Employee Benefits Overview

Transcription

1 BEREA COLLEGE MAGAZINE Employee Benefits Overview July 1, 2016 through June 30, 2017 Benefits overview intended for summary purposes only. Anna Skaggs, 17 HUMANAVITALITY MEDICAL FSA DENTAL VISION GROUP LIFE & AD&D DISABILITY VOLUNTARY LIFE AFLAC

2 Berea College recognizes the importance of being able to provide our employees and their families with quality benefits as part of their overall compensation package. Therefore, Berea College has developed a comprehensive benefits package that provides quality protection for you and your family, while satisfying the diverse needs of our workforce. This summary highlights the benefit options offered by Berea College for plan year Eligibility If you are a benefits eligible employee working 24 hours a week or more, you are eligible for all benefits outlined in this summary. Eligible employees may elect to cover their spouse, domestic partner and/or dependent child(ren) up to the age limitations specified by each insurance carrier. Medical, Dental and Vision benefits are effective on your date of hire and during the annual open enrollment period or with evidence of a Qualifying Event. All other benefits are effective as noted, and during the annual open enrollment period. The Berea College Employee Medical Benefit Plan does not permit a working spouse/partner with available PPACA compliant employer sponsored coverage to be covered on the Berea College Employee Medical Benefit Plan. For verification purposes, the spouse or partner s employer must complete an Affidavit. See Human Resources for more details. Open Enrollment is the annual period that allows you the opportunity to enroll in, cancel, or make changes to the following benefits: Medical, Dental, Vision, Flexible Spending or Health Savings Accounts and Voluntary Life Insurance. Open Enrollment elections/changes will take effect on July 1 annually, and are locked in until June 30, of the following year, unless you experience a Qualifying Event during the year. 2 Qualifying Events include such events as marriage, birth or adoption of a child, divorce, death and involuntary loss of coverage for you or a spouse or dependent. If one of these events occurs during the year, you must notify Human Resources within 30 days of the event if you wish to make changes to your benefits.

3 HumanaVitality Getting healthy just got more fun! HumanaVitality is a wellness and rewards program for everyone no matter your age or health status. It will put you on the path to healthier living whether you are a fitness buff, just working on losing a few pounds, or training for your first 5K race. It can help you quit smoking, lower your blood pressure and eat healthier. There are also activities that kids can participate in. Here s how HumanaVitality rewards you for making healthy choices: Earn Vitality Points Every time you complete a verified activity or achieve a wellness goal, you earn Vitality Points. Earning Vitality Points helps you work toward a higher Vitality Status. Earn Vitality Bucks Healthy activities not only build Vitality Points, they also earn you an equivalent amount of Vitality Bucks. Reward yourself with the things you want in the HumanaVitality mall by spending your vitality Bucks. Get Rewarded Choose rewards in the HumanaVitality Mall that include gift cards, movie tickets, fitness devices and more. The higher your Vitality Status, the greater your discount is in the Humana- Vitality Mall. Take your Health Assessment at 1 HumanaVitality.com. You ll learn your Vitality Age and automatically move to Bronze Vitality Status. The Path to Earning Vitality Points and Rewards: Create a MyHumana username/password and use it to sign in or register at HumanaVitality.com. Activate your goals. Based on 2 the information you share with Vitality in your Health Assessment, we ll recommend goals that you can activate on-line. Request a Vitality HealthyFood 3 Shopping card. To activate your Shopping card and start earning savings on healthier foods at Walmart, visit Humana.com/vitality/ healthy-food. Get a Vitality check at Berea 4 College (or with your personal physician. Your physician will need to complete a Vitality Check Form which can be found on the Vitality website). With this annual health check-up of your body mass index (BMI), blood pressure, blood glucose and cholesterol, you ll earn 2,000 Vitality Points. Choose your activities. Select 5 your path to achieving your goal. For example, reaching your fitness goals 3-5 times a week, taking an on-line course, joining an on-line conversation or working with a health coach. Watch your vitality points add up. 6 Earn Vitality Points with everything from taking an annual physical and getting a flu shot to watching a health webinar. 7 Cash in your Vitality Bucks. Use them to get the things you want at the on-line HumanaVitality Mall. 3

