Benefits Overview The information contained in this presentation is not a contract and - PowerPoint Presentation

1. Benefits OverviewThe information contained in this presentation is not a contract and is subject to change by the proper authorities. It should be understood that explanations in this summary cannot alter, modify or otherwise change the controlling legal documents or general statutes in any way, nor can any right by reason of any inclusion or omission of any statement in this presentation.

2. Who’s EligiblePermanent (non-temporary) part-time employees working 20 – 29 hours per week are eligible for many benefit programs, typically without employer contributionsPermanent (non-temporary) part-time employees working 30 to 39 hours per week or permanent full-time employees working 40 hours per week are considered to be benefits eligible2

3. Health Benefits

4. Health BenefitsState Health Plan of NC – administered by Blue Cross and Blue Shield of North Carolina (BCBSNC)Use any medical provider you chooseIn Network: Your costs are lower when you use a doctor, hospital or other provider from the BCBSNC Blue Options network.Out of Network: For other providers, your deductibles, coinsurance and copays may be higherChoose from three plan options:Traditional 70/30 Plan (lower contributions, lower coverage levels)Enhanced 80/20 Plan (higher contributions, higher coverage levels)Consumer-Directed Health Plan (CDHP) (higher deductible, Health Reimbursement Account (HRA))4

5. Traditional 70/30 Plan: Highlights5How Plan Coverage WorksPLAN DESIGN FEATUREIN NETWORKOUT OF NETWORKAnnual Deductible(Single/Family)$1,054/$3,162$2,108/$6,324CoinsuranceYou pay 30% of eligible expenses after deductibleYou pay 50% of eligible expenses after deductible, plus difference between charge and allowed amountPreventive CareOffice visit: $39Specialist visit: $92Only certain services are coveredOffice visits (non-preventive)Office visit: $39Specialist visit: $92You pay 50% after deductibleInpatient Care$329 copay, then 30% after deductible$329 copay, then 50% after deductibleEmergency Room$329 copay, then 30% after deductible$329 copay, then 50% after deductible

6. Enhanced 80/20 Plan: Highlights6How Plan Coverage WorksPLAN DESIGN FEATUREIN NETWORKOUT OF NETWORKAnnual Deductible(Single/Family)$700/$2,100$1,400/$4,200CoinsuranceYou pay 20% of eligible expenses after deductibleYou pay 40% of eligible expenses after deductible, plus difference between charge and allowed amountPreventive CareCovered at 100%Not coveredOffice visits (non-preventive)Office visit: $30 ($15 if you use the PCP on your ID card)Specialist visit: $70 ($60 if you use a Blue Options designated specialist)You pay 40% after deductibleInpatient Care$233 copay, then 20% after deductible; copay not applied if you use Blue Options designated hospital$233 copay, then 40% after deductibleEmergency Room$233 copay, then 20% after deductible; copay not applied if you use Blue Options designated hospital$233 copay, then 40% after deductible

7. CDHP (with HRA): Highlights7How Plan Coverage WorksPLAN DESIGN FEATUREIN NETWORKOUT OF NETWORKHRAThe Plan funds your Health Reimbursement Account (HRA ) annually based on coverage level you elect (Employee, Employee +1, Employee + 2 or more)Annual Deductible(Single/Family)$1,500/$4,500$3,000/$9,000CoinsuranceYou pay 15% of eligible expenses after deductibleYou pay 35% of eligible expenses after deductible, plus difference between charge and allowed amountPreventive CareCovered at 100%Not coveredOffice visits (non-preventive)You pay 15% after deductible; $25 added to HRA if you use PCP on ID; $20 added to HRA if you use Blue Options designated specialistYou pay 35% after deductibleInpatient CareYou pay 15% after deductible; $200 added to HRA if a Blue Options designated hospital is utilizedYou pay 35% after deductibleEmergency RoomYou pay 15% after deductible; $200 added to HRA if a Blue Options designated hospital is utilizedYou pay 35% after deductible

