Benefits Overview
The information contained in this presentation is not a contract and is subject to change
by the proper authorities. It should be understood that explanations in this summary
cannot alter, modify or otherwise change the controlling legal documents or general
statutes in any way, nor can any right by reason of any inclusion or omission of any
statement in this presentation.
Who’s Eligible
• Permanent (non-temporary) part-time
employees working 20 – 29 hours per week
are eligible for many benefit programs,
typically without employer contributions
• Permanent (non-temporary) part-time
employees working 30 to 39 hours per week
or permanent full-time employees working 40
hours per week are considered to be benefits
eligible
2
Health Benefits
Health Benefits
• State Health Plan of NC – administered by Blue Cross
and Blue Shield of North Carolina (BCBSNC)
• Use any medical provider you choose
– In Network: Your costs are lower when you use a doctor,
hospital or other provider from the BCBSNC Blue Options
network.
– Out of Network: For other providers, your deductibles,
coinsurance and copays may be higher
• Choose from two plan options:
– Basic 70/30 Plan
(lower contributions, lower coverage levels)
– Standard 80/20 Plan
(higher contributions, higher coverage levels)
4
Basic 70/30 Plan: Highlights
How Plan Coverage Works
PLAN DESIGN FEATURE
IN NETWORK
OUT OF NETWORK
Annual Deductible
(Single/Family)
$933/$2,799
$1,866/$5,598
Coinsurance
You pay 30% after
deductible
You pay 50% after deductible,
plus difference between
charge and allowed amount
Preventive Care
• Office visit: $35
• Specialist visit: $81
Not covered
Office visits (non-preventive)
• Office visit: $35
• Specialist visit: $81
You pay 50% after deductible,
plus difference between
charge and allowed amount
Inpatient Care
You pay 30% after
deductible and $291 copay
You pay 50% after deductible
and $291 copay
Emergency Room
You pay 30% after
deductible and $291 copay
You pay 30% after deductible
and $291 copay
5
Standard 80/20 Plan: Highlights
How Plan Coverage Works
PLAN DESIGN FEATURE
IN NETWORK
OUT OF NETWORK
Annual Deductible
(Single/Family)
$700/$2,100
$1,400/$4,200
Coinsurance
You pay 20% after
deductible
You pay 40% after deductible,
plus difference between
charge and allowed amount
Preventive Care
• Office visit: $30
• Specialist visit: $70
Not covered
Office visits (non-preventive)
• Office visit: $30
• Specialist visit: $70
You pay 40% after deductible,
plus difference between
charge and allowed amount
Inpatient Care
You pay 20% after
deductible and $233 copay
You pay 40% after deductible
and $233 copay
Emergency Room
You pay 20% after
deductible and $233 copay
You pay 20% after deductible
and $233 copay
6
Both PPO Plans – More Details
• Prescription coverage provided by Medco:
–
–
–
–
Generic: $12 co-pay, up to 30-day supply
Preferred Brand-name: $40 co-pay, up to 30-day supply
Non-preferred Brand-name: $64 co-pay, up to 30-day supply
Specialty: 25% coinsurance up to $100, 30-day supply
• NC HealthSmart: voluntary program offering tools and
resources to help you live a healthier life such as:
– Member Focus newsletter, information on the 24-hour nurse
line, the Stork Rewards program, Eat Smart, Move More,
Weigh Less program
• Sign up for the State Health Plan Member Newsletter
at www.shpnc.org
7
Monthly Rates for Health Coverage
Medical Coverage
EMPLOYEE
ONLY
EMPLOYEE
+ CHILDREN
EMPLOYEE
+ SPOUSE
EMPLOYEE
+ FAMILY
Basic PPO
$0.00
$198.06
$510.32
$543.54
Standard PPO
$22.76
$286.16
$629.64
$666.18
PLAN
8
NCFlex Health & Other
Insurance Programs
NCFlex Health & Other Insurance
Programs
• These voluntary programs provide a variety of plans
to meet the needs of you and your family
• You pay the full cost of coverage through payroll
deductions on a pre-tax basis
• Programs include: Dental, Vision, Health Care
Flexible Spending Account, Dependent Day Care
