HUMAN RESOURCE BENEFITS AND REQUIREMENTS

Editor’s Note: Policies included in this handbook are only those to which employees may need to refer more frequently. No attempt is made in this section to be all-inclusive. Complete information on all policies may be found in Board Policy Manuals available in each school library and from each school principal/director.

INSURANCE PROGRAMS

Benefits are offered to all employees who expect to work 30 hours or more per week for at least six months per year. Part-time teachers are eligible for health, dental, MoneyPlus and vision care on a prorated basis. Below are insurance programs that are offered by the state. Initial enrollment must be made within 31 days of hire. Complete descriptions and rules for all insurance programs listed can be found in the Insurance Benefits Guide and are the responsibility of the employee. New Insurance Benefits Guides are distributed to employees through the District’s Pony mail each year in January. Please call the Benefits Office to request an Insurance Benefits Guide if you did not receive one or it is misplaced.

Health Insurance

The State of South Carolina has made available a comprehensive health insurance plan for its eligible employees, retirees and their dependents. Claims made under this plan are funded by employer and employee contributions and administered by Blue Cross and Blue Shield of South Carolina. The employer pays the largest portion of the premium and the employee contributes a minimal amount for himself/herself. The employee pays the entire portion for his/her dependent(s). Coverage will begin the first day of the calendar month coinciding with or following the date of employment.

Late Entrant: To enroll in the State Health Plan as a late entrant, employees must enroll within 31 days of a special eligibility situation which may be marriage, birth, adoption, placement, or involuntary loss of other coverage applying only to those (spouses or eligible dependents) who lost the coverage or may enroll during an Open Enrollment*.

*Note: Open Enrollment is held in October of every ODD year (ex. 2003, 2005, 2007). All Open Enrollment changes take effect Jan. 1 of the following year.

Changes: Changes in coverage may be made during an Open Enrollment period or within 31 days of a status change. A status change may be marriage, birth, adoption, placement, legal custody, legal separation, divorce, death or change in job status.

Preexisting Condition: Benefits for a preexisting condition are payable only for treatment rendered 12 months after the enrollment date of a covered person. Certification of prior continuous coverage can be applied toward the waiting period for services related to a preexisting condition to be payable. One’s former insurance company provides this certification known as a Certificate of Creditable Coverage. This certificate must then be submitted to the Benefits Office so that it can be mailed to the Employee Insurance Program for processing.

Prescription Drug Program: The Prescription Drug Program is administered by Medco Health Solutions, Inc. An employee shows their State Health Plan identification card when purchasing prescriptions from a participating pharmacy and pays a copayment for either generic or brand name medications for up to a 31-day supply. If the price of the prescription is less than the copayment amount, an employee pays the lesser amount.

Additional Benefits: When an employee enrolls in the State Health Plan, he/she is provided with the following additional benefits at no charge (the employer pays the premiums):

¨ Basic Life Insurance - $3,000 coverage to employees under age 70 and $1,500 to employees age 70 or older

¨ Basic Long Term Disability – provides 62.5% of an employee’s basic monthly salary ($800 maximum) after a 90-day waiting period

Medi-Call

What Is It? Medi-Call is the State Health Plan's utilization review program. Medi-Call makes sure you and your covered family members receive appropriate medical care in the most beneficial, cost-effective manner.

When Must I Call? Participation in Medi-Call is mandatory. You must call 803-699-3337 in Columbia or 1-800-925-9724 in South Carolina, nationwide and in Canada when:

( You need inpatient care in a hospital;

( You need outpatient surgery for septoplasty, hysterectomy or sclerotherapy;

( You need a MRA, MRI or CT Scan;

( You will be receiving chemotherapy or radiation therapy;

( Your precertified outpatient services result in a hospital admission (you must call again);

( You need a second opinion;

( You are admitted to a hospital in an emergency situation (your admission must be reported within 48 hours or the next working day);

( You are diagnosed as being pregnant (you must call within the first three months of your pregnancy)*;

( You have an emergency admission during pregnancy*;

( You deliver your baby*;

( Your newborn has complications at birth;

( You are admitted to a skilled nursing facility, utilize home health care, hospice care or an alternative treatment program or need durable medical equipment;

( You or your covered family members decide to undergo any In Vitro Fertilization (IVF) procedure;

( You or your covered family member need to be evaluated for a transplant;

( You need inpatient rehabilitative services and related outpatient physical, speech and occupational therapies;

( Any procedure that may potentially be considered cosmetic in nature must be received in writing by Medi-Call seven days prior to surgery (i.e., blepharoplasty, reduction mammoplasty, TMJ or other jaw surgery).

