Treutlen County Board of Education

Treutlen County

Board of Education

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This material is for informational purposes only

and is neither an offer of coverage nor medical advice.

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It contains only a partial, general description of benefits and

does not constitute a contract or any part of one.

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For a complete description of the benefits available to you,

including procedures, exclusions and limitations, refer to your

specific plan documents

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All benefits are subject to coordination of benefits unless noted

otherwise.

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In case of a conflict between your plan documents and this

presentation, the Plan Documents will govern.

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This year’s Open Enrollment will be for the period of

April 1, 2015 through December 31, 2015 (9 months)

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Effective January 2016, the benefits plan year will run

from January 1

through December 31

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A new Open Enrollment will be conducted to re-align

all benefits to the new plan year

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Review your entire benefits program

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Discuss benefit options

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Assist you in the selection of all benefits

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Talk about how to enroll

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Sign up and activate

Treutlen County Board of Education

• Section 125

• Special Offer – Free AD&D Insurance

• Vision

• Dental

• Voluntary Benefits

• Disability – Short and Long Term

• Hospital Income

• Accident

• Cancer

• Critical Illness

Section 125 Plan -

Premium Only Plan

• Choose qualified insurance coverage and pay the premiums with pre-tax dollars.

• Dental Insurance and Colonial’s Accident, Cancer and Hospital Income plans are eligible

Without With Premium Premium Only Plan Only Plan

Gross pay $500.00 $500.00

Pretax reduction (major medical ins.) -0- - 50.00

Taxable gross 500.00 450.00

FICA, fed. & state taxes - 68.98 - 57.46

Net pay 431.02 392.54

-0-FREE Accidental Death and Dismemberment

• Plan is provided by Colonial Life for our valued customers.

• There is NO COST to you or you employer

• $5,000 AD&D benefits will remain in force for one year

• You must meet with our Benefits Counselors to designate a beneficiary

• This plan must be re-enrolled in order to continue

What is Voluntary Insurance?

• Voluntary insurance plans are not designed to replace insurance you already have.

• Voluntary insurance enhances your existing benefits package.

Delta Dental Plan

• Use any dentist you choose – out-of-network providers can be used

• Dependent children covered up to age 19, up to 26 if full-time students or dependent on employee for support

• Preventive - 100% after no deductible

• Basic - 80% after $50 deductible

• Includes root canals and periodontal

• Major - 50% after $50 deductible

• Crowns, inlays, bridges, dentures, and complex oral surgery

• Annual Maximum $750 year one, $1000 year two, $1500 year three and beyond

• Orthodontia services paid at 50%

• $50 annual deductible max of 3 per family

Dental Plan

Type I services: diagnostic

and preventative (exams and cleaning - 2 per year, x-rays, fluoride for children)

100% of reasonable and customary charges paid by insurer.

Type II services: basic restorative

(restorations-fillings, endodontics, periodontics, root canals, general anesthesia, extractions, oral surgery)

80% of reasonable and customary charges paid by insurer after $50 annual deductible is met.

Type III services: major services*

(full and partial dentures,

bridgework and crowns, inlay and outlay restorations)

50% of reasonable and customary charges paid by insurer after

Delta Dental Plan

Providers

• Delta Dental uses providers through the National Preferred Provider Organization

• Any Dental Provider can be used, but Delta Dental manages three provider networks:

• Delta Dental PPO – fees are based on PPO fee schedule

• Delta Dental Premier Dentists – these network providers are paid up to the Maximum Plan Allowance

• Non-Delta network – These out-of-network providers are paid up to the 90th percentile of what is considered “Usual and Customary” (The current plan pays up to the 75th _percentile)

Delta Dental Rates

Rates – no change for 2015

Coverage Premium Paid

Employee $45.31

Employee & One Dependent $85.11

Colonial Life

The Advantage of Colonial Life plans:

• Most plans pay in addition to other benefits you may have with other insurance companies.

• Benefits are paid directly to you, unless you specify otherwise.

• With most plans, you can keep your coverage even if you change jobs or retire.

• Most plans are guaranteed renewable.

Insurance Benefit

Short Term Disability

Period of Disability

Elimination Period Ends – File Short Term

Start of Disability – Enter Elimination Period

LTD

STD

Colonial Life

Product underwritten by Colonial Life & Accident Insurance Company.

Policies have exclusions and limitations that may affect benefits payable. All plans may not be available in all states and benefits provided may also vary by state.

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Short-Term Disability Insurance

• Helps protect your income and lifestyle if you are unable to work due to a covered accident or covered sickness.

• Use benefits to help pay for: • Mortgage or rent payments.

• Utility bills and other household expenses

• The

GA Educator Disability Plan

• A significant number of Treutlen Co. BOE employees still have these plans in-force, and Colonial will continue to honor them.

