SCHOOL BOARD OF CLAY COUNTY Annual Enrollment 2015 - 2016 Plan
Year
Slide 2
Annual Enrollment Highlights Passive enrollment = July 27
August 21 All current elections roll over into 2015-2016 with no AE
change, except FSA. Employees must re-enroll and make new FSA
elections NEW HSA Medical Plan Option There are 3 medical plan
options available through Florida Blue PCP required for new HMO and
HSA enrollees Without PCP designation, one will be assigned If
currently enrolled in the HMO, current PCP will remain on file (PCP
entered during AE will not overlay Florida Blue PCP on record)
Update Beneficiaries for Life Insurance Verify beneficiary shown or
collect new assignment Spouse Life and Child life beneficiary is
the employee 2
Slide 3
Benefits 101 New Hires All full-time (0.6 of an allocation)
contracted employees are eligible for benefits. Coverage becomes
effective on the first day of the month after you complete 45
calendar days of employment, provided you enroll and submit any
required forms to the Insurance Department before your effective
date of coverage. The Board provides a comprehensive benefit
program, and the cost of benefits are partially paid by the Board.
Review your options now and make your elections soon. Deductions
for coverage begins two pay periods in advance. If you delay your
enrollment, you could have a double deduction from a single
paycheck. 3
Slide 4
Read your Benefit Guide Your Benefits Guide contains details
about each plan. Read it and have it hand when youre ready to
enroll. Note the page numbers for where to find more information in
the Benefits Guide. 4
Slide 5
Benefits Overview Medical Election? YESYES YESYES Plan A NONO
NONO Plan B 5
Slide 6
Dependent Child Eligibility Children by birth, marriage,
adoption, or legal guardianship Pg. 6 Under age 19 Medical Dental
Vision Life Insurance (if not married or disabled) Accident and
Injury Whole Life Critical Illness Age 19-26 and full time student
Medical Dental Vision Life Insurance (If not married or disabled)
Accident and Injury Whole Life Critical Illness (age 24) Age 19-26
not a full time student Medical Dental Vision Accident and Injury
Whole Life Critical Illness Florida Mandate Medical Only for Age
26-30 Unmarried Not eligible for other coverage No children Florida
resident or Full Time Student 6
Slide 7
Is your Spouse a School Board of Clay County employee? 7 Yes,
and we both need medical coverage You both will be considered Plan
A. Notify the Insurance Department so your enrollment is processed
correctly. You may choose which of you will have deductions taken
from your pay Yes, but only one of us needs medical coverage The
spouse who needs medical coverage will be Plan A. The spouse who
does not need medical coverage will be Plan B. Dont elect coverage
for your spouse under any plan. You may not elect Spouse Life
Insurance because under the Life Insurance policy, you may not be
covered as an employee and a dependent. Only one of you may cover
your dependent children. Life Insurance
Slide 8
Plan A Benefits Medical Plan Pg. 21 Contributions are new and
subject to change Rates printed in the Benefit Guide are subject to
Collective Bargaining If rates change, all employees will be
notified and may be given an opportunity to modify coverage Board
provides Basic Life Insurance $20,000 Pg. 49 Plan A Employee pays
100% of all other benefits Medical Gap Pg. 33 Accident and Injury
Pg. 34 Dental Pg. 41 Vision Pg. 43 Short and Long Term Disability
Pg. 53 8
Slide 9
Plan B Benefits No Medical Coverage Board provides Basic Life
Insurance $50,000 Pg. 49 Board pays 100% for Employee Only coverage
in the following plans: Accident and Injury Pg. 34 Dental Pg. 41
Vision Pg. 43 Short Term Disability Pg. 53 Long Term Disability Pg.
