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Phyllis Perry DOC Personnel,Benefits Section 919/716-3780

Phyllis Perry DOC Personnel,Benefits Section 919/716-3780. To Save You Money!. How? Money contributed to benefits offered by NCFlex is done through payroll deduction on a pre-tax basis Benefits Include: Health Care Flexible Spending Account (HCFSA)

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Phyllis Perry DOC Personnel,Benefits Section 919/716-3780

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  1. Phyllis Perry DOC Personnel,Benefits Section 919/716-3780

  2. To Save You Money! How? Money contributed to benefits offered by NCFlex is done through payroll deduction on a pre-tax basis Benefits Include: Health Care Flexible Spending Account (HCFSA) Dependent Day Care Flexible Spending Account (DDCFSA) Vision Care Plan Voluntary Accidental Death and Dismemberment Insurance (AD&D) Dental Plan Supplemental Medical Plan What is the Purpose of NCFlex?

  3. Permanent, probationary or time limited State employees who work 20 or more hours per week Existing employees must enroll during annual enrollment October 13 -November 7, 2003 Participation will begin January 1st with deductions taken out of their paycheck at the end of the month Newly hired employees must enroll within 30 days of employment Participation will begin the first month after the enrollment form is signed with deductions taken out of their paycheck at the end of the month. Example: Employee signs enrollment form on August 1, 2003 Benefits will begin September 1, 2003 Deduction will be taken out of paycheck September 30, 2003 Who is Eligible to Participate in NCFlex?

  4. NCFlexDental Offers • A High Option Plan • A Low Option Plan • Coordination with the Health Care Flexible Spending Account • All Options Offer Coverage for the Participant and their Eligible Dependents

  5. High And LowDental Plan Options • Both Options Administered by Pacific Dental Benefits, Inc. and Underwritten by North Carolina Mutual • Participants can Select the Dentist of Their Choice • Participants or The Dentist can File the Claim • Participants will be Issued an I.D. Card

  6. Dental Comparisons

  7. Dental Provisions • Subject to Usual and Customary Charges • $1,000 Calendar Year Maximum per Person • Orthodontia Maximums (High Option only): $750/year and $1,500/Lifetime per Person for Dependent Children under Age 19

  8. Dental Waiting Periods • Current Dental Participants • Low Option to High Option - 12-month wait for major & orthodontia • High Option to Low Option - no wait • New Hire (enrolls within 30 days) • 12-month wait for orthodontia • Late Enrollees (employees/dependents) • 12-month wait for all services except diagnostic/preventive for both options

  9. High Option Dental PremiumPre-Tax Cost* Employee $31.60 $22.12 EE/SP $62.98 $44.09 EE/CH(ren) $60.46 $42.32 Family $103.64 $72.55 * Based on a 30% Tax Savings in the Premium Cost

  10. Low Option Dental PremiumPre-Tax Cost* Employee $17.38 $12.17 EE/SP $34.64 $24.25 EE/CH(ren) $33.26 $23.28 Family $57.00 $39.90 * Based on a 30% Tax Savings in the Premium Cost 17

  11. Provider Network Ophthalmologists (M.D.s) Optometrists (O.D.s) Opticians Optical Chain Locations Superior Vision Advantages Over 1,000 Providers

  12. Superior Vision Advantages • No Claim Forms • No Prior Eligibility Requirement • No Pre-notification Requirement • Receive Personalized I.D. Card • Refractive Surgery Discount Benefit • Two Year Commitment

  13. Two Plan Designs Offered • Plan #1 Provides • Comprehensive Eye Examination 12 Mos. • Lenses (Standard Glass or Plastic) 12 Mos. • Eye frame (Up to $100 Retail) 24 Mos. • Contact Lenses (Up to $100 Retail) 12 Mos. (Select Eyeglasses or Contact Lenses) Pay the Provider Directly for Non-covered Products & Services

  14. Plan #1 Provides Cont. • Eyeglasses • Lenses: Standard Glass or Plastic Lenses, any Rx, Single Vision, Bifocal, Trifocal, Lenticular with • Frames: Select any Frame from the Providers Inventory up to $100 with No Out-Of-Pocket Cost

  15. Plan #1 Provide Cont. • Contact Lenses • Benefit Allowance is $100 Retail Value • Available both In-network & Out-of-network • Elective Contacts: Applies to Most Wearers • Medically Necessary • Fitting Fee can be Included in the Allowance

  16. Plan #1 Provides Cont. • Available Discounts • Included in both Plan #1 & Plan #2 • 20% to 30% Discount on Additional Pairs of Eyeglasses & Contact Lenses. 10% on Disposable Contact Lenses • 20% (of UCR) Off RK, PRK (Laser), LASIK Surgery • Must Use In-network Provider

  17. Plan #2 (No Exam) • Eyeglass Lenses 12 Mos. • Eye frame (Up to $100 Retail)24 Mos. • Contact Lenses12 Mos. (Up to $100 Retail) (Select Eyeglasses or Contact Lenses) Pay the Provider Directly for Non-covered Products & Services

