2024-2025 Employee Benefits Guide

Welcome to your Benefits Open Enrollment Guide This guide is your summary of the benefit options that are available to eligible employees of Forest City Community School District. Each benefit is designed to protect your health and well-being as well as provide valuable financial protection.

Each section of the Benefits Enrollment Guide is structured to provide you with plan highlights as well as detailed, descriptive instructions to assist you in navigating through the web-based enrollment portal While the Benefits Open Enrollment Guide is an important component in the benefit communication process, Sara Meinders at the District Office will be available for questions and concerns regarding benefits throughout the plan year.

Please review the plans contained in the Benefits Open Enrollment Guide and see how these plans can work for you and your eligible dependents Your participation in the plans is voluntary The benefit plans have been chosen to provide a continuation of protection that complements the district’s leave policies and retirement plans. The plan year is in effect from July 1, 2024 to June 30, 2025.

This Benefits Enrollment Guide is intended for orientation purposes only. It is an abbreviated overview of the plan documents Please refer to the Certificate Booklet (the contract) available from the plan carriers for complete details Your Certificate Booklet will provide detailed information regarding copayments, coinsurance, deductibles, exclusions and other benefits. The certificate booklet will govern should a conflict arise relating to the information contained in this summary. This summary does not establish eligibility to participate in or receive benefits from any benefit plan

The information and materials presented in this booklet do not offer complete details of all plan provisions and requirements, nor is this booklet intended to be a legally binding document. Those documents and contracts are available to all staff on the employee website, and those official documents govern all plan activity. Sara

smeinders@forestcity.k12.ia.us

YOUR BENEFITS July 2024 - June 2025

Know WHEN you can change your coverage

Nancy just got hired!

As a new hire, Nancy has 30 days to enroll for benefits that become effective on the first of the month following their first day of employment Coverage choice will be in effect until June 30, 2025 unless a qualifying event occurs.

Juan and his wife just had a baby! During Benefit Enrollment

Having a baby is a qualifying life event, so Juan must contact the District Office within 30 days of birth to add his baby

Each Benefit Open Enrollment, all eligible employees may elect new coverage in effect July 1, 2024 through June 30, 2025

Other qualifying events include marriage or divorce, adoption of a child, custody status change of a child, a change in Medicare or Medicaid eligibility, or a change in you or your spouse ’ s work affecting benefits eligibility

Know WHO you can add to your plans

You may cover:

● Your legal spouse

● Your natural, adopted, foster, step children and children in your custody due to a court order until they reach age 26 or an unmarried full-time student enrolled in an accredited educational institute

If you have an adult child who became disabled before age 26, please contact the District Office for information on adding them to medical and dental insurance Know HOW to choose your

Online enrollment with Benefits Connect is simple, secure and can be done in a few minutes from any computer with internet access. After enrolling online, you will have access to your benefit information 24 hours a day, from any computer For your security Benefits Connect is 128-bit encrypted and password protected. Follow the steps below to learn how to access the system and enroll.

NOTE: All employees receiving benefits need to login and review their information, even if not requesting any changes! I will be able to track if you have logged in or not.

Flexible spending enrollment occurs each October so this will come at a later date.

1 TO GET STARTED, YOU WILL NEED

During the enrollment process you will need to provide some basic information that you should have available

➢ Your social security number

➢ Your dependent’s social security numbers and birth dates

2 USERNAME AND PASSWORD

Initially your username and password are defaulted to a standard format Upon completing your first login you will be prompted to enter and complete three security questions. From there you will be asked to change your password. Let’s walk through a sample login.

Your username is made up of the first six letters of your last name, followed by your first initial and the last four numbers of your social security number. The initial password for the system is your social security number (without dashes) You will be forced to change the password immediately upon sign-in Please make note of your new password for future use If you previously have used the online enrollment system your password will be what you selected last year during the enrollment process.

