Data Loading...
St Pauls Episcopal Flipbook PDF
St Pauls Episcopal
156 Views
34 Downloads
FLIP PDF 2.77MB
2022 Benefits Guide
Employee
Benefit Program MEDICAL | DENTAL | VISION | FSA | HSA | DISABILITY | LIFE | VOLUNTARY BENEFITS
Welcome! We recognize that our employees are our most valuable resource and therefore, your benefits program is extremely important to St. Paul’s Episcopal Day School. Therefore, it is our pleasure to offer our benefits-eligible employees a variety of solutions to help address your benefit needs, as well as the needs of your families. Our employees continue to be the driving force behind our past success and position us well for the future. Thank you for your ongoing commitment as we strive to be the best employer in our industry. We are proud to include all of you as part of the St. Paul’s Episcopal Day School family. This summary of benefits is intended only to highlight your benefits and should not be relied upon to fully determine coverage. This plan may not cover all your health care expenses. Please refer to the Certificate of Coverage for a complete listing of services, limitations, exclusions and a description of all the terms and conditions of coverage.
Questions? Contact Daniel Pennington, Human Resources at [email protected] or 816.268.6531
3
Eligibility Employees All full-time employees working 27.5 or more hours per week are eligible to enroll in our benefit program as the first of the month following your date of hire.
Eligible Dependents Your spouse and your eligible dependent children up to age 26* are eligible for medical, dental, and vision coverages. *Please note that dependents will age off their plan the end of the month in which they turn 26.
How to Enroll Complete your insurance and benefits enrollment through Employee Navigator. Please contact HR if you need assistance logging in or accessing your account.
When to Enroll The Annual Open Enrollment period is held the first two weeks of December with exact dates announced in November. You must enroll or decline benefits through Employee Navigator. If you are a New Hire joining the St. Paul’s team you are eligible to elect benefits that begin on the first of the month following (or coinciding with) your date of hire. If you choose not to enroll during open enrollment, you cannot enroll until the next open enrollment period, unless you have a Qualifying Event.
Qualified Life Event Updates You are eligible to enroll yourself and your eligible dependents in our group plans when you meet the eligibility requirements. Generally, the coverage you elect for yourself and your dependents may only be changed during the next annual enrollment period, unless you qualify to make a midyear change in coverage due to a qualifying event prescribed under HIPAA (the Health Insurance Portability & Accountability Act of 1996) and the Internal Revenue Code § 125. Qualified Life Events include: • • • • • • •
A change in your employment status, or your spouse’s employment status that affects eligibility for benefits; A change that causes your dependent children to become ineligible; A change in your marital status (such as marriage or divorce); A change in your spouse’s employment status; A change in the number of your dependents due to birth, adoption or death; Significant cost increases or benefit reductions in this plan, or your spouse’s open enrollment (significant increase not necessary); or Loss of your coverage or your dependent’s coverage under your spouse’s plan due to loss of eligibility under that plan.
Questions? Contact Daniel Pennington, Human Resources at [email protected] or 816.268.6531
4
Benefits Snapshot Medical Insurance
We will be offering medical insurance through Health Plans Inc (HPI), with the choice of three PPO plans: Two of the plans are High Deductible Health Plans allowing Health Savings Accounts.
Health Savings Account (HSA)
St. Paul’s Episcopal Day School offers a Health Savings Account (HSA) through Optum Bank as a way for you to save tax-advantaged dollars to spend on eligible medical and prescription expenses.
Flexible Spending Account Our Health Care Flexible Spending Account is managed by NueSynergy. (FSA) Dental Insurance
Two dental plans are offered through Delta Dental of Missouri. There is a base plan and a buy-up plan with greater benefits.
Vision Insurance
Vision Insurance is offered through Delta Dental of Missouri and covers benefits not typically covered under your medical insurance. In addition, vision discounts are available for a number of programs. Please see page 15 for specific updates regarding our plan.
Disability Insurance
St. Paul’s Episcopal Day School offers both a Short and Long Term Disability plan through MetLife. These plans pay you in the event you are ill or injured and unable to work.
Life and Accidental Death and Dismemberment
A Basic Life and AD&D plan is offered to all employees through MetLife. Voluntary Life and AD&D Insurance is also available if you would like to purchase additional coverage. Note! Now is a good time to update your beneficiary information on Employee Navigator!
Additional Benefits
Additional benefits are available to you for purchase on a voluntary basis such as Voluntary Life and AD&D, Critical Illness (think coverage for cancer or a heart attack), or Accidents (loss of sight, dismemberments, fractures, dislocations, etc.). In addition, St. Paul’s Episcopal Day School offers an Employee Assistance Plan (EAP) to all employees.
Detailed information is available throughout this document; however, you should refer to the actual carrier provided summaries for complete details on the plans.
