Post on 06-Aug-2020
2018-19
SEA Employees
New Hire Guide | Snohomish School District
Making the most of your benefits.
Forms and documents
Table of contents
Welcome ..................................... 1
Plan rates ..................................... 2
Medical plans .............................. 3
Medical plan comparison chart ... 4
Savings accounts ......................... 6
Dental and vision coverage ......... 8
Financial security plans ................ 9
Ready to enroll? ......................... 12
Contacts .................................... 13
Universal Availability Notice ....... 15
DefinitionsCoinsurance: The percentage of a covered service you pay after your deductible is met and continue to pay until your out-of-pocket maximum is met.
Copay: The fixed dollar amount you pay each time you use certain services until your out-of-pocket maximum is met.
Deductible: The amount you pay each calendar year before your plan starts to pay benefits toward certain services.
Flexible Spending Account (FSA): An account that you contribute pre-tax dollars to on a monthly basis to use for certain medical expenses. After
a 2½ month grace period, any unused money in your FSA will be forfeited.
Health Savings Account (HSA): An account that you own and contribute pre-tax dollars to on a monthly basis to use for certain medical expenses. This account can only be used with a high deductible health plan and any unused money will roll over from year to year.
Out-of-Pocket Maximum: The maximum amount you pay out of your own pocket for medical and/or prescription drug copays, deductible and coinsurance in a calendar year.
Welcome
Welcome to the Snohomish School District. We’re here to help you stay well, save you money and make the most of your benefits. You are our most important resource, and that’s why we’re committed to supporting your overall wellness with a comprehensive benefits program designed to meet your unique needs. This guide describes your health plan options and other important benefits. Use it to help you get started with your benefits and refer to it throughout the year whenever you have questions.
Getting started
Enrolling in your benefitsYou can enroll for coverage when you first become eligible for benefits and during the annual Open Enrollment period. If you don’t enroll during your initial eligibility date or during Open Enrollment, you will not receive health coverage during the plan year, unless you experience a qualified change in family status.
Making changes during the yearIf you experience a qualified change in family status, you’ll have the opportunity to make midyear changes to your benefit elections. Examples of a qualified change in family status include, but are not limited to:
• Marriage, divorce or legal separation
• Birth or adoption of a child
• Death of an enrolled family member
• Change in employment for you or your spouse that affects your benefit eligibility
• Loss of other health care coverage
It’s your responsibility to notify Snohomish School District within 60 days after a qualifying event.
Benefit dollars and poolingMedical pooling is the process in which unused medical contributions from the state are re-distributed among each union group to offset out-of-pocket costs to the employee. The medical allocation for the coming year is $852.88 per month per full-time equivalent employee. You must first use these dollars for mandatory benefits, including life insurance, long-term disability and dental. You can spend the balance on medical benefits. Any money remaining is “pooled” within bargaining units and divided among employees to use toward medical premiums. To help determine the funds you’ll have available for medical coverage, contact Payroll and Benefits.
To-do
Know your options and costs. Read this guide and review the health care premiums on page 2.
Enroll within 30 days. Select your health care plan and elect any voluntary life insurance coverage within 30 days from your date of eligibility to receive coverage for the upcoming plan year. See page 12 for enrollment instructions.
Designate a beneficiary. Life insurance requires you to designate a beneficiary to receive the life benefit in the event of your death.
Remember!Affordability of the plan is not a qualified change! Be sure to take the time to carefully choose your plan and dependent coverage. You won’t be able to change plans or drop a dependent due to the cost of the plan.
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Plan rates
Live well, spend lessA healthy lifestyle means spending less on health care.
➊ Use in-network providers whenever possible.
➋ Always ask for generic prescriptions.
➌ Visit the emergency room for true emergencies only — opt for an urgent care facility or your physician’s office for non-life-threatening conditions.
Medical Rates (monthly)
Coverage LevelPremera
Plan 5Premera
Plan 2Premera
Plan 3Premera
EasyChoicePremera
Basic Plan Premera QHDHP
Kaiser HMO
Employee only $1,074.35 $928.99 $849.31 $625.39 $504.83 $489.89 $986.94
Employee + child(ren) $1,466.00 $1,240.45 $1,134.16 $829.85 $669.53 $649.70 $1,379.17
Employee + spouse $2,064.84 $1,700.65 $1,554.96 $1,136.46 $916.55 $889.33 $1,916.46
Employee + family $2,487.53 $2,038.92 $1,864.44 $1,361.77 $1,098.08 $1,050.82 $2,308.65
Interested in critical illness or short-term disability coverage? See the plan summaries for more information and rates.
