Comprehensive Employee Benefits Overview

undefined
 
NEW HIRE
ORIENTATION
 
PRESENTED BY: 
EMPLOYEE BENEFITS
 
Eligibility
 
 
All Full-Time employees working at least 30 hours per week are
eligible on the 1
st
 of the month following date of hire.
 
All teachers working at least .41 FTE or 17 ½ hours per week.
 
Eligible dependents:
An eligible employee’s  spouse (unless legally separated) including common law spouse
An eligible employee’s current  same-gender domestic partner
An eligible employee’s current partner in a civil union
An eligible employee’s dependent child from birth to the end of the calendar month in which they turn
26 years of age
 
Making Changes During the Year
 
 
 
In most cases, your benefits remain in effect for the entire plan year (July
1 through June 30). During each open enrollment period, you will have the
opportunity to review your benefit elections and make changes for the
coming year.
 
 
You can make mid-year changes only if you have a Family Status Change:
Marriage, divorce, or legal separation
Birth, adoption, court order, disability, death, marriage, or reaching the dependent
age limit.
Changes in your spouse’s employment affecting benefit eligibility
Changes in your spouse’s benefit coverage with another employer that affects
benefit eligibility
 
 
Making Changes During the Year
 
 
You have 
31 days 
from the date of the of a Family Status Change to
turn in a completed enrollment/change form and supporting
documentation to Employee Benefits.
 
 
If you fail to turn in your documentation within 31 days, you will
have to wait until the next open enrollment period to make changes.
 
The effective  date of the Family Status Change is the day of the
event.
Example: you are married on 9/25, you will add your spouse effective 9/25.
 
Medical Plan
 
Kaiser Permanente Commercial Plan
 
 
2 Plans- Buy-Up Plan and the Base Plan
Buy-Up Plan
:  Lower deductibles and out-of-pocket costs , lower co-pays and more alternative health
options, including Acupuncture, Chiropractic and Massage Therapy.
Base Plan
:  Lower premiums with higher deductibles/MOOP, Acupuncture and Chiropractic, and same
access to physicians as the Buy-Up Plan
Both plans include Out of Network Benefits and membership to PeakMed Direct Primary Care offices
and services.
 
 
75/25 split with D11 paying 75% of the employee medical premium on the Buy-Up Plan
 
85/15 split with D11 paying 85% of the employee medical premium on the Base Plan
 
 
PeakMed Direct Primary Care
 
 
Direct Primary Care Service include
s, but is 
not limited to the following:
 
Adult & Pediatric Care
 
Chronic Disease Management
: High blood pressure, diabetes, etc.
 
Mental Health & Wellness
 
Sports Medicine
, including InBody 570 body composition analysis
 
On-Site Pharmacy 
with wholesale pricing
 
Blood draws with low-cost test results
 
Wound care
, including stitches, staples and/or surgical glue
 
Dermatology procedures
: skin tag and wart removal, skin biopsies
 
Annual & School Sports Physicals
 
EKG & Pulmonary Function Testing
 

$0 Cost Unlimited Primary Care

No deductibles

No waiting for appointments

Thorough consultations

Coordination with your Kaiser Medical Plan
 
Pharmacy Benefits
 
 
GETTING PRESCRIPTIONS FILLED WITH KAISER PERMANENTE
 
You are automatically enrolled in the prescription drug program, administered by 
Kaiser Permanente
,
when you enroll in the Colorado Springs School District 11 medical plan. The prescription drug program
provides both retail and mail-order pharmacy coverage. Your medical and prescription cards are combined
into one card, which will come from Kaiser. Learn more at kp.org/mobile. There you will find links to
download the Kaiser Permanente mobile app, which will include your digital ID card.
                                                     30-day Copay          90-Day Copay
 GENERIC 
 
                   
$10
 
                 $20
 
BRAND NAME
 
                   
$30
 
                 $60
 
NON-FORMULARY
 
 
$45
 
                 $90
 
SPECIALTY / INJECTABLES / IV
 
20% coins. up to $250 per RX
 
Not Available
 
Dental Plans
 
PPO + PREMIER PLAN #1563
Standard dental plan- you can see any dentist
100% coverage for preventative services (2 cleanings
per year)
80% coverage for Basic Services (fillings, root canal, oral
surgery)
50% coverage for Major Service (crowns, bridges,
partials, dentures)
60% coverage for Braces- no age limit
 
RIGHT START 4 KIDS PROGRAM-
Covers children up to their 13th birthday at 100% with no deductible (for the same services outlined in the plan, up to the annual maximum,
and subject to limitations and exclusions). The child must see a Delta Dental PPO or Premier provider to receive the 100% coinsurance. If an out-
of-network provider is seen, the adult coinsurance levels will apply. Orthodontics, if selected as part of the group’s plan, is not covered at 100%
but at the plan’s listed coinsurance.
 
