2019 Benefits Enrollment Guide

Transcription

1 2019 Benefits Enrollment Guide

2 Welcome to your 2019 Benefits Enrollment What s in the Guide? Enrollment Procedures..3 Mobile App.4 Medical.. 5 Health Savings Account.6 Flexible Spending Accounts..7 Dental....8 Vision.. 9 Voluntary Benefits Term Life and AD&D Insurance.12 Disability Identity Theft Protection...15 Important Contacts Life Events We are honored to present your 2019 Benefit Options! The elections you make during your enrollment will begin January 1, 2019 (or the first day of employment) through December 31, The cost of Medical, Dental and Vision benefits vary by your employment classification. Basic Life and AD&D is paid by Granville Exempted Village Schools for all employees. In addition, there are voluntary benefits (Voluntary Life and Accidental Death & Dismemberment, Short- Term Disability, Long-Term Disability, Accident, Cancer, Flexible Spending Accounts and LifeLock) with reasonable group rates that you can purchase through Granville Exempted Village Schools payroll deductions. When Can I Enroll? New hire initial enrollment and open enrollment allows for employees of the District to enroll or make changes in any of the plans without a qualifying event. Please reference each specific Plan Document to verify the Dependent Eligibility rules. Elections made now will begin January 1, 2019 (or the first day of employment) through December 31, 2019 unless you or your family member experience a qualifying event. If you experience a qualifying event, you must contact HR within 31 days of the event date. IMPORTANT This document is an outline of the coverage proposed by the carrier(s), based on information provided by your company. It does not include all of the terms, coverage, exclusions, limitations, and conditions of the actual contract language. The policies and contracts themselves must be read for those details. Policy forms for your reference will be made available upon request. The intent of this document is to provide you with general information regarding the status of, and/or potential concerns related to, your current employee benefits environment. It does not necessarily fully address all of your specific issues. It should not be construed as, nor is it intended to provide legal advice. Questions regarding specific issues should be addressed by your general counsel or an attorney who specializes in this practice area. 2 Granville Exempted Village Schools

3 Enrollment Process The benefits you elect during Open Enrollment will be effective January 1, Open Enrollment is the one time per year that you can make changes to your benefits without a qualifying life event. Qualifying life events can be found on page 17 (last page). Open Enrollment will be held from Monday, October 22nd through Friday, November 2nd If you are currently enrolled in a Flexible Spending Account (FSA), you will need to re-enroll in order to participate in the FSA for We are again partnering with Explain My Benefits, our technology/ benefit communication vendor to assist in our Open Enrollment. This year we will have a self-service online enrollment using the EMB Enroll online system. Options to Enroll Decide which of these three convenient enrollment options best fits your needs: Self-Service - available October 22nd - November 2nd Visit click on the blue Log into Your Benefit System button and move through the enrollment system at your own pace If choosing this option, be sure to click submit at the end of the process and make note of your confirmation number. If you do not receive a confirmation number you have not completed your enrollment and you will not be enrolled for the new plan year. Return to the system anytime and click your confirmation number to view your confirmation statement. Mobile App - Log into the Granville mobile app, select enroll from the menu on the right. Go through the enrollment and finalize by clicking Submit Call Center - available October 22nd - November 2nd Call the Explain My Benefit Call Center at , Option #1. 9:00am - 5:00pm EST; Monday - Friday during the enrollment period to speak with a benefit counselor one-on-one regarding your benefits. On-Site Benefit Counselor - October 29th - November 2nd Meet with a benefit counselor in person to discuss and help you enroll in your benefits for the upcoming plan year. See the Benefit Resource Website for location and schedule times. Reminders When using any of the above options for enrollment: Be sure to review the 2019 Benefit Guide and plan summaries prior to going through any enrollment process Be prepared by gathering dependent and beneficiary information (i.e. Social Security Numbers and Dates of Birth) Granville Exempted Village Schools 3

4 Mobile App 1. Visit the Apple or Android App Store 2. Search for: Explain My Benefits 3. Download the free app! 4. Enter company code: gevs 4 Granville Exempted Village Schools

