2015 employee benefits new hire guide cms new hires guide.pdf · component of your compensation ......

2015 Employee Benefits

New Hire Guide

New Hire Benefits Enrollment ............................................ 3

Employee Self Service Instructions ..................................... 4

Enrollment Instructions ....................................................... 5

Eligibility .............................................................................. 6

Health Benefits

Medical and Prescription Drug Plans ...................... 7

State Health Plan Rates .......................................... 8

Specified Disease with Optional Cancer Benefit ..... 9

Group Hospital Indemnity ..................................... 10

Dental Plans ........................................................... 11

Vision Plans ............................................................ 12

Flexible Spending Accounts ................................... 13

Financial Security Benefits

Disability Benefit Plans ..................................... 14‐16

Accident Insurance ................................................ 17

Term Life Insurance ............................................... 18

Premier Whole Life Insurance ............................... 19

Permanent Life Insurance ..................................... 20

Important Notices ........................................................ 21‐22

Employee Programs & The Legal Plan .............................. 23

Carrier Contacts ................................................................. 24

This guide is intended to summarize the benefits you receive from Charlotte‐Mecklenburg Schools. The actual determination of your benefits is based solely on the plan documents provided by the carrier of each plan. This summary is not legally binding, is not a contract, and does not alter any original plan documents. For additional information, please contact the Human Resources department.

Availability of Summary Health Information

As an employee, the health benefits

available to you represent a significant

component of your compensation

package. They also provide important

protection for you and your family in

the case of illness or injury.

Your plan offers a series of health

coverage options. Choosing a health

coverage option is an important

decision. To help you make an

informed choice, your plan makes

available a Summary of Benefits and

Coverage (SBC), which summarizes

important information about any

health coverage option in a standard

format, to help you compare across

options.

The SBC is available on the web at:

www.shpnc.org/myMedicalBenefits/

ppo/default.aspx

A paper copy is also available, free of

charge, by calling 1‐855‐859‐0966.

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Visit http://mycms.k12.nc.us

NEW HIRE BENEFITS ENROLLMENT

Before your enrollment, learn more about the plan choices and prices through

this guide, Employee Self‐Serve, and the State Health Plan website

(www.shpnc.org).

WELCOME TO YOUR BENEFITS ENROLLMENT

Charlotte‐Mecklenburg Schools provides a broad array of benefits so you can select the cover‐

age that best meets the needs of you and your family. This guide includes an overview of the

benefits and your initial enrollment process. Benefit elections for most plans are effective the

first day of the month following your hire date. Trustmark, Voya, Unum and Texas Life voluntary

policies will be effective one month after your medical benefits are effective.

You have 30 days from your date of hire in which to enroll in benefits. Some bene‐

fits may require an application with health questions if you do not enroll during your initial en‐

rollment period.

Medical and prescription drug coverage at CMS is provided by the State Health Plan of North

Carolina. See pages 8 and 9 or visit the State Health Plan website (www.shpnc.org/

mymedicalbenefits) for details.

REGISTER FOR YOUR PERSONAL ENROLLMENT SESSION TODAY!

Call 1.877.401.6390, or visit https://www.myenrollmentschedule.com/cms, to schedule

your personal enrollment session. A benefits counselor will explain your options and pric‐

ing, as well as help complete the online enrollment. They will also provide a benefits con‐

firmation statement to you.

For a wallet card of benefit carriers and their contact information, please stop by the lobby

of Human Resources at 1901 Herbert Spaugh Lane, Charlotte, NC 28208.

http://www.shpnc.org/mymedicalbenefits




https://www.myenrollmentschedule.com/cms

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EMPLOYEE SELF SERVICE LOGIN INSTRUCTIONS LogintotheCMSIntranet

http://my.cms.k12.nc.usNote:IfyouworkfromaschoollocationyoumustchangetheRealmfromcmsdomaintocmssites.

In the blue box on the left click “Check out your Benefits”

Click on “Employee Self Service”

Select either “Employee Self Service” or “Employee

Self‐Service from Home”

Your Lawson username and password are the same as what you use to log

in to your CMS Email account (you will not use @cms.k12.nc.us as part of

your user name). Your initial password is Cm$xxxxx (last 5 of your SSN).

http://my.cms.k12.nc.us

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ENROLLMENT INSTRUCTIONS As a CMS New Hire, you have 30 days from your hire date to enroll in most benefits. If you

miss this enrollment period, you cannot enroll until the next Annual Enrollment.

You may enroll in the optional retirement savings plans at any time. You may also sign up for

discounted home and auto insurance or use the discount purchasing program at any time

during the year; these plans do not require enrollment.

Every CMS new hire is offered a personalized enrollment session with a benefits counselor. A

benefits counselor will explain the available plan options and rates, answer your questions, and

help you complete enrollment.

