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Clay County District Schools

Clay County District Schools. Annual Enrollment 2014-2015 Plan Year. Annual Enrollment Highlights. Passive enrollment = July 29 – August 22 All current elections roll over into 2014-2015 with no AE change, except FSA. Employees must re-enroll and make new FSA elections

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Clay County District Schools

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  1. Clay County District Schools Annual Enrollment 2014-2015 Plan Year

  2. Annual Enrollment Highlights • Passive enrollment = July 29 – August 22 • All current elections roll over into 2014-2015 with no AE change, except FSA. • Employees must re-enroll and make new FSA elections • PCP required for NEW HMO enrollees • Without PCP designation, one will be assigned • If currently enrolled in the HMO, current PCP will remain on file (PCP entered during AE will not overlay Florida Blue PCP on record) • Supplemental Life Insurance Increase without EOI • Increase existing Employee Supplemental Term Life insurance by $10,000 (one increment) without EOI • New Elections for EE and Spouse Life insurance, and increases in excess of $10,000 will require EOI • Changing from Plan B to Plan A • May enroll in $30,000 in Supplemental Life Insurance without EOI • May enroll in STD and LTD without EOI • Update Beneficiaries for Life Insurance • Verify beneficiary shown or collect new assignment • Spouse Life and Child life beneficiary is the employee 2

  3. Benefits 101 – New Hires • All full-time (0.6 of an allocation) contracted employees are eligible for benefits. • Coverage becomes effective on the first day of the month after you complete 45 calendar days of employment, provided you enroll and submit any required forms to the Insurance Department before your effective date of coverage. • The District provides a comprehensive benefit program, and the cost of benefits are partially paid by the District. • Review your options now and make your elections soon. Deductions for coverage begins two pay periods in advance. • If you delay your enrollment, you could have a double deduction from a single paycheck.

  4. Read your Benefit Guide Your Benefits Guide contains details about each plan. Read it and have it hand when you’re ready to enroll. Note the page numbers for where to find more information in the Benefits Guide.

  5. Benefits Overview Medical Election? NO YES Plan A Plan B 5

  6. Florida Mandate Medical Only for Age 26-30 Dependent Child Eligibility • Unmarried • Not eligible for other coverage • No children • Florida resident or Full Time Student Children by birth, marriage, adoption, or legal guardianship – Pg. 6 6

  7. Is your Spouse a Clay County Schools employee? • You may not elect Spouse Life Insurance because as an employee you may not be covered as an employee and a dependent. • Only one of you may cover your dependent children. 7

  8. Plan A Benefits • Medical Plan – Pg. 19 • Contributions are new and subject to change • Rates printed in the Benefit Guide are subject to Collective Bargaining • If rates change, all employees will be notified and may be given an opportunity to modify coverage • District provides Basic Life Insurance $20,000 – Pg. 45 • Plan A Employee pays 100% of all other benefits • Medical Gap – Pg. 29 • Accident and Injury – Pg. 30 • Dental – Pg. 37 • Vision – Pg. 39 • Short and Long Term Disability – Pg. 49 8

  9. Plan B Benefits • District provides Basic Life Insurance $50,000 – Pg. 45 • District pays 100% for Employee Only coverage in the following plans: • Accident and Injury – Pg. 30 • Dental – Pg. 37 • Vision – Pg. 39 • Short Term Disability – Pg. 49 • Long Term Disability – Pg. 49 • Employee pays Dependent portion: • A&I, Dental, and Vision; not available without EE election • Dependent Spouse and Child Life 100% voluntary 9

  10. Florida Blue Medical Plans • HMO and PPO – Pg. 20 - 23 • Both have $3000 Annual Deductible • Preventive Care covered 100% • All copayments apply to Out of Pocket Maximums • Copayments for most services • Referrals are not required to see a Specialist • HMO • In-Network coverage only • Requires designation of a Primary Care Physician • New lower out of pocket maximum - $6,350/$12,700 • PPO • In- and Out-of-Network national provider access • PCP designation not required 10

