Presentation on theme: "Cobb County School District"— Presentation transcript:
1Cobb County School District 2015 Benefits open enrollment review
2ShawHankinsService Center- can answer questions on all benefits, including state healthAvailable extended hours 8:30 am – 7:00 pm during open enrollmentOct 27 – Nov 14Benefit website- shawhankinsbenefits.net/ccsd
3SHBP Changes for 2015-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 HMOUnited Healthcare: High Deductible Health Plan (HDHP) and statewide HMOKaiser Permanente: Regional HMO available to members who work or live in the 27 metro Atlanta counties.
4SHBP Changes for 2015- Plan Highlights Health Reimbursement Arrangement (HRA)Copays will no longer apply to medical and pharmacy expenses. All services will be subject to the plan deductible and/or co-insurance.Health Maintenance Organization (HMO)Members now have the choice of enrolling in statewide or regional HMO plan that offers co-payments for certain servicesHigh Deductible Health Plan (HDHP)Members now have the option of enrolling in an HDHP. With an HDHP you are also eligible to start a Health Savings Account (HSA) to set aside pre-tax dollars for medical expenses.Out of Pocket MaximumsThe medical and pharmacy out of pocket maximums will now be combinedCo-payments count toward the out of pocket maximums for the HMO plans
5How the HRA Plans WorksBronze, Silver and Gold options with different levels of coverageAll services are subject to the plan deductible and/or coinsurance, no copays apply for 2015SHBP contributes HRA credits to your HRA account based on the plan option and tier of coverage you chooseThese credits provide first dollar coverage for medical and pharmacy expensesHRA credits left at the end of the year will roll over to the next plan year, if you remain enrolled in an HRA optionIf you enroll in an HMO or HDHP plan, you will forfeit any remaining 2014 credits
6HRA Plan Features Preventive services covered at 100% After you meet your annual deductible, you pay a percentage of the cost, called co-insuranceYou are not required to obtain referrals from a PCP to see a SpecialistThe credits in your HRA account are used to help meet your deductible and out of pocket maxThe medical and pharmacy out of pocket maximum are combinedCertain drug costs are waived if you participate in one of the DM programs- diabetes, asthma, or coronary artery disease
9How 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) must be met before benefits are payable for any family memberEligible to establish a Health Savings Account (HSA) to set aside tax-free dollars to pay for eligible health care expenses.
10HDHP Plan Features Preventive services covered at 100% You pay co-insurance (70% in-network, 50% out of network) after you meet the plan deductible for all medical and pharmacy expenses, until you meet the out of pocket maximum ($6,450/$12,900)Medical and pharmacy out of pocket maximums are combinedNo co-pays applyEligible to contribute to Health Savings AccountContributions will not be taken through payroll deductions
13How the Statewide HMO Works Available through BCBS or UHCRates differ between the 2 carriersReceive covered services through in-network providers only (except emergency care)Be sure to confirm your providers are participating in the BCBS or UHC networkCo-payments apply to certain services- office visits, urgent care, emergency room and prescriptionsCo-payments count toward your out of pocket maximum, but not deductiblePreventive services covered at 100%
16How the Regional HMO Works Services only available through Kaiser HMO networkMust select a PCPPreventive services covered at 100%Plan available for members that live or work in one of the 27 metro Atlanta counties:BarrowCowetaGwinnettPauldingBartowDawsonHaralsonPickensButtsDeKalbHeardPikeCarrollDouglasHenryRockdaleCherokeeFayetteLamarSpaldingClaytonForsythMeriwetherWaltonCobbFultonNewton
19WellnessHealthways will continue as the Wellness vendor for the BCBS and UHC plan options with well-being resources and incentive programsAll health actions must be completed between January 15, 2015 and December 15, to earn well-being incentive creditsIf you choose one of the HRA plans, the well-being credits will be deposited into your HRA accountIf you choose a statewide HMO, well-being credits will be placed into incentive accountsIf you choose the HDHP plan, well being credits will be placed into an incentive accountYou must pay $1,300 toward your individual deductible or $2,600 toward family deductible prior to accessing these credits
21Wellness-Kaiser Permanente Resources AvailableTotal Health AssessmentBiometric screeningsOnline and onsite healthy living classesSign up at my.kp.org/shbp and complete at least one health action to be entered in monthly drawing for an iPad and a Fit Bit:Completed biometric screeningCompleted online Total Health AssessmentGet support to meet goals with KP wellness coachComplete one online health education classGet your annual flu shotReceived a preventive Cancer Screening- Colorectal Cancer, Breast Cancer or Cervical Cancer
22Tobacco Cessation Tobacco surcharges are included in all SHBP options Surcharge applies if you are not tobacco-free or do not complete tobacco cessation coaching programIf you do not make an indication for 2015 on your tobacco usage, you will continue to be assessed the surcharge.
23State Health Open Enrollment Open enrollment is from October 27th – November 14thmyshbpga.adp.comIf you do not login to enroll or make changes, you will be defaulted to your current HRA plan (without copays), coverage tier and tobacco status. If you are not currently covered and do not enroll, you will continue with no coverage.
24State Health Open Enrollment When making your benefit election make sure you have selected the correct option.Verify your coverage tier (you only, you + spouse, you + child(ren) or you + family)Confirm you have added all eligible dependents you wish to be included under your coverage.Confirm you have answered the tobacco question correctly.Review/Confirm your elections and click “Finish”. NOTE: If Finish is NOT clicked, your enrollment process has not been completed.Print or save a copy of your confirmation page for your records.
