Plan year begins September 1, 2011 and ends August 31, 2012

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Open Enrollment DatesApril 18 through May 6 – Supplemental

BenefitsFlexible Savings Accounts (must be elected to continue)DisabilityDentalLife InsurancesDread Disease Insurance (Cancer/Critical Care/Heart/Stroke)Accident InsuranceVision InsuranceMedical Gap InsuranceNo changes can be made to these benefits after May 6,

unless there is a status change and the benefit change is made within 30 days of the status change.

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Open Enrollment DatesHealth InsuranceApril 18 – May 6August 1 – August 31

Long Term CareEnrollment at Will

Retirement Accounts ( 403(b) and 457(b) )Enrollment at Will

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Current BenefitsCurrent benefits remain in effect until

September 1, 2011.

Benefits for terminating employees remain in effect until September 1, 2011 for those employees working 187 days who are finishing their contract year.

Benefit termination dates for retiring employees vary. I will contact you once I have received your retirement status form.

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Benefit ResourcesBenefits Web Site:

http://www.ffbenefits.com/coppellisd/How do I get there?Go to Main CISD Web Page – Employment –

Employee Benefits – Voluntary BenefitsU-Count – Staff Discounts and OffersMain CISD Web Page – Left Side – “U-Count”

TRS - http://www.trs.state.tx.us/

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No ChangesCancer InsuranceHeart Stroke InsuranceCritical Care InsurancePermanent Life InsuranceTerm Life InsuranceLong Term CareFlexible Spending Accounts (Medical

Reimbursement and Dependent Reimbursement must be elected each year. It does not carry over)

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Changes to Supplemental BenefitsHealth Insurance – premium increases along with

deductible and c0-pay increases. (This insurance will continue if you do not take action to change it.)

Disability – We are changing our disability provider. You must enroll in the new disability plan by May 6 if you want disability insurance for the new plan year.

Dental – We are changing our dental provider. You must enroll in the new dental plan by May 6 if you want dental benefits for the new plan year.

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Declination of Health InsuranceYou must decline yourself and/or your dependents for the

new plan year or you cannot enroll either yourself, or your dependents, for any reason, from 9/1/2011 through 8/31/2012.

There are no exceptions to this rule. Proof of prior insurance will no longer be accepted in lieu of the declination.

Decline yourself and any eligible dependents, by name if you are cancelling coverage or do not want coverage for the new plan year.

If you are covering yourself and only some or none of your eligible dependents make sure you decline the eligible dependents you are not covering for the new plan year.

If you are not changing your plan complete a new enrollment form declining all eligible dependents that are not covered.

*Eligible Dependents – spouses, children or step-children under the age of 26, married or unmarried, regardless of college status.

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Health Insurance ChangesExtension of coverage to dependent children until

age 26, whether or not they live with their parents, are claimed as a dependent on a parent’s tax return, or are married.

Pre-existing condition exclusions will not apply to any individual under the age of 19.

Enrollees may make plan changes during the plan year due to special enrollment events.

Individuals who voluntarily drop coverage during the plan year, and decline themselves and/or dependents for that plan year, may now re-enroll during the plan year due to a special enrollment event.

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Health InsuranceHealth Insurance TRS has increased premiums for all plans

Preventative (Wellness) Services are now covered without a co-pay on Plans 2 & 3

Preventative Services no longer have a $500 limit on Plans 1-HD & Plan 1

$5000 co-pay for Bariatric Surgery – All Plans

Enhanced Benefits for Skilled Nursing Care, Home Health Care, Chiropractic Services, and Hospice Care

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Plan 1 Services ComparisonPlan 1 Services Comparison2010 – 2011 Plan Year2010 – 2011 Plan Year 2011 – 2012 Plan Year2011 – 2012 Plan YearDeductible$1200 individual$3000 family

Pays at 80% after Deductible is met. Prescription costs apply to deductible.

$500 Wellness Benefit – cost for preventative services up to $500 limit.

DeductibleNo ChangeNo Change

No Change

Preventative Services Covered with no maximum.

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Plan 1 Premium ComparisonPlan 1 Premium Comparison2010 – 2011 Plan Year2010 – 2011 Plan Year 2011 – 2012 Plan Year2011 – 2012 Plan Year

Employee Only: $0

Employee & Spouse: $380

Employee & Children: $177

Employee & Family: $449

Employee Only: $14

Employee & Spouse: $430

Employee & Children: $208

Employee & Family: $506

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Plan 1 – HD (High Deductible)Premium for New Plan Year

Plan 1 – HD or Plan 1?$0 Employee Only$416 Employee/Spouse$161

Employee/Child(ren)$633 Employee/Family

$2400 deductible for Employee Only, Employee/Spouse/Child(ren)/Family before plan picks up at 80%.

