Transcript Let`s Talk Benefits Summer Enrollment.ppsx

Let’s Talk Benefits
Summer Enrollment
Presented by your Benefits Team:
Vickie Del Bello, Director of Benefits
Dorothy Webster, Benefits Coordinator
Brittany Waters, Benefits Coordinator
Sara Aranda, Benefits Coordinator
PHASE 3
SJC SUMMER ENROLLMENT
JULY 10 – July 24, 2015
SJC
Perks
If you here this sound, it means you
get an extra benefit
DEPENDENTS
DEPENDENT CHILDREN
• Can be covered until
the age of 26 on
health insurance –
regardless of marital
or educational status
• If child is married,
dental insurance,
AD&D and dependent
life insurance is not
available.
Ongoing
DEPENDENT AUDIT
- Employee required to submit documents to
ensure dependents are eligible for coverage.
- Example of Required Documents: Birth
Certificates, Marriage License, Tax Returns
- Will be contacted by Aon Hewitt for
documentation submission.
HealthSelect of Texas Plan
• The state pays full premium for full-time
employee health coverage
• San Jacinto College pays a portion of the premium
not covered by the state for dependents.
• Monthly Premiums (effective 09/01/2015)
Employee only
+ Spouse
+ Children
+ Family
$ 0.00
$165.12 (+$11.18)
$110.56 (+$7.50)
$275.68 (+$18.68)
HealthSelect of Texas Plan
• United HealthCare – Plan Administrator
• Point-of-Service (POS) plan with direct access for
eye exams and OB/GYN.
• A PCP is must be selected to receive In-Network
benefits.
• Referral is required for specialist visits.
• PCP Office Visit: $25 copay
• Specialist Office Visit: $40 copay
HealthSelect of Texas Plan
• Annual out-of-pocket maximums (increase from FY14)
• $6,450 individual, $12,900 for family
• Includes copays, coinsurance and pharmacy deductibles
• Urgent care facility benefits
• $50 copay + 20% coinsurance (In-Network)
• $5,000 Basic Group Life Insurance for employee
• United HealthCare Vision Rider program
• Specialist copay, includes discounts at certain providers for frames,
lenses or contacts.
• UnitedHealth Allies Program
• Smoking cessation, weight loss & disease management programs,
• Fitness club, cosmetic dentistry, fitness apparel & other discounts.
HealthSelect of Texas
Prescription Drug Plan
CAREMARK
Deductible
Tier 1
Generic
Tier 2
Preferred
Tier 3
Brand Specific
Each participant must pay a $50 annual deductible
Non-maintenance drug
bought at a participating
retail pharmacy
$10
up to a 30-day supply
$35
up to a 30-day supply
$60
up to a 30-day supply
Maintenance drug bought
at a participating retail
pharmacy
$20
up to a 30-day supply
$45
up to a 30-day supply
$75
up to a 30-day supply
Maintenance drug bought
through a mail order
pharmacy
$30
up to a 90-day supply
$105
up to a 90-day supply
$180
up to a 90-day supply
• Deductible now based on calendar year instead of fiscal year.
New deductible resets January 1, 2016.
KelseyCare Plan
• New HMO Plan available September 1, 2015
• Available to the following counties:
• Brazoria, Fort Bend, Galveston, Harris and
Montgomery
• More information will be available from ERS in
July.
KelseyCare Plan
• The state pays full premium for full-time
employee health coverage
• San Jacinto College pays a portion of the premium
not covered by the state for dependents.
• Monthly Premiums (effective 09/01/2015)
Employee only
+ Spouse
+ Children
+ Family
$ 0.00
$138.50
$92.74
$231.24
Tobacco User Certification
• Rate is dependent upon how many tobacco users are
covered on health insurance
Coverage
Fee
You, Spouse, or Child ONLY
$30
You + Spouse
$60
You + Spouse + Child
$90
• All employees are required to certify.
• Choose To Quit(CTQ) program available to receive
refund of tobacco fee each year.
Dental Insurance
Administered by Humana Dental
Humana Dental
(HMO)
State of Texas
Dental Choice
Dentist
Must use participating Dentist
Choose any dentist
Deductibles
None
Up to $100 per individual, per
calendar year
Coinsurance
Varying according to service
Specialty Dentistry Dentist will charge you
75% of his/her usual fee; Dental HMO $0
You pay $0 to 60%, depends on
service classification
Maximum Annual
Benefit
Unlimited annual and lifetime benefit
$1,500 maximum calendar year
benefit (excludes orthodontic &
preventative services)
Pays 40% for in-network services
after maximum is met.
Average cost of
cleaning/oral
exams
Varying according to service
Up to two cleaning/oral exams per
calendar year allowed
No cost
Up to two cleaning/oral exams per
calendar year allowed
Average cost for
Orthodontic
Coverage
Orthodontic services performed by a
general dentist listed in the directory with
an "0" treatment code: child - $1,800,
adult - $2,100. Orthodontic services
performed by specialist: See coinsurance
above.
Orthodontic services are only
available to dependents age 19 or
younger. You pay 50% of allowed
amount. You may be required to
pay the difference between the
allowed amount and billed
charges. Maximum lifetime
benefit of $1,500.