FOLLOW THESE STEPS TO ENROLL

Schedule your benefits counselor appointment. Call 1.877.401.6390 or visit

https://www.myenrollmentschedule.com/cms to do this.

You must enroll with a benefits counselor for the Short Term Disability, Whole or

Permanent Life, Specified Disease, Hospital Indemnity or Accident plans. Self‐service

enrollment is available for the other plans by going to the CMS Intranet at http://

mycms.k12.nc.us . Select “Check out your benefits” from the blue box on the left side of

the screen, then select “Employee Self Service”.

Prepare for your enrollment appointment. Review the available plan information by

logging into Employee Self Service from the CMS Intranet at http://mycms.k12.nc.us.

Be prepared for your enrollment session with the following information:

• Other insurance information ‐ insurance company name and policy number of

other insurance you pay for directly outside of CMS

• Dependent information ‐ names, birth dates and social security numbers of

spouse and/or dependent children you wish to cover

• Beneficiary information ‐ names, birth dates and social security numbers of

beneficiaries you wish to designate for Life and Disability insurance

To ensure the accuracy of your elections, review the confirmation statement from your

counselor or in the enrollment system before completing your enrollment. Also review

your initial paychecks to verify the premium deductions are correct.

https://www.myenrollmentschedule.com/cms

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ELIGIBILITY The chart below outlines the eligibility for the CMS sponsored plans for full‐time and part‐time employees. Employees must enroll in each benefit plan in order to have coverage, with the exception of Basic Term Life Insurance that CMS provides.

DEPENDENT ELIGIBILITY If you are eligible to participate in the benefits offered by CMS, your eligible dependents may also participate. For most benefit plans, dependents include:

• Your legal spouse • Your children up to the last day of the month that they turn age 26 • Your children covered by the plan who are over the age of 26 and who are/were

physically or mentally incapacitated on the date they turn/turned 26

Plan Full‐Time Employees Part‐Time Employees

State Health Plan (Medical/Rx)*

Specified Disease Insurance with Optional Cancer Benefit

Hospital Indemnity

Dental Plans

Vision Plans

Flexible Spending Accounts

Short Term Disability Insurance

Long Term Disability Insurance

Accident Insurance

Term Life Insurance*

Permanent Life Insurance

Legal Plan

* CMS pays for Basic Term Life and the cost of full‐time employee‐only coverage in the SHP 70/30 plan.

Premier Whole Life Insurance

Supplemental Term Life

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MEDICAL AND PRESCRIPTION DRUG PLANS The State Health Plan of North Carolina offers three medical plans to CMS employees for 2015: a Consumer Directed Health Plan (CDHP), a Traditional PPO and an Enhanced PPO plan. The CDHP option includes a high deductible health plan with a health reimbursement account, or HRA. The Enhanced Plan provides higher coverage levels in many categories compared to the Traditional Plan. The table below provides In‐Network highlights from each plan. Details about each plan are available on the State Health Plan website at www.shpnc.org.

CDHP w/HRA

Member In‐Network Expenses

Traditional Plan (70/30)

Enhanced Plan (80/20)

$1,500 Individual $4,500 Family

$ 933 Individual $ 2,799 Family

$ 700 Individual $ 2,100 Family

15% of eligible expenses after deductible



Out‐of‐Pocket Maximum $ 3,000 Individual $ 9,000 Family

Co‐insurance Maximum1 $ 3,793 Individual $ 11,379 Family

Co‐insurance Maximum1 $ 3,210 Individual $ 9,630 Family

15% after deductible $ 35 Primary Care2 $ 81 Specialist2

$ 30 Primary Care2 $ 70 Specialist2

15% after deductible $ 291 copay plus 30% co‐insurance after deductible

$ 233 copay plus 20% co‐insurance after deductible

15% after deductible $ 291 copay plus 30% co‐insurance after deductible

$ 233 copay plus 20% co‐insurance after deductible

Plan Feature

Benefit Year Deductible (Jan. 1 ‐ Dec. 31, 2015)

Member Co‐insurance

Benefit Year Co‐insurance or Out‐of‐Pocket Maximum

Office Visit Copays

Emergency Room

Inpatient

For full details on the State Health Plan, visit the Plan’s website at www.shpnc.org.

1The Traditional 70/30 and Enhanced 80/20 plans have an additional Rx $2,500 out‐of‐pocket maximum.

2In‐network hospital owned or operated practices may be subject to deductible and co‐insurance. Contact your physician’s office to determine if their practice is hospital owned or operated.

Prescription Drugs:

CDHP w/HRA plan: subject to the deductible, then 15% coinsurance.

