2015 Employee Benefits New Hire Guide CMS New Hires Guide.pdf · component of your compensation ......
Transcript of 2015 Employee Benefits New Hire Guide CMS New Hires Guide.pdf · component of your compensation ......
2015 Employee Benefits
New Hire Guide
New Hire Benefits Enrollment ............................................ 3
Employee Self Service Instructions ..................................... 4
Enrollment Instructions ....................................................... 5
Eligibility .............................................................................. 6
Health Benefits
Medical and Prescription Drug Plans ...................... 7
State Health Plan Rates .......................................... 8
Specified Disease with Optional Cancer Benefit ..... 9
Group Hospital Indemnity ..................................... 10
Dental Plans ........................................................... 11
Vision Plans ............................................................ 12
Flexible Spending Accounts ................................... 13
Financial Security Benefits
Disability Benefit Plans ..................................... 14‐16
Accident Insurance ................................................ 17
Term Life Insurance ............................................... 18
Premier Whole Life Insurance ............................... 19
Permanent Life Insurance ..................................... 20
Important Notices ........................................................ 21‐22
Employee Programs & The Legal Plan .............................. 23
Carrier Contacts ................................................................. 24
This guide is intended to summarize the benefits you receive from Charlotte‐Mecklenburg Schools. The actual determination of your benefits is based solely on the plan documents provided by the carrier of each plan. This summary is not legally binding, is not a contract, and does not alter any original plan documents. For additional information, please contact the Human Resources department.
Availability of Summary Health Information
As an employee, the health benefits
available to you represent a significant
component of your compensation
package. They also provide important
protection for you and your family in
the case of illness or injury.
Your plan offers a series of health
coverage options. Choosing a health
coverage option is an important
decision. To help you make an
informed choice, your plan makes
available a Summary of Benefits and
Coverage (SBC), which summarizes
important information about any
health coverage option in a standard
format, to help you compare across
options.
The SBC is available on the web at:
www.shpnc.org/myMedicalBenefits/
ppo/default.aspx
A paper copy is also available, free of
charge, by calling 1‐855‐859‐0966.
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NEW HIRE BENEFITS ENROLLMENT
Before your enrollment, learn more about the plan choices and prices through
this guide, Employee Self‐Serve, and the State Health Plan website
(www.shpnc.org).
WELCOME TO YOUR BENEFITS ENROLLMENT
Charlotte‐Mecklenburg Schools provides a broad array of benefits so you can select the cover‐
age that best meets the needs of you and your family. This guide includes an overview of the
benefits and your initial enrollment process. Benefit elections for most plans are effective the
first day of the month following your hire date. Trustmark, Voya, Unum and Texas Life voluntary
policies will be effective one month after your medical benefits are effective.
You have 30 days from your date of hire in which to enroll in benefits. Some bene‐
fits may require an application with health questions if you do not enroll during your initial en‐
rollment period.
Medical and prescription drug coverage at CMS is provided by the State Health Plan of North
Carolina. See pages 8 and 9 or visit the State Health Plan website (www.shpnc.org/
mymedicalbenefits) for details.
REGISTER FOR YOUR PERSONAL ENROLLMENT SESSION TODAY!
Call 1.877.401.6390, or visit https://www.myenrollmentschedule.com/cms, to schedule
your personal enrollment session. A benefits counselor will explain your options and pric‐
ing, as well as help complete the online enrollment. They will also provide a benefits con‐
firmation statement to you.
For a wallet card of benefit carriers and their contact information, please stop by the lobby
of Human Resources at 1901 Herbert Spaugh Lane, Charlotte, NC 28208.
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EMPLOYEE SELF SERVICE LOGIN INSTRUCTIONS LogintotheCMSIntranet
http://my.cms.k12.nc.usNote:IfyouworkfromaschoollocationyoumustchangetheRealmfromcmsdomaintocmssites.
In the blue box on the left click “Check out your Benefits”
Click on “Employee Self Service”
Select either “Employee Self Service” or “Employee
Self‐Service from Home”
Your Lawson username and password are the same as what you use to log
in to your CMS Email account (you will not use @cms.k12.nc.us as part of
your user name). Your initial password is Cm$xxxxx (last 5 of your SSN).
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ENROLLMENT INSTRUCTIONS As a CMS New Hire, you have 30 days from your hire date to enroll in most benefits. If you
miss this enrollment period, you cannot enroll until the next Annual Enrollment.
You may enroll in the optional retirement savings plans at any time. You may also sign up for
discounted home and auto insurance or use the discount purchasing program at any time
during the year; these plans do not require enrollment.
Every CMS new hire is offered a personalized enrollment session with a benefits counselor. A
benefits counselor will explain the available plan options and rates, answer your questions, and
help you complete enrollment.
