welcome! employee benefits orientation. benefits wading into the world of benefits can be daunting....

Welcome!Welcome!

EMPLOYEE BENEFITS EMPLOYEE BENEFITS ORIENTATIONORIENTATION

Benefits Benefits

Wading into the world of benefits can be Wading into the world of benefits can be daunting. This orientation is designed to guide daunting. This orientation is designed to guide you through the various benefits available to you through the various benefits available to you and assist you in making the best you and assist you in making the best selections for your specific needs and desires. selections for your specific needs and desires. Some enrollments require online registration/ Some enrollments require online registration/ enrollment and a printed form to WCU human enrollment and a printed form to WCU human resources, others require online enrollment resources, others require online enrollment only, others you will need to waive enrollment, only, others you will need to waive enrollment, and still others will require working directly with and still others will require working directly with independent vendors .independent vendors .

How this Benefits How this Benefits Orientation is Orientation is

DesignedDesignedThis orientation is divided into “Sections”. This orientation is divided into “Sections”.

Section 1Section 1 is an outline of what is an outline of what items New Fall Faculty will items New Fall Faculty will need to bring with them to Fall Faculty orientationneed to bring with them to Fall Faculty orientation in in August. August.

You need to allow yourself a couple hours to complete this You need to allow yourself a couple hours to complete this orientation and make your benefits selections. Those orientation and make your benefits selections. Those of you with spouses and families may want to include of you with spouses and families may want to include them in your review and selection of benefits. them in your review and selection of benefits.

If you start the process and have to stop in the middle, If you start the process and have to stop in the middle, just make a note to yourself where you left off. Then just make a note to yourself where you left off. Then when you return, left click anywhere inside the slide when you return, left click anywhere inside the slide show and you get a pop-up menu that will allow you to show and you get a pop-up menu that will allow you to “go to slide” and choose the slide you want to return “go to slide” and choose the slide you want to return to.to.

Tips to NavigationTips to Navigation

Other helpful tips:Other helpful tips: You can go to previous slide, next slide or end the slide show You can go to previous slide, next slide or end the slide show

by left clicking in the show OR run your cursor over the lower by left clicking in the show OR run your cursor over the lower left corner of any slide and you have those options as arrows.left corner of any slide and you have those options as arrows.

You can go to a particular Section from the Index by clicking on You can go to a particular Section from the Index by clicking on the Section. To return to the Index – left click anywhere and the the Section. To return to the Index – left click anywhere and the pop-up menu will allow you to choose “go to slide” and choose pop-up menu will allow you to choose “go to slide” and choose the “INDEX” slide you want to return to.the “INDEX” slide you want to return to.

Take time to read the instructions slides and even print those Take time to read the instructions slides and even print those slides as you enter the various benefits web sites. These will slides as you enter the various benefits web sites. These will serve as good guides as you make your selections and print serve as good guides as you make your selections and print forms, etc.forms, etc.

NOTE: You will need to view in “slide show view” in order for links to NOTE: You will need to view in “slide show view” in order for links to workwork

INDEX sections 1 to 4INDEX sections 1 to 4

Section 1 - Section 1 - Outline and Outline and Forms Checklist – – What you need to bring with you to Fall Faculty What you need to bring with you to Fall Faculty

OrientationOrientation Section 2 - Section 2 - Retirement Options

Teachers’ and State Employees’ Retirement System Teachers’ and State Employees’ Retirement System (TSERS)(TSERS)

Optional Retirement Plan (ORP)Optional Retirement Plan (ORP)Supplemental Retirement – available from vendorsSupplemental Retirement – available from vendors

Section 3 - Section 3 - Disability Income Benefit – NC provided– NC providedStatus changes that require your action!Status changes that require your action!

Section 4 –Section 4 –North Carolina State Health Plan (PPO)General information about the plan and links to sign General information about the plan and links to sign

up!up! Section 5 - Section 5 - Prescription Benefits

Explanation of the prescription benefits for PPO Explanation of the prescription benefits for PPO participantsparticipantsSection 6 –Section 6 – Health Coverage changes – what to do?– what to do?

INDEX Sections 5 to 9INDEX Sections 5 to 9

Section 7 – Section 7 – NCFlex optional benefit plansSection 7a – VisionSection 7b – DentalSection 7c - AD&DSection 7d - Term LifeSection 7e - CancerSection 7f - Critical Illness

Section 8 – Section 8 – NCFlex spending accountsDescribes what these pretax spending accounts can do for you Describes what these pretax spending accounts can do for you

and how to sign upand how to sign upSection 9 – Section 9 – Supplemental InsurancesSupplemental Insurances - - available from vendorsavailable from vendors

Section 9aSection 9a - - Supplemental Disability planSection 9bSection 9b - - Supplemental insurances - Life and Long Term - Life and Long Term

CareCare

INDEX Sections 10 to INDEX Sections 10 to 1515

Section 10 – Section 10 – Workers CompensationSection 11 – Section 11 – Tuition Waiver and Reimbursement Section 12 – Section 12 – Campus Health ServicesSection 13 – Section 13 – Unemployment InsuranceSection 14 – Section 14 – SEANC/SEIU– –

State Employees Association of North CarolinaState Employees Association of North Carolina

Section 1 – Section 1 – Outline and Forms ChecklistOutline and Forms Checklist

1. 1. Retirement:Retirement:– TSERS - if this is your choice,TSERS - if this is your choice, notify HR benefits specialist at Fall Faculty Orientation notify HR benefits specialist at Fall Faculty Orientation 0R0R– ORP – if this is your choice, ORP-1 Form ORP – if this is your choice, ORP-1 Form print and bring form to Fall Faculty Orientationprint and bring form to Fall Faculty Orientation

