Let’s Talk BenefitsSummer Enrollment
Presented by your Benefits Team:Vickie Del Bello, Director of Benefits
Dorothy Webster, Benefits CoordinatorBrittany Waters, Benefits Coordinator
Sara Aranda, Benefits Coordinator
ERS
BENEFI
TS
PHASE 3SJC SUMMER ENROLLMENT
JULY 10 – July 24, 2015
SJC Perks
If you here this sound, it means you get an
extra benefit
DEPENDENTS
• Can be covered until the age of 26 on health insurance – regardless of marital or educational status
• If child is married, dental insurance, AD&D and dependent life insurance is not available.
DEPENDENT CHILDREN
- Employee required to submit documents to ensure dependents are eligible for coverage.
- Example of Required Documents: Birth Certificates, Marriage License, Tax Returns
- Will be contacted by Aon Hewitt for documentation submission.
OngoingDEPENDENT AUDIT
HealthSelect of Texas Plan• The state pays full premium for full-time
employee health coverage• San Jacinto College pays a portion of the premium
not covered by the state for dependents.• Monthly Premiums (effective 09/01/2015)
Employee only $ 0.00+ Spouse $165.12 (+$11.18)
+ Children $110.56 (+$7.50)
+ Family $275.68 (+$18.68)
• United HealthCare – Plan Administrator• Point-of-Service (POS) plan with direct access for
eye exams and OB/GYN.• A PCP is must be selected to receive In-Network
benefits.• Referral is required for specialist visits.
• PCP Office Visit: $25 copay• Specialist Office Visit: $40 copay
HealthSelect of Texas Plan
• Annual out-of-pocket maximums (increase from FY14)• $6,450 individual, $12,900 for family• Includes copays, coinsurance and pharmacy deductibles
• Urgent care facility benefits• $50 copay + 20% coinsurance (In-Network)
• $5,000 Basic Group Life Insurance for employee• United HealthCare Vision Rider program
• Specialist copay, includes discounts at certain providers for frames, lenses or contacts.
• UnitedHealth Allies Program• Smoking cessation, weight loss & disease management programs,• Fitness club, cosmetic dentistry, fitness apparel & other discounts.
HealthSelect of Texas Plan
CAREMARK
Tier 1Generic
Tier 2Preferred
Tier 3Brand
Specific
Deductible Each participant must pay a $50 annual deductible
Non-maintenance drug bought at a participating retail pharmacy
$10up to a 30-day
supply
$35up to a 30-day
supply
$60up to a 30-day
supply
Maintenance drug bought at a participating retail pharmacy
$20up to a 30-day
supply
$45up to a 30-day
supply
$75up to a 30-day
supply
Maintenance drug bought through a mail order pharmacy
$30up to a 90-day
supply
$105up to a 90-day
supply
$180up to a 90-day
supply
HealthSelect of Texas Prescription Drug Plan
• Deductible now based on calendar year instead of fiscal year. New deductible resets January 1, 2016.
• New HMO Plan available September 1, 2015• Available to the following counties:
• Brazoria, Fort Bend, Galveston, Harris and Montgomery
• More information will be available from ERS in July.
KelseyCare Plan
KelseyCare Plan• The state pays full premium for full-time
employee health coverage• San Jacinto College pays a portion of the premium
not covered by the state for dependents.• Monthly Premiums (effective 09/01/2015)
Employee only $ 0.00+ Spouse $138.50+ Children $92.74+ Family $231.24
• Rate is dependent upon how many tobacco users are covered on health insurance
• All employees are required to certify.• Choose To Quit(CTQ) program available to receive
refund of tobacco fee each year.
Tobacco User Certification
Coverage FeeYou, Spouse, or Child ONLY $30You + Spouse $60You + Spouse + Child $90
Humana Dental(HMO)
State of TexasDental Choice
Dentist Must use participating Dentist Choose any dentist
Deductibles None Up to $100 per individual, per calendar year
Coinsurance Varying according to serviceSpecialty Dentistry Dentist will charge you 75% of his/her usual fee; Dental HMO $0
You pay $0 to 60%, depends on service classification
Maximum Annual Benefit
Unlimited annual and lifetime benefit $1,500 maximum calendar year benefit (excludes orthodontic & preventative services)Pays 40% for in-network services after maximum is met.
Average cost of cleaning/oral exams
Varying according to serviceUp to two cleaning/oral exams per calendar year allowed
No costUp to two cleaning/oral exams per calendar year allowed
Average cost for Orthodontic Coverage
Orthodontic services performed by a general dentist listed in the directory with an "0" treatment code: child - $1,800, adult - $2,100. Orthodontic services performed by specialist: See coinsurance above.
Orthodontic services are only available to dependents age 19 or younger. You pay 50% of allowed amount. You may be required to pay the difference between the allowed amount and billed charges. Maximum lifetime benefit of $1,500.
