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Paulding County School District 2016 BENEFITS OPEN ENROLLMENT REVIEW 1
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ShawHankins Service Center- can answer questions on all benefits, including state health Available extended hours 8:30 am – 7:00 pm during open enrollment Oct 19 – Nov 6, 2015 678-535-6369 Benefit website- shawhankinsbenefits.net/pcsd 2
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State Health Benefit Plan 3
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SHBP 2016-Carrier Options 3 carriers to choose from: BCBS of GA, United Healthcare, & Kaiser Permanente. BCBS of Georgia: 3 levels of HRA- Gold, Silver & Bronze and statewide HMO United Healthcare: High Deductible Health Plan (HDHP) and statewide HMO Kaiser Permanente: Regional HMO available to members who work or live in the 27 metro Atlanta counties. 4
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How the HRA Plans Works Bronze, Silver and Gold options with different levels of coverage All services are subject to the plan deductible and/or coinsurance, no copays apply SHBP contributes HRA credits to your HRA account based on the plan option and tier of coverage you choose These credits provide first dollar coverage for medical and pharmacy expenses Able to earn additional credits with wellness activities HRA credits left at the end of the year will roll over to the next plan year 5
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How the HDHP Works Low monthly premium Must satisfy high deductible ($3,500 individual, $7,000 family) for all medical and pharmacy expenses (except preventive care) If you have more than single coverage, the entire family deductible ($7,000) NO LONGER must be met before benefits are payable for any family member Eligible to establish a Health Savings Account (HSA) to set aside tax-free dollars to pay for eligible health care expenses. 8
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How the Statewide HMO Works Available through BCBS or UHC Rates differ between the 2 carriers Receive covered services through in-network providers only (except emergency care) Be sure to confirm your providers are participating in the BCBS or UHC network Co-payments apply to certain services- office visits, urgent care, emergency room and prescriptions 11
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How the Regional HMO Works Services only available through Kaiser HMO network Copay Only plan, no deductibles or coinsurance Plan available for members that live or work in one of the 27 metro Atlanta counties: 14
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SHBP Changes for 2016- Well-Being Incentive Credits Now able to rollover well-being incentive credits across vendors and plan options 2015 rollover credits available in April 2016 17
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Wellness Credits- BCBS & UHC 18
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Wellness-Kaiser Permanente Earn up to $480 and feel the benefits of taking care of your health! Sign up for the Kaiser Permanente Wellness Program at my.kp.org/shbp 19
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Tobacco Cessation Tobacco surcharges are included in all SHBP options Surcharge applies if you are not tobacco-free or do not complete tobacco cessation coaching program If you do not make an indication for 2016 on your tobacco usage, you will continue with your same tobacco usage election from 2015. 20
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State Health Open Enrollment Open enrollment is from October 19 th – November 6 th myshbpga.adp.com If you do not login to enroll or make changes, you will be defaulted to your current plan, coverage tier and tobacco status. If you are not currently covered and do not enroll, you will continue with no coverage. 21
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Ancillary Benefits 22
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bswift 23
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Enrollment When you choose the enrollment tab on the Benefit Resource Center site, you will be directed to the bswift enrollment page to complete your elections on all ancillary coverages. ◦Your user name is your first initial, last name and last 4 digits of your social security number ◦Your password is the last 4 digits of your social security number Once you complete the enrollment process you will receive a confirmation statement with all coverages and your total payroll deductions for 2016. 24
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Dental MetLife will be the dental carrier for 2016 Expansive national network, superior service Continue to have a Low and High plan options 25
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26 Plan Option 1- Low PlanPlan Option 2 – High Plan Coverage Type In-Network Out-of- Network In-NetworkOut-of-Network Type A – Diagnostics & Preventative 100% of Negotiated Fee* 100% of R&C Fee** 100% of Negotiated Fee* 100% of R&C Fee** Type B – Basic 40% of Negotiated Fee* 40% of R&C Fee** 80% of Negotiated Fee* 80% of R&C Fee** Type C – Major 25% of Negotiated Fee* 25% of R&C Fee** 50% of Negotiated Fee* 50% of R&C Fee** Type D – Orthodontia N/A 50% of Negotiated Fee* 50% of R&C Fee** Deductible † In-Network Out-of- Network In-NetworkOut-of-Network Individual$50.00 Family$150.00 Annual Maximum Benefit: In-Network Out-of- Network In-NetworkOut-of-Network Per Person$500.00 $1,000 Orthodontia Lifetime Maximum In-NetworkOut-of-Network Per Person$1,0001,000 MetLifeEmployeeEmployee + 1Family Low Plan$ 16.30$ 45.77$65.34 High Plan$ 24.40$68.51$97.81
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Vision Davis Vision will continue as the vision carrier for 2016 No change in plan coverage or rates 27
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Basic Life with AD&D PCSD provides basic life coverage at no cost to you This includes a life and accidental death and dismemberment benefit $30,000 for all Full Time Administrators & Technical Professional Employees $15,000 for all Other Full Time Employees Coverage available for dependents $5,000 for Spouse $3,000 for Children $1.65 to cover all dependents 29
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Supplemental Life with AD&D 30
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Short Term Disability No changes to STD benefit All sick leave must be exhausted prior to STD benefits beginning Late entrants or employees that wish to increase their level of coverage must submit an Evidence of Insurability Form and be approved before coverage is effective 31 BenefitAvailable Coverage Short Term Disability Benefits begin on the 15 th day of your disability. You can choose a benefit that is 40%, 50%, or 60% of your before tax weekly earnings. The maximum weekly benefit is $1,500. The short term disability coverage will last up to 11 weeks of disability.
