stafford municipal school district 2016 - 2017 · pdf file · 2016-06-15stafford...

STAFFORD MUNICIPAL SCHOOL DISTRICT 2016 - 2017 Benefit Guide

Plan Year: September 1, 2016 to August 31, 2017

Benefit Information Provided By: First Financial Group of America

Rosalyn Punch, CSR Cell Phone: 713-882-1015

Houston Branch Office 11811 North Freeway, Suite 900

Houston, TX 77060

“world-class education...small school setting”

Supplemental Benefits

Section 125 Cafeteria Plan

Supplemental Retirement

Table of Contents Topic Page

Important Details to Know .................................................................................................................................................... 1

Sec on 125 FAQ’s .................................................................................................................................................................. 3

Sec on 125 Cafeteria Plan .................................................................................................................................................... 4

Dental ...................................................................................................................................................................................... 4

Vision ....................................................................................................................................................................................... 5

Cancer ..................................................................................................................................................................................... 6

Disability .................................................................................................................................................................................. 6

Cri cal Illness .......................................................................................................................................................................... 7

Gap Insurance ......................................................................................................................................................................... 7

Accident ................................................................................................................................................................................... 8

Legal Plan ................................................................................................................................................................................. 8

Individual Life .......................................................................................................................................................................... 9

Group Term Life and AD&D Insurance ................................................................................................................................ 9

Unreimbursed Medical FSA ................................................................................................................................................. 10

Dependent Care FSA .............................................................................................................................................................. 10

Health Savings Account ......................................................................................................................................................... 11

403(b) Re rement Plan ......................................................................................................................................................... 12

457 Deferred Compensa on ................................................................................................................................................ 13

Please visit www.benefits.ffga.com/staffordmsd for additional plan details and rates.

Important Details to Know This Year ACA RULES Due to Federal Regulations under the Affordable Care Act (ACA), ALL EMPLOYEES must enroll in or decline coverage for themselves and their dependents in the TRS Medical Plan. TRS 2016 We anticipate the 2016 TRS plan information and rates will be released in the summer of 2016. At that time, information regarding your medical plan will be released to all employees of the district. AMERICAN FIDELITY HEALTH SAVINGS ACCOUNT (HSA) The 2016 maximum allowable is $3,400 for an individual or $6,750 for a family. New This Year! ALLSTATE CANCER AMERICAN FIDELITY DISABILITY DEARBORN NATIONAL HUMANA CRITICAL ILLNESS METLIFE ACCIDENT

Contacts

BENEFIT CONTACTS NAME PHONE WEB ADDRESS

Benefits and Certification Specialist Nancy Martinez 281‐261‐9271 [email protected]

BENEFIT VENDOR PHONE WEBSITE

Flexible Spending, Retirement & Cobra Administration

First Financial 800‐523‐8422 www.ffga.com

Health Savings Accounts American Fidelity 866‐326‐3600 www.afhsa.com

Disability American Fidelity 800‐654‐8489 www.americanfidelity.com

Critical Illness Humana 877‐378‐1505 www.humanavoluntarybenefits.com

Gap & Hospital Indemnity American Fidelity 800‐654‐8489 www.americanfidelity.com

Cancer Allstate 800‐521‐3535 www.allstateatwork.com

Accident Metlife 800‐438‐6388 www.mybenefits.metlife.com

Permanent Life Texas Life 800‐283‐9233 www.texaslife.com

Group Term Life Dearborn National 800‐348‐4512 www.dearbornnational.com

Dental PPO Ameritas 800‐487‐5553 www.ameritasgroup.com/member

Dental DHMO Assurant 888‐901‐6377 www.assurantemployeebenefits.com

Vision EyeMed 888‐ 581‐3648 www.eyemedvisioncare.com

Legal Plan Legal Shield 800‐654‐7757 www.mylegalshield.com

Please visit www.benefits.ffga.com/staffordmsd for additional plan details and rates.

