a summary of employee benefits · a summary of employee benefits . enrollment guide for the...
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A Summary of Employee Benefits Enrollment Guide for the 2017-2018 School Year
IMPORTANT The 2017-2018 open enrollment period is
August 21st - September 29th Kaiser Permanente has major changes to their Provider network.
MEA has chosen to go with plans offered through WEA which include the medical carriers Aetna and UnitedHealthcare. See Page 11
All other Groups are staying with Premera Blue Cross for their medical. See Page 11
The dental, vision and long term disability will remain the same for all employees.
Medicare Notification …. Pages 38-39
It is imperative that you take time to review the information so you can make informed decisions.
This guide is only a brief description of insurance coverage under the Marysville School District’s benefits program. The provisions of the actual plan
documents and contracts will govern in the case of any discrepancy.
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Changes to Federal & State Guidelines for Medical Benefits
Federal and State guidelines are changing the way we are able to offer medical benefits. The mandated changes are going to change many things regarding our medical benefits over the next few years. The changes are being implemented in stages. Many of the rules/guidelines are still unclear as to their intent of implementation. Therefore the information contained in this Open Enrollment booklet is as we know things to be at the time we published it. There could be, and most likely will be changes even in the 2017-2018 school (benefit) year. We will keep you apprised of the most current information as we learn it ourselves. A couple of the IMPORTANT changes in benefits being offered are:
There is a Qualified High Deductible Health Plan (QHDHP) being offered through Aetna, UnitedHealthcare, and Premera in conjunction with a Health Savings Account (HSA). There are many restrictions associated with the QHDHP and HSA. If you are interested in this type of a plan, we suggest that you go over your situation with a health plan representative to ensure you meet all the eligibility criteria. There is additional information contained later in the Open Enrollment booklet and you can contact Payroll with any questions you have.
ESSB 5940
ESSB 5940 is a State law that is intended to reform the way school districts administer medical benefits. The State has yet to confirm guidance to bring school districts into compliance with the intent of ESSB 5940. The three State agencies responsible for clarifying the information contained in ESSB 5940 are: Office of Insurance Commissioner (OIC); Health Care Authority (HCA); and Office of Superintendent of Public Instruction (OSPI).
Some of the more significant highlights of ESSB 5940 are:
• Each employee included in pooling arrangements and elects medical coverage pays a minimum premiumcharge subject to collective bargaining.
• Employee premiums are structured to ensure employees selecting richer benefit plans pay a higherpremium.
• School districts must offer a high deductible health plan with a health savings account.• School districts offering medical benefits shall make progress toward ensuring that full family coverage
premiums are not more than three times the premiums for employees purchasing single coverage.• School districts offering medical benefits shall offer at least one health benefit (medical) plan … in which
the employee share of the premium cost for a fulltime employee, regardless of whether the employeechooses employee-only coverage or coverage that includes dependents, does not exceed the share ofpremium cost paid by state employees during the state employee benefits year that started immediatelyprior to the school year. That percentage is approximately 15%
• School districts must use a competitive procedure when entering contracts/agreements for employeebenefits.
In complying with ESSB 5940’s requirement that a plan is offered where the employee’s monthly co- premium does not exceed that of a state employee, in 2015/2016 the WEA introduced a new lower cost option; Basic Plan.
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WEA-AON Benefits Resource Center
Important All MEA Staff: Your Premera BlueCross benefits will end 10/31/2017. To continue medical coverage, you must go out to the WEA UPoint website and select your new medical plan. The two carriers you have to select from are Aetna and UnitedHealthcare. Additionally, if you wish to change, add or drop dependents to or from your Delta Dental or Willamete Dental plans or if you need to add or drop dependents to or from your VSP vision plan during the Open Enrollment period of August 21, 2017 through September 29, 2017, you will need to do so online at the UPoint website http://resources.hewitt.com/wea, or by calling the WEA Select Benefits Center at (855) 668-5039. All Other Staff: If you wish to change, add or drop dependents to or from Delta Dental or Willamete Dental plans, or if you need to add or drop dependents to or from your VSP vision benefits during the Open Enrollment Period of August 21, 2017 through September 29, 2017, you will need to do so online at the Upoint website http://resources.hewitt.com/wea, or by calling the WEA Select Benefits Center at (855) 668-5039. If you wish to add or make changes to your Premera Blue Cross medical insurance, you will need to complete a Premera Blue Cross Enrollment and Change Form. These forms can be found on the Payroll website, or by contacting Cheri Hansen by phone at (360) 965-0100 or by email at [email protected]. Kaiser Permanente still requires a paper form for additions and changes. To obtain a form, please contact Cheri Hansen by email at [email protected] or by phone (360) 965-0100. See page 11 Concerning the process for making a change to your benefits outside of Open Enrollment due to a “life change”.
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UPoint/Alight AON-Hewitt/Alight Contact Information: Website: http://resources.hewitt.com/wea Phone: (855) 668-5039
The first time you access UPoint, click “Register as a New User”. Enter the last four digits of your Social Security Number, your date of birth, and your home ZIP code. You’ll be prompted to create a username (between 8 and 20 characters) and a password (between 8 and 20 characters). You’ll also be asked to answer a few security questions. If you forget your user ID or password, you can access your information by correctly answering the security questions. You can also enter a hint to help you remember your password. Once you have created your username and password, you will use it to log on to the “UPoint” website and/or to call the WEA Select Benefits Center. The sooner you register, the sooner you can view your WEA Select benefits information and manage your benefits. If you encounter difficulty or would rather register via telephone, you can do so by calling the number above. Also, throughout the year: • Review at-a-glance information about the WEA Select medical (Aetna and
UnitedHealthcare), dental (Delta Dental and/or Willamette Dental), and vision (VSP) benefits you and your dependents are enrolled in, including the total cost of coverage (not including District funding for benefits).
• Change your WEA Select benefits when you have a qualified status change or life event. Generally a life event includes marriage, divorce, child birth or adoption of a child or a dependent losing or gaining coverage in another plan. There is a 60 day window to make a change outside of Open Enrollment.
• Review coverage information. • Verify a dependent’s eligibility for benefits coverage. • Use your mobile device to access a mobile version of the site that allows you to review your
current health coverage . . . and more.
During the 2017-2018 Open Enrollment this fall, you can use the online tools to compare your WEA-provided benefit options and costs.
Online access to your benefits is available 24 hours a day, 7 days a week, 365 days a year. Customer Service Representatives are available by phone Monday through Friday from 7:30 a.m. to 5:00 p.m., Pacific Time, excluding holidays.
For information about non-WEA Select benefits (i.e. Premera BlueCross and Kaiser Permanente) or other questions about your benefits, please visit the Payroll website or contact one of the payroll staff members listed below:
Cheri Hansen (Benefits Payroll Analyst) (360) 965-0100 Kim Simon (Certificated Payroll Analyst) (360) 965-0104 Tana Belcher (Classified Payroll Analyst) (360) 965-0103
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Table of Contents
Letter from Employer ............................................................................................... 5
Flexible Spending Accounts (FSA) Section 125 ......................................................... 6 Open Enrollment ....................................................................................................... 7 Customer Service Representatives ........................................................................... 8 State Funding and Pooling ........................................................................................ 9 Enrollment Information .......................................................................................... 10
Eligibility ............................................................................................... 10 How to Enroll or Change Plans ................................................................. 11
Mandatory Benefits ................................................................................................ 12 Dental .................................................................................................. 12 Vision ................................................................................................... 13 Long Term Disability ............................................................................... 13 Retirement ............................................................................................ 13 Direct Deposit ....................................................................................... 13
Benefit Tips ............................................................................................................ 14 Updates ............................................................................................................ 15-18 How to Select a Medical Plan .................................................................................. 19 MEA Rates / Monthly Premiums ........................................................................ 20-21 MEA (Aetna & Untited Healthcare) Benefits at a Glance… ................................................ 22-23 All Others except MEA Rates / Monthly Premiums .................................................. 24 All Others except MEA Premera Benefits at a Glance……..………………….……….…25-27 Kaiser Permanente Benefits at a Glance……………………….……………………...……….…28 Health Savings Account/HSA ...................................................................................................................... 29 Optional Benefits ............................................................................................... 30-33
403(b) Plan - Pre-taxed and ROTH 403(b) - After Tax ................................. 30 Deferred Compensation Program (DCP) 457 Plan ........................................ 30 Voluntary Term Life Insurance ................................................................. 31 Supplemental Coverages – American Fidelity ............................................... 31 Supplemental Coverages – AFLAC ............................................................. 31 VEBA - Voluntary Employee Benefit Association .......................................... 32 Credit Unions ........................................................................................ 32 Marysville School District Foundation ........................................................ 32 United Way ........................................................................................... 32 Guaranteed Education Tuition Program (GET) ............................................. 32
Legal Shield – ID Shield ......................................................................... 33 Nationwide Pet Insurance ........................................................................ 33 Leave Share Program ............................................................................. 33
Payroll Information ................................................................................................ 34 Online Benefit and Payroll Information .................................................................. 35 Employee Assistance Program ................................................................................ 36 Legislative Resources ............................................................................................. 37
Health Insurance Portability and Accountability Act (HIPAA) ......................... 37 Family Medical Leave Act (FMLA) .............................................................. 37 The Consolidated Omnibus Budget Reconciliation Act (COBRA) ..................... 37
Medicare Notification—August 2016 .................................................................38-39 Health Insurance Marketplace Coverage ………..…………………………………………..….40
COBRA Qualifying Event Form.....................................................................................
