NACS offers group insurance programs to qualified employees. To be eligible the following guidelines must be met:

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2 Eligibility NACS offers group insurance programs to qualified employees. To be eligible the following guidelines must be met: 1. A full time employee (working or more hours per week), effective 6/4/02. All employees before June 4, 2002 working 30 or more hours per week and participating in the group insurance plan will be grandfathered and still receive those benefits. If you were working 30 hours or more per week and not in the group insurance, you will need to meet the new full time employee eligibility requirements. 2. Bus drivers are only eligible to participate in group life and health/dental/vision insurance. Life Insurance Anthem Life Insurance Company All hourly employees Board approved to work hours or more per week, and certified employees 50% or more are eligible for the NACS Life Insurance Program for an employee contribution of $1.00 per year (payroll deducted on February 19, 2016). Schedule of Coverage: Administrators $100,000 Certified Teachers $ 35,000 Classified Staff $ 20,000 This coverage includes accidental death and dismemberment insurance. Long-term Disability Insurance All hourly employees that are approved to work hours or more per week (with the exception of bus drivers), and certified employees 50% or more are eligible for the Long-term Disability Insurance participation for an employee contribution of $1.00 per year, (payroll deducted on February 19, 2016). To qualify, the employee must be off work for 90 consecutive calendar days. The monthly benefit is 60% of employees wage ($6,000 maximum monthly benefit). The disability injury must be reported immediately. Health Insurance NACS s health insurance is a self-funded program with Anthem as its health insurance carrier. NACS has an insurance investigating committee, which is composed of all employee groups. This committee meets regularly and makes benefit recommendations to the NACS Board. NACS will comply with all COBRA, FMLA and HIPAA requirements. In compliance with the federal Affordable Care Act, employees that averaged working 30 hours per week in the previous year will be eligible for health insurance for that particular year. 1

3 Dental/Vision Insurance Plan Premium NACS employees who desire only dental and vision insurance coverage may select this coverage. NACS will pay a designated amount toward the employee s dental/vision plan coverage. The premium will be deducted from the employee s payroll. This coverage has the same enrollment and cancellation deadline as the health insurance. See attached sheets. NACS will pay a designated amount toward the employee s health insurance premium; the balance will be deducted from the employee s payroll. New Enrollment A new employee must sign up by August 21, 2015 if they want to participate in the NACS Health Insurance Plan. Coverage will begin October 1, 2015 and end September 30, September 1 st coverage is available if the employee agrees to the terms. Qualifying Event Enrollment The NACS Health Insurance Plan is closed. Any eligible employees can only enroll in the NACS Insurance Plan if there is loss of coverage for a HIPAA qualifying event, (Such as death, divorce, legal separation, job termination, etc.) ; or at a designated open enrollment period. Health Insurance Plans There are three plans that NACS will offer, the High Deductible Health Plan/Health Savings Account (HDHP/HSA), Plan A, and Plan A+ (see attached for details). Every year you will have the opportunity to switch the plan you had elected the year before. The election to switch between HDHP/HSA, Plans A and A+ will need to be done by August 21, NACS will offer HDHP/HSA Plan with a choice of an effective date of 10/1/15 or 1/1/16. Payroll Deductions Employee payroll deductions for the selected plan will start with the September 4th payroll and continue for twenty (20) pays (see Premium Schedule for the amount). Cancellation of Coverage Any employee who decides to cancel health insurance coverage must notify Julie Striggle by the 20 th day prior to the month they wish to cancel coverage. 2

4 Changes of Plans or Coverage All status changes, name changes or additions by marriage or birth should be made in the Superintendent s office within 30 days of the event. Changes reported by the 20 th day of the month will be effective the next month. 3