Vision Rates (monthly)
Coverage Level RateEmployee only $20.05
Employee + child(ren) $34.01
Employee + spouse $40.18
Employee + family $56.09Employee Optional Life Insurance Rates (monthly)
Employee Age$90,000 Coverage
$180,000 Coverage
Under 20 $4.50 $9.00
20 to 24 $4.50 $9.00
25 to 29 $4.50 $9.00
30 to 34 $5.40 $10.80
35 to 39 $6.30 $12.60
40 to 44 $9.00 $18.00
45 to 49 $13.50 $27.00
50 to 54 $20.70 $41.40
55 to 59 $37.80 $75.60
60 to 64 $50.40 $100.80
65 to 69 $102.60 $205.20
70 and over $185.40 N/A
Spouse Optional Life Insurance Rates (monthly)
Spouse Age$20,000 Coverage
$40,000 Coverage
Under 20 $1.00 $2.00
20 to 24 $1.00 $2.00
25 to 29 $1.00 $2.00
30 to 34 $1.20 $2.40
35 to 39 $1.40 $2.80
40 to 44 $2.00 $4.00
45 to 49 $3.00 $6.00
50 to 54 $4.60 $9.20
55 to 59 $8.40 $16.80
60 to 64 $11.20 $22.40
65 to 69 $22.80 $45.60
70 and over N/A N/A
The tables below show your monthly rates for the benefit plans available to you.
Mandatory Dental Rates (monthly)
Carrier RateDelta Dental + Ortho Plan E $111.03
Willamette + Ortho Plan 3 $86.80
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Medical plans
Comparison of your medical plan optionsMedical Plans
Amount you pay for care
Amount you pay in premiums Pairs well with … Network
Premera PPO Plans 5, 2 and 3 Low High FSAs Plans 2, 3 and 5: Heritage
Premera EasyChoice A and B Medium Medium FSAs EasyChoice A: Heritage
EasyChoice B: Heritage
Premera Basic Plan High Low FSAs Heritage
Premera QHDHP High Low HSA, dependent care FSA Heritage
Kaiser HMO Low High FSAs Kaiser
For more information• For more information on the Premera Blue Cross plans, visit www.premera.com.
• For more information on the Kaiser Permanente plan, visit www.kp.org/wa.
• You can also reach out to the Payroll and Benefits Department for any questions by emailing payroll.department@sno.wednet.edu or calling 360-563-7235.
Your medical plan options are offered through Premera and Kaiser. For the Premera plans, you can visit any provider, but you’ll pay less when you see in-network providers. All Premera plans offer the Heritage network. For Kaiser plans, you must use providers within the Kaiser network.
Free preventive care!Take advantage of your plan’s network preventive care services — they’re 100% covered for both you and your covered family members. For a complete list of preventive health services, visit www.healthcare.gov/preventive-care-benefits/.
Pooled dollarsYou and the District share the cost of your health benefits. Your state allocation pays a generous portion of the total cost and you pay the remainder. The amount you pay is deducted from your paycheck. Remember, you may have remaining pooled dollars to use toward the purchase of medical benefits. Turn to page 1 to learn more about the Snohomish School District’s pooled dollars.
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Medical plan comparison chart
Benefits at-a-glancePremera Blue Cross
KAISER HMO3
Plan 5 Plan 2 Plan 3 EasyChoice A EasyChoice B Basic Plan QHDHPMedical
Deductible
Individual: Network: $200 Non-network: $350Family: Network: $600 Non-network: $350 per person
Individual: $300 (network/non-network combined)Family: $900 (network/non-network combined)
Individual: $500 (network/non-network combined)Family: $1,500 (network/non-network combined)
Individual: Network: $1,250 Non-network: $2,000Family: Network: $3,750 Non-network: $6,000
Individual: Network: $750 Non-network: $1,500Family: Network: $2,250 Non-network: $4,500
Individual: Network: $2,100 Non-network: $2,500Family: Network: $4,200 Non-network: $5,000
Individual: Network: $1,750 Non-network: $3,000Family: Network: $3,500 Non-network: $6,000
Individual: $200Family: $400
Coinsurance Network: 10% Non-network: 30%
Network: 20% Non-network: 40%
Network: 20% Non-network: 40%
Network: 20% Non-network: 50%
Network: 25% Non-network: 50%
Network: 30% Non-network: 50%
Network: 20% Non-network: 50% None
Out-of-Pocket Maximum
Individual: Network: $1,000 Non-network: No limitFamily: Network: $3,000 Non-network: No limit
Individual: Network: $2,000 Non-network: $3,400Family: Network: $6,000 Non-network: $10,200 per person
Individual: Network: $3,000 Non-network: $5,900Family: Network: $9,000 Non-network: $17,700 per person
