2017 benefit overview - tcs education system

1 TCS_2017_Benefit Summary v4

2017

Benefit Overview

--Plan Year 2017-- 2

TCS_2017_Benefit Summary v4

Disclaimer

This document is an outline of the coverage proposed by the carrier(s), based on information provided by them. It does not include all of the terms, coverage, exclusions, limitations, and conditions of the actual contract language. The policies and contracts themselves must be read for those details. Policy forms for your reference will be made available upon request. The intent of this document is to provide you with general information regarding the status of, and/or potential concerns related to, your current employee benefits environment. It does not necessarily fully address all of your specific issues. It should not be construed as, nor is it intended to provide, legal advice. Questions regarding specific issues should be addressed to your human resources department. For more information about each of the benefit plans, visit the Benefits worklet in Workday or contact your Human Resources Department.



Contents

Disclaimer .........................................................................................................................................................2

Contents ..........................................................................................................................................................3

Benefits Overview ......................................................................................................................................4

Benefit Plans Offered .......................................................................................................................................4 Eligibility for Benefits .......................................................................................................................................4 Electing Coverage .............................................................................................................................................5 When Coverage Begins ....................................................................................................................................5 When Coverage Ends .......................................................................................................................................5 Coverage for Dependents ................................................................................................................................6 Qualifying Life Events and Changing Your Elections ........................................................................................7

Employee Contribution Rates – 2017 Plan Year ........................................................................8

Medical Benefits .........................................................................................................................................9

Member ID Cards .............................................................................................................................................9 BCBSIL PPO Prescription Plan Change (effective 1/1/17) ................................................................................9 Overview of Medical Benefits ....................................................................................................................... 10

BCBSIL Resources .................................................................................................................................. 12

Doctor on Demand Virtual Visits .................................................................................................... 14

Dental Benefits ......................................................................................................................................... 15

Vision Benefits ......................................................................................................................................... 16

Finding Doctors and Dentists ........................................................................................................... 17

Flexible Spending Accounts .............................................................................................................. 18

Commuter Spending Accounts ........................................................................................................ 19

Life and Accidental Death & Dismemberment (AD&D) Insurance ................................ 20

Overview of Life and AD&D Insurance .......................................................................................................... 21

Disability Coverage ................................................................................................................................ 22

TCS 403(b) Plan ........................................................................................................................................ 23

Employee Assistance Program ........................................................................................................ 23

Resource Guide ........................................................................................................................................ 24

Contact Information ............................................................................................................................... 25



Benefits Overview

TCS Education System and your employer are proud to offer a comprehensive benefit package to eligible full-time and part-time employees. The complete benefit package is briefly summarized in this booklet. Employees share the costs of some benefits (medical, dental, and vision), and your employer provides other benefits at no cost to employees (life, accidental death & dismemberment, short-term disability, and long-term disability). In addition, there are voluntary benefits which may be purchased at reasonable group rates through payroll deductions and a 403(b) retirement plan to which you may contribute.

Benefit Plans Offered

Medical Dental Vision Doctor on Demand Healthcare Flexible Spending Account Dependent Daycare Flexible Spending Account Commuter Spending Accounts Basic Life and Accidental Death & Dismemberment Insurance Voluntary Employee, Spouse and Child Life and AD&D Insurance Short-Term Disability Long-Term Disability 403(b) Retirement Plan Employee Assistance Program

Eligibility for Benefits

Your eligibility for each of the benefits summarized in this Benefit Overview document depends on your employment type. The chart below provides an overview of each benefit and the employment types that qualify for each.

Employment Type and Benefit Plan Eligibility Indicator

Benefit Plan Regular Full-time (37.5+ hours/week)

Regular Part-time (20-37.4 hours/week)

Temporary* and Adjunct Faculty

Medical Employee Only

Dental Employee Only

Vision Employee Only

Doctor on Demand

Flexible Spending Accounts

Commuter Spending Accounts **

Basic and Voluntary Life and AD&D

Short- and Long-term Disability

Employee Assistance Program

TCS 403(b) Plan

*Temporary workers that are not employed by TCS Education System or an affiliate are excluded. **Applies only to temporary workers and adjunct faculty in Washington, D.C. Student workers are ineligible for any benefits except those who work in Washington, D.C; they are eligible to participate in the Commuter Spending Accounts.



Electing Coverage

If you are a new hire or a newly eligible employee, you must elect coverage for certain benefits within 30 calendar days of your hire date or status change date (your “eligibility date”). If you do not enroll within 30 calendar days of your eligibility date, you will not be permitted to enroll until the next open enrollment period or unless you experience a qualifying life event. (Refer to ”Qualifying Life Events and Changing Your Elections” for additional information.) If you want to participate in the following plans, you must elect coverage: medical, dental, vision, Voluntary Life and AD&D, Flexible Spending Accounts, Commuter Spending Accounts, and the 403(b) Plan. If eligible, you are automatically enrolled in the Basic Life and AD&D plan, Short- and Long-Term Disability Plans, and Employee Assistance Program. The benefits in which you enroll—when you are first eligible or during an open enrollment period—will generally stay in effect until the following open enrollment period and you will not be able to change your benefits during the plan year unless you have a qualifying life event.

When Coverage Begins

If you are a new hire or a newly eligible employee, the benefits you elect will become effective on the first calendar day of the month following your eligibility date. For example, if you are hired on July 6 and enroll in Medical insurance, your coverage will begin on August 1. Coverage under Doctor on Demand, the Basic Life and AD&D, Short Term Disability, and Long Term Disability plans will automatically begin on the first calendar day of the month following your eligibility date. If you elect Voluntary Life and AD&D coverage in excess of the guarantee issue amount, coverage amounts that require Evidence of Insurability (EOI) will not be effective unless Lincoln Financial Group approves coverage.