Note: If your last name is not six letters please use your entire last name, first initial and last four of our social security number as your username. Example: John Doe = doej1111 or Sara Meinders = meindes2222

3 LOGIN & BEGIN COMPLETING THE REQUIRED STEPS

After your initial login, the system will start you at the WELCOME SCREEN You will see to the left that you will need to update your Personal Information, Dependents/Beneficiaries, and Emergency Contacts before proceeding to the enrollment options Select “Get Started” to continue

School District

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PERSONAL INFORMATION

To get started, the 2nd screen is the Personal Information section Please complete all fields Fields with a RED Asterisk are required, and must be completed When you have completed all of the fields, click NEXT to proceed to the next screen.

5 DEPENDENT PROFILE & BENEFICIARIES

The system will now take you to the Dependent Information section:

➢ Currently covered dependents will already be listed Please view their individual information to verify the information entered for you by selecting the Edit button next to their name. Correct any incorrect or missing information.

➢ To add a spouse or child that is not currently listed, click the “ + Add Dependent” icon, enter information, and click Save

Note: You only need to add dependents that you would like to enroll for coverage You will choose which dependents to enroll for each plan when you reach the election screens

The beneficiary information can be ignored as this is only for plans that have Life Insurance. Please skip this section by selecting “NEXT”.

6 EMERGENCY CONTACTS

The emergency contact information is optional and does not need to be completed in Benefits Connect To view or update your emergency contact on file with the School District, log into your Web Link employee portal (where you signed your employee contracts). Please just select “NEXT”.

BENEFIT PLAN ELECTIONS

Next, the system will take you to the Benefit Plan Enrollment Section Each benefit and your options will be displayed one by one beginning with Medical, then Vision, then Dental and finally Long Term Disability (LTD).

The plan you are currently enrolled in will already be selected. You can switch to a different plan or you can decline enrollment if desired. If you need more information on each plan, you can select the “View Outline of Benefits” for their Summary of Benefits and Coverages In the following pages of this document there are also plan descriptions

To enroll in a plan, check “Selected” below the option you’d like, and check any dependents you want to cover or decline coverage by selecting “Decline Enrollment”

Click “Save” after each benefit selection making sure to pay attention to the dependents selected for each benefit plan

In the summary below, the test employee “Deb Test” is selecting the “PSF HDHP 2500 w/ HSA” plan for two people. The employee will be covered along with their child “Jane Test”. The monthly payroll deduction from the employee’s paycheck will be $431.63.

Note: If you are selecting either plan with HSA eligibility, you will need to print out and submit the “HSA Direct Deposit Authorization” form that is located in the “View Outline of Benefit” section of each plan. However, don’t worry, if you forget, the district office will be contacting you.

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CONSOLIDATED ENROLLMENT FORM

Once you have gone through enrollment for each plan available, the system will take you to the CONSOLIDATED ENROLLMENT FORM page This screen will show you a summary of the information you entered and the benefit elections you made.

➢ If you need to edit an election, simply click “Edit Election” next to the benefit you need to review and follow the steps again.

9 ONE LAST STEP

Review the “Benefit Cost Summary” located to the right hand side of the screen to ensure you understand your cost “My Cost” and the district’s costs “ER Cost” that you are signing up for. This will be your monthly payroll deduction minus the amounts selected for your HRA deductions if applicable

To complete the enrollment process: Please Click “Return to Home.”

If you need to log off before completing enrollment, any data you entered will be saved The next time you log on, you will be taken directly to the last saved screen.

Always make sure to log out upon completing any action on the system To logout, select the red circle with your initials in the top right corner and “logout”

The following pages give a more detailed explanation of the benefits being offered to you.

MEDICAL INSURANCE MADE SIMPLE - What happens when you need health care?

Be an educated health consumer. All three plans offered to employees cover in-network preventive care 100%. Beyond that, your responsibility depends on the plan you choose, the services you need, and where you receive your care.

