2015 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.
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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 – 39 hours per week or permanent full-time employees
working 40 hours per week are considered to be benefits
eligible
Health Benefits
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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: 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 three plan options:
– Traditional 70/30 Plan (lower contributions, lower coverage
levels)
– Enhanced 80/20 Plan (higher contributions, higher coverage
levels)
– Consumer-Directed Health Plan (CDHP) (higher deductible,
Health Reimbursement Account (HRA))
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Traditional 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% of eligible
expenses after deductible
You pay 50% of eligible
expenses 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
$291 copay, then 30% after
deductible
$291 copay, then 50% after
deductible
Emergency Room
$291 copay, then 30% after
deductible
$291 copay, then 50% after
deductible
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Enhanced 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% of eligible expenses
after deductible
You pay 40% of eligible expenses
after deductible, plus difference
between charge and allowed
amount
Preventive Care
Covered at 100%
Not covered
Office visits
• Office visit: $30 ($15 if you use the
PCP on your ID card)
• Specialist visit: $70 ($60 if you use
a Blue Options designated
specialist)
You pay 40% after deductible, plus
difference between charge and
allowed amount
Inpatient Care
$233 copay, then 20% after
deductible; copay not applied if you
use Blue Options designated hospital
$233 copay, then 40% after
deductible
Emergency Room
$233 copay, then 20% after
deductible; copay not applied if you
use Blue Options designated hospital
$233 copay, then 40% after
deductible
(non-preventive)
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CDHP (with HRA): Highlights
How Plan Coverage Works
PLAN DESIGN FEATURE
IN NETWORK
HRA
The Plan funds your Health Reimbursement Account (HRA ) annually based on
coverage level you elect (Employee, Employee +1, Employee + 2 or more)
Annual Deductible
(Single/Family)
$1,500/$4,500
$3,000/$9,000
Coinsurance
You pay 15% of eligible expenses after
deductible
You pay 35% of eligible expenses
after deductible, plus difference
between charge and allowed
amount
Preventive Care
Covered at 100%
Not covered
Office visits
You pay 15% after deductible
You pay 35% after deductible, plus
difference between charge and
allowed amount
Inpatient Care
You pay 15% after deductible; $50 added
to HRA if a Blue Options designated
hospital is utilized
You pay 35% after deductible, plus
difference between charge and
allowed amount
Emergency Room
You pay 15% after deductible; $50 added
to HRA if a Blue Options designated
hospital is utilized
You pay 35% after deductible, plus
difference between charge and
allowed amount
(non-preventive)
OUT OF NETWORK
Prescription Coverage –
70/30 and 80/20 Plans
• Prescription coverage (in-network) provided by Express
Scripts:
–
–
–
–
Generic: $12 copay, up to 30-day supply
Preferred Brand-name: $40 copay, up to 30-day supply
Non-preferred Brand-name: $64 copay, up to 30-day supply
Specialty: 25% coinsurance up to $100 or $150 (depending
on the medication), 30-day supply
– ACA preventive medications covered at 100% for 80/20
Plan; not applicable for 70/30 Plan
• Prescription coverage (out-of-network) provided by Express
Scripts:
– Applicable copay and the difference between charge and
allowed amount
– ACA preventive medications covered at 100% for 80/20
Plan; not applicable for 70/30 Plan
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Prescription Coverage – CDHP
• Prescription coverage (in-network) provided by Express
Scripts:
– Generic, Preferred Brand-name, Non-Preferred Brand-name:
15% coinsurance after deductible
– ACA preventive medications covered at 100%
– CDHP Preventive Medications covered at 15%, no
deductible
• Prescription coverage (out-of-network) provided by Express
Scripts:
– Generic, Preferred Brand-name, Non-Preferred Brand-name:
35% coinsurance after deductible
– ACA preventive medications covered at 100%
– CDHP Preventive Medications covered at 15%, no
deductible
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Additional Health Plan Resources
• 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
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Monthly Rates for Health Coverage
Medical Coverage
EMPLOYEE
ONLY
EMPLOYEE
+ CHILDREN
EMPLOYEE
+ SPOUSE
EMPLOYEE
+ FAMILY
Traditional 70/30 Plan
$0.00
$205.12
$528.52
$562.94
Enhanced 80/20 Plan
$63.56
$336.36
$692.10
$729.94
CDHP
$40.00
$224.60
$515.68
$546.64
PLAN
• If you are enrolled in the Enhanced 80/20 Plan or the ConsumerDirected Health Plan, you will have the opportunity to earn wellness
premium credits each year, which will reduce your monthly premiums
• Health insurance premiums are paid one month in advance of coverage
(i.e., January premiums pay for February coverage)
• No pre-existing condition exclusion
NCFlex Health & Other
Insurance Programs
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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
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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)
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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% on eligible
expenses, no deductible
Plan pays 100% on eligible
expenses after deductible
• Fillings, extractions, endodontics,
periodontics
• Most services: You pay
20% after deductible
• Periodontic: You pay 50%
after deductible
• Fillings and simple
extractions: You pay 20%
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
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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
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Vision Coverage
• Coverage provided through Superior Vision Services (SVS)
• Choose from three coverage options:
– Core Wellness Plan
– Basic Plan
– Enhanced Plan
• Under all options, can visit any provider but may pay lower
expenses with in-network SVS provider
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Vision Coverage: Core Wellness Plan
How Plan Coverage Works
PLAN DESIGN FEATURE
IN NETWORK
OUT OF NETWORK
Annual Comprehensive Eye
Exam
Plan pays 100% after $20
