Employee Insurance Benefits for 2024
Overview of Benefits
Spoon River College provides benefits that can help you enjoy increased well-being, deal with an unexpected illness or accident, build and protect your financial security, balance your personal and professional life and meet everyday needs. These benefits are affordable, comprehensive and competitive. The table below summarizes the benefits available to eligible staff and their dependents. These benefits are described in greater detail in the appropriate sections below.
Benefits At-A-Glance
| Coverage | Carrier |
|---|---|
| Medical | BlueCross BlueShield of Illinois |
| Dental | BlueCross BlueShield of Illinois |
| Vision | BlueCross BlueShield of Illinois |
| Life | BlueCross BlueShield of Illinois |
| Long-Term Disability | BlueCross BlueShield of Illinois |
| Accident / Cancer | AFLAC |
| 403(b) | AIG |
Eligibility: Full Time
Changes and Qualifying Events
When Coverage Begins and Ends:
Date of Hire
Your coverage under the benefits plans will end if you no longer meet the eligibility requirements, your contributions are discontinued or the Group Insurance Policy is terminated.
Qualifying Events:
Eligible employees may enroll or make changes to their benefits elections during the annual open enrollment period. As with most benefits, once you elect an option you are bound to that choice for the entire plan year unless you experience a “Qualifying Event”. These may include, but are not limited to:
- Changes in employment status
- Changes in legal marital status
- Changes in number of dependents
- Taking an unpaid leave of absence
- Dependent satisfies or ceases to satisfy eligibility requirement
- Family Medical Leave Act (FMLA) leave.
- A COBRA-qualifying event
- Entitlement to Medicare or Medicaid
- A change in the place of residence of the employee, resulting in the current carrier not being available
Medical
Summary of Coverage
| Plan Features | HDHP | PPO | ||
|---|---|---|---|---|
| IN NETWORK | ||||
| Calendar Year Deductibles (Indiv / Family) | $3,200 / $6,400 | $500 / $1,500 | ||
| Preventive Care | 0% | $0 | ||
| Primary Care Visit | 20% | $20 | ||
| Specialist Visit | 20% | $40 | ||
| Diagnostic Exam | 20% | $20 / $40 | ||
| X-Rays | 20% | 10% | ||
| Complex Images | 20% | 10% | ||
| Outpatient Procedure | 20% | 10% | ||
| Inpatient Visit | 20% | 10% | ||
| Emergency Room | 20% | $150 | ||
| Urgent Care | 20% | 10% | ||
| Pharmacy / RX Preferred | 10% / 10% / 20% /30% / 40% / 50% | $0 / $10 / $50 / $100 / $150 / $250 | ||
| AFTER deductible | ||||
| Pharmacy / RX Non-Preferred | 20% / 20% / 30% /40% / 40% / 50% | $10 / $20 / $70 / $120 / $150 / $250 | ||
| AFTER deductible | ||||
| Calendar Year | $6,200 / $12,400 | $1,500 / $4,500 | ||
| Out-of-Pocket Max (Indiv / Family) | ||||
| OUT OF NETWORK | ||||
| Calendar Year Deductibles (Indiv / Family) | $6,400 / $12,800 | $1,000 / $3,000 | ||
| Preventive Care | 40% | 30% | ||
| Primary Care / Specialist / Urgent Care | 40% | 30% | ||
| Diagnostic Exam / X-Ray / Complex Images | 40% | 30% | ||
| Outpatient Procedure / Inpatient Visit | 40% | 30% | ||
| Emergency Room | 40% | $150 | ||
| Pharmacy / RX (30 Day Supply) | see SBC | See SBC | ||
| Calendar Year | $18,600 / $37,200 | $4,500 / $13,500 | ||
| Out-of-Pocket Max (Indiv / Family) | ||||
| BI-WEEKLY DEDUCTIONS | ||||
| Employee | $53.49 | $99.51 | ||
| Employee + Spouse | $111.58 | $207.72 | ||
| Employee + Child(ren) | $96.55 | $178.45 | ||
| Employee + Family | $155.42 | $287.70 | ||
This is only an illustration and not a guarantee of benefits or claims payment.
The prescription benefit shown is for a 30 day supply. See your SBC for mail order details.
See EASE for additional information.
Coinsurance is applicable AFTER deductible has been met.
Dental and Vision Coverage
Summary of Coverage
| Blue Cross Blue Shield Dental | ||||
|---|---|---|---|---|
| In & Out of Network* | ||||
| Annual Deductible (Individual / Family) | $50 / $150 | |||
| Preventive Care | 100% | |||
| Basic Procedures (Extractions, fillings, etc.) | 80% | |||
| Major Procedures (Crowns, dentures, etc.) | 50% | |||
| Child Orthodontia | $1,500 50% | |||
| Calendar Year Maximum Benefit | $1,500 | |||
| Blue Cross Blue Shield Vision** | ||||
| Vision Exam | $10 | |||
| Lenses | ||||
| Single / Bifocal / Trifocal | $10 | |||
| Standard Progressive | $75 | |||
| Frames | $150 Allowance + 20% | |||
| Contact Lenses | $150 Allowance + 15% | |||
| Frequencies | ||||
| Exam / Lenses or contacts / Frames | 12 / 12 / 24 | |||
| BI-WEEKLY DEDUCTIONS | With Medical | Without Medical | ||
| Employee | $0.00 | $3.09 | ||
| Employee + Spouse | $0.00 | $6.19 | ||
| Employee + Child(ren) | $0.00 | $7.67 | ||
| Employee + Family | $0.00 | $11.56 | ||
This is only an illustration and not a guarantee of benefits or claims payment.