4 Medical Benefits The Berea College medical plans offer great flexibility for you and your family to manage your healthcare needs. These plans are offered through the Anthem Blue Access National Network and administered through ARC Administrators. Claims and coverage questions should be directed to ARC at Dependents are covered until the end of the calendar year in which the dependent turns age 26. You may visit the ARC website at to access claims payment, provider directories, request ID cards, and review prescription drug alternatives. See chart below for medical summary. Medical Benefits Summary In-Network Benefits Premium Core Plan 1 Plan 2 Calendar Year Annual Medical Deductible Coinsurance (Plan / Member) Medical Maximum Out-of-Pocket (includes deductible, coinsurance and Medical co-pays) Rx Max Out-of-Pocket (includes Rx co-pays) $750 individual $1,500 family See Member Cost Share below. $2,250 individual $4,500 family $4,350 individual $8,700 family $2,000 individual $4,000 family See Member Cost Share below. $4,000 individual $8,000 family $2,600 individual $5,200 family Employer Annual HSA Contributions* N/A N/A Covered Services Member Cost Share Member Cost Share $3,000 individual $6,000 family NOTE: A Life Policy of $15,000 is provided, at no cost, to EMPLOYEES ONLY covered on an Anthem Medical Plan. 4 $5,500 individual $11,000 family Deductible + 20% Deductible + 0% $4,000 individual $8,000 family Included in Medical Maximum Out-of-Pocket $500 individual $1,000 family Member Cost Share $5,500 individual $11,000 family Included in Medical Maximum Out-of-Pocket $750 individual $1,500 family Member Cost Share Primary Care Office Visit $20 co-pay $30 co-pay Deductible + 20% Deductible + 0% Specialist Office Visit $40 co-pay $60 co-pay Deductible + 20% Deductible + 0% Preventive Care No member cost No member cost No member cost No member cost Emergency Room $150 co-pay $250 co-pay Deductible + 20% Deductible + 0% Urgent Care Center $50 co-pay $75 co-pay Deductible + 20% Deductible + 0% Maternity $800 co-pay $800 co-pay Deductible + 20% Deductible + 0% Inpatient Facility Services Deductible + 0% Deductible + 0% Deductible + 20% Deductible + 0% Outpatient Surgery Deductible + 0% Deductible + 0% Deductible + 20% Deductible + 0% Other Outpatient Services Deductible + 20% Deductible + 20% Deductible + 20% Deductible + 0% Vision Exams (Optometrist)** $20 co-pay $30 co-pay Deductible + 20% Deductible + 0% Vision Exams (Ophthalmologist)** $40 co-pay $60 co-pay Deductible + 20% Deductible + 0% Rx Drug Co-pay (30 day supply) $8 / $35 / $50 4th Tier: 25% to $100 max per Rx $8 / $35 / $50 4th Tier: 25% to $100 max per Rx Deductible + 20% Deductible + 0% Mail in Pharmacy (90 day supply) $16 / $75 / $125 $16 / $75 / $125 Deductible + 20% Deductible + 0% See NEXT PAGE for Medical Payroll Deduction Rates for each Plan The above references in-network benefits only; for out-of-network benefits, see full summary of benefits. * Employees hired on, or prior to, December 31, 2016 will receive the full Employer HSA contribution. Employees hired on or after January 1, 2017 will receive 50% of the Employer HSA contribution. **Visit for special offers for glasses, contacts and LASIK or PRK laser vision correction.

