Cobb County School District 2015 BENEFITS OPEN ENROLLMENT REVIEW 1
Dec 15, 2015
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Cobb County School District2015 BENEFITS OPEN ENROLLMENT REVIEW
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ShawHankinsService Center- can answer questions on all benefits, including state healthAvailable extended hours 8:30 am – 7:00 pm during open enrollment Oct 27 – Nov 14
877-373-0730Benefit website- shawhankinsbenefits.net/ccsd
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SHBP Changes for 2015-Carrier Options3 carriers to choose from: BCBS of GA, United Healthcare, & Kaiser Permanente.
BCBS of Georgia: 3 levels of HRA- Gold, Silver & Bronze and statewide HMO United Healthcare: High Deductible Health Plan (HDHP) and statewide HMO Kaiser Permanente: Regional HMO available to members who work or live in the 27 metro
Atlanta counties.
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SHBP Changes for 2015- Plan HighlightsHealth Reimbursement Arrangement (HRA)
Copays will no longer apply to medical and pharmacy expenses. All services will be subject to the plan deductible and/or co-insurance.
Health Maintenance Organization (HMO)Members now have the choice of enrolling in statewide or regional HMO plan that offers
co-payments for certain servicesHigh Deductible Health Plan (HDHP)Members now have the option of enrolling in an HDHP. With an HDHP you are also eligible to
start a Health Savings Account (HSA) to set aside pre-tax dollars for medical expenses.Out of Pocket Maximums The medical and pharmacy out of pocket maximums will now be combined Co-payments count toward the out of pocket maximums for the HMO plans
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How the HRA Plans WorksBronze, Silver and Gold options with different levels of coverageAll services are subject to the plan deductible and/or coinsurance, no copays apply for 2015SHBP contributes HRA credits to your HRA account based on the plan option and tier of coverage you choose These credits provide first dollar coverage for medical and pharmacy expenses
HRA credits left at the end of the year will roll over to the next plan year, if you remain enrolled in an HRA option If you enroll in an HMO or HDHP plan, you will forfeit any remaining 2014 credits
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HRA Plan FeaturesPreventive services covered at 100%
After you meet your annual deductible, you pay a percentage of the cost, called co-insurance
You are not required to obtain referrals from a PCP to see a Specialist
The credits in your HRA account are used to help meet your deductible and out of pocket max
The medical and pharmacy out of pocket maximum are combined
Certain drug costs are waived if you participate in one of the DM programs- diabetes, asthma, or coronary artery disease
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How the HDHP WorksLow monthly premiumMust satisfy high deductible ($3,500 individual, $7,000 family) for all medical and pharmacy expenses (except preventive care)If you have more than single coverage, the entire family deductible ($7,000) must be met before benefits are payable for any family memberEligible to establish a Health Savings Account (HSA) to set aside tax-free dollars to pay for eligible health care expenses.
