2020-2021 Benefit Guide€¦ · Open Enrollment: May 6-20, 2020 Benefits Effective: September 1, 2020 - August 31, 2021. 2 | WICOMICO COUNTY PUBLIC SCHOOLS 2020-2021 BENEFIT GUIDE

2020-2021 Benefit Guide

Open Enrollment: May 6-20, 2020Benefits Effective: September 1, 2020 - August 31, 2021

2 | WICOMICO COUNTY PUBLIC SCHOOLS 2020-2021 BENEFIT GUIDE

QuestionsWe are here to help with any issues that may arise. If you require assistance with your benefits:

� Call the appropriate insurance carrier. You will need your ID number or Social Security number along with date of service and provider name.

� If you still need assistance, contact the Human Resources Department at 410-677-4595.

If you have questions about... Contact Phone Number Website or Email

Benelogic 1-866-263-1779 [email protected]

Medical Claims CareFirst 1-877-691-5856 www.carefirst.comCareFirst District Office CareFirst 1-410-742-3274 [email protected] Claims Retail CVS Caremark 1-800-241-3371Prescription Mail Order CVS Caremark 1-800-241-3371Dental Claims CareFirst 1-866-891-2802Vision Claims Davis Vision 1-800-783-5602

403(b) and 457(b) PlanVince Reagan,

Lincoln Financial Retirement Consultant

1-703-254-8715 [email protected]

Flexible Spending Account Navia Benefit Solutions 1-800-669-3539www.naviabenefits.com

[email protected]

Long Term Disability Insurance The Standard 1-800-348-3226General Human Resources and Benefit Questions Bunnie Stanley, WCPS 1-410-677-4595

ext. 65316 [email protected]

Voluntary Benefits The Warner Companies 1-866-870-5093 [email protected] - Employee Wellness Program US Wellness 1-844-542-9699 wellness.wcboe.org

[email protected]

Questions ..................................................................2Welcome ....................................................................3Eligibility and Enrollment ........................................4Health Insurance Rates ............................................5Online Enrollment (Benelogic) ................................6WellAware - Wellness Program ...............................7Benefits .....................................................................9

Medical ....................................................................9Pharmacy ................................................................12Retiree Health Insurance ........................................14

Dental ......................................................................15Vision .......................................................................16Voluntary Benefits ...................................................17Basic Life and AD&D ...............................................19Dependent Term Life ...............................................19Voluntary Supplemental Term Life ...........................20Flexible Spending Accounts ....................................21Long Term Disability ................................................22Employee Assistance Program ...............................23403(b) and 457(b) Plans .........................................25

Important Notices .....................................................26

What’s Inside

Questions and What’s Inside

WICOMICO COUNTY PUBLIC SCHOOLS 2020-2021 BENEFIT GUIDE | 3

Wicomico County Public Schools (WCPS) is proud to offer a comprehensive and competitive benefits package to its employees. Whether you are a new employee enrolling in benefits for the first time or considering your benefit options during open enrollment, this guide is designed to help you through the process. Please take the time to review this information and ask questions so you can make the best decisions for you and your family.

� Open Enrollment is from May 6 to May 20, 2020. This is your once a year opportunity to make benefit changes. � As a part of the Coronavirus Aid, Relief, and Economic Security (CARES) Act, many new health care products are

now eligible for purchase with Healthcare FSA funds. Feminine/menstrual care products are now medically eligible products and over-the-counter (OTC) drugs (antihistamines, antacids, cold medications, etc.) no longer require a prescription to be purchased with FSA dollars. You can use your Navia Benefits Card to purchase these items.

� Benefit changes must be submitted through Benelogic and will be effective for the September 1, 2020 to August 31, 2021 plan year. If you are adding a dependent to your health insurance coverage during Open Enrollment, dependent documentation must be submitted to Human Resources by May 29, 2020.

� Benelogic is the employee benefits portal where you will make your benefit elections. A link to Benelogic can be found in the XIA Links or log into Benelogic at wcps.benelogic.com. Your login for Benelogic is the same username and password as your WCPS computer login. More information on page 6.

� The following voluntary benefits cannot be canceled on Benelogic: Life Insurance with Accelerated Death Benefits, Critical Illness Insurance and Short-Term Disability Insurance. To cancel these benefits, contact the Voluntary Benefits Call Center at 1-866-870-5093.

� Earn a wellness incentive valued at up to $200 by participating in the WCPS employee wellness program called WellAware. A link to WellAware is in the XIA Links or log on at wellness.wbcoe.org with your WCPS computer username and password. More information on page 7.

� Flexible Spending Account (FSA) enrollments do not carry forward from one plan year to the next. You must make an FSA election during Open Enrollment to enroll for the next school year.

� The Healthcare Flexible Spending Account (HFSA) carryover rule allows employees to carry over up to $500 in unused funds. When the plan year ends on August 31, 2020, HFSA balances of up to $500 will carry over to the next plan year if you enroll in the HFSA benefit for the 2020-2021 plan year. To enroll in the HFSA benefit for the 2020-2021 plan year, you must make an annual election on Benelogic of at least $20 during Open Enrollment.

� Benefit elections stay in place until the next Open Enrollment period unless you have a Qualifying Life Status Event (QLE) as defined by the IRS. If you have a QLE, benefit changes must be completed within 30 days of the QLE by submitting the request through Benelogic and providing documentation to support the change request to Human Resources.

� Health insurance rates are projected to increase 8.2% for FY 2021. � WCPS continues to evaluate ways to improve the quality of your health care, keep our health plans competitively priced, and

control costs for you and WCPS. We encourage staff to become and remain engaged in these efforts by being educated on the plans and using them wisely. Participate in Employee Wellness programs and activities and partner with your physician to get appropriate preventative screenings. Also, consider programs like First Help (free 24-hour nurse advice line), CareFirst Video Visit with a doctor, mail order pharmacy and generic prescriptions to lower your copays and overall plan costs.

This benefit guide describes the highlights of our benefits in non-technical language. Your specific rights to benefits under the plan are governed solely, and in every respect, by the official documents and not the information in this summary. If there is any discrepancy between the descriptions of the programs as contained in this brochure and the official plan documents, the language of the official document shall prevail as accurate. Please refer to the plan-specific documents for detailed plan information. Any plan benefits may be modified in the future to meet Internal Revenue Service rules or otherwise as decided by Wicomico County Public Schools.

Welcome

Options for Completing Open Enrollment: � Option 1: Use Benelogic, the online portal, to elect your benefits (see page 6). Two ways to log on:

» Launch the Benelogic icon from the XIA Links » Enter wcps.benelogic.com into a web browser and log in with your WCPS computer login and password

� Option 2: New! Telephonic Enrollment – call 1-866-263-1779 to make your benefit elections over the phone. Hours: 8:30 a.m. to 5:00 p.m., Monday through Friday.

Note: Contact the Voluntary Benefits Call Center at 1-866-870-5093, same hours as above, for assistance with Life insurance, Critical Illness, Short Term Disability and Accident coverage. You can elect new coverage/increase/change current coverage, for certain amounts, with no medical questions asked. The Call Center can also assist with cancellation of benefits. For Accident coverage, you can cancel your coverage in Benelogic.


Who is an Eligible Dependent and What Documentation is Required? � Your legal spouse – a copy of the marriage certificate and the spouse’s social security card. � Dependent children – a copy of the official birth certificate and their social security card. Children may be covered on

the health insurance plan up to age 26. � Disabled adult child (special rules apply – contact HR)

When Does Coverage Begin for New Hires? � New hires have 30 days from their date of hire to make their benefit elections and if no

election is made then the benefit(s) is waived � Coverage begins on date of hire for Basic Life and Accidental Death and

Dismemberment Insurance � Coverage begins on the first of the month following date of hire for Medical, Prescription,

Vision, Dental � Coverage begins on the first of the month following thirty (30) days after date of hire for

Flexible Spending Accounts, Supplemental Life, Dependent Life, Long Term Disability, Life Insurance with Accelerated Death Benefits, Critical Illness, Short-Term Disability and Accident Insurance

� 403(b) and 457(b) Retirement Plan – You are eligible to enroll immediately upon your date of hire or any time thereafter. Deductions begin on the first pay period following completion of the enrollment process.

Eligibility and Enrollment

Log on to the CareFirst My Account View personalized information on your claims and out-of-pocket costs online with My Account.

Signing up is easy - visit www.carefirst.com, click on Log In or Register and then Not Yet Registered? to create your account. You’ll need your CareFirst Member ID card.

Additional Tools: � Review up to one year of medical claims � Request an ID card � Sign up for electronic communications and get your information faster and more securely � Download claim forms � Find in-network providers

Mobile Access - view the most-visited information in My Account on your smartphone or tablet. Download the free CareFirst app to your Apple or Android mobile device.


Includes Medical, Prescription, Vision and Dental Coverage

These rates are tentative subject to final adoption of the FY 2021 budget by WCPS.

Coverage LevelEPO Plan PPO Plan

Employee Cost Per Pay

Board Cost Per Pay

Employee Cost Per Pay

Board Cost Per Pay

Employee Only $40.00 $329.80 $45.00 $357.45

Employee + One Child $123.00 $550.51 $135.00 $595.14

Employee + Spouse $174.00 $686.64 $190.00 $741.92

Family Coverage $212.00 $788.49 $232.00 $851.76

Two Earner Family* $80.00 $920.49 $90.00 $993.76

*Two Earner Family = Both the employee and spouse work for WCPS, are both benefit eligible and have dependents.

How to Locate In-Network Providers � Go to www.carefirst.com � As a CareFirst Member, log into My Account then use the “Find a Doctor”. My Account automatically searches

providers for the plans that you are enrolled in.

2020-2021 Estimated Health Insurance Rates


Online Enrollment (Benelogic)

Benelogic is an online portal for benefits enrollment and information. Here you can learn about programs, choose your benefits and beneficiaries, and access tools and resources.

Open Enrollment 2020 – At a WCPS computer, launch the Benelogic icon from the XIA Links. You will land on the Home page of the Employee Portal which has detailed information about Employee Benefits and a WCPS Library of documents and forms.

