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HomeMy Public PortalAbout2016 Benefits Overview Booklet MSD Benefits Overview February 1, 2016 – January 31, 2017 Full-time employees are eligible for benefits upon 30 days of employment with the District. Medical The District offers two medical plan options to choose from. Both plans include prescription drug coverage and one annual refractive eye examination with an optometrist. The District pays 80% of the cost for employee only coverage and 70% toward dependent coverage. The costs of the medical plans are listed on the enclosed rate sheet. CIGNA Insurance Company is our medical provider. Preferred Provider Option (PPO) – Traditional Plan With the Traditional Plan, you have a higher payroll deduction and a lower annual deductible and out-of-pocket maximum. A summary of the plan is enclosed. High Deductible Health Plan (HDHP) With the High Deductible Plan, you have a lower payroll deduction and a higher annual deductible and out-of-pocket maximum. A summary of the plan is enclosed. MSD’s medical plans provide the following features:  Annual deductibles below the national average  No referrals for in-network providers  Low co-payments  In and out-of-network coverage  Vast range of in-network physicians to choose from Dental MSD offers comprehensive dental coverage through CIGNA Insurance Company for services ranging from X-rays and routine cleanings, to fillings and orthodontic care. There are two dental plans to choose from. The District contributes $10 towards the monthly cost of coverage. The costs of the dental plans are listed on the enclosed rate sheet. Dental Network (PPO) Plan In order to receive the greatest benefit of this plan, you must use a provider who is in- network. A summary of the plan is enclosed. Dental Passive (PPO) Plan This plan allows you the flexibility of using a dentist who is in or out-of-network. However, staying in-network allows you to receive higher levels of benefits. A summary of the plan is enclosed. MSD’s dental plans provide the following features:  Each family member has the freedom to go to a different dentist  $0 Annual Deductible for the Network Plan  Preventative and Diagnostic Services covered at 100% In-Network Out-of-Network *$600 single/$1,200 family - **$1,500 single/$3,000 family * $1,800 single/$3,600 family - ** $4,500 single/$9,000 family *$3,000 single /$6,000 family -**4,500 single/$9,000 family *$9,000 single/$18,000 family - **$13,500 single/$27,000 family Coinsurance 80%60% Lifetime Maximum Unlimited Unlimited Physician Office Visits Primary Care: $20 copay / Specialist: $30 copay Covered at 60% of eligible expenses after deductible Routine Annual Physical Exams (one/ cal. yr.)Covered at 100% of eligible expenses Not Covered Allergy Services - Diagnostic Primary Care: $20 copay / Specialist: $30 copay Covered at 60% of eligible expenses after deductible Injections No charge Covered at 60% of eligible expenses after deductible From birth to five - 100% All other preventative services covered in network only Maternity Care Pre Natal and Post Natal $20 copay (Initial visit only)/ Specialist: $30 copay Covered at 60% of eligible expenses after deductible Surgery and Related Services Covered at 80% of eligible expenses after deductible Covered at 60% of eligible expenses after deductible Mammograms Covered at 100% of eligible expenses Covered at 60% of eligible expenses after deductible Lab, Xray, and other Diagnostic Services Covered at 100% of eligible expenses Covered at 60% of eligible expenses after deductible Out-Patient Hospital Services Surgery and related services Covered at 80% of eligible expenses after deductible Covered at 60% of eligible expenses after deductible In-Patient Hosptial Services Unlimited days in a semi-private room including: Special care units Necessary ancillary services Covered at 80% of eligible expenses Maternity care including