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Letter from Employer Fall 2017
Dear Marysville School District Employee,
Thank you for taking a few minutes of your time to review the important information contained in this booklet. This guide provides an overview describing plan options. It will help you think about coverage issues and give you details for making important insurance benefit decisions. One of the biggest changes to benefits this year is the MEA’s decision to go with the WEA in regards to their medical plan options. MEA members must choose between the medical carriers, Aetna, UnitedHealthcare, Kaiser Permanente, or waive coverage. Each of these new carriers has two provider networks. To sum it up, MEA members will now have 28 plan choices. It is going to be extremely important that you take the time to review the documentation provided, research and come to the benefits fair to get all of your questions answered so you can make an informed decision. This guide also covers what’s new in benefits for 2017-2018. There were some premium increases and decreases this year. Please see the 2017-2018 updates beginning on page 15 for details of the current changes.
Please see pages 2-3 and 7 for open enrollment details and
information on how to access AON’s UPoint online enrollment site.
We encourage you to attend our Benefits Fair on Thursday, September 7, 2017 where you can talk with representatives from the various companies involved with your benefits. The fair runs from 3:30 p.m. – 6:30 p.m. and will be held at the New Cafeteria/Commons Area at Marysville Pilchuck High School. If you’re unable to attend, or have more questions, refer to the directory on page 8 for provider contact information.
Please take time over the next few weeks to review this guide, evaluate your benefit choices, consider your family’s needs, and choose the coverage that best fits your situation.
It is the expectation of the Marysville School District that employees check their email on a regular basis. Failure to do so could result in employees not receiving important information.
Hope you are having a wonderful summer.
Sincerely,
Marysville School District, Payroll Department
Disclaimer
This guide is a brief description of your coverage under the Marysville School District benefit program. It is not intended as a complete description of benefits. Although we’ve made every effort to ensure this guide is accurate, the controlling provisions are in the insurance carriers’ contracts and the pages of this booklet are not intended in any way to modify the meaning of those provisions. Insurance carrier’s contracts contain many other provisions not described in this booklet such as additional exclusions and limitations, requirements for filing claims, additional benefit provisions, etc. A copy of each insurance carrier’s contract is available for your inspection during business hours, in the Payroll Department.
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Flexible Spending Account (FSA) Section 125
Marysville School District Section 125 Plan A Flexible Spending Account (FSA) program enables you to set aside tax-free money to pay for health and day care costs. An FSA is the only individual choice benefit that actually saves you money on the cost of health care and/or day care expenses. Our plan year runs on a calendar year: January 1 through December 31.
Please note the enrollment deadlines for the 2017/2018 plan years:
Enrollment Deadline: Plan Year: 70-Day Grace Period- May Incur Claims:
End of 90-Day Run off. Claims must be filed (postmarked) no later than:
Closed 01/01/2017 to 12/31/2017 01/01/2018 to 03/11/2018 03/31/2018
12/19/2017 01/01/2018 to 12/31/2018 01/01/2019 to 03/11/2019 03/31/2019
We offer the following two accounts to choose from:
Unreimbursed Medical: Allows up to $2,600 per year of tax-free dollars to pay for out-of-pocket medical, dental or vision expenses, as well as prescriptions and some over-the-counter products, incurred by you and your dependents.
Dependent Care: Allows up to $5,000 per year of tax-free dollars to pay for work-related dependent care costs. This includes private day care, licensed day care, and elder care.
For both medical and day care expenses, claims must be filed (postmarked) by the end date of the 90- day run off period. Claims submitted on or near that day, that do not meet the requirements, could end up not being eligible to be paid.
You must enroll every year you wish to participate: You must sign up each year or your participation will automatically stop at the end of the plan year. Once the FSA deadline has passed, you cannot make any changes. There may be an exception due to an approved life change for Dependent Care Accounts.
Who is eligible? All employees who are eligible for group benefits.
How does it work? You can direct a part of your pay, on a pre-tax basis, into a special account that is then used to reimburse yourself for dependent day care expenses or unreimbursed medical expenses. Claims for expenses are submitted to American Fidelity and the reimbursement is issued directly to you. Participation in a Section 125 Plan results in a tax savings to you. You avoid paying Social Security and Medicare tax (7.65%) and Federal Income Tax (10-39.6%).
American Fidelity is available to answer any questions you have and to enroll you in one or both of the Flexible Spending plans. Please contact one of our Seattle area representatives at (866) 576-0201. For information further information, visit the American Fidelity website: www.afadvantage.com
Post Tax vs. Pre Tax: Since employee medical out-of-pocket costs fall under the Section 125 rules, they come out of your paycheck as a pre-tax deduction. If you choose, you may request that these deductions come out on a post-tax basis. If interested you will want to consult your tax advisor to discuss the pros and cons.
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Open Enrollment
********IMPORTANT******** This year’s open enrollment dates are
August 21st — September 29th Open Enrollment will run from August 21st through September 29th with a coverage
effective date of November 1, 2017 for, Aetna, UnitedHealthcare, Premera Blue Cross, Kaiser Permanente, Delta Dental, Willamette Dental and VSP.
See page 2 for the AON online enrollment information
*WEA ONLINE OPEN ENROLLMENT ENDS AT 10:00 PM, PACIFIC TIME, SEPTEMBER 29,
2017, PREMERA BLUE CROSS AND KAISER PERMANENTE OPEN ENROLLMENT ENDS AT 4:30 PM PACIFIC TIME SEPTEMBER 29, 2017.
EXCEPTION: Flexible Spending Accounts have their own deadline of
December 19, 2017 for the 2018 plan year. See page 6 for additional information.
Benefits Fair OPEN ENROLLMENT Thursday, September 7, 2017 August 21, 2017 through
The New Cafeteria/Commons Area at Marysville Pilchuck High School
September 29, 2017
*See Above 3:30 to 6:30 p.m.
Representatives from the insurance carriers will be available to answer questions about your plans, including making changes.
Door Prizes & Give-a-Ways!
The information herein is not a contract, it is a summary of benefits. Each plan described excludes certain conditions and types of treatment from coverage or payment. Detailed information regarding the contractual benefits, limitations and exclusions are available through each carrier. Access to all carriers’ summaries and benefit booklets may be found through our online benefit website (see page 35).
This summary was printed in August of 2017. Please note: revisions may be made by bargaining units or insurers at any time after this date. Please refer to the most current contract for up to date coverage limits.
