only on the plus plan.

Then down medical rates or dental rates, I'm sorry for employees will range on the standard from 159 $1.50 9 to 532. And then on the plus plan we're seeing slight increases of $2.58 to $8.41. Again, when you go to the website, you'll be able to see the breakout of the employee, share the coverage, type and the nonexempt and exempt.

For our vision plan, there were no benefit plan design changes for 2026. You get receive a plan or you receive an exam once every calendar year and a $0 copay and frames that are with the the contracting providers with Davis vision is also a $0 copay. Lenses are $20 copay for a single bifocal tri focal. However, you can get additional features added to your lenses at a at a cost. The premium breakout in the co-pays that are applied are in the details of our vision booklet. For you to look at.

For the Vision Plan, we are happy to report that there is no rate changes for all levels. Whether you are a single two person or family plan, Nonexempt or exempt for the 2026 plan year.

Now we're going to dive into Cornell flexible spending account offerings. So we have the health slash medical flexible spending account and then the dependent care flexible spending account.

So we'll go over a couple of the differences. So with the health medical care account these are for eligible expenses specifically for medical dental vision hearing aids prescription expenses for you and your eligible dependents. Whereas dependent care is specific for care for the individuals you need the funding for. So services for dependents under the age of 13, or a spouse or dependent who can't take care of themselves.

Annual contributions went up slightly for 2026 for the medical care. The medical care FSA, up to 3400. And then the dependent care we did see an increase, quite substantial amount from 5000 to 7500. The claim periods vary slightly for the medical care. You have a full calendar year or so from January 1st to December 31st. However, on the dependent care, you have the calendar year plus two and a half months. So starting January 1st of 2026 through March 15th of 2027, even though the claim period varies, the claim deadline. So the submission deadline for your claims during the claim period are both the same of April 30th of the following year. Carryover allowances for the medical care is limited, so anything over the carryover maximum of $660 is forfeited back to the fund.

So if you did not submit claims within the claim deadline for eligible expenses and say you had $1,000 that was still sitting in that account, the only amount that would roll over into the next year for 2027 would be a maximum of $660. So that would be $340. That would be forfeited back to the fund. So make sure when you're making your election, you're calculating your expenses correctly so you don't mind up losing anything. Or the biggest thing we see is that people don't meet that time. File deadline of April 30th. And there are reminders that go out. But just when you're making your calculations on your spend, that is something to keep in mind.

And then for the carryover allowed and the dependent care, there is no allowance that that's carrying over into the following year.

If you don't use it you lose it. And those funds do get forfeited.

Annual enrollments are required during open enrollment in workday for both of these accounts.

And another piece to note, which is not on this chart, is that if you are enrolled in the high deductible, medical plan, receiving an HSA, you are ineligible to receive an FSA account. So you can only have one or the other. And if you're in the high deductible, you automatically get that HSA, which makes you ineligible for the FSA.

Now, if you're enrolled in the CPP all or the while, or you're not enrolled in any medical at all, you can still elect the FSA.

All right. Into open enrollment. So 2026 endowed open enrollment will run from October 27th through November 14th. So your elections will be due, by November 14th. I believe that is a Friday. And we're going to go over your choices that you have, which we summarized earlier in this presentation. So your benefit plan options that you will have available to you, in workday for you to enroll or make planned changes, add or remove dependents.

So medical and prescription coverage is those three plans we went over all while or the high deductible plan. And that high deductible plan has that HSA enrollment that you would need to take action on. If you wanted to do an employee contribution. Then you'll also go in and you have that met those two met life dental plan so standard in the plans and then the vision plan through Davis vision.

All of these actions again will need to be done through workday if you're making any changes. FSA annual enrollment required. So if you elected an FSA, let's say medical FSA for 2025 and you elected $2,000, that election for 2026, $2,000 will not automatically roll over. You have to go in. Elect the button for which FSA you want medical dependent care, or both, depending on what your needs are, and then put in the amount that you want deducted on a per paycheck basis.

Or you can put in the annual amount and it will calculate the per paycheck, deduction for you.

things to keep in mind if you don't think you have to make any planned changes and you're not electing an FSA. No. Actions are required on your part. Your elections for 2025 will automatically roll over into 2026 for any medical, dental or vision plans that you have. However, if you want to change plans or make a new enrollment, say this past year you were on a spouse or domestic partners coverage and you wanted to enroll in Cornell's because the coverage options seem to fit your needs better for the upcoming year.

You would need to go in and do that. Or if you wanted to add or remove your dependents, say you have a 24 year old dependent. They have a job with health care offerings to them through there, so they're going to go on their employer coverage. You would want to go in and make sure that you're removing that dependent from your coverage for January 1st.