Know your terms!

PSF - Partially Self Funded account Your employer contracts with a third-party administrator (TPA) to administer all aspects of the health plan, including claim adjudication, but the employer funds the claims payments Advantage Administrators will again be the TPA for the District’s PSF services

Calendar Year - Deductible and Out of Pocket Maximums are based on a calendar year which begins January 1st - December 31st annually

Deductible - a fixed dollar amount that you pay for covered services in a benefit year before medical benefits become available

Out of pocket maximum - the most you will pay during the calendar year for covered expenses This includes copays, deductibles, coinsurance, and prescription drugs

Copay - a flat fee you pay whenever you use certain medical services, like a doctor visit

High Deductible Health Plan (HDHP) - a plan with a higher deductible than a traditional insurance plan that must be paid before insurance coverage kicks in

Health Savings Account (HSA) - a type of savings account that lets you set aside money on a pre-tax basis to pay for qualified medical expenses

PLAN OPTIONS - There are three (3) choices

1. PSF 500 = Partial Self Funded Plan with a $500 Per Person Deductible. The district purchases a $5000 deductible plan with Wellmark and self-funds it down to the $500 deductible with Advantage Administrators services to track and make payments

2. PSF 2500 HDHP w/ HSA = Partial Self Funded Plan with a $2500 High Deductible Health Plan that is eligible for Health Savings Account contributions. The district purchases a $5000 HDHP plan with Wellmark and self-funds it down to the $2500 deductible with Advantage Administrators services to track and make payments THIS IS A CHANGE As of July 1st the $2500 HDHP Plan will also be a PSF health plan with Advantage Administrators paying the claims between the district covered $2500 HDHP and the Wellmark Plan $5000 HDHP.

3. 5000 HDHP w/ HSA = A $5000 High Deductible Health Plan that is eligible for Health Savings Account contributions. Your Medical Coverage

YOUR COST FOR MEDICAL COVERAGE

We do our very best to get the most competitive prices while getting you the best possible coverage. These premiums are the amount you pay for your insurance each paycheck Remember that they come out before taxes, lowering your taxable income.

Note: Married Employees (two eligible full time employees sharing employee benefits) and Bus Route Driverssee your designated Plan Options on the pages following as they are different from below

HOW PARTIAL SELF FUNDING WORKS (PSF)

Phone: 319-352-1623

800-383-1623

Website: advantageadmin.com

Advantage Administrators is the District’s Self-Funded plan administrator They gather all the claims and pay the difference between the Wellmark policy and the District’s Self-Funded policy. If you have questions or concerns regarding a claim, feel free to call Advantage Administrators for assistance

Partial Self-Funding Defined: With a partially self-funded health plan, the employer contracts a health insurance carrier or third-party administrator (TPA) to administer all aspects of the health plan, including claims adjudication, but the employer funds the claims payments.

Who Makes the Payments?

1. Employee visits the Mercy Hospital in Mason City for an MRI of an injured knee (not an office visit).

2 Employee pays CoPay if required If the amount seems excessive, explain to Mercy that your employer partial self funds the Wellmark plan and that you have a lower deductible/out of pocket max They can contact Advantage Administrators at the number above to verify and ask for assistance Typically, Mercy Hospital will not require the down payment at the time of service if they are informed.

3 Mercy Hospital submits the medical claim to Wellmark (electronically)

4. Wellmark reviews plan deductibles and out of pocket maximums and makes payment to Mercy Hospital based upon higher deductible plan.

5 Wellmark issues Explanation of Benefits (EOB) to Employee

6. Wellmark shares employee’s EOB with Advantage Administrators.

7. Advantage Administrators reviews plan deductibles and out-of-pocket maximums and makes payment to Mercy Hospital based upon the partial self-funded (lower deductible) plan and makes additional payment to the provider.

