1 Treutlen County Board of Education Your 2015 Open Enrollment Benefits Briefing
2 Disclaimer This material is for informational purposes only and is neither an offer of coverage nor medical advice. It contains only a partial, general description of benefits and does not constitute a contract or any part of one. For a complete description of the benefits available to you, including procedures, exclusions and limitations, refer to your specific plan documents All benefits are subject to coordination of benefits unless noted otherwise. In case of a conflict between your plan documents and this presentation, the Plan Documents will govern.
3 Change!! This year s Open Enrollment will be for the period of April 1, 2015 through December 31, 2015 (9 months) Effective January 2016, the benefits plan year will run from January 1 st through December 31 st A new Open Enrollment will be conducted to re-align all benefits to the new plan year
4 Benefits Communication & Education Review your entire benefits program Discuss benefit options Assist you in the selection of all benefits Talk about how to enroll Sign up and activate
5 Treutlen County Board of Education Section 125 Special Offer Free AD&D Insurance Vision Dental Voluntary Benefits Disability Short and Long Term Hospital Income Accident Cancer Critical Illness Life Insurance Term Life and Permanent Life
6 Section 125 Plan - Premium Only Plan Choose qualified insurance coverage and pay the premiums with pre-tax dollars. Dental Insurance and Colonial s Accident, Cancer and Hospital Income plans are eligible Without Premium Only Plan With Premium Only Plan Gross pay $ $ Pretax reduction (major medical ins.) Taxable gross FICA, fed. & state taxes Net pay Payroll Deduction (major medical ins.) Take home pay $ $392.54
7 FREE Accidental Death and Dismemberment Plan is provided by Colonial Life for our valued customers. There is NO COST to you or you employer $5,000 AD&D benefits will remain in force for one year You must meet with our Benefits Counselors to designate a beneficiary This plan must be re-enrolled in order to continue benefits if you elected it last year.
8 What is Voluntary Insurance? Voluntary insurance plans are not designed to replace insurance you already have. Voluntary insurance enhances your existing benefits package. Benefits can be used to help pay expenses that other insurance plans don t cover.
9 Delta Dental Plan Use any dentist you choose out-of-network providers can be used Dependent children covered up to age 19, up to 26 if full-time students or dependent on employee for support Preventive - 100% after no deductible Basic - 80% after $50 deductible Includes root canals and periodontal Major - 50% after $50 deductible Crowns, inlays, bridges, dentures, and complex oral surgery Annual Maximum $750 year one, $1000 year two, $1500 year three and beyond Orthodontia services paid at 50% $50 annual deductible max of 3 per family Lifetime benefits max $1,000
10 Dental Plan Type I services: diagnostic and preventative (exams and cleaning - 2 per year, x-rays, fluoride for children) 100% of reasonable and customary charges paid by insurer. Type II services: basic restorative (restorations-fillings, endodontics, periodontics, root canals, general anesthesia, extractions, oral surgery) 80% of reasonable and customary charges paid by insurer after $50 annual deductible is met. Type III services: major services* (full and partial dentures, bridgework and crowns, inlay and outlay restorations) 50% of reasonable and customary charges paid by insurer after deductible is met.
11 Delta Dental Plan Providers Delta Dental uses providers through the National Preferred Provider Organization Any Dental Provider can be used, but Delta Dental manages three provider networks: Delta Dental PPO fees are based on PPO fee schedule Delta Dental Premier Dentists these network providers are paid up to the Maximum Plan Allowance Non-Delta network These out-of-network providers are paid up to the 90 th percentile of what is considered Usual and Customary (The current plan pays up to the 75 th percentile) There are Delta PPO and Delta Premier providers in the area, but using a non-network provider is permitted.
12 Delta Dental Rates Rates no change for 2015 Coverage Premium Paid Employee $45.31 Employee & One Dependent $85.11 Employee & Family $125.15
13 Colonial Life The Advantage of Colonial Life plans: Most plans pay in addition to other benefits you may have with other insurance companies. Benefits are paid directly to you, unless you specify otherwise. With most plans, you can keep your coverage even if you change jobs or retire. Most plans are guaranteed renewable. Prompt and courteous customer service.
14 Insurance Benefit Short Term Disability Period of Disability STD LTD Return to Work Benefits End Short Term Ends File Long Term Elimination Period Ends File Short Term Start of Disability Enter Elimination Period
15 Colonial Life Short-Term Disability Insurance Helps protect your income and lifestyle if you are unable to work due to a covered accident or covered sickness. Use benefits to help pay for: Mortgage or rent payments. Utility bills and other household expenses Use the money where it s needed most Product underwritten by Colonial Life & Accident Insurance Company. Policies have exclusions and limitations that may affect benefits payable. All plans may not be available in all states and benefits provided may also vary by state.
