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Plan year begins September 1, 2011 and ends August 31, 2012 1.

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Presentation on theme: "Plan year begins September 1, 2011 and ends August 31, 2012 1."— Presentation transcript:

1 Plan year begins September 1, 2011 and ends August 31,

2 Open Enrollment Dates April 18 through May 6 – Supplemental Benefits Flexible Savings Accounts (must be elected to continue) Disability Dental Life Insurances Dread Disease Insurance (Cancer/Critical Care/Heart/Stroke) Accident Insurance Vision Insurance Medical Gap Insurance No changes can be made to these benefits after May 6, unless there is a status change and the benefit change is made within 30 days of the status change. 2

3 Open Enrollment Dates Health Insurance April 18 – May 6 August 1 – August 31 Long Term Care Enrollment at Will Retirement Accounts ( 403(b) and 457(b) ) Enrollment at Will 3

4 Current Benefits Current benefits remain in effect until September 1, Benefits for terminating employees remain in effect until September 1, 2011 for those employees working 187 days who are finishing their contract year. Benefit termination dates for retiring employees vary. I will contact you once I have received your retirement status form. 4

5 Benefit Resources Benefits Web Site: How do I get there? Go to Main CISD Web Page – Employment – Employee Benefits – Voluntary Benefits U-Count – Staff Discounts and Offers Main CISD Web Page – Left Side – “U-Count” TRS - 5

6 No Changes Cancer Insurance Heart Stroke Insurance Critical Care Insurance Permanent Life Insurance Term Life Insurance Long Term Care Flexible Spending Accounts (Medical Reimbursement and Dependent Reimbursement must be elected each year. It does not carry over) 6

7 Changes to Supplemental Benefits Health Insurance – premium increases along with deductible and c0-pay increases. (This insurance will continue if you do not take action to change it.) Disability – We are changing our disability provider. You must enroll in the new disability plan by May 6 if you want disability insurance for the new plan year. Dental – We are changing our dental provider. You must enroll in the new dental plan by May 6 if you want dental benefits for the new plan year. 7

8 Declination of Health Insurance You must decline yourself and/or your dependents for the new plan year or you cannot enroll either yourself, or your dependents, for any reason, from 9/1/2011 through 8/31/2012. There are no exceptions to this rule. Proof of prior insurance will no longer be accepted in lieu of the declination. Decline yourself and any eligible dependents, by name if you are cancelling coverage or do not want coverage for the new plan year. If you are covering yourself and only some or none of your eligible dependents make sure you decline the eligible dependents you are not covering for the new plan year. If you are not changing your plan complete a new enrollment form declining all eligible dependents that are not covered. *Eligible Dependents – spouses, children or step-children under the age of 26, married or unmarried, regardless of college status. 8

9 Health Insurance Changes Extension of coverage to dependent children until age 26, whether or not they live with their parents, are claimed as a dependent on a parent’s tax return, or are married. Pre-existing condition exclusions will not apply to any individual under the age of 19. Enrollees may make plan changes during the plan year due to special enrollment events. Individuals who voluntarily drop coverage during the plan year, and decline themselves and/or dependents for that plan year, may now re-enroll during the plan year due to a special enrollment event. 9

10 Health Insurance TRS has increased premiums for all plans Preventative (Wellness) Services are now covered without a co- pay on Plans 2 & 3 Preventative Services no longer have a $500 limit on Plans 1-HD & Plan 1 $5000 co-pay for Bariatric Surgery – All Plans Enhanced Benefits for Skilled Nursing Care, Home Health Care, Chiropractic Services, and Hospice Care 10

11 Plan 1 Services Comparison 2010 – 2011 Plan Year 2011 – 2012 Plan Year Deductible $1200 individual $3000 family Pays at 80% after Deductible is met. Prescription costs apply to deductible. $500 Wellness Benefit – cost for preventative services up to $500 limit. Deductible No Change Preventative Services Covered with no maximum. 11

12 Plan 1 Premium Comparison 2010 – 2011 Plan Year 2011 – 2012 Plan Year Employee Only: $0 Employee & Spouse: $380 Employee & Children: $177 Employee & Family: $449 Employee Only: $14 Employee & Spouse: $430 Employee & Children: $208 Employee & Family: $506 12

