Why putting the best team on the field matters…… Our employees are our most valuable asset. For this very reason, IDEA Public Schools is committed to offering a comprehensive employee benefits program that helps our employees stay healthy, feel secure, and maintain a work/life balance. Benefits offered through the workplace can help protect important things such as your income and your assets if you become sick or injured. Other benefits can help cover expenses that might not be covered in your medical plan such as day care, travel expenses, rent, mortgage, and every day costs of living expenses. These benefits are not only valuable but also provide great protection for you and your family while reducing financial exposure in your medical plan. For this very reason we at IDEA Public Schools work to ensure that the benefits we offer are best-in-class. The voluntary benefits program that is offered is something we also find value in because these benefits work hand-in-hand with the medical plan in lowering financial exposure for you and your family while providing benefits over and above what is covered by a traditional medical plan. We understand that life can be busy. But we encourage you to take the time to read the material inside the booklet to familiarize yourself with the benefits available to you. Each year you will have the opportunity to meet with a Regions Benefits Counselor one-on-one to review your benefit options. Again, thank you for your efforts and we only wish you the very best. Sincerely, IDEA Public Schools Benefits Funding TRS Active Care IDEA contributes $325/month/ee towards monthly premiums Flexible Spending Account Employee Paid Dental - Guardian Employee Paid Vision - Guardian Employee Paid Short Term Disability Reliance Standard Long Term Disability – Reliance Standard Cancer Insurance Transamerica Accident Insurance Trustmark Employee Paid Employee Paid Employee Paid Employee Paid Critical Illness - Allstate Employee Paid Universal Life with LTC Trustmark Employee Paid Descriptions IDEA Public Schools provides you the opportunity to enroll in the TRS Active Care which offers you options of BlueCross BlueShield, Scott and White HMO, and Valley Baptist HMO plans. This is a tax savings account that allows you to pay for eligible out-of-pocket medical, dental, and vision expenses with tax free dollars. In addition, it comes with a dependent day care account that assist with eligible day care expenses. Provides benefits for preventive services, restorative care, periodontics, root canals, and major services. Provides benefits for eye exams, lenses, frames, and/or contacts. Benefit pays 60% of weekly salary up to $2,700 per week after a 7 day waiting period. Benefit pays 60% of monthly salary up to $15,000 per month after 90 day waiting period. Covers Radiation/Chemotherapy, New and Experimental Treatment, and comes with a Wellness Benefit. Provides coverage for Emergency Accidents, Hospital Admission, Office Visits, and comes with a Wellness Benefit. Pays a lump sum up to $10,000 for Heart Attack, Stroke, and all other major illness. Provides permanent life insurance coverage with long term care coverage. IDEA Enroll IDEA Enroll is IDEA Public Schools Benefits Enrollment Portal. Within this portal you will be able to select or make changes to any benefits that are available to you as an employee of IDEA Public Schools. Below is a guide to help you through the enrollment portal but at any time if you have questions pertaining to the benefits or if you want some to assist you while enrolling please do not hesitate to contact Total Benefit Solutions at 1-888-783-9653. Step 1: Logging In Forgot PIN Username: Social Security Number Password: Last 4 of social followed by year of birth (ex. 555584) Enrollment Guide: Once you enter into the site you will be prompted to change your pin and set up a security pass code. In the event you forgot your PIN, go to FORGOT PIN to reset for future use. Medical Insurance HMO AUSTIN ONLY Medical Insurance HMO Rio Grande Valley ONLY Austin Region 2013-2014 HEALTH INSURANCE PLANS – COST TO EMPLOYEE PER MONTH Full-time employees of IDEA Public Schools have standard deductions including Federal Withholding, Medicare and TRS (Teacher Retirement System of Texas). Health insurance benefits are payroll deducted. IDEA contributes $325 per month per employee enrolled in any plan. The totals represented below only include the employee’s monthly cost for each plan and has already been reduced by IDEA’s contribution. IDEA Public