NEW EMPLOYEE ORIENTATION RISK MANAGEMENT & INSURANCE BENEFlex - - PowerPoint PPT Presentation

NEW EMPLOYEE ORIENTATION RISK MANAGEMENT & INSURANCE

IMPORTANT INFORMATION FOR NEW HIRES! BENEFIT FORMS ARE DUE WITHIN 31 DAYS OF YOUR DATE OF HIRE PAYROLL DEDUCTIONS BEGIN ONE MONTH IN ADVANCE SOME BENEFITS OFFER “GUARANTEED ISSUE” DEPENDENTS REQUIRE DOCUMENTATION

BENEFlex 2020

PAYROLL DEDUCTIONS

20 Payroll Deductions per year.

• You pay for 12 months of coverage during the 10 month

school year.

• You pay one month in advance.
• Deductions include a portion for summer coverage.
• Summer premium may be owed upon your initial enrollment
• r if you change benefits during the year.
• If your deductions change during the year, you may owe

premium or you may be due a refund.

2020 Enrollment & Change Form – Required!

Form Required if Enrolling in Coverage Life Insurance Online Application to Enroll in Coverage

GUARANTEED ISSUE FOR NEW HIRES Employee coverage up to $100,000 elected on Enrollment & Change Form Employee coverage over $100,000 and spouse coverage require online Medical History Statement

All three medical plans offer:

• Preventive care covered 100%
• Annual physical
• Well woman care
• Well baby visits
• Flu shot
• Skin cancer screening
• Mammogram
• Colonoscopy
• No Primary Care Physician required
• No referrals required
• National provider networks
• Out of Pocket Maximum
• $4500 Individual/$9000 Family

Which Health Plan is Right for You?

Which Health Plan is Right for You?

Select Open Access

CDHP DHP + HRA Choice ce POS S II

Must stay in Network National Network: Open Access Aetna Select No deductible Co-pays for all services Must stay in Network National Network: Open Access Aetna Select Must meet a deductible:

$1500 individual/$3000 Family You pay 20% after deductible

Health Reimbursement Account provided

$500 individual/$1000 Family (MasterCard debit card mailed separately from ID cards)

In Network & Out of Network National Network: Choice POS II Must meet a deductible:

$500 individual/$1000 Family You pay 20% after deductible

Aetna Prescription Drug Program

Deductible on Non-Preferred Brand and Specialty medications must be met before copays will apply.

All major retail pharmacies in network Mandatory Maintenance Choice Program

Certain drugs will require step therapy, quantity limits & authorizations.

• The least expensive prescription, same effectiveness as a brand name drug
• NO DEDUCTIBLE

Generic $20 co-pay

• Preferred brand, higher cost prescription, brand name medications that

have proven to be most effective in their class

• NO DEDUCTIBLE

Preferred Brand $50 co-pay

• Higher cost, brand name medications, typically lower cost alternatives

available as Generic and Preferred Brand

• DEDUCTIBLE $250 Individual/$500 Family

Non-Preferred Brand $90 co-pay

• Higher cost drugs, often injectable or infused
• Used to treat complex or rare, chronic conditions
• DEDUCTIBLE $250 Individual/$500 Family

Specialty $120 co-pay

Save money by paying two co-pays for a 90 day supply of maintenance medications when obtaining those prescriptions through Aetna Mail Order or CVS Pharmacy Example: $20 for a 30 day supply ($60 for 3 month supply) $40 for one 90 day supply* *at home delivery, mail order pharmacy or CVS pharmacy You must call Aetna in order to opt-out and fill maintenance medications at any other pharmacy in the Aetna network (30 day fill option only)

Wellness Program

Aetna Health Promise

Employees can earn $250 or $350 dollars by participating in various wellness programs throughout the year.

Full list of approved Aetna Health Promise activities can be found on pcsb.org/wellness. Check your Credits in the Future!

Go to www.aetna.com to see how many credits you have. If you are missing credits that you have completed, reach out to Gina DeOrsey (pcs.deorseyg@pcsb.org) or Jessica O’Connell (pcs.deorseyg@pcsb.org).

Plan Employee Only Employee + Children Employee + Spouse Employee + Family 2 Board Family Plan Number of Credits 5 8 Incentive $250 $350

Visit www.pcsb.org/wellness

DENTAL

• Humana Advantage
• Met Life

VISION ACCIDENTAL DEATH & DISMEMBERMENT INSURANCE Disability HOSPITAL INDEMNITY PLAN FLEXIBLE SPENDING ACCOUNTS

• Healthcare FSA

If you do not need medical insurance, you are eligible to use a $75 per pay period Board Contribution Credit to enroll in eligible supplemental benefits

“No Health” Board Contribution

EXAMPLE Board Credit $75.00 Humana Advantage Dental (2P) $13.02 Eye Med Vision (2P) $ 2.83 AD&D $100,000/Fam $ 2.10 Disability – up to SSNRA $800/30 day $ 9.07 MetLife HIP (EE/Family) $21.00 Healthcare FSA $25.00 TOTAL USED $73.02

Dental Plans Comparison Chart

*Board Contribution (Flex Credits) may be used

Eye Med Vision Plan

KEY FEATURES KEY FEATURES

Free coverage for employee only. May purchase coverage for dependents Routine eye exam once every calendar year - $10 co-pay Single vision lenses OR contact lenses once every calendar year Frames once every two years National retail and private practice

• ptometrists & ophthalmologists

Standard plastic lens co-pay $15 Contact lens allowance $110 plus 20% off balance over $110 Frame allowance $110 RATES Employee Only Free Employee + 1 $2.83 Employee + Family $5.92

MetLife HOSPITAL INDEMNITY (HIP)

Covered Benefits: Hospital Admission - $500 Hospital Confinement - $250 per day, 30 day maximum Inpatient Rehabilitation Unit - $100 per day, 15 day maximum – Accident only Pre-existing conditions limitations apply. *Board Contribution (Flex Credits) may be used

The MetLife HIP pays a cash benefit when you or a covered dependent is hospitalized due to an accident or illness.