Flexible Spending Account, Cancer, Critical Illness,
Group Term Life Insurance, Core AD&D and Voluntary
AD&D Insurance
10
Dental Coverage
• Coverage provided through United Concordia
• Choose from two plan options:
– High Option: Includes orthodontia for children under 19
– Low Option: Does not include orthodontia
• Under both options:
–
–
–
–
Visit any provider
You are responsible for deductibles
You or your dentist may file claims
You may be subject to a waiting period before certain
benefits are payable under the plan (see “Benefit Waiting
Period” chart under Dental coverage on NCFlex website)
11
Dental Coverage
How Plan Coverage Works under Each Option
PLAN DESIGN FEATURE
HIGH OPTION
LOW OPTION
Annual Deductible
$50 person/$150 family
$25 person/$75 family
Preventive/Diagnostic
Services
Plan pays 100%, no
deductible
Plan pays 100% after
deductible
• Fillings, extractions, endodontics,
periodontics
• Most services: You pay
20% after deductible
• Periodontic: You pay 50%
after deductible
• Fillings and extractions: You
pay 50% after deductible
• Periodontic and other
services: You pay 50% after
deductible
Major Services
You pay 50% after deductible
Not covered
Maximum Annual Benefit
$1,250 per person (excluding
orthodontia)
$1,000 per person
Orthodontia for dependent
children under age 19
Plan pays 50% up to $1,500
lifetime benefit per person
Not covered
• Exams, cleanings, X-rays, etc.
Basic Services
• Crowns, inlays, dentures, bridges
12
Monthly Rates for Dental Coverage
Dental Coverage
EMPLOYEE
ONLY
EMPLOYEE
+ SPOUSE
EMPLOYEE
+ ONE CHILD
EMPLOYEE
+ TWO OR MORE
CHILDREN
FAMILY
High Option
$37.40
$75.00
$71.96
$90.96
$132.42
Low Option
$21.34
$43.04
$41.30
$52.62
$73.68
PLAN
13
Vision Coverage
• Coverage provided through Superior Vision
Services (SVS)
• Choose from three coverage options:
– Exam and Materials
– Materials Only
– Enhanced Exam and Materials
• Under all options, visit any provider but lower
expenses with SVS in-network provider
14
Vision Coverage: Exam and Materials Plan and
Enhanced Exam and Materials Plan
How Plan Coverage Works
PLAN DESIGN FEATURE
IN NETWORK
OUT OF NETWORK
Routine Eye Exam
Plan pays 100% after $20
copay
Plan pays up to $44 for
ophthalmologist; up to $39
for optometrist
Frames – once every 12
months
Plan pays up to $100 ($150
for Enhanced Plan); 20%
discount on coverages
Plan pays up to $50 ($81 for
Enhanced Plan)
Lenses
Plan pays 100%
Plan pays up to:
•
•
•
•
Single vision: $34
Bifocal: $48
Trifocal: $64
Lenticular: $88
Contact Lenses (elective)
Plan pays up to $120 ($150
for Enhanced Plan)
Plan pays up to $100
Contact Lenses (necessary)
Plan pays 100%
Plan pays up to $210
15
Vision Coverage:
Materials Only Plan
How Plan Coverage Works
PLAN DESIGN FEATURE
IN NETWORK
OUT OF NETWORK
Routine Eye Exam
Not covered
Not covered
Frames – once every 24
months
Plan pays up to $100; 20%
discount on coverages
Plan pays up to $50
Lenses
Plan pays 100%
Plan pays up to:
•
•
•
•
Single vision: $34
Bifocal: $48
Trifocal: $64
Lenticular: $88
Contact Lenses (elective)
Plan pays up to $120
Plan pays up to $100
Contact Lenses (necessary)
Plan pays 100%
Plan pays up to $210
16
Monthly Rates for Vision Coverage
Vision Coverage
PLAN
EMPLOYEE ONLY
FAMILY
Exam and Materials
$6.84
$17.38
Materials Only
$5.14
$12.72
Enhanced Exam and Materials
$9.98
$25.10
17
Health Care Flexible Spending Account
• Coverage provided through P&A Group
• Set aside money through pre-tax contributions to pay for eligible
out-of-pocket medical, dental and vision expenses:
–
–
–
–
Deductibles
Co-pays and coinsurance
Out-of-network expenses
Uncovered procedures
• Contribute from $120 to $2,500 per year
• Convenience card (debit card) for all participants
• “Use it or lose it” rule; you forfeit any unused contributions
– Expenses can be incurred between January 1, 2013 and March 15,
2014, provided you remain actively employed for all of 2013. Prior
year claims must be submitted by April 30, 2014.