– Supplemental Retirement Plans – work with vendors directlySupplemental Retirement Plans – work with vendors directly

2. 2. Health Insurance Enrollment FormHealth Insurance Enrollment Form complete online, print and bring to Fall Faculty Orientationcomplete online, print and bring to Fall Faculty Orientation

3. 3. NC Flex Enrollment FormsNC Flex Enrollment Forms complete online – print for your own information complete online – print for your own information

4. 4. Supplemental DisabilitySupplemental Disability complete form online, print and bring to Fall Faculty Orientationcomplete form online, print and bring to Fall Faculty Orientation– TSERS – Liberty MutualTSERS – Liberty Mutual– ORP – The Standard Insurance CompanyORP – The Standard Insurance Company

5. 5. Other Supplemental InsurancesOther Supplemental Insurances – Life and Long Term Care - work with vendor – Life and Long Term Care - work with vendor directlydirectly

Section 2 - RetirementSection 2 - Retirement

Retirement OptionsRetirement Options

Mandatory enrollment in either TSERS or ORPMandatory enrollment in either TSERS or ORP

TSERS (Teachers’ and State Employees’ TSERS (Teachers’ and State Employees’ Retirement System) Retirement System) Available to all SPA and Available to all SPA and EPA employees.EPA employees.

OROR ORP (Optional Retirement Plan) This plan is ORP (Optional Retirement Plan) This plan is

an option for EPA Faculty and EPA non-an option for EPA Faculty and EPA non-faculty employees. faculty employees. Not available to SPA Not available to SPA employees.employees.

TSERS OverviewTSERS Overview

Teachers’ and State Employees’ Retirement Teachers’ and State Employees’ Retirement SystemSystem

Defined Benefit PlanDefined Benefit Plan– Steady income until deathSteady income until death– Benefit determined by a formulaBenefit determined by a formula– Stable and secure retirement incomeStable and secure retirement income– Professional asset managementProfessional asset management– Accumulate retirement income without Accumulate retirement income without

individual riskindividual risk

TSERS OverviewTSERS Overview

You contribute 6%, and the university You contribute 6%, and the university contributes a total of 14.23% contributes a total of 14.23% – (5.30% goes into Retiree Health Plan (5.30% goes into Retiree Health Plan

Reserve, 8.33% in Retirement, .44% into Reserve, 8.33% in Retirement, .44% into Disability, .16% into Death Benefit).Disability, .16% into Death Benefit).

Death benefit paid to your beneficiary Death benefit paid to your beneficiary if you die in active serviceif you die in active service

Mandatory for SPA employeesMandatory for SPA employees

TSERS Benefit TSERS Benefit CalculationCalculation

Retirement benefits are based on:Retirement benefits are based on:– Years of ServiceYears of Service– Average Final CompensationAverage Final Compensation– Actuarial FormulaActuarial Formula– Payment Option ChosenPayment Option Chosen

Effective 8/1/11 you arevested after 10 yrs.

TSERS and ORBITTSERS and ORBIT

As new employees, you will need to notify the As new employees, you will need to notify the HR Benefits specialist if you choose TSERS as HR Benefits specialist if you choose TSERS as your retirement plan. After you are in the your retirement plan. After you are in the system, then you will be able to Log in to system, then you will be able to Log in to ORBITORBIT for information on your retirement plan for information on your retirement plan– ORBIT (Online Retirement Benefits through ORBIT (Online Retirement Benefits through

Integrated Technology) at:Integrated Technology) at:

https://orbit.myncretirement.com/orbit/https://orbit.myncretirement.com/orbit/Common/Pages/BPASLogin.aspxCommon/Pages/BPASLogin.aspx

ORP OverviewORP Overview

Defined Contribution PlanDefined Contribution Plan Optional for faculty (TSERS alternative)Optional for faculty (TSERS alternative)

– You contribute 6% You contribute 6% – the university contributes 12.58% the university contributes 12.58%

(6.84% goes into your account, 5.30% into Retiree (6.84% goes into your account, 5.30% into Retiree Health Plan Reserves, .44% in Disability Income Plan)Health Plan Reserves, .44% in Disability Income Plan)

Choice of carriersChoice of carriers– FidelityFidelity– Lincoln Lincoln – TIAA-CREFTIAA-CREF– VALICVALIC

ORP FeaturesORP Features

ORP features include:ORP features include:

– Greater control over investments.Greater control over investments.– Greater choice of distribution Greater choice of distribution

options.options.– Portability – the ability to transfer Portability – the ability to transfer

your retirement savings to a your retirement savings to a retirement plan sponsored by your retirement plan sponsored by your new institution.new institution.

ORP Investment ORP Investment ChoicesChoices

Investment options Investment options include fixed and include fixed and variable instruments variable instruments and mutual fundsand mutual funds– Stock and Bond Mutual Stock and Bond Mutual

FundsFunds– Stable Value and Fixed Stable Value and Fixed

InvestmentsInvestments– Lifecycle FundsLifecycle Funds– Specialty FundsSpecialty Funds

ORP VestingORP Vesting

You are 100% vested in the value of You are 100% vested in the value of employee contributions from day 1.employee contributions from day 1.

You are 100% vested in employer You are 100% vested in employer and employee contributions after 5 and employee contributions after 5 years participation in ORP.years participation in ORP.

ORP VestingORP Vesting

You are 100% vested in employer You are 100% vested in employer and employee contributions before and employee contributions before 5 years if:5 years if:– Your new employer is a higher education Your new employer is a higher education

institution.institution.– Your new employee offers a “like retirement Your new employee offers a “like retirement

plan” underwritten by one of the ORP carriers.plan” underwritten by one of the ORP carriers.– You begin participating in the successor plan You begin participating in the successor plan

within 12 months following the end of your within 12 months following the end of your UNC employment.UNC employment.