FOLLOW THESE STEPS TO ENROLL
Schedule your benefits counselor appointment. Call 1.877.401.6390 or visit
https://www.myenrollmentschedule.com/cms to do this.
You must enroll with a benefits counselor for the Short Term Disability, Whole or
Permanent Life, Specified Disease, Hospital Indemnity or Accident plans. Self‐service
enrollment is available for the other plans by going to the CMS Intranet at http://
mycms.k12.nc.us . Select “Check out your benefits” from the blue box on the left side of
the screen, then select “Employee Self Service”.
Prepare for your enrollment appointment. Review the available plan information by
logging into Employee Self Service from the CMS Intranet at http://mycms.k12.nc.us.
Be prepared for your enrollment session with the following information:
• Other insurance information ‐ insurance company name and policy number of
other insurance you pay for directly outside of CMS
• Dependent information ‐ names, birth dates and social security numbers of
spouse and/or dependent children you wish to cover
• Beneficiary information ‐ names, birth dates and social security numbers of
beneficiaries you wish to designate for Life and Disability insurance
To ensure the accuracy of your elections, review the confirmation statement from your
counselor or in the enrollment system before completing your enrollment. Also review
your initial paychecks to verify the premium deductions are correct.
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ELIGIBILITY The chart below outlines the eligibility for the CMS sponsored plans for full‐time and part‐time employees. Employees must enroll in each benefit plan in order to have coverage, with the exception of Basic Term Life Insurance that CMS provides.
DEPENDENT ELIGIBILITY If you are eligible to participate in the benefits offered by CMS, your eligible dependents may also participate. For most benefit plans, dependents include:
• Your legal spouse • Your children up to the last day of the month that they turn age 26 • Your children covered by the plan who are over the age of 26 and who are/were
physically or mentally incapacitated on the date they turn/turned 26
Plan Full‐Time Employees Part‐Time Employees
State Health Plan (Medical/Rx)*
Specified Disease Insurance with Optional Cancer Benefit
Hospital Indemnity
Dental Plans
Vision Plans
Flexible Spending Accounts
Short Term Disability Insurance
Long Term Disability Insurance
Accident Insurance
Term Life Insurance*
Permanent Life Insurance
Legal Plan
* CMS pays for Basic Term Life and the cost of full‐time employee‐only coverage in the SHP 70/30 plan.
Premier Whole Life Insurance
Supplemental Term Life
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MEDICAL AND PRESCRIPTION DRUG PLANS The State Health Plan of North Carolina offers three medical plans to CMS employees for 2015: a Consumer Directed Health Plan (CDHP), a Traditional PPO and an Enhanced PPO plan. The CDHP option includes a high deductible health plan with a health reimbursement account, or HRA. The Enhanced Plan provides higher coverage levels in many categories compared to the Traditional Plan. The table below provides In‐Network highlights from each plan. Details about each plan are available on the State Health Plan website at www.shpnc.org.
CDHP w/HRA
Member In‐Network Expenses
Traditional Plan (70/30)
Enhanced Plan (80/20)
$1,500 Individual $4,500 Family
$ 933 Individual $ 2,799 Family
$ 700 Individual $ 2,100 Family
15% of eligible expenses after deductible
30% of eligible expenses after deductible
20% of eligible expenses after deductible
Out‐of‐Pocket Maximum $ 3,000 Individual $ 9,000 Family
Co‐insurance Maximum1 $ 3,793 Individual $ 11,379 Family
Co‐insurance Maximum1 $ 3,210 Individual $ 9,630 Family
15% after deductible $ 35 Primary Care2 $ 81 Specialist2
$ 30 Primary Care2 $ 70 Specialist2
15% after deductible $ 291 copay plus 30% co‐insurance after deductible
$ 233 copay plus 20% co‐insurance after deductible
15% after deductible $ 291 copay plus 30% co‐insurance after deductible
$ 233 copay plus 20% co‐insurance after deductible
Plan Feature
Benefit Year Deductible (Jan. 1 ‐ Dec. 31, 2015)
Member Co‐insurance
Benefit Year Co‐insurance or Out‐of‐Pocket Maximum
Office Visit Copays
Emergency Room
Inpatient
For full details on the State Health Plan, visit the Plan’s website at www.shpnc.org.
1The Traditional 70/30 and Enhanced 80/20 plans have an additional Rx $2,500 out‐of‐pocket maximum.
2In‐network hospital owned or operated practices may be subject to deductible and co‐insurance. Contact your physician’s office to determine if their practice is hospital owned or operated.
Prescription Drugs:
CDHP w/HRA plan: subject to the deductible, then 15% coinsurance.