� Begin your 2020 Open Enrollment event by clicking ‘Go’ in the Attention box on the Home page. � Choose which enrollment path you prefer: Quick Enroll (this option takes you directly to the summary of benefits where

you can quickly access only those plans you want to elect or change) or Step-by-Step (leads you through the benefit election wizard where you can review, elect, or change your benefits).

� Please note: any changes or cancellations of the TransAmerica/Unum plans MUST be completed by calling the The Warner Companies at 1-866-870-5093.

� After reviewing your elections, click the Submit button at the top or the bottom of the page in order to commit your enrollment event.

� Once you have completed your enrollment event, click View Confirmation to display and then print your Enrollment Summary. This Enrollment Summary is always accessible from the Employee Portal.

New Hires – Benefits EnrollmentYou’ve been issued a WCPS username and temporary password. You must reset your password before you can access Benelogic. Follow these steps to reset your password:

� Go to reset.wcboe.org using any web browser � Enter username and temporary password

» USERNAME: enter in your assigned Username ([email protected]) » PASSWORD: enter in Temporary Password (password is case sensitive) » New Password » Confirm New Password

� Password requirements: » 8 characters in length (can be more but not less) » 1 number » Must include 1 upper and 1 lower case letter » Password can not include any part of your name

� Click Submit � Now, you may log into Benelogic to make your benefit elections � Enter wcps.benelogic.com into a web browser. Login with your WCPS username (ex. mworkema – drop the

“@wcboe.org”) and the password that you just created. � You will land on the Home page of the Employee Portal. � Begin making your benefit elections by clicking Go in the Attention box on the Home page. � Benelogic’s enrollment wizard will now take you through each benefit by displaying the plans and coverage levels

available for you to elect. � After you review and submit your elections for Medical, Rx, Dental, Vision and Basic Life/AD&D, click Go again to take

you through the enrollment wizard for the Voluntary products and Flexible Spending Accounts. � Once you have completed both sets of enrollments, click View Confirmation to display and then print your Enrollment

Summary. This Enrollment Summary is always accessible from the Employee Portal.

For technical assistance with the Benelogic Employee Portal, contact Benelogic Client Services at 1-866-263-1779 or [email protected].


WellAware - Wellness Program (5/1/2020−4/30/2021)

We are committed to giving you easy access to a variety of tools and activities to help you improve your health and happiness. We look forward to supporting you in your ongoing wellness journey!

� LEARN SOMETHING NEW - Enroll in interactive online workshops including stress management, goal setting, and physical health.

� INSPIRE OTHERS - Share your wellness story and inspire others on the path to better wellness.

� EARN WELLNESS INCENTIVES - Earn up to $200 in rewards by participating in the WellAware program.

� TRACK YOUR PROGRESS - Use the online health portal and Healthy Path app to see your results and track your goals.

1 2 3 54 6 7

HEALTH: Enter your own measurements and track your results over time or complete a Health Assessment here.

WELLNESS: Choose from over 30 online wellness learning modules! Enroll or cancel your workshops and see your workshop history.

NUTRITION: Calling all foodies! Log your food intake, track your calories, vitamins and minerals, see recipes and so much more. Dig in.

EXERCISE: You want it, you got it! See exercise plans, log your reps, get ideas and stay fit here!

NEWS: Find our latest (or your favorite oldies but goodies) newsletter and blog posts here.

INCENTIVE: Check your status toward your wellness incentive here! Enough said!

REFERENCE: Search the vast knowledge of the health and video library, change your profile and contact us.

1

2

3

5

4

6

7

Check here regularly to see new links and tips and see your dashboard for challenges, resources, information and reminders!

Getting StartedGetting started in the wellness program is easy! Launch the WellAware icon from a WCPS computer or visit wellness.wcboe.org and log in using your WCPS computer login credentials.

Navigating WellAwareWe have a variety of wellness areas to explore on WellAware. Let’s take a tour:


Wellness IncentivesThe resources on WellAware will help you maintain a healthy lifestyle and earn points toward your wellness incentives. By submitting your physician form and completing wellness activities throughout the year, you can earn rewards valued up to $200. The amount of your wellness incentive depends on your participation in the program.

Important Dates:

� Complete physician form by April 30, 2021 � Earn 50 points for Period 1 by October 31, 2020, and/or 50 points for Period 2 by April 30, 2021

Requirements Physician FormDue by 4/30/2021

50 Points in Period 1(5/1/2020 - 10/31/2020)

50 Points in Period 2(11/1/2020 - 4/30/2021)

$100 wellness rewards

OR

$200 wellness rewards

WellAware - Wellness Program (5/1/2020−4/30/2021)

How do I earn points?The WellAware program includes a variety of activities such as reducing your debt, cooking a healthy dinner, or reading a self-help/development book as ways to earn points. Activities in the program are worth between 5-25 points. Visit the WellAware portal and view the “Incentive” section to see the full list of activities and their point value.

How do I qualify for rewards?Once you meet the point goal and qualify for rewards, you may choose from the following incentive: a wearable fitness device, reimbursement for a wellness-related item such as a gym membership, or lower health insurance premiums. More information about incentives and their distribution can be found on the WellAware portal.

Who can participate?All benefit eligible employees may participate in the wellness program.

Is the program mandatory?No. The wellness program is a completely voluntary program. The program is administered according to federal rules permitting employer-sponsored wellness programs that seek to improve associate health or prevent disease, including the Americans with Disabilities Act of 1990, the Genetic Information Nondiscrimination Act of 2008, and the Health Insurance Portability and Accountability Act, as applicable, among others.

What if I am unable to participate in the wellness program due to a medical condition?Contact US Wellness at 844-542-9699 or [email protected] to discuss alternative options that may be available. Please do not contact the HR department to discuss health matters related to the wellness program.

Will my personal health information be shared with my employer?No. WCPS does not have access to your personal health information. US Wellness, WCPS’ wellness vendor, provides WCPS with aggregate health reports to understand the population as a whole and to determine future programs and resources to offer. For more information, please refer to the US Wellness Terms of Use on the WellAware portal or contact US Wellness at [email protected].

Have another question? We are glad to help! Contact US Wellness at [email protected] or 844-542-9699.


You have a choice between two medical options: a Preferred Provider Option (PPO) and an Exclusive Provider Option (EPO). Both give you access to a quality network of practitioners and hospitals in Maryland along with access to a national network. You may receive services from any provider. The benefit you receive will be based upon the network status of the provider as well as the plan you are enrolled in.

An Exclusive Provider Option (EPO) is a PPO Plan that does not provide coverage if you visit an out-of-network provider. If you do incur costs with an out-of-network provider, you will be responsible for 100% of the costs. In-network benefits are provided when you use Preferred Providers or In-Network Providers.

Preferred Provider Option (PPO) covers care provided both inside and outside the plan’s provider network. You will pay more out of your own pocket when you use practitioners who do not belong to the Preferred Provider Network. You may be required to pay a deductible and a greater portion of the cost of medical treatment. You may also need to file a claim.

NameEPO Option PPO Option

In-Network You Pay1,2 In-Network You Pay1,2 Out-of-Network You Pay1,3

FIRSTHELP—24/7 NURSE ADVICE LINEFree advice from a registered nurse. Visit: carefirst.com/needcare to learn more about your options for care.

When your doctor is not available, call FirstHelp at 800-535-9700 to speak with a registered nurse about your health questions and treatment options.

ANNUAL DEDUCTIBLE (Benefit period)4

Individual None None $200

Family None None $600

ANNUAL OUT-OF-POCKET MAXIMUM (Benefit period)5

Medical6 $1,200 Individual/$3,600 Family $1,200 Individual/$3,600 Family

Prescription Drug6 $5,400 Individual/$9,600 Family $5,400 Individual/$9,600 Family

LIFETIME MAXIMUM BENEFITLifetime Maximum None None

PREVENTIVE SERVICESWell-Child Care (including exams & immunizations) No charge* No charge* 20% of Allowed Benefit

Adult Physical Examination (including routine GYN visit) No charge* No charge* Deductible, then 20% of AB

Breast Cancer Screening No charge* No charge* CareFirst pays 100% of AB

Pap Test No charge* No charge* CareFirst pays 100% of AB

Prostate Cancer Screening No charge* No charge* CareFirst pays 100% of AB

Colorectal Cancer Screening No charge* No charge* CareFirst pays 100% of AB

OFFICE VISITS, LABS AND TESTINGOffice Visits for Illness $20 PCP/$30 Specialist per visit $20 PCP/$30 Specialist per visit Deductible, then 20% of AB

Imaging (MRA/MRS, MRI, PET, CAT scans) & X-ray Office/Freestanding Facility $20 PCP/$30 Specialist per visit $20 PCP/$30 Specialist per visit

Lab No charge* $20 PCP/$30 Specialist per visit

Allergy Testing/Allergy Shots $5 per visit $5 per visit Deductible, then 20% of AB

Allergy Serum $45 per visit $45 per visit Deductible, then 20% of AB

Outpatient Surgical Services

Outpatient Facility—$50 per visitOutpatient Physician—$30 per visit

Outpatient Office—$20 PCP/$30 Specialist


Outpatient Office—$20 PCP/$30 Specialist

Deductible, then 20% of AB

Physical, Speech and Occupational Therapy (limited to 50 visits/calendar for each type of therapy)


Outpatient Office—$30 per visit


Outpatient Office—$30 per visitDeductible, then 20% of AB

Radiation, Chemotherapy and Renal Dialysis No charge* Outpatient Facility-$40 per visitOutpatient Physician/Office-$30 per visit Deductible, then 20% of AB

Chiropractic/Acupuncture $30 per visit (limited to 20 visits/calendar year) $30 per visit Deductible, then 20% of AB

AB = Allowed BenefitThis summary is for comparison purposes only and does not create rights not given through the benefits contract.