5 Employee Monthly Contribution Comparison Employee Contribution RATES FOR NON-SMOKER AND NON-TOBACCO USER Base Payroll Deductions Premium Core Plan 1 Plan 2 Employee $ $ $ $62.38 Employee + Spouse/Partner $ $ $ $ Employee + Child(ren) $ $ $ $ Family $ $ $ $ RATES FOR SMOKER AND TOBACCO USER(S) ONE Employee or Spouse/Partner Use Employee Contribution Premium Core Plan 1 Plan 2 Employee $ $ $ $92.38 Employee + Spouse/Partner $ $ $ $ Employee + Child(ren) $ $ $ $ Family $ $ $ $ BOTH Employee and Spouse/Partner Use Employee Contribution Premium Core Plan 1 Plan 2 Employee + Spouse/Partner $ $ $ $ Family $ $ $ $ Current tobacco users can receive the non-tobacco discount by: Enrolling in and complying with an approved nicotine cessation program OR Providing a signed letter from your physician stating that ceasing use of nicotine and/or tobacco products would be unreasonably difficult due to a medical condition or it is medically inadvisable to quit nicotine use at this time OR Providing a new Affidavit after being tobacco-free for 90 days. Tobacco Affidavit required for non-tobacco user rates from the employee, spouse or partner, if covered by a Berea College medical plan. Smoking Cessation classes are being offered on Campus beginning June 21, 2016, September 1, 2016, and January 19, Contact the Director of Health & Wellness for detailed information on classes. If it is unreasonably difficult, due to a medical condition, for you to achieve the standards for the discount under this program, or if it is medically inadvisable for you to attempt to achieve the standards for the discount under this program, call the Director of Health and Wellness who will work with you to develop another way to qualify for the reward. NEW! Voluntary Vision Benefits Berea College is pleased to provide access to a comprehensive vision care program. The amount you pay for vision services depends upon whether you visit a network or non-network provider. Network providers for EyeMed Vision Care can be found at or call EyeMed s Customer Care Center at See below for a brief description of vision benefits. Dependent age is to the end of the calendar year in which the dependent turns age 19, or to the end of the calendar year in which the child attains age 24 (if the child qualifies as a full-time student and meets the IRS rules for qualified dependent). Vision Benefits Summary In Network Benefits Co-pays Exams Service Frequency Exams Lenses Frames Lens Coverage Single Vision Lenses Lined Bifocal Lenses Lined Trifocal Lenses Frames Contact Lenses Fitting Fees Elective Lenses Medically Necessary Vision Monthly Cost EyeMed Vision Care Member Cost Share* $10 co-pay Once every 12 Mos Once every 12 Mos Once every 24 Mos $25 co-pay $25 co-pay $25 co-pay $130 retail allowance; then 20% off remaining balance Standard Fit and Follow up: up to $55 / Premium Fit and Follow up: 10% off $130 allowance; then 15% off remaining balance Covered in full Employee $5.93 Employee + Spouse $11.27 Employee + Child(ren) $11.86 Family $17.43 *Upgrades to frames & lenses can result in additional out-of-pocket expenses. The above references in-network benefits only; for outof-network benefits see full summary of benefits. 5

