1. finance
2. personal finance
3. insurance
4. health insurance

Welcome to the 2015 Annual Benefits
Enrollment October 15 – 27, 2014
In This Issue
2015 Medical Plan Changes...... 2
Flexible Spending Accounts........ 2
MetLife Voluntary Plans.............. 3
HumanaVitality.......................... 3
Assurant Income
Protection Plans......................... 3
Medical Plans
Comparison Chart..................4-7
Making sure our employees have quality, affordable health care coverage is a
priority for Pinellas County Schools. The District’s Employee Satisfaction &
Well-Being Committee has been working hard to ensure that our BENEFlex
program offers our employees comprehensive coverage while controlling our
long-term health care costs.
This newsletter highlights the changes for 2015. Please attend a districtwide
meeting to learn more. See the schedule on page 11.
Make sure you have the coverage you need on January 1, 2015.
Review this newsletter and the BENEFlex Guide, available online only at
www.pcsb.org/annual-enrollment. Then, log in and confirm you have the
coverage you want before October 27. Use the Enrollment Checklist on page 11
to make sure you have everything you need to enroll. Enrolling or making
changes on Employee Self Service is quick and easy. See page 10 for instructions.
Payroll Deductions..................... 8
Dependent Eligibility Verification
Annual Enrollment Timeline...... 10
Adding a new dependent during annual enrollment? If you enroll a new
dependent in a Pinellas County Schools medical insurance plan, you will be
requested to submit evidence of eligibility during the month of December 2014.
For more information about dependent eligibility guidelines and the required
documentation, visit the PCS Risk Management website and select the Dependent
Audit Information link. Failure to submit the required documentation by the
deadline will result in loss of coverage for your dependents. Thank you for
helping us ensure that only eligible individuals are covered under our health plans.
Districtwide Meeting
Schedule................................. 11
Enrollment Checklist................. 11
Midyear Benefit Changes......... 11
Contact Information................. 12
Not Making Benefit Changes? No Action Required
If you don’t enroll or make any changes, your current benefit elections will
continue in 2015 at the new payroll deductions, coverage levels, and
plan designs where applicable.
2015 Medical Plan Changes and Highlights
Medical Plan Coverage Levels
We have added an additional coverage level, Employee + Child(ren), that allows employees to cover themselves
and their dependent children at a lower premium than family coverage. The coverage levels are:
• Employee only
• 2 board family
•
Employee + child(ren)
•
Employee + spouse • Employee + family: spouse + child(ren)
You can elect this coverage level during annual enrollment. If you currently only cover yourself and your
children and do not take action during annual enrollment, your coverage level and payroll deductions will be
automatically changed.
National Point-of-Service Plan (NPOS) Deductible Increase
NPOS Deductible
Increase From
Employee only
Employee + spouse
Employee + child(ren)
Employee + family
$100 to $300
$200 to $600
$200 to $600
$200 to $600
NPOS, Consumer Directed Health Plan (CDHP), and HMO Staff Plan Changes
Rx3 Prescription Drug Program
Co-pay Change From
Out-of-Pocket Maximums
Increase From
Tier 1
Tier 2
Tier 3
$15 to $20
$35 to $55
$60 to $95
Employee only
All other coverage levels
$3,000 to $3,500
$6,000 to $7,000
HMO Staff and CDHP Plan Reminders
The HMO Staff Plan and CDHP are in-network only. They do not provide out-of-network benefits. Additionally,
the HMO Staff Plan has a very limited network of providers. If you enroll in either plan, be sure to verify with
Humana (877-230-3318) that your doctor and other providers are members of the respective networks: HMO Staff
Network or, for the CDHP, the HMO Premier Network. Please note that the HMO Staff Plan also requires you to choose
a Primary Care Physician (PCP) and get referrals from your PCP to visit a specialist.
Save Money with Flexible Spending Accounts (FSAs)
If you’re not using the FSAs, you’re missing out on a great way to budget for health and/or dependent day care
expenses and save money on taxes. FSA contributions are made with pre-tax deductions from your pay, so you
don’t pay federal income tax or Social Security tax on your contribution amount. You can contribute to FSAs
even if you and/or your dependents are not enrolled in a PCS plan. Here’s how the Healthcare FSA works:
• Estimate your and your dependent’s out-of-pocket eligible
medical, dental, and vision expenses for 2015 and divide
the total by 20 pay periods to determine your pre-tax payroll
deduction. Estimate carefully. You’ll forfeit any account
balance at the end of the plan year.
