2024 Employee Benefit Guide
Table of Contents A Message to Our Employees
3
Vision Insurance
14
Benefits for You & Your Family
4
Short-Term Disability Insurance
15
Medical Insurance
5
Long-Term Disability Insurance
15
Pharmacy Coverage
6
Life Insurance
16
Health Savings Account (HSA)
7
Voluntary Accident & Critical Illness Insurance
17
Health Reimbursement Account
8
Wisconsin Retirement System
18
Flexible Spending Account
9
Wisconsin Deferred Compensation (WDC) 457
19
Prevea Onsite Health & Wellness Center
10
WEA Member Benefits
21
Prevea Employee Assistance Program (EAP)
11
HSSD Supplemental Retirement 403(b)
21
Making Informed Choices When Choosing Care
12
Paid Leave Benefits
21
Dental Insurance
13
Important Contacts
22
This brochure summarizes the benefit plans that are available to Howard-Suamico School District eligible employees and their dependents. Official plan documents, policies and certificates of insurance contain the details, conditions, maximum benefit levels and restrictions on benefits. These documents govern your benefits program. If there is any conflict, the official documents prevail. These documents are available upon request through the Human Resources Department. Information provided in this brochure is not a guarantee of benefits.
2
A Message to Our Employees
Hello, Howard-Suamico School District (HSSD) is committed to supporting your personal health and well being. Providing meaningful insurance coverage is part of our larger total compensation strategy to ensure that you have the support necessary to bring the best version of yourself to school every day. After all, when you are feeling good, students and colleagues directly benefit from your positive time, energy and attention. Although we remain challenged by rising inflation and escalating healthcare costs, almost 80 percent of HSSD respondents on the annual employee engagement survey indicated agreement that their benefits are competitive with similar jobs found elsewhere. That said, we believe there are always creative ways to get better. In her book, The Gifts of Imperfection, Brené Brown says, “Healthy striving is self-focused: How can I improve?" Let’s respond together by learning how to maximize these important resources. Therefore, I invite you to review this new Benefit Guide to learn more about our comprehensive insurance for you and your dependents. Our Organizational Development Team is ready to support and assist your efforts as we move forward together. In Good Health,
Damian LaCroix Superintendent of Schools
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Benefits for You & Your Family Howard-Suamico School District is pleased to announce our 2024 benefits program, which is designed to help you stay healthy, feel secure, and maintain a work/life balance. Offering a competitive benefits package is just one way we strive to provide our employees with a rewarding workplace employment experience. Please read the information provided in this guide carefully. For full details about our plans, please refer to the summary plan descriptions on the Staff Portal. Who is Eligible? Employees who meet the following weekly hour requirements are eligible for benefits: Weekly Hours
Benefits Available
30+ Hours Per Week:
Medical with Health Savings and Health Reimbursement Account Dental Insurance Access to the Prevea Onsite Health & Wellness Center when enrolled in the medical plan
24+ Hours Per Week:
Life Insurance Voluntary Accident and Critical Illness Insurance Long-Term and Short-Term Disability Insurance Wisconsin Retirement System Other Retirement Options: WEA 403(b) or WDC 457
20+ Hours Per Week:
Vision Flexible Spending Accounts
Less than 20 Hours Per Week:
Prevea Employee Assistance Program
When are you Eligible? For newly eligible employees, coverage is effective on the 1st of the month following your 1st day of employment or transfer into a benefit eligible role. Life Insurance is effective on the 1st of the month following 30 days of employment or transfer into a benefit eligible role. Annual Open Enrollment You may make changes to your benefit elections during annual open enrollment each year. Those changes take effect every January 1. Changing Coverage During the Year You may make benefit changes within 30 days of a qualified event. Qualified events include marriage, divorce, legal separation, birth or adoption of a child, change in child’s dependent status, death of spouse or dependent, or change in spouse’s benefits or employment status. Employee is responsible for notifying Mary Pliner at maryplin@hssdschools.org of any changes within 30 days of the qualifying event. Note: Employees are also responsible for verifying their payroll deductions and reporting any discrepancies to our Organizational Development or Payroll Departments. For all benefits listed within this guide, see Summary of Benefits for full policy details including limits and exclusions. Visit the Staff Portal to review summary plan descriptions.
