2025 Open Enrollment Guide
Introduction
Welcome to our Benefits Open Enrollment
Welcome
to our Benefits Open Enrollment
Our goal is to provide meaningful benefits that support your wellbeing and the well-being of your loved ones. In return, you are expected to take accountability for understanding and appropriately utilizing your benefits. We encourage you to take the time to learn about all of the benefits, review your current elections and make choices that are right for you and your family for 2025.
During Open Enrollment, staff members can enroll in the following benefits:
• Medical • Dental
• Vision • Voluntary Life
• Voluntary Accidental Death & Dismemberment (AD&D)
• Flexible Spending Accounts (FSAs)
How to Enroll or Waive Benefits Coverage for 2025
Be sure to read this guide in its entirety, as well as the other Open Enrollment resources on Worklife. Make your decisions and complete your enrollment or waive coverage in UKG.
Keep in mind that the benefit elections you made for 2024 do not automatically carry over. Be sure to make active elections for 2025 benefits during Open Enrollment in order to avoid a lapse in coverage. You will not be able to make changes during the year unless you experience a qualified life event.
Need help or have questions about our benefits?
Contact wellness@roomandboard.com.
2025 Open Enrollment Dates
November 4, 2024 – November 18, 2024
ENROLL HERE:
https://roomandboard.ultipro.com
Navigate to Menu > Myself > Open Enrollment
2025 Highlights
• The High Deductible Health Plan Design is changing. The deductible and out-of-pocket maximums for both single and family coverage on the High Deductible Health Plan will increase.
• Staff members will see changes to their health insurance biweekly paycheck deductions.
• We are offering a special Voluntary Life Enrollment opportunity.
• Dental and Vision premiums will not be increasing.
• Flexible Spending Account (FSA) contribution limits have increased from $3,200 to $3,300
• Health Savings Account (HSA) contribution limits have increased from $4,150 to $4,300 for individuals and from $8,300 to $8,550 for family
Health Care Coverage
www.healthpartners.com/roomandboard
1-800-883-2177
Room & Board is pleased to offer you two high-quality health care benefit options to choose from: the High Deductible Plan paired with a Health Savings Account (HSA) and the Copay Plan.
Both plans provide 100% coverage for preventive care. Keep in mind that choosing a network provider will most likely lower your cost for services.
CONTRIBUTIONS – BIWEEKLY
Network Coverage
HealthPartners provides your health care coverage and processes your claims. You get access to 1 million doctors and 6,000 hospitals in the United States. HealthPartners offers members nationwide access to providers through an alliance with Cigna Healthcare. HealthPartners administers the health plan coverage and processes the claims. Find more information about our network coverage in the HealthPartners-CIGNA network FAQs posted on Worklife.
Copay Plan
DEDUCTIBLE AND OUT-OF-POCKET MAXIMUM AMOUNT
EMPLOYEE (PER MEMBER)
$750 deductible amount
$3,000 out-of-pocket maximum
$1,150 deductible amount $4,500 out-of-pocket maximum
$1,500 deductible amount $6,000 out-of-pocket maximum $2,300 deductible amount
The information below shows the amount you are responsible for paying by type of care with copays and after the deductible is met.
Routine Preventive Care
• Preventive care
• Screening
• Immunization No charge
Office Visits
• Illness or injury
• Mental/behavioral health, substance use disorder
• Specialty visits
Online Care
• Virtual (available in select states)
50% coinsurance for eye exams
50% coinsurance for immunizations
50% coinsurance for other services
$35 copay
$35 copay
$75 copay Deductible then you pay 50%
• Doctor on Demand No charge Subject to applicable Office Visit copay Not covered
Emergency Care
• Urgent care
• Emergency care at hospital ER
• Ambulance
$100 copay for urgent care
$200 copay for ER 20% coinsurance for medical transportation
$100 copay for urgent care
$200 copay for ER 20% coinsurance for medical transportation
Inpatient Hospital Care Deductible then you pay 20% Deductible then you pay 50%
Outpatient Care
• Scheduled outpatient procedures
• Outpatient MRI and CT scans Deductible then you pay 20% Deductible then you pay 50%
BENEFITS OF THE COPAY PLAN
• It has a lower deductible
• You pay a flat $35 for each office visit ($75 for specialty care)
• Labs and x-rays are 100% covered
• Prescriptions have a flat copayment
Click here to view the full Summary of Benefits and Coverage (SBC) for the Copay Plan.