• Use the VISA debit card from Humana to pay eligible expenses.
It comes preloaded with your annual contribution amount.
• Save your receipts and Explanation of Benefits to submit to
Humana for verification of debit card expenses and electronic
or manual claims. Failure to provide receipts will cause your
FSA debit card to be deactivated.
• For more information, visit www.pcsb.org/FSA.
Page • 2
Declining a PCS Medical Plan?
You can have up to $25 per pay period
of your Board contribution deposited
into your Healthcare FSA. See the
BENEFlex Guide for details.
To learn more about how FSAs can help
you save money, and to check your FSA
balances online after you enroll, go to
www.MyHumana.com.
MetLife Voluntary Plans
Enrolling in MetLife Voluntary Plans
PCS offers several MetLife voluntary plans. You
cannot enroll in MetLife Legal, Pet Insurance, and
Auto & Home® on the PCS annual enrollment
website. To enroll in the MetLife voluntary plans
(except for the MetLife HIP), call the toll-free number
or visit the MetLife website.
For more information and to enroll:
- Call 800-GETMET8 (800-438-6388)
- Go to www.metlife.com/mybenefits
MetLife Hospital Indemnity
Plan (HIP)
Hospital stays can be costly and are often unexpected.
Even the best medical plans may leave you with extra
expenses to pay out of your pocket, like deductibles,
coinsurance, and co-pays. The MetLife HIP pays a cash
benefit when you or a covered dependent is hospitalized
due to an accident or illness; for example, you experience
chest pains and are admitted to the hospital to be checked
and monitored. For more information, call 800-438-6388.
You can enroll in the MetLife HIP on the PCS
annual enrollment website. If you opt out of medical
insurance, your Board contribution can be applied to
offset your payroll deductions for this coverage. If you
do not enroll in this plan during annual enrollment, you
cannot enroll in it until the next annual enrollment or
you experience an applicable change in status event.
Benefits
Hospital Admission
Benefit
Hospital Confinement
Benefit
Inpatient Rehabilitation
Benefit
MetLife Legal Plan
If you would like to enroll in or make changes to your
MetLife Legal Plan coverage, you must do so by calling
800-438-6388 or going to www.metlife.com/mybenefits
during the PCS annual enrollment period. If you are
currently enrolled in the legal plan and do not make
changes during annual enrollment, your current
coverage will be locked in for the 2015 calendar year.
If you are not currently enrolled in the legal plan and
do not enroll in this plan during the annual enrollment
period, you will not be able to enroll until the next
annual enrollment period.
Benefit Amount
$500
$250 per day, up to 30 days
per accident, per year
HumanaVitality
$100 per day, up to 15 days per
covered person, per accident, but not to
exceed 30 days per calendar year
Pre-existing conditions limitations apply. Benefits will not be payable
for pre-existing conditions for which, in 12 months before an insured
becomes covered they received medical advice, treatment, or care from
a physician; or the covered person had symptoms, or any medical or
physical conditions that would cause an ordinarily prudent person to
seek diagnosis, care, or treatment. Benefits reduced 25% for ages 65 to 69. Benefits reduced 50% for
age 70+.
DefenderSM Identity
Theft Protection
MetLife Defender provides protection for your sensitive
online data. Through their patented technology, Defender
continually scans the Internet to detect exposure of your
bank account, Social Security numbers, passwords and
more—up to 25 points of exposure. It also protects your
children from online predators and cyber bullies. You
can enroll in this plan at any time by contacting MetLife,
no contract is required. Watch for more information in
late October.
The free HumanaVitality voluntary wellness program
gives you and your covered dependents a personalized
plan and access to tools and resources that help you
set, meet, and keep your health and wellness goals.
It’s free if you are enrolled in a Humana Medical Plan.
Plus you can earn points for gift cards and wellness
items! The more you do to stay healthy, the more
Vitality PointsTM you can earn. Get your household
engaged and their healthy activities can earn Vitality
Points too! Register at www.humanavitality.com today.