Individual: Network: $4,000 Non-network: No limitFamily: Network: $8,000 Non-network: No limit
Individual: Network: $3,500 Non-network: No limitFamily: Network: $7,000 Non-network: No limit
Individual: Network: $6,600 Non-network: No limitFamily: Network: $13,200 Non-network: No limit
Individual: $5,000 Family: $10,000Network only; out-of-pocket maximum is not applicable toward non-network services
Individual: $2,500Family: $5,000
Office VisitNetwork: $20 PCP copay; Specialist $30Non-network: 30% coinsurance
Network: $25 PCP copay; Specialist $35Non-network: $30 copay
Network: $30 PCP copay; Specialist $40 copayNon-network: $40 copay
Network: $25 PCP copay; Specialist $35Non-network: 50% coinsurance
Network: $30 PCP copay; Specialist $40Non-network: 50% coinsurance
Network: $35 PCP copay; Specialist $50Non-network: 50% coinsurance
Network: 20% coinsurance after deductibleNon-network: 50% coinsurance after deductible
$25 copay
ER Copay (waived if admitted) $50 copay $75 copay $100 copay $100 copay $150 copay $200 copay 20% coinsurance after deductible $100 copay
Prenatal Care In-network prenatal care covered 100%, no deductible
In-network prenatal care covered 100%, no deductible
In-network prenatal care covered 100%, no deductible
In-network prenatal care covered 100%, no deductible
In-network prenatal care covered 100%, no deductible
In-network prenatal care covered 100%, no deductible
In-network prenatal care covered 100%, no deductible In-network prenatal care covered 100%, no deductible
Chiropractic Unlimited Unlimited Unlimited 12 visits per plan year 12 visits per plan year 12 visits per plan year 12 visits per plan year 10 visits per calendar year
Acupuncture Unlimited 12 visits per plan year 12 visits per plan year 12 visits per plan year 12 visits per plan year 12 visits per plan year 12 visits per plan year 12 visits per calendar year
Outpatient Rehabilitation (physical, occupational, massage and speech therapies)
45 visits per plan year, combined
Occupational, massage and speech therapy: 45 visits per plan year, combined Physical therapy: unlimited
Occupational, massage and speech therapy: 45 visits per plan year, combined Physical therapy: unlimited
30 visits per plan year, combined 45 visits per plan year, combined 30 visits per plan year, combined 15 visits per plan year, combined 45 visits per plan year, combined
Prescription Drugs
Deductible None None None $500, waived for generics $250, waived for genericsIndividual: Network: $750Family: Network: $1,500Non-network not covered
Included in medical deductible None
Retail Pharmacy (up to 30-day supply)
Generic: $10 copayPreferred brand: $15 copayNon-preferred brand: $30 copay
Generic: $10 copayPreferred brand: $20 copayNon-preferred brand: $35 copay1
Generic: $15 copayPreferred brand: $25 copayNon-preferred brand: $40 copay1
Generic: $10 copayPreferred brand: 30% coinsuranceNon-preferred brand: 30% coinsurance
Generic: $5 copayPreferred brand: $30 copayNon-preferred brand: $45 copay
Generic: $15 copayPreferred brand: $30 copayNon-preferred brand: $50 copay
20% coinsuranceGeneric: $15 copayPreferred brand: $30 copayNon-preferred brand: Not covered
Mail Order (up to 90-day supply)
Generic: $20 copayPreferred brand: $30 copayNon-preferred brand: $60 copay
Generic: $20 copayPreferred brand: $40 copayNon-preferred brand: $65 copay2
Generic: $30 copayPreferred brand: $50 copayNon-preferred brand: $70 copay2
Generic: $20 copayPreferred brand: 30% coinsuranceNon-preferred brand: 30% coinsurance
Generic: $10 copayPreferred brand: $75 copayNon-preferred brand: $112 copay
Generic: $30 copayPreferred brand: $60 copayNon-preferred brand: $100 copay
20% coinsuranceGeneric: $45 copayPreferred brand: $90 copayNon-preferred brand: Not covered
Specialty Drugs (up to 30-day supply) $50 copay $50 copay $60 copay 30% coinsurance 30% coinsurance 30% coinsurance 20% coinsurance
Injectable Drugs Self administered: Subject to applicable pharmacy copayAdministered by professional: $25 outpatient copayNon-preferred generic and brand: Not covered
1 Up to 34-day supply. 2 Up to 100-day supply. 3 With the Kaiser HMO, only network services are generally covered, unless you need immediate medical attention.