High Deductible (HSA) Plan
High Deductible (HSA) Plan
The information below shows the amount you are responsible for paying by type of care after the deductible is met.
Routine Preventive Care
• Preventive care
• Screening
• Immunization
Office Visits
• Illness or injury
• Mental/behavioral health, substance use disorder
• Physical, occupational and speech therapy
Online Care
• Virtuwell
• Doctor on Demand
Emergency Care
• Urgent care
• Emergency care at hospital ER
• Ambulance
Outpatient Care
• Scheduled outpatient procedures
• Outpatient MRI and CT scans
High Deductible (HSA) Plan
RETAIL (UP TO A 31-DAY SUPPLY)
MAIL ORDER (UP TO A 93-DAY SUPPLY)
BENEFITS OF THE HSA PLAN
• It has lower monthly premiums
• Room & Board contributes to your health savings account (HSA)
• Tax advantages – your HSA contributions are tax-deductible, you can spend your money tax-free, and any growth is tax-free too.
• It’s your money and your unused HSA money rolls over every year.
Click here to view the full summary of benefits and coverage (SBC) for the HSA Plan.
Health Savings Account (HSA)
A health savings account (HSA) is a personal healthcare bank account created exclusively for those staff members on a high deductible plan. Room & Board contributes bi-annually to your health savings account. This is our way of investing in your health and providing you with valuable financial support. We also want to encourage you to contribute to your HSA through pre-tax payroll contributions.
You own your HSA which is administered through Optum Bank. You determine how much you will contribute to your account, when to use your money to pay for qualified medical expenses, and when to reimburse yourself. Remember, this is a bank account; you must have money in the account before you can spend it.
HSAs offer you the following advantages:
• Tax savings: HSAs provide triple tax savings. Contributions are tax free; the account grows tax free, and spending is tax free (as long as it is on qualified medical costs).
• Reduced out-of-pocket costs: You can use the money in your HSA to pay for eligible medical expenses and prescriptions. The HSA funds you use can help you satisfy your plan’s annual deductible.
• A long-term investment that stays with you: Unused account dollars are yours to keep even if you retire or leave the company. Additionally, you can invest your HSA funds, so your available healthcare dollars can grow over time.
• The opportunity for long-term savings: Save unused HSA funds from year to year- you can use this money to reduce future outof-pocket health expenses. You can even save HSA dollars to use after you retire.
Once your account is opened Optum Bank will send you a debit card that you can use to pay your healthcare expenses.
Important HSA eligibility: The IRS does not allow you to open and fund an HSA if you have other healthcare coverage or are enrolled in Medicare. If you enroll in Medicare after you turn 65 the coverage is retroactive up to 6 months. You will want to stop contributing to your HSA 6 months prior to enrolling in Medicare if you are over 65.
Contact wellness@roomandboard.com if you have questions about your eligibility for an HSA.
How the Plans Work
In-network preventive care, such as annual check-ups, cancer screenings, well-child care and immunizations, are covered at 100%.
How the Copay Plan Works: IN-NETWORK PROVIDERS
$750 lndividual
$1500 Family
You pay a copay for o ce visits, prescriptions and 100% of other covered medical costs until you meet your deductible.
Once you meet your deductible, you pay 20% for services up to your out-of-pocket maximum.
$3000 lndividual
$6000 Family
If your accumulated out-ofpocket expenses reach the above maximums, the plan pays 100% for the remainder of the year.
