CURRENT HEALTH BENEFITS
2018 NEW VEHI Health Care Plans in effect as of January 1st, 2018!
Please be sure to carry your new ID cards for your new health plans. You will need to present the new ID card when accessing medical or pharmacy services. Be sure to alert your providers that you have new coverage. Your new cards begin with the prefix "VEI". Click here to see a sample card. You should destroy any outdated BC/BS ID cards to avoid confusion.
Information on New health care plan specifics is available are on the VEHI website at: http://www.vehi.org/benefits/navigating-2018-health-plans/employee-navigation/
January 1, 2018, New VEHI Health Plans Benefit booklet for ALL employees:ACCESS to SBSD Health Insurance Benefit Presentation (on Google limited access to those with SBSD email): Benefit Presentation
Health Reimbursement Arrangement (HRA): Tax-Free employer funded account-based benefit to help employees pay for some qualified out-of-pocket health care expenses defined by the plan; may be paired with any health insurance plan; works best with a High Deductible Health Plan.
Health Savings Account (HSA): HSAs are individual savings accounts that can be used to pay for qualified health care expenses with tax-free dollars; may be funded by the employer, the employee or both; must be paired with an HSA eligible High Deductible Health Plan.
Flexible Savings Account (FSA): An account that is set up and owned by the employer and funded by the employee through pre-tax payroll deductions to pay for qualifying medical and child care expenses.
Our Third Party Provider that processes FSA and HRA is Employees may set up access to their account and login through: myRSC.com
Cost Sharing Terms
Consumer Directed Health Plan (CDHP): A health plan that meets IRS regulations that allows for funded accounts to assist in the cost of health care. Such accounts may include a Health Savings Account (HSA), a Health Reimbursement Arrangement (HRA), or a Flexible Spending Account (FSA).
Co-insurance: A percentage of allowable charges that the employee must pay after reaching the deductibles. For example, after the required deductible is met, the insurance coverage for a specific service may pay for 80% of the charge and then the individual is responsible for the remaining 20% cost.
Co-payment: A fixed dollar amount paid to a service provider at the time of service. THE ONLY MEDICAL VISIT CO-PAYMENT IS FOR A YEARLY EYE EXAM WITH A PARTICIPATING PROVIDER
Deductible: The amounts set each year that the insured must pay towards medical costs prior to an insurance benefit payment is made by BCBS. There are two levels of deductibles that are used:
Stacked deductible: The amount required of an individual prior to the payment of insurance benefits
Aggregate deductible: The amount of a single or entire family that must be reached prior to the payment of insurance benefits.
Types of Health Spending Accounts
Requirements and Features
(Common. Funded by the District to cover bulk of deductibles)
(Elected by employee during
A health savings account that is owned by the employee and is savings plan that can be used for qualified medical expenses, as determined by the IRS. It can be paired with a qualifying plan.
A fund set up and funded by an employer for the benefit of an employee. A contribution is made each year to cover qualifying medical expenses not covered by the health plan such as deductibles or coinsurance.
An account that is set up and owned by the employer and funded by the employee through pre-tax payroll deductions to pay for qualifying medical and dependent care expenses.
· Employee may make deposits to an HSA on a pre-tax or post-tax basis.
· Employers may contribute to an employee’s fund.
· May be used to cover your medical expenses or those of your spouse and dependents.
· You own your HSA funds so the money you saved stays with you—even if you change employers.
· May be set up through an employer’s insurance carrier, bank, credit union, or other financial institution.
· If costs exceed the HSA fund balance, the employee may pay-out-of-pocket and then submit a reimbursement once the fund balance is regained.
· Payments may be made directly by using a debit card or check linked to the account.
· Funds are generally used to reduce premiums, pay coinsurance or deductibles.
· Funds are provided by the employer, not the employee.
· Funds may be tax exempt or tax deductible.
· Funds may be reimbursed or employees may be issued debit cards to pay for eligible expenses, depending on how the plan is designed, consistent with IRS regulations and insurance carrier limitations.
· A pre-determined maximum amount collected throughout the year and may help with reducing tax obligation.
