Cobb County School District
2015 BENEFITS OPEN ENROLLMENT REVIEW
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ShawHankins
Service Center- can answer questions on all benefits, including state health
Available extended hours 8:30 am – 7:00 pm during open enrollment
 Oct 27 – Nov 14
877-373-0730
Benefit website- shawhankinsbenefits.net/ccsd
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SHBP Changes for 2015-Carrier Options
3 carriers to choose from: BCBS of GA, United Healthcare, & Kaiser Permanente.
 BCBS of Georgia: 3 levels of HRA- Gold, Silver & Bronze and statewide HMO
 United Healthcare: High Deductible Health Plan (HDHP) and statewide HMO
 Kaiser Permanente: Regional HMO available to members who work or live in the 27 metro
Atlanta counties.
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SHBP Changes for 2015- Plan Highlights
Health Reimbursement Arrangement (HRA)
 Copays will no longer apply to medical and pharmacy expenses. All services will be subject to
the plan deductible and/or co-insurance.
 Health Maintenance Organization (HMO)
 Members now have the choice of enrolling in statewide or regional HMO plan that offers
co-payments for certain services
 High Deductible Health Plan (HDHP)
 Members now have the option of enrolling in an HDHP. With an HDHP you are also eligible
to start a Health Savings Account (HSA) to set aside pre-tax dollars for medical expenses.
 Out of Pocket Maximums
 The medical and pharmacy out of pocket maximums will now be combined
 Co-payments count toward the out of pocket maximums for the HMO plans
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How the HRA Plans Works
Bronze, Silver and Gold options with different levels of coverage
All services are subject to the plan deductible and/or coinsurance, no copays
apply for 2015
SHBP contributes HRA credits to your HRA account based on the plan option
and tier of coverage you choose
 These credits provide first dollar coverage for medical and pharmacy expenses
HRA credits left at the end of the year will roll over to the next plan year, if you
remain enrolled in an HRA option
 If you enroll in an HMO or HDHP plan, you will forfeit any remaining 2014 credits
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HRA Plan Features
Preventive services covered at 100%
After you meet your annual deductible, you pay a percentage of the cost, called co-insurance
You are not required to obtain referrals from a PCP to see a Specialist
The credits in your HRA account are used to help meet your deductible and out of pocket max
The medical and pharmacy out of pocket maximum are combined
Certain drug costs are waived if you participate in one of the DM programs- diabetes, asthma, or
coronary artery disease
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How the HDHP Works
Low monthly premium
Must satisfy high deductible ($3,500 individual, $7,000 family) for all medical
and pharmacy expenses (except preventive care)
If you have more than single coverage, the entire family deductible ($7,000)
must be met before benefits are payable for any family member
Eligible to establish a Health Savings Account (HSA) to set aside tax-free dollars
to pay for eligible health care expenses.
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HDHP Plan Features
Preventive services covered at 100%
You pay co-insurance (70% in-network, 50% out of network) after you meet the
plan deductible for all medical and pharmacy expenses, until you meet the out
of pocket maximum ($6,450/$12,900)
Medical and pharmacy out of pocket maximums are combined
No co-pays apply
Eligible to contribute to Health Savings Account
 Contributions will not be taken through payroll deductions
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How the Statewide HMO Works
Available through BCBS or UHC
 Rates differ between the 2 carriers
Receive covered services through in-network providers only (except emergency
care)
 Be sure to confirm your providers are participating in the BCBS or UHC network
 Co-payments apply to certain services- office visits, urgent care, emergency
room and prescriptions
 Co-payments count toward your out of pocket maximum, but not deductible
 Preventive services covered at 100%
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How the Regional HMO Works
Services only available through Kaiser HMO network
Must select a PCP
Preventive services covered at 100%
Plan available for members that live or work in one of the 27 metro Atlanta counties:
Barrow
Coweta
Gwinnett
Paulding
Bartow
Dawson
Haralson
Pickens
Butts
DeKalb
Heard
Pike
Carroll
Douglas
Henry
Rockdale
Cherokee
Fayette
Lamar
Spalding
Clayton
Forsyth
Meriwether
Walton
Cobb
Fulton
Newton
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Wellness
Healthways will continue as the Wellness vendor for the BCBS and UHC plan options