8. Prescription Coverage – 70/30 and 80/20 PlansPrescription coverage (In-Network) provided by Medco: 70/30-Generic: $15 copay, up to 30-day supply 70/30-Preferred Brand-name: $46 copay, up to 30-day supply70/30-Non-preferred Brand-name: $72 copay, up to 30-day supply70/30-Specialty: 25% coinsurance up to $100 per 30-day supply70/30-ACA preventive medications: not applicable80/20-Generic: $12 copay, up to 30-day supply80/20-Preferred Brand-name: $40 copay, up to 30-day supply80/20-Non-preferred Brand-name: $64 copay, up to 30-day supply80/20-Specialty: 25% coinsurance up to $100 per 30-day supply80/20-ACA preventive medications: covered at 100% 8

9. Prescription coverage (Out-of-Network) provided by Medco:Applicable copay and the difference between charge and allowed amount for both the 70/30 & the 80/20 PlanACA preventive medications covered at 100% for 80/20 Plan; not applicable for 70/30 Plan

10. Prescription Coverage – CDHP Prescription coverage (in-network) provided by Medco:Generic, Preferred Brand-name, Non-Preferred Brand-name: 15% coinsurance after deductibleACA preventive medications covered at 100%CDHP Preventive Medications covered at 15%, no deductiblePrescription coverage (out-of-network) provided by Medco:Generic, Preferred Brand-name, Non-Preferred Brand-name: 35% coinsurance after deductibleACA preventive medications covered at 100%CDHP Preventive Medications covered at 15%, no deductible10

11. Additional Health Plan ResourcesNC HealthSmart: voluntary program offering tools and resources to help you live a healthier life such as: Member Focus newsletter, information on the 24-hour nurse line, the Stork Rewards program, Eat Smart, Move More, Weigh Less programSign up for the State Health Plan Member Newsletter at www.shpnc.org11

12. Complete up to Three Wellness Activities80/20 Plan Premium CreditsCDHP PlanPremium CreditsSubscriber attests to being a non-smoker/commits to a cessation programand attests for spouse if applicable$40 per month$40 per monthSubscriber (only) completes a confidential Health Assessment (HA)$25 per month$20 per monthSubscriber and any covered dependents selects a Primary Care Provider$25 per month$20 per monthReduce your premium by up to…$90 per month$80 per monthLower Your Premiums with Wellness Premium Credits—

13. Consumer-Directed Health Plan (CDHP) with HRAA different kind of health plan with two componentsHealth Reimbursement Account (HRA)High-Deductible Health PlanThe Plan funds the members’ Health Reimbursement Accounts (HRA) annuallyHRA funding is based on the number of family members covered$600 for employee/retiree only$1,200 for employee/retiree + 1 $1,800 for employee/retiree + 2 or more dependentsHRA funds are used to pay a portion of the members’ deductibles & coinsuranceOnce the HRA is depleted, the member must pay the remaining deductible & coinsuranceIncentives available to add value to HRAUnused HRA funds are available the following year Covers the same services as other Plan options through the same PPO network The deductible is higher than other Plan options, but the coinsurance is lowerIn-network: $1,500 Individual/$4,500 FamilyOut-of-Network: $3,000 Individual/ $9,000 Family After the deductible is met, the member only pays the 15% coinsurance The deductible applies to both Pharmacy and Medical expenses If the member reaches his or her deductible and coinsurance out-of-pocket maximum, the Plan pays 100% of the covered expenses for the rest of the benefit year (medical and pharmacy)

14. How The HRA Helps The Member Meet Their DeductibleEmployee OnlyOut-of-NetworkRemaining Deductible $2,400$1,500Remaining Deductible $900First $600In-Network$3500Total DeductibleHRA PaysYou PayEmployee + One Family MemberOut-of-NetworkRemaining Deductible $4,800$3000Remaining Deductible $1,800In-Network$7000First $1,200Employee + Two or more Family MembersOut-of-NetworkRemaining Deductible $7,200$4,500*Remaining Deductible $2,700In-Network$9,000First $1,800Coverage Type*The HRA is a pooled account and is available to whichever family member needs it first. It is possible for one family member to use all the funds before another family member has a claim.

15. How the Consumer-Directed Health Plan with HRA Works#1#2#3#4#5#6To monitor HRA balance and claim’s payments, members may go online to www.shpnc.org and click on My Member Services.

