The content of this Power Point is designed
only for communication purposes and is not to
be considered a contract, nor does it
guarantee or imply coverage. Consult your
plan booklet or Administrator for detailed
coverage or pre-existing limitations.
Frenship Independent School District
2013 Benefit Open
Enrollment Plan Overview
Online Benefit Access 24·7
― Visit www.mybenefitshub.com/frenshipisd for all of
your benefit needs.
― Review Employee Benefit Guide.
― Find important links to all benefit carriers.
― Check your Flexible Spending Balance
Section 125 Cafeteria Plan
There are special rules and requirements to receive the pre-tax benefit
election plan privileges:
―
Frenship ISD must set a plan year. The district’s plan
year is January 1 to December 31 of each year.
― Although coverage is voluntary, every employee is required to review
their current elections, make changes if desired and *sign a Section 125
Benefit Election Form. (Currently all employee enrollments are completed
on-line and therefore all signatures are electronically received.)
― Any pre-tax elections will remain in effect unless you have a qualified
change in family status. Changes must be made within 31 days of the
event.
― Any pre-tax elections will remain in effect and cannot be revoked or
changed during the plan year unless you have one of the following
changes in family status: Marriage, Divorce, Birth/Adoption, Death,
Change in Dependent Eligibility, etc.
2013 Enrollment – Important Information
Open Enrollment Start Date – 11/2/2012
Open Enrollment End Date – 12/3/2012
**All Employees are required to meet with Financial
Benefit Services even if you are “declining” benefits.**
Coverage for benefit elections made during
this enrollment process will become effective
on January 1st, 2013.
Direct Reimbursement Dental Plan
* Plan allows you to visit the dentist of your choice!
―
You are covered at 100% of the 1st $100
― You are covered at 80% of the next $250
― You are covered at 50% of the next $1,400
― Annual maximum benefit per covered person is $1,000
― Orthodontia is covered for participants and has a lifetime benefit
of $1,000. Benefits are paid just like they are on dental.
― Exclusions: cosmetic dentistry, implants, TMJ
― Use of the NBS Flex Card is prohibited with dental claims; you
must file a paper claim form for Flex reimbursement after dental
claims are paid.
2013 Dental Plan Rates
Employee Only
$26.00
Employee & Spouse
$52.00
Employee & Children
$55.00
Employee & Family
$81.00
Vision Insurance · Block Vision
* Plan allows in-network and out-of-network benefits.
― Eye Exam Co-Pay $10
― Eyewear Co-Pay $20
― Frame allowance $125 Retail (in-network)
― Lenses allowance Paid In Full (in-network)
― Contact Lenses allowance up to $150 (in-network)
― Vision examination allowed once every 12 months
― Frames allowed once every 12 months
― Lenses allowed once every 12 months
― Contact Lenses allowed once every 12 months
2013 Vision Plan Rates
Employee Only
$8.10
Employee & Spouse
$13.85
Employee & Children
$14.65
Employee & Family
$22.00
Did you know…Cancer Insurance has you covered?!
― About 1,596,670 new cancer cases are expected to be diagnosed in 2011
― The National Institute of Health estimates the overall costs of cancer in
2010 at $263.8 Billion
― An estimated 240,890 new cases of prostate cancer
will occur in the US during 2011
― An estimated 230,480 new cases of invasive
breast cancer are expected to occur among
women in the US during 2011
2011 Cancer facts & figures,
American Cancer Society
Group Cancer Insurance · Loyal American
* Coverage is Guarantee Issue, no health questions asked!