· Employer may also contribute.
· You may decide how funds are spent as long as it meets IRS qualifications, for qualified medical, dental, prescriptions, or vision expenses or for dependent care.
Three kinds of plans:
- Health care that pays for medical expenses including copays and deductibles.
- Dependent care that pays for the care of dependent child or adult so you may work
- Limited purpose that helps pay for dental and vision expenses.
· Can be used for other expenses, but will suffer a 20% tax penalty unless over 65 and disabled.
· Can’t be used to pay insurance premiums.
· Can’t be used to pay for Medicare supplemental insurance or Medigap policy.
· You are responsible for maintaining receipts, in case of a tax audit.
· Employees may not make contributions.
· The Employer owns the accounts.
· The employer decides how funds left in the plan at the end of the year are managed. May or may not be rolled over.
· Funds may not be used to pay for monthly health insurance premiums.
· There is generally no payout on any balances
· Access to accounts once an employee terminates/retires may be limited or may end with employment.
· The employer may allow up to $500 remaining funds in one year to be rolled over to the next year.
· There may be a limited grace period of up to 2.5 months at the end of the year to use funds or funds are kept by the employer.
Upon Retirement or Termination
· You no longer may contribute to an HSA
· You can use your account tax-free for out-of-pocket expenses.
· You can use your account to pay Medicare premiums, deductibles, copays and coinsurance.
· Pay any retiree medical insurance premiums from the employer.
· Funding to the HRA ends with employment.
· May not have access for reimbursable expenses beyond a set point in time.
· No rollover of funds.
· Access to funds may be limited to a grace period or end with employment.
Non-qualifying reasons for eligibility
· Enrolled in Medicare
· Enrolled in a non-compatible HSA plan
· Enrolled in another health care plan
· Dependent on another person’s tax return
· Eligibility is contingent upon the plan design and continued eligibility for medical insurance through the employer.
· Eligibility is contingent upon the plan design and continued eligibility for medical insurance through the employer.
Teacher Specific Info:
- Teacher VEHI BCBS 2018 Cost and Health Care Savings Account Detail
- Teacher SBSD Future Planning Associates Health Reimbursement Arrangement
- Teacher Comparison Grid with SBSD specific TEACHER pricing
Support Staff Specific Info:
- Support Staff BCBS 2018 Cost and Health Care Savings Account Detail
- Support Staff Future Planning Associates Health Reimbursement Arrangement
- Support Staff Comparison Grid with SBSD specific Support Staff pricing
Vermont Education Health Initiative52 Pike DriveBerlin, VT 05602802-223-5040
Links to specific topics are listed below:
VEHI Health Plans (Effective 1/1/18):
VEHI Comparison Grid 4 Plans 2018
VEHI FAQ on VEHI Health Plan Choices
VEHI Slideshow on Health Plans:
VEHI Video Informational Series for New Plans
VEHI PowerPoint of Presentation by VEHI Staff
VEHI information on Stacked and Aggregate Deductibles:
VEHI and BCBS general info: About Stacked and Aggregate Deductibles
Link to: Blue Cross/Blue Shield
Login for Members: http://www.bcbsvt.com/login/resource-center
Health Care Provider Lists (EVERYONE ENROLLED NEEDS A PRIMARY CARE PHYSICIAN!) : http://www.bcbsvt.com/find-a-doctor.
BCBS VEHI Health insurance plan Form for new enrollees or changes to membership (name / address updates)
Information on BCBS Specific Rx Prescription Drug Info: BCBS VEHI Drug List Link
HSA / FSA SBSD LINKS:
- TRACK YOUR HRA AND / OR FSA accounts with online access! Click here to see A sample dashboard of a similar account. You can see your balance(s), track reimbursements, payments, etc. Sign up for online access to your "myRSC - A Resource Service Center for the Workplace."
- HRA / FSA REIMBURSEMENT FORM. Use this form to get reimbursed from your FSA or HRA accounts by DATAPATH for qualified medical expenses.