Traditional (70/30) and Enhanced (80/20) plans: Copay for 30‐day supply:
Tier 1 Tier 2 Tier 3 Tier 4 Tier 5
$12 $40 $64 25% up to $100 25% up to $150
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STATE HEALTH PLAN RATES 2015 For 12 month, Full‐Time Employees
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CDHP with HRA Traditional
70/30 Enhanced 80/20
Monthly Rate
HRA Fund Amount
Monthly rate Monthly rate
Employee $40.00 $500 $0.00 $63.56
Employee + Spouse $515.68 $1,000 528.52 $692.10
Employee + Child(ren) $224.60 $1,000 or $1,500*
$205.12 $336.36
Family $546.64 $1,500 $562.94 $729.94
*$1,000 Employee +1, $1,500 Employee + 2 or more.
Other Cost Saving Opportunities CDHP Enhanced 80/20 Plan
Visit your PCP (listed on your ID Card) $15 added to your HRA fund Copay reduced by $15
Visit a Blue Options Designated Specialist $10 added to your HRA fund Copay reduced by $10
Receive Inpatient Care in a Blue Options Designated Hospital
$50 added to your HRA fund $233 copay is not
applied
Wellness Activity Premium Credits Available (will reduce the premium amounts above)
CDHP with HRA Traditional
70/30 Enhanced 80/20
Quit Smoking $20 per Month Not applicable $20 Per Month
Health Assessment $10 per Month Not applicable $15 Per Month
Select a PCP $10 per Month Not applicable $15 Per Month
Total Credits Available $40 per Month Not applicable $50 Per Month
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GROUP SPECIFIED DISEASE INSURANCE If you or someone in your family suffers a serious disease, you can be hit hard with immediate medical expenses and reduced income from being out of a job. Health benefits will pay part of the medical bills, and disability insurance coverage can help ensure a continuing income. However, many immediate expenses may not be covered.
Specified Disease Insurance directly pays you a lump sum benefit at the diagnosis of a covered illness, such as a heart attack; stroke; major organ failure; or permanent paralysis. Cancer is also covered for an additional premium. Below is some additional information about Specified Disease insurance with optional cancer coverage:
THIS IS A LIMITED POLICY. This policy has exclusions and limitations which may affect any benefits payable. See the actual policy or your Unum representative for specific provisions and details of availability. Employees must be U.S. citizens or legally authorized to work in the U.S. to receive coverage. Spouses and dependents must live in the U.S. to receive coverage. Unum complies with state civil union and domestic partner laws when applicable. Underwritten by: Unum Life Insurance Company of America, Portland, Maine. Unum is a registered trademark and marketing brand of Unum Group and its insuring subsidiaries.
CE-13597 (8-14)
Plan Highlights:
• Guaranteed Issue—up to $20,000 benefit and simplified issue up to $50,000 benefit for employees.
• Guaranteed Issue—up to $10,000 benefit and simplified issue up to $30,000 benefit for covered spouses.
• Available to full‐time and part‐time employees
• Coverage options: Employee and Children, Employee, Spouse and Children
• Eligible children are automatically covered at 25% of the employee amount.
• No medical questions up to specified limits
• Pre‐existing conditions waived for all CMS employees and dependents
• No waiting periods
• You choose the level of coverage, from $10,000 to $50,000, in $1,000 incre‐ments.
• Coverage is portable upon request • Cancer is also covered for an additional premium
Please see policy definitions for complete details about these covered conditions.
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GROUP HOSPITAL INDEMNITY Don't let a hospital visit put your wallet in intensive care. Group Hospital Indemnity (GHI) insurance can complement your health insurance to help you pay for the costs associated with a hospital stay. Benefits can be used to pay for the out‐of‐pocket expenses your medical plan may not cover, such as co‐insurance, co‐pays and deductibles, or however you wish.
THIS IS A LIMITED POLICY. This coverage is a supplement to health insurance. It is not a substitute for comprehensive health insurance and does not qualify as minimum essential coverage. Employees must be U.S. citizens or legally authorized to work in the U.S. to receive coverage. Spouses and dependents must live in the U.S. to receive coverage. Unum complies with state civil union and domestic partner laws when applicable. This policy has exclusions and limitations which may affect any benefits payable. See the actual policy or your Unum representative for specific provisions and details of availability. Underwritten by: Unum Life Insurance Company of America, Portland, Maine. Unum is a registered trademark and marketing brand of Unum Group and its insuring subsidiaries.
