• Medical and Dependent Care Flexible Spending Accounts
• Legal Plan
State Health Benefit Plan
• State Health Medical Insurance How to Enroll in Campus Benefits
How to Enroll in State Health Benefit Plan 1. Visit
Select the “State Health”
Select “SHBP Enrollment Link” (Review the SHBP page within this guide for additional details)
Contact SHBP at 1.800.610.1863
SERVICE HUB/ SUPPORT CENTER
Campus Benefits is your dedicated advocate for all your voluntary benefits.
When
to
contact
the
Campus Benefits Service Hub
• Portability/Conversion
• Benefits Education
• Evidence of Insurability
• Qualified Life Event Changes
How to File a Claim
• Claims
• Card Requests
• Benefit Questions
• COBRA Information
1. Contact Campus Benefits via phone or email
2. Work with Campus Benefits’ claims specialist to complete the necessary paperwork
• Employee Portion
• Physician Portion
• Employer Portion
The Campus Benefits team understands the claims process and leverages the necessary carrier relationships to expedite the paperwork efficiently to ensure claims are not delayed due to improper paperwork completion.
3. Submit the necessary paperwork to Campus Benefits via the secure upload
• Secure upload located at www.evanscountybenefits.com/contact-campus
Frequently Asked Questions (FAQs):
Q: When must a qualifying life event change be made?
A: Please notify Campus Benefits within 30 days of the life event date. All SHBP life events must be made directly through the SHBP website.
Q: Am I required to contact Campus Benefits to file a claim?
A: No. However, in our experience the number one reason for claim denial or delay is due to incomplete or inaccurate paperwork. By working with Campus Benefits’ claim specialist, we can advocate on your behalf.
Q: How can I access my dental card or vision card quickly?
A: Your group dental and vision plan information is available at: www.evanscountybenefits.com
EMPLOYEE ASSISTANCE PROGRAMS
What is an EAP? A program offered to Evans County School System employees to provide guidance with personal issues, planning for life events or simply managing daily life which can affect your work, health and family. The two EAP programs below can be used in conjunction with one another.
OneAmerica EAP
Eligibility: Eligible Evans County School System employees, their household members and unmarried children up to age 26
• Coverage through OneAmerica
• Provides support, resources, and information for personal and work-life challenges
• Receive up to three sessions per issue per year
• CALL 1.855.387.9727 or visit www.guidanceresources.com, Web ID: ONEAMERICA3
Confidential Counseling
• Helps employees address stress, relationship and other personal issues for you and your family
• Sessions with highly trained master’s and doctoral level clinicians
• Stress anxiety and depression
• Relationship/marital conflicts
• Problems with children
Work-Life Solutions
• Job pressures
• Grief and loss
• Substance abuse
Work-Life Specialists will do the research for you, providing qualified referrals and customized resources for:
• Child and elder care
• Moving and relocation
• Making major purchases
• College planning
• Pet care
• Home repair
Financial Information and Resources
Speak by phone with a Certified Public Accountant and Certified Financial Planners on a wide range of financial issues, including:
• Getting out of debt
• Credit card or loan problems
• Tax questions
Online Resources
• Retirement planning
• Estate planning
• Saving for college
• Timely articles, HelpSheets, tutorials, streaming videos and self-assessments
• Child care, elder care, attorney and financial planner searches
Free Online Will Preparation
• EstateGuidance lets you quickly and easily write a will on your computer
• Go to www.guidanceresources.com and click on EstateGuidance link
• Follow the prompts to create and download your will at no COST
• Name an executor to manage your estate
• Choose a guardian for your children
• Specify your wishes for your property
• Provide funeral and burial instructions
Plan Rates
Coverage provided at no cost to you.
INCOME PROTECTION PLAN (DISABILITY INSURANCE)
What is Disability Insurance? A type of coverage that replaces a portion of your income if injury or illness prevents you from working. It provides financial security for you and any loved ones who may depend on your ability to earn a paycheck. You may also hear disability insurance referred to as disability income insurance or income protection.
Eligibility: Eligible full-time employees (as described on eligibility page)
• Coverage through OneAmerica
• Employee must be actively at work on the effective date
• No Health Questions Every Year!
• Pre-existing condition will apply when moving to an option with a shorter elimination period
• Options 1, 2, and 3 provide payments in addition to Sick Leave and Paid Parental Leave (without any offset). These benefits will not reduce your disability payments under these options, allowing you to receive both in full.
Disability Benefits Quick Summary
See important claims information on Service Hub page.
Coverage begins on Day 1 for hospitalization for the 7, 14, and 30 day elimination plans
Plan Options 1 – 3 offer the advantage of shorter elimination periods with the benefit of payment to SSNRA (Social Security Normal Retirement Age) after a 180 day elimination period. Please review plan certificates or contact Campus Benefits for details.
Option 4
Option 5
Option 6
Elimination Period: 60 Day - Accident & Sickness
Elimination Period: 90 Day - Accident & Sickness
Elimination Period: 180 Day - Accident & Sickness
Benefit Duration: SSNRA*
Benefit Duration: SSNRA*
Benefit Duration: SSNRA*
*Please note exclusions or limitations may apply for options 1-6. See plan certificate for details.