Per Pay Period Deductions Employee Per Pay Period Deductions - Plan Year January 1, 2022 to December 31, 2022 HPI Opt. 38 - $1,500 Deductible HPI Opt. 13 - $3,000 Deductible HPI Opt. 18 - $4,000 Deductible Employee Only Employee + Spouse Employee + Child(ren) Family
$130.00 $408.00 $367.00 $773.00
$89.00 $324.00 $288.00 $639.00
$15.00 $116.00 $92.00 $305.00
Dental Base Plan
Employee: $2.00
Emp. + Spouse: $14.00 Emp. + Child(ren): $14.00
Family: $29.00
Dental Buy-Up Plan
Employee: $10.00
Emp. + Spouse: $30.00 Emp. + Child(ren): $35.00
Family: $60.00
Vision Coverage
Employee: $1.00
Emp. + Spouse: $4.00
Family: $9.00
Emp. + Child(ren): $5.00
Please see specific plan summary pages for rate information for plans such as Voluntary Short Term Disability, Voluntary Life Insurance, Critical Illness, or Accident Insurance.
5
St. Paul’s Episcopal Day School - 2022 Employee Benefit Overview
Medical Plan, Option 1
Health Plans Inc
A complete summary of benefits is available on the on-line enrollment platform Employee Navigator. HPI Option 38, $1,500 Deductible
Network
Non-Network
Deductible, Individual / Family (per calendar yr.)
$1,500 / $3,000
$3,000 / $6,000
Out-of-pocket Max., Individual / Family (includes deductible)
$3,000 / $6,000
$9,000 / $18,000
80% after deductible
50% after deductible
$20 / $35 Copay
70% after deductible
Preventive Care Services
Covered 100%, deductible waived
70% after deductible
Adult and child immunizations
Covered 100%, deductible waived
70% after deductible
Mammograms, PSA, Pap Smear tests
Covered 100%, deductible waived
70% after deductible
Co-insurance Office visit / Specialist
Pharmacy prescription drug coverage: Level 1 / Level 2 / Level 3 / Level 4
$10 / $35 / $55 / 25% coinsurance
Mail order prescription drug coverage: Level 1 / Level 2 / Level 3 / Level 4
$25 / $87.50 / $137.50 / 25% coinsurance
Urgent care facility*
$100 Copay
70% after deductible
Inpatient hospital care
80% after deductible
50% after deductible
Outpatient hospital care
80% after deductible
50% after deductible
Outpatient lab services
Covered 100%, deductible waived
70% after deductible
80% after deductible
50% after deductible
Outpatient surgery and scopes Emergency services
$350 Copayment
Skilled nursing facility (60 day calendar year max.)
80% after deductible
50% after deductible
Durable medical equipment
80% after deductible
50% after deductible
$20 Copay per visit
70% after deductible
Physical & occupational therapy (up to 60 visits per calendar year In-Network and 10 visits Out-of-Network per person, per calendar year, combined with Occupational and Speech Therapy)
Lifetime maximum *Copayment
Unlimited
applies to the Office Visit Charge Only. Lab performed by a contracted urgent care is paid at 100%. Other services/procedures that are performed by
an urgent care provider are subject to the Network Deductible and Coinsurance level.
Rates per Pay Period Employee Pays
Employee Only
Employee/Spouse
Employee/Child(ren)
Family
$130.00
$408.00
$367.00
$773.00
In a Medical Emergency, you should go to the nearest emergency facility or call 911 or other local emergency access number. A Referral from your PCP is not needed. Your emergency room Member Cost Sharing is listed in the table above.
Questions? Contact Daniel Pennington, Human Resources at [email protected] or 816.268.6531
6
Medical Plan, Option 2
Health Plans Inc
A complete summary of benefits is available on the on-line enrollment platform Employee Navigator. HPI Option 13, $3,000 Deductible
Network
Non-Network
Deductible, Individual / Family (per calendar yr.)
$3,000 / $6,000
$6,000 / $12,000
Out-of-pocket Max., Individual / Family (includes deductible)
$3,000 / $6,000
$11,500 / $23,000
Co-insurance
100% after deductible
70% after deductible
Office visit / Specialist
100% after deductible
70% after deductible
Preventive Care Services
Covered 100%, deductible waived
70% after deductible
Adult and child immunizations
Covered 100%, deductible waived
70% after deductible
Mammograms, PSA, Pap Smear tests
Covered 100%, deductible waived
70% after deductible
Pharmacy prescription drug coverage: Level 1 / Level 2 / Level 3 / Level 4
Covered 100% after In-Network deductible is met
Mail order prescription drug coverage: Level 1 / Level 2 / Level 3 / Level 4
Covered 100% after In-Network deductible is met
Urgent care facility
100% after deductible
70% after deductible
Inpatient hospital care
100% after deductible
70% after deductible
Outpatient hospital care
100% after deductible
70% after deductible
Outpatient lab services
100% after deductible
70% after deductible
Outpatient surgery and scopes
100% after deductible
70% after deductible
Emergency services
Covered 100% after In-Network deductible is met
Skilled nursing facility (60 day calendar year max.)