Traditional (70/30) and Enhanced (80/20) plans: Copay for 30‐day supply:

Tier 1 Tier 2 Tier 3 Tier 4 Tier 5

$12 $40 $64 25% up to $100 25% up to $150


http://www.shpnc.org


STATE HEALTH PLAN RATES 2015 For 12 month, Full‐Time Employees

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CDHP with HRA Traditional

70/30 Enhanced 80/20

Monthly Rate

HRA Fund Amount

Monthly rate Monthly rate

Employee $40.00 $500 $0.00 $63.56

Employee + Spouse $515.68 $1,000 528.52 $692.10

Employee + Child(ren) $224.60 $1,000 or $1,500*

$205.12 $336.36

Family $546.64 $1,500 $562.94 $729.94

*$1,000 Employee +1, $1,500 Employee + 2 or more.

Other Cost Saving Opportunities CDHP Enhanced 80/20 Plan

Visit your PCP (listed on your ID Card) $15 added to your HRA fund Copay reduced by $15

Visit a Blue Options Designated Specialist $10 added to your HRA fund Copay reduced by $10

Receive Inpatient Care in a Blue Options Designated Hospital

$50 added to your HRA fund $233 copay is not

applied

Wellness Activity Premium Credits Available (will reduce the premium amounts above)

CDHP with HRA Traditional

70/30 Enhanced 80/20

Quit Smoking $20 per Month Not applicable $20 Per Month

Health Assessment $10 per Month Not applicable $15 Per Month

Select a PCP $10 per Month Not applicable $15 Per Month

Total Credits Available $40 per Month Not applicable $50 Per Month


GROUP SPECIFIED DISEASE INSURANCE If you or someone in your family suffers a serious disease, you can be hit hard with immediate medical expenses and reduced income from being out of a job. Health benefits will pay part of the medical bills, and disability insurance coverage can help ensure a continuing income. However, many immediate expenses may not be covered.

Specified Disease Insurance directly pays you a lump sum benefit at the diagnosis of a covered illness, such as a heart attack; stroke; major organ failure; or permanent paralysis. Cancer is also covered for an additional premium. Below is some additional information about Specified Disease insurance with optional cancer coverage:

THIS IS A LIMITED POLICY. This policy has exclusions and limitations which may affect any benefits payable. See the actual policy or your Unum representative for specific provisions and details of availability. Employees must be U.S. citizens or legally authorized to work in the U.S. to receive coverage. Spouses and dependents must live in the U.S. to receive coverage. Unum complies with state civil union and domestic partner laws when applicable. Underwritten by: Unum Life Insurance Company of America, Portland, Maine. Unum is a registered trademark and marketing brand of Unum Group and its insuring subsidiaries.

CE-13597 (8-14)

Plan Highlights:

• Guaranteed Issue—up to $20,000 benefit and simplified issue up to $50,000 benefit for employees.

• Guaranteed Issue—up to $10,000 benefit and simplified issue up to $30,000 benefit for covered spouses.

• Available to full‐time and part‐time employees

• Coverage options: Employee and Children, Employee, Spouse and Children

• Eligible children are automatically covered at 25% of the employee amount.

• No medical questions up to specified limits

• Pre‐existing conditions waived for all CMS employees and dependents

• No waiting periods

• You choose the level of coverage, from $10,000 to $50,000, in $1,000 incre‐ments.

• Coverage is portable upon request • Cancer is also covered for an additional premium

Please see policy definitions for complete details about these covered conditions.

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GROUP HOSPITAL INDEMNITY Don't let a hospital visit put your wallet in intensive care. Group Hospital Indemnity (GHI) insurance can complement your health insurance to help you pay for the costs associated with a hospital stay. Benefits can be used to pay for the out‐of‐pocket expenses your medical plan may not cover, such as co‐insurance, co‐pays and deductibles, or however you wish.

THIS IS A LIMITED POLICY. This coverage is a supplement to health insurance. It is not a substitute for comprehensive health insurance and does not qualify as minimum essential coverage. Employees must be U.S. citizens or legally authorized to work in the U.S. to receive coverage. Spouses and dependents must live in the U.S. to receive coverage. Unum complies with state civil union and domestic partner laws when applicable. This policy has exclusions and limitations which may affect any benefits payable. See the actual policy or your Unum representative for specific provisions and details of availability. Underwritten by: Unum Life Insurance Company of America, Portland, Maine. Unum is a registered trademark and marketing brand of Unum Group and its insuring subsidiaries.

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CE-13597 (8-14)

Plan Highlights:

• $1,000 for each covered hospital admission • $100 each day of your covered hospital stay, up to 15 days per confinement • $200 each day you spend in intensive care, up to 15 days per confinement • $150 for an emergency room visit due to accidental injury, once per calendar year • $100 per trip for ambulance transport, once per calendar year, accidents only • $500 per trip for air ambulance transport, once per calendar year, accidents only • Coverage is portable upon request, which means you may take the coverage with

you if you leave CMS or retire, without having to answer new health questions. • Benefits for a pre‐existing conditions (a sickness or injury for which medical advice,

diagnosis, care or treatment was received or recommended during the 12 months just prior to your effective date) will not be paid if the date of the covered loss occurs during the first 12 months after your effective date.


