Employee Benefits Guide - PDF Free Download

2016-2017 Employee Benefits Guide Benefits Office Educational Services Center 4700 South Yosemite Street Greenwood Village, CO 80111 benefits@cherrycreekschools.org

CHERRY CREEK SCHOOL DISTRICT EMPLOYEE BENEFITS BENEFITS DESIGNED TO MEET YOUR NEEDS All benefit plans are effective July 1, 2016 June 30, 2017 We are proud to provide the Cherry Creek Choice benefit program to our employees. Through its medical, dental, life, vision, and disability insurance coverage, the program offers valuable protection to you and your family. This program is considered to be one of the finest benefit programs in Colorado. The program allows you to choose among a variety of benefit options and to determine how your benefit dollars are spent. THIS WORKBOOK This workbook describes the benefit program available to all benefit eligible employees of Cherry Creek School District. This workbook: Explains your choices for each plan. Provides information about eligibility and changes to eligibility. Helps you make the benefit decisions that are right for you. Please use the Employee Self-Service Online Enrollment Tool to complete your enrollment. NOTE: This document is an outline of the coverage proposed by the carrier(s). It not intended as a complete benefit description of all coverage. The carrier(s) group policies govern all coverage, and contain all terms, covenants and conditions of coverage. The information contained in this workbook is only a guide. The benefit decisions are yours. 2

CHERRY CREEK SCHOOL DISTRICT EMPLOYEE BENEFITS AN INTRODUCTION WHAT IS CHERRY CREEK CHOICE? Cherry Creek Choice is the benefit program for eligible employees of Cherry Creek School District. Cherry Creek Choice is a cafeteria benefit plan which offers you choices of benefits. A cafeteria benefit plan enables you to choose plans with varying costs that fit your needs and the needs of your family. WHAT CHOICE OF BENEFITS DO I HAVE? You may make choices in these plans: Medical Coverage Dental Coverage Vision Coverage Medical Flexible Spending Account (FSA) Dependent Care Flexible Spending Account (FSA) Voluntary Life Insurance Voluntary Accidental Death & Dismemberment (AD&D) Plans which are part of this program, and are provided to eligible employees at no cost are: Basic Life Insurance/AD&D Long Term Disability (Refer to separate policy information for Basic Life Insurance & LTD) 3

MEDICAL OPTIONS Kaiser Permanente KHDP 5000 DHMO 1500 DHMO 500 Triple Option Waive Coverage - *Cafeteria Dollar eligible employee groups MUST provide proof of other group coverage. Individual plans will not be accepted including plans through Connect for Health Colorado DENTAL OPTIONS Delta Dental Premier Plus PPO (PPO Plus) Preferred Provider Option (PPO) Exclusive Provider Option (EPO) Waive Coverage Opt for Coverage VISION OPTIONS VSP Waive Coverage Medical Flexible Spending Account/FSA FLEX ACCOUNTS OPTIONS 24 Hour Flex Dependent Care Flexible Spending Account/FSA Voluntary Life Insurance VOLUNTARY LIFE INSURACE OPTIONS UNUM Voluntary Life AD&D COVERAGE FOR ELIGIBLE EMPLOYEES PAID BY THE DISTRICT Basic Life & AD&D Long Term Disability COVERAGE FOR ALL EMPLOYEES PAID BY THE DISTRICT Employee Assistance Program (EAP) * Please note that all benefits eligible employees receiving a district contribution must submit proof of other coverage to be able to waive the medical coverage offered by the district. Other coverage is defined as coverage from another group health plan, Medicare, Medicaid or Tri-County insurance. If you do not submit proof of other coverage, you will be automatically enrolled into the Kaiser DHMO 1500 plan. 4

TABLE OF CONTENTS Enrollment Periods... 7 Change of Status... 8 Eligibility... 9 Tax Elections... 10 Kaiser Permanente... 11 Kaiser Plan Summary... 18-19 DHMO 1500 Plan... 20-21 KHDP 5000 Plan... 22-43 DHMO 500 Plan... 24-25 Triple Option Added Choice Plan... 26-30 Additional Plan Information... 37-45 Delta Dental Plan... 45-51 VSP Vision Plan... 52-59 24 Hour Flex (Flexible Spending Accounts)... 60-68 Unum Life Insurance... 69-71 Employee Assistance Program (EAP)... 71-76 Retirement Plan Options... 77-85 Plan Contact Information... 86 5

Enrollment Periods & Eligibility Provisions 6

CHERRY CREEK SCHOOL DISTRICT EMPLOYEE BENEFITS ENROLLMENT PERIODS NEW EMPLOYEE ENROLLMENT All benefit eligible employees will receive an enrollment packet through e-mail via your Cherry Creek Schools email account. Please ensure you have access to your Active Directory and Password. If you do not receive an email, please contact your manager or the benefits department at benefits@cherrycreekschools.org. The benefit choices you make take effect the first day of the month following 30 days of continuous employment. Benefits are current month. This means that payroll deductions to pay for the coverage are current month. (i.e. June paycheck deduction to pay for coverage in June). ANNUAL OPEN ENROLLMENT Open Enrollment is held annually for all benefit eligible employees in Cherry Creek School District during the month of May with a benefit effective date of July 1. You cannot change your elections during the plan year unless you have a status change. The plan year is from July 1 through June 30. The premiums for renewed plans will be effective in July 1, for all employee groups. 7