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Medical Insurance WCA Group Health Trust / UMR Generally, you must pay all the costs from providers up to the deductible amount before this plan begins to pay. Out of network benefits are not available except for emergency care. WCA Group Health Trust HSSD Medical Plan Coverage
In-Network Benefits
Out-of-Network Benefits
Individual
$3,000
N/A
Family
$6,000
N/A
0%
N/A
Individual
$6,850
N/A
Family
$13,700
N/A
Primary Care
100% after deductible
Not Covered
Specialty Care
100% after deductible
Not Covered
Adult Periodic Exams
100%
Not Covered
Well-Child Care
100%
Not Covered
X-ray and Lab tests
100% after deductible
Not Covered
Complex Radiology
100% after deductible
Not Covered
Urgent Care Facility
100% after deductible
Not Covered
$250 copay, 100% after deductible
$250 copay, 100% after deductible
100% after deductible
Not Covered
Inpatient
100% after deductible
Not Covered
Outpatient
100% after deductible
Not Covered
Inpatient
100% after deductible
Not Covered
Outpatient
100% after deductible
Not Covered
100% after deductible
Not Covered
Annual Deductible
Coinsurance Maximum Out-of-Pocket*
Physician Office Visit
Preventative Care
Diagnostic Services
Emergency Room Facility Charges Outpatient Facility and Surgical Charges Mental Health
Substance Abuse
Other Services Chiropractic
HSSD Medical Premiums Employee Contributions (24 Pay Periods)
Employee Contributions (20 Pay Periods)
7% Premium Contribution
7% Premium Contribution
Employee Only
$27.03
Employee Only
$32.44
Employee + Family
$61.84
Employee + Family
$74.20
12% Premium Contribution
12% Premium Contribution
Employee Only
$46.34
Employee Only
$55.60
Employee + Family
$106.01
Employee + Family
$127.21
Cash In Lieu of Medical Insurance If you are eligible to receive Medical Insurance, you have the option to decline medical insurance through Howard-Suamico School District’s group medical plan and receive $6,000 annually in lieu of medical insurance. 5
HSSD Pharmacy Coverage
WCA Group Health Trust HSSD Pharmacy Coverage
In-Network Benefits
Out-of-Network Benefits
Retail (up to a 90 day supply)
100% after deductible
Not Covered
Specialty Drugs * (up to a 30 day supply)
100% after deductible
Not Covered
Mail Order (up to a 90 day supply)
100% after deductible
Not Covered
*Specialty prescriptions can only be obtained through a CVS Pharmacy or by CVS Caremark mail order to a maximum 30-day supply.
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Health Savings Account (HSA) When you are enrolled in a Qualified High Deductible Health Plan (QHDHP) and meet the eligibility requirements, the IRS allows you to open and contribute to a Health Savings Account (HSA). What is a Health Savings Account (HSA)? A HSA is a tax-sheltered bank account that you own, to pay for eligible health care expenses for you and/or your eligible dependents, for current or future healthcare expenses. The HSA is yours to keep, even if you change jobs or medical plans. There is no “use it or lose it” rule; your balance carries over year to year. Plus, you get extra tax advantages with a HSA because: Money you deposit into a HSA is exempt from federal income taxes. Interest in your account grows tax free; and you don’t pay income taxes on withdrawals used to pay for eligible healthcare expenses. (If you withdraw funds for non-eligible expenses, taxes and penalties apply.) You also have a choice of investment options which earn competitive interest rates so your unused funds grow over time. Are you eligible to open a Health Savings Account (HSA)? Although you may be able to enroll in the Qualified High Deductible Health Plan, not everyone is eligible to open and contribute to a HSA. You must meet these requirements to open a HSA: You must be enrolled in a Qualified High Deductible Health Plan (QHDHP). You must not be covered by another non-QHDHP health plan, such as a spouse’s PPO plan. You must not be enrolled in Medicare. You must not be in the TRICARE or TRICARE for Life military benefits program. You must not have received Veterans Administration (VA) benefits within the past three months. You cannot be claimed as a dependent on another person’s tax return. You cannot be covered by a traditional health care flexible spending account (FSA). This includes your spouse’s FSA. (Enrollment in a limited purpose health care FSA is allowed).
