2018-19 Employee Benefits Summary & Enrollment Guide This booklet produced by EbenConcepts is a brief summary of your benefits as of 8/1/2018 and is not considered Evidence of Coverage. Please refer to your policy/plan documents for a complete description of the controlling terms, coverages, exclusions, limitations, and conditions of your coverage. In case of discrepancy between this information and the actual plan documents, the actual plan documents will prevail. 1
Table of Contents BENEFIT SERVICE TEAM Contact for all general benefit questions or claim issues Clinton Office Angela Thornton, Account Manager Bobby Spell, Broker/Consultant Wilmington /Fayetteville Offices Kelly Sherrill, Account Manager Hughes Waren, Broker/Consultant Contact Information EbenConcepts / Group Benefit Services (910) 592-8611 avthornton@ebenconcepts.com rcspell@ebenconcepts.com (910) 323-0290 kelly@ebenconcepts.com hughes@ebenconcepts.com HEALTH INSURANCE: Customer Service Medical claims, benefit questions: Prescription Drug Card Questions/Claims Member Portal- Blue Connect Physician /Hospital Pharmacy Network Search: DENTAL & LIFE INSURANCE: Customer Service dental & death claims, benefit questions: Dental Provider List: Blue Cross Blue Shield NC Group #058047 (877) 258-3334 www.bluecrossnc.com/members Guardian Life Insurance Group# 490477 (800) 541-7846 www.guardiananytime.com Pages 5-9 Pages 10-14 VOLUNTARY VISION INSURANCE: Customer Service Vision claims, benefit questions: Vision Provider Network ACCIDENT/CRITICAL ILLNESS/DISABILITY : Customer Service claims, benefit questions: FLEXIBLE SPENDING ACCOUNTS (FSA) Community Eye Care (888) 254-4290 Page 15 www.cecvision.com AFLAC (800) 992-3522 Page 16 OrchestrateHR Customer Service FSA claims, balance questions, debit card email EMPLOYEE ASSISTANCE PROGRAM (EAP) (800) 550-8009 menu key 1,1,4,1 flexadmin@orchr.com Guardian WorkLife Matters Pages 17 Unlimited Telephonic Counseling Website portal username: Matters password: wlm70101 ATTORNEY SERVICES Contact Group Benefit Services for Questions (800) 386-7055 www.ibhworklife.com Page 18 LegalShield (910) 592-8611 Page 19 Refer to this list when you need to contact one of your benefit providers for detailed or private questions. For general information regarding personnel policy, contact: Nancy Dillman Human Resources Director (910) 592-6308 2
How to Enroll Our Cafeteria/125 Plan allows employees to have certain insurance premiums payroll deducted on a Pre-Tax basis. Your eligible premiums will be automatically pre-taxed unless you Opt-out. Annual benefit elections must be made within 31 days of your new hire eligibility date or during the Open Enrollment period beginning June 7 th and ending July 6 th. Make your benefit elections in the Blue Ocean benefit portal. Blue Ocean Portal: https://blueocean.orchr.com Click on the Benefits Tab then My Renewal Enrollment (new hires click Benefit Enrolment ) Click Add Dependents if you are enrolling new dependents in a plan Choose the benefit tier for each coverage You must either Enroll or Waive each coverage Adding new Voluntary life will require paper enrollment forms and Evidence of Insurability (EOI) located at the bottom of the enrollment screen. Print completed voluntary forms & return to human resources Finish on-screen enrollment and Print enrollment receipt for your files Review your Summary Benefits of Coverages & Federal Annual Notices located in Forms & Documents tab ***If you lost your Blue Ocean Login and Password please contact Patty Jackson pjackson@sampsonnc.com You can also find a more detailed instruction manual of how to complete the online Renewal Enrollment under Forms & Documents tab in Blue Ocean. When to Enroll New employees are eligible to enroll for benefits the 1 st of the month following a 60 day new hire waiting period. Once you have made your elections, you will not be able to change elections until the next open enrollment period unless you have a payroll approved qualified change in status. Open Enrollment Deadline: 7/6/18 When You Can Make Changes You can only make mid-year changes to benefit elections when you have a qualified change in status. Qualified changes in status include: Marriage / Divorce / Legal separation Birth or adoption Change in child s dependent status Change in residence due to employment transfer for you or your spouse Change in spouse s benefits or employment status. Loss of other coverage Note: You must notify the Human Resources department within 31 days of the qualified change. 3