Dental InsuranceAdministered by Humana Dental
• Not an insurance plan – No claims to file• No Deductible• No copayments• Save 20% - 60% on most dental work
• Includes routine oral exams, unlimited cleanings, dentures, roots canals and crowns
• 20% savings on orthodontics• Includes braces and retainers for children and adults
• Save on cosmetic services like veneers and whitening
Dental DiscountAdministered by Careington International
• Humana Dental (DHMO) planEmployee only $ 0.00+ Spouse $ 4.80 (-$0.20)+ Children $ 6.70 (-$0.30)+ Family $11.50 (-$0.46)
Dental Premiums
• Dental Discount PlanEmployee only $0.00+ Spouse $1.14+ Children $1.60+ Family $2.70
• State of Texas Dental ChoiceEmployee only $0.00+ Spouse $12.14 (+$0.34)+ Children $17.00 (+$0.48)+ Family $29.14 (+$0.84)
After tax deduction
• SJC pays premium for 2x annual salary• Evidence of Insurability (EOI) must be completed and approved if elected
during summer enrollment.
• May elect to pay premium for 3x or 4x• EOI must be completed and approved.
• Rates are age-banded• Maximum coverage amount of $400,000• Cost Example:
• 12 month salary: $35,000 Age: 37• 2x Monthly Premium: $6.00 (SJC Pays)• 3x Monthly Premium: $3.00 (Employee Pays)• 4x Monthly Premium: $6.00 (Employee Pays)
Optional Life Insurance
• $5,000 term life policy with AD&D rider• Unlimited number of dependents• EOI required if elected during Summer Enrollment• Monthly Premium: $1.38
Dependent Life Insurance
Voluntary AD&D• Protection for you and your family in the event of
accidental death or certain accidental injuries• Coverage from $10,000 to $200,000
Employee Only $0.02/$1,000 of coverage• Maximum Premium: $4.00/month
Employee + family $.04/$1,000 of coverage• Spouse covered at 50%, children at 20%• Maximum Premium: $8.00/month
• Premium $0.30/$100 of monthly salary• Up to 66% of monthly salary (max $10,000)
or $6,600, whichever is less• Must exhaust all leave• 30 day waiting period• Benefits are paid for up to 5 months• EOI required if elected during Summer
Enrollment
Short Term Disability
• Premium: $0 (San Jacinto College Pays)• Up to 60% of monthly salary (maximum $10,000) or
$6,000, whichever is less• Must exhaust all leave• 180 day waiting period • Benefit period depends on age when you become
totally disabled.• EOI Required if elected during Summer Enrollment
Long Term Disability
• New administrator – ADP• Set up a new online account• Website: www.texflex-fsa.com
• Online: September 1, 2015
• Health Care• Copays, prescriptions, coinsurance, eyewear
• Minimum annual contribution: $180• Maximum annual contribution: $2,544 (+$50 from last year)• Debit Cards will be mailed to ALL participants – No fee
• Dependent Care• Daycare, summer camps
• Minimum annual contribution: $180• Maximum annual contribution: $4,996• No longer a debit card option
• Annual Administrative Fee: $12 – FY2016: No Fee
TexFlexPre-Tax Spending Account
• ERS Discount Purchase Program• Available to employees, retirees, and their
immediate families• Discounts on many products and services, from
computers to theme park passes.• No sign-up fee• Visit today at www.discountprogramERS.com to
start saving!
Beneficiaries
• ERS Designation of Beneficiaries - Visit www.ers.state.tx.us to update your beneficiaries. For assistance, please contact ERS directly at 1-877-275-4377.
• TRS Designation of Beneficiaries - Complete the TRS 15 form, have it notarized, and submit it to TRS at 1000 Red River Street, Austin, TX 78701-2698.
Additional
BENEFITS
Employee only $9.03
Employee + 1 dependent $18.06
Employee + Family $25.21
$10-copay for exam• Frames or contacts every 12 months• Discounted laser surgery
Vision(formerly Spectera)
• Access legal counsel and advice from qualified lawyers
• Identity theft protection plans available.
Supplemental insurance used to cover costs incurred as a result of certain events.
• Accident, disability, wellness, cancer, etc• Costs vary according to salary, age, and elections. • Portable benefits • Can add family members to policies
&
Will be attending Vendor Fairs next
week
Mental Health• Family/parenting• Issues• Grief or bereavement• Eldercare issues• Marital or relationship • problems• Alcohol or drug
problems• Work or personal stress• Copping with Change
Financial• Tax/IRS Questions• Retirement Planning• Credit Service• College Tuition Planning• Personal budgeting• Debt Consolidation
Legal• Free Simple Will• Identity theft protection• Bankruptcy & Credit• Divorce & Family
Matters• Estate Planning• Consumer rights
$0.00 – SJC PaysFor more information please visit
www.uteap.org or call 1.800.346.3549.
• All employees can participate in a 403(b) and/or 457 plan.
• Maximum annual contributions based on age are set by the IRS.• Current annual maximums:
• Under age 50 $18,000• Over age 50 $24,000
• 10 Board approved vendors to choose from
Retirement Savings
SUMMER BENEFITS ENROLLMENTJULY 10 – July 24, 2015
SUMMER BENEFITS ENROLLMENTJULY 10 – July 24, 2015
Legal Disclaimer: All information presented is subject to change. The Plan Document pertinent
to each benefit supersedes any information provided.