Medical


Medical

NameEPO Option PPO Option

In-Network You Pay1,2 In-Network You Pay1,2 Out-of-Network You Pay1,3

EMERGENCY SERVICESUrgent Care Center $20 per visit $20 per visit Deductible, then 20% of AB

Emergency Room—Facility Services $150 per visit $150 per visit

Emergency Room—Physician Services $30 per visit $30 per visit

Ambulance (if medically necessary) No charge* No charge*

HOSPITALIZATION (Members are responsible for applicable physician and facility fees)Outpatient Facility Services $40 per visit $40 per visit Deductible, then 20% of AB

Outpatient Physician Services $20 PCP/$30 Specialist per visit $20 PCP/$30 Specialist per visit Deductible, then 20% of AB

Inpatient Facility Services $100 per admission $100 per admission Deductible, then $100 per admission, then 20% of AB

Inpatient Physician Services No charge* No charge* Deductible, then 20% of AB

HOSPITAL ALTERNATIVESHome Health Care/Hospice No charge* No charge* 20% of AB

Skilled Nursing Facility $100 per admission $100 per admission Deductible, then $100 per admission, then 20% of AB

MATERNITYPreventive Prenatal and Postnatal Office Visits No charge* No charge* Deductible, then 20% of AB

Delivery and Facility Services $100 per admission $100 per admission Deductible, then $100 per admission, then 20% of AB

Nursery Care of Newborn No charge* No charge* Deductible, then 20% of AB

Artificial and Intrauterine Insemination No charge* No charge* Deductible, then 20% of AB

In Vitro Fertilization Procedures7 (limited to 3 attempts per live birth up to $100,000 lifetime maximum)

No charge* No charge* Deductible, then 20% of AB

MENTAL HEALTH AND SUBSTANCE ABUSE (Members are responsible for applicable physician and facility fees)

Inpatient Facility Services $100 per admission $100 per admission Deductible, then $100 per admission, then 20% of AB

Inpatient Physician Services No charge* No charge* Deductible, then 20% of AB

Outpatient Facility Services/Outpatient Physician Services $30 per visit $30 per visit Deductible, then 20% of AB

Office Visits $20 per visit $20 per visit Deductible, then 20% of AB

Medication Management $20 per visit $20 per visit Deductible, then 20% of AB

MEDICAL DEVICES AND SUPPLIESDurable Medical Equipment No charge* No charge* Deductible, then 20% of AB

Hearing Aids for ages 0-18 (limited to 1 hearing aid per hearing impaired ear every 3 years) No charge* No charge*

Adult Hearing Exam Outpatient Physician-$30 per visit Office-$20 per visit

Outpatient Physician-$30 per visit Office-$20 per visit Deductible, then 20% of AB

Adult Hearing Aid (limited to 1 hearing aid per hearing impaired ear every 3 years; benefit limited to $1,000 maximum/hearing aid device)

No charge* No charge* Deductible, then 20% of AB

Hair Prosthesis (one per benefit period; not to exceed $350 maximum) No charge* No charge* Deductible, then 20% of AB

AB = Allowed Benefit* No copayment or coinsurance.1 When multiple services are rendered on the same day by more than one provider, Member payments are required for each provider.2 In-network: When covered services are rendered by a provider in the Preferred Provider network, care is reimbursed at the in-network level. In-network coinsurances are based on a percentage of the Allowed Benefit. The Allowed Benefit is generally the contracted rates or fee schedules that Preferred Providers have agreed to accept as payment for covered services. These payments are established by CareFirst BlueCross BlueShield (CareFirst), however, in certain circumstances, the Allowed Benefit for a Preferred Provider may be established by law.3 Out-of-network: When covered services are rendered by a provider not in the Preferred Provider network, care is reimbursed as out-of-network. Out-of-network coinsurances are based on a percentage of the Allowed Benefit. The Allowed Benefit is generally the contracted rates or fee schedules that Preferred Providers have agreed to accept as payment of covered services. These payments are established by CareFirst, however, in certain circumstances, the Allowed Benefit for an out-of-network provider may be established by law. When services are rendered by Non-Preferred Providers, charges in excess of the Allowed Benefit are the member’s responsibility.4 For family coverage only: When one family member meets the individual deductible, they can start receiving benefits. Each family member cannot contribute more than the individual deductible amount. The family deductible must be met before the remaining family members can start receiving benefits5 For Family coverage only: When one family member meets the individual out-of-pocket maximum, their services will be covered at 100% up to the Allowed Benefit. Each family member cannot contribute more than the individual out-of-pocket maximum amount. The family out-of-pocket maximum must be met before the services for all remaining family members will be covered at 100% up to the Allowed Benefit.6 Plan has separate out-of-pocket maximums for medical and drug expenses which accumulate independently.7 Members who are unable to conceive have coverage for the evaluation of infertility services performed to confirm an infertility diagnosis, and some treatment options for infertility. Preauthorization required.


Medical

CareFirst Mobile AppDownload the free app to your Apple or Android mobile device by searching for CareFirst in your favorite app store. Or type www.carefirst.com into your mobile web browser and you will be directed to our mobile site.

CareFirst Video Visit See a doctor 24/7 without an appointment! You can consult with a board-certified doctor on your smartphone, tablet or computer. Get treatment for common health issues such as allergies, a sinus infection, a cold or the flu. You can also schedule video visits for: therapy/psychiatry, diet/nutrition, and breastfeeding support. Visit www.carefirst.com/needcare for more information.

Free CareFirst Wellness Programs - SharecareTo get started, visit carefirst.com/sharecare. Enter your CareFirst My Account username and password and complete the one-time registration with Sharecare to experience the customized CareFirst program. Once you register, you can access your wellness resources from the web or download the Sharecare app from the App Store or Google Play.

One-on-One Health CoachingMembers have access to personal health coaching. You may also receive a call inviting you to participate. Lifestyle coaching can assist with tobacco cessation, weight management, physical activity, stress management, and healthy eating. Disease management coaching is available for asthma, diabetes, coronary artery disease, congestive heart failure, COPD, chronic low back pain, osteoarthritis, atrial fibrillation, irritable bowel syndrome, and fibromyalgia. We encourage you to take advantage of this voluntary and confidential phone-based program that can help you achieve your best possible health by calling 877-260-3253.

Scale Back Lifestyle Change ProgramScale Back is an interactive, telemedicine-based lifestyle change program offered at no cost through our wellness partner, Sharecare. Scale Back helps participants lose 5-10% of their body weight and significantly reduce the risk of developing type 2 diabetes and associated chronic diseases. Anyone who has either been identified as having prediabetes or at risk of developing prediabetes may be eligible to participate.

Craving to QuitTobacco use is the leading cause of preventable death and disease in the US. But quitting can be easier than you think with Craving to Quit, the Sharecare tobacco cessation program. It uses proven methods including the Craving to Quit app, telephonic support and online education. This voluntary, confidential program is free to health insurance participants.

Financial Well-Being™, powered by Dave RamseyFinancial expert Dave Ramsey will show you how to take small steps toward big improvements in your financial situation. Whether you want to stop living paycheck to paycheck, get out of debt, or send a child to college, the Financial Well-Being program can help.

Inspirations and Relax 360°Inspirations and Relax 360° can help you take control of stress. Both tools offer relaxation and wellness videos that help you experience freedom from stress, unwind at the end of the day, or ease into a restful night of sleep. Inspirations provides soothing video content for stress reduction and ambient white noise for sleep. Or enjoy the scenic sights and sounds of a 360° view of nature with Relax 360°.

To learn more, log in to My Account at carefirst.com/myaccount or call 877-260-3253.


Prescription Drug PlanRetail Pharmacies: CVS Caremark (CVS) is CareFirst’s Pharmacy Benefit Manager. Pharmacies in this network are not limited to CVS and include most independent and large retail pharmacies locally and nationally. You can receive your retail prescriptions from any pharmacy you choose. If a pharmacy is non-participating with CVS Caremark, you will be required to pay the full cost of the prescription at the time of purchase. Claims for these prescriptions should be sent to CVS Caremark on the appropriate claim form. Call CVS Caremark at 1-800-241-3371 to find a location near you or to verify that a particular pharmacy is participating.

Maintenance Choice offers you options and savings when it comes to filling your maintenance medications. Maintenance medications are drugs taken regularly for an ongoing condition such as high blood pressure, diabetes, etc. With Maintenance Choice, you can get up to a three-month supply of your maintenance drugs for the cost of a one- month supply. There are two ways to save when filling your maintenance drug prescriptions – CVS Mail Service and CVS Retail Pharmacy.

CVS Mail Service Pharmacy

� Enjoy convenient home delivery service � Refill your prescriptions online, by phone or email � Check account balances and make payments through an automated phone system � Sign up to receive email notifications of order status � Access a consulting pharmacist by phone 24 hours a day

CVS Retail Pharmacy

� Access the entire network of CVS pharmacies � Pick up your medications at a time convenient to you � Enjoy same-day prescription availability � Talk with a pharmacist face-to-face

If you fill a three-month prescription at any other retail pharmacy, you will pay three copays for each 90-day supply.

Prescription Drug Website Capabilities: www.carefirst.com � Drug Search - Look up drugs - search by drug name or by drug category. Find out what tier a drug falls under and

determine your copayment. See if there are alternatives available. � Get a Preferred Drug List � Prior Authorization - Search the list of drugs that require prior authorization � Maintenance Information - Get a listing of maintenance medications on the preferred drug list � Quantity Limits Information - See if your medication has a limitation on how much is prescribed at a given time � Rx News - Get the latest news concerning the Rx benefit including changes to the preferred drug list � Pharmacy Locater - Look up a pharmacy nationwide

Pharmacy Benefits


Prescription Drug Copays The copay amount is the dollar amount the pharmacy will collect for your prescription. Copays are determined by the type of prescription drug purchased (Tier).

Formulary 2 ■ 5-Tier ■ $50 Deductible ■ $10/35/50 ■ Specialty $35/50Plan Feature Amount You Pay DescriptionIndividual Deductible $50

Out-of-Pocket Maximum Individual—$5,400

Preventive Drugs(up to a 34-day supply) $0 (not subject to the deductible) A preventive drug is a prescribed medication or item on

CareFirst’s Preventive Drug List.*

Diabetic Supplies(up to a 34-day supply) $0 (not subject to the deductible) Diabetic supplies include needles, lancets, test strips and alcohol

swabs.

Generic Drugs (Tier 1)(up to a 34-day supply) $10 Generic drugs are covered at this copay level.

Preferred Brand Drugs (Tier 2)(up to a 34-day supply) $35 All preferred brand drugs are covered at this copay level.

Non-preferred Brand Drugs (Tier 3)(up to a 34-day supply) $50

All non-preferred brand drugs on this copay level are not on the Preferred Drug List.* Discuss using alternatives with your physician or pharmacist.

