welcome back longhorns! benefits department kathy shaw extension 4026 [email protected]
TRANSCRIPT
The content of this presentation is designed only for communication purposes and is not to be considered a contract, nor does it guarantee or imply coverage. Consult your Benefit Administrator for questions.
FRENSHIP ISD
2014-2015 Benefit Open Enrollment Plan Overview
Benefits at a Glance
MEDLink - American Public Life
Telehealth – MDLive **NEW BENEFIT**
Disability Income - Hartford
TRS ActiveCare – Aetna TRS ActiveCare – Aetna **NEW BENEFITS, RATES, and PLAN ADMINISTRATORS **
MEDLink – American Public Life
Dental – Basic and High - CIGNA
Vision – SuperiorVision **NEW RATES**
Disability Income – The Hartford
Benefits at a Glance
Cancer - TransAmerica
Basic Life and Voluntary Life - Dearborn National
. Every employee must elect or decline medical coverage.
Cancer - TransAmerica
Basic Life and Voluntary Life – Dearborn National
AD&D - Axis
Permanent Life – Texas Life
Flexible Spending and Dependent Child Care – NBS **NEW INFO**
Online Benefit Access 24/7
• Your Benefits Website: www.mybenefitshub.com/cedarhillisd
Section 125 Cafeteria Plan
Your Benefits Website: www.mybenefitshub.com/cedarhillisd
The plan year for Cedar Hill ISD is September 1 - August 31 of each year. Open Enrollment for returning employees will be held July 21 through August 31.
Although coverage is voluntary, every employee is required to review their personal information, current elections, make changes as desired, by completing the CHISD online enrollment.
Any pre-tax elections will remain in effect unless you have a qualified event change in family status. Qualifying event benefit changes must be made within 31 days of the event and changes must be consistent with the event.
Qualifying Event Examples: Marriage, Divorce, Birth or Adoption, Death, Change in Dependent Eligibility Status, etc.
CEDAR HILL ISD
TRS ActiveCare Select PlanEPO – Exclusive Provider Organization
• Baylor Scott & White Quality Alliance Network– Collin, Dallas, Denton, Ellis, Parker, Rockwall &
Tarrant County Residents Only– Accountable Care Organization
• Providers are rewarded for saving the Plan money• Personal information can be transferred to network
providers– MRI, CT scans, medications, etc.
TRS ActiveCare 1-HD and 2POS II Plans
• POS II Plans – Aetna Open Access Choice plan. Similar to a PPO plan.
• Plan pays for in network and out of network services HOWEVER benefits are reduced for out of network services.
TRS ActiveCare Select Plan(continued)
• Open Access Network– All other counties
• Referrals – Responsibility of employee to check for in network status
• In Network Coverage Only• Exception: Emergency Care
Accessibility
Your RESIDENCE must be in Collin, Dallas, Denton, Ellis, Parker, Rockwall and Tarrant counties
Baylor-Scott & White Quality Alliance Network
• 615 primary care physicians• 1,820 specialist physicians• 15 acute care hospitals. 7 short
stay hospitals• 14 imaging centers• 28 ambulatory surgical centers• 4 rehab hospital and 1 home
health agency• 42 outpatient rehab clinics• 6 retail pharmacies within
hospitals
What You Need To Know
• Aetna and Caremark/CVS are the plan administrators
• Each plan offers Teledoc phone physician services. Depending on the plan you choose, fees may apply.
• You will receive new Family ID cards from Aetna and Caremark/CVS– 1 card for Employee Only coverage– 2 cards for Employee/Spouse/Child/Family
What You Need To Know
• Transition of Care Form– This is a form to request Aetna cover ongoing care
at the highest level of benefits– Located at www.trsactivecareaetna.com under
Documents and Form– Follow instructions, complete and submit to TRS
ActiveCare Customer Service
What You Need To Know
• Split Premium – your spouse works for another ISD that participates in TRS ActiveCare
• May choose:– Shared Medical
• Split Primary or Split Secondary• Employee/Spouse OR Employee/Family Election Required
• Form may be obtained from the Benefits Office• If you have a current split premium in place and do
not have changes, you should not be required to complete a new form.
