Open Enrollment - nisdtx.org · embedded in your duty calendar •Pay day is the 25th of each...
Transcript of Open Enrollment - nisdtx.org · embedded in your duty calendar •Pay day is the 25th of each...
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Leave and BenefitsMedical
Open Enrollment
Accident
Flexible Spending
Sensible Choice
NISD Health and Wellness Center
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Calendar days, flex days, sick leave, personal time, and payroll
• Teachers are 187 calendar day employees
• There are 4 flex days and 2 day on-line training days embedded in your duty calendar
• Pay day is the 25th of each month, unless the 25th falls on a weekend in which case it is the Friday before the 25th
• September 25, 2018 first check
• 5 State Personal Days
• 5 Local Sick Days
• Children report Monday, August 27, 2018
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Leave, what is it and when can I take it ???Personal Leave Local Sick Leave State(P) Sick Leave
Limited to 5 days per calendar school year
Requires medical certification after 5 days or a questionable pattern of absences
Unused personal days convert to state(p) sick leave
Requires 5 days advance notice Illness of employee or immediate family
Service records will display the balance state(p) leave
Requires administrator approval Family Emergency Follows same requirements of local sick leave
Unused days will convert to state(p) sick leave
Death of employee’s immediate family
Unused state(p) leave balances transfer from district to district
Birth or adoption
Unused local sick leave will continue to accrue
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Benefits at a Glance
• Three self-Funded medical plans with Cigna as the Network Administrator
• Maxor – Prescription Benefit Management
• NISD Health and Wellness Center for
medical plan participants
• Three Dental Plans managed by Ameritas
• Vision Insurance managed by Ameritas
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Benefits at a Glance• Vision Insurance offered through Ameritas
• Alliance Work partners – Employee Assistance Plan
• SunLife Voluntary Life Insurance
• Texas Life Insurance
• American Fidelity Long-term Disability
• MetLife Group Accident Plan
• Allstate Cancer Plan
• iLock 360 Cyber Identity Theft Program
• 403(b) Retirement Plan
• 457(b) Retirement Plan
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Benefit Enrollment
Enrollment begins July 1, 2018– July 31, 2018
All employees must complete the enrollment regardless of participation
in the benefits offered by the district
Enrollment website https://benefits.ffga.com/northwestisd
Enrollment Assistance Available
July 16th, July 17th, July 18th, July 19th
July 23rd , July 24th , July 25th
8:00 a.m. to 4:00 p.m.
Administration Building
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NISD Medical Provider
Cigna Open Access Plus Network
www.askallegiance.com/nisd
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Medical Plan
NetworkProviders
Core Basic High Deductible
Individual Deductible $750 $1,100 $2,500
Family Deductible $1,500 $2,200 $5,000
Office visit co-Insurance 70% plan 30% participant 70% plan 30% participant 70% plan 30% participant
Urgent Care 80% plan 20% participant 80% plan 20% participant 80% plan 20% participant
Emergency Room $250 co-payment for each visit – 70% plan and 30% participant
$250 co-payment for each visit – 70% plan and 30% participant
$250 co-payment for each visit – 70% plan and 30% participant
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Prescription Plan
Network Provider Core Basic High Deductible
Prescription Deductible $250 – per participant $250 – per participant $250 – per participant
Generic medications Greater of $10 or 30% copayment
Greater of $10 or 30% copayment
Greater of $10 or 30% copayment
Name brand medications Greater of $45 or 30% copayment
Greater of $45 or 30% copayment
Greater of $45 or 30% copayment
Specialty medications $250 per prescription $250 per prescription $250 per prescription
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Core Plan Medical Premiums
Core Plan with PHA 2018-2019 Premium District Contribution PHA Incentive Monthly Premium
Employee 831.00$ (325.00)$ (25.00)$ 481.00$
Employee + Spouse 1,747.00$ (325.00)$ (50.00)$ 1,372.00$
Employee + Child(ren) 1,455.00$ (325.00)$ (25.00)$ 1,105.00$
Employee + Family 2,073.00$ (325.00)$ (50.00)$ 1,698.00$
Core Plan without PHA 2018-2019 Premium District Contribution PHA Incentive Monthly Premium
Employee 831.00$ (325.00)$ -$ 506.00$
Employee + Spouse 1,747.00$ (325.00)$ -$ 1,422.00$
Employee + Child(ren) 1,455.00$ (325.00)$ -$ 1,130.00$
Employee + Family 2,073.00$ (325.00)$ -$ 1,748.00$
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Basic Plan Medical Premiums
Basic Plan with PHA 2018-2019 Premium District Contribution PHA Incentive Monthly Premium
Employee 565.00$ (325.00)$ (25.00)$ 215.00$
Employee + Spouse 1,107.00$ (325.00)$ (50.00)$ 732.00$
Employee + Child(ren) 973.00$ (325.00)$ (25.00)$ 623.00$
Employee + Family 1,394.00$ (325.00)$ (50.00)$ 1,019.00$
Basic Plan without PHA 2018-2019 Premium District Contribution PHA Incentive Monthly Premium
Employee 565.00$ (325.00)$ -$ 240.00$
Employee + Spouse 1,107.00$ (325.00)$ -$ 782.00$
Employee + Child(ren) 973.00$ (325.00)$ -$ 648.00$
Employee + Family 1,394.00$ (325.00)$ -$ 1,069.00$
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High Deductible Medical Premiums
HDP with PHA 2018-2019 Premium District Contribution PHA Incentive Monthly Premium
Employee 450.00$ (325.00)$ (25.00)$ 100.00$
Employee + Spouse 858.00$ (325.00)$ (50.00)$ 483.00$
Employee + Child(ren) 774.00$ (325.00)$ (25.00)$ 424.00$
Employee + Family 1,098.00$ (325.00)$ (50.00)$ 723.00$
HDP without PHA 2018-2019 Premium District Contribution PHA Incentive Monthly Premium
Employee 450.00$ (325.00)$ -$ 125.00$
Employee + Spouse 858.00$ (325.00)$ -$ 533.00$
Employee + Child(ren) 774.00$ (325.00)$ -$ 449.00$
Employee + Family 1,098.00$ (325.00)$ -$ 773.00$
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New for 2018• Well Via telemedicine program effective September 1,
2018
• Physicians will be available around the clock via mobile application
• Any spouse who currently has medical coverage through their employer but elects to enroll in the NISD Medical plan will pay a $100 per month spousal surcharge
• Spouses that work for a company that does not offer medical coverage or who are self employed are not subject to the spousal surcharge
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Qualifying Event• During the plan year, certain qualifying events will permit an employee
to make changes other than during open enrollment:
– Marriage;
– Birth
– Divorce
– Adoption of a child or foster child placement
– Death
– Termination of a spouse’s employment;
– Full-time to part-time employment;
– Your spouse takes an unpaid leave of absence;
– Aging off a parent’s plan when child turns 26
• Employees must enroll the eligible dependent(s) within 31 days of the qualifying event or wait until the next open enrollment period.
