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Certificated Employee Benefits |
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The Certificated Employee Benefit Program is under the oversight of The Insurance Trust. The Insurance Trust consists of three School Board members and three elected certificated employees.
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Look up provider information in the Blue Network P Directory (formerly Blue Preferred)
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Check pharmacy information, including which drugs are considered “maintenance” drugs, whether a specific drug is considered generic (Tier 1), preferred (Tier 2), or non-preferred (Tier 3), or if a drug requires “prior authorization, etc. (From the homepage, click on “Pharmacy Info”)
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Notice: Beginning March 1, 2007 only Blue Cross Preferred Chiroprators will be covered. No benefits will be payable for non-network chiropractors. Chiropractors not currently in the network will be given the opportunity to join. |
Delta Dental Group Dental Plan Telephone: 255-3175
www.deltadentaltn.com/mnps
Look up provider information. (From homepage, click on “find a dentist”, then select your product (DeltaPremier or Delta PPO) PPO Dentists will have lower out of pocket expenses for you.
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CompBenefits Vision Plan Telephone: 1-866-416-4369
- www.compbenefits.com/custom/mnps/
Click on MyCompBenefits.com for members - and register. You can now access details about the plan, find a network doctor, and confirm information about your enrollment.
Individuals in either of the Blue Cross medical plans have VCP vision. |
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Employee Assistance Program (EAP) Telephone: 1-866-563-8762
- The EAP program provides pre-paid visits for you and your family. You can obtain guidance on such issues as: difficulties in relationships, emotional/psychological issues, stress and anxiety, depression, substance abuse, grief, legal or financial issues,
- The comprehensive WorkLife Services component can assist you in locating such personal needs as child/eldercare resources, pet care, colleges, etc.
- Horizon Health administers this program and all appointments and information is confidential. It is not necessary that you be enrolled in the Medical plan to use services through your EAP.
- www.horizoncarelink.com outlines the benefits and operation of an EAP. Login: mnps Password: eap
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Medical Flexible Spending Account (FSA) Telephone: 259-8648
http://www.myfbmc.com/ FSA Brochure
FSA Claim Form FBMC Telephone:(800) 342-8017
FSA Claim Instructions Toll Free Claims Fax: 1-866-440-7145 Fax: (850)425-4608
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“Plan year” means the calendar year. The Medical plan deductible year and the FSA year are the same.
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Participation in this program can save you substantial dollars on medical expenses not covered by insurance. The plan is administered by FBMC. Third-party administration assures complete confidentiality. You are issued a spending card, similar to a MasterCard, which allows you to pay for eligible expenses (co-pays, etc.) at the time of purchase. You may also send claims directly or arrange direct deposit.
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You may set aside up to $5,000 for eligible Medical expenses |
Dependent/Child Care Expense Account Telephone: 259-8648
FBMC Telephone: (800) 342-8017
The Dependent/Child Care FSA plan year is also the calendar year. Expenses must be incurred during the plan year, and are separate from Medical FSA.
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Retirement TCRS Telephone: 741-1971
- Only TN Consolidated Retirement System (TCRS) can provide you with exact information about your years of retirement credit and an estimate of your retirement income. The annual statement you receive each year outlines your TCRS record as of the date issued. You may calculate your own estimate by using the benefits calculator at www.treasury.state.tn.us/tcrs.
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Social Security Telephone: 1-800-772-1213
- You may contact Social Security Administration for answers to your questions, to request forms, schedule appointments, etc. www.socialsecurity.gov provides vast amounts of information.
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| Eligibility Rules for Participation and Continuation
Active Certificated Employees
Certificated Employees of Metropolitan Nashville Public Schools (MNPS) are eligible for the Group Benefits Plan upon the completion of the required waiting period. The group plan consists of:
- Comprehensive Medical Plan
- Group Dental Plan
- Life Insurance with Accidental Death & Dismemberment
- Vision Care
Effective Date of Coverage: Your coverage is effective on the day following one (1) month of active full-time employment, provided completed enrollment forms are received on or before the date of employment. Otherwise, coverage is effective on the day following one (1) month from the date completed enrollment forms are receive in the MNPS Employee Benefit Services office.