When Coverage Ends

In general, you will be covered by the benefits you elect until your employment ends or until you are no longer considered an eligible employee. If your employment ends or you are otherwise ineligible for benefits, your coverage under Medical, Dental, and Vision will end on the last day of the calendar month in which your employment status changes. Your coverage under the Flexible Spending Accounts (FSAs), Basic and Voluntary Life and AD&D plans, the Short Term Disability plan, and the Long Term Disability plan will end on the date your employment status changes. As long as you remain employed in any capacity (other than a student worker), you may continue to access the Doctor on Demand benefit. When a covered child reaches the limiting age, their coverage will end as of the last day of the month in which the limiting age is reached.



Coverage for Dependents

If you are a full-time employee, you may elect coverage for your eligible dependents under the Medical, Dental, Vision, and Voluntary Life insurance plans. Eligible dependents include your spouse, domestic partner, civil union partner, and children under age 26, regardless of their student status. If you are enrolling your dependents for the first time, or enrolling a new dependent, you must provide proof of eligibility when enrolling. The chart below lists the documents that are accepted as proof of eligibility for each dependent type. Part-time employees are eligible for employee-only coverage under the Medical, Dental, and Vision plans.

Dependent Type Acceptable Documentation

Spouse

Legal Spouse Marriage certificate; or If the most recent income tax return was filed jointly, a copy of the first page of the

IRS Form 1040 (with the financial information blacked out)

Civil Union Partner

Legal Civil Union Partner Civil union certificate; or If the most recent income tax return was filed jointly, a copy of the first page of the

IRS Form 1040 (with the financial information blacked out)

Domestic Partner

Same Sex or Opposite Sex Domestic Partner

TCS Education System Affidavit of Domestic Partnership

Child

Biological Child Birth certificate showing the employee or qualifying partner as a parent; or If the child was claimed as a dependent on the employee’s most recent income tax

return, a copy of the first page of the IRS Form 1040 (with the financial information blacked out)

Adopted Child

Official adoption paperwork showing the employee or qualifying partner as a parent; or

If the child was claimed as a dependent on the employee’s most recent income tax return, a copy of the first page of the IRS Form 1040 (with the financial information blacked out)

Stepchild

Birth certificate showing the employee’s spouse or as a parent; or If the child was claimed as a dependent on the employee’s most recent income tax

return, a copy of the first page of the IRS Form 1040 (with the financial information blacked out)

Legal Guardianship of Child

Court orders stating that employee or qualifying partner is the legal guardian of child

Incapacitated dependent (age 26 or older)

Statement from the child’s treating physician attesting that the child is physically or mentally incapable of self-care



Qualifying Life Events and Changing Your Elections

In most cases, your benefit elections will remain in effect for the entire year (January 1 - December 31). During each open enrollment period, you will have the opportunity to review your benefit elections and make changes for the coming year. You are responsible for reviewing your paystubs each pay period to ensure that the correct deductions are being taken from your pay, and for notifying your Human Resources department immediately if you believe a correction needs to be made. Certain coverages allow limited changes to your benefit elections during the year. These benefits include the medical, dental, vision and flexible spending accounts. For these benefits, you may only make changes to your elections during the year if you experience a qualifying life event. The benefit election changes you make must be consistent with your qualifying life event. You have 30 days from the date of the event to request your enrollment change. In most cases, your election will become effective the day of the qualifying event. Otherwise, you must wait until the next annual enrollment period to make a change to your elections. The table below explains some of the qualifying life events and the types of changes you can make when they occur. If you are not sure if you’ve had a qualifying life event, contact your Human Resources department for assistance.

Benefit Type and Election Change Allowed

Qualifying Life Event

Medical, Dental, and/or Vision Voluntary Life and AD&D Medical FSA Dependent Daycare FSA

Change in Employee’s Marital Status

Marriage Add spouse (and children, if applicable)

Drop coverage to join spouse’s plan

Increase voluntary employee coverage*

Enroll in voluntary spouse coverage

Enroll or increase

Divorce, legal separation, annulment

Drop coverage for spouse Enroll self and/or children (if

lost under former spouse’s plan)

Drop voluntary spouse coverage

Enroll in voluntary child coverage (if lost under former spouse’s plan)

Decrease No change

Death of spouse Drop coverage for spouse Enroll self and/or children (if

lost under deceased spouse’s plan)

Drop voluntary spouse coverage

Enroll in voluntary child coverage (if lost under deceased spouse’s plan)

Decrease Enroll or increase (if lost under deceased spouse’s plan)

Increase in Number of Dependents

Birth, adoption, placement for adoption

Enroll self and/or child Enroll or increase voluntary employee and/or child coverage*

Enroll or increase

Decrease in Number of Dependents

Reaching limiting age

Drop child’s coverage (age 26) Drop voluntary child coverage (age 19)

Decrease (age 26)

No change

Death of child Drop coverage for deceased dependent

No change No change Decrease

Change in Spouse’s or Dependent’s Employment

Start new job and gain coverage

Drop coverage for self and dependents who are enrolling in new coverage

Drop coverage for self and dependents who are enrolling in new coverage

No change

Terminate employment and lose coverage

Enroll yourself and spouse and/or child(ren)

Enroll or increase* Enroll or increase

*Evidence of insurability (EOI) may be required before enrollment or coverage increases are approved.



Employee Contribution Rates – 2017 Plan Year

You pay for your benefits via payroll deductions from each of your bi-weekly paychecks. Your medical, dental, and vision coverages are paid for on a pretax basis. This means that premiums are withheld from your pay before federal, state (in most cases), and FICA taxes are calculated. This can reduce the amount of taxes you pay per paycheck. You are responsible for reviewing your paystubs to ensure proper deductions are being withheld. Bi-weekly contribution rates are provided in the chart below.