100% after deductible
70% after deductible
Durable medical equipment
100% after deductible
70% after deductible
100% after deductible
70% after deductible
Physical & occupational therapy (up to 60 visits per calendar year In-Network and 10 visits Out-of-Network per person, per calendar year, combined with Occupational and Speech Therapy)
Lifetime maximum
Rates per Pay Period Employee Pays
Unlimited
Employee Only
Employee/Spouse
Employee/Child(ren)
Family
$89.00
$324.00
$288.00
$639.00
In a Medical Emergency, you should go to the nearest emergency facility or call 911 or other local emergency access number. A Referral from your PCP is not needed. Your emergency room Member Cost Sharing is listed in the table above.
7
St. Paul’s Episcopal Day School - 2022 Employee Benefit Overview
Medical Plan, Option 3
Health Plans Inc
A complete summary of benefits is available on the on-line enrollment platform Employee Navigator. HPI Option 18, $4,000 Deductible
Network
Non-Network
Deductible, Individual / Family (per calendar yr.)
$4,000 / $8,000
$6,000 / $12,000
Out-of-pocket Max., Individual / Family (includes deductible)
$6,350 / $12,700
$19,050 / $38,100
Co-insurance
80% after deductible
50% after deductible
Office visit / Specialist
80% after deductible
50% after deductible
Preventive Care Services
Covered 100%, deductible waived
70% after deductible
Adult and child immunizations
Covered 100%, deductible waived
70% after deductible
Mammograms, PSA, Pap Smear tests
Covered 100%, deductible waived
70% after deductible
Pharmacy prescription drug coverage: Level 1 / Level 2 / Level 3 / Level 4
Covered 80% after In-Network deductible is met
Mail order prescription drug coverage: Level 1 / Level 2 / Level 3 / Level 4
Covered 80% after In-Network deductible is met
Urgent care facility
80% after deductible
50% after deductible
Inpatient hospital care
80% after deductible
50% after deductible
Outpatient hospital care
80% after deductible
50% after deductible
Outpatient lab services
80% after deductible
50% after deductible
Outpatient surgery and scopes
80% after deductible
50% after deductible
Emergency services
Covered 80% after In-Network deductible is met
Skilled nursing facility (60 day calendar year max.)
80% after deductible
50% after deductible
Durable medical equipment
80% after deductible
50% after deductible
80% after deductible
50% after deductible
Physical & occupational therapy (up to 60 visits per calendar year In-Network and 10 visits Out-of-Network per person, per calendar year, combined with Occupational and Speech Therapy)
Lifetime maximum
Rates per Pay Period Employee Pays
Unlimited
Employee Only
Employee/Spouse
Employee/Child(ren)
Family
$15.00
$116.00
$92.00
$305.00
In a Medical Emergency, you should go to the nearest emergency facility or call 911 or other local emergency access number. A Referral from your PCP is not needed. Your emergency room Member Cost Sharing is listed in the table above.
Questions? Contact Daniel Pennington, Human Resources at [email protected] or 816.268.6531
8
Flexible Spending Accounts If you do not have an HSA, Flexible Spending Accounts (FSA) allow you to set aside pre-tax dollars to pay yourself back for eligible health care expenses.
Health Care FSA: For our 2022 plan, you may elect up to IRS maximum of $2,850 to receive reimbursement for out-of-pocket health care expenses for you and your family members. These medical, dental, vision or other health care related expenses cannot be eligible for reimbursement through any insurance or other benefit program. Out-of-pocket health care expenses incurred by you and your family are eligible if the service occurred during the plan year and while you are making contributions to the plan. You can be reimbursed up to your full annual election, less any previous reimbursements.
Pre-Tax Savings Example Without FSA
With FSA
$25,000
$25,000
$0
-$1,000
Taxable Income
$25,000
$24,000
Taxes*
-$6,413
-$6,156
Take Home Pay after Taxes
$18,587
$17,844
Health Care Expenses
-$1,000
-$1,000
Available Income
$17,587
$16,844
$0
$1,000
$17,587
$17,844
Gross Pay Health Care FSA Contribution
Tax-Free Reimbursement from FSA Net Income
NueSynergy ***************** Health Care FSA Updates ***************** Changes made in the Consolidated Appropriations Act of 2021 allow you to carryover unlimited unused funds from 2021 into 2022. This rollover amount does not impact your maximum election for the following plan year. (e.g. If you have a maximum election limit of $2,850 and rollover $1,000, you could have access to up to $3,850 for the next plan year.) In addition, you may modify your election amount without the need for a qualifying event.
That’s a savings of $257 for the year!
*Assumes federal withholding of 15%, state withholding equal to 20% of federal and social security withholding of 7.65%. For illustrative purposes only. Actual dollar amounts and savings may vary.
Eligible Health Care FSA Expenses Include: Acupuncture
Diagnostic services and tests
Therapy, physical or speech
Ambulance services
Drugs (prescriptions)
Artificial limb/teeth
Eye Surgery (includes cataract, LASIK, etc.)
Eyeglasses, prescription (includes prescription sunglasses and over-the-counter reading glasses)
Bandages, Band -Aids, wraps, and splints Birth control pills (Norplant, ovulation kits) Chiropractor professional fees Contact Lenses/solution Contraceptives Crutches/braces & supports Dental treatment
Physical therapy Pregnancy test kits Psychologist fees Schools and education (for mentally impaired or physically disabled person – see IRS Publication 502) Speech Therapy
Hearing aids and batteries Hospital services Insulin, syringes Laboratory fees Orthodontia X-ray fees
Smoking cessation program
A list of eligible FSA expenses is available on the IRS website, www.irs.gov. Please consult your tax advisor should you require specific tax advice.