Submitting Enrollment Forms: You may submit enrollment forms anytime within the first 60 days of employment. If proper forms are not filed with Employee Benefit Services within the initial 60 days, enrollment will not be permitted until the next Annual Enrollment (except in cases of qualifying events).
Eligible dependents, defined as follows, may also enroll:
(a) Your spouse, if not an active MNPS employee; and
(b) your unmarried children, under 25 years of age, and are primarily dependent on you for support.
(c) Your children include: your biological children, adopted children, stepchildren (providing your spouse has permanent legal custody), any other child for whom you are legal guardian or for whom you have legal custody and who lives with you in a parent-child relationship, and any child for whom you are obligated to pay medical expenses or provide medical insurance pursuant to a court order. Handicapped children over the age of 25 must meet certain requirements in order to continue to be covered.
No person may be covered both as an employee and dependent and no person may be covered as a dependent of more than one employee.
Outline of Benefits - The following pages briefly outline the benefits provided under each plan. Complete details are contained in plan documents issued to the Trustees of the Insurance Trust and are located in the MNPS Benefits Office. The Board of Education reserves the right to modify the benefits as is deemed appropriate. Upon enrollment, complete information booklets will be issued to you.
Cost of Coverage – The cost of the group benefits plan is shared: 75% paid by MNPS; 25% paid by you. (Employees who are job sharing/partial position pay a larger portion of the cost.)
Tax-free Treatment of Premium - Special arrangements (through IRS Section 125 Cafeteria Plan) permit the employee to pay his/her share of premium from earnings before federal income tax. No action on your part is needed to realize these savings.
Optional Benefits – Optional benefits, paid entirely by the employee, are available for voluntary participation.
Your Responsibility
Please remember that it is your responsibility to complete the appropriate enrollment forms within the first 60 days of eligibility. If you do not activate enrollment, it is assumed that you have chosen not to participate in the program. No follow-up will occur.
It is also your responsibility to advise Employee Benefit Services of any family changes which may occur (i.e. birth of a child, divorce, child losing eligibility because of age, dependency, etc.). These changes must be reported within 60 days of the date of the event. Premiums deducted because of failure to report changes cannot be refunded.
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Medical Plan Comparison
MNPS offers its Certificated Employees two different health plans. Both plans utilize the Blue Cross Network P, the broadest statewide Blue Cross Network. The two plans are called "The Traditional Plan" and the "Co-Pay Plan". The Traditional Plan utilizes a deductible and coinsurance for hospital services, the Co-Pay Plan uses Co-Pays. These links will provide benefit and cost information for both plans.
For information regarding plan descriptions, and cost click on the links below:
2008 Plans
Cost |
Prescription Drug Coverage
Prescription Drug is Co-Pay for Both Plans
Whether you are enrolled in the Co-Pay plan or the traditional PPO plan, you will only pay a co-pay when you purchase your prescription drugs:
- $ 0 Generic
- $15 Preferred
- $35 Non-preferred
The $ 0 co-pay for generic drugs allows you to get your prescription at no cost as long as your doctor thinks that a generic drug is appropriate for you and as long as a generic is available.
How does the co-pay work?
If a brand name drug is prescribed for which there is a generic equivalent (identical active ingredient), the pharmacist will dispense the generic in place of the brand drug and your co-pay will be $ 0.
If a brand name is to be dispensed even though the generic equivalent is available, the physician may state ‘dispense as written’ (DAW). In such case, the brand name drug will be dispensed and the higher co-pay will apply.
If a generic equivalent is available and your doctor does not state ‘dispense as written’ but you instruct the pharmacist to fill the prescription with the brand name anyway, you will be required to pay the cost difference between the brand and generic drug.
Co-pays do not count toward the calendar year out-of-pocket maximum.
Why is the co-pay for generic drugs $0 ?
