2019-20 employee benefits
TRANSCRIPT
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2019-20 Employee Benefits
Summary & Enrollment Guide
This booklet produced by EbenConcepts is a brief summary of your benefits as of 8/1/2019 and is not considered “Evidence of Coverage.” Please refer to your policy/plan documents for a complete description of the controlling terms, coverages, exclusions, limitations, and conditions of your coverage. In case of discrepancy between this information and the actual plan documents, the actual plan documents will prevail.
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Table of Contents Contact Information BENEFIT SERVICE TEAM Contact for all general benefit questions or claim issues
Clinton Office Angela Thornton, Account Manager
Bobby Spell, Broker/Consultant
Wilmington /Fayetteville Offices Kelly Sherrill, Account Manager
Hughes Waren, Broker/Consultant
EbenConcepts / Group Benefit Services (910) 592-8611 [email protected] [email protected] (910) 323-0290 [email protected] [email protected]
HEALTH INSURANCE:
Customer Service – Medical claims, benefit questions: Prescription Drug Card Questions/Claims
Member Portal- Blue Connect
Physician /Hospital Pharmacy Network Search:
Blue Cross Blue Shield NC Group #058047
(877) 258-3334 www.bluecrossnc.com/members
Pages 5-11
DENTAL & LIFE INSURANCE:
Customer Service – dental & death claims, benefit questions: Dental Provider List:
Guardian Life Insurance Group# 490477
(800) 541-7846 www.guardiananytime.com
Pages 12-16
VOLUNTARY VISION INSURANCE: Customer Service – Vision claims, benefit questions:
Vision Provider Network
Community Eye Care (888) 254-4290 www.cecvision.com
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ACCIDENT/CRITICAL ILLNESS/DISABILITY : Customer Service – claims, benefit questions:
AFLAC (800) 992-3522
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FLEXIBLE SPENDING ACCOUNTS (FSA)
Customer Service – FSA claims, balance questions, debit card email
OrchestrateHR (800) 550-8009 menu key 1,1,4,1 [email protected]
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EMPLOYEE ASSISTANCE PROGRAM (EAP)
Unlimited Telephonic Counseling Website portal
username: Matters password: wlm70101
Guardian WorkLife Matters (800) 386-7055 www.ibhworklife.com
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ATTORNEY SERVICES Contact Group Benefit Services for Questions
LegalShield (910) 592-8611
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Refer to this list when you need to contact one of your benefit providers for detailed or private questions. For general information regarding personnel policy, contact:
Nancy Dillman – Human Resources Director (910) 592-6308
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How to Enroll Our Cafeteria/125 Plan allows employees to have certain insurance premiums payroll deducted on a Pre-Tax basis. Your eligible premiums will be automatically pre-taxed unless you Opt-out. Annual benefit elections must be made within 31 days of your new hire eligibility date or during the Open Enrollment period beginning in mid-June and ending July 12th.
Make your benefit elections in the Blue Ocean benefit portal. Blue Ocean Portal: https://blueocean.orchr.com
• Click on the Benefits Tab then “My Renewal Enrollment” (new hires click “Benefit Enrolment”)
• Click “Add Dependents” if you are enrolling new dependents in a plan • Choose the benefit tier for each coverage • You must either Enroll or Waive each coverage • Adding new Voluntary life will require paper enrollment forms and Evidence of
Insurability (EOI) located at the bottom of the enrollment screen. • Print completed voluntary forms & return to human resources • Finish on-screen enrollment and Print enrollment receipt for your files • Review your Summary Benefits of Coverages & Federal Annual Notices located in Forms &
Documents tab
***If you lost your Blue Ocean Login and Password please contact Patty Jackson [email protected] You can also find a more detailed instruction manual of how to complete the online Renewal Enrollment under Forms & Documents tab in Blue Ocean.