PPO IN-NETWORK ONLY PLAN #9098
In-Network coverage only
100% coverage for preventative services (2
cleanings per year)
60% coverage for Basic Services (fillings, root canal,
oral surgery)
40% coverage for Major Service (crowns, bridges,
partials, dentures)
50% coverage for Braces- no age limit
 
Dental Plan Provider- Delta Dental of Colorado
 
Vision Plan
 
Up to $140 allowance for contacts
annually ​
 
 
15% off of Lasik ​
 
 ​
20% discount off of non-
prescription sunglasses
 
 
Annual Exam- $10 Copayment ​
 
 
Up to $140 allowance for
frames every 12 months​
 
 
$25 copayment for lenses annually
 
Vision Provider- EyeMed Vision Care
 
Life Insurance
 
 
Policy through Sun Life Financial
 
 
Basic Life Insurance
100% paid by D11
2 x annual salary with a minimum benefit of $50,000
Flat $50,000 for bus drivers and food service
 
 
Voluntary Life Insurance
Elect up to $100,000 additional coverage for yourself, $25,000 for your spouse and $10,000 for each
child up to age 26, guaranteed issue! Guaranteed issue  during your initial eligibility period only.
Election is also available during our next full open enrollment in April/May, but you will be required to
answer health questions for all levels of coverage.
 
Voluntary Short-Term and Long-Term Disability
 
 
Policy through Sun Life Financial
 
 
Short-Term Disability
Wage replacement for short-term injuries, illness or having a baby
Elect to receive $50 per week up to 60% of your salary per week
15 day waiting period before benefits are paid
6-8 weeks paid for maternity
 
 
Long-Term Disability
Wage replacement for long-term illness or accidents
Pays 60% of your salary monthly
90-day waiting period before benefits are paid
 
Flexible Spending Account (FSA)
 
 
Provider: Rocky Mountain Reserve
 
 
2 Accounts Available
Medical FSA
Dependent Care FSA
 
 
Medical FSA
Pay for out-of-pocket medical, dental and vision expenses incurred by you and your dependents with pre-tax dollars.
$610 Annual Maximum Rollover/$20 Minimum Rollover
 
 
Dependent Care FSA
Pay for work-related childcare expenses with pre-tax dollars
 
 
Why FSA?
Every dollar of earnings converted to from wages to tax-free benefits means fewer taxes (no PERA, Medicare,
Federal, or State withholding taxes are subtracted from this money)…which means more money for you!!
 
Profile EAP
 
Confidential counseling for all employees and their dependents
Appointments scheduled Monday – Friday. A counselor is available 24 hours per day, 7 days per week for crisis assistance.
 
Counseling Benefit
 
(8) Eight sessions per person, per problem, per plan year (7/1-6/30)Legal/financial services
Free consultation
Discounted rates on additional services
Unlimited access to information resources on
 
www.ProfileEAP.org
Click Signup to create and account. 
Use COMPANY CODE: CSD11    
There is 
NO COST 
to employees or dependents!
The EAP licensed professional counselors are there to help with life's problems.
Relationship issues
Family problems
Grief
Stress, depression or anxiety
Substance abuse
Workplace difficulties
Almost any personal or professional problem is appropriate for seeking assistance through EAP.
24/7 Crisis Service
If you need help handling a crisis, after hours, a counselor can be reached 24 hours a day.
 
D11 Website
 
 
www.d11.org
 
 
Employees
 
 
Employee Benefits
 
Access your “Self-Service” account to view your paycheck and
benefit elections.
 
View all benefit plan documents, Health Promotion Program
information and much more.
 