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Plan Highlights:
• $1,000 for each covered hospital admission • $100 each day of your covered hospital stay, up to 15 days per confinement • $200 each day you spend in intensive care, up to 15 days per confinement • $150 for an emergency room visit due to accidental injury, once per calendar year • $100 per trip for ambulance transport, once per calendar year, accidents only • $500 per trip for air ambulance transport, once per calendar year, accidents only • Coverage is portable upon request, which means you may take the coverage with
you if you leave CMS or retire, without having to answer new health questions. • Benefits for a pre‐existing conditions (a sickness or injury for which medical advice,
diagnosis, care or treatment was received or recommended during the 12 months just prior to your effective date) will not be paid if the date of the covered loss occurs during the first 12 months after your effective date.
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DENTAL PLANS Eligible CMS employees have a choice between three dental plans ‐ 2 dental PPOs and 1 dental HMO ‐ insured by Cigna. Eligible services, coverage levels and premium rates vary by plan. To make the best plan selection for you, review the highlights shown in the table below and the more detailed benefit summaries and monthly premium rates on Employee Self Service, accessed through the CMS Intranet at http://mycms.k12.nc.us. You will also find instructions for locating Cigna participating in‐network dentists.
Plan Feature
Dental HMO PPO Basic Plan PPO Standard Plan
In‐Network Only1
In‐ Network
Out‐of‐Network
In‐Network
Out‐of‐Network
Plan Year Benefit Maximum None $750 $750 $1,500 $1,000
Plan Year Deductible Individual / Family
N/A $50 / $150 $50 / $150 $25 / $75 $75 / $225
Office Visit Fee (copay) $5 N/A N/A N/A N/A
Preventive & Diagnostic Exams, Cleanings, X‐rays
Member copays apply. See Cigna
Patient Charge
Schedule for
details.
100%, no deductible
100%, no deductible
100%, no deductible
100%, no deductible
Basic Restorative Fillings, Extractions, Oral Surgery
80% after deductible
80% after deductible
90% after deductible
80% after deductible
Major Restorative Crowns, Periodontics, Dentures
50% after deductible
50% after deductible
60% after deductible
50% after deductible
Orthodontia22 Not covered Not covered
50%, no deductible
50%, no deductible
Orthodontia Lifetime Maximum
None N/A N/A $1,000 $1,000
1Each enrollee in the Dental HMO must select and utilize a Primary Care Dentist in Cigna’s Dental HMO network.
2Child and adult orthodontia are covered under the Dental HMO; Child orthodontia is covered under the PPO Standard Plan.
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VISION PLANS CMS offers eligible employees the option to purchase insurance plans through UnitedHealthcare. There are two available options ‐ the Standard Plan and the Premium Plan. The table below includes plan highlights. You can view more detailed benefit summaries and monthly premium rates through Employee Self Service, accessed through the CMS Intranet at http://mycms.k12.nc.us.
Plan Feature
Standard Plan Premium Plan
In‐Network Out‐of‐
Network* In‐Network
Out‐of‐Network*
Exam (every 12 months) $10 copay $45 allowance $10 copay $45
Materials $20 copay See below $20 copay See below
Frames (every 24 months Standard / 12 months Premium)
$100 allowance $45 $175 allowance $45
Lenses (every 12 months) Single Vision Bifocal Trifocal Lenticular
Covered in full after materials
copay.
$40 $60 $80 $80
Covered in full after materials
copay.
$40 $60 $80 $80
Contact Lenses (every 12 months)
Elective
Up to 4 boxes covered in full after copay. For contact lenses outside
covered selection, $105 allowance is
applied and materials copay is
waived.
$105
Up to 6 boxes covered in full after copay. For contact lenses outside selection, $175 allowance is applied and
materials copay is waived.
$175
Necessary Covered in full after materials
copay $210
Covered in full after materials
copay. $210
* Out‐of‐network amounts shown are reimbursement amounts.
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FLEXIBLE SPENDING ACCOUNTS
A Flexible Spending Account (FSA) allows you to put aside money for important expenses and help you reduce your income taxes at the same time. CMS offers two types of Flexible Spending Accounts ‐ a Healthcare FSA and a Dependent Care FSA. These accounts allow you to set aside pre‐tax dollars to pay for certain out‐of‐pocket health care or dependent care expenses.
HOW FLEXIBLE SPENDING ACCOUNTS WORK
1. As a new hire and each year during Annual Enrollment, you decide how much to set aside for health and/or dependent care expenses.
2. Your contributions are deducted from your paycheck on a pre‐tax basis in equal installments throughout the year. A $48.00 annual administrative fee is deducted along with your contributions.
3. After you incur eligible expenses throughout the benefit year, submit a claim form for reimbursement. Your claim will be processed and you will be reimbursed from your account. For some healthcare expenses, you may also use your FSA debit card to pay at the point of sale.
Please note that the health and dependent care accounts are separate; you may choose to participate in one, both or neither. You may not use money from the Health Care FSA to cover expenses under the Dependent Care FSA or vice versa.