When to Enroll New employees are eligible to enroll for benefits the 1st of the month following a 60 day new hire waiting period. Once you have made your elections, you will not be able to change elections until the next open enrollment period unless you have a payroll approved qualified change in status. Open Enrollment Deadline: 7/10/19
When You Can Make Changes You can only make mid-year changes to benefit elections when you have a qualified change in status.
Qualified changes in status include: • Marriage / Divorce / Legal separation • Birth or adoption • Change in child’s dependent status • Change in residence due to employment transfer for you or your spouse • Change in spouse’s benefits or employment status. • Loss of other coverage
Note: You must notify the Human Resources department within 31 days of the qualified change.
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Enrollment Guide This guide will explain who is eligible to participate and when they can enroll in the employer sponsored benefit plans. The cost and summary description of benefits are included to help you make well-informed choices. We encourage you to review all of your options and also encourage you to use our benefit service team, EbenConcepts/Group Benefit Services, for
advice or assistance in making your choices. This guide is intended as only a summary of the plans offered and is not meant to be a complete plan document. The
complete description of plan specifications, coverage, limitations and exclusions is available on your benefit portal: https://blueocean.orchr.com
Open Enrollment Our Cafeteria/125 Plan allows employees to have certain insurance premiums payroll deducted on a Pre-Tax basis. Your eligible benefits will be automatically pre-taxed
unless you Opt-out. Annual benefit elections must be made during the Open Enrollment period in June and coverage is effective August 1st. Mid-year changes are
only allowed if completed within 31 days of a qualifying event. Health and Wellbeing Benefits Offered
• Health Insurance (pre-tax) • Dental Insurance (pre-tax) • Vision Insurance (pre-tax) • Employee Assistance Program
Financial Security Benefits Offered
• Basic Life Insurance with Accidental Death & Dismemberment • Voluntary Life Insurance with Accidental Death & Dismemberment • Accident Insurance, Short Term Disability, Critical illness
Your health and wellbeing is important to Sampson County
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Who is Eligible and When: Full-time employees, spouses, children up to age 26, & County Commissioners are eligible for the health benefits on the 1stof the month following 60 days of employment. Employees can add or change coverage during open enrollment with coverage taking effect August 1st
Employee Pays: The employee’s cost is determined by length of service and annual pay. Sampson County contributes to the employee premium and a portion of the dependent premium based on the scale listed on page 9.
BCBSNC Group #058047
Health Insurance – BlueCross BlueShield of NC
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Outpatient Diagnostic Services
BCBSNC has implemented a new program 8/1/2107 that requires your provider to get approval, called a prior authorization, for diagnostic imaging tests. These tests include CT, CTA, MRI, MRA, PET, Cardiac and Nuclear Medicine. This prior authorization is for procedures in the outpatient hospital setting, freestanding radiology offices or provider offices. This prior authorization is not required at the inpatient, ER, or 23 hour observation settings.
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Mail Order Prescription Drugs - 90 Day Supply (2.5 x copay) Tier 1 – Generic Drugs $10.00 copayment Tier 2 – Preferred Brand-Name $112.50 copayment Tier 3 – Non-preferred Brand-Name $150.00 copayment www.myprimemail.com (888)274-5180
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$15 Copay
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$15
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Health Insurance Payroll Deductions: The County and employees share the cost for individual and family coverage. The employee cost of health insurance includes a financial incentive for those employees who participate in the County’s voluntary wellness plan. Those who do not participate in the voluntary wellness plan will have an additional $30 per month pay reduction added to the deductions listed below.
Monthly Payroll Deductions Annual Salary at July 1, 2018
Employee Only
Employee + Child
Employee + Family
Less than 25,000 $0.00 $150 $435 25,001-35,000 $14.00 $164 $449 35,001-45,000 $25.00 $175 $460 45,001-55,000 $49.00 $199 $484 55,001-65,000 $75.00 $225 $510
65,001 and over $100.00 $250 $535
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Who is Eligible and When: Full-time employees, spouse & children up to age 26 are eligible are for the dental benefits the 1st of the month following 60 days of employment. Employees can add or change coverage during open enrollment with coverage taking effect August 1
st
Employer Pays: Sampson County contributes the majority of the employee premium and 0% of the dependents premium.
