Presentation on theme: "Santa Rosa County School Board Employee Benefits"— Presentation transcript:
1Santa Rosa County School Board Employee Benefits 2013 Benefit Plan Year
2Benefits Offered to Full Time Employees: MedicalDentalVisionBasic and Supplemental LifeLong Term DisabilityFlexible Spending Accounts- Health & Dependent CareHealth Care Saving Accounts (if enrolled in HDHP)Tax Sheltered Annuities, Cancer & LifeRetirement(Interim employees need to check with HR for coverage eligibility)
3General GuidelinesNew 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 employmentBenefits elected will be effective thru 12/31/13Benefit plan year January 1 to December 31Open enrollment conducted annually (November) for the following calendar yearBenefits end on the last day of the month employment terminatesRetirement plan must be selected before the end of the fifth month following his/her month of hireWill receive retirement information packet directly from FRS
4MedicalFlorida Blue (formerly Blue Cross and Blue Shield of Florida) – 4 plan optionsBlue Options PPO #05773 (high option)Blue Options PPO #05301 (low option)Blue Options High Deductible Health Plans #05182 & (high option)Blue Options High Deductible Health Plans #05192 & (low option)Plan tiersEmployee onlyEmployee + SpouseEmployee + Child(ren)Employee + FamilyTwo Employee FamilyCost of plan varies based on plan and tier electedSchool Board pays a large percentage of premiumAll four plans have the same provider network (Blue Options)All four plans offer out of the network and/or out of the area coverageEffective 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
5Blue Options PPO #05773Flexibility to choose physicians from a network ofproviders that includes primary care and specialistsCalendar year deductible (CYD) – in network$2,000 per individual and $6,000 family aggregateOffice Visit Co-pays: $35.00 Primary Care and $65.00 SpecialistHospital Inpatient – $350 Per Admission DED + CYD + 30% co-insurancePreventive Care – 100% coverage in-networkAnnual Out of Pocket Maximum - $5000/$10,000 in-network per individual/family aggregateReference plan summary for specific services and applicable co-paymentsParticipating physician’s network availableCo-pay Prescription drug program included in plan (retail & mail order)
6Blue Options PPO #05301Flexibility to choose physicians from a network of providers that includes primary care and specialistsCalendar year deductible (CYD) – in network$5,000 per individual and $10,000 family aggregateOffice Visit Co-pays: $25 Primary Care and $45 Specialists (first six visits). After six visits subject to CYD + 30% coinsuranceHospital Inpatient – CYD + 30% co-insurancePreventive Care – 100% coverage in networkAnnual Out of Pocket Maximum - $7,500/$15,000 in-network per individual/family aggregateReference plan summary for specific services and applicable co-paymentsParticipating physician’s network availableCo-pay prescription drug program for Generics only included in plan (retail & mail order)
7Blue 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-networkAnnual Out of Pocket Maximum - $5,000/$10,000 in-network per individual/family aggregateReference plan summary for specific services and applicable coinsuranceParticipating physicians network availablePrescription drug program included in plan (retail & mail order) subject to calendar year deductible.
8Blue 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-networkAnnual Out of Pocket Maximum - $5,000/$10,000 in-network per individual/family aggregateReference plan summary for specific services and applicable co-paymentsParticipating physicians network availablePrescription 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.
9Health Savings Account (HSA) IRS eligibility guidelines:Covered by a high deductible health plan (HDHP)Not covered under another medical plan that is not a HDHPNot enrolled in MedicareNot eligible to be claimed under another person’s tax returnSRCSB contributes $750 or $1500 to HSA (semi-annual deposits in January and July)HSA contribution pro-rated for new hiresEmployees may also make pre-tax contributions thru payroll deductionIRS annual contribution limits for $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.
10Special 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/DivorceBirth, adoption or placement for adoptionSpouse’s job changeSpouse’s open enrollmentLoss of other health coverageRequest to enroll or make changes must be made within 30 days of the qualifying eventContact Risk Management
11My Blue ServiceWebsite for member self-service capabilities including:Request replacement ID cardHealth DialogBlue 360eMedicineHealthcare AdvisorClaim status informationBenefits informationOnline provider directoryRequest benefit bookletForms center
12Blue Dental Choice PPO Two dental plans to choose from High option – pays 100% for preventive care; 80% for basic care after CYDLow option – pays 80% for preventive care; 70% for basic care after CYDMajor services – pays 50% after CYD under both plansOrthodontic services - pays at 100% after CYD under both plans up to a lifetime maximum of $1,000Annual dental benefit maximum is $1,000 per personFlexibility to choose a dentist from a network of participating providersDental network availableReference plan summaries for specific services and applicable deductible and co-paymentsParticipating 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 premiumEmployees 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 dependentsWill receive a membership card in the mailFlorida Combined Life is the dental carrier
13Vision CareCoverage for all routine eye care, including eye exams and eyeglasses (lenses and frames) or contactsNetwork of participating physicians to choose fromReference plan summary for specific services covered and applicable co-paymentsEmployee pays total costAvailable to employees and eligible dependentsWill receive a membership cardDavis Vision is the vision carrier
14Basic & Supplemental Life Insurance The SRCSB provides all employees basic life and AD & D insurance in the amount of $50,000Amount 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 $300,000Guarantee issue up to $200,000 if employee enrolls during the first 30 days of employmentEvidence of insurability required for coverage in excess of $200,000Late enrollments (after 30 days of employment or during annual open enrollment ) requires evidence of insurability for any amountCost of additional supplemental life based on ageING is the life insurance carrierDesignate primary and contingent beneficiaries on BenefitHelp
15Flexible 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 accountDependent care reimbursement accountReference plan summary for covered expensesPlan year runs concurrent with health plan year (January – December)Maximum annual election $2,500 – Use it or lose itThree options for reimbursement:Pay with Flexible Spending Account debit cardSubmit claim forms and receiptsFile on-line atTotal Administrative Services Corporation (TASC) is the FSA third party administrator for the School BoardEmployees who open a Health Savings Account (HSA) may not elect toparticipate in a health care flexible spending plan (IRS guidelines).
16Long Term DisabilityMonthly benefit equal to 60% of your salary up to $5,000Benefits start after 60 days of disabilityBenefits paid to age 65Employee pays the total costRates based on age and salaryPremiums waived during disability periodFlorida Combined Life is the LTD carrier.
17Tax Sheltered Annuities Cancer, Life, Long Term Care Insurance Products available for individual purchasePayroll deductions for approved vendorsList of vendors, agents and contact information on the Risk Management website
18Florida Retirement System Two plans to choose from:Pension PlanInvestment PlanThe 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 hireResources for information:Human Resources WebsiteMyFRS.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 counselorsEmployee workshops
19District Liability Insurance Programs Insurance coverage for all School Board employees that includes:Comprehensive General LiabilitySchool Leaders Error and OmissionsSexual HarassmentSexual MolestationExclusion for “intentional acts”