Download 2017 Benefits Presentation

2016-17 Benefit Presentation
Important Dates To Remember
Enrollment Window:
ALL benefit eligible employees must complete their
enrollment by November 30, 2016
Effective Date of Coverage:
All coverage changes are effective January 1, 2017
Payroll Dates:
Remember to double check your January paycheck(s)
to confirm deductions
Self-Enrollment Instructions
Benefits Enrollment Website: www.in-roll.com
• Login Credentials: first initial, last name, last 4 of social
Ex. John Smith 123-45-6789 = jsmith6789
• Initial password “eisd”
• You will be prompted to change password for security reasons
• Once logged in click to follow specific enrollment track
• Make enrollment selections and beneficiary designations
• Review your confirmation statement when complete
• Email or print the confirmation statement for you records
Enrollment Guide: Page(s) 7-9
Medical Plan
• Edgewood ISD plan is transitioning the district’s health insurance
program to Aetna effective 1/1/2017
• Choice of 3 medical plans with varying deductibles, premiums, and
networks
• To search for providers visit www.aetna.com/docfind or by calling
855-824-4112
• More information and premium rates for all group insurance plans
offered through EISD can be found in your benefits packet or online
at www.EISD.net under Directory/Employee Benefits
Enrollment Guide: Page(s) 7-9
Medical Plan
EPO Plan
PPO Low Plan
PPO High Plan
Deductible
• $2,000 Individual
• $4,000 Family
Coinsurance
• 20%
Out of Pocket Maximum
• $4,500 Individual
• $9,000 Family
Prescription Drugs
• Generic - $10
• Formulary - $35
• Non-Formulary - $60
Deductible
• $3,500 Individual
• $7,000 Family
Coinsurance
• 30%
Out of Pocket Maximum
• $6,600 Individual
• $13,200 Family
Prescription Drugs
Deductible
• $1,000 Individual
• $2,000 Family
Coinsurance
• 10%
Out of Pocket Maximum
• $3,500 Individual
• $7,000 Family
Prescription Drugs
•
•
•
•
•
•
*Must stay within the
Baptist Health System in San
Antonio
*Members have access to
Aetna’s Managed Choice
National network
Generic - $10
Formulary - $35
Non-Formulary - $60
Generic - $10
Formulary - $35
Non-Formulary - $60
*Members have access to
Aetna’s Managed Choice
National network
Enrollment Guide: Page 10
Dental DHMO
• Payment for services are based on the schedule of benefits
• Participants will need to choose a primary dentist by calling 800-880-1800
• You will need to contact MetLife if you would like to change your dentist
• No waiting periods
• ID cards will NOT be mailed, generic cards available on EISD website
• Preventative, basic, major, and orthodontic services
• No claims forms
• Children covered up to age 26
Your plan costs:
Employee only
Employee and Spouse
Employee and Children
Employee and Family
$10.40
$19.74
$20.78
$32.20
per month
per month
per month
per month
Enrollment Guide: Page(s) 11-13
Dental PPO
• You may choose any dentist, but your benefit dollars will go farther if you
use network dentists. Visit www.metlife.com/mybenefits for a list of
providers.