Schools also offers supplemental insurance benefits to its employees through our third party administrator, Regions Insurance, and is also payroll deducted. Services Deductible Out-of-Pocket Maximum (individual/family; does not include deductibles) ActiveCare 1-HD ActiveCare 3 Scott & White Employee Family Individual Family Individual Family Individual Family $2,400 $4,800 $1,000 $3,000 $300 $900 $1,000 $3,000 $3,850 $4,200 $4,000 $8,000 $1,000 $1,000 $3,000 $6,000 Coinsurance 80% / 20% (Plan pays/ participant pays) Office Visit Copay ActiveCare 2 20% after deductible 80% / 20% 80% / 20% 80% / 20% $30 for primary $20 for primary $50 for specialist $30 for specialist $50 for specialist $20 for primary Preventive Care Plan pays 100% (deductible waived) Plan pays 100% (no copay required) Plan pays 100% (no copay required) Plan pays 100% (no copay required) Prescription Drug Deductibles Subject to plan year deductible $0 generic; $200 brand $75 $100 applies to brand & nonpreferred only Cost to Eligible Employees Employee Only $0.00 Employee Only $204.00 Employee Only $471.00 Employee Only $93.42 Employee and Spouse $469.00 Employee and Spouse $878.00 Employee and Spouse $1485.00 Employee and Spouse $620.10 Employee and Children $247.00 Employee and Children $516.00 Employee and Children $944.00 Employee and Children $339.00 Employee and Family $735.00 Employee and Family $998.00 Employee and Family $1665.00 Employee and Family $723.54 RGV Region 2013-2014 HEALTH INSURANCE PLANS – COST TO EMPLOYEE PER MONTH Full-time employees of IDEA Public Schools have standard deductions including Federal Withholding, Medicare and TRS (Teacher Retirement System of Texas). Health insurance benefits are payroll deducted. IDEA contributes $325 per month per employee enrolled in any plan. The totals represented below only include the employee’s monthly cost for each plan and has already been reduced by IDEA’s contribution. IDEA Public Schools also offers supplemental insurance benefits to its employees through our third party administrator, Regions Insurance, and is also payroll deducted. Services Deductible Out-of-Pocket Maximum (individual/family; does not include deductibles) ActiveCare 1-HD ActiveCare 3 Valley Baptist Employee Family Individual Family Individual Family Individual Family $2,400 $4,800 $1,000 $3,000 $300 $900 $500 $1,000 $3,850 $4,200 $4,000 $8,000 $1,000 $1,000 $4,000 $8,000 Coinsurance 80% / 20% (Plan pays/ participant pays) Office Visit Copay ActiveCare 2 20% after deductible 80% / 20% 80% / 20% 80% / 20% $30 for primary $20 for primary $50 for specialist $30 for specialist $60 for specialist $25 for primary Preventive Care Plan pays 100% (deductible waived) Plan pays 100% (no copay required) Plan pays 100% (no copay required) Plan pays 100% (no copay required) Prescription Drug Deductibles Subject to plan year deductible $0 generic; $200 brand $75 $100 Cost to Eligible Employees Employee Only $0.00 Employee Only $204.00 Employee Only $471.00 Employee Only $62.06 Employee and Spouse $469.00 Employee and Spouse $878.00 Employee and Spouse $1485.00 Employee and Spouse $616.04 Employee and Children $247.00 Employee and Children $516.00 Employee and Children $944.00 Employee and Children $282.86 Employee and Family $735.00 Employee and Family $998.00 Employee and Family $1665.00 Employee and Family $635.14 San Antonio Region 2013-2014 HEALTH INSURANCE PLANS – COST TO EMPLOYEE PER MONTH Full-time employees of IDEA Public Schools have standard deductions including Federal Withholding, Medicare and TRS (Teacher Retirement System of Texas). Health insurance benefits are payroll deducted. IDEA contributes $325 per month per employee enrolled in any plan. The totals represented below only include the employee’s monthly cost for each plan and has already been reduced by IDEA’s contribution. IDEA Public Schools also offers supplemental insurance benefits to its employees through our third party administrator, Regions Insurance, and is also payroll deducted. Services Deductible ActiveCare 1-HD Family Individual Family Individual Family $2,400 $4,800 $1,000 $3,000 $300 $900 $4,200 $4,000 $8,000 $1,000 $3,850 Coinsurance 80% / 20% 80% / 20% $30 for primary $20 for primary $50 for specialist $30 for specialist Plan pays 100% (deductible waived) Plan pays 100% (no copay required) Plan pays 100% (no copay required) Subject to plan year deductible $0 generic; $200 brand $75 Office Visit Copay Prescription Drug Deductibles Cost to Eligible Employees $1,000 80% / 20% (Plan pays/ participant pays) Preventive Care ActiveCare 3 Employee Out-of-Pocket Maximum (individual/family; does not include deductibles) ActiveCare 2 20% after deductible Employee Only $0.00 Employee Only $204.00 Employee Only $471.00 Employee and Spouse $469.00 Employee and Spouse $878.00 Employee and Spouse $1485.00 Employee and Children $247.00 Employee and Children $516.00 Employee and Children $944.00 Employee and Family $735.00 Employee and Family $998.00 Employee and Family $1665.00 Summary of a Flexible Spending Account WHAT IS A FLEXIBLE SPENDING ACCOUNT? • Flexible Spending Accounts (FSAs), were developed as part of Internal Revenue Code Section 125 to provide employees with tax relief for their out-of-pocket medical and dependent day-care costs. FSAs enable employees to utilize pre-tax dollars and save federal, FICA, and, in most cases, state taxes. There are two types of Flexible Spending Accounts: 1) Medical Reimbursement Accounts: Accounts used to pay for eligible un-reimbursed medical expenses such as co-pays, deductibles, dental, vision, prescription, over-the-counter medications (prescription required), and more 2) Dependent Day-Care Reimbursement Accounts: Accounts used to pay for the daily care of an eligible child or adult dependent (as defined by law) Visit www.flex125.com for a complete list of eligible expenses • To further enhance the benefits of implementing FSAs, AmeriFlex offers the AmeriFlex Convenience Card MasterCard®. This single-platform debit card allows for the automatic electronic transfer of pre-tax dollars from an FSA when paying for qualified expenses. Most importantly, the AmeriFlex Convenience Card® can accommodate and administer all three accounts on the same card without an incremental fee. A pretty smile brightens up everyone’s day!!! You have the opportunity to enroll in the Guardian Dental plan. This plan provides a high level of benefits for you and your family. You can also get discounts on services offered by dentists who are members of Guardian’s network. Please take time to review these benefits and if you have any questions don’t hesitate to speak with a benefits consultant. Summary of Dental Benefits Summary Guardian Choice Network Access Plan Value Benefit Deductibles & Maximums Calendar year deductible Individual $50 Per Person $50 Per Person Annual Benefit Maximum Individual $1,250 Family $1,250 Per Person $1,250 $1,250 Per Person Covered Services Preventive care (cleaning, x-rays, fluoride treatments, sealants) 100% Basic services (fillings, simple extractions, root canal, endodontics, oral surgery) Major services (crowns, inlays, onlays, veneers, bridges, dentures) Orthodontia 100% 80% 100% 50% 60% 50% coverage up to $1,000 lifetime max; dependents to age 19 only eligible Value Plan Tip Please note that if you elect the Value Plan you will need to see an in-network provider. In the event you elect the Value Plan and go out-of-network then you will be subject to out-of-network benefits which can result in higher out-of-pocket costs. Employee Only Employee + 1 Family Monthly Premium $14.09 $27.42 $50.61 This is a brief description of your Dental Plan. Please refer to the actual plan documents or your plan administrator for more information. Your eyes are the window to your soul You have the opportunity to enroll in the Block Vision plan and with this program you get personalized eye care for yourself and your entire family. Block Vision will help you achieve the quality care you deserve with yearly exams all the way to purchasing the frames and lenses you want. Take this opportunity to review the benefits and if you have any questions don’t hesitate to take the opportunity to speak with a benefit consultant. Your Vision Benefits Summary In-network Eye examination Prescription lenses Single vision lenses Lined bifocal vision lenses Lined trifocal vision lenses Lenticular lenses Frames $10 co-pay; covered in full every 12 months $25 co-pay; covered in full every 12 months $25 co-pay; covered in full every 12 months $25 co-pay; covered in full every 12 months $25 co-pay; covered in full every 12 months $25 co-pay; up to $130 allowance with a 20% discount on the difference every 24 months Contacts (in lieu of glasses) Medical Necessity Elective $25 co-pay; covered in full every 12 months Up to $130 allowance * Benefits for exams and lenses are provided every 12 months and every 24 months for frames. Employee Only Employee + 1 Family Monthly Premium $7.75 $15.99 $22.50 This is a brief description of your Vision Plan. Please refer