Pre-tax Deduction per Bi-Weekly Paycheck

Benefit Plan Employee

Only

Employee +

child(ren)

Employee +

Spouse

Employee +

Family

BlueAdvantage HMO $55.00 $169.00 $174.00 $251.00

BCBS PPO ($1,000 Deductible) $77.00 $189.00 $194.00 $288.00

BCBS PPO ($250 Deductible) $90.00 $220.00 $227.00 $336.00

Kaiser HMO $47.00 $185.00 $203.00 $296.00

GroupHealth HMO $69.00 $173.00 $180.00 $268.00

MetLife Dental $7.00 n/a n/a $15.00

VSP Vision $1.85 $2.97 $3.03 $4.89

Deductions and Imputed Income per Bi-Weekly Paycheck

Employee + Domestic Partner Employee + Domestic Partner + Child(ren)

Benefit Plan Pre-Tax Deduction

Post-Tax Deduction

Imputed Income

Pre-Tax Deduction

Post-Tax Deduction

Imputed Income

BlueAdvantage HMO

$55.00 $119.00 $144.98 $169.00 $82.00 $160.48

BCBS PPO ($1,000 Deductible)

$77.00 $117.00 $174.58 $189.00 $99.00 $192.59

BCBS PPO ($250 Deductible)

$90.00 $137.00 $203.14 $220.00 $116.00 $224.14

Kaiser HMO

$47.00 $156.00 $160.11 $185.00 $111.00 $205.10

GroupHealth HMO

$69.00 $111.00 $168.58 $173.00 $95.00 $184.59

MetLife Dental

$7.00 $8.00 $17.35 $11.00 $4.00 $8.67

VSP Vision

$1.85 $1.17 $0.95 $2.97 $1.92 $1.56

Refer to the Benefits worklet in Workday for Voluntary Employee, Spouse, and Child Life and AD&D rates.



Medical Benefits

Administered by BlueCross and BlueShield of Illinois (BCBS) (All locations) or Insured by Kaiser Permanente (CA & WA only)

Comprehensive and preventive healthcare coverage is important in protecting you and your family from the financial risks of unexpected illness and injury. A little prevention usually goes a long way— especially in healthcare. Routine exams and regular preventive care provide an inexpensive review of your health. Small problems can potentially develop into large expenses. By identifying the problems early, often they can be treated at little cost. Comprehensive healthcare also provides peace of mind. In case of an illness or injury, you and your family are covered with an excellent Medical plan through TCS Education System. TCS Education System offers you a PPO or an HMO Medical plan (only employees who reside in Illinois, California, or Washington state may enroll in an HMO).

With the PPO, you may select where you receive your medical services and see specialists without getting a referral. If you use in-network providers, your costs will be less.

With an HMO, you must receive care from your chosen primary

care physician (“PCP”) or women’s healthcare provider. If you need to see a specialist, your PCP will refer you.

If you enroll in BlueAdvantage HMO, you will need to call BCBS to tell them your PCP choice once they receive your enrollment.

Member ID Cards

You will receive a member ID card at your home after BCBS, Kaiser, or GroupHealth processes your enrollment. If you enroll in an HMO, each covered member in your family will receive a member ID card. If you enroll in the PPO, you will receive two cards, each under the employee’s name (they are not personalized to each covered family member). You may request additional cards at any time by contacting your medical carrier.

BCBSIL PPO Prescription Plan

Change (effective 1/1/17)

CVS pharmacies and CVS pharmacies in Target

stores will no longer be a part of Blue Cross and

Blue Shield of Illinois PPOs’ standard pharmacy

network.

IT IS IMPORTANT TO KNOW WHAT DEDUCTIBLES, COINSURANCE, AND COPAYS ARE SO YOU CAN BETTER UNDERSTAND YOUR BENEFITS.

A deductible is the amount you pay for

health care services before your health

insurance begins to pay.

Copayments or Copays are fixed dollar

amounts (for example, $20) you pay for

covered health care, usually at the time

you receive the service.

Coinsurance is your share of the costs of

a covered service, calculated as a

percent of the allowed amount for the

service.

For example, if the plan’s allowed

amount for an overnight hospital stay is

$1,000, your coinsurance payment of

20% would be $200. Your total cost may

vary based on whether you have met

your deductible.

Important

Pharmacy

Change

Notice!

--Plan Year 2017-- 10


Overview of Medical Benefits

The charts below and on the following page give an overview of the deductibles, copays, and coinsurance under each Medical option. For more information, please refer to the Benefits worklet in Workday.

Blue Cross and Blue Shield Participating Provider Options

PPO ($250 Deductible) PPO ($1,000 Deductible)

In-Network Out-of-Network* In-Network Out-of-Network*

Lifetime Benefit Maximum Unlimited Unlimited Unlimited Unlimited

Annual Deductible $250 Single $750 Family

$500 Single $1,500 Family

$1,000 Single $3,000 Family


Annual Out-of-Pocket Maximum





Prescription Out-of-Pocket Maximum



Coinsurance (amount you pay after you meet the deductible, excluding copays)

20% 40% 20% 40%

DOCTOR’S OFFICE

Primary Care Visit $20 copay 40% coinsurance $30 copay 40% coinsurance

Specialist Office Visit $40 copay 40% coinsurance $50 copay 40% coinsurance

Wellness Care (routine

exams, x-rays/test, immunizations, well baby care, and mammograms)