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Customer Service Representatives MARYSVILLE SCHOOL DISTRICT Payroll Department Staff Fax:
(360) 965-0092
Benefits Payroll Analyst: Cheri Hansen ext. 20100 or (360) 965-0100 [email protected]
Certificated Payroll Analyst: Kim Simon ext. 20104 or (360) 965-0104 [email protected]
Classified Payroll Analyst: Tana Belcher ext. 20103 or (360) 965-0103 [email protected]
Payroll Secretary: Brenda Silva ext. 20101 or (360) 965-0101 [email protected]
Payroll Supervisor: Jim Nowlin ext. 20102 or (360) 965-0102 [email protected]
Plan Website Phone Number AON-Hewitt Benefit’s Resource Center http:// resources.hewitt.com/wea
(855) 668-5039
Aetna
www.weaselect.com
(855) 878 – 4101 Monday – Friday 8:00am – 6:00pm
UnitedHealtcare
www.weaselect.com
(844) 219-3630 Monday – Friday 7:00am – 8:00pm
Premera Blue Cross Plans
www.premera.com
(855) 756-0798 Monday – Friday 5:00am – 8:00pm
Kaiser Permanente
www.kp.org/wa
(888) 901-4636
Delta Dental/WEA
www.deltadentalwa.com
(800) 554-1907
Willamette Dental/WEA
www.willamettedental.com
(800) 360-1909
Vision Service Plan/WEA
www.vsp.com
(800) 877-7195
The Hartford—Long Term Disability
www.thehartford.com
(800) 303-9744 (206) 292-7879
American Fidelity— Supplemental Coverages & Flexible Spending
See Open Enrollment link on Payroll webpage www.msd25.org
(800) 654-8489 (800) 325-0654
AFLAC – Supplemental Coverages See Open Enrollment link on Payroll webpage www.msd25.org
(800) 992-3522
APS Healthcare www.apshealthcare.com (800) 999-1077
Legal Shield/ID Shield www.legalshieldassociate.com/mwall
(360) 710-1069
Pet Insurance www.PetsNationwide.com (877) 738-7874
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State Funding and Pooling
The 2017-2018 school year state allocation will increase to $820.00 per month, per full-time FTE.
The amount of money you will receive each month for benefits depends on how many hours per day and days per year you work, which are used in calculating your benefit FTE.
Currently, everyone’s benefits are pooled in September and October. Additionally, SEIU 10 and 12 month members are pooled in November and December, MEA members are pooled in February and MAA members are pooled in July. As much as we would like to give employees exact benefits costs during open enrollment time, it is impossible to do as the pooling can change significantly from year to year and month to month when employees add and change benefits and dependents, all which affect the final pooling dollars for each group.
The pooled monies for each group are first used to pay for negotiated mandatory benefits such as long-term disability, vision and dental. The balance of the pool is then available for employees to spend toward the purchase of medical benefits depending on their benefit FTE. No portion of the state allocation or pooling dollars can be applied to the purchase of voluntary insurance programs.
Domestic Partners
All employees who qualify for benefits are eligible to enroll a domestic partner. For more information, please contact Cheri Hansen at (360) 965-0100 or [email protected].
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Enrollment Information Eligibility Employees Contracted employees are eligible for the plans described in this booklet according to the employees’ group participation. To be eligible for health benefits, an employee must work the minimum number of hours per week as per their bargaining unit. New employees who qualify are eligible for benefits the first of the month following their date of hire. Enrollment must be completed within 30 days of the benefit effective date or you must wait until the next open enrollment period.
Dependents Enrolled employees may enroll eligible dependents in the same plan(s). Eligible dependents are as follows:
• Your lawful spouse • Your married or unmarried dependent children up to age 26 - natural children,
stepchildren, legally adopted children, children for whom you assume a legal obligation for support in anticipation of adoption, or children specified in a court order or divorce decree.
• The Patient Protection and Affordable Care Act allows your adult children, married or unmarried, to stay on their parents’ employer medical plan up to age 26. The WEA sponsored vision and dental plans have agreed to allow dependent children to also participate until the end of the month they reach age 26.
• Qualified domestic partner and children of a domestic partner.
Please note that most domestic partners do not qualify as tax dependents, and as such, premium amounts that you pay for domestic partner coverage will not occur on a pre- tax basis unless you submit evidence of tax dependency. In addition, the portion of the domestic partner premium that the company pays for is required to be included on your W-2 as imputed income, and is subject to taxation accordingly.
Coordination of Benefits Under-age dependents covered under two plans will follow the “birthday rule.” The “birthday rule” states that if an eligible dependent has insurance coverage under both parents, the parent whose birthday comes first in the calendar year will be considered the primary subscriber. The other parent’s insurance carrier will provide the secondary coverage. For divorced parents, please refer to your benefit booklet.
Dependent Eligibility Verification (Medical, Dental and Vision Plans) As a reminder, employees who enroll dependents on the Medical, Dental and/or Vision Plans will be asked to provide documentation to verify their dependents’ eligibility for coverage.
New dependents should be added to the AON Online enrollment site. You will be asked to “certify” that you are adding valid dependent(s). Shortly thereafter, you will receive a request notice from the WEA Select Dependent Verification Team, which will describe the process, including the documentation needed to verify eligibility and the deadline. Unverified dependents will be removed from the plan(s) prospectively.
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Enrollment Information
How to Enroll or Change Plans Generally, the choices made during the open enrollment period remain in effect for the plan year. Follow these steps:
1. Read about the benefit choices and review the rates.2. Decide whether to continue with current benefit coverage or change.
If you are making changes to WEA products, you must contact the WEA Select Benefits Center by phone no later than 5:00pm Pacific Time on September 29, 2017 or online before 10 PM Pacific Time, September 29, 2017 for November 1, 2017 coverage.
If you are making changes to your Premera BlueCross or Kaiser Permanente coverage, please fill out the applicable Enrollment and Change Form and return it to the Payroll Department on or before 4:30 PM Pacific Time, September 29, 2017 for November 1, 2017 coverage.
Please see pages 2-3 for more details and differences on the processes for enrolling or changing coverage with any of the WEA products. WEA products include Aetna or UnitedHealthcare medical plans, Delta Dental, Willamette Dental and Vision Service Plan.
• For all MEA members, your current medical benefits with Premera Blue Cross will end10/31/2017. To continue medical benefits you must contact the WEA Select BenefitsTeam by either signing in to the online UPoint system or by calling the WEA SelectBenefits Team. You will need choose between the 28 plans available, or you also havethe option of selecting Kaiser Permanente which requires you to complete an Enrollment& Change Form.
• For the Administrators, MAA, SEIU 10, SEIU 12, PSE and Exempt/Non Represented groups,no action is required if you are not making any changes to your current medical, dental orvision coverage.
Changing Elections After Open Enrollment:
Changes cannot be made after the open enrollment deadline unless there is a “life change”, meaning a change in family status, such as:
• Marriage / Divorce• Birth / Adoption *• Enrolled family member dies• Employee or spouse goes on an unpaid leave of absence• Employee or spouse has a significant change in employment status (part-time to
full-time or vice versa)• Loss of coverage
You must contact your medical provider within sixty (60) days of the change.
• For all WEA benefits, you need to contact the WEA Select Benefits Team by phone at (855) 668-5039.
• If you have Premera Blue Cross or Kaiser Permanente, you must complete an Enrollment and ChangeForm. Forms can be found on the Payroll website or by contacting Cheri Hansen in payroll.
* We encourage all parents of newborns to add them to your vision and dental coveragesat the time of their birth, even though they will not need the services for a few years.
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Mandatory Benefits
Dental The District’s dental plans will remain the same for 2017-2018. The two plans to choose from are Delta Dental or Willamette Dental. These options have different approaches to providing dental services and benefits.
Delta Dental is a traditional dental plan. It is incentive (*) based. Member dentists will submit claims directly to Delta Dental for the subscriber. Non-member dentists will not submit claims. Subscribers using non-member dentists are required to submit claims using the claim form available on the Delta Dental website. Dental fees may be higher for non-member dentists.
Willamette Dental is an HMO plan. This means you choose from a list of clinics staffed by approved dentists. Services must be provided by the Willamette Dental providers in order to receive coverage. There is no outside of network coverage; however, more procedures are covered and your costs are lower than under Delta Dental. Your co-pay depends upon the type of service, and there is no annual maximum.
The following comparison shows other differences between these plans to help you choose. Review the plan comparison below carefully before making your election.
Delta Dental / WEA Willamette Dental / WEA
Providers
Choice of member or Non-member
dentists. Member dentists are paid at a higher level.
Must choose a Willamette Dental clinic staffed with approved dentists. Services will not be paid outside the
Willamette network.