Questions? Contact Daniel Pennington, Human Resources at [email protected] or 816.268.6531
9
Health Savings Account
Optum Bank
When you enroll in one of our HSA eligible medical plans, you may open and make contributions to a Health Savings Account (HSA) with Optum Bank. The eligible plans are the Option 13 $3,000 and the Option 18, $4,000 plans. An HSA is a tax-advantaged medical savings account you can make contributions to up to IRS calendar year limits. You can then use the funds to pay for qualified health care expenses, such as medical and prescription drug expenses until you meet your deductible, coinsurance, copays, and other out-of-pocket expenses including dental and vision expenses, for you and your dependents— even if they are not covered under your medical plan! If you choose payroll deductions to contribute to this account, the school will open the account and pay the administration fee on your behalf. This plan is administered by Optum Bank.
HSA Highlights The Optum Bank HSA features: •
•
•
Easy access to your funds. Use your Optum Bank Visa debit card to pay eligible costs at the doctor’s office, pharmacy or wherever else Visa debit cards are accepted. Remember to keep your receipts in case they’re needed by the IRS to verify eligible expenses. Easy tracking of health care costs. You can view balances and recent activity online at any time. All your expenditures will be reported in a single monthly statement. Investment options available after you reach a minimum threshold in your account.
You can set up an automatic per pay deposit to fund your HSA on a regular basis without any hassle. Your contributions will be deducted pre-tax from your pay and deposited into your Optum Bank account. The total annual contribution limits set forth by the IRS for calendar year 2022 are: Individual - $3,650 All other tiers / Family - $7,300 In addition, individuals age 55 or older as of December 31st, 2022 may contribute an additional $1,000.
A list of eligible HSA expenses is available on the IRS website, www.irs.gov. Please consult your tax advisor should you require specific tax advice.
CARES ACT: Signed 3/27/20 The CARES Act repeals the rule enacted in the Affordable Care Act that prohibited over-the-counter medicines (i.e., non-prescribed) other than insulin from being “qualified medical expenses.” Thus, users of Health Savings Accounts (HSAs) or Flexible Spending Accounts (FSAs) would be able to use funds in those accounts to cover over-the-counter medical products, including those needed in quarantine and social distancing, without a prescription. One of the major changes enacted by the CARES Act is the recognition of menstrual care products as medical care. As such, they are now reimbursable via plans like HSAs and FSAs. Under the law, menstrual care products are defined as tampons, pads, liners, cups, sponges or other similar items used in respect to menstruation.
10
St. Paul’s Episcopal Day School - 2022 Employee Benefit Overview
Dental Plan
Delta Dental of MO
St. Paul’s Episcopal Day School will contribute a monthly benefits is available on the online enrollment platform.
of
Delta Dental Base Plan
Network
Annual maximum benefit
Non-Network $1,500 per person
Deductible For Basic and Major services (below)
None
Dependent age limit
End of the month following 26th birthday
Preventive dental services • Oral exams, twice per calendar year • Prophylaxis (cleanings), twice per calendar year • Periapical x-rays, as required • Bitewing x-rays, one set per calendar year • Full-mouth x-rays (pano), once in any 36 month period • Sealants for dependent children under age 16, once in 5 years • Space Maintainers for dependent children under age 16, once in 5 years • Topical fluoride treatments for dependent children under age 16, once in any calendar year • Emergency palliative treatment
100%
100%
Basic dental services • Periodontal maintenance, twice per calendar year – subject to the prophylaxis frequency limitation) • Fillings – amalgam restorations; composite (white) restorations limited to anterior and bicuspid teeth • Endodontics • Simple Extractions
80%
80%
Major dental services
N/A
N/A
Orthodontic dental services
N/A
N/A
Rates per Pay Period Employee Pays
Employee Only
Employee/Spouse
Employee/Child(ren)
Family
$2.00
$14.00
$14.00
$29.00
Questions? Contact Daniel Pennington, Human Resources at [email protected] or 816.268.6531
11
Dental Plan, Buy Up
Delta Dental of MO
St. Paul’s Episcopal Day School will contribute a monthly benefits is available on the online enrollment platform.