to the actual plan documents or your plan administrator for more information. Your Disability Benefits How important is your paycheck? As Americans we insure our homes, we insure our cars, we insure our boats. So why would you not insure your income? Our income is our most valuable asset. Think about it. If you don’t have an income how are you going to pay the bills? Maybe you have a week or two of sick leave or earned time off, but after that, what happens? Fortunately, IDEA Public Schools provides you Short Term Disability Insurance through Reliance Standard. It will pay you a percentage of your income if you become disabled due to a covered illness or off-the-job accident after 7 days of being off of work. As an employee you may also purchase voluntary Long Term Disability Insurance that protects you up to Social Security Normal Retirement Age. It starts after the 90th day for Accident and the 90th day for Sickness. Below is a brief description of your plan design. Please take the opportunity to review. Voluntary Short Term Disability Benefits th Elimination Period: 7 day for Accident th 7 day for Sickness (Maternity) Benefit Duration: 12 Weeks Protection: 60% up to $2,700 a Week Pre-existing Condition: 3/6 (Any injury/sickness occurring 3 months prior to the effective date will not be covered under the plan for 6 months after the effective date.) All employees on the current American Fidelity Plan are grandfathered meaning the pre-existing condition is waived. If you are new to the plan you are Guarantee Issue but are subject to the Pre-Existing Condition clause. Contribution: 100% Employee Paid (Please see benefit counselor for your per pay rate.) Benefit Calculation: (Your annual salary) x 60%/ 52 = Weekly Benefit Voluntary Long Term Disability Benefits Elimination Period: 90 days for Accident 90 days for Sickness Benefit Duration: Social Security Retirement Age Protection: Pre-existing Condition: 60% up to $15,000 in a monthly benefit 12/12 (Any injury/sickness occurring 12 months prior to effective date will not be covered under plan for 12 months after effective date.) All employees on the current American Fidelity Plan are grandfathered. If you are new to the plan you are GI but are subject to the Pre-Existing condition. Contribution: 100% Employee Paid (Please see a benefit counselor for your per pay rate.) Benefit Calculation: (Your annual salary) x 60%/ 12 = Monthly Benefit Why Cancer insurance you ask? Did you know? 1 out of 5 people who are diagnosed with cancer use all or most of their savings.* Roughly 65% of all cancer related costs are not covered by traditional health insurance.* Men have slightly less than a one in two lifetime risk of developing cancer; for women, the risk is a little more than one in three. **    A cancer/specified-disease insurance policy can also help protect your income and savings from expenses that aren't covered by your major medical health insurance policy, including: * Cancer Facts and Figures 2008, American Cancer Society ** Cancer Facts and Figures 2009, American Cancer Society  Deductibles  Out of network specialists  Experimental cancer treatment  Travel and lodging when treatment is far from home  Child care and household help Transamerica Enhanced Cancer Plan Benefit Summary Your Transamerica Cancer Plan includes the following coverage’s and up to three plan offerings……The below description is of the Cancer Plan.           Inpatient/Outpatient Benefits: Radiation/Chemotherapy Benefits: Initial Diagnosis Benefit: New/Experimental Treatment Benefit: Surgery Benefit: Anesthesia for Surgery: Bone Marrow Transplant Benefit: Prosthesis Benefit: Stem Cell Transplant Benefit: Wellness Benefit: $200 per day for 90 days, $400 for each day after up to $15,000 of actual incurred charges $1,000 lump sum benefit up to $15,000 per calendar year up to $3,000 in-patient, up to $4,500 for outpatient 25% of covered surgery benefit up to $15,000 of actual incurred charges up to $1,500 per device up to $15,000 of actual incurred charges $50 each insured on the plan Enhanced Plan Rates Coverage Monthly Premium Employee $23.56 1 Parent Family $26.45 Family $42.29 Why Cancer insurance you ask? Did you know? 1 out of 5 people who are diagnosed with cancer use all or most of their savings.* Roughly 65% of all cancer related costs are not covered by traditional health insurance.