Insurance Choices. Merrillville Community School Corporation

Transcription

1 Insurance Choices 2015 BENEFITS OVERVIEW Merrillville Community School Corporation This is a summary presentation only. If there are any differences between the information in this presentation and the information MCSC Benefits Plan documentation and/or insurance certificates, the Plan documents and/or insurance certificates will govern. MCSC Insurance Choices

2 Agenda YOUR CONTACTS 2014 BENEFITS OVERVIEW QUESTIONS & ANSWERS MCSC Insurance Choices

3 Merrillville CSC Benefits Team INSURANCE DEPT. JENNIFER HOSTETLER / JAMIE BANASHAK Coordinates the enrollment/change process Answers your questions Can research issues between you and your insurance provider. INSURANCE COMMITTEE Comprised of employees from various departments INSURANCE NOTIFICATIONS Add insurance_committee@mvsc.k12.in.us to your address book to receive important messages about your benefits. MCSC Insurance Choices

4 Who s Eligible Employees Dependents Spouse Children up to age 26 Must verify your dependents eligibility within 30 days MCSC Insurance Choices

5 Waving Coverage YOU DON T NEED HEALTH COVERAGE THROUGH MCSC? You can waive/decline coverage except Basic Life & LTD Please fill out the Waiver of Medical Coverage and return to the Insurance Department MCSC Insurance Choices

6 Health Plans MEDICAL, DENTAL AND VISION PLANS MCSC Insurance Choices

7 Aetna PPO NETWORK Must use network provider Deductibles Apply $500 Single $1,000 Family Out of Pocket Limit $1,500 Single $3,000 Family $20 copay for Office Visits 90% benefit coverage after deductible for most services. Prescription Drugs: 30 day supply $5/$20/$45 copays* OUT OF NETWORK Any Licensed Provider Deductibles Apply $500 Single $1,000 Family Out of Pocket Limit $1,500 Single $3,000 Family 80% per visit after deductible 80% benefit coverage after deductible for most services. Prescription Drugs: See Plan for complete details and cost. * Prescription Drug has it s own out of pocket maximum; $2,500 individual & $5,000 family. MCSC Insurance Choices

8 Aetna High Deductible Health Plan NETWORK Must use network provider Deductibles Apply $3,000 Individual $6,000 Family 100% benefit coverage of Preventative care with the deductible waived. 100% benefit coverage after deductible for all other coverage. Out of pocket Maximum $3,000 Individual $6,000 Family OUT OF NETWORK Any Licensed Provider Deductibles Apply $4,000 Individual $8,000 Family 70% benefit coverage of Preventative care coverage after deductible 70% benefit coverage after deductible for all other coverage. Out of pocket Maximum $5,000 Individual $10,000 Family MCSC Insurance Choices

9 Heath Savings Account (HSA) Only available if enrolled in the High Deductible Health Plan Special savings account you open and fund Use account to pay unreimbursed health care expenses No year end forfeiture; it s your money in your HSA Contribute up to $3,350 (individual) or $6,650 (family) for 2015 MCSC contributes to your First Midwest Bank HSA account, even if you don t! Up to $1,200 per calendar year for an individual plan. Up to $2,400 per calendar year for a family plan. MCSC Insurance Choices

10 Aetna Informed Health Line Sometimes your health questions can t wait until your doctor s visit. Or event the next morning. With Informed Health Line, you can speak to a registered nurse about health issues that are on your mind when ever you need to. Turn to the Informed Health Line for helpful health information instead of unneeded trips to the emergency room Find out about medical test and procedures Get help preparing for a doctors visit. Toll free number, call as many times you need at no extra charge and all covered family members can use it, too. MCSC Insurance Choices

11 Humana Dental NETWORK Must use network provider 100% benefit coverage for Preventive Service Exam, cleaning, x rays Annual Deductible $25 individual / $75 family 90% benefit coverage for Basic Services after deductible. Fillings, oral surgery, periodontics 60% benefit coverage after Crowns, Inlays, Dentures, etc. OUT OF NETWORK Must use licensed provider 100% benefit coverage* for Preventive Service Exam, cleaning, x rays Annual Deductible $25 individual / $75 family 80% benefit coverage* for Basic Services Fillings, oral surgery, periodontics 50% benefit coverage* for Major Services Crowns, Inlays, Dentures, etc. *maximum allowed fee Orthodontia Child orthodontia covers children through age 20. Plan pays 50% of covered orthodontia services, up to a life time maximum of $1,500. MCSC Insurance Choices

12 VSP Vision Benefits Offers one benefit allowance for glasses or contacts every 12 months Covers a routine eye exam every 12 months In Network benefits Lenses: single vision, lined bi focal or lined tri focal Contacts: $120 allowance Frames: $120 $140 allowance Laser Vision Correction Discounts Available Out of Network see plan details complete details and cost MCSC Insurance Choices

13 Flexible Spending Accounts (FSA) A special account you fund from pre tax payroll deductions Use account to pay for qualified out of pocket health care expenses for you and your family. Maximum annual contribution is $2,550 Cannot enroll in a Health Savings Account (HSA) Remember: Use it or Lose It! MCSC Insurance Choices

14 Dependent Care Flexible Spending Account (FSA) A special account you fund from pre tax payroll deductions Use account to pay child (up to age 13) and elder day care expenses. Pays nursery school, day camp, day care, practical nursing care for an adult only if it allows you and your spouse to work. Maximum annual contribution is $5,000 per family Does not cover health care expenses Remember: Use it or Lose It! MCSC Insurance Choices

15 Life Plans LIFE PLANS MCSC Insurance Choices

16 Employee Life and AD&D Insurance No cost to employee Basic Life & AD&D Insurance Please refer to your Insurance Worksheet for exact amount OPTIONAL COVERAGE YOU CAN BUY Supplemental Life $10,000 increments up to the lesser of 7x annual salary or $500,000 in coverage Guarantee Issue Amount $100,000 * Supplemental Accidental Death & Dismemberment (AD&D) Insurance $10,00 increments up to the lesser of 7x annual salary or $500,000 in coverage Guarantee Issue Amount $100,000 * *Evidence of Insurability needed for over Guarantee Issue amount MCSC Insurance Choices

17 Dependent Life Insurance and AD&D OPTIONAL COVERAGE YOU CAN BUY Dependent Spouse Supplemental Life & AD&D $10,000 increments to a max of the lesser of 50% of the Employees Supplemental Life or $100,000* Guarantee Issue Amount $30,000 * Dependent Child Life $5,000 or $10,000 coverage amount available Includes all dependent children *Evidence of Insurability needed for over Guarantee Issue amount MCSC Insurance Choices

18 Enrollment NOW WHAT? MCSC Insurance Choices

19 Changing Your Elections Currently we have a closed enrollment plan The only way to add coverage is with a Qualified Life Event Change Examples: Marriage, Divorce, New Baby You have 31 days from the event to make your new elections. The qualified life event changes will be effective the date of the event. You will need to provide proof of eligibility Birth Confirmation or Birth Certificate Marriage Certificate / Divorce Decree MCSC Insurance Choices

20 Things to remember Enroll by the deadline 30 days from your date of hire. If you do not enroll will not have medical, dental or vision insurance. Fill out your forms and return to the Insurance Department located at the Administrative Service Center (Central Office) Verify your dependents eligibility within 30 days of enrollment or they will receive no coverage. If you have any questions please call Jennifer Hostetler or Jamie Banashak at MCSC Insurance Choices