2017 enrollment benefits roadmap · benefits eligibility ... financial dependency, ... the...

2017 ENROLLMENT

BENEFITS ROADMAP

http://www.edsisolutions.com/

This booklet is intended for illustrative and informational purposes only. The plan documents, insurance certificates and policies will serve as the governing documents. In the case of conflict between the information in this booklet and the official plan documents, the plan documents will always govern.

2

TABLE OF CONTENTS

Contact Information ................................................................................................. 3

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

Dependent Eligibility ................................................................................................ 5

Health Care Benefits Overview ............................................................................... 6

Health Savings Account (HSA) Overview ............................................................... 7

Teledoc Overview .................................................................................................... 8

Hylant Script Navigator Online Tool Overview ........................................................ 9

Choosing the Right Plan for You ........................................................................... 10

Dental Benefits Overview ...................................................................................... 11

Vision Benefits Overview ...................................................................................... 12

Employee Contributions (Payroll Deductions) ...................................................... 13

Life and AD&D Insurance Overview...................................................................... 14

Disability Overview ................................................................................................ 15

Flexible Spending Accounts (FSA) Overview ....................................................... 16

Healthcare FSA Overview ..................................................................................... 17

Dependent Care FSA Overview ............................................................................ 18

Employee Assistance Program ............................................................................. 19

This booklet is intended for illustrative and informational purposes only. The plan documents, insurance certificates and policies will serve as the governing

documents. In the case of conflict between the information in this booklet and the official plan documents, the plan documents will always govern. 3

CONTACT INFORMATION

CONTACT INFORMATION

General Claims and Benefit Information

Health Care CoreSource (800) 521-1555 www.coresource.com www.mycigna.com

Prescription Drug EHIM (800) 311-3446 www.ehimrx.com

Health Savings

Account

BenefitWallet HSA (through Bank of New

York Mellon) (877) 472-4200 www.mybenefitwallet.com

Telemedicine TelaDoc (800) 362-2667 www.teladoc.com

Dental Delta Dental of Michigan (800) 524-0149 www.deltadentalmi.com www.consumertoolkit.com

Vision EyeMed (866) 939-3633 www.eyemedvisioncare.com

Life/AD&D Lincoln Financial Group (800) 423-2764 www.LincolnFinancial.com

Reference ID: EDUDATASYS

Disability Lincoln Financial Group (800) 423-2764 www.LincolnFinancial.com

Reference ID: EDUDATASYS

Flexible Spending

Account Infinisource (866) 370-3040 www.infinisource.com

Employee Assistance

Program

EmployeeConnectSM (through Lincoln

Financial Group)

(888) 628-4824 www.Lincoln4Benefits.com or

www.Guidanceresources.com

Login:

Password: LFGsupport LFGSupport1

Travel Assistance

Program

TravelConnectSM (through Lincoln

Financial Group)

(800) 527-0218 www.Lincoln4Benefits.com

Global ID#: 322541

General information

and Life status

changes

Human Resources

Katie Theisen (313) 271-2660 [email protected]

When contacting any of the companies above, it is important to have the insurance card or ID number(s) of the subscriber for the

coverage you are calling about as well as any appropriate paperwork, such as an explanation of benefits, a denial letter, receipts, etc.

http://www.coresource.com/

http://www.mycigna.com/

http://www.ehimrx.com/

https://www.mybenefitwallet.com/

http://www.teladoc.com/

http://www.deltadentalmi.com/

http://portal.eyemedvisioncare.com/

http://www.lincolnfinancial.com/

http://www.lincolnfinancial.com/

http://www.infinisource.com/

http://www.lincoln4benefits.com/

http://www.guidanceresources.com/

http://www.lincoln4benefits.com/

mailto:[email protected]


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2017 BENEFITS ELIGIBILITY OVERVIEW

Health and welfare plans

are available to all

employees who work 30

or more hours per week.

Educational Data Systems, Inc. is pleased to offer its

employees an excellent benefits program. These health

and welfare benefits are designed to protect you and

your family while you are an active employee.

Eligibility Health and welfare plans are available to all employees

who work 30 or more hours per week.

Open Enrollment This is the only opportunity you will have to make

changes to your benefit elections. During the Open

Enrollment period you may add, drop or modify

coverage.

Annual Elections It is important that you make your choices carefully,

since changes to those elections can generally only be

made during the annual open enrollment period.