INCOME PROTECTION PLAN (DISABILITY INSURANCE)
Condition 3/12
Illness or injury for which you received treatment the 3 months prior to your effective date will not be covered for the first 12 months (Applies to new enrollees only)
LIFE INSURANCE
The need for life insurance depends on each individual life situation. If loved ones are financially dependent on you, then buying life insurance coverage can absolutely be worth it. Even if you don’t have financial dependents yet, life insurance can be a valuable solution for making death easier on a family (at least financially.) There are two voluntary life insurance options offered through your employer: Term Life Insurance and Permanent Life Insurance. Below is an overview of differences. Term Life and Permanent Life work best used in conjunction with one another. Term Life can protect your family in your younger working years and Permanent Life can protect your family in your retirement years.
INSURANCE 101
TERM LIFE INSURANCE
Term Life insurance is illustrated on the bell curve below. The term life offered is a group policy which allows you to get more benefit for less premium.
• Term life insurance is for the unexpected death
• Includes an Accidental Death & Dismemberment Benefit
• Term life insurance is flexible and allows changes to your benefit amount each year depending on life changes. For example, as you get married and have children the need for term insurance often increases. As you near retirement, the need for term life insurance often decreases.
• Coverage is portable at retirement or if you leave the employer (premium will change)
• Premiums are based on age and increase as you get older
PERMANENT LIFE INSURANCE
Permanent Life Insurance is illustrated above along the bottom of the graph with a straight blue arrow.
• Permanent life insurance offers a stable premium along the lifetime of the policy
• Permanent life offers a level premium and is meant to take into retirement
• Permanent life is an issue age policy and is based on the age when the policy is issued
• This is an individual plan you can take with you regardless of where you work
The
BASIC LIFE AND AD&D
What is Basic Life Insurance? A financial and family protection plan paid for by Evans County School System, which provides a lump-sum payment, known as a death benefit, to a beneficiary upon the death of employee.
Eligibility: Eligible full-time and 49% employees (as described on eligibility page), spouse and unmarried children
• Coverage through OneAmerica
• Premiums paid by Evans County School System
• Conversion option is available for coverage but portability is not included
• Must be actively at work on the effective date of coverage
• Remember to update beneficiaries annually
• Dependents must be entered into the system to be eligible for coverage
(children up to age 19, up to 25 if full time student)
ADDITIONAL PLAN FEATURES
50% at age 75 (based on employee’s age)
VOLUNTARY TERM LIFE & AD&D INSURANCE
What is Voluntary-Term Life and Accidental Death & Dismemberment Insurance? A financial protection plan which provides a cash benefit to a beneficiary upon the death of the insured. Proceeds can be used to replace lost income during working years and help ensure your family’s financial goals will still be met. AD&D coverage is included as a part of life insurance benefits, and will pay out a lumpsum death benefit in the event you die accidentally or pass away as the direct result of an accident. This plan also has a dismemberment benefit which provides an additional lump sum payment if an insured becomes dismembered in an accident.
Eligibility: Eligible full-time and 49% employees (as described on eligibility page), spouse and unmarried children (up to age 26)
• Coverage through OneAmerica
• Employee must elect coverage on themselves in order to cover spouse and/or children
• Must be actively at work on the effective date of coverage
• If electing for the first time outside of the initial open enrollment or above the guaranteed issue amount, health questions will be required
Voluntary-Term Life and AD&D Quick Summary
Employee
Spouse
Child(ren)
Increments of $10,000; $500,000 (5x Salary) maximum
Increments of $5,000; $500,000 (up to 100% of Employee Election)
Increments of $2,500; $10,000 maximum
AD&D AMOUNT
Employee Equal to Life Amount
Spouse Equal to Life Amount
Child(ren) Equal to Life Amount
GUARANTEED
Increase in
Employee & Spouse: If currently enrolled, increase up to Guaranteed Issue at any open enrollment with no health questions
(Terms at age 70)
*Spouse rate is based on employee’s age Child(ren) Life and AD&D Rates:
UNIVERSAL LIFEEVENTS
What is Universal LifeEvents Insurance? An innovative concept in life insurance, Universal LifeEvents is uniquely designed to match the needs of insureds throughout their lifetime. Universal LifeEvents pays a higher death benefit during an employee’s working years, when expenses are high and families need maximum protection. At age 70 (or the 15th policy anniversary, whichever is later), when financial needs are typically lower, the death benefit reduces to one third. However, higher benefits for Long Term Care (LTC) never reduce — they continue for the life of the policy, to help meet one’s greater need for LTC in retirement. Benefits Designed for a Lifetime.
Eligibility: Eligible full-time and 49% employees (as described on eligibility page), spouse and children (up to age 23)
• Coverage through Trustmark
• Must be actively at work on the effective date
• Guaranteed Issue Amounts available for New Hires or 1st time eligible employees
• Keep your coverage, at the same cost, even if you retire or change employers
• Underwriting may be required. Coverage is not guaranteed
Universal LifeEvents Benefits Quick Summary
Employee Up to $300,000
Spouse Up to $300,000
Child
Employee (maximum issue age 64)
Spouse (maximum issue age 64)
Child Juvenile Policy - 0-17
Up to $34,000 based on age GUARANTEED ISSUE (FIRST TIME ELIGIBLE)
Up to age $100,000
Modified Guaranteed Issue (2 questions)
Amount purchased by $13 per month or $5,000 benefit whichever is greater
Modified Guaranteed Issue (2 questions)
Full-Time Student/Dependent on Parent - 18-22
Grandchildren - 0-18
Death Benefit Age Reduction
Child Buy-Up Option
Long-Term Care Benefit
Death Benefit Restoration*
Extension of LTC*
Amount purchased by $15.08 to $20.50 per month based on issue age ($10,000 - $34,600 face amount) Grandchildren - Simplified Issue
OTHER FEATURES
Life benefit pays full amount up to age 69. At age 70, death benefits reduce to 1/3 of the original face amount. Living/ Long-term Care benefits do not reduce.