Links to VEHI GENERAL information on Healthcare Spending Accounts (HRA, HSA, FSA):
VEHI general info: About Health Care Spending Accounts
VEHI general info: Things to Know About HRA, HSA, and FSA Accounts
FSA ENROLLMENT FORM Flexible Spending Account also know as Section 125 Plan for employees in CDHP health plans (Used by employees who elect to contribute pre tax monies from their paycheck to pay for qualified medical expenses. (deductibles, copays, prescriptions, etc.)
HRA ENROLLMENT FORM for ALL employees enrolling in HRA for SBSD Contributions towards deductibles
HSA FORM ONLY for employees enrolling in HSA Teachers must match $ for $
Employees engaged in regular active full time employment performing at least 1,000 hours of service per year are eligible. Part time, temporary or regular employees working less than 1,000 hours are not eligible for coverage.
Spouses and the unmarried, dependent children (under the age of 19) of eligible employees are eligible for enrollment. Certain requirements may also allow dependent children of eligible employees who are enrolled full time at an accredited school or college up to the age of 23.
Coverage will begin on the first day of the calendar month of eligibility, varies by employee group. Coverage includes:
- 100% of Reasonable and Customary costs of Diagnostic and Preventive care.
- 80% of Reasonable and Customary cost of Basic Restorations, Endodontics, Periodontics, Prosthodontics Maintenance and Oral Surgery.
- 50% of Reasonable and Customary costs of Major Restorations, Dentures and Bridgework.
- 50% of Reasonable and Customary costs of Orthodontics.
Calendar Year Deductibles:
$25 Individual Coverage Deductible
$75 Aggregate Family Coverage Deductible
For Basic Restorations, Endodontics, Periodontics, Prosthodontic Maintenance, Oral Surgery, Major Restorations, Dentures, Bridgework and Orthodontics.
- $1750 per person per year for Diagnostic and Preventive services, Basic Restorations, Endodontics, Periodontics, Prosthodontics Maintenance, Oral Surgery, Major Restorations, Dentures and Bridgework.
- $1,000 per person per lifetime for Orthodontics
Life, Accidental Death & Disability Insurances
Eligible employees are welcomed to participate in the following group insurance plans offered through the District. To be eligible, employees must be regularly employed for at least 1,000 hours per year. The insurance coverage and costs vary according to employee group and are as follows:
- Support Staff: $50,000 to age 70 and $12,500 after age 70.
- Teachers: 2 times annual salary.
- Administrators: $250,000 to age 70 and $50,000 after age 70. or $125,000 to age 70 and $50,000 after age 70.
Accidental Death & Dismemberment (AD&D)
- Support Staff: $25,000.
- Teachers: 2 times salary.
- Administrators: $250,000 or $125,000.
Long Term Disability Coverage
- Support Staff: OPTIONAL, AT EMPLOYEE'S expense, enroll at initial hire
- Teachers: 2 times salary. 60%, must be elected on paperwork, EMPLOYER paid
- Administrators: OPTIONAL, AT EMPLOYEE'S expense, enroll at initial hire
Elimination Period: 180 days. If deemed eligible, benefits begin the day after the elimination period is completed.
Minimum Hours Requirement: Eligible employee must be working at least 1,000 hours per year.
Monthly Benefit: Benefits may be reduced by deductible sources of income and disability earnings. Some disabilities may not be covered or may have limited coverage under this plan.
- Support Staff: 60% of monthly earnings to a maximum of $3,000 per month.
- Teachers: 60% of monthly earnings to a maximum of $3,000 per month.
- Administrators: 66.6667% of monthly earnings to a maximum benefit of $3,000 per month.
Employee Assistance Program
Purpose of Service: The Employee Assistance Program (EAP) is a human service program which provides counseling and referral services to employees of the South Burlington School District. The District has contracted Vermont School Boards Insurance Trust (VSBIT) to provide a trained counselor outside the District who can work with the employee or the employee’s household member to resolve personal concerns. Occasionally healthy, productive working people can be affected by short term or long term personal concerns. It is important to resolve these difficulties before work performance is negatively impacted and the EAP through trained counselors can help. Counselors are available to talk on the phone or meet face-to-face.