5 Medical You have a choice of 2 Medical Insurance Plans to choose from. Both are High Deductible Health Plans with Medical Mutual of Ohio. You also have the option to set up a Health Savings Account (HSA) through Park National Bank. We strongly encourage you to set aside some money each pay period to put into your Health Savings Account. Maximum Annual HSA Contributions (total of employer and employee contributions): Individual - $3,500 Family - $7,000 If you are 55 years or older, you may contribute an additional $1,000 annually Non-Embedded: 1 or more in the Family contract must satisfy the Family Deductible before the plan will pay. Embedded: Inside the Family contract, one person may satisfy the Single Deductible. HDHP/HSA - Low Plan Medical Mutual of Ohio HDHP/HSA - High Plan In Network Out of Network In Network Out of Network Deductible Non-Embedded Embedded Individual $2,000 $5,000 $4,000 $10,000 Family $4,000 $10,000 $8,000 $20,000 Coinsurance 100% 60% 100% 60% Out of Pocket Maximum Individual (Includes Deductible) $2,000 $10,000 $4,000 $20,000 Family (Includes Deductible) $4,000 $20,000 $8,000 $40,000 Doctor s Office Office Visit (PCP/ Specialist) 100% after Deductible 60% after Deductible 100% after Deductible 60% after Deductible Preventive Care Services (routine exams, x-rays/tests, immunizations, well baby care and mammograms) Hospital Services 100% Covered 60% after Deductible 100% Covered 60% after Deductible Emergency Room 100% after Deductible 60% after Deductible 100% after Deductible 60% after Deductible Urgent Care Center Services 100% after Deductible 60% after Deductible 100% after Deductible 60% after Deductible Inpatient 100% after Deductible 60% after Deductible 100% after Deductible 60% after Deductible Outpatient Surgery 100% after Deductible 60% after Deductible 100% after Deductible 60% after Deductible Other Services Chiropractic (12 visits per benefit period) 100% after Deductible 60% after Deductible 100% after Deductible 60% after Deductible Physical Therapy (60 visits per benefit period) 100% after Deductible 60% after Deductible 100% after Deductible 60% after Deductible Prescriptions Retail - Generic/Formulary/Non-Formulary 100% after Deductible 60% after Deductible 100% after Deductible 60% after Deductible Mail Order (90 days) 100% after Deductible Not Covered 100% after Deductible Not Covered Granville Exempted Village Schools 5

6 Health Savings Account (HSA) What is an HSA? A health savings account (HSA) is a tax-favored savings account. Money in the savings account helps pay your deductibles, coinsurance and out of pocket expenses. Once the deductible is met, the plan starts paying. Money left in the savings account may earn interest and is yours to keep. Health Savings Account Plans High- Deductible Insurance + Savings Account HSAs have many benefits: The money you put in your HSA account is pre-tax and tax deductible. You don t pay taxes on withdrawals when paying for qualified medical expenses. YOUR HSA balance can be carried over year after year. You own the savings account and you decide when to use the funds in it to pay for qualified medical expenses! Granville Exempted Village Schools will make a contribution to your Health Savings Account. The contribution that applies to you will be shown when you process your enrollment transaction, if you are able to open and fund a Health Savings Account (see questions below to see if you qualify to open and fund an Health Savings Account). Maximum Annual HSA Contributions (total of employer and employee contributions): Individual - $3,500 Family - $7,000 If you are 55 years or older, you may contribute an additional $1,000 annually If you answer YES to any of the following questions, you are NOT eligible to open or fund a Health Savings Account: 1. In 2019, will you be covered by another non-qualified medical plan such as a PPO, Medicare or Tricare? 2. In 2019, will you or a spouse participate in a General Purpose Flexible Spending Account? 3. In 2019, will you be enrolled in either Medicare Part A, Part B, Part C or Part D? 4. In 2019, if you are under age 26, will you be claimed as a dependent on your parents tax return, or covered under your parents health insurance plan? 6 Granville Exempted Village Schools