13 Plan 1 – HD (High Deductible) Premium for New Plan Year Plan 1 – HD or Plan 1? $0 Employee Only $416 Employee/Spouse $161 Employee/Child(ren) $633 Employee/Family $2400 deductible for Employee Only, Employee/Spouse/Child(ren) /Family before plan picks up at 80%. Plan 1 -Employee Only $14 per month with a $1200 deductible Plan 1-HD -Employee Only $0 per month with a $2400 deductible Plan 1 – HD can be a viable option especially for Employee/Spouse/Child/Family coverage. 13

14 Plan 2 Services Comparison 2010 – 2011 Plan Year 2011 – 2012 Plan Year Deductible $500 Individual $1500 Family Co-pays for Office Visits $30 for Primary $50 for Specialist Prescription Co-pays ($50 Deductible) $10/$25/$45 Retail Short-term $15/$35/$60 Retail Maintenance $20/$62.50/$ Mail Order Specialty Drugs Standard Co-pays Deductible $750 Individual $2250 Family No Change Prescription Co-Pays ($100 Deductible) $15/$35/$60 Retail Short-term $20/$45/$75 Retail Maintenance $45/$105/$180 Mail Order Specialty Drugs $200 C0-pay per fill 14

15 Plan 2 Premium Comparison 2010 – 2011 Plan Year 2011 – 2012 Plan Year $99 Employee Only $604 Employee & Spouse $333 Employee & Children $694 Employee & Family $123 Employee Only $676 Employee & Spouse $379 Employee & Children $774 Employee & Family 15

16 Plan 1 & 2 One Year Cost Comparison Plan 1 – Employee Only Plan 2 – Employee Only Per Month: $14 Per Year: $168 Wellness Checks: No Charge $1200 Deductible that must be met before plan picks up at 80%. Prescription costs contribute to the deductible. Per Month: $123 Per Year: $1476 Wellness Checks – No Co-pay. Must pay 20% of services not performed in doctor’s office. $30 Primary Care $50 Co-pay Specialist Co-pays for Prescriptions $150 Co-pay for ER visits, out patient surgery, and hospitalization 16

17 Which Plan Is Right for You? Plan 1 and Plan 2 have access to the same network of BCBSTX providers. By opting for Plan 1 Employee Only Coverage instead of Plan 2 Employee Only Coverage an employee could potentially save up to $1308 over the course of year. Plan 1 does not have Office Visit co-pays, Hospital Co- pays, or Emergency Room co-pays. These co-pays continue with Plans 2 & 3 even when all deductibles and out of pocket maximums are met. 17

18 Health Insurance Decisions 18 Remember that Davis Vision Discount plan is a part of your health insurance. Use your health insurance card at participating stores to receive the discount. Find providers on the Benefits web site. One vision exam per year is covered through your health insurance. Look at yearly costs as well as monthly costs when choosing a plan. Factor in known costs such as prescriptions, physician visits, upcoming surgical procedures, and expenses associated with pregnancy before making a choice. Consider Medical Reimbursement and/or Medical Bridge Insurance to help you meet prescription costs, co-pays and deductibles, or hospitalization costs.

19 Disability Plan Comparison American Fidelity (Current) Metlife Educator (New) Can choose up to 70% of gross monthly pay Must satisfy waiting periods for all plans except for Plan 1. Accidental Death Benefit Must choose 60% of gross monthly pay Waiver of waiting period on 8 and 15 Day plans after 18 hours of hospitalization No Accidental Death Benefit 19

20 Disability Premium Comparisons – (Based on $3000 Monthly Benefit) Current American Fidelity Plan New Metlife Educator Plan 1st Day of Hospitalization or 4 th Day of Illness/Accident Premium - $ th Day of Hospitalization or Accident/Illness Premium - $ th Day of Hospitalization or Accident/Illness Premium - $87 1 st Day of hospitalization or 8 th day of Illness/Accident (8 days waived after 18 hours of hospitalization) Premium - $ st Day of Hospitalization or 15 th Day of Accident/Illness (15 days waived after 18 hours of hospitalization) Premium - $ th Day of Hospitalization or Accident/Illness Premium - $

