HomeMy Public PortalAbout2017 Benefit Overview Booklet
2017 MSD
Benefits Overview
This document is an outline of the coverage proposed by the carrier(s). It does not include all of the terms, coverage, exclusions, limitations, and conditions of the actual contract language. The policies and contracts themselves must be read for those details. Policy forms for your reference are available upon request.
The intent of this document is to provide you with general information regarding the status of, and/or potential concerns related to employee benefits. It should not be construed as, nor is it intended to provide, legal advice.
BENEFITS OVERVIEW
Metropolitan St. Louis Sewer District is proud to offer
a comprehensive benefits package to eligible, full-time
employees and their dependents.
Employees share the cost of some benefits (Medical,
Dental), and MSD provides other benefits at no cost
(Basic Life and Accidental Death & Dismemberment
(AD&D), Long-Term Disability. In addition, there are
voluntary benefits (Voluntary Life and AD&D, Legal
Services Plan, Accident, Hospital Indemnity, and
Critical Illness) with reasonable group rates that can be
purchased through MSD payroll deductions.
Benefit Plans Offered
Q Medical
Q Dental
Q Basic Life and Accidental Death & Dismemberment (AD&D) Insurance
Q Flexible Spending Account (FSA)
Q Voluntary Life and AD&D
Q Long-Term Disability
Q Legal Services Plan
Q Voluntary Benefits
Q Accident Insurance
Q Hospital Indemnity
Q Critical Illness
Eligibility
Full-time employees and their eligible dependents are qualified for MSD’s benefits upon 30 days of employment.
Eligible dependents are your spouse, children under age 26, or disabled dependents of any age. Elections remain in
effect until the next open enrollment unless you or your family members experience a qualifying event.
MEDICAL BENEFITS Administered by Cigna
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.
Open Access Plan (PPO) High Deductible Health Plan (HDHP)
In-Network Out-of-Network In-Network Out-of-Network
Lifetime Benefit Maximum Unlimited Unlimited
Annual Deductible $600 single / $1,200 family $1,800 single / $3,600 family $1,500 single / $3,000 family $4,500 single / $9,000 family
Annual Out-of-Pocket Maximum
(including deductible, coinsurance, and
copays)
$3,000 single / $6,000 family
$9,000 single / $18,000 family
$4,500 single / $9,000 family
$13,500 single / $27,000 family
Coinsurance 80% / 20% 60% / 40% 80% / 20% 60% / 40%
DOCTOR’S OFFICE
Primary Care Office Visit $25 copay Deductible, 60% / 40% $25 copay Deductible, 60% / 40%
Specialist Office Visit
(including Urgent Care) $35 copay Deductible, 60% / 40% $35 copay Deductible, 60% / 40%
Wellness Care
(routine exams, x-rays/tests,
immunizations, well baby care and
mammograms)
100% covered
Covered In-Network only
100% covered
Covered In-Network only
PRESCRIPTION DRUGS
Retail—Generic Drug
(31-day supply) $15 copay $15 copay $15 copay $15 copay
Retail—Formulary Drug
(31-day supply) $35 copay $35 copay $35 copay $35 copay
Retail—Nonformulary Drug
(31-day supply)
$70 copay
$70 copay
$70 copay
$70 copay
Mail Order—Generic Drug
(90-day supply) $37.50 copay Not Covered $37.50 copay Not Covered
Mail Order—Formulary Drug
(90-day supply) $87.50 copay Not Covered $87.50 copay Not Covered
Mail Order—Nonformulary Drug
(90-day supply) $175 copay Not Covered $175 copay Not Covered
HOSPITAL SERVICES
Emergency Room $200 copay, waived if admitted $200 copay, waived if admitted