Your health and wellbeing is important to Sampson County Enrollment Guide This guide will explain who is eligible to participate and when they can enroll in the employer sponsored benefit plans. The cost and summary description of benefits are included to help you make well-informed choices. We encourage you to review all of your options and also encourage you to use our benefit service team, EbenConcepts/Group Benefit Services, for advice or assistance in making your choices. This guide is intended as only a summary of the plans offered and is not meant to be a complete plan document. The complete description of plan specifications, coverage, limitations and exclusions is available on your benefit portal: https://blueocean.orchr.com Open Enrollment Our Cafeteria/125 Plan allows employees to have certain insurance premiums payroll deducted on a Pre-Tax basis. Your eligible benefits will be automatically pre-taxed unless you Opt-out. Annual benefit elections must be made during the Open Enrollment period in June and coverage is effective August 1 st. Mid-year changes are only allowed if completed within 31 days of a qualifying event. Health and Wellbeing Benefits Offered Health Insurance (pre-tax) Dental Insurance (pre-tax) Vision Insurance (pre-tax) Employee Assistance Program Financial Security Benefits Offered Basic Life Insurance with Accidental Death & Dismemberment Voluntary Life Insurance with Accidental Death & Dismemberment Accident Insurance, Short Term Disability, Critical illness 4
Health Insurance BlueCross BlueShield of NC Who is Eligible and When: Full-time employees, spouses, children up to age 26, & County Commissioners are eligible for the health benefits on the 1 st of the month following 60 days of employment. Employees can add or change coverage during open enrollment with coverage taking effect August 1 st Employee Pays: The employee s cost is determined by length of service and annual pay. Sampson County contributes to the employee premium and a portion of the dependent premium based on the scale listed on page 9. BCBSNC Group #058047 5
Outpatient Diagnostic Services BCBSNC has implemented a new program 8/1/2107 that requires your provider to get approval, called a prior authorization, for diagnostic imaging tests. These tests include CT, CTA, MRI, MRA, PET, Cardiac and Nuclear Medicine. This prior authorization is for procedures in the outpatient hospital setting, freestanding radiology offices or provider offices. This prior authorization is not required at the inpatient, ER, or 23 hour observation settings. 6
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Mail Order Prescription Drugs - 90 Day Supply (2.5 x copay) Tier 1 Generic Drugs $10.00 copayment Tier 2 Preferred Brand-Name $112.50 copayment Tier 3 Non-preferred Brand-Name $150.00 copayment www.myprimemail.com (888)274-5180 8
Health Insurance Payroll Deductions: The County and employees share the cost for individual and family coverage. The employee cost of health insurance includes a financial incentive for those employees who participate in the County s voluntary wellness plan. Those who do not participate in the voluntary wellness plan will have an additional $30 per month pay reduction added to the deductions listed below. Monthly Payroll Deductions Annual Salary at July 1, 2018 Employee Only Employee + Child Employee + Family Less than 25,000 $0.00 $150 $435 25,001-35,000 $14.00 $164 $449 35,001-45,000 $25.00 $175 $460 45,001-55,000 $49.00 $199 $484 55,001-65,000 $75.00 $225 $510 65,001 and over $100.00 $250 $535 9
Dental Insurance Who is Eligible and When: Full-time employees, spouse & children up to age 26 are eligible are for the dental benefits the 1 st of the month following 60 days of employment. Employees can add or change coverage during open enrollment with coverage taking effect August 1 st Employer Pays: Sampson County contributes the majority of the employee premium and 0% of the dependents premium. Guardian Group# 490477 10