of
Delta Dental Buy-Up Plan
Network
Annual maximum benefit
Non-Network $2,000 per person
Deductible For Basic and Major services (below)
$50 individual / $150 family limit
Dependent age limit
End of the month following 26th birthday
Preventive dental services • Oral exams, twice per calendar year • Prophylaxis (cleanings), twice per calendar year • Periapical x-rays, as required • Bitewing x-rays, one set per calendar year • Full-mouth x-rays (pano), once in any 36 month period • Sealants for dependent children under age 16, once in 5 years • Space Maintainers for dependent children under age 16, once in 5 years • Topical fluoride treatments for dependent children under age 16, once in any calendar year • Emergency palliative treatment
100%
100%
Basic dental services • Periodontal maintenance, twice per calendar year – subject to the prophylaxis frequency limitation) • Fillings – amalgam restorations; composite (white) restorations limited to anterior and bicuspid teeth • Endodontics • Simple Extractions
90%
90%
50%
50%
50%
50%
Major dental services • Surgical extractions and other oral surgery • Non-surgical and surgical periodontics • Crowns, inlays, onlays – once every 7 years per tooth • Bridges and dentures, once in 7 years • Implants, as well as bone grafts, are a covered benefit. Limited to once in 7 years. • General anesthesia in conjunction with a covered surgical procedure Orthodontic dental services • Orthodontic services subject to separate lifetime maximum of $1,500 per person
Rates per Pay Period Employee Pays
12
Employee Only
Employee/Spouse
Employee/Child(ren)
Family
$10.00
$30.00
$35.00
$60.00
St. Paul’s Episcopal Day School - 2022 Employee Benefit Overview
Vision Plan
Delta Dental
Vision insurance helps protect the health of your eyes, including routine visits to the optometrist for eye exams as well as coverage for glasses and contacts. Make sure your eyes remain in great shape at any age – no matter how much time you spend staring at digital screens. Vision Plan Updates! Effective January 2022, your Vision Plan is still provided by DeltaVision but the network of vision providers is changing to EyeMed. All members will receive new ID cards from EyeMed that reflect the EyeMed Insight network in mid-December for use starting on January 1, 2022. The welcome packet will include a customized listing of nearby providers. Members can utilize the DeltaVision member portal for plan information and to print a temporary ID card at www.deltavisionmo.com/Members/Login. To search for a vision provider before January 1, 2022, members can visit www.EyeMed.com and utilize the Find an Eye Doctor Tool, choosing the Insight Network for their search. To search for a vision provider after January 1, 2022, members can visit the DeltaVision website, www.DeltaDentalMO.com/vision. Benefit
In-Network
Out-of-Network Reimbursement
$0 copay
Up to $40
Up to $40 allowance (no copay)
Not covered
$10 copay $10 copay $10 copay $10 copay 20% off balance over $150 allowance Covered in full Additional $60 copay Additional $60 copay $10 copay, then 15% off balance over $150 allowance $10 copay; $250 allowance
Up to $20 Up to $40 Up to $60 Up to $100 Up to $60 Not covered Up to $40 Up to $40 Up to $90
Description DeltaVision, EyeMed Network
Comprehensive Eye Exam Contact Lens Fit & Follow-up
• Focuses on your eyes and overall wellness
(Once every calendar year) • Contacts in lieu of eyeglasses
Lenses / Materials Copay (limited to once every 12 months) Eyeglass Lenses
• Single vision lenses • Bi-focal lenses • Tri-focal lenses
Eyeglass Frames & Enhancements
• Lenticular lenses • Frames covered once every calendar year. • Polycarbonate lenses (children under 20) • Standard Progressive Lenses
• Photochromatic Lenses Contact Lenses • Conventional, Elective Contact Lenses (instead of glasses) • Medically necessary
Extra Savings and Discounts
Up to $250
DeltaVision Value Discounts • Discounts are available at select participating discount provider locations. Look for the star on our online provider search! ◦ Polycarbonate Lenses (members over age 20): $40 ◦ Laser Vision Correction: Preferred Pricing through U.S. Laser Network The DeltaVision Value Discounts program is not part of your insured benefit. You must pay providers directly for all services or materials you receive under this program
Rates per Pay Period Employee Pays
Employee Only
Employee/Spouse
Employee/Child(ren)
Family
$1.00
$4.00
$5.00
$9.00
Questions? Contact Daniel Pennington, Human Resources at [email protected] or 816.268.6531
13
Life Insurance
MetLife
Nobody knows what life has in store for them from one day to the next. It’s not something that we like to dwell on, but the fact of the matter is that a sudden and fatal accident or illness could result in our family being left to fend for themselves. This could lead to all sorts of problems for your loved ones, most notably financial difficulty. Left to try and deal with monthly commitments and family debts, your family may be unable to cope financially without your income. Life insurance is a contract between an insurer and a policyholder in which the insurer guarantees payment of a death benefit to named beneficiaries upon the death of the insured. The insurance company promises a death benefit in consideration of the payment of premium by the insured. St. Paul’s Episcopal Day School offers employees a Basic Life and Accidental Death policy, and you also have the opportunity to purchase additional coverage for you, your spouse, and your dependents through a supplemental policy.
Basic Life and Accidental Death & Dismemberment Maximum Benefit, Basic Life and AD&D
1x your Annual Salary up to $200,000.
Age Reductions
At age 65, your benefit amount will reduce by 35% of the original benefit amount. At age 70, your benefit amount will reduce by 50% of the original benefit amount. Your benefits terminate at retirement.
Cost
This plan is 100% paid for by St. Paul’s Episcopal Day School.
Supplemental Life and Accidental Death & Dismemberment Insurance In addition to the above life insurance paid for by St. Paul’s Episcopal Day School, you may purchase additional Supplemental Life and Accidental Death & Dismemberment Insurance (paid for by you) to cover yourself, your spouse, and your dependents.