Plan 1 -Employee Only $14 per month with a

$1200 deductible

Plan 1-HD -Employee Only $0 per month with a

$2400 deductible

Plan 1 – HD can be a viable option especially for Employee/Spouse/Child/Family coverage.

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Plan 2 Services ComparisonPlan 2 Services Comparison2010 – 2011 Plan Year2010 – 2011 Plan Year

2011 – 2012 Plan Year2011 – 2012 Plan Year Deductible $500 Individual $1500 Family

Co-pays for Office Visits $30 for Primary $50 for Specialist

Prescription Co-pays ($50 Deductible) $10/$25/$45 Retail Short-term $15/$35/$60 Retail

Maintenance $20/$62.50/$112.50 Mail Order Specialty Drugs Standard Co-pays

Deductible $750 Individual $2250 Family

No Change

Prescription Co-Pays ($100 Deductible) $15/$35/$60 Retail Short-term $20/$45/$75 Retail

Maintenance $45/$105/$180 Mail Order Specialty Drugs $200 C0-pay per fill

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Plan 2 Premium ComparisonPlan 2 Premium Comparison2010 – 2011 Plan Year2010 – 2011 Plan Year 2011 – 2012 Plan Year2011 – 2012 Plan Year$99 Employee Only

$604 Employee & Spouse

$333 Employee & Children

$694 Employee & Family

$123 Employee Only

$676 Employee & Spouse

$379 Employee & Children

$774 Employee & Family

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Plan 1 & 2 One Year Cost ComparisonPlan 1 & 2 One Year Cost ComparisonPlan 1 – Employee OnlyPlan 1 – Employee Only

Plan 2 – Employee OnlyPlan 2 – Employee OnlyPer Month: $14

Per Year: $168

Wellness Checks: No Charge

$1200 Deductible that must be met before plan picks up at 80%. Prescription costs contribute to the deductible.

Per Month: $123

Per Year: $1476

Wellness Checks – No Co-pay. Must pay 20% of services not performed in doctor’s office.

$30 Primary Care $50 Co-pay Specialist Co-pays for Prescriptions $150 Co-pay for ER visits,

out patient surgery, and hospitalization

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Which Plan Is Right for You?Which Plan Is Right for You?Plan 1 and Plan 2 have access to the same

network of BCBSTX providers.

By opting for Plan 1 Employee Only Coverage instead of Plan 2 Employee Only Coverage an employee could potentially save up to $1308 over the course of year.

Plan 1 does not have Office Visit co-pays, Hospital Co-pays, or Emergency Room co-pays. These co-pays continue with Plans 2 & 3 even when all deductibles and out of pocket maximums are met.

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Health Insurance DecisionsHealth Insurance Decisions

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Remember that Davis Vision Discount plan is a part of your health insurance. Use your health insurance card at participating stores to receive the discount. Find providers on the Benefits web site. One vision exam per year is covered through your health insurance.

Look at yearly costs as well as monthly costs when choosing a plan.

Factor in known costs such as prescriptions, physician

visits, upcoming surgical procedures, and expenses associated with pregnancy before making a choice.

Consider Medical Reimbursement and/or Medical Bridge Insurance to help you meet prescription costs, co-pays and deductibles, or hospitalization costs.

Disability Plan ComparisonAmerican Fidelity (Current) Metlife Educator (New)

Can choose up to 70% of gross monthly pay

Must satisfy waiting periods for all plans except for Plan 1.

Accidental Death Benefit

Must choose 60% of gross monthly pay

Waiver of waiting period on 8 and 15 Day plans after 18 hours of hospitalization

No Accidental Death Benefit

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Disability Premium Comparisons – (Based on $3000 Monthly Benefit)Current American Fidelity Plan

New Metlife Educator Plan

1st Day of Hospitalization or 4th Day of Illness/Accident

Premium - $145.8015th Day of Hospitalization

or Accident/IllnessPremium - $106.2030th Day of Hospitalization

or Accident/IllnessPremium - $87

1st Day of hospitalization or 8th day of Illness/Accident

(8 days waived after 18 hours of hospitalization)

