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HomeMy Public PortalAbout2020 MSD Benefits GuideOURGUIDE. YOURADVOCATE. 2020 Employee Benefits YOUR GUIDE YOUR ADVOCATE METROPOLITAN ST. LOUIS SEWER DISTRICT 2 BENEFITS OVERVIEW Metropolitan St. Louis Sewer District is proud to offer a comprehensive benefits package to eligible, full-time employees. You will receive plan booklets, which give you more detailed information about each of these programs upon hire. You share the costs of some benefits (Medical, Dental), and MSD provides other benefits at no cost to you ((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, Critical Illness, and Short Term Disability) with reasonable group rates that you can purchase through MSD payroll deductions. Benefit Plans Offered o Medical o Dental o Basic Life and Accidental Death & Dismemberment (AD&D) o Flexible Spending Account (FSA) o Voluntary Life and AD&D o Long-Term Disability o Voluntary Short-Term Disability o Legal Services Plan o Voluntary Benefits  Accident  Hospital Indemnity  Critical Illness  Short Term Disability Eligibility You and your dependents are eligible 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 made now will remain in effect until the next open enrollment unless you or your family members experience a qualifying event. If you experience a qualifying event, you must contact HR within 30 days. 3 MEDICAL BENEFITS Administered by Cigna MSD offers you a choice of a PPO or a High Deductible (HDHP) medical plan. Both plans include prescription drug coverage and one annual refractive eye exam 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/Telemedicine $25 copay Deductible then 60% $25 copay Deductible then 60% Specialist Office Visit (including Urgent Care) $35 copay Deductible then 60% $35 copay Deductible then 60% 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—Non-formulary Drug (31-day supply) $70 copay $70 copay $70 copay $70 copay Mail Order—Generic Drug (90-day supply) $37 copay Not covered $37 copay Not covered Mail Order—Formulary Drug (90-day supply) $87 copay Not covered $87 copay Not covered Mail Order—Non-formulary 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 then 80% Deductible then 60% Deductible then 80% Deductible then 60% Outpatient Surgery Deductible then 80% Deductible then 60% Deductible then 80% Deductible then 60% Ambulance Service 100% 100% 4 PPO Traditional Per Pay Period Single $63.20 Single + Spouse $201.96 Single + Child(ren) $183.50 Family $279.90 High Deductible Health Plan Per Pay Period Single $41.22 Single + Spouse $155.12 Single + Child(ren) $140.94 Family $214.98 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 then 80% Deductible then 60% Deductible then 80% Deductible then 60% Outpatient Services $35 copay Deductible then 60% $35 copay Deductible then 60% OTHER SERVICES All Other Maternity Hospital/ Physician Services Deductible then 80% Deductible then 60% Deductible then 80% Deductible then 60% Muscle Manipulation Services 26 day annual maximum benefit $35 copay Deductible then 60% $35 copay Deductible then 60% Physical Therapy Services 60 days per calendar year $25 copay Deductible then 60% $25 copay Deductible then 60% Occupational and Speech Therapy Services 20 days per calendar year per therapy type $25 copay Deductible then 60% $25 copay Deductible then 60% Skilled Nursing 120 days per calendar year combined with other care facilities Deductible then 80% Deductible then 60% Deductible then 80% Deductible then 60% 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 5 DENTAL BENEFITS Administered by Cigna The District offers 2 dental plans. The District contributes $10 towards the monthly cost 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% 100% 100% Basic Dental Services (fillings, root canal therapy, oral surgery) Deductible then 80% Deductible then 50% Deductible then 80% Deductible then 80% Major Dental Services (extractions, crowns, inlays, onlays, bridges, dentures, repairs) Deductible then 50% Deductible then 20% Deductible then 50% Deductible then 50% Orthodontia Services Lifetime Maximum $1,500 $1,000 $1,500 $1,500 Orthodontic Services 50% Covered for children and adults Deductible then 50% Covered for children and adults Deductible then 50% Coverage for dependent children under age 19 Deductible then 50% Coverage for dependent children under age 19 Employee Dental Rates Passive PPO EE Cont. / Pay Period Single $17.59 EE + 1 $40.88 Family $69.50 Network PPO EE Cont. / Pay Period Single $4.84 EE + 1 $14.74 Family $26.92 6 LIFE AND ACCIDENTAL DEATH & DISMEMBERMENT INSURANCE (AD&D) Insured by Cigna Life Insurance Life insurance provides financial security for the people who depend on you. Your beneficiaries will receive a lump-sum payment if you die while employed by MSD. 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 Active Service. Accidental Death and Dismemberment (AD&D) Insurance Accidental Death and Dismemberment (AD&D) insurance provides 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 FLEXIBLE SPENDING ACCOUNTS (FSAs) Administered by Tri-Star Systems 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. Healthcare Spending Limit $2,750 Dependent Care Spending Limit $5,000 Tri-Star Systems is the administrator of two individual Flexible Spending Accounts—one for healthcare expenses and one for dependent childcare and elder care expenses. You can enroll in one or both FSAs. You use each account separately, but they work similarly. Here’s How an FSA Works 1. You decide the annual amount (up to $2,700 for Healthcare Spending or $5,000 for Dependent Care Spending) you want to contribute to either or both FSAs based on your expected healthcare and/or dependent childcare/ elder care expenses. 2. Your contributions are deducted from each paycheck before income and Social Security taxes, and deposited into your FSA. You don’t pay taxes on your contributions! 