Supplemental Life Insurance Benefit Maximum $10,000 increments up to $500,000, not to exceed 5x your annual earnings. $5,000 increments up to $100,000, not to exceed 50% of your employee election.
Employee Spouse
Employee
Spouse
0-29
$0.060
$0.060
30-34
$0.080
$0.080
35-39
$0.092
$0.092
40-44
$0.120
$0.120
45-49
$0.180
$0.180
50-54
$0.276
$0.276
$100,000 $25,000
55-59
$0.470
$0.470
60-64
$0.660
$0.660
$10,000
65-69
$1.270
$1.270
70-74
$2.06
$2.06
75+
$2.06
$2.06
5 options up to $10,000, not to exceed 100% of your employee election.
Child(ren) (age 14 days to 26)
Guarantee Issue Amounts, under age 65 Employee Spouse Child(ren)
Age Banded Rates per $1,000 per month Age:
Dependent Child Rate $0.291 (includes AD&D) Voluntary AD&D Rate $0.017
14
St. Paul’s Episcopal Day School - 2022 Employee Benefit Overview
Disability Insurance
Guardian
Voluntary Short Term Disability An injury or illness that keeps you out of work for a significant time could have a devastating impact on your income, jeopardizing your ability to cover basic household expenses. Short term disability insurance provides a portion of your income for up to 11 weeks if you are unable to work due to pregnancy, illness or injury. Short term disability coverage is available for all full time eligible employees and is paid for by the employee.
Short Term Disability
Age/Rate Table
There is a 14 day waiting period. Benefits begin on the 15th day regardless of whether disability is due to an accident or illness
Elimination/ Waiting Period Benefits Duration
Up to 11 weeks 60% of your weekly pay to a maximum of $1,500 per week
Weekly Benefit
Age
Rate per $10 Weekly
0-29
$0.409
30-39
$0.420
40-44
$0.430
45-49
$0.513
50-54
$0.628
55-59
$0.776
60-64
$0.817
65-99
$.923
Employer Paid Long Term Disability Long term disability provides a portion of your income for an extended period of time if you are unable to work due to an injury or illness. Long term disability coverage is available for all full time eligible employees and is paid for by St. Paul’s Episcopal Day School. There is no cost to you for this benefit.
Long Term Disability Elimination/Waiting Period
There is a 90 day waiting period. Benefits begin on the 91st day regardless of whether disability is due to an accident or illness
Maximum Payment Period
Social Security Normal Retirement Age
Monthly Benefit
Earnings Definition
60% of your monthly earnings to a maximum of $6,000 per month Earnings means your monthly earnings excluding bonuses, expense accounts, and any other extra compensation. Earnings include the average of your commissions for the previous 12 months.
Questions? Contact Daniel Pennington, Human Resources at [email protected] or 816.268.6531
15
Employee Assistance Program
Professional support and guidance for everyday life Life doesn’t always go as planned. And while you can’t always avoid the twists and turns, you can get help to keep moving forward. We can help you and your family, those living at home, get professional support and guidance to make life a little easier. Our Employee Assistance Program (EAP) is available to you in addition to the benefits provided with your MetLife insurance coverage. This program provides you with easy-to-use services to help with the everyday challenges of life — at no additional cost to you.
Expert advice for work, life, and your well-being The program’s experienced counselors provided through LifeWorks — one of the nation’s premier providers of Employee Assistance Program services — can talk to you about anything going on in your life, including:
Help is always at your fingertips. Our mobile app makes it easy for you to access and personalize educational content important to you. Search “LifeWorks” on iTunes App Store or Google Play. Log in with the user name: metlifeeap and password: eap
•
Family: Going through a divorce, caring for an elderly family member, returning to work after having a baby
•
Work: Job relocation, building relationships with co-workers and managers, navigating through reorganization
•
Money: Budgeting, financial guidance, retirement planning, buying or selling a home, tax issues
•
Legal Services: Issues relating to civil, personal and family law, financial matters, real estate and estate planning
•
Identity Theft Recovery: ID theft prevention tips and help from a financial counselor if you are victimized
•
Health: Coping with anxiety or depression, getting the proper amount of sleep, how to kick a bad habit like smoking
•
Everyday Life: Moving and adjusting to a new community, grieving over the loss of a loved one, military family matters, training a new pet
Convenient and confidential help when you want it, how you want it Your program includes up to 5 in person, phone or video consultations with licensed counselors for you and your eligible household members, per issue, per calendar year. You can call 1-888-319-7819 to speak with a counselor or schedule an appointment, 24/7/365. When you call, just select “Employee Assistance Program” when prompted. You’ll immediately be connected to a counselor. If you’re simply looking for information, the program offers easy to use educational tools and resources, online and through a mobile app. There is a chat feature so you can talk with a consultant to guide you to the information you are looking for or help you schedule an appointment with a counselor. Log on to metlifeeap.lifeworks.com, user name: metlifeeap and password: eap
Answers to important questions Are Employee Assistance Program services confidential? Yes. Any personal information provided to LifeWorks stays completely confidential.*
When you need some support, we’re here to help.