FSA Plan Maximum Annual Contribution Examples of Eligible Expenses*
Health Care FSA $2,500 Medical, Rx, dental, vision copays,
deductibles, coinsurance, etc.
Dependent Care FSA $5,000 ($2,500 if married and filing
separate tax returns) Day care, nursery school, elder care
* See IRS Publications 502 and 503 for a more complete list of eligible expenses.
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Disability coverage provides a benefit in the event you cannot work due to a covered illness or injury. CMS employees have access to multiple disability income replacement options depending on vesting with the State Disability Program and election of supplemental coverage.
STATE DISABILITY PROGRAM Short Term and Long Term Disability benefits are provided by the North Carolina State Retirement System to employees who contribute to the Teachers’ and State Employees Retirement System (TSERS). You must meet the plan’s vesting requirements before becoming eligible for coverage. The table below outlines some key features of these programs.
DISABILITY PLANS ‐ STATE DISABILITY
Benefit Feature Short Term Disability
Extended Short Term Disability
Long Term Disability
Maximum Benefit Period
Up to 1 year Up to an additional year Until eligible for unre‐duced retirement
Benefit Amount (Taxable Benefit)
50% of 1/12th of annual pay up to $3,000/month
50% of 1/12th of annual pay up to $3,000/month
65% of annual pay up to $3,900/month*
Eligibility Members with at least 1 year of contributing ser‐vice
Members with at least 1 year of contributing ser‐vice with a temporary disability
Members with at least 5 years of contributing ser‐vice with a permanent disability
Elimination Period 60 days After Short Term Disabil‐ity benefits are exhausted
After all Short Term Dis‐ability benefits are ex‐hausted
* See State Disability Program information for employees with less than 5 years of service as of 7/31/2007.
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Program Component Short Term Disability (STD) Long Term Disability (LTD)
Insurance Carrier Trustmark The Hartford
AM Best Rating A‐ (Excellent) A‐ (Excellent)
Elimination Period Choice of two options: 1) 0 Days Injury / 7 Days Illness 2) 14 Days Injury / 14 Days Illness
365 Days
Maximum Benefit Period 12 months To normal retirement age for dis‐abilities occurring before age 62
Maximum Benefit Amount (in increments of $100)
Vested in State STD: 25% of pay Not vested in State STD: 60% of pay
60% of pay
Monthly Benefit Maximum $6,000 $8,000
Minimum Monthly Benefit $300 The greater of $100 or 15% of the monthly benefit
Rate Basis Age banded Age banded
Maternity Coverage? Yes No
Guarantee Issue during Annual Enrollment
Yes, to $5,000 monthly benefit maximum, except for employees who previously applied for coverage that is no longer in force
No
Premium Withholding Basis Post‐tax (for tax‐free benefit) Post‐tax (for tax‐free benefit)
Benefits offset by other cover‐age payments?
No Yes, by other group or individual LTD coverage and/or Social Security
DISABILITY PLANS ‐ SUPPLEMENTAL To supplement the state program, CMS offers two Disability plan options:
Short Term Disability through Trustmark
Long Term Disability through The Hartford
How does it work? Disability Income insurance replaces part of your paycheck when you are disabled and unable to work. It can help you meet financial obligations when you don’t have a paycheck coming in. Your disability insurance benefits are yours to use any way you want. Before you are vested in the State Disability plans, or even after you are vested, coverage through one of these programs may be beneficial for you and your family. The following table provides an overview of key components of each program and carrier.
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SHORT TERM DISABILITY Imagine life without a paycheck. You count on your paycheck to provide the things you need today and to achieve the dreams you have for tomorrow. But, what would happen if it were suddenly discontinued because of an unexpected injury or illness? That’s when Trustmark Disability Income insurance can help. It can help you live your story, your way – even when a disability gets in the way.
What’s covered? Total disability due to:
Non‐occupational sickness or injury
Disability due to pregnancy or complications of pregnancy
Plan Details Two elimination period options: 1. 14‐day accident/14‐day sickness 2. 0‐day accident/7‐day sickness
Benefits continue up to 12 months while you remain totally disabled.
No medical questions up to the specified limits, if you apply during the Fall 2015 annual enrollment, except for employees who previously applied for coverage that is no longer in force.
Benefit payment is subject to terms and conditions of coverage.
Even for those with 5 qualifying years of service that are covered under the NC TSERS disability, this plan provides some supplemental features which can enhance your long term income protection. These include:
Minimum additional tax free monthly benefit (the greater of $100 or 15% of the monthly benefit), regardless of what the State plan pays or what other benefits you qualify for from Social Security, individual plans, or any other coverage.