Annual Maximum
$1,750 (November 1 - October 31)
The annual maximum increases to $2,000 when a PPO Provider is used
None, except, some benefits, such as orthognathic surgery and TMJ do have a benefit
maximum
Annual Deductible None None
Diagnostic and Preventive Care 70% - 100% Incentive* $15 co-pay, then 100%
Restorative Care 70% - 100% Incentive* co-pay depends upon type
Crowns 70% - 100% Incentive* co-pay depends upon type
Major—Dentures/Bridges/Partials 50% co-pay depends upon type
*How the incentive plan works: Delta Dental of Washington encourages regular dental care. They pay 70% of covered services for preventive and restorative care during the first plan year of coverage. This advances by 10% annually providing the plan is used at least once per benefit year for applicable services to a maximum of 100%. Failure to use the plan once each benefit year causes the level to drop by 10% below the last level of payment, but never below the original 70%. Each eligible employee and dependent creates his or her own percentage point level. The incentive plan does not apply to the 50% allowance for the cost of Major Care.
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Mandatory Benefits
Vision
Vision Service Plan (VSP) VSP allows for an eye exam and new lenses once every calendar year. New frames are allowed once every other calendar year. Contact lenses may be purchased in lieu of frames and lenses, once every 24 months. Contact Vision Service Plan for detailed information. (800) 877-7195 www.vsp.com
Long Term Disability
The Hartford Long Term Disability (LTD) coverage will pay a percentage of monthly earnings in the event of an illness or injury preventing an employee from working. Marysville School District currently has two LTD classifications. If a member under classification one becomes disabled, as defined by the plan, the plan will pay a maximum of 60% of your monthly earnings to a maximum benefit of $3,000 per month; a member of classification two the benefit is 60% of your monthly earnings up to a maximum benefit of $5000 per month. Both classifications are subject to reduction by deductible sources of income or Disability Earnings. To determine which classification you fall into, see page 21 or 24. The LTD benefit includes several value added services that will help you fully utilize these benefits, including but not limited to, counseling services and travel assistance. For more information on LTD coverage or these added benefits, please contact The Hartford directly. (800) 303-9744 or (206) 292-7879
Retirement
Department of Retirement (DRS) - Mandatory if Eligible Both the employee and the employer make contributions to The State of Washington Department of Retirement Systems (DRS). For detailed information, or to obtain a booklet, you can reach DRS directly at (800) 547-6657, visit their website www.drs.wa.gov, or visit the Marysville School District benefit website. See page 35 for instructions on how to log on to the online benefit site.
Direct Deposit
The Marysville School District has a mandatory Direct Deposit participation policy. The only exception is if you are a Marysville School District student. Direct Deposit therefore, is a condition of employment.
We are able to offer the ability to split your Direct Deposit to three different financial institutions. This option is currently only available to regular employees. It is not available to guest (substitute) employees. If you utilize the multiple institutions option, you will need to identify one as the primary account for your net pay after deducting the amounts you designate to your second and/or third institution.
You can obtain a new Direct Deposit form from our Benefits Website. You can access the form by logging on to www.msd25.org, click on menu, click on departments, click on benefits/payroll, click on payroll and benefit forms.
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Benefit Tips
Identification Cards: Everybody who is enrolled in a medical plan will receive a new ID card this year.
• Aetna and UnitedHealthcare: All enrollees will be sent ID cards to their home address. • Premera Blue Cross: All enrollees will be sent ID cards to their home address. • Kaiser Permanente: All enrollees will be sent ID cards to their home address. • Vision Service Plan (VSP): ID cards will not be issued. Effective November 1, 2017
your identification number will be the last four numbers of your (employee’s) Social Security Number. The VSP Group number specific to Marysville School District is 07113507/Plan C.
• Delta Dental: The District’s group ID# is 00186. Delta Dental has assigned randomly selected identification numbers to plan participants in place of Social Security Numbers. They made this change to address concerns about identity theft and to ensure the privacy of your information. You may notice your explanations of benefits (EOB) will have an alternate number as your Member ID rather than your Social Security Number. Information you see from Delta Dental will reference this number as your unique identifier. You will be able to use either your alternate ID number or your Social Security Number when you: • Visit your dental office
• Check your benefits on the Delta Dental web site
• Contact the customer service department If you would like to view or print an ID card with your alternate ID number, please login at www.deltadentalwa.com/wea.
Name and Address Changes: It is critical that employees notify the Payroll Department, if there is a change of a name, address or telephone number. Documents are mailed out regularly, therefore failure to notify Payroll will prevent employees from receiving the most up- to-date information concerning their personal data, plan changes, and legislative changes.
Over-Age Dependents: A dependent loses coverage the first of the month following their 26th birthday. Employees are required to submit notification of this qualifying event. There is a Qualifying Event form that may be copied and used in the back of this booklet or printed from the online benefit site. You may also call or email Payroll. A COBRA Election Notice will be mailed to the Qualified Beneficiary (QB) offering continuation of benefits. The QB will have 60 days to enroll in the plan.
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2017-2018 Updates Premera Blue Cross Plans Two, Three, Five, Easy Choice A & B, Basic, and the Qualified High Deductible Health Plan (QHDHP).
See pages 25—27 for the “Benefits At-A-Glance”
The following is a brief summary of benefit modifications/enhancements only for those plans with changes. Refer to plan booklets online at www.premera.com for a full description of benefits, limitations and exclusions or Contact Premera at (855) 756-0798.
Premera Blue Cross Renewal Rates: -7% decrease
All Premera Blue Cross plan options will remain the same with the following benefit enhancements effective November 1, 2017: • All Premera plan options will include the Heritage Network. • All plans will have a shared medical/Rx Out-of-Pocket (OOP) maximum. The separate RX OOP maximum has been
removed. • EviCore Prior Authorization no longer applies. This requirement is removed from all medical plan options. • The embedded life coverage will increase from $12,500 to $25,000. • Easy Choice A plan and the “Other Professional Diagnostic Imaging & Laboratory/Pathology”: The first $1,000 is
paid in full, then in-network deductible/coinsurance applies. • Prenatal care will be covered in full (considered preventive care); postnatal care deductible and coinsurance
applies. • Vivacity Embedded Wellness plan on all medical plan options:
o Includes 3 face-to-face Employee Assistance Plan (EAP) visits o Online Health Assessment
• Overage incapacitated dependents provision will remain the same • Deductible and OOP will be credited November 1, 2017 – December 31, 2017.
o Members will receive credit on deductible and OOP when switching from one plan to another (11/1/17 – 12/31/17 will be credited).
o 4th Quarter carryover provision remains on all plans EXCEPT the Qualified High Deductible Health Plan (QHDHP) – due to IRS rules.
• Domestic Partner (DP) coverage without being state registered, and coverage for children of DP both state registered and non-state registered are covered. Non-state registered DP will have an additional declaration to complete.
• Coordination of Benefit (COB) coverage between married employees will remain the same. • Maternity coverage covers all members (including children of dependent daughters) however a dependent
grandchild is covered for first 21 days of life per Erin Act only. • Strike/Labor dispute provision will remain the same • Leave of Absence provision will remain the same • Surviving Spouse benefit will remain the same • Medicare Premiums for disabled will remain the same
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2017 – 2018 Updates Continued
Premera Blue Cross Plan changes continued
• Transition of Care (TOC) – if for some reason your provider leaves the Premera network, you can apply for TOC benefits from Premera. If approved, Premera will continue to process claims for that provider at the in-network benefit level described in your benefits booklet. You may still need to pay for charges that exceed the maximum allowable amount. Your TOC benefits may also be limited to a defined period of time based on the treatment plan. Although not all requests will meet the requirements for approval, Premera will work closely with you and your healthcare provider to help find the best course of treatment.
• Appeals Process – The final level of any claim appeal will be with an Independent Review Organization (IRO). This process involves an external review organization, separate from Premera. When the requests are received, Premera lets the OIC know they have a request, and they assign the IRO company through a rotation. There are about 10 different IRO’s that make up the rotation. Once the IRO receives the request, the reviewer will depend on what type of case it is: for clinical judgment it is typically a physician, for contractual, it is typically an attorney, but this can be different depending on the particular IRO. Premera does not get to choose who it is sent to or who reviews the case once it is received at the IRO.
To find providers, go to www.premera.com and select “Find a Doctor”. Your Premera Plan is called a “Heritage” plan. It uses a network of contracted providers to provide health care services to you. These providers are also called “network providers.” NOTE: Network Providers are subject to change at any time. Please contact Premera to confirm your provider’s contract status at the time of service. Your plan provides a higher level of benefits (and lower out-of-pocket costs) when you use network providers. The plan also features an out-of-network option. When you use a licensed health care provider who is not part of the network (also called an out-of-network provider), benefits for covered services are provided at a lower level of benefits (and higher out-of-pocket costs).