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NISD Employee Health and Wellness Center
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NISD Employee Health and Wellness Center
• Employees and covered dependents in the medical plan may utilize the Wellness Center
• There is no charge for visits or procedures done in the Wellness Center
• Consider the benefits of the clinic when electing your benefits
• There are 80 generic medicines that are available with no cost to participants
• The Wellness Center is open:
Monday through Friday
8:00 a.m. to 5:00 p.m.
• The Wellness Center is open year around except for designated holidays
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Services Performed in the Wellness Center
• Personal Health Assessment
• Sports physicals
• Annual well women exams
• Strains/sprains/musculoskeletal problems
• Sore throats/cough/sinus/ear infections
• Headache
• Allergies
• Minor Surgical Procedures
• Diabetic Counseling
• Designated Diabetic Supplies
• Flu Shots
• Can become your health care home
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Examples of Medication in the Health and Wellness Center
• Generic
• Allergy
• Antibiotic
• Anti-fungal
• Antiviral
• Birth control
• Blood pressure
• Cholesterol
• Depression
• Designated Diabetic Medicine Medication
• Designated Diabetic Supplies
• Zero cost to participants
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Personal Health Assessment (PHA)
• Participants annually participate in the PHA receive premium discounts
• Employees and covered spouses receive premium discount
• PHA appointments are available beginning September 1, 2018
• Must be completed by November 30, 2018 to receive discount
Employees and covered dependents can contact the clinic at 817-215-0936 to schedule a time to review the data. The physician will conduct a follow-up meeting discuss the results of the PHA. The results of the PHA will be posted to the participant’s MyCare site. All participants are encouraged to set up a MyCare Account to view their medical information.
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Ameritas Dental Plans
High Plan Low Plan Sensible Choice
Deductible $50 per participant $50 per participant % of first $25080% plan 20% participant
Family deductible 3 Family Members All Family Members All Family Members
Annual Maximum $1,500 per participant $1,500 per participant $1,500 per participant
Routine cleaning andExamination – Level 1
Plan pays 100% Plan pays 100% % of first $25080% plan 20% participant
Fillings, extractions, etc. Level 2
80% plan 20% participant 80% plan 20% participant 80% plan 20% participant
Crowns, dentures – Level3
50% plan 50% participant 50% plan 50% participant 50% plan 50% participant
Dental rewards Annual dental expenses that do not exceed $750 can result in a $250 annual carryover not to exceed $1,000. Must have one dental claim per year.
Annual dental expenses that do not exceed $750 can result in a $250 annual carryover not to exceed $1,000. Must have one dental claim per year.
N/A
Orthodontia up to age 18 50% $1,000 LifetimeMaximum
Not covered Not covered
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Dental Premiums
Coverage Level High Plan Low Plan Sensible Choice
Employee Only $ 54.65 $26.28 $20.66
Employee + Spouse $102.18 $48.19 $41.52
Employee + Children $ 85.54 $39.43 $32.96
Employee + Family $139.01 $62.43 $53.80
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Ameritas Vision Plan
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Employee Assistance Plan
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District Paid Life Insurance• Coverage is provided by SunLife
• An Active employee of Northwest ISD working 25 hours per week or more
• $15,000 of Basic Life Insurance
• 100% Employer Contribution
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Supplemental Long Term Disability
• Income replacement for accident or sickness
• Purchase up to 66 2/3% of your salary
• Choice of elimination periods
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Other benefits available
• Unreimbursed medical
• Dependent day care
• Sunlife voluntary Life Insurance
• Texas Life permanent portable life insurance
• Metlife - Accident Insurance
• Allstate - Cancer Insurance
• American Fidelity – Critical Illness Insurance
• I-Lock 360 Identity Theft Protection
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Retirement Options
403(B)
• Comprised of annuities or mutual funds
457(B)
• Comprised of fixed annuities, bonds, and/or mutual funds
Other available options
• Traditional IRA
• Roth IRA
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Contact Information
Kitty Poehler, PHR
Executive Director of Benefits and Risk Management
817-215-0071
Cheryl Kacvinsky
Benefits Specialist
817-215-0096
Tracy Schutz
Administrative Assistant
817-215-0043