3. You can budget for your large expenses like orthodontia, eyeglasses, and hearing aids, in addition to your medical expenses.. 4. You can pay with the Healthcare FSA debit card for eligible healthcare expenses. For dependent care, you pay for eligible expenses when incurred, and then submit a reimbursement claim form or file the claim online. 5. You are reimbursed from your FSA. So, you actually pay your expenses with tax-free dollars. Healthcare FSA Debit Card Your Healthcare FSA Debit Card (previously known as Benny Card) eliminates up-front out-of-pocket cash payments for eligible expenses and the need to file a claim. At the time that an eligible expense is incurred, participants in the Health Care Reimbursement Account (HCRA) can use the Healthcare FSA Debit Card to pay for unreimbursed health care expenses and/or dependent care expenses with participating providers. Always save receipts for HCRA purchases made with your Healthcare FSA Debit Card. You may be required to submit some receipts to verify that your expenses comply with IRS guidelines 7 VISION HEALTHCARE REIMBURSEMENT ACCOUNT (HRA) Administered by Tri-Star Systems You may use up to $100 in a plan year (July 1 – June 30) toward the cost of prescription eyewear. You can submit claims on an annual basis for reimbursement of your vision care expenses, not covered by the medical plan, up to $100 per year. The plan allows you to be reimbursed for certain vision expenses (eyeglasses, contacts, safety glasses and Lasik Surgery/Eye Surgery) which are incurred by you and your enrolled dependents. You may carry over the balance of the account for up to a maximum of $300 in a plan year. The money deposited in this account by MSD is provided for your vision expenses. The Vision HRA is administered by Tri-Star Systems. You may use the vision healthcare reimbursement account for your vision expenses, your spouse’s expenses, and expenses for your dependent children up to age 26. LONG-TERM DISABILITYINSURANCE Insured by Lincoln Meeting your basic living expenses can be a real challenge if you become disabled. Your options may be limited to personal savings, spousal income and possibly Social Security. Disability insurance provides protection for your most valuable asset—your ability to earn an income. MSD provides Long-Term Disability insurance (LTD) coverage for you at no cost. Your coverage begins upon 30 days of Active Service. LTD coverage provides income when you have been disabled for 90 days or more. Your benefit is 60% of your monthly earnings up to $6,000 per month during the time you are disabled. This amount may be reduced by other deductible sources of income or disability earnings. Benefit payments can continue to age 65 if you are under age 60 at the time of disability. VOLUNTARY SHORT-TERM DISABILITY INSURANCE Insured by Lincoln Short-Term Disability insurance provides income if you become disabled due to an injury or illness. Benefits begin on the 31st day of any injury, hospitalization or illness and can continue for up to 60 days or when LTD benefits begin. Benefit Amounts 60% of income Benefit Maximum $1,500 per week WORKSITE VOLUNTARY BENEFIT PLANS In addition to your core benefits, MSD understands that you may want additional coverage to fill the gaps. MSD is offering the following Voluntary Plans to help fill your personal needs. Accident Insurance Insured 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 Insured 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 Insured 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. 8 EMPLOYEE CONTRIBUTIONS FOR BENEFITS (2020) For rates for the Critical Illness Plan (Aflac) please see the Critical Illness brochure. $0.253 per $10 of covered weekly payroll Voluntary Short-Term Disability Rates Benefit Plan Monthly Participation 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 Benefit Plan Rates Dependent Life Insurance $2.23 per employee regardless of number of eligible dependent children Single Voluntary AD&D $.03 per $1,000 / Insurance Family $.05 per $1,000 Hyatt Legal $18.25 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 Group Accident Plan (Voya) Employee $9.03 Employee + Spouse $15.22 Employee + Child $17.14 Family $23.33 Hospital Indemnity Plan (Voya) Employee $17.80 Employee + Spouse $38.09 Employee + Child $28.19 Family $48.48 9 There is the potential to have up to 5 floating holidays in a payroll year! VACATION  SICK LEAVE  HOLIDAYS VACATION (Eligible to use upon successful completion of original Probationary period. Accrual begins upon hire) 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 SICK LEAVE (Eligible to use upon successful completion of three months of service. Accrual begin upon hire) 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 HOLIDAYS (Eligible upon hire) 10 per year 2020 MSD HOLIDAYS OBSERVANCE NEW YEARS’ DAY January 1 Wednesday, January 1 MARTIN LUTHER KING’S BIRTHDAY Third Monday in January Monday, January 20 PRESIDENT’S DAY Third Monday in February Monday, February 17 MEMORIAL DAY Last Monday in May Monday, May 25 INDEPENDENCE DAY July 4 Friday, July 3 LABOR DAY First Monday in September Monday, September 7 VETERAN’S DAY As designated by the Governor of Mo. Wednesday, November 11 THANKSGIVING DAY As designated by the President of the US Thursday, November 26 THANKSGIVING FRIDAY The Friday following Thanksgiving Friday, November 27 CHRISTMAS DAY December 25 Friday, December 25 SPECIAL HOLIDAYS As designated by the Executive Director and approved by the Board of Directors. As scheduled & approved in advance. GOOD ATTENDANCE AND FLOATING HOLIDAY LEAVE (Eligible upon successful completion of 6 month probationary period) Employees are entitled to two (2) Floating Holidays Each Payroll Year Absences in a Calendar Year Additional Days to Earn the Following Payroll 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 10 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 t o s a v e 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.