16. Monthly Rates for Health Coverage16Medical CoveragePLANEMPLOYEEONLYWellness Premium Credits*Net Monthly PremiumEmployee Only*EMPLOYEE+ CHILDRENEMPLOYEE+ SPOUSEEMPLOYEE + FAMILYTraditional 70/30 Plan$0.00N/A$0.00$210.92$543.46$578.86Enhanced 80/20 Plan$104.20$90.00*$14.20*$294.72*$660.52*$699.42*CDHP$80.00$80.00*$0.00*$189.82*$489.14*$520.96*If you are enrolled in the Enhanced 80/20 Plan or the Consumer-Directed Health Plan, you will have the opportunity to earn wellness premium credits each year, which will reduce your monthly premiumsHealth insurance premiums are paid one month in advance of coverage (i.e., January premiums pay for February coverage) No pre-existing condition exclusion*Assumes completion of three wellness activities

17. NCFlex Health & Other Insurance Programs

18. NCFlex Health & Other Insurance ProgramsThese voluntary programs provide a variety of plans to meet the needs of you and your familyYou pay the full cost of coverage through payroll deductions on a pre-tax basisPrograms include: Dental, Vision, Health Care Flexible Spending Account, Dependent Day Care Flexible Spending Account, Cancer, Critical Illness, Group Term Life Insurance, Core AD&D and Voluntary AD&D Insurance18

19. Dental CoverageCoverage provided through United ConcordiaChoose from two plan options:High Option: Includes orthodontia for children under 19Low Option: Does not include orthodontiaUnder both options:Visit any providerYou are responsible for deductiblesYou or your dentist may file claimsYou may be subject to a waiting period before certain benefits are payable under the plan (see “Benefit Waiting Period” chart under Dental coverage on NCFlex website)19

20. Dental Coverage20How Plan Coverage Works under Each OptionPLAN DESIGN FEATUREHIGH OPTION LOW OPTIONAnnual Deductible$50 person/$150 family$25 person/$75 familyPreventive/Diagnostic ServicesExams, cleanings, X-rays, etc.Plan pays 100% on eligible expenses, no deductiblePlan pays 100% on eligible expenses after deductibleBasic ServicesFillings, extractions, endodontics, periodonticsMost services: You pay 20% after deductible Periodontic: You pay 50% after deductibleFillings and extractions: You pay 50% after deductiblePeriodontic and other services: You pay 50% after deductible Major ServicesCrowns, inlays, dentures, bridgesYou pay 50% after deductibleNot coveredMaximum Annual Benefit$2,500 per person (excluding orthodontia)$1,000 per personOrthodontia for dependent children under age 19Plan pays 50% up to $1,500 lifetime benefit per personNot covered

21. Monthly Rates for Dental Coverage21Dental CoveragePLANEMPLOYEEONLYEMPLOYEE + SPOUSEEMPLOYEE + ONE CHILDEMPLOYEE + TWO OR MORE CHILDRENFAMILYHigh Option$36.88$73.96$70.96$89.70$130.58Low Option$21.22$42.78$41.04$52.28$73.22

22. Vision CoverageCoverage provided through Superior Vision Services (SVS)Choose from three coverage options:Core WellnessBasic PlanEnhanced PlanUnder all options, visit any provider but may pay lower expenses with in-network SVS provider22

23. Vision Coverage: Core Wellness Plan23How Plan Coverage WorksPLAN DESIGN FEATUREIN NETWORKOUT OF NETWORKAnnual Comprehensive Eye ExamPlan pays 100% after $20 copayNot coveredFrames and LensesDiscounts availableNot covered

24. Vision Coverage: Basic and Enhanced Plan24How Plan Coverage WorksPLAN DESIGN FEATUREIN NETWORKOUT OF NETWORKRoutine Eye Exam$20 copayUp to $44 allowance for ophthalmologistUp to $39 allowance for optometristFrames – once every 24 monthsUp to $125 allowance ($175 allowance for Enhanced Plan) plus 20% discount on coveragesUp to $50 allowance ($81 for Enhanced Plan) LensesPlan pays 100%Plan pays up to:Single vision: $34Bifocal: $48Trifocal: $64Lenticular: $88Contact Lenses (elective)Plan pays up to $120 ($150 for Enhanced Plan) allowancePlan pays up to $100 allowanceContact Lenses (necessary)Plan pays 100%Plan pays up to $210 allowance

