1. Risk Management & Insurance
– Fax

2. 2018 Enrollment & Change Form – Required!

3. Form Required if Enrolling in Coverage
Online Application to Enroll in Coverage
GUARANTEED ISSUE
FOR NEW HIRES
Employee coverage up to $100,000 elected on Enrollment & Change Form
Employee coverage over $100,000 and spouse coverage require online Medical History Statement

4. WHEN ARE MY BENEFITS EFFECTIVE?
Benefits are effective the first day of the month following 60 days of employment.
Example:
Hire Date Benefits Effective
8/ /1
4/ /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.

5. 20 Payroll Deductions per year.
You pay for 12 months of coverage during the 10 month school year.
 You pay one month in advance.
Deductions include a portion for summer coverage.
Summer premium may be owed upon your initial enrollment or if you change benefits during the year.
If your deductions change during the year, you may owe premium or you may be due a refund.

6. Terms and Definitions DEDUCTIBLE
You pay 100% of the cost up to the amount of the deductible*
CO-INSURANCE
You pay 20% of the cost up to the out of pocket limit
OUT OF POCKET LIMIT
Humana pays 100% of the costs after the costs reach $4000 for an individual, $8000 for a family
*All individual deductible amounts will count toward the family deductible, but an individual will not have to pay more than the individual deductible amount.

7. Which Health Plan is Right for You?

8. Pharmacy Benefits Rx4 Traditional
Pay two co-pays for a 90 day supply at a participating pharmacy or mail order through Humana Pharmacy (after deductible on Tier 3 & Tier 4 medications).
Check our website for manufacturer programs that help with Rx costs!

9. With Doctor on Demand, you pay less than a visit to urgent care:
Staff HMO: $25 co-pay
NPOS and CDHP: $40 or 20% of $40 after deductible has been met.
Visit doctorondemand.com/humana or download the free Doctor on Demand app from the App Store or Google Play.

10. Healthcare Bluebook can help you find high-quality medical care at the best cost.  
Go Green to Get Green
You can look up a Fair Price, compare provider prices, and find the best value in your area. Click the “Go Green to Get Green” banner and you’ll earn a $25, $50, or $100 reward (on select procedures) when you choose a Fair Price provider.
Download the free Healthcare Bluebook
mobile app to start shopping
for prices and facilities!

11. Set goals – create a personalized plan!
go365 is 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 Points™ and shop at the Mall with Bucks!
Learn the value of making healthy choices to experience personal results!
Employees reaching Silver Status or above by August 31, 2018, will be eligible for a premium credit during 2019!
Employee Only              $10 credit per pay period 
  Employee + Spouse      $15 credit per pay period
  Employee + Child/ren   $15 credit per pay period
  Employee + Family        $20 credit per pay period
Better health, great rewards – it’s all a part of Humana go365!

12. “No Health” Board Contribution
Use your $75 per pay period Board Credit for:
Dental
Vision
Accidental Death & Dismemberment Insurance
Short Term/Long Term Disability
MetLife HOSPITAL INDEMNITY (HIP)
Flexible Spending Account
Mark “Refuse” in box #1
Complete and sign page 2
EXAMPLE
Board Credit $75.00
Humana Advantage Dental (2P) $13.02
Eye Med Vision (2P) $ 2.83
AD&D $100,000/Fam $ 2.10
Short Term Disability
$800/16 day $12.88
Long Term Disability
$ $ 4.05
MetLife HIP (2P) $13.00
Healthcare FSA $25.00
TOTAL USED $72.88

13. Dental Plans Comparison Chart
*Board Contribution (Flex Credits) may be used

14. Eye Med Vision Plan KEY FEATURES KEY FEATURES
Free coverage for employee only. May purchase coverage for dependents
Routine eye exam once every calendar year - $10 co-pay
Single vision lenses OR contact lenses once every calendar year
Frames once every two years
National retail and private practice optometrists & ophthalmologists
Standard plastic lens co-pay
$15
Contact lens allowance
$110 plus 20% off
balance over $110
Frame allowance
$110
RATES
Employee Only Free
Employee + 1 $2.83
Employee + Family $5.92

15. MetLife HOSPITAL INDEMNITY (HIP)
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.

16. 13

17. Short Term/Long Term Disability
Short Term Disability (Base Plan) pays up to 2 years for illness, up to 5 years for injury.
Long Term Disability pays after the base plan.
Pregnancy benefits: up to 6 weeks post partum for a normal deliver, 8 weeks post partum for a cesarean section.
Monthly benefits are paid after the waiting/elimination period.

18. The Standard Life Insurance
BOARD PAID LIFE – Employee Coverage:
1 X your annual salary, rounded to the next $ Minimum coverage is $15,000.
VOLUNTARY FAMILY TERM LIFE
Spouse and Children - $5,000 each
Premium covers all eligible dependents
VOLUNTARY OPTIONAL TERM LIFE
Employee: $10,000 - $500,000**
Spouse: $10,000 - $100,000
Online Medical Statement REQUIRED
May not exceed employee coverage amount
Children: $2,000 - $10,000
Mark election on Enrollment & Change Form
**GUARANTEED ISSUE
FOR NEW HIRES
Employee coverage up to $100,000 elected on Enrollment & Change Form
Employee coverage over $100,000 and spouse coverage require online Medical History Statement

19. Pay for day care costs for your dependent child up to age 13.
PCS offers both a Healthcare FSA and a Dependent Care FSA to help you save.
HEALTHCARE FSA:
You have access to your full annual election amount on the very first day of the plan year!
Pay for eligible medical, dental and vision expenses for you and your family members.
Minimum deduction of $10 per pay period, not to exceed $2500 per year
Keep your receipts – you may be asked to provide documentation when you use your FSA debit card.
DEPENDENT CARE FSA:
Pay for day care costs for your dependent child up to age 13.
The IRS annual dependent care limit is $5000 per household/family.
Funds become available as they are deducted from your paycheck and deposited into your account.
Use it or lose it – the amount deposited into FSA may be used for services incurred for the plan year ending 12/31
Keep your receipts! Documentation may be required!

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

21. Dependent Eligibility
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
For Medical:
Dependent children up to age 30, please contact Risk Management at 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.

22. 5

23. Short term assistance with personal issues:
Stress
Depression
Family problems
Substance abuse
Online training & Webinars:
Financial and legal issues
Childcare and Eldercare
Time Management
Debt Management
Online courses
Certificate of Distinction
Educator continuing education
Covers all eligible employees and family members
Up to 8 free counseling sessions (in person or virtual per incident)
Strictly confidential

24. 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 20

25. Retirement Florida Retirement System (FRS)
You will contribute 3% of your gross pay
You must decide within eight months of your hire date, which plan to select
FRS Pension Plan
FRS Investment Plan
No election – you will default into the Investment Plan
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.)
NO contributions /matching funds from PCS 19

26. PCS COVERAGE VS. THE HEALTHCARE MARKETPLACE
Pinellas County Schools health insurance coverage meets the standard for minimum essential coverage and is considered affordable under the Affordable Care Act.
Benefit eligible employees who enroll in the Marketplace plans would not be eligible for Advanced Premium Tax Credits (tax subsidy) and would not receive premium assistance.

27. QUESTIONS
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Please do not ask questions of coworkers, school secretaries, department heads, principals. They may not have the answers that best meet your needs.
Instead, contact the
RISK MANAGEMENT BENEFITS TEAM
for the most accurate answer at
Or visit our website at