6 Flexible Spending Account (FSA) Berea College has adopted and maintains a Section 125 Plan. This plan allows payroll deductions for certain insurance to be made on a pre-tax basis. A Flexible Spending Account allows you to payroll deduct some of your income on a pre-tax basis to pay for certain health or dependent care expenses that may not be covered under your benefit plans. Berea College offers the following accounts: The Health Care Account helps you pay for medical, dental, and vision care expenses not covered by the benefit plans. This includes any deductibles, co-payments, coinsurance and such items as orthodontia, glasses, and contact lenses. The annual maximum contribution is $2,500. The Dependent Care Account can help to fund the care of children under the age of 13, or a disabled spouse, child or parent while you work. This account can be used for daycare, preschool, after school care, summer day camp, or elder care. The annual maximum contribution is $5,000 (or $2,500 if married, filing separately). The Plan Year for both of these accounts is July 1st June 30th. The Dependent Care Account must be used within the plan year or forfeited; however, the Health Care Account allows for a carryover of $500 of unused money in your Health Care Flexible Spending Account at the end of the plan year (June 30th). The carryover amount can be used to pay or reimburse medical expenses incurred during the entire Plan Year to which it is carried over. The rollover does not affect the IRS cap of $2,550 on the Health FSA annual contributions. Health Savings Account (HSA) If you elect a High Deductible Health Plan () then you can contribute to a Health Savings Account (HSA). This is a personal savings account which allows you to payroll deduct pre-tax money to pay for any Qualified out-of-pocket expenses on your medical, dental or vision plans (ie: deductible, co-insurance, co-pays). Money in this account is always yours and goes with you, even if you leave Berea College. These funds can also be used for Qualified medical, dental and vision expenses for your spouse and dependents even if they are not covered on your insurance plans. For a full list of Qualified expenses, go to: pub/irs-pdf/p502.pdf 6 Health Savings Account Eligibility: You are NOT eligible for a Health Savings Account if: You, or your spouse, contribute to a general purpose flexible spending account. You are entitled to a government sponsored medical plan (Medicare or Medicaid). Health Savings Account Annual Contributions: $3,350 Single / $6,750 w/dependents (age 55 and older can contribute an additional $1000 annually) Note: Your contribution limit is mandated by IRS regulations and includes both your employer s annual contribution in addition to any amount you wish to contribute. Dental Benefits Staying healthy includes obtaining quality dental care for you and your family. The Berea College dental plan is provided through the Anthem National Dental Network and administered through ARC Administrators. Claims and coverage questions should be directed to ARC at See chart below for dental summary. Dependent age is to the end of the calendar year in which the dependent turns age 19, or to the end of the calendar year in which the child attains age 24 (if the child qualifies as a fulltime student and meets the IRS rules for qualified dependent). Dental Benefits Summary Dental Benefits In-Network Plan Year Annual Dental Deductible (July 1 - June 30) Maximum Annual Benefit for Type I, II & III Services Maximum Annual Benefit for Type IV Services Maximum Lifetime Benefit for Type IV Services Covered Services Type I - Basic Services - Clinical Oral Exams - Dental prophylaxis - Bitewing & Full Mouth X-rays - Fluoride & Sealant Treatment (Child only) - Space Maintainers (Child only) - Emergency Care Treatment Type II - Minor Services - Oral Surgery - Periodontal and/or Endodontic Minor Services - Extractions - Re-cementing Crowns, Bridges, In-Lays - Amalgams - General Anesthesia Administration - Antibiotic Drugs Type III - Major Services - Crowns - Prosthodontic Services - Periodontal Adjunctive Services - Periodontal Surgical Services - Occlusal Guards Type IV Orthodontic Services -Braces (Must be on the plan 12 months before being eligible for Orthodontics) Orthodontic Age Limit Dental Monthly Cost $0 Deductible $1,000 per covered person $750 per covered person $1,500 per covered person Member Cost Share No member cost 20% 50% $750 Annually / $1,500 Lifetime Dependent Children under age 19 Employee $4.00 Family $30.00 The benefits outlined here are for illustrative purposes only. The carrier s master policy will be relied upon exclusively in determining benefit reimbursement.