25. Monthly Rates for Vision Coverage25Vision Coverage PLAN EMPLOYEE ONLYFAMILYCore Wellness$0.00N/AExam and Materials$5.56$15.46Enhanced Exam and Materials$8.58$22.88

26. Health Care Flexible Spending AccountCoverage provided through P&A GroupSet aside money through pre-tax contributions to pay for eligible out-of-pocket medical, dental and vision expenses:DeductiblesCo-pays and coinsuranceOut-of-network expensesUncovered proceduresContribute from $120 to $2,550 per yearConvenience card (debit card) for all participants“Use it or lose it” rule; you forfeit any unused contributionsExpenses can be incurred between January 1, 2016 and March 15, 2017, provided you remain actively employed for all of 2016. Prior year claims must be submitted by April 30, 2017.26

27. Dependent Day Care Flexible Spending AccountSet aside money through pre-tax contributions to pay eligible child care and adult day care expenses so you (and your spouse) can work or attend school full-time:Care of dependent children under age 13Care of dependent adult who lives with you at least 8 hrs/dayYou may contribute from $120 to $5,000 per year“Use it or lose it” rule: you forfeit any unused contributionsExpenses can be incurred between January 1, 2016 and March 15, 2017, provided you remain actively employed for all of 2016. Prior year claims must be submitted by April 30, 2017.27

28. Other NCFlex Health ProgramsCancer Insurance provided through American Heritage Life: pays benefits for cancer-related expensesEmployee Only or Employee + Family CoverageLow, High and Premium optionsCritical Illness Insurance provided through Met Life: pays lump sum benefit in event of certain health conditions Employee, Spouse, Children or Family CoverageThree categories of coverage available28

29. Monthly Rates for Cancer Coverage29Cancer InsurancePLANEMPLOYEE ONLYEMPLOYEE + FAMILYLow Option$6.38$10.56High Option$15.18$25.16Premium Option$20.28$33.54

30. Monthly Rates for Critical Illness Coverage30Critical Illness CoverageAGEEMPLOYEESPOUSELess than 25$1.30$1.3025-29$1.40$1.4030-34$2.60$2.6035-39$4.10$4.1040-44$7.40$7.4045-49$12.00$12.0050-54$18.60$18.6055-59$27.80$27.8060-64$42.60$42.6065-69$64.20$64.2070-74$84.40$84.4075-79$101.40$101.4080-84$119.50$119.5085 and older$119.50$119.50Employees may also cover eligible dependent children.

31. Voluntary Group Term Life InsuranceGroup Term Life provided through INGCoverage available for yourself, your spouse and child(ren). You must be enrolled to cover your spouse/child(ren) Employee only and Employee & Spouse coverage in $10,000 increments, from $20,000 to $500,000 (limited to five times your base annual earnings); spouse coverage cannot exceed 100% of employee’s elected amountCoverage over $100,000 subject to Evidence of Insurability (EOI)Dependent child(ren) coverage for $5,000 or $10,00031

32. Monthly Rates for Life Insurance Coverage32Voluntary Group Term Life InsuranceYOUR AGERATE PER $1,000 OF COVERAGEUnder 24$0.05025-29$0.06030-34$0.08035-39$0.09040-44$0.10045-49$0.15050-54$0.25055-59$0.46060-64$0.72065-69$1.48070-74$2.200

33. Monthly Rates for Life Insurance Coverage33Voluntary Group Term Life Insurance for Child(ren)Per Dependent Unit$5,000$0.68$10,000$1.36

34. Accident InsuranceCore Accidental Death and Dismemberment (AD&D) Insurance provided through A.C. NewmanElect coverage of $10,000 for yourself onlyUniversity pays full cost of coverage; however, you must enroll for coveragePayment to your beneficiaries in case of your accidental deathPayment to you in case of your accidental dismembermentVoluntary AD&D Insurance provided through A.C. NewmanElect coverage up to $500,000 for you and your familyYou pay the full cost of coverage34