What You Need To Know
• Pooled Premium – you and your spouse work for Cedar Hill ISD
• May choose:– Shared Medical
• Pooled Primary or Pooled Secondary• Employee/Spouse OR Employee/Family Election
Required
• Form may be obtained from the Benefits Office
What You Need To Know• PREMIUMS – TRS ActiveCare billing cycle requires payment of
premiums at the beginning of the month. Our payroll dates are at the end of the month, therefore, it is necessary to deduct premiums one month in advance.
• PLEASE BE AWARE that premium changes effective September 1 will be accessed on September paychecks for September and October coverage months. – Example: Currently enrolled in AC1-HD premium is $569.00. Make no plan
changes. New Rate is $625.00. Increase is $56.00. September deduction will be $681.00. October deduction $625.00 (and thereafter)
• All other premium deductions (dental, vision, etc.) will be deducted during the coverage month.
TRS-ActiveCare 1-HDCoverage Tier 2013-2014 Plan Year 2014-2015 Plan YearEmployee only $100.00 $100.00 Employee and Spouse $569.00 $625.00 Employee and Child(ren) $347.00 $347.00 Employee and Family $835.00 $920.00
TRS-ActiveCare Select PlanCoverage Tier 2013-2014 Plan Year 2014-2015 Plan YearEmployee only N/A $225.00 Employee and Spouse N/A $819.00 Employee and Child(ren) N/A $484.00 Employee and Family N/A $1,013.00
TRS-ActiveCare 2 PlanCoverage Tier 2013-2014 Plan Year 2014-2015 Plan YearEmployee only $304.00 $330.00 Employee and Spouse $978.00 $1,062.00 Employee and Child(ren) $616.00 $650.00 Employee and Family $1,098.00 $1,098.00
Information Resources• TRS Website – www.trs.state.tx.us
• Aetna-TRS ActiveCare Website – www.trsactivecareaetna.com
• The HUB website – www.mybenefitshub.com/cedarhillisd and will be available to you beginning July 21, 2014.
• Aetna/Caremark TRS-ActiveCare Customer Service team – 1-800-222-9205
• Benefits Guide will be available online at The HUB website by July 21, 2014.
• Enrollment Guide available online at the TRS website and the Aetna-TRS ActiveCare website
• TRS-ActiveCare Benefits Booklet will be available online September 1, 2014 at the TRS website and the Aetna-TRS ActiveCare website
• List of providers can be found at the TRS website and the Aetna-TRS ActiveCare website
MEDLink® Plan by American Public Life
MEDlink is designed to supplement your employer’s medical plan. This plan provides supplemental coverage to help offset out-of-pocket costs that you may experience due to deductibles and coinsurance of your employer’s medical plan.
In-Hospital BenefitPays expenses you incur as an Inpatient (at least 18 continuous hours) up to $2,500 per confinement.
Out-patient BenefitPays up to $500.00 per treatment in: Hospital Emergency Room Outpatient surgery in a Hospital Outpatient Facility Outpatient surgery in a free-standing Outpatient Surgical Center Diagnostic testing in a Hospital Outpatient Facility Diagnostic testing in a MRI Facility
You are not eligible for the MEDlink plan if the following applies to you:
Employees (or their dependents) who are not covered under a TRS ActiveCare medical plan.
Employees not actively at work on the plan effective date.
MEDlink® – Example of Savings
INPATIENT HOSPITAL EXAMPLE:Illness: $11,000 In-hospital Cost – Emp. Only Age 45
Plan 1-HDDeductible $ 2,500 + 20% co-insurance $ 1,700EE out of pocket $ 4,200
MEDlink® pays $ 2,500Total Out of Pocket $ 1,700MedLink Gap Premium/Monthly $ 29.04TRS Medical Premium $ 100.00TRS with MedLink Monthly cost $ 129.04
Telehealth by MDLive This plan is available beginning September 1. New Benefit offered to you by Cedar Hill ISD.
MDLive provides access to U.S. based licensed physicians for real-time treatment or diagnosis of common
conditions via phone 24/7/365, even on holidays. This plan is designed to complement your primary care
coverage and help reduce the cost and frequency of in-person consultations.