with well-being resources and incentive programs
All health actions must be completed between January 15, 2015 and December 15,
2015 to earn well-being incentive credits
If you choose one of the HRA plans, the well-being credits will be deposited into your
HRA account
If you choose a statewide HMO, well-being credits will be placed into incentive
accounts
If you choose the HDHP plan, well being credits will be placed into an incentive account
 You must pay $1,300 toward your individual deductible or $2,600 toward family deductible
prior to accessing these credits
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Earning Wellness Credits
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Wellness-Kaiser Permanente
Resources Available
 Total Health Assessment
 Biometric screenings
 Online and onsite healthy living classes
 Sign up at my.kp.org/shbp and complete at least one health action to be entered in
monthly drawing for an iPad and a Fit Bit:
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Completed biometric screening
Completed online Total Health Assessment
Get support to meet goals with KP wellness coach
Complete one online health education class
Get your annual flu shot
Received a preventive Cancer Screening- Colorectal Cancer, Breast Cancer or Cervical Cancer
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Tobacco Cessation
Tobacco surcharges are included in all SHBP options
Surcharge applies if you are not tobacco-free or do not complete tobacco
cessation coaching program
If you do not make an indication for 2015 on your tobacco usage, you will
continue to be assessed the surcharge.
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State Health Open Enrollment
 Open enrollment is from October 27th – November 14th
myshbpga.adp.com
If you do not login to enroll or make changes, you will be defaulted to your
current HRA plan (without copays), coverage tier and tobacco status. If you are
not currently covered and do not enroll, you will continue with no coverage.
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State Health Open Enrollment
•When making your benefit election make sure you have selected the correct option.
•Verify your coverage tier (you only, you + spouse, you + child(ren) or you + family)
•Confirm you have added all eligible dependents you wish to be included under your coverage.
•Confirm you have answered the tobacco question correctly.
•Review/Confirm your elections and click “Finish”. NOTE: If Finish is NOT clicked, your enrollment
process has not been completed.
•Print or save a copy of your confirmation page for your records.
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Ancillary Benefits
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Dental
MetLife will be the dental carrier for 2015
 Expansive national network, superior service
 All members will receive a new ID card
 Continue to have a Base and Plus plan option
 Review benefit details, as base plan copay schedule differs from 2014
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Benefit Summary
Plan Option 1- Base Plan
(Copay Plan)
Plan Option 2 – Plus Plan
Coverage Type
In-Network
Out-of-Network
In-Network
Out-of-Network
Type A – Diagnostics &
Preventative
See Schedule
85% of R&C Fee
100%
100%
Type B – Basic
See Schedule
50% of R&C Fee
Type C – Major
See Schedule
40% of R&C Fee
Type D – Orthodontia
50% of Maximum
Allowed Charge
50% of R&C Fee
Deductible†
In-Network
Out-of-Network
In-Network
Out-of-Network
75% After Plan
Deductible
50% After Plan
Deductible
40% After Plan
Deductible
75% of R&C Fee
50% of R&C Fee
40% of R&C Fee
Individual
N/A
$50.00
$50.00
$50.00
Family
N/A
$150.00
$150.00
$150.00
Annual Maximum
Benefit:
In-Network
Out-of-Network
In-Network
Out-of-Network
Per Person
$750 of Combined
In-Network
Covered Dental
Expenses and Outof-Network
Covered Dental
Expenses
$500 of Combined InNetwork Covered
Dental Expenses and
Out-of-Network
Covered Dental
Expenses
$1,000
$1,000
Orthodontia Lifetime
Maximum
In-Network
Out-of-Network
In-Network
Out-of-Network
Per Person
$750
$500
$1,000
1,000
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Vision
Avesis will continue as the vision carrier for 2015
Basic and Preferred Plus Option
No change in plan coverage or rates
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Basic Life with AD&D
CCSD provides basic life coverage at no cost to you
This includes a life and accidental death and dismemberment benefit
Non-tobacco users receive a $13,000 benefit
Tobacco users receive a $10,000 benefit
Life benefit is portable, AD&D benefit is not portable
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Contributory Basic Life with AD&D
Additional term life and AD&D coverage available to purchase
2.5 times your salary
$113,000 maximum