35. Monthly Rates for Accident Insurance35Accidental Death & Dismemberment (AD&D) Insurance (Examples)BENEFIT AMOUNTEMPLOYEE ONLY COVERAGEEMPLOYEE + FAMILY COVERAGE$50,000$0.96$1.50$75,000$1.42$2.26$100,000$1.90$3.00$125,000$2.38$3.74$150,000$2.86$4.50$175,000$3.32$5.26$200,000$3.80$6.00$250,000$4.76$7.50$300,000$5.70$9.00$350,000$6.64$10.50$400,000$7.60$12.00$500,000$9.50$15.00

36. Income Protection Programs

37. Income Protection ProgramsPrograms designed to provide you and/or your family with financial protection in the event of your death, disability or long-term illnessSome are offered at no cost to you; others require you to pay for coverage37

38. Disability PlansDisability coverage provided under the Disability Income Plan of North Carolina (DIP-NC)Short-Term Disability Provided to eligible employees at no costAfter one year of contributing membership to TSERS or participation in the ORP.Pays 50% of base compensation up to $3,000/monthPayable up to 365 days, after 60-day waiting periodLong-Term Disability Provided to eligible employees at no costAfter five years of contributing membership to TSERS or participation in ORPPays 65% of base compensation up to $3,900/monthPayable as long as you remain permanently disabled, until eligibility for unreduced service retirement38

39. Supplemental Disability PlansCan help fill gaps in State coverage Replacement income while you are ineligible for state Short-Term Disability PlanWaiting period: 90 daysPays 66-2/3% of gross monthly salary up to $10,000Voluntary benefit; you pay full cost of coverage after-tax Coverage through The Standard if you elect ORPIncludes continuing ORP contributions into your ORP account on your behalfCoverage through Liberty Mutual if you elect TSERS39

40. Retirement Programs

41. Retirement ProgramsParticipation in a retirement program is mandatoryYou may choose between:The North Carolina Teachers' and State Employees' Retirement System (TSERS), a defined benefit plan or The UNC Optional Retirement Program (ORP), a defined contribution plan5 year vesting You contribute 6% of your pay on pre-tax basisYou must make your election between TSERS and ORP within 60 days of your date of hireOnce you make the choice it cannot be changed; it is irrevocable41

42. TSERS Plan HighlightsDefined benefit planState controls the investmentBenefit you receive is based on a formula (factors include your age, your average final compensation and your years/months of creditable service)42

43. ORP Plan HighlightsDefined contribution planYou control your investmentsThe benefit you receive at retirement is based on investment performance and payment option chosenEach provider has a four-tier structure for their fund lineup. Choose from two investment providers: Fidelity InvestmentsTIAA-CREF43

44. Retirement Plan ResourcesTo review the booklet in greater detail, click on the picture to open the document.Or copy and paste these addresses:http://www.northcarolina.edu/hr/Mandatory_Retirement_Plan_Decision_Guide.pdfhttp://www.northcarolina.edu/hr/Guide_to_Investing.pdf

45. Your Retirement, Your Choice Video45

46. Retirement Plan Resources46Two more resources to assist you in making a decision between TSERS and the ORP. Click on the either image to open a link to that tool.

47. Supplemental Retirement PlansAllows you to put money away on a pre-tax basis for your retirement in addition to the 6% you contribute to TSERS or the ORPThere are three types of plans available403(b) plan administered by two different vendors, Fidelity and TIAA-CREF, and sponsored by the University A 401(k) plan administered through Prudential and sponsored by the State of North Carolina A 457 plan administered through Prudential and sponsored by the State of North Carolina You may elect to begin, change the amount you contribute or stop your participation at anytimeYou may elect to participate in the 403(b), 401(k) and the 457 at the same time, however there are limits to the amount you can contribute47

48. Full-time faculty and staff who are eligible for membership in the retirement system are eligible to enroll in (3) three courses per academic year at a reduced rate, subject to approval by the employee's supervisor and Human Resources.Tuition Assistance Sitehttp://www.wcu.edu/about-wcu/campus-services-and-operations/human-resources-and-payroll/general-hr-resources/benefits/tuition-assistance.aspWCU Employee Tuition Waiver

49. Health ServicesUniversity Health Services (UHS) provides convenient care for faculty and staff in the Bird Building.  UHS does not replace primary care services, but compliments that care by providing quick assessment and treatment of common complaints such as colds, sore throats, and headache. Health Center Information Center for Family Medicine located in the Health and Human Sciences Building. Clinic open to anyone in need of primary care. Patti Sparling, a family nurse practitioner who received her advanced practice nursing degree from WCU, provides excellent care and will mentor nurse practitioner students rotating through the clinic. To make an appointment, call 828-631-8800.

