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Phyllis Perry DOC Personnel,Benefits Section 919/716-3780. To Save You Money!. How? Money contributed to benefits offered by NCFlex is done through payroll deduction on a pre-tax basis Benefits Include: Health Care Flexible Spending Account (HCFSA)

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Phyllis Perry DOC Personnel,Benefits Section 919/716-3780

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Phyllis perry doc personnel benefits section 919 716 3780

Phyllis Perry

DOC Personnel,Benefits Section

919/716-3780


What is the purpose of ncflex

To Save You Money!

How?

Money contributed to benefits offered by NCFlex is done through payroll deduction on a pre-tax basis

Benefits Include:

Health Care Flexible Spending Account (HCFSA)

Dependent Day Care Flexible Spending Account (DDCFSA)

Vision Care Plan

Voluntary Accidental Death and Dismemberment Insurance (AD&D)

Dental Plan

Supplemental Medical Plan

What is the Purpose of NCFlex?


Who is eligible to participate in ncflex

Permanent, probationary or time limited State employees who work 20 or more hours per week

Existing employees must enroll during annual enrollment October 13 -November 7, 2003

Participation will begin January 1st with deductions taken out of their paycheck at the end of the month

Newly hired employees must enroll within 30 days of employment

Participation will begin the first month after the enrollment form is signed with deductions taken out of their paycheck at the end of the month.

Example:

Employee signs enrollment form on August 1, 2003

Benefits will begin September 1, 2003

Deduction will be taken out of paycheck September 30, 2003

Who is Eligible to Participate in NCFlex?


Ncflex dental offers

NCFlexDental Offers

  • A High Option Plan

  • A Low Option Plan

  • Coordination with the Health Care Flexible Spending Account

  • All Options Offer Coverage for the Participant and their Eligible Dependents


High and low dental plan options

High And LowDental Plan Options

  • Both Options Administered by Pacific Dental Benefits, Inc. and Underwritten by North Carolina Mutual

  • Participants can Select the Dentist of Their Choice

  • Participants or The Dentist can File the Claim

  • Participants will be Issued an I.D. Card


Dental comparisons

Dental Comparisons


Dental provisions

Dental Provisions

  • Subject to Usual and Customary Charges

  • $1,000 Calendar Year Maximum per Person

  • Orthodontia Maximums (High Option only): $750/year and $1,500/Lifetime per Person for Dependent Children under Age 19


Dental waiting periods

Dental Waiting Periods

  • Current Dental Participants

    • Low Option to High Option - 12-month wait for

      major & orthodontia

    • High Option to Low Option - no wait

  • New Hire (enrolls within 30 days)

    • 12-month wait for orthodontia

  • Late Enrollees (employees/dependents)

    • 12-month wait for all services except

      diagnostic/preventive for both options


High option dental

High Option Dental

PremiumPre-Tax Cost*

Employee $31.60 $22.12

EE/SP $62.98 $44.09

EE/CH(ren) $60.46 $42.32

Family $103.64 $72.55

* Based on a 30% Tax Savings in the Premium Cost


Low option dental

Low Option Dental

PremiumPre-Tax Cost*

Employee $17.38 $12.17

EE/SP $34.64 $24.25

EE/CH(ren) $33.26 $23.28

Family $57.00 $39.90

* Based on a 30% Tax Savings in the Premium Cost

17


Superior vision advantages

Provider Network

Ophthalmologists (M.D.s)

Optometrists (O.D.s)

Opticians

Optical Chain Locations

Superior Vision Advantages

Over 1,000 Providers


Superior vision advantages1

Superior Vision Advantages

  • No Claim Forms

  • No Prior Eligibility Requirement

  • No Pre-notification Requirement

  • Receive Personalized I.D. Card

  • Refractive Surgery Discount Benefit

  • Two Year Commitment


Two plan designs offered

Two Plan Designs Offered

  • Plan #1 Provides

    • Comprehensive Eye Examination12 Mos.

    • Lenses (Standard Glass or Plastic) 12 Mos.

    • Eye frame (Up to $100 Retail)24 Mos.

    • Contact Lenses (Up to $100 Retail)12 Mos.

      (Select Eyeglasses or Contact Lenses)

      Pay the Provider Directly for Non-covered Products & Services


P lan 1 provides cont

Plan #1 Provides Cont.

  • Eyeglasses

    • Lenses: Standard Glass or Plastic Lenses, any Rx, Single Vision, Bifocal, Trifocal, Lenticular

      with

    • Frames: Select any Frame from the Providers Inventory up to $100 with No Out-Of-Pocket Cost


Plan 1 provide cont

Plan #1 Provide Cont.

  • Contact Lenses

    • Benefit Allowance is $100 Retail Value

    • Available both In-network & Out-of-network

    • Elective Contacts: Applies to Most Wearers

    • Medically Necessary

    • Fitting Fee can be Included in the Allowance


Plan 1 provides cont

Plan #1 Provides Cont.

  • Available Discounts

    • Included in both Plan #1 & Plan #2

    • 20% to 30% Discount on Additional Pairs of Eyeglasses & Contact Lenses. 10% on Disposable Contact Lenses

    • 20% (of UCR) Off RK, PRK (Laser), LASIK Surgery

    • Must Use In-network Provider


Plan 2 no exam

Plan #2 (No Exam)

  • Eyeglass Lenses12 Mos.

  • Eye frame (Up to $100 Retail)24 Mos.

  • Contact Lenses12 Mos.