― Very Competitive Rates
― Two options are available on the cancer plan:
High Option and Low Option
― Annual Cancer Screening Benefit: $50 per calendar year
― First Occurrence Benefit: High Option $2,000, Low Option $500
― Daily Radiation/Chemotherapy Benefit: High Option $400,
Low Option $200
― Daily Hospital Confinement Benefit: High Option $200/Day, Low Option
$100/Day
― Optional ICU Benefit: $1,000/Day for the 1st 30 days of ICU Confinement
― Optional Specified Disease Benefit: Available with ICU Benefit
― Transportation and Lodging: $0.50 per mile and up to $75/Day for Lodging
2013 Cancer Rates · Low Plan
Low Option:
Low Option w/ICU & Specified
Disease Riders:
Employee Only
$11.56
Employee Only
$16.70
Single Parent Family
$13.03
Single Parent Family
$21.85
Family
$18.36
Family
$29.65
2013 Cancer Rates · High Plan
High Option:
High Option w/ICU & Specified
Disease Riders:
Employee Only
$19.92
Employee Only
$25.06
Single Parent Family
$22.56
Single Parent Family
$31.38
Family
$31.97
Family
$43.26
Did you know…Disability Insurance Protects?!
* Insure your paycheck!
― 7 out of 10 employees between the ages of 35 to 65 will
suffer a disability longer than 3 months
― 48% of all home foreclosures are due to disability
― 1 out of 2, 35 year olds will suffer a disability
lasting longer than 90 days before they reach
the age of 65
New Long-Term Disability Insurance · Aetna
* Coverage is Guarantee Issue, no health questions asked!
― Coverage is guaranteed up to $7,500 of monthly benefit
based on your annual income
― New coverage and increased benefits amounts are subject to a
12 month pre-existing condition exclusion
― Benefits can last while you are under a doctor’s care to age 65
due to illness or injury
― You may choose waiting periods in days of:
0/7, 14/14, 30/30, 60/60, 90/90 and 180/180,
based on your individual needs.
― Disability benefits are received tax free
Accident Insurance · American Public Life
* Benefits are paid directly to you!
― Pays regardless of any other medical coverage
― Benefits are paid directly to you
― Protects you 24 hours a day on or off the job
― Issue ages for employee and spouse are
18-64
― Policy is guaranteed renewable up to
age 70
― Benefits are available from 1 to 4 units
― There is no limit on the number of
accidents covered
2013 Accident Rates · 1-2 Units
1 Unit:
Employee Only
$10.80
2 Units:
Employee Only
$17.10
Employee & Spouse
$19.40
Employee & Spouse
$29.80
Employee & Children
$21.20
Employee & Children
$34.90
Employee & Family
$29.80
Employee & Family
$47.60
2013 Accident Rates · 3-4 Units
3 Units:
Employee Only
$21.50
4 Units:
Employee Only
$24.50
Employee & Spouse
$38.90
Employee & Spouse
$44.90
Employee & Children
$45.20
Employee & Children
$52.00
Employee & Family
$62.60
Employee & Family
$72.40
Employer Paid Base Life Insurance
Frenship ISD provides a $20,000 Basic Life and AD&D
policy at “No Cost to the Employee”. Employees
working 30 hours or more per week are eligible.
Did you know…Life Insurance is Key to Financial Planning?!
― Life Insurance should be part of your financial plan
― The risk of premature death is significant, thus leaving financial
obligations unfulfilled
― Think of family life changes that would have an impact on
normal expenses:
· Car Loans
· Rent or Mortgage Payments
· Credit Card Payments
· Children’s Education Expenses
· Everyday Living Expenses
Group Life Insurance · Aetna
* Coverage is Guarantee Issue, no health questions asked!
― This year only!! All employees can get up to $200,000 or max 5
times salary on a Guarantee Issue basis. This means no health
questions asked!
― Spouse can elect up to 50% of the employee’s amount. Spouse
coverage is Guarantee Issue up to $75,000
― Children are Guarantee Issue up to $10,000. One rate for all children
covered. If you have 5 kids with $10,000, the total premium would
only be $1.00
― The new Voluntary Life coverage through Aetna has lower rates than
the current plan offered through CIGNA
― Employees can elect AD&D coverage on a stand alone basis. AD&D is
available for both employee or for the employee and family.
