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BENEFLex 2014

BENEFLex 2014. Risk Management & Insurance. Please do not ask questions of coworkers, school secretaries, department heads, principals. They may not have the answers that best meet your needs. QUESTIONS. Instead, contact the RISK MANAGEMENT BENEFITS TEAM for the most accurate answer at

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BENEFLex 2014

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  1. BENEFLex 2014 Risk Management & Insurance

  2. Please do not ask questions of coworkers, schoolsecretaries, department heads, principals. They may not have the answers that best meet your needs. QUESTIONS Instead, contact the RISK MANAGEMENT BENEFITS TEAM for the most accurate answer at 727-588-6197 Or visit our website at www.pcsb.org/risk-benefits

  3. #1 Question…When are my benefits effective? • Benefits are effective the first day of the month following 60 days of employment. Example: • Hire DateBenefits Effective 8/17 11/1 3/16 6/1 • You must turn in your Enrollment and Change form in person or by pony (interoffice envelope) to Risk Management and Insurance Department within -- 31 days -- of your hire date or full time position date.

  4. For Medical, Dental & Vision coverages: Legally married spouse Same sex domestic partner, requires additional documentation Dependent children may be covered through end of calendar year in which they reach age 26 Family OTL and Dependent Child(ren) Life Insurance coverages: Legally married spouse Dependent children may be covered up to age 26: A.) if they are dependent upon you for support: OR B.) they are a full-time student Dependent Eligibility • DOCUMENTATION IS REQUIRED FOR DEPENDENTS • enrolled in health, dental or vision coverage: marriage certificate for a spouse, birth certificates for children. Photocopies are acceptable. • For Medical: • Dependent children up to age 30, please contact Risk Management at 588-6197 for further details and documentation.

  5. Staff HMO – Modest premium, narrow network of physicians and service area, access limitations • NPOS– Broader national network, out of network options, 80%/20% co-insurance • Consumer Directed Health Plan (CDHP) – Lowest premium, in-network only, greater risk (cost). • Under all 3 plans • Preventative physicals, GYN care, mammography and colonoscopy exams covered at no charge

  6. HMO Staff Co-paymnets • PCP : $ 25 • Specialist: $ 50 • Outpatient surgery: $500 • Inpatient hospital: $500 per day for the first 5 days • ER: $300 • Urgent Care $ 50 • Maximum out-of-pocket • EE only $3,000 • EE+1, EE + Family $6,000 • NOTE: You must stay within the Humana network to receive benefits. There is no coverage out of network, except for life threatening illness and emergencies. (In most cases you will have to return to the service area for follow-up care.)

  7. Choosing a Doctor

  8. In Network Benefits Deductible- $100 Employee $200 E +1 $200 EE + Family Broad network of doctors No referral to specialist Co-insurance 80%/20% Inpatient hospital: $500 Per day for a max of 5 days Out of Network Benefits differences Co-insurance 60%/40% Inpatient hospital: 60%/40% Annual routine adult physical/GYN exam/mammography and colonoscopy – covered 40% NPOS (National Point of Service) • Maximum out of pocket in/out-of network: • $3,000 - individual • $6,000 – EE+1, EE+ family

  9. In-Network Only Broad network of doctors No referral to specialist Deductible: $1500 EE $3000 EE + or EE + Family After deductible has been met, all expenses covered at 80% except prescription cost Member Allowance: $ 500 - EE only $1000 – EE+1or EE+ Family Maximum out of pocket $3,000 - individual $6,000 – EE+1, EE+ family CDHP Benefit Plan(Consumer Directed Health Plan) • NOTE: You must stay within the Humana network to receive benefits. There is no coverage out of network, except for life threatening illness and emergencies. (In most cases you will have to return to the service area for follow-up care.)