Inpatient Deductible, 80% / 20% Deductible, 60% / 40% Deductible, 80% / 20% Deductible, 60% / 40%
Outpatient Surgery Deductible, 80% / 20% Deductible, 60% / 40% Deductible, 80% / 20% Deductible, 60% / 40%
Ambulance Service 100% 100%
Open Access Plan (PPO) High Deductible Health Plan (HDHP)
In-Network Out-of-Network In-Network Out-of-Network
MENTAL HEALTH & SUBSTANCE ABUSE SERVICES
Inpatient Services Deductible,
80% / 20%
Deductible,
60% / 40%
Deductible,
80% / 20%
Deductible,
60% / 40%
Outpatient Services $35 copay Deductible,
60% / 40%
$35 copay Deductible,
60% / 40%
OTHER SERVICES
All other maternity
hospital/ physician
services
Deductible,
80% / 20%
Deductible,
60% / 40%
Deductible,
80% / 20%
Deductible,
60% / 40%
Muscle Manipulation Services
26 day annual maximum benefit $35 copay
Deductible,
60% / 40%
$35 copay
Deductible,
60% / 40%
Physical Therapy Services
60 days per calendar year $25 copay Deductible, 60% / 40% $25 copay Deductible, 60% / 40%
Occupational and Speech
Therapy Services 20 days per calendar year per therapy type
$25 copay
Deductible, 60% / 40%
$25 copay
Deductible, 60% / 40%
Skilled Nursing
120 days per calendar
year combined with other
care facilities
Deductible, 80% / 20%
Deductible, 60% / 40%
Deductible, 80% / 20%
Deductible, 60% / 40%
Vision Exam
One Eye Exam per
calendar year Materials
are not covered
$25 copay
Covered In-Network only
$25 copay
Covered In-Network only
Urgent Care $35 copay $35 copay $35 copay $35 copay
EMPLOYEE MEDICAL RATES
DENTAL BENEFITS Administered by Cigna
MSD offers comprehensive dental coverage 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.
Network Dental Plan Passive PPO Plan
In-Network Out-of-Network In-Network Out-of-Network
Annual Deductible $0 single / $0 family $100 single / $300 family $50 single / $150 family $50 single / $150 family
Annual Benefit Maximum
(per person)
$2,000
$1,000
$1,500
$1,500
Preventive Dental Services
(cleanings, exams, x-rays)
100%
70% / 30% Deductible waived
100% Deductible waived
100% Deductible waived
Basic Dental Services
(fillings, root canal therapy, oral surgery)
80% / 20%
Deductible, 50% / 50%
Deductible, 80% / 20%
Deductible, 80% / 20%
Major Dental Services
(extractions, crowns, inlays, onlays,
bridges, dentures, repairs)
50% / 50%
Deductible, 20% / 80%
Deductible, 50% / 50%
Deductible, 50% / 50%
Orthodontia Services Lifetime
Maximum
$1,500
$1,000
$1,500
$1,500
Orthodontic Services
50% / 50%
Covered for children and adults
Deductible, 50% / 50%
Covered for children and adults
Deductible, 50% / 50%
Coverage for dependent
children under age 19
Deductible, 50% / 50%
Coverage for dependent
children under age 19
EMPLOYEE DENTAL RATES
$17.59
$40.88
$69.50
$4.84
$14.74
$26.92
LIFE AND ACCIDENTAL DEATH & DISMEMBERMENT INSURANCE (AD&D)
Administered by Cigna
Life Insurance
The company provides basic life insurance of one times your Annual Compensation up to $200,000 at no cost
to you. Life coverage begins upon 30 days of employment.
Accidental Death and Dismemberment (AD&D) Life Insurance
Accidental Death and Dismemberment (AD&D) insurance provides a benefit payment to you or your
beneficiaries if you lose a limb or die in an accident. MSD provides AD&D coverage of one times your
Annual Compensation up to $200,000 at no cost to you. This coverage is in addition to your company-paid
life insurance described above. AD&D coverage begins upon 30 days of active service.
