Transcript Frenship ISD 2013

The content of this Power Point is designed
only for communication purposes and is not to
be considered a contract, nor does it
guarantee or imply coverage. Consult your
plan booklet or Administrator for detailed
coverage or pre-existing limitations.
Frenship Independent School District
2014 Benefit Open
Enrollment Plan Overview
Section 125 Cafeteria Plan
There are special rules and requirements to receive the pre-tax benefit
election plan privileges:
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Frenship ISD must set a plan year. The district’s plan
year is January 1 to December 31 of each year.
― Although coverage is voluntary, every employee is required to review
their current elections, make changes if desired and *sign a Section 125
Benefit Election Form.
― Any pre-tax elections will remain in effect unless you have a qualified
change in family status. Changes must be made within 31 days of the
event.
― Any pre-tax elections will remain in effect and cannot be revoked or
changed during the plan year unless you have one of the following:
Marriage, Divorce, Birth/Adoption, Death,
Change in Dependent Eligibility, etc.
Direct Reimbursement Dental Plan
* Plan allows you to visit the dentist of your choice!
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You are covered at 100% of the 1st $100
― You are covered at 80% of the next $250
― You are covered at 50% of the next $1,400
― Annual maximum benefit per covered person is $1,000
― Orthodontia is covered for participants and has a lifetime benefit
of $1,000. Benefits are paid just like they are on dental.
― Exclusions: cosmetic dentistry, implants, TMJ
― Use of the NBS Flex Card is prohibited with dental claims; you
must file a paper claim.
2014 Dental Plan Rates
Employee Only
$26.00
Employee & Spouse
$52.00
Employee & Children
$55.00
Employee & Family
$81.00
Vision Insurance · Superior Vision
* Plan allows in-network and out-of-network benefits.
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Eye Exam Co-Pay $10
Eyewear Co-Pay $20
Contact Lens Fitting Co-pay $25
Frame allowance $125 Retail (in-network)
Lenses allowance Paid In Full (in-network)
Contact Lenses allowance up to $150 (in-network)
Vision examination allowed once every 12 months
Frames allowed once every 12 months
Lenses allowed once every 12 months
Contact Lenses allowed once every 12 months
Contact Lenses fitting fee once every 12 months
NEW 2014 Vision Plan Rates
Employee Only
$7.28
Employee & Spouse
$13.80
Employee & Children
$13.98
Employee & Family
$21.46
Group Cancer Insurance · Loyal American
* Coverage is Guarantee Issue, no health questions asked!
― Very Competitive Rates
― Two options are available on the cancer plan:
High Option and Low Option
― Annual Cancer Screening Benefit: $50 per calendar year
― First Occurrence Benefit: High Option $2,000, Low Option $500
― Daily Radiation/Chemotherapy Benefit: High Option $400,
Low Option $200
― Daily Hospital Confinement Benefit: High Option $200/Day, Low Option
$100/Day
― Optional ICU Benefit: $1,000/Day for the 1st 30 days of ICU Confinement
― Optional Specified Disease Benefit: Available with ICU Benefit
― Transportation and Lodging: $0.50 per mile and up to $75/Day for Lodging
2014 Cancer Rates · Low Plan
Low Option:
Low Option w/ICU & Specified
Disease Riders:
Employee Only
$11.56
Employee Only
$16.70
Single Parent Family
$13.03
Single Parent Family
$21.85
Family
$18.36
Family
$29.65
2014 Cancer Rates · High Plan
High Option:
High Option w/ICU & Specified
Disease Riders:
Employee Only
$19.92
Employee Only
$25.06
Single Parent Family
$22.56
Single Parent Family
$31.38
Family
$31.97
Family
$43.26
Long-Term Disability Insurance · Aetna
* Coverage is Guarantee Issue, no health questions asked!
― Coverage is guaranteed up to $7,500 of monthly benefit
based on your annual income
― New coverage and increased benefits amounts are subject to a
12 month pre-existing condition exclusion
― Benefits can last while you are under a doctor’s care to age 65
due to illness or injury
― You may choose waiting periods in days of:
0/7, 14/14, 30/30, 60/60, 90/90 and 180/180,
based on your individual needs.
― Disability benefits are received tax free
Accident Insurance · American Public Life
* Benefits are paid directly to you!