Important Details to Know This Year Cont’d ONLINE ENROLLMENT

How do I view my benefits?

Go to https://ffga.benselect.com/enroll

What is my login and PIN?

Login is your social security number (no dashes) and your PIN is the last four digits of your social security number and the last two digits of your birth year (678977)

Once you login you will see a Welcome Presentation. Once finished, Click “Next”, then:

• Verify your personal information • Verify all dependent information (ssn/date of birth) **Very Important** • View employment information

You will then see a brief presentation on each benefit available. Notify the Benefits Office of any discrepancies. USEFUL INFORMATION TO KNOW

• You must enroll in Medical Reimbursement, Dependent Care Reimbursement and Health Savings Account (HSA) every year. These benefits DO NOT automatically renew.

• Write your PIN number down • Contact First Financial # 800‐523‐8422 with any technical questions • No changes will be permitted until annual enrollment, unless you have an IRS S125 qualified

event

Stafford Municipal School District 2016‐2017 Plan Year

This is an outline of benefits only. If there is a conflict between the terms of this outline of benefits and the contract, the terms of the contract will prevail.

Section 125 CAFETERIA PLAN FAQs What is Section 125? Section 125 is part of the Internal Revenue Code that allows employees to convert a taxable cash benefit (salary) into non‐taxable benefits. Under a Section 125 program, you may choose to pay certain qualified benefit premiums before any taxes are deducted from your paycheck. Do I have to participate in a Section 125 plan? No. You are under no obligation to participate in a Section 125 program. However, you are required to sign an election form to indicate your choice. Can I enroll in a Section 125 plan whenever I want? Your employers Section 125 plan is an annual plan. You must enroll in the Section 125 plan during the eligible enrollment period or during the plan year if you experience a qualifying event or change in family status. Can I use the tax credit for medical expense deduction on my income tax return? No. Expenses reimbursed under this plan may not be used when calculating your medical expense Deduction.

What is the maximum monthly amount I can have deducted from my check (pre‐tax) for Medical reimbursement? $208.33 per month is the maximum for medical reimbursement. If my spouse has a Health Saving account (HSA), can I enroll in a Flexible spending plan (FSA)? No. Due to IRS regulations you would not be eligible to enroll in a Flexible Spending plan (FSA).

What happens if I don’t incur enough expenses to get back the money deposited in my Reimbursement account? Any expense dollars not used for expenses is forfeited. This is what is known as the “Use it or Lose It” provision of the Section 125. It is very important to be conservative and accurate in estimating your expenses for the plan year. You will be reminded periodically (based on activity) of the balance in your account. You also have up to 90 days to file for expenses incurred during the previous plan year or within 90 days after termination to file for expenses incurred prior to termination.



Section 125 Cafeteria Plan Rules A Cafeteria Plan (under IRS Code Section 125) is a benefit available when you choose an eligible health plan with your employer. It allows you to withhold a portion of your pretax salary to cover your insurance premiums and certain medical and child care expenses. This allows you to pay less taxes and increase your take home pay at the same time. As a district employee, you are eligible to participate in a Section 125 Flexible Benefit Plan. Enrollment opportunities are limited to the plan year dates for your district. You must make your election each plan year to continue your eligibility for cafeteria plan benefits. You cannot change your benefit elections for the plan year unless the benefits office receives notification in writing within 31 days of the status change. If the Benefits Office is not notified within 31 days of the status change, no benefit change can be made until the next annual Open Enrollment. IRS specified changes in family status include:

• Marriage or Divorce • Birth, adoption, death of a spouse/child • Change in spouse’s or dependent’s employment status • Change in eligibility status of a dependent • Substantial increase in a benefit premium • Becoming Medicare eligible • Spousal Open Enrollment

Please contact the Stafford benefits office at 281.261.9271 for assistance with qualified changes throughout the plan year.