DENTAL PLANS Eligible CMS employees have a choice between three dental plans ‐ 2 dental PPOs and 1 dental HMO ‐ insured by Cigna. Eligible services, coverage levels and premium rates vary by plan. To make the best plan selection for you, review the highlights shown in the table below and the more detailed benefit summaries and monthly premium rates on Employee Self Service, accessed through the CMS Intranet at http://mycms.k12.nc.us. You will also find instructions for locating Cigna participating in‐network dentists.

Plan Feature

Dental HMO PPO Basic Plan PPO Standard Plan

In‐Network Only1

In‐ Network

Out‐of‐Network

In‐Network

Out‐of‐Network

Plan Year Benefit Maximum None $750 $750 $1,500 $1,000

Plan Year Deductible Individual / Family

N/A $50 / $150 $50 / $150 $25 / $75 $75 / $225

Office Visit Fee (copay) $5 N/A N/A N/A N/A

Preventive & Diagnostic Exams, Cleanings, X‐rays

Member copays apply. See Cigna

Patient Charge

Schedule for

details.

100%, no deductible

100%, no deductible

100%, no deductible

100%, no deductible

Basic Restorative Fillings, Extractions, Oral Surgery

80% after deductible




Major Restorative Crowns, Periodontics, Dentures





Orthodontia22 Not covered Not covered

50%, no deductible

50%, no deductible

Orthodontia Lifetime Maximum

None N/A N/A $1,000 $1,000

1Each enrollee in the Dental HMO must select and utilize a Primary Care Dentist in Cigna’s Dental HMO network.

2Child and adult orthodontia are covered under the Dental HMO; Child orthodontia is covered under the PPO Standard Plan.

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VISION PLANS CMS offers eligible employees the option to purchase insurance plans through UnitedHealthcare. There are two available options ‐ the Standard Plan and the Premium Plan. The table below includes plan highlights. You can view more detailed benefit summaries and monthly premium rates through Employee Self Service, accessed through the CMS Intranet at http://mycms.k12.nc.us.

Plan Feature

Standard Plan Premium Plan

In‐Network Out‐of‐

Network* In‐Network

Out‐of‐Network*

Exam (every 12 months) $10 copay $45 allowance $10 copay $45

Materials $20 copay See below $20 copay See below

Frames (every 24 months Standard / 12 months Premium)

$100 allowance $45 $175 allowance $45

Lenses (every 12 months) Single Vision Bifocal Trifocal Lenticular

Covered in full after materials

copay.

$40 $60 $80 $80


copay.

$40 $60 $80 $80

Contact Lenses (every 12 months)

Elective

Up to 4 boxes covered in full after copay. For contact lenses outside

covered selection, $105 allowance is

applied and materials copay is

waived.

$105

Up to 6 boxes covered in full after copay. For contact lenses outside selection, $175 allowance is applied and

materials copay is waived.

$175

Necessary Covered in full after materials

copay $210


copay. $210

* Out‐of‐network amounts shown are reimbursement amounts.

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FLEXIBLE SPENDING ACCOUNTS

A Flexible Spending Account (FSA) allows you to put aside money for important expenses and help you reduce your income taxes at the same time. CMS offers two types of Flexible Spending Accounts ‐ a Healthcare FSA and a Dependent Care FSA. These accounts allow you to set aside pre‐tax dollars to pay for certain out‐of‐pocket health care or dependent care expenses.

HOW FLEXIBLE SPENDING ACCOUNTS WORK

1. As a new hire and each year during Annual Enrollment, you decide how much to set aside for health and/or dependent care expenses.

2. Your contributions are deducted from your paycheck on a pre‐tax basis in equal installments throughout the year. A $48.00 annual administrative fee is deducted along with your contributions.

3. After you incur eligible expenses throughout the benefit year, submit a claim form for reimbursement. Your claim will be processed and you will be reimbursed from your account. For some healthcare expenses, you may also use your FSA debit card to pay at the point of sale.

Please note that the health and dependent care accounts are separate; you may choose to participate in one, both or neither. You may not use money from the Health Care FSA to cover expenses under the Dependent Care FSA or vice versa.

FSA Plan Maximum Annual Contribution Examples of Eligible Expenses*

Health Care FSA $2,500 Medical, Rx, dental, vision copays,

deductibles, coinsurance, etc.

