Flour bluff isd. EMPLOYEE BENEFITs CENTER

Transcription

1 PLAN YEAR: december 1, 2017 november 30, 2018 Flour bluff isd What s inside? EMPLOYEE BENEFITS CENTER HOW TO ENROLL S125 PLAN INFORMATION FLEXIBLE SPENDING ACCOUNTS AVAILABLE RESOURCES BENEFITS AT A GLANCE CONTACT INFORMATION EMPLOYEE BENEFITs CENTER EDELIA TREVINO, ACCOUNT MANAGER 2009 RANCH RD 620 N STE 123, AUSTIN TX OFFICE: CELL: EDELIA.TREVINO@FFGA.COM

2 This guide contains a summary of the benefits offered by your employer. If there is a conflict between the terms of this outline of benefits and the actual contracts, the terms of the contracts will prevail. For a more detailed explanation of benefits you may contact your Account Manager or First Financial Administrators at or visit

3 Employee benefits center NEW employee benefits center - your guide to your benefits! We ve created a custom site just for you! Find detailed information about current and upcoming benefits, voluntary product offerings and employer programs, Section 125 & Flex Information, important contact numbers and links, and downloadable forms and brochures.

4 How to Enroll Your First Financial Account Manager will be on site to assist you in enrolling in your benefits. To find out when your Account Manager will be at your location, view the schedule online or contact your site director. You also have the option to enroll online 24/7 through FFenroll during your enrollment period. To prepare for your enrollment, visit your Employee Benefits Center at Once you have reviewed available benefits for the upcoming plan year, visit FFenroll, to review currently enrolled benefits and dependent information. ON SITE ENROLLMENT What to have ready for your enrollment: Social Security Numbers for all dependents Any Status/Life Event or address changes Questions about available benefits ONLINE ENROLLMENT To enroll online, log in to FFenroll ( For detailed information on how to enroll, visit the how to enroll tab on your Employee Benefits Center Login and PIN Your login is your social security number (no dashes) and your PIN is the last four digits of your social security number and the last two digits of your birth year (678977) Once you login you will arrive at the Welcome Screen. Click Next, then: Verify your personal information Verify all dependent information (ssn/date of birth) **Very Important** View employment information USEFUL INFORMATION TO KNOW Write your PIN number down Contact First Financial at with any technical questions No changes will be permitted until annual enrollment, unless you have an IRS S125 qualified event Plan Information and Rules

5 Section 125 Plan Information and rules A Section 125 Plan provides a tax-saving way to pay for eligible medical or dependent care expenses. The funds are automatically deducted from your paycheck on a pre-tax basis. Here s How It Works A Section 125 Plan reduces your taxes and increases your spendable income by allowing you to deduct the cost of eligible benefits from your earnings before tax. Plus, the plan is available to you at no cost, and you re already eligible. All you have to do is enroll. Is It Right for Me? The savings you may experience with a Section 125 Plan are outlined below. By utilizing the Section 125 Plan, you would have $70 more every month to apply toward insurance benefits or other needs. That s a savings of $840 a year!

6 Flexible Spending Accounts Medical FSA Medical Flexible Spending Accounts (FSA) allow you to set aside pre-tax payroll deductions each paycheck to pay for out of pocket medical, dental and vision expenses for you and your family. During open enrollment you will estimate the amount you think you will need during the year. This amount will be taken out of each paycheck. Your full annual election will be available to you at the beginning of the plan year. Your employer has chosen the 2.5 month grace period for your plan. This option allows you the opportunity to continue to incur eligible expenses if you have unused funds in your account on the plan year end date for an additional 2.5 months. If the money is not used during the 2.5 months it will be forfeited. FSA Plan Year is: december 1, 2017 november 30, 2018 FSA MAX: The maximum you can set aside each year is $2,600. DEPENDENT CARE FSA With a Dependent Care Flexible Spending Account (FSA), you can set aside part of your pay on a pre-tax basis to pay for eligible dependent care expenses, such as: Day Care Centers Before/After School Care Mothers-Day-Out Program Nursery Schools Babysitters Nanny Au Pair/Day Camps You may allocate up to $5,000 per tax year for reimbursement of dependent day care services. ($2,500 if you are married and file a separate tax return). This account allows you to pay for day care expenses for your qualifying dependent/child with pre-tax dollars while you (and your spouse) are working, seeking employment, and/or attending school as a full time student (for at least five months of the year). Eligible dependents must be claimed as an exemption on your tax return. For full plan details, view the FSA Booklet available on the Employee Benefit Center.

