Employee Benefits - CM Regent Insurance Company · employee benefits programs including Life,...

Employee BenefitsP R O G R A M S A N D S E R V I C E S

CM Regent Insurance Company and CM Regent Solutions,formerly School Boards Insurance Company and SchoolClaims Services, are wholly owned subsidiaries of ChurchMutual Insurance Company and are PSBA endorsed.

By leveraging their parent company’s strengths and expertise, CM RegentInsurance Company and CM Regent Solutions will continue to provideprotection choices to meet the unique needs of your school district, college or university. Our employees strive to make resolving claims easy, and our riskmanagement team is dedicated to helping you prevent losses so that you canremain focused on education. We call it, “Protecting the Greater Good.”

CM Regent Solutions is dedicated to serving education through a variety ofemployee benefits programs including Life, Disability, Dental and more. We’reeducation benefits experts. Rest assured that our plans, carriers and programs meet the highest standards of quality and stability.

Working in Partnership

Some programs offered by CM Regent Solutions are administered through our partners Sun Life Financial, United Concordia, National VisionAdministrators and Keenan Pharmacy Services. These industry-leadingcompanies make it possible for us to offer your district and your employees a broad and appealing range of insurance plans and other benefits ataffordable prices.

Group Term Life Insurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

Disability Income Protection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

COBRA, Vision and Dental Services. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Pharmacy Benefits. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

1EMPLOYEE B ENEF I T S P ROGRAMS AND S ERV I C E S

2 EMPLOYEE B ENEF I T S P ROGRAMS AND S ERV I C E S

Count On Us for Group Term Life InsuranceSchool district employees regard life insurance coverage as one of the most important benefits they receive. They look for life insurance to meet a wide range of needs for their loved ones in the event of their deaths.Together with Sun Life Financial, CM Regent Solutionsoffers plans that suit the unique and varied needs ofschool employees.

CM Regent Solutions, in partnership with Sun Life Financial, enables school entities to offer their employees term life insurance at group rates.Your district can meet its benefit plan goals and give your employeespeace of mind. Program features and options will allow you to build theright plan for your employees—from a basic group life insurance plan to a multi-featured plan that includes options such as accidental death anddismemberment, dependent life and supplemental life.

Plan Features and Options to Meet Employee Needs

Flexible Plan Schedules – Because each participating district has uniqueneeds, there is no cookie-cutter approach to plan schedules. Each districtcan design its own plan from a variety of schedule options.

Dependent Life Option – Extends life insurance protection to eligibledependents.

Supplemental Term Life Option – Offers additional coverage on an employee-paid basis.

AD&D Coverage Option – Provides additional benefits if loss is due to accidental death or dismemberment.


Available Plan Choices

Accidental Death & Dismemberment

AD&D coverage provides a payment in the event of an employee’s loss of life, limb or eyesight as a direct result of an accident—provided the lossoccurs within 365 days of the accident. Includes a higher education andautomobile accident benefit.

Dependent Life

This benefit provides life insurance to eligible dependents. A variety ofschedules are available.

Supplemental Life

Supplemental term life insurance provides an opportunity for employees to increase their term life insurance protection at their own cost. Schedules,participation and rates are customized to the group.

Voluntary Group Term Life Insurance

Most school districts may already provide a basic employee life insurancebenefit. But it may not be enough for some school employees—particularlyfor those with a mortgage or children in college.

You can help solve that problem by offering the Voluntary Term Lifeprogram that is offered by CM Regent Solutions in partnership with SunLife Financial. This is a 100% employee-paid program that allows you toincrease benefits without significantly increasing costs. Allowing employeesto purchase additional coverage at group rates helps to provide greaterpeace of mind while giving you another important benefit to cite whenrecruiting quality, experienced employees.

Plan highlights include:

Employee Coverage – In units of $10,000, up to the lesser of $500,000 or five times annual pay (minimal elections $20,000).

AD&D Coverage – Additional benefits for accidental death ordismemberment for employee coverage only. The amount will match theVoluntary Life amount selected.

