2017-2018 Employee Benefits Booklet - Bowling Green City Schools [PDF]

Discover which benefits are right for you - at Youville ®

The right benefits can help provide financial protection during challenging times. But how do you determine which options best fit your life? Youville is an online resource that helps you quickly become more knowledgeable about your employee benefits. The website enables you to: „ Access information on financial protection. „ View personalized benefit recommendations. „ Learn about insurance terms. „ Find out about changing needs at different life stages. „ Sign up for The Youville Reporter for tips about health and financial protection.

A better 1-to-1 benefits session  Click on “Visit Youville” to complete a brief questionnaire for recommended benefit needs.

 Print out your personal benefit recommendations and summary.

 Take the printout with you to a 1-to-1 session with your Colonial Life benefits counselor. You’ll be more informed about the benefit options that can help protect what you’ve worked so hard to build.

Review your benefits at:

Visityouville.com/BowlingGreenCitySchools ©2014 Colonial Life & Accident Insurance Company, Columbia, SC | Colonial Life insurance products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand.

12-14 | 100990-1

Legal  Plan  –  covers  you,  your  spouse  or  domestic  partner,  never-­‐married  children  under  age  26  living  at  home, dependent  children  under  age  18  for  whom  the  member  is  the  legal  guardian,    never  married  dependent  children   who  are  full-­‐time  college  students  up  to  age  26,  and  physically  or  mentally  disabled  children  living  at  home.  

Advice  &  Consultation  

Document  Preparation  

Toll-­‐free  phone  consultations  with  your     Provider  Law  Firm  for  any  personal  legal     Matter,  even  on  pre-­‐existing  conditions.    

Will  preparation  and  annual  reviews  and  updates   for  covered  members;   Other  documents  available:    Living  Will,  Heath  Care   Power  of  Attorney.  

Letters  and  Phone  Calls  on  Your  Behalf  

Contract  and  Document  Reviews  

24/7  Emergency  Assistance-­‐     After-­‐hours  legal  consultation  for  covered   Legal  emergencies.    Specific  coverage  depends   On  plan.  Emergencies  include:    arrest,  seriously   Injured  or  served  a  warrant.  

Residential  Loan  Document  Assistance   Mortgage  documents  (as  required  of  the  borrower   by  the  lending  institution)  prepared  for  the  purchase   of  your  primary  residence.  

Family  Matters  (family  plan  only)  

Auto  

IRS  

Additional  Benefits  -­‐  -­‐Preferred  Member  Discounts  

Everyone  deserves  legal  protection.    LegalShield  is  creating  a  world  where  everyone  can  access  legal  protection  -­‐  -­‐  -­‐   and  everyone  can  afford  it.    You  will  have  access  to  a  quality  law  firm  24/7,  for  covered  personal  situations.  

Identity  Theft  Plan  –  covers  you,  your  spouse  or  domestic  partner,  and  up  to  8  dependents  under  the  age  of  18. Your  identity  is  personal.    Keep  it  that  way.    Identity  theft  affects  millions  of  Americans  each  year.    And  while  it  can   take  just  minutes  to  happen,  recovering  from  the  financial  damage  and  emotional  toll  it  inflicts  often  takes  years.     Identity  Shield  equips  you  with  the  information  and  expertise  you  need  to  help  prevent  theft  and  resolve  issues   related  to  identity  theft.  

Credit  Report  and  Personal  Credit  Score  

Continuous  Monitoring  with  Safety  Alerts  

Identity  Consultation  and  Restoration  Services  

Safeguard  for  Minors  

Per  Pay  Rates:  

Per  Pay  Rates:  

Single  Unmarried    =  8.48   Family    =    9.48  

Single  Unmarried    =  4.48   Family    =  9.48  

Legal  Only:      

ID  Shield  Only:      

Family  Bundle  Rate    =  16.96   **Save  $4  per  month  for  bundle  

Single  Bundle  Rate    =  12.96  

6

Bowling Green Independent School District

Ask your vision the prem care provider ab out ium No-G lare lens

Your vision health is an important part of complete wellness. Avesis is pleased to present your vision benefits which are designed to give you and your covered family members the care, value and service to help maintain good vision and overall health.

