DarlingtonCountySchool District - Summary of 2010 Employee Benefits

The information contained in this handout is designed to summarize the Employee Benefits package offered by the State of South Carolina. For more detailed information on your benefits options please refer to the Employee Insurance Program’s Insurance Benefits Guide, or contact the District Benefits Department at (843) 398-2308 or 398-2309.

Health Plan Options

State Health Plan
Savings Plan / State Health Plan
Standard Plan / BlueChoice
HealthPlan / Cigna
HMO
PROVIDERS /
  • Coverage worldwide
/
  • Coverage worldwide
/
  • All care must be directed by a Primary Care Physician (PCP) & approved by the HMO
/
  • All care must be directed by a Primary Care Physician (PCP) & approved by the HMO

Tobacco users will pay a $25 per month surcharge in addition to their health premium. See “Act Now to Avoid Tobacco Surcharge” on page 1 for details in The Insurance Advantage 2009.
ANNUAL DEDUCTIBLE
Single/Family / (no per-occurrence deductible)
$3,000/$6,000 / $350/$700 / $250/$500 / NONE
HOSPITALIZATION &
EMERGENCY CARE / No per-occurence deductibles or
copay
Medi-Call approval required / Outpatient Hosp.: $75 per visit, deductible
Emergency care: $125 per visit, deductible
Medi-Call approval required / Inpatient: $200 copay
Outpatient: $100 copay /first 3 visits
Emergency care: $125 copay
HMO pays 85% after copays
You pay 15%
Urgent Care: $35 copay, then
HMO pays 100% / Inpatient: $500 copay, per admission,
then HMO pays 80%
Outpatient: $250 copay per admission,
then HMO pays 80%
Emergency: $100 copay,
then HMO pays 100%
COINSURANCE / In-Network Out-of-Network
Plan pays 80% 60%
You pay 20% 40% / In-Network Out-of-Network
Plan pays 80% 60%
You pay 20% 40% / HMO pays 85% after copays & deductible
You pay 15% after copays & deductible / HMO pays 80% after copays
You pay 20% after copays
COINSURANCE MAX
In-Network Single/Family
Out of Network Single/Family / $2,000/$4,000
$4,000/$8,000
(excludes deductible) / $2,000/$4,000
$4,000/$8,000
(excludes deductible) / $2,000/$4,000
(excludes deductible) / $2,000/$4,000
(includes inpatient, outpatient, copays and coinsurance)
PHYSICIAN VISITS / Chiropractic payments limited to $500 a year, per person
______
No Per occurrence deductible
In-Network Out-of-Network
Plan pays 80% 60%
You pay 20% 40%
Preventative Care / Chiropractic payments limited to $2,000 a year, per person
______
$10 Per visit deductible then:
In-Network Out-of-Network
Plan pays 80% 60%
You pay 20% 40%
Preventative Care / $15 PCP copayment
$15 OB/GYN well-woman exam
$40 specialist copayment
$35 urgent care copayment / $15 PCP copayment
$15 OB/GYN well woman exam
$30 specialist copayment
PRESCRIPTION DRUGS / Participating pharmacies only:
You pay allowable cost until deductible is met. Afterward, the plan will reimburse 80% of the allowable cost; you pay 20%. When coinsurance max is reached, Plan will reimburse 100% of allowable cost.
*Pay the Difference / Participating pharmacies only:
$9 generic
$30 preferred brand
$50 non-preferred brand
(up to 31 day supply)
Copay maximum: $2,500
*Pay the Difference / Participating pharmacies only:
$8/$15generic
$35 preferred brand
$55 non-preferred brand
$80/125 specialty
*Generics First / Participating pharmacies only:
$7 generic
$25 preferred brand
$50 non-preferred brand
(up to 30 day supply)
LIFETIME MAX / $2,000,000 / $2,000,000 / $2,000,000 / $2,000,000

State Dental Plan

Class / Services Covered / Deductibles / Percent Covered / Maximum Benefit
Class I – Diagnostic and Preventative / Diagnostic and preventative procedures (x-rays, cleaning and scaling of teeth, fluoride treatments) / None / 100% of allowable charges / $1,000 per person each benefit year combined for Classes I, II & III.
Class II – Basic / Fillings, simple extractions, oral surgery, surgical extractions / $25 annually combined for Classes II & III, limited to 3 per family per year. / 80% of allowable charges / $1,000 per person each benefit year combined for Classes I, II & III.
Class III – Prosthetics / Onlays, crowns, bridges, dentures, repair of prosthetic appliances / $25 annually combined for Classes II & III, limited to 3 per family per year. / 50% of allowable charges / $1,000 per person each benefit year combined for Classes I, II & III.
Class IV - Orthodontia / Limited to covered children under age 19 / None / 50% of allowable charges / $1,000 per lifetime for each covered child.

* The State Dental Plan is administered by BlueCross BlueShield of South Carolina.

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Dental Plus

Supplemental dental coverage is available under a program called Dental Plus. Dental Plus provides a higher level of dental coverage at affordable rates for the same services covered under the State Dental Plan. (Please note that Dental Plus does not offer additional orthodontia benefits). It is not an offset program that pays what the State Dental Plan does not. Instead, it covers the same procedures and services (except orthodontia) at the same percentage rate of coverage as the State Dental Plan, but at a higher allowance, or dollar amount, for the charges. Dental Plus also increases the maximum benefit amount to $2,000 per person each benefit year combined for Classes I, II & III

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NOTE: Employees may only enroll in the State Dental Plan & Dental Plus program or cancel coverage during Open Enrollment (every 2 years) or within 31 days of a special eligibility situation.