See EASE for additional information.
*Dental coverage Out Of Network is based on U&C.
**Vision Network is EyeMed.
If you elect Medical coverage you will be automatically enrolled for Dental & Vision with the same dependent coverage.
If you do not elect Medical coverage but enroll in Dental you will be automatically enrolled for Vision with the same dependent coverage.
LIFE INSURANCE
Summary of Coverage
| Employer-PAID Basic Life Insurance | space | |
|---|---|---|
| Employer-PAID Basic Life Insurance | ||
| Class 1: All Active Full-Time Administrators, Professional Support Staff and Faculty | ||
| Benefit Amount | 2x Salary to $300,000 | |
| AD&D Benefit | 2x Salary to $300,000 | |
| Class 2: All Full-Time Classified Staff | ||
| Benefit Amount | $25,000 | |
| AD&D Benefit | $25,000 | |
| Age Reduction | ||
| No age reduction | ||
| Employee Supplemental Term Life / ADD Insurance | space | |
|---|---|---|
| Employee Supplemental Term Life / ADD Insurance | ||
| Employee Benefit | $10,000 - $750,000, not to exceed 7x salary | |
| Increments | $10,000 | |
| Guarantee Issued | $150,000 | |
| Spouse Supplemental Term Life / ADD Insurance> | ||
| Spouse Benefit | $10,000 - $750,000, not to exceed 100% of Employee | |
| Guarantee Issued | $50,000 | |
| Child(ren) Supplemental Term Life / ADD Insurance | ||
| Birth to 13 Days | $0 | |
| 14 days to age 26 | $2,500 - $10,000 in increments of $10,000 | |
| Age Reduction | ||
| No age reduction | ||
| Employee / Spouse Supplemental Term Life / ADD cost per $1000 | ||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Employee / Spouse Supplemental Term Life / ADD cost per $1000 | ||||||||||||||||||||
| Age | 0-29 | 30-34 | 35-39 | 40-44 | 45-49 | 50-54 | 55-59 | 60-64 | 65-69 | 70+ | ||||||||||
| Rate | 0.067 | 0.086 | 0.086 | 0.133 | $0.29 | 0.314 | 0.513 | 0.817 | 1.283 | $2.60 | ||||||||||
| Child(ren) | $0.22 per $1,000 | |||||||||||||||||||
This is only an illustration and not a guarantee of benefits or claims payment.
If you previously waived the Supplemental Life benefit for yourself and/or dependents and wish to enroll at open enrollment or would like to increase the benefit above the guarantee issued amounts, you and/or dependents will be required to provide Evidence of Insurability.
– At Open Enrollment: Enroll for an additional $10,000 benefit up to the Guarantee Issued amount without Evidence of Insurability if you are currently enrolled.
Health Savings Account (HSA)
Thru MidAmerica National Bank
For 2024 Spoon River College is offering a Health Savings Account (HSA) IF you are covered under the Blue Cross Blue Shield HDHP with Spoon River College. This is how an HSA works:
A health savings account (HSA) is a health care account and savings account in one. The main purpose of this account is to offset the cost of a qualifying high deductible health plan (HDHP) and provide savings for your out-of-pocket eligible health care expenses – those you and your tax dependents may have now, in the future, and during your retirement.
This is a “portable” account. You own your HSA! It’s included in your employee benefits package, but after you set up your account, it’s yours to keep, even if you change jobs or retire.
Once your HSA is established, money is contributed to your account by you, Spoon River College or friends and family, and you can then use your HSA dollars tax-free to pay for eligible health care expenses. You save money on expenses you’re already paying for, like doctors’ office visits, prescription drugs, and much more. Best of all, you decide how and when to use your HSA dollars.
Why is it a good idea to have an HSA?
HSAs benefit everyone who is eligible to have this account – single individuals, families, and soon-to-be retirees. You save money on taxes in three ways:
- Tax-free deposits – The money you contribute to your HSA isn’t taxed (up to the IRS annual limit).
- Tax-free earnings – Your interest and any investment earnings grow tax-free.
- Tax-free withdrawals – The money used toward eligible health care expenses isn’t taxed – now or in the future.
- Setting aside pre-tax dollars into your HSA means you pay fewer taxes and increase your take-home pay by your tax
savings. You save money on eligible expenses that you are paying for out of your pocket. The amount you save
depends on your tax bracket. For example, if you are in the 30 percent tax bracket, you can save $30 on every $100
spent on eligible health care expenses.
HSA funds roll over from year to year and accumulate in your account. There is no “use-it-or-lose-it” rule with HSAs, and you decide how and when to use your HSA funds, which can be used for eligible expenses you have now, in the future, or during retirement. And when you have a certain balance in your HSA, investment opportunities are available.
Spoon River College is contributing into the HSA for any employee that is enrolled in the offered Blue Cross Blue Shield HDHP with a one time lump sum & monthly deposits (pro-rated if you are electing coverage during the plan year!):
Employee: $2,450 – total annual Employer contribution
Employee/Child(ren): $4,325 – total annual Employer contribution
Employee/Spouse: $5,150 – total annual Employer contribution
Family: $7,000 – total annual Employer contribution
Refer to your HSA documentation for more information and annual limits! Please log into EASE!