Benefits pay all the way up to Social Security Normal Retirement Age, even if you never qualify for Social Security disability, if you remain disabled under the policy terms. (NC state disability plan benefits cease if you are not awarded Social Security disability benefits within 3 years.)
$8,000 maximum monthly benefit vs. $3,900 under the NC TSERS plan.
Since you pay for this coverage with after tax dollars, any benefits payable would be non‐taxable.
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LONG TERM DISABILITY
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ACCIDENT INSURANCE Accident Insurance is a limited benefit policy. This is not health insurance and does not satisfy the requirement of minimum essential coverage under the Affordable Care Act. It can help pay for unexpected costs due to accidents that occur every day, from the baII field to the ski slope and the highway in between. With Accident Insurance offered by Voya Employee Benefits (previously ING Employee Benefits) you can focus your energy on recovery rather than worry about how you are going to pay your biIIs. The policy pays a specified benefit amount for the following:
• Initial care, including ambulance services, emergency room and initial doctor's office visit • Follow‐up care, including outpatient services and medical appliances • Injuries, including burns, dislocations and fractures • Catastrophic accidents and accidental death
Other Accident Insurance Features:
• Coverage is available without answering any health questions, and pre‐existing conditions do not apply.
• Pays in addition to other medical coverage and benefits are paid directly to you.
ACCIDENT WELLNESS BENEFIT RIDER
In addition to the above benefits, you will automatically receive a Wellness benefit rider which provides an annual benefit of up to $100 per certificate for covered health screening tests. Review the rider brochure for a list of the covered tests.
A 30‐day waiting period (applies only to the rider) from the effective date of coverage does apply. Please refer to the product brochure for additional information about Accident Insurance.
This is a very brief summary of the product. Please refer to the product brochures and certificate of
coverage for complete provisions, limitations and exclusions. Insurance is issued and underwritten by
ReliaStar Life Insurance Company, a member of the VoyaTM family of companies.
Policy form Number: RL‐ACC2005‐POL
Policy form numbers and specific provisions may vary by state.
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TERM LIFE INSURANCE
BASIC TERM LIFE INSURANCE
Eligible CMS employees are automatically enrolled in Basic Term Life Insurance paid for by CMS. A benefit of $9,300 is payable to your beneficiary upon your death.
SUPPLEMENTAL TERM LIFE INSURANCE
You may also apply for supplemental term life insurance through The Hartford to help provide you and your family with additional financial protection at affordable group rates. You have the option to purchase coverage for yourself, your spouse and your dependent children.
• Employee: Select an amount between $10,000 and $1,000,000, in increments of $10,000, not to exceed 5 times your basic annual earnings.
• Spouse: Select an amount between $5,000 and $100,000, in increments of $5,000, not to exceed 50% of the employee’s coverage.
• Child(ren): Select an amount between $2,500 and $10,000, in increments of $2,500 for each child up to age 26 years old.
During your initial enrollment period, CMS employees may enroll for an amount up to the lesser of 3 times your basic annual earnings or $650,000 without having to provide Evidence of Insurability. Spouse and dependent coverage is contingent upon employee coverage. Evidence of Insurability will be required for all late entrants—those who do not enroll for coverage for themselves or their spouse within 30 days of their date of hire. Dependent coverage is contingent upon employee coverage. Supplemental Term Life rates vary based on your age and the amount of coverage you choose.
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PREMIER WHOLE LIFE INSURANCE
Premier Whole Life insurance is designed to provide a base of life insurance coverage for your lifetime. It offers life insurance protection, cash accumulation and cash value loan privileges all in one policy. The premium you pay is based on the death benefit you select, the optional riders you choose, your age, and your tobacco status. Plan options are:
• Employees: Guaranteed Issue up to $25 per week, not to exceed $125,000 (ages 15‐65); Contingent Issue up to $50,000
• Spouse: Contingent Issue greater of $5/week or $5,000 (ages 15‐65); above contingent issue amounts require full underwriting.
• Dependent Children: Contingent coverage limits of $12,500, $15,000, $20,000 or $25,000 (15 days through 24 years.)
(Note: Amounts above Guaranteed/Contingent Issue Amounts are available with additional underwriting.)
The policy offers the following optional riders:
• Accidental Death Benefit provides an additional benefit equal to the face amount if the insured dies in a covered accident.
• Children’s Term Insurance offers up to $10,000 of coverage for each child. • Waiver of Premium allows the continuation of coverage by waiving the monthly
premiums after the insured has been totally disabled for four consecutive months. • Accelerated Death Benefit Rider provides a benefit if the insured is diagnosed with a
terminal illness or if they suffer from a long term care illness and are receiving qualified care (offered in North Carolina only).
