1. Benefits Presentation
Insurance Services
Benefits Presentation

2. Workers’ Compensation What If I Get Injured At Work
Immediately Report the injury to your supervisor
Contact Insurance Services
at to file a First Report of Injury

3. Benefits Without District Insurance
Happy Lights
Available in the fall and winter months –
check with your Site Wellness Representative
Employee Assistance
Program (EAP)
An opportunity to discuss any issues, concerns, or problems.
The District pays for one session per year
Call Center for Effective Living at
Employee Discounts
Found on the district intranet for a wide variety of businesses
and events in the area
Flexible Spending Account
(FSA)
You can have pre-tax dollars deducted from your paycheck to
pay for health and/or dependent care expenses
AFLAC
Call the AFLAC agent at

4. Flexible Spending Account
All District employees are eligible to participate
Maximum amounts per year:
Health/Dental/RX Expenses - $2, per individual
Up to $500 can be carried over
Dependent Care Expenses - $4, per family
($2, if married filing separately)
Any amounts remaining will be forfeited

5. Age 26 limit for dependent coverage
Dental Plan –
Age 26 limit for dependent coverage
Coverage
Calendar year maximum - $1, per person
$25.00 deductible per person
1st Visit of coverage year paid at 100% -
Charges will be included in your calendar year maximum
Includes bitewing x-rays, fluoride treatment, cleanings, oral
evaluation/exam
2nd Visit of coverage year paid at 80%
Major Services
50% after deductible – crowns, bridges, implants, root canals, etc.
Orthodontia Benefit (Separate)
Paid at 50% after waiting periods met
Maximums apply depending on age

6. Age 26 limit for dependent coverage
Health Plan –
Age 26 limit for dependent coverage
There are two health plans:
Copay Plan
High Deductible Health Plan (HDHP)
with Health Reimbursement Arrangement (HRA)
Benefit coverage is the calendar year
Deductible carry-over applies to both plans

7. Health Reimbursement Arrangement – HRA Administered by Mid America
For employees who elect to participate in the HDHP (with District Contributions)
District will make an annual contribution
Single coverage -- $750
Family coverage -- $1500
Must be enrolled in the HDHP as of January 1 of each calendar year
Contributions for new hires are not prorated

8. Deductibles/Out of Pocket Maximums
CO-Pay Plan
HDHP with HRA
Deductibles
$ per person
$1, per family
$1, per person
$3, per family
Out of Pocket Maximums
$3, per person
$6, per family
$4, per person
$8, per family   

9. Monthly Insurance Premiums - Teachers
Health
CO-Pay Plan
HDHP with HRA
Single
$58.00 Employee Cost
$ District Cost
$0 Employee Cost
$ District Cost
Family
(Employee + Dependent Coverage)
$ Employee Cost
$1, District Cost
$76.54 Employee Cost   

10. Monthly Insurance Premiums – Other Staff
Health
CO-Pay Plan
HDHP with HRA
Single
$97.00 Employee Cost
$ District Cost
$0 Employee Cost
$ District Cost
Family
(Employee + Dependent Coverage)
$ Employee Cost
$1, District Cost
$ Employee Cost   

11. Monthly Insurance Premiums - Dental  
Dental – All Staff
Single
$0 Employee Cost
$41.00 District Cost
Family
(Employee + Dependent Coverage)
$ District Cost

12. Health Plans CO-Pay Plan HDHP w/HRA Office Visits for Illness/Injury
Health Plans
CO-Pay Plan
HDHP w/HRA
Office Visits for Illness/Injury
Preventive Care (routine physical,
Dr on demand, hearing, vision,
cancer screening, immunizations
and well child)
Mental Health/Substance Abuse
Investigative & Experimental
Emergency Room
Ambulance
Diagnostic lab/X-ray
Prenatal
Delivery
Chiropractic - 20 visits per year
$30 copay, then 80%
100%
 $1,000 deductible per year, then 80%
$50 copay, 80% after deductible
80% after deductible
Same as Co-Pay Plan
 80% after deductible   

13. Prescription Drugs (RX)
 CO-Pay Plan
 HDHP with HRA
Generic Formulary
Formulary Brand
Non-Formulary Brand
Specialty Pharmacy
RX Out-of-Pocket Maximum
(OOP)
$12 copay
$30 copay
$55 copay
$60 copay
$1,500 per person
$3,000 per family   

14. Other Benefits with District Insurance  
Fitness Program
Pays up to $20.00 per month towards your fitness center dues – if you work out at least 12 days a month
Per IRS rules, this is a taxable benefit & will be reported on your W-2
Vision Products
Employee Only –
Lenses and contacts paid at 50% up to $150.00

15. Coordination of Benefits
RPS will be YOUR primary insurance
Spousal Surcharge May Apply
(if spouse declines his/her employer’s insurance)
Health Co-Pay Plan – Surcharge = $ per month
HDHP – Surcharge = $ per month
Dental Plan – Surcharge = $60.00 per month   

16. Life Insurance Calculation
Coverage & premium determined by employment contract
Cost = 11¢ per $1,000 units of coverage
Value of plan divide by $1,000 units x .11 = total monthly premium
Total monthly premium divide by 2 = employee monthly cost
Example: $40, (value of plan) = $2.20 per month
$75, (value of plan) = $4.13 per month
$100, (value of plan) = $5.50 per month
After 30 days from your hire date:
You will be required to complete an additional form
Coverage is at the discretion of Madison National Life   

17. LTD Insurance
Basic Long Term Disability – Pays 66 2/3% of salary, after a 90 calendar day wait period
Cost = 27¢ per $100 units of salary
Salary divided by $100 = number of units
Units x .27 = yearly premium divided by 12 = monthly premium
Total monthly premium divided by 2 = employee monthly cost
Example: $30, = $3.38 per month
$45, = $5.06 per month
$75, = $8.44 per month
Coverage & premium determined by employment contract
Supplemental Disability – Pays 85% of your salary, after a 90 calendar day wait period - employee pays 100% of cost
Cost = 21¢ per $100 plus the cost of basic LTD
After 30 days from your hire date: You will be required to complete
an additional form – Coverage at discretion of Madison National Life   

18. Notes   
HIPAA Privacy
Requires written authorization to release information
Release of Information (ROI)
If you wish to have your (or dependents age 18 & over) medical, dental, and/or flexible spending information disclosed to anyone for any purpose, we need you to complete the ROI form.