$0 copay 40% coinsurance $0 copay 40% coinsurance

PRESCRIPTION DRUGS

Retail (34-day supply) Generic Formulary Non-Formulary

$15 copay $30 copay $50 copay

$15 copay1 $30 copay1 $50 copay1

1plus 25% of eligible amount



1plus 25% of eligible amount

Mail Order (90-day supply) Generic Formulary Non-Formulary

$30 copay $60 copay

$100 copay

n/a n/a n/a

$30 copay $60 copay

$100 copay

n/a n/a n/a

HOSPITAL SERVICES

Emergency Room $150 copay $150 copay $150 copay $150 copay

Hospital Deductible n/a $300/admission n/a $300/admission

Inpatient 20% coinsurance 40% coinsurance 20% coinsurance 40% coinsurance Outpatient Surgery 20% coinsurance 40% coinsurance 20% coinsurance 40% coinsurance Ambulance Service 20% coinsurance 20% coinsurance 20% coinsurance 20% coinsurance MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES

Inpatient Services 20% coinsurance 40% coinsurance after $300 deductible

20% coinsurance 40% coinsurance after $300 deductible

Outpatient Services $20 copay 40% coinsurance $30 copay 40% coinsurance

OTHER SERVICES

Maternity Services $20 copay for first visit

40% coinsurance $30 copay for first visit

40% coinsurance

All other maternity hospital/physician services

Paid same as medical/surgical

services


services


services


services

Muscle Manipulation Services

20% coinsurance (up to 25 visits per plan

year)


year)


year)


year)

Physical, Occupational and Speech Therapy Services

20% coinsurance 40% coinsurance 20% coinsurance 40% coinsurance

TMJ and Related Services 20% coinsurance 40% coinsurance 20% coinsurance 40% coinsurance

Skilled Private Nursing 20% coinsurance 40% coinsurance 20% coinsurance 40% coinsurance

Other Services (artificial

limbs and other prosthetic devices; blood and blood components; leg, arm and neck braces; surgical dressing; casts and splints)

20% coinsurance 40% coinsurance 20% coinsurance 40% coinsurance

*If an out-of-network provider charges more than the allowed amount, you may have to pay the difference.

--Plan Year 2017-- 11


Overview of Medical Benefits - continued

Health Maintenance Organization (HMO) Options

BCBS BlueAdvantage HMO (IL Residents)

Kaiser HMO (CA Residents)

GroupHealth HMO (WA Residents)

In-Network (no benefits are provided Out-

of-Network)

In-Network (no benefits are provided Out-of-

Network)

In-Network (no benefits are provided Out-of-

Network)

Lifetime Benefit Maximum Unlimited Unlimited Unlimited

Annual Deductible n/a n/a n/a

Annual Out-of-Pocket Maximum




Prescription Out-of-Pocket Maximum


Coinsurance (amount you pay after you meet the deductible, excluding copays)

0% 0% 0%

DOCTOR’S OFFICE

Primary Care Visit $30 copay $10 copay $10 copay

Specialist Office Visit $50 copay $10 copay $10 copay

Wellness Care (routine

exams, x-rays/test, immunizations, well baby care, and mammograms)


PRESCRIPTION DRUGS

Retail (34-day supply) Generic Formulary Non-Formulary



2Up to a 90-day supply


Mail Order (90-day supply) Generic Formulary Non-Formulary

$30 copay $60 copay

$100 copay

n/a n/a n/a


HOSPITAL SERVICES

Emergency Room $150 copay $50 copay $100 copay

Inpatient Hospital $250/day for first 5 days $250/admission $100/admission

Outpatient Surgery 0% coinsurance $10 copay/procedure $10 copay/procedure

Ambulance Service 0% coinsurance $50 copay/trip $100 copay/trip

MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES

Inpatient Services $250/day for up to 5 days $250/admission $100/admission

Outpatient Services $30 copay $10/visit $10/visit

OTHER SERVICES

Maternity Services $30 copay for first visit $0 copay $10 copay

Maternity hospital services $250/day for up to 5 days $250/admission $100/admission

Muscle Manipulation Services

$30 copay Not covered $10/visit (up to 10 visits per plan year)

Physical, Occupational and Speech Therapy Services

$0 copay (up to 60 visits per plan year)

$10/visit $10/visit (up to 60 visits per plan year)

TMJ and Related Services Not covered Not covered $100/stay inpatient, $10/visit outpatient

Skilled Private Nursing $0 copay $0 copay (up to 100 visits per plan year)

$0 copay (up to 100 visits per plan year)

Other Services (artificial

limbs and other prosthetic devices; blood and blood components; leg, arm and neck braces; surgical dressing; casts and splints)

$0 copay 20% coinsurance 20% coinsurance

--Plan Year 2017-- 12


BCBSIL Resources

If you enroll in a PPO or the BlueAdvantage HMO, you have access to a wide variety of services offered by BCBS that will help keep you and your family healthy.

24/7 Nurseline–Around the Clock

Toll-free Support at 800.299.0274

The 24/7 Nurseline is available 24 hours a day, 7 days a week. The registered nurses can: • Help you decide if you should call your doctor, go to the ER or treat the problem yourself

• Answer many of your health-related questions

• Help you understand your condition

When should you call? The toll-free Nurseline can help you or a covered family member get answers to questions regarding many health-related topics, including:

• Asthma, back pain or chronic health issues

• Dizziness or severe headaches

• High fever

• A baby’s nonstop crying

• Cuts or burns

• Sore throat

Urgent Care Center or Free-Standing ER

Knowing the difference can save you money. Urgent Care Centers and Free Standing Emergency Rooms (ERs) can be hard to tell apart. Free standing ERs often look a lot like Urgent Care Centers, but costs are higher, just as if you went to the ER at a hospital. Here are some ways to know if you are at a Free Standing ER. Free-Standing ERs:

• Look like Urgent Care Centers, but include EMERGENCY in facility names.

• Are open 24 hours a day, 7 days a week.

• Are physically separate from a hospital.

• Are subject to the deductible (urgent care has copay on the Traditional Plan).

• Are staffed by ER physicians.

