PRE-OPEN ENROLLMENT COMMUNICATION
COMMUNITY ACTION, INC. OF CENTRAL TEXAS
Thank you for your continuing commitment to CAI; without your dedicated efforts to those we
serve, we would be unable to provide needed services.
Recently we met with our "Benefits Advisor" and have made the following decisions:

Medical Insurance: we have elected to remain with Humana again this year
beginning January 1, 2014 with three plan options. CAI has received an increase to the
premiums due to the continued high cost of medical care and new Affordable Care Act
Fees. However it was decided that Humana continues to offer the best options and
freedom of choice of providers and quality benefit options given the competition.
CAI is dedicated to offering employees the most affordable benefits as possible.
Therefore, to help minimize the increase, CAI will continue to pay a majority of the
employee only premium. However, even with the increase in employer contribution
there will also be an increase to your premiums.
Keep in mind, beginning no later than March 31st, 2014, you are required by the Federal
Government to have some form of Health Insurance or face a tax penalty of the greater
of $95.00 or 1% of your 2013 income.
All employees have the option of going to the Government Health Insurance
Marketplace, online at https://www.healthcare.gov/ , or to the BKCW Benefits
Advisor’s website at http://bkcw.com/quote/healthcare-marketplace, to search for
individual coverage. Should you elect to purchase coverage through either source, you
will lose all premium contributions that CAI elects to provide. Full time, benefit eligible
employees and dependents will not qualify for a subsidy as CAI is offering a plan that is
considered “affordable” by the Department of Health & Human Services guidelines. The
Government Health Insurance Marketplace or BKCW Benefit Advisor’s websites may be a
good option for part time employees with no current options for employer-sponsored
medical coverage.
We recommend that if you have dependent children under the age of 19, that
you contact Texas Chip/Medicaid website http://www.chipmedicaid.org/ or
call 2-1-1 to see if you qualify for low or no cost coverage and other programs
available.
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January 2014
EMPLOYEE BENEFITS OVERVIEW
Key Open Enrollment Dates
Open Enrollment Selections – “NEW THIS YEAR” Representatives with Assurant Employee
Benefits will be at CAI locations December 2nd – 4th to assist employees in completing
insurance enrollment selections for the 2014 benefit year. Please review the 2014 benefits
packet as it contains important information that will be necessary to make informed
decisions. Contact Debra in Human Resources if you should have any questions.
BENEFITS PACKAGE
(Regular Full Time employees hired on or after November 30, 2013 will have a 30 day waiting period
for benefits; Benefits will be effective the 1st of the month following 30 of continuous employment)
CAI Provides to Regular Full Time Employees when eligible:
$20,000 of Employer Paid Basic Term Life and AD&D Life Insurance Benefits
Employee Medical Insurance (Three Plan options available)
Employee Voluntary Dental Insurance (Two Plan options available)
Employee Voluntary Vision Insurance
Employee Voluntary Short Term Disability Insurance
Voluntary Worksite policies including Accident and Critical Illness with Cancer
Section 125/Cafeteria Tax Plan
The employee may contribute before tax dollars for:
Employee Medical Insurance
Voluntary Dental
Voluntary Vision
Voluntary Accident Coverage
Voluntary Critical Illness with Cancer
The employee may contribute after-tax dollars for:
Voluntary Term Life & AD&D Insurance
Voluntary Dependent Life & AD&D Insurance
Voluntary Short Term Disability Insurance
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CAI
2014 BENEFITS YEAR
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CORE BENEFITS
HUMANA RATES FOR GROUP HEALTH INSURANCE
It is important to refer to the summary of benefits for complete details of the medical plan selected.
The below description is brief and does not include all of the specific coverage’s for each plan.
CAI PROVIDES THREE OPTIONS FOR YOU TO CHOOSE FROM AND WILL CONTRIBUTE
$ 566.53 PER MONTH
TOWARDS THE PLAN OF YOUR CHOICE
PLAN 1 High Deductible Health Plan (HSA qualified plan)
($5000 DEDUCTIBLE 100% COINSURANCE $5000 EE OUT OF POCKET MAXIMUM)
(Employer contributes additional $98.79 monthly into HSA account)
12 Month Employee
10 Month Employee
Monthly Cost
Monthly Cost
Per Pay Period
Per Pay Period
(Total)
To Employee
Cost to Employee
Cost to Employee
Employee Only
Employee & Spouse
Employee & Child(ren)
Employee & Family
$467.74
$926.12
$757.73
$1,216.11
$0.00
$458.38
$289.99
$748.37
$0.00
$229.19
$145.00
$374.19
$0.00
$275.03
$173.99
$449.02
PLAN 2 NEW Humana Simplicity Plan
($0 DEDUCTIBLE 100% COINSURANCE $5000 EE OUT OF POCKET MAXIMUM)
12 Month Employee
10 Month Employee
Monthly Cost
Monthly Cost
Per Pay Period
Per Pay Period
(Total)
To Employee
Cost to Employee
Cost to Employee
Employee Only
Employee & Spouse
Employee & Child(ren)
Employee & Family
$637.46
$1,262.16
$1,032.68
$1,657.38
$70.93
$695.63
$466.15
$1,090.85
$35.47
$347.82
$233.08
$545.43
$42.56
$417.38
$279.69
$654.51
PLAN 3 Humana Plan CF3000
($3000 DEDUCTIBLE 100% COINSURANCE $6250 EE OUT OF POCKET MAXIMUM INCLUDING ALL
MEDICAL AND RX COPAYS)
12 Month Employee
10 Month Employee
Monthly Cost
Monthly Cost
Per Pay Period
Per Pay Period
(Total)
To Employee
Cost to Employee
Cost to Employee
Employee Only
Employee & Spouse
Employee & Child(ren)
Employee & Family
$629.48
$1,246.38
$1,019.76
$1,636.66
$62.95
$679.85
$453.23
$1,070.13
$31.48
$339.93
$226.62
$535.07
$37.77
$407.91
$271.94
$642.08
Medical Plan Enhancements
1.