Guaranteed issue for new hires. Late entrants must complete the Personal
Health Application and be approved for coverage
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Supplemental Life with AD&D
Eligible to elect if you purchase the Contributory Basic Life coverage
1 times your annual salary
Maximum 6 times your annual salary, to $500,000
 $500,000 maximum is no longer combined with other life policies
New hires guaranteed up to 2 times your salary or $100,000 without answering
health questions
Late entrants must complete the Personal Health Application for all amounts of
coverage
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Supplemental Life- Dependents
Spouse or Dependent Children
$10,000 or $25,000 in coverage
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Short Term Disability
No changes to STD benefit
Choice between 2 salary replacement percentage levels- 50% or 66.67%
Choose your start date for benefits, based on how many days of sick leave you have
All sick leave must be exhausted prior to STD benefits beginning
Late entrants or employees that wish to increase their level of coverage must submit a Personal
Health Application and be approved before coverage is effective
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STD Plan
Options
Benefits Start Date
(from the date of
Disability)
Benefit
Percentage
Monthly
Premium
1
8th calendar day
66.67%
$13.53
2
15th calendar day
66.67%
$11.21
3
31st calendar day
66.67%
$7.35
4
61st calendar day
66.67%
$7.16
5
8th calendar day
50%
$9.89
6
15th calendar day
50%
$8.19
7
31st calendar day
50%
$5.37
8
61st calendar day
50%
$5.22
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Long Term Disability
Cost paid fully by CCSD
Benefit begins after you are disabled for 6 months
Pays 50% of your gross monthly earnings up to a maximum of $7,500 a month
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Flexible Spending Accounts
Two separate accounts- Medical Spending Account and Dependent Care
Spending Account
Allows you to set aside pre-tax dollars to spend on qualified expenses, saving on
your taxable income
Must make new elections for 2015
If enrolling in the HDHP medical plan, you are not eligible to contribute to FSA
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Flexible Spending Accounts
Medical Spending Account
 Maximum contribution of $2,500
 Some eligible expenses- Deductibles, copayments, dental expense, vision services and
materials
 Dependent Care Spending Account
 $5,000 for married couple filing joint income tax returns, $2,500 if unmarried or married and
filing separate income taxes
 Some eligible expenses- any care of a dependent that allows you and your spouse to work:
day care, after school program, in-home care, camps
 New! You may rollover up to $500 left at the end of the 2014 plan year to use
in 2015 for your Medical Spending Account
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Cancer Coverage
Pays a cash benefit directly to you if diagnosed with Cancer or 29 additional
specified disease
Coverage available for you and your family
Pays based on the type of services received: inpatient care, surgery, medication
3 levels of benefits available- Economy, Standard, Deluxe
Convertible to individual policy
Waiver of premium after 90 days of disability
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Critical Illness Coverage
Pays a lump sum benefit to you at the time of diagnosis of a covered illness.
Employee benefit: $10,000
Spouse and child benefit: $5,000
 Children covered at no extra charge
 Some covered illnesses: Heart Attack, Stoke, Coronary Artery Bypass, Major
Organ Transplant, End Stage Renal Failure
 Wellness Benefit: Pays you $50 benefit when you have a annual preventive
screening: Ex) colonoscopy, EKG, Stress Test, Mammogram, Skin Cancer Biopsy
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Legal Coverage
In-Office Attorney Services: reviewing and preparing documents, providing legal advice and
consultation, representation in court
Telephonic Advice: assistance in reviewing and preparing documents, will preparation, financial
education and counseling
Online Resources: Guidebooks and videos, DIY Docs- state specific legal documents, online
financial tools
New for 2015! Identify Theft Protect- No additional cost
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Covers up to $1 million for expenses associated with restoring your identity
Lost wallet services- cancel and reissue credit cards, driver’s license, etc
Credit monitoring- monitors and informs members of changes to credit report
Internet surveillance- monitors websites for your personal information being traded or sold
Child monitoring- monitors your minor’s identity
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Questions?
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