Dependent Care FSA $5,000 ($2,500 if married and filing

separate tax returns) Day care, nursery school, elder care

* See IRS Publications 502 and 503 for a more complete list of eligible expenses.

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Disability coverage provides a benefit in the event you cannot work due to a covered illness or injury. CMS employees have access to multiple disability income replacement options depending on vesting with the State Disability Program and election of supplemental coverage.

STATE DISABILITY PROGRAM Short Term and Long Term Disability benefits are provided by the North Carolina State Retirement System to employees who contribute to the Teachers’ and State Employees Retirement System (TSERS). You must meet the plan’s vesting requirements before becoming eligible for coverage. The table below outlines some key features of these programs.

DISABILITY PLANS ‐ STATE DISABILITY

Benefit Feature Short Term Disability

Extended Short Term Disability

Long Term Disability

Maximum Benefit Period

Up to 1 year Up to an additional year Until eligible for unre‐duced retirement

Benefit Amount (Taxable Benefit)

50% of 1/12th of annual pay up to $3,000/month

50% of 1/12th of annual pay up to $3,000/month

65% of annual pay up to $3,900/month*

Eligibility Members with at least 1 year of contributing ser‐vice

Members with at least 1 year of contributing ser‐vice with a temporary disability

Members with at least 5 years of contributing ser‐vice with a permanent disability

Elimination Period 60 days After Short Term Disabil‐ity benefits are exhausted

After all Short Term Dis‐ability benefits are ex‐hausted

* See State Disability Program information for employees with less than 5 years of service as of 7/31/2007.

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Program Component Short Term Disability (STD) Long Term Disability (LTD)

Insurance Carrier Trustmark The Hartford

AM Best Rating A‐ (Excellent) A‐ (Excellent)

Elimination Period Choice of two options: 1) 0 Days Injury / 7 Days Illness 2) 14 Days Injury / 14 Days Illness

365 Days

Maximum Benefit Period 12 months To normal retirement age for dis‐abilities occurring before age 62

Maximum Benefit Amount (in increments of $100)

Vested in State STD: 25% of pay Not vested in State STD: 60% of pay

60% of pay

Monthly Benefit Maximum $6,000 $8,000

Minimum Monthly Benefit $300 The greater of $100 or 15% of the monthly benefit

Rate Basis Age banded Age banded

Maternity Coverage? Yes No

Guarantee Issue during Annual Enrollment

Yes, to $5,000 monthly benefit maximum, except for employees who previously applied for coverage that is no longer in force

No

Premium Withholding Basis Post‐tax (for tax‐free benefit) Post‐tax (for tax‐free benefit)

Benefits offset by other cover‐age payments?

No Yes, by other group or individual LTD coverage and/or Social Security

DISABILITY PLANS ‐ SUPPLEMENTAL To supplement the state program, CMS offers two Disability plan options:

Short Term Disability through Trustmark

Long Term Disability through The Hartford

How does it work? Disability Income insurance replaces part of your paycheck when you are disabled and unable to work. It can help you meet financial obligations when you don’t have a paycheck coming in. Your disability insurance benefits are yours to use any way you want. Before you are vested in the State Disability plans, or even after you are vested, coverage through one of these programs may be beneficial for you and your family. The following table provides an overview of key components of each program and carrier.

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SHORT TERM DISABILITY Imagine life without a paycheck. You count on your paycheck to provide the things you need today and to achieve the dreams you have for tomorrow. But, what would happen if it were suddenly discontinued because of an unexpected injury or illness? That’s when Trustmark Disability Income insurance can help. It can help you live your story, your way – even when a disability gets in the way.

What’s covered? Total disability due to:

Non‐occupational sickness or injury

Disability due to pregnancy or complications of pregnancy

Plan Details Two elimination period options: 1. 14‐day accident/14‐day sickness 2. 0‐day accident/7‐day sickness

Benefits continue up to 12 months while you remain totally disabled.

No medical questions up to the specified limits, if you apply during the Fall 2015 annual enrollment, except for employees who previously applied for coverage that is no longer in force.

Benefit payment is subject to terms and conditions of coverage.

Even for those with 5 qualifying years of service that are covered under the NC TSERS disability, this plan provides some supplemental features which can enhance your long term income protection. These include:

Minimum additional tax free monthly benefit (the greater of $100 or 15% of the monthly benefit), regardless of what the State plan pays or what other benefits you qualify for from Social Security, individual plans, or any other coverage.

Benefits pay all the way up to Social Security Normal Retirement Age, even if you never qualify for Social Security disability, if you remain disabled under the policy terms. (NC state disability plan benefits cease if you are not awarded Social Security disability benefits within 3 years.)

$8,000 maximum monthly benefit vs. $3,900 under the NC TSERS plan.

Since you pay for this coverage with after tax dollars, any benefits payable would be non‐taxable.

