Idea Transcript
EMPLOYEE BENEFIT HANDBOOK
2013-2014 Plan Year
IMPORTANT PHONE NUMBERS
First Financial Group of America
1-800-672-9666
www.ffga.com
Accident-American Fidelity Assurance
1-800-654-8489
www.afadvantage.com
Cancer-American Fidelity Assurance
1-800-654-8489
www.afadvantage.com
Dental-Ameritas
1-800-487-5553
www.ameritasgroup.com
Disability-American Fidelity Assurance
1-800-654-8489
www.afadvantage.com
Heart and Stroke-Allstate
1-800-521-3535
www.allstateatwork.com
Life Insurance Group Life-UNUM
1-866-679-3054
www.unum.com
Individual Life-Texas Life
1-800-283-9233
www.texaslife.com
Term Life-American Fidelity Assurance
1-800-654-849
www.afadvantage.com
Long Term Care-Lifesecure
1-866-582-7701
www.YourLifeSecure.com
Medical Bridge-Colonial Life
1-800-521-3535
www.coloniallife.com
Medical Reimbursement
1-800-523-8422
www.ffga.com
Dependent Care Reimbursement
1-800-523-8422
www.ffga.com
Vision-Block Vision
1-866-265-0517
www.blockvision.com
For detailed plan information and brochures, please visit:
www.ffbenefits.com/georgetownisd
INTRODUCTION First Financial has been hired by the Georgetown Independent School District to explain and enroll all benefit plans with the exception of the health plan. The following is a guide to the supplemental insurance benefits that are offered to all full-time eligible employees of Georgetown Independent School District. This description only outlines the coverages that are offered. For a full and complete understanding of the products, please read the product brochures and discuss any questions with the Insurance representatives. When reviewing the plans and premiums, remember that the cost will be deducted on a pre-tax basis for most products. *The Life Insurance and Disability products should not be pre-taxed. SPECIAL RULES REGARDING THE GEORGETOWN INDEPENDENT SCHOOL DISTRICT CAFETERIA PLAN There are two very important issues to keep in mind: 1. Although all coverages are voluntary (you may pick and choose), every employee is required to sign their Section 125 Benefit Election Form, even if they select no benefits or choose to keep current benefits the same. 2. Any “pre-tax” elections will remain in effect and cannot be revoked or changed during the plan year unless you have one of the following changes in family status: marriage, divorce, birth, adoption, death, termination or change in spouse’s employment or, change in eligibility status of a dependent. It is also possible to change your medical coverage if there is a substantial increase in the premium and you have like coverage elsewhere. SUMMARY OF BENEFITS Medical Insurance TRS ActiveCare offers four PPO plans with BlueCross BlueShield, and one HMO plan with Scott and White. Dental Insurance Ameritas Dental Plan-2 plans offered 1. Low Plan-Annual Maximum of $750 calendar year per person, $25 deductible. Preventative at 100%, Basic 50%, Major at 30%. No waiting period. 2. High Plan- Annual Maximum of $1,000 calendar year per person, $50 deductible. Preventative at 100%, Basic 80%, Major at 50%. No waiting period. Includes child orthodontia.
Monthly Rates Option 1 Employee Only Employee/Spouse Employee/child(ren) Employee/Family
$18.16 $35.44 $37.32 $51.44
Option 2 Employee Only Employee/Spouse Employee/child(ren) Employee/Family
$40.56 $79.04 $80.60 $116.12
Vision Block Vision offers two PPO Indemnity Plans. For more information 1-866-265-0517. Monthly Rates Option 1 Employee Only Employee/Spouse Employee/child(ren) Employee/Family
$8.35 $14.23 $15.06 $22.58
Option 2 Employee Only Employee/Spouse Employee/child(ren) Employee/Family
$13.10 $22.31 $23.61 $35.41
Accident Insurance-American Fidelity Assurance Accident insurance pays benefits for different accidental injuries. The accident plan helps cover the expenses for emergency room costs, follow-up treatments, medical imaging, hospital confinement, and many other expenses associated with accidental injuries. This plan can help with medical expenses and living costs when you get hurt unexpectedly. After being enrolled for twelve months the employee is eligible for a wellness benefit.
