An Employee’s
Guide to Benefits
For Fiscal Year 2014
Insurance Retirement Paid Leave Flex Plan
Employee Wellness
Mandatory Benefits
Statement of Purpose: The Piedmont Triad Regional Council hires and maintains staff that is at the top of their field. Employees of this stature deserve the most comprehensive and competitive benefits we can provide within our means. We believe that healthy employees with good piece of mind are productive employees. Therefore, this plan offers top level health benefits in all areas of interest to our employees – physical and emotional. We also pledge to assist our employees with their plan for life changes and life after work by providing competitive plans for leave and retirement. If there are gaps in our offerings that you feel will help you and the rest of our staff you are encouraged to communicate that to the leadership team for future consideration.
Matthew Dolge
Insurance Coverage
Group Health Insurance – 100% of the employee premium for medical insurance coverage is paid. Employees may elect to obtain dependent coverage at their own expense.
The health insurance premium rates for FY 2014 are as follows:
Employee Only / Employee + Spouse / Employee + Child(ren) / FamilyPaid in Full by PTRC
A Value of $170.01 / Employee Portion
$228.81 / Employee Portion
$161.50 / Employee Portion
$388.96
The current provider’s website, Blue Cross Blue Shield, may be accessed via www.bcbsnc.com.
PTRC uses a Health Reimbursement Arrangement (HRA) to keep insurance costs low and deliver excellent benefits to employees. Please see “Explanation of the HRA Plan” at the end of this publication for more information.
Group Dental Insurance – 100% of the employee premium for dental insurance coverage is paid. Employees may elect to obtain dependent coverage at their own expense.
The dependent dental insurance rates for FY 2014 are as follows:
Employee Only / Employee + Spouse / Employee + Child(ren) / FamilyPaid in Full by PTRC A Value of $16.85 / Employee Portion
$16.85 / Employee Portion
$18.46 / Employee Portion
$27.23
Forms for the current provider’s website, North Carolina Municipal Insurance Trust, may be accessed via
www.nclm.org/risk‐management/benefits/employers/Pages/Forms.aspx
Group Vision Insurance – 100% of the employee premium for vision insurance coverage is paid. The dependent dental insurance rates for FY 2014 are as follows:
Employee Only / Employee + One / Employee + Children / FamilyPaid in Full by PTRC
A Value of $2.47 / Employee Portion
$2.42 / Employee Portion
$2.33 / Employee Portion
$4.82
Group Life Insurance ‐ $50,000 life insurance is provided at no cost to the employee. Additional insurance can be purchased under this plan for employees and their dependents in additional increments of $10,000 up to a maximum of $300,000. Some age limits apply to coverage, as well as coverage limits for child(ren) coverage. Evidence of insurability may be required for certain coverage levels. Conversion privilege is available.
Supplemental Insurance and Accidental Death and Disability Insurance – Various supplemental and accidental death and disability policies are available for the employee to purchase through payroll deduction.
AFLAC’s website is available for review at www.aflac.com, or you may contact our broker, Tom
Luebchow, directly at (336) 945‐2520.
Retirement
Retirement – PTRC is a participating employer in the North Carolina Local Governmental
Employees’ Retirement System (LGERS). Employees are required to participate and contribute
6% of their gross earnings. This is a state program authorized by the General Assembly and managed by the North Carolina Treasurer’s Office. PTRC pays the employer portion of the retirement plan and has elected to provide and contribute for the death benefit.
Handbooks and forms are available from the Treasurer’s website via www.nctreasurer.com/dsthome/RetirementSystems.
North Carolina Supplemental Retirement Plan 401(k) ‐ Employees may contribute to this plan pre‐tax through payroll deduction and choose their investment portfolio. The PTRC makes an employer contribution of 2.5% of your gross earnings.
Forms and additional information related to the 401(k) plan are available from Prudential
Retirement at www.retirement.prudential.com/cws/ncplans/flash_index.html.