This benefit provides evaluation, diagnosis and prescription medication (as appropriate) for common
conditions, such as: Allergies Cold & Flu Infections Nausea Sinus Conditions Rashes
Unlimited calls for you and your family absolutely FREE!
1-888-632-2738
Getting Started!
1Register online or by phone
Go to: mdlive.com/companyYou will need your Employee ID Number, Date of Birth and Select TRS Active Care/ Aetna ID number.
You may also register over the phone by calling: 1-888-632-2738
2Complete medical history
Just complete your medical history during registration.
3Request a consultation
Staff is available 24/7/365 by online video or phone!
Visit mdlive.com or call toll free 1-888-632-2738 to get started and make your appointment to day!
Do not confuse this with Teledoc. Free to EVERYONE! You will receive a card for your wallet.
When to Use MDLIVE For non-emergency medical issues (especially as an
alternative to the high cost of an emergency room or urgent care center)
Anytime, anywhere including night, weekends and even holidays
Your doctor or pediatrician is not available on your schedule When it’s not convenient to leave your home or work You are traveling and need medical care You need a prescription refill
CIGNA PPO Dental Insurance
CIGNA offers two PPO plan options:
PPO plans allow the freedom to choose any dentist, however, if you go to a network provider, benefits will be based on a reduced fee schedule. Utilizing a network provider gives you “more bang for your buck”.
If you choose to go to an out-of-network provider, PPO plan Option 2 has less out of pocket cost / balance billing versus Option 1.
Base DPPO Plan – $1,000 annual maximum, $50 Deductible. Orthodontics for children to age 19: $1,000 lifetime maximum. Out-of-Network Reimbursement is based on the in-network fee schedule.
High DPPO Plan – $1,000 annual maximum, $50 Deductible. Orthodontic for children to age 19: $1,000 lifetime maximum. Out-of-Network Reimbursement at 90% UCR.
PPO In-Network Benefits: 100% Preventive services, 80% Basic services, 50% Major services and 50% Orthodontics (for child to age 19).
PPO dental network: CORE network.
CIGNA Dental Monthly Premiums
CIGNA Dental DPPO Plans Base Plan Employee Only $23.34
Employee + One Dependent $45.47
Employee + Family $68.50
High PlanEmployee Only $32.96
Employee + One Dependent $65.20
Employee + Family $99.42
Superior Vision Insurance In-Network Benefits:
$10 Exam and $25 Materials co-pay
Prescription Lenses – once every 12 months
One Frame (up to $125) – once every 24 months
OR you may choose contacts instead of lenses
Contacts (up to $120) – once every 12 months
Extra Discounts and Savings10% to 30% savings on additional purchases of eyewear and
contact lenses.
Superior Vision Monthly Premiums
New RatesVision Monthly Premium
Employee Only $ 7.34
Employee + One Dependent $14.26
Employee + Family $20.96
Hartford Educator Select Disability Coverage is guaranteed issue up to $7,500 monthly benefit (based on
income). New coverage and increased coverage is subject to a 12-month pre-
existing condition exclusion. However, there is a four week benefit paid. Benefits can last while you are under a doctor’s care to age 65 due to
illness or injury. You may choose waiting periods in days of: 0/7, 14/14, 30/30, 60/60,
90/90, and 180/180, based on your need. Waiting period is waived if you elect a 30 day elimination or less plan, and you are hospitalized.
Telephonic Claims for faster, easier processing
TransAmerica Cancer Insurance
.
This is a supplemental plan designed to help cover out of pocket expenses not covered by your medical plan and pays benefits directly to you.
Coverage is available for employees age 18 or over, and their spouse and unmarried, dependent children up to age 25.
This coverage is offered to employees who have not been diagnosed with cancer, or who have been cancer and treatment free for the last 10 years.
Annual Cancer Screening Benefit - $50 per calendar year Hospital Indemnity Benefit - $100 a day Radiation/Chemotherapy – options of $5,000 or $15,000 per 12 month period Lodging Benefit – Up to $50 a day for non-local treatment up to 50 days First Occurrence benefit- $1000 or $2000 Intensive Care Optional Rider - $300 or $600 An application must be completed and approved
Dearborn National Group Life Insurance
New Employees can enroll within the first 30 days of employment for the lesser of $150,000 or 7-times your annual salary and 50% of employee amount up to $50,000 for your spouse and up to $10,000 for your dependent child(ren) without a statement of health (must meet actively at work requirements).
