Benefits Overview The information contained in this presentation is not a contract and is subject to change by the proper authorities. It should be understood.

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Presentation transcript:

Benefits Overview The information contained in this presentation is not a contract and is subject to change by the proper authorities. It should be understood that explanations in this summary cannot alter, modify or otherwise change the controlling legal documents or general statutes in any way, nor can any right by reason of any inclusion or omission of any statement in this presentation.

Who’s Eligible Permanent (non-temporary) part-time employees working 20 – 29 hours per week are eligible for many benefit programs, typically without employer contributions Permanent (non-temporary) part-time employees working 30 to 39 hours per week or permanent full-time employees working 40 hours per week are considered to be benefits eligible 2

Health Benefits

State Health Plan of NC – administered by Blue Cross and Blue Shield of North Carolina (BCBSNC) Use any medical provider you choose –In Network: Your costs are lower when you use a doctor, hospital or other provider from the BCBSNC Blue Options network. –Out of Network: For other providers, your deductibles, coinsurance and copays may be higher Choose from two plan options: –Basic 70/30 Plan (lower contributions, lower coverage levels) –Standard 80/20 Plan (higher contributions, higher coverage levels) 4

Basic 70/30 Plan: Highlights 5 How Plan Coverage Works PLAN DESIGN FEATUREIN NETWORKOUT OF NETWORK Annual Deductible (Single/Family) $933/$2,799$1,866/$5,598 CoinsuranceYou pay 30% after deductible You pay 50% after deductible, plus difference between charge and allowed amount Preventive CareOffice visit: $35 Specialist visit: $81 Not covered Office visits (non-preventive)Office visit: $35 Specialist visit: $81 You pay 50% after deductible, plus difference between charge and allowed amount Inpatient CareYou pay 30% after deductible and $291 copay You pay 50% after deductible and $291 copay Emergency RoomYou pay 30% after deductible and $291 copay

Standard 80/20 Plan: Highlights 6 How Plan Coverage Works PLAN DESIGN FEATUREIN NETWORKOUT OF NETWORK Annual Deductible (Single/Family) $700/$2,100$1,400/$4,200 CoinsuranceYou pay 20% after deductible You pay 40% after deductible, plus difference between charge and allowed amount Preventive CareOffice visit: $30 Specialist visit: $70 Not covered Office visits (non-preventive)Office visit: $30 Specialist visit: $70 You pay 40% after deductible, plus difference between charge and allowed amount Inpatient CareYou pay 20% after deductible and $233 copay You pay 40% after deductible and $233 copay Emergency RoomYou pay 20% after deductible and $233 copay

7 Both PPO Plans – More Details Prescription coverage provided by ExpressScripts: –Generic: $12 co-pay, up to 30-day supply –Preferred Brand-name: $40 co-pay, up to 30-day supply –Non-preferred Brand-name: $64 co-pay, up to 30-day supply –Specialty: 25% coinsurance up to $100, 30-day supply NC HealthSmart: voluntary program offering tools and resources to help you live a healthier life such as:NC HealthSmart –Member Focus newsletter, information on the 24-hour nurse line, the Stork Rewards program, Eat Smart, Move More, Weigh Less program Sign up for the State Health Plan Member Newsletter at

Monthly Rates for Health Coverage 8 Medical Coverage PLAN EMPLOYEE ONLY EMPLOYEE + CHILDREN EMPLOYEE + SPOUSE EMPLOYEE + FAMILY Basic PPO$0.00$198.06$510.32$ Standard PPO$22.76$286.16$629.64$666.18

NCFlex Health & Other Insurance Programs

These voluntary programs provide a variety of plans to meet the needs of you and your family You pay the full cost of coverage through payroll deductions on a pre-tax basis Programs include: Dental, Vision, Health Care Flexible Spending Account, Dependent Day Care Flexible Spending Account, Cancer, Critical Illness, Group Term Life Insurance, Core AD&D and Voluntary AD&D Insurance 10

Dental Coverage Coverage provided through United Concordia Choose from two plan options: –High Option: Includes orthodontia for children under 19 –Low Option: Does not include orthodontia Under both options: –Visit any provider –You are responsible for deductibles –You or your dentist may file claims –You may be subject to a waiting period before certain benefits are payable under the plan (see “Benefit Waiting Period” chart under Dental coverage on NCFlex website) 11