8 Advantage Administrators issues EOB to employee

9. Employee pays the remaining balance to Mercy Hospital. Wellmark

Advantage Administrators

Employee Pays Pays on behalf of the Pays District Balance Due

HEALTH SAVINGS ACCOUNT (HSA)

The HSA is a great way to handle any medical expenses not covered by your medical insurance. You make regular contributions to your account through payroll – and the contributions are tax free

AND THAT’S NOT ALL:

● You own the account, even if you change plans or jobs;

● Your contributions are tax-free to pay for medical, prescription, dental and vision expenses;

● There are federal, state and FICA tax savings;

● Your funds roll over from year to year;

● Any withdrawal for qualified medical expenses is tax-free

Once you enroll in the $2500 HDHP plan or the $5000 HDHP you will need to open a Health Savings Account at your financial institution (your bank). Once it’s open, you can begin making contributions.

The maximum combined employee/employer contribution amount cannot exceed the IRS stated maximums of $4,150 for individual coverage ($345.83 per month) and $8,300 for 2-person or family coverage ($691.67 per month) for the 2024 calendar year

Note: Individuals age 55 and older can make an additional $1,000 catch up contribution Check the IRS guidelines for maximum contributions at www.treas.gov and click on Health Savings Accounts.

HOW YOUR HSA WORKS

Brad has an individual HSA

He saves directly from his paycheck into his HSA

$2,340 ($195 per month)

Angie doesn’t have an HSA

She saves independently for medical expenses

$2,340 ($195 per month)

No income tax is applied -$585 (25% federal income tax)

$2,340

Tax-free money to cover medical expenses

$1,755 Post-tax money to cover medical expenses

It’s good to know your funds are available as soon as they are deposited and you can use your money in two ways:

1. Pay for out-of-pocket costs if you receive medical, prescription, dental, or vision care

2 Leave the money in your account so it will carry over from year-to-year and grow tax-free

Please remember that you’ll need to enroll in one of the two HDHP plans to join our HSA. Also, you can’t contribute to an HSA if you’re in another medical plan (including Medicare or TRICARE) or are a dependent on someone else’s tax return. In these cases, you can still enroll in the HDHP plan, but you’ll need to opt out of the HSA. You also are not allowed to contribute to a medical flexibility account (cafeteria) if you are contributing to a HSA.

HSA ELIGIBILITY LIST

The following is a summary of common expenses claimed against Health Savings Accounts (HSAs) Due to frequent updates to the regulations governing these accounts and arrangements, this list does not guarantee reimbursement and is to be utilized as a guide for the submission of claims. For more information on IRS-qualified medical expenses, click here

Common IRS-Qualified Medical Expenses

Acupuncture

Ambulance

Artificial limbs

Artificial teeth*

Birth control treatment

Blood sugar test kits for diabetics

Breast pumps and lactation supplies

Chiropractor

Contact lenses and solutions*

COVID-19 diagnostic testing and treatment

Crutches

Dental treatments (including X-rays, cleanings, fillings sealants braces and tooth removals*)

Doctor’s office visits and co-pays

Drug prescriptions

Eyeglasses (Rx and reading)*

Fluoride treatments*

Feminine hygiene products

Fertility enhancement (including in-vitro fertilization)

Flu shots

Guide dogs

Hearing aids and batteries

Infertility treatment

Inpatient treatment at a therapeutic center for alcoholism or drug addiction

Insulin

Laboratory fees

Laser eye surgery *

Medical alert bracelet

Medical records charges

Midwife

Occlusal guards to prevent teeth grinding

Orthodontics*

Orthotic Inserts (custom or off the shelf)

Over-the-counter medicines and drugs (see more information below)

Personal protective equipment (PPE) like masks and hand sanitizer

Physical therapy

Psychiatric care

Psychoanalysis

Psychologist

Special education expenses that include tutoring for a child with learning disabilities caused by mental impairments (recommended by doctor)

Speech therapy

Stop-smoking programs (including nicotine gum or patches if prescribed)

Surgery, excluding cosmetic surgery

Vaccines

Vasectomy

Vision exam *

Walker cane

Wheelchair

Reminder: your deductible and maximum benefits accrue from January through December each year.