53 Employee pays Dependent portion: A&I, Dental, and Vision;
not available without EE election Dependent Spouse and Child Life
100% voluntary 9
Slide 10
Florida Blue Medical Plans HMO, PPO, HSA Pg. 22 - 27 HMO and
PPO have $3,000 Annual Deductible HSA has $1,500 Annual Deductible
Preventive Care covered 100% All copayments apply to Out of Pocket
Maximums Copayments for most services Referrals are not required to
see a Specialist HMO In-Network coverage only Requires designation
of a Primary Care Physician (PCP) PPO In- and Out-of-Network
national provider access PCP designation not required HSA
In-Network coverage only Deductible applies for all services
Copayments for prescriptions apply only after deductible has been
met. Requires designation of a PCP Participants may choose to
contribute to a Health Savings Account through payroll deductions
10
Slide 11
Florida Blue Networks/PCP The three plans have different
networks HMO and HSA BlueCare network PPO BlueOptions network (also
called Network Blue) HMO and HSA require all covered members to
designate a Primary Care Physician Employees can log on to
www.floridablue.com and search under Find a Doctor using the
residence zip code.www.floridablue.com If PCP is not collected at
time of enrollment, then the member will be assigned a PCP by
Florida Blue based on their zip code Only for new enrollees current
PCP assignments will not change Member will receive a letter
notifying them of the PCP that has been assigned with instructions
to change Employees should watch for the letter and contact Florida
Blue immediately if they wish to change 11
Slide 12
Medical Gap Insurance MUST be enrolled in a Major Medical Plan
SBCC Medical or Spouses group medical plan Excludes Medicare,
TRICARE, and CHAMPUS Pays based on what appears on the Explanation
of Benefits from the Major Medical Plan Two Plans Based on
Inpatient Benefit Pg. 33 KemperGap 3000 KemperGap 1500 Outpatient =
50% of Inpatient Benefit $350 Ambulance coverage for Accident only
12
Slide 13
Dental Plan Delta Care Prepaid Plan Pg. 41-42 Requires election
of Primary Care Dentist No out of network coverage Lower cost per
pay period Delta Dental PPO Plan Pg. 41-42 Broader network of
dentists In and out of network coverage 13
Slide 14
Vision Plan Vision Care Plan with Humana Pg. 43 Coverage for
exams, lenses, and frames or contact lenses In and Out of Network
coverage Includes coverage for Lasik Members receive an ID card
14
Slide 15
Flexible Spending Accounts FSA with Health Equity Pg. 45 - 47
Healthcare Flexible Spending $2,500 Annual Maximum contribution
Debit Card provided to all participants Most medical claims passed
through Florida Blue claims system can be automatically
substantiated Members can view balances, submit claims online, and
provide substantiation documentation if necessary at
www.myhealthequity.com www.myhealthequity.com Not eligible if
enrolled in the HSA Medical Plan Dependent Care Flexible Spending
$5,000 Annual Maximum Child Care or Elderly care 15
Slide 16
Health Savings Account 16 * Participants 55+ = $1,000
additional catch up contribution permitted Employee OnlyFamily
Coverage55+ Participants* IRS Annual Limit$ 3,350$6,650$1,000
catch-up Per 20-pay$167.50$332.50$50 Individually owned account -
Pg. 12 Must be under age 65 and enrolled in the HSA Medical Plan
The most an individual may contribute into an HSA is based on the
level of medical coverage elected. Deposited balance may be used to
pay eligible medical, prescription drug, dental, and vision
expenses. Funds rollover each year and balance earns interest.
Slide 17
Term Life Insurance Basic Life Pg. 49 Plan A - $20,000 Plan B -
$50,000 Supplemental Life Pg. 50-52 New Employees may elect up to
$100,000 in Employee Life Insurance and Spouse Life Insurance
without answering medical questions Elections over $100,000 require
completion of Evidence of Insurability questionnaire Plan A may
elect up to a total of $180,000 Plan B may elect up to a total of
$150,000 Employee and Spouse rates are age banded based on
Employees age as of October 1, 2015 Child flat rate for $5,000 or
$10,000 Children who are married and/or disabled are ineligible
Verify / Update Beneficiaries 17
Slide 18
Annual Enrollment Opportunity Supplemental Term Life Pg. 50-52
Employees may increase Voluntary Life by $10,000 without submitting
Evidence of Insurability (EOI) during Annual Enrollment New
elections and increase more than one increment require EOI Plan A
may elect up to a total of $180,000 Plan B may elect up to a total
of $150,000 Employee and Spouse rates are age banded based on
Employees age as of October 1, 2015 Child flat rate for $5,000 or
$10,000 Children who are married and/or disabled are ineligible
Evidence of Insurability required if electing coverage for the
first time or for Employee Life in excess of $10,000 18
Slide 19
Disability Short Term Disability Pg. 53-55 EOI is required for
Plan A employees who are not currently enrolled and electing
coverage for the first time EOI is not required if changing from
Plan B to Plan A Long Term Disability Pg. 56-57 EOI is required for
Plan A employees who are not currently enrolled and electing
coverage for the first time EOI is not required if changing from
Plan B to Plan A 19
Slide 20
Voluntary Benefits Accident and Injury Pg. 34 Paid by Employer
100% for Plan B Employee Only Sickness Rider for all enrollments
Interest Sensitive Whole Life Pg. 58 Employee Spouse Child
Specified Critical Illness Pg. 60 Employee Only Employee + Spouse
20
Slide 21
Key Dates First Day of Enrollment = July 27 Last Day to Enroll
= August 21 First payroll deduction = September 15 Effective Date
of Coverage = October 1 21