To enroll in ORP (Optional Retirement Program) To enroll in ORP (Optional Retirement Program) go to the University of North Carolina Optional go to the University of North Carolina Optional Retirement Page at:Retirement Page at:

http://www.northcarolina.edu/hr/ga/http://www.northcarolina.edu/hr/ga/benefits/retirement/ORP/ORPMain.htmbenefits/retirement/ORP/ORPMain.htm

AndAnd

– Complete Form ORP-1 – Print and bring to Fall Complete Form ORP-1 – Print and bring to Fall Faculty OrientationFaculty Orientation

ENROLLING IN ORP

TSERS vs. ORPTSERS vs. ORP

TSERsTSERs ORPORPAgeAge May favor employees May favor employees

45+ years of age who 45+ years of age who plan to retire from UNC.plan to retire from UNC.

May favor employees who May favor employees who enter at an early age.enter at an early age.

Risk and Risk and DecisionsDecisions

Low investment risk and Low investment risk and no investment no investment decisions.decisions.

May encounter greater May encounter greater investment risk – depends investment risk – depends on investment choices. on investment choices. Requires decision making.Requires decision making.

PortabilityPortability Portable only to other Portable only to other North Carolina agencies North Carolina agencies and credits available for and credits available for transferring to local transferring to local government employers.government employers.

Portable to other university Portable to other university employers who sponsor a employers who sponsor a “like” plan.“like” plan.

RetirementRetirement Full and reduced Full and reduced retirement options that retirement options that depend on age and depend on age and years of service.years of service.

Retirement at any age with Retirement at any age with a 10% penalty for a 10% penalty for withdrawals before age 59 withdrawals before age 59 and a half. and a half.

Supplemental Supplemental RetirementRetirement

Save $$$ by making contributions on a Save $$$ by making contributions on a pre-tax basis (except for the NC401(k) pre-tax basis (except for the NC401(k) Roth Option).Roth Option).

Contributions are payroll deducted.Contributions are payroll deducted.

Loan options are available.Loan options are available.

Plans are portable.Plans are portable.

Plan ComparisonPlan Comparison

403(b)403(b) 457457 401(k)401(k)Carriers TIAA-CREF

Fidelity

Prudential Prudential (Traditional Pre-Tax and Roth Options Available)

Available Products

403(b)(1) fixed and variable annuity accounts.403(b)(7) custodial accounts investing in mutual funds.

Fixed accounts, variable accounts and mutual funds.

Stable Value Fund and 8 mutual funds. Asset allocation tools available.

Retirement andRetirement and Health Insurance Health Insurance

Employees hired on or after 10/1/2006 Employees hired on or after 10/1/2006 must satisfy minimum service must satisfy minimum service requirements to be eligible for health requirements to be eligible for health insurance upon retirementinsurance upon retirement..– Free coverage for retirees with 20 or more Free coverage for retirees with 20 or more

years of retirement credit.years of retirement credit.– 50% premium reduction for retirees with 10 to 50% premium reduction for retirees with 10 to

20 years of retirement credit.20 years of retirement credit.– No reduction (you pay full cost) for retirees No reduction (you pay full cost) for retirees

with 5 – 10 years of retirement credit.with 5 – 10 years of retirement credit.

Section 3 – DisabilitySection 3 – Disability Income Income

The state of North Carolina The state of North Carolina provides a basic disability income provides a basic disability income

plan to all employees who plan to all employees who participate in a North Carolina participate in a North Carolina

retirement plan.retirement plan.

Disability Income PlanDisability Income Plan

Less Than 5 Years in a Retirement Less Than 5 Years in a Retirement SystemSystem– No disability benefit for the first year No disability benefit for the first year

of membershipof membership– After one year of membership, a After one year of membership, a

short-term benefit of (50%) for one short-term benefit of (50%) for one year onlyyear only

Disability Income PlanDisability Income Plan

Five or More Years in a Retirement Five or More Years in a Retirement SystemSystem– One year of short-term benefits One year of short-term benefits

(50%)(50%)– Long-term benefit (65%) until you Long-term benefit (65%) until you

qualify for unreduced retirement qualify for unreduced retirement benefitsbenefits

Family Medical Family Medical LeaveLeave

Eligible employees receive 12 Eligible employees receive 12 weeks of unpaid, job-protected for weeks of unpaid, job-protected for certain family and medical eventscertain family and medical events

Eligibility: 12 months employment Eligibility: 12 months employment for at least 1,040 hours.for at least 1,040 hours.

Physician certification required.Physician certification required.

FMLA Eligible FMLA Eligible SituationsSituations

Birth of a child/care for the child after Birth of a child/care for the child after birth.birth.

Care for a child placed with an Care for a child placed with an employee for adoption.employee for adoption.

Care for an employee’s child, spouse, Care for an employee’s child, spouse, and/or parent with serious health and/or parent with serious health condition.condition.

Employee unable to work resulting Employee unable to work resulting from a serious health condition.from a serious health condition.

Policy 89Policy 89

Serious Illness and Disability Leave Serious Illness and Disability Leave for Faculty.for Faculty.

Provides 60 Days of paid leave at Provides 60 Days of paid leave at full salary.full salary.

Runs concurrently with FMLA.Runs concurrently with FMLA. Physician Certification is required.Physician Certification is required. Link provided in section 4.14 of the Link provided in section 4.14 of the

Faculty Handbook.Faculty Handbook.