7 RESOURCES FOR FSA MANAGEMENT FLEXIBLE BENEFITS CARD The Flex Benefits Card is available to all employees that participate in Medical FSA and or a Dependent Care FSA. The Benefits Flex Card gives you immediate access to your money at the point of purchase. Cards are available for participating employees, their spouse and eligible dependents that are at least 18 years old. The IRS requires validation of most transactions. You must submit receipts for validation of expenses when requested. If you fail to substantiate by providing a receipt to First Financial within 60 days of the purchase or date of service your card will be suspended until the necessary receipt or explanation of benefits from your insurance provider is received. FF FLEX MOBILE APP With the FF Flex Mobile App you can submit claims, view account balance & history, see claim status, view alerts, upload receipts and documentation and more! The FF Flex Mobile App is available for Apple or Android TM devices on the App Store SM or the Google Play Store TM. Your Employer ID Number is FFA181. You must have this number or your Flex Benefits Card number to register your account on the FF Flex Mobile App. FSA STORE First Financial has partnered with the FSA Store to bring you an easy to use online store to better understand and manage your FSA. Visit for more details & special deals! Shop at FSA Store for eligible items from bandages to wheel chairs and thousands of products in between Browse or search for eligible products and services using the FSA Eligibility List Visit the FSA Learning Center to help find answers to questions you may have about your FSA

8 EMPLOYER BENEFIT SOLUTIONS FOR YOUR EDUCATION Disability Income Insurance NO HEALTH QUESTIONS asked during this special enrollment. Special Enrollment Opportunity November 9th - November 17th with No Health Questions Asked! If your paycheck suddenly stopped today, would you be prepared? Could you afford everyday living expenses and other necessities while maintaining the lifestyle you have been accustomed to? Disability Income Insurance can help. During this special enrollment, there are no required medical questions or exams, making it faster and easier to sign up for the plan. Why You Need Disability Income Insurance Income Protection for You and Your Loved Ones. The plan makes it easy to help protect your future finances in case of a sudden accident or illness by providing a monthly benefit to cover expenses while you are unable to work. Benefit Payments Made Directly to You. Your monthly benefit payments may be deposited directly into your bank account. This gives you the freedom to pay your living expenses and make other purchases as you see fit. Special Enrollment Opportunity for Flour Bluff ISD! Available to Applicants: Enroll today up to $4,000 without answering health questions! MCH 4610, MCP 62515, , , , , , Take steps now during this special enrollment period to help protect your finances with Disability Income Insurance from American Fidelity Assurance Company. *This product may contain limitations, exclusions, and waiting periods. All benefit amounts will be subject to the plan s pre-existing condition limitation. At no time can the benefit amount exceed the percent of covered salary stated in the schedule of benefits. All riders are subject to normal underwriting rules. Visit with your account manager to learn more about Disability Income Insurance. Edelia Trevino Senior Account Executive First Financial Group Branch Office 2009 Ranch Road 620 North, Suite 123 Austin, TX Edelia.Trevino@ffga.com americanfidelity.com SB

9 Benefits at a Glance Visit for rates and benefit information. medical Aetna Medical coverage details are provided in a separate booklet and/or found on district website. disability American Fidelity Disability insurance pays a cash benefit and is designed to help protect you if you can t work due to a covered injury or sickness. It pays a monthly benefit amount based on a percentage of your gross income, so you may continue to pay for everyday living expenses. CANCER INSURANCE American fidelity If cancer touches someone in your family, this plan may help ease the impact on your finances. Benefit payments are made directly to you, allowing you to pay for expenses like copayments, hospital stays, and house and car payments. Dental - Aetna Oral care can be a significant financial expense. Having dental insurance can help cover the costs. Help keep your family's smiles healthy with dental insurance. Vision Eyetopia vision Vision insurance is a way to help cover expenses incurred for eye care services from eye care professionals such as optometrists and ophthalmologists. Regular eye exams can offer more than just measuring your eye sight! They can identify serious eye diseases early, allowing time for treatment. Most people don't realize that eye exams can also reveal the early signs of serious illnesses like diabetes, heart disease and high blood pressure.

