Enrollment 2013

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Enrollment 2013

Guide covers:• What’s new this year• How to enroll• Plan descriptions• Cost• Important Contacts

Enrollment Overview

• Enrollment Timeline: • Overview of Plans• Coverage• Cost• Enrollment Instructions

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Enrollment Details for Medical Coverage

• You are strongly encouraged to go online and actively enroll in your medical coverage

• If you do not go online and enroll: – Medical coverage defaults to OAP Deductible Plan (formerly Option

2) – Participants in HRA (formerly Option 3) who do not re-enroll will lose any accumulated HRA dollars

– All other lines of coverage will remain the same, with the exception of the FSA

• Enroll at: www.employease.com

• Refer to pages 2-3 of your Benefit Enrollment Guide for more details

http://www.employease.com/

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Health Care Reform

• Preventive Care

– All three medical options will cover preventive services at 100% - no deductible or copay required when you use in-network providers.

– Refer to page 6 of your benefit enrollment guide for more details.

• Medical Flexible Spending Account (FSA)

– The most you can contribute to the Medical Reimbursement Account is being lowered to $2,500.

– Refer to page 10 of your benefit enrollment guide for more details.

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New Life Insurance Option with a Long-Term Care benefit

• New benefit offered by Fidelity Life

– Permanent Term Life policy with coverage to age 121– Level premiums to age 100– Includes a long-term care benefit– Guarantee issued at this open enrollment with no medical

questions.– Is fully portable; you can take it with you if you leave

• Refer to page 13 of your benefit enrollment guide or the Fidelity Life brochure in your benefit enrollment packet for more details

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More on the New LifeTime Term Insurance option

with long-term care benefit

Current Life insurance coverage

• You have excellent life insurance at work during your working years

• Life insurance benefits provided by an employer often end, are dramatically reduced or the cost increase when you leave employment. This is especially true at retirement age. For many employees this news is delivered too late, when your age or health prevents the purchase of a new policy.

• This can be a problem because according to the Wall Street Journal, 60% of males and 71% of females age 65 will live to age 80.

• Now you have an opportunity to enroll in a term life Insurance plan that doesn't reduce or end.

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LifeTime Term Insurance with a long-term care benefit

• The new LifeTime Benefit Term insurance provides coverage to age 121

• Paid up values starting after 5 years• LifeTime Insurance base policy has a guaranteed level premium • Long Term Care rider included • Guaranteed coverage with no medical questions (this year only)

Employee – up to $50,000– Spouse guaranteed a Term Rider if they don’t qualify – Children term rider for age 15 days – 24 (insured to 26 if

dependent)

• You keep the plan at the same price if you leave employment

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Long Term Care Benefit

• Provides a monthly benefit equal to 4% of the base policy for up to 25 months for medically necessary ADL Assistance Provided By:– Nursing Home– Adult Day Care– Assisted Living Facility – Home Health Care

• EXAMPLE: $50,000 x 4% = $2,000 per month for 25 months• Maximum issue ages apply

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Living Benefits For Long Term Care

• Trigger = Insured Needs Help With 2 of 6 ADL’s (Medically Necessary)

OR

• Cognitive Impairment (Such as Alzheimer’s or other nervous/mental disorder caused by clinically organic disease)

ADL’s

Transferring

Continence

Bathing

Eating

Dressing

Going to theToilet

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What’s new for employees hired after

October 1, 2011?

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Hired after October 1, 2011

• You will be receiving personalized enrollment forms mailed to your home regarding the following benefits: – Accident insurance– Cancer insurance– Critical illness insurance

• You will need to indicate if you would like your premiums deducted pre or post tax by checking “yes” or “no” in the Section 125 box

• If you have questions, please contact BeneSync at 1-888-808-1664 ext. 298

• Refer to pages 12-13 in your benefit enrollment guide for more details

• Provided by Allstate Workplace Division

All new hires during this period must accept or decline coverage

Existing Voluntary Benefits through Allstate

• Cancer insurance – designed to assist with the out of pocket expenses of battling cancer

• Critical Illness Insurance – designed to provide a lump sum benefit when an insured is diagnosed with one of the covered conditions:

• Cancer• Heart Attack, Stroke, Heart Transplant, Bypass Surgery,

Angioplasty, Stent Placement• Major Organ Transplant, Renal Failure, Multiple Sclerosis,

Alzheimer’s Disease, Paralysis

• Accident insurance – Pays a benefit directly to the insured for expenses resulting from an injury resulting from a covered accident

All Newly Eligible Employees will receive an enrollment kit – previously eligible employees can call

1-877-848-925114

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Allstate Product feature review

• Guarantee issue – no medical questions for new hires during this period

• Portable: you keep policies when you leave • Family options available• Cash benefits paid directly to you to assist with out-of-

pocket expenses not covered by medical insurance• Wellness reimbursement/Outpatient Physician’s

Treatment Benefit on Accident, Cancer and CI

Complete all enrollment forms for the Allstate Products and submit to the Risk Management Department by Friday,

October 26th

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What are my benefits?