Dental Coverage 12 How Plan Coverage Works under Each Option PLAN DESIGN FEATUREHIGH OPTION LOW OPTION Annual Deductible$50 person/$150 family$25 person/$75 family Preventive/Diagnostic Services Exams, cleanings, X-rays, etc. Plan pays 100%, no deductible Plan pays 100% after deductible Basic Services Fillings, extractions, endodontics, periodontics Most services: You pay 20% after deductible Periodontic: You pay 50% after deductible Fillings and extractions: You pay 50% after deductible Periodontic and other services: You pay 50% after deductible Major Services Crowns, inlays, dentures, bridges You pay 50% after deductibleNot covered Maximum Annual Benefit$1,250 per person (excluding orthodontia) $1,000 per person Orthodontia for dependent children under age 19 Plan pays 50% up to $1,500 lifetime benefit per person Not covered

Monthly Rates for Dental Coverage 13 Dental Coverage PLAN EMPLOYEE ONLY EMPLOYEE + SPOUSE EMPLOYEE + ONE CHILD EMPLOYEE + TWO OR MORE CHILDRENFAMILY High Option$37.40$75.00$71.96$90.96$ Low Option$21.34$43.04$41.30$52.62$73.68

Vision Coverage Coverage provided through Superior Vision Services (SVS) Choose from three coverage options: –Exam and Materials –Materials Only –Enhanced Exam and Materials Under all options, visit any provider but lower expenses with SVS in-network provider 14

Vision Coverage: Exam and Materials Plan and Enhanced Exam and Materials Plan 15 How Plan Coverage Works PLAN DESIGN FEATUREIN NETWORKOUT OF NETWORK Routine Eye ExamPlan pays 100% after $20 copay Plan pays up to $44 for ophthalmologist; up to $39 for optometrist Frames – once every 12 months Plan pays up to $100 ($150 for Enhanced Plan); 20% discount on coverages Plan pays up to $50 ($81 for Enhanced Plan) LensesPlan pays 100%Plan pays up to: Single vision: $34 Bifocal: $48 Trifocal: $64 Lenticular: $88 Contact Lenses (elective)Plan pays up to $120 ($150 for Enhanced Plan) Plan pays up to $100 Contact Lenses (necessary)Plan pays 100%Plan pays up to $210

Vision Coverage: Materials Only Plan 16 How Plan Coverage Works PLAN DESIGN FEATUREIN NETWORKOUT OF NETWORK Routine Eye ExamNot covered Frames – once every 24 months Plan pays up to $100; 20% discount on coverages Plan pays up to $50 LensesPlan pays 100%Plan pays up to: Single vision: $34 Bifocal: $48 Trifocal: $64 Lenticular: $88 Contact Lenses (elective)Plan pays up to $120Plan pays up to $100 Contact Lenses (necessary)Plan pays 100%Plan pays up to $210

Monthly Rates for Vision Coverage 17 Vision Coverage PLANEMPLOYEE ONLYFAMILY Exam and Materials$6.84$17.38 Materials Only$5.14$12.72 Enhanced Exam and Materials$9.98$25.10

Health Care Flexible Spending Account Coverage provided through P&A Group Set aside money through pre-tax contributions to pay for eligible out-of-pocket medical, dental and vision expenses: –Deductibles –Co-pays and coinsurance –Out-of-network expenses –Uncovered procedures Contribute from $120 to $5,000 per year Convenience card (debit card) for all participants “Use it or lose it” rule; you forfeit any unused contributions –Expenses can be incurred between January 1, 2012 and March 15, 2013, provided you remain actively employed for all of Prior year claims must be submitted by April 30,

Dependent Day Care Flexible Spending Account Set aside money through pre-tax contributions to pay eligible child care and adult day care expenses so you (and your spouse) can work or attend school full-time: –Care of dependent children under age 13 –Care of dependent adult who lives with you at least 8 hrs/day You may contribute from $120 to $5,000 per year “Use it or lose it” rule: you forfeit any unused contributions –Expenses can be incurred between January 1, 2012 and March 15, 2013, provided you remain actively employed for all of Prior year claims must be submitted by April 30,