2.
Maximum Out of Pocket costs include Medical and RX Co-payments, Deductibles and Co-insurance
No Pre-Existing Conditions
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CAI
2014 BENEFITS YEAR
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VOLUNTARY BENEFITS
ASSURANT EMPLOYEE BENEFITS GROUP INSURANCE RATES FOR
VOLUNTARY DENTAL INSURANCE
CAI offers a choice of two voluntary Dental plans.
It is important to refer to the summary of benefits for complete details on the dental plan.
Employee Only
Employee & Spouse
Employee & Child(ren)
Employee & Family
Employee Only
Employee & Spouse
Employee & Child(ren)
Employee & Family
BASIC PLAN
100% preventive / 50% basic / 0% major
$1000 maximum / $50 ded basic
12 Month Employee
Monthly Cost
Per Pay Period
To Employee
Cost to Employee
10 Month Employee
Per Pay Period
Cost to Employee
$10.78
$23.62
$26.67
$41.55
$6.47
$14.17
$16.00
$24.93
$5.39
$11.81
$13.34
$20.78
HIGH PLAN
100% preventive / 80% basic / 50% major
$1000 maximum / $50 ded basic-major
12 Month Employee
Monthly Cost
Per Pay Period
To Employee
Cost to Employee
10 Month Employee
Per Pay Period
Cost to Employee
$31.52
$60.78
$70.98
$101.37
$18.91
$36.47
$42.59
$60.82
$15.76
$30.39
$35.49
$50.69
ASSURANT VOLUNTARY VISION INSURANCE
It is important to refer to the summary of benefits for complete details on the Vision plan.
12 Month Employee
10 Month Employee
Monthly Cost
Per Pay Period
Per Pay Period
To Employee
Cost to Employee
Cost to Employee
Employee Only
Employee & Spouse
Employee & Child(ren)
Employee & Family
$9.24
$18.38
$20.20
$29.33
$4.62
$9.19
$10.10
$14.67
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$5.54
$11.03
$12.12
$17.60
CAI
2014 BENEFITS YEAR
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VOLUNTARY BENEFITS
ASSURANT VOLUNTARY LIFE INSURANCE/ACCIDENTAL DEATH & DISMEMBERMENT (AD&D)
Guarantee Issue amount $130,000 Employee, $50,000 Spouse, $10,000 Child
Maximum amount $500,000 or 5X annual Salary
Premiums based on Age and amount of benefit elected.
ASSURANT VOLUNTARY SHORT TERM DISABILITY INSURANCE
Weekly benefit of up to 60% of income for up to 26 weeks
Premiums based on age and amount of benefit elected.
ASSURANT VOLUNTARY OFF THE JOB ACCIDENT POLICY
The Accident policy provides a fixed benefit for accidental injuries such as fractures, dislocations
and related expenses, such as emergency room visits, and physical therapy that happen off the job.
Daily hospital and ICU benefits are included as well as an AD&D benefit and a wellness benefit.
Employee Only
Employee & Spouse
Employee & Child(ren)
Employee & Family
Monthly Cost
To Employee
12 Month Employee
Per Pay Period
Cost to Employee
10 Month Employee
Per Pay Period
Cost to Employee
$20.88
$28.14
$31.03
$38.29
$10.44
$14.07
$15.52
$19.15
$12.53
$16.88
$18.62
$22.97
ASSURANT VOLUNTARY CRITICAL ILLNESS WITH CANCER POLICY
Critical Illness policies pay a lump sum benefit at the first diagnosis of a critical illness, including
heart attack stroke, paralysis, Cancer and more. Policy includes a wellness benefit.
Premiums based on age at issue of policy, the amount of benefit elected and are based on
Tobacco/non-tobacco usage.
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CAI
2014 BENEFITS YEAR
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Family Status Changes
What are the applicable changes in status events? The following events are "Change in Status"
events, the occurrence of which permit an election change that is on account and corresponds with
a change that impacts eligible for coverage under an employer's plan (the "Consistency Rule"):
Change in employee's legal marital status. A change in the employee's marital status due to
marriage, divorce, death of spouse, legal separation, and annulment. [ Treas. Reg. §1.1254(c)(2)(i)]
Change in number of dependents. A change in the number of dependents resulting from
birth, adoption, placement for adoption, and death. [ Treas. Reg. §1.125-4(c)(2)(ii)]
Change in employment status. Any of the following events that change the employment
status of the employee, the employee's spouse, or the employee's dependent:
 a termination or commencement of employment;
 a commencement of or return from an unpaid leave of absence; and
 a change in worksite.
Dependent satisfies (or fails to satisfy) dependent eligibility requirements under an employer
plan. An event that causes a dependent to satisfy or cease to satisfy the requirements for
coverage due to attainment of age, gain or loss of student status, marriage or any similar
circumstances. For example, if the child reaches the limiting age under the accident or
health plan, a change in status occurs and the participant may make an election change that
is consistent with the event.
Residence change. A change in the place of residence of an employee, spouse or dependent
that impacts eligibility for coverage under the plan. An employee who changes his/her
residence could only change his/her election if the employee is no longer eligible for
his/her current health coverage as a result of the residence change.
Adoption Assistance. A commencement or termination of adoption proceedings permits a
change to an Adoption Assistance Program election.
For a comprehensive listing of Change of Status qualifying events please refer to the website
at: http://www.changeofstatus.com/index.asp
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