How the High Deductible HSA Plan Works: IN-NETWORK PROVIDERS
In-network preventive care, such as annual check-ups, cancer screenings, well-child care and immunizations, are covered at 100%.
You pay 100% of medical and prescription drug costs until you meet your deductible. Room & Board will make a contribution to your HSA based on the tier of coverage you select. (Employee= $600, Employee + (Child)ren/Spouse/ Partner =$900, Family= $1,200). You can withdraw these funds tax-free and put them towards meeting your deductible or save them to help o set future expenses.
Once you meet your deductible, you pay 20% for services and prescriptions* up to your out-of-pocket maximum.
If your accumulated out-ofpocket expenses reach the above maximums, the plan pays 100% for the remainder of the year.
*For specialty drugs, you pay 20% up to $200 maximum of the cost per prescription per month.
Plan Considerations
It’s important to consider your options when selecting your medical plan. Deciding on a plan is a personal decision for you and your family. When choosing the plan that’s right for you, it’s important to think about your total costs:
Fixed costs (annual premium contributions) + variable costs (out-of-pocket expenses) = total costs
Here are a few things to think about when choosing a medical plan:
• Consider your per paycheck premium contribution.
• How do you and your family use your health care? Consider the number of office visits you make in an average year, the number and cost of prescription drugs you use, and the number of foreseeable hospital visits you anticipate in the upcoming plan year (pregnancy, chronic conditions, etc.).
• Enrolling in our High Deductible Plan gives you access to a health savings account (HSA). HSA dollars can be used for qualified health care expenses, including vision and dental for yourself and any tax dependents. Your HSA dollars will rollover year-toyear, giving you the ability to save for future health care expenses. To learn more about HSAs, go to www.optumbank.com.
• You may also make contributions to your HSA up to the IRS maximums: $4,300/single and $8,5500/family.
• If you are age 55+, you are eligible to make an additional $1,000 “catch-up” contribution. Be sure to factor in your Room & Board contribution with these limits. There are some tax advantages to contributing to an HSA; see right.
• If you enroll in our Copay Plan, you have the ability to open a Medical Flexible Spending Account that allows you to set aside pre-tax money from your paycheck to pay for eligible medical, vision and dental expenses. (See page 16 for more information.)
HSA TAX ADVANTAGES
• Staff member contributions are tax-free, reducing your taxable income.
• Distributions of HSA funds are tax-free when used to cover qualified health care expenses.
• HSA balances grow tax-free.
Vision Coverage
The vision plan through EyeMed allows you and your covered family members to receive an eye exam at an EyeMed in-network provider for just a $10 copay. You also receive a $150 allowance toward your choice of a complete pair of eyeglasses or contact lenses. There are also other great discount benefits as an EyeMed member when you go to an “Insight” in-network provider.
With EyeMed, you have access to independent providers, LensCrafters, Pearle Vision and Target Optical as well as online retailers contactsdirect.com, glasses.com, lenscrafters.com and rayban.com.