Preferred Specialty Drugs (Tier 4)(up to a 34-day supply) $35 Must be filled through Exclusive Specialty Pharmacy Network.

Non-preferred Specialty Drugs (Tier 5)(up to a 34-day supply)

$50 Must be filled through Exclusive Specialty Pharmacy Network.

Maintenance Drugs(up to a 90-day supply)

Mail order or CVS:Generic: $10Preferred Brand: $35Non-preferred Brand: $50Preferred Specialty: $35Non-preferred Specialty: $50

At any other Retail:Generic: $30Preferred Brand: $105Non-preferred Brand: $150Preferred Specialty: N/ANon-preferred Specialty: N/A

Non-specialty maintenance drugs (Tiers 1, 2 and 3): Up to a 90-day supply is available for one monthly copay through Mail Service Pharmacy or a CVS retail pharmacy. A 90-day supply is available at any pharmacy for three copays.

Specialty maintenance drugs (Tiers 4 and 5): Maintenance specialty drugs must be filled through Exclusive SpecialtyPharmacy Network. Up to a 90-day supply is available for one monthly copay through Exclusive Specialty Pharmacy Network.

* Visit carefirst.com/rxgroup for the most up-to-date drug lists, including the prescription guidelines. Prescription guidelines indicate drugs that require your doctor to obtain prior authorization from CareFirst before they can be filled and drugs that can be filled in limited quantities.

This plan summary is for comparison purposes only and does not create rights not given through the benefit plan.

Pharmacy Benefits


Retiree Health Insurance

The following chart defines eligibility requirements for retiree health insurance. Both the eligibility for retiree health insurance and the amount of the Board contribution is determined by hire/rehire date and bargaining unit. “Rehire Date” refers to a benefited employee who separates from employment then is rehired back at a later date as a benefited employee. The “later date” of re-employment is the rehire date. The rehire date will determine eligibility for retiree health insurance.

An employee must be enrolled in the MD State Retirement System or Aetna Pension Plan and enter retirement directly from service with WCBOE to be eligible for retiree health insurance. Additionally, the employee must be enrolled in the employee health insurance plan for at least one full plan year immediately prior to retirement. Refer to the Board policy titled “Health Insurance Benefit for Retired Employees Policy” for the full list of conditions that apply to retiree health insurance. This policy is subject to change at the sole discretion of Wicomico County Board of Education. Retiree health insurance rates can be found at wcboe.org.

Eligibility for Retiree Health Insurance

Bargaining Unit Hire or Rehire Date Minimum Years of Service

Board Contribution for Retiree

Board Contribution for Retiree’s Dependents

Unit 1 - Teachers Before 7/1/2016 10 70% 0%

Unit 1 - Teachers On or After 7/1/201615 to 19.920 to 24.925 or more

50%60%70%

0%0%0%

Unit 2 - Admin. & Supervisors All 10 70% 0%

Unit 3 - Classified Before to 7/1/2016 10 70% 0%

Unit 3 - Classified On or After 7/1/201615 to 19.920 to 24.925 or more

50%60%70%

0%0%0%


A Preferred (PPO) Dental coverage is offered through CareFirst. Reduce your out-of-pocket expenses by visiting a dentist who participates in our network of preferred and traditional providers. Non-participating providers may bill you the difference between the CareFirst allowed benefit and the provider’s total charge.

In-Network You Pay Out-of-Network You Pay

Preferred Dental Provider

Traditional Dental ORNon-Participating Dental

ProviderDeductible Applies to All Basic and Major ServicesThere is a separate deductible for in-and out-of-network services

$25 Individual $75 Family

$25 Individual $75 Family

Annual Maximum Applies to All Services Except Orthodontic Plan pays $1,000 per member

PREVENTIVE & DIAGNOSTIC SERVICES PLAN PAYMENT• Oral Exams (two per benefit period)• Prophylaxis (two cleanings per

benefit period)• Bitewing X-rays• Full mouth X-ray or panograph and

bitewing X-ray combination and one cephalometric X-ray (once per 36 months)

• Fluoride treatments (two per benefit period per member, until the end of the year the member reaches the age 19)

• Sealants on permanent molars (once per tooth per 36 months per member, until the end of the year the member reaches the age 19)

• Space maintainers (once per 60 months)

• Palliative emergency treatment

80% of Allowed Benefit1

BASIC SERVICES• Direct placement fillings using

approved materials (one filling per surface per 12 months)

• Periodontal scaling and root plan-ing (once per 24 months, one full mouth treatment)

• Simple extractions

50% of Allowed Benefit after deductible1

MAJOR SERVICES—SURGICAL• Surgical periodontic services

including osseous surgery, mucogingival surgery and occlusal adjustments (once per 60 months)

• Endodontics (treatment as required involving the root and pulp of the tooth, such as root canal therapy)

• Oral surgery (surgical extractions, treatment for cysts, tumor and abscesses, apicoectomy and hemi-section)

• General anesthesia rendered for a covered dental service


MAJOR SERVICES—RESTORATIVE• Full and/or partial dentures (once

per 60 months)• Fixed bridges, crowns, inlays and

onlays (once per 60 months)• Denture adjustments and relining

(limits apply for regular and immediate dentures)

• Recementation of crowns, inlays and/or bridges (once per 12 months)

• Repair of prosthetic appliances as required (once in any 12 month period per specific area of appliance)

• Dental implants, subject to medical necessity review (once per 60 months)


ORTHODONTIC SERVICES• Benefits for orthodontic services may be available for covered members

under age 19 who meet treatment criteria.50% of

Allowed Benefit150% of

Allowed Benefit1

• Orthodontic Lifetime Maximum Plan pays $1,500 per member

1 NOTE: CareFirst payments are based on the CareFirst Allowed Benefit. Participating and Preferred Dentists accept 100% of the CareFirst Allowed Benefit as payment in full for covered services. Non-participating dentists may bill the member for the difference between the Allowed Benefit and their charges.

Summary of Exclusions: Not all services and procedures are covered by your benefits contract. This plan summary is for comparison purposes only and does not create rights not given through the benefit plan.

Dental


BlueVision Plus

Professional vision services including routine eye examinations, eyeglasses and contact lenses offered by CareFirst BlueCross BlueShield, through the Davis Vision, Inc. national network of providers.

How the plan worksHow do I find a provider?To find a provider, go to carefirst.com and utilize the Find a Provider feature or call Davis Vision at 800-783-5602 for a list of network providers closest to you. Be sure to ask your provider if he or she participates with the Davis Vision network before you receive care.

How do I receive care from a network provider?Simply call your provider and schedule an appointment. There are no claim forms to file.

What if I go out-of-network?Staying in-network gives you the best benefit, but BlueVision Plus does offer an out-of-network allowance schedule as well. You will be responsible for all payments up-front. You will also be responsible for filing the claim with Davis Vision for reimbursement and paying any balances over the allowed benefit to the non-participating provider.

Can I get contacts and eyeglasses in the same benefit period?With BlueVision Plus, the benefit covers one pair of eyeglasses or a supply of contact lenses per benefit period.

In-Network You PayEYE EXAMINATIONSRoutine Eye Examination with dilation (per benefit period) No copay

FRAMESDavis Vision Frame Collection $20 for approximately 400 frames

Non-Collection Frame Plan pays $45 towards wholesale price (or equivalent allowance at a retailer), you pay balance

SPECTACLE LENSESBasic Single Vision (including lenticular lenses) $20

Basic Bifocal $20

Basic Trifocal $20

CONTACT LENSES (initial supply)Medically Necessary Contacts No copay with prior approval

Davis Vision Contact Lens Collection $40

Other Single Vision Contact Lenses Plan pays $97, you pay balance

Other Bifocal Contact Lenses Plan pays $127, you pay balance

A more detailed Summary of Vision Benefits is on www.wcboe.org under Benefits for Current Employees then Vision.

Vision

ExclusionsThe following services are excluded from coverage:1. Diagnostic services, except as listed in What’s Covered under the Evidence of Coverage.2. Medical care or surgery. Covered services related to medical conditions of the eye may be covered under the Evidence of Coverage.3. Prescription drugs obtained and self-administered by the Member for outpatient use unless the prescription drug is specifically covered under the Evidence of Coverage or a rider or endorsement purchased by your Group and attached to the Evidence of Coverage.4. Services or supplies not specifically approved by the Vision Care Designee where required in What’s Covered under the Evidence of Coverage.5. Orthoptics, vision training and low vision aids.6. Replacement, within the same benefit period of frames, lenses or contact lenses that were lost.7. Non-prescription glasses, sunglasses or contact lenses.8. Vision Care services for cosmetic use.


Life Insurance with Accelerated Death Benefits for Chronic ConditionsLife Insurance will be offered to WCPS employees at very affordable rates through Transamerica Life Insurance Company. The premiums are based on the death benefit you select, your tobacco status, and your age when the policy is issued. Your premiums will never increase due to your age.

Coverage is available for you, your spouse, your eligible dependent children and your grandchildren. For new hires, guaranteed issue underwriting is available. This means there are no medical questions asked for the amounts of coverage listed below.

Employee – up to $150,000Spouse – up to $25,000Child Life – $25,000

During Open Enrollment, employees (other than new hires) choosing coverage for the first time, can elect up to $50,000 and $25,000 for child coverage, without medical questions. Employees who have existing coverage and want additional coverage can elect coverage in increments of $25,000 ($100,000 maximum including existing coverage) without medical questions. For spouse coverage, you can enroll by meeting with a Benefit Counselor or contacting the call center at 866-870-5093.

Included coverage at no extra cost:

� Chronic Conditions - provides a benefit if you have the inability to perform at least two activities of daily living (ADL) without substantial assistance or suffer severe cognitive impairment that is expected to be permanent. ADL examples include eating, bathing, transferring, dressing, etc.

� All coverage is portable. � Life insurance that has a guaranteed 3% interest rate. � Convenience of payroll deduction.

Voluntary Critical Illness InsuranceWCPS employees have the opportunity to enroll in the voluntary Critical Illness insurance plan through Transamerica Life Insurance Company. Critical Illness insurance can help relieve the financial impact of a sudden, life-threatening illness. The policy provides a lump sum cash benefit upon the diagnosis of a covered critical illness. Covered critical illnesses are limited to the specific definitions found in the policy. Examples of covered illnesses include:

� Heart attack � Stroke � Cancer � Burns

A Wellness Benefit of $100 per insured per calendar year is available for completing certain cancer screening tests.