10 Benefits at a Glance Visit for rates and benefit information. Permanent, Portable Life Insurance texas life Ensuring your family is financially covered in the event of a loss is an important way of showing them you care about their needs. Life Insurance can help. Portable, Individual Life Insurance policies may help your family in the event of your death. The application process is simple. You only have to answer three health questions, and there are no medical exams required. GROUP LIFE - dearborn Group life insurance allows you to purchase affordable life insurance on yourself, spouse and dependent children. This is term insurance, available as long as you are employed by district. Employees enrolling in the coverage after the first 31 days of their employment will be subject to insurability and must complete a health questionnaire prior to coverage being issued. Term Life Insurance American fidelity Life insurance is an important purchase to make. It is impossible for life insurance to emotionally compensate for a loss, but it may help ease the financial obligations left to your loved ones such as your mortgage, college tuition, other debts, and daily living expenses. Term Life Insurance offers protection during your peak earning years when you have financial responsibilities such as paying a mortgage or supporting your family.

11 FLOUR BLUFF ISD - AETNA DENTAL INSURANCE Plan Name 2018 Renewal Monthly Premium PREVENTATIVE PLUS BASE OPTION Employee Only $ Employee & Spouse $ Employee & Children $ Family $ TRADITIONAL PLUS OPTION Employee Only $ Employee & Spouse $ Employee & Children $ Family $

12 Preventative Plus Base Option Dental Benefits Summary Flour Bluff Independent School District Effective Date: Passive PDN With PDNII Network Annual Deductible* Individual $50 Family $150 Preventive Services 100% Basic Services 50% Major Services Annual Benefit Maximum $1,000 Office Visit Copay N/A Orthodontic Services Orthodontic Deductible Orthodontic Lifetime Maximum *The deductible applies to: Preventative, Basic & Major services Partial List of Services Passive PDN With PDNII Network Preventive Oral examinations (a) 100% Cleanings (a) Adult/Child 100% Fluoride (a) 100% Sealants (permanent molars only) (a) 100% Bitewing Images (a) 100% Full mouth series Images (a) 100% Space Maintainers 100% Basic Amalgam (silver) fillings 50% Composite fillings (anterior teeth only) 50% Stainless steel crowns 50% Surgical removal of impacted tooth (partial bony/ full bony)* 50% Incision and drainage of abscess* 50% Uncomplicated extractions 50% Surgical removal of erupted tooth* 50% Surgical removal of impacted tooth (soft tissue)* 50% Major Inlays Onlays Crowns Root canal therapy Anterior teeth / Bicuspid teeth Root canal therapy, molar teeth Scaling and root planing (a) Gingivectomy* Full & partial dentures Pontics Root canal therapy, molar teeth Osseous surgery (a)* General anesthesia/intravenous sedation* Denture repairs Crown Build-Ups *Certain services may be covered under the Medical Plan. Contact Member Services for more details. (a) Frequency and/or age limitations may apply to these services. These limits are described in the booklet/certificate.

13 Traditional Plus Option Dental Benefits Summary Flour Bluff Independent School District Effective Date: Passive PDN With PDNII Network Annual Deductible* Individual $50 Family $150 Preventive Services 100% Basic Services 80% Major Services 50% Annual Benefit Maximum $1,000 Office Visit Copay N/A Orthodontic Services** 50% Orthodontic Deductible None Orthodontic Lifetime Maximum $1,000 *The deductible applies to: Preventative, Basic & Major services **Orthodontia is covered only for children (appliance must be placed prior to age 20). Partial List of Services Passive PDN With PDNII Network Preventive Oral examinations (a) 100% Cleanings (a) Adult/Child 100% Fluoride (a) 100% Sealants (permanent molars only) (a) 100% Bitewing Images (a) 100% Full mouth series Images (a) 100% Space Maintainers 100% Basic Amalgam (silver) fillings 80% Composite fillings (anterior teeth only) 80% Stainless steel crowns 80% Incision and drainage of abscess* 80% Uncomplicated extractions 80% Surgical removal of erupted tooth* 80% Surgical removal of impacted tooth (soft tissue)* 80% Major Inlays 50% Onlays 50% Crowns 50% Root canal therapy 50% Anterior teeth / Bicuspid teeth 50% Root canal therapy, molar teeth 50% Scaling and root planing (a) 50% Gingivectomy* 50% Full & partial dentures 50% Pontics 50% Root canal therapy, molar teeth 50% Osseous surgery (a)* 50% Surgical removal of impacted tooth (partial bony/ full bony)* 50% General anesthesia/intravenous sedation* 50% Denture repairs 50% Crown Build-Ups 50% *Certain services may be covered under the Medical Plan. Contact Member Services for more details. (a) Frequency and/or age limitations may apply to these services. These limits are described in the booklet/certificate.