*Contacting Medi-Call for the delivery of your baby does not add that baby to your health insurance. You must add your child by completing and filing an NOE with the Benefits Office within 31 days of birth for benefits to be payable. Medi-Call approval does not guarantee payment of benefits. Claim payments are still subject to the rules of the Plan.

Dental Insurance

The State of South Carolina has a dental insurance plan for its eligible employees, retirees and their dependents. There is a small premium to cover the spouse and dependents. The district pays the entire cost for the employee. Dental Plus is an additional dental program that provides a higher level of coverage for dental services and premiums are paid in full by the employee. Changes in coverage may be made during an Open Enrollment period or within 31 days of a status change.

State Optional Life

Optional Life is a term life plan insured by The Hartford. All eligible employees may enroll within 31 days of hire without medical evidence. Employees may elect coverage in $10,000 increments up to 3 times their basic annual earnings. Medical evidence of good health will be required to increase optional life, and it is necessary to refer to the Insurance Benefits Guide for specific rules as to when optional life increases and decreases are allowed. Premiums are calculated according to age and coverage amounts. Benefits are reduced for active employees who reach age 70.

Dependent Life Insurance

Dependent Life Spouse and Child are insured by The Hartford. An employee may purchase Dependent Life Spouse coverage ($10,000 or $20,000) for their spouse. An employee may also purchase Dependent Life Child coverage ($10,000) for their eligible children. Employees may enroll their dependents within 31 days of hire or within 31 days of when an eligible dependent is acquired. Employees may enroll their spouses throughout the year by providing medical evidence of good health and may enroll their children throughout the year, but medical evidence is not required.

Supplemental Long Term Disability

Employees may enroll in the Supplemental Long-Term Disability benefit, administered by Standard Insurance Company. Benefits are payable at 65% of an employee’s basic monthly salary ($8,000 maximum). Employees may choose one of two benefit waiting periods (90 day or 180 day). This is a coordinated benefit with Basic Long Term Disability, the State Retirement Disability, Social Security, annual leave, sick pay, Worker’s Compensation, etc. Premiums are based on salary, the benefit waiting period and age bracket.

Long Term Care Insurance

The Aetna offers Long Term Care for active employees, spouses, parents and parents-in-law of active employees. Long Term Care refers to a wide range of personal care and health and social services that can be provided to people of any age who suffer a chronic disease or long-lasting disability. It can be provided in a nursing facility, an adult care center or a home and can involve some skilled or intermediate nursing care. Premiums are based on age and are paid in full by the employee.

MoneyPlus

MoneyPlus, administered by Fringe Benefits Management Company, is a flexible benefits program that helps an employee keep more spendable income by enabling an employee to pay health, dental and optional life premiums from their pretax income. MoneyPlus can be used to pay dependent-care expenses and out-of-pocket medical expenses with money that is not taxed. The three MoneyPlus features an employee can choose are the Pretax Group Insurance Premium Feature, the Dependent Care Spending Account, and the Medical Spending Account. Each benefit has its own small administrative charge.

VISION CARE PROGRAM

The Vision Care Program offers discounted vision care services to full-time or part-time employees, retirees and their dependents free of charge. An employee does not have to subscribe to the State Health Plan for vision benefits. Participating ophthalmologists charge no more than $50 for a routine, comprehensive eye exam. Participating providers, which also include opticians, give a 20% discount on all eyewear (except disposable contact lenses).

Retirement Plans

South Carolina Retirement System (SCRS): A defined benefit plan. In a defined benefit plan, the state bears the investment risk and provides a guaranteed monthly pension based on a statutory formula, not on your account balance.

State Optional Retirement Program (ORP): A defined contribution plan. In a defined contribution plan, you invest your funds within the plan’s investment choices and then bear the risk, or enjoy the benefit, based on the performance of your investments. Your retirement benefit is based on the balance in your account when you retire.

For either plan, the employee contributes 6% of his/her salary and the district also makes a contribution. In addition, if an employee dies while actively employed, his/her beneficiary is entitled to an amount of life insurance equal to the annual salary of the employee (provided the employee has been employed for one year).