Other NCFlex Health Programs Cancer Insurance provided through American Heritage Life: pays benefits for cancer-related expenses –Employee Only or Employee + Family Coverage –Low, High and Premium options Critical Illness Insurance provided through Met Life: pays lump sum benefit in event of certain health conditions –Employee, Spouse, Children or Family Coverage –Three categories of coverage available 20

Monthly Rates for Cancer Coverage 21 Cancer Insurance PLANEMPLOYEE ONLYEMPLOYEE + FAMILY Low Option$6.78$11.26 High Option$15.68$26.06 Premium Option$21.64$35.96

Monthly Rates for Critical Illness Coverage 22 Critical Illness Coverage AGEEMPLOYEESPOUSE Less than 25$ $ $ $ $ $ $ $ $ $ $ $ $ and older$ Employees may also cover eligible dependent children. Employee will pay one flat rate ($0.92) no matter how many children are covered.

Voluntary Group Term Life Insurance Group Term Life provided through ING: coverage in $10,000 increments, from $20,000 to $500,000 (limited to five times your base annual earnings) Coverage over $100,000 subject to Evidence of Insurability (EOI) Coverage available for yourself only 23

Monthly Rates for Life Insurance Coverage 24 Voluntary Group Term Life Insurance YOUR AGERATE PER $1,000 OF COVERAGE Under 24$ $ $ $ $ $ $ $ $ $ $2.520

Accident Insurance Core Accidental Death and Dismemberment (AD&D) Insurance provided through A.C. Newman –Elect coverage of $10,000 for yourself only –University pays full cost of coverage; however, you must enroll for coverage –Payment to your beneficiaries in case of your accidental death –Payment to you in case of your accidental dismemberment Voluntary AD&D Insurance provided through A.C. Newman –Elect coverage up to $500,000 for you and your family 25

Monthly Rates for Accident Insurance 26 Accidental Death & Dismemberment (AD&D) Insurance (Examples) BENEFIT AMOUNTEMPLOYEE ONLY COVERAGEEMPLOYEE + FAMILY COVERAGE $50,000$0.96$1.50 $75,000$1.42$2.26 $100,000$1.90$3.00 $125,000$2.38$3.74 $150,000$2.86$4.50 $175,000$3.32$5.26 $200,000$3.80$6.00 $250,000$4.76$7.50 $300,000$5.70$9.00 $350,000$6.64$10.50 $400,000$7.60$12.00 $500,000$9.50$15.00

Income Protection Programs

Programs designed to provide you and/or your family with financial protection in the event of your death, disability or long-term illness Some are offered at no cost to you; others require you to pay for coverage 28

Disability Plans Disability coverage provided under the Disability Income Plan of North Carolina (DIP-NC) Short-Term Disability –Provided to eligible employees at no cost After one year of contributing membership to TSERS or participation in the ORP. –Pays 50% of base compensation up to $3,000/month –Payable up to 365 days, after 60-day waiting period Long-Term Disability –Provided to eligible employees at no cost After five years of contributing membership to TSERS or participation in ORP –Pays 65% of base compensation up to $3,900/month –Payable as long as you remain permanently disabled, until eligibility for unreduced service retirement 29

Supplemental Disability Plans Can help fill gaps in State coverage –Replacement income while you are ineligible for state Short-Term Disability Plan –Waiting period: 90 days –Pays 66-2/3% of gross monthly salary up to $10,000 Voluntary benefit; you pay full cost of coverage after-tax Coverage through The Standard if you elect ORP –Includes continuing ORP contributions into your ORP account on your behalf Coverage through Liberty Mutual if you elect TSERS 30

Retirement Programs

Participation in a retirement program is mandatory You may choose between: –The North Carolina Teachers' and State Employees' Retirement System (TSERS), a defined benefit plan or –the UNC Optional Retirement Program (ORP), a defined contribution plan You must make your election between TSERS and ORP within 60 days of your date of hire Once you make the choice it cannot be changed; it is irrevocable 32

TSERS Plan Highlights Defined benefit plan State controls the investment Benefit you receive is based on a formula (factors include your age, your average final compensation and your years/months of creditable service) You must contribute 6% of your pay on pre-tax basis The University contribution is determined by the General Assembly. The current percentage is 8.33% 33

ORP Plan Highlights Defined contribution plan You control your investments The benefit you receive at retirement is based on investment performance and payment option chosen Program serves as an alternate option to TSERS for certain faculty and EPA non-faculty and other employees as approved by the UNC Board of Governors You must contribute 6% of your pay on a pre-tax basis The University contributes 6.84% Choose from four investment providers (Fidelity Investments, Lincoln Financial Group, TIAA-CREF and VALIC) 34