Section 4Section 4State Health PlanState Health Plan

http://www.shpnc.org/index.htmlhttp://www.shpnc.org/index.html

Health Insurance Health Insurance DefinitionsDefinitions

Plan YearPlan Year – – based on the State of based on the State of North Carolina’s fiscal year (July 1 to North Carolina’s fiscal year (July 1 to June 30)June 30)

Plan Year DeductiblePlan Year Deductible - - The The amount of allowable charges that amount of allowable charges that members must pay each Plan year members must pay each Plan year before benefits are payable.before benefits are payable.

Health Insurance Health Insurance DefinitionsDefinitions

CoinsuranceCoinsurance - - The amount the member must The amount the member must contribute toward the cost of covered medical contribute toward the cost of covered medical expenses. Once the Plan year deductible is met, expenses. Once the Plan year deductible is met, the Plan pays 80% of allowable charges while the the Plan pays 80% of allowable charges while the member pays 20%.member pays 20%.

Co-paymentCo-payment - - Specified portion of a charge for Specified portion of a charge for which the member is responsible. Co-payments which the member is responsible. Co-payments are required for services such as prescription are required for services such as prescription drugs, professional services, emergency room drugs, professional services, emergency room visits, outpatient hospital, ambulatory surgical visits, outpatient hospital, ambulatory surgical facility, and inpatient hospital benefitsfacility, and inpatient hospital benefits..

SHP Enrollment SHP Enrollment (PPO)(PPO)

Eligibility and EnrollmentEligibility and Enrollment

Permanent employees Permanent employees Must enroll within 30 days to cover pre-Must enroll within 30 days to cover pre-

existing conditionsexisting conditions Employee coverage paid by WCU except Employee coverage paid by WCU except

for small premium with Smart Choice Plus.for small premium with Smart Choice Plus. Spouse and dependent coverage paid by Spouse and dependent coverage paid by

staff memberstaff member Premiums are deducted on pre-tax basis.Premiums are deducted on pre-tax basis.

NC NC SmartSmartChoiceChoice PPO Options PPO Options

EMPLOYEE MONTHLY CONTRIBUTION RATES

Coverage Types Basic Standard State

Monthly

70/30 80/20 Contribution

Employee only $0 $22.76 $432.56

Employee + Child(ren) $198.06 $286.16 $432.56

Employee + Spouse $510.32 $629.64 $432.56

Employee + Family $543.54 $666.18 $432.56

NC NC SmartSmartChoiceChoice PPO Options PPO Options

PPO utilizes the extensive Blue Options Network which includes:

• Participating providers in all 100 counties• More than 22,000 health care providers• 90% of the primary care physicians in the state• 85% of the specialists in the state• 97% of the hospitals in the state• Providers available nationwide and worldwide

PPO utilizes the extensive Blue Options Network which includes:

• Participating providers in all 100 counties• More than 22,000 health care providers• 90% of the primary care physicians in the state• 85% of the specialists in the state• 97% of the hospitals in the state• Providers available nationwide and worldwide

PPO OPTIONSPPO OPTIONS

Basic (70/30) Standard(80/20 )

In-Network Out In-Network

Out

Annual Annual DeductibleDeductible

(Individual/(Individual/

Family)Family)

$933/$2,799

$1,866/$5,598

$700/$2,100

$1,400/$4,200

Plan Plan CoinsurancCoinsurancee

(what you (what you pay)pay)

30% of eligible expenses after

deductible

50% of eligible expenses after deductible and the difference between the allowed amount and the charge

20% of eligible

expenses after

deductible

40% of eligible expenses after deductible and the difference between the allowed amount and the charge

CoinsurancCoinsurance Maximume Maximum

(Ind/Fam)(Ind/Fam)

$3,793 /$11,379

$7,589/ $22,758

$3,210/$9,630

$6,420/$19,260

PPO OPTIONSPPO OPTIONS

Basic StandardIn-Network Out In-Network Out

Physician Office Physician Office VisitsVisits

Primary CarePrimary Care

SpecialistSpecialist

$351

$811

50% coinsurance

after deductible.

$301

$701

40% coinsurance

after deductible.

Urgent CareUrgent Care $87 Same as in-network

$87 Same as in-network

Inpatient CopayInpatient Copay $291, plus 30%

coinsurance after

deductible

$291, then 50%

coinsurance after

deductible

$233, plus 20%

coinsurance after

deductible

$233, then 40%

coinsurance after

deductible

Outpatient Hosp Outpatient Hosp & & Amb Surg Ctr Amb Surg Ctr CopayCopay

30% coinsurance

after deductible

50% coinsurance

after deductible

20% coinsurance

after deductible

40% coinsurance

after deductible

Emergency Room Emergency Room CopayCopay

$291, plus 30%coinsurance after deductible

Same as in-network

benefit

$233, plus 20%

coinsurance after

deductible

Same as in-network

benefit

1. In-network hospital owned or operated practices may be subject to deductible and coinsurance. Please call your physician or see the Provider Directory to determine if your physician’s practice is hospital owned or operated.

Online EnrollmentOnline Enrollment

https://Wcu.hrintouch.comhttps://Wcu.hrintouch.com

LOGIN ID – first name/initial of last LOGIN ID – first name/initial of last name and last 4 digits of social name and last 4 digits of social security numbersecurity number

Password is “social”Password is “social” Change your password to a new Change your password to a new

passwordpassword Complete your enrollmentComplete your enrollment

Section 5 - Prescription Section 5 - Prescription BenefitsBenefits

Prescription benefits for PPO participantsPrescription benefits for PPO participants

– Administered by Medco – Pharmacy Benefit Administered by Medco – Pharmacy Benefit ManagerManager

– You are issued an ID card which you take to You are issued an ID card which you take to any participating pharmacy. any participating pharmacy.