2024 HSA Contributions You are able to contribute to your Health Savings Account on a pre-tax basis through payroll deductions up to the IRS statutory maximums. The IRS has established the following maximum HSA contributions for the 2024 tax year: $4,150 Individual $8,300 Family If you are age 55 and over, you may contribute an extra $1,000 catch up contribution. HSSD Health Savings Account Annual Contributions Coverage
Contribution
Employee Only
$1,500
Employee + Family
$3,000
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Health Reimbursement Account Employee Benefit Corporation (EBC) What is a Health Reimbursement Account? A health reimbursement account or arrangement (HRA) is true to its name. Howard-Suamico School District will fund the account so you can be reimbursed for eligible expenses applied to the medical plan deductible. How does the Howard-Suamico School District's Health Reimbursement Account work? The Howard-Suamico School District will set the HRA up for you. It’s a different arrangement than a flexible spending account or health savings account, where you can contribute money. For the 2024 Benefit Plan year, the Howard-Suamico School District will be funding the HRA: $750 when enrolled on the single plan, and $1,500 when enrolled on the family plan. The HRA dollars are intended for the plan year and they do not carry over. Employee Benefits Corporation (EBC) will be the HRA administrator. Employees will automatically be reimbursed by EBC when they incur additional deductible expenses above $1,600 on the single plan and $3,200 on the family plan. Employees are required to cover the FIRST $1,600 for single coverage $3,200 for family coverage Health Reimbursement Account (HRA) covers the NEXT $750 for single coverage $1,500 for family coverage
HSSD Health Reimbursement Account Annual Contributions Coverage Employee Only
$750
Employee + Family
$1,500
Employee Only Coverage
$3,000
Deductible $2,350 - $3,000
Family Coverage
$6,000
Deductible $4,700 - $6,000
$3,000 - $2,250 = $750 Employee Responsibility
$6,000 - $4,500 = $1,500 Employee Responsibility
Deductible $1,601 - $2,350
Deductible $3,201 - $4,700
$750 HSSD HRA Reimbursement
$1,500 HSSD HRA Reimbursement
Deductible $1 - $1,600
Deductible $1 - $3,200
$1,500 HSSD HSA Contribution $0
Contribution
$3,000 HSSD HSA Contribution $0
The above examples are when seeing in-network providers.
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Flexible Spending Account Employee Benefit Corporation (EBC) The Limited Flexible Spending Account (FSA) plan with Employee Benefits Corporation (EBC) allows you to set aside pre-tax dollars to cover qualified expenses you would normally pay out of your pocket with post-tax dollars. You pay no federal or state income taxes on the money you place in a FSA. How a FSA works: Choose a specific amount of money to contribute each pay period, pre-tax, to one or both accounts during the year. The amount is automatically deducted from your pay at the same level each pay period. As you incur eligible expenses, you may use your flexible spending debit card to pay at the point of service OR submit the appropriate paperwork to be reimbursed by the plan. Important rules to keep in mind: The IRS has a strict “use it or lose it” rule. If you do not use the full amount in your limited-purpose FSA, you will lose it. You cannot change your contribution amount during the year unless you experience a qualifying life event. You cannot transfer funds from one FSA to another. Please plan your limited-purpose FSA contributions carefully, as any funds not used by the end of the year will be forfeited. Limited Care FSA A limited-purpose health flexible spending account (referred to as a limited-purpose FSA) is much like a typical, general-purpose health FSA; however, under a limited-purpose FSA, eligible expenses are limited to qualifying dental and vision expenses. If contributing to a HSA, this is the only FSA available to you. The annual maximum amount you may contribute to a limited purpose FSA is $3,200. Dependent Care FSA A Dependent Care FSA allows you to pay for child or elder care expenses using tax-free dollars. These expenses must be incurred while you are employed and must be for the care of a qualified dependent.