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GA Educator Benefits:

• Benefits fill the gap between time of disability and long term disability

• Maximum 40% of salary coverage available, up to $2000 monthly

• Benefit amount selected at time of enrollment in $100 increments

• 3, 7, 14, 30, and 60 day elimination periods for sickness

• Elimination periods waived if admitted

• Pre-existing condition limitations 12 months from effective date

• Portable & Guaranteed Renewable to 65 & age 70 if still employed

• Employees may upgrade disability benefits by enrolling in Disability 1000

Georgia Educator

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GA Educator Benefits (con’t)

• Accident Only Benefits:

• Hospital Confinement - $1,200/month ($40 daily) for 3 months

• Medical fees for accidents - $25

• Emergency Treatment - $25 minimum payment, only when other benefits are not payable.

• Complete Fractures - $120 to $1,500 depending on injury

• Complete dislocations - $120 to $1,3050 depending on injury

• Other injuries - $50 to $600 (burns, lacerations, tendon/ligament injuries, ruptured discs, eye injuries, knee cartilage)

• Sickness Benefits:

• Hospital Confinement - $1,200 month ($40 daily)

• More detailed accident or hospitalization benefits are available through Colonial’s Accident Care or Medical Bridge 3000 plans.

Georgia Educator

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Benefits fill the gap between time of disability and

long term disability benefit

• Maximum 66 2/3% of salary coverage available

• Monthly maximum benefit of $3000.00

• Choice of elimination periods, waived if admitted

• 3, 6,

12*

or 24 month benefit period

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12-month option aligns with the LTD elimination period

• Pre-existing condition limitations in force for 12 months

• Simplified underwriting

• Portable & Renewable to 65 & age 70 if employed

• We would that each policy holder review their coverage at

Disability 1000

• 24 hour coverage, worldwide coverage

• 365 day elimination period for injury or sickness

• Monthly Gross Disability Benefit = 60%

• Benefits are integrated with other retirement or disability income

• Monthly Benefit Maximum = $6,000

• Benefit period = to age 65

• No premiums while disabled

• Pre-existing conditions not covered for 24 months

• Standard underwriting rules are in effect.

Insurance Benefit

• When are you considered disabled?

• When proof is provided that you:

• are disabled due to sickness or injury

• require the regular care of a physician

• How is your benefit determined?

• Benefits are based upon a percentage of income to be replaced.

• What if your disability occurs again?

• If a disability reoccurs within 6 months, it will be treated as a continuation.

Insurance Benefit

Medical Bridge 3000

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Hospital Confinement Indemnity Insurance

• Designed to supplement your existing major medical coverage.

• Lump-sum benefit helps you to pay medical and non-medical expenses associated with a hospital stay, such as:

• Hospital Confinement – you choose $500 or $1000 lump-sum, payable per admission with no annual maximum

• Out-patient surgery - $500 or $1000 depending on procedure ($1500 annual maximum)

• Wellness benefit - $50 annually for 18 different tests

• $150 Emergency Room benefits

• $250 Diagnostic testing benefit

• In general, there are two forms of life insurance:

• Term Life:

• Term life is simply a death benefit

• Easy to get and inexpensive

• No cash build-up, no additional value

• Protect your family and their future

• Permanent Life

• Universal Life, Whole Life

• Cash value builds as policy ages

• As a cash building policy, these plans add value to your self-worth

• Premium never changes

• Invest in your own, or your families future

Colonial Supplemental Insurance

• If you have Life Insurance in force, regardless of the type of plan or carrier you should regularly do some “policy maintenance:

• Who is your beneficiary, and does it need to be updated. We can update your

beneficiary with a single form. But, our agents DO NOT have access to your beneficiary information. Contact the Colonial Home Office (800-325-4368) and our support team can help you.

• Are the “covered persons” still eligible? Permanent Life (Universal Life ,

Whole Life) can be maintained on the “named insured” for their entire life. Polices on children who have grown, can be maintained or if you choose, or can be transferred to them to maintain.

• Dependent Children coverage on the Voluntary Group Life or Child Life Riders (attachments to UL or WL policies) , not “named insured”

coverage, cannot be maintained on children after age 25. These coverage are a flat rate for “all eligible children”. The remains the same for as many children as listed on the policy. However, after the last child “ages out” the coverage should be terminated. If this affects you, be sure to ask about correcting this.

• We also suggest that everyone reviews their life insurance situation

regularly. Need change with time, and we can help you make the needed

Colonial Supplemental Insurance

• Group term Life takes the total population and treats them as a single risk. This lowers the rates and makes this (in most cases) a very affordable plan:

• Coverage Options:

• Employee: up to $100,000 maximum in $10,000 increments

• Spouse: $5,000 increments up to employee amount selected

• Dependent Children: Up to age 18, 25 for full time students. $1,000 increments, up to $10,000 max for each child.

