Open Enrollment Employee Benefits Presentation for The King’s Academy Presented by

Open Enrollment Employee Benefits Presentation

for

The King’s AcademyPresented by

BenefitEdge Insurance Services, Inc.

(888) 995-EDGE (3343)(408) 995-EDGE (3343)www.benefitedge.net

Lic#0F37564

http://www.benefitedge.net/

Who is BenefitEdge Insurance?

We are the Employee Benefits Broker for your Medical, Dental, Vision, & Life Insurance Plans

We will work in support of your HR team in resolving any benefit related issues throughout the year

Servicing Reminder for 2010Website Address:

www.tkabenefits.comEmail:

[email protected]

http://www.tkabenefits.com/

mailto:[email protected]

2010 Benefit Enhancements Keeping the same medical, dental carriers and plans Contributions are only going up slightly HSA funding will remain Voluntary vision insurance plan

Medical Insurance

This is open enrollment and your opportunity to make changes to your plans

Any requested changes after open enrollment will require a “qualifying event”.

Any changes will take effect on October 1, 2010.

Medical Insurance

There are currently medical insurance plan options provided through two different insurance carriers – Kaiser Permanente & Blue Shield of California

Medical Insurance - HMO Kaiser plan, you have to use their facilities

Blue Shield - You must use a primary care physician (PCP) for each of your family members

Your PCP will provide all of your routine care and with a few exceptions, must provide a referral in order for you to receive care from a specialist

HMO OPTIONS Kaiser HMO Blue Shield HMO

Group Numbers 602375 H30932Plan $20 Plan $20 PlanDeductible None None Physician's Office CareOffice Visit Copay $20 $20 Routine Physicals $20 $20 Well Baby Care $5 (0-23mos.) $20 Labs and X-rays No Charge No ChargeChiropractic $15 Copay - 30 visits $10 Copay - 30 visits Prescription DrugsGeneric $10 $10 Brand Name $30 $25 Hospital CareIn-Patient Hospital $500 / admit $250 / admit + 25%Out-Patient Services $20 / procedure $125 / surgery + 25%Hospital Emergency $100 / visit $100 / visit Maximum Out-of-PocketIndividual $1,500 $3,000 Family $3,000 $9,000 Max. Lifetime Benefit Unlimited No Maximum

Blue Shield – With the PPO plan you can see any doctor of your choice and will save money using a contracted provider

You have access to a larger network of doctors and also allows you to use non-contract physicians at a reduced coverage level

You do not need a referral to use a specialist. You may “self direct” your care as needed

Medical Insurance - PPO

PPO OPTIONS Blue Shield Spectrum PPO 500-90/70Group Numbers 920782Plan Contracted Providers Non-Contract ProvidersDeductible $500 Single, $1,000 2 Person, $1,500 Family Physician's Office CareOffice Visit Copay $15 (Deductible Waived) 30%Routine Physicals $15 (Deductible Waived) Not CoveredWell Baby Care $15 (Deductible Waived) Not CoveredLabs and X-rays $15 30%Chiropractic $25 Copay - 12 visits 30% Prescription DrugsGeneric $10 Brand Name $25 Hospital CareIn-Patient Hospital 10% 30%Out-Patient Services 10% 30%Hospital Emergency 10% 30% Maximum Out-of-PocketIndividual $2,000 $5,000 Family $4,000 x 2, $6,000 Fam $10,000 x 2, $15,000 FamMax. Lifetime Benefit $6,000,000

Health Savings Account (H.S.A.)

What is an H.S.A?

Health Savings Accounts are tax-exempt accounts where funds grow to pay for medical expenses. They were created to help give control back to consumers and lower healthcare costs.

2 Parts

1. A High Deductible, IRS Approved Health Plan

2. A Health Savings Account (Bank Account)

Intended to cover serious illness or injury once the deductible has been met.

Used to cover all IRS approved medical expenses until the deductible is met.

Health Savings Account (H.S.A.)

Part 1

PPO OPTIONS Kaiser $1,500 H.S.A. Blue Shield Spectrum Savings 1500 H.S.A.Group Numbers 602375 920914

Plan $1,500 DHMO Contracted Providers Non-Contract ProvidersDeductible $1,500 Single, $3,000 Fam $1,500 Single, $3,000 Family (2 or more) Physician's Office CareOffice Visit Copay No Charge after Deductible 20% 40%Routine Physicals No Charge 20% 40%Well Baby Care No Charge No Charge Not CoveredLabs and X-rays No Charge No Charge Not CoveredChiropractic Not Available 20% 40% Prescription DrugsGeneric No Charge after Deductible $10 25% + $10Brand Name No Charge after Deductible $25 25% + $25 Hospital CareIn-Patient Hospital No Charge after Deductible 20% 40%Out-Patient Services No Charge after Deductible 20% 40%Hospital Emergency No Charge after Deductible 20% 20% Maximum Out-of-PocketIndividual $1,500 $4,500

Family $3,000 $9,000 Max. Lifetime Benefit Unlimited $6,000,000

Health Savings Account (H.S.A.)Funds are deposited into your account

Funds deposited and not used remain in your account and they roll over every year

Your HSA funds can be used for any medically necessary expenses per IRS rules.