Kaiser Permanente: See page 28 for the “Benefits At-A-Glance” 11.12% increase; no changes in coverage, however there is a New Provider Network
WEA/Delta Dental:
-2% decrease; Plan A will now cover composite (tooth colored) fillings on any tooth
WEA/Willamette Dental: No change; Willamette Dental managed dental plan will now cover composite fillings on any tooth.
WEA/Vision Service Plan C:
-5.91% decrease; no changes in coverage.
The Hartford Long Term Disability: -16.29% decrease
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2017 – 2018 Updates Continued
WEA (Aetna and UnitedHealthcare) Medical Plan Changes
See pages 22—23 for the “Benefits At-A-Glance”
To ensure consistency across carriers, a number of benefits have been modified.
• Deductible and out-of-pocket maximum periods - In the past, these amounts accumulated over the calendar year (January 1 – December 31). Beginning November 1, 2017, both will be synchronized with the plan year (November 1 – October 31). If you have already met these amounts and have other health care needs, plan accordingly as the deductible and out-of-pocket maximum will reset with the new plan year.
• EasyChoice Plans have different premiums – The EasyChoice Plans (A and B) have historically had the same monthly premiums. It is no longer possible to maintain the same monthly premiums. Therefore, beginning November 1, 2017, each plan will have its own rate.
• Inpatient co-pays (Plan 2, 3, and 5 only) – The per-day inpatient co-pay will be converted to a per-admission co-pay.
• Massage therapy – A diagnosis from a provider is still needed; however, no prior authorization is required. As a result, the Community Health Benefits is no longer needed and is being eliminated.
• Home health care – Home health services will now be covered up to 200 visits per year.
• Acupuncture (Plan 5 only) – Acupuncture services will be limited to 52 visits per year.
• Physical therapy, speech therapy, and occupational therapy – No prior authorization is required for Aetna. No prior authorization is required for the initial visit for UnitedHealthcare. For additional visits, UnitedHealthcare uses national information on the condition and expected recovery to determine the number of visits to authorize.
• Outpatient rehabilitation therapy visits (Plans 2 and 3 only) – Physical therapy will now be included in the outpatient rehabilitation benefit along with speech therapy, occupational therapy, and massage therapy. The outpatient rehabilitation benefit will be limited to 80 visits per year for all therapies combined.
• Chiropractic services (Plans 2, 3, and 5 only) – These services will be limited to 52 visits per year.
• Pain Management – Programs are available to help manage chronic pain. You opt-in if you are interested in these services.
• Transplants – The limit for travel and lodging for transplants will increase to $10,000 for the recipient, companion, and donor. In accordance with IRS regulations, the lodging reimbursement is $50 per night per person or $100 per night (excluding meals).
• Wigs – Wig coverage will be expanded. Health conditions covered include, but are not limited to: Alopecia Areata, Totalis, Universalis, Chemotherapy, Radiation, or Lupus. Wigs will be covered annually, subject to the deductible and coinsurance. There is no dollar maximum when a contracted provider is used and a maximum of $500 when a non-contracted provider is used.
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2017 – 2018 Updates Continued
WEA (Aetna and UnitedHealthcare) Medical Plan Changes
• Concierge-style customer service – With real people who answer the phone when you call your insurance company. Friendly customer service provided by people who understand what you need when you call. Both Aetna and UnitedHealthcare call centers pride themselves on their “no homework” policies. That means the customer service representatives will take ownership of your concerns and do the research for you.
• New cost estimator tools – These online tools help you find the cost of a specific service
by provider, using the provider’s actual contracted rates and reflecting the real-time status of your deductible, coinsurance, and out-of-pocket maximum. Plus, the tool provides quality information about the provider so you know you’re not only getting a good price, but high-quality care too.
• Free opt-in access to wellness tools and programs
• Free virtual care – With 24-hour access to talk with a doctor. Aetna uses Teledoc. UnitedHealthcare uses Doctors on Demand and AmWell. Does not apply to the Qualified High Deductible Health Plan (QHDHP).
• Prenatal services will be covered in full – The delivery and postnatal care will be subject to the deductible /coinsurance.
• More services will be covered on an unlimited basis – Including hospice, inpatient rehabilitation, inpatient neurodevelopmental therapy, and orthotics. Previously, these services had visit, day, or dollar limitations.
• More services will be covered by the standard deductible and coinsurance of
the plans – Including ambulance use and Temporomandibular Joint disorder (TMJ). Previously, these services were subject to co-pay before deductible/coinsurance or had a higher level of coinsurance.
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How to Select a Medical Plan
Preferred Provider Organization (PPO) Plan choices:
MEA participants have the option to select medical benefits from two traditional medical carriers which are Aetna and UnitedHealthcare. Aetna has two provider network options which are Open Choice and Whole Health. UnitedHealthcare also has two provider network options which are Choice Plus and Navigate Balanced. The plans make available to you sufficient numbers and types of providers to give you access to all covered services in compliance with applicable state regulations governing access to providers.
Your plan provides the highest level of benefits, (and lower out-of-pocket costs) when you use a network provider. The plans may also feature an out-of-network option. When you use a licensed health care provider, who is not part of the network, (also called an out-of-network provider) benefits for covered services are provided at a lower level of benefits (and higher out-of-pocket costs) or may not be covered at all.
To get further information on the plans available and to see if your provider is covered, you can contact the carrier directly.
All other employees, other than MEA, are continuing with Premera Blue Cross and now have access to Premera’s Heritage network, which is the largest network of doctors and medical facilities Premera offers.
Health Maintenance Organization (HMO)/Managed Care Plan Choice:
Kaiser Permanente - The HMO/Managed Care type plan provides you with managed benefits usually at a lower cost at the time of service. However, this plan requires that you select a primary care provider (PCP) from their list of providers. Your PCP will then either provide or coordinate all of your care (except in the case of a medical emergency). Kaiser Permanente is no longer using the Alliance Network of Providers. The new network they are using is Core HMO.
Choosing a primary care doctor, or any doctor for that matter, is probably the most important health care decision you will make. Primary care doctors have the expertise to provide medical care over a long period of time. They help you stay healthy, manage your care, and will recommend specialists for particular conditions when warranted.
Researching and meeting several doctors before making your choice may be time-consuming, but is well worth your effort. Together, you and your doctor can manage your overall health and well-being and address any concerns you have with quality and\or cost-effective treatments.
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MEA Medical Plan Choices and Rates
Plan Coverage
Aetna UnitedHealthcare
PPO High
Performance PPO High
Performance Open
Choice Whole Health
Choice Plus
Navigate Balanced
PLAN 5
Employee Only $1,135.00 $1,031.24 $1,194.42 $1,078.14 Employee + Spouse $2,185.31 $1,984.54 $2,300.00 $2,075.03 Employee + Child(ren) $1,544.89 $1,403.27 $1,625.68 $1,467.01 Employee, Spouse + Child(ren) $2,633.37 $2,391.21 $2,771.99 $2,500.62
PLAN 2
Employee Only $972.29 $883.57 $1,023.14 $923.67 Employee + Spouse $1,783.32 $1,619.68 $1,877.25 $1,693.79 Employee + Child(ren) $1,303.25 $1,183.95 $1,371.77 $1,238.02 Employee, Spouse + Child(ren) $2,137.89 $1,941.49 $2,250.17 $2,030.04
PLAN 3
Employee Only $883.50 $802.98 $929.71 $839.35 Employee + Spouse $1,620.77 $1,472.14 $1,706.19 $1,539.39 Employee + Child(ren) $1,183.91 $1,075.63 $1,245.83 $1,124.35 Employee, Spouse + Child(ren) $1,941.52 $1,763.27 $2,043.66 $1,843.65
Easy Choice A
Employee Only $658.33 $598.60 $692.61 $625.61 Employee + Spouse $1,199.78 $1,090.04 $1,262.77 $1,139.67 Employee + Child(ren) $879.09 $798.97 $925.08 $835.20 Employee, Spouse + Child(ren) $1,432.16 $1,300.95 $1,507.46 $1,360.28
QHDHP
Employee Only $505.70 $460.07 $531.95 $480.71 Employee + Spouse $926.58 $842.08 $975.19 $880.30 Employee + Child(ren) $674.14 $612.96 $709.00 $640.33 Employee, Spouse + Child(ren) $1,100.05 $999.52 $1,158.05 $1,045.15
Easy Choice B *
Employee Only $684.23 $622.11 $719.89 $650.20 Employee + Spouse $1,250.40 $1,135.99 $1,315.79 $1,187.46 Employee + Child(ren) $913.85 $830.52 $961.41 $867.95 Employee, Spouse + Child(ren) $1,492.46 $1,355.68 $1,571.09 $1,417.64
BASIC PLAN *
Employee Only $551.20 $501.37 $579.82 $523.90 Employee + Spouse $1,013.88 $921.31 $1,067.11 $963.22 Employee + Child(ren) $734.88 $668.08 $772.96 $698.03 Employee, Spouse + Child(ren) $1,206.52 $1,096.16 $1,269.64 $1,145.80
Please note that employees on WEA Select Premera's Easy Choice B or the Basic Plan are enrolled in a High Performance Network. Therefore, the most appropriate comparison for future coverage
is Aetna and UnitedHealthcare's High Performance Networks.