― Pays regardless of any other medical coverage
― Benefits are paid directly to you
― Protects you 24 hours a day on or off the job
― Issue ages for employee and spouse are
18-64
― Policy is guaranteed renewable up to
age 70
― Benefits are available from 1 to 4 units
― There is no limit on the number of
accidents covered
2014 Accident Rates · 1-2 Units
1 Unit:
Employee Only
$10.80
2 Units:
Employee Only
$17.10
Employee & Spouse
$19.40
Employee & Spouse
$29.80
Employee & Children
$21.20
Employee & Children
$34.90
Employee & Family
$29.80
Employee & Family
$47.60
2014 Accident Rates · 3-4 Units
3 Units:
Employee Only
$21.50
4 Units:
Employee Only
$24.50
Employee & Spouse
$38.90
Employee & Spouse
$44.90
Employee & Children
$45.20
Employee & Children
$52.00
Employee & Family
$62.60
Employee & Family
$72.40
Employer Paid Base Life Insurance
Frenship ISD provides a $20,000 Basic Life and AD&D
policy at “No Cost to the Employee”. Employees
working 30 hours or more per week are eligible.
Group Life Insurance · Aetna
Employees may elect additional coverage in $10,000 increments up
to $500,000 not to exceed 5 times annual salary.
Employees may elect up to 50% of the employee’s amount on their
spouse.
Children may be insured for $10,000 for $1.00 with one rate for all
children.
Any increases in coverage does require an evidence of insurability to be completed.
Employees can elect AD&D coverage on a stand alone basis. AD&D
is available for both employee or for the employee and family.
Universal Life Insurance with Long Term
Care - Trustmark
― Flexible permanent coverage with portable death
protection and long term care rider.
― Frenship ISD is still offering this benefit. If you have
questions please consult with an enroller.
Medical Gap Insurance · American Public Life
― Designed to cover your out-of-pocket expenses such as copayments, deductibles and co-insurance
― In-Hospital Benefit: pays up to the maximum amount chosen
for Covered Charges incurred when a Covered Person is confined in a
Hospital for 18 hours. $1,500 or $2,500 in-patient benefit available
― Outpatient Benefits: pays a $200 benefit for Covered Charges
incurred for treatment in a Hospital Emergency Room, outpatient
facility or a free-standing outpatient surgery center *Same condition
must be separated by 90 days
― Physician Benefit: pays for a physician visit up to $25 per visit, for up
to five visits per family, per calendar year for treatment received
outside of a Hospital as an outpatient. Also includes treatment at
your Physician’s Office, Emergency Room or Clinic
2014 Medical Gap Rates · $1,500
Ages Under 55:
Employee Only
$21.50
Ages 55-59:
Employee Only
$32.00
Ages 60+:
Employee Only
$49.00
Employee & Spouse
$39.50
Employee & Spouse
$59.00
Employee & Spouse
$88.00
Employee &
Children
$36.50
Employee &
Children
$47.00
Employee &
Children
$64.00
Employee & Family
$54.50
Employee & Family
$74.00
Employee & Family
$103.00
2014 Medical Gap Rates · $2,500
Ages Under 55:
Employee Only
$28.00
Ages 55-59:
Employee Only
$44.50
Ages 60+:
Employee Only
$68.50
Employee & Spouse
$51.50
Employee & Spouse
$81.50
Employee & Spouse
$122.50
Employee &
Children
$45.50
Employee &
Children
$62.00
Employee &
Children
$86.00
Employee & Family
$69.00
Employee & Family
$99.00
Employee & Family
$140.00
Flex Plan Admin · National Benefit Services
― Plan Year: January 1, 2014 to December 31, 2014
― Plan Maximum: $2,500 Annually
― Services must be incurred in plan year
― Flex funds are fronted to you at beginning of plan year on a Visa
Benny Card.
― 2 ½ month grace period to incur claims following plan year
― 90 day grace period to file claims following plan year
― Can be used for all IRS Classified Dependents
― “Use it or lose it”
Medical Reimbursement Account · NBS
― Tax Free Account for Out-of-Pocket Medical Expenses
on a Pre-Loaded Visa Card
Examples are:
· Doctor Office Co-Payments
· Prescription Co-Payments
· Dental Expenses
· Vision – Glasses, Contacts, etc.
· Over the Counter Medications with
Doctor’s Prescription ONLY
Dependent Care Reimbursement Account · NBS
― Tax Free Account for eligible
Dependent/Child Care Expenses
― Tax Free Deduction via payroll
vs. deduction on income tax
― Annual Maximum: $5,000 for
married couple filing jointly or
$2,500 if filing single
H S A Account Information
H S A Eligible Participants: Employees that
contribute to an H S A account are restricted to a
limited-purpose Health F S A, for reimbursement
for dental and vision care expenses only.
Thank you for your attendance.
FBS Customer Service (800) 583-6908
Director of Sales Coby James
Account Manager Larry Bowen
Account Executive Debbie Walter
Client Service Representative Kim Graham