1. Insurance Open Enrollment April 22 – May 24, 2013 2013-2014 Plan Year
Welcome to open enrollment 2013
The following presentation will outline the voluntary benefit program that will take effect on September 1st. There are many exciting changes coming to your employee benefit program this year and this presentation should assist you in making an informed decision about which option is best for you and your family.
Open enrollment this year will begin April 22 and continue through May 24.
Meetings will be held on each campus to assist you in completing your open enrollment process.
Please watch for an with specific times and dates for your campus meeting
Denton ISD

2. Voluntary Insurance Changes for 2013-14
New Third Party Administrator for Benefits
Flex Plan Administration
Dental Insurance
Vision Insurance
Cancer Insurance
New Permanent Life Insurance
Basic and Supplemental Term Life Ins.
Disability Insurance
New Medical Gap Plan
New Group Accident Policy
On-Line Enrollment System
U.S. Employee Benefits Services Group
Old
New
Pay Flex Systems USA
TASC
Cigna
Lincoln Benefit
SuperiorVision
Humana Vision
Humana
Colonial
N/A
Fidelity Life
ING
Ft. Dearborn
Standard
SIS
Humana Accident
CoreSource
InRoll
The changes to your voluntary benefit program for next year are shown below.
Administratively you will see changes to your Flex Plan administrator, your 403b administrator, and your on-line enrollment system.
Total Administrative Services Corporation or (TASC) will be the new Flex Plan administrator. They will provide medical expense reimbursement, dependent care reimbursement, and a debit card for you to use to pay for qualified medical and dependent care expenses. This change will also bring you improved technology, faster claims service, and smart phone apps and capabilities to improve your access to your funds.
There will also be changes in your dental, vision, life, and disability carriers for next year and there will be 3 new benefits including a permanent Life insurance option, group accident policy and a medical gap policy.

3. New Carrier 2013-14 Lincoln Benefit
PPO Dental Plan
New Carrier Lincoln Benefit
Replaces current Cigna dental plan
100/80/50 Plan design option with $1500 maximum annual benefit
No Waiting period for open enrollment and new hires
Coverage for dependent children up to age 26
Orthodontia included for children up to age 19
Matched current rates - premiums are guaranteed for 2 years
Employee Only
$34.99 per month
Employee & Spouse
$74.75 per month
Employee & Child
$67.76 per month
Employee & Family
$ per month
Lincoln Benefit will be the new carrier for your dental plan.
Your benefits with Lincoln will remain the same your current plan and your rates will continue for an additional 2 years without increasing.
Employees insured under the current plan will be fully covered under the new Lincoln Benefit plan. All work in progress will transition over to Lincoln on September the first
Claims and expenses incurred prior to 9/1 will need to be submitted to Cigna for processing.

4. New DHMO Carrier- 2013-14 Lincoln Benefit
DHMO Dental Plan
New DHMO Carrier Lincoln Benefit
Replaces current QCD discount plan, much larger provider network
No co-pay on office visit; many other deeply discounted services
No annual maximum benefits or deductibles
Members must choose a provider from the network to receive benefits
Premiums guaranteed for 2 years
Employee Only
$14.69 per month
Employee & Spouse
$28.62 per month
Employee & Child
$30.97 per month
Employee & Family
$44.76 per month
Lincoln Benefit will also be providing a new dental DHMO option. This option will replace the QCD dental plan currently in place.
A dental DHMO plan provides very rich benefits and does not limit your maximum annual benefit. It also does not have deductibles or coinsurance limits. A DHMO plan does however require you to access care from a network provider. You will have to select a primary care dentist and utilize that dentist for all of your dental care. Services provided by a non network provider or a dentist other than your selected dental provider will not be covered under a dental DHMO plan.
If you are an individual that wants the freedom to pick and choose their dentist, a dental DHMO plan may not be for you