Watch for more information in November.
Assurant Plans
The Assurant Hospital Indemnity Plan (HIP) will be
terminated as of December 31, 2014. If you want to
continue HIP coverage, you’ll need to enroll in the new
MetLife Hospital Indemnity Plan.
The Assurant Short- and Long-Term Disability Plans
will remain in effect with no changes. If you want to apply
for new coverage or increase your current coverage, you
will need to complete a medical questionnaire through
Assurant. Your coverage will become effective as soon
as administratively possible after Assurant approves your
application. Pre-existing limitations apply.
Page • 3
Please note: the dollar amounts are
co-pays, deductibles, and maximums,
which you pay; the percentages are
coinsurance amounts, which you pay
after you meet applicable deductibles.
The amount the plan pays may be
based on usual, reasonable, and
customary (URC) fees for out-of-network
services only.
Understanding How
Much You Have to Pay
•Member Allowance
(CDHP only). Use your
up-front allowance to
pay your deductible,
coinsurance, and Rx
co-pays, reducing your
out-of-pocket costs.
•Medical Plan Deductible
(CDHP and NPOS).
The amount you pay
for certain medical
expenses before the
plan begins paying
benefits.
•Rx3 Deductible (all
plans). The amount you
pay for Tier 2 and/or
Tier 3 drugs before you
begin paying Rx co-pays
for those tiers.
•Combined Out-of-Pocket
(OOP) Maximum. The
maximum amount you
pay for eligible medical
and Rx expenses during
a plan year.
•Coinsurance (CDHP and
NPOS). The percentage
of eligible medical
expenses you pay after
paying the deductible
for most services.
•Co-pays. The fixed
amount you pay for
medical care and
prescriptions.
Humana Member Services
877-230-3318
Benefit
HMO Staff
Q7444
In-Network Only
Service Areas
Any provider in the HMO Staff
Network for Citrus, Hernando,
Hillsborough, Manatee, Pasco,
Pinellas, Polk, Sarasota counties
Personal Care Account (PCA)—Individual/Family
N/A
Deductibles—Individual/Family
N/A
Medical Out-of-Pocket Maximum—Includes
medical deductible, coinsurance, and/or co-pays
$3,500 Individual;
$7,000 Family
Combined Out-of-Pocket Maximum—Includes
deductible, coinsurance, and/or co-pays,
and Rx deductible and co-pays
$6,250 Individual;
$12,500 Family
Lifetime Maximum
Physician Office Visits
Primary Care Physician (PCP)
Unlimited
You Pay:
$25 co-pay
Specialist (SPC)
$50 co-pay
Preventive Adult Physical Exams
No co-pay
Preventive GYN Care (including Pap test)
direct access to participating providers
No co-pay
Mammography Preventive Screening
No co-pay
Immunizations
No co-pay
Allergy Injections
Co-pay waived for allergy
injections billed
separately
Allergy Tests
Lab
X-Ray Outpatient
Advanced Outpatient Radiology Services
(MRI, CAT scan, PET scan, etc.)
$50 co-pay
No co-pay
$50 co-pay
$250 co-pay
Colonoscopy Screenings—Preventive and
Diagnostic
No co-pay
Chiropractic Services
(direct access to participating providers)
Hearing Exam
$50 co-pay;
20 visits per calendar year
$25 co-pay
This chart provides a brief outline of the medical coverage options available to you through
Humana. Complete details are in the official plan documents. In any conflict between the
plan documents and this basic comparison chart, the plan documents will control.
