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Santa Rosa County School Board Employee Benefits. 2013 Benefit Plan Year. Benefits Offered to Full Time Employees:. Medical Dental Vision Basic and Supplemental Life Long Term Disability Flexible Spending Accounts- Health & Dependent Care
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Santa Rosa County School BoardEmployee Benefits 2013 Benefit Plan Year
Benefits Offered to Full Time Employees: • Medical • Dental • Vision • Basic and Supplemental Life • Long Term Disability • Flexible Spending Accounts- Health & Dependent Care • Health Care Saving Accounts (if enrolled in HDHP) • Tax Sheltered Annuities, Cancer & Life • Retirement (Interim employees need to check with HR for coverage eligibility)
General Guidelines • New employees must enroll for benefits within first 30 days of employment (exception – retirement) • Enrollment for benefits via BenefitHelp on-line system (exception – retirement benefits) • Benefits become effective the first of the month following one month of employment • Benefits elected will be effective thru 12/31/13 • Benefit plan year January 1 to December 31 • Open enrollment conducted annually (November) for the following calendar year • Benefits end on the last day of the month employment terminates • Retirement plan must be selected before the end of the fifth month following his/her month of hire • Will receive retirement information packet directly from FRS
Medical • Florida Blue (formerly Blue Cross and Blue Shield of Florida) – 4 plan options • Blue Options PPO #05773 (high option) • Blue Options PPO #05301 (low option) • Blue Options High Deductible Health Plans #05182 & 05183 (high option) • Blue Options High Deductible Health Plans #05192 & 05193 (low option) • Plan tiers • Employee only • Employee + Spouse • Employee + Child(ren) • Employee + Family • Two Employee Family • Cost of plan varies based on plan and tier elected • School Board pays a large percentage of premium • All four plans have the same provider network (Blue Options) • All four plans offer out of the network and/or out of the area coverage • Effective date of coverage is the first of the month following one month of employment. • Example: Hire Date August 12, 2013; benefits begin October 1, 2013. • Medical insurance premiums are pre-paid one month prior to the actual month of coverage (Payroll deduction in September 2013 pays the October 2013 monthly premium) • Will receive a membership card in the mail
Blue Options PPO #05773 • Flexibility to choose physicians from a network of providers that includes primary care and specialists • Calendar year deductible (CYD) – in network • $2,000 per individual and $6,000 family aggregate • Office Visit Co-pays: $35.00 Primary Care and $65.00 Specialist • Hospital Inpatient – $350 Per Admission DED + CYD + 30% co-insurance • Preventive Care – 100% coverage in-network • Annual Out of Pocket Maximum - $5000/$10,000 in-network per individual/family aggregate • Reference plan summary for specific services and applicable co-payments • Participating physician’s network available on-line @ www.bcbsfl.com • Co-pay Prescription drug program included in plan (retail & mail order)
Blue Options PPO #05301 • Flexibility to choose physicians from a network of providers that includes primary care and specialists • Calendar year deductible (CYD) – in network • $5,000 per individual and $10,000 family aggregate • Office Visit Co-pays: $25 Primary Care and $45 Specialists (first six visits). After six visits subject to CYD + 30% coinsurance • Hospital Inpatient – CYD + 30% co-insurance • Preventive Care – 100% coverage in network • Annual Out of Pocket Maximum - $7,500/$15,000 in-network per individual/family aggregate • Reference plan summary for specific services and applicable co-payments • Participating physician’s network available on-line @ www.bcbsfl.com • Co-pay prescription drug program for Generics only included in plan (retail & mail order)
Blue Options High Deductible Health Plans 05182 & 05183 • Calendar Year Deductible (CYD) – In network • $2,500 single coverage • $5,000 all other tiers (EE + Spouse, EE + Child/ren, EE + Family) • The SRCSB makes an annual HSA contribution of $750 for single contracts and $1500 for family contracts. • Co-insurance 20% after calendar year deductible is met (no co-pays) • Preventive care not subject to the calendar year deductible or coinsurance – 100% coverage in-network • Annual Out of Pocket Maximum - $5,000/$10,000 in-network per individual/family aggregate • Reference plan summary for specific services and applicable coinsurance • Participating physicians network available on-line @www.bcbsfl.com • Prescription drug program included in plan (retail & mail order) subject to calendar year deductible.
Blue Options High Deductible Health Plans 05192 & 05193 • Calendar Year Deductible (CYD) – In network • $2,500 single coverage • $5,000 all other tiers (EE + Spouse, EE + Child/ren, EE + Family) • The SRCSB makes an annual HSA contribution of $750 for single contracts and $1500 for family contracts. • Co-insurance 20% after calendar year deductible is met (no co-pays) • Preventive care not subject to the calendar year deductible or coinsurance – 100% coverage in-network • Annual Out of Pocket Maximum - $5,000/$10,000 in-network per individual/family aggregate • Reference plan summary for specific services and applicable co-payments • Participating physicians network available on-line @www.bcbsfl.com • Prescription drug program included in plan (retail and mail order) subject to calendar year deductible. After CYD has been satisfied member responsibility is 20% of the cost of the prescription.