Unlike the Health Care FSA, Dependent Care FSA funds are not available to you day one. These funds must accumulate before you can reimburse yourself, and you can only be reimbursed up to the amount you have in the account at any given time.
Examples of Eligible Dependent Care Expenses: Pre-School Charges Before and After School Care Day Care Centers Summer Day Camps
The annual maximum amount you may contribute to the Dependent Care FSA is $5,000 (or $2,500 if married or filing separately) per calendar year. Dependent Care election amounts can be changed during the year as cost changes. Flex Debit Card
The Flex Debit Card allows you to pay for your healthcare needs on the spot at qualified locations without having to wait for a reimbursement check. The card can be used at hospitals, physician offices, dental offices, vision service providers and pharmacies. Copies of receipts for some expenses still need to be submitted. Flex Debit Card Advantage Payment comes directly from your Health Care FSA account, which reduces your out-of-pocket expense Limits the need to submit claim forms and wait for reimbursement FSA plan year is January 1st through December 31st Any changes in election (other than January 1) can only happen if there is a family status change (marriage, divorce, birth or death). In order for the employee’s child to claim to be paid, the child must be a dependent of the employee by the IRS. Maximum Annual Election Health Care FSA
$3,050
Dependent Care FSA
$5,000
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Prevea Onsite Health & Wellness Center The Howard-Suamico School District partners with Prevea Health to offer an onsite employer clinic located in Bay Port High School. All employees and dependents on the health insurance plan are welcomed and encouraged to use the onsite clinic.
10
Prevea Employee Assistance Program
You're not alone. Help is just a call away.
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Making Informed Choices When Choosing Care The Howard-Suamico School District, in partnership with Prevea Health, offers employees and their insured family members healthcare options at low cost. The chart below is intended to help you identify the right setting for your specific needs. Type of Care
HSSD Onsite Health & Wellness Center
Prevea Partnered Health
Prevea Partnered Health Urgent Care
Prevea EAP
Teladoc Virtual Care
Retail Clinic
Your Doctor’s Office
Urgent Care
Emergency Room
Common Services
Approximate Wait Time
Cost Level
Primary Care Physicals Lab services Minor treatments Coughs, colds, flu
Physical Therapy Personal injury consultation Muscle/Joint pain Strengthening Post-surgery therapy
Same Day or next day availability
$5
Primary Care Physicals Lab services Minor treatments Cold, cough, flu
Physical Therapy Personal injury consultation Muscle/Joint pain Strengthening Post-surgery therapy
Same Day or next day availability
$15
Allergies Bites and stings Colds, cough, flu Earaches Minor infections
Injuries Musculoskeletal care Sore throat Minor lacerations Rashes
20 – 30 Minutes
$15
Behavioral Health Mental Health Crisis
Stress Anxiety Relationships Financial Concerns
Same day for crisis events 5 days for non-crisis
FREE
Rashes & Bug Bites Minor Injury Cold, cough, flu Bronchitis
Sinus problems Allergies Dermatology Behavioral health
Medical Care: 20 Minutes Dermatology: 30 Minutes Behavioral Health: 4 Hours
FREE
Cold, cough, flu Sinus infection Allergies Vaccinations/Screenings
Headaches Sore throat Minor sprain Minor burn
15 Minutes
$50 +
Preventative services Vaccinations Disease management
Medical problems or symptoms that are not an immediate, serious threat to your health or life