7 Flexible Spending Accounts FSAs help to fill coverage gaps between health plans and out-of-pocket expenses. An FSA allows you to pay for certain medical, dental vision and dependent care expenses with pre-tax dollars. You won t pay taxes on the funds you put into your FSA because they are deducted on a pre-tax basis. There are 2 Medical FSAs and a Dependent Care FSA available and are administered by Discovery Benefits. General Purpose FSA Limited Purpose FSA Dependent Care FSA Who is Eligible? Maximum Annual Contribution Granville employees who enroll in one of the medical plans and cannot have a Health Savings Account or who waive coverage under both medical plans. Granville employees who are enrolled in one of the Granville medical HDHP Plans and who have an HSA. Granville employees with a qualifying dependent. $2,650 per employer $2,650 per employer $5,000 per family Sample of Qualified Expenses Co-pays/Deductibles Prescriptions Dental Work Vision Exams Eyeglasses Lasik Chiropractic Care Contact Lenses & Supplies Dental & Vision Expenses Only Dental Work Vision Exams Eyeglasses Lasik Contact Lenses & Supplies Babysitters Daycare Centers Elder Care Day Camps Preschool After-School Care Eligible dependents are children up to age 13 and/or elder dependents (i.e. aging parents) that live in your home. Also covers a spouse or dependent who is physically or mentally challenged and for whom you claim an exemption. Granville Exempted Village Schools 7

8 Dental Good oral care enhances overall physical health, appearance and mental well-being. Problems with the teeth and gums are common and easily treated health problems. Keep your teeth healthy and your smile bright with the Granville Exempted Village Schools dental benefit plan through Delta Dental. Delta Dental PPO Calendar Year Deductible Individual / Family* PPO Dentist Premier Dentist $25 / $75 Non-Participating Dentist Annual Maximum $2,000 Preventative Services Exams, Cleanings, X-Rays, etc. Plan pays 100% Deductible is waived. Deductible Applies Basic Services Fillings, Oral Surgery, Root Canals, Crowns, etc. Major Services Implants, Bridges Dentures, etc. 80% Covered 80% Covered 80% Covered 80% Covered 80% Covered 80% Covered Orthodontics Lifetime Annual Maximum (to age 19 or to age 25 if full-time student) Deductible does not apply to Orthodontic services. $1,000 60% Covered Go to to locate a network PPO provider. Please note that your out-of-pocket costs may be more if you choose to go to an out-of-network provider. *Unmarried dependent children to the end of the calendar year in which they turn 19, and your dependent unmarried children to the end of the calendar year in which they turn 25 if a full-time student and who are eligible to be claimed by you as a dependent under the U.S. Internal Revenue code. 8 Granville Exempted Village Schools

9 Vision Regular eye examinations cannot only determine your need for corrective eyewear, but also may detect general health problems in their earliest stages. Protection for your eyes should be a major concern to everyone. Vision is offered through VSP. Basic/Low Option Premier/High Option Comprehensive Eye Exam Once every 12 months Prescription Glasses Once every 12 months Frames Once every 12 months In-Network Out-of-Network In-Network Out-of-Network $10 co-pay Up to $45 reimbursement $10 copay $25 copay $25 copay Up to $45 reimbursement $150 Allowance Up to $70 $150 Allowance Up to $70 Eyeglass Lenses Once every 12 months Once every 12 months Single Vision, Lined Bifocal & Trifocal Included Up to $30 / $50 / $65 Included Up to $30 / $50 / $65 Polycarbonate lenses for dependent children Included N/A Included N/A Standard Progressive $55 Up to $50 Included Up to $50 Premium Progressive $95 - $105 Up to $50 Included Up to $50 Custom Progressive $150 - $175 Up to $50 Included Up to $50 Anti-Reflective Coating Discount Applies N/A Included N/A Scratch Resistant Coating Discount Applies N/A Included N/A Other Lens Options 20-25% Off N/A 20-25% Off N/A Contact Lenses (in lieu of glasses) Once every 12 months Once every 12 months Conventional (Elective) Contact lens exam $150 allowance Up to $60 N/A $150 Allowance Up to $60 N/A *Unmarried dependent children are covered up to the end of the month in which they turn age 19 or to the end of the month in which they turn age 25 if full time student. Granville Exempted Village Schools 9