Supplemental Retirement Plans Allows you to put money away on a pre-tax basis for your retirement in addition to the 6% you contribute to TSERS or the ORP There are three types of plans available –403(b) plan administered by two different vendors, Fidelity and TIAA-CREF, and sponsored by the University –A 401(k) plan administered through Prudential and sponsored by the State of North Carolina –A 457 plan administered through Prudential and sponsored by the State of North Carolina You may elect to begin, change the amount you contribute or stop your participation at anytime You may elect to participate in the 403(b), 401(k) and the 457 at the same time, however there are limits to the amount you can contribute 35

Enrolling in Your Benefits

When Coverage Becomes Effective 37 Coverage Effective Dates PLAN NAMECOVERAGE EFFECTIVE Health BenefitsFirst of the month or first of the second month following employment date NCFlex BenefitsFirst of the month following employment date Short-Term DisabilityAfter one year of contributing membership to TSERS or ORP Long-Term DisabilityAfter five years of contributing membership to TSERS or ORP Supplemental Disability PlanEmployment date TSERSEmployment date ORPEmployment date Supplemental Retirement PlansMay enroll at anytime

Enrollment for Health Benefits You must enroll within 30 days of your employment date To enroll follow the instructions in the Employee Instructions for Completing Your Benefit Enrollment Online: – Link to UNC Asheville’s dedicated enrollment site – Health insurance premiums are paid one month in advance of coverage –(i.e., January premiums pay for February coverage) No pre-existing condition exclusion or waiting periods if you enroll when first eligible 38

Enrollment for NCFlex Programs To enroll visit the NCFlex Enrollment Website – All employees must complete online enrollment within 30 days of their employment date. 39

Enrollment for Income Protection Programs All employees must complete online enrollment within 60 days of their employment date Enroll for Supplemental Disability Insurance (after-tax) through The Standard, if you choose the UNC ORP, by completing the enrollment forms located online at Enroll for Supplemental Disability Insurance (after-tax) through Liberty Mutual, if you choose TSERS, by completing the enrollment forms located online at

Enrollment in TSERS Choose the TSERS option on the “Enrollment in a Mandatory Retirement Program” form and return it to Human Resources. You must designate a beneficiary by completing the following forms AFTER your first contribution/payroll deduction: –Form 2DB - Designating Beneficiary(ies) for the Death Benefit –Form 2RC - Designating Beneficiary(ies) for The Retirement System Return of Contributions –For these two forms visit ms.aspx?formCat=F3BENDESG ms.aspx?formCat=F3BENDESG 41

Enrollment in the ORP You must complete the following forms: –Choose the ORP on the “Enrollment in a Mandatory Retirement Program” form. –Form ORP-1 The University of North Carolina Optional Retirement Program (ORP) Election And Forfeiture Agreement –ORP Carrier Enrollment Application (Complete the ORP Carrier form(s) for the carrier you want for your contributions and the University contributions.) Follow the instructions provided by your campus Human Resources/Benefits Office for instructions on where to return forms You must enroll within 60 days of your date of hire or you will automatically be enrolled in TSERS 42

Enrollment in the Supplemental Retirement Plans 403(b) Plan –Visit Ret/403bMain.htmwww.northcarolina.edu/hr/ga/benefits/retirement/Suppmtl- Ret/403bMain.htm –Complete a Salary Reduction Agreement (form and instructions available on the website) –Enroll in the Plan with Fidelity and/or TIAA-CREF 457 Plan –Visit –Complete an NC 457 Deferred Compensation Plan Enrollment Form (forms and instructions available on the website) –Send the form to: NC Plans Processing Center, PO Box 5340, Scranton, PA 18505, or fax to

Enrollment in the Supplemental Retirement Plans State 401(k) Plan –Visit –Complete an NC 401(k) Plan Enrollment Form (forms and instructions available on the website –Send the form to: NC Plans Processing Center, PO Box 5340 Scranton, PA 18505, or fax to

For More Information Visit for more information about the benefits provided by the Universitywww.northcarolina.edu/hr/unc/benefits/index.htm You can also check or contact Amy Owenby at or via at 45