5. Vision Plan- High and Low Options
Humana High Option-New Carrier
Exam and eyewear co-pay of $10 and $20
Contact lens evaluation - 15% discount
Frame allowance up to $150 retail and contact lens allowance up to $150 retail
Photo chromic, Polycarbonate, and Scratch Resistant lenses covered
2nd pair of glasses or contacts allowed per benefit frequency
Discounts on Lasik
Employee Only
$18.50 per month
Employee & Spouse
$39.80 per month
Employee & Child
$29.95 per month
Employee & Family
$54.60 per month
Humana Low Option-New Carrier
Exam and eyewear co-pay of $15 and $20
Contact lens evaluation - 15% discount
Frame allowance up to $40 wholesale (Approximately $120 retail) contact lens allowance up to $150 retail
N/A
Discounts on Lasik
Employee Only
$9.98 per month
Employee & Spouse
$21.48 per month
Employee & Child
$16.16 per month
Employee & Family
$29.50 per month
Beginning September 1, Denton ISD employees will have 2 options for their vision insurance
Humana Vision will replace Superior vision as the carrier for Denton ISD
The Humana policy will include a high option and a low option
$40 wholesales is approximately $120 retail
In addition to better benefits, the high option also provides for a second pair of glasses or contacts within each benefit period, and photo chromic, polycarbonate, and scratch resistant lenses are provided a standard benefit. There is no need to purchase these items at an additional fee under the high option
Employees currently insured under the Superior vision plan will default to the low option. If you desire o buy up to the high option you will need to select the high option during open enrollment

6. Cancer Plan Colonial Cancer Plan 2013-14
Single plan option including Cancer coverage, ICU rider, Specified Disease Coverage, and 1st Occurrence Benefit
Hospital Confinement Benefit
Radiation/Chemo
Surgery Schedule Benefit
Initial Diagnosis
Screening Rebate
$300 per day
$300 per day with $10,000 per year
Up to $4,500 max
$5,000
$100
Open Enrollment, Guaranteed issue coverage
Credit for time insured for those with the current cancer plan, no pre-existing limitations on new plan if you have been covered previously for 12 months
Employee Only
$29.85 per month
Employee & Family
$49.55 per month
Colonial Insurance will be the new carrier for the Denton ISD cancer plan
Colonial is offering a guaranteed issue product and providing full take over for individuals insured under the current Humana policy. A guaranteed issue policy allows anyone, regardless of health, to apply for and receive coverage under this policy. Individuals currently insured under the Humana policy will receive credit for time insured and will not be subjected to any pre-existing condition limitation if you have been insured for 12 consecutive months as of September 1.
Benefits and pricing on this policy are very competitive and the rates are the same for all employees regardless of age.
Should you leave your employment the policy is portable and you can continue the coverage on a direct basis.
Colonial is offering guaranteed issue so no one can be declined.  They are also giving credit for time insured for employees currently on the DISD payroll bill so pre-ex does not affect current insured.  Here is the pre-ex language.

7. Basic & Voluntary Group Term Life Plan
Lincoln Benefit- Group Term Life Plan
New Carrier
$10,000 Life Insurance Coverage for all eligible Employees - Provided at no cost by Denton ISD
Additional voluntary coverage available at group rates.
ex: $50,000 Coverage
Age 25- $2.50
Age 35- $3.50
Age 45- $7.50
Age 55- $18.50
Age 65- $57.00
Spouse Coverage also available, Child Life up to age 26
Guaranteed Issue Coverage to $200,000 employee, $50,000 Spouse
Annual increases of $20,000 up to the guaranteed issue limit on voluntary life each year at open enrollment.
Your employer will continue to provide each employee with a 1basic level of coverage at no cost to the employee
Each employee will also have the option of purchasing additional coverage on themselves , their spouse and children
Group term life insurance provides a very inexpensive opportunity to supplement your life insurance protection while you work.
The rates on this coverage are age banded in 5 year increments and will increase as you grow older.
When you leave your employment, group term life insurance coverage will can not be continued

8. Standard Insurance Disability
New Carrier
2 Benefit Duration Options:
3 year Sickness benefit, Accident protection to age 65, Plan 3/65.
Sickness and Accident protection to age 65, Plan 65/65.
Multiple elimination period options.
0/7, 14/14, 30/30, 60/60, 90/90, 180/180
1st Day hospital confinement benefit- Waives elimination period on 0/7, 14/14, 30/30 elimination period plans.
Insure up to 66.67% of annual salary - $8000 maximum monthly benefit.
Plan 3/65
Rate Per $1000
Plan 65/65
0/7
$26.40
$35.90
14/14
$21.60
$31.60
30/30
$17.70
$26.80
60/60
$14.50
$17.40
90/90
$12.10
$15.00
180/180
$9.10
$11.00
The disability coverage for Denton ISD will be upgraded substantially this year.
Standard insurance will be the new provider for this plan.
The benefit design will be one that is much more suitable to educators. The Educator Plan offered by Standard includes both short term and long term protection coverage
The product is offered on a fully guaranteed issue basis so every employee who wants coverage will qualify.
There are both short term and long term elimination period options and you can pick and chose the amount of coverage you want up to 66 and 2/3 % of income.
You will need to select your level of coverage during open enrollment.
Rates shown are an example of a $20,000 salary.

