COSTCO EMPLOYEE BENEFIT PROGRAM
ANNUAL OPEN ENROLLMENT 2010
Welcome to the 2010 Annual Open Enrollment for the Costco Employee Benefits Program. Annual Open Enrollment begins on November 1 and ends on November 24, 2009. This is your Annual Open Enrollment package which includes the Annual Open Enrollment Guide, a personalized Benefit Enrollment Worksheet and a copy of the Medicare Part D Notice. This provides you with the information necessary for you to make your benefit choices for 2010. The selections that you make will become effective on January 1, 2010. As you review this package please keep in mind the following important notes:
- The Benefit Enrollment Worksheet shows your benefit plan selections as of October 9, 2010. Any changes you made after that date can be viewed on the Enrollment Website.
- The Benefits reflected on the worksheet (except Healthcare and Dependent Care Reimbursement accounts) will carry over to 2010 if you do not make changes.
- Your Health Care and Dependent Care Reimbursement Account Elections WILL NOT carry over to 2010. You must make a new election to participate in 2010.
- To change your benefit selections or covered dependents you must access the enrollment website or call the enrollment center during Annual Open Enrollment.
- Be sure to review your covered dependents carefully. It is your responsibility to make sure that only those who are eligible for coverage are enrolled. Former spouses and domestic partners as well as their children are not eligible if you divorce or terminate your domestic partnership.
- The Benefit Worksheet lists dependents that will have coverage on January 1, 2010. Any dependent child that has not been approved as a full-time student before October 9, 2010 will be reflected as not enrolled. Dependent children turning 23 before January 1, 2010 will also show as not enrolled because they are not eligible once they turn 23.
Annual Open Enrollment elections can be made two ways - on the Enrollment Website by visiting or by contacting the CostcoEnrollmentCenter at 1-800-541-6205. You may not submit the Benefits Enrollment Worksheet included with this package to make changes to your current 2009 Elections. It is only intended to be a tool to help you organize your benefit changes for 2010. You should also use the Enrollment Website or Costco Enrollment Center if you experience a change in status that should go into effect prior to January 1, 2010 such as enrolling a newborn, adding a new spouse, removing a former spouse, change in employment status(e.g., part-time to full-time, hourly to salary) or transfer to a different location. Upon approval these changes would automatically carry forward into 2010:
You may need additional information and forms to complete Annual Open Enrollment. These forms are available on or from your location’s payroll clerk or benefits representative. These include:
Summary Plan Description / Declaration of Domestic PartnershipDecline Coverage Acknowledgment Form / Declaration of Legal Guardianship
Life Insurance Beneficiary Designation Form / Declaration of Plan Eligibility for Step-Child
Highlights Booklet / Rate Booklet
On the following pages we have described the changes to the Benefit Programs that will take effect on January 1, 2010. We encourage you to take a few minutes to review these changes as they may impact the decisions that you make for your 2010 Benefits. We have also provided helpful tips to expedite your enrollment selections.
WHAT’S NEW JANUARY 1, 2010…..
Beginning Right Maternity Program – In 2004 Costco added this program to help educate expectant mothers on pre-natal care and identify high risk pregnancies. The program included an incentive to encourage expectant mothers to enroll in and complete the program. After 5 years our results have shown that expectant mothers have little interest in the program. So effective January 1,2010 this program will no longer be offered.
If you have already completed the program your $100 co-pay for your newborn will still be waived, even if your delivery date is after January 1, 2010. New enrollments will not be allowed after December 31, 2009.
Aetna Commuter Benefits – This new program allows you to pay for your eligible transportation and parking expenses using pre-tax payroll deductions. You can elect up to $460 a month - $230 for transportation expenses such as bus, train or ferry plus $230 for parking expenses.
Participating is easy – simply register on and order your vouchers. Orders must be placed before the 10th of the current month so you have your vouchers in time for the following month. For example – if you want to begin participating in January 2010 you must register and order vouchers before December 10, 2009. To participate in February 2010 you must place your order before January 10, 2010.
For more information go to and click on the moving banner at the top of the page or on Other Programs in the top navigation bar.
Hearing Aids – Your Costco Employee Benefits Program provides a hearing aid benefit of $1,000 every 4 years. Getting your hearing aids at a Costco Hearing Aid Center is the most efficient way to use your benefit. Not only do you get high quality equipment at the best price, the Hearing Aid Center can submit your claim directly to Aetna for reimbursement. You no longer have to pay for the full cost of your hearing aid and wait for reimbursement from Aetna.
Voluntary Short Term Disability – The cost for this coverage has been reduced to 1.48% of eligible earnings. This benefit is not available to salaried employees or hourly employees located in California, New York, New Jersey or Hawaii.
Supplemental Life Insurance – The cost for this coverage has been reduced. See the chart on page 5 for the new rates.
Supplemental Accidental Death and Dismemberment Insurance – The cost for this coverage has increased. See the chart on page 6 for the new rates.