14 Find us on facebook.com/eyetopiavision Eyetopia (120/145) Flour Bluff ISD Benefit Summary Eyetopia Vision Care Benefits Co-pay 1 Eyetopia provides two vision benefits each eligibility period. By coordinating your coverage with your Health Insurance you have the opportunity to maximize your Eyetopia benefits. Benefit One 2 (choose either one of the following 2 options every 12 months): 1. Refractive Exam. One refraction (CPT code 92015) or one routine Vision Exam. $ A $45 allowance toward medical co-pays or any material or service of an equal or lesser value. Benefit Two (choose only one of the following Vision Correction Options): Eyetopia Vision Care provides you with three (3) options for correcting your vision. If your prescription has changed at least ½ diopter or your eye doctor recommends a change of lenses, you may select one of the following every 12 months: 1. Prescription Eye Wear (lenses and/or frame) 3 Standard Prescription Lenses covered 100% Non-coated CR-39 plastic single vision, bifocal, trifocal or $120 allowance toward Progressive lenses 4. Eyetopia Labs standard single vision or bifocal flat top 28 lenses with premium Anti-Reflective Coating 5. Child dependents (under age 26) can upgrade to EyetopiaLabs polycarbonate lenses 5. Basic Anti-Reflective Coating (Ultra Violet Protection & Scratch Resistant Coating) Standard Tints (Gradient and Solid) Polycarbonate upgrade 6 Warranted Anti-Reflective Coating Eyetopia Labs high definition PAL or premium SV in CR-39 with a premium anti-reflective coating. 5 Frame: The member may select any frame on display. Eyetopia Vision Care provides an allowance of $ to be applied toward the frame selected. The member pays any amount exceeding the $ allowance. 2. Contact Lens Option: 7 Eyetopia Vision provides a $ allowance to be applied toward the Participating Provider s usual and customary (U&C) fees toward prescription contact lenses. This allowance can be applied toward the contact lens fitting fee and all other charges including follow-up visits and contact lenses. Medically necessary spectacle or contact lenses - $400 total allowance Refractive Surgery Option. 9 You may select refractive surgery instead of spectacles or contact lenses during each plan period. Eyetopia Vision Care provides a $350 per eye allowance for in-network surgeons and a $75 per eye allowance for out-of-network surgeons toward the fees for the following procedures: LASIK, ASA, ICL or RLE. The member pays any amount exceeding the per eye allowance. For more information please contact customer service at toll-free ProviderServices@Eyetopia.org or $20.00 $25.00 $12.00 $35.00 $65.00 $65.00 $ The co-pay must be paid to the Participating Provider at the time of service. 2 When Health Insurance Carriers offer an annual wellness eye exam it creates an overlap in benefits for Eyetopia Members. If this occurs, the Member may choose another option under Benefit One as described, a $10.00 co-pay is still required to exercise these other options. 3 Special Lens Materials and Non-covered Items: Transition, ultra light, premium PALs, rush service, service agreements, other special lens materials, oversize, other extras and any items not specifically mentioned above may be substituted provided the Member pays any amount exceeding the price of the covered benefit and the Participating Provider s usual and customary fees for the upgrade at the time of service. 4 Standard Progressive Lenses are defined as any brand of PAL offered by the Participating Provider with up to a $ retail value. 5 Members can upgrade from standard non-coated lens to the Eyetopia Labs premium coated lenses at no charge. They can upgrade to the Eyetopia Labs high definition PAL or single vision in CR-39 plastic for an additional $ Child Dependents not being prescribed Resolution polycarbonate lenses, Members (employees) and Dependent Spouses are charged a polycarbonate upgrade fee. 7 If the contact lens exam or fitting is performed and the patient decides against getting contact lenses, the patient is responsible for the cost of the contact lens fitting fee. 8 The Participating Provider must pre-authorize medical necessity. 9 Non-covered Items and Exclusions Facility fees, medications and enhancements or treatments related to complications. Access to surgeons must come by referral from a Primary Eye Care Provider who provides pre and post-op care and counseling. Included Services and/or Eye Wear. Only those professional vision care services and/or vision correction options specifically referenced herein are included in the Eyetopia Vision Care. In-Network coverage is available through Participating Providers. Out of network services are not covered. Exclusions & Limitations None Additional Professional Services and/or Vision Corrections. The member may select professional services and/or vision correction items not specifically referenced as included in Eyetopia Vision Care. However, these services and/or items are the member s responsibility at the Participating Provider s (U&C) charge, payable at the time of service or of ordering. Employee $10 Employee + 1 $19 Family $27