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Benefits at-a-glancePremera Blue Cross
KAISER HMO3
Plan 5 Plan 2 Plan 3 EasyChoice A EasyChoice B Basic Plan QHDHPMedical
Deductible
Individual: Network: $200 Non-network: $350Family: Network: $600 Non-network: $350 per person
Individual: $300 (network/non-network combined)Family: $900 (network/non-network combined)
Individual: $500 (network/non-network combined)Family: $1,500 (network/non-network combined)
Individual: Network: $1,250 Non-network: $2,000Family: Network: $3,750 Non-network: $6,000
Individual: Network: $750 Non-network: $1,500Family: Network: $2,250 Non-network: $4,500
Individual: Network: $2,100 Non-network: $2,500Family: Network: $4,200 Non-network: $5,000
Individual: Network: $1,750 Non-network: $3,000Family: Network: $3,500 Non-network: $6,000
Individual: $200Family: $400
Coinsurance Network: 10% Non-network: 30%
Network: 20% Non-network: 40%
Network: 20% Non-network: 40%
Network: 20% Non-network: 50%
Network: 25% Non-network: 50%
Network: 30% Non-network: 50%
Network: 20% Non-network: 50% None
Out-of-Pocket Maximum
Individual: Network: $1,000 Non-network: No limitFamily: Network: $3,000 Non-network: No limit
Individual: Network: $2,000 Non-network: $3,400Family: Network: $6,000 Non-network: $10,200 per person
Individual: Network: $3,000 Non-network: $5,900Family: Network: $9,000 Non-network: $17,700 per person
Individual: Network: $4,000 Non-network: No limitFamily: Network: $8,000 Non-network: No limit
Individual: Network: $3,500 Non-network: No limitFamily: Network: $7,000 Non-network: No limit
Individual: Network: $6,600 Non-network: No limitFamily: Network: $13,200 Non-network: No limit
Individual: $5,000 Family: $10,000Network only; out-of-pocket maximum is not applicable toward non-network services
Individual: $2,500Family: $5,000
Office VisitNetwork: $20 PCP copay; Specialist $30Non-network: 30% coinsurance
Network: $25 PCP copay; Specialist $35Non-network: $30 copay
Network: $30 PCP copay; Specialist $40 copayNon-network: $40 copay
Network: $25 PCP copay; Specialist $35Non-network: 50% coinsurance
Network: $30 PCP copay; Specialist $40Non-network: 50% coinsurance
Network: $35 PCP copay; Specialist $50Non-network: 50% coinsurance
Network: 20% coinsurance after deductibleNon-network: 50% coinsurance after deductible
$25 copay
ER Copay (waived if admitted) $50 copay $75 copay $100 copay $100 copay $150 copay $200 copay 20% coinsurance after deductible $100 copay
Prenatal Care In-network prenatal care covered 100%, no deductible
In-network prenatal care covered 100%, no deductible
In-network prenatal care covered 100%, no deductible
In-network prenatal care covered 100%, no deductible
In-network prenatal care covered 100%, no deductible
In-network prenatal care covered 100%, no deductible
In-network prenatal care covered 100%, no deductible In-network prenatal care covered 100%, no deductible
Chiropractic Unlimited Unlimited Unlimited 12 visits per plan year 12 visits per plan year 12 visits per plan year 12 visits per plan year 10 visits per calendar year
Acupuncture Unlimited 12 visits per plan year 12 visits per plan year 12 visits per plan year 12 visits per plan year 12 visits per plan year 12 visits per plan year 12 visits per calendar year
Outpatient Rehabilitation (physical, occupational, massage and speech therapies)
45 visits per plan year, combined
Occupational, massage and speech therapy: 45 visits per plan year, combined Physical therapy: unlimited
Occupational, massage and speech therapy: 45 visits per plan year, combined Physical therapy: unlimited
30 visits per plan year, combined 45 visits per plan year, combined 30 visits per plan year, combined 15 visits per plan year, combined 45 visits per plan year, combined
Prescription Drugs
Deductible None None None $500, waived for generics $250, waived for genericsIndividual: Network: $750Family: Network: $1,500Non-network not covered
Included in medical deductible None
Retail Pharmacy (up to 30-day supply)
Generic: $10 copayPreferred brand: $15 copayNon-preferred brand: $30 copay
Generic: $10 copayPreferred brand: $20 copayNon-preferred brand: $35 copay1
Generic: $15 copayPreferred brand: $25 copayNon-preferred brand: $40 copay1
Generic: $10 copayPreferred brand: 30% coinsuranceNon-preferred brand: 30% coinsurance
Generic: $5 copayPreferred brand: $30 copayNon-preferred brand: $45 copay
Generic: $15 copayPreferred brand: $30 copayNon-preferred brand: $50 copay
20% coinsuranceGeneric: $15 copayPreferred brand: $30 copayNon-preferred brand: Not covered
Mail Order (up to 90-day supply)
Generic: $20 copayPreferred brand: $30 copayNon-preferred brand: $60 copay
Generic: $20 copayPreferred brand: $40 copayNon-preferred brand: $65 copay2
Generic: $30 copayPreferred brand: $50 copayNon-preferred brand: $70 copay2
Generic: $20 copayPreferred brand: 30% coinsuranceNon-preferred brand: 30% coinsurance
Generic: $10 copayPreferred brand: $75 copayNon-preferred brand: $112 copay
Generic: $30 copayPreferred brand: $60 copayNon-preferred brand: $100 copay
20% coinsuranceGeneric: $45 copayPreferred brand: $90 copayNon-preferred brand: Not covered
Specialty Drugs (up to 30-day supply) $50 copay $50 copay $60 copay 30% coinsurance 30% coinsurance 30% coinsurance 20% coinsurance
Injectable Drugs Self administered: Subject to applicable pharmacy copayAdministered by professional: $25 outpatient copayNon-preferred generic and brand: Not covered
1 Up to 34-day supply. 2 Up to 100-day supply. 3 With the Kaiser HMO, only network services are generally covered, unless you need immediate medical attention.