According to the Congressional Budget Office, generic drugs save consumers an estimated $8 billion to $10 billion a year at retail pharmacies. Even more billions are saved when hospitals use generics. This means that the use of generic drugs saves both you and the plan money. Therefore, it is appropriate to provide a way for you to obtain your generic prescription at no cost.
Are generic drugs approved by FDA - Are they safe and effective?
Yes*. The FDA requires that all drugs be safe and effective. The FDA won't permit drugs to be made in sub-standard facilities. Generics use the same active ingredient and work the same way in the body as their brand counterpart.
* http://www.fda.gov/cder/consumerinfo/generics_q&a.htm
Check your prescription drugs: http://www.bcbst.com/drugsearch/start.do
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Dental Coverage
At MNPS we know that dental care is an improtant part of your overall health.
Dental Coverage is included as a part of the basic MNPS benefit package.
The plan is through Delta Dental of Tennessee utilizing their Premier Network, which is their broadest network.
Benefits are provided for basic, restorative, major restorative, and orthodontia for children under age 19.
Your plan pays for 2 cleanings a year at 100%, and not subject to the deductible.
For a complete description of benefits, provider look-up, and other tools go to: www.deltadentaltn.com/mnps.
Questions: (615) 259-8463
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VISION CARE PLAN
CompBenefits
The Metro Teachers’ vision care program through CompBenefits is a companion benefit for those enrolled in the Blue Cross Blue Shield self-insured medical plan.
CompBenefits is a nationwide network of optometrists which allows plan members to receive special pricing when care is provided through the CompBenefits network. However, you are not required to use a network doctor. You may also choose to use a network doctor for your eye exam but purchase your frames through another distributor.
The plan pays for examinations, lenses and frames, and contacts. By using CompBenefits network Optometrists you will maximize your benefits, and reduce your out of pocket expense.
For details on the plan, information on participating eye doctors, and claim information go to www.compbenefits.com/custom/mnps/.
Questions: 1-866-416-4369
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GROUP LIFE INSURANCE PLAN
Minnesota Life Insurance Company
Life Policy, Summary, and Forms
The Group Life Insurance Plan provides needed funds to the family in the event of unexpected death from any cause.
Amount of Employee Life Insurance - Basic
• $50,0000 paid by MNPS.
Amount of Employee Life Insurance - Optional
Optional Life Rates
Employees may purchase optional life in amounts from $10,000 to $300,000.
Amounts are Guarantee Issue during initial enrollment.
Amount of Dependent Life Insurance
• Spouse ………………………………………………………… $25,000
• Unmarried dependent child ……………… ………………… $ 10,000 (Age 14 days to 25 years)
ACCIDENTAL DEATH & DISMEMBERMENT
Minnesota Life Insurance Company
The Accidental Death & Dismemberment (AD&D) Insurance Plan adds a “double indemnity” feature to the life Insurance for the employee. Benefits are also provided for accidental dismemberment.
Amount of Employee AD&D
For accidental loss of
• Life …………………..………….. 100% of the amount of Life Insurance
• One arm, leg or eye ……………… 50% of the above amount
• Two arms, legs or eyes ………….. 100% of the above amount
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Employee Assistance Program (EAP)
Horizon Health
Benefits
Metro teachers’ Employee Assistance Program (EAP) provides professional service designed to help employees identify and resolve problems through assessment, brief counseling or referral. This employer-sponsored benefit encourages employees to deal with personal, family or work problems before job performance is affected.
Any services by EAP counselors are provided at no cost for the employee. If you require a specialist or long term counseling, the EAP counselor will talk with you about resources, out-of-pocket costs and what may be covered by health insurance.
Employee Assistance Program (EAP)
Horizon Health
Benefits
Metro teachers’ Employee Assistance Program (EAP) provides professional service designed to help employees identify and resolve problems through assessment, brief counseling or referral. This employer-sponsored benefit encourages employees to deal with personal, family or work problems before job performance is affected.
Any services by EAP counselors are provided at no cost for the employee. If you require a specialist or long term counseling, the EAP counselor will talk with you about resources, out-of-pocket costs and what may be covered by health insurance.