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HDHP Plan FeaturesPreventive services covered at 100%You pay co-insurance (70% in-network, 50% out of network) after you meet the plan deductible for all medical and pharmacy expenses, until you meet the out of pocket maximum ($6,450/$12,900)Medical and pharmacy out of pocket maximums are combinedNo co-pays applyEligible to contribute to Health Savings Account Contributions will not be taken through payroll deductions
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How the Statewide HMO WorksAvailable through BCBS or UHC Rates differ between the 2 carriers
Receive covered services through in-network providers only (except emergency care) Be sure to confirm your providers are participating in the BCBS or UHC network
Co-payments apply to certain services- office visits, urgent care, emergency room and prescriptions
Co-payments count toward your out of pocket maximum, but not deductiblePreventive services covered at 100%
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How the Regional HMO WorksServices only available through Kaiser HMO network
Must select a PCP
Preventive services covered at 100%
Plan available for members that live or work in one of the 27 metro Atlanta counties:Barrow Coweta Gwinnett PauldingBartow Dawson Haralson PickensButts DeKalb Heard PikeCarroll Douglas Henry RockdaleCherokee Fayette Lamar SpaldingClayton Forsyth Meriwether WaltonCobb Fulton Newton
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WellnessHealthways will continue as the Wellness vendor for the BCBS and UHC plan options with well-being resources and incentive programs
All health actions must be completed between January 15, 2015 and December 15, 2015 to earn well-being incentive credits
If you choose one of the HRA plans, the well-being credits will be deposited into your HRA account
If you choose a statewide HMO, well-being credits will be placed into incentive accounts
If you choose the HDHP plan, well being credits will be placed into an incentive account You must pay $1,300 toward your individual deductible or $2,600 toward family deductible
prior to accessing these credits
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Earning Wellness Credits
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Wellness-Kaiser PermanenteResources Available
Total Health Assessment Biometric screenings Online and onsite healthy living classes
Sign up at my.kp.org/shbp and complete at least one health action to be entered in monthly drawing for an iPad and a Fit Bit:
Completed biometric screeningCompleted online Total Health AssessmentGet support to meet goals with KP wellness coachComplete one online health education classGet your annual flu shotReceived a preventive Cancer Screening- Colorectal Cancer, Breast Cancer or Cervical Cancer
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Tobacco CessationTobacco surcharges are included in all SHBP optionsSurcharge applies if you are not tobacco-free or do not complete tobacco cessation coaching programIf you do not make an indication for 2015 on your tobacco usage, you will continue to be assessed the surcharge.
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State Health Open Enrollment Open enrollment is from October 27th – November 14th
myshbpga.adp.comIf you do not login to enroll or make changes, you will be defaulted to your current HRA plan (without copays), coverage tier and tobacco status. If you are not currently covered and do not enroll, you will continue with no coverage.
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State Health Open Enrollment•When making your benefit election make sure you have selected the correct option.
•Verify your coverage tier (you only, you + spouse, you + child(ren) or you + family)
•Confirm you have added all eligible dependents you wish to be included under your coverage.
•Confirm you have answered the tobacco question correctly.
•Review/Confirm your elections and click “Finish”. NOTE: If Finish is NOT clicked, your enrollment process has not been completed.
•Print or save a copy of your confirmation page for your records.
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Ancillary Benefits
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DentalMetLife will be the dental carrier for 2015 Expansive national network, superior serviceAll members will receive a new ID cardContinue to have a Base and Plus plan optionReview benefit details, as base plan copay schedule differs from 2014
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Benefit Summary Plan Option 1- Base Plan (Copay Plan) Plan Option 2 – Plus Plan
Coverage Type In-Network Out-of-Network In-Network Out-of-Network
Type A – Diagnostics & Preventative See Schedule 85% of R&C Fee 100% 100%
Type B – Basic See Schedule 50% of R&C Fee 75% After Plan Deductible 75% of R&C Fee
Type C – Major See Schedule 40% of R&C Fee 50% After Plan Deductible 50% of R&C Fee
Type D – Orthodontia 50% of Maximum Allowed Charge 50% of R&C Fee 40% After Plan
Deductible 40% of R&C Fee
Deductible† In-Network Out-of-Network In-Network Out-of-Network
Individual N/A $50.00 $50.00 $50.00
Family N/A $150.00 $150.00 $150.00
Annual Maximum Benefit: In-Network Out-of-Network In-Network Out-of-Network
Per Person
$750 of Combined In-Network Covered Dental Expenses and Out-of-Network Covered Dental Expenses
$500 of Combined In-Network Covered Dental Expenses and Out-of-Network Covered Dental Expenses
$1,000 $1,000