18
Dependent Day Care
Flexible Spending Account
• Set aside money through pre-tax contributions to pay eligible
child care and adult day care expenses so you (and your
spouse) can work or attend school full-time:
– Care of dependent children under age 13
– Care of dependent adult who lives with you at least 8 hrs/day
• You may contribute from $120 to $5,000 per year
• “Use it or lose it” rule: you forfeit any unused contributions
– Expenses can be incurred between January 1, 2013 and March
15, 2014, provided you remain actively employed for all of 2012.
Prior year claims must be submitted by April 30, 2014.
19
Other NCFlex Health Programs
• Cancer Insurance provided through American
Heritage Life: pays benefits for cancer-related
expenses
– Employee Only or Employee + Family Coverage
– Low, High and Premium options
• Critical Illness Insurance provided through
Met Life: pays lump sum benefit in event of
certain health conditions
– Employee, Spouse, Children or Family Coverage
– Three categories of coverage available
20
Monthly Rates for
Cancer Coverage
Cancer Insurance
PLAN
EMPLOYEE ONLY
EMPLOYEE + FAMILY
Low Option
$6.78
$11.26
High Option
$15.68
$26.06
Premium Option
$21.64
$35.96
21
Monthly Rates for
Critical Illness Coverage
Critical Illness Coverage
AGE
EMPLOYEE
SPOUSE
Less than 25
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-74
75-79
80-84
85 and older
$1.50
$1.80
$2.84
$5.10
$9.14
$16.04
$25.80
$40.34
$61.20
$93.14
$134.84
$190.94
$239.70
$257.54
$1.50
$1.80
$2.84
$5.10
$9.14
$16.04
$25.80
$40.34
$61.20
$93.14
$134.84
$190.94
$239.70
$257.54
Employees may also cover eligible dependent children. Employee will pay one flat rate ($0.92) no matter
how many children are covered.
22
Voluntary Group Term Life
Insurance
• Group Term Life provided through ING:
coverage in $10,000 increments, from $20,000
to $500,000 (limited to five times your base
annual earnings)
• Coverage over $100,000 subject to Evidence
of Insurability (EOI)
• Coverage available for yourself only
23
Monthly Rates for Life Insurance
Coverage
Voluntary Group Term Life Insurance
YOUR AGE
RATE PER $1,000 OF COVERAGE
Under 24
$0.049
25-29
$0.059
30-34
$0.079
35-39
$0.089
40-44
$0.139
45-49
$0.198
50-54
$0.337
55-59
$0.564
60-64
$0.840
65-69
$1.730
70-74
$2.520
24
Accident Insurance
• Core Accidental Death and Dismemberment (AD&D)
Insurance provided through A.C. Newman
– Elect coverage of $10,000 for yourself only
– University pays full cost of coverage; however, you must
enroll for coverage
– Payment to your beneficiaries in case of your accidental
death
– Payment to you in case of your accidental dismemberment
• Voluntary AD&D Insurance provided through A.C.