VOLUNTARY LIFE AND AD&D INSURANCE
Insured by Cigna
You may purchase life and AD&D insurance in addition to the company-provided coverage. You may also
purchase life and AD&D insurance for your dependents if you purchase additional coverage for yourself. You
are guaranteed coverage (up to the lesser of two times your salary not to exceed $500,000, and $10,000 for your
spouse) without answering medical questions if you enroll when you are first eligible. Voluntary Life and AD&D
coverage begins after 30 days of active service.
Employee – Up to five times your salary in increments of your annual compensation - $500,000 maximum
amount
Spouse-$10,000 Children-$5,000 – You can apply for Voluntary Life and/or Voluntary AD&D for yourself and
your dependents at any time during the year. However, after your initial enrollment period of the first 30 days of
employment, you must provide evidence of insurability. Any amount of coverage above the Guaranteed Amount also
requires evidence of insurability. If you receive a salary increase that causes your voluntary coverage to increase
above the Guaranteed Amount, you must provide evidence of insurability for that additional amount.
The amount you are covered for, whether for Basic or Voluntary Life, increases once a year at the plan
anniversary date, February 1.
FLEXIBLE SPENDING ACCOUNTS (FSAs)
Administered by BeneFlex
There are two individual Flexible Spending Accounts- one for healthcare expenses and one for dependent
childcare. You can enroll in one or both FSAs. You use each account separately, but they work similarly. You
can save money on your healthcare and/or dependent day care expenses with an FSA. You set aside funds
each pay period on a pretax basis and use them tax- free for qualified expenses. You pay no federal income or
Social Security taxes on your contributions to an FSA (That's where the savings comes in). Your FSA
contributions are deducted from your paycheck before taxes are withheld, so you save on income taxes and
have more disposable income.
The maximum Healthcare Spending limit is $2,600 and Dependent Care Spending limit is $5,000.
VISION REIMBURSEMENT ACCOUNT
(HRA)
Administered by BeneFlex
MSD provides each employee and/or their dependents
$100 per fiscal plan year (July 1 – June 30) towards
vision expenses (eyeglasses, contacts, safety glasses
and Lasik Surgery/Eye Surgery).
You may carry over the balance of the account for up to
a maximum of $300 in a plan year.
LONG-TERM DISABILITY INSURANCE
Administered by Liberty Mutual
MSD provides Long-Term Disability insurance (LTD)
coverage for at no cost.
LTD coverage provides income when you have been
disabled for 90 days or more. The benefit is 60% of
your monthly earnings up to $6,000 per month during
the time you are disabled.
VOLUNTARY BENEFIT PLANS
Accident Insurance
Administered by Voya
Accident insurance provides coverage for a wide variety
of accidental injuries, including broken bones,
concussions, and burns, and covered events such as
medical treatment or hospitalization due to an accident. It
pays fixed benefits for events tied to a covered accident
and can be used for any purpose you choose.
Hospital Indemnity Insurance
Administered by Voya
Hospital Confinement Indemnity Insurance provides a
benefit for eligible hospital confinements. Benefits
include a hospital confinement benefits, Critical Care
Unit benefits and Rehabilitation Facility benefits. As
with Accident Insurance, you choose how to use the
benefit you receive.
Critical Illness and Cancer Insurance
Administered by Aflac
Critical Illness insurance provides a lump sum cash
benefit when the insured experiences a covered
condition. This lump sum payment can be spent on
anything — whether it is directly related or not to the
critical illness including:
Q Medical copays and deductibles
Q Mortgage and rent payments
Q Other household expenses
Your benefit is paid in full regardless of any other
insurance you may have in force. Critical illness
typically covers the following:
Q Heart Attack
Q Stroke
Q Cancer
Q Variety of other conditions depending on the policy
This coverage is also available for spouses and
children. Also included is a wellness benefit that pays
the cost of one health screening test per calendar year, up
to $50 maximum.