Page • 4
National Point-of-Service (NPOS)
548085
Consumer Directed Health Plan (CDHP)
548085
In-Network
Out-of-Network1
In-Network Only
Any provider
in the NPOS Open Access
Network (national network)
Any provider
Any provider
in the HMO Premier Network
(includes Florida and several other states)
N/A
N/A
$500 Individual;
$1,000 Family
(No maximum rollover amount)
$300 Individual;
$600 Family
(combined in- and out-of-network)
$1,500 Individual;
$3,000 Family
$3,500 Individual;
$7,000 Family
(combined in- and out-of-network)
$3,500 Individual;
$7,000 Family
$6,250 Individual;
$12,500 Family
(combined in- and out-of-network)
$6,250 Individual;
$12,500 Family
Unlimited
Unlimited
You Pay:
20% after deductible
You Pay:
40% after deductible
You Pay:
20% after deductible
20% after deductible
40% after deductible
20% after deductible
0%
40% after deductible
0% no deductible
0%
40% after deductible
0% no deductible
0%
40% after deductible
0% no deductible
0%
40% after deductible
0% no deductible
20% after deductible;
allergy injections billed
separately
40% after deductible;
injections billed
separately
20% after deductible
40%
40%
40%
40%
20%
20%
20%
20%
20%
20%
20%
20%
after
after
after
after
deductible
deductible
deductible
deductible
after
after
after
after
deductible
deductible
deductible
deductible
after
after
after
after
deductible
deductible
deductible
deductible
0%
40% after deductible
0% no deductible
20% after deductible
40% after deductible
20% after deductible
20 visits per calendar year in- or out-of-network
20% after deductible
40% after deductible
20% after deductible
Usual, customary, reasonable (UCR) fees. Out-of-network charges that exceed
UCR fees may be billed to the member.
1
= PCS Plan Changes
Continued on next page
Page • 5
Please note: the dollar amounts are
co-pays, deductibles, and maximums,
which you pay; the percentages are
coinsurance amounts, which you pay
after you meet applicable deductibles.
The amount the plan pays may be
based on usual, reasonable, and
customary (URC) fees for out-of-network
services only.
Humana Member Services
877-230-3318
Benefit
In-Network Only
Hospital
Inpatient (Includes maternity and newborn services)
$500 co-pay per day; up to
5-day maximum
Outpatient Surgery (including facility charges)
$500 co-pay
$300 co-pay
Emergency Room Services
Rx3 for Tier 2 and
Tier 3 Drugs
No co-pay
Ambulance
$50 co-pay
Urgent Care Facility
You must pay the $250
per person or $500 per
family Rx deductible
before you begin paying
Tier 2 and/or Tier 3
co-pays.
$50 co-pay for initial visit only
Maternity Care/OB Visits
Mental Health Services
Outpatient Mental Health Services
Inpatient Mental Health Services
Miscellaneous
Home Health Care
Rx3 Preferred Pharmacy
You must use one of the
preferred pharmacies
to receive the preferred
Rx3 benefits: CVS,
Walmart, Sam’s Club, and
RightSourceRx.
$50 co-pay
$500 co-pay per day; up to
5-day maximum
No co-pay
Hospice—Inpatient
$500 co-pay per day; up to
5-day maximum2
Skilled Nursing Facility
$500 co-pay per day; up to
5-day maximum2
Short-Term Rehabilitation/Outpatient
Therapy (speech, physical, occupational)
$50 co-pay per visit
60-visit limit per calendar year
for all therapies combined
Diabetic Supplies (syringes, test strips)
See the Diabetes Care Program, page 47
See prescription
drugs below
Durable Medical Equipment
Rx3 Prescription Drug Program
Some drugs may be subject to step-therapy or
precertification
Up to 30-day supply
This chart provides a brief
outline of the medical coverage
options available to you through
Humana. Complete details are
in the official plan documents.
In any conflict between the
plan documents and this basic
comparison chart, the plan
documents will control.