Exceptions will be made for changes in family status

during the year, allowing you to make a midyear benefit

change. A family status change includes one or more of

the following:

Marriage

Divorce

Birth or adoption

Death of a dependent

Change in your spouse’s employment

Loss of coverage by a spouse

If you have a family status change, you must change

your benefit elections within 30 days of the qualifying

event. Otherwise, you will need to wait until the next

annual open enrollment period.

New Hire Coverage As a new hire, your plan eligibility date is the first of the

month following 30 days of employment with Educational

Data Systems, Inc. for Medical, Dental, Vision, Voluntary

Life/AD&D and FSA benefits and 1st of the month

following 60 days of employment for Basic Life/AD&D,

and Disability benefits.

New employees have up to 30 days after their hire date

to enroll. If you do not enroll by that deadline, you will not

be eligible for coverage until the following annual open

enrollment period unless you experience a qualifying

event.

COBRA Continuation Coverage When you or any of your dependents no longer

meet the eligibility requirements for health and

welfare plans, you may be eligible for continued

coverage as required by the Consolidated Omnibus

Budget Reconciliation Act (COBRA)

of 1985.



DEPENDENT ELIGIBILITY

If you wish, your dependents may also be covered under the medical, dental, vision and voluntary life

plans.

Eligible dependents include:

Legal spouse, as defined by federal law. Employees can only cover a spouse if they do not have other

coverage available (i.e. through their employer); and

Children under age 26; and

MEDICAL – Your children up to age 26 regardless of marital status, financial dependency,

residency with the eligible employee, student status, employment status, or eligibility for

other coverage. Coverage will terminate at the end of the year in which the child turns age

26.

DENTAL – Your children up to age 26 regardless of marital status, financial dependency,



26.

VISION – Your children up to age 26 regardless of marital status, financial dependency,



26.

VOLUNTARY LIFE – Your children up to age 26 regardless of marital status, financial

dependency, residency with the eligible employee, student status, employment status, or

eligibility for other coverage. Coverage will terminate at the end of the year in which the

child turns age 26.

YOUR UNMARRIED CHILDREN THROUGH AGE 20, OR THROUGH AGE 24 IF THEY

ARE FULL-TIME REGISTERED STUDENT THE CHILD TURNS AGE 26. It is your responsibility to provide the Human Resources Department with proof of your dependents’

eligibility, if requested. If you do not provide the required documentation your dependents will not be

covered. A list of acceptable documentation is illustrated below:

Relationship Acceptable Documentation

Spouse Copy of most recent Federal Income Tax Return, Copy of Marriage

Certificate

Child (Biological,

Adopted and Stepchild

under 26)

Copy of most recent Federal Income Tax Return, Copy of Birth/Adoption and

Marriage Certificate (if applicable)


6

HEALTH CARE BENEFITS OVERVIEW

HEALTH CARE BENEFITS ARE AMONG THE MOST IMPORTANT AND NECESSARY PARTS OF YOUR

BENEFIT PACKAGE. The following is a summary of your medical benefits offered through CoreSource using the Cigna network. For a more

detailed explanation of benefits, please refer to your certificate of coverage. You may access a list of participating

providers through the carrier’s website (see page 3 of this guide for contact information).

Traditional PPO 500 Traditional PPO 1750 HSA PPO 1500

In

Network

Out of

Network

In

Network

Out of

Network

In

Network

Out of

Network

What you pay What you pay What you pay

DEDUCTIBLES Calendar Year Calendar Year Calendar Year

Individual $500 $1,000 $1,750 $3,500 $1,500 $3,000

Family $1,000 $2,000 $3,500 $7,000 $3,000 $6,000

COINSURANCE

Plan Pays 80% 60% 100% 80% 80% 60%

You Pay 20% 40% 0% 20% 20% 40%

Individual Maximum $500 $4,000 $0 $5,000 N/A N/A

Family Maximum $1,000 $8,000 $0 $10,000 N/A N/A

SERVICES

Preventive Care Services Covered 100% Not covered Covered 100% Not covered Covered 100% Not covered

Primary Care Office Visits $20 copay 40% after ded $30 copay 20% after ded 20% after ded 40% after ded

Specialist Office Visits $20 copay 40% after ded $30 copay 20% after ded 20% after ded 40% after ded

Urgent Care $30 copay 40% after ded $50 copay 20% after ded 20% after ded 40% after ded