ACCIDENTAL DEATH & DISMEMBERMENT (AD&D)

• Benefits provided
• If death due to an accident
• Loss of eyesight, speech, hearing, paralysis or

dismemberment due to an accident

• $2000 coverage provided FREE to all eligible employees
• Coverage amounts $50,000, $100,00, $200,000, $300,000
• Employee Only and Employee + Family coverage available
• No application required

Board Contribution (Flex) credits may be used

Long Term Disability

Monthly benefits are paid after the waiting/elimination period.

Pregnancy Benefits Up to 6 weeks post partum for a normal deliver, 8 weeks post partum for a cesarean section. Lifetime Security Benefit

• SSNRA Plan Option ONLY
• Continue disability benefits

after SSNRA if certain conditions are met.

Pre-existing Condition Limitations apply.

**GUARANTEED ISSUE FOR NEW HIRES Employee coverage up to $100,000 elected on Enrollment & Change Form Employee coverage over $100,000 and spouse coverage require online Medical History Statement

The Standard Life Insurance

BOARD PAID LIFE – Employee Coverage:

• 1 X your annual salary, rounded to the next

$1000. Minimum coverage is $15,000. VOLUNTARY FAMILY TERM LIFE

• Spouse and Children - $5,000 each
• Premium covers all eligible dependents

VOLUNTARY OPTIONAL TERM LIFE

• Employee: $10,000 - $500,000**
• Spouse: $10,000 - $100,000
• Online Medical Statement REQUIRED
• May not exceed employee coverage amount
• Children: $2,000 - $10,000
• Mark election on Enrollment & Change Form

Emplo loyees ees must t complete lete the benefici iciary ary sectio tion n for Board d Life. Primary imary and Secondar ary y benefici iciar aries es must t equal 100%: %:

BENEFICIARY INFORMAITON

Dependent Eligibility

For Medical, Dental & Vision, Family Term Life, Dependent Life:

• Legally married spouse
• Biological children, adopted children, children for whom you have permanent

legal custody or Foster Children

• Dependent children may be covered through end of calendar year in which

they reach age 26

DOCUMENTATION IS REQUIRED FOR DEPENDENTS enrolled in health, dental or vision coverage: marriage certificate for a spouse, birth certificates for children. Photocopies are acceptable.

FAMILY STATUS CHANGES

Changes may only be made within 31 days of a change in family status to the current plans that you are enrolled in: Examples:  Marriage or Divorce  Birth or Adoption of a child  Your spouse begins or terminates employment  You begin or return from a leave of absence  Your dependent loses eligibility under the plan Changes may also be made during the Annual Enrollment period every year in the fall, effective January 1st of the following year.

Employee Assistance Program 800-848-9392

• Stress management
• Work/life balance
• Family Issues
• Grief and loss
• Depression
• Anxiety
• Substance Abuse
• Child care, parenting, adoption
• Summer programs for kids
• Summer & financial aid research
• Care for older adults
• Pet Care
• Home repair & improvement
• Household services

 FREE to you and members of your household, including adult children up to age 26 (whether or not they live at home).  Up to 8 counseling sessions per incident

Voluntary Products

• Convenient payroll deductions
• Enroll anytime throughout the year after your eligibility begins
• Group Legal Services may only enroll as a new hire or during annual

enrollment

Home & Auto Insurance Pet Insurance Group Legal Services

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EMPLOYEE DISCOUNTS!

• Banking
• Cell Phones
• Tickets at Work
• Perk Spot
• Theme Parks
• Special Events
• Concerts
• Sporting events
• Shows

Retirement

• Florida Retirement System (FRS)

– You will contribute 3% of your gross pay – You must decide within eight months of your hire date, which plan to select

• FRS Pension Plan
• FRS Investment Plan

– No election – you will default into the Investment Plan

• Tax Deferred Annuity Program

– Defer up to 25% of pay, not to exceed $15,500 per year.

• (If you turn age 50 or older this year, you can contribute and additional $5,000.)

– NO contributions /matching funds from PCS

Pinellas County Schools health insurance coverage meets the standard for minimum essential coverage and is considered affordable under the Affordable Care Act. Benefit eligible employees who enroll in the Marketplace plans would not be eligible for Advanced Premium Tax Credits (tax subsidy) and would not receive premium assistance.

PCS COVERAGE VS. THE HEALTHCARE MARKETPLACE

Contact the RISK MANAGEMENT BENEFITS TEAM for the most accurate answer at 727-588-6197 Or visit our website at www.pcsb.org/risk-benefits