21 Disability Plan Comparison – Plan 3 (Based on $3000 Monthly Benefit) Current American Fidelity Plan New Metlife Educator Plan 60th Day of Hospitalization or Accident/Illness Premium - $ th Day of Hospitalization or Accident/Illness Premium - $ Days not offered 90 th Day of Hospitalization or Accident/Illness Premium - $16 21

22 Dental Plan Comparison Current Dental Select Plan New Metlife PDP Plan Dental Select Platinum PPO 100% of cleanings 80% - fillings 50% - major services after a 1 year wait. $1000 yearly maximum____ $ Employee Only $79.72 – Employee + 1 $ – Employee + Family Metlife PDP Plan 100% - cleanings 80% - fillings 50% - major services after a 6 month wait $1000 yearly maximum____ $ Employee Only $ Employee + Spouse $ Employee + Children $ Employee + Family 22

23 Dental Plan Comparison Current Dental Select Gold Plan New MetLife Low Dental Plan Pays via Fee Schedule Cleanings, fillings, and all major services Network specialists 20% discount No deductible/No yearly maximum_____________ $14.06 – Employee Only $30.06 – Two Party $41.30 – Family Coverage 100% - Type A – Preventative Cleanings, fluoride treatments 80% - Type B – Basic - Fillings, sealants, periodontal maintenance, etc. Major services such as root canals not covered. $750 Yearly Maximum $50 individual deductible applies only to Type B_________________ $16.51 – Employee Only $31.96 – Employee + Spouse $38.39 – Employee + Child(ren) $57.89 – Employee + Family 23

24 Choosing a Dental Plan Always use contract, network dentists – this will save you the most. A dental office that “accepts” your insurance is not always in network. Ask specifically if the dental office is contracted and in-network with your dental plan. 24

25 New Insurances Accident Insurance Vision Insurance Medical Bridge Insurance 25

26 AFA Accident Only Insurance Plan Covers you in the event of an accident. Benefit payment not reduced by Workers Compensation. Pays along with Workers’ Compensation. Benefit Payments made directly to you. Benefits pay regardless of other coverage. Individual and Family plans. Wellness Benefit of $50 or $75 after 1 year of coverage. Plan premiums begin at $14.60 for employee only basic coverage. 26

27 Vision Insurance 27 VSP Choice Plan B Eye Exam – $10 co-pay Single vision and lined bifocal and trifocal lenses - $25 co-pay Frames – covered up to $130 Contact lenses (in lieu of glasses) - $130 _______________________________________________________ _______________________________________________________ $7.60 – Employee Only $15.20 – Employee + Spouse $16.26 – Employee + Child(ren) $25.97 – Employee + Family

28 Medical Bridge Insurance Can help to defray hospitalization or outpatient surgery cost Does not cover prescription drugs or doctor visits High Plan Hospital Benefit - $1500 per year Outpatient Surgery - $1000/$2000/$3000 Low Plan Hospital Benefit - $500 per year Outpatient Surgery - $750/$1500/$2500 Both plans offer a $50 Wellness Benefit Both plan premiums are age banded. Premiums begin at $14.89 per month for the age group and end at $62.94 for the 65+ age group. 28

29 Medical Bridge Decisions If you have a high deductible plan this may be a cost saving option in the case of a catastrophic event. ActiveCare 1 Employee Only $14.00 (per month) Medical Bridge $27.10 (per month) For a total of $41.10 per month you could cover the $1200 deductible in the case of a hospitalization or surgery. This would be a savings of $81.90 per month over Plan 2 coverage. Please keep in mind that Medical Bridge Insurance does not cover prescription drugs or doctor visits. 29

30 Conclusion Open Enrollment Dates Supplemental Benefits April 18 – May 6 (check web site for times and locations) Health Insurance 1. April 18 – May 6 (same locations and times as supplemental benefits) 2. August 1 – August 31 (through Benefits Office) 3. Decline yourself and/or any eligible dependent for health insurance by August 31 so that you can enroll for health insurance if you lose other coverage during the new plan year! This year you must elect dental and disability insurance if you want coverage for the new plan year. Every year you must elect Flexible Spending if you want it for the new plan year

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