Referrals: Employees generally initiate contact with EAP either at the suggestion of another person or on their own. To request services for an employee or the employee’s household member, call the EAP at Invest EAP at 1-800- 287-2173, give our password or go to their website www.investeap.org. An appointment will be made with an EAP Counselor within three working days at a location that is convenient for the employee. Crisis service is available 24 hours a day, 7 days a week. Supervisory Referral is made when the supervisor detects a slack in work performance. The employee is offered the opportunity to meet with an EAP counselor off-site to identify and address any personal problems that may be affecting work performance. Self Referral occurs when an employee contacts the EAP counselor on his or her own. A Third Party Referral is made when a co-worker, family member or a friend suggests and EAP referral. Consultations for Supervisors/Principals: The EAP can be helpful to a supervisor or principal in providing consultation and guidance for a difficult workplace situation.
Types of Issues EAP Can Assist With: EAP can provide assistance with any problems that are affecting the well being of employees either at home or at work such as: Marital and family difficulties; Alcohol and Drug Abuse; Stress on and off the job; Relationship Problems; Parenting Dilemmas; Eldercare Resources; Feelings of Depression or Anxiety; Childcare Resources; Financial Concerns/Resources; Legal Issues; Low Self Esteem; and Anger Management.
EAP is Confidential: Information concerning an employee’s contact with the EAP is kept in confidence. No personal information about an employee’s or employee’s household member’s use of the program will be released without written authorization from the employee.
Contact Information: The South Burlington School District Employee Assistance Program: Invest EAP, 1-800-287-2173 or www.investeap.org
The Vermont State Teachers Retirement System:
If you were employed as a public school teacher within the State of Vermont on or after July 1, 1990, you are automatically a Group "C" member. If you were hired before July 1, 1990 and were a Group"B" member in service on July 1, 1990 you are now a Group "C" member. Group "C" members make annual pre-tax contributions equal to 3.70% of pay into a trust fund. Trust fund earnings and contributions by the State of Vermont pay your benefit.
Members will receive retirement service credit for each year they are employed as a full time teacher while an active member in the System. Members who work part time will receive partial credit based on the percentage of full time pay.
Once you have ten years of service you are vested and cannot lose your credit, unless you elect to withdraw your contribution balance. If you have less than ten years of service, you must withdraw your contributions.
For more information about retirement, please contact the Vermont State Teachers Retirement Office (VSTERS), 133 State Street, Montpelier, VT 05633-6901 Telephone: 1-800-642-3191 or (802) 828-2305.
Support Staff Retirement
Support staff members with five full years of service (1,000 hours per year) or more are considered vested in the District's retirement program. The plan is administered by an external vendor which offers several retirement options from which to select. The annual retirement benefit is calculated at the rate of one and one-quarter percent (1.25%) times the salary per year of the last 5 years of credited services.
A one time retirement payment from the District is also made available to vested eligible support staff members. This amount is equal to 5% of the average of their three highest paid years of service with the school district.
In order to be eligible for retirement, employees must reach age 62. Retirement notice to the Business Office is required in writing by January 1 in order for payment to begin in July of the next fiscal year. Late notification will delay the start of the benefit.
Important Information About Your 403(b) and 457 Retirement Savings Plans:
In 2009, the South Burlington School District adopted the State of Vermont's supplemental retirement plans, both 403(b) and 457 savings plans, with Empower Retirement (a.k.a Great West) as the benefit provider. The State's retirement system recently made a decision to change to Prudential Retirement to administer these funds. In that light, the District changed their administrator as well. This change took place on February 1, 2018.
Please reach out to our dedicated Prudential Retirement Counselor, Gilles Owen, if you have any questions regarding that program or any other questions with your account.
Gilles Owen at email@example.com , phone: 802-622-4240
By following the prompts HERE,you should be able to set up your access to your Prudential online account. You will need your social security number and other personal data in order to create a login:
Vermont Retirement System (vermont.retirepru.com)
If you are not able to access your account, please contact the Prudential service center at 1-877-RET-VERM (1-877-738-8376).