1. Let’s Talk Benefits Presented by your Benefits Team:
Sara Aranda, Benefits Coordinator
Brittany Heim, Benefits Coordinator
Tracy Willis, Benefits Manager
Vickie Del Bello, Director of ER & Benefits

2. 2017 Summer
Enrollment
TBD

3. DEPENDENTS DEPENDENT CHILDREN Ongoing DEPENDENT AUDIT
Can be covered until the age of 26 on health insurance – regardless of marital or educational status
If child is married, dental insurance, AD&D and dependent life insurance is not available.
Ongoing
DEPENDENT AUDIT
Employee required to submit documents to ensure dependents are eligible for coverage.
Example of Required Documents: Birth Certificates, Marriage License, Tax Returns
Will be contacted by Aon Hewitt for documentation submission.

4. Dental Options After tax deduction PPO Plan Can choose any dentist
HMO Plan
Must use dentist in HMO network
Discount Plan
Not an insurance plan – offers discounts from participating providers
Employee Only
$0.00
+ Spouse
$13.32
$4.80
$1.14
+ Children
$18.64
$6.70
$1.60
+ Family
$31.94
$11.50
$2.70
After tax deduction

5. Dependent Life Insurance
Optional Life Insurance
SJC pays premium for 2x annual salary
Evidence of Insurability (EOI) must be completed and approved if elected during summer enrollment.
May elect to pay premium for 3x or 4x
EOI must be completed and approved.
Rates are age-banded
Maximum coverage amount of $400,000
Dependent Life Insurance
Voluntary AD&D
$10,000 - $200,000 of coverage
Employee Only
$0.02/$1,000 of coverage
Maximum Premium: $4.00/month
Employee + family
$.04/$1,000 of coverage
Spouse covered at 50%, children at 20%
Maximum Premium: $8.00/month
$5,000 term life policy with AD&D rider
Unlimited number of dependents
EOI required if elected during Summer Enrollment
Monthly Premium: $1.38

6. Texas Income Protection Plan Short Term & Long Term Disability
STD
Premium $0.30/$100 of monthly salary
30 day waiting period
Pays up to 66% of your monthly salary
Benefits are paid for up to 5 months
LTD
Premium: $0.63/$100 monthly salary (paid by SJC)
180 day waiting period
Pays up to o 60% of your monthly salary
Benefit period depends on age when you become totally disabled
Must exhaust all leave
EOI required if elected during Summer Enrollment

7. State of Texas Vision Administrator – Superior Vision
Superior National Network with over 6000 providers in Texas
In-Network Co-Pays
Routine Eye Exam: $25.00
Contact Lens Fitting: $25.00(standard) $35.00(specialty)
Frames or Contacts Allowance: $150 retail
Monthly Premiums
Employee Only $6.69
+ Spouse $13.38
+ Children $14.38
+ Family $21.07

8. HEALTH PLANS HealthSelect of Texas
Point-of-Service Health Plan
KelseyCare by Community Health Choice
Kelsey Seybold HMO Health Plan
Consumer Directed HealthSelect
High-Deductible Health Plan(HDHP) with a Health Savings Account option(HSA)

9. All Health Plans
Annual in-network out-of-pocket maximums (increase from FY16)
$6,550 individual, $13,100 for family
Includes copays, coinsurance and pharmacy deductibles
$5,000 Basic Group Life Insurance for employee
Vision Rider
Specialist copay, includes discounts at certain providers for frames, lenses or contacts.

10. Tobacco User Premium
Rate is dependent upon how many tobacco users or non-certified members are covered on health insurance
All employees are required to certify.
Choose To Quit(CTQ) program available to receive refund of tobacco fee each year.
Coverage
Fee
You, Spouse, or Child ONLY
$30
You + Spouse
$60
You + Spouse + Child
$90

11. HealthSelect of Texas Plan
United HealthCare – Plan Administrator
Point-of-Service (POS) plan with direct access for eye exams and OB/GYN.
A PCP is must be selected to receive In-Network benefits.
Referral is required for specialist visits.
PCP Office Visit: $25 copay
Specialist Office Visit: $40 copay
Urgent care facility benefits
$50 copay + 20% coinsurance (In-Network)

12. KelseyCare Plan powered by Community Health Choice
Kelsey Seybold HMO Plan
Benefits similar to UHC plan
Available to the following counties:
Brazoria, Fort Bend, Galveston, Harris and Montgomery
Must use a KelseyCare network doctor
$15 PCP copay
$25 Specialist copay – no referral required
More information at