delivery after deductible Physician Services Surgery and related services Administration of anesthesia Emergency Services Hospital Emergency Room $200 copay; copay waived if admitted Benefits paid at in-network level Urgent Care Facility $35 copay Covered at 60% of eligible expenses after deductible Convenience Care Clinics $20 copay Covered at 60% of eligible expenses after deductible CIGNA (OPEN ACCESS PLUS) PLAN (GENERAL SUMMARY ONLY) (*Traditional) (**High Deductible) Covered at 60% of eligible expenses after deductible Annual (Calendar Year) Deductible Includes copays - Separate in- and out-of network deductible Maximum Out-Of-Pocket (Calendar Year)Maximums include deductibles and copays - Separate in- and out-of network maximums. Immunizations No charge 100% coverage of eligible expenses for comprehensive annual physical exams! Hey - Get an annual physical exam! Using an Urgent Care Facility or "convenience clinic" rather than an Emergency Room will save you money. In-Network Out-of-Network Refractive Eye Examinations - One calendar year (optometrist) Mental Health Out-Patient $30 copay Covered at 60% of eligible expenses after deductible In-Patient Covered at 80% of eligible expenses after deductible Covered at 60% of eligible expenses after deductible Substance Abuse In-Patient Covered at 80% of eligible expenses after deductible Covered at 60% of eligible expenses after deductible Covered at 80% of eligible expenses after deductible Covered at 60% of eligible expenses after deductible Physical, Speech, Occupational Therapy $20 copay Covered at 60% of eligible expenses after deductible (Out-patient)60 visits physical therapy, 20 visits occupational therapy, 20 visits speech therapy, 20 visits pulmonary rehabilitation, 20 visits cardiac rehabilitation. 60 visits physical therapy, 20 visits occupational therapy, 20 visits speech therapy, 20 visits pulmonary rehabilitation, 20 visits cardiac rehabilitation. Durable Medical Equipment Covered at 100% of eligible expenses Covered at 60% of eligible expenses after deductible Covered at 60% of eligible expenses after deductible - up to 120 days per calendar year, combined in- and out-of-network $30 copay Covered at 60% of eligible expenses after deductible Ambulance Services Covered at 100% of eligible expenses Covered at 100% of eligible expenses Prescription Drugs Pharmacy - Tier 1 - $10 / Tier 2 - $30 / Tier 3 - $60 Up to a 31 day Supply (limited to CIGNA Network Pharmacy cost) Mail Order - Tier 1 - $25 / Tier 2 - $75 / Up to a 90 day Supply Tier 3 - $150 Covered at 100% after $20 copay Not covered Chiropractic Care (Maximum 26 visits per calendar year - combined in- and out-of-network) Home Health Care (Limited to 40 visits max. per cal. year in- or out-of-network) Limits are per calendar year and combined in- and out-of network. Out-Patient - Physician Office Services Covered at 60% of eligible expenses after deductible $30 per visit REFER TO THE CIGNA SUMMARY OF BENEFITS FOR MORE SPECIFIC DETAILS ABOUT BENEFITS, LIMITS AND EXCLUSIONS Skilled Nursing Facility Covered at 80% of eligible expenses after deductible - up to 120 days per calendar year, combined in and out- of-network In-Network Benefits Only Tier 1 - $10 / Tier 2 - $30 / Tier 3 - $60 The MSD plan offers a $0 Generic Mail Order Co-Pay Waiver Program for: Anti-Hypertension, Lipids, Asthma, Diabetic meds, Anti-Coagulants, Osteoporosis, Prenatal Vitamins Don't forget the $100 a year for employee & spouse eyewear. That's a nice extra! COMPARISON OF DENTAL PLAN OPTIONS GENERAL SUMMARY ONLY Annual Deductible (calendar year) Individual Family Preventitive / Diagnostic Services Covered % Office Visit for Oral Exam & Teeth Cleaning X-Rays Covered % Bitewing X-Rays & Full Mouth Series Periapical Basic Services Covered % Minor Restorations Root Canal Therapy with X-Rays and Cultures Anterior and Periapical Molar Teeth Major Services Covered % Inlays, Onlays, Crowns, Full & Partial Dentures Orthodontic Adults Dependent Children Covered % Orthodontic Deductible Lifetime Maximum Annual Benefit Maximum per Person Network Plan **** Passive PPO Plan PARTICIPATING DENTISTS* (In-Network) PARTICIPATING DENTISTS* (In-Netw ork) NON-PARTICIPATING DENTISTS** None None 100% 100% 100% 80% 80% 80% 50% Covered Covered up to age 19 50% None $1,500 $2,000 $50*** $150*** 100% 100% 100% 80% 80% 80% 50% Not Covered Covered up to age 19 50% None $1,500 $1,500 $50*** $150*** 100% 100% 100% 80% 80% 80% 50% Not Covered Covered up to age 19 50% None $1,500 $1,500 * PPO participating dentists have agreed to provide care at a negotiated fee schedule. ** Non-network benefits are paid using the 90th percentile of Usual, Customary and Reasonable. *** The Annual Deductible is waived for Preventive / Diagnostic services. **** This is a network based plan with very reduced coverage when selecting a non-network provider. NOTE: Frequency and/or age limits may apply. Life Insurance CIGNA Insurance Company is our life insurance provider. The District provides company-paid Basic Life Insurance (term life) and Accidental Death and Dismemberment (AD&D) Insurance of 1 times your annual base salary rounded up to the next higher $1,000. Voluntary Life Insurance You can choose from multiples of 1 to 5 times your annual base salary rounded up to the next higher $1,000, up to the maximum amount of $500,000. You may also elect family life insurance – $10,000 for spouse and $5,000 coverage for each dependent child (children are covered up to age 26). The costs of the AD&D plans are listed on the enclosed rate sheet. Voluntary Accidental Death and Dismemberment (AD&D) Insurance You may purchase up to $500,000 in increments of $10,000 on an individual basis or a family plan. For the AD&D benefit, the plan pays up to 100% for the employee, up to 50% for the spouse, and up to 10% of the child contingent on the type of claim. The costs of the AD&D plans are listed on the enclosed rate sheet. Reimbursement Accounts Reimbursement Accounts (Flexible Spending) allows you to have deductions from your paycheck on a pre-tax basis to pay for out-of-pocket medical and/or dental expenses or dependent care expenses – SAVING YOU MONEY! Beneflex is MSD’s Reimbursement Account Administrator. There are two Reimbursement Accounts to choose from. Health Care Reimbursement Account (HCRA) This account allows you to use funds to pay for medical and dental expenses, such as co-pays, deductibles, and expenses not covered by your medical and/or dental plan. You can use this account for any family members whom you claim as a dependent on your taxes – even for family members not enrolled in the MSD medical and/or dental plan(s). The maximum contribution amount to contribute is $2,550. Dependent Care Reimbursement Account (DCRA) This account allows you to use funds to pay for qualified dependent care expenses. The maximum contribution amount to contribute is $5,000. 4 Pre-Paid Legal Plan Hyatt Premier Legal Services is our Pre-Paid Legal Plan provider. Hyatt provides affordable and reliable legal counsel and telephone advice for everyday life matters such as debt predicaments, Wills and Estate planning, real estate matters, identity theft defense and much more. This plan provides assistance to you and covers most legal matters at 100% when you work with an in- network attorney. The cost of the Pre-Paid Legal plan is listed on the enclosed rate sheet. Employee Assistance Program (EAP) EAP is a free service provided by MSD. This service is administered by BJC. This program provides confidential assessments, counseling and referral services for all employees and their eligible dependents who may need help in areas such as the following:  Marital and family issues  Alcohol and other drug dependency  Stress-related issues  Legal and financial referrals Vision Program Beneflex is our Vision Program administrator. This