Universal Life Insurance with Long Term
Care - Trustmark
― Flexible permanent coverage with portable death
protection and cash value accumulation
― Employees can adjust their death benefit, cash value
and premiums as needs change, take policy loans and
access living benefits for Long Term Care needs
Universal Life Insurance · Trustmark LTC Benefit
― Provides a monthly benefit equal to 4% of the base policy for
up to 25 months for medically necessary ADL Assistance
provided by:
· Nursing Home
$50,000 Death Benefit
With LTC Benefits:
· Adult Day Care
$50,000 x 4% = $2,000 Per Month
· Home Health Care
· Assisted Living Facility
* Maximum Issue Age is 70
* Universal Life Events:
Maximum Issue Age is 64
0
25
Months of Benefits
50
Universal Life Insurance · Trustmark LTC Benefit
― Triggered by 2 of 6 Activities of Daily Living:
Transferring
Continence
Bathing
Dressing
Eating
Going To
The Toilet
― Or Cognitive Impairment (such as Alzheimer’s or other
nervous/mental disorder caused by clinically organic disease)
― Benefits are paid as an acceleration and proportionately reduce
the death benefit
― Waiting Period: Benefits begin after the Insured has been confined in
a Long Term Care Facility or Assisted Living Facility or received Home
Health Care or Adult Day Care services for 90 days (premium is
waived after 90 days from the inception of a Long Term Care Benefit
Universal Life Insurance · Trustmark Living Benefits
How Does Universal LifeEvents With Living Benefits For LTC Work?
Example: $100,000 Death Benefit
Universal Life is flexible. You can adjust the death benefit, cash value and premiums as
your financial needs change.
Long Term Care Benefit (LTC)
Pays a monthly benefit equal to 4 percent of your death
benefit for up to 25 months.
The LTC benefit accelerates the death benefit and
proportionately reduces it.
Benefit Restoration
Restores the death benefit that is reduced to pay for LTC.
Maximum Benefit Amount
UL All Ages &
LE Before Age 70:
LE Age 70+:
$100,000
$100,000
$100,000
$33,000
$200,000
$133,000
Total Maximum Benefit
Living Benefits can double the value of your life
insurance.
Universal Life Insurance · Trustmark EZ Value Option
― Automatically raises coverage without additional underwriting
requirements
― Increases coverage each year by the amount that an additional $1 or
$2 weekly premium purchases
― Employee and/or Spouse through age 60
· Increase is the amount purchased by $1 per week on the
first 10 anniversaries
― Employee and/or Spouse through age 64
· Increase is the amount purchased by $1 per week on the
first 5 anniversaries
― Employee through age 64
· Increase is the amount purchased by $2 per week on the
first 5 anniversaries
Medical Gap Insurance · American Public Life
― Designed to cover your out-of-pocket expenses such as copayments, deductibles and co-insurance
― In-Hospital Benefit: pays up to the maximum amount chosen
for Covered Charges incurred when a Covered Person is confined in a
Hospital for 18 hours. $1,500 or $2,500 in-patient benefit available
― Outpatient Benefits: pays a $200 benefit for Covered Charges
incurred for treatment in a Hospital Emergency Room, outpatient
facility or a free-standing outpatient surgery center *Same condition
must be separated by 90 days
― Physician Benefit: pays for a physician visit up to $25 per visit, for up
to five visits per family, per calendar year for treatment received
outside of a Hospital as an outpatient. Also includes treatment at
your Physician’s Office, Emergency Room or Clinic
2013 Medical Gap Rates · $1,500
Ages Under 55:
Employee Only
$21.50
Ages 55-59:
Employee Only
$32.00
Ages 60+:
Employee Only
$49.00
Employee & Spouse
$39.50
Employee & Spouse
$59.00
Employee & Spouse
$88.00
Employee &
Children
$36.50
Employee &
Children
$47.00
Employee &
Children
$64.00
Employee & Family
$54.50
Employee & Family
$74.00
Employee & Family
$103.00
2013 Medical Gap Rates · $2,500
Ages Under 55:
Employee Only
$28.00
Ages 55-59:
Employee Only
$44.50
Ages 60+:
Employee Only
$68.50
Employee & Spouse
$51.50
Employee & Spouse
$81.50
Employee & Spouse
$122.50
Employee &
Children
$45.50
Employee &
Children
$62.00
Employee &
Children
$86.00
Employee & Family
$69.00
Employee & Family
$99.00
Employee & Family
$140.00
Flex Plan Admin · National Benefit Services
― Plan Year: January 1, 2013 to December 1, 2013
― Plan Maximum: $2,500 Annually (new maximum for 2013 as a result
of the “Healthcare Reform Act”)
― Services must be incurred in plan year
― Flex funds are fronted to you at beginning of plan year on a Visa Benny Card.