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Savings accounts
Health Savings Account
Using your HSAOnce you’ve enrolled in the QHDHP plan, Navia will email you information on setting up your Health Savings Account within 2–4 weeks. You may withdraw available funds from your HSA whenever you have a qualified medical expense by using your debit card, submitting an online request or mailing a distribution form.
For more information on the HSA, visit Navia Benefits Solutions at www.naviabenefits.com or call 800-669-3539.
Flexible Spending Account (company code SS2)
Flexible Spending Accounts (FSAs) are a great way to save money because they allow you to set aside money from your paycheck before taxes. You can contribute to an FSA with any health care plan.
Your FSA optionsOnce you’ve contributed to an FSA, you can withdraw the money tax-free when you need it to pay for eligible out-of-pocket health care and dependent care expenses.
Snohomish School District offers two FSAs:
Health Care FSA
• Pay for eligible health care expenses, such as plan deductibles, copays and coinsurance.
• Contribute up to $2,650 in 2018.
• If you choose the QHDHP and elect a Health Savings Account as well, your FSA will become “limited,” meaning you will only be able to use it for dental and vision expenses.
Dependent Care FSA
• Pay for eligible dependent care expenses, such as day care for a child, that are necessary for you and/or your spouse to work, look for work or attend school full time.
• Contribute up to $5,000 in 2018, or $2,500 if you are married and filing separately.
Health Savings Account (HSA) eligibilityTo establish and contribute to an HSA, you:
• Must be enrolled in the Premera QHDHP
• Can only participate in a limited health care Flexible Spending Account (FSA)
• Cannot be eligible for Medicare
• Cannot be claimed as a dependent on someone else’s tax return
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Estimate carefullyUnlike an HSA, FSAs are “use-it-or-lose-it” accounts. You’ll have a 2½ month grace period after the end of the plan year to use up your funds, but after that ends, you’ll forfeit any other money left in the account. Be sure to carefully estimate your contribution amount.
What’s an eligible expense?• Health Care FSA — plan deductibles, copays, coinsurance and other medical
expenses. To learn more, see IRS publication 502 at www.irs.gov.
• Dependent Care FSA — child day care, babysitters, home care for dependent elders and related expenses. To learn more, see IRS Publication 503 at www.irs.gov.
Savings accounts can save you moneySavings accounts for medical or dependent care expenses can help you save money. The money you contribute comes out of your paycheck before taxes, so the more you contribute, the more you save on taxes. Check out the chart below for information about your savings account options.
Account What can I use it for?How much can I
contribute? Does the money expire?
Health Care Flexible Spending Account
Medical, dental and vision expenses your plan doesn’t cover, including deductibles, copays and coinsurance
Up to $2,650 annually
Yes. You must use the money in your account by the end of the plan year, or you lose it.
Dependent Care Flexible Spending Account Child care expenses $5,000 annually
Yes. You must use the money in your account by the end of the plan year, or you lose it.
Health Savings Account (available only with the QHDHP plan)
Medical, dental and vision expenses your plan doesn’t cover, including deductibles, copays and coinsurance
Up to $3,450 in 2018, $3,500 in 2019 for employee-only coverage
Up to $6,900 in 2018, $7,000 in 2019 for family coverage
No. The money rolls over year to year and is yours to keep, even if you leave Snohomish or retire.
Note: If you participate in an HSA, you are not eligible for a Health Care FSA.
For more informationContact Navia Benefits Solutions at www.naviabenefits.com or call 800-669-3539.
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Dental and vision coverage
Dental coverageSnohomish School District offers dental plans through Delta Dental of Washington and Willamette Dental.
Benefits at-a-glanceDental Coverage Delta Dental Willamette Dental
Provider ChoiceServices can be received from any dentist. Benefits are highest when you use a network dentist.
Services must be received from a provider within the Willamette Dental of Washington Clinics (WDW).
Premium $111.03 $86.80
Max Annual Benefit (includes copays and coinsurance)
$1,750 per person ($2,000 if you use a network dentist) None
Deductible None None
Office Visit None $15 copay
Preventive Services (exams, x-rays, cleanings) 70% through 100% covered Covered in full
Basic Services (fillings, extractions) 70% through 100% covered Covered in full
Restorative Services (crowns, onlays) 70% through 100% coveredPorcelain-metal crowns: $50 copayDentures: $50 copayBridge: $50 per tooth
Major Services (dentures, partials, bridges, implants) 50% coinsurance Covered in full
Orthodontia 50% payable, up to a maximum lifetime benefit of $1,250
Pre-orthodontic service: $150 copay for adults; $2,000 copay for children
Vision coverageYou can enroll in voluntary vision coverage through MetLife. You’ll receive higher benefit coverage if you visit a doctor within the network.
Benefits at-a-glanceVision Coverage Frequency Voluntary Plan (Certificated employees only)
Premium Every month
Employee: $20.05Employee + child: $34.01Employee + spouse: $40.18Employee + family: $56.09
Routine Eye Exam Once every 12 months Covered in full after copay
Frames Once every 12 months $200 retail, plus 20% of any amount over $200 after copayCostco: $110 allowance
Lenses Once every 12 months Covered in full
Contacts Once every 12 months Elective: $200 retailNecessary: Covered after copay
Contact Lens Fitting Exam Once every 12 months Covered in full with a maximum copay of $60
For more information on your dental and vision benefits, email Payroll and Benefits at payroll.department@sno.wednet.edu.
