Santa Fe Public Schools

Benefits Orientation

WELCOME!

• • • • • • • • • • AGENDA Introduction Sick Bank SFPS Benefits website Benefits Eligibility Summary Mandatory contributions Core benefits Costs of Medical, Dental and Vision Required forms Voluntary benefits Reminders

Benefits Staff

• Kay Greenfield – Benefits Specialist Phone: 505-467-2037 Email: [email protected]

• Cheryl Baca – Benefits Specialist Phone: 505-467-2027 Email: [email protected]

Hours: Monday – Friday 8:00 – 5:00

Please call for an appointment.

Sick Bank

• • • • • Provides continued income from additional Sick days when employee has incurred a catastrophic illness, disability or injury Donate 1 to 5 of your Sick Days May apply for a grant of sick days (max. 30 per request) after you have used all other accrued leave For personal use only, does not include family members Open Enrollment each September

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SFPS Benefits website

• www.sfps.info/benefits

Summary

• Who is eligible?

Employees who work at least 20 hours per week (equal to a 0.5 or 0.6 FTE) • • When can I enroll?

Must enroll within 31 days of your start date or at the next annual Open Enrollment (unless you have a Qualifying Event mid-year) What will it cost?

Combination of Mandatory, Core Benefits (based on salary bracket) and any Voluntary Benefits (employee pays 100%) that are selected

SFPS Premium Contributions

• • The District pays a portion of Medical, Dental, Vision and Long-Term Disability premiums as follows: For Salary: Less than $15,000 District Pays: 75% $15,000 - $19,999 $20,000 - $24,999 $25,000 and over 70% 65% 60%

Summary

continued • Who can I cover?

Legal spouse Domestic Partner (requires notarized affidavit) Married/Unmarried children up to age 26 See Program Guide page 10 for additional eligible dependents • or When can I make changes?

During annual Open Enrollment in October – changes go into effect as of January 1.

Within 30 days of incurring a Qualifying Event

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Qualifying Events

Change in legal marital status (marriage, divorce, annulment or death of spouse) or domestic partnership status • • • • • • • • • Birth or adoption of a child or placement of a foster child Commencement of or a return from a leave of absence Marriage of a dependent child New eligibility for coverage under another employer’s plan for yourself, spouse, domestic partner or dependent Involuntary loss of coverage under your own or a spouse’s or domestic partner’s plan Loss of prior coverage under a Medicaid or other State health plan New eligibility for coverage under a Medicaid or other State health plan Becoming eligible for Medicare (you or your spouse) Judgment or court order to provide coverage for a dependent

Qualifying Events

continued • The effective date for changes (except in the case of the birth or adoption of a child) would be the first of the month following the receipt of your Change Form.

Change Form must be received by the benefits department within 30 days of the date of the Qualifying Event.

• You must provide documentation of your Qualifying Event (for example, marriage certificate, birth certificate, notice of loss of prior coverage, etc.) as requested. • Please contact the benefits department if you have questions about changes to your coverage.

Other Changes

• Life Insurance and ERB Retirement Beneficiary changes can be made at any time contact the Benefits Office to complete a new Beneficiary Designation form • Address & Phone Number changes Go to iVisions on the SFPS website www.sfps.info

Mandatory Contributions

All employees contribute to these three items: • Educational Retirement Board (ERB) Based on salary Annual salary $20,000+ : Employee contributes 10.7% and SFPS contributes 13.9% Annual salary less than $20,000 : Employee contributes 7.9% and SFPS contributes 13.9% • New Mexico Retiree Health Care Authority (NMRHCA) All employees contribute 1.0% of gross wages • Worker’s Compensation fee $2.00 once at the end of each quarter/District pays $2.30

Core Benefits

refer to the Program Guide included in your Benefits folder • • • • • • Basic Life Additional (Voluntary) Life Long Term Disability Medical Dental Vision

Core Benefits

continued • Provided through the New Mexico Public Schools Insurance Authority (NMPSIA) • NMPSIA covers 88 out of 89 NM public school districts, member schools are provided with quality employee benefit plans

NMPSIA Customer Service Contact Numbers • • • Inside the front and back covers of the Program Guide Can also access information on the NMPSIA website: www.nmpsia.com

Look up health care providers, forms, links to insurance carriers - print temporary cards, request replacement cards

NMPSIA Requirements and Information

• Two year Vision rule • No NMPSIA Double Coverage Rule • Confirmation of Enrollment and Changes

Basic Life Insurance

Standard Insurance Company program guide page 15 • District provided, no cost to you • $25,000 insurance benefit payment to your beneficiary • Medex Travel Assistance Passport/Document replacement Emergency transport / evacuation Medical / prescription assistance