Dependent Life Option – Spouse coverage in units of $5,000, up to thelesser of 50% of the employee’s amount or $250,000. Amounts for childrenare $5,000; $10,000; or $20,000 (but not more than 50% of employeeamount).

Continued …

School districts

may choose a

benefit schedule

that is based on a

multiple of earnings,

flat amounts or a

combination of the

two and can include

accidental death and

dismemberment,

dependent life and

supplemental

life. Occupationally

defined benefit

schedules are also

available.


Generous Guarantee Issue Amounts

Accelerated Benefit – Allows employee access to the life insurance benefit if diagnosed with a life-threatening medical condition with anexpected lifespan of 12 months or fewer. This “living benefit” can pay up to 80% of the life insurance amount (maximum $250,000) when anemployee needs it most.

Waiver of Premium – Relieves further payment of premium for employeeswho are disabled according to the life insurance policy. Multiple optionsavailable.

Conversion Privilege – Allows terminated life coverage and anydependent life coverage to be converted to an individual plan withoutproof of good health if application is made and premiums are paid within31 days of termination.

Provider Fund – A personal checking account that is automaticallyestablished for beneficiaries receiving proceeds from this life insuranceplan of $10,000 or more.

Survivor Financial Counseling – Automatically available for individualsreceiving life, dependent life or accelerated benefit payments of $50,000 or more.

Sun Life Financial

has earned the

endorsement of

CM Regent Solutions

for the Group Life

Insurance programs.

Our partnership

is based on a

commitment to

providing sound

underwriting and

superior claims

service to member

districts.

Eligible Employees Employee Spouse Child

<100 $120,000 $50,000 $10,000

100<200 $150,000 $50,000 $10,000

200<500 $180,000 $50,000 $10,000

500+ $200,000 $50,000 $20,000


Count On Us for Disability Income Protection The ability to earn an income is one of a person’s mostvaluable assets. When disability strikes, income maystop—but the expenses of daily living do not. A groupdisability plan can protect employees’ incomes, familiesand lifestyles. Together with Sun Life Financial, CM RegentSolutions offers disability plans that suit the needs of yourdistrict and your employees.

CM Regent Solutions, in partnership with Sun Life Financial, enables school entities to offer their employees disability insurance at group rates.Doing so can help support your district’s benefit plan goals while givingyour employees peace of mind. Simplified program options are designedto provide broad financial protection while focusing on quality of care andreturn-to-work.

Plan Features and Options to Meet Employee Needs

Flexible Plan Schedules – Each district can design its own plan from avariety of plan design options, including elimination period, percentage of pay covered and benefit duration.

Premium Funding Options – Schools may choose district-paid oremployee-shared.

Multiple Coverage Options – Districts may select coverage for allemployees or specific classes of employees, choose to provide short- or long-term disability insurance and have options regarding integration or accumulated sick days.

Short-term Disability

This plan is designed to help disabled employees who do not have enoughaccumulated sick days to meet the elimination period for long-termdisability. Benefits can commence as early as the eighth day of disabilityand pay up to six months or more.


Long-term Disability

Benefits start when sick leave or short-term disability benefits have beenexhausted. Long-term disability insurance can pay up to Social Securitynormal retirement age.

In addition to employer choice of eliminationperiod, amount of benefit and plan benefitperiod, plan features and options includeemployer choice of integration with sick leave:

• Benefits begin after the elimination periodand all accumulated sick days are exhaustedOR

• Once the elimination period is satisfied, the employee chooses either to receivedisability payments or continue using sick days, if available.

Options for the length of “own occupation”protection include 24, 36 or 60 months.

Benefit add-ons include:

Activities of Daily Living (ADL) Benefit – Pays a supplemental disabilitybenefit to individuals who are unable to perform at least two of the sixADLs (bathing, dressing, eating, toileting, continence and transferring).

Survivor Benefit – Used as a “bridge” benefit to help eligible survivorsbetween the time of the employee’s death and the point at which lifeinsurance proceeds may be received.