Lump sum cash benefits are intended to help cover some of the expenses not covered by medical insurance. Examples include: experimental treatments, out-of-pocket deductibles and copays, child care, travel expenses, and anything else you choose. Coverage is portable.

You can purchase coverage for yourself, for yourself and your children, or for your entire family. For new hires, there is guarantee issue of $40,000 with no medical questions asked. During Open Enrollment, employees other than new hires, can elect up to $25,000 without medical questions. Employees with existing policies who want to increase their coverage can increase by one increment of $5,000 ($40,000 maximum including existing coverage).

� Permanent paralysis � Major organ transplant surgery � End-stage renal (kidney) failure � Coronary bypass surgery

Voluntary Benefits


Voluntary Short-Term Disability Income Insurance This type of insurance is designed to help protect your income if you ever get sick or hurt and cannot work. Disability Income Insurance helps replace up to 60% of your salary if you are unable to work because of a disability. You can select the benefit amount you want to receive per month in $100 increments. You can elect up to $2,500 per month during this enrollment without answering any medical questions if you are electing coverage for the first time. For new hires, coverage is guaranteed issue up to $4,000 with no medical questions asked. Employees with existing policies can increase their coverage by $300 ($4,000 maximum including existing coverage). The plan requires you use your sick leave days first and then the elected disability income plan benefits will start.

Premiums will be waived once an insured employee has been totally disabled for 90 days or met the elimination period, whichever is later. Voluntary Short-Term Disability Income Insurance is offered through Transamerica Life Insurance Company.

Accident Insurance Accident insurance is designed to help you with out-of-pocket expenses associated with an off-the-job accidental injury. Lump sum benefits are paid directly to you based on the amount of coverage listed in the schedule of benefits and are in addition to any other coverage you may have including health insurance.

All coverage is guaranteed issue, so no health questions are required. This coverage is available for you and your family through Unum.

Coverage includes lump sum payments for treatment and services as the result of an accident such as Urgent Care, Hospitalization, Therapy Services, Burns, Fractures and Dislocations, etc.

This coverage also includes a $100 Wellness Benefit. Unum will pay the benefit one time per year, per insured, while coverage is in force, if a covered health test is performed which includes mammography, stress test, chest x-ray, colonoscopy, blood test and much more.

You can also cover your spouse and children and all coverage is portable upon employment ending.

Open Enrollment Period: May 6 - May 20, 2020Licensed Benefit Counselors from The Warner Companies will be available to assist you with your enrollment. Please contact The Warner Companies Call Center at 866-870-5093 to make changes to your voluntary benefits coverage. Benefit Counselors are available from Monday through Friday, 9:00 a.m. – 5:00 p.m.

This is a summary only. Refer to the policy certificate and riders for complete details.

Voluntary Benefits


Basic Term Life Insurance and AD&D BenefitsWCPS provides basic group term life insurance and accidental death and dismemberment (AD&D) insurance to all benefit eligible employees through The Standard. The coverage is automatic and the premiums are 100% employer paid.

Employees enrolled in the Aetna Retirement Plan receive an additional layer of basic term life insurance and AD&D coverage. The coverage is automatic and the premiums are 100% employer paid.

Life Insurance Description Coverage Coverage MaximumBasic Group Term Life All Benefit Eligible Employees 1.5 x Annual Salary $150,000AD&D All Benefit Eligible Employees 1.5 x Annual Salary $150,000Aetna Plan Participants Additional Basic Life & AD&D Aetna Retirement Plan Participants 1 x Annual Salary $100,000

� Life and AD&D Benefits reduce to 75% at age 70 and 67% at age 75. � Benefits terminate at retirement or resignation. � Accelerated Benefit Provision - active employees can elect a payment of up to 90% of the Basic Term Life Insurance

coverage if their life expectancy is twelve (12) months or less

Dependent Term Life Insurance � Coverage Requirement (1) amount of insurance on any dependents may not exceed 100% of employee’s basic and

supplemental life insurance combined (2) if both spouses work for WCPS, dependent life insurance will not provide life insurance coverage for the spouse; only the children will be covered

� Spouse Benefit Coverage - $25,000

� Dependent Child(ren) Benefit Coverage - your child from live birth to age 25 or your disabled child - $10,000

� During Open Enrollment - Evidence of Insurability (EOI) is required for all dependents

� Cost for the coverage is $2.82 per pay regardless of the number of eligible dependents

� 100% employee paid

Portability of Dependent Term Life Insurance and Voluntary Supplemental Term Life Insurance

� If employee retires or resigns, the employee can elect to keep their coverage on a direct-billed basis

� Premiums remain the same as long as WCPS is an active group with The Standard

� Supplemental Term Life benefits will reduce to 60% at age 65; 50% at age 70 and terminate at age 75

Basic Life and AD&D and Dependent Term Life


Voluntary Supplemental Term Life Insurance � Term Life Insurance is available in increments of $10,000 up to $200,000 from The Standard � During Open Enrollment:

» For employees who currently do not have Supplemental Life Insurance, you may elect $10,000 in coverage guarantee issue (no medical review). To elect coverage of more than $10,000, complete the online Evidence of Insurability (EOI).

» Employees with Supplemental Life Insurance may increase their coverage by $10,000 guarantee issue (no medical review). To increase coverage by more than $10,000, complete the online Evidence of Insurability (EOI).

� Rates are based on your age and the coverage amount elected � Rates each plan year are based on the employee’s age as of September 1st � Age Reduction Formula:

» 75% at age 70 » 66 2/3% at age 75

� At initial hire, guarantee issue for any amount up to the $200,000 � Accelerated Benefit Provision - active employee can elect a payment of up to 90% of the Supplemental Term Life

Insurance coverage if their life expectancy is twelve (12) months or less � 100% employee paid

Employee’s Age: Per Pay Deduction for each $10,000 of coverageunder age 30 $0.19Age 30 to 34 $0.25Age 35 to 39 $0.37Age 40 to 44 $0.62Age 45 to 49 $1.11Age 50 to 54 $1.67Age 55 to 59 $2.41Age 60 to 64 $3.64Age 65 to 69 $5.87Age 70 and higher $19.13

Voluntary Supplemental Term Life Insurance


Health Care Flexible Spending Account (HCFSA) Navia Benefit Solutions administers the HCFSA. HCFSA allows you to pay for out-of-pocket medical expenses with tax-free dollars. Think of the HCFSA as a tool to pay for all your regular medical expenses throughout the plan year.

� Expenses for you, your spouse and tax dependents are eligible for reimbursement, even if they are not enrolled on the WCPS health insurance plan.

� The Health Care FSA is a pre-funded benefit. This means you have access to your full annual election amount at any time during the plan year. Annual elections may range from $20 to $2,750.

Carry Over - When the current plan year ends on August 31, 2020, HCFSA balances of up to $500 will carry over to the next plan year if you enroll in the HCFSA benefit for the 2020-2021 plan year by making an annual election of at least $20. Carryover amounts will be credited after the claim filing period ends.

Dependent Care Flexible Spending Accounts (DCFSA) Child care can be one of the single largest expenses for a family with children. A Day Care FSA (DCFSA) or Dependent Care FSA can be used to pay for your qualified day care expenses with pre-tax dollars which can save you up to $1,700 per year!

� The DCFSA limit is set by the IRS and is a calendar year limit of $5,000 per household, $2,500 if married and filing separately.

� Expenses can be for your dependent children 12 and under, and in some cases elder care, and must be enabling you to work, actively look for work or be a full-time student.

Common Eligible Expenses � Prescription drugs � Copays for medical care � Dental work � Orthodontia � Glasses and Contacts � Chiropractic � Over-The-Counter Drugs

Common Eligible Expenses � Child Care � Preschool � Before and after school care � Day Camps

Expenses for school tuition and overnight camps are not eligible.

Health Care & Dependent Care FSAs

How Does it Work? � During Open Enrollment estimate your expenses for the plan year and enroll in the plan � Your annual election amount will be evenly deducted pre-tax from

your paycheck throughout the plan year � You cannot change your annual election amount after Open

Enrollment unless you have a qualified life event such as birth of a baby, marriage or divorce, etc.

Navia MasterCard Rather than filing a claim and waiting for reimbursement, you can use the debit card to pay your provider directly for qualified expenses. Be sure to hang on to your receipts in case Navia needs to see them to verify the expense eligibility. If Navia needs to see a receipt, you will notice an alert on your mobile app and Navia will send you an email reminder.

Flexible Spending Accounts


Long Term DisabilityLong Term Disability (LTD) coverage is a voluntary benefit provided through The Standard and the employee pays 100% of the premium cost. The coverage is guarantee issue (no medical review) if elected at date of hire. If an employee applies for long term disability insurance after their initial hire date, the employee will be subject to a medical review and may be denied the coverage.

There are two Elimination Periods - 90 days and 180 days. The elimination period is the number of days that an employee is absent from work before the coverage begins to replace their monthly income.

The coverage replaces 60% of your base pay. The maximum monthly benefit is $7,658.

The LTD benefit amount is determined by multiplying your insured pre-disability earnings by a specified benefit percentage which is 60%. The amount is then reduced by other income you receive or are eligible to receive while LTD benefits are payable.

The cost for LTD coverage is based on your annual earnings, your age and whether you elect a 90 day or 180 day elimination period.

Contact Information:

The Standard Customer Service: 1-800-348-3226

Flexible Spending Accounts & Long Term Disability

Health Care & Dependent Care FSAs continuedAccessing Your Benefits Navia wants to make accessing your benefits as simple and efficient as possible.

� Online Account Access: Order additional debit cards, update bank and address information and see up to date details of your benefits.

� Online Claims Submission: Upload your documentation, complete the on line wizard, and a reimbursement will be on its way within a few days!

� Flexconnect: Sync your various medical, dental and vision benefits with your FSA plan for a quick and easy reimbursement. No need to submit documentation, we’ll get it from the insurance carrier!

Open EnrollmentYou must make a Flex Spending Account (FSA) election during Open Enrollment to enroll for the next school year. Your participation in the FSA plan does not continue automatically from one plan year to the next.