Children can call Trustmark to increase coverage as an adult
Designed to accelerate Death Benefit at 4% per month for up to 25 months to pay for long-term care in an assisted living or long-term care facility, or home health care or adult day care. Payments reduce death benefit.
Fully restores the death benefit reduced by LTC each time a benefit is paid. Allows beneficiaries to receive the full death benefit.
Extends LTC benefits up to 25 months, allowing the insured to receive LTC benefits for a total of up to 50 months.
*Combining Benefit Restoration and LTC Extension of Benefits can as much as triple the policy value.
Plan Rates
Please consult with a Campus Benefits Counselor or log into the enrollment system for rate details.
VISION INSURANCE
What is Vision Insurance? A health and wellness plan designed to reduce your costs for routine preventive eye care including eye exams and prescription eye wear (eyeglasses and contact lenses).
Eligibility: Eligible full-time and 49% employees (as described on eligibility page), spouse and children* (up to age 26)
• Coverage through EyeMed
• Claims must be submitted within 90 days of service
• The chart below is a sample of covered services. Please see Plan Certificate for a detailed listing of services in their entirety. Plan certificate available on your Employee Benefits website.
*Child marital status does not impact benefit eligibility
Elective Contacts (in lieu of lenses)
WELLNESS INCENTIVES GET REWARDED FOR PREVENTIVE CARE
What are Wellness Incentives? An annual reimbursement for covered members who complete one of the eligible screening procedures on your critical illness, cancer, accident and hospital indemnity plans.
Eligibility: You, your spouse and dependents who are covered on the critical illness, cancer, accident and hospital indemnity plans
How it works:
• If you or a covered dependent get one of the eligible screenings, you can file a wellness claim
• Once approved, you will receive a check for the wellness benefit amount
• The wellness incentive can be filed annually as long as your critical illness, cancer, accident and hospital indemnity plans are in force
• Additional Wellness information can be found on your employee benefits website www.evanscountybenefits.com
UNUM Critical Illness Plan $50/year Guardian Cancer Plan
for details
Qualifies as Wellness ?
• Blood test for triglycerides
• Fasting blood glucose test
• Mammography
• Pap smear
• Serum cholesterol test to determine HDL and LDL levels
• Serum protein electrophoresis (blood test for myeloma)
• Testicular ultrasound
• Thermograph
• Annual physical exam
• Biopsies for cancer
• Blood test to determine total cholesterol/triglycerides
• Bone marrow testing Breast MRI, ultrasound, sonogram
• Cancer antigen 15-3 and 125 blood test for breast cancer (CA 15-3)/ovarian cancer (CA 125)
• Carcinoembryonic antigen blood test for colon cancer (CEA)
• Carotid doppler
• Chest x-rays
• Clinical testicular exam
• Colonoscopy; Digital rectal exam (DRE)
• Complete blood count (CBC)
• Coronavirus Testing
• Dental Exam Doppler screening for cancer
• Doppler screening for peripheral vascular disease
• Echo cardiogram; Electrocardiogram (EKG)
• Electroencephalogram (EEG)
• Endoscopy
• Eye exam
• Fasting blood glucose/plasma test
• Flexible sigmoidoscopy
• Hearing test
• Hemoccult stool specimen
• Hemoglobin A1C
• Human papillomavirus (HPV) vaccination Lipid panel
• Mammogram
• Oral cancer screening
• Pap smears or thin prep pap test
• Prostate-specific antigen (PSA) test
• Serum cholesterol test to determine LDL or HDL
• Serum protein electrophoresis Skin Exam; Skin cancer biopsy; screening
• Stress test on bicycle or treadmill Successful completion of smoking cessation program
• Tests for sexually transmitted infections (STIs)
• Thermography
• Ultrasounds for abdominal aortic aneurysms
• Virtual colonoscopy
CRITICAL ILLNESS INSURANCE
What is Critical Illness Insurance? A health and wellness plan in which you receive a lump sum cash payment if diagnosed with one of the specific illnesses on the predetermined list of critical illnesses.
Eligibility: Eligible full-time and 49% employees (as described on eligibility page), spouse and unmarried children (up to age 26)
• Coverage through UNUM
• Elect Critical Illness with or without Cancer coverage based on your individual needs
• Issue Age - Rates are locked in and will not increase with age
• Underwriting health questions will be required
• Keep your coverage at the same cost, even if you retire or change employers
• The chart below is a sample of covered services. Please see Plan Certificate for a detailed listing of services in their entirety. Plan certificate available on your Employee Benefits website.
Illness Benefits Quick Summary
(see Wellness Incentives page)
CANCER INSURANCE
What is Cancer Insurance? Cancer insurance is a form of supplemental insurance meant to offset cancer-related expenses so you can focus on recovery.