Compare your Medical options (In-Network)Medical OAP Copay Plan OAP Ded. Plan HRA Plan

EE premiumEE+Spouse premiumEE+Children premiumFamily premium

$505.20/yr. $1,236.00/yr.$1,088.88/yr.$1,706.88/yr.

$577.44/yr. $1,412.64/yr.$1,244.52/yr.$1,950.84/yr.

$0 $0$0$0

County’s HRA contribution $0 $750/per / $1,500/family

Deductible $750/per/1,500/family $500/per/$1,000/family $1,500/per/$3,000/family

Preventive care 100%; no deductible 100%; no deductible

Office Visits $30 (PCP)/$50 SPEC copay

80% after deductible 90% after deductible

Emergency Room $150 per visit copay 80% after ded; add. $250 copay per visit

90% after deductible

Coinsurance Plan pays 80% Plan pays 90%

Out-of-pocket maximum (includes deductible)

$3,750/person $7,500/family

$2,550/person$4,850/family

$5,000/person$10,000/family

Prescription Drugs-Generics (retail, 30-day)-Generics (on-site medical)--Preferred Brand-Non-preferred brand-Out of Pocket Maximum

100% after $5 copay100%

$30 copay$60 copay

$1,250/person; $2,500/family

100% after $5 copay100%

80%; no deductible65%; no deductible

$1,250/person; $2,500/family

70% after deductible100%

60% after deductible50% after deductible

Included in Medical Maximum

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Medical ContributionsBOE - 10 mo. Deduction

OAP Copay OAP Deductible

HRA

Employee $50.52/mo. $57.74/mo. $0.00/mo.Ee+spouse $123.60/mo. $141.27/mo. $0.00/mo.

Ee+children $108.89/mo. $124.45/mo. $0.00/mo.

Family $170.69/mo. $195.08/mo. $0.00/mo.

County - 12 mo. Deduction


HRA

Employee $42.10/mo. $48.12/mo. $0.00/mo.

Ee+spouse $103.00/mo. $117.72/mo. $0.00/mo.

Ee+children $90.74/mo. $103.71/mo. $0.00/mo.

Family $142.24/mo. $162.57/mo. $0.00/mo.

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Which Plan Is Right For You?Employee Only Coverage – 4 Doctors Visits, 12 Rx and 1

ER Visit


HRA

Annual Employer Premium $505 $577 $0Doctor visit $30 copay or Cigna negotiated rate (avg $100)

$120 $400 $400

Rx - $30 copay or Cigna negotiated rate (avg. $80)

$360 $192 $960

Annual Employer HRA Contribution

$0 $0 $750

Total Employee Annual Cost $985 $1,169 $610

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Medical HRA Option

• See pages 6-7 in the Enrollment Guide• No premiums – County pays entire cost• Free preventive care (in-network)• $50 copay to Med Point for non-preventive

care. • County contribution to help you meet

deductible:– $750/person– $1,500/family

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Medical HRA OptionHow it works:1. Enroll in plan; no paycheck deductions2. County establishes your HRA:

– $750/person; $1,500/family3. Use HRA dollars to pay eligible expenses4. HRA funds are available upfront5. Unused HRA fund may rollover each year; however, County

contributions cannot exceed the annual deductible within a given year.

6. If you use all HRA dollars, you pay expenses until you reach deductible

7. Then plan pays 90% for in-network benefits8. If you reach out-of-pocket maximum, plan pays 100%

Compare your Dental options

1 Out-of-network benefits are subject to reimbursable limits. 2 Bitewing x-rays are covered at each preventive visit; panoramic x-rays are covered every five years. 3 Major restorative and orthodontia benefits are payable after enrollee has been in the plan for 12 consecutive months.4 There is a one-year waiting period for orthodontia procedures.

Dental Option 1 Option 2 Employee cost per month (pre-tax)

Single Family

County (based on 12 mos.)

$6.40 $42.67

Board of Ed. (based on 10 mos.)

$7.67$51.20


$17.45 $77.08


$20.95 $92.51

In-network Out-of-network1 See any dentist1

Annual deductible $50/person$150/family

$100/person$300/family $50/person $150/family

Plan pays...