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MEA Rates / Monthly Premiums
Medical
Kaiser Permanente
Subscriber $1161.92
Subscriber + Spouse $2256.19
Subscriber + Family $2717.83
Subscriber + Child(ren) $1623.54
Dental Willamette / WEA Dental Plan 1
Monthly Composite Rate $101.70 Monthly Composite Rate $78.40
Vision
Long Term Disability The Hartford
Employee $14.64 $17.63
Vision Service Plan
Entire Family—Plan C $31.05
In order for dependents to be covered, it is the employee’s responsibility to add dependents to
UPoint
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MEA\WEA - Aetna & UnitedHealthcare Benefits at a Glance
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MEA\WEA - Aetna & UnitedHealthcare Benefits at a Glance
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Monthly Premiums for all others except MEA
Medical
Kaiser Permanente
Subscriber $1161.92
Subscriber + Spouse $2256.19
Subscriber + Family $2717.83
Subscriber + Child(ren) $1623.54
Premera Blue Cross PPO 5 PPO 2 PPO 3 Easy
Choice Basic Plan QHDHP
Employee $1054.10 $911.30 $833.15 $613.50 $495.25 $480.60
Employee + Spouse
$2025.85 $1668.20 $1525.30 $1114.80 $899.10 $872.40
Employee + Family $2440.55 $2000.00 $1828.85 $1335.80 $1077.15 $1030.80
Employee + Child (ren)
$1438.35 $1216.80 $1112.55 $814.05 $656.80 $637.35
Rate increases may result in out-of-pocket costs for employees. The monthly premium will be deducted on a pre-tax basis, if applicable. Dental
Willamette / WEA Dental Plan 1
Monthly Composite Rate $101.70 Monthly Composite Rate $78.40
Vision
Long Term Disability The Hartford
Employee $14.64 $17.63
Vision Service Plan
Entire Family—Plan C $31.05
In order for dependents to be covered, it is the employee’s responsibility to add dependents to
UPoint
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Premera Benefits at a Glance
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Premera Benefits at a Glance
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Premera Benefits at a Glance
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Kaiser Permanente Benefits at a Glance
Kaiser Permanente
Plan / Network Core HMO
Website www.kp.org/wa
Dependent Age Limit to age 26
Deductible Per Calendar Year $0 per person $0 family
Office Visit Exam Copay $20 co-pay
Lab & X-Ray: Preventive Other
0% 0%
Preventive Care Exam 0%
Coinsurance 0%
Hospitalization: Inpatient $100 per admission
Hospitalization: Outpatient $20 copay Emergency Room Copay (waived if admitted) $100 copay
Prescription Drugs Separate deductible
Retail: up to 30 day supply
n/a
Generic $15 co-pay
Preferred Brand $30 co-pay
Non Preferred Not applicable
Specialty Not applicable
Mail Order Maintenance up to 90 day supply $45 / $90
Spinal Manipulation same as office
visit 10 visits pcy
Vision Exam same as office visit
once every 12 months
Out-of-Pocket maximum $2,000 per person $4,000 family
Life Insurance not included
*These services are not subject to your calendar year deductible. pcy= per calendar
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Health Savings Account (in conjunction with a QHDHP)
Health Savings Account (HSA) Plan Year November 1, 2017—October 31, 2018
A Health Savings Account (HSA) is an account that you can use to pay medical expenses. • Must be in conjunction with a Qualified High Deductible Health Plan (QHDHP)• You own the account, even if you leave the District• Tax-advantages: contribute pre-tax money, funds accrue tax-free and withdraw funds tax-
free when used for eligible medical expenses• Funds rollover each year so you can use your HSA to save tax-free money for retirement
How does the HSA/QHDHP work? • You contribute money to the H.S.A• You can use HSA dollars to pay your health insurance deductible, along with other
qualified medical expenses such as dental or vision services• Once you meet your deductible, your insurance pays additional covered expenses in
accordance with our plan
Who is eligible for an HSA? Anyone who is: • Covered by an QHDHP• Not enrolled in Medicare• Not covered under other health insurance (does not include specific disease or illness
insurance, accident, disability, dental care, vision care, and long term care insurance)• Not another person’s dependent
HSA Contribution Limits Each year the IRS sets contribution limits 2017/2018 Limits: • $3400/$3450 for individual coverage• $6750/$6900 for family coverage• For individuals ages 55-plus, the I.R.S. allows additional “catch-up contributions”.
Eligible individuals may contribute an extra $1,000 for the year
HSA Distribution Rules • Distributions from your HSA are tax-free if they are taken for “qualified medical expenses”• Your HSA can only be used for expenses that are incurred on or after the date the HSA was
established• HSA distributions can be taken for qualified medical expenses for the following people:
Account holder (person covered by the QHDHP) Spouse of that individual (even if not covered by the QHDHP) Dependents of that individual (even if not covered by the QHDHP)
• You cannot contribute funds to a general purpose Flexible Spending Account (Section 125)or Health Reimbursement Account (VEBA) and an HSA at the same time
Qualified Medical Expenses • Most medical care that is subject to your deductible• Prescription drugs• Over-the-counter drugs, only if you obtain a prescription• Insulin• Dental and vision care
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Optional Benefits
403(b) Plan - Pre-taxed and ROTH 403(b) - After Tax
A 403(b) plan, also known as a tax-sheltered annuity (TSA), is a voluntary supplemental retirement plan for employees of public schools and offer tax incentives for investing for retirement.
The Marysville School District 403(b) Plan also includes an option to participate in a ROTH 403 (b) Plan (after tax deductions). After a complete, comprehensive review of existing regulationsby the IRS, it was determined that effective January 1, 2009 the employer will be responsible forreporting all contributions made, ensuring full compliance with 403(b) regulations. Prior toJanuary 1, 2009, the employees’ investment agency bore this responsibility. Given this changein reporting responsibility, Marysville School District selected a 403(b) independent third partyadministrator to meet the new requirements as established by the IRS.
Our third party administrator is The Omni Group.
Employees electing to participate in our 403(b) plan need to work directly with OMNI and an approved 403(b) vendor. All employees of the Marysville School District are eligible to participate. Guest (substitute) employees that choose to participate must make deductions based on a percentage of their gross pay. Employees with contracts or pay plans can make their deductions in either dollar amounts or based on a percentage of their gross pay.
If you elect to participate in our 403(b) program, you will need to select and contact an approved vendor of your choice, complete their enrollment forms to set up an account and then complete and submit to OMNI, their Salary Reduction Agreement form found on their website at www.omni403b.com. Completing these steps will set up your payroll deduction with Marysville School District.
If you need additional information regarding setting up an account with OMNI (which in turn sets up your payroll deduction with Marysville School District), please call the OMNI Group at (877) 544-6664.
Deferred Compensation Program (DCP) 457 Plan
The Deferred Compensation Program (DCP) is a retirement savings program offered by the Department of Retirement (DRS) only to Washington public employees. With DCP, you save pretax dollars for retirement and the earnings on your investment grow tax-deferred. To set up an account and begin contributions, complete a participation agreement found on the DCP website and follow the mailing instructions. For more information visit the DCP website or call the number below.
(888) 327-5596 or www.drs.wa.gov/dcp
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Optional Benefits The following three pages contain a brief explanation of optional benefits that you may participate in. For a more detailed description of these plans and summaries, please visit our online benefits site.
