BENEFLex 2014 Risk Management & Insurance

Please do not ask questions of coworkers, school secretaries, department heads, principals. They may not have the answers that best meet your needs. Instead, contact the RISK MANAGEMENT BENEFITS TEAM for the most accurate answer at Or visit our website at QUESTIONS

#1 Question… When are my benefits effective? Benefits are effective the first day of the month following 60 days of employment. Example: Hire Date Benefits Effective 8/17 11/1 3/16 6/1 You must turn in your Enrollment and Change form in person or by pony (interoffice envelope) to Risk Management and Insurance Department within days -- of your hire date or full time position date.

Dependent Eligibility For Medical, Dental & Vision coverages: Legally married spouse Same sex domestic partner, requires additional documentation Dependent children may be covered through end of calendar year in which they reach age 26 Family OTL and Dependent Child(ren) Life Insurance coverages: Legally married spouse Dependent children may be covered up to age 26: –A.) if they are dependent upon you for support: OR –B.) they are a full-time student For Medical: Dependent children up to age 30, please contact Risk Management at for further details and documentation. DOCUMENTATION IS REQUIRED FOR DEPENDENTS enrolled in health, dental or vision coverage: marriage certificate for a spouse, birth certificates for children. Photocopies are acceptable. DOCUMENTATION IS REQUIRED FOR DEPENDENTS enrolled in health, dental or vision coverage: marriage certificate for a spouse, birth certificates for children. Photocopies are acceptable.

Staff HMO – Modest premium, narrow network of physicians and service area, access limitations NPOS – Broader national network, out of network options, 80%/20% co- insurance Consumer Directed Health Plan (CDHP) – Lowest premium, in-network only, greater risk (cost). Under all 3 plans Preventative physicals, GYN care, mammography and colonoscopy exams covered at no charge

HMO Staff Co-paymnets PCP :$ 25 Specialist:$ 50 Outpatient surgery: $500 Inpatient hospital: $500 per day for the first 5 days ER: $300 Urgent Care$ 50 Maximum out-of-pocket –EE only$3,000 –EE+1, EE + Family$6,000

Choosing a Doctor

NPOS (National Point of Service) In Network Benefits Deductible- $100 Employee –$200 E +1 –$200 EE + Family Broad network of doctors No referral to specialist Co-insurance 80%/20% Inpatient hospital: $500 Per day for a max of 5 days Out of Network Benefits differences Co-insurance 60%/40% Inpatient hospital: 60%/40% Annual routine adult physical/GYN exam/mammography and colonoscopy – covered 40% Maximum out of pocket in/out-of network: $3,000 - individual $6,000 – EE+1, EE+ family

CDHP Benefit Plan (Consumer Directed Health Plan) In-Network Only Broad network of doctors No referral to specialist Deductible: $1500 EE $3000 EE + or EE + Family After deductible has been met, all expenses covered at 80% except prescription cost Member Allowance: $ EE only $1000 – EE+1 or EE+ Family Maximum out of pocket $3,000 - individual $6,000 – EE+1, EE+ family NOTE: You must stay within the Humana network to receive benefits. There is no coverage out of network, except for life threatening illness and emergencies. (In most cases you will have to return to the service area for follow-up care.)

Health Plan Premiums Payroll deductions are PER PAY pays. These are after the Board contribution has been applied. This applies to all employees no matter what pay options is selected (pages 6 & 7 in BeneFlex Guide) To be eligible for Two Board Family, you and your spouse are employees of the School Board, both qualify for benefits and have at least one child who meets the eligibility guidelines

The Reimbursement Accounts Health Care Reimbursement Acct. (HCRA) & Dependent Care Reimbursement Acct. Box #9, #10 Set aside your money (or up to $25 of board contribution for HCRA only) on a pretax basis in a separate account to pay for out-of-pocket medical, dental, vision expenses (for all family members) and dependent day care Examples of Covered Expenses –office visit and prescription co-pays and plan deductibles –Some over the counter medications, if prescribed by PCP or Specialist –Expenses that exceed medical or dental plan limits (braces) –hearing aids –vision expenses not covered by vision plan –children under age 13 who are enrolled in a licensed day care or after school center or individual day care provided by caregiver (must give social security number)

Reimbursement Accounts Advantages Reduce Federal & FICA income taxes Results in more money in paycheck Access to amount declared immediately for Health Care Acct. In many instances, greater tax advantage through employer plan vs. annual tax filing Disadvantages Must estimate carefully IRS Use it or Lose it Rule

Dental Plans 1. Humana/ CompBenefits (Dental HMO) –copayments – network providers 2. Met Life PPO (reimbursement plan) –chose any dentist, save on preferred providers *Board Contribution (Flex Credits) may be used

EyeMed VISION COVERAGE

Prudential Life Insurance Application Video information on the life insurance plans: mms://video.pinellas.k12.fl.us/2008Risklifea_d Sample on page 19 of the Beneflex Guide

Assurant Disability Application Video information on the disability plans: mms://video.pinellas.k12.fl.us/2008Riskincomeprotect Sample on Page 18 in BeneFlex Guide

“No Health” Board Contribution Use your $75 per pay period Board Credit for: Dental Cover yourself or your family through Met Life or Comp Benefits Vision Quality vision care for you and your family through EyeMed Vision Care Accidental Death & Dismemberment Insurance Help for dealing with financial consequences of an accident for you and your family Income Protection Short and Long Term coverage will provide a monthly benefit if you are unable to work due to illness or injury (employee only) Flexible Spending Account Apply up to $25 to a Health Care Reimbursement Account. Use your FSA to pay for eligible medical expenses not covered by insurance.

Wellness Program Be Smart Worksite Wellness Program, see the Wellness Champion at your worksite for programs based on the staff survey Diabetes Care Program, free testing supplies once requirements are met. Tobacco Cessation Program, with Rx available (telephonic coaching required) District wide programs –stress reduction, proper hydration, skin cancer screenings, blood pressure screenings and more All Humana Participants: Free Telephonic Health Coaching for Weight Mgt., Physical Activity, Nutrition, Back Care, Stress Mgt. Employee Assistance Plan. (CCW)

Employee Assistance Program Covers all eligible employees and family members 8 free counseling sessions per incident.(no co-pays) Strictly confidential Stress (on & off the job) Family & Marital problems Divorce Substance or Alcohol Abuse Depression Elder Care Referral Legal Assistance Referrals Corporate Care Works

Voluntary Products Convenient payroll deductions Enroll anytime throughout the year after your eligibility begins Met Life: Great rates for cars, recreational vehicles and motorcycles MetLife – Auto/Motorcycle/Recreation Vehicle, Group Legal Services and Veterinary Pet Insurance

Retirement Savings Plans Tax Deferred Annuity Program –Defer up to 25% of pay, not to exceed $15,500 per year. (If you turn age 50 or older this year, you can contribute and additional $5,000.) –Money deducted from you salary reduction is deferred from Federal income taxes –Principal and interest accumulate through variety of investment options –4 monetary changes per year –NO contributions /matching funds from PCS

Florida Retirement System (FRS) –You will contribute 3% of your gross pay –You must decide after receiving your packet from FRS in 60 days which plan to select FRS Pension Plan FRS Investment Plan Free help is available at MyFRS.com or Retirement Savings Plans (continued)

Risk Management & Insurance Department We offer a comprehensive and flexible benefit program that meets your needs today & tomorrow. We are here to serve you, our customer. Please call us anytime M-F, 8:00 – 4: Good luck & Welcome to Pinellas County Schools