Emergency Room $150 copay $150 copay 20% after ded

Labs and X-rays 20% after ded 40% after ded 0% after ded 20% after ded 20% after ded 40% after ded

Hospital Care 20% after ded 40% after ded 0% after ded 20% after ded 20% after ded 40% after ded

Mental Health Treatment 20% after ded 40% after ded 0% after ded 20% after ded 20% after ded 40% after ded

Chiropractic Care $20 copay 40% after ded $30 copay 20% after ded 20% after ded 40% after ded

24 visits per calendar year 24 visits per calendar year 24 visits per calendar year

Telemedicine

TelaDoc Visit $0 $0 $45 copay

PRESCRIPTIONS EHIM Prescription Drug Program

Generic $10 $10 $10 after ded

Preferred $50 $50 $50 after ded

Non-preferred $100 $100 $100 after ded

90 Day Retail or Mail Order 2 times applicable copay 2 times applicable copay 2 times applicable copay after ded

ANNUAL MEDICAL OUT OF POCKET MAXIMUMS (Deductibles, Copays & Coinsurance)

Individual

Medical

Rx

TOTAL

$4,100

$2,500

$6,600

N/A

$4,100

$2,500

$6,600

N/A

Combined

$3,000

N/A

Family

Medical

Rx

TOTAL

$8,200

$5,000

$13,200

N/A

$8,200

$5,000

$13,200

N/A

Combined

$6,000

N/A

LIFETIME MAXIMUM Unlimited Unlimited Unlimited



HEALTH SAVINGS ACCOUNT (HSA) OVERVIEW

HSAs are tax savings tools. Here are some things you should know:

You must be covered by a high-deductible health

plan to be eligible.

HSAs are portable, meaning you can keep your HSA

even if you change jobs, change medical coverage or

make other life changes. As the owner of the HSA,

you are responsible for annually reporting HSA

contributions and distributions to the IRS as an

attachment to their IRS Form 1040.

An HSA is a tax-exempt savings account established

for the purpose of paying for the individual and/or his

or her spouse and tax dependents. HSAs are

designed to provide eligible individuals with triple

federal tax-free benefits: 1) HSA contributions are

tax-free. 2) Interest and other earnings on HSA

contributions accumulate tax-free. 3) Amounts

distributed from an HSA for qualified medical

expenses are tax-free as well.

You can contribute up to $3,400 / $6,750 (single /

family) for 2017 by payroll deduction or by writing a

check. Your contributions are tax deductible.

You can even make a one-time transfer from your IRA.

Contributions can be made until April 15 of the following

year. Those 55 or over can contribute $1,000 more.

You do not need to submit expenses for

reimbursement; it is up to you to use the money

appropriately. We are all subject to an IRS audit; the

penalty for using ineligible HSA money in 2017 is

20 percent.

You can always find the most up-to-date list of

qualifying expenses online, in Publication 502 on the

IRS website (www.irs.gov). Below are a sampling of

qualifying expenses:

Long-term care (medical expenses &

insurance)

Nursing services

Medical doctors

Physical therapy

Christian Science practitioners

Psychoanalysis

Emergency care

Chiropractic care

Use for treatments not covered by insurance:

Dental care including dentures

Medical equipment

Vision care

Alcoholism or drug addiction treatment

Fertility treatment

Over-the-counter medications (with prescription)

Hearing aids

Trips/travel exclusively for a treatment

What Expenses Do NOT Qualify? The following expenses are just a sampling of

expenses you can’t pay for with your HSA.

(Remember, most over-the-counter medications are

no longer eligible without a prescription.)

Cosmetic surgery

Teeth whitening

Household help or babysitting

Health club dues

Food supplements not prescribed by a

doctor

Hair transplants

Over-the-counter vitamins or diet drinks

Dependent Coverage and Your HSA The company plan allows for employees to elect

coverage for their dependents to age 26; however,

the money in the employee’s HSA account may only

be used for eligible expenses incurred by covered

dependents that meet the IRS definition of a tax

dependent. If you list a dependent on your federal

income tax return, then you can use the money in

your HSA account for the eligible expenses. When an

adult dependent child does not qualify as a tax

dependent, then any HSA distributions for the child

would be taxable and subject to IRS penalty.


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TELADOC OVERVIEW

Your access to Teladoc® allows you to talk to a doctor anytime, no matter where you happen to be. Teladoc gives you 24/7/365 access to a doctor who can resolve many medical conditions through phone or video consults.