MyNavia Mobile AppMyNavia allows you to simply snap a photo and submit for reimbursement direct from your mobile device. The MyNavia app is free to download on both iPhone and Android.


Employee Assistance Program (EAP)

What is an EAP?Your Employee Assistance Program (EAP) provides you and your household members with FREE, confidential assistance to help with personal or professional problems that may interfere with work or family responsibilities.

How Does it Work?A Care Coordinator will confidentially assess the problem, assist with any emergencies and connect you to the appropriate resources. The Care Coordinator then becomes your personal point of contact and will keep in touch to ensure you achieve your desired outcomes.

What is Included?You and your household members can receive up to 6 short-term problem resolution sessions (which include assessment, follow-up and referral services) per issue, per year.

Common Reasons to Call Your EAP � Depression/anxiety � Grief/loss � Trauma � Anger � Job loss/stress � Chronic conditions

� Diagnosis of disease

� Relationship issues � Work-life balance � Career stress � Substance abuse

� Addiction � Suicidal thoughts � Injury/accidents

Program Features: � Services are available

24-hours a day, 7-days a week via a toll-free number.

� This program is a FREE benefit provided and paid for by your employer.

� BHS adheres to federal and state privacy laws and holds client information in the strictest of confidence. Information about a client’s problem cannot be released without the written permission of that individual

Contact Your EAPHelp is just a phone call away. Simply call BHS’ toll-free number: 800-327-2251

MyBHS PortalMyBHS Portal contains a variety of resources to help improve your overall wellbeing, including articles, videos, health assessments, quizzes and interactive tools.You can view program announcements, access Live Chat, read monthly newsletters and tip sheets, register for events, participate in regularly scheduled webcasts and more.

1

2

3

Visit portal.BHSonline.com.

Enter MyBHS username ESMEC and click the “Login Now” button.

Browse through resources including articles, videos, health assessment tools, quizzes and interactive tools.


Employee Assistance Program (EAP)

Work Life Services

BHS provides up-to-date, carefully screened, national resources and referrals for a range of childcare needs including:

■ Adoption and Special Needs ■ Before and After School Programs ■ Emergency and Back-Up Care ■ Family Daycare and Group Homes

■ Nanny and Au Pair Services ■ Nurseries and Preschools ■ Summer Camps

BHS provides up-to-date, national resources and referrals for a range of eldercare needs including: ■ Home-Based Services: Nutrition, Meals on Wheels, Cleaning and Repair

■ Housing: Retirement Communities, Subsidized Housing

■ In-Home Care: Medical and Nursing Rehabilitation Services

■ Inpatient Services: Nursing Homes, Intermediate Care Facilities, Respite Care and Assisted Living Facilities

■ Older Adult Services: Support/ Advocacy Groups, Volunteer Opportunities and Adult Day Care

■ Transportation Services

When faced with a legal matter, simply contact BHS and you will be connected to an attorney with expertise specific to your needs. Legal benefits under the program include:*

■ Free 30-minute consultations ■ In office or telephonic with local plan providers ■ 25 percent off the attorney’s hourly rate when an hourly rate is quoted for services beyond consultation

■ Each consultation must be over a new legal topic ■ Document review up to six pages ■ Simple dispute resolution call or letter

* Limitations and exclusions apply. This benefit summary is intended only to highlight benefits and should not be relied upon to fully determine coverage. EAP legal services are administered by Legal Access Plans, L.L.C. Home Office: 5850 San Felipe, Suite 600, Houston, TX

The EAP provides unlimited telephonic financial consultation, information and education to you and your household members per problem, per year. Should you or your household member need further financial consultation, you will be connected to a local advisor and/ or community resource at a discounted rate. Typical financial matters include:

■ Budgeting ■ College Funding ■ Credit Counseling

■ Debt Management and Consolidation ■ Retirement Funding ■ Tax Planning and Preparation

Locator Services

BHS shall provide participants with a resource that allows for searches to be performed based on specific requirements regarding child and eldercare needs. This resource is available through the MyBHS portal.

CHILDCARE

ELDERCARE

LEGAL

FINANCIAL

LOCATOR

Contact Your EAPHelp is just a phone call away. Simply call BHS’ toll-free number: 800-327-2251


403(b) Plan in BriefA 403(b) retirement plan is similar to a 401(k) plan. Both plans allow participants to set aside additional money for retirement. The 403(b) plan is designed for employees of public schools.

Through the program you may set aside a portion of your income for retirement and invest it. The WCPS 403(b) plan offers investment choices with the Lincoln Financial Group and includes a traditional (pre-tax) and a Roth (post-tax) option.

You have the option of contributing pre-tax and/or post-tax funds to your 403(b) account. Both options offer you the following:

� Participation is voluntary � Allows you the opportunity to accumulate additional retirement funds, as a supplement to your MD State Retirement

System (MSRS) or Aetna Retirement pension � Provides you the option to either contribute a percent of your salary or a flat dollar amount determined by you which is

deducted from your paycheck. The amount of income that can be contributed is subject to IRS limitations. � You may begin participating in the 403(b) Plan at any time � You decide how much to contribute and how to invest your contributions � You can increase, decrease or discontinue your contribution rate at any time � You can set up your contributions to auto increase at any rate and frequency desired until reaching your preferred

maximum level of contribution � A 403(b) account is an individual account with no vesting schedule - you always have 100% ownership of the assets

in your retirement account

What is a 457(b) Plan?The 457(b) is a retirement plan available to public school employees. The 457(b) can be an excellent way to save money for retirement. It can serve as a supplement to a traditional pension plan or other retirement plans such as the 403(b) plan.You determine the pre-tax amount that you want to defer (up to the IRS maximum) and how it is to be invested.

How a 457(b) WorksEmployees may enroll in the 457(b) plan through Lincoln Financial. Contributions to a 457(b) are made on a pre-tax basis.The amount by which the salary is reduced (payroll deduction) is directed to investments offered through Lincoln Financial. These contributions are called elective deferrals and are excluded from the employee’s taxable income. Contributions grow tax-deferred until retirement, when withdrawals are taxed as ordinary income.

Lincoln Financial Retirement Consultant Vince Reagan, the Lincoln Financial Retirement Consultant for Wicomico County Public Schools, has onsite office hours every Thursday. To schedule an appointment use the online scheduler at www.lfg.com/WICOMICOschedule and select from the available appointments. Once you’ve set up your appointment, you’ll receive a confirmation email, as well as a reminder email the day before the appointment. Appointments are 30 minutes in length and are held at the Central Office Building.

Contact Information Vince ReaganPhone: 703-254-8715E-mail: [email protected]

403(b) and 457(b) Plans


COBRAUnder the Consolidated Budget Reconciliation Act (COBRA) of 1985, COBRA qualified beneficiaries (QB’s) generally are eligible for group coverage during a maximum of 18 months for qualifying events due to employment termination or a reduction of hours of work. Certain qualifying events, or a second qualifying event during the initial period of coverage, may permit a beneficiary to receive a maximum of 36 months of coverage.

COBRA coverage is not extended for those terminated for gross misconduct. Upon termination, or other COBRA qualifying event, the former employee and any other QB’s will receive COBRA enrollment information.

Qualifying events for employees include voluntary/ involuntary termination of employment, and the reduction in the number of hours of employment. Qualifying events for spouses or dependent children include those events above, plus, the covered employee’s becoming entitled to Medicare; divorce or legal separation of the covered employee; death of the covered employee; and the loss of dependent status under the plan rules.

If a QB chooses to continue the group benefits under COBRA, they must complete an enrollment form and return it to the Plan Administrator with the appropriate premium due. Upon receipt of premium payment and enrollment form the coverage will be reinstated. Thereafter, premiums are due on the 1st of the month. If the premium payments are not received in a timely manner, Federal Law stipulates that your coverage will be canceled after a 30 day grace period.

If you have any questions about COBRA or the Plan, please contact your HR Department. Please note, if the terms of the Plan and any response you receive from the Plan Administrator’s representative conflict, the Plan document will control.

Coordination of BenefitsCoordination of Benefits applies if you or your covered dependents are insured under more than one health insurance plan. The plans coordinate with each other on payments so that there are no duplicate payments for the same medical service. The order in which payments are made is determined as follows:

The plan that covers the patient as a dependent is the secondary plan.

When a dependent child is covered by the plan of more than one parent (unless court ordered), generally the plan of the parent whose birthday falls earlier in the year is considered the primary plan.

Notice of Grandfathered Health Plan StatusThe Wicomico County Board of Education believes the Wicomico County Public Schools Health Insurance Plan is not a grandfathered health plan under the Patient Protection and Affordable Care Act.

Questions regarding which protections apply and which protections do not apply to a grandfathered health plan and what might cause a plan to change from grandfathered health plan status can be directed to the HR Department. You may also contact the Employee Benefits Security Administration, United States Department of Labor at 1-866-444-3272 or www.dol.gov/ebsa/healthreform. This website has a table summarizing which protections do and do not apply to grandfathered health plans.

HIPAA Privacy NoticeThe HIPAA Privacy Rules require health plans to provide a Notice of Privacy Practices to persons covered under the plan. The initial notice was provided in April 2002 to all current employees and to new hires during orientation. The Rules also require health plans to periodically provide a reminder. This serves as a reminder that the HIPAA Notice of Privacy Practices is available at www.wcboe.org under Human Resources then Health Insurance.

Prescription Drug Coverage and MedicareThe Wicomico County Board of Education has determined that the prescription drug coverage under the Wicomico County Public Schools Health Insurance Plan is considered Creditable Coverage. You can keep this coverage and not pay a higher premium, or penalty, if you later decide to join a Medicare drug plan.

Special Enrollment RightsIf you are declining enrollment for yourself, your spouse, or your dependents in the medical plan because of other medical coverage, you may be able to enroll yourself and your family in this plan if your other coverage ends (provided that you request enrollment within 30 days). In addition, if you have a new dependent as a result of marriage, birth, adoption or placement for adoption, you may be able to enroll yourself and your dependents provided that you request enrollment within 30 days of the marriage, birth, adoption or placement for adoption.

If you decline enrollment for yourself or for an eligible dependent (including your spouse) while Medicaid coverage or coverage under a state children’s health insurance program is in effect, you may be able to enroll yourself and your dependents in this plan if you or your dependents lose eligibility for that other coverage. However, you must request enrollment within 60 days after your or your dependents’ coverage ends under Medicaid or a state children’s health insurance program.