Accident Only insurance Premiums Monthly Premiums individual individual & Spouse individual & Child(ren) family
$19.90 $28.30
$26.10 $34.90
$31.50
$41.00
$39.90
$49.80
Cancer Insurance-American Fidelity Assurance Cancer insurance is designed to be a supplemental and pays for many of the costs not covered by your major medical. This plan pays in addition to other coverage you may have. The premium rates are stated in the brochure along with a description of the various available riders, which gives you the flexibility of choosing the desired coverage to meet your special needs. Employee is eligible for a wellness
benefit.
Disability Income-American Fidelity Assurance This insurance is designed to protect your most valuable asset: your ability to earn an income. This plan will provide you with income (you can insure up to 70% of your salary) should you become disabled, and has various waiting periods you can select depending on when you would like your benefits to begin. There is also a doctor bill benefit payable (if you are sick and miss a day of work and go to a doctor) for out-of- pocket expenses up to $50 for illness and up to $100 for a non-disabling injury. This is only a benefit during the school year. There are two plans available to choose from, so that you may select the plan that best meets your needs. Heart and Stroke Insurance-Allstate The Heart and Stroke plan provides protection for you and your family against the cost associated with heart disease by providing benefits for angiograms, cardiograms, heart transplants and surgery. Individual Monthly – ½ unit $8.98
Family (if covered) Monthly – ½ unit $17.32
Individual Monthly – 1 unit $17.96
Family (if covered) Monthly – 1 unit $34.64
LIFE INSURANCE Group Life-UNUM Georgetown ISD offers Group Life insurance through UNUM. You may apply for coverage up to four times your annual salary. Additional coverage is also available for spouse and dependent children. Individual Life Insurance-Texas Life Georgetown ISD is offering its employees the opportunity to purchase individual permanent life insurance through Texas Life. These policies are portable at the same price and coverage. Coverage can be purchased for dependents including spouses, children and grandchildren. Coverage is guaranteed to age 121. Term Life Insurance-American Fidelity Assurance Term Life insurance is a policy that covers you during your earning years when you need it the most. You choose the term, 10, 20 or 30 years that you decide is best for you and your family. Long Term Care-Lifesecure Georgetown ISD is offering employees a Long Term Care plan through Lifesecure. This benefit will help you protect your financial independence and preserve your freedom to choose how to live life on your terms and reduce the effects of long term care on your family. Medical Bridge-Colonial Life Hospital Confinement Indemnity Plans can help to fill gaps and help protect against out-of-pocket expenses. Major benefits include: Wellness Benefit, Outpatient Surgical Benefit, Hospital Confinement Benefit, and Rehabilitation Unit Benefit. Employee is eligible for a wellness benefit.
Flexible Spending Account (FSA) Georgetown ISD allows employees to set aside up to $2,500 per year for unreimbursed medical expenses and/or up to $5,000 per year for dependent day care expenses on a pre-tax basis. Federal regulations effective January 1, 2011 will exclude over-the-counter medications from being eligible expenses. Medical Reimbursement-Administered by First Financial Group A reimbursement account is established with funds deducted from the employee’s monthly paycheck. The maximum annual amount that can be set aside is $2,500. Medical costs not covered by insurance (eyeglasses, chiropractic treatments, etc.) are paid for; the employee then submits his/her receipts with a voucher and is then sent funds from the reimbursement account thus circumventing taxes on all those expenses (NOTE: First Financial has the ability to wire transfer this money directly into your bank account). The employee must estimate the expenses he/she expects to incur over the twelve-month period, and divide this amount by twelve months to determine the amount to be deducted from his/her paycheck. This benefit is a “USE IT OR LOSE IT” benefit; any monies left in the account at the end of the year are retained by the district and are not refunded to the employee. An employee should consider this benefit carefully. You have the entire plan year to incur qualified expenses plus an additional 2 ½ months. You have 90 days after the plan year for reimbursement of expenses. The Metavante debit card will be available for your medical expense reimbursement purchases in lieu of submitting receipts and vouchers. . All over the counter items eligible for reimbursement must be accompanied by a doctor’s prescription and reimbursement request claim form. OTC claims may no longer be purchased using the FFA Benefits Debit. Serious Consideration
The employee is locked into the payroll deduction for the length of the Plan Document year May 1, 2013 – April 30, 2014.