GET THE CARE YOU NEED Teladoc doctors can treat many medical conditions, including: • Cold & flu symptoms • Allergies • Bronchitis • Urinary tract infection • Respiratory infection • Sinus problems • And more! MEET OUR DOCTORS

Teladoc is simply a new way to access qualified doctors. All Teladoc doctors: • Are practicing PCPs, pediatricians, and family medicine physicians • Average 15 years experience • Are U.S. board-certified and licensed in your state • Are credentialed every three years, meeting NCQA standards WHEN CAN I USE TELADOC?

Teladoc does not replace your primary care physician. It is a convenient and affordable option for quality care. • When you need care now • If you’re considering the ER or urgent care center for a nonemergency issue • On vacation, on a business trip, or away from home • For short-term prescription Refill

With your consent, Teladoc is happy to provide information about your Teladoc consult to your primary care physician.

Talk to a doctor anytime for Free

Teladoc's U.S. board-certified doctors are available 24/7/365 to resolve many of your medical issues through phone or video consults. Set up your account today so when you need care now, a Teladoc doctor is just a call or click away. SET UP YOUR ACCOUNT It's quick and easy online. Visit the Teladoc website at MyDrConsult.com, click "Set up account" and provide the required information. You can also call Teladoc for assistance over the phone.

REQUEST A CONSULT Once your account is set up, request a consult anytime you need care.

PROVIDE MEDICAL HISTORY Your medical history provides Teladoc doctors with the

information they need to make an accurate diagnosis. Online: Log into MyDrConsult.com and click "My Medical History". Mobile app: Log into your account and complete the "My Health Record" section. Visit Teladoc.com/mobile to download the app. Call Teladoc: Teladoc can help you complete your medical history over the phone


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Hylant Script Navigator Online Tool Overview

The Hylant Script Navigator

(www.hylantscriptnavigator.com) is the ultimate

pharmacy search engine that will help you identify

discounted generic drug programs that are available

at pharmacies throughout the USA. Just log on and

enter the following:

1

Name of the drug

2

Dosage

3

Zip code

Pharmacies nationwide sell select generic

drugs at a discounted rate. You can find the

best deals on your medications by identifying

the pharmacies that offer these programs.

Generic drugs are distributed as the equivalent

to the brand name however you should talk to

your doctor if you have specific questions

about your prescription. Below are just a few of

the current discounts available:

Meijer: a variety of oral antibiotics for

FREE

Kroger: get a 30-day supply for ONLY

$4 and a 90-day supply for $10

Wal-Mart: $4 for a 30-day supply and

$10 for a 90-day supply of some

generic medications

Walgreens: Over 300 generics for

$12.99 for a 90-day supply

To find out more, call your local pharmacy or

visit its website.

Many pharmacies

now offer discount

prescriptions—often

even lower than your

copay.

http://www.hylantscriptnavigator.com)/


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CHOOSING THE RIGHT PLAN FOR YOU

Choosing between plans can be confusing. Review the basics of each plan and consider your total

cost – including payroll deductions, predicted copays, and other expenses toward deductibles:

Traditional PPO

500

Traditional PPO

1750

HSA PPO

1500

A) Annual payroll deductions

B) Gross contribution to HSA/FSA

C) Tax savings (25% x B)

D) Net contribution to HSA (B-C)

E) # of office visits at $ (or copays)

F) # of prescriptions at $ (or copays)

G) X-ray and lab, hospital, other

H) Dental, vision, other

I) Out-of-pocket expenses (D+E+F+G+H)

J) Total cost (I-B)+A

Things to Consider Before You Pick a Plan:

1. What does the plan cover?

2. How much does the plan cost?

3. Which doctors and hospitals are in-

network?



DENTAL BENEFITS OVERVIEW

Dental Coverage – Provided through Delta Dental of Michigan The dental coverage is provided by Delta Dental. With Delta Dental you have access to an extensive network of dentist’s.

With the flexibility of a PPO you have the option of visiting any provider, however, by choosing a network provider you’ll

receive the highest level of benefit and save on out of pocket costs. For a more detailed explanation of benefits, please

refer to your certificate of coverage. You may access a list of participating providers through the carrier’s website (see

page 3 of this guide for contact information).