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Long Term Disability Late entrants or employees that wish to increase their level of coverage must submit an Evidence of Insurability Form and be approved before coverage is effective 32 BenefitAvailable Coverage Long Term Disability Benefits begin on the 90 th day of your disability. Your benefit is equal to 60% of your before tax monthly earnings. The maximum monthly benefit is $10,000. Long Term Disability coverage will last until you are able to return to work or until you reach your Social Security Normal Retirement Age.
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Flexible Spending Accounts Two separate accounts- Medical Spending Account and Dependent Care Spending Account Allows you to set aside pre-tax dollars to spend on qualified expenses, saving on your taxable income Must make new elections for 2016 If enrolling in the HDHP medical plan, you are not eligible to contribute to FSA TASC will administer FSA account for 2016 33
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Flexible Spending Accounts Medical Spending Account Maximum contribution of $2,550 Some eligible expenses- Deductibles, copayments, dental expense, vision services and materials Dependent Care Spending Account $5,000 for married couple filing joint income tax returns, $2,500 if unmarried or married and filing separate income taxes Some eligible expenses- any care of a dependent that allows you and your spouse to work: day care, after school program, in-home care, camps You may rollover up to $500 left at the end of the 2015 plan year to use in 2016 for your Medical Spending Account 34
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Whole Life Benefit never decreases, premiums never increase You own the policy 35
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Critical Illness Coverage Critical Illness Insurance is offered through UNUM. This benefit is designed to help employees offset the financial effects of a catastrophic illness with a lump sum benefit if an insured is diagnosed with a covered critical illness. Pays a lump sum benefit to you at the time of diagnosis of a covered illness. Benefit Choice: From $5,000 to $50,000 for Employees and $5,000 to 30,000 for Spouse coverage. Able to cover you and your family Some covered illnesses: Heart Attack, Stoke, Coronary Artery Bypass, Major Organ Transplant, End Stage Renal Failure. Wellness Benefit: Pays you $75 benefit when you have a annual preventive screening: Ex) colonoscopy, EKG, Stress Test, Mammogram, PSA. 36
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Group Accident Insurance Accident insurance is provided through Unum. This coverage can help provide financial protection if you suffer a covered injury and need treatment. It pays the benefit directly to you to offset the high cost of copays, deductibles and other expenses your medical insurance may not cover. This plan also covers on the job accidents. Examples of conditions covered include Accidental Death, Skin Grafts, Paralysis, Coma, Ruptured Disc etc. 37
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Hospital Indemnity Insurance Hospital Indemnity is offered through UNUM. This coverage pays a cash benefit directly to you when admitted to the hospital. 38 Unum Hospital Indemnity Hospital Confinement $1,000 per insured per calendar year Daily Hospital Confinement$100 per day (maximum 15 days) Hospital Intensive Care$100 per day (maximum 15 days) Pregnancy CoveredYes Waiting Period30 days for new employees
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Legal Coverage In-Office Attorney Services: reviewing and preparing documents, providing legal advice and consultation, representation in court Telephonic Advice: assistance in reviewing and preparing documents, will preparation, financial education and counseling Online Resources: Guidebooks and videos, DIY Docs- state specific legal documents, online financial tools Identity Theft Protect- No additional cost 39
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Questions? 40 Service Center- can answer questions on all benefits, including state health Available extended hours 8:30 am – 7:00 pm during open enrollment Oct 19 – Nov 6 678-535-6369 Benefit website- shawhankinsbenefits.net/pcsd
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