Benefits Update for 2014

Thomas R. Tomberlin

Director, District Human Resources Services

thomas.tomberlin@dpi.nc.gov

(919) 807-3440

Parental Involvement Leave

• § 95-28.3. Leave for parent involvement in schools.

• The statute does apply to school personnel (including classroom teachers).

• Mutually agreed upon time – 48 hour notice• Employer may require documentation of visit.• LEA is not required to pay for this leave time.

Annual Leave Bonus

• Eligibility:– Any person who is eligible to earn annual leave

AND– was a permanent employee of LEA on July 1st,

2013

OR– was under contract to be employed for the 2013-

2014 school year on July 1st, 2013.

Annual Leave Bonus• The bonus leave cannot be paid out except for a

retiring employee.• The bonus leave can be used for any purpose for

which regular annual leave is used.• Bonus leave may not be used on an instructional day

if the employee requires a substitute.• Bonus leave cannot be donated as Voluntary Shared

Leave (VSL).• Bonus leave can be applied to negative leave

balance but not if the negative leave was incurred prior to July 1st, 2013.

Annual Leave Bonus• LEAs may designate 5 of the built-in annual leave

days in the calendar as bonus leave, but they should provide clear communication to employees to avoid any confusion.

• Bonus Leave is coded to 29 – “2013-14 Bonus Leave”

• The bonus leave does not count toward the maximum rollover balance at December 31st.

Embracing a Healthy Lifestyle through the State Health PlanNew Plan Options and Incentives for 2014

Health Plan Options for 2014Enhanced 80/20 Plan

NEW: Consumer-Directed Health Plan (CDHP) with HRA

Traditional 70/30 Plan

• The current Standard 80/20 Plan with a new name to match the new features

• $0 ACA Preventive Services

• $0 ACA Preventive Medications

• New Wellness Incentives

• Reduced medical copay opportunities

• A new health plan option

• A high-deductible medical plan

• A Health Reimbursement Account (HRA) to help offset the deductible

• 85/15 Coinsurance

• $0 ACA Preventive Services

• $0 ACA Preventive Medications

• CDHP Preventive Medication List ($0 deductible)

• New wellness incentives

• Additional HRA funds for visiting certain providers

• The current Basic 70/30 Plan with a new name

• No incentives available

• No $0 ACA Preventive Services

• No $0 ACA Preventive Medications

Open Enrollment will be conducted October 1 – 31, 2013. You must complete enrollment—otherwise, you and your covered family members will be

enrolled in the Traditional 70/30 Plan effective January 1, 2014.

A New Focus On WellnessEnhanced 80/20 Plan

NEW: Consumer-Directed Health Plan (CDHP) with HRA

Traditional 70/30 Plan

• Wellness premium credits when:• Subscriber completes a Health

Assessment• Subscriber attests for him/herself

and spouse (if applicable) to not smoking...or to being in a smoking cessation program

• Selecting a Primary Care Provider (PCP) for self and all dependents

• Additional wellness incentives• $15 copay reduction for utilizing

the PCP (or someone in that practice) listed on the ID card

• $10 specialist copay reduction for utilizing a Blue Options Designated Specialist

• $0 inpatient hospital copay for utilizing a Blue Options Designated Hospital

• Wellness premium credits when:• Subscriber completes a Health

Assessment• Subscriber attests for him/herself

and spouse (if applicable) to not smoking...or to being in a smoking cessation program

• Selecting a Primary Care Provider (PCP) for self and dependents

• Additional wellness incentives• $15 added to the HRA when the

PCP (or someone in that practice) listed on the ID card is seen

• $10 added to the HRA when a Blue Options Designated Specialist is seen

• $50 added to the HRA when a Blue Options Designated Hospital is utilized for inpatient services

• No incentives available

• No $0 ACA Preventive Services

• No $0 ACA Preventive Medications

Lower Your Premiums with Wellness Premium Credits—The Enhanced 80/20 Plan

Complete up to Three Wellness ActivitiesBy October 31, 2013

Enhanced Plan Premium Credits

Subscriber attests to being a non-smoker/commits to a cessation programand attests for spouse if applicable