Eligibility: Eligible full-time employees (as described on eligibility page), spouse and children* (up to age 26)
• Coverage through Guardian
• Payments made directly to you and do not offset with medical insurance
• No health questions - Every Year! (Pre-existing condition will apply for new participants)
• Keep your coverage even if you retire or change employers
• The chart below is a sample of covered services. Please see Plan Certificate for a detailed listing of services in their entirety. Plan certificate available on your Employee Benefits website. *Child marital status does not impact benefit eligibility
Bone Marrow/Stem Cell
Ambulance (per confinement)
Air Ambulance (limit 2 trips)
Transportation (local or non-local)
Outpatient or Family Lodging (daily)
Bone Marrow: $10,000
Stem Cell: $2,500
benefit for 2nd transplant
$1,500 benefit if a donor
MISCELLANEOUS BENEFITS
$250
Bone Marrow: $7,500
Stem Cell: $1,500
50% benefit for 2nd transplant
$1,000 benefit if a donor
$100 $75 Physical or Speech Therapy (daily)
Experimental Treatment
Prosthetic
Skin Cancer
Wellness Incentive
(see Wellness Incentives page)
$200 per day / $2,400 per month
$300 - $6,000
Biopsy Only: $100
Reconstructive Surgery: $250
Excision of a skin cancer: $375
Excision of a skin cancer with flap or graft: $600
$75
Waiting Period (initial diagnosis) 30 days
Pre-Existing Condition Limitation (must be cancer free for 5 years if previously diagnosed)
$100 per day / $1,000 per month
$200 - $4,000
Biopsy Only: $100
Reconstructive Surgery: $250
Excision of a skin cancer: $375
Excision of a skin cancer with flap or graft: $600
$50
12/12= Any illness or injury for which you received treatment the 12 months prior to your effective date will not be covered for the first 12 months.
Riders Included: Specified Illness Rider
Age Reduction None
Disclaimer:
ACCIDENT INSURANCE
What is Accident Insurance? This coverage is designed to help offset medical and out- of- pocket costs associated with unforeseen accidents. Payments made directly to you and benefits do not offset with medical insurance.
Eligibility: Eligible full-time and 49% employees (as described on eligibility page), spouse and children* (up to age 26)
• Coverage through MetLife
• No health questions - Every Year!
• 24-Hour coverage (on-and-off the job)
• Keep your coverage even if you retire or change employers
• The chart below is a sample of covered services. Please see Plan Certificate for a detailed listing of services in their entirety. Plan certificate available on your Employee Benefits website.
*Child marital status does not impact benefit eligibility
INJURIES
DEATH
* Actual benefit amount paid depends on the type of covered
Please see certificate for details of covered
(Accident)
HOSPITAL INDEMNITY
What is Hospital Indemnity Insurance? A plan which pays you benefits when you are confined to a hospital, whether for planned or unplanned reasons.
Eligibility: Eligible full-time and 49% employees (as described on eligibility page), spouse and children* (up to age 26)
• Coverage through MetLife
• Benefits do not coincide with health insurance; payments made directly to you
• No Health Questions - EVERY YEAR!
• The chart below is a sample of covered in-network services. Please see the Plan Certificate on your Employee Benefits for a detailed listing of services, as well as out-of-network allowances in their entirety. *Child marital status does not impact benefit eligibility Hospital Indemnity Benefits Quick Summary
Hospital Admission
Hospital Confinement
Hospital Intensive Care Unit Stay
Newborn Nursery Care Stay
Pre-existing condition limitation
Age Reduction
Wellness Incentive
$1,000 per day (No elimination period. Limited to 4 times a year, benefit every 90 days)
$100 per day (No elimination period. Max 365 days per confinement.)
Match the confinement (No elimination period. Max 31 days per confinement.)
$200 per day (Limited to 3 days, 1 benefit per newborn child - Benefit is payable to the employee if child coverage is not elected)
None
None
$50 (see Wellness Incentives page)
MEDCARECOMPLETE
THE SMART WAY TO REDUCE YOUR HEALTHCARE COSTS
What is MedCareComplete? A bundle of services constructed to save you time and money while simplifying your life.
Eligibility: Eligible full-time and 49% employees (as described on eligibility page), spouse, and unmarried children (up to age 26)
• Coverage through MedCareComplete
• This is a supplemental benefit and does not replace health insurance.
• Current MedCareComplete Lite participants will have the option to say on the lite version or move to the enhanced version. You cannot re-enroll in the lite version if you choose to drop it during this enrollment.
• Register at MCC: www.medcarecomplete.com/members to access the full range of benefits
• Register at 1800MD: www.1800md.com or call 1.800.388.8785 to access telemedicine benefits
Included with the MedCareComplete Membership:
Medical Bill Negotiator
Medication Management
Telemedicine
Medical & ID Theft Monitoring
Medical Bill Negotiator
Restoration Expert
Identity Loss Expense Reimbursement
Social Media Tracking
Sex Offender Alerts
A medical bill advocate will identify and appeal common billing errors and overcharges on your behalf. Advocates provide continuous support throughout the appeal that typically results in an average savings of 40% on 80% of the bills reviewed.
Telemedicine
Get 24/7/365 on-demand telephone access to Board-certified physicians for diagnosis, and prescriptions for common and acute illnesses. There are no co-pays and no limit to how many times you can utilize this feature.
Acute Illnesses include but are not limited to the following:
Asthma Fever
Headache
Infections
Medical
Migraines Rashes
Bacterial Infections
Diarrhea
& ID Theft Protection
Heartburn
Sinus Conditions
Urinary Tract
Infections
Bronchitis
Ear Infection
Gout
Joint Aches
Pink Eye
Sore Throat
Cold & Flu
Nausea & Vomiting
Service monitors the internet for instances of your personal health and financial information to protect you from becoming a victim of identity theft. The security of your personal health information (PHI) can have a large impact on the medical care you receive.