Main Benefits:

Visit your dentist two times per calendar year at $0 00 for Oral Evaluations and Dental Cleaning!

X-Rays are a benefit every 12 months at $0.00 charge to covered members.

Complete Delta Dental Plan Booklet can be found here. COVERED EMPLOYEES ON DELTA DENTAL

For information on your dental benefits visit: deltadentalia.com

Call Toll-Free: 1-800-544-0718

Be sure to have the member’s identification number ready to help them serve you better Register for an online account at www.deltadental.com where you can view claims, estimate costs, view annual maximum balances remaining and more!

Delta Dental PPO Plus Premier

PPO Plus Premier plans give you the same broad access to dentists in the Delta Dental Premier network, PLUS the opportunity to save even more when you visit a dentist in the Delta Dental PPO network.

When dentists join our PPO (Preferred Provider Organization) network, they agree to accept fees lower than those in our Delta Dental Premier network If you have a PPO Plus Premier plan and visit a dentist in our PPO network, you may have lower out-of-pocket costs It is most often to your financial advantage to receive services from a PPO Panel Dentist or a Participating Delta Dental Dentist You can search for a PPO dentist near you here

VISION INSURANCE

Focus on your vision

Reliable & Dependable - Avēsis is a national leader in providing exceptional vision care benefits for millions of commercial members throughout the country The Avēsis vision care products give our members an easy-to-use wellness benefit that provides excellent value and protection AvesisPlan Premiums

Here’s How It Works

When you need to see an eye care professional, simply visit www.avesis.com or contact Avesis Customer Service Monday through Friday, 7 a.m. to 8 p.m. (EST) at 800-828-9341 to receive a listing of providers in your area.

LONG TERM DISABILITY INSURANCE (LTD)

All full-time active employees are eligible to participate in our long-term disability plan through UNUM..

Our long term disability plan provides financial protection for you by paying a portion of your income while you are disabled The amount you receive is based on the amount you earned before your disability In some cases, you can receive disability payments even if you work while you are disabled.

Elimination Period: 90 Days Benefits begin the day after the elimination period is completed

Monthly Benefit (The lesser of):

● 60% of monthly earnings to a maximum benefit of $4,050 per month; or

● 75% of monthly earnings less any deductible sources of income

Maximum Period of Payment:

Monthly premium payment = 0 24% of your monthly wage (To calculate monthly payments, take your annual salary x 0 0024 / 12)

Monthly premiums are also available upon enrollment in Benefits Connect.

If you have previously been offered LTD Insurance and decline enrollment and want to enroll an insurability questionnaire must be completed and coverage may be declined.

OTHER BENEFITS - Tax Sheltered Annuity (403B)

Welcome Education-Related Employees!

Employer-specific plan details

The Retirement Investors' Club (RIC) 403b is a voluntary retirement savings benefit offered by participating employers of education-related institutions. There are no vesting requirements.

The RIC 403b plan is designed to supplement your pension (IPERS, TIAA) and social security income benefits at retirement. You choose how much of your current income to save pretax, through automatic salary reductions. Your contributions and earnings grow tax-deferred. See plan details specific to your employer's 403b plan here.

Take advantage of this great employee benefit today!

Enrollment is always open!

The provider you choose has everything you need to open your accounts and begin salary reductions. At no additional cost, advisors can explain the investments and help you complete the enrollment process. See frequently asked questions. For a summary of the provider phone numbers and a list of investment options, view the RIC 403b At-A-Glance.

OTHER BENEFITS - Work Injury Insurance (Work Comp)

CONTACT INFORMATION

STAFF RESOURCES

https://www.forestcity.k12.ia.us/employment/staff-resources