Newman
– Elect coverage up to $500,000 for you and your family
25
Monthly Rates for Accident
Insurance
Accidental Death & Dismemberment (AD&D) Insurance (Examples)
BENEFIT AMOUNT
EMPLOYEE ONLY COVERAGE
EMPLOYEE + FAMILY COVERAGE
$50,000
$0.96
$1.50
$75,000
$1.42
$2.26
$100,000
$1.90
$3.00
$125,000
$2.38
$3.74
$150,000
$2.86
$4.50
$175,000
$3.32
$5.26
$200,000
$3.80
$6.00
$250,000
$4.76
$7.50
$300,000
$5.70
$9.00
$350,000
$6.64
$10.50
$400,000
$7.60
$12.00
$500,000
$9.50
$15.00
26
Income Protection
Programs
Income Protection Programs
• Programs designed to provide you and/or your
family with financial protection in the event of
your death, disability or long-term illness
• Some are offered at no cost to you; others
require you to pay for coverage
28
Disability Plans
• Disability coverage provided under the Disability Income Plan of
North Carolina (DIP-NC)
• Short-Term Disability
– Provided to eligible employees at no cost
• After one year of contributing membership to TSERS or participation
in the ORP.
– Pays 50% of base compensation up to $3,000/month
– Payable up to 365 days, after 60-day waiting period
• Long-Term Disability
– Provided to eligible employees at no cost
• After five years of contributing membership to TSERS or participation
in ORP
– Pays 65% of base compensation up to $3,900/month
– Payable as long as you remain permanently disabled,
until eligibility for unreduced service retirement
29
Supplemental Disability Plans
• Can help fill gaps in State coverage
– Replacement income while you are ineligible for state
Short-Term Disability Plan
– Waiting period: 90 days
– Pays 66-2/3% of gross monthly salary up to $10,000
• Voluntary benefit; you pay full cost of coverage aftertax
• Coverage through The Standard if you elect ORP
– Includes continuing ORP contributions into your ORP account on
your behalf
• Coverage through Liberty Mutual if you elect TSERS
30
Retirement Programs
Retirement Programs
• Participation in a retirement program is mandatory
• You may choose between:
– The North Carolina Teachers' and State Employees'
Retirement System (TSERS), a defined benefit plan or
– the UNC Optional Retirement Program (ORP), a defined
contribution plan
• You must make your election between TSERS and
ORP within 60 days of your date of hire
• Once you make the choice it cannot be changed; it
is irrevocable
32
TSERS Plan Highlights
• Defined benefit plan
• State controls the investment
• Benefit you receive is based on a formula
(factors include your age, your average final
compensation and your years/months of
creditable service)
• You must contribute 6% of your pay on pre-tax
basis
33
ORP Plan Highlights
• Defined contribution plan
• You control your investments
• The benefit you receive at retirement is based on
investment performance and payment option chosen
• Program serves as an alternate option to TSERS for certain
faculty and EPA non-faculty and other employees as
approved by the UNC Board of Governors
• You must contribute 6% of your pay on a pre-tax basis
• The University contributes 6.84%
• Choose from four investment providers (Fidelity
Investments, Lincoln Financial Group, TIAA-CREF and VALIC)
34
Retirement Plan Resources
To review the booklet in greater detail, click on the picture to open the document.
35
Your Retirement, Your Choice
Video
36
Retirement Plan Resources
Two more resources to assist you in making a decision between TSERS and the ORP.
Click on the either image to open a link to that tool.