If you or your dependents (including your spouse) become eligible for a state premium assistance subsidy from Medicaid or through a state children’s health insurance program with respect to coverage under this plan, you may be able to enroll yourself and your dependents in this plan. However, you must request enrollment within 60 days after your or your dependents’ determination of eligibility for such assistance.

To request special enrollment or to obtain more information, contact the HR Department.

Women’s Health and Cancer Rights ActAll of The Wicomico County Board of Education medical plans provide benefits for mastectomy-related services including reconstruction and surgery to achieve symmetry between breasts, prostheses, and complications resulting from a mastectomy (including lymphedema). If you have questions, please call the number on your medical plan ID card to speak with a Member Services Representative.

Important Notices


Newborns’ and Mothers’ Health Protection ActGroup health plans and health insurance issuers generally may not, under federal law, restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a vaginal delivery, or less than 96 hours following a cesarean section. However, federal law generally does not prohibit the mother’s or newborn’s attending provider, after consulting with the mother, from discharging the mother or her newborn earlier than 48 hours (or 96 hours as applicable) following delivery. In any case, a plan may not require a physician or other health care provider to obtain authorization for prescribing a hospital stay in accordance with the NMHPA.

USERRA (The Uniformed Services Employment and Reemployment Rights Act)Individuals who voluntarily or involuntarily leave their job to perform military services have the right to elect to continue their existing employer-based health plan coverage for themselves and their dependents for up to 24 months while in the military. Even if individuals don’t elect to continue coverage during their military service, they have a right to be reinstated in their employer’s health plan when they are reemployed, generally without any waiting periods or exclusions (e.g. pre-existing condition exclusions) except for service-connected illnesses or injuries.

Premium Assistance Under Medicaid and the Children’s Health Insurance Program (CHIP)If you or your children are eligible for Medicaid or CHIP and you’re eligible for health coverage from your employer, your state may have a premium assistance program that can help pay for coverage, using funds from their Medicaid or CHIP programs. If you or your children aren’t eligible for Medicaid or CHIP, you won’t be eligible for these premium assistance programs but you may be able to buy individual insurance coverage through the Health Insurance Marketplace. For more information, visit www.healthcare.gov.

If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed below, contact your State Medicaid or CHIP office to find out if premium assistance is available.

If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, contact your State Medicaid or CHIP office or dial 1-877-KIDS NOW or www.insurekidsnow.gov to find out how to apply. If you qualify, ask your state if it has a program that might help you pay the premiums for an employer-sponsored plan.

If you or your dependents are eligible for premium assistance under Medicaid or CHIP, as well as eligible under your employer plan, your employer must allow you to enroll in your employer plan if you aren’t already enrolled. This is called a “special enrollment” opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance. If you have questions about enrolling in your employer plan, contact the Department of Labor at www.askebsa.dol.gov or call 1-866-444-EBSA (3272).If you live in one of the following states, you may be eligible for assistance paying your employer health plan premiums. The following list of states is current as of January 31, 2020. Contact your State for more information on eligibility.ALABAMA – MedicaidWebsite: http://myalhipp.com/Phone: 1-855-692-5447

ALASKA – MedicaidThe AK Health Insurance Premium Payment ProgramWebsite: http://myakhipp.com/ Phone: 1-866-251-4861Email: [email protected]

Medicaid Eligibility: http://dhss.alaska.gov/dpa/Pages/medicaid/default.aspx

ARKANSAS – MedicaidWebsite: http://myarhipp.com/Phone: 1-855-MyARHIPP (855-692-7447)

CALIFORNIA – Medicaid Website: https://www.dhcs.ca.gov/services/Pages/TPLRD_CAU_cont.aspx Phone: 1-800-541-5555

COLORADO – Health First Colorado (Colorado’s Medicaid Program) & Child Health Plan Plus (CHP+)Health First Colorado Website: https://www.healthfirstcolorado.com/ Health First Colorado Member Contact Center: 1-800-221-3943/State Relay 711CHP+: https://www.colorado.gov/pacific/hcpf/child-health-plan-plus CHP+ Customer Service: 1-800-359-1991/State Relay 711

FLORIDA – MedicaidWebsite: http://flmedicaidtplrecovery.com/hipp/Phone: 1-877-357-3268

GEORGIA – Medicaid Website: https://medicaid.georgia.gov/health-insurance-premium-payment-program-hippPhone: 678-564-1162 ext 2131

INDIANA – Medicaid Healthy Indiana Plan for low-income adults 19-64Website: http://www.in.gov/fssa/hip/Phone: 1-877-438-4479All other MedicaidWebsite: http://www.indianamedicaid.comPhone 1-800-403-0864

IOWA – Medicaid and CHIP (Hawki)Medicaid Website: https://dhs.iowa.gov/ime/membersMedicaid Phone: 1-800-338-8366Hawki Website: http://dhs.iowa.gov/HawkiHawki Phone: 1-800-257-8563

KANSAS – MedicaidWebsite: http://www.kdheks.gov/hcf/default.htmPhone: 1-800-792-4884

KENTUCKY – MedicaidKentucky Integrated Health Insurance Premium Payment Program (KI-HIPP) Website: https://chfs.ky.gov/agencies/dms/member/Pages/kihipp.aspxPhone: 1-855-459-6328Email: [email protected] Website: https://kidshealth.ky.gov/Pages/index.aspx Phone: 1-877-524-4718Kentucky Medicaid Website: https://chfs.ky.gov

LOUISIANA – MedicaidWebsite: www.medicaid.la.gov or www.ldh.la.gov/lahippPhone: 1-888-342-6207 (Medicaid hotline) or 1-855-618-5488 (LaHIPP)

MAINE – MedicaidWebsite: http://www.maine.gov/dhhs/ofi/public-assistance/index.htmlPhone: 1-800-442-6003, TTY: Maine relay 711

MASSACHUSETTS – Medicaid and CHIPWebsite: http://www.mass.gov/eohhs/gov/departments/masshealth/Phone: 1-800-862-4840

MINNESOTA – MedicaidWebsite: https://mn.gov/dhs/people-we-serve/children-and-families/health-care/health-care-programs/programs-and-services/medical-assistance.jsp (Under ELIGIBILITY tab, see “what if I have other health insurance?”)Phone: 1-800-657-3739

Important Notices


MISSOURI – MedicaidWebsite: http://www.dss.mo.gov/mhd/participants/pages/hipp.htmPhone: 573-751-2005

MONTANA – MedicaidWebsite: http://dphhs.mt.gov/MontanaHealthcarePrograms/HIPPPhone: 1-800-694-3084

NEBRASKA – Medicaid Website: http://www.ACCESSNebraska.ne.govPhone: 1-855-632-7633Lincoln: 402-473-7000 / Omaha: 402-595-1178

NEVADA – MedicaidMedicaid Website: http://dhcfp.nv.govMedicaid Phone: 1-800-992-0900

NEW HAMPSHIRE – MedicaidWebsite: https://www.dhhs.nh.gov/oii/hipp.htmPhone: 603-271-5218Toll free number for the HIPP program: 1-800-852-3345, ext. 5218

NEW JERSEY – Medicaid and CHIPMedicaid Website: http://www.state.nj.us/humanservices/dmahs/clients/medicaid/Medicaid Phone: 609-631-2392CHIP Website: http://www.njfamilycare.org/index.htmlCHIP Phone: 1-800-701-0710

NEW YORK – MedicaidWebsite: https://www.health.ny.gov/health_care/medicaid/Phone: 1-800-541-2831

NORTH CAROLINA – MedicaidWebsite: https://medicaid.ncdhhs.gov/Phone: 919-855-4100

NORTH DAKOTA – MedicaidWebsite: http://www.nd.gov/dhs/services/medicalserv/medicaid/Phone: 1-844-854-4825

OKLAHOMA – Medicaid and CHIPWebsite: http://www.insureoklahoma.orgPhone: 1-888-365-3742

OREGON – MedicaidWebsite: http://healthcare.oregon.gov/Pages/index.aspx

http://www.oregonhealthcare.gov/index-es.htmlPhone: 1-800-699-9075

PENNSYLVANIA – MedicaidWebsite: https://www.dhs.pa.gov/providers/Providers/Pages/Medical/HIPP-Program.aspxPhone: 1-800-692-7462

RHODE ISLAND – Medicaid and CHIPWebsite: http://www.eohhs.ri.gov/Phone: 1-855-697-4347, or 401-462-0311 (Direct RIte Share Line)

SOUTH CAROLINA – MedicaidWebsite: https://www.scdhhs.govPhone: 1-888-549-0820

SOUTH DAKOTA - MedicaidWebsite: http://dss.sd.govPhone: 1-888-828-0059

TEXAS – MedicaidWebsite: http://gethipptexas.com/Phone: 1-800-440-0493

UTAH – Medicaid and CHIPMedicaid Website: https://medicaid.utah.gov/CHIP Website: http://health.utah.gov/chipPhone: 1-877-543-7669

VERMONT– MedicaidWebsite: http://www.greenmountaincare.org/Phone: 1-800-250-8427

VIRGINIA – Medicaid and CHIPWebsite: https://www.coverva.org/hipp/Medicaid Phone: 1-800-432-5924CHIP Phone: 1-855-242-8282

WASHINGTON – MedicaidWebsite: https://www.hca.wa.gov/ Phone: 1-800-562-3022

WEST VIRGINIA – MedicaidWebsite: http://mywvhipp.com/Toll-free phone: 1-855-699-8447

WISCONSIN – Medicaid and CHIPWebsite: https://www.dhs.wisconsin.gov/publications/p1/p10095.pdfPhone: 1-800-362-3002

WYOMING – MedicaidWebsite: https://wyequalitycare.acs-inc.com/Phone: 307-777-7531

To see if any other states have added a premium assistance program since January 31, 2020, or for more information on special enrollment rights, contact either:

U.S. Department of LaborEmployee Benefits Security Administrationwww.dol.gov/agencies/ebsa1-866-444-EBSA (3272)

U.S. Department of Health and Human ServicesCenters for Medicare & Medicaid Serviceswww.cms.hhs.gov1-877-267-2323, Menu Option 4, Ext. 61565

Paperwork Reduction Act StatementAccording to the Paperwork Reduction Act of 1995 (Pub. L. 104-13) (PRA), no persons are required to respond to a collection of information unless such collection displays a valid Office of Management and Budget (OMB) control number. The Department notes that a Federal agency cannot conduct or sponsor a collection of information unless it is approved by OMB under the PRA, and displays a currently valid OMB control number, and the public is not required to respond to a collection of information unless it displays a currently valid OMB control number. See 44 U.S.C. 3507. Also, notwithstanding any other provisions of law, no person shall be subject to penalty for failing to comply with a collection of information if the collection of information does not display a currently valid OMB control number. See 44 U.S.C. 3512.