― 2 ½ month grace period to incur claims following plan year
― 90 day grace period to file claims following plan year
― Can be used for all IRS Classified Dependents
― “Use it or lose it”
― Dental Claims must be filed on paper, not on the NBS Flex Card
― Flex cards will be issued to each participant enrolled in plan
― Please Note: If you elect to participate in the Flex through NBS, you will
receive 2 Benny Flex Cards from NBS in January 2013. If currently have a Flex
Card with NBS it will be reloaded in January. Please do not destroy your
current card. May take 7 to 10 days after January 1, 2013 before your existing
Flex Card will loaded with your 2013 Flex Funds.
Medical Reimbursement Account · NBS
― Tax Free Account for Out-of-Pocket Medical Expenses
on a Pre-Loaded Visa Card
Examples are:
· Doctor Office Co-Payments
· Prescription Co-Payments
· Dental Expenses
· Vision – Glasses, Contacts, etc.
· Over the Counter Medications with
Doctor’s Prescription ONLY
Dependent Care Reimbursement Account · NBS
― Tax Free Account for eligible
Dependent/Child Care Expenses
― Tax Free Deduction via payroll
vs. deduction on income tax
― Annual Maximum: $5,000 for
married couple filing jointly or
$2,500 if filing single
How to File Claims ·National Benefit Services
― Visit www.mybenefitshub.com/frenshipisd and click
on Reimbursement Plans/Healthcare FSA/Claim Form
― Claim Form may be faxed, mailed or emailed to
National Benefit Services direct
― You may receive your reimbursement via check or
direct deposit
― Claims may be viewed on your benefit website 24·7
How to check your Flex Balance ·National Benefit
Services
― Visit www.mybenefitshub.com/frenshipisd and click
on Check FSA on the gray toolbar at top of page.
― Balances may be viewed on your benefit website 24·7
H S A Account Information
H S A Eligible Participants: Employees that
contribute to an H S A account are restricted to a
limited-purpose Health F S A, for reimbursement
for dental, vision and preventative care expenses
only. Reimbursement of expenses for medical
care under IRS Code Section 213(d), including
over-the-counter as well as prescription drugs will
not be allowed under your plan.
Important Enrollment Information
For complete benefit information and enrollment instructions
log onto www.mybenefitshub.com/frenshipisd
Remember enrollment dates start
November 2nd – December 3.
You may self enroll for your benefits.
Remember to print out and sign your election form and give
to your campus administrator. Enrollers will be available
beginning November 2nd. Check your campus schedule for
the date they will be on your Campus.
2012 Enrollment Schedule by Time & Campus
Friday 11/2:
8am – 4pm
Willow Bend
8am – 4pm
FMS
Thursday 11/8:
8am – 4pm
Crestview
Friday 11/9:
8am – 4pm
Custodians,
Maintenance,
Operations @ Casey
Building
Wednesday 11/14:
8am – 4pm
North Ridge
12:00am – 4pm
Reese Center
Thursday 11/15:
8am – 4pm
TVMS
Tuesday 11/13:
8am – 4pm
FHS
8am – 4pm
HMS
8am – 4pm
Bennett
2012 Enrollment Schedule by Time & Campus
Friday 11/16:
8am – 4pm
Westwind
8am – 4pm
Oak Ridge
8am – 4pm
Central Office
Monday 11/19:
8am – 4pm
Clean Up
Casey Building
Thank you for your attendance.
FBS Customer Service (800) 583-6908
Account Manager
Coby James
Larry Bowen
Client Service Representative
Debbie Walter