paulding county school district 2016 benefits open enrollment review 1

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Paulding County School District2016 BENEFITS OPEN ENROLLMENT REVIEW

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ShawHankinsService Center- can answer questions on all benefits, including state healthAvailable extended hours 8:30 am – 7:00 pm during open enrollment

Oct 19 – Nov 6, 2015

678-535-6369Benefit website- shawhankinsbenefits.net/pcsd

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State HealthBenefit Plan

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SHBP 2016-Carrier Options3 carriers to choose from: BCBS of GA, United Healthcare, & Kaiser Permanente.

BCBS of Georgia: 3 levels of HRA- Gold, Silver & Bronze and statewide HMO United Healthcare: High Deductible Health Plan (HDHP) and statewide HMO Kaiser Permanente: Regional HMO available to members who work or live in the 27 metro

Atlanta counties.

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How the HRA Plans WorksBronze, Silver and Gold options with different levels of coverageAll services are subject to the plan deductible and/or coinsurance, no copays apply SHBP contributes HRA credits to your HRA account based on the plan option and tier of coverage you choose These credits provide first dollar coverage for medical and pharmacy expenses Able to earn additional credits with wellness activities

HRA credits left at the end of the year will roll over to the next plan year

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How the HDHP WorksLow monthly premiumMust satisfy high deductible ($3,500 individual, $7,000 family) for all medical and pharmacy expenses (except preventive care)If you have more than single coverage, the entire family deductible ($7,000) NO LONGER must be met before benefits are payable for any family memberEligible to establish a Health Savings Account (HSA) to set aside tax-free dollars to pay for eligible health care expenses.

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How the Statewide HMO WorksAvailable through BCBS or UHC Rates differ between the 2 carriers

Receive covered services through in-network providers only (except emergency care) Be sure to confirm your providers are participating in the BCBS or UHC network

Co-payments apply to certain services- office visits, urgent care, emergency room and prescriptions

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How the Regional HMO WorksServices only available through Kaiser HMO network

Copay Only plan, no deductibles or coinsurance

Plan available for members that live or work in one of the 27 metro Atlanta counties:

Barrow Coweta Gwinnett PauldingBartow Dawson Haralson PickensButts DeKalb Heard PikeCarroll Douglas Henry RockdaleCherokee Fayette Lamar SpaldingClayton Forsyth Meriwether WaltonCobb Fulton Newton

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SHBP Changes for 2016-Well-Being Incentive Credits Now able to rollover well-being incentive credits across vendors and plan options

2015 rollover credits available in April 2016

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Wellness Credits- BCBS & UHC

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Wellness-Kaiser Permanente Earn up to $480 and feel the benefits of taking care of your health!

Sign up for the Kaiser Permanente Wellness Program at my.kp.org/shbp

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Tobacco CessationTobacco surcharges are included in all SHBP optionsSurcharge applies if you are not tobacco-free or do not complete tobacco cessation coaching programIf you do not make an indication for 2016 on your tobacco usage, you will continue with your same tobacco usage election from 2015.

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State Health Open EnrollmentOpen enrollment is from October 19th – November 6th

myshbpga.adp.comIf you do not login to enroll or make changes, you will be defaulted to your current plan, coverage tier and tobacco status. If you are not currently covered and do not enroll, you will continue with no coverage.

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Ancillary Benefits

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bswift

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Enrollment When you choose the enrollment tab on the Benefit Resource Center site, you will be directed to the bswift enrollment page to complete your elections on all ancillary coverages.

◦ Your user name is your first initial, last name and last 4 digits of your social security number◦ Your password is the last 4 digits of your social security number

Once you complete the enrollment process you will receive a confirmation statement with all coverages and your total payroll deductions for 2016.

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DentalMetLife will be the dental carrier for 2016Expansive national network, superior serviceContinue to have a Low and High plan options

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Plan Option 1- Low Plan Plan Option 2 – High Plan

Coverage Type In-Network Out-of-

Network In-Network Out-of-Network

Type A – Diagnostics & Preventative

100% of Negotiated

Fee*

100% of R&C Fee**

100% of Negotiated Fee*

100% of R&C Fee**

Type B – Basic

40% of Negotiated

Fee*

40% of R&C Fee**

80% of Negotiated Fee*

80% of R&C Fee**

Type C – Major25% of

Negotiated Fee*

25% of R&C Fee**

50% of Negotiated Fee*

50% of R&C Fee**

Type D – Orthodontia N/A N/A 50% of

Negotiated Fee*50% of R&C

Fee**

Deductible† In-Network Out-of-Network In-Network Out-of-Network

Individual $50.00 $50.00 $50.00 $50.00

Family $150.00 $150.00 $150.00 $150.00

Annual Maximum Benefit:

In-Network Out-of-Network In-Network Out-of-Network

Per Person $500.00 $500.00 $1,000 $1,000

Orthodontia Lifetime Maximum

In-Network Out-of-Network

Per Person $1,000 1,000

MetLife Employee Employee + 1 Family

Low Plan $ 16.30 $ 45.77 $65.34

High Plan $ 24.40 $68.51 $97.81

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VisionDavis Vision will continue as the vision carrier for 2016No change in plan coverage or rates

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Basic Life with AD&DPCSD provides basic life coverage at no cost to youThis includes a life and accidental death and dismemberment benefit

$30,000 for all Full Time Administrators & Technical Professional Employees

$15,000 for all Other Full Time Employees

Coverage available for dependents$5,000 for Spouse

$3,000 for Children

$1.65 to cover all dependents

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Supplemental Life with AD&D

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Short Term DisabilityNo changes to STD benefit

All sick leave must be exhausted prior to STD benefits beginning

Late entrants or employees that wish to increase their level of coverage must submit an Evidence of Insurability Form and be approved before coverage is effective

Benefit Available Coverage

Short Term Disability

Benefits begin on the 15th day of your disability.You can choose a benefit that is 40%, 50%, or 60% of your before tax weekly earnings.The maximum weekly benefit is $1,500.The short term disability coverage will last up to 11 weeks of disability.

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Long Term DisabilityLate entrants or employees that wish to increase their level of coverage must submit an Evidence of Insurability Form and be approved before coverage is effective

Benefit Available Coverage

Long Term Disability

Benefits begin on the 90th day of your disability.Your benefit is equal to 60% of your before tax monthly earnings.The maximum monthly benefit is $10,000.Long Term Disability coverage will last until you are able to return to work or until you reach your Social Security Normal Retirement Age.

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Flexible Spending AccountsTwo separate accounts- Medical Spending Account and Dependent Care Spending AccountAllows you to set aside pre-tax dollars to spend on qualified expenses, saving on your taxable incomeMust make new elections for 2016If enrolling in the HDHP medical plan, you are not eligible to contribute to FSATASC will administer FSA account for 2016

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Flexible Spending AccountsMedical Spending Account Maximum contribution of $2,550 Some eligible expenses- Deductibles, copayments, dental expense, vision services and

materialsDependent Care Spending Account $5,000 for married couple filing joint income tax returns, $2,500 if unmarried or married and

filing separate income taxes Some eligible expenses- any care of a dependent that allows you and your spouse to work:

day care, after school program, in-home care, camps

You may rollover up to $500 left at the end of the 2015 plan year to use in 2016 for your Medical Spending Account

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Whole LifeBenefit never decreases, premiums never increase

You own the policy

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Critical Illness Coverage

Critical Illness Insurance is offered through UNUM. This benefit is designed to help employees offset the financial effects of a catastrophic illness with a lump sum benefit if an insured is diagnosed with a covered critical illness.

Pays a lump sum benefit to you at the time of diagnosis of a covered illness.

Benefit Choice: From $5,000 to $50,000 for Employees and $5,000 to 30,000 for Spouse coverage.

Able to cover you and your familySome covered illnesses: Heart Attack, Stoke, Coronary Artery Bypass, Major Organ Transplant, End Stage

Renal Failure.Wellness Benefit: Pays you $75 benefit when you have a annual preventive screening: Ex) colonoscopy,

EKG, Stress Test, Mammogram, PSA.

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Group Accident Insurance Accident insurance is provided through Unum. This coverage can help provide

financial protection if you suffer a covered injury and need treatment. It pays

the benefit directly to you to offset the high cost of copays, deductibles and

other expenses your medical insurance may not cover. This plan also covers on

the job accidents.

Examples of conditions covered include Accidental Death,

Skin Grafts, Paralysis, Coma, Ruptured Disc etc.

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Hospital Indemnity Insurance Hospital Indemnity is offered through UNUM. This coverage pays a cash benefit directly to you when admitted to the hospital.

Unum Hospital Indemnity

Hospital Confinement $1,000 per insured per calendar year

Daily Hospital Confinement $100 per day (maximum 15 days)

Hospital Intensive Care $100 per day (maximum 15 days)

Pregnancy Covered Yes

Waiting Period 30 days for new employees

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Legal CoverageIn-Office Attorney Services: reviewing and preparing documents, providing legal advice and consultation, representation in courtTelephonic Advice: assistance in reviewing and preparing documents, will preparation, financial education and counselingOnline Resources: Guidebooks and videos, DIY Docs- state specific legal documents, online financial toolsIdentity Theft Protect- No additional cost

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Questions?Service Center- can answer questions on all benefits, including state health

Available extended hours 8:30 am – 7:00 pm during open enrollment Oct 19 – Nov 6 678-535-6369

Benefit website- shawhankinsbenefits.net/pcsd