CHANGE IN STATUS AND SPECIAL ENROLLMENT RULES As a participant in the Benefit Cafeteria Plan, you are entitled to revoke your prior benefits election and enter into a new election in the event of certain changes in status. The change in your benefits election must be due to and be consistent with the change in status. The change must be acceptable under the regulations issued by the Department of Treasury, and with the District Summary Plan document. A change to your elections must be made within thirty-one days of the qualifying event. Supporting documentation is required. Change in Marital Status Change in legal marital status including marriage, death of the spouse, divorce, legal separation or annulment. Change in Number of Tax Dependents Change in the number of tax dependents including birth, adoption, and placement for adoption or death of a dependent, permanent legal guardianship. Changes in Spouse, or Dependent s Eligibility under an Employer s Plan Change in dependent status in satisfying or ceasing to satisfy the eligibility requirements of the plan, such as change in marital status. Gain or loss of Medicaid or Medicare entitlement. Entitlement to COBRA. Special Requirements relating to the Family and Medical Leave Act (FMLA). Change in Employment Status that Changes Eligibility Status Change of employment status, such as termination or commencement of employment by the employee, spouse or dependent. Change in work schedule, such as a reduction or increase in hours of employment by the employee, spouse or dependent, including a switch between part-time and full-time, a strike or lockout, a change in worksite, or commencement or return from an unpaid leave of absence. Change in eligibility due to change in residency of the employee, spouse or dependent. Change in Cost or Coverage Significant cost increase in your or your dependent s coverage. Significant curtailment of your or your dependent s coverage. Addition or elimination of benefit package option under your or your dependent s employer s plan. Change in coverage or open enrollment of spouse or dependent under other employer s plan provided that the employee, spouse or dependent elects coverage under the dependent s plan. Cost or coverage change of status is not applicable for Medical Spending or Dependent Care Flexible Spending Accounts (FSAs). Applicable for Dependent Care Flexible Spending Accounts only: Change in dependent care provider. Change in dependent care costs. Dependent attains the age of 13. 8

CHERRY CREEK SCHOOL DISTRICT EMPLOYEE BENEFITS ELIGIBILITY PROVISIONS WHO IS ELIGIBLE? Eligible employees: You are eligible for Cherry Creek Choice benefits package if you are a regular employee working 50 percent of a full-time contract in an eligible employee group. For more information on eligibility see our benefits page in the Backyard. Eligible dependents: Your legal spouse (must submit marriage license), common law spouse (must sign common law affidavit) or civil union spouse (must submit civil union certificate). Child indicates your dependent children. This definition includes: natural children, stepchildren, legally adopted children, a child placed for adoption, or children under permanent courtappointed legal guardianship. An eligible child is defined as a child of the employee through the end of the month in which the child turns age 26. With the exception of legal guardianship, dependent children do not have to reside in the household of the subscriber. Cherry Creek requires proof of such relationships (legal adoption papers, legal custody papers, etc.) that the dependent qualifies for coverage. NOTE: Foster children are not considered eligible dependents and may not be enrolled. An unmarried child who is 26 years of age or older incapable of self-support because of mental incompetence or severe physical handicap as certified by a physician and by the insurance carriers. You may enroll your eligible dependents in some of the plans that you are enrolled in and are not required to enroll them in all of your plans. Dependents must be enrolled in the same plan type as you are - for example: You can not be enrolled in Kaiser Triple Option and have your dependents in Kaiser DHMO 500 plan. You do not have to go to the same providers. If you do not enroll all of your eligible dependents now, you may do so at future open enrollments only (unless a change in status occurs). See Change in Status Section for details on special enrollments. 9

CHERRY CREEK SCHOOL DISTRICT EMPLOYEE BENEFITS TAX ELECTIONS FOR PREMIUMS PRE-TAX CONTRIBUTIONS If the benefit plans you select cost more than the District s monthly contribution, you may contribute benefit dollars out of your paycheck with pre-tax dollars for these plans: Medical Coverage Dental Coverage Vision Coverage Medical Flexible Spending Account (FSA) Dependent Care Flexible Spending Account (FSA) Cherry Creek will automatically default your tax selection to a pre-tax basis. You pay no federal or state income, Medicare, or PERA taxes on your pre-tax contributions. AFTER-TAX CONTRIBUTIONS When you approach the final four years before retirement, PERA recommends that if your benefit selections exceed your district contribution, you may wish to change your status to after-tax. The amount that exceeds the district contribution is taken directly out of your salary and when deducted on a pre-tax basis, this reduces the earnings reported to PERA and lowers your highest average salary. If your premium totals are less than the district contribution, this will not affect your PERA earnings and may only be contributed on a pre-tax basis. Please contact PERA if you have questions related to your highest average salary. An employee may elect to have Medical, Dental, Vision, Voluntary life and Voluntary AD&D premiums on an after tax basis. You cannot participate in the Medical FSA or Dependent Care FSA on an after-tax basis. Once elected, this selection will continue for the full plan year. A change can only be made during open enrollment. 10