Orthodontia Lifetime Maximum In-Network Out-of-Network In-Network Out-of-Network
Per Person $750 $500 $1,000 1,000
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VisionAvesis will continue as the vision carrier for 2015Basic and Preferred Plus OptionNo change in plan coverage or rates
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Basic Life with AD&DCCSD provides basic life coverage at no cost to youThis includes a life and accidental death and dismemberment benefitNon-tobacco users receive a $13,000 benefitTobacco users receive a $10,000 benefitLife benefit is portable, AD&D benefit is not portable
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Contributory Basic Life with AD&DAdditional term life and AD&D coverage available to purchase2.5 times your salary$113,000 maximumGuaranteed issue for new hires. Late entrants must complete the Personal Health Application and be approved for coverage
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Supplemental Life with AD&DEligible to elect if you purchase the Contributory Basic Life coverage1 times your annual salary Maximum 6 times your annual salary, to $500,000 $500,000 maximum is no longer combined with other life policies
New hires guaranteed up to 2 times your salary or $100,000 without answering health questionsLate entrants must complete the Personal Health Application for all amounts of coverage
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Supplemental Life- DependentsSpouse or Dependent Children$10,000 or $25,000 in coverage
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Short Term DisabilityNo changes to STD benefit
Choice between 2 salary replacement percentage levels- 50% or 66.67%
Choose your start date for benefits, based on how many days of sick leave you have
All sick leave must be exhausted prior to STD benefits beginning
Late entrants or employees that wish to increase their level of coverage must submit a Personal Health Application and be approved before coverage is effective
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STD Plan Options
Benefits Start Date (from the date of
Disability)
Benefit Percentage
Monthly Premium
1 8th calendar day 66.67% $13.53
2 15th calendar day 66.67% $11.21
3 31st calendar day 66.67% $7.35
4 61st calendar day 66.67% $7.16
5 8th calendar day 50% $9.89
6 15th calendar day 50% $8.19
7 31st calendar day 50% $5.37
8 61st calendar day 50% $5.22
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Long Term DisabilityCost paid fully by CCSD Benefit begins after you are disabled for 6 monthsPays 50% of your gross monthly earnings up to a maximum of $7,500 a month
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Flexible Spending AccountsTwo separate accounts- Medical Spending Account and Dependent Care Spending AccountAllows you to set aside pre-tax dollars to spend on qualified expenses, saving on your taxable incomeMust make new elections for 2015If enrolling in the HDHP medical plan, you are not eligible to contribute to FSA
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Flexible Spending AccountsMedical Spending Account Maximum contribution of $2,500 Some eligible expenses- Deductibles, copayments, dental expense, vision services and
materialsDependent Care Spending Account $5,000 for married couple filing joint income tax returns, $2,500 if unmarried or married and
filing separate income taxes Some eligible expenses- any care of a dependent that allows you and your spouse to work:
day care, after school program, in-home care, camps
New! You may rollover up to $500 left at the end of the 2014 plan year to use in 2015 for your Medical Spending Account
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Cancer CoveragePays a cash benefit directly to you if diagnosed with Cancer or 29 additional specified diseaseCoverage available for you and your familyPays based on the type of services received: inpatient care, surgery, medication3 levels of benefits available- Economy, Standard, DeluxeConvertible to individual policyWaiver of premium after 90 days of disability
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Critical Illness CoveragePays a lump sum benefit to you at the time of diagnosis of a covered illness.Employee benefit: $10,000Spouse and child benefit: $5,000
Children covered at no extra chargeSome covered illnesses: Heart Attack, Stoke, Coronary Artery Bypass, Major
Organ Transplant, End Stage Renal FailureWellness Benefit: Pays you $50 benefit when you have a annual preventive
screening: Ex) colonoscopy, EKG, Stress Test, Mammogram, Skin Cancer Biopsy
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Legal CoverageIn-Office Attorney Services: reviewing and preparing documents, providing legal advice and consultation, representation in court
Telephonic Advice: assistance in reviewing and preparing documents, will preparation, financial education and counseling
Online Resources: Guidebooks and videos, DIY Docs- state specific legal documents, online financial tools
New for 2015! Identify Theft Protect- No additional cost Covers up to $1 million for expenses associated with restoring your identity Lost wallet services- cancel and reissue credit cards, driver’s license, etc Credit monitoring- monitors and informs members of changes to credit report Internet surveillance- monitors websites for your personal information being traded or sold Child monitoring- monitors your minor’s identity
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Questions?