Delta Dental Low Plan High Plan

You Pay You Pay

PPO Dentist Premier®

Dentist*

Non-Network

Dentist* PPO Dentist

Premier®

Dentist*

Non-Network

Dentist*

Diagnostic & Preventive Services: Covered 100% 10% after

deductible

10% after

deductible Covered 100% Covered 100% Covered 100%

Basic Services: 40% after

deductible

50% after

deductible

50% after

deductible

20% after

deductible

20% after

deductible

20% after

deductible

Major Services: 50% after

deductible

75% after

deductible

75% after

deductible

50% after

deductible

50% after

deductible

50% after

deductible

* When services are received from a Premier or Nonparticipating Dentist, the percentages in these columns indicate the portion of Delta Dental's PPO dentist Schedule (or the Nonparticipating Dentist Fee) that will be paid for those services. This amount may be less than what the dentist charges or Delta Dental approves and you are responsible for that difference.

ANNUAL DEDUCTIBLE Calendar Year Deductible Calendar Year Deductible

Individual / Family

$50 / $150*

($100 / $300 when visiting premier

or non-participating dentists)

$50 / $150*

*Diagnostic & Preventive Services Waived

ANNUAL MAXIMUM BENEFIT

Per Covered Person

$1,000

($750 when visiting premier

or non-participating dentists)

$1,000


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VISION BENEFITS OVERVIEW

Voluntary Vision Coverage – Provided through EyeMed EyeMed’s vision care network consists of private practicing optometrists, ophthalmologists, opticians and optical retailers.

You have the option of visiting any provider. However, by choosing a network provider, you’ll receive the highest level of

benefit and save on out-of-pocket costs. You may access a list of participating providers through the carrier’s website (see

page 3 of this guide for contact information).

EyeMed Insight Network

In Network Out of Network *

Vision Care Services Member’s Cost Reimbursement

Examination

Eye Exams $10 copay Up to $35

Standard Contact Lens Up to $55 N/A

Premium Contact Lens 10% off Retail Price N/A

Standard Plastic Lenses

Single Vision $25 copay Up to $25

Bifocal $25 copay Up to $40

Trifocal $25 copay Up to $60

Standard Progressive Lens $90 copay Up to $40

Lens Options

UV Treatment $15 N/A

Tint (Solid and Gradient) $15 N/A

Standard Plastic Scratch Coating $15 N/A

Standard Polycarbonate $40 N/A

Standard Anti-Reflective Coating $45 N/A

Other add-ins 20% off Retail Price N/A

Frames $0 copay; $120 allowance

20% off balance over $120 Up to $48

Contact

Lenses

Conventional $0 copay; $135 allowance

15% off balance over $135 Up to $95

Disposable $0 copay; $135 allowance

plus balance over $135 Up to $95

Medically Necessary $0 copay Up to $200

Laser Vision Correction 15% off Retail Price, or

5% off promotional price N/A

Additional Pairs Benefits

Members also receive 40% discount off complete

pair of eyeglass purchase and a 20% discount off

non-prescription sunglasses along with 20% off the

remaining balance beyond plan coverage

N/A

Hearing Care 40% off hearing exams and low price guarantee on

discounted hearing aids N/A

Frequency

Examination Once every 12 months

Lenses or Contact Lenses Once every 12 months

Frame Once every 12 months

* Member Reimbursement Out of Network will be the lesser of the listed amount or the member’s actual cost from the out of network provider. In

certain states members may be required to pay the full retail rate and not the negotiated discounted rate with certain participating providers. Please

see EyeMed’s online provider locator to determine which participating providers have agreed to the discounted rate.



EMPLOYEE CONTRIBUTIONS (PAYROLL DEDUCTIONS)

Payroll Deductions

Employee

Only

Employee +

Spouse

Employee +

Family

HEALTH CARE Monthly Bi-weekly Monthly Bi-weekly Monthly Bi-weekly

Traditional PPO 500 $262.06 $120.95 $929.00 $428.77 $1,225.10 $565.43

Traditional PPO 1750 $66.00 $30.46 $487.00 $224.77 $670.00 $309.23

HSA PPO 1500 $33.00 $15.23 $243.50 $112.38 $335.00 $154.62

DENTAL

Delta Dental – Low Plan $13.50 $6.23 $26.66 $12.30 $51.39 $23.72

Delta Dental – High Plan $29.34 $13.54 $56.95 $26.28 $95.10 $43.89

VISION

EyeMed $6.23 $2.88 $11.77 $5.43 $17.28 $7.98

HSA Employer Contribution

If you enroll in the HSA PPO 1500 plan EDSI will make an annual contribution to your HSA in the amount of $300 for

single enrolled and $600 for double and family enrolled. You will also be able to make pre-tax contributions into your

HSA.