The public reporting burden for this collection of information is estimated to average approximately seven minutes per respondent. Interested parties are encouraged to send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the U.S. Department of Labor, Employee Benefits Security Administration, Office of Policy and Research, Attention: PRA Clearance Officer, 200 Constitution Avenue, N.W., Room N-5718, Washington, DC 20210 or email [email protected] and reference the OMB Control Number 1210-0137.

Patient Protection DisclosureThe Wicomico County Board of Education’s medical plan generally does not require the designation of a primary care provider. However, you have the right to designate any primary care provider who participates in our network and who is available to accept you or your family members. For children, you may designate a pediatrician as the primary care provider. You do not need prior authorization from The Wicomico County Board of Education or from any other person (including a primary care provider)

Important Notices


in order to obtain access to obstetrical or gynecological care from a health care professional in our network who specializes in obstetrics or gynecology. The health care professional, however, may be required to comply with certain procedures, including obtaining prior authorization for certain services, following a pre-approved treatment plan, or procedures for making referrals. For information on how to select a primary care provider, or for a list of the participating primary care providers including participating health care professionals who specialize in obstetrics or gynecology, go to www.carefirst.com or call 410-742-3274 for assistance in selecting a PCP or contact Human Resources at 410-677-4595.

The Genetic Information Nondiscrimination Act (GINA) GINA prohibits a group health plan from adjusting group premium or contribution amounts for a group of similarly situated individuals based on the genetic information of members of the group. GINA prohibits a group health plan from requesting or requiring an individual or a family member of an individual to undergo genetic tests. Genetic information means information about an individual’s genetic tests, the genetic tests of family members of the individual, the manifestation of a disease or disorder in family members of the individual or any request for or receipt of genetic services, or participation in clinical research that includes genetic services by the individual or a family member of the individual. The term genetic information includes, with respect to a pregnant woman (or a family member of a pregnant woman) genetic information about the fetus and with respect to an individual using assisted reproductive technology, genetic information about the embryo. Genetic information does not include information about the sex or age of any individual.

Wicomico Public Schools 403(b) Plan - 2020 Universal Availability Notice This notice is required to be provided annually to all employees and provides important information regarding the 403(b) plan in which you are eligible to participate (the “plan”). You may want to take this opportunity to either (1) begin making pre-tax and/or Roth 403(b) elective deferral contributions or (2) review your current elections and decide if you want to make changes. Before making any initial elections or changes, be sure to consult the written plan and any other materials provided to you that explain the terms of the plan.

When can I enroll?You are eligible to enroll immediately upon your date of hire or any time thereafter. You may choose your initial elective deferral rate by visiting LincolnFinancial.com, meeting with a Lincoln Financial Retirement Consultant or speaking with a Lincoln Financial Customer Service Representative by phone at 1-800-234-3500. The Lincoln Financial Retirement Consultant for Wicomico County Public Schools is Vince Reagan and he can be reached at 1-703-254-8715 or [email protected]. Schedule an appointment with Mr. Reagan by using the on online scheduler at https://lfg.com/wicomicoschedule and select from the available time slots. Appointments are held at Central Office, 2424 Northgate Drive, Suite 100, Salisbury, MD 21801.

Can I change or stop my elective deferral contributions?You may change your elective deferral contributions daily during the plan year. You are permitted to revoke or cancel your election at any time during the plan year.

When are my elective deferral contributions effective?After completing the enrollment requirements, your elective deferral contributions will begin on the next pay period or as soon as administratively possible.

What is the maximum amount that I can contribute?The Internal Revenue Code limits the annual contributions you can make to a 403(b) plan and the limits are adjusted each year. The 2020 limits are as follows:

� Elective deferral limit $19,500 � Age 50 catch-up $ 6,500 � 15 years of service catch-up $ 3,000*

* The 15 years of service catch-up contribution applies before the age 50 catch-up contribution and is based on a formula that takes into account all past contributions to the plan and the employee’s total years of service to the employer. The maximum allowable for the 15 years of service catch-up is $3,000 per year up to a $15,000 lifetime benefit, but an employee’s actual catch-up may be lower than this maximum.

Will my employer make additional contributions?In addition to your pre-tax and/or Roth 403(b) elective deferral contributions, the plan may allow for additional employer contributions. Please see your written plan for additional contributions that may be available to you under the plan.

Whom do I contact for additional information?To learn more about 403(b) plans, please visit http://www.irs.gov and search for Publication 571. If you have any questions about how the plan works or your rights and obligations under the plan, please contact your plan administrator at:

Tina M. Vincent, Lead Human Resource Specialist2424 Northgate Dr., Suite 100P.O. Box 1538Salisbury, MD [email protected]

Important Notices


Important Notices

New Health Insurance Marketplace Coverage Options and Your Health Coverage

PART A: General InformationWhen key parts of the health care law took effect in 2014, there began a new way to buy health insurance: the Health Insurance Marketplace. To assist you as you evaluate options for you and your family, this notice provides some basic information about the new Marketplace and employment based health coverage offered by your employer.

What is the Health Insurance Marketplace?The Marketplace is designed to help you find health insurance that meets your needs and fits your budget. The Marketplace offers “one-stop shopping” to find and compare private health insurance options. You may also be eligible for a new kind of tax credit that lowers your monthly premium right away. Open enrollment for health insurance coverage through the Marketplace began in October 2013 for coverage starting January 1, 2014.

Can I Save Money on my Health Insurance Premiums in the Marketplace?You may qualify to save money and lower your monthly premium, but only if your employer does not offer coverage, or offers coverage that doesn’t meet certain standards. The savings on your premium that you’re eligible for depends on your household income.

Does Employer Health Coverage Affect Eligibility for Premium Savings through the Marketplace?Yes. If you have an offer of health coverage from your employer that meets certain standards, you will not be eligible for a tax credit through the Marketplace and may wish to enroll in your employer’s health plan. However, you may be eligible for a tax credit that lowers your monthly premium, or a reduction in certain cost-sharing if your employer does not offer coverage to you at all or does not offer coverage that meets certain standards. If the cost of a plan from your employer that would cover you (and not any other members of your family) is more than 9.5% of your household income for the year, or if the coverage your employer provides does not meet the “minimum value” standard set by the Affordable Care Act, you may be eligible for a tax credit.1

Note: If you purchase a health plan through the Marketplace instead of accepting health coverage offered by your employer, then you may lose the employer contribution (if any) to the employer-offered coverage. Also, this employer contribution -as well as your employee contribution to employer-offered coverage- is often excluded from income for Federal and State income tax purposes. Your payments for coverage through the Marketplace are made on an after-tax basis.

How Can I Get More Information?For more information about your coverage offered by your employer, please check your summary plan description or contact Bunnie Stanley in Human Resources at [email protected] or Ext. 65316 (410.677.4595).

The Marketplace can help you evaluate your coverage options, including your eligibility for coverage through the Marketplace and its cost. Please visit HealthCare.gov for more information, including an online application for health insurance coverage and contact information for a Health Insurance Marketplace in your area.

1 An employer-sponsored health plan meets the "minimum value standard" if the plan's share of the total allowed benefit costs covered by the plan is no less than 60 percent of such costs.


Important Notices

New Health Insurance Marketplace Coverage Options and Your Health Coverage

PART B: Information About Health Coverage Offered by Your EmployerThis section contains information about any health coverage offered by your employer. If you decide to complete an application for coverage in the Marketplace, you will be asked to provide this information. This information is numbered to correspond to the Marketplace application.

3. Employer nameWicomico County Public Schools

4. Employer Identification Number (EIN)52-6001052

5. Employer addressP.O. Box 1538, 2424 Northgate Drive

6. Employer phone number410.677.4400

7. CitySalisbury

8. StateMaryland

9. ZIP code21802-1538

10. Who can we contact about employee health coverage at this job?Bunnie Stanley in Human Resources

11. Phone number (if different from above)410-677-4595

12. Email [email protected]

Here is some basic information about health coverage offered by this employer:

� As your employer, we offer a health plan to: � All employees. : Some employees. Eligible employees are: All eligible, active members of a bargaining unit or a member of the executive staff. Retirees of the Board of Education of Wicomico County who qualify for retiree health insurance according to the Board Policy titled “Health Insurance Benefit for Retired Employees Policy”.

� With respect to dependents: : We do offer coverage. Eligible dependents are: spouse - opposite sex/same sex and dependent children who meet eligibility criteria. You can cover your eligible dependent child through the end of the month in which they turn age 26. Disabled Adult Children must meet the eligibility criteria as stated in the Dependent Eligibility Documentation Requirements chart.

� We do not offer coverage.

: If checked, this coverage meets the minimum value standard, and the cost of this coverage to you is intended to be affordable, based on employee wages.

** Even if your employer intends your coverage to be affordable, you may still be eligible for a premium discount through the Marketplace. The Marketplace will use your household income, along with other factors, to determine whether you may be eligible for a premium discount. If, for example, your wages vary from week to week (perhaps you are an hourly employee or you work on a commission basis), if you are newly employed mid-year, or if you have other income losses, you may still qualify for a premium discount.

If you decide to shop for coverage in the Marketplace, HealthCare.gov will guide you through the process. Here’s the employer information you’ll enter when you visit HealthCare.gov to find out if you can get a tax credit to lower your monthly premiums.

2424 Northgate Drive, Suite 100 Salisbury, Maryland 21801

410-677-4595

Documents

2020-2021 Benefit Guide€¦ · Open Enrollment: May 6-20, 2020 Benefits Effective: September 1, 2020 - August 31, 2021. 2 | WICOMICO COUNTY PUBLIC SCHOOLS 2020-2021 BENEFIT GUIDE