– Anticipate a 3-4 week wait for cards and plan Anticipate a 3-4 week wait for cards and plan accordingly.accordingly.

www.shpnc.orgwww.shpnc.org

Prescription BenefitsPrescription Benefits

Higher benefit for medications listed on Higher benefit for medications listed on the Preferred Drug Listthe Preferred Drug List

http://www.shpnc.org/myPharmacyBenefits/http://www.shpnc.org/myPharmacyBenefits/default.aspxdefault.aspx

Co-payment for each 30-day Co-payment for each 30-day supply:supply:

$12.00 Generic$12.00 Generic $40.00 Preferred Brand without Generic$40.00 Preferred Brand without Generic $64.00 Non-Preferred Brand$64.00 Non-Preferred Brand

Section 6 - Health Section 6 - Health Coverage changesCoverage changes

You may want to initiate coverage You may want to initiate coverage changes if status change occurs.changes if status change occurs.– Change in marital statusChange in marital status– Dependent change due to birth, Dependent change due to birth,

adoption or death of dependentadoption or death of dependent– Court order to provide coverageCourt order to provide coverage

Notify the Human Resources Benefits Notify the Human Resources Benefits specialist immediately when a specialist immediately when a

change in status occurs.change in status occurs.

Health CoverageHealth Coverage

Adding a dependentAdding a dependent – effective date of – effective date of coverage is the first day of the month coverage is the first day of the month following an eligibility event – such as following an eligibility event – such as marriage.marriage.

NewbornNewborn – mother must be an enrolled – mother must be an enrolled employee or enrolled spouse to receive employee or enrolled spouse to receive newborn benefits. Effective date – is birth newborn benefits. Effective date – is birth date of child – change to employee/child date of child – change to employee/child first of the month in which child is born.first of the month in which child is born.

Health CoverageHealth CoverageGeneral InformationGeneral Information

PPO Customer Service:PPO Customer Service:

888-234-2416888-234-2416

Website:Website:http://www.shpnc.orghttp://www.shpnc.org

Section 7 - NCFlex –Section 7 - NCFlex –Optional Benefit PlansOptional Benefit Plans

NCFlexNCFlex

VisionVision DentalDental Accidental Death and DismembermentAccidental Death and Dismemberment Core AD&D up to $10,000 – no premiumCore AD&D up to $10,000 – no premium Term Life InsuranceTerm Life Insurance Supplemental Cancer InsuranceSupplemental Cancer Insurance Critical IllnessCritical Illness

Section 7a – Vision Three Plan Designs Offered – Superior

Vision Plan 1 provides fully-insured eye exams & materials Plan 2 provides fully-insured materials only Plan 3

Enhanced Plan – all services every 12 months– $150.00 frame allowance– $150.00 contact lens allowance– Covered contact lens exam after $25.00 copay

NCFlex VisionNCFlex Vision

Plan OnePlan One– $6.84 (employee) or $6.84 (employee) or – $17.38 (family)$17.38 (family)– Exam, lenses and contacts every 12 Exam, lenses and contacts every 12

monthsmonths– Contacts covered up to $100 if not Contacts covered up to $100 if not

medically necessarymedically necessary– $20 co-payment for exams (In-Network)$20 co-payment for exams (In-Network)– Eyeglass frames every 24 monthsEyeglass frames every 24 months


Plan TwoPlan Two– $5.14 (employee) or $5.14 (employee) or – $12.72 (family)$12.72 (family)– Examinations not coveredExaminations not covered– Eyeglass lenses and contacts every 12 Eyeglass lenses and contacts every 12


medically necessarymedically necessary– Eyeglass frames every 24 monthsEyeglass frames every 24 months


Plan ThreePlan Three– $9.98 (employee) or $9.98 (employee) or – $25.10 (family)$25.10 (family)– Exam, lenses and contacts every 12 Exam, lenses and contacts every 12


medically necessarymedically necessary– $20 co-payment for exams (In-Network)$20 co-payment for exams (In-Network)– Eyeglass frames every 12 monthsEyeglass frames every 12 months


Provider NetworkProvider Network

Ophthalmologists (M.D.s)Ophthalmologists (M.D.s)

Optometrists Optometrists (O.D.s)(O.D.s)

OpticiansOpticians

Optical Chain Optical Chain LocationsLocations

LenscraftersLenscrafters Wal-Mart OpticalsWal-Mart Opticals Sears OpticalsSears Opticals J C Penney OpticalsJ C Penney Opticals Pearle VisionPearle Vision Sam’s ClubSam’s Club

3333

Use In-Network Providers to enjoy maximum benefits

Section 7b - NCFlex Section 7b - NCFlex Dental – High or Low Dental – High or Low

optionoptionHigh Option Services Benefit

Oral Exams/Prophylaxis (every 6 months)

100% no deductible

X-rays (1 bitewing per calendar yr) 100% no deductible

Basic Services (Fillings, Extractions, Root Canal, General Anesthesia, Wisdom Teeth)

80% after deductible

Major Services (Crowns, Dentures, Bridges)


Child Orthodontics 50% up to $1500 lifetime max

NCFlex DentalNCFlex Dental

Low Option Services Benefit

Oral Exams/Prophylaxis 100% after deductible

X-rays (1 bitewing per calendar yr) 100% after deductible

Basic Services (Fillings, Extractions, Periodontal)


Section 7c – Section 7c – NCFlex AD&DNCFlex AD&D

Accidental Death and Dismemberment Accidental Death and Dismemberment InsuranceInsurance– Insured by A.C. NewmanInsured by A.C. Newman– As little as $0.96 per month for employee As little as $0.96 per month for employee

for $50,000 coveragefor $50,000 coverage– As high as $9.50 per month for employee As high as $9.50 per month for employee

for $500,000 coveragefor $500,000 coverage– Family coverage available, ranging from Family coverage available, ranging from

$1.50 ($50,000) to $15.00 per month $1.50 ($50,000) to $15.00 per month ($500,000)($500,000)

NCFlex AD&DNCFlex AD&DASSIST AMERICAASSIST AMERICA

Worldwide Emergency Assistance Services for TravelersWorldwide Emergency Assistance Services for Travelers– Emergency air evacuationEmergency air evacuation– Transportation of a friend or relativeTransportation of a friend or relative– Care of a minor childCare of a minor child– Medically supervised repatriationMedically supervised repatriation– Return of mortal remainsReturn of mortal remains

Participants Receive an I.D. CardParticipants Receive an I.D. Card

1919

Section 7d – Section 7d – NCFlex Term LifeNCFlex Term Life

The plan pays a benefit to your The plan pays a benefit to your beneficiaries if you die while covered.beneficiaries if you die while covered.