Assurant DHMO Dental Plan Because you are a valued employee, we are pleased to offer you the opportunity to enroll in a dental benefit plan provided by United Dental Care of Texas, Inc. and administered by Union Security Insurance Company. This prepaid dental plan offers benefits through a network of Plan Dentists. When you enroll for benefits, treatments you receive from your selected Plan Dentist will be provided at reduced fees called copayments. The DHMO plan is an affordable plan that features no deductibles, no pre‐existing conditions, no waiting periods and no claim forms. To use the plan, you must select a dentist from the providers list. Upon your visit, you pay a predetermined reduced fee directly to the dentist. DHMO providers are listed at www.assurantemployeebenefits.com.

ELIGIBLE BENEFITS UNDER SECTION 125 CAFETERIA PLAN

Medical Insurance

Gap Insurance

Cancer Insurance

Critical Illness Insurance

Dental Insurance

Vision Insurance

Accident Insurance

Flexible Spending Accounts

- Medical Reimbursement (up to $2,550 per Plan Year)

- Dependent Care Reimbursement (up to $5,000 per Plan Year)

Health Savings Account

- $3,400 Individual

- $6,750 Family

To learn more about the about the benefits available under the cafeteria plan, please contact Rosalyn Punch at 713‐882‐1015 or your Benefits and Certification Specialist, Nancy Martinez at 281‐261‐9271.

DHMO Rates (Semi‐Monthly)

Employee Only $6.11

Employee + Family $14.87



Ameritas PPO Dental Plan Dependents up to age 26

Oral care can be a significant financial expense. Having dental insurance can help cover the costs. Help keep your family's smiles healthy with dental insurance.

Ameritas PPO Plan Summary In‐Network Benefit

Annual deductible $50/Calendar Year Type 2 & 3 (Waived Type 1)

Annual maximum (per person) $1,500 per calendar year (No family maximum)

Preventative care (e.g., cleaning, exam, x‐rays) 100%

Basic services (e.g., fillings, extractions, root canal) Covered at 80% after deductible is met

Major services (e.g., crowns, dentures) Covered at 50% after deductible is met

Orthodontia $1,000 per person ‐ child only coverage

EyeMed Vision Plans Dependents up to age 26

Vision insurance is a way to help cover expenses incurred for eye care service from eye care professionals such as optometrists and ophthalmologists. Regular eye exams can offer more than just measuring your eye sight! They can identify serious eye diseases early, allowing time for treatment. Most people don’t realize that eye exams can also reveal the early signs of serious illnesses like diabetes, heart disease and high blood pressure.

Must choose in‐Network EyeMed Vision Provider for less out‐of‐ pocket expenses

Benefit pays for eyeglasses or contact lenses once a year for each person on the plan

Additional benefits available at a discounted price

PPO Rates (Semi‐Monthly)

Employee Only $16.80

Employee + Family $46.74

Vision Plan Summary In‐Network Benefit Out of Network

Benefit

Eye Exam $10 Copay Up to $30

Standard Lenses $25 Copay Up to $25

Frame Allowance $125 allowance and 80% of

charge over $125 Up to $63

Standard Contact Lens Fit and Follow‐Up Up to $55 N/A

Contact Lenses $150 allowance; plus

balance over $150 Up to $120

Vision Rates (Semi‐Monthly)

Employee Only $3.44

Employee + Spouse $6.54

Employee + Children $6.88

Family $10.11



Allstate Cancer Plan

Dependents up to age 26

A cancer diagnosis can be devastating, both personally and financially. It is likely that your major medical coverage will not cover all of the costs associated with a cancer diagnosis. The plan pays the following benefits for the necessary treatment of cancer or a specified disease, and for any other conditions caused or aggravated by the cancer or specified disease. During open enrollment Allstate is offering a Guaranteed Issue.