Medical Premium Payment Supplement (MPPS) – Pay the employee’smonthly contribution for medical insurance premiums directly to theemployer while the employee is receiving disability benefit payments.

Waiver of Premium – Relieves further payment of premium for employeeswho are disabled according to the disability insurance policy.

Conversion Privilege – Allows terminated coverage to be converted to an individual plan without proof of good health.

Sound Rehabilitation Incentives – Includes increases to the employee’sbenefit amount when participating in an approved rehabilitation plan, afamily care expense credit, a worksite accommodation benefit, and more.


Definition of Disability

The foundation of all of our disability plans is a definition of disability thatprovides a wide financial safety net for your employees. The dual definition of disability qualifies employees for disability benefits if they meet either an occupation test or an earnings test, rather than having to meet bothcriteria as other contracts may require. Additionally, total disability is neverrequired to qualify for benefit.

If an employee meets the occupation test, works less than full-time orworks full-time but doesn’t perform all of the material duties of his/herregular occupation, then the qualifying period and the period of disabilitywill not be interrupted. This means a claimant can work part-time andcontinue to receive disability benefit, facilitating a gradual return to work.

Sun Life Financial

has earned the

endorsement of

CM Regent Solutions

for the Group Life

Insurance programs.

Our partnership

is based on a

commitment to

providing sound

underwriting and

superior claims

service to member

districts.


Count On Us for COBRA, Vision and Dental Services Many school employees consider cost-effective vision anddental care key aspects of their benefits package—makingself-funded discount programs highly attractive to schoolentities. Additionally, your district may be seeking ways to better manage COBRA services. CM Regent Solutionsprovides programs that address these varied demands onbehalf of your district and employees.

COBRA Continuation Coverage and Premium Collection Services

This self-funded third-party COBRA claims administration program from CM Regent Solutions includes coordination of benefits and providerdiscounts. This plan, designed to help districts save money while maintainingsound, high quality benefit programs, is IRS-compliant.

For less than the 2% surcharge of premium that districts can charge toadminister COBRA obligations, CM Regent Solutions handles the notificationprocess as well as the tracking and remittance of premiums. We also handleany follow-up required for collection, which removes the school entity fromthis potentially uncomfortable situation.

Self-funded Vision

CM Regent Solutions and National Vision Administrators (NVA) havepartnered to give public school entities the opportunity to participate in self-funded vision plans. This third-party claims administration planincorporates features designed to lower costs, improve cash flow and provide proper and timely administration of claims.

Benefits:

• Stable administration fees

• Quick and accurate claims processing

• Automatic invoicing after claims have been processed and paid

• Flexible plan designs

• Low cost—no hidden fees

• Access to NVA’s network of quality eye care professions

• Available Opti-Vision discount program


Opti-Vision Discount Program

This special discount program, from CM Regent Solutions and NVA, isdesigned for ease of use. Employees and eligible dependents simply showtheir identification card to a participating provider and the followingbenefits will apply:

Schedule of Vision Benefits:

Examination: $38

Frame: Wholesale Cost + 50%

Contact Lenses1: Retail, less 25%2

1 Additional professional services related to contact lenses(evaluation/fitting fees) are included in the discounted amount.

2 Discount is not applicable to mail order; however, you may get betterpricing through Contact Fill.

Lens Options: The employee/dependent will be charged by theparticipating provider up to the wholesale cost, plus 50% on each optionselected, or the reasonable and customary fee, whichever is less.

Discounted Lens Options Include: Photochromatic, Scratch Resistant,Fashion, Gradient, Solid Tints, Progressive or No-line Multifocals, Anti-reflective, Polycarbonate, Prescription Sunglasses, UV Coatings,Transitions, Polarized, High Index.

Lenses Glass Plastic

Single vision $30 $31

Bifocal $41 $45

Trifocal $50 $55

All Walmart stores

participate in the

Opti-Vision program,

but do not accept

the discount prices

above. The

negotiated discount

for materials with

Walmart is 5% off

their “everyday low

prices.” Not all

doctors are

affiliated with

Walmart; therefore,

participation for

exams varies.