Delta Dental is mobile!Download the Delta Dental mobile app from the App Store (Apple) or Google Play (Android) to:
• Find a dentist• Check your claim
status• View coverage
details• Display your ID card
You don’t need an ID card for dental or vision
Just the doctor’s office the name of your provider and your Social Security number and they’ll do the rest!
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Basic Life and AD&D insuranceAs an important part of your personal financial planning, Snohomish School District offers you Basic Life and Accidental Death and Dismemberment (AD&D) insurance through two different administrators to protect your family if you die, become disabled or experience an injury or illness. Benefits are provided by the District and eligible employees are automatically enrolled.
Cigna Basic Life and AD&D:
• You receive a flat benefit of $10,000.
Symetra Basic Life and AD&D:
• Enrollees on the Premera medical plans will receive a $25,000 life insurance benefit through Symetra in addition to the Cigna benefit above.
It’s important to choose a beneficiary and keep the information up to date. In the event of your death, your beneficiary will receive the benefit paid by a life insurance policy.
Optional Life insuranceYou can enroll yourself, your spouse and your children in additional voluntary life insurance through Cigna, in the amounts shown below. This coverage doesn’t require evidence of insurability and all amounts shown are guarantee issue.
Employee Spouse Children
Amount covered $90,000 or $180,000 $20,000 or $40,000 $10,000
In addition to medical, dental and vision benefits, Snohomish School District provides a number of other plans to help protect your finances if you’re unable to work. You receive basic life and disability at no cost to you and can also enroll in optional plans. Consider the voluntary benefits below. They are generous plans at affordable rates and can help your family remain financially secure. Additional information and applications for the benefits listed below are available from the Payroll and Benefits Department or the contact listed.
Financial security plans
What is AD&D insurance?Should you lose your life, sight, hearing, speech or use of your limb(s) in an accident, AD&D provides additional benefits to help keep your family financially secure. AD&D benefits are paid as a percentage of your coverage amount, depending on the type of loss.
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Financial security plans (continued)
Short-Term Disability insurance You can enroll in Short-Term Disability (STD) through Cigna. The STD benefit protects your income if you’re ill or injured for a certain period of time.
Short-Term Disability
Eligibility All active teachers regularly working a minimum of 18.75 hours per week
Maximum benefit $8,000 per month; $2,000 per week paid weekly
Covered earnings 66.67% of total monthly earnings
Elimination period 7 days
Benefit duration 8 weeks for accident, and 8 weeks for sickness
Short-Term Disability Rates
Age Rate per $10 of Weekly Covered Benefit
Up to age 54 $0.344
55–59 $0.383
60–64 $0.445
65 and over $0.489
Long-Term Disability insuranceLong-Term Disability (LTD) through Cigna is paid for with your allocation dollars. It provides income replacement if you’re disabled and can’t work for an extended period of time due to an illness or accident.
Long-Term Disability
Eligibility All active teachers regularly working a minimum of 18.75 hours per week
Minimum benefit $100 per month
Maximum benefit $10,000 per month
Covered earnings 60% of total monthly earnings
Waiting period 60 days
Benefit period To age 65
Monthly cost $10.96 (employer-paid)
Calculate your STD cost!➊ Enter your weekly gross pay (the amount should not exceed $2,999).
$_______
➋ Multiply by 66.67% to determine your weekly
benefit. $_______
➌ Multiply your weekly benefit by your age-graded rate, available to the right. $_______
➍ Divide by 10 to determine the premium that will be deducted from your paycheck each month. $_______
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Can you afford to be out of work?Most people aren’t financially prepared for sudden illnesses or unplanned surgeries that keep them out of work for longer than a few days. That’s where Critical Illness and Short-Term Disability insurances can help! These benefits are paid to you when you’re unable to work for a certain period of time, so you’re not without an income. They’re convenient and affordable, so consider enrolling in them now! You won’t have another opportunity until the next annual enrollment.
Critical illness insurance Critical illness insurance through Cigna offers you a lump-sum payment for medical expenses not covered by your regular health plan if you’re diagnosed with a major illness such as a heart attack, stroke, coma, paralysis, major organ transplant or renal failure.
Critical Illness
Participant Benefit amount
Employee Select a benefit amount of $10,000, $15,000 or $20,000; Guarantee Issue: $20,000
Spouse Up to 50% of the employee-paid benefit amount
Child(ren) Up to 25% of the employee-paid benefit amount
403(b) retirement planThe 403(b) retirement plan, also known as a Tax-Sheltered Annuity (TSA), is a tax-deferred retirement plan provided for employees of certain tax-exempt, governmental organizations or public education institutions. You can see full details in the Universal Availability Notice on page 15.