Pays you directly to offset expenses related to the treatment of cancer

Pays you based on schedule of benefits

Initial Diagnosis Rider pays up to $3,000 upon initial cancer diagnosis

Pays up to $20,000 annually for chemotherapy, radiation and immunology

Experimental Treatment

Specialty Hospitals

Travel Expenses Wellness benefit pays up to $100

Cancer (Semi‐Monthly Rates)

Plan EE EE + SP EE + EC F

Low $9.34 $14.50 $13.25 $18.39

Med $16.03 $24.91 $22.85 $31.72

High $21.77 $33.90 $31.05 $43.18

Please see a First Financial Representative or review plan summary in the Employee Benefits Center at www.benefits.ffga.com/staffordmsd.

American Fidelity Disability Plan

Highlights

$100 increments; up to 70% of salary or maximum of $7,500/Month

Guarantee issue coverage for everyone. Benefits are subject to pre‐existing condition limitations.

Benefits begin upon satisfying the elimination period.

If your paycheck suddenly stopped today, could you afford to pay for your mortgage, car payments, food and other monthly expenses? How could you maintain your current lifestyle? American Fidelity Assurance Company knows one of the most important assets a person possesses is their ability to earn an income. Our Disability Income Insurance is a cost‐effective solution designed to help protect you if you become disabled and cannot work due to a covered injury or sickness.



Humana Critical Illness Plan Dependents up to age 24 Critical illness insurance offers you financial protection when you need it the most with cash benefits paid directly to you. Since benefits are provided in a lump sum at the time a covered diagnosis occurs, there is flexibility in how you use your benefits. Whether for medical expenses, or the cost of daily living, the decision is yours to use the benefits in a way that best fits your needs so you can focus on your recovery.

Supplementing your major medical with critical illness insurance helps you pay for your care so you can focus on getting well. Critical Illness insurance may cover:

Rates start as low as $3.19 per month

Guarantee Issue: $20,000 for employee

Contingent GI: $10,000 for spouse and $5,000 for child

$50 Wellness benefit per year

Plan is portable up to age 70

Pre‐Existing Condition Limitations apply


American Fidelity Gap Insurance Dependents up to age 26 Rising health care costs can be a financial concern. When faced with a hospital expense, how would you manage to pay your share, including the deductible and co‐pays? The Hospital GAP PLAN® Choice™ can help! The Inpatient Hospital Benefit pays the difference between the actual hospital expenses you incur as an inpatient and the amount your primary medical plan covers. Benefit amounts available range from $1,000 to $7,500. Your reimbursement cannot exceed the benefit amount you initially select under this plan. The Outpatient Benefit pays the difference between the actual outpatient expenses incurred and the amount paid by your primary medical plan.

Highlights

Plan covers the following Critical Illnesses:

Heart Attack

Stroke

Coma

Severe Burns

Major organ transplant

Permanent paralysis due to an accident

End stage renal (kidney) failure

Occupational HIV

Coronary artery bypass surgery (25%)



MetLife Accident Plan

Accident insurance is a way to protect you and your family from the unexpected expenses of an accident. Not only can the policy assist with hospital stays and medical exams, but travel costs as well. With benefits paid directly to you, you can determine where to spend the money.


LegalShield Legal Plan Dependents up to age 26 for LegalShield. Up to age 18 for IDShield.

Unexpected legal questions arise every day and with a pre‐paid legal plan, you can have access to a quality law firm for a low monthly fee. From letters written on your behalf to document review, speeding tickets to will preparation and more, attorneys are on hand to provide legal advice – no matter how traumatic or trivial it may seem. With a pre‐paid plan you will be protected and empowered to worry less and live more.