26Dental MetLife will be the dental carrier for 2015 Expansive national network, superior serviceAll members will receive a new ID cardContinue to have a Base and Plus plan optionReview benefit details, as base plan copay schedule differs from 2014
27Plan Option 1- Base Plan (Copay Plan) Benefit SummaryPlan Option 1- Base Plan (Copay Plan)Plan Option 2 – Plus PlanCoverage TypeIn-NetworkOut-of-NetworkType A – Diagnostics & PreventativeSee Schedule85% of R&C Fee100%Type B – Basic50% of R&C Fee75% After Plan Deductible75% of R&C FeeType C – Major40% of R&C Fee50% After Plan Deductible50% of R&C FeeType D – Orthodontia50% of Maximum Allowed Charge40% After Plan Deductible40% of R&C FeeDeductible†IndividualN/A$50.00Family$150.00Annual Maximum Benefit:Per Person$750 of Combined In-Network Covered Dental Expenses and Out- of-Network Covered Dental Expenses$500 of Combined In- Network Covered Dental Expenses and Out-of-Network Covered Dental Expenses$1,000Orthodontia Lifetime Maximum$750$5001,000
28Vision Avesis will continue as the vision carrier for 2015 Basic and Preferred Plus OptionNo change in plan coverage or rates
30Basic Life with AD&DCCSD provides basic life coverage at no cost to youThis includes a life and accidental death and dismemberment benefitNon-tobacco users receive a $13,000 benefitTobacco users receive a $10,000 benefitLife benefit is portable, AD&D benefit is not portable
31Contributory Basic Life with AD&D Additional term life and AD&D coverage available to purchase2.5 times your salary$113,000 maximumGuaranteed issue for new hires. Late entrants must complete the Personal Health Application and be approved for coverage
32Supplemental Life with AD&D Eligible to elect if you purchase the Contributory Basic Life coverage1 times your annual salaryMaximum 6 times your annual salary, to $500,000$500,000 maximum is no longer combined with other life policiesNew hires guaranteed up to 2 times your salary or $100,000 without answering health questionsLate entrants must complete the Personal Health Application for all amounts of coverage
33Supplemental Life- Dependents Spouse or Dependent Children$10,000 or $25,000 in coverage
34Short Term Disability No changes to STD benefit Choice between 2 salary replacement percentage levels- 50% or 66.67%Choose your start date for benefits, based on how many days of sick leave you haveAll sick leave must be exhausted prior to STD benefits beginningLate entrants or employees that wish to increase their level of coverage must submit a Personal Health Application and be approved before coverage is effective
35(from the date of Disability) STD Plan OptionsBenefits Start Date(from the date of Disability)Benefit PercentageMonthly Premium18th calendar day66.67%$13.53215th calendar day$11.21331st calendar day$7.35461st calendar day$7.16550%$9.896$8.197$5.378$5.22
36Long Term Disability Cost paid fully by CCSD Benefit begins after you are disabled for 6 monthsPays 50% of your gross monthly earnings up to a maximum of $7,500 a month
37Flexible Spending Accounts Two separate accounts- Medical Spending Account and Dependent Care Spending AccountAllows you to set aside pre-tax dollars to spend on qualified expenses, saving on your taxable incomeMust make new elections for 2015If enrolling in the HDHP medical plan, you are not eligible to contribute to FSA
38Flexible Spending Accounts Medical Spending AccountMaximum contribution of $2,500Some eligible expenses- Deductibles, copayments, dental expense, vision services and materialsDependent Care Spending Account$5,000 for married couple filing joint income tax returns, $2,500 if unmarried or married and filing separate income taxesSome eligible expenses- any care of a dependent that allows you and your spouse to work: day care, after school program, in-home care, campsNew! You may rollover up to $500 left at the end of the 2014 plan year to use in 2015 for your Medical Spending Account
39Cancer CoveragePays a cash benefit directly to you if diagnosed with Cancer or 29 additional specified diseaseCoverage available for you and your familyPays based on the type of services received: inpatient care, surgery, medication3 levels of benefits available- Economy, Standard, DeluxeConvertible to individual policyWaiver of premium after 90 days of disability
40Critical Illness Coverage Pays a lump sum benefit to you at the time of diagnosis of a covered illness.Employee benefit: $10,000Spouse and child benefit: $5,000Children covered at no extra chargeSome covered illnesses: Heart Attack, Stoke, Coronary Artery Bypass, Major Organ Transplant, End Stage Renal FailureWellness Benefit: Pays you $50 benefit when you have a annual preventive screening: Ex) colonoscopy, EKG, Stress Test, Mammogram, Skin Cancer Biopsy
41Legal CoverageIn-Office Attorney Services: reviewing and preparing documents, providing legal advice and consultation, representation in courtTelephonic Advice: assistance in reviewing and preparing documents, will preparation, financial education and counselingOnline Resources: Guidebooks and videos, DIY Docs- state specific legal documents, online financial toolsNew for 2015! Identify Theft Protect- No additional costCovers up to $1 million for expenses associated with restoring your identityLost wallet services- cancel and reissue credit cards, driver’s license, etcCredit monitoring- monitors and informs members of changes to credit reportInternet surveillance- monitors websites for your personal information being traded or soldChild monitoring- monitors your minor’s identity