Evidence of Insurability is not necessary if Evidence of Insurability is not necessary if you elect coverage when first offered you elect coverage when first offered (unless you elect coverage above (unless you elect coverage above $100,000).$100,000).

Be aware of tax implications for insurance Be aware of tax implications for insurance amounts over $50,000 – explained on amounts over $50,000 – explained on NCFlex website.NCFlex website.

NCFlex Term LifeNCFlex Term Life

Calculate the amount of income Calculate the amount of income added to your pay - visit added to your pay - visit www.ncflex.org for instructions www.ncflex.org for instructions and example. The death benefit and example. The death benefit under TSERS is also included in under TSERS is also included in calculation.calculation.

Section 7e – Section 7e – NCFlex Cancer InsuranceNCFlex Cancer Insurance

High, Low, and Premium Options for High, Low, and Premium Options for Employee and Employee/FamilyEmployee and Employee/Family

Benefits for:Benefits for:– Hospital ConfinementHospital Confinement– Surgery Surgery – Radiation/ChemotherapyRadiation/Chemotherapy– Bone Marrow/Stem Cell TransplantBone Marrow/Stem Cell Transplant– Cancer ScreeningCancer Screening– HospiceHospice– Many other benefitsMany other benefits

NCFlex Cancer NCFlex Cancer InsuranceInsurance

Coverage for Employees & their dependents

Guaranteed issue when first eligible Pre-existing conditions apply Evidence of Insurability (EOI)* required for:

– Late applicants– Those moving from Low to High option

*EOI must be approved by vendor within 60 days from date of election form or automatically denied. Effective first of the month following approval.

Section 7f – Section 7f – Critical IllnessCritical Illness

This insurance is administered by MetLife This insurance is administered by MetLife and complements your existing medical and complements your existing medical coverage, but does not replace it. A coverage, but does not replace it. A lump-sum payment of $15,000 is paid lump-sum payment of $15,000 is paid directly to you when you experience a directly to you when you experience a covered condition:covered condition:

– Cancer Related ConditionsCancer Related Conditions– Heart-Related ConditionsHeart-Related Conditions– Other Conditions:Other Conditions:

Major organ transplantMajor organ transplant Kidney failure Kidney failure

Category of Benefits

Category 1: Cancer-RelatedConditions

Full Benefit CancerPartial BenefitCancer*Bone Marrow Transplant

Category 3:Other

Conditions

Major OrganTransplant**Kidney Failure

Category 2: Heart-RelatedConditions

Heart AttackStrokeCoronary Artery Bypass GraftHeart Transplant

*For some types of cancer and a coronary bypass graft, the covered employee will receive 25% of the category benefit amount. The remaining 75% is available should that employee experience another one of the covered conditions in that category while the certificate is in force.

**Other than bone marrow transplant and heart transplant.

Benefit Payment Example

DiagnosedCoveredCondition

CategoryImpacted

Lump-sumBenefit

PaymentReceived

Category 1:Cancer

RemainingBenefit

Category 2:Heart

RemainingBenefit

Category 3:Other

RemainingBenefit

You arediagnosed ashaving lungcancer

Category 1: Cancer

$15,000 $0 $15,000 $15,000

Two years later,you have acoronary arterybypass graft

Category 2: Heart

$3,750 $0 $11,250 $15,000

The followingyear, you suffera debilitatingstroke

Category 2: Heart

$11,250 $0$0 $0$0 $15,000

Three yearslater, you havekidney failure

Category 3: Other

$15,000 $0 $0 $0

Total = 45,000

Waiting Period &Pre-existing

ConditionsWaiting Period A 30-day waiting period for all covered

conditions applies

Pre-existing Conditions A pre-existing condition is a sickness or injury for which,

in the 12 months before a covered person becomes insured under a certificate, medical advice or treatment or care was sought by a covered person, or recommended by, prescribed by or received from a physician or other practitioner of healing arts

MetLife will not pay benefits for a covered condition that is caused by or results from a pre-existing condition if the covered condition occurs during the first 12 months that a covered person is insured under the certificate

Section 8 – NCFlex Section 8 – NCFlex Spending AccountsSpending Accounts

Spending accounts are simple to use. When you join, you choose to contribute a set amount to your account through payroll deduction on a pre-tax basis. When you have an expense that qualifies for reimbursement, you attach your receipt or the insurance company explanation of benefits (EOB) to a claim form and you will receive a tax-free reimbursement.

With these accounts, you are reimbursed with the pre-tax dollars you set aside to pay for eligible expenses.

Carry over of BalanceIf you have funds leftover on Dec. 31 you may continue to be reimbursed using your 2012 contributions through March 15 (unless you terminate the plan prior to Dec. 31)

Any fund not reimbursed by April 30th are lost.