1 Week or More
$150 +
Sprains or strains Mild asthma attack Minor infections Minor injury
Medical problems or symptoms that are not an immediate, serious threat to your health or life
20 – 30 Minutes
$150 +
Sudden change in vision Sudden trouble talking Large open wounds Major burn
Severe head injury Heavy bleeding Chest pain Major broken bone
3–12 Hours Estimated wait time for non-critical cases
$1,200 +
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Dental Insurance Healthy teeth and gums are important in maintaining your overall health and well-being. Howard-Suamico School District will continue to offer two dental programs. Members are required to pay the difference between the plan payment and the provider’s actual fee for covered services. Therefore, the out-of-pocket expenses may be lower if services are provided by a Participating Provider. The chart below is a brief outline of the plans. Please refer to the summary plan descriptions for complete plan details. Delta Dental of Wisconsin
Coverage
CarePlus Dental
In-Network Benefits
Out-of-Network Benefits
In-Network
Individual
$0
$0
$0
Family
$0
$0
$0
Per Person/Family
$1,200
$1,200
$1,700
Preventative Oral Exams Cleanings X-Rays
100%
100%
100%
Basic Crowns Inlays Onlays
80%
80%
100%
50%
50%
100% 100% 75%
50%
50%
50%
Adults (and covered full-time Students, if Eligible)
Full-Time Students Only up to age 24
Full-Time Students Only up to age 24
Adults and Dependents up to age 26
Dependent Child(ren)
Covered up to age 19
Covered up to age 19
Covered up to age 26
Lifetime Maximum
$1,500
$1,500
$2,000
Annual Deductible
Annual Maximum
Major Prosthetics Partial Dentures and Complete Dentures Implants Orthodontia Benefit Percentage
HSSD Dental Premiums Employee Contributions (24 Pay Periods)
Employee Contributions (20 Pay Periods)
Delta Dental
Care Plus
Delta Dental
Care Plus
Employee Only
$2.62
$2.05
Employee Only
$3.36
$2.45
Employee + Family
$7.32
$5.52
Employee + Family
$8.78
$6.62
To identify an in-network provider for Delta Dental, go to www.deltadentalwi.com Children can remain on the Delta Dental plan if they are full-time students until age 24 and to age 19 if not enrolled in college. If you see a non-PPO dentist, you will be responsible for any charges over the Reasonable and Customary amount. To identify an in-network provider for Care Plus Dental, go to www.careplusdentalplans.com Dental Associates locations are the only in-network providers for the Care Plus plan.
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Vision Insurance
Superior Vision Eye care can be an important benefit for you and your family, which is why we provide vision insurance through Superior Vision.
Superior Vision Plans Coverage
Examination Standard Lenses Single Bifocal Trifocal Frames Contact Lenses (In lieu of glasses) Medically Required LASIK Correction
Platinum with Eye Exam Plan
Platinum without Eye Exam Plan
Frequency
In-Network Benefits
Out-of-Network Benefits
Frequency
In-Network Benefits
Out-of-Network Benefits
12 months
Not Covered
Not Covered
12 months
Covered in Full
Up to $35
12 months
No Charge
Reimbursement up to $25 up to $40 up to $45
12 months
No Charge
Reimbursement up to $25 up to $40 up to $45
12 months
$150 Allowance
Reimbursement up to $70
12 months
$150 Allowance
Reimbursement up to $70
12 months
$150 Allowance
Reimbursement up to $125
12 months
$150 Allowance
Reimbursement up to $125
12 months
Covered in Full
Reimbursement up to $150
12 months
Covered in Full
Reimbursement up to $150
12 months
$200 Allowance
12 months
$200 Allowance
*One eye exam per year is covered under the medical plan for eligible employees.