    (Up to $100 Retail)

    (Select Eyeglasses or Contact Lenses)

    Pay the Provider Directly for Non-covered Products & Services


Superior vision monthly premiums

Superior Vision Monthly Premiums

Plan 1Plan 2

(With Exam)(No Exam)

Employee$7.98 $5.64

(30% Tax Savings)$5.59 $3.95

Family$20.24$13.98

(30% Tax Savings)$14.17$9.79

42


Out of network benefits

Out-of-Network Benefits

  • Call SVS for Eligibility Check & Authorization Number

  • Receive Services & Pay the

    Non-network Provider

  • Obtain Itemized Receipt/Invoice

  • Mail to SVS Claims Department

  • Include Name, Address, & Authorization Number


Accidental death dismemberment

Accidental Death & Dismemberment

  • Accidental Death is the Leading Cause of Death under Age 39

  • Coverage for Participant & their Family

  • Coverage Levels $50,000 to $500,000

  • Dependent Coverage Equals Percentage of Employee Coverage

  • No Double Covering Family Members

  • Additional Benefits Listed in Booklet


Accidental death dismemberment1

Accidental Death & Dismemberment

  • ASSIST AMERICA Provides:

    • Worldwide Emergency Assistance Services for Travelers

    • Direct Access to prompt Medical Emergency Assistance when traveling More than 100 Miles from Home

    • Hospital Admission Guarantee

    • Emergency Evacuation/Air Ambulance

    • Dispatch of Prescribed Medication

    • Care/Transport of Minor Children

    • Transport of Family Member to Join Patient

    • Legal Referrals

      Participants Receive an I.D. Card


Accidental death dismemberment2

Accidental Death & Dismemberment

Coverage and Monthly Cost

AmountEmployeeFamilyAmountEmployeeFamily

$50,000 $1.36 $2.00 $200,000 $5.40 $8.00

75,000 2.02 3.00 250,000 6.76 10.00

100,000 2.70 4.00 300,000 8.10 12.00

125,000 3.38 5.00 350,000 9.46 14.00

150,000 4.06 6.00 400,000 10.80 16.00

175,000 4.727.00 500,000 13.50 20.00

Tax Savings will Reduce the Costs by 30% or More


Phyllis perry doc personnel benefits section 919 716 3780

Spending Accounts

  • A smart way to

Increase Your Benefits

Increase Your Take Home Pay and

Save Taxes !!!

25% to 42%


Phyllis perry doc personnel benefits section 919 716 3780

Spending Accounts

  • Plan Year

    (January 1, 2004 - December 31, 2004)

  • Must incur expenses during Plan Year

  • Elections must be set during the Plan

    Year, unless you have a

    family/employment status change event.


Health care spending account

Health Care Spending Account

  • $3,600 account maximum

  • Health care expenses can be on You,

    Your spouse & Your dependent children regardless if they are covered by the State Health Plan

  • Eligible expenses -

    • Medical - deductibles, coinsurance, chiropractor

    • Vision - exam, lenses/frames, contacts, LASIK surgery

    • Dental - deductible, coinsurance, orthodontics

    • Prescription Drugs - copays

  • Ineligible expenses -

    • insurance premiums, elective cosmetic procedures, over-the-counter drugs/vitamins/supplements

      Check the web at www.ncflex.org


Tax savings example

Tax Savings Example

State Health Plan Deductible$ 350

Contact lenses, solutions,

enzymes, eye glasses$ 200

Dental$ 330

Prescription drugs copay$ 120

$1,000

30% Tax RateX .3

Tax Savings$ 300


Dependent day care spending account

Dependent DayCare Spending Account

  • $5,000 account maximum for most employees

  • Both Parents must work to be eligible

  • Eligible Expenses

    • Child day care through age 12

    • After/before-school care through age 12

    • Dependent adult care


Claims processing

Claims Processing

  • Claims kit sent to employees home

  • Mail or fax claim to Aon

    • Minimum claim reimbursement: $25

    • Claims processed weekly

    • Payment by check or direct deposit

  • Health Care Account

    • Attach EOB if covered by health/dental plan

    • Reimbursement up to plan election

  • Dependent Day Care Account

    • Attach allowable receipt (need Provider’s Tax ID)

    • Reimbursement limited to Account balance


Supplemental medical plan

Supplemental Medical Plan

  • Helps Bridge the Gap in Your Medical Plan - Not a Replacement

  • Coverage for the employee & dependents


Coverages cont

Coverages Cont.

Benefit Paid Directly to Employee & in Addition to Other Insurance


Supplemental medical plan1

SupplementalMedical Plan


Pre tax premium advantage

Pre-Tax PremiumAdvantage

  • Example:Amy is Age 35 and Single. Monthly

  • Premium is $16.08 or $192.96 for the Year.

  • Annual Physical Exam Benefit(+)$100.00

  • (2) Office Visits (Sickness) Benefit(+)$100.00$200.00

  • $192.96 Premium with

  • 30% Tax Savings(-)$135.07

  • Amy Saves$64.93


Phyllis perry doc personnel benefits section 919 716 3780

Do Not Write in this Area

Payroll Unit Number is 033

Effective Date is the month after signed

Employees Information

Must Be Completed

Make sure applicable boxes are marked

Without Signature and Date Enrollment Form will not be Processed

NO FAXED COPIES


Important deadlines

Important Deadlines!!

  • Original Enrollment Forms to

    Benefits Section:Friday, October

    31, 2003

    • Cannot Accept Fax Copies due to

      Scanning

  • Benefit Elections are Effective

    January 1, 2004


Phyllis perry doc personnel benefits section 919 716 3780

  • NCFlex is a wonderful way to save money and provide valuable benefits to our employees and their families

  • For more information:

    • Review your Brochure

    • Look up NCFlex on the web at www.ncflex.org

    • Call me at 919/716-3780


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