Vision Plan
• Exam
• Retinal Imaging
CONTACT LENS FIT AND FOLLOW-UP
• Fit and Follow-up - Standard
• Fit and Follow-up - Premium
• Any available frame at provider location
STANDARD PLASTIC LENSES
• Single Vision
• Bifocal
• Trifocal
• Lenticular
• Progressive - Standard
• Progressive - Premium Tier 1 - 4
copay
copay
copay
copay
copay
copay
Premium progressives and premium anti-reflective designations are subject to annual review by EyeMed’s Medical Director and are subject to change based on market conditions. Fixed pricing is reflective of brands at the listed product level. All providers are not required to carry all brands at all levels. Benefits are not provided from services or materials arising from: 1) Orthoptic or vision training, subnormal vision aids and any associated supplemental testing; Aniseikonic lenses; 2) Medical and/or surgical treatment of the eye, eyes or supporting structures; 3) Any eye or Vision Examination, or any corrective eyewear required by a Policyholder as a condition of employment; Safety eyewear; 4) Services provided as a result of any Workers’ Compensation law, or similar legislation, or required by any governmental agency or program whether federal, state or subdivisions thereof; 5) Plano (non-prescription) lenses; 6) Non-prescription sunglasses; 7) Two pair of glasses in lieu of bifocals; 8) Services or materials provided by any other group benefit plan providing vision care; 9) Services rendered after the date an Insured Person ceases to be covered under the Policy, except when Vision Materials ordered before coverage ended are delivered, and the services rendered to the Insured Person are within 31 days from the date of such order; 10) Lost or broken lenses, frames, glasses, or contact lenses will not be replaced except in the next Benefit Frequency when Vision Materials would next become available. Benefits may not be combined with any discount, promotional offering, or other group benefit plans. Standard/Premium Progressive lens not covered-fund as a Bifocal lens. Standard Progressive lens covered-fund Premium Progressive as a Standard. Benefit allowance provides no remaining balance for future use within the same benefit year. Fees charged for a non-insured benefit must be paid in full to the Provider. Such fees or materials are not covered.
Vision Plan
SUMMARY OF BENEFITS
LENS OPTIONS
• Anti Reflective Coating - Standard
• Anti Reflective Coating - Premium Tier 1-3
• Photochromic - Non-Glass
• Scratch Coating - Standard Plastic
• Tint - Solid or Gradient
• UV Treatment
• All Other Lens Options
CONTACT LENSES
• Contacts - Conventional
• Contacts - Disposable
• Contacts - Medically Necessary
OTHER
• Hearing Care from Amplifon NetworkCare
$0 copay
$12-$85 copay $75
$0 copay $0 copay $0 copay 20% off retail
$0 copay; 15% off balance over $150 allowance $0 copay; $100% of balance over $150 allowance $0 copay; Paid-In-Full
• Lasik or PRK from U.S. Laser Network Discounts on hearing exam and aids; call 1-877-203-0675 15% off retail or 5% off promo price; call 1-800-988-4221
FREQUENCIES (Plan allows member to receive either contacts and frame, or frames and lens services)
• Exam
• Frame
• Lenses
• Contacts Once every plan year Once every plan year Once every plan year Once every plan year
Dental Coverage
Routine dental care can not only improve your oral health but your overall health as well.
New for 2025, our plan will offer the same benefits at both PPO and Premier providers. Network providers are covered at the same level of benefits.
Four out of five dentists nationally are Delta Dental Network dentists. You can choose to see a dentist outside of the network, but your expenses may be higher, and you may be responsible for submitting your own claim. To find a participating dentist, simply visit www.deltadentalmn.org and use the interactive ‘’Find a Dentist” tool or call Customer Service toll-free at 800-448-3815.
Dental Plan
SUMMARY OF BENEFITS
This is a summary of benefits only and does not guarantee coverage. For a complete list of covered services and limitations/exclusions, please refer to the Dental Benefit Plan Summary.
**Dentists who have signed a participating network agreement with Delta Dental have agreed to accept the maximum allowable amount as payment-in-full. Non-participating dentists have not signed an agreement and are not obligated to limit the amount they charge; the member is responsible for paying any difference to the non-participating dentists.
Flexible Spending Accounts (FSAs)
FSAs are voluntary accounts that allow you to use pre-tax funds to pay for certain expenses. You can set up three separate accounts — one for qualified health care expenses, one for qualified dependent care expenses and one for work-related parking/ transit expenses.
Medical Flexible Spending Account
The Medical FSA provides a way to pay for your family’s eligible medical, vision and dental expenses with pre-tax money that is deducted from your paycheck.
Contributions
You may make pre-tax contributions of up to $3,300 per year to your Medical FSA. If you have money left over at the end of the calendar year, you will be able to rollover up to $660 of your balance to the following calendar year.