Preventive/diagnostic2 100%; no deductible 80% after deductible 100%; no deductible

Basic restorative 80% after deductible 60% after deductible 80% after deductible

Major restorative3 50% after deductible 40% after deductible 50% after deductible

Orthodontia (dependents up to age 19)3

50% after separate$50 deductible

40% after separate$100 deductible 50% after separate $50 deductible

Annual benefit max $1,000/person $1,000/person

Lifetime orthodontia max4 $1,000/person $1,000/person

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New Dental Option

1 Out-of-network benefits are subject to reimbursable limits. 2 Bitewing x-rays are covered at each preventive visit; panoramic x-rays are covered every five years. 3 Major restorative and orthodontia benefits are payable after enrollee has been in the plan for 12 consecutive months.4 There is a one-year waiting period for orthodontia procedures.

Dental Option 1 Buy-Up

Employee cost per month (pre-tax)

Single Family


$7.74 $46.87


$9.29$56.24

In-network Out-of-network1

Annual deductible $50/person$150/family

$100/person$300/family

Plan pays...

Preventive/diagnostic2 100%; no deductible 80% after deductible

Basic restorative 80% after deductible 60% after deductible

Major restorative3 50% after deductible 40% after deductible

Orthodontia (dependents up to age 19)3



Annual benefit max $1,000/person

Lifetime orthodontia max4 $2,500/person

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Life/AD&D Option

1 You must elect supplemental life for yourself in order to elect it for your spouse/domestic partner; however, your spouse/domestic partner’s total life insurance amount cannot exceed 50% of your supplemental life insurance amount.

2 From 15 days to age 19, age 25 if you receive an income tax exemption for the child.

Employer Paid Life and AD&D

Basic Employee Life and AD&D $35,000

Employee Paid Life and AD&D

Supplemental employee life and AD&D Up to 5 times your annual salary or $500,000 (in $10,000 increments), whichever is less

Dependent Life

Basic spouse/domestic partner life Up to $25,000 (in $5,000 increments)

Supplemental spouse/domestic partner life and AD&D1

Up to $250,000 (in $5,000 increments)

Child life2 $5,000 or $10,000

If you want to increase or drop supplemental life coverage, please call Risk Management. Refer to pages 9 in your benefit enrollment guide for more details

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Flexible Spending Account Option(Must Enroll Annually)

1 If you’re married and file separate tax returns, the maximum you can contribute is $2,500/year. 2 Rules and restrictions apply.

Medical Reimbursement Account Dependent Care Reimbursement Account

You can contribute... Up to $2,500 /year -- tax free Up to $5,000/year – tax free

To reimburse yourself for...

Medical, dental and visionexpenses not covered by

insurance2

Care expenses for your eligible dependents2

As a reminder, effective January 1, 2011Over-the-Counter (OTC) drugs can no longer be reimbursed under the FSA/Medical

Reimbursement Account unless you provide a physician’s prescription.

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Disability Option

1 If you are age 60 or older when your covered disability begins, your benefits duration may differ. See your summary plan description.

Short-term disability Reliance Standard (optional)

Long-term disability Cigna (provided to benefits-eligible employees at no cost)

Benefits begin... After 8 days of disability due to illness On 1st day of disability due to an accident

After 180 days of disability

The plan pays... Up to 60% of your pay Limit: $1,250/week

Up to 66.67% of your monthly earnings Limit: $6,000/month

Benefits generally continue...

Up to 26 weeks Until your disability ends or you reach normal retirement age, whichever

comes first1

For claims call the Rutherford County Risk Management Department Phone: 615-898-7715

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Other benefits

• No changes to the following benefits:– Retirement Plans

• 457(b)• 403(b)

– Employee Assistance Program– Wellness Program

• Wellness Website: www.rutherfordcountytn.gov/rm/wellness.htm

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How do I enroll?

Log onto : https://adp.eease.com/

Logging In

.

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For additional information, please reference the benefit enrollment guide.

https://adp.eease.com/

Open Enrollment Welcome Page

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We recommend “Walk me through this process” to confirm all Benefit plan data

and options

Please read through basic instructions on dates and areas of importance

If adding NEW Dependents select “Yes” and follow the prompts

“Walk me through this process” Option

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PLEASE NOTEDocumentation is required if adding new

dependents. Refer to the Benefit Enrollment Guide for detailed information.

IMPORTANT – you must select

for finalizing your benefit elections

Confirmation – ALMOST FINISHED Screen

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Changes Submitted Successfully

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Printing Confirmation of Benefits Statement

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IMPORTANT:

• Select the Specific Date Option

• Enter 1/1/2013• Then select Go >>

IMPORTANT:

• Select the Specific Date Option• Enter 1/1/2013

• Then select Go >>

• What’s new for 2013?• New plans?• Online enrollment process?

Questions about…

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Review the benefit enrollment guide

Don’t miss the benefits enrollment

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Enrollment 2013

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