• No waiting periods
• ID cards will NOT be mailed, generic cards available on EISD website
• Preventative, basic, major, and orthodontic services
• See summary sheet for deductibles and calendar year maximums
• Children covered up to age 26
Your plan costs:
Employee only
Employee and Spouse
Employee and Children
Employee and Family
$21.28
$43.04
$55.38
$75.52
per month
per month
per month
per month
Enrollment Guide: Page(s) 14-15
Vision Insurance
• In-Network and Out-of-Network Provider benefits
• For a provider listing visit www.davisvision.com (client code is 7730)
• Includes Eye Exam and Frames/Lenses or Contact Lenses every 12 months
2013-2014 Benefits Guide
• No Waiting Periods
• ID cards will be mailed
• Children covered to age 26
• See summary sheet for details
Your Plan Costs:
Employee
Employee + Spouse
Employee + Child(ren)
Employee + Family
$ 5.48 per month
$10.94 per month
$10.40 per month
$16.34 per month
Enrollment Guide: Page(s) 16-23
Group Life Insurance
• All employees are eligible for guarantee issue (no health questions)
coverage if enrolled during open enrollment
• Group Insurance in force only while employed with Edgewood ISD
• Minimum and maximum coverage limitations apply
• Spouse and dependents are eligible
• All benefit eligible employees receive $15,000 of basic life insurance
(provided by Edgewood ISD at no cost to employee)
Your plan costs:
InRoll will calculate your cost based on current age
Enrollment Guide Page(s) 24-28
Portable Life Insurance
• Express Issue: Limited health questionnaire
• Permanent, Portable Life Insurance
• Guaranteed death benefit to age 121
• Accelerated Death Benefit Included
• Coverage for Spouse and Children
• Minimum and maximum coverage limitations apply
Your plan costs:
InRoll will calculate your cost based on current age
Enrollment Guide: Page(s) 29-36
Long Term Disability Insurance
Long term disability insurance helps protect your income if you are unable to
work due to illness or injury
Benefit Amount
• Monthly benefit amount is 66 2/3
percent of your
gross monthly
2013-2014
Benefits
Guide earnings
Benefit Waiting Period and Maximum Benefit Period (page 12)
• Must be continuously disabled before benefits become payable
• Benefits are not payable during the benefit waiting period
• Waiting period options of 0/3,14, 30, 60, 90, and 180 calendar days
• The maximum benefit period is the period for which benefits are payable
• Pre-existing condition limitations apply for new enrollments
Your Plan Costs:
InRoll will automatically calculate your cost based on your eligible
income with Edgewood ISD.
Enrollment Guide: Page(s) 37-40
Cancer Insurance
• Cancer coverage provides cash directly to you to help offset out of
pocket costs
• Pays in addition to medical insurance
• Treatments determine benefits
• Screening benefits for annual check-ups
• No health questions during open enrollment (pre-ex limitation)
• Portable
Plan Costs:
Employee Only
Employee & Spouse
Employee & Child(ren)
Employee & Family
Low Plan
$15.60
$24.90
$21.46
$30.72
High Plan
$24.36
$38.06
$34.10
$47.78
Enrollment Guide– Pages 41-47
Critical Illness Insurance
• Critical Illness coverage provides cash directly to you to help offset
out of pocket costs
• Covered illnesses include invasive cancer, heart attack, stroke, and
major organ transplants
• Lump sum benefit options of $10,000 or $20,000
• No health questions during open enrollment (pre-ex limitation)
• Portable if you leave or retire from EISD
Your plan costs:
InRoll will calculate your cost based on current age
Enrollment Guide– Pages 48-49
Flexible Spending Account:
Healthcare
• Contribute on a pre-tax basis
• Pay for eligible medical, dental, or vision expenses
• Over the counter not eligible medication (in most cases)
• Annual Contribution Limit of $2,600
• Plan year ends December 31
• Debit cards (mailed to address on file)
• Track your account online at www.tasconline.com
• Keep your receipts!
Enrollment Guide– Pages 48-49
Flexible Spending Account:
Dependent Care
• Contribute on a pre-tax basis
• Pay for eligible dependent care expenses
• Use-it-or-Lose-it by December 31
• Annual Contribution Limits of $5,000
• Consult with your tax advisor (potential impact on other available
dependent care tax benefits)
• Debit cards (mailed to address on file)
• Track your account online at www.tasconline.com
• Keep your receipts!
Questions?
Padilla
with
EnrollmentContact
Guide–Gina
Page
23 - 27
U.S. Employee Benefits at 830.606.5100
Summary
• All employees must meet with a representative or login to
www.in-roll.com to complete enrollment
• Open enrollment ends November 30, 2016
• Plans changes are effective January 1, 2017
• VERY IMPORTANT - Review first paycheck to confirm all
deductions are accurate.
Thank you for being part of the
Edgewood ISD family!
Please feel free to contact Human Resources/Risk
Management if you have any questions.