Voluntary Term Life Insurance (VTL) - Unum
Employees have the option of enrolling themselves in voluntary life insurance coverage through a WEA Select Voluntary Life Plan. This is now done by logging in to the WEA online enrollment website, UPoint. One hundred percent (100%) of the monthly premium is paid by the employee through payroll deduction. Rates are based on age and the coverage elected.
Supplemental Coverages – American Fidelity
Short-Term disability insurance is a voluntary participation program. When an employee with this coverage is determined disabled/unable to work by a physician, they are eligible to apply for short-term disability for a maximum of 90 calendar days. Short-term disability offsets against other sources of income from day 1 with the exception of sick leave which is 30 days.
Claim forms are available from the Human Resources Department or by visiting our online benefits site.
One hundred percent (100%) of the monthly premium is paid by the employee through an after tax payroll deduction. Benefits paid are based on the coverage elected, which is a percentage of your gross salary, up to plan limits.
American Fidelity also offers products such as life, accident, and cancer insurance. Please contact an American Fidelity representative directly if you are interested in any of these additional products.
If you have questions or would like more information on any of the plans American Fidelity offers, you can call their Seattle office at (866) 576-0201.
* See the Payroll website for the link that will take you to a dedicated site AmericanFidelity has set up just for Marysville School District employees.
Supplemental Coverages – (AFLAC) American Family Life Assurance Company
AFLAC offers various supplemental policies, including accident coverage, a hospitalization plan, cancer plan, life insurance and short-term disability. The short-term disability offered by AFLAC does not have any offset from income received from sick leave pay during the disability.
Employees must complete an application process with the AFLAC agent for these coverages. One hundred percent (100%) of the monthly premium is paid by the employee through payroll deduction. Premiums for these coverages vary depending on elections. Contact the AFLAC representative, Lisa Peters, directly for more information.
(425) 870-5638 email: [email protected] www.aflac.com
* See the Payroll website for the link that will take you to a dedicated site AFLAC hasset up just for Marysville School District employees.
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Optional Benefits
VEBA is a tax-free health reimbursement plan. Participation in VEBA is determined by a vote taken each year within each pooling group. If your pooling group votes to participate in VEBA, it becomes a mandatory benefit.
Contributions to VEBA are made by monthly payroll deductions and/or leave cash-outs. Again, each of those options needs to be voted on by every pooling group each year when the benefits vote is taken. Employees who participate can be reimbursed for health related out-of-pocket expenses tax-free either before or after retirement.
For more information you may contact Payroll or VEBA Service Group. VEBA: (888) 828-4953 or www.veba.org
Credit Unions
As a School District employee, you may choose to join one or both Credit Unions listed below. Contact the credit union(s) directly for details. Inspirus Credit Union (888) 628-4010 Mountain Crest Credit Union (360) 435-5400
Marysville School District Foundation
This is a voluntary deduction available to all employees for purposes of a charitable contribution. The Foundation uses these donations to provide college scholarships for qualifying students of Marysville School District employees. Contributions can be made via payroll deduction. For more information please contact the Foundation president. Lori James (425) 870-9232
United Way
United Way is a voluntary program where employees can make donations via a payroll deduction. The United Way campaign begins in the fall; deductions are effective the first payday in January and run through the calendar year. For more information contact:
MaryAnn Ballew (360) 965-0010
Guaranteed Education Tuition Program (GET)
GET is currently not accepting new enrollments or unit purchases for a period of up to two years, while the GET Committee completes their legislatively mandated feasibility study.(800) 955-2318 email: [email protected] www.get.wa.gov
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Optional Benefits
Legal Shield/ID Shield (NEW) - Was founded in 1972 to make equal justice under law a reality for North Americans. Membership includes, Legal advice, residential loan document assistance, prepare your Will and much more. One hundred percent (100%) of the monthly premium is paid by the employee through payroll deduction.
Brenda Wall (360) 710-1069 email [email protected]
Nationwide Pet Insurance (NEW) – Provides coverage for veterinary expenses related to accidents and illnesses. Policies are available for dogs, cats, birds, reptiles and other exotic pets. One hundred percent (100%) of the monthly premium is paid by the employee through payroll deduction.
Call (877) 738-7874 and tell the pet insurance specialist the name of your company and you will receive a group discount on your base medical policy.
Leave Share Program - WAC 392-126-(004-104)
Leave share is a program in which the District permits employees to donate leave to a fellow employee who is suffering from, or has a relative or household member suffering from, an ex- traordinary or severe illness, injury, impairment or physical or mental condition, or has been called to service in the uniformed services, which has caused or is likely to cause the employee to take leave without pay or terminate his/her employment with the District.
In order to be eligible to receive leave share donations, an employee must complete the leave share application process. If leave share is approved, an email will be sent from Human Re- sources to all District employees to communicate an employee’s need for donated leave. Leave share application forms are available in Human Resources.
In order to donate leave to an approved recipient, you must maintain a balance of 22 days for sick leave donations and a balance of 10 days for vacation leave donations. Personal day donations do not require a minimum balance. Leave donation forms are available on the District’s intranet website, Payroll and Human Resources.
The donation of sick leave, vacation or personal days is voluntary. No employee shall solicit leave donations from another employee. All eligible employees can donate to one another regardless of union affiliation or classification.
Complete information on our Leave share program can be obtained through Human Resources.
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Payroll Information
The Payroll Department Webpage
The Payroll Department webpage can be found by going to www.msd25.org, click on Menu, Departments, Benefits/Payroll. From here you can find links to: Department of Retirement, Employee Access and our Forms page, just to name a few. The Employee Access link allows you to view and print your wage information. See page 35.
If you encounter any problems or have suggestions on how we can improve this webpage for you, please contact Payroll at (360) 965-0101.
Need a copy of your bargaining agreement? You can find it on the Human Resource webpage.
Pay Day Information Some months we still seem to have questions as to what day payday falls on. Please remember, it is ALWAYS the last business day of each month. We hope this clarifies any questions you may have.
Pay Dates
Month – Year Pay Day August 2017 Thursday – August 31st
September 2017 Friday – September 29th October 2017 Tuesday – October 31st
November 2017 Thursday – November 30th December 2017 Friday – December 29th January 2018 Wednesday – January 31st February 2018 Wednesday – February 28th
March 2018 Friday – March 30th April 2018 Monday – April 30th May 2018 Thursday – May 31st June 2018 Friday – June 29th July 2018 Tuesday – July 31st
August 2018 Friday – August 31st
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Marysville School District Online Benefits Site, Employee Access and UPoint
Access all three sites from anywhere with internet access!
********Online Benefits Site********
Instantly Access Your Employee Benefits Information
Benefit Plan Summaries ● Plan Providers ● Resources ● Forms
Go to the Marysville School District website: www.msd25.org Click on: Then:
Then: Then: Username: MSD
Menu Departments Benefits/Payroll Online Benefits Information Password: Marysville25
********Employee Access******** Want to play with your withholding to see how it would affect your check, view or print your pay stubs,
or check your leave balances?You can do all of these things and more on Employee Access:
Go to the Marysville School District website: www.msd25.org
Click on: Menu Then: Departments Then: Benefits/Payroll Then: Skyward Employee Access
You will need a log-in and password. If you do not have one, please e-mail one of the following: Jim Nowlin at [email protected]; Kim Simon at [email protected]; Tana Belcher at [email protected]
Pay stubs are available to view as soon as we have batched our payroll which is typically 3-4 days prior to pay day.
********WEA-AON UPoint******** This website should be reviewed periodically to ensure your coverages are what you think they should be and that the dependents you think are covered really are.
To log on go to the Marysville School District Website: www.msd25.org
Click on: Menu Then: Departments Then: Benefits/Payroll Then: WEA-AON Hewitt UPoint
If you are a new user, you will need to establish a log-in and password to view the information on UPoint
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Employee Assistance Program
Marysville School District provides an Employee Assistance Program (EAP) through KEPRO EAP.
They have many services available to employees, their immediate families (spouse and dependent children) and anyone living in the employee’s household (related or unrelated). These services are available at no cost and are completely confidential.
They are as follows:
• Counseling ServicesA voluntary and confidential, professional assessment, grief counseling and referralprogram. They offer up to five (5) face-to-face sessions per incident (not per year) and a24-hour crisis hotline, staffed by master’s level counselors.