LegalShield Plan Services ID Shield Plan Services

Legal Advice – unlimited personal issues Credit Report

Letters/calls made on your behalf Personal Credit Score with Analysis

Contracts & Documents reviewed up to 15 pages Continuous Monitoring with Activity Alerts

Attorneys prepare ‐ Will, Living Will, Child Trust and Healthcare Power of Attorney

Identity Restoration Services

Separation, divorce, adoption and name change

Traffic‐Related Issues Plan Rates (Semi‐Monthly) Individual Family

Trial Defense ‐ Pre‐Trial and Trial LegalShield $9.48 $9.48

IRS Audit Assistance IDShield $4.48 $9.48

Combined $13.95 $16.95

Benefit Type Low Plan High Plan

Fractures $50 ‐$3,000 $100 ‐ $6,000

Dislocations $50 ‐$3,000 $100 ‐ $6,000

Coma $5,000 $10,000

Burns $50 ‐$5,000 $100 ‐ $10,000

Emergency Care $25 ‐ $50 $50 ‐ $100

Hospital Admission $500 or $1,000 $1,000 or $2,000

Ambulance Air ‐ $750 Ground ‐ $200 Air ‐ $1,000 Ground ‐ $300

Accident Rates (Semi ‐Monthly)

Low Plan High Plan

Employee Only $4.05 $7.70

Employee & Spouse $6.12 $11.60

Employee & Child $7.83 $14.85

Family $10.08 $19.11



Texas Life Individual Life Insurance Plan

Voluntary permanent life insurance can be an ideal complement to the group term and optional term your employer might provide. Designed to be in force when you die, this voluntary universal life product is yours to keep, even when you change jobs or retire, as long as you pay the necessary premium. Group and voluntary term, on the other hand, typically are not portable if you change jobs and even if you can keep it after you retire, usually costs more and declines in death benefit.

You may apply for this permanent, portable coverage, not only for yourself, but also for your spouse, and minor children and grandchildren.1,2

Please see the Purelife‐Plus brochure in the EBC for additional information and rates.

1. Policies not available for children and grandchildren in Washington. 2. Texas Life complies with all state laws regarding marriages, domestic and civil union partnerships, and legally recognized familial relationships.


Dearborn National Group Term Life and AD&D Insurance Dependents up to age 26. Employee must designate a beneficiary.

Eligible Employees – Subject to Underwriting • Stafford MSD employees working 20+ hours per week will receive a $10,000 district paid Basic

Life and AD&D policy. • Employee: Up to 5x salary in increments of $10,000. Not to exceed $500,000. • Spouse: Up to 100% of employee’s amount in increments of $5,000. Not to exceed $250,000. • Child: Up to 100% of employee’s coverage amount in increments of $5,000. Not to exceed

$15,000. (The maximum death benefit for a child between the ages of live birth and 6 months is $1,000)

New Hires (within 31 days of hire) – Guarantee Issue (any amount over GI will be subject to insurability)

• If you and your eligible dependents do not enroll within 31 days of your eligibility date, you can apply for coverage only during an annual enrollment period and will be required to furnish evidence of insurability for the entire amount of coverage.

• Employee: Guaranteed 5x annual salary up to $150,000 of coverage. • Spouse: Guaranteed up to $50,000 of coverage. Not to exceed 100% of employee

coverage. • Child: Guaranteed $10,000 of coverage.

Highlights

Portable; rate locks ate age you begin the policy

Coverage available to age 121

AD&D benefit included for ages 17‐59

Child Term Life Rider available for ages 15 days through 18 years old

Accelerated Death Benefit



Flexible Spending Account (FSA) – Medical If you don’t use it, you lose it! You MUST re‐enroll every year.

Medical Flexible Spending Accounts (FSA) allow you to set aside pre‐tax payroll deductions each pay check to pay for out of pocket medical, dental and vision expenses for you and your family. During open enrollment you will estimate the amount you think you will need during the year. This amount will be taken out of each paycheck. Your full annual election will be available to you at the beginning of the plan year. The maximum you can set aside each year is $2,550. A debit card is available for this plan.

Resources for FSA Management:

FF Flex Mobile App‐ submit claims, view account balance and history, view alerts and upload receipts.

FSA Store ‐ Shop for eligible items from bandages to wheel chairs and thousands of products in between.


Flexible Spending Account (FSA) – Dependent Care If you don’t use it, you lose it! You MUST re‐enroll every year.