Policy form numbers, product and rider availability may vary by state. Insurance is issued and underwritten by ReliaStar Life Insurance Company, a member of the VoyaTM Family of companies. Policy Form Numbers: RL‐WL2‐POL‐07, Policy Form #RL‐WL2‐ADBR‐08, CTR Rider RL‐WL2‐CTR‐07 , ABR Rider NP‐B‐ORD‐AB‐04; ADBR RL‐WL2‐ADBR‐08‐NC.
Whole Life Insurance Highlights:
• Builds cash value (and loans are available against this cash value) • No medical questions for employees up to specified limits, and pre‐existing condi‐
tions do not apply
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PERMANENT LIFE INSURANCE
Permanent life insurance from Texas Life can be an ideal complement to your group term life insurance. Designed to be in force when you die, this voluntary universal life product is yours to keep, even when you change jobs or retire, as long as you pay the necessary premium.
PLAN FEATURES
• Express Issue—Employees and spouses only have to answer three work‐related and health‐related questions to qualify for significant amounts of coverage; children and grandchildren only have to answer one health‐related question.
• High Death Benefit—With one of the highest death benefits available at the worksite,1 PURELIFE gives your loved ones peace of mind knowing there will be significant life insurance in place should you die prematurely.
• Minimal Cash Value—Designed to provide high death benefit, PURELIFE does not compete with the cash accumulation in your employer‐sponsored retirement plans.
• Long Guarantees—Guaranteed death benefit to age 121 and level premium that guarantees premium coverage for a significant period of time (after the guaranteed period, premiums may change).
• Refund of Premium—Unique in the marketplace, PURELIFE offers you a refund of five years’ premium should you surrender the policy if the premium you pay when you buy the policy ever increases (conditions apply).
• Family Coverage—You may apply for coverage for yourself, your spouse, minor children and grandchildren.
1 Voluntary and Universal Whole Life Products, Eastbridge Consulting Group, October 2008
PURELIFE PORTABLE PERMANENT LIFE INSURANCE FOR YOU AND YOUR FAMILY
Permanent, individual life insurance can be an ideal way to provide money for your family when they need it most. To help ensure that your family has money when you die, consider applying for this policy.
20
IMPORTANT NOTICES
Premium Assistance Under Medicaid & Children’s Health Insurance Program (CHIP)
If you or your children are eligible for Medicaid or CHIP and you’re eligible for health coverage from your employer, your state may have a premium assistance program that can help pay for coverage, using funds from their Medicaid or CHIP programs. If you or your children aren’t eligible for Medicaid or CHIP, you won’t be eligible for these premium assistance programs but you may be able to buy individual insurance coverage through the Health Insurance Marketplace. For more information, visit www.healthcare.gov.
If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed below, contact your State Medicaid or CHIP office to find out if premium assistance is available.
If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, contact your State Medicaid or CHIP office or dial 1‐877‐KIDS NOW or www.insurekidsnow.gov to find out how to apply. If you qualify, ask your state if it has a program that might help you pay the premiums for an employer‐sponsored plan.
If you or your dependents are eligible for premium assistance under Medicaid or CHIP, as well as eligible under your employer plan, your employer must allow you to enroll in your employer plan if you aren’t already enrolled. This is called a “special enrollment” opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance. If you have questions about enrolling in your employer plan, contact the Department of Labor at www.askebsa.dol.gov or call 1‐866‐444‐EBSA (3272).
21
North Carolina South Carolina
Website: www.ncdhhs.gov/dma
Phone: 919‐855‐4100
Website: www.scdhhs.gov
Phone: (888) 549‐0820
MAKING CHANGES DURING THE PLAN YEAR Once you enroll during your new hire initial eligibility period, you are required to maintain most of your benefit elections throughout the benefit year, unless you experience a Qualified Life Event, as defined by the IRS. These include:
• Marriage, death of a spouse, divorce, annulment or legal separation
• A change in the number of dependent children; including birth, adoption, placement for adoption, becoming responsible for a stepchild who will reside in your home or death of a child
• Employment change by the employee, spouse or dependent child that results in a loss or gain of health coverage
• Child’s loss of eligibility due to age or marriage
• For Dependent Day Care FSA – enrollment into or removal from day care
If you experience a Qualified Life Event during January 1 ‐ December 31, 2015, you have 30 calendar days from the date you experience the event to change your benefit elections. The benefit changes you make must be consistent with your life event, and you must provide CMS with documentation of the event (e.g., birth certificate, marriage certificate, COBRA or HIPAA letter showing loss of coverage) within the same 30 day window. If you do not make the change within 30 calendar days of the qualified life event or if you do not provide documentation within that period, you must wait until the next annual enrollment period to make an election change. To report a Qualified Life Event and to make your mid‐year benefit changes online, visit Employee Self Service through the CMS Intranet at http://mycms.k12.nc.us.