7 Group Life / AD&D A Life Insurance/Accidental Death & Dismemberment policy in the amount of 1.5 times your current base salary (up to a maximum of $300,000) is available for purchase by each employee on a cost-sharing basis with the College. Spouse/ Dependent plans are also available. See Human Resources for more details. Benefit begins on the 1st of the month following date of hire. As a newly hired employee you are guaranteed the right to purchase life insurance regardless of any health issue or concern. If you choose not to enroll in the life insurance plan as a new hire, but decide to purchase coverage at a later date, you will be required to submit evidence of medical insurability and will be subject to medical underwriting and possibly denied coverage. Long-Term Disability The financial consequences of not being able to work due to a disabling accident or illness can be devastating. Berea College certainly recognizes this risk and is pleased to provide you with long-term disability benefits. This benefit is available on the 1st of the month following 6 months from date of hire. Long-term disability coverage provides up to 60% of pre-disability earnings to a monthly maximum of $6,000 (inclusive of Social Security or Workmen s Compensation) after 6 months of total disability. Partial benefit is also available if, due to a disability, you are unable to work full-time. There is no charge for the benefit. However, you will pay tax on the premium in order to get the highest level of benefit in the event of disability. All claims are underwritten and administered by the insurance carrier (OneAmerica) who is solely responsible for any disability determination or decision. Voluntary Life / AD&D OPTIONAL EMPLOYEE LIFE* You may also purchase up to 5 times your salary to a maximum of $300,000 in additional life insurance (in $10,000 increments). Guaranteed Issue: $200,000** (no medical questions) OPTIONAL DEPENDENT LIFE Benefits for Spouse Coverage Amount: Increments of $5,000 not to exceed 50% of the employee s enrolled amount (to a maximum of $100,000). Guaranteed Issue: $50,000** Benefits for Children Coverage Amount: $10,000 for dependents age 6 months to 19 years (age 25 if full-time student).** Coverage Amount: $1,000 for dependents from live birth to age 6 months. * Benefit and age reductions will apply ** Guarantee Issue is only available to newly eligible employees and/or their Dependents NOTE: During the Open Enrollment period each year, any employees who are enrolled in Voluntary Life coverage can increase their coverage by $10,000 without answering any medical questions. This increase is no longer available after the Guarantee Issue amount is reached. AFLAC Voluntary Benefits Berea College allows payroll deductions for various AFLAC products* such as: 24 Hour Accident-Only coverage: Cash benefits paid directly to you to help with expenses incurred due to an injury. Cancer Care: Pays cash benefit upon initial diagnosis of a covered cancer, with a variety of other benefits payable throughout cancer treatment. Short-Term Disability: Pays cash benefit for a disability caused by a covered sickness or covered off-the-job injury that occurs while the policy is in force. Critical Care and Recovery: Cash benefits for specified health events that are covered by the Critical Care and Recovery policy. *See policy brochures and full benefit materials provided by your AFLAC Representative. Preventive Care Take advantage of your preventive care benefits - Routine physical exams, mammograms, prostate screening, annual PAP tests, immunizations for your children, blood pressure and cholesterol readings. Preventive care is covered at no cost to you. 7

8 403(b) Retirement Plan The Berea College Retirement Plan is a defined contribution plan that operates under section 403(b) of the Internal Revenue Code. All benefit eligible full-time and part-time employees may participate in this plan. You can begin participating in the Plan on your date of hire. College contributions begin on the first day of the month after you fulfill the following requirements: You complete one year of service at the College; If you worked for another college or university in a benefit-eligible position and have been covered by the retirement plan of that college or university; and, you must have been employed there for longer than one year; and, you must have the previous employer validate your employment history and your inclusion as a member of their plan. See Human Resources for additional information; Former College employees who are re-employed, and who previously completed the service requirement for Plan eligibility prior to terminating their employment, will begin participation in the Plan immediately after re-employment if working in a benefit eligible full-time or part-time position. When you begin participation in the Plan, contributions will be made automatically to the funding vehicles that you ve chosen. Plan contribution as a percentage of compensation by the College is 8%. IRS limitation is $18,000 for You are fully and immediately vested in the benefits arising from contributions made under this Plan. Such amounts are non-forfeitable. LiveHealth Online is a convenient way to interact with a US Board-Certified doctor via live, two-way video on your computer or mobile device 24 hours a day/7days a week! Doctors can eprescribe to local pharmacies as your State allows. The cost for an online doctor visit is a $10 co-pay for an office visit under your s, and $49 if you have an Plan. To register, go to: CONTACTS AT-A-GLANCE QUESTIONS COMPANY WHO ARE THEY? TELEPHONE WEB ADDRESS Benefit Health & Wellness Medical / Dental Human Resources Benefits Coordinator Director of Health & Wellness Insurance Company / Third Party Administrator N/A Voluntary Vision Insurance Company Park Community Credit Union/HSA Account Info HSA Account Administrator Heather Resor ext accounts/hsa/ Pharmacy Insurance Company Life / AD&D / Long Term Disability / Voluntary Life AFLAC Voluntary Benefits 403(b) Retirement Plan Insurance Company AFLAC Representative Administrator Lawrence.Fugate@ us.aflac.com Phone Counseling Center: Automated Phone service: berea The benefits overview is intended for summary purposes only. It is not to be relied upon for the determination of any policy benefits, limitations or exclusions. The master insurance policies issued by the respective carriers will be relied upon exclusively to determine all benefits. Berea College 2016/2017 EBO - rev FNL Benefit Insurance Marketing 1151 Red Mile Rd Lexington, KY teambim.com