Provider contact information and websites
 
Questions
 
Contact Your Employee Benefits Team!
Andrea Palos – Benefits Manager
Ang Kammerer – Benefits Specialist
Mackenzie Minazumi – Benefits Admin
 
Monday-Friday from 8am-5pm
719.520.2178
Employee.Benefits@d11.org
Slide Note
Embed
Share

This orientation provides detailed information on employee benefit eligibility, making changes during the year, medical plans including Kaiser Permanente options, and PeakMed Direct Primary Care services. Eligibility criteria, dependent coverage, and key enrollment timelines are outlined. The medical plans offer varying benefits like lower deductibles, out-of-pocket costs, and alternative health options. PeakMed services include unlimited primary care, chronic disease management, mental health support, and more. Stay informed to make the most of your employee benefits package.


Uploaded on Jul 01, 2024 | 1 Views


Download Presentation

Please find below an Image/Link to download the presentation.

The content on the website is provided AS IS for your information and personal use only. It may not be sold, licensed, or shared on other websites without obtaining consent from the author. Download presentation by click this link. If you encounter any issues during the download, it is possible that the publisher has removed the file from their server.

E N D

Presentation Transcript


  1. NEW HIRE ORIENTATION PRESENTED BY: EMPLOYEE BENEFITS

  2. Eligibility All Full-Time employees working at least 30 hours per week are eligible on the 1stof the month following date of hire. All teachers working at least .41 FTE or 17 hours per week. Eligible dependents: An eligible employee s spouse (unless legally separated) including common law spouse An eligible employee s current same-gender domestic partner An eligible employee s current partner in a civil union An eligible employee s dependent child from birth to the end of the calendar month in which they turn 26 years of age

  3. Making Changes During the Year In most cases, your benefits remain in effect for the entire plan year (July 1 through June 30). During each open enrollment period, you will have the opportunity to review your benefit elections and make changes for the coming year. You can make mid-year changes only if you have a Family Status Change: Marriage, divorce, or legal separation Birth, adoption, court order, disability, death, marriage, or reaching the dependent age limit. Changes in your spouse s employment affecting benefit eligibility Changes in your spouse s benefit coverage with another employer that affects benefit eligibility

  4. Making Changes During the Year You have 31 days from the date of the of a Family Status Change to turn in a completed enrollment/change form and supporting documentation to Employee Benefits. If you fail to turn in your documentation within 31 days, you will have to wait until the next open enrollment period to make changes. The effective date of the Family Status Change is the day of the event. Example: you are married on 9/25, you will add your spouse effective 9/25.

  5. Medical Plan Kaiser Permanente Commercial Plan 2 Plans- Buy-Up Plan and the Base Plan Buy-Up Plan: Lower deductibles and out-of-pocket costs , lower co-pays and more alternative health options, including Acupuncture, Chiropractic and Massage Therapy. Base Plan: Lower premiums with higher deductibles/MOOP, Acupuncture and Chiropractic, and same access to physicians as the Buy-Up Plan Both plans include Out of Network Benefits and membership to PeakMed Direct Primary Care offices and services. 75/25 split with D11 paying 75% of the employee medical premium on the Buy-Up Plan 85/15 split with D11 paying 85% of the employee medical premium on the Base Plan

  6. PeakMed Direct Primary Care Direct Primary Care Service includes, but is not limited to the following: $0 Cost Unlimited Primary Care No deductibles No waiting for appointments Thorough consultations Coordination with your Kaiser Medical Plan Adult & Pediatric Care Chronic Disease Management: High blood pressure, diabetes, etc. Mental Health & Wellness Sports Medicine, including InBody 570 body composition analysis On-Site Pharmacy with wholesale pricing Blood draws with low-cost test results Wound care, including stitches, staples and/or surgical glue Dermatology procedures: skin tag and wart removal, skin biopsies Annual & School Sports Physicals EKG & Pulmonary Function Testing

  7. Pharmacy Benefits GETTING PRESCRIPTIONS FILLED WITH KAISER PERMANENTE You are automatically enrolled in the prescription drug program, administered by Kaiser Permanente, when you enroll in the Colorado Springs School District 11 medical plan. The prescription drug program provides both retail and mail-order pharmacy coverage. Your medical and prescription cards are combined into one card, which will come from Kaiser. Learn more at kp.org/mobile. There you will find links to download the Kaiser Permanente mobile app, which will include your digital ID card. 30-day Copay 90-Day Copay GENERIC $10 $20 BRAND NAME $30 $60 NON-FORMULARY $45 $90 SPECIALTY / INJECTABLES / IV 20% coins. up to $250 per RX Not Available