Employee must cover themselves to cover a spouse or dependent child. Employees cannot be enrolled as both an employee and a spouse. If both
parents are employees, only one may elect coverage on dependent children.
Premiums are age-banded.
Axis AD&D Insurance
This plan is designed to help provide you with peace of mind against the risk of covered accidental death or dismemberment.
Coverage is available for employee or family. The amount of insurance you select is called the “Principal Sum”. Employee principal sum can be elected for $200,000, $100,000 or
$50,000. Spouse and child coverage is a percentage of principal sum of employee coverage.
Texas Life Individual Life Insurance
Offers guaranteed level coverage to age 121; premium stays level for a significant period of time.
You and your family continue coverage without loss of benefits or increase in costs should you terminate your employment.
Policies can be purchased on spouse, children and grandchildren through age 18 without employee coverage.
Application must be made and approved for this coverage.
Contact the Benefits Office at extension 4026 OR call Financial Benefit Services at 469-385-4640 for an application.
FSA Administrator – National Benefit Services The Cedar Hill ISD Flexible Spending Account (FSA) Plan Year - September 1, 2014
to August 31, 2015
Plan Maximum- $2,500 each plan year – MUST be re-elected each year.
Services must be incurred in plan year.
Carryover up to $500 to next plan year. NEW THIS PLAN YEAR! Participants have a 90 day grace period to file claims following plan year. FSA accounts can be used for all IRS Classified Dependents. FSA accounts are “Use it or lose it” (except for Carryover) – plan contributions
carefully!
Healthcare Reimbursement Flex Card
The flex card is Broker paid MasterCard for CHISD employees NEW CARDS The NBS Flex Card makes using your FSA quick and easy – just swipe it as a
payment for your eligible expenses and the funds are automatically deducted from your FSA.
All participating employees will receive 2 NBS flex cards; additional cards may be ordered for family members for $5.00. Keep your cards, flex cards are valid for four years. Cards are reloaded by September 15.
Always keep your receipts! In the event of an audit an itemized receipt may be required for substantiation of expenses.
There is a $5 replacement fee for lost/stolen cards.
Healthcare Reimbursement Account
Examples Are: (included but not limited
to)
Doctor office co-pays
Prescription co-pays
Dental Expenses
Vision – Glasses, Contacts, Etc.
TAX FREE ACCOUNT FOR OUT-OF-POCKETMEDICAL EXPENSES on a PRE-LOADED MASTERCARD
Dependent Care Reimbursement Account
Tax Free Account for eligible Dependent Child Care Expenses
Tax Free Deduction via payroll
vs. deduction on income tax Annual Maximum - $5,000/family Must be re-elected every year
How to file a claim with NBS:
Visit www.mybenefitshub.com/cedarhillisd & click forms to download Reimbursement Claim Form
Claim Form may be Faxed, Mailed or Emailed to National Benefit Services
You may choose receive your reimbursement via check or direct deposit
Claims may be viewed on your benefit website
NEED ASSISTANCE ENROLLING?
• Financial Benefit Services will provide trained, licensed enrollers to assist you with the enrollment process
• Enrollers will be at the Central Office and Maintenance Facility (see calendar on next page)
• FBS has also set up a Customer Service Hotline to assist you with the enrollment process
• Monday - Friday• 469-385-4685• 8:00am – 5:00pm July 21, 2014 – August 15, 2014• 8:00am – 7:00pm August 18, 2014 – August 29, 2014
Red Boxes - Central Office 8am - 5pm
Black Box - Maintenance Facility 8am - 4:30pm
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LAST DAY OPEN
ENROLLMENT
NOTE:New hire enrollment period – 31 days following start dateEXAMPLE:Start Date – August 15, 2014Enrollment Period: August 15 – September 14Every effort will be made to have your personal data in the HUB prior to August 1
Have a Great Year!
• Kathy Shaw• Benefits Department• 972-291-1581 x4026• [email protected]
ARE YOU READY?