15 Eyetopia Gold (150/250) Flour Bluff ISD Summary of Benefits Eyetopia Vision Care Benefits Co-pay 1 Eyetopia provides two vision benefits each eligibility period. By coordinating your coverage with your health insurance wellness eye exam you have the opportunity to maximize your Eyetopia benefits. BENEFIT ONE (choose either one of the following 2 options every 12 months): 1. Refractive Exam-One refraction (CPT Code 92015) or one Routine Vision Exam $ A $65 allowance toward medical co-pays or any material or service of an equal or lesser value. BENEFIT TWO (choose only one of the following Vision Correction Options): Eyetopia Vision Care Provides you with three (3) options for correcting your vision. You may select one of the following every 12 months: 1. Prescription Eye Wear (lenses and/or frame) 2,3 Prescription High Index or Polycarbonate single vision, bifocal, trifocal or a $120 allowance toward PAL lenses that also include a Basic Anti- Reflective Coat covered 100%. Members can get Eyetopia Labs lenses that come with premium None anti-reflective coatings and are covered 100%. Specific to Eyetopia Labs Lenses Only: Premium Anti-glare, anti-smudge, anti-scratch with UV Protection Optimized Manufacturing Technology Tint (Solid and Gradient) Transition or Polarized Lenses 2 Warranted Anti-Reflective Coating Premium Anti-Reflective Coating 2 Frame: The member may select any frame on display. Eyetopia Vision Care provides an allowance of $ to be applied toward the frame selected. The member pays any amount exceeding the $ allowance. 2. Contact Lens Option 3,4 Eyetopia Vision provides a $ allowance to be applied toward the Participating Provider s usual and customary (U&C) fees toward prescription contact lenses. This allowance can be applied toward the contact lens fitting fee and all other charges including follow-up visits and contact lenses. Medically necessary spectacle or contact lenses - $400 total allowance 5 3. Refractive Surgery Option. 6 You may select refractive surgery instead of spectacles or contact lenses during each plan period. Eyetopia Vision Care provides a $500 per eye allowance for innetwork surgeons and a $125 per eye allowance for out-of-network surgeons toward the fees for refractive surgery, for the following procedures: LASIK, ASA, ICL or RLE. The member pays any amount exceeding the per eye allowance. $12.00 Note 2 $65.00 Note 2 1 The co-pay must be paid to the Participating Provider at the time of service. 2 Special Lens Materials: The member may select special lens materials (transition, ultra light, premium PALs, etc.) provided they pay any amount exceeding the participating provider s U&C fees for the covered lenses. 3 Non-covered items: Any items not specifically mentioned above, including but not exclusive to rush service, service agreements, special lens materials, oversize and other extras are paid for by the patient at the time of service. Standard Progressive Lenses are defined as any brand of PAL offered by the Participating Provider with a retail value of $ or less. 4 If the contact lens exam or fitting is performed and the patient decides against getting contact lenses, the patient is responsible for the cost of the contact lens fitting fee. 5 The Participating Provider must pre-authorize medical necessity. 6 Non-covered Items and Exclusions Facility fees, medications and enhancements or treatments related to complications. Access to surgeons must come by referral from a Primary Eye Care Provider who provides pre and post-op care and counseling. Included Services and/or Eye Wear. Only those professional vision care services and/or vision correction options specifically referenced herein are included in the Eyetopia Vision Care. In-Network coverage is available through Participating Providers. Out of network services are not covered. Exclusions & Limitations None None None Additional Professional Services and/or Vision Corrections. The member may select professional services and/or vision correction items not specifically referenced as included in Eyetopia Vision Care. However, these services and/or items are the member s responsibility at the Participating Provider s (U&C) charge, payable at the time of service or of ordering. Find us on facebook.com/eyetopiavision Employee $20 Employee + 1 $39 Family $54 For more information please contact customer service at ProviderServices@Eyetopia.org or

16 IMPORTANT CONTACTS Edelia trevino, ACCOUNT MANAGER OFFICE: CELL: Hollie Crenshaw, district employee benefits OFFICE: Benefit Vendor Phone Website Medical Aetna Dental Aetna Vision Eyetopia Disability American Fidelity Cancer American Fidelity Life Texas Life Term Life American Fidelity Group Life Dearborn Medical FSA and Dependent Care First Financial