Open Enrollment Benefits 2013-2014 April 22- May 24 Wylie
ISD
Slide 3
Health Care Reform What does it mean for me? Individual mandate
under the Affordable Care Act goes into effect on January 1, 2014
All individuals are required to have minimum essential coverage for
medical unless you qualify for an exemption Minimum essential
coverage includes coverage under the following plans: Employer
sponsored coverage (TRS Active Care) Individual coverage purchased
by you Medicare/Medicaid/CHIP Certain types of Veterans health
coverage TRICARE Individuals will have access to insurance
exchanges in 2014 if coverage is gained due to buying less
expensive coverage through exchange you can drop TRS Active Care
Individual mandate, by itself, going into effect on January 1 is
not a qualifying event to enroll in TRS Active Care Get more
information on health care reform by going to www.healthcare.gov
www.healthcare.gov
Slide 4
Whats new for TRS Active Care Plans? Active Care 1 will be
discontinued Deductibles and out-of-pocket maximums will increase
for Active Care 1HD and Active Care 2 Premiums increasing
Non-contracting providers will be paid at BCBS of TX allowable
amount rather than at 50% of billed charges (more out of pocket for
participant if using out-of-network providers) New Benefits Value
Advisor New Uniform Summary of Benefits Coverage New ID cards for
medical if you make a plan change or are on Active Care 1 currently
New ID cards for prescriptions if you make a plan change or are on
Active Care 1HD and Active Care 2
Slide 5
TRS Active Care Plan Changes TRS Active Care Plan 1 Plan no
longer offered in 2013-2014 Employees currently on this plan will
automatically switch during open enrollment to Active Care 1HD
unless election is made for another plan
Slide 6
TRS Active Care Plan Changes (cont.) TRS Active Care Plan 1HD
Family deductible from $2,400 to $4,800 Individual Out-of-Pocket
Max from $3,000 to $3,850 Family Out-of-Pocket Max from $5,000 to
$4,200 Can utilize an HSA plan through your bank if you choose this
plan (contact your benefits specialist for more information on HSA)
(Out-of-pocket max exclude deductibles)
Slide 7
TRS Active Care Plan Changes (cont.) TRS Active Care Plan 2
Individual deductible from $750 to $1,000 Family deductible from
$2,250 to $3,000 Individual Out-of-Pocket Max from $2,000 to $4,000
Family Out-of-Pocket Max from $6,000 to $8,000 Increase all
prescription co-pays by $5 (Out-of-pocket max exclude deductibles
and copays) TRS Active Care Plan 3 No plan design changes
Slide 8
TRS Active Care Plan Rates 2013-2014 Active Care 1 No Longer
Available Active Care 1 HD EE Only$100 EE + Spouse$569 EE +
Child(ren)$347 EE + Family$835 *Amounts reflected are after $225
contributed by state/district. Active Care 2 EE Only$304 EE +
Spouse$978 EE + Child(ren)$616 EE + Family$1,098 Active Care 3 EE
Only$571 EE + Spouse$1,585 EE + Child(ren)$1,044 EE +
Family$1,765
Slide 9
Medical Gap Plan New Plan Offering for 2013-2014 through
Specialty Insurance Service Bridges the gap between Active Care 1HD
and Active Care 2 benefits by: Paying $1,500 per year for each
covered person for hospital confinement Paying $4,500 ($1,500 per
occurrence) max per year for 3 occurrences of outpatient services
includes ER visit, MRI, x-ray, lab, outpatient surgery (excludes
doctor office visit cost) Guaranteed issue No pre-existing
condition if not subject to pre-existing condition on medical plan
Also bridges the gap between Active Care 2 and Active Care 3
benefits Employee Only Employee Spouse >40 $25.98 $47.76 40-49
$34.21 $62.85 50+ $71.85 $132.02 Employee Children Employee Family
$62.45 $83.64 $67.22 $95.11 $123.81 $182.41
Slide 10
Medical Gap Example 1 A Hospital Stay + Surgery = $18,000 Total
Expenses (Employee Only at age 43) Active Care 1HD w/out Med Gap
Active Care 1HD with Med Gap Annual Premium$1,200$1,610.52
Deductible$2,400 Co-Insurance$3,120 Co-Payn/a Total
Out-of-Pocket$6,720$7,130.52 Med Gap Benefit$ -- $1,500 Total
Cost$6,720$5,630.52 You save$1,089.48 You also save $2,037.48 per
year in premiums by electing Active Care 1HD with medical gap
rather than upgrading to Active Care 2.
Slide 11
Medical Gap Example 2 Outpatient Benefit of $1,500 per
occurrence up to 3 occurrences for Employee and Family coverage
with Employee at age 43 Active Care 1HD w/out Med Gap Active Care
1HD with Med Gap Deductible to meet$4,800 Annual
Premium$10,020$11,161.32 Occurrence 1 you pay$1,000$ - Occurrence 2
you pay$2,000$500 Occurrence 3 you pay$1,500$ - Total
Out-of-Pocket$14,520$11,661.32 You save$2,858.68 You also save
$2,014.68 per year in premiums by electing Active Care 1HD with
medical gap rather than upgrading to Active Care 2.