National Benefit Services (NBS) is our third-party administrator for TSAs. All TSA requests are handled by them. Please contact NBS at 800-274-0503, ext. 5 or at www.nbsbenefits.com/403b.
Deferred Compensation Program/457 plansFor information and enrollment materials for the Deferred Compensation Program, please contact the Department of Retirement Systems at 888-327-5596 or at www.drs.wa.gov/dcp.
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Ready to enroll?
Once you’ve carefully reviewed this guide and selected your benefits, it’s time to enroll.
Follow these steps to enroll: ➊ Review this guide and make educated benefit decisions for 2018-19.
➋ To enroll for Delta Dental and Willamette dental benefits, including making changes to your current plans or adding or dropping dependents, visit http://resources.hewitt.com/wea. To enroll by phone, call 855-668-5039 (Access Direct, Your Benefit Resource Center).
➌ To enroll in or decline coverage for medical benefits, short-term disability, critical illness, supplemental life and MetLife vision insurance, complete and return an Enrollment/Change Form to the Payroll Department within 30 days of your eligibility date.
➍ To participate in an FSA or HSA for the 2018-19 plan year, complete and return a Navia Benefits Solutions Enrollment Form to the Payroll Department within 30 days of your eligibility date.
Need enrollment forms?Send an email to payroll.department@sno.wednet.edu to get your Premera, Kaiser, FSA and Voluntary Benefit Enrollment Forms.
Employee Assistance Program (EAP)The EAP through KEPRO is a valuable benefit available at no cost to you. Paid for by Snohomish, the EAP is there to help you and your family with personal issues. Call 800-999-1077 at any time of the day or night for confidential assistance.
Enroll in an FSATo participate in an FSA, complete and return a Navia Benefits Solutions Enrollment Form to the Payroll Department.
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Contacts
Provider contact informationIf you have a question on the status of a claim or specific questions regarding your coverage, please reach out to your provider directly. If you’re not sure who to contact, email the Payroll and Benefits Department at payroll.department@sno.wednet.edu or call 360-563-7235.
Provider contacts
Benefit Provider Phone No.Group No. /
Company Code Website
Premera Medical Plans Premera Blue Cross 855-756-0798 Group No. 4012278 www.premera.com
Kaiser HMO Medical Plan Kaiser Permanente 888-901-4636 Group No. 0069700 www.kp.org/wa
Delta Dental Plans Delta Dental of Washington 800-554-1907 Group No. 00186 www.deltadentalwa.com/
wea
Willamette Dental Plans Willamette Dental 800-359-6019 Group No. W201 www.willamettedental.com
Dental EnrollmentAon HewittYour Benefits Resources (YBR)
855-668-5039 Not available http://resources.hewitt.com/wea
Vision Plan MetLife 855-638-3931 Group No. 5921517 www.metlife.com/mybenefits
Health Savings Account (HSA)
Navia Benefits Solutions 800-669-3539 Company Code: SS2 www.naviabenefits.com
Flexible Spending Account (FSA)
Navia Benefits Solutions 800-669-3539 Company Code: SS2 www.naviabenefits.com
• Life Insurance• Short- and Long-Term
Disability• Critical Illness
Cigna Insurance Co. 800-362-4462• FLX – 962642• VDT – 961935• CI960111
www.cigna.com
Workers’ CompensationPuget Sound Workers’ Compensation
877-955-9675 Not available www.psesd.org/Programs
Retirement Department of Retirement Systems 800-547-6657 Not available www.drs.wa.gov
Tax-Sheltered Annuity/403(b)
National Benefit Services, LLC
800-274-0503, ext. 5 Not available www.nbsbenefits.
com/403b
Deferred Compensation Department of Retirement Systems 888-327-5596 Not available www.drs.wa.gov/dcp
Employee Assistance Program (EAP) KEPRO 800-999-1077 Company Code:
EAPNOW www.kepro.com
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Contacts (continued)
Payroll and Benefits Department contact informationIf you have general questions about your benefits, reach out to your Payroll and Benefits Department representative listed below. They’re available all year and are here to help guide you through your benefit needs.
Contacts
Department Representative Phone No. Email
Benefits and Leaves of Absence — Certificated Kelly Anderson 360-563-7236 kelly.anderson@sno.wednet.edu
Benefits and Leaves of Absence — Classified Dawn Persha 360-563-7237 dawn.persha@sno.wednet.edu
Certificated Staff (SEA) and COBRA Kim Smith 360-563-7336 kim.smith@sno.wednet.edu
Classified Staff (PSE) Kristine Cook 360-563-7235 kristine.cook@sno.wednet.edu
Retirement and Workers’ Compensation Susan Smith 360-563-7267 susan.smith@sno.wednet.edu
Director of Payroll and Benefits Jessica Ajeto 360-563-7235 jessica.ajeto@sno.wednet.edu
Paid benefits2018-19 District-paid benefits
UNION SEA
10,000 Life/AD&D $1.07 X
50,000 Life/AD&D $4.43
LTD Insurance $10.96 X
MetLife Vision $30.69
Delta Dental Plan A $99.79
Delta Dental + Ortho Plan E
$111.03 X
Willamette Plan 1 $82.95
Willamette + Ortho Plan 3 $86.80 X
Cost with Delta Dental $123.06
Cost with Willamette $98.83
Payroll departmentThe Payroll and Benefits Department is available all year:
• Monday – Friday • 8:00 a.m. – 4:30 p.m.• 360-563-7235
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Plan highlightsCongratulations! You are eligible to participate in the 403(b) retirement plan provided by the Snohomish School District #201. Contributing to a 403(b) plan will give you peace of mind through financial security during your retirement. A 403(b) plan allows you to contribute a portion of your compensation as a pre-tax or post-tax (Roth) contribution in order to save for retirement. Participation in the 403(b) plan is completely voluntary. If you are already contributing to the 403(b) plan, now is a perfect time to increase your contributions.