50. Enrolling in Your Benefits

51. When Coverage Becomes Effective51Coverage Effective DatesPLAN NAMECOVERAGE EFFECTIVEHealth BenefitsFirst of the month or first of the second month following employment dateNCFlex BenefitsFirst of the month following employment dateShort-Term DisabilityAfter one year of contributing membership to TSERS or ORPLong-Term DisabilityAfter five years of contributing membership to TSERS or ORPSupplemental Disability PlanEmployment dateTSERSEmployment dateORPEmployment dateSupplemental Retirement PlansMay enroll at anytime

52. Enrollment for Health BenefitsYou must enroll within 30 days of your employment dateLink to enrollment site: https://shp-login.hrintouch.com/ Health insurance premiums are paid one month in advance of coverage (i.e., January premiums pay for February coverage)No pre-existing condition exclusion or waiting periods if you enroll when first eligible52

53. Enrollment for Income Protection ProgramsAll employees must complete online enrollment within 60 days of their employment dateEnroll for Supplemental Disability Insurance (after-tax) through The Standard, if you choose the UNC ORP, by completing the enrollment forms located online at http://www.northcarolina.edu/hr/unc/benefits/financial/index.htmEnroll for Supplemental Disability Insurance (after-tax) through Liberty Mutual, if you choose TSERS, by completing the enrollment forms located online at http://www.northcarolina.edu/hr/unc/benefits/financial/index.htm53

54. Enrollment in TSERSYou do not need to complete an enrollment form for TSERS, but will be automatically enrolled. You must designate a beneficiary by completing the following forms: Form 2DB - Designating Beneficiary(ies) for the Death Benefit Form 2RC - Designating Beneficiary(ies) for The Retirement System Return of Contributions For these two forms visit https://orbit.myncretirement.com/Orbit/Info/Pages/ListAllForms.aspx?formCat=F3BENDESG54

55. Enrollment in the ORPYou must complete the following forms:Form ORP-1 The University of North Carolina Optional Retirement Program (ORP) Election And Forfeiture AgreementORP Carrier Enrollment Application (Complete the ORP Carrier form(s) for the carrier you want for your contributions and the University contributions.)Follow the instructions provided by your campus Human Resources/Benefits Office for instructions on where to return formsYou must enroll within 60 days of your date of hire or you will automatically be enrolled in TSERS55

56. Enrollment in theSupplemental Retirement Plans403(b) PlanVisit www.northcarolina.edu/hr/ga/benefits/retirement/Suppmtl-Ret/403bMain.htmComplete a Salary Reduction Agreement (form and instructions available on the website)Enroll in the Plan with Fidelity and/or TIAA-CREF457 PlanVisit www.retirement.prudential.com/cws/ncplansComplete an NC 457 Deferred Compensation Plan Enrollment Form (forms and instructions available on the website)Send the form to:NC Plans Processing Center, PO Box 5340, Scranton, PA 18505, or fax to 1-866-439-860256

57. Enrollment in the Supplemental Retirement PlansState 401(k) PlanVisit www.retirement.prudential.com/cws/ncplansComplete an NC 401(k) Plan Enrollment Form (forms and instructions available on the websiteSend the form to:NC Plans Processing Center, PO Box 5340 Scranton, PA 18505, or fax to 1-866-439-860257

58. For More InformationVisit www.northcarolina.edu/hr/unc/benefits/index.htm for more information about the benefits provided by The University of North Carolina system. You may also check http://www.wcu.edu/about-wcu/campus-services-and-operations/human-resources-and-payroll/contact-human-resources-and-payroll.asp for WCU’s HR and Payroll Office contacts.58