LEGAL PLAN
What is a Legal Plan? A plan which provides valuable legal and financial educational resources for a variety of life events and needs.
Eligibility: Eligible full-time and 49% employees (as described on eligibility page), spouse, and unmarried children (up to age 26)
• Coverage through MetLife
• Elder Care extends to parents and in-laws
• Visit www.legalplans.com/why-enroll or call 1.800.821.6400 for additional information
• Non-members & members create an account and select Employer for plan information (creating an account doesn’t enroll you in plans)
• High Plan: For non-covered matters that are not otherwise excluded, your plan provides four hours of network attorney time and services per year
• Additional plan information available on your Employee Benefits Website (www.evanscountybenefits.com)
Low Plan Quick Summary
• Identity Theft Defense
Money Matters
Home & Real Estate
Estate Planning
• Negotiations with Creditors
• Promissory Notes
• Debt Collection Defense
• Tax Collection Defense
• Deeds
• Mortgages
• Foreclosure
• Tenant Negotiations
• Eviction Defense
• Security Deposit Assistance
• Simple and Complex Wills
• Healthcare Proxies
• Living Wills
• Codicils
• Powers of Attorney (Healthcare, Financial, Childcare, Immigration
• Guardianship
• Conservatorship
• Name Change
Family & Personal
Civil Lawsuits
• Review of ANY Personal Legal Document
• School Hearings
• Demand Letters
• Affidavits
• Personal Property Issues
• Garnishment Defense
• Domestic Violence Protection
• Disputes over Consumer Goods & Services
• Administrative Hearings
• Incompetency Defense
Consultation & Document review for issues related to your (or spouse’s) parents:
• Medicare
Elder Care Issues
Vehicle & Driving
• Medicaid
• Prescription Plans
• Nursing Home Agreements
• Leases
• Promissory Notes
• Deeds
• Wills
• Power of Attorney
• Repossession
• Defense of Traffic Tickets
• Driving Privileges Restoration
• License Suspension due to DUI
High Plan Quick Summary
• Identity Theft Defense
• Negotiations with Creditors
• Promissory Notes
• Debt Collection Defense
• Tax Collection Defense
• Deeds
• Mortgages
• Foreclosure
• Tenant Negotiations
• Eviction Defense
• Security Deposit Assistance
• Simple and Complex Wills
• Healthcare Proxies
• Living Wills
• Codicils
• Powers of Attorney (Healthcare, Financial, Childcare, Immigration
Consultation & Document review for issues related to your (or spouse’s) parents:
• Medicare
• Medicaid
• Prescription Plans
• Nursing Home Agreements
• Leases
• Promissory Notes
• Deeds
• Wills
• Power of Attorney
• Repossession
• Defense of Traffic Tickets
• Driving Privileges Restoration
• License Suspension due to DUI
Disclaimer: The Benefits Guide is provided for illustrative purposes only and actual benefits and/or premiums may change after printing. Eligibility, benefits, limitations, services, premiums, claims processes and all other features & plan designs are offered and governed exclusively by the insurance provider or vendor contract and associated Summary Plan Description (SPD). All employees should review carrier documents posted on your employer’s benefits website or request documents before electing coverage.
FLEXIBLE SPENDING ACCOUNTS
What are Medical Flexible Spending Accounts (FSAs)? A pre-tax benefit account used to pay for outof-pocket healthcare costs such as deductibles, co-pays, prescribed medication, and some over the counter medications.
What are Dependent Care Accounts? A pre-tax benefit account used to pay for dependent care services such as preschool, summer day camp, before or after school programs, and child or elder daycare.
Eligibility: Eligible full-time and 49% employees (as described on eligibility page), spouse and children* (up to age 26) *For dependent care children ages 12 and under and adults for adult day care
• Coverage through Consolidated Admin Services
• Plan year is from January 1- December 31 and employees must re-elect each year
• Married and not filing jointly participants limited to $3,750 deferral for Dependent Care
• Transfer of funds between the Dependent Care and Medical Care accounts are prohibited
• Only family status changes will allow you to change your annual election. The altered election must be consistent with the status change. *Children must be eligible for an exemption on your federal tax return
of funds carried
to the next year, Must enroll in
is only available as the funds are payroll deducted
RUNOUT PERIOD- The amount of time to turn in receipts for services rendered during the plan year.
days after end date to turn in receipts All receipts should be kept to submit if verification is requested
IMPORTANT NOTE:
Dependent Care FSA is for eligible expenses related to the care of your child, disabled spouse, elderly parent, or other dependent who is physically or mentally unable for self-care (i.e. day care, adult day care) or is disabled. Medical expenses for your dependent are not eligible for reimbursement under the Dependent Care account.
HELPFUL FSA RESOURCES
What is covered under Medical FSA Account?
• Medical coinsurance and deductible
• Doctor’s office visit co-pays
• Emergency Room costs
• Dental co-pays and out-of-pocket costs
• Vision co-pays and out-of-pocket costs
• Contacts and glasses
• Prescriptions
FSA Eligibility List
www.fsastore.com/fsa-eligibility-list
FSA Calculator (estimates how much you can save with an FSA) www.fsastore.com/fsa-calculator
• Please see the full eligibility list for other covered expenses
Who is covered under a Dependent Care Account?
