1. Santa Rosa County School Board Employee Benefits
2014 Benefit Plan Year

2. Benefits Offered to Full Time Employees:
Medical
Dental
Vision
Basic and Supplemental Life
Long Term Disability
Flexible Spending Accounts- Health & Dependent Care
Health Care Saving Accounts (if enrolled in HDHP)
Tax Sheltered Annuities, Cancer & Life
Retirement
(Interim employees need to check with HR for coverage eligibility)

3. General Guidelines
New 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 employment
Benefits elected will be effective thru 12/31/14
Benefit plan year January 1 to December 31
Open enrollment conducted annually (November) for the following calendar year
Benefits end on the last day of the month in which employment terminates
Retirement plan must be selected before the end of the fifth month following his/her month of hire
Will receive retirement information packet directly from FRS

4. Medical
Florida Blue (formerly Blue Cross and Blue Shield of Florida) – 2 plan options
Blue Options PPO #05773 (high option)
Blue Options High Deductible Health Plans #05192 & (low option)
Plan tiers
Employee only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Two Employee Family
Cost of plan varies based on plan and tier elected
School Board pays a large percentage of premium
Both plans have the same provider network (Blue Options)
Both plans offer out of the network and/or out of the area coverage
Effective date of coverage is the first of the month following one month of employment.
Example: Hire Date August 11, 2014; benefits begin October 1, 2014.
Medical insurance premiums are pre-paid one month prior to the actual month of coverage (Payroll deduction in September 2014 pays the October 2014 monthly premium)
Will receive a medical id card in the mail from Florida Blue

5. Blue Options PPO #05773
Flexibility to choose physicians from a network of
providers that includes primary care and specialists
Calendar year deductible (CYD) – in network
$2,000 per individual and $6,000 family aggregate
Office Visit Co-pays: $35.00 Primary Care and $65.00 Specialist
Hospital Inpatient – $500 Per Admission DED + CYD + 30% co-insurance
Preventive Care – 100% coverage in-network
Annual Out of Pocket Maximum - $5000/$10,000 in-network per individual/family aggregate
Reference plan summary for specific services and applicable co-payments
Participating physician’s network available
Co-pay Prescription drug program included in plan (retail & mail order)

6. Blue 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 $1,000 for single contracts and $2,000 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-network
Annual Out of Pocket Maximum - $5,000/$10,000 in-network per individual/family aggregate
Reference plan summary for specific services and applicable coinsurance
Participating physicians network available
Prescription 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.

7. Special 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. The following are examples of qualifying events:
Marriage/Divorce
Birth, adoption or placement for adoption
Spouse’s job change
Spouse’s open enrollment
Loss of other health coverage
Request to enroll or make changes must be made within 30 days of the qualifying event
Contact Risk Management to make changes

8. My Blue Service
Website for member self-service capabilities including:
Request replacement ID card
Health Dialog
Blue 365
eMedicine
Healthcare Advisor
Claim status information
Benefits information
Online provider directory
Request benefit booklet
Forms center

9. Blue Dental Choice PPO Two dental plans to choose from
High option – pays 100% for preventive care; 80% for basic care after CYD
Low option – pays 80% for preventive care; 70% for basic care after CYD
Major services – pays 50% after CYD under both plans
Orthodontic services - pays at 100% after CYD under both plans up to a lifetime maximum of $1,000
CYD is $50 for single coverage under both plans/ $100 for high option family plan and $150 for low option family plan
Annual dental benefit maximum is $1,000 per person
Flexibility to choose a dentist from a network of participating providers
Dental network available
Reference plan summaries for specific services and applicable deductible and co-payments
Participating 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 the dental premium
Employees 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 dependents
Will receive a membership card in the mail
Florida Combined Life is the dental carrier

10. Vision Care
Coverage for all routine eye care, including eye exams and eyeglasses (lenses and frames) or contacts
Network of participating physicians to choose from
Reference plan summary for specific services covered and applicable co-payments
Employee pays total cost
Available to employees and eligible dependents
Will receive a membership card
Davis Vision is the vision carrier

11. Basic & Supplemental Life Insurance
The SRCSB provides all employees basic life and AD & D insurance in the amount of $50,000
Amount 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 $300,000
Guarantee issue up to $200,000 if employee enrolls during the first 30 days of employment
Evidence of insurability required for coverage in excess of $200,000
Late enrollments (after 30 days of employment or during annual open enrollment ) requires evidence of insurability for any amount
Cost of additional supplemental life based on age
ING is the life insurance carrier
Designate primary and contingent beneficiaries on BenefitHelp

12. Flexible 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 account
Dependent care reimbursement account
Reference plan summary for covered expenses
Plan year runs concurrent with health plan year (January – December)
Maximum annual election $2,500 – Use it or lose it
Three options for reimbursement:
Pay with Flexible Spending Account debit card
Submit claim forms and receipts
File on-line at
Total Administrative Services Corporation (TASC) is the FSA third party administrator for the School Board
Employees who open a Health Savings Account (HSA) may not elect to
participate in a health care flexible spending plan (IRS guidelines).

13. Health Savings Account (HSA)
IRS eligibility guidelines:
Covered by a high deductible health plan (HDHP)
Not covered under another medical plan that is not a HDHP
Not enrolled in Medicare
Not eligible to be claimed under another person’s tax return
SRCSB contributes $1,000 or $2,000 to HSA (semi-annual deposits in January and July)
HSA contribution pro-rated for new hires
Employees may also make pre-tax contributions thru payroll deduction
IRS annual contribution limits for $3,300 single; $6,550 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 from year to year.
Santa Rosa County Federal Credit Union is the School Board’s designated HSA Custodian.
Can enroll in the High Deductible Health Plan (HDHP) even if you
are not eligible for an Health Savings Account (HSA).

14. Long Term Disability
Monthly benefit equal to 60% of your salary up to $5,000
Benefits start after 60 days of disability
Benefits paid to age 65
Employee pays the total cost
Rates based on age and salary
Premiums waived during disability period
Florida Combined Life is the LTD carrier.

15. Tax Sheltered Annuities Cancer, Life, Long Term Care Insurance
Products available for individual purchase
Payroll deductions for approved vendors
List of vendors, agents and contact information on the Risk Management website

16. Florida Retirement System
Two plans to choose from:
Pension Plan
Investment Plan
The 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 hire
Resources for information:
Human Resources Website
MyFRS.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 counselors
Employee workshops

17. District Liability Insurance Programs
Insurance coverage for all School Board employees that includes:
Comprehensive General Liability
School Leaders Error and Omissions
Sexual Harassment
Sexual Molestation
Exclusion for “intentional acts”

18. Questions
If you have questions regarding benefits please call the Risk Management Office at