NCFlex NCFlex Spending Account – (HCFSA)Spending Account – (HCFSA)

The Health Care Flexible Spending Account

You choose to contribute a set amount to your account through payroll deduction on a pre-tax basis. With this account, you are reimbursed with the pre-tax dollars you set aside to pay for medical, dental or other health care expenses not reimbursed by a health plan. This account can benefit almost all eligible employees, their spouses, children and dependents who satisfy the “Dependent Eligibility” rules as defined in the NCFlex Program section on line.

NCFlex NCFlex Spending Account – (HCFSA)Spending Account – (HCFSA)

Health Care Spending AccountHealth Care Spending Account– $10 – minimum per month$10 – minimum per month– $416.66 – maximum per month$416.66 – maximum per month– Reimbursement is made up to the Reimbursement is made up to the

amount you have agreed to put in the amount you have agreed to put in the plan for the year, not the amount you plan for the year, not the amount you have in your account currently.have in your account currently.

– Participants must re-enroll each year.Participants must re-enroll each year.

NCFlex NCFlex Spending Account – (DDCFSA)Spending Account – (DDCFSA)

The Dependent Day Care Flexible Spending Account (DDCFSA) is designed to benefit employees with young dependent children or disabled dependents of any age. Eligible day care expenses may be reimbursed for your “qualifying child” as per guidelines found on NCFlex web site.

NCFlex NCFlex Spending Account – (DDCFSA)Spending Account – (DDCFSA)

Dependent Care Spending AccountDependent Care Spending Account $10 – minimum per month$10 – minimum per month $416.66 – maximum per month$416.66 – maximum per month Reimbursement is made up to the amount Reimbursement is made up to the amount

in your account.in your account. Participants must re-enroll each year.Participants must re-enroll each year.

NCFlex Spending NCFlex Spending AccountsAccounts

ExamplesExamples With Spending Account

Without Account

Gross PayGross Pay $32,000 $32,000

Pre-Tax Pre-Tax ContributionContribution

-1,000

Taxable IncomeTaxable Income $31,000 $32,000

Federal Income Federal Income TaxTax

-3,180 -3,330

NC State Income NC State Income TaxTax

-1,497 -1,567

Social Security & Social Security & MedicareMedicare

-2,372 -2,448

After-tax After-tax ExpensesExpenses

-1,000

Take-Home PayTake-Home Pay $23,951 $23,655

Contribute a set amount to your account through payroll deduction Contribute a set amount to your account through payroll deduction on a pre-taxon a pre-tax basisbasis..

NCFlex Spending NCFlex Spending AccountsAccounts

When you incur expenses, send When you incur expenses, send in documentation with a claim in documentation with a claim form or use your optional form or use your optional Convenience Card.Convenience Card.

NCFlex Convenience CardNCFlex Convenience Card

Allows payment for eligible Spending Allows payment for eligible Spending Account expensesAccount expenses

Checks your Spending Account for Checks your Spending Account for available balancesavailable balances

BenefitsBenefits– Fewer out-of-pocket Fewer out-of-pocket

expensesexpenses– No reimbursement delaysNo reimbursement delays

$6 annual fee$6 annual fee Receipts must be submitted.Receipts must be submitted.

NCFlex Online EnrollmentNCFlex Online Enrollment

Register for first-

time visitors

Go to: www.ncflexonline.org and click Register.


On the First Time Visitor page, enter the Personal Information requested and click Continue.

Note that required fields are marked with a *


Create your own username and password in the fields provided and click REGISTER

For help in creating your username and password click the yellow question mark icon.


Click Enroll Online to begin enrolment

Click Enroll Online to

Begin enrollment

Click links for benefits

information


You are eligible to enroll in all of the benefits You are eligible to enroll in all of the benefits listed on the left side of the NCFlex screen.listed on the left side of the NCFlex screen.

For more information about each benefit, For more information about each benefit, click on the name of each benefitclick on the name of each benefit

If you want to enroll in some but not in other If you want to enroll in some but not in other benefits you will benefits you will need to waiveneed to waive the ones you the ones you do not want to enrolldo not want to enroll in. in.

Review the welcome message displayed for Review the welcome message displayed for specific informationspecific information


To begin the enrollment process click on the To begin the enrollment process click on the yellow Enroll Online button.yellow Enroll Online button.

Review the enrollment instructions and click Review the enrollment instructions and click the yellow Start Enrollment button or select the yellow Start Enrollment button or select the benefit you would like to enroll in from the benefit you would like to enroll in from your To Do List (this list is conveniently your To Do List (this list is conveniently located on the NCFlex website as you begin located on the NCFlex website as you begin your election of enrollments for NCFlex your election of enrollments for NCFlex optional benefits.) optional benefits.)

Be sure to “waive” any you do not want to Be sure to “waive” any you do not want to participate inparticipate in


Review Your InformationReview your personal and

dependent/beneficiary information. To add a dependent’s or beneficiary’s information, click the yellow Add Dependent/Beneficiary button and follow directions.

IMPORTANT

Providing dependent and beneficiary information here does not automatically enroll a dependent in coverage or designate the beneficiary for your Group Term Life insurance and/or AD&D coverage


Review Benefit Summary:•Verify that you have elected all of the correct coverage amounts and dependent elections on the benefits

•Below the benefits summary, verify that you have designated beneficiaries for both your basic life and supplemental AD&D (if applicable) coverage.

•Print benefits summary by clicking the yellow Printer Friendly Version button at the bottom of the page for your files.

•Click the Exit Enrollment link located at the bottom of your To-Do List.

Section 9 - Supplemental Section 9 - Supplemental InsurancesInsurances

Other various supplemental insurances are available to you as

a Western Carolina University employee.