Self-funded Dental

CM Regent Solutions and United Concordia are working together todeliver enhanced dental plan coverage for school district employees. This self-funded dental plan helps districts save money while employeesand their dependents enjoy quality benefits at a reasonable cost.

School Entities:

Zero Dollar ASO – The unique zero dollarAdministrative Services Only (ASO) dental provides multiple benefits for school districts:

• Zero Dollar ASO eliminates the district-paidadministrative cost. United Concordia retains all the administrative expenses from in-networkclaims savings generated from their extensivedental network.

• A conventional Per Employee Per Month (PEPM) charge is not charged to school districts participating in this plan.

• Administrative fees are based on achieved in-network savings deliveredby United Concordia’s network of dentists and the discounts negotiatedwith them.

Employees and Their Dependents:

A Large Network – The Alliance Network provides access to more dentists who accept allowances as payment in full for non-covered services(i.e. whitening and veneers) and services above the annual programmaximum.

Award-winning Customer Service – Knowledgeable, U.S.-basedrepresentatives can resolve problems and provide solutions.

Innovative Technologies for Managing Coverage – Online tools such as “My Dental Benefits” and “Find a Dentist,” coupled with a mobile app,help employees and their dependents access benefits information.

State-of-the-art Claims System – Real-time processing eliminates the waitfor claim approval.


Pharmacy Benefits

It’s hard to find ways to save money. You can cut programs, reduce staff orslash services—none of these are good options. CM Regent Solutions hasfound a way for your district to put money back into the classroom to fundthe programs and services that are important to your teachers, studentsand parents—without cutting benefits.

CM Regent Solutions is pleased to offer you a new Prescription DrugPurchasing Coalition that delivers cost savings and the most advancedprescription management capabilities for self-funded districts. TheCoalition is powered by Keenan Pharmacy Services and currently has an enrollment of more than 400,000 and growing!

For more than 40 years,Keenan has managedemployee benefitprograms for PublicEmployer pools and JointPowers Authorities. It iscurrently the endorsedpharmacy program forNew York State Boards of Cooperative EducationServices, the MarylandAssociation of Boards ofEducation and the National School Boards Association.

This program provides you significant and guaranteed improvement in all areas of drug cost management without changing your existing plan design:

• Volume-based pricing

• Greater retail and mail order discounts

• Lower dispensing fees

• Higher guaranteed rebates

• Improved generic utilization


How the Coalition Works for Your District

• Each participating district keeps its own program flexibility, usingexisting plan provisions.

• The Coalition has partnered with Express Scripts, providing a nationalnetwork of more than 50,000 pharmacies that includes all major retailchains.

• Financial, performance and implementation guarantees provideassurance that you will experience a seamless transition, enhanceemployee satisfaction and save money.

• A third-party auditor monitors everything to ensure you receive thesavings and rebates you are promised.

• You can also receive complete Medicare Part D administration andsupport, saving you from an additional administrative burden.

And most importantly …

• We fight for schools! The Coalition is on your side to protect you from the contrived complexity and mysterious pricing schemes of thePharmacy Benefit Manager (PBM) industry.

The Coalition Delivers Savings

The table below illustrates how customers will save by implementing theirprescription drug plans through the Coalition, based on their ownutilization and existing plan designs:

District

Client Employees CurrentCost

CoalitionCost

Savings

270

11K

1K

CommunityCollege

Multi-District JPA

$682K $563K$119K

$31.6M $27M

$500K

$4.6M

$2.2M $1.7M

P.O. Box 812New Cumberland, PA 17070-0812

Toll-free 866-403-7700CMRegent.com

CM Regent Solutions is a registered trademark of CM Regent Insurance Company. This brochure provides a basic summary of benefits available and does not constitutea guarantee of eligibility. Consult the applicable insurance policy or benefit program document for a complete description of coverage, benefits and conditions.

Employee Benefits - CM Regent Insurance Company · employee benefits programs including Life,...

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