With a Dependent Care Flexible Spending Account (FSA), you can set aside part of your pay on a pre‐tax basis to pay for eligible dependent care expenses. Stafford MSD provides a $500 rollover option for your FSA.

This account allows you to pay for day care expenses for your qualifying dependent/child with pre‐tax dollars while you (and your spouse) are:

• Working • Seeking Employment • Attending school as a full time student (for at least five months of the year)

Eligible Medical Expenses

Co‐Payments

Prescriptions

Deductibles



Flexible Spending Account (FSA) – Dependent Care Cont’d Eligible dependents must be claimed as an exception on your tax return. You may allocate up to $5,000 per tax year for reimbursement of dependent day care services ($2,500 if you are married and file a separate tax return). A debit card is available for this plan.

American Fidelity Health Savings Account (HSA) A Health Savings Account (HSA) provides you with the power to choose the best way to use the money typically spent on your healthcare expenses by providing a vehicle that allows you to save for future health costs. With an HSA, you will have the savings potential, flexibility, portability and tax savings unlike any other medical savings vehicle. The 2016 maximum allowable contribution is $3,400 for an i ndividual or $6,750 for a family.

HOW THE ACCOUNT WORKS An HSA may be used for the reimbursement of eligible medical expenses for you, your spouse and your tax dependents. The funds in your HSA are interest bearing and roll over from year to year. PLAN HIGHLIGHTS:

Pays out‐of‐pocket medical expenses

Deductible, co‐payments and other HSA‐qualified expenses

Provides excellent tax advantages

Contributions can be taken pre‐tax from your paycheck, your account balance earns tax‐free interest and any disbursements for HSA‐qualified expenses are tax‐free

Balance can grow throughout the years

Unused contributions are able to roll over into following years. Use your account for retirement purposes. After turning age 65, you may withdraw money for non‐qualified expenses, penalty free.

Debit Card available

Eligible Daycare Expenses

Before/After School Care

Mother’s Day Out Program

Nursery Schools

Babysitters

Nanny

Au Pair

Day Camps



American Fidelity Health Savings Account (HSA) Cont’d

My Notes to Ask Benefits Advisor

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403(b) Retirement Savings Plan

A 403(b) plan, also known as a Tax Sheltered Annuity (TSA) is a retirement plan for certain employees of public schools and tax‐exempt organizations. 403(b)’s are similar to 401k plans because they allow you to place an amount of your salary into an employer‐sponsored plan that helps you save for retirement. The benefit is that you do not pay income tax on allowable contributions until you begin making withdrawals from the plan, usually after you retire. Allowable contributions to a 403(b) plan are either excluded or deducted from your income. However, if your contributions are made to a Roth contribution program, this benefit does not apply. Instead, you pay income tax on the contributions to the plan but distributions from the plan (if certain requirements are met) are tax free. Benefits Include:

Tax deferred growth: no annual taxation on earnings

Investment options: fixed annuities, variable annuities, or mutual funds

Competitive interest rates

Flexibility: start, stop, and adjust your contributions as allowed by your employer's plan.

Receive periodic account statements



457(b) Retirement Plan

A 457(b) plan is a Tax Deferred Retirement Plan available to employees of state and local governmental agencies, including public school employees. They are similar to 401k plans because they allow you to place a percentage of your salary into an employer‐sponsored plan that helps you save for retirement. You will not have to pay taxes on what you contribute or earnings made until you withdraw the money.

Benefits Include:

Investment options: fixed annuities, variable annuities, or mutual funds

Flexibility: start, stop, and adjust your contributions as allowed by your employer's plan

Receive periodic account statements

There's no 10% federal penalty on interest or earnings for early withdrawal

There's no current federal income taxes on the money you put into the plan until it is time to take withdrawals


First Financial Group of America

11811 North Freeway, Suite 900

Houston, TX 77060

(800) 523-8422

(281) 847-8422