10 Voluntary Benefits What are Voluntary Benefits? Voluntary Benefits are offered to strengthen your overall benefits package. You customize the benefit based on need and affordability. Ownership Policies are fully portable and belong to you if you leave your employer, same price and same plan Benefits are payroll deducted Cash benefits are paid directly to you, not to a hospital or to a doctor Benefits are paid regardless of any other coverage you may have Level premiums Rates do not increase with age Guaranteed Renewable Designed to provide additional cash flow to assist with out of pocket medical costs and other bills The Voluntary Benefits offered are Accident through Trustmark and Cancer and Universal Life through Transamerica. Trustmark Accident A plan that helps pay for the unexpected expenses that result from an accident On and off the job coverage = 24 hours per day, 7 days a week Family coverage available Sports related injuries covered as well Just a few examples of benefits included in the plan: Emergency room Visits - $200 Hospitalization - $2,000 admission benefit, $400 per day benefit Fractures - up to $10,000 Dislocations - up to $8,000 Health Screening Benefit - $100 per insured per year Semi-Monthly Payroll Deductions Employee Employee & Spouse Employee & Children* Family* $9.53 $14.54 $17.68 $22.69 *Dependents up to age 26 can be covered regardless of student status. 10 Granville Exempted Village Schools

11 Transamerica Cancer Plan The Cancer Plan will pay benefits to you if you are diagnosed with cancer. This plan pays you directly. Some benefits pay by the day or treatment, while others reimburse you for expenses you incur. Either way, it can be a source of financial support just when you and your family need it most! Just a few examples of benefits included in the plan: Initial Diagnosis - $3,000 Hospital Confinement - $200 per day Surgery - up to $3,000 (Inpatient), up to $4,500 (Outpatient) Radiation & Chemotherapy - $10,000 per 12 month period Bone Marrow and/or Stem Cell - $10,000 per 12 months period An Annual Cancer Screening Benefit is included in your policy and Transamerica pays $100 for each insured. Each covered person will get one cancer screening test per calendar year. Examples of Cancer Screenings: Mammogram Pap Smear Prostate-Specific Antigen Test (PSA) Chest X-ray Bone Marrow Testing Semi-Monthly Payroll Deductions Employee Employee & Spouse Employee & Children* Family* $12.28 $22.21 $14.03 $22.21 Transamerica Universal Life Universal Life with Long Term Care includes both a death benefit and a living benefit. Universal Life with Long Term Care is a permanent life insurance that is designed to match your needs throughout your lifetime. The Universal Life with Long Term Care is priced to remain the same cost to you until age 100. The Living Benefit, Long Term Care is 4% of the death benefit per month for up to 25 months if confined in a nursing or assisted living facility or 2% of the death benefit per month for up to 50 months if receiving home health care or day care. Monthly premiums are waived while using the Long Term Care benefits. If you use the Long Term Care benefit, your death benefit amount does reduce. Coverage available for spouse and children as well. Rates Special Underwriting for Initial Offering Guaranteed Issue Up to $100,000 employee / up to $15,000 spouse / $25,000 children This benefit is customized by each employee so rates vary, but can start as little as a few dollars a week. Your specific rate will be calculated for you in the electronic enrollment system. Granville Exempted Village Schools 11

12 Basic Life and AD&D The amount of life insurance that is right for you depends on a variety of factors, including your age, family status, personal savings, financial commitments, etc. Granville Exempted Village Schools offers a variety of programs to meet your life insurance needs. Granville Exempted Village Schools provides a basic life and accidental death and dismemberment (AD&D) insurance coverage through Mutual of Omaha to all benefit eligible employees at no cost to the employee based on your contract. Voluntary Term Life and AD&D You also have the opportunity to purchase voluntary coverage for yourself, spouse (up to a max of $40,000) and dependents (up to a max of $20,000). Please note that dependent children include unmarried adopted, natural or stepchildren age 15 days to age 26. You may elect Voluntary Life Insurance in increments of $10,000 to a maximum of $500,000, not to exceed 10x base salary. Guaranteed Issue Amount (At initial offering only) The lesser of 10x base salary or to $150,000 maximum - employee / $20,000 spouse / $10,000 Child(ren) Age Band Employee & Spouse Life Monthly Rate per $1,000* Monthly Rates for Voluntary Term Life and AD&D Age Band Employee & Spouse Life Monthly Rate per $1,000* All Children Rate per $1,000 <24 $ $0.195 $ $ $ $ $ $ $ $ $1.648* $0.131 *Spouse coverage terminates at age 70 Example: A 36 year old female, Sally, wants to purchase $50,000 of term life insurance..084 x 50 = $4.20 Monthly rate per $1,000 # of units/$1,000 monthly 12 Granville Exempted Village Schools