Additional (Voluntary) Life

Standard Insurance Company program guide pages 16-18 • • Employee pays 100% of cost 1, 2 or 3 times your annual salary in additional life insurance Example: John Doe with a salary of $30,000 can take additional life coverage in the amount of: $30,000 (1x), $60,000 (2x), or $90,000 (3x)

Additional (Voluntary) Life

continued program guide pages 16-18 • Dependent life coverage available: Spouse or Domestic Partner coverage up to one times salary – cost is based on age & amount selected • Children - $5,000 benefit for each child for $0.24 total per month • Calculate monthly cost with NMPSIA calculator at www.nmpsia.com

A Proof of Good Health form is required to be completed if you choose not to enroll within 31 days of your start/benefits eligibility date, but can apply at any time

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Long Term Disability

Standard Insurance Company program guide pages 19-20 What is it?

Partial income replacement when you are unable to perform the duties of your own occupation as a result of physical disease, injury, pregnancy or mental disorder • Pays 66 2/3% of pre-disability earnings Example: $2,500 salary per month X 0.6667 = $1,667 • 30 calendar day waiting period • District contributes a portion of premium Benefit lasts until you: •Return to work •Qualify for Federal or State Disability •Reach the Social Security Normal Retirement Age (limited after reaching SSNRA) • Be sure to read the policy booklet for more specific information, definitions, pre existing limitations, exclusions, etc.

• A Proof of Good Health form is required if you choose not to enroll within 31 days of your start/benefits eligibility date, but can apply at any time

Medical

program guide pages 24-34 • • • • • Two companies included: Blue Cross Blue Shield & Presbyterian High and Low Option plans available with both companies Services covered are exactly the same with both companies Major differences are: Blue Cross provider network (outside NM) is larger Blue Cross premium deductions are slightly higher Prescription plan through Express Scripts on all medical plans – separate card (same prescription benefit on all plans)

Medical Plan Comparison

In-Network Coverage per Individual see Program Guide for Out of Network coverage amounts • program guide pages 30-33 Deductible High Option $300 Low Option $1,500 • Office visit copay $20 pc/ $30spec • Routine services plan pays 100% • Co-insurance 20% • Out of Pocket limit $2,800 $25 pc/ $35spec plan pays 100% 25% $3,500 * Note: deductions are higher for the High Option plan – refer to the rate sheet in your folder

Worst case scenario to meet Out of Pocket Maximum

Example is for an individual on the High Option Medical Plan $300 deductible Plan pays 80% of next $12,500* (Member pays 20% or $2,500) * This amount may be less if co-pays were also paid $2,800 Out of Pocket met ($300 + $2,500) The plan will then pay 100% of all charges for the remainder of the calendar year.

Prescription Drugs program guide pages 35-37 • • • • • • • Max days per copay Generic Drugs Preferred brand name drugs Local pharmacy* 30 days $3 co-pay $18-$50 co-pay Mail Order 90 days $7.50 co-pay $45 co-pay Nonpreferred Specialty Immunizations 70% co-pay $50 co-pay** Contact Member Services 70% co-pay See Program guide Not covered Diabetes meds & supplies Contact Member Services Contact Member Services * - see amounts for Walgreens on Program Guide page 36 ** - after $500 in Specialty drug co-pays, co-pay amounts are reduced for remainder of calendar year

Prescription Drugs

continued • www.express-scripts.com

• Price medications • Locate a pharmacy • Check order status of mail order prescriptions • Check prescription history and claims

• • • Deductible

Dental - Plan Comparison

United Concordia - *Advantage Plus network* program guide pages 40-43 In-Network Coverage per Individual High Option Low Option $50 $50 • • • Calendar Max. paid by plan (per person) Preventive Services (cleanings, xrays) $1,250 100% $1,250 100% Basic Services (extractions, fillings) 80% 80% Major Services (crowns, partials) 50% Not covered Orthondontia (adults & children) 50%* *Lifetime max. $1,500 Not covered

Davis Vision • • • • Eye Exam (every 12 months) Eyeglass frames (every 24 months) Eyeglass lenses (every 12 months) Contact lenses (in lieu of eyeglasses)

Vision

program guide pages 44-45 In-Network $10 co-pay $15 co-pay* $15 co-pay** 100% or $110 allowance Out-of-Network see program guide * - for frames selected from Davis Vision collection, $40 allowance for non-collection frames ** - for standard lenses, see program guide page 45 for lens option costs

Vision

continued • NMPSIA requires you to be enrolled at least 2 years • www.davisvision.com

• Find an eyecare provider • View the frame collection – approximately 300 to choose from • Discounts available on Mail Order contact lenses and Laser vision correction

Rate Sheet Medical, Dental, Vision

• Deductions are taken out of every paycheck for the next month’s coverage Example: August’s deductions pay for September’s coverage • • • Find plan on the left side Find your coverage level (Single, 2 party or Family) Then find the amount in the correct salary column

Pre-Tax Deductions

• Your deductions for medical, dental and vision coverage will automatically be taken out on a “pre-tax” basis.

