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BENEFlex 2015

BENEFlex 2015. Risk Management & Insurance. PLEASE TURN OFF YOUR CELL PHONES. Please Be Nice & Turn Off That Device Sit back, relax & give your phone a rest, so when you enroll in benefits you won’t have to make a guess. #1 Question… When are my benefits effective?.

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BENEFlex 2015

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  1. BENEFlex 2015 Risk Management & Insurance

  2. PLEASE TURN OFF YOUR CELL PHONES Please Be Nice & Turn Off That DeviceSit back, relax & give your phone a rest, so when you enroll in benefits you won’t have to make a guess.

  3. #1 Question…When are my benefits effective? • Benefits are effective the first day of the month following 60 days of employment. Example: • Hire DateBenefits Effective 8/17 11/1 3/16 6/1 • You must turn in your Enrollment and Change form in person or by pony (interoffice envelope) to Risk Management and Insurance Department within -- 31 days -- of your hire date or full time position date.

  4. For Medical, Dental & Vision coverages: Legally married spouse Dependent children may be covered through end of calendar year in which they reach age 26 Family OTL and Dependent Child(ren) Life Insurance coverages: Legally married spouse Dependent children may be covered up to age 26: A.) if they are dependent upon you for support: OR B.) they are a full-time student Dependent Eligibility • For Medical: • Dependent children up to age 30, please contact Risk Management at 588-6197 for further details and documentation. • DOCUMENTATION IS REQUIRED FOR DEPENDENTS • enrolled in health, dental or vision coverage: • marriage certificate for a spouse, birth certificates for children. • Photocopies are acceptable.

  5. Board Contribution FOR EMPLOYEES WHO DO NOT SIGN UP FOR THE DISTRICT HEALTH INSURANCE….. You may receive up to$75.00 per pay period creditto apply toward the following benefits (♦ designated on enrollment form): Board Contribution FOR EMPLOYEES WHO DO NOT SIGN UP FOR THE DISTRICT HEALTH INSURANCE….. You may receive up to$75.00 per pay period creditto apply toward the following benefits (♦ designated on enrollment form):

  6. Staff HMO – Modest premium, narrow network of physicians and service area, access limitations, primary care physician (PCP) required, referrals to specialists required • NPOS– Broader national network, out of network options, 80%/20% co-insurance, deductible $300 individual/$600 family, direct access to specialists • Consumer Directed Health Plan (CDHP) – Lowest premium, in-network only (HMO Premier), deductible $1500 individual/$3000 family, health care allowance, greater risk (cost). • Under all 3 plans: • Preventative physicals, GYN care, mammography and colonoscopy exams covered at no charge

  7. HMO Staff Co-payments • PCP : $ 25 • Specialist: $ 50 • Outpatient surgery: $500 • Inpatient hospital: $500 per day for the first 5 days • ER: $300 • Urgent Care $ 50 • Maximum out-of-pocket • EE only $3,500 • EE+1, EE + Children $7,000 • EE + Family • NOTE: You must stay within the Humana network to receive benefits. There is no coverage out of network, except for life threatening illness and emergencies. (In most cases you will have to return to the service area for follow-up care.)

  8. In Network Benefits Deductible: Employee $300 EE+1, EE. + Family $600 EE + Spouse, EE + Children Broad network of doctors No referral to specialist Co-insurance 80%/20% Inpatient hospital: $500 Per day for a max of 5 days Out of Network Benefits differences Deductible: Employee $300 EE. + Family $600 EE + Spouse, EE + Children Co-insurance 60%/40% Inpatient hospital: 60%/40% Annual routine adult physical/GYN exam/mammography and colonoscopy – covered 40% NPOS (National Point of Service) • Maximum out of pocket in/out-of network: • $3,500 – individual • $7,000 – EE+1, EE+ family

  9. In-Network Only Broad network of doctors No referral to specialist Deductible: $1500 EE only $3000 EE+ Spouse, EE + Children, EE + Family After deductible has been met, all expenses covered at 80% except prescription cost Member Allowance: $ 500 - EE only $1000 –EE + Spouse, EE + Children, EE + Family Maximum out of pocket $3,500 – individual $7,000 – EE + Spouse, EE + Children, EE+ family CDHP Benefit Plan(Consumer Directed Health Plan) • NOTE: You must stay within the Humana network to receive benefits. There is no coverage out of network, except for life threatening illness and emergencies. (In most cases you will have to return to the service area for follow-up care.)