13 Short Term Disability As an employee of Granville Exempted Village Schools with fewer than 80 days of banked sick leave, you are able to enroll in Short Term Disability (STD) coverage through Mutual of Omaha. STD coverage supplements your lost wages should you be unable to work due to an illness, injury or pregnancy. STD coverage begins after missing the specific elimination period below due to a medically certified reason. Benefits are payable up to the specific benefit duration period below. Elimination Period for sickness, accident or pregnancy: 14 days* Maximum Benefit Period: Weekly Benefit: 13 weeks 60% of your weekly earnings to a maximum of $1,250 *Please consult the Short Term Disability Certificate Documents for all terms and provisions. Pre-Existing Condition: Anything you received medical treatment, advice or consultation, care or services including diagnostic measures, or had drugs or medicine prescribed or taken in the 3 months prior to your insurance effective date will not be covered for the first 12 months of the policy. Attained Age Monthly Rate Per $10 of Weekly Benefit Attained Age Monthly Rate Per $10 of Weekly Benefit < 24 $ $ $ $ $ $ $ $ $ $ $0.390 Premium Calculation Example: 40 Year Old Employee with a $50,000 annual salary Step 1: (Annual Salary) $50,000 / 52 = $ Weekly Salary Step 2: (Weekly Salary) $ x 60% = $ Weekly Benefit Step 3: (Weekly Benefit) $ / 10 = # Units Step 4: (# Units) x $0.370 (Rate) = $21.35 Monthly Premium Step 5: (Monthly Premium) $21.35 x 12 = $ (Annual Premium) / 24 = $10.68 Payroll Deduction Granville Exempted Village Schools 13

14 Long Term Disability As an employee of Granville Exempted Village Schools, you are able to enroll in a choice of Long Term Disability (LTD) coverage through Mutual of Omaha. LTD coverage supplements your lost wages should you be unable to work due to an illness or injury. LTD coverage begins after missing the specified elimination period below due to a medically certified reason. Benefits are payable up to the specified benefit duration period below. Pre-Existing Condition: Anything you received medical treatment, advice or consultation, care or services including diagnostic measures, or had drugs or medicine prescribed or taken in the 12 months prior to your insurance effective date will not be covered for the first 12 months of the policy. Option 1 Option 2 Elimination Period 90 Days 90 Days Max. Benefit Period 5 Years SSNRA Benefit Percentage 60% Monthly Earnings 60% Monthly Earnings Max. Monthly Benefit $5,000 $5,000 Monthly Premium Rate per $100 of Monthly Covered Payroll (5 Year Benefit Period) Age Rate Age Rate Age Rate Age Rate <24 $ $ $ $ $ $ $ $ $ $ $1.39 Monthly Premium Rate per $100 of Monthly Covered Payroll (SSNRA Benefit Period) Age Rate Age Rate Age Rate Age Rate <19 $ $ $ $ $ $ $ $ $ $ $ $0.89 Example for 5 Year Benefit Period: 40 Year Old Employee with a $45,000 annual salary Step 1: (Annual Salary) $45,000 / 12 = $3,750 Covered Monthly Payroll Step 2: (Covered Monthly Payroll) $3,750 / 100 = 37.5 # Units Step 3: (# Units) 37.5 x.28 (Rate) = $10.50 Premium Per Month Step 4: (Monthly Premium) $10.50 x 12 = $126 (Annual Premium) / 24 = $5.25 Payroll Deduction 14 Granville Exempted Village Schools