Section 125 Cafeteria Plan The Section 125 Cafeteria Plan allows you to contribute “before-tax” dollars to pay for your coverage under a portion

of the company’s benefit plans (e.g., medical, dental and vision coverage). By paying your premiums with “before-

tax” dollars, you generally may reduce the amount of income and Social Security taxes that you otherwise would be

required to pay. The elections you make during the Cafeteria Plan enrollment period are effective for the entire 12-

month plan year. You generally cannot change your elections during the year unless you experience a change-in-

status event (refer to your benefits booklet for the definition of a “change in status”). The circumstances that permit a

change of election vary from one benefit to another. If you believe you have experienced a change-in-status event

and you wish to change your elections, notify HR within 30 days of the change.


14

LIFE AND AD&D INSURANCE OVERVIEW

Life and Accidental Death & Dismemberment (AD&D) Insurance Provided through Lincoln Financial Group at no cost to the employee. Life insurance provides a monetary benefit to your

beneficiary in the event of your death while you are employed at Educational Data Systems, Inc. AD&D insurance is equal

to your life insurance benefit amount and is payable to your beneficiary in the event of your death as a result of an

accident and may also pay benefits in certain injury instances. It is important to keep your beneficiary information up to

date.

Life and AD&D Coverage

Life Insurance $10,000

Accidental Death and Dismemberment $10,000

Benefit Reduction Schedule (of the original amount) 35% at age 70 and an additional 20% at age 75

Voluntary Life Insurance Employees have the opportunity to elect Voluntary Life/AD&D Insurance. This will provide an additional life insurance

benefit for you, your spouse and/or your dependent child(ren). Contributions for these premiums are 100% employee

paid. If you waive voluntary life coverage when you are initially eligible you will be required to provide Evidence of

Insurability (EOI) when enrolling at a later date. EOI is the documentation of good health in order to be approved for

coverage. The carrier will review and determine approval based on EOI documentation. Benefits may be limited and/or

denied based on EOI results. Claims incurred prior to the approval of your coverage will not be covered. It is important to

keep your beneficiary information up to date.

Voluntary Life/AD&D Coverage

Employee Life/AD&D Insurance Increments of $10,000, up to 5 times your annual salary (rounded to the next higher

$10,000) to a maximum of $150,000

Guarantee Issue Amounts Newly Eligible Employees: $150,000

Spouse Life/AD&D Insurance*

Increments of $5,000, up to 2 1/2 times the employee’s annual salary (rounded to the

next higher $10,000) to a maximum of $75,000, not to exceed 50% of the employee

benefit amount

Guarantee Issue Amounts Newly Eligible Spouses: $50,000

Dependent Child(ren) Life Insurance*

Birth to age 14 days old: No benefit

14 days old to 6 months: $250

6 months to 26 years old: $1,000, $5,000 or $10,000

Guarantee Issue Amounts All amounts guaranteed

Benefit Reduction Schedule (of the original amount) 35% at age 70 and an additional 20% at age 75

* The employee must elect coverage in order for dependents (Spouse and/or Child(ren) to be covered. Spouse rates are based on employee’s age. Dependent Child(ren) rates cover all eligible

children

Please Note: For 2017 there will be a “True Open Enrollment” – if you have previously waived voluntary life insurance you have a one-time opportunity to enroll in the plan up to the guarantee issue

maximum with no evidence of insurability (EOI). After that, you will be eligible to elect or increase your coverage equal to 2 benefit levels on a Guaranteed Issue amount during the Open Enrollment

period without EOI. Any amount over the GI will need a completed EOI approved by the carrier.



DISABILITY OVERVIEW

Short Term Disability Insurance Provided through Lincoln Financial Group at no cost to the employee. Short Term Disability Insurance provides income

protection in the event you become disabled and are unable to work due to sickness or non-occupational injury, including

pregnancy, for a short period of time.

Short Term Disability Coverage

Benefit Amount 60% of weekly earnings

Benefit Maximum $350 per week

Elimination Period 8th calendar days for accident / illness

Maximum Benefit Period Up to 13 weeks

Long Term Disability Insurance Provided through Lincoln Financial Group at no cost to the employee. Long Term Disability Insurance provides income

protection in the event you become disabled and are unable to work for an extended period of time.