Group Details

In-Network Benefits Vision Examination

Your vision exam is covered in full after a co-pay.

$200* average retail

Effective Date: Group Number: Plan #:

1/1/16 10776-1003 924

Benefit Frequency Vision Exam Spectacle Lenses Frames Contact Lenses

FRAMES Providers typically charge between $100 - $150* for frames covered in full by your plan allowance.

Every: 12 Months 12 Months 24 Months 12 Months

AND Co-Pays Vision Examination Materials

SPECTACLE LENSES Standard lenses are covered in full. Providers typically charge between $60 - $120* for standard lenses.

$10.00 $10.00

Rates Contact Lenses

In lieu of frames and spectacle lenses, members receive an allowance up to $130 for materials and fit and follow-up exam Medically necessary contact lenses are covered in full (prior authorization is required)

LASIK Surgery

Members receive a one-time/lifetime allowance of $150

Additional Discounts Progressive Lenses

Specialty Lenses

Are discounted up to 20% off retail in addition to a $50 allowance

Are discounted up to 20% off retail in addition to the corresponding standard lens allowance

Lens Options, Non-Covered Items and Additional Purchases

LASIK Surgery 5% - 25% off retail

Are discounted up to 20% off retail

* **

Values provided may be more or less depending on the providers retail pricing. Provider wholesale frame pricing for your plan is $50. Participating Wal-Mart locations cover frames up to a $68 retail value, additional discounts on lenses and options do not apply.

Underwritten by: Fidelity Security Life Insurance Company, Kansas City, MO

Policy #: VC-16, Form M-9059

Employee Paid Rates Per Month

Employee Only Employee + Spouse Employee + Child(ren) Employee + Family

$8.42 $14.74 $17.68 $21.86

Out-of-Network Reimbursement

Up to: $35.00 Exam Standard Single Vision $25.00 $40.00 Standard Bifocal $50.00 Standard Trifocal Standard Lenticular $80.00 Progressive $40.00 Specialty Lenses Corresponding Standard Lens Reimbursement $45.00 Frame $130.00 Contact Lenses (Elective) Contact Lenses (Med. Necessary) $250.00 $150.00 LASIK Surgery

www.avesis.com

Using Out-of-Network Providers 0HPEHUVZKRHOHFWWRXVHDQRXWRIQHWZRUNSURYLGHUPXVWSD\WKHSURYLGHULQIXOODWWKHWLPHRIVHUYLFHDQGVXEPLWDFODLPWR$YƝVLVIRU UHLPEXUVHPHQW5HLPEXUVHPHQWOHYHOVDUHLQDFFRUGDQFHZLWKWKHRXWRIQHWZRUNUHLPEXUVHPHQWVFKHGXOHSUHYLRXVO\OLVWHG2XWRIQHWZRUNEHQH¿WV DUHVXEMHFWWRWKHVDPHHOLJLELOLW\DYDLODELOLW\IUHTXHQF\RIEHQH¿WVDQGOLPLWDWLRQDQGH[FOXVLRQSURYLVLRQVRIWKHSODQDQGDUHLQOLHXRIVHUYLFHV SURYLGHGE\DSDUWLFLSDWLQJ$YƝVLVSURYLGHU2XWRIQHWZRUNFODLPIRUPVFDQEHREWDLQHGE\FRQWDFWLQJ$YƝVLV¶&XVWRPHU6HUYLFH&HQWHURU\RXUJURXS administrator, or by visiting www.avesis.com.