If any funds have not been used (reimbursed) by the employee at the end of the Plan Document Year, those unused funds cannot be returned to the employee. Therefore, one must be certain to never have an amount withheld from one’s paycheck, which will exceed the actual amount paid for out-of-pocket medical expenses.
A qualified dependent child must be under the age of 19; if a full-time student, they must be under the age of 24.
Dependent Care Reimbursement-First Financial Group This benefit is available to any employee who wishes to save tax dollars on the cost of child care. The employee estimates the cost of child care he/she expects to incur over the Plan Year May 1, 2013 – April 30, 2014. , and divide this amount by twelve months to determine the amount to be deducted each month. The dependent care is paid for and the employee turns in a receipt with a voucher. In turn, the employee is sent funds from the reimbursement account thus circumventing taxes on expenses. This benefit is a “USE IT OR LOSE IT” benefit; any monies left in the account at the end of the year are retained by the district and are not refundable to the employee. An employee should consider this benefit carefully. You have 90 days after the plan year for reimbursement of expenses incurred during the twelve-month period.
Serious Considerations
You are locked into the payroll deduction for the length of the Plan Document Year May 1, 2013 – April 30, 2014. That means that if you are paying $300/month for child care and decide after three months to let a relative care for the child free, the $300/month will continue coming out of the paycheck for the remaining 9 months.
If any funds have not been used (reimbursed) by you at the end of the Plan Document Year, those unused funds cannot be returned to you. Therefore, it is important to be certain to never have an amount withheld from your paycheck, which will exceed the actual amount, which will be paid for dependent care.
(A teacher may only pay for day care 9 months of the year. She will want to make sure the funds taken out monthly are equal to what she will pay over the 9-month period divided by 12 pay periods). EXAMPLE: Mrs. Smith pays her daycare center $300/month for 9 months to watch little Johnny. She wishes to use the Dependent Care benefit of the Cafeteria Plan. Her deduction for child care is made over 12 months. (9 x $300 = $2,700; $2,700/12 = $225) She should not take more than $225/month out of her pay for the 12-month period.
You will be out both the expenses of child care and the payroll deduction for the benefit in the first month of the plan. That means you will have the $300 cost and the $225 deduction made in that month. It will be the next month before the $225 in the dependent care account is mailed back to you.
The person providing the child care will be expected to pay taxes on the cost of that care. To be sure that this is the case, you must provide the social security number of the provider when you turn in the voucher.
Individuals making an adjusted gross income of $28,000 or less will be better off taking the child care deduction credit off their 1040 form rather than using the Section 125 Dependent Care shelter.
Expenses reimbursed under this plan may not be used when calculating your medical expense deduction or the dependent care tax credit. Because it is sometimes more advantageous to take the dependent care tax credit on your tax return than to participate in the dependent care expense reimbursement account, you should discuss which alternative is the best for you with your tax consultant.
Qualifying Dependent Expenses In order to comply with IRS regulations, the following conditions must be met in order for expenses to be eligible for reimbursement.
Expenses for services must be incurred during the plan year to which it applies. Payment receipts must show the periods for child care services. FOR EXAMPLE: The plan year for your plan is May 1, 2013 – April 30, 2014, only expenses incurred after May 1, 2013 and prior to April 30, 2014 are eligible.
Each individual for whom you incur the expenses is: (a) A dependent under the age of 13 whom you are entitled to claim as a dependent on your federal income tax return, or (b) A spouse, parent or other tax dependent who is physically or mentally incapable of caring for himself or herself.
The expenses are incurred for the care of a dependent as defined above, or for related household services, and are incurred to enable you to be gainfully employed.
If the expenses are incurred for services provided by a child care center (a facility that provides care for more than six individuals not residing at the facility), the center must comply with all state & local laws and regulations.
The expenses are not paid or payable to a child of yours who is under the age of 19 at the end of the year in which the expenses are incurred.
The expenses are not paid or payable to an individual for whom you or your spouse is entitled to a personal tax exemption as a dependent.
The reimbursement (when added to all other reimbursements received by you under the plan during the same year) may not exceed the least of the following limits: (a) The maximum amount allowed under your plan (Item E, 2(a) of the Adoption Agreement) (b)$5,000 if you are married and filing a joint tax return; $2,500 if separate returns filed; (c) Your taxable compensation (after all salary redirection elections); (d) If married, your spouse’s actual or deemed earned income.