Eligible Medical Expenses
Eligible expenses can be found here through WEX: https://www.wexinc.com/insights/ benefits-toolkit/eligible-expenses/
Limited Purpose Medical FSA Contributions
You may make pre-tax contributions of up to $3,300 per year to your Limited Purpose Medical FSA. If you have money left over at the end of the calendar year, you will be able to rollover up to $660 of your balance to the following calendar year.
Eligible Expenses Include:
• Dental expenses
• Vision expenses
• Out-of-pocket medical expenses after you reach the federally-qualified High Deductible HSA Plan annual deductible ($1,650 for single coverage, $3,300 for family coverage).
Dependent Care FSA Contributions
You may contribute up to $5,000 per year, per family household, on a pre-tax basis to the Dependent Care FSA. This annual maximum applies to all contributions made by you and your spouse to a Dependent Care account.
Eligible Dependents
You can be reimbursed for dependent care expenses if they are necessary to allow you or your spouse to work. The services must be provided by a qualified dependent care provider to care for your child, disabled spouse, elderly parent or other dependent who is physically or mentally incapable of self-care.
Commuter Expenses
Staff members who incur work-related commuter expenses, including transportation or parking, may participate in this benefit. In 2025 you are able to deduct up to $325 per month pre-tax from your paycheck for transit expenses and $325 per month for parking expenses.
How Does the Commuter Benefit Work?
• You decide how much of your paycheck you want to deposit into your transit or parking account each pay period.
• Your deduction will be loaded onto a debit card for you to pay for transit or parking expenses. You can also submit requests for reimbursements.
• Transactions or reimbursement requests cannot exceed the $325 IRS monthly maximums.
• Any amount remaining at the end of the calendar year will roll forward to the next calendar year.
Use it to Pay for Things Like:
• Bus passes, commuter van, light rail, train and subway fares
• Parking ramps
FSA Example
The following illustrates the tax benefits of an FSA. This example compares costs for single-employee coverage. Your actual costs and tax savings will vary.
Substantiation of Claims for all FSAs
We find great value in using our flex debit card to pay for claims at the time of service. The card gives you instant access to the funds in your account. The IRS regulations mandate that all claims incurred in an FSA must be substantiated. When a claim cannot be automatically substantiated (e.g., a prescription co-payment), WEX Benefits will request documentation. It is imperative when asked for documentation that you provide it to WEX Benefits as soon as possible. If documentation is not provided, the IRS requires you to pay back the plan.
Voluntary Life and AD&D Insurance
Voluntary Life Insurance
Room & Board pays for basic term life insurance in the amount of 2 1⁄2 times the annual salary for all staff members who work 20 hours or more per week. You can elect Voluntary Life Insurance through VOYA for you, your spouse or domestic partner, and your dependent children, up to the benefit maximums listed below.
Voluntary Accidental Death and Dismemberment (AD&D)
Room & Board pays for basic term AD&D insurance in the amount of 21⁄2 times the annual salary for all staff members who work 20 hours or more per week. You may also elect additional AD&D insurance for yourself and eligible dependents. If elected, this benefit is paid in addition to the life benefit if you or a covered dependent dies in a covered accident. If you survive a serious accident, it can pay you a benefit for certain severe injuries such as loss of vision, hearing and limbs.
How These Benefits Work
Coverage Amounts: You can choose a benefit amount up to five times your annual salary in increments of $10,000 to a maximum of $500,000. You can purchase coverage for your spouse/domestic partner in amounts of $5,000 up to a maximum of $500,000, and coverage for dependent children in amounts of $5,000 and $10,000.
Evidence of Insurability (EOI): If you elect coverage or increase it after your initial eligibility period, you will need to provide EOI for Voluntary Life Insurance.
Special Opportunity: Only During Open Enrollment
During this year’s enrollment period, you have a special opportunity to elect up to $200,000 in Voluntary Life Insurance coverage for yourself and $50,000 for a spouse/ partner without providing Evidence of Insurability (EOI). This means no health questionnaire or medical exam is required for coverage amounts up to $200,000, making it easier than ever to secure this protection.