15 Identity Theft Protection Identity theft in the United States is a major problem that continues to be on the rise. Professional protection and assistance have become important tools in fighting the identity theft epidemic. Thieves today can get a hold of your personal information from trash cans, dumpsters, stolen mail, and even shoulder surfing. Once thieves have your information, it s a simple matter to open new fraudulent accounts and make purchases in your name. When you enroll in LifeLock, you can be confident knowing that they are available 24 hours a day, 7 days a week, and committed 100% to helping protect your information as if it were their own. LifeLock offers Proactive Protection in both of the plans offered: Benefit Elite Plan LifeLock Identity Alert System Lost Wallet Protection Address Change Verification Black Market Website Surveillance Live Member Service Support LifeLock Privacy Monitor Reduce Pre-Approved Credit Card Offers Identity Restoration Support Stolen Funds Replacement - up to $100,000 Fictitious Identity Monitoring Court Records Scanning Data Breach Notifications Investment Account Activity Alerts Ultimate Plan Provides all of the benefits of the Benefit Elite Plan plus: Stolen Funds Replacement - up to $1,000,000 Credit Card, Checking & Savings with Account Activity Alerts Online Annual Credit Report Online Annual Credit Score Checking & Savings Account Application Alerts Bank Account Takeover Alerts Credit Inquiry Alerts Online Annual Tri-Bureau Credit Reports & Scores Monthly Credit Score Tracking File Sharing Network Searches Sex Offender Registry Reports Priority Live Member Service Support $1 Million Total Service Guarantee LifeLock s proactive approach works to help stop identity theft before it happens. As a LifeLock member, if you become a victim of identity theft because of a failure in their service, they will help fix it at their expense, up to $1,000,000. Semi Monthly Payroll Deductions Employee Employee & Spouse Employee & Children* Family* Benefit Elite Plan $4.25 $8.49 $7.43 $11.68 Ultimate Plan $12.75 $25.49 $18.06 $30.81 *Employee & Children and Family Tiers: You may enroll up to 8 children with 4 of those children between the ages of 18 and 26. Granville Exempted Village Schools 15

16 Important Contacts Vendor Phone Website Dental Delta Dental District Insurance Broker Gallagher Benefit Services Flexible Spending Accounts Discovery Benefits FMLA Absence Pro Health Savings Account Park National Bank Human Resources Director of HR - Tonya Sherburne Secretary - Marie Kreger Payroll - Cari Butler tsherburne@granvilleschools.org mkreger@granvilleschools.org cbutler@granvilleschools.org Identity Theft Protection LifeLock Medical Medical Mutual of Ohio Term Life and Disability Mutual of Omaha Trustmark & Transamerica Claims Help Explain My Benefits Vision Vision Service Plan (VSP) Voluntary Benefits Trustmark (Accident) Transamerica (Cancer & Universal Life) Life Disability , Option 3 service@explainmybenefits.biz Benefit Guide Description Please Note: This guide provides Information regarding the Granville Exempted Village Schools benefit program. More detailed information is available from the plan documents and administrative contacts. The plans and policies stated in this information are not a contract or a promise of benefits of any kind, and therefore, should not be interpreted as such. 16 Granville Exempted Village Schools

17 Life Events Qualified Events are listed below. You have 31 days from the date of the event to notify HR and make coverage changes to add or remove dependents from coverage. Notify Human Resources within 31 days of getting married. You may enroll your spouse and dependent children within 31 days from the date of marriage. Also, do not forget to review your Life Insurance needs as well. You will have 31 days to make changes to your Life Insurance policies or enroll a spouse or child(ren) in Dependent Life Insurance. Notify Human Resources within 31 days after a divorce. You have 31 days to cancel coverage for your spouse, and benefits will cancel as of the date of the divorce. Your spouse may have the right to Port or Convert Voluntary Life Insurance, if enrolled, and will need to contact the Life Insurance carrier for information on how to apply and rates. Notify Human Resources within 31 days of a birth or adoption. Coverage for your new bundle of joy will be effective the date of birth or date of adoption. If you are given guardianship over a dependent child, also notify HR within 31 days and coverage will begin the date of guardianship. Yikes! LOSS OF COVERAGE If you need to enroll a dependent spouse (or child/ren) because they have had a reduction in work hours or otherwise lost benefits or eligibility at their place of employment, you have 31 days from the date of the event to enroll them as a dependent on your plan. Benefits that are payroll deducted under a pre-tax 125 Plan cannot be changed or cancelled throughout the benefit plan year without certain Life Events such as marriage, birth or divorce. Granville Exempted Village Schools 17

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