  10. Payroll Deduction Chart • Payroll deductions are PER PAY -- 20 pays. These are after the Board contribution has been applied. This applies to all employees no matter what pay options is selected (pages 6 & 7 in BeneFlex Guide) • To be eligible for Two Board Family, you and your spouse are employees of the School Board, both qualify for benefits and have at least one child who meets the eligibility guidelines

  11. 3 Tier Prescription Plan $250 Individual/$500 family deductible added to all health plans on tiers 2 and 3 prescriptions before the co-pays apply Preferred Humana Network – CVS. Wal-Mart & Sam’s Club Non preferred pharmacy is subject to the deductible, co-payment and 30% coinsurance Mandatory generics dispensed as written Step Therapy & Preauthorization required for certain types of drugs

  12. “No Health” Board Contribution Use your $75 per pay period Board Credit for: Dental Cover yourself or your family through Met Life or Comp Benefits Vision Quality vision care for you and your family through EyeMed Vision Care Accidental Death & Dismemberment Insurance Help for dealing with financial consequences of an accident for you and your family Short Term/Long Term Disability Short and Long Term coverage will provide a monthly benefit if you are unable to work due to illness or injury (employee only) MetLife HOSPITAL INDEMNITY (HIP) You can receive cash benefit when you or a covered dependent is hospitalized due to an accident or illness. Flexible Spending Account Apply up to $25 to a Health Care Reimbursement Account. Use your FSA to pay for eligible medical expenses not covered by insurance.

  13. Health Care Reimbursement (HCRA)Dependent Care Reimbursement (DCRA) Health Care Reimbursement Set aside your money up to $2500 (or up to $25 of Board contribution for HCRA only) on a pretax basis in a separate account to pay for out-of-pocket medical, dental, vision expenses (for all family members) Dependent Day Care (Dependent Care FSA) Up to $5000 for two working parents Pretax savings for day care expenses Children up to age 13 Advantages Reduce Federal & FICA income taxes Results in more money in paycheck Access to amount declared immediately for Health Care Acct. only •In many instances, greater tax advantage through employer plan vs. annual tax filing Disadvantages •Must estimate carefully •IRS Use it or Lose it Rule

  14. Dental PlansBox #2 • 1. Humana/CompBenefits (Dental HMO) • copayments – network providers • 2. Met Life PPO (reimbursement plan) • chose any dentist, save on preferred providers *Board Contribution (Flex Credits) may be used

  15. Dental Comparison ChartBegins on page 48

  16. EyeMed VISION COVERAGE Box #3

  17. Employees must complete the beneficiary section for Board Life. Primary and Secondary beneficiaries must equal 100%:

  18. Prudential Life Insurance Application Sample on page 19 of the Beneflex Guide

  19. TO ENROLL IN DISABILITY COVERAGE: 1Complete the top section 2 Choose New Enrollment 3Check Short Term Disability and Waiting Period 4 List benefits requested in white area of form (see page 7 of Beneflex Guide for rates) 5 List deduction amount under “20 Salary Deductions Per Year 6 Sign and date the bottom of the form 1 2 3 4 5 6

  20. MetLife HOSPITAL INDEMNITY (HIP) Box #4 The MetLife HIP pays a cash benefit when you or a covered dependent is hospitalized due to an accident or illness. • Covered Benefits: • Hospital Admission - $500 • Hospital Confinement - $250 per day, 30 day maximum • Inpatient Rehabilitation Unit - $100 per day, 15 day maximum – Accident only • Pre-existing conditions limitations apply. • *Board Contribution (Flex Credits) may be used • Rates are listed on page 7 in the Beneflex Guide.