  10. Health Plan Premiums • Payroll deductions are PER PAY -- 20 pays. These are after the Board contribution has been applied. This applies to all employees no matter what pay options is selected (pages 6 & 7 in BeneFlex Guide) • To be eligible for Two Board Family, you and your spouse are employees of the School Board, both qualify for benefits and have at least one child who meets the eligibility guidelines

  11. The Reimbursement AccountsHealth Care Reimbursement Acct. (HCRA) & Dependent Care Reimbursement Acct.Box #9, #10 Set aside your money (or up to $25 of board contribution for HCRA only) on a pretax basis in a separate account to pay for out-of-pocket medical, dental, vision expenses (for all family members) and dependent day care Examples of Covered Expenses office visit and prescription co-pays and plan deductibles Some over the counter medications, if prescribed by PCP or Specialist Expenses that exceed medical or dental plan limits (braces) hearing aids vision expenses not covered by vision plan children under age 13 who are enrolled in a licensed day care or after school center or individual day care provided by caregiver (must give social security number)

  12. Reimbursement Accounts Advantages •Reduce Federal & FICA income taxes •Results in more money in paycheck •Access to amount declared immediately for Health Care Acct. •In many instances, greater tax advantage through employer plan vs. annual tax filing Disadvantages •Must estimate carefully •IRS Use it or Lose it Rule

  13. Dental Plans • 1. Humana/CompBenefits (Dental HMO) • copayments – network providers • 2. Met Life PPO (reimbursement plan) • chose any dentist, save on preferred providers *Board Contribution (Flex Credits) may be used

  14. EyeMed VISION COVERAGE

  15. Prudential Life Insurance Application Sample on page 19 of the Beneflex Guide Video information on the life insurance plans: mms://video.pinellas.k12.fl.us/2008Risklifea_d

  16. Assurant Disability Application Sample on Page 18 in BeneFlex Guide Video information on the disability plans: mms://video.pinellas.k12.fl.us/2008Riskincomeprotect

  17. “No Health” Board Contribution Use your $75 per pay period Board Credit for: Dental Cover yourself or your family through Met Life or Comp Benefits Vision Quality vision care for you and your family through EyeMed Vision Care Accidental Death & Dismemberment Insurance Help for dealing with financial consequences of an accident for you and your family Income Protection Short and Long Term coverage will provide a monthly benefit if you are unable to work due to illness or injury (employee only) Flexible Spending Account Apply up to $25 to a Health Care Reimbursement Account. Use your FSA to pay for eligible medical expenses not covered by insurance.

  18. Wellness Program • Be Smart Worksite Wellness Program, see the Wellness Champion at your worksite for programs based on the staff survey • Diabetes Care Program, free testing supplies once requirements are met. • Tobacco Cessation Program, with Rx available (telephonic coaching required) • District wide programs –stress reduction, proper hydration, skin cancer screenings, blood pressure screenings and more • All Humana Participants: Free Telephonic Health Coaching for Weight Mgt., Physical Activity, Nutrition, Back Care, Stress Mgt. • Employee Assistance Plan. (CCW)

  19. Employee Assistance Program • Stress (on & off the job) • Family & Marital problems • Divorce • Substance or Alcohol Abuse • Depression • Elder Care Referral • Legal Assistance Referrals • Corporate Care Works • 1-800-327-9757 • Covers all eligible employees and family members • 8 free counseling sessions per incident.(no co-pays) • Strictly confidential

  20. Voluntary Products • Convenient payroll deductions • Enroll anytime throughout the year after your eligibility begins • Met Life: Great rates for cars, recreational vehicles and motorcycles • MetLife – Auto/Motorcycle/Recreation Vehicle, Group Legal Services and Veterinary Pet Insurance

  21. Tax Deferred Annuity Program Defer up to 25% of pay, not to exceed $15,500 per year. (If you turn age 50 or older this year, you can contribute and additional $5,000.) Money deducted from you salary reduction is deferred from Federal income taxes Principal and interest accumulate through variety of investment options 4 monetary changes per year NO contributions /matching funds from PCS Retirement Savings Plans

  22. Retirement Savings Plans(continued) • Florida Retirement System (FRS) • You will contribute 3% of your gross pay • You must decide after receiving your packet from FRS in 60 days which plan to select • FRS Pension Plan • FRS Investment Plan • Free help is available at MyFRS.com or 1-866-446-9377

  23. Risk Management & Insurance Department • We offer a comprehensive and flexible benefit program that meets your needs today & tomorrow. • We are here to serve you, our customer. Please call us anytime M-F, 8:00 – 4:30 588-6197 Good luck & Welcome to Pinellas County Schools

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