HSSD Vision Premiums Employee Contributions (24 Pay Periods) Platinum w/o Exam
Platinum with Exam
Employee Only
$3.98
$5.57
Limited Family
$7.96
Employee + Family
$10.53
Employee Contributions (20 Pay Periods) Platinum w/o Exam
Platinum with Exam
Employee Only
$4.78
$6.68
$11.13
Limited Family
$9.95
$13.35
$14.72
Employee + Family
$12.63
$17.66
To identify an in-network provider go to www.superiorvision.com
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Short-Term Disability Insurance Mutual of Omaha Howard-Suamico School District offers Short-Term Disability in the event you become disabled from a non-work-related injury or sickness, including pregnancy. Short-Term Disability benefits are provided as a source of income. Short-Term Disability Benefit Begins
1st Day of Disability Due to Accidental Injury 8th Day of Disability Due to Sickness including Pregnancy
Benefit Duration
Up to 9 weeks
Percentage of Income Replaced
60% of your Weekly Income
Maximum Benefit
$800 Per Week
Rate
$.56 Per $10 of Weekly Benefit
Weekly Benefit Amount & Cost per pay period calculation example: $50,000 (your annual earnings/salary) x 60% = $30,000 / 52 = $576.92 (weekly benefit amount) / 10 * $.56 (rate at $.56 per $10 of weekly benefit) = $32.30 / 2 = $16.15 semi-monthly premium
Long-Term Disability Insurance Mutual of Omaha Howard-Suamico School District offers long-term income protection through Mutual of Omaha and pays for the cost of this benefit on your behalf. Long-term Disability provides income protection in the event you become disabled from a non-work-related injury or sickness for an extended period of time. Long-Term Disability Elimination Period
60 Calendar Days of Disability Caused by Sickness or Injury
Benefit Duration
To Social Security Normal Retirement Age
Percentage of Income Replaced
60% of your Monthly Income
Maximum Benefit
$8,000 Per Month 15
Group Life Insurance The Minnesota Life Insurance Company The life Insurance program offers employees coverage up to five times your annual earnings. You may elect additional units of coverage, beyond basic, for a monthly premium cost to you. Coverage options include: Basic Plan (1x annual salary) is paid for by the Board of Education. Supplemental Plan provides coverage equal to your earnings for the previous year, rounded up to the next $1,000. Additional Plan provides up to three units of coverage. Each unit of coverage equals your earnings for the previous year, rounded up to the next $1,000. You may choose up to three units of additional coverage. Spouse & Dependent Plan provides coverage for your spouse and all dependent(s). If you elect one unit of coverage, your spouse will have $10,000 in coverage and each dependent (regardless of number) will have $5,000 in coverage. If you elect two units, your spouse will have $20,000 in coverage and each dependent will have $10,000 in coverage. Each unit of insurance is $1.60 per month. Sample Calculation: Lucy is 42 and earned $ 53,200 last year. The life insurance benefit rounds up to the next $1,000, which is $54,000. Lucy would take 54 x .08 = $4.32 to determine what her cost is for 1 additional unit of life insurance. If adding more than 1 unit she multiplies the cost by the number units she is adding. 2022 Monthly Employee Premium Rates per $1,000 of Insurance Insured Employee’s Attained Age
Rate
Under 30
$.05
30-34
$.06
35-39
$.07
40-44
$.08
45-49
$.12
50-54
$.22
55-59
$.39
60-64
$.49
65-69
$.57
When an active employee reaches age 70: Basic coverage continues at a reduced level without further premiums Supplemental coverage ceases Additional coverage will continue until the employee cancels coverage, stops paying premiums or ends employment Additional coverage rates for employees age 70 and older are listed below Insured Employee’s Attained Age
Monthly Rate per $10 of Weekly Benefit
70
$1.00
71
$1.15
72
$1.25
73
$1.45
74
$1.60
75
$1.80
76
$1.95
77
$2.06
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Voluntary Accident and Critical Illness Insurance Mutual of Omaha
Accident and Injury Insurance No one plans to have an accident. But, it can happen at any moment throughout the day, whether at work or at play. Most major medical insurance plans only pay a portion of the bills. Our policy can help pick up where other insurance leaves off and provide cash to cover the expenses. Our accident coverage helps offer peace of mind when an accidental injury occurs. Critical Illness Insurance The signs pointing to a critical illness are not always clear and may not be preventable, but our coverage can help offer financial protection in the event you are diagnosed. Mutual of Omaha Insurance Company group voluntary critical illness coverage provides a lump-sum cash benefit to help you cover the out-of-pocket expenses associated with a critical illness. Review the tables on the following pages to see premiums for Voluntary Accident and Critical Illness Insurance.