HMO Staff
Q7444
Tier 1
Tier 2
Tier 3
90-day Supply (maintenance medications)
at retail or mail order (mail order must be
through RightSourceRx)
Tier 1
Tier 2
Tier 3
Subject to usual, customary, reasonable (UCR) fees
Waived if transferred from hospital
1
2
Page • 6
No co-pay
Preferred Pharmacy
Mandatory Generics Unless
Dispensed As Written
$20 co-pay; no Rx deductible
$55 co-pay; after Rx deductible
$95 co-pay; after Rx deductible
Mandatory Generics Unless
Dispensed As Written
$40 co-pay; no Rx deductible
$110 co-pay; after Rx deductible
$190 co-pay; after Rx deductible
National Point-of-Service (NPOS)
548085
Consumer Directed Health Plan (CDHP)
548085
In-Network
Out-of-Network1
In-Network Only
$500 co-pay per day
after deductible; up to
5-day maximum
40% after deductible
20% after deductible
20% after deductible
40% after deductible
20% after deductible
20% after deductible
20% after deductible
20% after deductible
20% after deductible
20% after deductible
20% after deductible
20% after deductible
40% after deductible
20% after deductible
20% after deductible
40% after deductible
20% after deductible
20% after deductible
40% after deductible
20% after deductible
$500 co-pay per day
after deductible; up to
5-day maximum
40% after deductible
20% after deductible
20% after deductible
40% after deductible
20% after deductible; 150-visit limit per calendar year
$500 co-pay per day
after deductible; up to
5-day maximum2
40% after deductible;
30-day lifetime max; 90day limit per calendar year
20% after deductible
90-day limit per calendar year
$500 co-pay per day
after deductible; up to
5-day maximum2
40% after deductible
20% after deductible
120-day per calendar year
120 days per calendar year
20% after deductible
40% after deductible
60-visit limit per calendar year for all
therapies combined3
20% after deductible
60-visit limit per calendar year for all
therapies combined
See prescription
drugs below
See prescription
drugs below
See prescription
drugs below
20% after deductible
40% after deductible
20% after deductible
Preferred Pharmacy
Non-Preferred Pharmacy
Preferred Pharmacy
Mandatory Generics with
Dispense As Written
30% of submitted cost after:
$20 co-pay; no Rx deductible
$55 co-pay; after Rx deductible
$95 co-pay; after Rx deductible
$20 co-pay; no Rx deductible
Rx deductible and $55 co-pay
Rx deductible and $95 co-pay
Mandatory Generics with Dispense As Written
$20 co-pay; no Rx deductible
$55 co-pay; after Rx deductible
$95 co-pay; after Rx deductible
Mandatory Generics with
Dispense As Written
Mandatory Generics with
Dispense As Written
30% of submitted cost after:
$40 co-pay; no Rx deductible
$40 co-pay; no Rx deductible
$110 co-pay; after Rx deductible Rx deductible and $110 co-pay
$190 co-pay; after Rx deductible Rx deductible and $190 co-pay
$40 co-pay; no Rx deductible
$110 co-pay; after Rx deductible
$190 co-pay; after Rx deductible
= PCS Plan Changes
Page • 7
Payroll Deduction Rate Chart
Board Contribution—If you purchase medical insurance, the rates below reflect your per-pay-period payroll deduction (20 pays)
after the Board Contribution has been applied. If you do not purchase medical insurance, you may receive up to a $75 per-pay-period
credit toward the cost of, Dental, Vision, AD&D, and/or Short-term and Long-term Disability, and the Hospital Indemnity Plan. You may
also contribute between $10 and $25 of these credits to a Healthcare FSA. You may not use these credits to purchase Optional Employee
and/or Dependent Term Life or apply them toward the Dependent Care FSA, or MetLife Voluntary Benefits.
Humana Medical Plans
Coverage Level
Humana
HMO Staff
Humana
NPOS
Humana Consumer Directed
Health Plan
Employee
Employee + Spouse
Employee + Child(ren)
Employee + Family
Two Board Family*
$48.00
158.00
151.00
230.00
137.00
$63.00
182.00
175.00
262.00
169.00
$30.00
120.00
115.00
178.00
85.00
Payroll deduction per-pay-period (20 pays) AFTER the Board Contribution has been applied.
* To be eligible for Two Board Family, three or more individuals must be covered under the plan and your legal spouse or
same-sex domestic partner must be a benefits-eligible employee of the School Board.
Dental Plans
Coverage Level
Employee
Employee + 1
Employee + Family
Two Board Family**
Vision Plan
HumanaCompBenefits
Advantage
Dental Coverage
$6.70
12.47
18.22
16.22
MetLife® PDP
Dental Coverage
$12.62
23.34
33.69
31.69
Coverage Level
Employee
1 Dependent
Family
Two Board Family
EyeMed
Vision Coverage
No Charge
$2.48
4.36
4.36
Payroll deduction per pay period (20 pays) AFTER the Board Contribution has been applied.
** To be eligible for Two Board Family, three or more individuals must be covered under the plan and your legal spouse or
same-sex domestic partner must be a benefits-eligible employee of the School Board.
