Retirees/COBRA Benefits Guide 2023-2024

Welcome to your Benefits Open Enrollment Guide This guide is your summary of the benefit options that are available to eligible retirees 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, 2023 to June 30, 2024.

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 retirees upon request.

Sara Meinders

641-585-2323 ext 2204

smeinders@forestcity.k12.ia.us

YOUR BENEFITS July 2023 - June 2024

What’s New:

Online Enrollment! No more paper forms and entering your personal information each year. Instructions begin on page 5

Know HOW to choose your coverage

Enrollment Quikstart Log into https://enroll benefitsconnect net/300334

BENEFIT OPEN ENROLLMENT GUIDELINES

Benefit Open Enrollment will be available from April 12, 2023 through May 5, 2023

Forest City Community School District is now conducting benefit open enrollment online at https://enroll.benefitsconnect.net/300334

For Online Enrollment Technical Assistance - please call Sara Meinders - Forest City Community School District Business Manager - 641-585-2323 or email smeinders@forestcityk12 ia us

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 retirees 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.

Forest City Community School District 2023-2024 Benefits | 4

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.

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.

4 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 Please just select “NEXT”

7 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.

As a retiree/COBRA enrollee, you are not eligible for the Vision coverage. Please decline.

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” Please decline the Vision insurance as you are not eligible for this as a retiree/COB

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.

8 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 Retirees/COBRA that 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!

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

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.

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. Traditional Plan, $1,000 Deductible = $1,000 deductible or $2,000 out of pocket maximum per person per calendar year.

2. 2500 HDHP w/ HSA = Partial Self Funded Plan with a $2500 High Deductible Health Plan that is eligible for Health Savings Account contributions.

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

DENTAL INSURANCE BENEFITS AND PREMIUMS

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