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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.

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Presentation on theme: "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."— Presentation transcript:

1 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.

2 Frenship Independent School District 2014 Benefit Open Enrollment Plan Overview

3 ― 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. ― 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: 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:

4 ― 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. Direct Reimbursement Dental Plan * Plan allows you to visit the dentist of your choice!

5 2014 Dental Plan Rates Employee Only $26.00 Employee & Spouse $52.00 Employee & Children $55.00 Employee & Family $81.00

6 ― Eye Exam Co-Pay $10 ― Eyewear Co-Pay $20 ― Contact Lens Fitting Co-pay $25 ― 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 ― Contact Lenses fitting fee once every 12 months Vision Insurance · Superior Vision * Plan allows in-network and out-of-network benefits.

7 NEW 2014 Vision Plan Rates Employee Only $7.28 Employee & Spouse $13.80 Employee & Children $13.98 Employee & Family $21.46

8 ― 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!

9 2014 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

10 2014 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

11 ― 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 Long-Term Disability Insurance · Aetna * Coverage is Guarantee Issue, no health questions asked!

12 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

13 2014 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

14 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 2014 Accident Rates · 3-4 Units

15 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.

16 Employees may elect additional coverage in $10,000 increments up to $500,000 not to exceed 5 times annual salary. Employees may elect up to 50% of the employee’s amount on their spouse. Children may be insured for $10,000 for $1.00 with one rate for all children. Any increases in coverage does require an evidence of insurability to be completed. 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

17 Universal Life Insurance with Long Term Care - Trustmark ― Flexible permanent coverage with portable death protection and long term care rider. ― Frenship ISD is still offering this benefit. If you have questions please consult with an enroller.

18 ― 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

19 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 2014 Medical Gap Rates · $1,500 Ages 60+: Employee Only $49.00 Employee & Spouse $88.00 Employee & Children $64.00 Employee & Family $103.00

20 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 2014 Medical Gap Rates · $2,500 Ages 60+: Employee Only $68.50 Employee & Spouse $122.50 Employee & Children $86.00 Employee & Family $140.00

21 ― Plan Year: January 1, 2014 to December 31, 2014 ― Plan Maximum: $2,500 Annually ― 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” Flex Plan Admin · National Benefit Services

22 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

23 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

24 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 and vision care expenses only. H S A Account Information

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28 Thank you for your attendance. FBS Customer Service (800) 583-6908 Director of Sales Coby James Account Manager Larry Bowen Account Executive Debbie Walter Client Service Representative Kim Graham


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