Employee Contributions for Benefits
Benefit Plan Rates
$2.23 per
employee
regardless of
number of
eligible
dependent
children
Dependent Life
Insurance
Single
$.03 per $1,000/ Voluntary AD&D
Insurance Family
$.05 per $1,000
Hyatt Legal $18.25
Hospital Indemnity Plan
Employee $17.80
Employee + Spouse $38.09
Employee + Child $28.19
Family $48.48
Group Accident Plan
Employee $9.03
Employee + Spouse $15.22
Employee + Child $17.14
Family $23.33
Benefit Plan
Monthly
Rate
OPEN ACCESS PLAN (OAP)
Employee $136.94
Employee + Spouse $437.58
Employee + Child(ren) $397.58
Family $606.45
HIGH DEDUCTIBLE PLAN (HDHP)
Employee $89.30
Employee + Spouse $336.08
Employee + Child(ren) $305.36
Family $465.78
DENTAL PLAN (Cigna) PASSIVE PPO
PLAN
Employee $38.12
Employee + One $88.58
Employee + Family $150.58
Voluntary Life Rates
AGE BAND RATE PER $1,000
<25 $.074
25 – 29 $.077
30 – 34 $.102
35 – 39 $.130
40 – 44 $.154
45 – 49 $.228
50 – 54 $.379
55 – 59 $.678
60 – 64 $.952
65 – 69 $1.799
70+ $2.915
VACATION SICK LEAVE HOLIDAYS
VACATION
(Eligible to use upon successful completion of original Probationary period. Accrual begins upon hire.)
SICK LEAVE
(Eligible to use upon successful completion of
three months of service. Accrual begins upon hire.)
HOLIDAYS
(Eligible upon hire)
GOOD ATTENDANCE AND FLOATING HOLIDAY LEAVE
(Eligible upon successful completion of 6 month probationary period.)
There is the potential to have up to 5 floating holidays in a payroll year!
Length of Continuous Service Monthly
Accrual Rate
Annual
Accrual
Max. Accumulation at
End of Payroll Year
Less than 5 years .833 10 days 30 days
5 but less than 10 years 1.250 15 days 35 days
10 but less than 20 years 1.666 20 days 40 days
20 or more years 2.083 25 days 45 days
Length of Continuous Service Monthly
Accrual Rate
Annual
Accrual
Up to 5 years .833 10 days
5 to 20 years .916 11 days
20 years or longer 1 12 days
10 per year 2017 MSD HOLIDAYS
OBSERVANCE
NEW YEARS’ DAY January 1 Monday, January 2
MARTIN LUTHER KING’S BIRTHDAY Third Monday in January Monday, January 16
PRESIDENT’S DAY Third Monday in February Monday, February 20
MEMORIAL DAY Last Monday in May Monday, May 29
INDEPENDENCE DAY July 4 Tuesday, July 4
LABOR DAY First Monday in September Monday, September 4
VETERAN’S DAY As designated by the Governor
of Mo. Friday, November 10
THANKSGIVING DAY As designated by the President
of the US Thursday, November 23
THANKSGIVING FRIDAY The Friday following
Thanksgiving Friday, November 24
CHRISTMAS DAY December 25 Monday, December 25
SPECIAL HOLIDAYS
As designated by the Executive
Director and approved by the
Board of Directors
As scheduled & approved in
advance.
Employees are entitled to two (2) Floating Holidays Each Payroll Year
Absences in a Calendar Year Additional Days to Earn the Following Payroll Year
3 Days or Less Earn 1 Floating Holiday
1 Day or Less Earn 2 Floating Holidays
No Absences Earn 3 Floating Holidays
Eligibility After 6 Months of Employment for Additional Days
Status Days Eligible
Employees hired on or before January 1 3
Employees hired January 2 through March 31 2
Employees hired April 1 through August 31 1
Employees hired after August 31 Ineligible
RETIREMENT
Administered by Vanguard
Defined Contribution Plan (401a)
The Defined Contribution Plan 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.
Deferred Compensation Plan (457)
The Deferred Compensation Plan enables you to save and invest for retirement
without paying federal or state income taxes on the contributions until funds are
distributed.
Convenient savings through payroll
deduction!
You are 100% vested in the value of
your account!
MSD pays the administrative fee for all
participants!
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.
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!