  11. Florida Blue Networks/PCP • The two plans have different networks • HMO – BlueCare network • PPO – BlueOptions network (also called Network Blue) • HMO requires all covered members to designate a Primary Care Physician • Employees can log on to www.floridablue.com and search under “Find a Doctor” using the residence zip code. • If PCP is not collected at time of enrollment, then the member will be assigned a PCP by Florida Blue based on their zip code • Only for new enrollees – current PCP assignments will not change • Member will receive a letter notifying them of the PCP that has been assigned with instructions to change • Employees should watch for the letter and contact Florida Blue immediately if they wish to change 11

  12. Medical Gap Insurance • MUST be enrolled in a “Major Medical” Plan • CCDS Medical or Spouse’s group medical plan • Excludes Medicare, TRICARE, and CHAMPUS • Pays based on what appears on the Explanation of Benefits from the Major Medical Plan • Two Plans – Based on Inpatient Benefit – Pg. 29 • KeyGap 3000 • KeyGap 1500 • Outpatient = 50% of Inpatient Benefit • $350 Ambulance coverage for Accident only 12

  13. Dental Plan • Delta Care Prepaid Plan – Pg. 37 • Requires electionof Primary Care Dentist • No out of network coverage • Lower cost per pay period • Delta Dental PPO Plan – Pg. 37 • Broader network of dentists • In and out of network coverage 13

  14. Vision Plan • Vision Care Plan with Humana – Pg. 39 • Coverage for exams, lenses, and frames or contact lenses • In and Out of Network coverage • Includes coverage for Lasik • Members receive an ID card 14

  15. Flexible Spending Accounts • FSA with Health Equity – Pg. 41-43 • Healthcare Flexible Spending • $2,500 Annual Maximum contribution • Debit Card provided to all participants • Most medical claims passed through Florida Blue claims system can be automatically substantiated • Members can view balances, submit claims online, and provide substantiation documentation if necessary at www.myhealthequity.com • Dependent Care Flexible Spending • $5,000 Annual Maximum • Child Care or Elderly care 15

  16. Term Life Insurance Verify / Update Beneficiaries • Basic Life – Pg. 45 • Plan A - $20,000 • Plan B - $50,000 • Supplemental Life – Pg. 46-48 • New Employees may elect up to $100,000 in Employee Life Insurance and Spouse Life Insurance without answering medical questions • Elections over $100,000 require completion of Evidence of Insurability questionnaire • Plan A may elect up to a total of $180,000 • Plan B may elect up to a total of $150,000 • Employee and Spouse rates are age banded based on Employee’s age as of October 1, 2014 • Child flat rate for $5,000 or $10,000 • Children who are married and/or disabled are ineligible 16

  17. Annual Enrollment Opportunity • Supplemental Term Life – Pg. 46-48 • Employees may increase Voluntary Life by $10,000 without submitting Evidence of Insurability (EOI) during Annual Enrollment • New elections and increase more than one increment require EOI • Plan A may elect up to a total of $180,000 • Plan B may elect up to a total of $150,000 • Employee and Spouse rates are age banded based on Employee’s age as of October 1, 2014 • Child flat rate for $5,000 or $10,000 • Children who are married and/or disabled are ineligible • Evidence of Insurability required if electing coverage for the first time or for Employee Life in excess of $10,000 17

  18. Disability • Short Term Disability – Pg. 50-51 • EOI is required for Plan A employees who are not currently enrolled and electing coverage for the first time • EOI is not required if changing from Plan B to Plan A • Long Term Disability – Pg. 52-53 • EOI is required for Plan A employees who are not currently enrolled and electing coverage for the first time • EOI is not required if changing from Plan B to Plan A 18

  19. Voluntary Benefits • Accident and Injury – Pg. 30 • Paid by Employer 100% for Plan B Employee Only • Sickness Rider for all enrollments • Interest Sensitive Whole Life – Pg. 54 • Employee • Spouse • Child • Specified Critical Illness – Pg. 56 • Employee Only • Employee + Spouse 19

  20. Key Dates • First Day of Enrollment = July 29 • Last Day to Enroll = August 22 • First payroll deduction = September 15 • Effective Date of Coverage = October 1 20

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