13. Prescription Drug Plan HealthSelect or KelseyCare
Tier 1
Generic
Tier 2
Preferred
Tier 3
Brand Specific
Deductible
Each participant must pay a $50 annual deductible
Non-maintenance drug bought at a participating retail pharmacy
$10 up to a 30-day supply
$35 up to a 30-day supply
$60 up to a 30-day supply
Maintenance drug bought at a participating retail pharmacy
$20 up to a 30-day supply
$45 up to a 30-day supply
$75 up to a 30-day supply
Maintenance drug bought through a mail order pharmacy
$30 up to a 90-day supply
$105 up to a 90-day supply
$180 up to a 90-day supply
HealthSelect deductible based on calendar year January – December
KelseyCare deductible based on fiscal year September – August

14. TexFlex
Pre-Tax Spending Account for HealthSelect and KelseyCare participants
Administrator – ADP
Set up an online account
Website:
Health Care
Copays, prescriptions, coinsurance, eyewear
Minimum annual contribution: $180
Maximum annual contribution: $2,544
Debit Cards will be mailed to ALL participants – No fee
Dependent Care
Daycare, summer camps
Maximum annual contribution: $4,996
No debit card option

15. Consumer Directed HealthSelect
Play Video

16. Consumer Directed HealthSelect
United HealthCare – Plan Administrator
No PCP or referrals required.
Must meet deductible before plan pays ANYTHING for health and prescriptions except in-network preventive care.
Deductibles
Deductibles are based on a calendar year. If you switch, the deductibles and out-of pocket maximums will start over on January 1.
Individual
Family
After Deductible Plan Pays
In-Network
$2,100
$4,200
80%
Out-of-Network
$8,400
60%

17. Health Spending Account (HSA) Available to Consumer Directed HealthSelect Members
Administrator – Optum Bank, a subsidiary of United HealthCare Services
Pre-tax contribution to assist with out-of-pocket expenses for HDHP.
Must be setup BEFORE eligible expenses are incurred.
Available to non-Medicare eligible employees
Cannot be covered under any other traditional health plan (ie. spouse or parents)
Contributions and Limits for Plan Year 2017
Individual Plan
Family Plan
State Contribution
$540 ($45 monthly)
$1,080 ($90 monthly)
Maximum Participant Contribution
$2,810
$5,670

18. Limited Flexible Spending Account Available to Consumer Directed HealthSelect Members
Administrator – ADP (same as TexFlex)
Pre-tax contribution for eligible vision and dental care ONLY
Contributions Limits for Plan Year 2017
Same as TexFlex Health
$180 minimum annual contribution ($15 monthly)
$2,544 maximum annual contribution ($212 monthly)
Employees who switch to Consumer Directed HealthSelect that have $25 - $500 remaining in their TexFlex account will automatically be enrolled in the LFSA

19. Because of the possibility of much higher out-of-pocket costs, you should think carefully before signing up for Consumer Directed HealthSelect.
You need to understand all the costs and benefits, to know if the plan is right for you and your family.
If you cannot afford thousands of dollars in upfront out-of-pocket costs before the plan starts paying for ANY covered health services and prescriptions (except preventive care), you should NOT enroll in Consumer Directed HealthSelect.

20. Health Coverage Rates Employee Only $0.00 + Spouse $176.84 $138.50
$159.16
+ Children
$118.40
$92.74
$106.56
+ Family
$295.24
$231.24
$265.72

21. Additional
BENEFITS

22. HealthSelect and Consumer Directed HealthSelect Members
Virtual Visits: Consultation with licensed physician from computer or mobile device to diagnose and treat non-emergency medical conditions such as sinus problems, sore throat, pink eye and bronchitis.
$10 copay HealthSelect
$40 visit for Consumer Directed HS until deductible is met then $8.00
Real Appeal: FREE online weight loss program available to employees and their dependents over 18 and not enrolled in Medicare part B – with a body mass index(BMI) of 23 or higher.

23. Available to All ERS Members
ERS Discount Purchase Program
Available to employees, retirees, and their immediate families
Discounts on many products and services, from computers to theme park passes.
No sign-up fee
Visit today at to start saving!

24. Beneficiaries
ERS Designation of Beneficiaries - Visit to update your beneficiaries. For assistance, please contact ERS directly at
TRS Designation of Beneficiaries - Complete the TRS 15 form, have it notarized, and submit it to TRS at 1000 Red River Street, Austin, TX

25. Retirement Savings
All employees can participate in a 403(b) and/or 457 plan.
Maximum annual contributions based on age are set by the IRS.
Current annual maximums:
Under age 50 $18,000
Over age 50 $24,000
10 Board approved vendors to choose from

26. Vision also known as

27. Upcoming events

28. ERS Events
TBD
For more info on ERS sessions, visit

29. SUMMER BENEFITS ENROLLMENT
TBD

30. SUMMER BENEFITS ENROLLMENT
TBD