• For New Employees Only:

• Guaranteed issue up to $50,000, $25,000 a spouse and $10,000 for dependent children

Group Term Life

Special Features

• Portability: Keep coverage if you retire, reduce hours or leave

place of employment. Application is required at the time of conversion.

• SurvivorSupport: Financial Counseling Service, Objective financial

planning and advice to your survivors

• Accelerated Death Benefit: 60% of your life insurance benefit paid

if you are diagnosed terminally ill, with 12 months or less to live

• Maximum benefit paid $250,000

• Remainder paid to beneficiary

• Waiver of Monthly Premium: Monthly premium is waived in the

• Universal Life is a permanent life insurance plan, once issued it is yours for the rest of your life (to age 100)

• Policy is YOURS -- even if you change jobs or retire -- only payment method changes – premiums do not change!!

• Flexibility to increase or decrease face amounts and change premium payments

• Premiums will not increase because you get older

• Premiums build cash value

• Coverage available for employee, spouse or children as named insured

• Spouse Coverage

• Universal Life -- Duplicate the same benefits as offered to you -- even if you don’t buy a policy for yourself

• Spouse Term Coverage in addition to your Life Policy

• For amounts less than $50,000 spouse signature not required

• Juvenile Coverage

• Universal Life -- policy for each child

• NEW!! Amounts up $100,000 available for Juvenile plans

• Low rates at younger age, coverage continues even if health problems develop

• Opportunity to increase coverage at age 18, 21 & 24 with no health questions asked. Maximum face value $100,000

• A tremendous value for children under the age of ten – premiums for $25,000 typically less than $10 monthly

Colonial Supplemental Insurance

• Optional Coverage Available

• Accidental Death - Death benefit doubles if death is due to an accident

• Waiver of Monthly Deduction -- Protects your policy in the event you become totally disabled before the age of 60

• Both are recommended on policies of $50,0000 or less

• Additional Coverage Term

• Term life riders as part of the basic policy.

• Term Life riders are available for the named insured or for spouse or children

• Guaranteed Purchase Option

• The opportunity to increase the original face value at certain intervals, with NO HEALTH QUESTIONS ASKED

• Long Term Care Rider

Accident Care

• Accident Insurance

• Helps pay the direct (medical) and indirect (non-medical) expenses that may result from a covered accident.

• Initial Care - $150 ER benefit, $100 Ambulance benefit, $50 Doctors Office benefit

• Injury Benefits – Broken bones, dislocations, burns, concussions, lacerations, and more

• Benefits range from $50 (broken toe or finger) to $4,000 (dislocated hip)

• Hospitalization - $750 on admission, $200 daily for 365 days

• Other benefits – Follow-up doctor visits, physical therapy, wheelchairs, crutches, accidental death

Cancer 1000

• Cancer Insurance

• Helps protect you against the indirect costs and other expenses associated with cancer diagnosis and treatment.

• Benefits payable for:

• Annual Wellness: $75 or $100 depending on plan

• Diagnosis of skin cancer.

• Hospital confinement - $200 or $300 daily

• After 30 days, benefit doubles if still hospitalized

• Radiation/chemotherapy - $200 or $300 daily

• Monthly maximums' apply depending on delivery method

• Transportation – 50 cents/mile for $1500 mile round trip. Payable for insured and traveling companion

Critical Illness

• Critical Illness Insurance

• Helps protect your financial security if you experience a specified critical illness or catastrophic illness

• Heart attack (myocardial infarction), Stroke, Organ

Transplant, Kidney failure (end-stage renal failure), Bypass surgery

• Pays a lump-sum benefit upon diagnosis. Benefit is paid directly to you.

• Up to $75,000 for employees and $40,000 for spouse

• Amounts above $10,000 require normal underwriting

• Spouse and dependent children may be included

• The benefit is paid to you unless you specify otherwise—use

What Happens Next?

• Take advantage of your options. Review your current needs and spend your money where it is needed.

• Don’t be afraid to ask questions. Our benefit counselors have product and rate information and the expertise to help you make an informed decision

• We will meet with you individually to help you tailor your benefits plan to your needs.

• A separate Open Enrollment letter has been sent that includes rate information.

• Colonial Benefit Counselors will be available:

• February 18th – 19th

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This year’s Open Enrollment will be for the period of

April 1, 2015 through December 31, 2015 (9 months)

•

Effective January 2016, the benefits plan year will run

from January 1

through December 31

•

A new Open Enrollment will be conducted to re-align

all benefits to the new plan year

What Happens Next??

For claims, assistance or questions contact:

• Hal Doyle, your Colonial Representative

• at 706-951-8839 or e-mail haldoyle@comcast.net

• The Colonial Life Home Office at 800-325-4368

• Claim forms can be downloaded at www.coloniallife.com

• Your Benefits Counselor will ask you to complete a brief