--Plan Year 2017-- 13


BCBSIL Resources - continued

Blue Care Connection

Sometimes managing your health requires more than doctor visits, lab tests and prescriptions. Blue Cross and Blue Shield of Illinois offers resources through Blue Care Connection, a program to help you and your covered family members reach your health and wellness goals. Some of these resources include:

• Lifestyle Management Programs – Provide tools and information which may help you lose weight, quit smoking or reduce your risk for developing heart disease, stroke or diabetes

• Utilization Management – You and your doctor can obtain information about your benefits and easily navigate the healthcare system to help you maximize your benefits for covered services

• CCEISM Care Coordination and Early Intervention – If you are in the hospital, a care management specialist may call to help coordinate special care you might need when you get home

• Condition Management – Blue Care® Advisors (registered nurses and other healthcare professionals) work with you and your doctor to provide education, coaching and monitoring if you are at risk for or already have a chronic condition

• Health Education and Support – There are tutorials on more than 170 health topics available online or by mobile device through your Blue Care Advisor (many tutorials are available in Spanish as well)

• Healthy Tips by Text – Receive secure text messages on such topics as diabetes prescription drug reminders, blood sugar reminders, coronary artery disease care management and diet tips, as well as exercise and fitness tips

• Special Beginnings®’ – Maternity program offering expectant mothers ongoing support and education from prenatal to postpartum care, including convenient online and mobile tools and educational materials

• Case Management – Case managers, registered nurses with specialized training and clinical experience, help you navigate complex medical situations and access the services you need

• Behavioral Health – Licensed behavioral health professionals help you access services and offer support with coexisting medical conditions and disorders such as anxiety, depression, etc.

Blue365 — A Discount Plan for Members www.blue365deals.com/bcbsil.com

Save money on healthcare products and services that are not covered by your health plan. Sign up on the Blue365 website and start receiving weekly “Featured Deals.” In addition to the Featured Deals, here are some of the Blue365 deals available to members:

• Davis Vision – Save on eyeglasses, contact lenses, exams and accessories through Davis Vision network providers

• Dental Solutions – Receive a dental discount card which provides access to discounts up to 50% at more than 61,000 participating dentists

• Jenny Craig, Nutrisystem and Seattle Sutton’s

• Procter & Gamble dental products – Save on dental packages with Oral B power toothbrushes and Crest products

• TruHearing – Save on hearing aids

• CORD:USE – Save on cord blood processing and storage fees

• Reebok – Enjoy 20% off plus free shipping on Reebok.com

• SeniorLink Care – Save on a 3- or 12-month SeniorLink Care membership, which offers help to caregivers and assistance with planning care

• Life Time Fitness – Sign up online for $0

• RetrofitSM – Receive 15 percent off Retrofit’s online, private weight loss coaching sessions

• Handstand Kids – The Handstand Kids cookbook brings the family together in the kitchen, cooking and eating healthy, delicious meals. You may save up to 25 percent on cooking accessories and cookbook

--Plan Year 2017-- 14


Doctor on Demand Virtual Visits

What is Doctor on Demand?

Doctor on Demand offers all employees and their families the opportunity to access physicians for non-emergency medical needs from anywhere, even the comfort of your own home. Doctor on Demand board-certified physicians are available for consultations via computer, smartphone, tablet or telephone 24 hours a day, 7 days a week and can even prescribe medications. You will automatically be enrolled for this benefit on January 1, 2017, or the first day of the month following your eligibility date, whichever is later. This benefit is available to all employees (except student workers) and their household family members.

What can Doctor on Demand treat?

Doctor on Demand physicians can help treat the following conditions and more: Cough, cold, flu, rash, pink eye, sports injury, bug bite, urinary tract infection, vomiting, travel issues, and sore throat.

What does Doctor on Demand cost?

Doctor on Demand is not only convenient but also cost effective at a $20 copay per standard medical visit.

How do I get started?

1. Download the app, visit the App Store, Google Play, or text ENROLL to 68398

2. Follow prompts to register, be sure to enter TCS Education System when setting up your account.

NEW in

2017!

--Plan Year 2017-- 15


Dental Benefits

Insured by MetLife

Good oral care enhances overall physical health, appearance, and mental well-being. Problems with the teeth and gums are common and easily treated health problems. Keep your teeth healthy and your smile bright with the TCS Education System Dental benefit plan. The chart below is an overview of the benefits provided by the dental plan. For more information, please refer to the Benefits worklet in Workday.

In-Network Out-of-Network*

Annual Benefit Maximum $2,000 $1,250

Annual Deductible (Basic and Major Services)

$50/person $150 family limit

$75/person $225 family limit

Preventive Dental Services (cleanings, exams, x-rays)

100%, no deductible

Basic Dental Services (fillings,

root canal therapy, oral surgery) 80% after deductible 60% after deductible

Major Dental Services

(extractions, crowns, inlays, onlays, bridges, dentures, repairs)

50% after deductible

Orthodontia Services (covered to age 19)

50% to $1,500 Lifetime Maximum


Mobile App To download and install the app on your devise visit the App Store (Apple) or Google Play (Android) and search for MetLife. Use the app on your iOS or Android powered device to:

• Find a dentist • View your plan summary and claims • View your ID card

--Plan Year 2017-- 16


Vision Benefits

Insured by VSP

Regular eye examinations cannot only determine your need for corrective eyewear, but also may detect general health problems in their earliest stages. Protection for the eyes should be a major concern for everyone. The chart below is an overview of the benefits provided by the vision plan. For more information, please refer to the Benefits worklet in Workday.