Long Term Disability Coverage

Benefit Amount 60% of monthly earnings

Benefit Maximum $6,000 per month

Elimination Period 90 days

Maximum Benefit Period Social Security Normal Retirement Age


16

FLEXIBLE SPENDING ACCOUNTS (FSA) OVERVIEW

All eligible employees may participate in a Flexible Spending

Account (FSA) program administered through Infinisource.

What Is a Flexible Spending Account? A Flexible Spending Account, also known as a Section 125

Cafeteria Plan, allows you to set aside money from your

paycheck before income taxes to be used to pay for various

out-of-pocket medical expenses and dependent care

expenses.

What Are the Types of FSAs? 1. Healthcare FSA. You can use this account to pay for

healthcare expenses that you or your dependents

incur even if they are not enrolled in the company

sponsored medical plan.

Healthcare FSA – for those enrolled in the Traditional

PPO plans

Limited Purpose – for those enrolled in the HSA PPO

plan (for post medical deductible, dental and vision

ONLY)

2. Dependent Care FSA. This account is for DAYCARE

expenses ONLY and cannot be used for medical

expenses.

3. Transit and Parking FSA. You can use this account

to set aside money to pay for the expense of getting to

and from work such as parking costs and public

transportation.

How does an FSA Work? First, estimate the amount of out-of-pocket expenses you

expect to incur in the upcoming year (known as your election

amount). This is divided by the frequency of pay periods.

This amount is then deducted from your paycheck each pay

period on a pretax basis. When you incur expenses during

the plan year, you can swipe your FSA debit card at point of

sale or you can submit a receipt for reimbursement.

How Much Can I Contribute to the

FSA Plan? Healthcare Flexible Spending

Annual maximum contribution: $2,600

Dependent Care Flexible Spending

Annual maximum contribution:

$5,000 married couple filing jointly

($2,500 per person if filing separate returns)

Transit and Parking Flexible Spending

Annual maximum contribution: $3,060 each

The Use It or Lose It Rule Section 125 plans are governed by the “use it or

lose it” rule, whereby any amounts remaining at the

end of the year are forfeited due to the IRS

regulations. All claims must be submitted no later

than 90 days after the end of the plan year.

Things to Consider Before You Contribute

to an FSA

Be sure to fund the account wisely as the

funds are use it or lose it

You cannot take income tax deductions for

expenses you pay with your Healthcare

Dependent Care FSA

You cannot stop or change contributions to

your FSA during the year unless you have

a change in status consistent with your

change in contributions

You may have a Health Savings Account

and a Limited Purpose Healthcare FSA



HEALTHCARE FSA OVERVIEW

Healthcare FSA Claims Reimbursement Through Infinisource, you have a variety of

reimbursement options: debit card, online

submission, fax or email.

Debit Card You will receive a debit card, which is the most

convenient way to receive reimbursement. Simply

swipe your debit card at your provider’s office,

pharmacy, hospital, etc., at time of service and your

claim will be paid instantly. It is important when you

are utilizing the debit card to still ask for and keep an

itemized receipt on file. You may still receive a letter

from www.infinisource.com requesting this receipt

for IRS documentation purposes. Even if you use

the debit card, YOU are ultimately responsible to the

IRS for documentation (i.e., a receipt). YOU are

required to keep it and submit it so the plan is

compliant with government regulations.

Please be advised that if you do not respond to

Infinisource’s request for an itemized receipt,

your card and your account will be suspended.

Online You can submit your claims online at

www.infinisource.com. To log in to your account, go

to www.infinisource.com. Once you are registered

and logged in, you can view your account balance(s)

and see the status of any claims you have

submitted.

Fax or Email You are also able to submit your claim via fax at (800)

379-5670 or by email at [email protected].

Sample Medical Eligible Expenses The following is a partial list of expenses that are

reimbursable tax-free with a Medical Expense FSA. For

a complete list, visit the IRS’s website at www.irs.gov

and search for Section 213 expenses.

Ambulance service

Chiropractic care

Contact lenses (corrective)*

Diagnostic tests

Doctor’s fees*

Drugs (prescription only**)

Eyeglasses

Injections and vaccinations

X-rays

*To be eligible for reimbursement, some treatments, prescription drugs or

services deemed cosmetic in nature require written proof of medical necessity

from your health care provider

**Not all drugs requiring a prescription are approved by the IRS as eligible for

reimbursement.