How do I get help? Getting professional help is just a phone call away. Simply call 1-888-319-7819 to speak with a counselor or to schedule an in person, phone or video conference appointment. These services are available 24 hours a day, 7 days a week. When is the right time to call? That’s up to you. Counselors are here whenever you need them —whether you simply need to talk or want guidance on something you are going through. Is my Employee Assistance Program included with my MetLife coverage? Yes. There is no cost to you because your employer pays for the services provided within our program. While we offer a broad range of services, there may be some assistance that’s not included. You can still work with counselors for these services by arranging to pay for them directly. Does the program have any limitations? While we offer a broad range of services, we may not cover all services you may need. Your Employee Assistance Program does not provide: •
Inpatient or outpatient treatment for any medically treated illness
•
Prescription drugs
•
Treatment or services for intellectual disability or autism
•
Counseling services beyond the number of sessions covered or requiring longer term intervention
•
Services by counselors who are not LifeWorks providers
•
Counseling required by law or a court, or paid for by Workers’ Compensation
Phone 1-888-319-7819
Web metlifeeap.lifeworks.com user name: metlifeeap and password: eap
Mobile App user name: metlifeeap and password: eap
Does the program offer Cognitive Behavioral Therapy (CBT)? Many LifeWorks EAP providers are trained in this type of counseling and the foundation of LifeWorks' CareNow digital programs, available through the programs website and mobile app, are built upon Cognitive Behavioral Therapy (CBT) techniques . CareNow provides instant access to a range of self-service programs developed by world leading experts, focused on behavior change in the areas of anxiety, stress, depression, and more.
*MetLife and LifeWorks abide by federal and state regulations regarding duty to warn of harm to self or others. In these instances, the consultant may have a duty to intervene and report a situation to the appropriate authority.
Some restrictions may apply to all of the above-mentioned services. Please contact your employer or MetLife for details. EAP services provided through an agreement with LifeWorks US Inc. (LifeWorks by Morneau Shepell). LifeWorks is not a subsidiary or affiliate of MetLife.
Metropolitan Life Insurance Company | 200 Park Avenue | New York, NY 10166 OPT2/3
L0721015353[exp0722][All States][DC,GU,MP,PR,VI] © 2021 MetLife Services and Solutions, LLC
ACCIDENTS HAPPEN. HOW FINANCIALLY PREPARED ARE YOU? Over 40 million Americans received emergency room treatment for an accidental injury3 63% of Americans with medical insurance used all of their savings for out-of-pocket medical costs4 AMBULANCE
$100
KNEE BRACE
$75
HOSPITAL ADMISSION
$1,000
X-RAY
$100
EMERGENCY ROOM VISIT
$100
KNEE CARTILAGE TEAR
$500
HOSPITAL CONFINEMENT (1 DAY)
$250
2 FOLLOW-UP VISITS
$100
MEDICAL RESONANCE IMAGING (MRI)
$250
TOTAL CASH BENEFIT PAID FOR COVERED SERVICES:
$2,475
The average cost of an emergency room visit for people between the ages of 45-64 is $2,1765 MONTHLY RATES EMPLOYEE EMPLOYEE & SPOUSE EMPLOYEE & CHILD FAMILY
LEARN MORE ABOUT ACCIDENT INSURANCE AT WWW.GUARDIANANYTIME.COM
2018-57760 [0420]
VALUE PLAN
ADVANTAGE PLAN
$9.20
$18.10
$14.50
$27.60
$14.50
$27.60
$19.80
$37.10
ACCIDENT INSURANCE
VALUE PLAN COVERAGE*
BENEFIT ACCIDENT COVERAGE TYPE CHILD(REN) AGE LIMITS ACCIDENT EMERGENCY TREATMENT ACCIDENT FOLLOW-UP VISIT – DOCTOR AMBULANCE APPLIANCE BURNS (2ND DEGREE/3RD DEGREE) BURN – SKIN GRAFT CHILD ORGANIZED SPORT CHIROPRACTIC VISITS COMA CONCUSSIONS DISLOCATIONS DIAGNOSTIC EXAM (MAJOR) EYE INJURY FRACTURE HOSPITAL ADMISSION HOSPITAL CONFINEMENT HOSPITAL ICU ADMISSION HOSPITAL ICU CONFINEMENT INITIAL PHYSICIAN’S OFFICE/ URGENT CARE FACILITY TREATMENT KNEE CARTILAGE JOINT REPLACEMENT (HIP/KNEE/SHOULDER) LACERATION OCCUPATIONAL OR PHYSICAL THERAPY REHABILITATION UNIT CONFINEMENT RUPTURED DISC WITH SURGICAL REPAIR SURGERY (CRANIAL, OPEN ABDOMINAL, THORACIC) SURGERY EXPLORATORY OR ARTHROSCOPIC TENDON/LIGAMENT/ROTATOR CUFF X-RAY
ADVANTAGE PLAN COVERAGE*
On & Off Job Birth to 26 years (26 if full-time student), subject to state limitations
On & Off Job Birth to 26 years (26 if full-time student), subject to state limitations
$100
$300
$50/day up to 2 visits
$50/day up to 2 visits
$100 $75 9 sq inches to 18 sq inches: $0/$2,000 18 sq inches to 35 sq inches: $1,000/$4,000 Over 35 sq inches: $3,000/$12,000 50% of burn benefit 20% increase to child benefits $30/day up to 5 visits $7,500 $150 Schedule up to $4,000 $250 $250 Schedule up to $5,000 $1,000 $250/day up to 1 year $2,000 $500day, up to 30 days