plan allows you and/or your spouse to use  Emotional problems  Health  Personal growth $100 per fiscal year (07/01 – 06/30) towards your prescription eyewear. The program allows for any unused amounts to be rolled over up to the plan maximum of $300. Long-Term Disability (LTD) Liberty Mutual Insurance Company is our LTD administrator. MSD provides company-paid coverage to you. This benefit provides income replacement to you in the event you are unable to work due to a qualified disability under the terms of the plan, subject to approval by Liberty Mutual. Retirement The MSD Deferred Compensation Plan (457) enables you to save and invest for retirement without paying federal or state income taxes on the contributions until funds are distributed. Vanguard is the plan administrator.  Convenient savings through payroll deduction!  You are 100% vested in the value of your account!  MSD pays the administrative fee for all participants! The MSD Defined Contribution Plan (401a) enables you to save for retirement by combining a Fixed Contribution of 7% contributed by the District with an opportunity for you to make a voluntary contribution to your Deferred Compensation Plan of up to 4% and receive a District Matching Contribution of 50% without paying federal or state income taxes on the contributions or the earnings until it is distributed from the Plan. Vanguard is the plan administrator. Employees are 100% vested in the Employee Voluntary contribution and the District’s Matching Contribution. The District’s Fixed Contribution is subject to a 20% per year vesting schedule. Wellness The BALANCE Program: Promoting Better Health for MSD Employees & Retirees MSD and CIGNA partner to carryout the MSD Balance Wellness Program which is designed to improve the health and well-being of employees and retirees. The program offers resources to employees and retirees so they can learn how to be healthy and teach their families how to be healthy as well. We have many well-being programs available to employees such as annual biometric screenings, stress management programs, physical activity and nutrition programs. Also, we have an Onsite Wellness Coordinator on staff. MSD provides 7% automatically for Defined Contribution (401a) If you make a contribution of 4% towards your Deferred Compensation (457) MSD will provide an additional 2% towards your Defined Contribution (401a) You can receive 13% per paycheck towards retirement! Dependent Eligibility Benefits coverage is available to all eligible dependents of MSD Employees. Dependent Criteria WHO CAN BE COVERED UNDER YOUR BENEFITS? If you enroll yourself in MSD benefits, you may also enroll your eligible dependents who include:  Your legal spouse  Your eligible children – up to age 26 for medical, voluntary life & AD&D insurance, pre- paid legal, and reimbursement accounts; up to age 25 for dental insurance An eligible child can be your:  Biological child  Legally adopted child  Child for whom you are the court-appointed legal guardian  Stepchild  Your incapacitated child who is unable to support themselves and depends on you for support; the incapacity must have occurred before age 26 and be validated by the vendor WHO CANNOT BE COVERED UNDER YOUR BENEFITS? Examples of ineligible dependents are:  Ex-spouse (even if court-ordered)  Common Law Spouse or Domestic Partners  Children (Grandchild, nieces, nephews, etc.) who are not the child of you or your spouse, for whom you do not Medical Rates* Coverage Level CIGNA PPO – Traditional Plan (bi-weekly rate) CIGNA High Deductible Plan (bi-weekly rate) Employee only $57.30 $34.39 Employee & spouse $183.08 $134.30 Employee & child(ren) $166.35 $122.02 Employee & family $253.74 $186.13 Dental Rates* Coverage Level CIGNA Passive PPO Plan (bi-weekly rate) CIGNA Network Plan (bi-weekly rate) Employee only $19.08 $5.47 Employee + one dependent $43.94 $16.05 Family $74.48 $29.04 Voluntary Employee