Part 2

Health Savings Account (H.S.A.)Who is Eligible?

Members covered by an HSA-compatible, IRS approved plan

Who is Not Eligible?

Anyone enrolled in Medicare or 65 or older

Part 2

Acupuncture Chiropractic Blood testsBlood transfusionsContact Lenses Dental, Dental X-rays, DenturesDrugs (prescription) EyeglassesGum treatment

***Also pays for COBRA, long term care and Medicare part B & D premiums.

APPENDIX: SAMPLE OF HSA QUALIFIED EXPENSES (Short List)Source: IRS Code Sec 213(d) Publication 502 (WWW.IRS.GOV)

Hearing aids Hospital billsInsulin Lab testsOpticianOptometristOral surgeryPrenatal carePsychotherapyVaccinesVitamins (if prescribed)X-rays

Part 2

Accessing Funds

Signature Based Debit Visa Card Received 2-3 weeks after account set up

Online AccessRegister for the site with SS#, Debit Card #, Zip CodeTrack deposits, balances, and payments

Part 2

Health Savings Account Limits

Part 2

H.S.A. Deposit Limits Per IRS Code

2010-2011 Plan Year IRS Annual Limit

Single $3,050Family (2 or more) $6,150Catch-UP (55 or older) $1,000

TKA Contribution Annually

Part 2

Health Savings Acct TKA ContributionEmployee

$500Employee + Spouse

$1,000Employee + Child(ren)

$1,000Employee + Child(ren)

$1,000

Part 2

HSA Comparison

Items for Consideration before making a change: Your monthly contributions from your paycheck Amount you typically spend out of pocket on

your medical expenses per year Medical plan deductibles Medical plan out-of-pocket maximums

HSA vs. HMO – Example 1 – Employee Only Coverage

Current Plan HMO 20 HSA Plan 1500

ACurrent Deductible $0 ADeductible $1,500

BOut-of-Pocket Max $1,500 Out-of-Pocket Max $1,500

EE Monthly Cost $55 EE Monthly Cost $10

CAnnual Cost $660 BAnnual Cost $120

Savings from HMO $540

TKA HSA Contribution $0 TKA HSA Contribution $500

C Total $1,040

Annual Scenarios Annual Scenarios

Worst Case (A+B+C) $2,160 Worst Case (A+B-C) $460

Low Utilization $1,310 Low Utilization -$220

HSA vs. HMO – Example 2 – Employee + Spouse Coverage



BOut-of-Pocket Max $3,000 Out-of-Pocket Max $3,000


CAnnual Cost $1,452 BAnnual Cost $240

Savings from HMO $1,212

TKA HSA Contribution $0 TKA HSA Contribution $1,000

C Total $2,212


Worst Case (A+B+C) $1,952 Worst Case (A+B-C) $1,028

Low Utilization $1,452 Low Utilization -$1,622

HSA vs. HMO – Example 3 – Employee Only Coverage



BOut-of-Pocket Max $3,000 BOut-of-Pocket Max $3,000


CAnnual Cost $1,392 CAnnual Cost $300

Savings from HMO $1,092

TKA HSA Contribution $0 TKA HSA Contribution $500

D Total $1,592


Worst Case (A+B+C) $4,392 Worst Case (A+B+C-D) -$92

Low Utilization $2,042 Low Utilization $308

HSA vs. HMO – Example 4 – Employee + Children






Savings from HMO $948


D Total $1,948


Worst Case (A+B+C) $10,368 Worst Case (A+B+C-D) $7,472

Low Utilization $1,368 Low Utilization -$228

HSA vs. PPO – Example 5 – Employee + SpouseCurrent Plan PPO 30 HSA Plan 1500

ACurrent Deductible $1,000 ADeductible $3,000




Savings from PPO $2,292


D Total $3,292




HSA vs. PPO – Example 6 – Employee + Family

Current Plan PPO 30 HSA Plan 1500

ACurrent Deductible $1,500 ADeductible $3,000




Savings from PPO $5,412


D Total $6,412




Dental Insurance – Guardian

Guardian Dental PPO $50 deductible which is waived for preventive care. Calendar year maximum out-of-pocket is $1,500 In

Network and $1,000 Out -of-network. Preventive services are covered at 100% Rollover Benefit – 2011 calendar year

Dental Insurance – Guardian

Preventive Advantage - ReminderMembers can access preventive care without having the

benefit deducted from their annual maximum.The entire annual maximum amount is preserved for other

dental needsExamples of preventive items - Oral exams, cleanings, x-

rays, fluoride treatments

* UCR (Usual, Customary, Reasonable)

Dental PPO Guardian Dental, Group # 441291Benefits Contracted Provider Non-Contract ProviderCalendar Year Max. Benefit $1,500 $1,000 Calendar Year Deductible $50 Per Member, 3 Per Family

Preventive Services: 100% 80% (Subject to UCR)