* Men have slightly less than a one in two lifetime risk of developing cancer; for women, the risk is a little more than one in three. **    A cancer/specified-disease insurance policy can also help protect your income and savings from expenses that aren't covered by your major medical health insurance policy, including: * Cancer Facts and Figures 2008, American Cancer Society ** Cancer Facts and Figures 2009, American Cancer Society  Deductibles  Out of network specialists  Experimental cancer treatment  Travel and lodging when treatment is far from home  Child care and household help Transamerica Premium Cancer Plan Benefit Summary Your Transamerica Cancer Plan includes the following coverage’s and up to three plan offerings……The below description is of the Cancer Plan.           Inpatient/Outpatient Benefits: Radiation/Chemotherapy Benefits: Initial Diagnosis Benefit: New/Experimental Treatment Benefit: Surgery Benefit: Anesthesia for Surgery: Bone Marrow Transplant Benefit: Prosthesis Benefit: Stem Cell Transplant Benefit: Wellness Benefit: $300 per day for 90 days, $600 for each day after up to $20,000 of actual incurred charges $2,000 lump sum benefit up to $20,000 of actual incurred charges up $2,000 inpatient, up to $3,000 for outpatient 25% of covered surgery benefit up to $20,000 of actual incurred charges up to $1,000 per device up to $20,000 of actual incurred chargees $100 each insured on the plan Premium Plan Rates Coverage Monthly Premium Employee $33.30 1 Parent Family $37.68 Family $60.06 5 Why do I need accident insurance? Though most people do not like to think about it, accidents can happen at any place, at any time and can be devastating. You could have an accident while driving to work, doing chores around the house, exercising, enjoying outdoor activities such as sports and hunting or just playing with your kids. After an accident you may have expenses you've never thought about before. Can your finances handle them? It's reassuring to know that an accident insurance policy can be there for you through the many stages of recovery, from the initial emergency treatment or hospitalization, to follow up treatments or physical therapy. Did you know?    In 2007, more than 34 million people sought medical attention for an injury.* In 2006, more than 42 million visits to hospital emergency departments were due to injuries.* Falls are the leading cause of unintentional injuries that are treated in hospital emergency departments.* The below description is of the Trustmark Accident Plan.           Accidental Death: Emergency Treatment Benefit: Appliance Benefit: Accident Benefit: Follow up treatment Benefit: Physical Therapy Benefit: Hospital Admission Benefit: Hospital Confinement and ICU Benefit: Urgent Care and Walk In Clinic: Wellness Benefit: up to $100,000 for catastrophic accidents up to $200 up to $150 up to $10,000 (see brochure for details) up to $100 $50 per treatment up to 6 treatments $1,500 $200 for normal stay/$400 for ICU up to $100 $50 per insured Monthly Premiums Coverage Employee Employee/Spouse Employee/Child(ren) Family $13.52 $19.85 $26.04 $32.32 Why do I need critical illness insurance? Although medical insurance and other insurance coverage’s you may have are essential, they won't cover everything. Medical treatment has never been better, but is also expensive. People today can experience financial hardship because of the expenses their insurance plan does not cover. Critical illness insurance could be a strong supplement to other health insurance. Did you know?  1 in 5 men suffer a critical illness before their normal retirement age.*  1 in 6 women suffer a critical illness before their normal retirement age.*  The probability of surviving a critical illness before age 65 is almost twice as great as dying.*  Approximately 1.5 Americans suffer a heart attack each year, of those 1.1 million will survive at least 3 years.* * Munich Reinsurance Co. 2000 Your Allstate Critical Illness plan includes the following coverage’s:       Heart Attack: Stroke: End Stage Renal Disease: Quadriplegia Benefit: Major Organ Transplant: Bypass Surgery Benefit: $10,000/$5,000 $10,000/$5,000 $10,000/$5,000 $10,000/$5,000 $10,000/$5,000 $10,000/$5,000  Balloon, Angioplasty, or Stent Benefit: $10,000/$5,000   Employee Guarantee Issue Benefit: Dependent Guarantee Issue Benefit: $10,000 $5,000 PLEASE NOTE THAT AS AN EMPLOYEE YOU ARE ELIGIBLE FOR $10,000 IN A GUARANTEE ISSUE BENEFIT AND YOUR DEPENDENTS ARE ELIGIBLE FOR A $5,000 GUARANTEE ISSUE BENEFIT. Age Employee Employee/Spouse Employee/Child Family Monthly Premiums-Non-Tobacco 18-35 36-50 51-60 $2.73 $6.93 $14.73 $3.55 $9.88 $21.58 $2.73 $6.93 $14.73 $3.55 $9.88 $21.58 Age Employee Employee/Spouse Employee/Child Family 18-35 $4.12 $5.68 $4.12 $5.68 Monthly Premiums-Tobacco 36-50 51-60 $11.61 $25.00 $16.90 $37.01 $11.61 $25.00 $16.90 $37.01 61-63 $24.53 $36.27 $24.53 $36.27 63+ $38.82 $57.72 $38.82 $57.72 61-63 $38.61 $57.42 $38.61 $57.42 63+ $61.53 $91.78 $61.53 $91.78 Trustmark Universal Life with Long Term Care Many people don’t think about LTC when they are young because they feel it won’t affect them until they are old. That’s not always the case. In fact, 40 percent of people currently receiving LTC are between the ages of 18 and 64. Unfortunately, when people finally realize they need LTC, most don’t get coverage because they either can’t afford it or can’t qualify for it anymore, which is why it’s important to purchase it as early as possible — before the need occurs. And young, working adults qualify easily and have lower premiums. Inflation protection is also available, just like with traditional LTC policies. Benefit increases are automatic, guaranteed and fully portable for both employees and spouses. People purchase life insurance for many reasons, like taking care of their family should something happen. But having the option to wrap in LTC coverage is invaluable. How does it work? If the life insurance benefit amount is $100,000, LifeEvents advances 4 percent of that — or $4,000 a month — to help pay for care. Some LTC policies limit benefits to a type of care or daily benefit. LifeEvents doesn’t. It pays benefits directly to the policy owner and enables a choice of care facilities: home care, assisted living, adult day care and nursing home. If a policyholder never uses the money in the policy for LTC, it just goes back to the family as a death benefit. Face the facts Most people are not financially prepared should something happen to them or their spouse. Nearly a third of U.S. households have no life insurance coverage and many do not know where to get help buying life insurance. Yet, it’s necessary to think about how a family would survive without the extra income of their spouse if he or she were no longer there. Not to mention the impact to savings and future costs such as a child’s college tuition. Universal LifeEvents protects employees and their families with permanent coverage that’s affordable and flexible. It’s time to meet life’s challenges head on. Let employees tell their story the way they would want it to be told. Why it’s valuable      Guarantee Issue: Portability: Family Coverage: Benefit Restoration: Living Benefits:     Extension of LTC: Accidental Death: Child Coverage: EZ Value: As an employee you can elect up to $200,000 or $8.00 per week It is 100% completely portable, regardless of job changes or retirement Coverage is available for spouses even if the employee does not participate Restores the death benefit that is reduced to pay for LTC Helps supplement the cost of home healthcare, assisted living, adult day care and nursing home care Extends LTC benefit an additional 25 months Doubles the death benefit if death occurs by accident Covers children, from newborn to 23 years old Guaranteed automatic increases to Death Benefit and all Living Benefits Disclosures Active Employment Applies to group insurance products. You are considered an active employee if on the day you sign up for coverage, you are being paid by IDEA Public Schools the required minimum hours each week while performing the duties of your regular occupation. Actively at Work Applies to all insurance products. Being actively at work means that when you sign up for coverage you are working at IDEA Public Schools for the required minimum hours each week. You are not actively at work if your normal job duties are limited due to health reasons or leave of absence. Additional Information Applies to the Cancer, Accident, and Critical Illness plans. The benefit summary is intended to be a brief explanation of the policies available to you as an employee of IDEA Public Schools. The policy definitions, exclusions, and limitations will be used to determine eligibility. After the policy is issued you will have a 30 day free look period. You may cancel the policy during those 30 days with no cost to you. Disclaimer The benefit summary is designed to give you a better understanding of what policies are available to you as an employee of IDEA Public Schools. The summary only provides a brief description of your coverage’s. Please review your certificate of coverage’s or summary plan descriptions for a full schedule of coverage’s.