  8. Dental Plans Dental Plan Provider- Delta Dental of Colorado PPO IN-NETWORK ONLY PLAN #9098 In-Network coverage only 100% coverage for preventative services (2 cleanings per year) 60% coverage for Basic Services (fillings, root canal, oral surgery) 40% coverage for Major Service (crowns, bridges, partials, dentures) 50% coverage for Braces- no age limit PPO + PREMIER PLAN #1563 Standard dental plan- you can see any dentist 100% coverage for preventative services (2 cleanings per year) 80% coverage for Basic Services (fillings, root canal, oral surgery) 50% coverage for Major Service (crowns, bridges, partials, dentures) 60% coverage for Braces- no age limit RIGHT START 4 KIDS PROGRAM- Covers children up to their 13th birthday at 100% with no deductible (for the same services outlined in the plan, up to the annual maximum, and subject to limitations and exclusions). The child must see a Delta Dental PPO or Premier provider to receive the 100% coinsurance. If an out- of-network provider is seen, the adult coinsurance levels will apply. Orthodontics, if selected as part of the group s plan, is not covered at 100% but at the plan s listed coinsurance.

  9. Vision Plan Vision Provider- EyeMed Vision Care Up to $140 allowance for contacts annually Annual Exam- $10 Copayment Up to $140 allowance for frames every 12 months 15% off of Lasik 20% discount off of non- prescription sunglasses $25 copayment for lenses annually

  10. Life Insurance Policy through Sun Life Financial BASIC LIFE INSURANCE 100% paid by D11 2 x annual salary with a minimum benefit of $50,000 Flat $50,000 for bus drivers and food service VOLUNTARY LIFE INSURANCE Elect up to $100,000 additional coverage for yourself, $25,000 for your spouse and $10,000 for each child up to age 26, guaranteed issue! Guaranteed issue during your initial eligibility period only. Election is also available during our next full open enrollment in April/May, but you will be required to answer health questions for all levels of coverage.

  11. Voluntary Short-Term and Long-Term Disability Policy through Sun Life Financial SHORT-TERM DISABILITY Wage replacement for short-term injuries, illness or having a baby Elect to receive $50 per week up to 60% of your salary per week 15 day waiting period before benefits are paid 6-8 weeks paid for maternity LONG-TERM DISABILITY Wage replacement for long-term illness or accidents Pays 60% of your salary monthly 90-day waiting period before benefits are paid

  12. Flexible Spending Account (FSA) Provider: Rocky Mountain Reserve 2 ACCOUNTS AVAILABLE Medical FSA Dependent Care FSA MEDICAL FSA Pay for out-of-pocket medical, dental and vision expenses incurred by you and your dependents with pre-tax dollars. $610 Annual Maximum Rollover/$20 Minimum Rollover DEPENDENT CARE FSA Pay for work-related childcare expenses with pre-tax dollars WHY FSA? Every dollar of earnings converted to from wages to tax-free benefits means fewer taxes (no PERA, Medicare, Federal, or State withholding taxes are subtracted from this money) which means more money for you!!

  13. Profile EAP Confidential counseling for all employees and their dependents Appointments scheduled Monday Friday. A counselor is available 24 hours per day, 7 days per week for crisis assistance. Counseling Benefit (8) Eight sessions per person, per problem, per plan year (7/1-6/30)Legal/financial services Free consultation Discounted rates on additional services Unlimited access to information resources on www.ProfileEAP.org Click Signup to create and account. Use COMPANY CODE: CSD11 There is NO COST to employees or dependents! The EAP licensed professional counselors are there to help with life's problems. Relationship issues Family problems Grief Stress, depression or anxiety Substance abuse Workplace difficulties Almost any personal or professional problem is appropriate for seeking assistance through EAP. 24/7 Crisis Service If you need help handling a crisis, after hours, a counselor can be reached 24 hours a day.

  14. D11 Website www.d11.org Employees Employee Benefits Access your Self-Service account to view your paycheck and benefit elections. View all benefit plan documents, Health Promotion Program information and much more. Provider contact information and websites

  15. Questions Contact Your Employee Benefits Team! Andrea Palos Benefits Manager Ang Kammerer Benefits Specialist Mackenzie Minazumi Benefits Admin Monday-Friday from 8am-5pm 719.520.2178 Employee.Benefits@d11.org

Related


More Related Content

giItT1WQy@!-/#giItT1WQy@!-/#giItT1WQy@!-/#giItT1WQy@!-/#giItT1WQy@!-/#giItT1WQy@!-/#giItT1WQy@!-/#