There are at least

two significant

ways to benefit

from an FSA.

1

2

Take advantage of the tax savings. By reducing your gross income,

you pay less in taxes, take home more pay, and have the freedom to

choose how your money is used.

The second benefit is the “cash flow” increase built into the

healthcare FSA (not the dependent day care FSA). This means that

no matter how much money you have actually contributed to the plan

at any given point, you can still be reimbursed up to your entire

annual election. So a major medical expense at the beginning of the

claim period can be reimbursed even though few, if any, deposits

have been made into the account at that time.




http://www.irs.gov/


18

DEPENDENT CARE FSA OVERVIEW

Below is a list of expenses that qualify for reimbursement from the

Dependent Care Account. Generally, eligible expenses include the

cost of childcare for dependents under age 13 or care for a disabled

spouse or dependent that allows you – or you and your spouse – to

work. You’ll also find examples of expenses that do not qualify for

reimbursement because they are not considered legitimate

deductions for federal income tax purposes. To see a full list of IRS-

qualified dependent care expenses, go to www.irs.gov and search for

“publication 503.”

Eligible Expenses Fees paid to a child care center or day care camp that complies

with all applicable state and local regulations if providing care for

more than six children

Full amount paid to a nursery school, even though the cost may

include lunch and education services

Fees paid to a babysitter in or outside your home

Fees paid to a relative who provides dependent care services, other than

your spouse, your child under age 19, or a dependent you claim for federal

income tax purposes

Fees paid to a housekeeper or cook who also is responsible for providing care for an eligible

dependent

Fees paid to a nurse or home health care agency for care for your spouse or legal dependent who is

physically or mentally incapable of self-care

Legally mandated amounts paid on behalf of the provider – Social Security (FICA), federal (FUTA) and

state (SUTA) unemployment taxes

Ineligible Expenses Food, clothing and education

Transportation to and from the place where dependent care services are provided

Fees paid for a child care center that provides care for more than six children but does not comply with all

applicable laws

Expenses for which a federal child care tax credit is taken or which are claimed under the

health care account

Search fees for a dependent care provider

http://www.irs.gov/



EMPLOYEE ASSISTANCE PROGRAM

The

Some problems just can’t be solved alone. We all need help sometimes. Relationships are tested,

children act out, parents become ill, plans fail, and emotions

take on a life of their own. Recognizing that we may need

help in these situations is the first and most important step

to solving our problems. All too often, we don’t know where

to turn for assistance.

Educational Data Systems, Inc. recognizes that any

problem affecting your wellbeing and happiness also affects

your job performance and satisfaction and has made available

to you and EAP through EmployeeConnectSM to help.

EmployeeConnectSM provides confidential assistance to you and your eligible family members when personal

problems are affecting quality of life and/or job performance.

Our goal is to help you and your family lead fuller and more productive lives.

Your counselor will help you:

Identify problems and better understand the issues that caused you to seek assistance.

Develop options and explore ways of addressing the problem(s)

Decide on a course of action

The services you receive are completely confidential. No information, written or verbal, will be given to your employer or anyone else without your written consent.

Benefits You Receive: Unlimited telephonic counseling and up to 4 face to face visits per issue.

You and your family can get help with a wide variety of issues, including:

Personal and Work Stress

Depression

Family Relationships

Alcohol/Drug Problems

Elder Care and Aging Concerns

Grief and Loss Issues

Financial Counseling Referrals

Legal Referrals

Stress and Anxiety

Anger Management

Domestic Violence

Employee Assistance

Program is a free benefit

for you, your spouse,

and any eligible

dependents, and it is

totally confidential,

beginning with your first

phone call.

2017 ENROLLMENT

BENEFITS ROADMAP

This booklet is intended for illustrative and informational purposes only. The plan documents, insurance certificates and

policies will serve as the governing documents. In the case of conflict between the information in this booklet and the

official plan documents, the plan documents will always govern. Educational Data Systems, Inc. reserves the right to

change or terminate at any time, in whole or in part, the employee benefit package, with respect to all or any class of

employees, former employees and retireees, if appicable.

http://www.edsisolutions.com/

2017 enrollment benefits roadmap · benefits eligibility ... financial dependency, ... the...

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