Guardian Group# 490477
Dental Insurance
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Dental Employee Payroll Deductions:
TYPE OF COVERAGE
MONTHLY PAYROLL DEDUCTION
All Employees $5.00 Employee + 1 Dependent $55.79
Employee + 2 or More $80.50
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Who is Eligible and When: Full-time employees are eligible for the life benefit the 1st of the month following 60 days of employment. The coverage is guaranteed issue for new hires.
Employer Pays: Sampson County contributes 100% of the employee premium.
Benefits Reduction: There are benefit reductions of 35% at age 65, 60% of original amount at age 70 and 75% of the original amount at age 75.
Basic Life/AD&D
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Who is Eligible and When: Full-time employees and their legal spouses & dependents are eligible for the life benefit the 1st of the month following 60 days of employment. Ex-Spouses are not eligible for coverage. The coverage is guaranteed issue for new hires.
Employer Pays: Sampson County does not contribute to the employee’s premium.
Benefits Reduction: There are benefit reductions of 35% at age 65, 60% of original amount at age 70 and 75% of the original amount at age 75.
Voluntary Life/AD&D
Spouse’s coverage cannot exceed 50% of the employee coverage
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Who is Eligible and When: Full-time employees are eligible for the vision benefits the 1st of the month following 60 days of employment. Employees can add or change coverage during open enrollment with coverage taking effect August 1st.
Employer Pays: Sampson County does not contribute to the vision premium. Benefits:
Voluntary Vision
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FLEXIBLE SPENDING ACCOUNTS HEALTHCARE REIMBURSEMENT
If you or qualified dependents are currently paying for non-reimbursed healthcare expenses such as:
- Doctor visit copays, prescription drug copays & health plan deductible - Dental expenses and Orthodontia expenses - Eyeglasses, lenses and vision correction surgery
You may elect to have those future expenses deducted from your paycheck and placed in a flexible spending account (FSA) on a pre-tax basis. The FSA can save you approximately 30% in taxes on the money you contribute.
HOW IT WORKS - The Plan Year runs from August 1st – July 31st - You may elect up to a maximum of $ 2,600 per family per plan year. - Your annual election is divided evenly and deducted over 12 pay periods. - You are reimbursed the tax-free FSA money as you file claims for eligible
expenses or use your FSA Debit Card at eligible healthcare providers. - FSA balances must be spent during the plan year or forfeited. Up to $500 of
unused funds may be carried over into the new plan year. - You may elect expenses from your qualified tax dependents even if they
are not covered by your employer’s medical, dental or vision plans.
ADVANTAGES - Easy way to save for expected healthcare expenses. - Employees have access to their entire annual election after the first payroll
deduction. - 30% tax savings (the higher your tax bracket the greater the savings)
CHILD/DEPENDENT CARE REIMBURSEMENT
If you are currently paying for child or dependent care on a qualified person, you may elect to have those expenses deducted from your paycheck and placed in a flexible spending account (FSA) on a pre-tax basis. This can save you approx.30% in taxes on the money you place in it. Children under 13 years old are eligible or qualified dependent adults.
HOW IT WORKS - You may elect to deduct up to $5,000 per family per calendar year (filing a
joint return). - Your annual election is divided evenly and deducted over 12 pay periods. - You are reimbursed the tax-free FSA money as you file claims for eligible
expenses or use your FSA Debit Card at eligible daycare providers. - FSA balances must be spent during the plan year or forfeited. Up to $500
of unused funds may be carried over into the new plan year. - If your family income is over $25,000 you will most likely benefit from this
plan rather than taking dependent tax credit on your tax return.
* Balance statements will be sent to each employee 30 days before the end of the plan year. Any money deducted and not spent by the end of the plan year’s grace period is forfeited. Debit Card receipts should be kept for tax purposes.
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Employer Pays: Sampson Country provides this benefit at no cost to the employee.
Employee Assistance Program
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