16 Georgia Educator Short Term Disability The GA Educator Disability Plan has not been available for sale or increase for several years A significant number of Treutlen Co. BOE employees still have these plans in-force, and Colonial will continue to honor them. GA Educator Benefits: Benefits fill the gap between time of disability and long term disability Maximum 40% of salary coverage available, up to $2000 monthly Benefit amount selected at time of enrollment in $100 increments 3, 7, 14, 30, and 60 day elimination periods for sickness Elimination periods waived if admitted Pre-existing condition limitations 12 months from effective date Portable & Guaranteed Renewable to 65 & age 70 if still employed Employees may upgrade disability benefits by enrolling in Disability 1000
17 Georgia Educator Short Term Disability GA Educator Benefits (con t) Accident Only Benefits: Hospital Confinement - $1,200/month ($40 daily) for 3 months Medical fees for accidents - $25 Emergency Treatment - $25 minimum payment, only when other benefits are not payable. Complete Fractures - $120 to $1,500 depending on injury Complete dislocations - $120 to $1,3050 depending on injury Other injuries - $50 to $600 (burns, lacerations, tendon/ligament injuries, ruptured discs, eye injuries, knee cartilage) Sickness Benefits: Hospital Confinement - $1,200 month ($40 daily) More detailed accident or hospitalization benefits are available through Colonial s Accident Care or Medical Bridge 3000 plans.
18 Disability 1000 Short Term Disability Benefits fill the gap between time of disability and long term disability benefit Maximum 66 2/3% of salary coverage available Monthly maximum benefit of $ Choice of elimination periods, waived if admitted 3, 6, 12* or 24 month benefit period 12-month option aligns with the LTD elimination period Pre-existing condition limitations in force for 12 months Simplified underwriting Portable & Renewable to 65 & age 70 if employed We would that each policy holder review their coverage at least every two to three years
19 Insurance Benefit UNUM Long Term Disability 24 hour coverage, worldwide coverage 365 day elimination period for injury or sickness Monthly Gross Disability Benefit = 60% Benefits are integrated with other retirement or disability income Monthly Benefit Maximum = $6,000 Benefit period = to age 65 No premiums while disabled Pre-existing conditions not covered for 24 months Standard underwriting rules are in effect.
20 Insurance Benefit UNUM Long Term Disability When are you considered disabled? When proof is provided that you: are disabled due to sickness or injury require the regular care of a physician How is your benefit determined? Benefits are based upon a percentage of income to be replaced. What if your disability occurs again? If a disability reoccurs within 6 months, it will be treated as a continuation.
21 Medical Bridge 3000 Hospital Confinement Indemnity Insurance Designed to supplement your existing major medical coverage. Lump-sum benefit helps you to pay medical and non-medical expenses associated with a hospital stay, such as: Hospital Confinement you choose $500 or $1000 lump-sum, payable per admission with no annual maximum Out-patient surgery - $500 or $1000 depending on procedure ($1500 annual maximum) Wellness benefit - $50 annually for 18 different tests $150 Emergency Room benefits $250 Diagnostic testing benefit Rehabilitation benefit - $100 daily for 15 days (30 days annual max)
22 Colonial Supplemental Insurance Life Insurance In general, there are two forms of life insurance: Term Life: Term life is simply a death benefit Easy to get and inexpensive No cash build-up, no additional value Protect your family and their future Permanent Life Universal Life, Whole Life Cash value builds as policy ages As a cash building policy, these plans add value to your self-worth Premium never changes Invest in your own, or your families future
23 Colonial Supplemental Insurance Life Insurance If you have Life Insurance in force, regardless of the type of plan or carrier you should regularly do some policy maintenance: Who is your beneficiary, and does it need to be updated. We can update your beneficiary with a single form. But, our agents DO NOT have access to your beneficiary information. Contact the Colonial Home Office ( ) and our support team can help you. Are the covered persons still eligible? Permanent Life (Universal Life, Whole Life) can be maintained on the named insured for their entire life. Polices on children who have grown, can be maintained or if you choose, or can be transferred to them to maintain. Dependent Children coverage on the Voluntary Group Life or Child Life Riders (attachments to UL or WL policies), not named insured coverage, cannot be maintained on children after age 25. These coverage are a flat rate for all eligible children. The remains the same for as many children as listed on the policy. However, after the last child ages out the coverage should be terminated. If this affects you, be sure to ask about correcting this. We also suggest that everyone reviews their life insurance situation regularly. Need change with time, and we can help you make the needed adjustments.