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LONG TERM DISABILITY


ACCIDENT INSURANCE Accident Insurance is a limited benefit policy. This is not health insurance and does not satisfy the requirement of minimum essential coverage under the Affordable Care Act. It can help pay for unexpected costs due to accidents that occur every day, from the baII field to the ski slope and the highway in between. With Accident Insurance offered by Voya Employee Benefits (previously ING Employee Benefits) you can focus your energy on recovery rather than worry about how you are going to pay your biIIs. The policy pays a specified benefit amount for the following:

• Initial care, including ambulance services, emergency room and initial doctor's office visit • Follow‐up care, including outpatient services and medical appliances • Injuries, including burns, dislocations and fractures • Catastrophic accidents and accidental death

Other Accident Insurance Features:

• Coverage is available without answering any health questions, and pre‐existing conditions do not apply.

• Pays in addition to other medical coverage and benefits are paid directly to you.

ACCIDENT WELLNESS BENEFIT RIDER

In addition to the above benefits, you will automatically receive a Wellness benefit rider which provides an annual benefit of up to $100 per certificate for covered health screening tests. Review the rider brochure for a list of the covered tests.

A 30‐day waiting period (applies only to the rider) from the effective date of coverage does apply. Please refer to the product brochure for additional information about Accident Insurance.

This is a very brief summary of the product. Please refer to the product brochures and certificate of

coverage for complete provisions, limitations and exclusions. Insurance is issued and underwritten by

ReliaStar Life Insurance Company, a member of the VoyaTM family of companies.

Policy form Number: RL‐ACC2005‐POL

Policy form numbers and specific provisions may vary by state.

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TERM LIFE INSURANCE

BASIC TERM LIFE INSURANCE

Eligible CMS employees are automatically enrolled in Basic Term Life Insurance paid for by CMS. A benefit of $9,300 is payable to your beneficiary upon your death.

SUPPLEMENTAL TERM LIFE INSURANCE

You may also apply for supplemental term life insurance through The Hartford to help provide you and your family with additional financial protection at affordable group rates. You have the option to purchase coverage for yourself, your spouse and your dependent children.

• Employee: Select an amount between $10,000 and $1,000,000, in increments of $10,000, not to exceed 5 times your basic annual earnings.

• Spouse: Select an amount between $5,000 and $100,000, in increments of $5,000, not to exceed 50% of the employee’s coverage.

• Child(ren): Select an amount between $2,500 and $10,000, in increments of $2,500 for each child up to age 26 years old.

During your initial enrollment period, CMS employees may enroll for an amount up to the lesser of 3 times your basic annual earnings or $650,000 without having to provide Evidence of Insurability. Spouse and dependent coverage is contingent upon employee coverage. Evidence of Insurability will be required for all late entrants—those who do not enroll for coverage for themselves or their spouse within 30 days of their date of hire. Dependent coverage is contingent upon employee coverage. Supplemental Term Life rates vary based on your age and the amount of coverage you choose.

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PREMIER WHOLE LIFE INSURANCE

Premier Whole Life insurance is designed to provide a base of life insurance coverage for your lifetime. It offers life insurance protection, cash accumulation and cash value loan privileges all in one policy. The premium you pay is based on the death benefit you select, the optional riders you choose, your age, and your tobacco status. Plan options are:

• Employees: Guaranteed Issue up to $25 per week, not to exceed $125,000 (ages 15‐65); Contingent Issue up to $50,000

• Spouse: Contingent Issue greater of $5/week or $5,000 (ages 15‐65); above contingent issue amounts require full underwriting.

• Dependent Children: Contingent coverage limits of $12,500, $15,000, $20,000 or $25,000 (15 days through 24 years.)

(Note: Amounts above Guaranteed/Contingent Issue Amounts are available with additional underwriting.)

The policy offers the following optional riders:

• Accidental Death Benefit provides an additional benefit equal to the face amount if the insured dies in a covered accident.

• Children’s Term Insurance offers up to $10,000 of coverage for each child. • Waiver of Premium allows the continuation of coverage by waiving the monthly

premiums after the insured has been totally disabled for four consecutive months. • Accelerated Death Benefit Rider provides a benefit if the insured is diagnosed with a

terminal illness or if they suffer from a long term care illness and are receiving qualified care (offered in North Carolina only).

Policy form numbers, product and rider availability may vary by state. Insurance is issued and underwritten by ReliaStar Life Insurance Company, a member of the VoyaTM Family of companies. Policy Form Numbers: RL‐WL2‐POL‐07, Policy Form #RL‐WL2‐ADBR‐08, CTR Rider RL‐WL2‐CTR‐07 , ABR Rider NP‐B‐ORD‐AB‐04; ADBR RL‐WL2‐ADBR‐08‐NC.