Slide 12
PPO Dental Plan High Option New Carrier 2013-14- Lincoln
Benefit- High Option Lincoln will take over all currently insured
dental plan members 100% for preventative care / 80% for basic
services / 50% for major services with $1000 maximum annual benefit
Benefits for oral surgery, surgical extractions, and anesthesia
will move from Basic type 2 services covered at 80%, to major type
3 services covered at 50% Claims paid at 90 th percentile of usual
& customary fees rather than a MAC schedule Coverage for
dependent children up to age 26 Orthodontia included for children
and adults Premium will increase by 2% and are guaranteed for 2
years Employee Only$35.34 per month Employee & Spouse$76.44 per
month Employee & Child$70.28 per month Employee &
Family$123.28 per month
Slide 13
PPO Dental Plan Low Option New Carrier 2013-14- Lincoln
Benefit- Low Option Provides a lower more basic level of coverage.
100% for preventative services / 70% for basic services / 40% for
major services with $750 maximum annual benefit Benefits for oral
surgery, surgical extractions, and anesthesia will be covered as
major services at 40% Claims paid at 90 th percentile of usual
& customary fees Coverage for dependent children up to age 26
No Orthodontia coverage Premium are guaranteed for 2 years Employee
Only$25.18 per month Employee & Spouse$54.02 per month Employee
& Child$48.50per month Employee & Family$85.22 per
month
Slide 14
DHMO Dental Plan New DHMO Carrier- 2013-14- Lincoln Benefit
Replaces current Safeguard, lower premiums No co-pay on office
visit; many other deeply discounted services No annual maximum
benefits or deductibles Members must choose a provider from the
network to receive benefits Premiums guaranteed for 2 yearsCoverage
for dependent children to age 26 Employee Only$14.69 per month
Employee & Spouse$28.62 per month Employee & Child$30.97
per month Employee & Family$44.76 per month
Slide 15
Vision Plan New Carrier - Block Vision 2013-2014 Exam and
eyewear co-pay of $15 Elective Contact lens allowance of $150; Paid
in full if medically necessary Frame allowance up to $125 retail
value $200 allowance on Lasik Dependent children can be covered up
to age 26 Employee Only$7.40 per month Employee & Spouse$12.58
per month Employee & Child$13.30 per month Employee &
Family$19.98 per month
Slide 16
Standard Insurance Disability Same Carrier for 2013-2014
Premiums will remain the same for 2013 Open enrollment, guaranteed
issue opportunity in 2013 Protects against a loss of income due to
sickness or accident 1 st Day hospital confinement benefit- Waives
elimination period on 0/7, 14/14, 30/30 elimination period plans.
Insure up to 66.67% of annual salary- $8000 maximum monthly
benefit. Elimination PeriodRate Per $1000 0/7$37.80 14/14$33.30
30/30$28.20 60/60$18.30 90/90$15.80
Slide 17
Basic & Voluntary Group Term Life Plan New Carrier -
Lincoln Benefit- Group Term Life Plan- 2013-14 $15,000 Life
Insurance Coverage for all Employees- Provided at no cost by Wylie
ISD Additional voluntary coverage available at group rates. ex:
$50,000 Coverage Age 25- $4.75 Age 35- $6.25 Age 45- $13.00 Age 55-
$30.00 Age 65- $65.50 Spouse Coverage also available, Child Life up
to age 26 Guaranteed Issue Coverage to $200,000 employee, $50,000
Spouse Annual increases of $20,000 up to the guaranteed issue limit
on voluntary life each year at open enrollment. Any current
coverage over the guaranteed issue amount will continue with new
carrier without having to provide proof of good health. Coverage
good while employed with Wylie ISD.
Slide 18
Fidelity Permanent Life Plan Same Carrier for 2013-2014
Permanent, Guaranteed Issue, Life Time Protection, Term Life
Insurance Policy. Plus- Long Term Care Rider equal to 4% of death
benefit, payable for 75 months. Ex: $25,000 death benefit or $1000
monthly LTC benefit payable for 75 Months. 75 month LTC benefit is
new for 2013, current policies include a 25 month LTC benefit
Portable upon termination of employment- Premium remains the same
Insure yourself, spouse, and children Guaranteed issue for all
employees up to $100,000. Rates Based on age at issue, guaranteed
for life ex: $25,000 Non-Smoker Benefit, monthly premium: Age 35-
$15.77 Age 45- $26.27 Age 55- $47.50
Slide 19
Cancer Plan New Carrier - Colonial Cancer Plan- 2013-14 Single
plan option including Cancer coverage, ICU rider, Specified Disease
Coverage, and 1 st Occurrence Benefit Hospital Confinement Benefit
Radiation/Chemo Surgery Schedule Benefit Initial Diagnosis
Screening Rebate $300 per day $300 per day with $10,000 per year Up
to $4,500 max $5,000 $100 Open Enrollment, Guarantee issue
coverage. Take over of current insured participants Dependent
children can be covered up to age 26 Credit for time insured for
those with the current cancer plan, no pre-existing limitations on
take over if you have been covered previously for 12 months
Employee Only$29.85 per month Employee & Family$49.55 per
month
Slide 20
Flexible Spending Accounts Maximum allowable election amount
per year is now $2,500 per participant for the medical FSA Maximum
allowable election for dependent care FSA remains $5,000 per family
New administrator will be TASC get a debit card, improved
technology with smart phone app that allows you to take a picture
of your receipt and file the claim immediately for
reimbursement.