What is a 403(b) plan?A 403(b) plan, also known as a Tax-Sheltered Annuity (TSA), is a tax-deferred retirement plan provided for employees of certain tax-exempt, governmental organizations or public education institutions.
What are the benefits of contributing to a 403(b) Plan?Lower taxes!The 403(b) contributions you make can be on a pre-tax basis. This means that the money used to invest in the 403(b) plan is not taxed until the funds are withdrawn. For example, if your federal marginal income tax rate is 25%, and you contribute $100 a month to a 403(b) plan, you have reduced your federal income taxes by nearly $25. In effect, your $100 contribution costs you only $75. The tax savings grow with the size of your 403(b) contribution.
Tax-deferred growthIn your 403(b) plan, interest and earnings grow tax-deferred. This means that your interest will grow tax-free until the time of your withdrawal. The compounding interest on your 403(b) plan allows your account to grow more quickly than money saved in a taxable account where interest and earnings are taxed each year.
Taking the initiativeContributing to a 403(b) retirement plan helps you take control of your future retirement needs. Other sources of retirement income, including state pension plans and Social Security, often do not adequately replace a person’s salary upon retirement. A 403(b) plan can be a great way to supplement your income at retirement.
Possible tax creditsPre-tax contributions may put you in a lower tax bracket reducing your overall tax rate.
RothYou may also choose to invest part of your income on an after-tax (Roth) basis. Roth contributions are taxed at the time of the investment though contributions and earnings grow tax-free until withdrawn. Qualified distributions will allow you to withdraw your money tax-free.
Higher limitsAnnual contribution limits are much higher than those of an IRA.
How much can you contribute to a 403(b) Plan?
You may elect to save:
• 100% of your income up to $18,500 (2019)
• Extra $6,000 if age 50+
Universal Availability Notice
Plan Contact Person
Susan Smith1601 Avenue DSnohomish, WA 98290Phone: 360-563-7267
Contact NBS if you have questions about the retirement plan
NBS Retirement Service Center8523 S. Redwood Rd.West Jordan, UT 84088Phone: 800-274-0503, ext. 5Fax: 800-597-8206Website: NBSbenefits.com/403b
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How to enroll in the planYour employer has provided investment option(s) for you. A list of approved vendor(s) and the Salary Reduction Agreement (SRA) can be found by visiting the National Benefit Services (NBS) website at NBSbenefits.com/403b or by contacting NBS (contact information to the right).
Once you have chosen an approved vendor, please open a 403(b) account directly with them. To begin investing, send the completed SRA form to NBS who will work with your employer to begin contributions.
Investment choicesAnnuity contracts made available through insurance companies or custodial accounts through a retirement account custodian are allowed in 403(b) plans. For more information and a list of approved investment providers for your plan, visit NBSbenefits.com/403b. You will need to contact the investment providers for a comprehensive listing and information regarding the available investment options.
ExchangesAs a participant in the 403(b) plan, you have the option to move funds, or “exchange”tax-free between different vendors within the same plan.
RolloversYou also have the option of rolling retirement funds from previous employers to your current employer’s plan thus simplifying retirement management.
Distributions from the planYou or your beneficiary will be able to withdraw your vested balance when one of the following occurs:1. Retirement2. Termination of employment3. Attainment of age 59½ 4. Total disability5. Death
Note: The vendors may require additional paperwork.
LoansYou may borrow up to 50% of your vested balance up to $50,000 (whichever is less). Contact your current vendor about their specific loan provisions.
Hardship distributionsAn in-service hardship distribution may be allowed if you satisfy certain criteria. Contact NBS for more information about the requirements. If you take a hardship distribution you are required to stop making contributions for 6 months.
Required Minimum Distributions (RMD)Distributions are required at age 70½. Exceptions may apply.
Universal Availability Notice (continued)
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Documents for reference
This guide highlights some of the provisions of Snohomish School District’s benefits program. Complete details may be found in the official plan documents. While every effort has been made to ensure accuracy of this benefits guide, the plan documents and contracts will prevail in case of discrepancy between this brochure and the plan documents and contracts. The District reserves the right to amend or terminate any benefit plans at any time.