In-Network Provider Out-of-Network Provider*

Eye Exam (once every 12 months) $10 copay $10 copay, then $25 benefit

Lenses (once every 12 months) Single Vision Lenses Lined Bifocal Lenses Lined Trifocal Lenses Lenticular Lenses

$25 copay (lenses

and/or frames) plus $130 allowance,

then 80%

$25 copay, then $30 benefit $35 benefit $45 benefit $60 benefit

Frames (once every 24 months) $25 copay (lenses and/or frames) plus

allowance

Up to $45

Contact Lenses (once every 12 months if you elect contacts instead of lenses/frames)

Covered 100% if medically necessary;

up to $130 if elective

Up to $210 if necessary; up to $105 if elective


--Plan Year 2017-- 17


Finding Doctors and Dentists

Finding doctors and dentists who participate in the medical, dental, and vision networks is easy. Simply follow the instructions below.

BlueCross / BlueShield PPO

Go to www.BCBSIL.com Click “Provider Finder” In the new window (or tab) that opens, select the state in which you live and click “Start Search” When asked to choose your plan network, select “Participating Provider Organization [PPO]” Enter any

additional search criteria and click “Search”

BlueAdvantage HMO (Illinois residents only)

Go to www.BCBSIL.com

Click “Provider Finder” In the new window (or tab) that opens, select the state in which you live and

click “Start Search” When asked to choose your plan network, select “BlueAdvantage HMO [ADV]” Enter any additional search criteria and click “Search”

Kaiser HMO (California residents only)

Go to www.kp.org Click “Find a doctor” Select an area from the dropdown menu and click “Go” Enter any additional search criteria and click “Search”

Group Health HMO (Washington residents only)

Go to www.ghs.org/provider

Choose your search and select plan Core/Group Health Choose your search Enter in location and any additional search criteria and click “Search”

MetLife

Go to www.MetLife.com

Click “Find a Dentist” Enter your zip code and select the “PDP Plus Network” Click “Go”

VSP

Go to www.VSP.com At the top of the page, click “Find a Doctor” Enter your zip code or address Under “Doctor Network”, select “Signature” Enter other optional search criteria and click “Search”

BEFORE YOU CHOOSE A PRIMARY CARE PHYSICIAN, IT IS A GOOD

IDEA TO CALL THE PCP TO ENSURE THE PROVIDER IS ACCEPTING

NEW PATIENTS.

http://www.bcbsil.com/


http://www.kp.org/

http://www.metlife.com/

http://www.vsp.com/

--Plan Year 2017-- 18


Flexible Spending Accounts (FSA)

Administered by ADP Spending Accounts

There are two types of FSAs offered by your employer: Healthcare FSA and Dependent Care FSA. When enrolling in your benefits, you can choose to participate in either, both or neither FSA. The FSA plans allow you to save by putting money aside for healthcare expenses not covered by your medical plan and dependent daycare expenses — TAX FREE! There are no Federal income, State income (in most cases) or Social Security taxes withheld for dollars contributed toward an FSA plan. Because contributions are made on a pretax basis, the IRS requires that changes to your election can only be made when you experience an approved status change and must be made within 30 days of the status change.

Healthcare Flexible Spending Account

With your Healthcare Flexible Spending Account, you can use tax-free dollars to pay for eligible medical, dental, vision and hearing expenses incurred by you or an eligible dependent if the expenses are not paid by other plans. The maximum annual amount that you may contribute to this plan in 2017 is $2,600. You can use the Healthcare FSA to pay for healthcare-related expenses such as:

• Copays and coinsurance

• Cost of eligible service above reasonable and customary limits or above other plan limits

• Other health-related expenses not paid by other plans that are eligible for tax reduction by Section 213 of the IRC.

• A full list of eligible Healthcare FSA expenses can be found at www.irs.gov, publication 502.

ADP Spending Accounts administers

the spending accounts If you want

more information before enrolling,

visit their website at

MySpendingAccount.ADP.com

The Healthcare and Dependent Daycare

spending accounts are “use it or lose

it”. The FSA plan year (incurral period) is

January 1 to December 31. You must

submit your claims for reimbursement

no later than March 15. Any remaining

balance after all claims have been

processed for the incurral period will be

forfeited. Please plan carefully.

Consult your tax advisor regarding

potential tax implications associated

with participation in these pre-tax

benefit plans.

Note:

Over-the-counter (OTC) medications are no longer reimbursable through the Healthcare FSA unless prescribed by a physician

When submitting a claim, Healthcare FSA participants will need to provide a receipt detailing the eligible purchase, including an Rx number for prescriptions

--Plan Year 2017-- 19


Dependent Care Flexible Spending Account (for expenses such as daycare)

You can receive tax-free reimbursement from your Dependent Care FSA for expenses incurred by you for the care of eligible dependents, such as daycare for children. The expenses must enable you and your spouse, if you are married, to be gainfully employed or attending school full-time for the period that you have eligible dependents. The IRS maximum annual contribution to a Dependent Care FSA in 2017 is a per household limit of $5,000. If you are married, the most you and your spouse can contribute is a combined $5,000. A qualifying eligible dependent is any individual considered your dependent within the same meaning of Section 152 of the IRC who meet the following criteria:

• A dependent under the age of 13 for whom you are entitled to a deduction for income taxes

• A spouse or dependent who is physically or mentally incapable of taking care of himself or herself

Commuter Spending Accounts

Administered by ADP Spending Accounts

The Commuter Spending Accounts allow you to pay for your transit and parking expenses with pre-tax dollars, which can reduce the cost of your daily commute to and from work. Unlike most of the other benefits offered, you are not limited to an annual enrollment for these benefits. You may start and stop participation in one or both accounts on a monthly basis. The deadline to enroll, make changes, or cancel participation is the fifth calendar day of each month. The IRS limits the amount of pre-tax dollars you can use to pay for your commuting expenses each month. If your expenses exceed the monthly limit, the difference will be withheld from your paychecks on a post-tax basis. The monthly pre-tax contribution limits for each of the spending accounts is shown below:

Transit: $255 Parking: $255

Please note: Payroll deductions for the Commuter Spending Accounts are withheld from the first two paychecks of each month, on a current-month basis. For example, if you order a train ticket in February to be used in March, half of the ticket’s cost will be deducted from your first March paycheck and half from your second March paycheck.