Types of Problems that May be Addressed
- Family Issues – Marriage, parenting, divorce/remarriage, aging, grief or loss
- Emotional Problems/Personal Crisis – Anxiety, depression, panic, stress, work or home
- Alcohol or Drug Concerns – Other addictions, self or family
- Financial and Legal Matters - financial planning and debt management. Legal consultation and referral to discounted services.
Accessing Service
For initial appointments and after-hour emergencies, call Horizon Health at …1-866-563-8762. When the appointment is scheduled, ask about the location most convenient to you. Non-urgent appointments will be offered within three to five days of your call. You and your family members may use the EAP directly without referral from any other source.
Additionally you may access the web at www.horizoncarelink.com login: mnps password:eap
Confidentiality
The confidentiality of EAP services is protected by state and federal laws. Certain exclusions of privileged communication apply to issues of threat to self, threat to others, and child abuse. The EAP is external to the Board of Education, and only statistical reports containing no identifying information is provided to your employer to document the cost of the program.
Additional Services
Administrative referrals may be directed to the EAP if the administrator feels this may be helpful. However, use of the EAP is voluntary.
Other available services include consultation, crisis and trauma debriefing, and workshops for teachers and administrators.
Questions: 1-866-563-8762
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Flexible Spending Account (FSA)
The FSA program provides a way for a certificated employee to direct a portion of salary into an account which can be used to pay certain eligible medical and/or dependent care expenses. The advantage of the FSA is that no federal income taxes and no social security taxes are payable on money redirected into the account.
The employee chooses the amount of salary to be redirected into the FSA, up to the plan maximum of $5,000 per plan year. The amount is deposited into the account from each bi-weekly paycheck throughout the year.
Medical FSA - Examples of eligible health care expenses (not covered by any other insurance) are:
• Deductibles and other patient-liability portion of claims
• Eyeglasses, vision and hearing exams
• Other IRS-allowable medical expenses, i.e. prescribed preventative care, orthodontics
The plan year is January 1 through December 31. Each year, approximately November 1, employees are mailed enrollment details, including information to aid in selecting the amount of salary redirection. The amount cannot be changed (or the plan discontinued) during the year unless there is a qualifying change in family status or there is a loss of spouse’s job.
Care must be given in determining the amount redirected since IRS regulations rule that any unused balance as of the end of the plan year is forfeited and cannot be returned in cash. There is, however, a grace period (to March 15) following the end of the plan year during which you incur eligible expenses and file them against the prior year’s deposits.
FBMC administers the plan and provides a Medical Spending Account card. You may use the card to pay for qualifying expenses at the time of purchase. Of course you also have the option to submit your claims directly to FBMC for reimbursement. Copies of receipts must be submitted to FBMC for reimbursement. Please call the number shown below for assistance with understanding and using this valuable benefit.
Dependent Care FSA - A Dependent Care FSA is an IRS tax-favored account you can use to pay for eligible dependent care expenses. These funds are set aside from your salary before taxes are deducted, allowing you to pay for these expenses tax free. You can contribute up to $5,000 (single and head of household, or married and filing jointly), or $2,500 (married and filing separately) fo a Dependent Care FSA each year.
Expenses can be paid directly to the provider.
If your financial circumstances change and dependent care is no longer needed you may stop your Dependent Care FSA deduction.
FSA Claim Filing Instructions FSA Brochure
FSA Claim Form Toll Free Claims Fax Number 1-866-440-7145
count may be established which can be used to pay eligible dependent/child care expenses. The Plan Year, IRS rules, and the administration are generally the same as for the Medical FSA, except that the spending card is available only for medical-type expenses. Complete information is distributed during the open enrollment each year.
Questions: FBMC (800) 342-8017
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Supplemental Accident Insurance
24-HOURACCIDENTAL DEATH & DISMEMBERMENT
Hartford Accident and Indemnity Company
Certificated employees may enroll for high volumes of Accidental Death & Dismemberment (AD&D) insurance at low group rates. Enrollment may be for “Employee’ or “Family” coverage. Coverage is provided 24 hours a day — anywhere in the world — on or off the job. This coverage is in addition to, and separate from, the basic (AD&D).