Prudential Life Insurance Plans***
Basic
Optional Employee and Dependent Term Life
Employee
Term Life
Insurance
Employee & Spouse
Age (as of effective
date of coverage)
One times base annual under 30
earnings rounded
30–34
up to next $1,000 is
provided
for all eligible
PCS employees
at no cost to you.
Minimum:
$15,000
Maximum:
$200,000
*** Keep
35–39
40–44
45–49
50–54
55–59
60–64
65–69
70+
Rates (per
$10,000)
$ 0.34
0.48
0.54
0.60
0.90
1.38
2.58
3.96
7.62
12.36
in mind that the amount of coverage you
elect will be reduced at certain ages. The $12.36
contribution shown for age 70 and above actually
buys coverage of $6,500 at ages 70–74, $4,500
at ages 75–79, and $3,000 at age 80 and above.
Children
Family
Rates
(per $2,000)
$0.31
Formerly “Dependent Life”
Rates (per family unit)
$1.00
This coverage is “guarantee issue” and no evidence of good
health is required.
Optional Employee Term Life: $10,000 minimum, up to
$200,000 in $10,000 increments or $250,000, up to
$500,000 maximum in $50,000 increments; “guarantee
issue” (new hire only) to $100,000 or your current
coverage amount; for additional amounts, you must
provide evidence of good health; subject to reduction
schedules at age 70.
Optional Dependent Term Life for Spouse: $10,000 increments
to $100,000; evidence of good health is required; coverage
terminates at age 70.
Optional Dependent Term Life for Child(ren): $2,000
increments to $10,000; one premium covers all eligible
child(ren).
Optional Family Term Life: One premium covers spouse and
eligible child(ren).
Page • 8
Prudential Accidental Death & Dismemberment Insurance
Benefit
Amount
$50,000
$100,000
Employee
Only
$0.77
$1.54
Employee +
Family
$1.28
$2.57
Benefit
Amount
$200,000
$300,000
Employee
Only
$3.07
$4.61
Employee +
Family
$5.13
$7.70
Basic Employee
Accidental Death
& Dismemberment
Insurance is provided
for all eligible PCS
employees at no cost to
you. Coverage Amount:
$2,000
Assurant Income Protection Short-term Disability Plan (STD) (Base Plan)
An eligible employee may select one of the benefit levels outlined below, provided the Monthly Disability Benefit does not
exceed 66 2/3% of the person’s regular monthly base salary.
If Your
Annual Base
Salary Is at Least
Monthly
Disability
Benefit
$ 7,200
10,800
14,400
18,000
21,600
25,200
28,800
32,400
37,800
43,200
48,600
54,000
63,000
72,000
81,000
90,000
$ 400
600
800
1,000
1,200
1,400
1,600*
1,800*
2,100*
2,400*
2,700*
3,000*
3,500*
4,000*
4,500*
5,000*
20 deductions per year when Accident and Sickness
Benefits begin after the WAITING/ELIMINATION PERIOD:
15-Day Plan
30-Day Plan
$ 6.78
10.17
13.56
16.94
20.33
23.72
27.11
30.50
35.58
40.67
45.75
50.83
59.30
67.78
76.25
84.72
$ 5.47
8.20
10.94
13.67
16.41
19.14
21.88
24.61
28.72
32.82
36.92
41.02
47.86
54.70
61.53
68.37
60-Day Plan
$ 4.24
6.35
8.47
10.59
12.71
14.83
16.94
19.06
22.24
25.42
28.59
31.77
37.07
42.36
47.66
52.95
* Subject to medical underwriting approval.
Assurant Long-term Disability Plan (LTD)
If Your Annual
Base Salary Is
at Least
$ 7,200
10,800
14,400
18,000
21,600
25,200
28,800
32,400
Accident and
Sickness Monthly
Disability Benefit
$ 400
600
800
1,000*
1,200*
1,400*
1,600*
1,800*
20
Deductions
Per Year
If Your Annual
Base Salary Is
at Least
Accident and
Sickness Monthly
Disability Benefit
20
Deductions
Per Year
$2.44
3.66
4.88
6.10
7.32
8.54
9.76
10.98
$37,800
43,200
48,600
54,000
63,000
72,000
81,000
90,000
$2,100*
2,400*
2,700*
3,000*
3,500*
4,000*
4,500*
5,000*
$12.81
14.64
16.48
18.31
21.36
24.41
27.46
30.51
* Subject to medical underwriting approval.