Deferred Compensation – Employees may also contribute to a deferred compensation plan
(Section 457 of the Internal Revenue Code) through payroll deduction.
Forms and additional information are available via the Nationwide Retirement Solutions website at www.nrsforu.com.
Paid Leave
Holidays – PTRC schedules eleven to twelve paid holidays per year.
Holiday / Date Observed for FY 2014Independence Day / Thursday, July 4
Labor Day / Monday, September 2
Veteran’s Day / Monday, November 11
Thanksgiving Holidays / Thursday, Friday November 28 and 29
Christmas Holidays / Monday, Tuesday, and Wednesday
December 24, 25, 26
New Years Day / Wednesday, January 1
Martin Luther King’s Birthday / Monday, January 20
Good Friday / Friday, April 18
Memorial Day / Monday, May 26
Vacation Leave – Employees earn vacation leave according to length of service. The maximum accumulation of vacation leave is 240 hours or 32 days. Vacation leave accumulated over 240 hours convert to sick leave at the end of the fiscal year. Vacation leave is earned on an hourly pro‐rata basis.
Length of Service / Days / Hours(Earned on an hourly pro‐rata basis)
Less than 2 years / 12 days / 90 hours (7.5 hrs. per mo.)
2 to 4 years / 13 days / 97.5 hours (8.125 hrs. per mo.)
5 to 9 years / 16 days / 120 hours (10 hrs. per mo.)
10 to 14 years / 19 days / 142.5 hours (11.875 hrs. per mo.)
15 to 19 years / 22 days / 165 hours (13.75 hrs. per mo.)
20 or more years / 25 days / 187.5 hours (15.625 hrs. per mo.)
Sick Leave – Employees earn one day of sick leave for each month of service completed, or 12 days per year, 7.5 hours per month. Sick leave is earned on an hourly pro‐rata basis.
Family Medical Leave – Full-time PTRC employees with the requisite service are eligible for benefits under the Federal Family Medical Leave Act. This law provides safeguards to employees who need time off to deal with longer term personal or family medical issues. Please contact the human resources department if you need to inquire about long-term leave.
Flex Plan (Section 125 Plan)
A Flex Plan (also known as Section 125 Plan or Cafeteria Plan) gives preferential tax treatment to three types of expenses which otherwise are paid with after‐tax dollars. These "out‐of‐ pocket" expenses include employer‐sponsored insurance premiums, eligible medical/dental/vision expenses, and work‐related dependent care (child care).
Deductible Reimbursement Plan provides that the premiums paid for dependents on PTRC’s group health and dental plans are deducted and paid with pre‐tax dollars. All employees electing dependent coverage on group health plans are automatically enrolled. If an employee wishes to opt out of the deductible reimbursement plan, a waiver form must be submitted.
Medical/Dental/Vision flex plan can be used to pay for eligible unreimbursed medical expenses (not covered or paid by any insurance) incurred by you, your spouse, and your dependents regardless of whether they are covered by PTRC’s group insurance plans.
Dependent Care flex plan can be used to pay for eligible dependent care expenses (daycare, childcare) so you and your spouse can work, look for work, or attend school full‐time.
Covered expenses must be for the following:
· Dependent children age 12 and under; or
· A person of any age whom you claim as a dependent on your taxes and who is mentally or physically incapable of caring for himself or herself.
Eligible expenses include childcare (nursery, preschool or private sitter), before and after school care, and day camps.
Information on rules governing participation in the flex plan can be obtained by visiting www.probenefits.com (PTRC’s third party administrator).
Disclaimer – This is a simplified description of the Flex “FSA” Plan. The Flex “FSA” Plan document is the final authority on all plan benefits and is available for your review and copy. A copy of the Flex “FSA” Plan document is available via ADP Resources – Online Tools.
Employee Wellness
Employee Assistance Program (EAP) – The EAP offers assistance for personal and/or professional concerns by providing free, confidential, short‐term counseling and personal consultation. The EAP has a network of counselors that are located near your home and/or work‐site. They can help you improve or resolve personal difficulties whether big or small, personal or work related.