$20 per month

Subscriber (only) completes a confidential Health Assessment (HA)

$15 per month

Subscriber and any covered dependents selects a Primary Care Provider

$15 per month

Reduce your premium by up to… $50 per month

Lower Your Health Care Costs with Wellness Incentives—The Enhanced 80/20 Plan

Things you can do to reduce your costs…

Enhanced Plan Incentives

Visit the PCP listed on ID card Your copay is reduced by $15

Visit a Blue Options Designated specialist Your copay is reduced by $10

Get inpatient care in a Blue Options Designated hospital

Your $233 copay is not applied

Remember:

Get preventive services through an in-network provider in a non-hospital setting

100% coverage – this is provided at no cost to you

ACA preventive medication list100% coverage – this is provided at no cost to you

The Consumer-Directed Health Plan (CDHP) with HRA

A different kind of health plan with two components

Health Reimbursement Account (HRA)

High-Deductible Health Plan

• The Plan funds the members’ Health Reimbursement Accounts (HRA) annually

• HRA funding is based on the number of family members covered

• $500 for employee/retiree only

• $1,000 for employee/retiree + 1

• $1,500 for employee/retiree + 2 or more dependents

• HRA funds are used to pay a portion of the members’ deductibles & coinsurance

• Once the HRA is depleted, the member must pay the remaining deductible & coinsurance

• Incentives available to add value to HRA

• Unused HRA funds are available the following year

• Covers the same services as other Plan options through the same PPO network

• The deductible is higher than other Plan options, but the coinsurance is lower

• In-network: $1,500 Individual/$4,500 Family

• Out-of-Network: $3,000 Individual/ $9,000 Family

• After the deductible is met, the member only pays the 15% coinsurance

• The deductible applies to both Pharmacy and Medical expenses

• If the member reaches his or her deductible and coinsurance out-of-pocket maximum, the Plan pays 100% of the covered expenses for the rest of the benefit year (medical and pharmacy)

Lower Premiums with Wellness Premium Credits—CDHP

Complete up to Three Wellness ActivitiesBy October 31, 2013

CDHPPremium Credits

Subscriber attests to being a non-smoker/commits to a cessation programand attests for spouse if applicable

$20 per month

Subscriber (only) completes a confidential Health Assessment (HA)

$10 per month

Subscriber selects a Primary Care Provider (and any covered dependents)

$10 per month

Reduce subscriber premium by … $40 per month

Lower Member Health Care Costs with Wellness Incentives—CDHP

Things you can do to reduce your costs…

CDHP Incentives

Visit the PCP listed on ID card $15 added to the HRA

Visit a Blue Options Designated specialist $10 added to the HRA

Get inpatient care in a Blue Options Designated hospital $50 added to the HRA

Remember:

Get preventive care through an in-network provider in a non-hospital setting

100% coverage – this is provided at no cost to the member

ACA preventive medication list 100% coverage – this is provided at no cost to the member

CDHP preventive medication list 15% of eligible expense with no deductible

The Traditional 70/30 Plan

• Traditional 70/30 Plan – The new name for the current 70/30 Basic Plan; there are no changes to the Plan’s benefits for 2014

• Copays and Deductibles – The copays and deductibles on the Traditional 70/30 PPO plan are the same as they are today on the 70/30 Basic Plan. There will be no opportunities for copay reductions on the Traditional 70/30 Plan.

• Network Services – Members may visit any provider, but they will pay less when they go to a BCBSNC network provider

• Preventive Services – Copays still apply to preventive services.

Salary and Benefits Statement

• Pursuant to Session Law 2009-63, House Bill 1221, DPI will maintain a website for school employees to calculate their full compensation (salary and benefits) package.

• http://apps.schools.nc.gov/benefitstatement

Salary and Benefits Statement

• Districts are responsible for keeping their local benefits updated.

• DPI will update the page with current information

• Please contact me if you need to update your local benefits provider on the webpage.

Salary and Benefits Statement

Thomas R. Tomberlin

thomas.tomberlin@dpi.nc.gov

919-807-3440

Questions/Comments