MetLife Plans
Enroll on PCS AE Website
Coverage Level
Hospital Indemnity
Plan (HIP)
Employee Only
Call MetLife (800-438-6388) to Enroll
Defender Identity
Theft Protection
$8.00
$9.00
Employee + Spouse
$13.00
$12.00
Employee + Children up to age 26
Employee + Family
$17.00
$21.00
$15.00
$18.00
Page • 9
Legal
Plan
$10.80
(no coverage level
selection required)
Annual Enrollment Timeline
When What you can expect…
October 7 – 27
Verify you have an active PCS network user ID* and password. Call the
Help Desk at 727-588-6060 for assistance. (Hint: Do not wait until the
last few days of the enrollment period.)
Review the BENEFlex Guide. An electronic version of the BENEFlex Guide
is available on the District’s website at www.pcsb.org/beneflex-guide.
October 15 – 27
Online annual enrollment. Follow these instructions:
1. Open an Internet browser. You may access the annual
enrollment link through Pinellas County Schools’ home page at
https:www.pcsb.org/annual-enrollment and click “2015 BENEFlex
Annual Enrollment Self Service.”
* If you do not have an
active user ID, contact
the PCS User Tech Help
Desk at 727-588-6060.
Hours are 6:45 a.m.
to 4:30 p.m. Monday
through Friday.
2. Log in to PCS Employee Self Service.You must have an active PCS
Network user ID and password.* This is the same user ID and
password you use to access the District’s intranet and your District
Outlook account or to view your paycheck stub. Your user ID is
usually your last name followed by your first name initial.
3. Click the “BENEFlex 2015 Annual Enrollment” link.
4. Continue through the Wizard Enrollment Process to verify and
select insurance benefits for 2015.
5. Once you’ve completed your enrollment, print your Confirmation
Notice. Confirmation Notices will also be available online on
Employee Self Service after November 1, 2014.
Note: All new coverage elections will not be effective until
your Evidence of Insurability is received and approved by the
insurance company.
December 5
Supporting Services payroll deductions begin for 2015 insurance
elections.
December 12
Instructional, Administrative, and PTS payroll deductions begin for
2015 insurance elections.
January 1, 2015
Newly elected coverage and changes take effect.
January 2
Supporting Services payroll deductions begin for 2015 flexible
spending accounts and MetLife Legal.
January 9
Instructional, Administrative, and PTS payroll deductions begin for
2015 flexible spending accounts and MetLife Legal.
Questions About Your Benefits? Call 727-588-6197
Or Visit: www.pcsb.org/annual-enrollment
Page • 10
Annual Enrollment Meeting Schedule
Representatives from Florida KidCare will be presenting at all meetings and available to answer questions.
DateLocation
Time
Room
October 13
Dunedin Middle School
170 Patricia Ave., Dunedin
4:45 pm, 6:00 pm
Highlander Hall
October 14
Pinellas Park High School
6305 118th Ave. N., Pinellas Park
4:45 pm, 6:00 pm
Auditorium
October 15
Pinellas Technical College
901 34th St. S., St. Petersburg
4:45 pm, 6:00 pm
G - 8, Second Floor
October 16
Walter Pownall Service Center 3:00 pm
11111 South Belcher Rd., Largo October 21
Palm Harbor Middle School
1800 Tampa Rd., Palm Harbor
4:45 pm, 6:00 pm
Media Center
October 22
Largo Administrative Building
301 4th St. SW., Largo
4:45 pm, 6:00 pm
Conference Hall
Your Enrollment Checklist
Cafeteria
Health Care Reform and You

Use all your resources to help you make informed enrollment decisions:
 Attend an Annual Enrollment meeting.
Visit www.pcsb.org/annual-enrollment.
 Read your 2015 Annual Enrollment newsletter and online BENEFlex Guide.

Log in to PCS Employee Self Service and actively enroll between
October 15 and 27.* Be sure to:
 Verify that your spouse and dependents are eligible for coverage.