5 Northwest Allen County Schools Health Insurance Benefit Design Plan A Plan A+ HDHP/HSA Network/Non-network Network/Non-network Network/Non-network Lifetime Maximum Unlimited Unlimited Unlimited Deductible Individual $500.00/$1, $200.00/$ $3,000.00/$6, $1,000.00/$2, $400.00/$ $6,000.00/$12, Out of Pocket Individual $3,000.00/$6, $1,000.00/$2, $3,000.00/$12, $6,000.00/$12, $2,000.00/$4, $6,000.00/$24, Preventive Care 100%/60% 100%/60% 100%/70% Coinsurance 80%/60% 80%/60% Primary Care Office Visits $30 copay/60% $20 copay/60% Specialist Office Visit $40 Copay/60% $30 copay/60% Emergency Room $150 copay $150 copay $50 copay $50 copay Once deductible Urgent Care Ambulance 100% of U&C 100% of U&C has been met, plan pays at 100% Mental Health Inpatient Outpatient 80%/60% $30 copay/60% 80%/60% $20 copay/60% Substance Abuse Inpatient Outpatient Prescription Drugs Retail Copay Mail-order 80%/50% $30 copay/50% $10 Generic $25 Brand $50 Non-formulary $20 Generic $50 Brand $100 Non-formulary 80%/50% $20 copay/50% $10 Generic $25 Brand $50 Non-formulary $20 Generic $50 Brand $100 Non-formulary All RX applies towards deductible. Once deductible has been met, plan pays at 100%. 4

6 Health Insurance Premium Schedule Plan Year - October 1, September 30, 2016 Payroll Deduction Schedule - 20 Payroll Deductions Beginning 9/4/15 and Ending 5/27/16 Health & Dental/Vision Insurance Plans HDHP/HSAPlan Employee Per Pay Employee Total , Corporation Total Contribution 5, , , Total Premium 5, , , Plan A Employee Per Pay Employee Total 1, , , Corporation Total Contribution 5, , , Total Premium 7, , , Plan A+ Employee Per Pay Employee Total 2, , , Corporation Total Contribution 5, , , Total Premium 7, , , Dental/Vision Insurance Plan (For Employees Not Participating in the Health Program) Dental/Vision Employee Per Pay Employee Total Corporation Total Contribution , , Total Premium , , Note: Part-time certified employees will receive their percentage of a day towards the Corporation share for the health and/or dental/vision plans 1 Employees: Both spouses are NACS employees and both are in an employment position that qualifies for the health insurance plan. 5

7 Northwest Allen County Schools Coldwater Road, Fort Wayne, Indiana Phone: (260) Fax: 60) To: NACS Employees Eligible for Health Insurance From: NACS Central Office Date: July 14, 2015 Re: Health Insurance Open Enrollment For NACS employees that are eligible for the NACS Health Insurance Plan, there will be an open enrollment period July 20, 2015 to August 21, 2015 for joining the plan, effective October 1, The first premium payroll deduction will occur on the September 4, 2015 payroll. Please find enclosed: Health Insurance Premium Schedule. The total premiums did not change from last year; the schedule gives the share amount for the employees and the school corporation. Health Insurance Benefit Design Summary. The copays were increased and are reflected on this page. Plan Selection Form Under the federal Affordable Care Act, we are requiring a completed and signed Plan Selection Form to be submitted by August 21, 2015 from all eligible employees who currently do not have NACS Health Insurance Plan coverage or employees that are changing plans. Check one of the boxes for the plan you choose or the box indicating your waiver of coverage, then complete the bottom of the form and submit it to the NACS Central Office. This will also be included in your Orientation Packet on August 11 and can be submitted at that time. If you currently are enrolled in the NACS Health Insurance Plan and do not want to make any changes, you do not need to turn in the Plan Selection Form. A requirement of the Affordable Care Act is that NACS must report all individuals covered by the NACS Health Insurance Plan to the IRS. In the near future, NACS will be requesting social security numbers for everyone in your family that is covered by the Plan, in order to complete this IRS mandate. To be eligible under the Affordable Care Act, an employee is required to average 30 hours of work per week over the previous year. Therefore, those that are board approved for 30 hours per week does not necessarily equate to an average of 30 hours worked. This is calculated annually; therefore, each year, one s eligibility may change. Julie Striggle and Bill Mallers will be holding optional informational health insurance meetings, where you can also complete the enrollment process. These meetings are scheduled for: Wednesday, July 29, 2015, 10:00 a.m. at Maple Creek Middle School Thursday, August 6, 2015, 10:00 a.m. at Carroll Middle School Wednesday, August 12, 2015, 3:30 p.m. at Carroll Middle School Thursday, August 13, 2015, 3:30 p.m. at Maple Creek Middle School Monday, August 17, 3:30 p.m. at Maple Creek Middle School Additional information about the NACS Health Insurance Plan can be found on the NACS website, under the Human Resources Department tab.

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