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The content of this Power Point is designed only for communication purposes and is not to be considered a contract, nor does it guarantee or imply coverage. Consult your plan booklet or Administrator for detailed coverage or pre-existing limitations.
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Frenship Independent School District 2013 Benefit Open Enrollment Plan Overview
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― Visit www.mybenefitshub.com/frenshipisd for all of your benefit needs. ― Review Employee Benefit Guide. ― Find important links to all benefit carriers. ― Check your Flexible Spending Balance Online Benefit Access 24·7
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― Frenship ISD must set a plan year. The district’s plan year is January 1 to December 31 of each year. ― Although coverage is voluntary, every employee is required to review their current elections, make changes if desired and *sign a Section 125 Benefit Election Form. (Currently all employee enrollments are completed on-line and therefore all signatures are electronically received.) ― Any pre-tax elections will remain in effect unless you have a qualified change in family status. Changes must be made within 31 days of the event. ― Any pre-tax elections will remain in effect and cannot be revoked or changed during the plan year unless you have one of the following changes in family status: Marriage, Divorce, Birth/Adoption, Death, Change in Dependent Eligibility, etc. Section 125 Cafeteria Plan There are special rules and requirements to receive the pre-tax benefit election plan privileges:
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2013 Enrollment – Important Information Open Enrollment Start Date – 11/2/2012 Open Enrollment End Date – 12/3/2012 **All Employees are required to meet with Financial Benefit Services even if you are “declining” benefits.** Coverage for benefit elections made during this enrollment process will become effective on January 1 st, 2013.
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― You are covered at 100% of the 1 st $100 ― You are covered at 80% of the next $250 ― You are covered at 50% of the next $1,400 ― Annual maximum benefit per covered person is $1,000 ― Orthodontia is covered for participants and has a lifetime benefit of $1,000. Benefits are paid just like they are on dental. ― Exclusions: cosmetic dentistry, implants, TMJ ― Use of the NBS Flex Card is prohibited with dental claims; you must file a paper claim form for Flex reimbursement after dental claims are paid. Direct Reimbursement Dental Plan * Plan allows you to visit the dentist of your choice!
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2013 Dental Plan Rates Employee Only $26.00 Employee & Spouse $52.00 Employee & Children $55.00 Employee & Family $81.00
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― Eye Exam Co-Pay $10 ― Eyewear Co-Pay $20 ― Frame allowance $125 Retail (in-network) ― Lenses allowance Paid In Full (in-network) ― Contact Lenses allowance up to $150 (in-network) ― Vision examination allowed once every 12 months ― Frames allowed once every 12 months ― Lenses allowed once every 12 months ― Contact Lenses allowed once every 12 months Vision Insurance · Block Vision * Plan allows in-network and out-of-network benefits.
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2013 Vision Plan Rates Employee Only $8.10 Employee & Spouse $13.85 Employee & Children $14.65 Employee & Family $22.00
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Did you know…Cancer Insurance has you covered?! ― About 1,596,670 new cancer cases are expected to be diagnosed in 2011 ― The National Institute of Health estimates the overall costs of cancer in 2010 at $263.8 Billion ― An estimated 240,890 new cases of prostate cancer will occur in the US during 2011 ― An estimated 230,480 new cases of invasive breast cancer are expected to occur among women in the US during 2011 2011 Cancer facts & figures, American Cancer Society
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― Very Competitive Rates ― Two options are available on the cancer plan: High Option and Low Option ― Annual Cancer Screening Benefit: $50 per calendar year ― First Occurrence Benefit: High Option $2,000, Low Option $500 ― Daily Radiation/Chemotherapy Benefit: High Option $400, Low Option $200 ―Daily Hospital Confinement Benefit: High Option $200/Day, Low Option $100/Day ―Optional ICU Benefit: $1,000/Day for the 1 st 30 days of ICU Confinement ―Optional Specified Disease Benefit: Available with ICU Benefit ―Transportation and Lodging: $0.50 per mile and up to $75/Day for Lodging Group Cancer Insurance · Loyal American * Coverage is Guarantee Issue, no health questions asked!
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2013 Cancer Rates · Low Plan Low Option: Employee Only $11.56 Single Parent Family $13.03 Family $18.36 Low Option w/ICU & Specified Disease Riders: Employee Only $16.70 Single Parent Family $21.85 Family $29.65
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2013 Cancer Rates · High Plan High Option: Employee Only $19.92 Single Parent Family $22.56 Family $31.97 High Option w/ICU & Specified Disease Riders: Employee Only $25.06 Single Parent Family $31.38 Family $43.26
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Did you know…Disability Insurance Protects?! * Insure your paycheck! ― 7 out of 10 employees between the ages of 35 to 65 will suffer a disability longer than 3 months ― 48% of all home foreclosures are due to disability ― 1 out of 2, 35 year olds will suffer a disability lasting longer than 90 days before they reach the age of 65
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― Coverage is guaranteed up to $7,500 of monthly benefit based on your annual income ― New coverage and increased benefits amounts are subject to a 12 month pre-existing condition exclusion ― 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 individual needs. ― Disability benefits are received tax free New Long-Term Disability Insurance · Aetna * Coverage is Guarantee Issue, no health questions asked!