37
Supplemental Retirement Plans
• Allows you to put money away on a pre-tax basis for your retirement in
addition to the 6% you contribute to TSERS or the ORP
• There are three types of plans available
– 403(b) plan administered by two different vendors, Fidelity
and TIAA-CREF, and sponsored by the University
– A 401(k) plan administered through Prudential and
sponsored by the State of North Carolina
– A 457 plan administered through Prudential and sponsored
by the State of North Carolina
• You may elect to begin, change the amount you contribute or stop your
participation at anytime
• You may elect to participate in the 403(b), 401(k) and the 457 at the
same time, however there are limits to the amount you can contribute
38
Enrolling in Your
Benefits
When Coverage Becomes Effective
Coverage Effective Dates
PLAN NAME
COVERAGE EFFECTIVE
Health Benefits
First of the month or first of the
second month following
employment date
NCFlex Benefits
First of the month following
employment date
Short-Term Disability
After one year of contributing
membership to TSERS or ORP
Long-Term Disability
After five years of contributing
membership to TSERS or ORP
Supplemental Disability Plan
Employment date
TSERS
Employment date
ORP
Employment date
Supplemental Retirement Plans
May enroll at anytime
40
Enrollment for Health Benefits
• You must enroll within 30 days of your employment date
• To enroll follow the instructions in the Employee Instructions for
Completing Your Benefit Enrollment Online:
– http://shpnc.org/library/pdf/ebenefitsnow-enrollmentinst.pdf
• Link to your campus dedicated enrollment site
– http://shpnc.org/library/pdf/hr-intouch-urls.pdf
• Health insurance premiums are paid one month in
advance of coverage
– (i.e., January premiums pay for February coverage)
• No pre-existing condition exclusion or waiting periods if you
enroll when first eligible
41
Enrollment for NCFlex Programs
• To enroll visit the NCFlex Enrollment Website
– http://www.ncflexonline.org
• All employees must complete online
enrollment within 30 days of their
employment date.
42
Enrollment for Income Protection
Programs
• All employees must complete online enrollment within
60 days of their employment date
• Enroll for Supplemental Disability Insurance (after-tax)
through The Standard, if you choose the UNC ORP, by
completing the enrollment forms located online at
http://www.northcarolina.edu/hr/unc/benefits/financial/index.htm
• Enroll for Supplemental Disability Insurance (after-tax)
through Liberty Mutual, if you choose TSERS, by
completing the enrollment forms located online at
http://www.northcarolina.edu/hr/unc/benefits/financial/index.htm
43
Enrollment in TSERS
• You do not need to complete an enrollment form for
TSERS, but will be automatically enrolled.
• You must designate a beneficiary by completing the
following forms:
– Form 2DB - Designating Beneficiary(ies) for the Death Benefit
– Form 2RC - Designating Beneficiary(ies) for The Retirement
System Return of Contributions
– For these two forms visit
https://orbit.myncretirement.com/Orbit/Info/Pages
/ListAllForms.aspx?formCat=F3BENDESG
44
Enrollment in the ORP
• You must complete the following forms:
– Form ORP-1 The University of North Carolina Optional
Retirement Program (ORP) Election And Forfeiture
Agreement
– ORP Carrier Enrollment Application (Complete the ORP
Carrier form(s) for the carrier you want for your
contributions and the University contributions.)
• Follow the instructions provided by your campus
Human Resources/Benefits Office for instructions on
where to return forms
• You must enroll within 60 days of your date of hire or
you will automatically be enrolled in TSERS
45
Enrollment in the
Supplemental Retirement Plans
• 403(b) Plan
– Visit www.northcarolina.edu/hr/ga/benefits/retirement/SuppmtlRet/403bMain.htm
– Complete a Salary Reduction Agreement (form and instructions
available on the website)
– Enroll in the Plan with Fidelity and/or TIAA-CREF
• 457 Plan
– Visit www.retirement.prudential.com/cws/ncplans
– Complete an NC 457 Deferred Compensation Plan Enrollment Form
(forms and instructions available on the website)
– Send the form to:
• NC Plans Processing Center, PO Box 5340, Scranton, PA 18505,
or fax to 1-866-439-8602
46
Enrollment in the
Supplemental Retirement Plans
• State 401(k) Plan
– Visit www.retirement.prudential.com/cws/ncplans
– Complete an NC 401(k) Plan Enrollment Form
(forms and instructions available on the website
– Send the form to:
• NC Plans Processing Center,
PO Box 5340
Scranton, PA 18505,
or fax to 1-866-439-8602
47
For More Information
• Visit
www.northcarolina.edu/hr/unc/benefits/inde
x.htm for more information about the benefits
provided by The University of North Carolina
system.
• You can also check
http://www.wcu.edu/12305.asp for WCU’s HR
and Benefits Office contacts.
48