Slide 21
New Administrator as of 9/1/13 Omni No more fees Easy
accessibility to accounts Seamless change for 403(b) Minimal change
for 457(b) More information to come on change to new carrier 403(b)
and 457(b)
Slide 22
In-Roll for Online Enrollment Log-In Instructions for In Roll
Site Access- To access your employer on-line enrollment site,
InRoll, you can click on the Employee benefit Website provided by
your employer or simply log in to www.in-roll.com. Once at this
location you will see a screen like the one shown
below.www.in-roll.com User Name- Every employee will have a system
assigned user name to enable them to access the InRoll sight. Your
user name will be the first initial of the legal name on record
with your employer, followed by your entire last name, followed by
the last 4 digits of your SS#. Ex: employee name- Robert Smith, SS#
123-45-6789User Name will be: rsmith6789 Default Password- Your
default password for the initial log in will be wisd
Slide 23
In-Roll for Online Enrollment Welcome Page- Please read the
information and instructions included on the Welcome Page. This
page includes important information about your new benefits and how
to enroll in the coverage. Once you have read the Welcome Page,
click on the link at the bottom of the page to continue your
enrollment.
Slide 24
In-Roll for Online Enrollment Verify Information- This page
contains information about yourself. Your name, address, date of
birth etc. will be listed on this page. Please check for accuracy.
This is also the page where you will enter dependent information.
InRoll will not allow you to enroll dependents for coverage if you
do not enter each dependents information. Once you have entered all
required information and confirmed it for accuracy, click the link
at the bottom of the page to submit and continue. Dependent
Enrollment- Many of your benefit offerings will include options to
enroll your spouse and children for coverage. If you do not see an
option to enroll your spouse or child, you have not entered their
information on the Verify Information page in InRoll. You will need
to return to the Verify Information page and enter the information
for each dependent. Do this by clicking on the Add Dependent link
and entering the RED items on the Dependents page. Once entered,
click the Submit Information button at the bottom of the page.
Repeat this process for each dependent. Once all dependents are
entered, return to the enrollment screen you were on by clicking on
the green plan name link on the left side of the page under the
Status Bar.
Slide 25
In-Roll for Online Enrollment Benefit Enrollment- Your employer
provides you with a selection of supplemental benefits that you can
choose from, and pay for, on payroll deduction. Each of these
benefits will be outlined in detail in the InRoll system with Plan
Specific information on each benefit page. Simply follow the
instructions on each page to enroll in or decline coverage. Once
you make your choice, and submit your election, you will move to
the next benefit page. Some benefits will require responses on
multiple pages. This will typically be for verification of your
benefit election, identification of insured dependents, or
completion of any required applications.
Slide 26
In-Roll for Online Enrollment Confirmation Statement- Once you
have completed your enrollment, you will see a Confirmation
Statement. This page shows you the benefit selections made, the
cost of these benefits, and dependents entered into the system.
Click the Print and Save button at the bottom of this page to
create a printable version of this document. Once the printable
version appears, click file/print to print a copy for your records.
Note: If you have a valid email address in the system, you can also
request to have a copy of your Confirmation Statement emailed to
you. If the option to email a statement does not appear, return to
the Verify Information screen and make sure you have a valid email
address entered in InRoll. After this document prints, click the
Exit link at the top of the page to close your enrollment
site.
Slide 27
You Have Resources! You have several resources to assist you in
making good benefit choices: Wylie ISD Benefits Booklet Vendor
websites (you can always register and view claims and eligibility
information for yourself and your dependents) all websites can be
found in the Benefits Booklet or on the Payroll/Benefits website
under http://payroll--
benefits.wylieisd.schoolfusion.ushttp://payroll--
benefits.wylieisd.schoolfusion.us Wylie ISD Benefits Portal
Employee benefits website at www.in-roll.comwww.in-roll.com Janie
Emmert, Benefits Specialist, 972-429-3046 or
[email protected]@wylieisd.net US Employee
Benefits Services Group, 972-636-9944 or
www.usebsg.comwww.usebsg.com