NOTE: Employees who choose Dental Plus must pay premiums for the State Dental Plan as well as the Dental Plus Premiums.

Premium Per Month for Both State Dental Plan & Dental Plus

State Dental Plan / Dental Plus / Total
Employee Only / $0.00 / $22.04 / $22.04
Employee/Spouse / $7.64 / $41.72 / $49.36
Employee/Child(ren) / $13.72 / $45.54 / $59.26
Full Family / $21.34 / $65.22 / $86.56

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Health Savings Account

If you enroll in the State Health Plan Savings Plan, you may also elect to participate in a Health Savings Account (HSA). For more information on HSA’s please refer to page 165 in your Insurance Benefits Guide.

Long Term Disability (Basic & Supplemental)

The two long term disability plans offeredare designed to help you protect a portion of your income if you become disabled. The State Basic Long Term Disability plan is provided automatically at no additional cost if you enroll in any one of the four health plans. After you have been disabled for 90 days, the plan will replace 62.5% of your base salary, reduced by deductible income, up to $800 per month. The Supplemental Long Term Disability plan isa voluntary plan. After a 90 day or 180 day waiting period (depending on the plan selected), the plan will replace 65% of the first $12,307.69 of your pre-disability earnings, reduced by deductible income, up to $8,000 per month. The cost is based on your age and the plan selected. Please refer to page 136 in your Insurance Benefits Guide for information on Supplemental Long Term Disability rates

Short Term Disability

Short term disability is available to all full-time employees of DarlingtonCountySchool District. Rates are based on salary and the 14, 29, or 44-day benefit waiting period selected. This plan pays 60 percent of an employee’s salary with a maximum weekly benefit of $1,500.

MoneyPlu$

MoneyPlu$ can help you keep more spendable income by enabling you to pay your health and dental premiums from pre-tax dollars. There are three features to MoneyPlu$ (1) Pretax Group Insurance Premium Feature, (2) Dependent Care Spending Account, and (3) Medical Spending Account (with optional EZ Reimburse MasterCard). There is an administrative fee of $0.28per month for premium conversion and a fee of $3.50 per month for each spending account. (Employees are eligible to participate in the medical spending account feature the first of the year following one full year of employment).

Life Insurance

The State of S.C. provides $3,000 in Term Life Insurance. This coverage is provided to each employee who enrolls in a health plan, at no cost to the employee.

After one year of employment, The South Carolina Retirement System provides an additional term life benefit equal to the employee’s annual salary, at no cost to the employee. This term life benefit is provided to all employees participating with the SCRS or the State ORP retirement plans.

Optional Life Insurance

Full-time, permanent employees may purchase additional term life insurance. Employees can elect coverage in $10,000 increments to a maximum of $500,000. This policy includes accidental death and dismemberment protection. The cost of this insurance is based on the amount of coverage selected and the age of the employee. A rate sheet is included in your benefits package and you may also refer to pages 221- 223 in your Insurance Benefits Guide.

Dependent Life Insurance

Employees may purchase term life insurance coverage for their eligible dependents. Spouse coverage can be selected in $10,000 increments and may not exceed 50% of the employee’s Optional Life coverage or $100,000, whichever is less. Premiums for the spouse’s coverage will be based upon the employee’s age using the Optional Life Insurance rate sheet. Dependent child(ren) can be enrolled in a $15,000 life insurance plan at a premium of $1.24 per month.

Long Term Care Insurance

Employees may purchase Long Term Care insurance through Prudential(877-214-6588. It assists in paying expenses associated with the custodial care of individuals suffering from chronic diseases or long lasting disability. Employees, their spouses, parents and parents-in-law are eligible to participate. Three plan options are available and the cost varies according to the plan and daily benefit amount selected.

Vision Care

Certain providers throughout the state of South Carolina have agreed to charge no more than $60.00 for a routine, comprehensive eye exam. Participating providers have also agreed to give a 20% discount on most eye wear. Provider information can be access through the Employee Insurance Program’s website at MUSC option provides $75 for routine eye exam and $75 towards eyewear per benefit period (2 years). EyeMed Vision does not coordinate with this program.

EyeMed Vision Care

Employees may select this plan as their vision benefit program. This plan replaces Vision Care. The plan allows you to improve your health through a comprehensive eye exam with a participating provider at a cost to you as little as $10 copay and 140 allowance for frames.

Benefit Frequency: Exam once every year and Frames once every two years. Standard Plastic Lenses or Contact Lenses once every year. The plan is available through providers throughout the state of South Carolina. To see a complete list of participating providers near you, go to EIP website at

Employee Assistance Program

To help employees and their families address personal and job related problems that are often faced in life, DarlingtonCountySchool District offers an Employee Assistance Program (EAP). Through CarolinaFamilyCenter and their representatives, you can have a professional and very confidential consultation and/or referral, that is designed to assist those that are facing difficult personal problems.

Retirement Options

  • The State Retirement Plan

All district employees are eligible to participate in this defined benefit retirement program. The employee is vested after five years of creditable service. Employee contributions are tax deferred.

  • Optional Retirement Program

All District employees are eligible to participate in this defined contribution retirement program. Employee contributions are tax deferred.

Trustmark

Employees may purchase permanent voluntary coveragefor themselves, their spouse, their children and their grandchildren. Life, Critical Illness, and Cancer are policiesoffered. For more information on these policies contact Ward Services at 1-800-673-6472.

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