24 Colonial Supplemental Insurance Voluntary Group Term Life Group term Life takes the total population and treats them as a single risk. This lowers the rates and makes this (in most cases) a very affordable plan: Coverage Options: Employee: up to $100,000 maximum in $10,000 increments Spouse: $5,000 increments up to employee amount selected Dependent Children: Up to age 18, 25 for full time students. $1,000 increments, up to $10,000 max for each child. For New Employees Only: Guaranteed issue up to $50,000, $25,000 a spouse and $10,000 for dependent children
25 Group Term Life Special Features Portability: Keep coverage if you retire, reduce hours or leave place of employment. Application is required at the time of conversion. SurvivorSupport: Financial Counseling Service, Objective financial planning and advice to your survivors Accelerated Death Benefit: 60% of your life insurance benefit paid if you are diagnosed terminally ill, with 12 months or less to live Maximum benefit paid $250,000 Remainder paid to beneficiary Waiver of Monthly Premium: Monthly premium is waived in the event you become permanently disabled. Must be disabled for 270 days for eligibility
26 Colonial Supplemental Insurance Universal Life Insurance Universal Life is a permanent life insurance plan, once issued it is yours for the rest of your life (to age 100) Policy is YOURS -- even if you change jobs or retire -- only payment method changes premiums do not change!! Flexibility to increase or decrease face amounts and change premium payments Premiums will not increase because you get older Premiums build cash value Coverage available for employee, spouse or children as named insured
27 Colonial Supplemental Insurance Universal Life Insurance Spouse Coverage Universal Life -- Duplicate the same benefits as offered to you -- even if you don t buy a policy for yourself Spouse Term Coverage in addition to your Life Policy For amounts less than $50,000 spouse signature not required Juvenile Coverage Universal Life -- policy for each child NEW!! Amounts up $100,000 available for Juvenile plans Low rates at younger age, coverage continues even if health problems develop Opportunity to increase coverage at age 18, 21 & 24 with no health questions asked. Maximum face value $100,000 A tremendous value for children under the age of ten premiums for $25,000 typically less than $10 monthly
28 Colonial Supplemental Insurance Universal Life Insurance Optional Coverage Available Accidental Death - Death benefit doubles if death is due to an accident Waiver of Monthly Deduction -- Protects your policy in the event you become totally disabled before the age of 60 Both are recommended on policies of $50,0000 or less Additional Coverage Term Term life riders as part of the basic policy. Term Life riders are available for the named insured or for spouse or children Guaranteed Purchase Option The opportunity to increase the original face value at certain intervals, with NO HEALTH QUESTIONS ASKED Long Term Care Rider Use your Universal Life Plan to fund Long Term Care expenses without diminishing the original face value
29 Accident Care Accident Insurance Helps pay the direct (medical) and indirect (non-medical) expenses that may result from a covered accident. Initial Care - $150 ER benefit, $100 Ambulance benefit, $50 Doctors Office benefit Injury Benefits Broken bones, dislocations, burns, concussions, lacerations, and more Benefits range from $50 (broken toe or finger) to $4,000 (dislocated hip) Hospitalization - $750 on admission, $200 daily for 365 days Other benefits Follow-up doctor visits, physical therapy, wheelchairs, crutches, accidental death Optional benefits include wellness benefit, sickness hospitalization and spouse disability
30 Cancer 1000 Cancer Insurance Helps protect you against the indirect costs and other expenses associated with cancer diagnosis and treatment. Benefits payable for: Annual Wellness: $75 or $100 depending on plan Diagnosis of skin cancer. Hospital confinement - $200 or $300 daily After 30 days, benefit doubles if still hospitalized Radiation/chemotherapy - $200 or $300 daily Monthly maximums' apply depending on delivery method Transportation 50 cents/mile for $1500 mile round trip. Payable for insured and traveling companion Lodging - $75/night for 70 nights
31 Critical Illness Critical Illness Insurance Helps protect your financial security if you experience a specified critical illness or catastrophic illness Heart attack (myocardial infarction), Stroke, Organ Transplant, Kidney failure (end-stage renal failure), Bypass surgery Pays a lump-sum benefit upon diagnosis. Benefit is paid directly to you. Up to $75,000 for employees and $40,000 for spouse Amounts above $10,000 require normal underwriting Spouse and dependent children may be included The benefit is paid to you unless you specify otherwise use the money where it s needed most!
32 What Happens Next? Take advantage of your options. Review your current needs and spend your money where it is needed. Don t be afraid to ask questions. Our benefit counselors have product and rate information and the expertise to help you make an informed decision We will meet with you individually to help you tailor your benefits plan to your needs. A separate Open Enrollment letter has been sent that includes rate information. Colonial Benefit Counselors will be available: February 18 th 19 th Bus Drivers are encouraged to see agents on their routes
33 Change!! This year s Open Enrollment will be for the period of April 1, 2015 through December 31, 2015 (9 months) Effective January 2016, the benefits plan year will run from January 1 st through December 31 st A new Open Enrollment will be conducted to re-align all benefits to the new plan year
34 What Happens Next?? For claims, assistance or questions contact: Hal Doyle, your Colonial Representative at or The Colonial Life Home Office at Claim forms can be downloaded at Your Benefits Counselor will ask you to complete a brief online survey about our performance in order to see how we can improve. Any employee completing the survey will be entered into a drawing for a $100 AmEx gift card. Winners are selected monthly by the Colonial Home Office.
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