First-time Enrollees in the Commuter Spending Accounts

If you would like to enroll in the Commuter Spending Accounts for Parking and/or Transit benefits, send an e-mail to [email protected]. The subject of your e-mail must read “Commuter Plan Enrollment Request”. Within two business days, you will receive a reply which will include a link to ADP’s spending account website which will allow you to register and enroll. Returning enrollees may use their exiting Commuter Spending Account User ID and Password.

mailto:[email protected]

--Plan Year 2017-- 20


Life and Accidental Death & Dismemberment (AD&D)

Insurance

Insured by Lincoln Financial Group

With Lincoln Life and Accidental Death and Dismemberment (AD&D) insurance, your family will be protected with benefits and a variety of support services designed to help them cope with both emotional and financial issues. It can help you preserve your dream of a secure lifestyle for your family, even if you can’t be there. If you are a regular full-time employee, your employer provides Basic Employee Life and AD&D insurance of $50,000* at no cost to you. Your employer understands not everyone’s personal situation is the same; your family needs may be different from the needs of your coworkers. For this reason you are offered voluntary life and AD&D for yourself and your dependents, which can be purchased at group rates, above and beyond the employer provided coverage. Rates for the voluntary coverage can be found on the Benefits worklet in Workday. The chart on the following page presents an overview of the benefits provided by the life and AD&D plans. For more information, please refer to the Benefits worklet in Workday. *Coverage amount is reduced at age 65 and older. See chart on following page.

Guarantee Issue and Evidence of Insurability

The insurance company provides a guarantee issue of a certain amount of life insurance if you meet certain enrollment and age requirements. If you elect coverage over the guarantee issue amount, the insurance company will require you to provide evidence of insurability (“EOI”) before the additional coverage amount is approved. EOI is required by the insurance company if any of the following apply:

You are electing voluntary employee or spouse coverage over the guarantee issue amount during your initial eligibility enrollment period

You are enrolling in voluntary employee or spouse coverage after your initial eligibility enrollment period If EOI is required, your Human Resources representative will provide you with a form to complete and fax to Lincoln Financial Group. Enrollments for coverage amounts that require EOI will not be processed unless the life insurance company approves coverage.

Annual Open Enrollment Opportunity

Each year during annual enrollment new enrollees and existing enrollees in the Voluntary Employee Life and AD&D insurance plans may elect or increase insurance coverage equal to two benefit levels on a guaranteed acceptance basis provided that you or your spouse have not been previously declined, withdrawn, or pending for coverage.

--Plan Year 2017-- 21


Overview of Life and AD&D Insurance

The chart below is an overview of the benefits provided by the Life and AD&D plans. For more information, please refer to the Benefits worklet in Workday.

Basic Employee Life and AD&D Plan

Benefit Employee Spouse Child

Life Amount Guarantee Issue

$50,000 $50,000

n/a n/a

AD&D Amount Guarantee Issue

Equal to Life Amount n/a n/a

Benefits will reduce: 35% at age 65; An additional 25% of the original amount at age 70; and An additional 15% of the original amount at age 75. Benefits terminate at retirement.

n/a n/a

Voluntary Life and AD&D Plans

Life Benefit Employee Spouse Child

Life Amount AD&D Amount

Choice of $10,000 increments. Not to exceed 7 times your annual salary. Employees age 70 and older, maximum benefit is $50,000. Same as Life Amount

Choice of $5,000 increments. Employee must elect Voluntary Employee coverage for spouse to be eligible. Not to exceed 50% of Employee elected amount.

$250: 14 days to 6 months $10,000: 6 months to age 19 (to age 25 if full-time student) Newborn children to age 14 days are not eligible for a benefit. Employee must elect Voluntary Employee coverage for child to be eligible.

Minimum Amount $10,000 $5,000 $10,000

Maximum Amount $500,000, limited to 7 tjmes your annual salary Employees age 70 and older, maximum benefit is $50,000

$250,000, limited to 50% of employee amount

$10,000

Guarantee Issue $200,000 $20,000 age 70-74 No Guarantee Issue age 75 and older

$30,000 if employee is under age 60 No Guarantee Issue if employee is age 60 and older

$10,000

Benefit Reduction Employee Spouse Child

Benefits will reduce: 35% at age 65; An additional 25% of the original amount at age 70; and An additional 15% of the original amount at age 75. Benefits terminate at retirement.

35% at employee age 65 Benefits terminate at employee age 70 or retirement, whichever occurs first.

n/a

--Plan Year 2017-- 22


Disability Coverage

Administered by Lincoln Financial Group

Meeting your basic living expenses can be a real challenge if you become disabled over a long period of time. Your options may be limited to personal savings, spousal income and possibly Social Security. Disability insurance provides protection for your most valuable asset — your ability to earn an income.

Short-Term Disability

Short-Term Disability (STD) coverage provides income if you become disabled due to a non-work-related injury or illness. STD coverage provides you a benefit of 60% of your weekly earnings, up to $1,500. Benefits begin immediately for an injury and after 7 calendar days for an illness and are payable for up to 13 weeks. If eligible, enrollment is automatic and coverage is provided at no cost to you.

Long-Term Disability

Your employer also provides Long-Term Disability (LTD) insurance coverage, which pays 60% of your monthly base salary up to a monthly maximum (see below) after 90 calendar days do disability, for as long as you are found to be disabled (until you reach age 65*). If your annual salary is less than $120,000, your benefit maximum is $7,500 per month. If your annual salary is $120,000 or greater, your benefit maximum is $12,500 per month. If eligible, enrollment is automatic and coverage is provided at no cost to you. *See your LTD Policy Certificate for more details on the LTD benefit.