  18. Superior Vision Monthly Premiums Plan 1 Plan 2 (With Exam)(No Exam) Employee $7.98 $5.64 (30% Tax Savings)$5.59 $3.95 Family$20.24 $13.98 (30% Tax Savings)$14.17 $9.79 42

  19. Out-of-Network Benefits • Call SVS for Eligibility Check & Authorization Number • Receive Services & Pay the Non-network Provider • Obtain Itemized Receipt/Invoice • Mail to SVS Claims Department • Include Name, Address, & Authorization Number

  20. Accidental Death & Dismemberment • Accidental Death is the Leading Cause of Death under Age 39 • Coverage for Participant & their Family • Coverage Levels $50,000 to $500,000 • Dependent Coverage Equals Percentage of Employee Coverage • No Double Covering Family Members • Additional Benefits Listed in Booklet

  21. Accidental Death & Dismemberment • ASSIST AMERICA Provides: • Worldwide Emergency Assistance Services for Travelers • Direct Access to prompt Medical Emergency Assistance when traveling More than 100 Miles from Home • Hospital Admission Guarantee • Emergency Evacuation/Air Ambulance • Dispatch of Prescribed Medication • Care/Transport of Minor Children • Transport of Family Member to Join Patient • Legal Referrals Participants Receive an I.D. Card

  22. Accidental Death & Dismemberment Coverage and Monthly Cost AmountEmployeeFamilyAmountEmployeeFamily $50,000 $1.36 $2.00 $200,000 $5.40 $8.00 75,000 2.02 3.00 250,000 6.76 10.00 100,000 2.70 4.00 300,000 8.10 12.00 125,000 3.38 5.00 350,000 9.46 14.00 150,000 4.06 6.00 400,000 10.80 16.00 175,000 4.72 7.00 500,000 13.50 20.00 Tax Savings will Reduce the Costs by 30% or More

  23. Spending Accounts • A smart way to Increase Your Benefits Increase Your Take Home Pay and Save Taxes !!! 25% to 42%

  24. Spending Accounts • Plan Year (January 1, 2004 - December 31, 2004) • Must incur expenses during Plan Year • Elections must be set during the Plan Year, unless you have a family/employment status change event.

  25. Health Care Spending Account • $3,600 account maximum • Health care expenses can be on You, Your spouse & Your dependent children regardless if they are covered by the State Health Plan • Eligible expenses - • Medical - deductibles, coinsurance, chiropractor • Vision - exam, lenses/frames, contacts, LASIK surgery • Dental - deductible, coinsurance, orthodontics • Prescription Drugs - copays • Ineligible expenses - • insurance premiums, elective cosmetic procedures, over-the-counter drugs/vitamins/supplements Check the web at www.ncflex.org

  26. Tax Savings Example State Health Plan Deductible $ 350 Contact lenses, solutions, enzymes, eye glasses $ 200 Dental $ 330 Prescription drugs copay $ 120 $1,000 30% Tax Rate X .3 Tax Savings $ 300

  27. Dependent DayCare Spending Account • $5,000 account maximum for most employees • Both Parents must work to be eligible • Eligible Expenses • Child day care through age 12 • After/before-school care through age 12 • Dependent adult care

  28. Claims Processing • Claims kit sent to employees home • Mail or fax claim to Aon • Minimum claim reimbursement: $25 • Claims processed weekly • Payment by check or direct deposit • Health Care Account • Attach EOB if covered by health/dental plan • Reimbursement up to plan election • Dependent Day Care Account • Attach allowable receipt (need Provider’s Tax ID) • Reimbursement limited to Account balance

  29. Supplemental Medical Plan • Helps Bridge the Gap in Your Medical Plan - Not a Replacement • Coverage for the employee & dependents

  30. Coverages Cont. Benefit Paid Directly to Employee & in Addition to Other Insurance

  31. SupplementalMedical Plan

  32. Pre-Tax PremiumAdvantage • Example:Amy is Age 35 and Single. Monthly • Premium is $16.08 or $192.96 for the Year. • Annual Physical Exam Benefit(+)$100.00 • (2) Office Visits (Sickness) Benefit(+)$100.00$200.00 • $192.96 Premium with • 30% Tax Savings(-)$135.07 • Amy Saves$64.93

  33. Do Not Write in this Area Payroll Unit Number is 033 Effective Date is the month after signed Employees Information Must Be Completed Make sure applicable boxes are marked Without Signature and Date Enrollment Form will not be Processed NO FAXED COPIES

  34. Important Deadlines!! • Original Enrollment Forms to Benefits Section:Friday, October 31, 2003 • Cannot Accept Fax Copies due to Scanning • Benefit Elections are Effective January 1, 2004

  35. NCFlex is a wonderful way to save money and provide valuable benefits to our employees and their families • For more information: • Review your Brochure • Look up NCFlex on the web at www.ncflex.org • Call me at 919/716-3780

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