$200 $125 9 sq inches to 18 sq inches: $0/$2,000 18 sq inches to 35 sq inches: $1,000/$4,000 Over 35 sq inches: $3,000/$12,000 50% of burn benefit 20% increase to child benefits $50/day up to 5 visits $10,000 $300 Schedule up to $8,000 $500 $500 Schedule up to $10,000 $2,000 $500/day up to 1 year $4,000 $1,000day, up to 30 days
$50
$100
$500
$500
$1,500/$750/$750
$2,500/$1,250/$1,250
Schedule up to $400
Schedule up to $800
$25/day up to 10 days
$50/day up to 10 days
$150/day up to 15 days
$150/day up to 15 days
$500
$500
$1,000; Hernia: $125
$1,250; Hernia: $150
$150
$250
1: $250; 2 or more: $500
1: $500; 2 or more: $1,000
$100
$200
*The services, exclusions, and limitations listed above do not constitute a contract and are a summary only. The Guardian plan documents are the final arbiter of coverage. This document is a summary of the major features of the referenced insurance coverage. It is intended for illustrative purposes only and does not constitute a contract. The insurance plan documents, including the policy and certificate, comprise the contract for coverage. The full plan description, including the benefits and all terms, limitations and exclusions that apply will be contained in your insurance certificate. Coverage terms may vary by state and employer-sponsored plan. The premium amounts reflected in this summary are an approximation; if there is a discrepancy between this amount and the premium deducted from your paycheck, the latter prevails. SUMMARY OF PLAN LIMITATIONS AND EXCLUSIONS This plan will not pay benefits for any injury caused by or related to: • Declared or undeclared war, act of war, or armed aggression; taking part in a riot or civil disorder; or commission of, or attempt to commita felony; Intentionally self inflicted injury, while sane or insane; suicide or attempted suicide, while sane or insane • The covered person being legally intoxicated • Treatment rendered or hospital confinement outside the United States or Canada • Travel or flight in any kind of aircraft, including any aircraft owned by or for the employer except as a fare-paying passenger on a common carrier • Participation in any kind of sporting activity for compensation or profit, including coaching or officiating • Riding in or driving any motor-driven vehicle in a race, stunt show or speed test • Participation in hang gliding,bungee jumping, sailgliding, parasailing, parachuting, ballooning, parachuting, and/or skydiving • Job related or on the job injuries • Injuries to a dependent child received during the birth • An accident that occurred before the covered person is covered by this plan • Sickness, disease, mental infirmity or medical or surgical treatment • Employees must be legally working in the United States in order to be eligible for coverage. Underwriting must approve coverage for employees on temporary assignment: (a) exceeding one year ; or (b) in an area under travel warning by the U.S. Department of State, subject to state specific variations. • A pre-existing condition includes any condition for which an employee, in the specified time period prior to coverage in this plan, consults with a physician, receives treatment, or takes prescribed drugs. Please refer to the plan documents for specific time periods. State variationsmay apply. This applies to the Disability or Hospital Confinement Sickness riders only. • This proposal summarizes the major features of the Guardian Accident benefit plan. It is not intended to be a complete representation of the proposed plan. For full plan features, including exclusions and limitations, please refer to your policy.
HELPS PROTECT YOUR SAVINGS FROM LIFE’S UNEXPECTED MOMENTS
FOCUS ON RECOVERY, NOT YOUR FINANCES
A SERIOUS ILLNESS IMPACTS YOU AND YOUR FAMILY
HERE’S AN EXAMPLE OF HOW GUARDIAN’S CRITICAL ILLNESS INSURANCE WORKS** Sue suffers a hear attack and receives a cash payment of $15,000 from her Critical Illness Plan. Four years later she has a stroke and receives an additional payment of $15,000 from her Plan. During both of these illnesses, her plan provided the financial support to cover a variety of expenses, such as mortgage and car payments, while she recovered. CONDITION
FORMULA
BENEFIT FOR EACH COVERED CONDITION
HEART ATTACK
100% of covered benefit X $15,000
$15,000
STROKE
100% of covered benefit X $15,000
$15,000
Every minute of every day, an American becomes seriously ill1 Medical expense account for approximately 62% of personal bankruptcies in the US2 72% of people who filed bankruptcy due to medical expenses had some type of medical insurance2
TOTAL CASH BENEFIT PAID: $30,000
LEARN MORE ABOUT CRITICAL ILLNESS INSURANCE AT WWW.GUARDIANANYTIME.COM
2018-58025 (04-20)
CRITICAL ILLNESS INSURANCE EMPLOYEE
BENEFIT AMOUNTS Non-Tobacco Rate Tobacco Rate
$15,000 $15,000