Limitations and Exclusions 6RPHSURYLVLRQVEHQH¿WVH[FOXVLRQVRUOLPLWDWLRQVOLVWHGKHUHLQPD\YDU\GHSHQGLQJRQ\RXUVWDWHRIUHVLGHQFH Limitations: 7KLVSODQLVGHVLJQHGWRFRYHUH\HH[DPLQDWLRQVDQGFRUUHFWLYHH\HZHDU,WLVDOVRGHVLJQHGWRFRYHUYLVXDOQHHGVUDWKHUWKDQFRVPHWLFRSWLRQV6KRXOG WKHPHPEHUVHOHFWRSWLRQVWKDWDUHQRWFRYHUHGXQGHUWKHSODQDVVKRZQLQWKHVFKHGXOHRIEHQH¿WVWKHPHPEHUZLOOSD\DGLVFRXQWHGIHHWRWKH SDUWLFLSDWLQJ$YƝVLVSURYLGHU%HQH¿WVDUHSD\DEOHRQO\IRUVHUYLFHVUHFHLYHGZKLOHWKHJURXSDQGLQGLYLGXDOPHPEHU¶VFRYHUDJHLVLQIRUFH ([FOXVLRQV 7KHUHDUHQREHQH¿WVXQGHUWKHSODQIRUSURIHVVLRQDOVHUYLFHVRUPDWHULDOVFRQQHFWHGZLWKDQGDULVLQJIURP 1) Orthoptics or vision training; 2) Subnormal vision aids and any supplemental testing, aniseikonic lenses; 3) Plano (non-prescription) lenses, sunglasses; 4) Two pair of glasses in lieu of bifocal lenses; 5) Any medical or surgical treatment of eye or supporting structures;  5HSODFHPHQWRIORVWRUEURNHQOHQVHVFRQWDFWOHQVHVRUIUDPHVH[FHSWZKHQWKHPHPEHULVQRUPDOO\HOLJLEOHIRUVHUYLFHV  $Q\H\HH[DPLQDWLRQRUFRUUHFWLYHH\HZHDUUHTXLUHGE\DQHPSOR\HUDVDFRQGLWLRQRIHPSOR\PHQWDQGVDIHW\H\HZHDU  6HUYLFHVRUPDWHULDOVSURYLGHGDVDUHVXOWRI:RUNHUV¶&RPSHQVDWLRQ/DZRUVLPLODUOHJLVODWLRQUHTXLUHGE\DQ\JRYHUQPHQWDODJHQF\ZKHWKHU Federal, State, or subdivision thereof.  6HUYLFHVRUPDWHULDOVSURYLGHGE\DQ\RWKHUJURXSEHQH¿WSODQSURYLGLQJYLVLRQFDUH 5HIUDFWLYH6XUJHU\9LVLRQ%HQH¿W([FOXVLRQV %HQH¿WVDUHQRWSD\DEOHIRUDQ\RIWKHIROORZLQJ  5RXWLQHYLVLRQH[DPLQDWLRQVRUFRUUHFWLYHYLVLRQPDWHULDOVLQFOXGLQJFRUUHFWLYHH\HJODVVHV¿WWLQJVOHQVHVIUDPHVRUFRQWDFWOHQVHVRU 2) Medical or surgical procedures, services, or treatments: D QRWVSHFL¿FDOO\FRYHUHGXQGHUWKLV5LGHU b. provided free of charge in the absence of insurance F SD\DEOHXQGHUDQ\:RUNHUV¶&RPSHQVDWLRQODZRUVLPLODUVWDWXWRU\DXWKRULW\ d. payable under governmental plan or program, whether Federal, state, or subdivisions thereof.

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Notes and Disclaimers The contact lens allowance may be used all at once or throughout the plan year as needed or may be applied toward contact lenses only, or both contact OHQVHVDQGSURIHVVLRQDOVHUYLFHV¿WWLQJIHHV 5HIUDFWLYH/DVHU6XUJHU\LVFRQVLGHUHGDQHOHFWLYHSURFHGXUHDQGPD\LQYROYHSRWHQWLDOULVNVWRSDWLHQWV $YƝVLVLVQRWUHVSRQVLEOHIRUWKHRXWFRPHRIDQ\UHIUDFWLYHVXUJHU\

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AVESIS E-SSENTIALS OUR NEW MOBILE APP: VISION BENEFITS ON THE GO.

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