Aetna Aexcel Specialty Networks- Aexcel is a network of specialists who have been identified as consistently delivering quality, effective care with fewer complications and repeat procedures. These specialties include:
- Cardiology
- Neurology
- Otolaryngology/ENT
- Cardiothoracic Surgery
- Neurosurgery
- Plastic Surgery
- Gastroenterology
- OB/GYN
- Urology
- General Surgery
- Orthopedics
- Vascular Surgery
While Aexcel Specialists are available under both the Freedom of Choice and the Choice Plus medical plans, employees enrolled in the Choice Plus plans have the added benefit of a reduced co-pay.
In 2010 the Aexcel Specialty Networks will be available in the following areas:
Arizona (except 466) / MarylandCalifornia – Los Angeles
Northern California
(except 125, 133, 136)
Central Valley
(except 29, 438, 464, 471, 765, 771)
San Diego (except 121) / Michigan (except 744, 784)
Colorado (except 637) / Missouri (except 368, 382)
Connecticut / New Jersey (except 749
Delaware / New York
Florida (except 351, 354, 621) / Ohio
Georgia / Pennsylvania (except 245, 248, 317, 327)
Illinois / Texas (except 284, 768, 932)
Indiana / Virginia (except 202, 238, 247)
Kansas / WashingtonDC - Metro
Kentucky / Washington – Seattle
Like other networks, Aexcel networks can change periodically. It's always a good idea to confirm that your provider is still in network before you schedule a visit.
More Information about the benefit plans and enrollment rules can be found on-line at or by contacting your location’s payroll or Benefits representative. You can also contact Costco’s Benefit Department at 1-800-284-4882 or by e-mail to .
TIPS FOR SUCCESSFUL ANNUAL OPEN ENROLLMENT…..
Tip #1: Submitting Supporting Documentation
You may be required to submit additional forms and supporting documentation before your elections can be processed and go into effect. All additional forms and documents must be received in the Benefit Department no later than NOVEMBER 30, 2009. You or your payroll clerk or benefits representative may submit your documents directly to the Benefit Department in one of the following ways:
by fax to 425/427-3069
by intercompany mail to Costco Benefits Department #99
by U.S. Mail to P.O. Box 34195, Seattle, WA98214-1195 Attn: Benefits Department
Tip #2: Adding Family Members
The first step to adding a family member is entering the information through the enrollment system. Once you have completed the enrollment process you must still send the documentation to prove that this family member is eligible for coverage under Costco’s Employee Benefits Program. This includes marriage certificates, birth certificates, proof of full-time student status, Declaration of Domestic Partner, Declaration of Legal Guardianship and Declaration of Plan Eligibility for Stepchild. This documentation must be received in the Benefit Department no later than NOVEMBER 30, 2009.
Provided your supporting documentation is received by the required deadline, coverage for your family member will be effective January 1, 2010.
Tip #3: Adding Domestic Partners
To avoid any delay in processing your request be sure that you are using the correct form. The current form can be found on – click on Booklets and Forms. There are some differences in tax liability and premium payment that applies to Domestic Partners that you should be aware of before you add a Domestic Partner. Be sure to read the Domestic Partner Overview carefully before you add your Domestic Partner for coverage.
To enroll your Domestic Partner you will access the enrollment system and follow the same steps for adding any other eligible family member. You must complete a Declaration of Domestic Partner and submit it along with the required supporting documentation to the Benefit DepartmentNO LATER THAN NOVEMBER 30, 2009. Review your documents carefully before you submit them – incomplete documents will not be processed and will be returned to you. Coverage for your domestic partner will not go into effect until Costco has reviewed and approved the documentation.
Tip #4: Enrolling in/or Increasing Supplemental Life Insurance
If you are already enrolled in Supplemental Life Insurance you may increase your coverage by $20,000 and $10,000 for your spouse without completing the Evidence of Insurability forms. The insurance carrier must approve any amount you elect over $20,000 for yourself or $10,000 for your spouse before coverage will become effective.
If you were eligible for Supplemental Life Insurance before this Annual Open Enrollment and are enrolling for the first time, the insurance carrier must approve any amount you elect before the coverage will become effective. NOTE: If you are on an approved Leave of Absence your coverage changes will not take effect until you have returned to active employment and, if required, Costco receives approval from the Insurance Carrier.
Evidence of Insurability is always required if the amount of additional coverage you are requesting will result in a total amount of coverage that exceeds $300,000 for you or $150,000 for your spouse.
If Evidence of Insurability is required, Unum will mail the Evidence of Insurability forms to you at your home address in December 2009. The letter will include instructions and due dates for completing the Evidence of Insurability forms. Forms that are not received by the deadline will not be processed and you will be required to reapply during the next Annual Open Enrollment. To check the status of your Supplemental Life Insurance election contact Unum at 1-877-403-9348.
Supplemental Life Insurance payroll deductions are listed on the chart below.
EmployeeAge / Rate per $10,000 of Coverage
Under Age 30 / $0.19
30 to 34 / $0.22
35 to 39 / $0.27
40 to 44 / $0.43
45 to 49 / $0.79
50 to 54 / $1.24
55 to 59 / $1.93
60 to 64 / $3.01
65 to 69 / $4.98
70 and over / $8.88
Please Note: Your actual payroll deductions reflected on your paycheck may be different than these printed rates due to rounding.