9. Fidelity Permanent Life Plan
NEW for
Permanent, Guaranteed Issue up to age 70, Life Time Protection, Term Life Insurance Policy. Evidence of Insurability required if applied for over age 70.
Plus- Long Term Care Rider equal to 4% of death benefit, payable for 75 months. Ex: $25,000 death benefit or $1000 monthly LTC benefit payable for 75 Months.
Portable upon termination of employment- Premium remains the same.
Insure yourself, spouse, and children.
Guaranteed issue up to $100,000 age subject to minimum face amount
Rates Based on age at issue, guaranteed for life
ex: $25,000 Non-Smoker Benefit, monthly premium:
Age 35- $15.77
Age 45- $26.27
Age 55- $47.50
Age 65- $98.75
Age 70- $159.54
A new benefit offering this year for Permanent life insurance will be available to all employees.
Fidelity life will be offering a guaranteed issue permanent life insurance policy that also contains benefits for long term care
You can purchase coverage on yourself and your spouse and children
Your Spouse will need to complete and Evidence of Insurability form…
Once you purchase this plan your rates will be locked in for life and your policy will build paid up insurance values allowing you to stop premium payments in the future and still have some level of paid up insurance and long term care coverage.
Unlike group life insurance, this policy is your to keep even after you terminate your employment and your rates and benefits stay the same.

10. Humana Accident NEW for 2013-2014 Guaranteed Issue Accident Policy.
Pays actual medical charges for accidents up to $1500 per occurrence.
Pays in addition to group medical; supplements out of pocket expenses related to accidental injury
Insure yourself, spouse, and children.
Age 18-50
Employee Only $ 8.38
Employee Spouse $16.75
Employee Child $20.43
Employee family $28.80
Age 50 and over
Employee Only $ 9.31
Employee Spouse $18.61
Employee Child $21.36
Employee family $30.66
Another new benefit for 2013 is an accident policy offered by Humana
Accident policies provide supplemental benefits for expenses related to accidental injuries
The Humana policy pays the actual expenses associated with an accidental injury up to the $1500 policy maximum for each accidental injury
Many employees utilize an accident policy to offset expenses for accidents that would be subject to medical plan deductibles and co-insurance
You can purchase coverage on yourself and your spouse and children

11. New Plan Offering for 2013-2014 through Specialty Insurance Service
Medical Gap Plan
New Plan Offering for through Specialty Insurance Service
Bridges the gap between Active Care 1HD and Active Care 2 benefits by:
Paying $1,500 per year for each covered person for hospital confinement
Paying $4,500 ($1,500 per occurrence) max per year for 3 occurrences of outpatient services – includes ER visit, MRI, x-ray, lab, outpatient surgery (excludes doctor office visit cost)
Guaranteed issue
No pre-existing condition if not subject to pre-existing condition on medical plan
Also bridges the gap between Active Care 2 and Active Care 3 benefits
Employee Only Employee Spouse
> $ $47.76
$ $62.85
$ $132.02
Employee Children Employee Family
$ $83.64
$ $95.11
$ $182.41
With the changes in the TRS medical plan this year, many employees will be faced with a very high deductible and the difficult coinsurance levels associated with Plan 1 HD
Buying up to Plan 2 offers an alternative, but comes with a very high monthly premium.
As an alternative to assuming the high deductibles and coinsurance levels of Plan 1HD or buying up to Plan 2, you have the option of purchasing a Medical Gap policy.
A medical gap policy bridges the Gap between the deductible and coinsurance levels of Plan 1HD and Plan 2, and plan 2 and plan 3. It gives you an affordable alternative to simply buying up to a higher plan to reduce your deductible and coinsurance exposure
The chart on the following slide will show you the savings associated with this plan compared to buying up to Plan 2 or 3.
This plan is guaranteed issue and does not include any pre-existing condition restrictions. If the claim is covered on your medical plan, it will be covered on the Medical Gap plan.
You do not have to be covered by TRS to purchase this plan but you do have to have medical coverage somewhere.
An important note- If you purchase Plan 1HD and open an HSA account, you can not purchase this medical gap policy.

