Open Enrollment

Open Enrollment for FY16

Open Enrollment begins May 11th (8:00 AM) and continues through May 27th (11:59 PM).

During Open Enrollment you may make the following types of changes:

  • change insurance plans
  • add or drop insurance
  • buy additional supplemental life insurance
  • enroll in flexible spending accounts
  • add or remove eligible dependents from insurance plans

All changes are made by logging into your PRISM account and selecting ACGA Employee Self-Service / Benefits.  You can’t make changes until May 11th, and your changes will not be effective until July 1, 2015.

What’s New for FY16?

Premiums:  Premiums will increase 5.3% for Kaiser and 7.5% for Cigna plans.  Depending on the plan you choose and your level of coverage, your biweekly premium increase may be as little as $3.60.  There will be no premium increase for Delta Dental in FY16.  See the FY16 Employee Rate Charts for details.

Plan Changes
Kaiser Permanente Signature HMO

Kaiser copays will change in FY16 for the first time in six years.  The new office visit copays are $20 for Primary Care and $40 for Specialists.  Please review the Out-of-Pocket Expense Comparison to see a list of the most common copays.

Cigna……… Good News!            

· In compliance with the Affordable Care Act, beginning July 1, 2015, prescription drug copays will now count toward your out-of-pocket maximum (OOPM).  As a result, the OOPM for all Cigna plans is increasing by $250 for individual and $500 for family.  Learn more about the OOPM.

· Need to get physical therapy?  As of July 1, for the Cigna OAP IN Copay plan, the copay for physical therapy will be reduced from $60 to $45!


Flexible Spending Account (FSA)

· The IRS has increased the annual contribution limit for the health care FSA to $2,550.

· Remember:  up to $500 of unspent funds in your health care FSA will automatically roll over from FY15 to FY16.


Out-of-Pocket Maximum Amounts

The out-of-pocket maximum (OOPM) is a requirement of the Affordable Care Act. The OOPM exists to protect you against catastrophic medical expenses.  This year the Affordable Care Act requires that prescription drug copays be included in the OOPM annual amount.  Because of the addition of prescription drug copays, the Cigna OOPM will increase by $250 per individual and $500 per family.   Below are the new Out-of-Pocket Maximium amounts.

​Kaiser Permanente HMO ​Cigna OAP IN Copay Plan ​Cigna OAP IN Coinsurance Plan ​Cigna OAP
​$3,500 Individual 
$9,400 Family
​$6,600 Individual
$13,200 Family
​​$2,250 Individual
$4,500 Family
​$2,250 Individual
$4,500 Family
Out-of-Network
$3,250 Individual
$6,500 Family

Reminder: the OOPM is tracked on a calendar year basis and resets to $0 every January 1st.

If you switch plans during
Open Enrollment:
This may impact what out-of-pocket maximum (OOPM) you must meet for the calendar year.
For a better understanding of how the OOPM works — especially if you decide to change health plans — please review What is an Out of Pocket Maximum?

What Must You Do During Open Enrollment?

  • If you would like to change the plan in which you are enrolled or add/remove
    eligible dependents, you must make this change in PRISM during Open Enrollment.
  • Flexible Spending Account participants must re-enroll during Open Enrollment
    to continue participation in FY16.
  • No action is required if you wish to keep the same health and/or dental coverage.