Tip #5: Enrolling in or Increasing Supplemental AD&D
You can elect the maximum amount allowed under the Supplemental AD&D plan without evidence of insurability. The Benefit Enrollment Worksheet refers you to this chart to determine the cost of your Supplemental AD&D elections:
Full BenefitAmount / Employee Only / Employee & Children / Employee
Family / Full Benefit
Amount / Employee Only / Employee & Children / Employee
Family
$50,000 / $0.37 / $0.44 / $0.63 / $800,000 / $5.91 / $7.02 / $9.97
$100,000 / $0.74 / $0.88 / $1.25 / $850,000 / $6.28 / $7.46 / $10.60
$150,000 / $1.11 / $1.32 / $1.87 / $900,000 / $6.65 / $7.90 / $11.22
$200,000 / $1.48 / $1.76 / $2.50 / $950,000 / $7.02 / $8.34 / $11.84
$250,000 / $1.85 / $2.20 / $3.12 / $1,000,000 / $7.39 / $8.77 / $12.47
$300,000 / $2.22 / $2.64 / $3.74 / $1,050,000 / $7.76 / $9.21 / $13.09
$350,000 / $2.59 / $3.07 / $4.37 / $1,100,000 / $8.13 / $9.65 / $13.71
$400,000 / $2.96 / $3.51 / $4.99 / $1,150,000 / $8.50 / $10.09 / $14.34
$450,000 / $3.33 / $3.95 / $5.61 / $1,200,000 / $8.87 / $10.53 / $14.96
$500,000 / $3.70 / $4.39 / $6.24 / $1,250,000 / $9.24 / $10.97 / $15.58
$550,000 / $4.07 / $4.83 / $6.86 / $1,300,000 / $9.60 / $11.40 / $16.20
$600,000 / $4.44 / $5.27 / $7.48 / $1,350,000 / $9.97 / $11.84 / $16.83
$650,000 / $4.80 / $5.70 / $8.10 / $1,400,000 / $10.34 / $12.28 / $17.45
$700,000 / $5.17 / $6.14 / $8.73 / $1,450,000 / $10.71 / $12.72 / $18.07
$750,000 / $5.54 / $6.58 / $9.35 / $1,500,000 / $11.08 / $13.16 / $18.70
Tip #6: Enrolling in Voluntary Short Term Disability
If you previously declined coverage under the Voluntary Short Term Disability plan you may enroll during this Annual Open Enrollment. However your coverage will not take effect until July 1, 2010. For coverage to take effect you must be actively at work on July 1, 2010 and working at least 10 hours a week.
Tip #7: Declining Health Benefits
You may wish to decline health coverage if you have coverage through another Costco Employee, coverage under a plan other than Costco’s or simply don’t want coverage at all. To decline health coverage during Annual Open Enrollment you must make your election on the enrollment system and you must complete a Decline Coverage Acknowledgement form.
If you do not complete this form, you will remain enrolled in your current benefit plan selections, except for Health Care Reimbursement Account or Dependent Care Assistance Plan.
Tip #8: Enrolling in the Health Care Reimbursement Account and Dependent Care Assistance Plan
Your elections for 2009 will not be carried forward to 2010. Even if you participated in one or both of these accounts in 2009, you must re-enroll during this Annual Open Enrollment to participate in 2010.
When making your elections remember that the Health Care Reimbursement Account is for out-of-pocket medical expenses for you and all family members and the Dependent Care Assistance Plan is for daycare expenses.
When you elect to participate in the Health Care Reimbursement Account your account is automatically setup for a process called Streamlining Claims. With Streamlining, Aetna can automatically reimburse you for any eligible health care expenses that Aetna processes without a paper claim form or receipts. It also allows Aetna to pay your pharmacy co-pays directly from your FSA account to the Costco or Network pharmacy. While most Employees like streamlining it doesn’t work for everyone. You should contact Aetna to have your streamline option turned off:
- If you or your family members have other insurance coverage and you want to submit your claims to the other insurance company first.
- If you wish to use your FSA account for a specific service such as orthodontia.
Special Note: Expenses incurred by your domestic partner or their children are not eligible for reimbursement from your Health Care Reimbursement Account. Aetna will turn off Streamlining for any employee that has a domestic partner on the plan.
To turn off your Streamline you will need to notify Aetna. You can do this on-line at then link to Aetna Navigator or by contacting Aetna directly at 1-888-238-6226.
You may also elect to have your reimbursements directly deposited into your bank account. Simply complete the Direct Deposit form and fax it to Aetna as directed on the form. The form is available on – click on Booklets and Forms.
Once you have elected to participate in a reimbursement account you will receive a confirmation statement. If you notice an error in your election you must notify Costco before January 1, 2010. No changes are allowed to your Health Care Reimbursement Account elections after January 1, 2010 and changes to your Dependent Care Assistance Plan elections are only allowed under limited circumstances.
Tip #9: What to Expect After Annual Open Enrollment Ends
Final Confirmation Statements – A final confirmation statement reflecting your 2010 benefit selections will be mailed to you at your home address in early December. You will be given an opportunity to report any errors to the Benefit Department for correction.
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