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Accident Insurance · American Public Life * Benefits are paid directly to you! ― Pays regardless of any other medical coverage ― Benefits are paid directly to you ― Protects you 24 hours a day on or off the job ― Issue ages for employee and spouse are 18-64 ― Policy is guaranteed renewable up to age 70 ― Benefits are available from 1 to 4 units ― There is no limit on the number of accidents covered
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2013 Accident Rates · 1-2 Units 1 Unit: Employee Only $10.80 Employee & Spouse $19.40 Employee & Children $21.20 Employee & Family $29.80 2 Units: Employee Only $17.10 Employee & Spouse $29.80 Employee & Children $34.90 Employee & Family $47.60
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3 Units: Employee Only $21.50 Employee & Spouse $38.90 Employee & Children $45.20 Employee & Family $62.60 4 Units: Employee Only $24.50 Employee & Spouse $44.90 Employee & Children $52.00 Employee & Family $72.40 2013 Accident Rates · 3-4 Units
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Employer Paid Base Life Insurance Frenship ISD provides a $20,000 Basic Life and AD&D policy at “No Cost to the Employee”. Employees working 30 hours or more per week are eligible.
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Did you know…Life Insurance is Key to Financial Planning?! ― Life Insurance should be part of your financial plan ― The risk of premature death is significant, thus leaving financial obligations unfulfilled ― Think of family life changes that would have an impact on normal expenses: · Car Loans · Rent or Mortgage Payments · Credit Card Payments · Children’s Education Expenses · Everyday Living Expenses
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― This year only!! All employees can get up to $200,000 or max 5 times salary on a Guarantee Issue basis. This means no health questions asked! ― Spouse can elect up to 50% of the employee’s amount. Spouse coverage is Guarantee Issue up to $75,000 ― Children are Guarantee Issue up to $10,000. One rate for all children covered. If you have 5 kids with $10,000, the total premium would only be $1.00 ― The new Voluntary Life coverage through Aetna has lower rates than the current plan offered through CIGNA ― Employees can elect AD&D coverage on a stand alone basis. AD&D is available for both employee or for the employee and family. Group Life Insurance · Aetna * Coverage is Guarantee Issue, no health questions asked!
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Universal Life Insurance with Long Term Care - Trustmark ― Flexible permanent coverage with portable death protection and cash value accumulation ― Employees can adjust their death benefit, cash value and premiums as needs change, take policy loans and access living benefits for Long Term Care needs
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― Provides a monthly benefit equal to 4% of the base policy for up to 25 months for medically necessary ADL Assistance provided by: · Nursing Home · Adult Day Care · Home Health Care · Assisted Living Facility * Maximum Issue Age is 70 * Universal Life Events: Maximum Issue Age is 64 Universal Life Insurance · Trustmark LTC Benefit $50,000 Death Benefit With LTC Benefits: $50,000 x 4% = $2,000 Per Month Months of Benefits
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― Triggered by 2 of 6 Activities of Daily Living: ― Or Cognitive Impairment (such as Alzheimer’s or other nervous/mental disorder caused by clinically organic disease) ― Benefits are paid as an acceleration and proportionately reduce the death benefit ― Waiting Period: Benefits begin after the Insured has been confined in a Long Term Care Facility or Assisted Living Facility or received Home Health Care or Adult Day Care services for 90 days (premium is waived after 90 days from the inception of a Long Term Care Benefit Universal Life Insurance · Trustmark LTC Benefit Transferring ContinenceBathing Dressing Eating Going To The Toilet
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Universal Life Insurance · Trustmark Living Benefits How Does Universal LifeEvents With Living Benefits For LTC Work? Example: $100,000 Death Benefit Universal Life is flexible. You can adjust the death benefit, cash value and premiums as your financial needs change. Long Term Care Benefit (LTC) Pays a monthly benefit equal to 4 percent of your death benefit for up to 25 months. The LTC benefit accelerates the death benefit and proportionately reduces it. $100,000 Benefit Restoration Restores the death benefit that is reduced to pay for LTC. $100,000 $33,000 Total Maximum Benefit Living Benefits can double the value of your life insurance. $200,000$133,000 Maximum Benefit Amount UL All Ages & LE Before Age 70: LE Age 70+:
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― Automatically raises coverage without additional underwriting requirements ― Increases coverage each year by the amount that an additional $1 or $2 weekly premium purchases ― Employee and/or Spouse through age 60 · Increase is the amount purchased by $1 per week on the first 10 anniversaries ― Employee and/or Spouse through age 64 · Increase is the amount purchased by $1 per week on the first 5 anniversaries ― Employee through age 64 · Increase is the amount purchased by $2 per week on the first 5 anniversaries Universal Life Insurance · Trustmark EZ Value Option