copay
Not covered
Frames and Lenses
Discounts available
Not covered
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Vision Coverage:
Basic and Enhanced Plan
How Plan Coverage Works
PLAN DESIGN FEATURE
IN NETWORK
OUT OF NETWORK
Routine Eye Exam
$20 copay
•
Up to $44 allowance for
ophthalmologist
•
Up to $39 allowance for
optometrist
Frames – once every 24
months
Up to $125 allowance ($175
allowance for Enhanced
Plan) plus 20% discount on
coverages
Up to $50 allowance ($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)
allowance
Plan pays up to $100
allowance
Contact Lenses (necessary)
Plan pays 100%
Plan pays up to $210
allowance
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Monthly Rates for Vision Coverage
Vision Coverage
PLAN
EMPLOYEE ONLY
FAMILY
Core Wellness Plan
$0.00
N/A
Basic Plan (Exams and Materials)
$5.76
$15.98
Enhanced Plan
(Enhanced Exams and Materials)
$8.88
$23.62
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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, 2015 and
March 15, 2016, provided you remain actively employed for
all of 2015. Prior year claims must be submitted by April 30,
2016.
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, 2015 and
March 15, 2016, provided you remain actively employed for
all of 2015. Prior year claims must be submitted by April 30,
2016.
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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
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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
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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
$1.42
$1.64
$2.78
$4.56
$7.70
$13.00
$20.04
$30.34
$45.46
$68.28
$99.64
$157.68
$197.64
$213.62
$1.42
$1.64
$2.78
$4.56
$7.70
$13.00
$20.04
$30.34
$45.46
$68.28
$99.64
$157.68
$197.64
$213.62
Employees may also cover eligible dependent children. Employee will pay one flat rate ($0.90)
no matter how many children are covered.
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Voluntary Group Term Life Insurance
• Group Term Life provided through ING
• Coverage available for yourself, your spouse and
child(ren). You must be enrolled to cover your
spouse/child(ren)
• Employee only and Employee & Spouse coverage in
$10,000 increments, from $20,000 to $500,000 (limited to
five times your base annual earnings); spouse coverage
cannot exceed 100% of employee’s elected amount
• Coverage over $100,000 subject to Evidence of Insurability
(EOI)
• Dependent child(ren) coverage for $5,000 or $10,000
Monthly Rates for Life Insurance
Coverage
Voluntary Group Term Life Insurance for Employee Only and Employee & Spouse
YOUR AGE
RATE PER $1,000 OF COVERAGE
Under 24
$0.048
25-29
$0.058
30-34
$0.078
35-39
$0.088
40-44
$0.12
45-49
$0.18
50-54
$0.28
55-59
$0.512
60-64
$0.764
65-69
$1.56
70-74
$2.28
75 and above
$2.28
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Monthly Rates for Life Insurance
Coverage
Voluntary Group Term Life Insurance for Child(ren)
Per Dependent Unit
$5,000
$0.68
$10,000
$1.36
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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
– You pay the full cost of coverage
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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
Income Protection Programs
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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
33
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
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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 after-tax
• 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
Retirement Programs
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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
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TSERS Plan Highlights
• Defined benefit plan
• State controls the investments
• 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
38
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
• You must contribute 6% of your pay on a pre-tax basis
• The University contributes 6.84%
• Choose from four investment providers (Fidelity
Investments and TIAA-CREF)
39
Retirement Plan Resources
To review the booklet in greater detail, click on the picture to open the
document.
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Your Retirement, Your Choice Video
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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.
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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 several types of plans available
– UNC 403(b) plan administered through Fidelity and TIAACREF, and sponsored by the University
– UNC 457(b) plan administered through 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 the IRS limits the amount you can
contribute
Enrolling in Your Benefits
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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
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Enrollment for Health & NCFlex Benefits
• You must enroll within 30 days of your employment date
• To enroll, follow these simple steps:
–
–
–
–
–
Log on to https://unc.hrintouch.com/
Enter your campus Login ID and Password
Select the “Enroll Now” button
Select “Get Started” and follow the prompts
At the end, you will see a Summary screen. Review your
information and click “Save” to save your elections
– Print a copy of your Benefit Summary before logging out
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
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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/ListAllFor
ms.aspx?formCat=F3BENDESG
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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
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
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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
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For More Information
• Follow the instructions you are provided and enroll on a
timely basis. If you delay any of your benefit elections, you
may incur “retroactive” deductions to cover the cost of your
elected benefit coverages.
• Visit www.northcarolina.edu/hr/unc/benefits/index.htm for
more information about the benefits provided by the
University
• You can also check your campus’ website for additional
details and HR/Benefit Office contacts