Amount of Coverage Available
• $10,000 to $250,000— in units of $10,000
Description of Coverage
• For accidental loss of
—Life …………………………………… ……..100% of amount selected
—One arm, leg or eye …………………………. 50% of amount selected
—Two arms, legs or eyes …………………….. 100% of amount selected
Family Coverage
If “Family” coverage is chosen, each eligible family member has coverage which is a percentage of the amount selected by the employee:
• If there is a spouse only …………………… Spouse amount 50%
• If there is a spouse and child(ren) …………. Spouse amount 40%; Each child amount 10%
• If there are children but no spouse ………… Each child amount 15%
Your Cost Each Pay Period for Each 10,000 of Coverage
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If paid 21 times |
If paid 26 times |
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Employee Only Coverage |
$ 0.23 |
$ 0.18 |
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Employee & Family |
0.34 |
0.28 |
Questions: (615) 259-8463 |
Long Term Disability
Hartford Life & Accident Company
Certificated employees may enroll for long term disability income protection at low group rates. If you enroll within 30 days of your first day of work you are guaranteed acceptance into the plan.
This coverage provides a monthly benefit of 60% of your earning if you are sick or injured and unable to work. Benefits are payable following a period of 90 days of total disability. Benefits are paid as long as you remain disabled or until age 65 (or older depending on when you are disabled). Benefit payments are tax free since you pay the premium with “after-tax” dollars.
Coverage is provided 24 hours per day and is offset for other income sources such as social security disability benefits, workers compensation, and other jobs.
Amount of Coverage Available
60% of monthly earnings to a maximum of $5,000 per month
($100 or 10% minimum).
Benefit Waiting Period
90 days from onset of disability
Duration of Payments
To age 65 (or older if you are disabled at age 62 or older).
Definition of Disability
Your “own occupation” for 2 years; “any occupation” thereafter
*Special limitations for pre-existing conditions, mental/nervous and substance abuse. See coverage booklet for details.
Questions: (615) 259-8463
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Various Providers Available
Special tax legislation allows employees of a public school system to save and invest a portion of before-tax earnings into a tax deferred investment. This is often referred to as a Tax Deferred Annuity (TDA). The employee enters into an agreement with the employer to reduce taxable earnings by an amount of money the employee chooses to invest into a TDA account arranged through an insurance company or mutual fund.
The amount invested into the TDA is not subject to current federal income tax. Any interest payments or investment earnings that are added to the account also accumulate free of current income tax. Of course, since all TDA contributions are made from before- tax income, any amount withdrawn at a future date is reportable as income for the tax year in which the funds are received.
During calendar year 2007 an employee can defer as much as $15,500, and if over age 50, an additional $5,000 catch-up contribution.
1. Participate - Saving a small amount at a younger age will be easier than playing catch-up when you get older. Try 3-5% of pay to start, it will not dramatically affect your net pay.
2. Invest Wisely - If you are not a hands-on investor, choose a so-called target date retirement fund. You select a fund whose date is closest to the year you expect to retire. Professional fund managers do the rest. This will make sure you are appropriately diversified and gradually shift to more conservative investments as you approach retirement.
3. Don't borrow.
4. Don't cash out.
The Board of Education does not endorse any specific TDA product but processes the tax deferred contributions with a company/mutual fund that has met certain Board-approved guidelines. There are several such companies/mutual funds currently available, and a list of these is available from the Employee Benefit Services Office. The employee must initiate the contact with representatives since personal information is not released for solicitation purposes.
TDA products vary greatly from one company to another. The employee may find it advisable to review several programs before making a decision. It is relatively easy to compare such features as
• Earnings
• Administrative cost
• Withdrawal penalties
• Stability of the company
• Services to be provided
List of Insurance Companies and Mutual Funds with Active TDA Accounts:
IRC 403(b) and 403(b)(7)
Fax: (615) 214-8665
Questions: (615) 259-8438
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