 Enter your eligible dependents’ Social Security numbers.
 If you enroll in the HMO Staff Plan, enter the PCP (Primary Care Physician)
information for yourself and each eligible covered dependent.
Your coverage becomes effective January 1, 2015.
* The MetLife Legal and MetLife Defender Identity Theft plans requires you to enroll or
make changes by calling 800-438-6388 or online at www.metlife.com/mybenefits.
Midyear Benefit Changes
The choices you make during annual enrollment are effective January 1 through
December 31, 2015 unless you experience a qualified change in status event.
Change in status events include, but are not limited to: marriage or divorce; death
of spouse or other dependent; birth or adoption of a child, or placement of a child
for adoption; you, your spouse, or dependent experience a change in employment
that affects your benefits eligibility; your eligible child(ren) loses coverage under a
federal or state-sponsored health program, like Florida KidCare.
You may enroll, change, or cancel your or your dependents’ health insurance
and/or supplemental insurance elections (dental, vision, life, AD&D, or income
protection) consistent with the change in status. Your request to change benefits
must be submitted within 31 calendar days of the change in status, and changes are
effective the first day of the following month after your paperwork is received by
Risk Management and Insurance. Review the BENEFlex Guide for details.
Page • 11
The Affordable Care Act (ACA)
requires most Americans to purchase
health insurance or pay a penalty. This
is called the “individual mandate.” The
medical plans offered by PCS meet or
exceed the affordability and coverage
requirements of the ACA. If you have
a family, the individual mandate also
applies to your spouse and children.
If you cannot afford to enroll them in
a PCS medical plan, consider the
following:
• Children: Consider Florida
KidCare, the state-sponsored
health care program for children
from birth through age 18
who meet specific eligibility
requirements. Family income is
not considered when determining
eligibility. For more information,
call 800-821-5437 or visit
www.floridakidcare.org.
• Spouse and/or child(ren): If your
spouse is employed, consider his
or her employer’s group health
insurance. If your spouse is not
employed or his or her employer
doesn’t offer group health
insurance, the federal Health
Insurance Marketplace may offer
cost-effective alternatives. You can
also enroll your child(ren) in a
Marketplace plan.
For more information about
health care reform, go to:
www.pcsb.org/affordable-care-act.
CONTACT INFORMATION
Onsite Representatives
Humana (Claims Advisor) Humana (Medical—Patient Advocate) Humana (Health & Wellness/HumanaVitality Advocate) Assurant (Disability) 727-588-6367
727-588-6137
727-588-6134
727-588-6444
Risk Management and Insurance
Main Number
727-588-6195 • (Fax) 727-588-6182
Insurance Benefits and Deductions—Employee
727-588-6197
Retirement727-588-6214
Tax-Deferred Accounts 727-588-6141
Wellness 727-588-6031
Workers’ Compensation727-588-6196
Insurance Carriers
Assurant—Disability Insurance Claims866-376-9478
Corporate Care Works (CCW)800-327-9757
Employee Assistance Program (EAP)www.corporatecareworks.com
Humana FSA Administration
800-604-6228
www.MyHumana.com
Humana Medical Member Services and Claims 877-230-3318
www.humana.com or www.MyHumana.com
Humana RightSourceRx (Mail Order Rx)800-379-0092
www.RightSourceRx.com
EyeMed Vision Care888-203-7437
www.eyemedvisioncare.com
HumanaCompBenefits—Advantage Dental (AVF1)
800-342-5209
www.compbenefits.com/custom/pinellascountyschools
800-942-0854
MetLife® Dental Plan—PDP (G95682)
www.metlife.com/dental
MetLife® Voluntary Benefits800-438-6388
www.metlife.com/mybenefits
Non-PCS Programs
Florida KidCare800-821-5437
www.floridakidcare.org
Federal Health Insurance Marketplace
800-318-2596
www.healthcare.gov
This newsletter describes Pinellas County Schools employee benefit programs that will be effective for the plan year beginning
January 1, 2015. This is only a summary of the benefit programs. Additional restrictions and/or limitations not included in this
guide may apply. In the event of a conflict between this guide and the plan documents, the plan documents will control.
Page
Page •• 12
12