• Children ages 12 and under (including stepchildren, grandchildren, adopted or foster children, and children related to you who are eligible for a tax exemption on your federal tax return)
• Tax dependents residing with you and incapable of self-care (this could include your spouse, a child age 13 and over, and elderly parents)
The CARES Act permanently reinstates over-the counter products, and adds menstrual care products for the first time, as eligible expenses for your FSA funds WITHOUT A PRESCRIPTION!
Eligible items for purchase without a prescription now include, but are not limited to:
• Children’s pain relievers, allergy medicines, and digestive aids
In the App Store go to: Consolidated Admin Services Online Portal and Access to information: www.consolidatedadmin.com
IMPORTANT NOTE:
Dependent Care FSA is for eligible expenses related to the care of your child, disabled spouse, elderly parent, or other dependent who is physically or mentally unable for self-care (i.e. day care, adult day care) or is disabled. Medical expenses for your dependent are not eligible for reimbursement under the Dependent Care account.
ADDITIONAL RESOURCES
Campus Benefits Service Team
Phone: 1. 866.433.7661, opt 5
Email: mybenefits@campusbenefits.com
OneAmerica Guardian MetLife
EyeMed Trustmark UNUM Cigna CAS
MedCare Complete
State Health Benefit Plan
Main Call Center
Phone: 800.610.1863
Anthem Blue Cross Blue Shield of GA
UnitedHealthcare
Kaiser Permanente Healthways
Express Scripts
AirMedCare
Becky Palmer
Email: Rebecca.Palmer@gmr.net
Phone: 912.347.7776
Horace Mann
Melissa Coleman
Phone: 912.225.1123
Email: Melissa.coleman@horacemann.com
Professional Association of Georgia
Education (PAGE)
Well Esters
Phone: 706.980.5966
Email: westers@pageinc.org
New York Life
Kevin Odell
Phone: 912.739.4812
Email: ksodell@ft.newyorklife.com
Teacher Focused Advisors
Mike Yawn
Phone: 912.536.1451
Core Credit Union
Julie Morrison
Phone: 912.764.9846
Email: Julie.morrison@coreecu.org
Valuteachers
Ken Love
Phone: 706.975.6589
Email: kenlove@valuteachers.com
Corebridge Financial
Dan Silva
Phone: 478.405.5005
Email: dan.silva@corebridgefinancial.com
LegalShield
Sherranda Ivey
Phone: 478.227.6248
Email: sherranda@slibiz.com
Email: mikeyawn@teacherfocusedadvisors.com
Thomas Jenkins
Phone: 478.299.1154
Email: thomasjenkins@teacherfocusedadvisors.com
STATE HEALTH BENEFIT PLAN
Eligibility: Please review the SHBP Decision Guide for plan eligibility rules.
• Coverage through Anthem, United Healthcare, or Kaiser Permanente
• All qualifying life events must be submitted via the SHBP Portal
• Notice: Your employer offers all eligible employees health insurance through the Georgia State Health Benefit Plan. During the fall annual open enrollment, you have the opportunity to review all available options and make elections
SHBP Decision Guide:
1. Go to www.myshbpga.adp.com
2. Enter your Username and Password and click Login. If you need assistance, click on “Forgot User ID?” or “Forgot Your Password?”.
3. If you have not registered, click “Register Here”
4. Your registration code is SHBP-GA
SHBP Wellness Portal:
www.bewellshbp.com
In this Guide is a brief explanation about each health benefit option, a benefit comparison guide, and a list of things to consider before making plan decisions.
Access the decision guide at www.shbp.georgia.gov/enrollment/ open-enrollment
Information based on 2026 data Please review the Active Decision Guide for full incentive program details and requirements. *Kaiser members will receive a $500 gift card after satisfying KP’s Wellness Program requirements
**Spouse’s can earn 240 bonus credits, please see decision guide for details and rules
2026 SHBP PLANS & PRICING
HRA (Health Reimbursement Arrangement) Credits
SHBP LEGAL NOTICES
Availability of Summary Health Information Summary of Benefits & Coverage (SBC)
As an employee, the SHBP health benefits available to you represent a significant component of your compensation package. They also provide important protection for you and your family in the case of illness or injury.
SHBP offers a series of health coverage options. Choosing a health coverage option is an important decision. To help you make an informed choice, SHBP makes available a Summary of Benefits and Coverage (SBC), which summarizes important information about any health coverage option in a standard format, to help you compare across options.
The SBC is available on the web at: www.shbp.georgia.gov/plan-documents. A paper copy is also available, free of charge, by calling 912-739-3544.
About the Following Notices:
The following important legal notices are also posted on the State Health Benefit Plan (SHBP) website at www.shbp.georgia.gov/plan-documents under Plan Documents.
Penalties for Misrepresentation
If a SHBP participant misrepresents eligibility information when applying for coverage during change of coverage or when filing for benefits, the SHBP may take adverse action against the participants, including but not limited to terminating coverage (for the participant and his or her dependents) or imposing liability to the SHBP for fraud for indemnification (requiring payment for benefits to which the participant or his or her beneficiaries were not entitled). Penalties may include a lawsuit, which may result in payment of charges to the Plan or criminal prosecution in a court of law. To avoid enforcement of the penalties, the participant must notify the SHBP immediately if a dependent is no longer eligible for coverage or if the participant has questions or reservations about the eligibility of a dependent. This policy may be enforced to the fullest extent of the law.