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Voluntary Accident Insurance Voluntary Accident Coverage Catastrophic Benefits Principal Sum Employee/Spouse/Child
$25,000 / $10,000 / $5,000
Basic Accidental Death
100%
Accidental Death Common Carrier
300%
Dismemberment and Paralysis
25% - 100%
Reasonable Modifications
Up to 10%
Coma
50%
Initial Care and Transportation Benefits ER Treatment
$200
Urgent Care
$125
Initial Physician Office Visit
$100
Ground Ambulance
$300
Air Ambulance
$1,500
Major Injuries Factures: Closed
$200 - $3,000
Fractures: Open
$400 - $6,000
Dislocations: Closed
$225 - $4,500
Dislocations: Open
$450 - $9,000
Burns
$250 - $15,000
Skin Grafts
25% of Burn Benefit
Lacerations
$50 - $800
Dental Crown or Filling Repair
$300
Extraction
$100
Hospital Admission
$1,500
Daily Confinement (Up to 365 Days)
$300 per Day
ICU Confinement (Up to 15 Days)
$600 per Day
Rehab, Facility Confinement (Up to 30 Days)
$150 per Day
Surgeries
$150 - $2,000
X-Ray
$75
Diagnostic Exam
$300
Follow Up Care Physician Follow Up (Up to 6 per Accident)
$75
Therapy Services (Up to 6 per Accident)
$25
Medical Device
$100
Prosthetic Device (Up to 2 per Accident)
$750
Transportation (Up to 3 Trips for Accident)
$300 per Trip
Lodging (Up to 30 Nights per Accident)
$125 per Night
Childcare (Up to 30 Days per Accident)
$20 per Day
HSSD Voluntary Accident Premiums Employee Rates (24 Pay Periods) Employee Only Employee + Spouse Employee + Child(ren) Employee + Family
$2.86 $4.75 $6.62 $8.51
Employee Rates (20 Pay Periods) Employee Only $3.43 Employee + Spouse $5.70 Employee + Child(ren) $7.94 Employee + Family $10.21
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Voluntary Critical Illness Insurance Voluntary Critical Illness Plan Features and Benefits
Employee $10,000
Spouse 100% of EE Benefit to $10,000
Benefit Maximum
25% of EE Benefit to $5,000
Benefit Increment
$10,000
$10,000
25% of EE Benefit to $5,000
Benefit Minimum
$10,000
$10,000
25% of EE Benefit to $5,000
Guaranteed Issue*
$10,000
$10,000
$3,000
50% at Age 70
50% at Age 70
N/A
$75
$75
$75
Age Reduction Annual Wellness Screening Benefit Separation Period
Child
3 Months Between Different Categories
Additional Occurrence Waiting Period
12 Months Between Diagnosis
Maximum Benefit
400% per Condition
Recurrence Waiting Period
12 Months
Recurrence Maximum
100% of Initial Diagnosis Benefit, 1 Time per Applicable Condition
Pre-Existing Condition Limitation
12/12
Covered Conditions
Benefit as % of Principal Sum
Heart Attack
100%
Stroke
100%
Coronary Artery Bypass
25%
Major Organ Failure
100%
End Stage Renal Failure
100%
Benign Brain Tumor
25%
Type 1 Diabetes
100%
Cancer (Invasive)
100%
HSSD Voluntary Critical Illness Premiums Employee Rates (24 Pay Periods)
Employee Rates (20 Pay Periods)
Age Band $10,000 Benefit
Age Band $10,000 Benefit
Under 25
$1.40
Under 25
$1.68
25-29
$1.79
25-29
$2.15
30-34
$2.08
30-34
$2.50
35-39
$2.68
35-39
$3.22
40-44
$3.19
40-44
$3.83
45-49
$3.77
45-49
$4.52
50-54
$5.75
50-54
$6.90
55-59
$5.67
55-59
$6.80
60-64
$11.39
60-64
$13.67
65-99
$19.86
65-99
$23.83
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Retirement Wisconsin Retirement System Benefits are administered by the Department of Employee Trust Funds (ETF). If you work a minimum of 4.8 hours per day, you will automatically be enrolled. The District and you will each contribute 6.9% of your gross income to the Wisconsin Retirement System (WRS). Unless you elect to participate in the Variable Trust Fund, 100% of your contributions will be deposited in the Core fund. See chart below for participation standards. Variable Trust Fund If you elect this option, 50% of the funds contributed by you and the District will be placed in a variable rate (primarily in common stocks). Those participating must be prepared for the possibility that poor stock market performance could result in investment losses. You can only enroll once and opt out once. WRS Participation Standards: Initially Employed Before 7/1/2011
Initially Employed On or After 7/1/2011
Must be expected to work: At least ⅓ of full time for at least one year
Must be expected to work: At least ⅔ of full time for at least one year
440 Hours
880 Hours
For more information, please see the Wisconsin Retirement System Handbook or visit: https://etf.wi.gov/retirement/wrs-retirement-benefit Wisconsin Deferred Compensation (WDC) 457 Deferred compensation programs allow eligible employees to save and invest before-tax and/or after-tax (Roth) dollars through voluntary paycheck contributions, supplementing any existing retirement/pension benefits. Visit www.wdc457.org for more information.