Whole Life Insurance Highlights:

• Builds cash value (and loans are available against this cash value) • No medical questions for employees up to specified limits, and pre‐existing condi‐

tions do not apply

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PERMANENT LIFE INSURANCE

Permanent life insurance from Texas Life can be an ideal complement to your group term life insurance. Designed to be in force when you die, this voluntary universal life product is yours to keep, even when you change jobs or retire, as long as you pay the necessary premium.

PLAN FEATURES

• Express Issue—Employees and spouses only have to answer three work‐related and health‐related questions to qualify for significant amounts of coverage; children and grandchildren only have to answer one health‐related question.

• High Death Benefit—With one of the highest death benefits available at the worksite,1 PURELIFE gives your loved ones peace of mind knowing there will be significant life insurance in place should you die prematurely.

• Minimal Cash Value—Designed to provide high death benefit, PURELIFE does not compete with the cash accumulation in your employer‐sponsored retirement plans.

• Long Guarantees—Guaranteed death benefit to age 121 and level premium that guarantees premium coverage for a significant period of time (after the guaranteed period, premiums may change).

• Refund of Premium—Unique in the marketplace, PURELIFE offers you a refund of five years’ premium should you surrender the policy if the premium you pay when you buy the policy ever increases (conditions apply).

• Family Coverage—You may apply for coverage for yourself, your spouse, minor children and grandchildren.

1 Voluntary and Universal Whole Life Products, Eastbridge Consulting Group, October 2008

PURELIFE PORTABLE PERMANENT LIFE INSURANCE FOR YOU AND YOUR FAMILY

Permanent, individual life insurance can be an ideal way to provide money for your family when they need it most. To help ensure that your family has money when you die, consider applying for this policy.

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IMPORTANT NOTICES

Premium Assistance Under Medicaid & Children’s Health Insurance Program (CHIP)

If you or your children are eligible for Medicaid or CHIP and you’re eligible for health coverage from your employer, your state may have a premium assistance program that can help pay for coverage, using funds from their Medicaid or CHIP programs. If you or your children aren’t eligible for Medicaid or CHIP, you won’t be eligible for these premium assistance programs but you may be able to buy individual insurance coverage through the Health Insurance Marketplace. For more information, visit www.healthcare.gov.

If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed below, contact your State Medicaid or CHIP office to find out if premium assistance is available.

If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, contact your State Medicaid or CHIP office or dial 1‐877‐KIDS NOW or www.insurekidsnow.gov to find out how to apply. If you qualify, ask your state if it has a program that might help you pay the premiums for an employer‐sponsored plan.

If you or your dependents are eligible for premium assistance under Medicaid or CHIP, as well as eligible under your employer plan, your employer must allow you to enroll in your employer plan if you aren’t already enrolled. This is called a “special enrollment” opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance. If you have questions about enrolling in your employer plan, contact the Department of Labor at www.askebsa.dol.gov or call 1‐866‐444‐EBSA (3272).

21

North Carolina South Carolina

Website: www.ncdhhs.gov/dma

Phone: 919‐855‐4100

Website: www.scdhhs.gov

Phone: (888) 549‐0820

MAKING CHANGES DURING THE PLAN YEAR Once you enroll during your new hire initial eligibility period, you are required to maintain most of your benefit elections throughout the benefit year, unless you experience a Qualified Life Event, as defined by the IRS. These include:

• Marriage, death of a spouse, divorce, annulment or legal separation

• A change in the number of dependent children; including birth, adoption, placement for adoption, becoming responsible for a stepchild who will reside in your home or death of a child

• Employment change by the employee, spouse or dependent child that results in a loss or gain of health coverage

• Child’s loss of eligibility due to age or marriage

• For Dependent Day Care FSA – enrollment into or removal from day care

If you experience a Qualified Life Event during January 1 ‐ December 31, 2015, you have 30 calendar days from the date you experience the event to change your benefit elections. The benefit changes you make must be consistent with your life event, and you must provide CMS with documentation of the event (e.g., birth certificate, marriage certificate, COBRA or HIPAA letter showing loss of coverage) within the same 30 day window. If you do not make the change within 30 calendar days of the qualified life event or if you do not provide documentation within that period, you must wait until the next annual enrollment period to make an election change. To report a Qualified Life Event and to make your mid‐year benefit changes online, visit Employee Self Service through the CMS Intranet at http://mycms.k12.nc.us.

OTHER NOTICES To view the health plan legal notices, visit the State Health Plan of North Carolina website at www.shpnc.org.