OTHER NOTICES To view the health plan legal notices, visit the State Health Plan of North Carolina website at www.shpnc.org.
Charlotte‐Mecklenburg Schools reserves the right to amend, modify, suspend or terminate ‐ in whole or in part ‐ the plan at any time without approval, consent or acceptance of participants. This reservation applies to all active benefit plans including all medical and prescription drug plans, and includes the right to change contributions and available benefits. Charlotte‐Mecklenburg Schools will make reasonable efforts to maintain personal information, but it is entirely the responsibility of employees to maintain accurate and current personal information, including address, with the company. Failure to do so could result in loss of coverage.
It is the responsibility of employees and their covered dependents to notify Charlotte‐Mecklenburg Schools of changes that may affect the eligibility of covered dependents, including but not limited to (1) the death of the covered employee, (2) divorce or legal separation of the covered employee, (3) a covered dependent child ceasing to qualify as a “dependent child” under the terms of the plan, and (4) a covered member’s entitlement to Medicare. Notice of change must be made within 30 days of the change. Failure to notify may result in loss of coverage.
IMPORTANT NOTICES 22
RATE NOTICE AND ESCROW NOTICE FOR LESS THAN 12 MONTH EMPLOYEES
In order to provide continuous medical coverage for less than 12‐month employees and their dependents during the summer months (June−August), CMS deducts addi onal amounts, called escrow payments, to cover the summer months' deductions. The total premiums for January are divided equally into nine monthly deductions beginning in February.
To see your individual rates per paycheck, log on to Employee Self Service through the CMS Intranet at http://mycms.k12.nc.us.
EMPLOYEE PROGRAMS / LEGAL PLAN 23
PURCHASING POWER PURCHASING PROGRAM Through the Purchasing Power program you can buy various household items and other goods and pay for them via payroll deduction. Things like computers, televisions, appliances and many more items are available. Visit www.cms.purchasingpower.com for more details.
HOME & AUTO INSURANCE DISCOUNT PROGRAM
Four insurance companies partner with CMS to offer employees discounts on home and automobile insurance. The four vendors are:
For more information about what each carrier offers, you may contact them directly. Telephone numbers are listed on page 23 of this Guide.
LEGAL PLAN
Finding an affordably‐priced lawyer to represent you when you have trouble with creditors, buy or sell a home, or even prepare a will can be a challenge. Hyatt Legal Plans is a legal service program that provides legal representation for you, your spouse and dependents at a price that won’t break your budget.
This plan gives you a resource at your fingertips for important legal services such as:
• Court appearances
• Document review & preparation
• Debt collection defense
• Wills
• Family matters
• Real estate matters
• Liberty Mutual
• MetLife
• Nationwide
• Horace Mann
Coverage Carrier/
Administrator Website Phone Number
Medical North Carolina
State Health Plan www.shpnc.org
Medical—888‐234‐2416 Rx—800‐336‐5933
Specified Disease and/or Hospital Indemnity
Unum www.unum.com/employees 800‐635‐5597
Dental Cigna www.mycigna.com 800‐244‐6224
Vision UnitedHealthcare www.myuhcvision.com 800‐638‐3120
Flexible Spending Accounts Flores & Associates www.flores247.com 800‐532‐3327
Short Term Disability Trustmark www.trustmarksolutions.com 800‐918‐8877
Long Term Disability The Hartford www.thehartfordatwork.com 877‐778‐1383
Accident Insurance Voya Employee
Benefits http://voya.com/products‐
services/employee‐benefits‐work 855‐730‐2902
Whole Life Voya Employee
Benefits http://voya.com/products‐
services/employee‐benefits‐work 800‐537‐5024
Permanent Life Texas Life www.texaslife.com 800‐283‐9233, ext 6814
Term Life The Hartford www.thehartfordatwork.com 877‐778‐1383
Purchasing Program Purchasing Power www.cms.purchasingpower.com 866‐670‐3479
Legal Hyatt Legal members.legalplans.com 800‐821‐6400
Discount Home & Auto Insurance Programs
Met Life Liberty Mutual Nationwide Horace Mann
800‐438‐6388 800‐835‐0894 704‐549‐4800 704‐532‐1111
CARRIER CONTACTS 24
25
NOTES
This guide is intended to summarize the benefits available to eligible employees of Charlotte‐Mecklenburg Schools. The actual determination of your benefits is based solely on the plan documents provided by the carrier of each plan. This summary is not legally binding, is not a contract, and does not alter any original plan documents. For additional information, please contact the Human Resources department.
All printed materials, raffle prizes and giveaways have been provided
or donated by CMS benefit carriers.
2015
Rev. 05/1/2015