12. Medical Gap Example 1
A Hospital Stay + Surgery = $18,000 Total Expenses (Employee Only at age 43)
Active Care 1HD
w/out Med Gap
with Med Gap
Annual Premium
$1080
$1,610.52
Deductible
$2,400
Co-Insurance
$3,120
Co-Pay
n/a
Total Out-of-Pocket
$6,600
$7,130.52
Med Gap Benefit
$ -
- $1,500
Total Cost
$5,630.52
You save
$969.48
You also save $2, per year in premiums by electing Active Care 1HD with medical gap rather than upgrading to Active Care 2.
As you can see here if you are an employee age 43 on Active Care 1HD plan, then you will see a savings of approximately $969 with this example of a $18,000 hospital stay. This savings is in addition to the savings you will get on your premium deductions by not electing Active Care 2.

13. Medical Gap Example 2
Outpatient Benefit of $1,500 per occurrence up to 3 occurrences for
Employee and Family coverage with Employee at age 43
Active Care 1HD w/out Med Gap
Active Care 1HD with Med Gap
Deductible to meet
$4,800
Annual Premium
$10,020
$11,161.32
Occurrence 1 – you pay
$1,000
$ -
Occurrence 2 – you pay
$2,000
$500
Occurrence 3 – you pay
$1,500
Total Out-of-Pocket
$14,520
$11,661.32
You save
$2,858.68
You also save $2, per year in premiums by electing Active Care 1HD with medical gap rather than upgrading to Active Care 2.
As you can see here if you are an employee and family with the employee at age 43 – premiums are based on employee’s age - on Active Care 1HD plan, then you will see a savings of approximately $2, This example shows 3 different medical conditions or occurrences and the total amount you will pay out-of-your pocket for each occurrence without the medical gap and then with the medical gap. Even if you have the medical gap plan, you are still working towards satisfying your deductible even though you are being reimbursed for the amount by the plan.
This savings is in addition to the savings you will get on your premium deductions by not electing Active Care 2.

14. Medical Gap Plan (cont.) How Employees Can Save on Medical Premiums
TRS ActiveCare 1-HD
Deductible / Out-of Pocket
AC 1-HD Rates
Gap Rates Under 40
Gap Benefits
Total
Savings form AC 2
Annual Savings
Employee Only
$2400 / $6250 $ $ $ $ $
Employee & Spouse
$4800 / $9000 $ $ $ $ $
Employee & Child(ren) $ $ $ $
$ 2,478.60
Employee & Family $ $ $ $
$ 2,152.32
Gap Rates $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $
Gap Rates Over 50 $ $ $ $ $ $ $ $ $ $ $ $ $
$ 1,007.41 $ $
TRS ActiveCare 2
AC 2 Rates
Savings form AC 3
$1000 / $4000 $ $ $ $
$3000 / $8000 $
$ 1,015.76 $ $ $ $ $ $
$ 1,088.00
$ 1,171.64 $ $ $ $ $
$ 1,030.85 $ $ $ $ $
$ 1,183.11 $ $ $ $ $
$ 1,100.02 $
$ 5,699.76 $ $ $
$ 1,270.41 $ $
This slide outlines the total savings of purchasing a medical gap plan versus buying up to plans 2 or 3

15. The Following Slides Are For Informational Purposes Only TRS ActiveCare Medical
The following slides will help outline the changes occurring with the TRS Medical Plan
These slides are for information only

16. TRS ActiveCare Rate increase effective September 1, 2013
ActiveCare 1HD ActiveCare ActiveCare 3
9% % %
Why did rates increase?
Increase was driven by rising health care costs, higher use of medical and prescription drug services.
Claims expense exceeded premiums by $142 million
The previous plan year was heavily impacted by high cost claimant activity. Claims for the prior year exceeded premiums by $142 million dollars.
As a result, Active care 1HD will increase by 9%, Active care 2 by 15%, and Active Care 3 by 25%

17. TRS ActiveCare High Cost Claimant Impact
Plan Year Claimants with Over Plan Year
1, $100,000 in paid claims 1,362
$250,000 in paid claims 265
15 $1 million in paid claims 5
$3.4 million Top Claimant $1.7 million
The high cost claimant activity is shown here. This chart illustrates the significant differences between the past two plan years and why premium increases are necessary this year to cover the cost of claims.
The number of million dollar claimants tripled from one year to the next with the top claim exceeded 3.4 million dollars.
All of these factors, including the increasing cost of health care, this too will drive up the cost of health care.