Life Rates (monthly rate)  Age (as of February 1) Rate Per $1,000 Age Rate Per $1,000 Less than 25 $0.074 50 - 54 $0.379 25 - 29 $0.077 55 - 59 $0.678 30 - 34 $0.102 60 - 64 $0.952 35 - 39 $0.130 65 - 69 $1.799 40 - 44 $0.154 70 - 74 $2.915 45 - 49 $0.228 75 and over $2.915 Voluntary Family Life Rate (monthly rate)  Spouse & Child(ren) - $2.23 per family unit Voluntary Accidental Death and Dismemberment (AD&D) Insurance Rates (monthly)  rate) Employee only Family $0.03 per $1,000 $0.05 per $1,000 Pre-Paid Legal Plan Rate (bi-weekly rate) $8.08 *Pre-tax deduction After-tax deduction VOLUNTARY ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE AMOUNT INDIVIDUAL COVERAGE EMPLOYEE & DEPENDENT COVERAGE AMOUNT INDIVIDUAL COVERAGE EMPLOYEE & DEPENDENT COVERAGE ELECTED (Monthly Premium: 3¢ / $1,000) (Monthly Premium: 5¢ / $1,000) ELECTED (Monthly Premium: 3¢ / $1,000) (Monthly Premium: 5¢ / $1,000) $10,000 $0.30 $0.50 $260,000 $7.80 $13.00 $20,000 $0.60 $1.00 $270,000 $8.10 $13.50 $30,000 $0.90 $1.50 $280,000 $8.40 $14.00 $40,000 $1.20 $2.00 $290,000 $8.70 $14.50 $50,000 $1.50 $2.50 $300,000 $9.00 $15.00 $60,000 $1.80 $3.00 $310,000 $9.30 $15.50 $70,000 $2.10 $3.50 $320,000 $9.60 $16.00 $80,000 $2.40 $4.00 $330,000 $9.90 $16.50 $90,000 $2.70 $4.50 $340,000 $10.20 $17.00 $100,000 $3.00 $5.00 $350,000 $10.50 $17.50 $110,000 $3.30 $5.50 $360,000 $10.80 $18.00 $120,000 $3.60 $6.00 $370,000 $11.10 $18.50 $130,000 $3.90 $6.50 $380,000 $11.40 $19.00 $140,000 $4.20 $7.00 $390,000 $11.70 $19.50 $150,000 $4.50 $7.50 $400,000 $12.00 $20.00 $160,000 $4.80 $8.00 $410,000 $12.30 $20.50 $170,000 $5.10 $8.50 $420,000 $12.60 $21.00 $180,000 $5.40 $9.00 $430,000 $12.90 $21.50 $190,000 $5.70 $9.50 $440,000 $13.20 $22.00 $200,000 $6.00 $10.00 $450,000 $13.50 $22.50 $210,000 $6.30 $10.50 $460,000 $13.80 $23.00 $220,000 $6.60 $11.00 $470,000 $14.10 $23.50 $230,000 $6.90 $11.50 $480,000 $14.40 $24.00 $240,000 $7.20 $12.00 $490,000 $14.70 $24.50 $250,000 $7.50 $12.50 $500,000 $15.00 $25.00 Employees may purchase up to $500,000 maximum. V AC AT ION / HOLIDAYS / SICK LEAVE VAC ATION (Eligible to use upon successful completion of original probationary period. Accrual begins from date-of-hire.) Length of Continuous Service Monthly Accrual Rate Annual Accrual Max. Accumulation at End of Payroll Year Less than 5 years .833 days 10 days 30 days 5 but less than 10 years 1.250 15 days 35 days 10 but less than 20 years 1.666 days 20 days 40 days 20 or more years 2.083 25 days 45 days SICK LEAVE ACCRURAL (Eligible upon completion of three months of service. Accrual begins from date-of-hire.) There is no maximum accumulation for sick leave accrual. MSD Service Accrual Rate / Mo. Annual Accrual Up to 5 years .833 days per month 10 days 5 years to 20 years .916 days per month 11 days 20 years and longer 1 day per month 12 days PERSONAL HOLIDAYS (Eligible upon successful completion of six months probationary period.) Employees are also entitled to two (2) Personal Holidays each new payroll year. Employees who are absent 3 days or less in a payroll year can earn up to three (3) additional personal holidays the following payroll year. 01/25/2016 HOLIDAYS (10 / year) – No w aiting period NEW YEARS’ DAY January 1 MARTIN LUTHER KING’S BIRTHDAY Third Monday in January PRESIDENT’S DAY Third Monday in February MEMORIAL DAY Last Monday in May INDEPENDENCE DAY July 4 LABOR DAY First Monday in September VETERAN’S DAY As designated by the Governor of Mo. THANKSGIVING DAY As designated by the President of the US THANKSGIVING FRIDAY The Friday f ollowing Thanksgiving CHRISTMAS DAY December 25 SPECIAL HOLIDAYS As designated by the Executive Director and approved by the Board of Directors 2015 MSD HOLIDAYS Friday, January 1 Monday, January 18 Monday, February 15 Monday, May 30 Monday, July 4 Monday, September 5 Friday, November 11 Thursday, November 24 Friday, November 25 Monday, December 26 As scheduled & approved in advance.