BENEFITS PAID BY THE STD AND LTD PLANS ARE REDUCED BY

OTHER BENEFITS YOU ARE ELIGIBILE TO RECEIVE, SUCH AS FROM A

STATE DISABILITY PROGRAM.

--Plan Year 2017-- 23


TCS 403(b) Plan

Recordkeeper: Transamerica Retirement Solutions

With the TCS 403(b) Plan you can save for your retirement with convenient payroll deductions. You choose how much to save and whether to contribute pre-tax or after-tax dollars. In addition, the 403(b) plan offers a wide variety of investment options to help you meet your retirement goals. You can also rollover your retirement savings from other employers’ qualified retirement plans. In 2017, you may contribute up to $18,000 to the 403(b) plan and, if you are age 50 or over, you may contribute an additional $6,000. This additional amount is called a “catch-up contribution”. You can enroll in the TCS 403(b) Plan and change or cancel your payroll deductions at any time. You can also change your investment elections at any time (some investments require a minimum investment period). For more information, contact Transamerica Retirement Solutions.

Employee Assistance Program

Administered by ComPsych GuidanceResources

The Employee Assistance Program (EAP) is a program that your employer offers at no cost to you, for you and your household members. It’s here to help you with life’s challenges, whether workplace or personal. At no cost to you, the EAP can help you with concerns such as:

• Stress and depression • Caring for children and aging parents • Family, work or personal relationship issues • Alcoholism or substance abuse • Bereavement • Coping with a chronic illness • Job or career anxiety

Call the EAP to speak with a licensed counselor by telephone 24 hours a day, seven days a week. Refer to ”Contact Information” in this guide for information on how to reach ComPsych for assistance.

YOUR EMPLOYER MAY MAKE A CONTRIBUTION TO THE TCS 403(B)

PLAN ON YOUR BEHALF IF YOU MEET CERTAIN ELIGIBILITY

REQUIREMENTS. CONTACT YOUR HUMAN RESOURCES

REPRESENTATIVE FOR MORE INFORMATION.

--Plan Year 2017-- 24


Resource Guide

The chart below will help you figure out which website to access or who to call when you want to take advantage of your benefits.

Action I want to take I can access or contact… Is there a deadline?

As a new employee or newly eligible employee, I want to enroll in: Medical Dental Vision Voluntary Life and AD&D Healthcare FSA Dependent Daycare FSA

The Benefits worklet in Workday

Yes, 30 calendar days from your hire or eligibility date

Change my benefit elections due to a qualifying life event such as: Having a baby Getting married or divorced Losing other coverage

The Benefits worklet in Workday

Yes, 30 calendar days from the qualifying event date

I have coverage under an HMO and I want to change my Primary Care Physician

If you’re enrolled in the BlueAdvantage HMO, call BCBS at 800.892.2803 If you’re enrolled in the Kaiser HMO, call them at 800.464.4000

Check with carrier for deadlines

I want to enroll or change my order in the: Transit Spending Account Parking Spending Account

First-time enrollees: e-mail [email protected] to request enrollment Returning enrollees: use your existing Spending Accounts User ID and Password at www.MySpendingAccount.ADP.com

Yes, by the 10th calendar day of any month to affect your order(s) for the following month

I want to file claims for the: Healthcare FSA Dependent Daycare FSA Commuter Spending Accounts

ADP Spending Account’s website at www.MySpendingAccount.ADP.com First time visitors, click “New Users - Register Here”

March 15th of the year following the calendar year in which expenses were incurred

I want to enroll in the TCS 403(b) Plan I want to change my contributions to the TCS 403(b) Plan I want to change my investment elections

Transamerica at https://tcs403b.trsretire.com

No (New employees may enroll as soon as the week after they receive their first paycheck)

REMEMBER: BENEFIT CHANGES DUE TO A QUALIFYING LIFE EVENT

MUST BE MADE WITHIN 30 CALENDAR DAYS OF THE EVENT.

mailto:[email protected]

http://www.myspendingaccount.adp.com/


https://tcs403b.trsretire.com/

--Plan Year 2017-- 25


Contact Information

If you have specific questions about a TCS Education System benefit plan, please contact the carrier or your Human Resources Representative, according to the table below:

Benefit Contact Phone Website

BCBS PPO Options Blue Cross Blue Shield of Illinois 800.828.3116 www.bcbsil.com

BlueAdvantage HMO Blue Cross Blue Shield of Illinois 800.892.2803 www.bcbsil.com

Kaiser HMO Kaiser Permanente 800.464.4000 www.kp.org

GroupHealth HMO GroupHealth 888.901.4636 member.ghc.org

To register: ghc.org/register

Dental MetLife 800.942.0854 www.MetLife.com

Vision VSP 800.877.7195 www.vsp.com

FSAs – Healthcare, Dependent Daycare, and Commuter

ADP Spending Accounts 800.654.6695 www.MySpendingAccount.ADP.com

Life and AD&D Your Human Resources Representative

Short- and Long-Term Disability Your Human Resources Representative

Employee Assistance Program ComPsych GuidanceResources 800.272.7255 www.guidanceresources.com

Web ID: COM589

TCS 403(b) Plan Transamerica 800.755.5801 https://tcs403b.trsretire.com

Discount program Working Advantage https://workingadvantage.com

Member ID: 827198009



http://www.kp.org/

http://www.metlife.com/

http://www.vsp.com/


http://www.guidanceresources.com/

https://tcs403b.trsretire.com/

https://workingadvantage.com/

2017 benefit overview - tcs education system

Documents