• This means that your taxable income is reduced by the annual amount of the deductions.

• If you are enrolled with a Domestic Partner, IRS regulations do not allow pre-tax deductions for the deduction amount attributable to the Domestic Partner ** The value of the partner’s insurance is added to your income as taxable income to each paycheck.** • If you wish to opt-out and have your deductions taken on an after-tax basis, you will need to complete and sign a form each year.

Forms

• 4 required forms : Sick Leave Bank enrollment form ERB – beneficiary designation NMPSIA Life Insurance– beneficiary designation NMPSIA Enrollment Application for core benefits Please return all forms together at one time.

ERB beneficiary designation

• Be sure to sign in front of a Notary

Life Insurance beneficiary designation

• Be sure your percentages add up to 100% • A Contingent Beneficiary is the person who would receive the payment if your primary beneficiary has died.

• Sign in front of a witness (preferably an ESC employee)

Core Benefit Enrollment Application

• Complete Sections 1-5 • Your coverage start date will be determined by the date your forms are returned • Remember to include the required Social Security Numbers and provide copies of the documentation required for all dependents you are enrolling (copy of marriage certificate or affidavit of domestic partnership and copies birth certificates for all children)

Voluntary Benefits  403b/457b Voluntary Retirement Savings Programs   WageWorks Flexible Spending Accounts – Medical/Dependent Care Accounts, Commuter/Public Transportation Expenses Allstate Cancer Hospitalization Short-term Disability  Legal plan Family plans  Life Insurance Term and Whole Life o Home and Auto insurance discounts ▪ Payroll deducted benefit deduction)

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Individual pay benefit (not a payroll

Voluntary 403b/457b Retirement Plans

• • • These are voluntary retirement plans that permit you to make payroll contributions to a retirement plan, called a 403(b) or 457 (b) Plan under the IRS Tax Code.

The contributions are made on a “pre-tax” basis (also called tax deferred) which means you can save now on the amount of state and federal taxes you owe.

In retirement, when you withdraw money from your account, you pay taxes on the money you withdraw, often at a lower tax percentage.

Voluntary 403b/457b Retirement Plans

For more details and to set up an account contact :

Nila Moore

with Competitive Benefits Administration ** See the contact sheet in your benefit folder for phone number and email address

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WageWorks Flexible Spending Accounts

Medical Reimbursement and Dependent Care Account options • Commuter/Public Transportation expenses • Pre-tax contributions • Set aside a portion of each paycheck for medical or dependent care expenses. This amount is deducted from your paycheck before taxes are calculated, so the taxes you owe decrease • Reimburse yourself for things like doctor’s office co-pays, daycare expenses • Use it, or Lose it!! Make your annual election wisely.

• Contact Competitive Benefits ** See the contact sheet in your benefit folder for phone number and email address

Allstate

• Individual policies available for: Cancer, Hospital expenses, Short-Term Disability and others • Contact Competitive Benefits at 1-866-738-4500

LegalEASE

A wide range of covered legal matters are 100% paid-in-full when you work with a Network Attorney.

Some covered items include: • Consumer Protection Issues • Family Law • Real Estate Matters • Wills and Estate Planning Family members covered See plan brochure for details. •Debt-related matters • Landlord/Tenant Issues • Tax Issues Contact Joe Lopez at 866-738-4500 or [email protected]

questions with

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Globe Life Insurance

Complements the current $25,000 group life insurance provided to employees by Santa Fe Schools.

Whole and Term Life options. Premiums remain level and never increase then stop at age 65, but coverage remains in place.

Policy can continue even if you are no longer working for SFPS.

Family members are eligible for coverage too.

No physical or medical exam is required to qualify – just answer a few “Yes/No” health questions* *Subject to certain limitations.

For more information contact: Competitive Benefits Administration at 866-738-4500

Liberty Mutual

• • • Discounts on Home and Auto Insurance available Coverage features exclusively for educators Deductible waived for damage incurred on school property or while on school business Up to $2,500 coverage for educational materials or school property damaged while in or stolen from your vehicle If interested in a quote contact Ed Kibbee ** See the contact sheet in your benefit folder for phone number and email address

Reminders

• 31 days from start date to enroll • • • • • • NMPSIA website: www.nmpsia.com

Look for your confirmation in the mail Review your pay summary to ensure correct enrollment and confirm deduction amounts 31 days to make changes after a Qualifying Event Remember dependent SSN’s and required documentation (marriage & birth certificates) Voluntary benefit contact list in Benefit folder

Questions?