Premium - $78.651st Day of Hospitalization or

15th Day of Accident/Illness (15 days waived after 18 hours of

hospitalization)Premium - $76.1630th Day of Hospitalization

or Accident/IllnessPremium - $42.03

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Disability Plan Comparison – Plan 3 (Based on $3000 Monthly Benefit)Current American Fidelity Plan

New Metlife Educator Plan

60th Day of Hospitalization or Accident/Illness

Premium - $51.60

90th Day of Hospitalization or Accident/Illness

Premium - $51.60

60 Days not offered

90th Day of Hospitalization or Accident/Illness

Premium - $16

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Dental Plan ComparisonCurrent Dental Select Plan

New Metlife PDP PlanDental Select Platinum PPO100% of cleanings80% - fillings50% - major services after a

1 year wait.$1000 yearly maximum____$41.78 -Employee Only $79.72 – Employee + 1$116.78 – Employee +

Family

Metlife PDP Plan100% - cleanings80% - fillings50% - major services after a 6

month wait$1000 yearly maximum____$23.92 - Employee Only$50.96 - Employee + Spouse $55.92 - Employee +

Children $82.96 - Employee + Family

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Dental Plan ComparisonCurrent Dental Select Gold Plan

New MetLife Low Dental Plan

Pays via Fee ScheduleCleanings, fillings, and all

major servicesNetwork specialists 20%

discountNo deductible/No yearly

maximum_____________$14.06 – Employee Only$30.06 – Two Party$41.30 – Family Coverage

100% - Type A – Preventative Cleanings, fluoride treatments

80% - Type B – Basic - Fillings, sealants, periodontal maintenance, etc.

Major services such as root canals not covered.

$750 Yearly Maximum $50 individual deductible

applies only to Type B_________________

$16.51 – Employee Only $31.96 – Employee + Spouse $38.39 – Employee + Child(ren) $57.89 – Employee + Family

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Choosing a Dental PlanAlways use contract, network dentists – this

will save you the most.

A dental office that “accepts” your insurance is not always in network. Ask specifically if the dental office is contracted and in-network with your dental plan.

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New InsurancesAccident Insurance

Vision Insurance

Medical Bridge Insurance

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AFA Accident Only Insurance PlanCovers you in the event of an accident.Benefit payment not reduced by Workers

Compensation.Pays along with Workers’ Compensation.Benefit Payments made directly to you.Benefits pay regardless of other coverage.Individual and Family plans.Wellness Benefit of $50 or $75 after 1 year of

coverage.Plan premiums begin at $14.60 for employee

only basic coverage.26

Vision Insurance

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VSP Choice Plan BEye Exam – $10 co-paySingle vision and lined bifocal and trifocal lenses - $25

co-payFrames – covered up to $130Contact lenses (in lieu of glasses) - $130______________________________________________________________________________________________________________$7.60 – Employee Only$15.20 – Employee + Spouse$16.26 – Employee + Child(ren)$25.97 – Employee + Family

Medical Bridge Insurance Can help to defray hospitalization or outpatient surgery

cost Does not cover prescription drugs or doctor visits High Plan Hospital Benefit - $1500 per year Outpatient Surgery - $1000/$2000/$3000 Low Plan Hospital Benefit - $500 per year Outpatient Surgery - $750/$1500/$2500 Both plans offer a $50 Wellness Benefit Both plan premiums are age banded. Premiums begin at

$14.89 per month for the 18 -49 age group and end at $62.94 for the 65+ age group.

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Medical Bridge Decisions If you have a high deductible plan this may be a cost saving

option in the case of a catastrophic event.

ActiveCare 1 Employee Only $14.00 (per month)Medical Bridge $27.10 (per month)

For a total of $41.10 per month you could cover the $1200 deductible in the case of a hospitalization or surgery.

This would be a savings of $81.90 per month over Plan 2 coverage .

Please keep in mind that Medical Bridge Insurance does not cover prescription drugs or doctor visits.

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Conclusion Open Enrollment DatesSupplemental BenefitsApril 18 – May 6 (check web site for times and locations)Health Insurance1. April 18 – May 6 (same locations and times as supplemental

benefits)2. August 1 – August 31 (through Benefits Office)3.Decline yourself and/or any eligible dependent for

health insurance by August 31 so that you can enroll for health insurance if you lose other coverage during the new plan year!

This year you must elect dental and disability insurance if you want coverage for the new plan year.

Every year you must elect Flexible Spending if you want it for the new plan year.

scookey@coppellisd.com 214-496-6028 30

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