Dental Employee Payroll Deductions: MONTHLY TYPE OF COVERAGE PAYROLL DEDUCTION All Employees $5.00 Employee + 1 Dependent $55.79 Employee + 2 or More $80.50 11
Basic Life/AD&D Who is Eligible and When: Full-time employees are eligible for the life benefit the 1 st of the month following 60 days of employment. The coverage is guaranteed issue for new hires. Employer Pays: Sampson County contributes 100% of the employee premium. Benefits Reduction: There are benefit reductions of 35% at age 65, 60% of original amount at age 70 and 75% of the original amount at age 75. 12
Voluntary Life/AD&D Who is Eligible and When: Full-time employees and their legal spouses & dependents are eligible for the life benefit the 1 st of the month following 60 days of employment. Ex-Spouses are not eligible for coverage. The coverage is guaranteed issue for new hires. Employer Pays: Sampson County does not contribute to the employee s premium. Benefits Reduction: There are benefit reductions of 35% at age 65, 60% of original amount at age 70 and 75% of the original amount at age 75. Spouse s coverage cannot exceed 50% of the employee coverage 13
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Voluntary Vision Who is Eligible and When: Full-time employees are eligible for the vision benefits the 1 st of the month following 60 days of employment. Employees can add or change coverage during open enrollment with coverage taking effect August 1 st. Employer Pays: Sampson County does not contribute to the vision premium. Benefits: 15
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FLEXIBLE SPENDING ACCOUNTS HEALTHCARE REIMBURSEMENT If you or qualified dependents are currently paying for non-reimbursed healthcare expenses such as: - Doctor visit copays, prescription drug copays & health plan deductible - Dental expenses and Orthodontia expenses - Eyeglasses, lenses and vision correction surgery You may elect to have those future expenses deducted from your paycheck and placed in a flexible spending account (FSA) on a pre-tax basis. The FSA can save you approximately 30% in taxes on the money you contribute. HOW IT WORKS - The Plan Year runs from August 1 st July 31 st - You may elect up to a maximum of $ 2,600 per family per plan year. - Your annual election is divided evenly and deducted over 12 pay periods. - You are reimbursed the tax-free FSA money as you file claims for eligible expenses or use your FSA Debit Card at eligible healthcare providers. - FSA balances must be spent during the plan year or forfeited. Up to $500 of unused funds may be carried over into the new plan year. - You may elect expenses from your qualified tax dependents even if they are not covered by your employer s medical, dental or vision plans. ADVANTAGES - Easy way to save for expected healthcare expenses. - Employees have access to their entire annual election after the first payroll deduction. - 30% tax savings (the higher your tax bracket the greater the savings) CHILD/DEPENDENT CARE REIMBURSEMENT If you are currently paying for child or dependent care on a qualified person, you may elect to have those expenses deducted from your paycheck and placed in a flexible spending account (FSA) on a pre-tax basis. This can save you approx.30% in taxes on the money you place in it. Children under 13 years old are eligible or qualified dependent adults. HOW IT WORKS - You may elect to deduct up to $5,000 per family per calendar year (filing a joint return). - Your annual election is divided evenly and deducted over 12 pay periods. - You are reimbursed the tax-free FSA money as you file claims for eligible expenses or use your FSA Debit Card at eligible daycare providers. - FSA balances must be spent during the plan year or forfeited. Up to $500 of unused funds may be carried over into the new plan year. - If your family income is over $25,000 you will most likely benefit from this plan rather than taking dependent tax credit on your tax return. * Balance statements will be sent to each employee 30 days before the end of the plan year. Any money deducted and not spent by the end of the plan year s grace period is forfeited. Debit Card receipts should be kept for tax purposes. 17
Employee Assistance Program Employer Pays: Sampson Country provides this benefit at no cost to the employee. 18
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