Federal Patient Protection and Affordable Care Act Notices
Choice of Primary Care Physician
The Plan generally allows the designation of a Primary Care Physician/Provider (PCP). You have the right to designate any PCP who participates in the Claims Administrator’s network, and who is available to accept you or your family members. For children, you may also designate a pediatrician as the PCP. For information on how to select a PCP, and for a list of participating PCPs, call the telephone number on the back of your Identification Card.
Access to Obstetrical and Gynecological (OB/ GYN) Care
You do not need prior authorization from the Plan or from any other person (including a PCP) in order to obtain access to obstetrical or gynecological care from a health care professional in the Claims Administrator’s network who specializes in obstetrics or gynecology. The healthcare professional, however, may be required to comply with certain procedures, including obtaining prior authorization for certain services, following a pre-approved treatment plan, or procedures for making referrals. For a list of participating health care professionals who specialize in obstetrics or gynecology, call the telephone number on the back of your Identification Card.
HIPAA Special Enrollment Notice
If you decline enrollment for yourself or your Dependents (including your spouse) because of other health insurance or group health plan coverage, you may be able to enroll yourself and your Dependents if you or your Dependents lose eligibility for that other coverage (or if the employer stops contributing towards your or your Dependents’ other coverage) your other health insurance coverage ends. However, you must request enrollment within 31 days after your or your Dependents’ other coverage ends (or after the employer stops contributing toward the other coverage). In addition, if you have a new Dependent as a result of marriage, birth, adoption or placement for adoption, you may be able to enroll yourself and your new Dependents. However, you must request enrollment within 31 days after the marriage or adoption, or placement for adoption (or within 90 days for a newly eligible dependent child).
Eligible Covered Persons and Dependents may also enroll under two additional circumstances: The Covered Person’s or Dependent’s Medicaid or Children’s Health Insurance Program (CHIP) coverage is terminated as a result of loss of eligibility; or The Covered Person or Dependent becomes eligible for a subsidy (State Premium
Assistance Program).
NOTE: The Covered Person or Dependent must request Special Enrollment within sixty (60) days of the loss of Medicaid/CHIP or of the eligibility determination. To request Special Enrollment or obtain more information, call the SHBP Member Services Center at 800-610-1863 or contact your Benefit Coordinator/Payroll Location.
Women’s Health and Cancer Rights Act of 1998
The Plan complies with the Women’s Health and Cancer Rights Act of 1998. Mastectomy, including reconstructive surgery, is covered the same as other surgery under your Plan option. Following cancer surgery, the SHBP covers:
• All stages of reconstruction of the breast on which the mastectomy has been performed
• Reconstruction of the other breast to achieve asymmetrical appearance
• Prostheses and mastectomy bras
• Treatment of physical complications of mastectomy, including lymph edema
NOTE: Reconstructive surgery requires prior approval, and all Inpatient admissions require prior notification. For more detailed information on the mastectomy related benefits available under the Plan, call the telephone number on the back of your Identification Card.
Newborns’ and Mothers’ Health Protection Act of 1996
The Plan complies with the Newborns’ and Mothers’ Health Protection Act of 1996. Group health plans and health insurance issuers generally may not, under Federal law, restrict Benefits for any Hospital length of stay in connection with childbirth for the mother or newborn to less than 48 hours following a vaginal delivery, or less than 96 hours following a cesarean section. However, federal law generally does not prohibit the mother’s or newborn’s attending Provider, after consulting with the mother, from discharging the mother or her newborn earlier than 48 hours (or 96 hours, as applicable). In any case, plans and issuers may not, under Federal law, require that a Provider obtain authorization from the Plan or the insurance issuer for prescribing a length of stay not in excess of 48 hours (or 96 hours, as applicable).
HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT NOTICE OF INFORMATION PRIVACY PRACTICES
Georgia Department of Community Health
State Health Benefit Plan Notice of Information Privacy Practices
Revised August 4, 2015
The purpose of this notice is to describe how medical information about you, which includes your personal information, may be used and disclosed and how you can get access to this information. Please review it carefully.
The Georgia Department of Community Health (DCH) and the State Health Benefit Plan Are Committed to Your Privacy.
DCH understands that your information is personal and private. Certain DCH employees and companies hired by DCH to help administer the Plan (Plan Representatives) use and share your personal and private information in order to administer the Plan. This information is called “Protected Health Information” (PHI), and includes any information that identifies you or information in which there is a reasonable basis to believe can be used to identify you and that relates to your past, present, or future physical or mental health or condition, the provision of health care to you, and payment for those services. This notice tells how your PHI is used and shared by DCH and Plan Representatives. DCH follows the information privacy rules of the Health Insurance Portability and Accountability Act of 1996(“HIPAA”).
Only Summary Information is Used When Developing and/or Modifying the Plan.
The Board of Community Health, which is the governing Board of DCH, the Commissioner of DC Hand the Chief of the Plan administer the Plan and make certain decisions about the Plan. During those processes, they may review certain reports that explain costs, problems, and needs of the Plan. These reports never include information that identifies any individual person. If your employer is allowed to leave the Plan entirely, or stop offering the Plan to a portion of its workforce, DCH may provide Summary Health Information (as defined by federal law) for the applicable portion of the workforce. This Summary Health Information may only be used by your employer to obtain health insurance quotes from other sources and make decisions about whether to continue to offer the Plan. Please note that DCH, Plan Representatives, and your employer are prohibited by law from using any PHI that includes genetic information for underwriting purposes.