Some examples of concerns that the EAP addresses include the following:
· / Family conflict / · / Depression and anxiety· / Relationship issues / · / Communication breakdowns
· / Grief and loss / · / Financial difficulties
· / Stress / · / Work related issues
· / Balancing work and family / · / Alcohol or drug use/abuse
Confidentiality is one of the most important features of the EAP. Employees can be confident that their privacy and confidentiality will be honored. No one will know that you have used this resource unless you offer that information or unless someone’s safety is threatened. There is no cost to you for your phone calls or face‐to‐face visits with the EAP.
The EAP is provided by McLaughlin Young Group. For more information on the EAP, please view their website at www.mygroup.com or contact them at 1‐800‐633‐3353.
PatientWays – The PatientWays program is a confidential source providing tools to help employees make informed choices and decisions regarding their healthcare. Employees are provided with the following program services:
· Confidential access to a personal health advocate
· Assistance locating specialists in or outside of networks
· Data on current medical technology/treatment options
· Direction on handling claims/benefit concerns
· Protected health information concerns
· Pathways for support groups
· Assistance with drafting Healthcare
Power of Attorney or Living Will
Additional information related to this benefit can be found at www.patientways.com.
Mandatory Benefits
The PTRC complies with federal and state law to provide all mandatory benefits including workers’ compensation coverage and the employer’s Social Security contributions.
Explanation of the Health Reimbursement Arrangement (HRA Plan)
What is an HRA Plan & How does it work?
Health Reimbursement Arrangements (“HRAs”) allow employers to reimburse employees for certain types of medical expenses. The PTRC’s HRA plan is linked to participation in the group health plan. If you are a participant in the group health plan, you are automatically enrolled in the HRA/Deductible Reimbursement Plan. Eligible expenses may be reimbursed by the HRA Plan for you, as well as family members covered by your group insurance.
Claims & Reimbursement
After you incur eligible medical expenses, you should complete and submit a claim for reimbursement. You must provide a copy of the applicable Explanation of Benefits (“EOB”) provided by the health insurance carrier. Please submit the EOB copy with the claim form. Claim filing instructions and forms are available online at www.probenefits.com
Reimbursement Schedule & Amounts
The HRA Plan will reimburse a portion of eligible in‐network deductible expenses incurred by employees
and/or covered dependents on the PTRC’s group health plan. Out‐of‐network expenses are excluded from reimbursement through the HRA Plan.
Employee only coverage: The employee is solely responsible for the first $250 of incurred in‐network deductible expenses. The HRA Plan will reimburse the remainder of the incurred in‐network deductible expenses. Once the deductible has been satisfied, the employee will be reimbursed for all incurred in‐ network expenses up to the limits of insurance coverage. However, employees are responsible for continuing to submit claims to the HRA Plan administrator (ProBenefits).
Employee + dependents: The maximum responsibility of the employee with dependent coverage is
$500. Regardless of who incurs the expenses, the employee is solely responsible for the first $250 of incurred in‐network deductible expenses. The HRA Plan will reimburse the next $3,250 of the incurred in‐network deductible expenses. The employee is responsible for the next $250 of the incurred in‐ network deductible expenses. Once the $500 deductible has been satisfied, the employee will be reimbursed for all incurred in‐network expenses up to the limits of insurance coverage. However, employees are responsible for continuing to submit claims to the HRA Plan administrator (ProBenefits).
Always remember to have your medical provider file their charges for service through the insurance carrier. The carrier’s contract allows for network discounts that will allow you to pay less out‐of‐pocket for the service provided. The HRA Plan claim should be filed only after the charges have been processed through the health insurance system.
Disclaimer – This is a simplified description of the HRA Plan. The HRA Plan document is the final authority on all plan benefits and is available for your review and copy. A copy of the HRA plan document is available via ADP Resources – Online Tools.