  21. A wellness and rewards program for employees enrolled in a Humana health plan that gives its members an opportunity to: • Set goals – create a personalized plan! • Earn Vitality Points™ and shop at the Vitality Mall with Vitality Bucks! • Learn the value of making healthy choices to experience personal results! • Employees reaching Silver Status or above by August 31, 2015, will be eligible for a premium creditduring 2016! • Employee Only              $10 credit per pay period  •   Employee + Spouse      $15 creditper pay period •   Employee + Child/ren   $15 creditper pay period •   Employee + Family        $20 creditper pay period • Better health, great rewards- • it's all part of Humana Vitality!

  22. How does it work?

  23. Wellness Program • Be Smart Worksite Wellness Program, see the Wellness Champion at your worksite for programs based on the staff survey • Diabetes Care Program, free testing supplies once requirements are met. • Tobacco Cessation Program, with Rx available (telephonic coaching required) • District wide programs –stress reduction, proper hydration, skin cancer screenings, blood pressure screenings and more • All Humana Participants: Free Telephonic Health Coaching for Weight Mgt., Physical Activity, Nutrition, Back Care, Stress Mgt. • Employee Assistance Plan. (CCW)

  24. Employee Assistance Program • Stress (on & off the job) • Family & Marital problems • Divorce • Substance or Alcohol Abuse • Depression • Elder Care Referral • Legal Assistance Referrals • Corporate Care Works • 1-800-327-9757 • Covers all eligible employees and family members • Up to 8 free counseling sessions per incident.(no co-pays) • Strictly confidential

  25. Voluntary Products • Convenient payroll deductions • Enroll anytime throughout the year after your eligibility begins - Group Legal Services may only enroll as a new hire or during annual enrollment • Met Life: Great rates for cars, recreational vehicles and motorcycles • MetLife – Auto/Motorcycle/Recreation Vehicle, and Veterinary Pet Insurance Enrollment any time during the year through: 1-800-Get Met 8 (438-6388)

  26. MetLife Defender Benefits • ID Theft Monitoring • Personal Identity Monitoring and Security • Patented Peer-to-Peer Network Monitoring • Junk Mail Removal • Health Data Protection • Financial Data Protection • On-Line Child Safety Payroll Deduction • Employee Only - $9.00 • Employee + Spouse - $15.00 • Employee + Children - $12.00 • Employee + Family - $18.00 Enrollment any time during the year through: http://pinellas.enrollmetdefender.com For additional information, call 1-800-Get Met 8 (438-6388)

  27. Tax Deferred Annuity Program Defer up to 25% of pay, not to exceed $15,500 per year. (If you turn age 50 or older this year, you can contribute and additional $5,000.) Money deducted from you salary reduction is deferred from Federal income taxes Principal and interest accumulate through variety of investment options 4 monetary changes per year NO contributions /matching funds from PCS Retirement Savings Plans

  28. Retirement Savings Plans(continued) • Florida Retirement System (FRS) • You will contribute 3% of your gross pay • You must decide after receiving your packet from FRS in 60 days which plan to select • FRS Pension Plan • FRS Investment Plan • Free help is available at MyFRS.com or 1-866-446-9377

  29. Please do not ask questions of coworkers, schoolsecretaries, department heads, principals. They may not have the answers that best meet your needs. QUESTIONS Instead, contact the RISK MANAGEMENT BENEFITS TEAM for the most accurate answer at 727-588-6197 Or visit our website at www.pcsb.org/risk-benefits

  30. Risk Management & Insurance Department • We offer a comprehensive and flexible benefit program that meets your needs today & tomorrow. • We are here to serve you, our customer. Please call us anytime 588-6197 Good luck & Welcome to Pinellas County Schools

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