Plan “Enrollment Information” and “Claims Information” are Used in Order to Administer the Plan. PHI includes two kinds of information, Legal Notices (cont.) “Enrollment Information” and “Claims Information.” “Enrollment Information” includes, but is not limited to, the following types of information regarding your plan enrollment: (1) your name, address, email address, social security number and all information that validates you (and/or your Spouse and Dependents) are eligible or enrolled in the Plan; (2) your Plan enrollment choice; (3) how much you pay for
Disclaimer: The Benefits Guide is provided for illustrative purposes only and actual benefits and/or premiums may change after printing. Eligibility, benefits, limitations, services, premiums, claims processes and all other features & plan designs are offered and governed exclusively by the insurance provider or vendor contract and associated Summary Plan Description (SPD). All employees should review carrier documents posted on your employer’s benefits website or request documents before electing coverage.
GLOSSARY OF TERMS
Definitions Disclaimer: The definitions below are for illustrative purposes only. Actual plan definitions are governed exclusively by the provider contract and associated Summary Plan Description (SPD). Please visit evanscountybenefits.com for each plans policy document/certificates and actual benefit definitions.
Accelerated Life Benefit - An accelerated life benefit, also known as a terminal illness rider, is a life insurance policy add-on that allows you to access your policy’s death benefit before you die if you’re diagnosed with a qualifying serious illness — typically a terminal one.
Age Reduction – A reduction of the face amount of your group insurance policy when you reach a certain age. Please review the age reductions on the Basic Life insurance.
Beneficiary - A life insurance beneficiary is the person or entity that will receive the money from your policy’s death benefit when you pass away. When you purchase a life insurance policy, you choose the beneficiary of the policy. Please update your beneficiaries as needed for your Basic Life Insurance, Voluntary Term Life Insurance and/or Permanent Life Insurance.
Conversion - Conversion is when you convert your term life insurance policy into a permanent life insurance policy. Please refer to the plan certificate for detail on converting your term life coverage.
Dependents – The definition of eligible dependents vary by insurance carrier. Eligible dependents may include your spouse and taxable dependent children who are under the age of 26. Child marital status will impact benefit eligibility. Please refer to each plans policy document for verification of dependent eligibility.
Elimination Period - Elimination period is a term used to refer to the time period between an injury and the receipt of benefit payments. In other words, it is the length of time between the beginning of an injury or illness and receiving benefit payments from an insurer.
Guaranteed Issue - A plan’s guaranteed issue (GI) is the amount of life insurance available to an employee without having to provide Evidence of Insurability, or EOI/ no health questions. This is particularly helpful if you have health issues which may make you otherwise uninsurable.
Indemnity - Security or protection against a loss or other financial burden.
Portability – The portability provision allows you to take coverage with you when you leave your place of employment. The portability rate will differ from current plan rates and are determined by the plan carrier at the time of portability. Portability must be completed with a specific time frame. Please refer to the plans policy certificate for details on portability.
Pre-existing Condition - An illness or injury experienced before enrollment in an insurance plan may be considered a pre-existing condition. Pre-existing conditions can include health issues such as cancer, diabetes, lupus, depression, acne, pregnancy, or just about any other health condition you can imagine. Refer to each plans document for pre-existing condition limitations.
Qualifying Life Event Change - A change in your situation — like getting married, having a baby, or losing benefit coverage — that can make you eligible for a Special Enrollment Period, allowing you to enroll in insurance outside the yearly Open Enrollment Period.
Waiver of Premium - A waiver of premium rider is an insurance policy clause that waives premium payments if the policyholder becomes critically ill, seriously injured, or physically impaired. Other stipulations may apply, such as meeting specific health and age requirements.
U&C - The amount paid for dental services in a geographic area based on what providers in the area usually charge for the same or similar service. For the dental high plan, the U&C reimbursement allowance covers what 9.9 out of 10 dentists in your geographical location covers. The low plan is an In-Network only plan.
Waiting Period - A waiting period is the amount of time an insured must wait before some or all of their coverage comes into effect. The insured may not receive benefits for claims filed during the waiting period. Waiting periods may also be known as elimination periods and qualifying periods.
Disclaimer: The Benefits Guide is provided for illustrative purposes only and actual benefits and/or premiums may change after printing. Eligibility, benefits, limitations, services, premiums, claims processes and all other features & plan designs are offered and governed exclusively by the insurance provider or vendor contract and associated Summary Plan Description (SPD). All employees should review carrier documents posted on your employer’s benefits website or request documents before electing coverage.
• Portability/Conversion
• Benefits Education
• Evidence of Insurability
• Qualified Life Event Changes
• Claims
• Card Requests
• Benefit Questions
• COBRA Information Phone: 1.866.433.7661, opt 5 Email: mybenefits@campusbenefits.com
website address: www.evanscountybenefits.com
The 2026 Benefits Enrollment Guide is provided for illustrative purposes only. Actual benefits, services, premiums, eligibility, claims processes and all other features and plan designs for coverage offered is governed exclusively by the insurance contract and associated Summary Plan Description (SPD). In case of discrepancies between this document and the insurance contract and SPD, the contract and SPD will prevail. We reserve the right to change, modify, revise, amend or terminate these plan offerings at any time. Updates, changes and notices are all located at www.evanscountybenefits.com These should be reviewed fully prior to electing any benefits.