Charlotte‐Mecklenburg Schools reserves the right to amend, modify, suspend or terminate ‐ in whole or in part ‐ the plan at any time without approval, consent or acceptance of participants. This reservation applies to all active benefit plans including all medical and prescription drug plans, and includes the right to change contributions and available benefits. Charlotte‐Mecklenburg Schools will make reasonable efforts to maintain personal information, but it is entirely the responsibility of employees to maintain accurate and current personal information, including address, with the company. Failure to do so could result in loss of coverage.

It is the responsibility of employees and their covered dependents to notify Charlotte‐Mecklenburg Schools of changes that may affect the eligibility of covered dependents, including but not limited to (1) the death of the covered employee, (2) divorce or legal separation of the covered employee, (3) a covered dependent child ceasing to qualify as a “dependent child” under the terms of the plan, and (4) a covered member’s entitlement to Medicare. Notice of change must be made within 30 days of the change. Failure to notify may result in loss of coverage.

IMPORTANT NOTICES 22

RATE NOTICE AND ESCROW NOTICE FOR LESS THAN 12 MONTH EMPLOYEES

In order to provide continuous medical coverage for less than 12‐month employees and their dependents during the summer months (June−August), CMS deducts addi onal amounts, called escrow payments, to cover the summer months' deductions. The total premiums for January are divided equally into nine monthly deductions beginning in February.

To see your individual rates per paycheck, log on to Employee Self Service through the CMS Intranet at http://mycms.k12.nc.us.

EMPLOYEE PROGRAMS / LEGAL PLAN 23

PURCHASING POWER PURCHASING PROGRAM Through the Purchasing Power program you can buy various household items and other goods and pay for them via payroll deduction. Things like computers, televisions, appliances and many more items are available. Visit www.cms.purchasingpower.com for more details.

HOME & AUTO INSURANCE DISCOUNT PROGRAM

Four insurance companies partner with CMS to offer employees discounts on home and automobile insurance. The four vendors are:

For more information about what each carrier offers, you may contact them directly. Telephone numbers are listed on page 23 of this Guide.

LEGAL PLAN

Finding an affordably‐priced lawyer to represent you when you have trouble with creditors, buy or sell a home, or even prepare a will can be a challenge. Hyatt Legal Plans is a legal service program that provides legal representation for you, your spouse and dependents at a price that won’t break your budget.

This plan gives you a resource at your fingertips for important legal services such as:

• Court appearances

• Document review & preparation

• Debt collection defense

• Wills

• Family matters

• Real estate matters

• Liberty Mutual

• MetLife

• Nationwide

• Horace Mann

Coverage Carrier/

Administrator Website Phone Number

Medical North Carolina

State Health Plan www.shpnc.org

Medical—888‐234‐2416 Rx—800‐336‐5933

Specified Disease and/or Hospital Indemnity

Unum www.unum.com/employees 800‐635‐5597

Dental Cigna www.mycigna.com 800‐244‐6224

Vision UnitedHealthcare www.myuhcvision.com 800‐638‐3120

Flexible Spending Accounts Flores & Associates www.flores247.com 800‐532‐3327

Short Term Disability Trustmark www.trustmarksolutions.com 800‐918‐8877

Long Term Disability The Hartford www.thehartfordatwork.com 877‐778‐1383

Accident Insurance Voya Employee

Benefits http://voya.com/products‐

services/employee‐benefits‐work 855‐730‐2902

Whole Life Voya Employee

Benefits http://voya.com/products‐

services/employee‐benefits‐work 800‐537‐5024

Permanent Life Texas Life www.texaslife.com 800‐283‐9233, ext 6814

Term Life The Hartford www.thehartfordatwork.com 877‐778‐1383

Purchasing Program Purchasing Power www.cms.purchasingpower.com 866‐670‐3479

Legal Hyatt Legal members.legalplans.com 800‐821‐6400

Discount Home & Auto Insurance Programs

Met Life Liberty Mutual Nationwide Horace Mann

800‐438‐6388 800‐835‐0894 704‐549‐4800 704‐532‐1111

CARRIER CONTACTS 24


http://www.unum.com/employees

http://www.mycigna.com

http://www.myuhcvision.com

http://www.flores247.com

http://www.trustmarksolutions.com

mailto:www.thehartfordatwork.com

http://voya.com/products-services/employee-benefits-work








http://www.texaslife.com/

http://www.thehartfordatwork.com

http://www.cms.purchasingpower.com

25

NOTES

This guide is intended to summarize the benefits available to eligible employees of Charlotte‐Mecklenburg Schools. The actual determination of your benefits is based solely on the plan documents provided by the carrier of each plan. This summary is not legally binding, is not a contract, and does not alter any original plan documents. For additional information, please contact the Human Resources department.

All printed materials, raffle prizes and giveaways have been provided

or donated by CMS benefit carriers.

2015

Rev. 05/1/2015

2015 employee benefits new hire guide cms new hires guide.pdf · component of your compensation ......

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