Section 9a - Supplemental Section 9a - Supplemental Disability PlanDisability Plan

TSERS participants can purchase a TSERS participants can purchase a supplemental plan through supplemental plan through Liberty Mutual for additional Liberty Mutual for additional coveragecoverage– Benefit up to 66 2/3% of earnings up Benefit up to 66 2/3% of earnings up

to $10,000 monthlyto $10,000 monthly– Benefits available during the first Benefits available during the first

yearyear– Cost of .00233 of monthly salaryCost of .00233 of monthly salary

Supplemental DisabilitySupplemental Disability

ORP participants can purchase a supplemental plan ORP participants can purchase a supplemental plan through The Standardthrough The Standard– Benefit up to 66 2/3% of earnings up to Benefit up to 66 2/3% of earnings up to

$10,000 monthly$10,000 monthly– Benefits available during the first yearBenefits available during the first year– Contributions continue into retirement planContributions continue into retirement plan– Cost of .00209 of monthly salaryCost of .00209 of monthly salary

Section 9b – Life and Long Section 9b – Life and Long Term CareTerm Care

Voluntary additional Life Insurance Voluntary additional Life Insurance available for purchase from:available for purchase from:– Prudential Life InsurancePrudential Life Insurance– Boston MutualBoston Mutual

Long-Term Care Benefits plan Long-Term Care Benefits plan available for purchase from:available for purchase from:– Prudential Insurance CompanyPrudential Insurance Company

Comparison of Comparison of Optional Life InsuranceOptional Life Insurance

Prudential

AGE Life Amount Premium

Under 25 $50,000 $3.25

Age 50 $50,000 $14.50

SEANC (requires monthly dues)


Under 35 $50,000 $4.00

Age 50 $50,000 $24.50

ING (through NCFLEX)


Under 25 $50,000 $2.70

Age 50 $50,000 $18.30

Section 10 - Workers Section 10 - Workers CompensationCompensation

Used for job related or occupational illnesses.Used for job related or occupational illnesses.

Accidents or occupational disease must be Accidents or occupational disease must be reported to your supervisor as soon as reported to your supervisor as soon as possible.possible.

The employee is responsible for filing.The employee is responsible for filing.

Workers Compensation information can be Workers Compensation information can be found at: found at: http://www.wcu.edu/11810.asphttp://www.wcu.edu/11810.asp

Section 11 - Tuition Section 11 - Tuition WaiverWaiver

Permanent employees working at least 30 Permanent employees working at least 30 hours per week are eligible.hours per week are eligible.

Courses may be taken at any of the 17 UNC Courses may be taken at any of the 17 UNC constituent institutions.constituent institutions.

Tuition waived for two courses per year (fall or Tuition waived for two courses per year (fall or spring).spring).

Supervisor involvement and approval is Supervisor involvement and approval is required.required.

Tuition Tuition ReimbursementReimbursement

Permanent employees working at least 30 hours per Permanent employees working at least 30 hours per week are eligible.week are eligible.

Courses must be deemed directly related to the Courses must be deemed directly related to the employee’s classification.employee’s classification.

Courses may be taken at accredited colleges or Courses may be taken at accredited colleges or universities.universities.

Supervisor involvement and approval is required.Supervisor involvement and approval is required.

Section 12 – Campus Section 12 – Campus Health ServicesHealth Services

The WCU Campus Health center has options for The WCU Campus Health center has options for faculty and staff – check the web site for faculty and staff – check the web site for information at: information at: http://www.wcu.edu/7862.asphttp://www.wcu.edu/7862.asp

Mandatory $3.00 monthly contributionMandatory $3.00 monthly contribution Up to 3 free visits per Fiscal YearUp to 3 free visits per Fiscal Year Fee for visits beyond threeFee for visits beyond three Treatment for occasional illnesses and injuryTreatment for occasional illnesses and injury Not available for chronic conditions or Not available for chronic conditions or

ongoing condition managementongoing condition management

Section 13 - Section 13 - Unemployment Unemployment

InsuranceInsurance

For information and eligibility For information and eligibility requirements for unemployment, requirements for unemployment, go to the Employment Security go to the Employment Security Commission web site.Commission web site.

https://www.ncesc.com/default.aspxhttps://www.ncesc.com/default.aspx

Section 14 – SEANC/SEIUSection 14 – SEANC/SEIU State Employees Association of North Carolina State Employees Association of North Carolina

This is an association of NC employees that:This is an association of NC employees that:– Serves as an advocate for its members in state Serves as an advocate for its members in state

governmentgovernment– Offers benefits to its members:Offers benefits to its members:

AD&D InsuranceAD&D Insurance Boston Mutual Group Term LifeBoston Mutual Group Term Life Auto, home and renter’s insuranceAuto, home and renter’s insurance Supplemental medicalSupplemental medical Scholarships and educational loansScholarships and educational loans Group buying discountsGroup buying discounts

Participation is voluntary and cost is an $8.00 monthly Participation is voluntary and cost is an $8.00 monthly payroll-deducted feepayroll-deducted fee

For information see SEANC at: For information see SEANC at: http://www.seanc.org/http://www.seanc.org/

Congratulations! You have reached the Congratulations! You have reached the end of your Benefits Orientation. Be end of your Benefits Orientation. Be

sure to complete the forms as outlined sure to complete the forms as outlined in Section 1 and bring with you to Fall in Section 1 and bring with you to Fall

Faculty Orientation in August.Faculty Orientation in August.

Welcome Aboard! Welcome Aboard!To end this show – right click for pop up and choose “end show” or click square in lower left – below.

To end this show – right click for pop up and choose “end show” or click square in lower left – below.

welcome! employee benefits orientation. benefits wading into the world of benefits can be daunting....

Documents

previous slide

prescription benefits

faculty orientation

vendors section

benefits selections

particular section

world of benefits

selection of benefits