Health Savings Account(HSA) • IRS eligibility guidelines: • Covered by a high deductible health plan (HDHP) • Not covered under another medical plan that is not a HDHP • Not enrolled in Medicare • Not eligible to be claimed under another person’s tax return • SRCSB contributes $750 or $1500 to HSA (semi-annual deposits in January and July) • HSA contribution pro-rated for new hires • Employees may also make pre-tax contributions thru payroll deduction • IRS annual contribution limits for 2013 - $3,250 single; $6,450 family. Catch up provision of $1,000 available age 55+. • Funds can be used to help pay eligible medical expenses prior to meeting calendar year deductible. • Unused funds roll over. • Santa Rosa County Federal Credit Union is the School Board’s designated HSA Custodian. Can enroll in the HDHP and not open a HSA.
Special Enrollment Rights • If you decline enrollment during the first 30 days of employment or during the annual open enrollment, you may be eligible to enroll at a future date for one of the following qualifying events: • Marriage/Divorce • Birth, adoption or placement for adoption • Spouse’s job change • Spouse’s open enrollment • Loss of other health coverage • Request to enroll or make changes must be made within 30 days of the qualifying event • Contact Risk Management
My Blue Service • Website for member self-service capabilities including: • Request replacement ID card • Health Dialog • Blue 360 • eMedicine • Healthcare Advisor • Claim status information • Benefits information • Online provider directory • Request benefit booklet • Forms center
Blue Dental Choice PPO • Two dental plans to choose from • High option – pays 100% for preventive care; 80% for basic care after CYD • Low option – pays 80% for preventive care; 70% for basic care after CYD • Major services – pays 50% after CYD under both plans • Orthodontic services - pays at 100% after CYD under both plans up to a lifetime maximum of $1,000 • Annual dental benefit maximum is $1,000 per person • Flexibility to choose a dentist from a network of participating providers • Dental network available on-line @ www.bcbsfl.com • Reference plan summaries for specific services and applicable deductible and co-payments • Participating providers will file claims for you. Non-participating providers may require you to bring a claim form with you to your appointment. Forms may be obtained from the Risk Management website or the BenefitHelp system. • Employee pays premium • Employees who decline health coverage may elect the low option dental plan that is paid in full by the SRCSB (does not apply to two employee families with health coverage) • Available to employees and eligible dependents • Will receive a membership card in the mail • Florida Combined Life is the dental carrier
Vision Care • Coverage for all routine eye care, including eye exams and eyeglasses (lenses and frames) or contacts • Network of participating physicians to choose from • Reference plan summary for specific services covered and applicable co-payments • Employee pays total cost • Available to employees and eligible dependents • Will receive a membership card • Davis Vision is the vision carrier
Basic & SupplementalLife Insurance • The SRCSB provides all employees basic life and AD & D insurance in the amount of $50,000 • Amount is $100,000 for employees who waive health coverage • (Does not apply to Two Employee Families with health coverage) • Employees may elect additional supplemental life insurance in $10,000 increments from $20,000 up to $300,000 • Guarantee issue up to $200,000 if employee enrolls during the first 30 days of employment • Evidence of insurability required for coverage in excess of $200,000 • Late enrollments (after 30 days of employment or during annual open enrollment ) requires evidence of insurability for any amount • Cost of additional supplemental life based on age • ING is the life insurance carrier • Designate primary and contingent beneficiaries on BenefitHelp
Flexible Spending Accounts (FSA) • Section 125 of the Internal Revenue Code allows employees to have pre-tax amounts withheld from their paychecks placed into spending accounts. Reimbursement is made to the employee for qualified expenses. • Employees have the option of selecting from two different types of FSA’s: • Health care reimbursement account • Dependent care reimbursement account • Reference plan summary for covered expenses • Plan year runs concurrent with health plan year (January – December) • Maximum annual election $2,500 – Use it or lose it • Three options for reimbursement: • Pay with Flexible Spending Account debit card • Submit claim forms and receipts • File on-line at www.tasconline.com • Total Administrative Services Corporation (TASC) is the FSA third party administrator for the School Board Employees who open a Health Savings Account (HSA) may not elect to participate in a health care flexible spending plan (IRS guidelines).
Long Term Disability • Monthly benefit equal to 60% of your salary up to $5,000 • Benefits start after 60 days of disability • Benefits paid to age 65 • Employee pays the total cost • Rates based on age and salary • Premiums waived during disability period • Florida Combined Life is the LTD carrier.
Tax Sheltered AnnuitiesCancer, Life, Long Term Care Insurance • Products available for individual purchase • Payroll deductions for approved vendors • List of vendors, agents and contact information on the Risk Management website
Florida Retirement System • Two plans to choose from: • Pension Plan • Investment Plan • The majority of your FRS retirement plan is funded by the School Board; a mandatory 3% pre-tax contribution is deducted from your payroll check each month and deposited into your retirement account with FRS. • Must make a choice before the end of the fifth month following his/her month of hire • Resources for information: • Human Resources Website • MyFRS.com (FAQ’s, brochures, forms, investment facts, Advisor Service and Choice Service) • MyFRS toll-free Financial Guidance Line staffed by Ernst & Young financial planners and DOR counselors • Employee workshops
District Liability Insurance Programs • Insurance coverage for all School Board employees that includes: • Comprehensive General Liability • School Leaders Error and Omissions • Sexual Harassment • Sexual Molestation • Exclusion for “intentional acts”