18. TRS ActiveCare
District and state contributions have not increased since TRS inception in The majority of the participating districts/entities contribute the minimum amount required to the cost of TRS-ActiveCare coverage:
$75 per month from the state ($900 per year)
$150 per month from employer ($1,800 per year)
Individual District and State level contributions have not increased since 2002
The State of Texas contributes $75 per month per employee towards the cost of the plan
Employers are required to contribute a minimum of $150 per month per employee
Denton ISD currently contributes an additional $10 per month per employee for a total contribution of $160 per month

19. TRS ActiveCare Plan Changes
Plan no longer offered in
Plan Changes that will take effect September 1, 2013 will include the following
TRS Active Care Plan 1 will no longer be offered.
Employees currently covered on Plan 1 must enroll in another plan for coverage beginning September 1.
Active care Plan 1 HD will become the lowest priced plan offering for 2013

20. TRS ActiveCare Plan Changes (cont.)
TRS ActiveCare Plan 1HD
$2400 applies to employee only coverage
Family deductible from $2,400 to $4,800 – this can be met by one family member or a combination of family members.
Individual Out-of-Pocket Max from $3,000 to $3,850
Family Out-of-Pocket Max from $5,000 to $4,200
(Out-of-pocket max exclude deductibles and copays)
Changes to ActiveCare 1HD are as follows
Employee only coverage will have a deductible of $2400.
Active care 1HD family deductible is increasing to $4,800. This is the same for employee/spouse, employee/child or employee/family
Individual out of pocket maximum is increasing from $3000 to $3850
Family out of pocket maximum is being reduced to $4200 from $5000
Out of pocket maximums do not include deductibles and co-pays
Employees and families covered on Active care 1HD may contribute pretax dollars into a health savings account (HSA) to help pay for current health expenses and save for future qualified medical expenses on a tax-free basis
Active care 1HD meets the IRS definition of a high deductible health plan for all coverage tiers
Individuals wishing to establish an HSA account should contact their bank or credit union.

21. TRS ActiveCare Plan Changes (cont.)
TRS ActiveCare Plan 1HD (cont.)
Meets IRS definition of a high deductible health plan for all coverage tiers
May contribute pretax dollars into a health savings account (HSA)
Individual can establish an HSA with banks and credit union (the district does not offer the HSA)
ActiveCare 1HD meets IRS definition of a high deductible health plan for all coverage tiers
Individuals can establish an HSA account to help pay for qualified out of pocket expenses.
HAS accounts can be established with banks and credit unions
Contributions are on tax-free basis
You have the opportunity to contribute pretax dollars into a health savings account (HSA) to help pay for current health expenses and save for future qualified medical expenses

22. TRS Active Care Plan Changes (cont)
Individual deductible from $750 to $1,000
Family deductible from $2,250 to $3,000
Individual Out-of-Pocket Max from $2,000 to $4,000
Family Out-of-Pocket Max from $6,000 to $8,000
Increase in retail short term and retail maintenance prescription co-pays by $5
(Out-of-pocket max excludes deductibles and copays)
TRS Active Care 2 will have the following changes
The individual deductible will increase from $750 - $1000
The family deductible will increase from $2250 to $3000
The individual out of pocket maximum will increase from $2000 to $4000
And the family out of pocket maximum will increase from $6000 to $8000
There will also be a $5 increase in the short term and retail maintenance prescription co-pays

23. TRS Active Care Plan Changes (cont)
There were no plan changes
TRS Active care plan 3 will not have any plan changes for 2013

24. TRS ActiveCare Plan Rates
ActiveCare 1
EE Only
$103
EE + Spouse
$536
EE + Child(ren)
$305
EE + Family
$615
ActiveCare 1 HD
$63
$496
$231
$722
ActiveCare 1
No Longer Available
ActiveCare 1 HD
EE Only
$90
EE + Spouse
$559
EE + Child(ren)
$337
EE + Family
$825
The 2013 rates for Active care plan 1 HD are shown here
These premiums represent the employee cost for the coverage as these premiums include the district contribution
*Amounts reflected are after $235 contributed by district.

25. TRS ActiveCare Plan Rates (cont.)
ActiveCare 2
EE Only
$225
EE + Spouse
$811
EE + Child(ren)
$496
EE + Family
$915
ActiveCare 3
$402
$1,213
$780
$1,357
ActiveCare 2
EE Only
$294
EE + Spouse
$968
EE + Child(ren)
$606
EE + Family
$1,088
ActiveCare 3
$561
$1,575
$1,034
$1,755
These rates represent the premiums for Plan 2 and Plan 3
These premiums also include the district contribution
*Amounts reflected are after $235 contributed by district.