Medical Plans 11

Kaiser Permanente DHMO 1500 20

Kaiser Permanente DHMO 500 Plan 22

Kaiser Permanente Added Choice 26

Additional Plan Information 37

Vision Plan 52

Flexible Spending Accounts (FSA) 60

CHERRY CREEK SCHOOL DISTRICT EMPLOYEE BENEFITS FLEXIBLE SPENDING ACCOUNTS 24HourFlex is the administrator of two individual Flexible Spending Accounts (FSA): one for healthcare (medical) expenses and one for dependent childcare/elder care expenses. You can enroll in one or both FSAs. You can save money on your healthcare and/or dependent day care expenses with an FSA. You set aside funds each pay period on a pretax basis and use them tax-free for qualified expenses. You pay no federal income taxes on your contributions to an FSA. (That s where the savings comes in.) Your FSA contributions are deducted from your paycheck before taxes are withheld, so you save on income taxes and have more disposable income. You and your tax qualified dependents do not need to be enrolled in the CCSD Medical, Dental, or Vision plans to enroll in the FSA. Medical FSA Limit: $2,550 If eligible, you are able to contribute up to $500 of unused cafeteria monies towards your Medical Spending Account. If you were hired prior to July 1, 2006 and have the option of keeping the district contribution as cash, your total Medical Spending Account limit remains $2,550. If you were hired after July 1, 2006 your total Medical Spending Account limit is $3,050 ($2550, plus the additional $500 in cafeteria monies). Dependent Care FSA Limit: $5,000 individual or joint tax return/$2,500 married filing separate tax return per calendar year. You will receive an FSA Debit Card once you ve enrolled for the new plan year. If you already have a debit card and it is not expired, it will be loaded with your new election. The debit card can be used to pay for any eligible expense. Use it at your doctor s office, to pay for prescriptions, and for dental or vision expenses. Be sure to save any itemized receipts. 24HourFlex may ask you to substantiate the charges. An eligible receipt is one that lists the date of service, who the provider was, what service or product was purchased, and the amount. A credit card slip is not an eligible receipt. 61

Voluntary Life & AD&D Insurance Plans 69

Employee Assistance Program 72

Retirement Plan Options 77

CHERRY CREEK SCHOOL DISTRICT EMPLOYEE BENEFITS RETIREMENT ACCOUNTS How to Enroll in a Cherry Creek Supplemental Retirement Saving Plan 401(k) Traditional or Roth To obtain forms for New Enrollment or Changes Employee Self Service https://my.cherrycreekschools.org Payroll in the Backyard https://backyard.cherrycreekschools.org/departments/payroll/pages/default.aspx After your first payroll deduction you will login to: https://www.copera.org/programs/ peraplus-401k457-and-pera-dc-plan-information and choose your investment options. 403(b) Traditional To obtain information for Enrollment and current 403(b) Vendor List Employee Self Service https://my.cherrycreekschools.org Payroll in the Backyard https://backyard.cherrycreekschools.org/departments/payroll/ Pages/default.aspx Employees should first choose and contact an Agent from the Approved Vendor List along with completing the Salary Reduction Agreement Form (SRA). 457 Traditional or Roth Login to: https://www.copera.org/programs/peraplus-401k457-and-pera-dc-plan-information or call 1-800-759-7372 to enroll and make your investment options. For more information please visit the Payroll department page in The Backyard: https://backyard.cherrycreekschools.org/departments/payroll/pages/default.aspx 80

CARRIER CONTACT INFO Kaiser Permanente Added Choice Triple Option Customer Service www.kp.org www.phcs.com 303-338-3800 Delta Dental of Colorado Customer Service Premier Plan (#1108) PPO Plan (#1726) EPO Plan (#7094) Vision Service Providers (VSP) Customer Service 24 Hour Flex Help Center www.deltadentalco.com 303-741-9305 or 800-610-0201 Providers: Premier Network Providers: PPO Network (DPO) Providers: PPO Network www.vsp.com 1-800-877-7195 www.24hourflex.com 303-369-7886 or 1-800-651-4855 Unum Life Insurance Employee Assistance Program (EAP) Compsych HealthSmart (COBRA) Customer service Lincoln Financial Group (LTD) Customer service www.unum.com 1-800-421-0344 www.guidanceresources.com 1-888-628-4824 1-800-423-4445 1-800-368-1135 PERA Customer service www.copera.org 303-832-9550 Retirement Accounts (401k, 403b, 457 plans, etc.) 86 payroll@cherrycreekschools.org