Exam, X-rays, Cleaning Deductible Waived

General/Basic Services: 80% 70% (Subject to UCR)Fillings, Endodontic, Perio. Major Services: 50% 40% (Subject to UCR)Crowns, Bridges, Dentures Orthodontic Services: 50% 50% (Subject to UCR)Child and Adult Orthodontics Lifetime Max $1,000 Maximum Rollover Threshold $500, In network $350 ($250 Out), limit $1,000

DHMO Option

Dental DHMO Guardian Dental, Group # 441291

Calendar Year Max. Benefit(Unlimited) See The Guardian

Employee Booklet Page 7Calendar Year Deductible $0, Select a Primary Care Dentist

Preventive Care

$0 for Cleanings and Exams$20 for Periodontal Maintenance

$5 for Sealants

Basic Care

$5 for Fillings$235 Periodontal Surgery$80-175 for Root Canals

Major Care

$220-255 Bridges and Dentures$80-155 Inlays, Veneers

$180 Single Crowns

Vision Discount Plan

Vision Discount Plan Incl w/ Guardian or Blue Shield

Included 15% - 20% Discount

NEW Voluntary Vision Insurance – Guardian VSP

Guardian VSP, Group # 458105Benefits Contract Provider Non-Contract ProvdrExams $10.00 Materials $25.00 Lenses Single Vision Covered in Full $47 Bifocal Covered in Full $66 Trifocal Covered in Full $85 Contacts Medically Nec. Contacts Covered in Full $210 Cosmetic $120 Allowance $120 Frames $120 + 20% $47

Benefit FrequencyExam Every 12 Months Lenses Every 24 Months Frames Every 24 Months

Basic Life Insurance Plan

Guardian Life Insurance-Employee Only

$15,000 Flat Basic Life Ins. w/ AD&DPaid by TKA

Group # 441291

Colonial Voluntary Products

These Plans are available on a VOLUNTARY basis

DISABILITY

ACCIDENT

LIFE INSURANCE - TERM & UNIVERSAL

MEDICAL BRIDGE - HMO & HSA

CANCER

CRITICAL ILLNESS

Additional BenefitsOptional FSA Plan Available

Personal Pre-Tax Contributions may be made to your FSA up to $2,000

If the eligible employee elects not to receive the medical insurance benefit, a $500 unreimbursed medical allotment is

available upon request.

Pension Plan In July of 2005, The King's Academy initiated a retirement plan for all full- time employees. This program is being administered through Envoy Financial. During the 2010-2011 school year TKA will contribute 2% of each eligible individual’s base salary or hourly compensation to a 403(b) account in that employee’s name. A matching 2% is also available when the employee contributes 2% or more to this fund. Eligibility for this plan begins after twelve months of employment. Additional voluntary contributions may be made by the employee to their 403(b) account administered by Envoy Financial. Please contact Envoy @ 1-888-879-1376 to initiate this benefit.

Employee Resource Online System

Personal Benefits Portal Access to all of your plan and benefit

information at any time View benefit summaries, carrier

information and websites, & contributions

Employee Resource Online SystemSTEP 1

Click on the link provided in the email from the HR Department

Enter your Username = first initial and last name (no spaces/no hyphens, up to 10 characters)

Enter your Password = last four digits of your social security number or the password you previously setup

Review your personal information on the My Family page. It is important to review all of your personal information

to ensure accuracy

Steps1. Click the Make

Changes link to update your personal info. You can also change your password in this area.

2. Click here to add your spouse.

3. Click here to add your dependents.

STEP 2Enroll in your benefitsIf your enrollments have not been previously set up in the system, you can make your selections by following the instructions below:1. Click a link under the Benefits menu to review a particular category of

benefits.2. In each benefit block, make a selection from your list of Manage Benefit

options and click Go.

STEP 3Change existing benefitsYour current elections will appear in a similar fashion as shown in the picture below. To make a change, select an option from the list in the Manage Benefit section and click Change.

1. Click here to select a Manage Benefits option, then click Go. The system will guide you through the process of making changes to your elections.

STEP 4Finalize your changes, then approve them

You can review your changes during the log out process

Making Your Enrollment Changes

All enrollment changes will be made using the BeneTrac system

Changes must be made between September 6th – 15th

All Employees must log in and confirm their personal information and elections for 2010-2011

Thank you for your time.

Please make sure to make your changes online between September 6th - 15th

We look forward to serving you and helping with any benefit related issues.

Please don’t hesitate to call.

Frequently Asked Questions:How long will it take to receive my cards? It will take 2-3 weeks

What if I need to see a Doctor? If you need to see a Doctor before you receive your member cards, you may have your doctor contact our office to verify coverage. Also, the temporary card will suffice until the permanent one arrives.

What if I need a prescription? Try to refill prescription prior to September 30th if you are changing plans or carriers. If you need a prescription before you receive your member cards, you may need to pay the cost of the prescription and then do one of the following;

1. If you receive your member card with 1-2 weeks of purchasing the prescription, most pharmacies will allow you to present your member card and they will provide you with a refund.

2. If the pharmacy will not refund your cost, you can submit a claim directly to the insurance carrier. We will provide you with the claim form and assist you.

Documents

Open Enrollment Employee Benefits Presentation for The King’s Academy Presented by