• Legal ServicesA 30 minute telephone or in-person consultation with an attorney.
• Financial ConsultationA 30 minute financial consultation per issue, on the phone only.
There are many ways EAP services may be helpful. Employees and their families are encouraged to call if counseling, legal and/or financial services become necessary. For more information about the program contact Risk Management at (360) 965-0110.
CONFIDENTIAL HELP
Available 24 hours a day, 7 days a week
(800) 999-1077
www.EAPhelplink.com
A company code will need to be entered: MSVL
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Legislative Resources
Health Insurance Portability and Accountability Act (HIPAA)
In December 2000, the U.S. Department of Health and Human Services released final regulations that place restrictions on how personal identifiable health information may be used and disclosed by certain organizations. These regulations implement the privacy requirements contained within the Administrative Simplification subtitle of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). While some states have laws that protect health information, this Federal regulation establishes a uniform, minimum level of privacy protections for all health information. www.hhs.gov/ocr www.healthprivacy.org
Family Medical Leave Act (FMLA)
On February 5, 1993, President Clinton signed into law the Federal Family and Medical Leave Act of 1993 (FMLA). This law became effective on August 5, 1993. Generally, the Family and Medical Leave Act of 1993 provides that covered employers must comply with certain criteria when an eligible employee requests a leave under the terms of this law.
www.dol.gov/whd/fmla
The Consolidated Omnibus Budget Reconciliation Act (COBRA)
COBRA requires that employers provide employees and dependents that lose group health benefits with an opportunity to continue group health insurance coverage under certain circumstances. For more information about individual COBRA rights and requirements, please contact the Payroll Department or reference the websites listed below. www.DOL.gov www.IRS.gov
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Important Notice from Marysville School District About Your Prescription Drug Coverage and Medicare
Please read this notice carefully and keep it where you can find it. This notice has information about your current prescription drug coverage with Marysville School District and about your options under Medicare’s prescription drug coverage. This information can help you decide whether or not you want to join a Medicare drug plan. If you are considering joining, you should compare your current coverage, including which drugs are covered at what cost, with the coverage and costs of the plans offering Medicare prescription drug coverage in your area. Information about where you can get help to make decisions about your prescription drug coverage is at the end of this notice.
There are two important things you need to know about your current coverage and Medicare’s prescription drug coverage:
1. Medicare prescription drug coverage became available in 2006 to everyone with Medicare. Youcan get this coverage if you join a Medicare Prescription Drug Plan or join a Medicare AdvantagePlan (like an HMO or PPO) that offers prescription drug coverage. All Medicare drug plans provideat least a standard level of coverage set by Medicare. Some plans may also offer more coveragefor a higher monthly premium.
2. Marysville School District has determined that the prescription drug coverage offered by yourMarysville School District sponsored Health Plan is, on average for all plan participants, expectedto pay out as much as standard Medicare prescription drug coverage pays and is thereforeconsidered Creditable Coverage. Because your existing coverage is Creditable Coverage, you cankeep this coverage and not pay a higher premium (a penalty) if you later decide to join a Medicaredrug plan.
When Can You Join A Medicare Drug Plan?
You can join a Medicare drug plan when you first become eligible for Medicare and each year from October 15th to December 7th.
However, if you lose your current creditable prescription drug coverage, through no fault of your own, you will also be eligible for a two (2) month Special Enrollment Period (SEP) to join a Medicare drug plan.
What Happens To Your Current Coverage If You Decide to Join A Medicare Drug Plan? If you decide to join a Medicare drug plan, your current Marysville School District coverage will not be affected.
If you do decide to join a Medicare drug plan and drop your current Marysville School District coverage, be aware that you and your dependents may not be able to get this coverage back.
See Reverse
Page 1 of 2 Revised August 2017
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When Will You Pay A Higher Premium (Penalty) To Join A Medicare Drug Plan?
You should also know that if you drop or lose your current coverage with Marysville School District and don’t join a Medicare drug plan within 63 continuous days after your current coverage ends, you may pay a higher premium (a penalty) to join a Medicare drug plan later.
If you go 63 continuous days or longer without creditable prescription drug coverage, your monthly premium may go up by at least 1% of the Medicare base beneficiary premium per month for every month that you did not have that coverage. For example, if you go nineteen months without creditable coverage, your premium may consistently be at least 19% higher than the Medicare base beneficiary premium. You may have to pay this higher premium (a penalty) as long as you have Medicare prescription drug coverage. In addition, you may have to wait until the following October to join.
For More Information About This Notice Or Your Current Prescription Drug Coverage…
Contact the person listed below for further information. NOTE: You’ll get this notice each year. You will also get it before the next period you can join a Medicare drug plan, and if this coverage through Marysville School District changes. You also may request a copy of this notice at any time.
For More Information About Your Options Under Medicare Prescription Drug Coverage…
More detailed information about Medicare plans that offer prescription drug coverage is in the “Medicare & You” handbook. You’ll get a copy of the handbook in the mail every year from Medicare. You may also be contacted directly by Medicare drug plans.
For more information about Medicare prescription drug coverage: • Visit www.medicare.gov• Call your State Health Insurance Assistance Program (see the inside back cover of your copy of
the “Medicare & You” handbook for their telephone number) for personalized help• Call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.
If you have limited income and resources, extra help paying for Medicare prescription drug coverage is available. For information about this extra help, visit Social Security on the web at www.socialsecurity.gov, or call them at 1-800-772-1213 (TTY 1-800-325-0778).
Remember: Keep this Creditable Coverage notice. If you decide to join one of the Medicare drug plans, you may be required to provide a copy of this notice when you join to show whether or not you have maintained creditable coverage and, therefore, whether or not you are required to pay a higher premium (a penalty).
Date: 08/01/2017 Name of Entity/Sender: Marysville School District Contact--Position/Office: Payroll Office Address: 4220 80th Street NE Marysville WA 98270 Phone Number: (360) 965-0101
Page 2 of 2 Revised August 2017
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Notes
COBRA Qualifying Event
Use this notice to notify the employer’s Plan administrator of a “qualifying event” that may entitle a spouse or dependent child to a COBRA coverage period of 36-months.
Procedure: This form, and any required or requested documentation, must be completed and returned to the employer’s Plan administrator within the notification period by mail or personal delivery unless an alternate means of notification is approved in advance by the employer’s Plan administrator. Oral notice is not acceptable.
Notification Period: There is a 60-day notification period that begins with the date of the qualifying event or, if later, the date coverage is lost. This form, and any requested documentation, must be provided to the employer’s Plan administrator within the 60-day notification period. A timely notification will be determined by a postmark date or date of personal delivery. You are responsible for providing proof of timely submission. If the submission is not timely, you may lose your rights to COBRA.
Who May Provide Notice: The covered employee, a qualified beneficiary, or a representative acting on their behalf. A notice provided by any of these individuals will satisfy any responsibility to provide notice on behalf of all related qualified beneficiaries.
More Information: For more information regarding your rights and obligations under COBRA, refer to this General Notice, the Summary Plan Description (SPD) or contact the employer’s Plan administrator.
Mailing or Delivery Address: It is your responsibility to obtain current mailing or delivery information from your SPD or by contacting your employer’s Plan administrator.
Date of the qualifying event:
Qualifying events resulting in COBRA entitlement:
Divorce of employee and spouse. Attach a copy of the divorce decree.
Legal separation of employee and spouse. Attach a copy of the legal separation document.
Dependent child no longer meets the plan requirements to maintain dependent status.
Name: Reason*: age not in school marriage
*Additional proof may be requested such as a marriage certificate, birth certificate, or school transcript. Youwill have 15 business days to provide the requested information. All required documentation must beprovided within the 60-day notification period.
I certify that the above information is true.
Completed by: employee spouse dependent child other (describe)
Address: If the address of the qualified beneficiary is different from the one on record, please write in the new address in Comments, at the bottom of form, or contact the employer’s Plan administrator for instructions.
Print Name:
First 5-digits of SSN: _____
Signature: Date:
Phone Number:
E-mail:
Employer:
Comments:
This form can also be found on the Benefits Website.
Marysville School District #25 Payroll Department 4220 80th Street N.E. Marysville, WA 98270
There are major changes to our benefits this year. It is imperative that you take time to review the documentation
so you can make informed decisions.
Important Enrollment dates are
August 21st - September 29th
Final Revised 8/3/2017