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HSSD Supplemental Retirement WEA Member Benefits 403(b) As an eligible public school employee, the 403(b) retirement plan, sometimes referred to as a tax-sheltered annuity (TSA), is a salary deferral plan that allows you to contribute to your retirement through a payroll deduction. This is similar to a 401(k) plan offered in the private sector. Voluntary contributions can be made on a before-tax and/or after-tax (Roth) basis. Visit www.weabenefits.com for more information. Annual Contribution Amount Administrators
$3,000
Teachers, Student Services & Coordinators
$2,000
Support Staff: Supervisors, Managers & Coordinators
$2,000
Support Staff: Specialists, Technicians, Custodians, Secretaries, Student Advocates & School Nutrition Supervisors
$1,500
Support Staff: Aides & School Nutrition
$1,000 *Employees are 100% vested in all District contributions.
Supplemental Retirement Qualifications: Employees must work a minimum of 30 hours per week in order to be eligible for this benefit. Employer contributions will be made in March each year. This amount is prorated based on FTE. Employee must be an active employee of the Howard-Suamico School District on the date of the contribution in order to receive it. All employer contributions made prior to an employee’s death will become immediately vested upon their death.
Paid Leave Benefits Paid Time Off, Vacation and Bereavement Leave The Howard-Suamico School District believes in providing employees flexibility to support a healthy work/life balance. Eligible employees receive Paid Time Off (PTO), Vacation (full-year only) and Bereavement leave annually. Leave benefits are prorated based on employment start date and the length of hours the employee works each day. PTO and Vacation may be used for any reason, however, there are guidelines in place for requesting time off. Please refer to your Employee Handbook for specific details. 21
Important Contacts BENEFIT
CARRIER
CONTACT INFORMATION
Medical PPO
WCA Group Health Trust/UMR
(800)207-3172 www.umr.com Group Number: 76-440252
Prevea Onsite Health & Wellness Clinic
Prevea Health
(833)576-0684 https://www.hssdschools.org/staff/clinic-information
Prevea Partnered Health Program
Prevea Health
www.Prevea.com/PartneredHealth
Employee Assistance Program
Prevea Health
(920)272-1200 Green Bay (920)458-5557 Sheboygan
Dental PPO
Delta Dental of Wisconsin Inc.
(800)236-3712 www.deltadentalwi.com Group Number: 99007
Managed Dental Care
Care-Plus Dental Plans, Inc.
(800)318-7007 www.careplusdentalplans.com also known as Dental Associates Group Number: PPD309
Vision
Versant Health
(800)507-3800 www.superiorvision.com Group Number: 14490101
Short Term Disability (STD) Long Term Disability (LTD) Accident & Voluntary Critical Illness
Mutual of Omaha Insurance Company
(800)369-3809 www.mutualofomaha.com Group Number: G000BP42
Health Reimbursement Account (HRA) Flexible Spending Accounts: Limited Purpose FSA Dependent Care FSA
Employee Benefits Corporation
(800)346-2126 https://www.ebcflex.com
Wisconsin Department of Employee Trust Funds
(877)533-5020 https://etf.wi.gov Number: 69-036-4384-000
403(b) Retirement Investment Options
WEA Member Benefits
(800)279-4030 www.weabenefits.com Unit ID: 0335.0 HSSD Representative: Theron Wahlberg
403(b) Retirement Investment Options
Wisconsin Deferred Compensation
(877) 457-9327 www.wdc457.org Group ID: 98971-01
USI Benefit Resource Center Benefit Questions 10:00 a.m. – 8:00 p.m. (CST)
USI
(855)874-0742 Email: BRCMT@usi.com
Wisconsin Retirement System
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