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2016 BENEFITS OPEN ENROLLMENT REVIEW
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ShawHankinsService Center- can answer questions on all benefits, including state healthAvailable extended hours 8:30 am – 7:00 pm during open enrollment Oct 19 – Nov 6877-373-0730
Benefit website- shawhankinsbenefits.net/ccsd
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State HealthBenefit Plan
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SHBP 2016-Carrier Options3 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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How the HRA Plans WorksBronze, Silver and Gold options with different levels of coverageAll services are subject to the plan deductible and/or coinsurance, no copays apply 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 Able to earn additional credits with wellness activities
HRA credits left at the end of the year will roll over to the next plan year
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How the HDHP WorksLow monthly premiumMust 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) NO LONGER must be met before benefits are payable for any family memberEligible to establish a Health Savings Account (HSA) to set aside tax-free dollars to pay for eligible health care expenses.
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How the Statewide HMO WorksAvailable 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
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How the Regional HMO WorksServices only available through Kaiser HMO network
Copay Only plan, no deductibles or coinsurance
Plan available for members that live or work in one of the 27 metro Atlanta counties:
Barrow Coweta Gwinnett PauldingBartow Dawson Haralson PickensButts DeKalb Heard PikeCarroll Douglas Henry RockdaleCherokee Fayette Lamar SpaldingClayton Forsyth Meriwether WaltonCobb Fulton Newton
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SHBP Changes for 2016-Well-Being Incentive Credits Now able to rollover well-being incentive credits across vendors and plan options
2015 rollover credits available in April 2016
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Wellness Credits- BCBS & UHC
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Wellness-Kaiser Permanente Earn up to $480 and feel the benefits of taking care of your health!
Sign up for the Kaiser Permanente Wellness Program at my.kp.org/shbp
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Tobacco CessationTobacco surcharges are included in all SHBP optionsSurcharge applies if you are not tobacco-free or do not complete tobacco cessation coaching programIf you do not make an indication for 2016 on your tobacco usage, you will continue with your same tobacco usage election from 2015.
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State Health Open EnrollmentOpen enrollment is from October 19th – November 6th
myshbpga.adp.comIf you do not login to enroll or make changes, you will be defaulted to your current plan, 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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Ancillary Benefits
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bswift
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Enrollment When you choose the enrollment tab on the Benefit Resource Center site, you will be directed to the bswift enrollment page to complete your elections on all ancillary coverages.
◦ Your user name is your first initial, last name and last 4 digits of your social security number◦ Your password is the last 4 digits of your social security number
Or you can use the bswift app to log in and make elections from your phone.◦ You will use the same log in information◦ Company ID is cobbk12
The system will require you to enter your confirmation number from SHBP enrollment
Once you complete the enrollment process you will receive a confirmation statement with all coverages and your total payroll deductions for 2016.
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DentalMetLife will continue as the dental carrier for 2016
Base and Plus plan option
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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 75% After Plan Deductible 75% of R&C Fee
Type C – Major See Schedule 40% of R&C Fee 50% After Plan Deductible 50% of R&C Fee
Type D – Orthodontia 50% of Maximum Allowed Charge 50% of R&C Fee 40% After Plan
Deductible 40% of R&C Fee
Deductible† In-Network Out-of-Network In-Network Out-of-Network
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 Out-of-Network Covered Dental Expenses
$500 of Combined In-Network 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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VisionAvesis will continue as the vision carrier for 2016
Basic and Preferred Plus Option
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Basic Life with AD&DCCSD provides basic life coverage at no cost to youThis includes a life and accidental death and dismemberment benefitNon-tobacco users receive a $13,000 benefitTobacco users receive a $10,000 benefit
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Supplemental Life with AD&DContributory Basic Life coverage will no longer be offered, as all life coverage may be purchased with the Supplemental Life plan for employees and their dependents1 times your annual salary Maximum 7 times your annual salary, to $500,000New hires guaranteed up to 2 times your salary without answering health questionsLate entrants must complete the Personal Health Application for all amounts of coverage
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Supplemental Life- DependentsSpouse or Dependent Children$10,000 or $25,000 in coverage
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Short Term DisabilityChoice 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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Long Term DisabilityCost paid fully by CCSD Benefit begins after you are disabled for 6 monthsPays 50% of your gross monthly earnings up to a maximum of $7,500 a month
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Flexible Spending AccountsTwo separate accounts- Medical Spending Account and Dependent Care Spending AccountAllows you to set aside pre-tax dollars to spend on qualified expenses, saving on your taxable incomeMust make new elections for 2016If enrolling in the HDHP medical plan, you are not eligible to contribute to FSA
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Flexible Spending AccountsMedical Spending Account Maximum contribution of $2,500 Some eligible expenses- Deductibles, copayments, dental expense, vision services and
materialsDependent 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
You may rollover up to $500 left at the end of the 2015 plan year to use in 2016 for your Medical Spending Account
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Cancer CoveragePays a cash benefit directly to you if diagnosed with Cancer or 29 additional specified diseaseCoverage available for you and your familyPays based on the type of services received: inpatient care, surgery, medication3 levels of benefits available- Economy, Standard, DeluxeConvertible to individual policyWaiver of premium after 90 days of disability
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Critical Illness CoveragePays a lump sum benefit to you at the time of diagnosis of a covered illness.Employee benefit: $10,000Spouse and child benefit: $5,000
Children covered at no extra chargeSome covered illnesses: Heart Attack, Stoke, Coronary Artery Bypass, Major
Organ Transplant, End Stage Renal FailureWellness 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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Accident CoverageCovers accidents on and off the job
Accidental Death Emergency room or physician care Hospitalization Appliances Fractures Dislocations Lacerations Paralysis Dental Work Ambulance Travel
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Hospital Indemnity Coverage Pays a benefit to the member when inpatient hospital care is required.
◦ $500 for 1st day of hospital confinement◦ $100 per day of hospital confinement (up to 10 days)
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ShawHankins AdvantageTeladoc
Health Advocacy
Medical Bill Saver
Nurseline
Doctors Online
Health Wealth Connection
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Legal CoverageIn-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
Identity Theft Protect- No additional cost
New for 2016- Plan covers legal assistance for contested and uncontested divorce, bankruptcy
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Questions?Service Center- can answer questions on all benefits, including state health
Available extended hours 8:30 am – 7:00 pm during open enrollment Oct 19 – Nov 6 877-373-0730
Benefit website- shawhankinsbenefits.net/ccsd