Dental Discount
Administered by Careington International
•
•
•
•
Not an insurance plan – No claims to file
No Deductible
No copayments
Save 20% - 60% on most dental work
•
Includes routine oral exams, unlimited cleanings, dentures, roots canals and
crowns
• 20% savings on orthodontics
•
Includes braces and retainers for children and adults
• Save on cosmetic services like veneers and
whitening
Dental Premiums
• State of Texas Dental Choice
Employee only
+ Spouse
+ Children
+ Family
$0.00
$12.14 (+$0.34)
$17.00 (+$0.48)
$29.14 (+$0.84)
• Humana Dental (DHMO) plan
Employee only
+ Spouse
+ Children
+ Family
$ 0.00
$ 4.80 (-$0.20)
$ 6.70 (-$0.30)
$11.50 (-$0.46)
• Dental Discount Plan
Employee only
+ Spouse
+ Children
+ Family
$0.00
$1.14
$1.60
$2.70
After tax deduction
Optional Life Insurance
• SJC pays premium for 2x annual salary
• Evidence of Insurability (EOI) must be completed and approved if elected
during summer enrollment.
• May elect to pay premium for 3x or 4x
• EOI must be completed and approved.
• Rates are age-banded
• Maximum coverage amount of $400,000
• Cost Example:
• 12 month salary: $35,000 Age: 37
• 2x Monthly Premium: $6.00 (SJC Pays)
• 3x Monthly Premium: $3.00 (Employee Pays)
• 4x Monthly Premium: $6.00 (Employee Pays)
Dependent Life Insurance
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•
•
•
$5,000 term life policy with AD&D rider
Unlimited number of dependents
EOI required if elected during Summer Enrollment
Monthly Premium: $1.38
Voluntary AD&D
• Protection for you and your family in the event of
accidental death or certain accidental injuries
• Coverage from $10,000 to $200,000
Employee Only
$0.02/$1,000 of coverage
• Maximum Premium: $4.00/month
Employee + family
$.04/$1,000 of coverage
• Spouse covered at 50%, children at 20%
• Maximum Premium: $8.00/month
Short Term Disability
• Premium $0.30/$100 of monthly salary
• Up to 66% of monthly salary (max
$10,000) or $6,600, whichever is less
• Must exhaust all leave
• 30 day waiting period
• Benefits are paid for up to 5 months
• EOI required if elected during Summer
Enrollment
Long Term Disability
• Premium: $0 (San Jacinto College Pays)
• Up to 60% of monthly salary (maximum $10,000) or
$6,000, whichever is less
• Must exhaust all leave
• 180 day waiting period
• Benefit period depends on age when you become
totally disabled.
• EOI Required if elected during Summer Enrollment
TexFlex
Pre-Tax Spending Account
•
New administrator – ADP
• Set up a new online account
• Website: www.texflex-fsa.com
• Online: September 1, 2015
•
Health Care
•
Copays, prescriptions, coinsurance, eyewear
• Minimum annual contribution: $180
• Maximum annual contribution: $2,544 (+$50 from last year)
• Debit Cards will be mailed to ALL participants – No fee
•
Dependent Care
•
Daycare, summer camps
• Minimum annual contribution: $180
• Maximum annual contribution: $4,996
• No longer a debit card option
•
Annual Administrative Fee: $12 – FY2016: No Fee
• ERS Discount Purchase Program
• Available to employees, retirees, and their
immediate families
• Discounts on many products and services, from
computers to theme park passes.
• No sign-up fee
• Visit today at www.discountprogramERS.com to
start saving!
Beneficiaries
• ERS Designation of Beneficiaries - Visit
www.ers.state.tx.us to update your beneficiaries. For
assistance, please contact ERS directly at 1-877-2754377.
• TRS Designation of Beneficiaries - Complete the TRS
15 form, have it notarized, and submit it to TRS at
1000 Red River Street, Austin, TX 78701-2698.
Vision(formerly Spectera)
Employee only
$9.03
Employee + 1 dependent
$18.06
Employee + Family
$25.21
$10-copay for exam
• Frames or contacts every 12 months
• Discounted laser surgery
•
•
Access legal counsel and advice from qualified
lawyers
Identity theft protection plans available.
&
Supplemental insurance used to cover costs incurred as a
result of certain events.
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•
Will be attending
Vendor Fairs next
week
Accident, disability, wellness, cancer, etc
Costs vary according to salary, age, and elections.
Portable benefits
Can add family members to policies
Mental Health
• Family/parenting
• Issues
• Grief or bereavement
• Eldercare issues
• Marital or relationship
• problems
• Alcohol or drug
problems
• Work or personal stress
• Copping with Change
Financial
• Tax/IRS Questions
• Retirement Planning
• Credit Service
• College Tuition Planning
• Personal budgeting
• Debt Consolidation
Legal
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Free Simple Will
Identity theft protection
Bankruptcy & Credit
Divorce & Family
Matters
Estate Planning
Consumer rights
$0.00 – SJC Pays
For more information please visit
www.uteap.org or call 1.800.346.3549.
Retirement Savings
• All employees can participate in a 403(b) and/or
457 plan.
• Maximum annual contributions based on age are
set by the IRS.
• Current annual maximums:
• Under age 50
• Over age 50
$18,000
$24,000
• 10 Board approved vendors
to choose from
SUMMER BENEFITS ENROLLMENT
JULY 10 – July 24, 2015
SUMMER BENEFITS ENROLLMENT
JULY 10 – July 24, 2015
Legal Disclaimer: All information presented is
subject to change. The Plan Document pertinent
to each benefit supersedes any information
provided.