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― Designed to cover your out-of-pocket expenses such as co- payments, deductibles and co-insurance ― In-Hospital Benefit: pays up to the maximum amount chosen for Covered Charges incurred when a Covered Person is confined in a Hospital for 18 hours. $1,500 or $2,500 in-patient benefit available ― Outpatient Benefits: pays a $200 benefit for Covered Charges incurred for treatment in a Hospital Emergency Room, outpatient facility or a free-standing outpatient surgery center *Same condition must be separated by 90 days ― Physician Benefit: pays for a physician visit up to $25 per visit, for up to five visits per family, per calendar year for treatment received outside of a Hospital as an outpatient. Also includes treatment at your Physician’s Office, Emergency Room or Clinic Medical Gap Insurance · American Public Life
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Ages Under 55: Employee Only $21.50 Employee & Spouse $39.50 Employee & Children $36.50 Employee & Family $54.50 Ages 55-59: Employee Only $32.00 Employee & Spouse $59.00 Employee & Children $47.00 Employee & Family $74.00 2013 Medical Gap Rates · $1,500 Ages 60+: Employee Only $49.00 Employee & Spouse $88.00 Employee & Children $64.00 Employee & Family $103.00
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Ages Under 55: Employee Only $28.00 Employee & Spouse $51.50 Employee & Children $45.50 Employee & Family $69.00 Ages 55-59: Employee Only $44.50 Employee & Spouse $81.50 Employee & Children $62.00 Employee & Family $99.00 2013 Medical Gap Rates · $2,500 Ages 60+: Employee Only $68.50 Employee & Spouse $122.50 Employee & Children $86.00 Employee & Family $140.00
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― Plan Year: January 1, 2013 to December 1, 2013 ― Plan Maximum: $2,500 Annually (new maximum for 2013 as a result of the “Healthcare Reform Act”) ― Services must be incurred in plan year ― Flex funds are fronted to you at beginning of plan year on a Visa Benny Card. ― 2 ½ month grace period to incur claims following plan year ― 90 day grace period to file claims following plan year ― Can be used for all IRS Classified Dependents ― “Use it or lose it” ― Dental Claims must be filed on paper, not on the NBS Flex Card ― Flex cards will be issued to each participant enrolled in plan ― Please Note: If you elect to participate in the Flex through NBS, you will receive 2 Benny Flex Cards from NBS in January 2013. If currently have a Flex Card with NBS it will be reloaded in January. Please do not destroy your current card. May take 7 to 10 days after January 1, 2013 before your existing Flex Card will loaded with your 2013 Flex Funds. Flex Plan Admin · National Benefit Services
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Medical Reimbursement Account · NBS ― Tax Free Account for Out-of-Pocket Medical Expenses on a Pre-Loaded Visa Card Examples are: · Doctor Office Co-Payments · Prescription Co-Payments · Dental Expenses · Vision – Glasses, Contacts, etc. · Over the Counter Medications with Doctor’s Prescription ONLY
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Dependent Care Reimbursement Account · NBS ― Tax Free Account for eligible Dependent/Child Care Expenses ― Tax Free Deduction via payroll vs. deduction on income tax ― Annual Maximum: $5,000 for married couple filing jointly or $2,500 if filing single
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How to File Claims ·National Benefit Services ― Visit www.mybenefitshub.com/frenshipisd and click on Reimbursement Plans/Healthcare FSA/Claim Form ― Claim Form may be faxed, mailed or emailed to National Benefit Services direct ― You may receive your reimbursement via check or direct deposit ― Claims may be viewed on your benefit website 24·7
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How to check your Flex Balance ·National Benefit Services ― Visit www.mybenefitshub.com/frenshipisd and click on Check FSA on the gray toolbar at top of page. ― Balances may be viewed on your benefit website 24·7
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H S A Eligible Participants: Employees that contribute to an H S A account are restricted to a limited-purpose Health F S A, for reimbursement for dental, vision and preventative care expenses only. Reimbursement of expenses for medical care under IRS Code Section 213(d), including over-the-counter as well as prescription drugs will not be allowed under your plan. H S A Account Information
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Important Enrollment Information For complete benefit information and enrollment instructions log onto www.mybenefitshub.com/frenshipisd Remember enrollment dates start November 2nd – December 3. You may self enroll for your benefits. Remember to print out and sign your election form and give to your campus administrator. Enrollers will be available beginning November 2nd. Check your campus schedule for the date they will be on your Campus.
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2012 Enrollment Schedule by Time & Campus Friday 11/2: 8am – 4pm Willow Bend 8am – 4pm FMS Thursday 11/8: 8am – 4pm Crestview Friday 11/9: 8am – 4pm Custodians, Maintenance, Operations @ Casey Building 12:00am – 4pm Reese Center Tuesday 11/13: 8am – 4pm FHS Wednesday 11/14: 8am – 4pm North Ridge 8am – 4pm HMS Thursday 11/15: 8am – 4pm TVMS 8am – 4pm Bennett
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2012 Enrollment Schedule by Time & Campus Friday 11/16: 8am – 4pm Westwind 8am – 4pm Oak Ridge 8am – 4pm Central Office Monday 11/19: 8am – 4pm Clean Up Casey Building
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Thank you for your attendance. FBS Customer Service (800) 583-6908 Account Manager Coby James Larry Bowen Client Service Representative Debbie Walter
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