This is the time that you would want to do it. And then of course, the FSA, elections, whether it's for a new enrollment you've never enrolled before or re enrollment for the plan year. So we know how much you want deducted from your paycheck.

2026 rates and payroll deductions. Again, the rates will be posted on the Cornell University's website, specifically under the open enrollment website, by Monday, October 27th.

And then, ironically, the bi weekly and the semi monthly check dates for 2026 are both on the same day of January 15th.

Now we're going to get into coordination of benefits, what it is and why it's important. Considerations if this applies to you. So coordination and benefits is when you or another participant on your insurance policy has more than one insurance plan that's providing coverage. So there's usually somebody who pays primary and somebody who pays secondary between the two insurance.

And you most frequently see this when you're filling out your paperwork at your doctor's office as a new patient, or for new forms for the beginning of the year. They'll ask which one is primary, which one is secondary? And sometimes you might not know. So do you need to do anything if there is more than one policy?

Yes. So you would notify Cornell insurance plans, Aetna, MetLife Davis Vision. All three of those benefit lines would need to know if there's other coverage out there. And then you would let the other insurance plans know about your coverage through Cornell. So you'd exchange the information between the insurance companies. You would also inform your providers that you had more than one plan providing coverage for you.

And then once those are coordinated between the two insurance in the provider's office, you would want to make sure those explanations of benefits that you're getting from the insurance carriers is confirming that both insurance policies have been applied to your medical bills.

So why would some people have more than one health plan? Most often, having more than one one insurance plan may save money by increasing coverage. Common scenarios where we see this as both employees or, I'm sorry, both an employee and a spouse and domestic partner have coverage. Say you have coverage through Cornell University as an employee, and then your spouse or domestic partner has union coverage, which is an automatic, benefit to them as part of their negotiated benefit package.

So if it's no additional cost, it's not uncommon that that union member has the coverage available to them, and they're enrolled and they put their spouse on or their domestic partner, both parents of a child have coverage. Oftentimes we see this in divorce separated, cases or when the parents are no longer living together. Usually we will receive a qualified medical support order, an individual who will have Medicare, Medicaid or VA benefits or military coverage such as Tricare.

All common scenarios. What factors determine the primary and secondary payer? Insurance providers review several code factors to determine who pays first. There's actually whole departments dedicated to CLB. And these are just a couple of examples. However, they get the final determination. You can't go into a provider's office and kind of just pick and choose which one you would want.

So policyholder, if you are carrying the coverage, that would be most scenarios be, primary for you. And then if you were on your spouse or domestic partners coverage, their coverage would be secondary and then the rules would reverse. So your spouse for domestic partners coverage through their say employer would be primary for them, secondary for you.

The birthday rule usually applies to children who have coverage through multiple people, whether that's through either parent or a parent and a step parent. So that would be when the whatever birthday is first within the year. It's not that. It's not based on the age of the policyholder, it is based on the month. So if I have a birthday in March and my partner has a birthday in August, my coverage would be first because March is before August.

Qualified medical support orders. We do have to enforce those. And if the either parent is ordered to provide coverage for their child, that would be the determination on who pays first and then who pays secondary. And then other factors for the types of plans you know can be based on service location. In the specific type of plan it is, if it's a catastrophic plan, if it's a PPO plan.

So there's all these factors, that come into play which do usually require, a conversation with the insurance company for you to determine.

example of CLB and why it's important to you and to make sure that the coordination is properly applied to your medical bills. And this is just for illustrative purposes, folks, and easy numbers for quick math.

So plan A is a 9010 plan. And in both of these plans we're assuming that the deductibles have already been met. It just makes it for a cleaner example for us. So say you have a dependent child who had surgery to have tubes put in their ears. Between all the providers. The total amount was 35,000. The contracting rate was 10,000.

The plan paid 9000, leaving the patient responsibility of $1,000 left over. Plan B, which is an 8020 plan, will take that remaining balance of $1,000 and it will pay the 80%, which is 800. So the patient responsibility is 200. So on a provider bill that was originally $3,000, and even based on the contracting rate of 10,000, you can get it reduced by running it through both insurance.

Now this does depend on how the plans are coordinated. It does depend on the types of plans they are and how they process coordination of benefits. If you have a PPO plan that pays primary and a catastrophic plan that pays secondary, you might not even see that catastrophic plan pick anything up. But you should be receiving EOB fees from a plan A and a plan B, showing that those bills were ran through both insurance.

If you have any questions over the information that we went over today or on open enrollment elections, please can contact H.R., STC, this is the H.R. Services and Transition Center with any of your benefit questions. They're available Monday through Friday, 830 to 430. The email listed below or at the telephone number as well.

And I want to thank everyone for their time.