Benefits Open Enrollment Guide 2023

Open enrollment for the 2022-23 school year is October 15, 2022 – November 15, 2022. Any changes or new elections made during open enrollment will be effective January 1, 2023.

Flexible Spending Accounts (FSA) must be renewed every year. That means to continue with or to initiate new enrollment into an FSA for 2023, you MUST (re)enroll during the Open Enrollment period.

All other benefits will remain the same unless you make changes during Open Enrollment. Possible changes might include, for example, changing from Dean to GHC, or changing from a POS plan to an HMO plan.

What do I need to do?

• If you want to have a Flexible Spending Account for 2023, you must complete your enrollment at the MMSD’s Benefits Enrollment Website (https://standard.benselect.com).

• If you want to make any changes to your existing benefits, you must make those changes at the MMSD’s Benefits Enrollment Website (https://standard.benselect.com).

• If you are not making any changes to your current benefits AND are NOT electing a flexible spending account for 2023, you do not need to do anything.

What will I need if I’m making changes?

Step 1: Gather the required information for you and your dependents. This will include complete legal names, dates of birth and Social Security Numbers.

Step 2: Log in to the MMSD’s Benefits Enrollment Website (https://standard.benselect.com)

• Your username is your b number without the “b”
• If you have not previously logged in, your default PIN is the last 4 digits of your SSN followed by the last 2 digits of your year of birth. You will be required to create a more secure PIN. Please be sure to save your new password for future logins. If you do not remember your PIN, email benefits@madison.k12.wi.us for assistance.
• Once logged in, click the “Next” button on the top right portion of the page to navigate through your benefit elections. Continue to click “Next” until all benefit elections have been made.
• Step-by-step directions can be found here

Step 3: Review and complete your elections and/or changes no later than November 15, 2022.

• To save and submit your benefit elections, you must click “I Agree” on the Submit Your Enrollment page. Once submitted, a confirmation page will be displayed. Save or print this page for your records.
• Elections will be processed and sent to the insurance carriers in early December for a January 1, 2023 effective date. Insurance cards will be mailed to your home prior to January 1, 2023 if you made any changes.

Plan Year

The Madison Metropolitan School District benefits plan year is January 1 through December 31. This guide outlines the benefits available during this identified plan year.

Annual Deductible Year

The annual deductible for all Madison Metropolitan School District benefit plans is January 1 through December 31. The annual deductible resets each year on January 1.

Eligibility

Eligibility is outlined in the Employee Handbook. In general, employees who are a part of the following employee units are eligible for coverage if working 19 or more hours per week.

• Administrator

• Custodial

• Educational Assistant / Special Educational Assistant

• Food Service

• Non-Union Clerical

• Play and Learn

• Professional (NUP)

• Professional Instruction (PR-I)

• Security Assistant

• Supportive Educational Employee

• Teacher

• Trades

All other MMSD employees who are not eligible for benefits may be eligible for health insurance for 2023 if working an average of 30 hours per week between the time frame of October 5, 2021 – October 4, 2022. Employees in this category will be notified if eligible to enroll in health insurance.

Dependent Coverage

In addition to covering yourself, you can elect to cover your eligible dependents. Your eligible dependents include:

• Your spouse

• Your child(ren) through the year in which they turn 26

• Your child of any age who is not self-supporting due to a mental and/or physical disability

Waive Option

You have the option of not participating in the insurance plans available to you. If you do not enroll in the health insurance plan offered, please indicate you are waiving coverage and your reason. If you waive the health insurance, you are still eligible to enroll in the other benefit options.

Making Changes To Your Benefits

The Internal Revenue Service (IRS) states that eligible employees may only make elections to the plan once a year; annual open enrollment benefit choices are binding through December 31, 2023.

Qualifying life events allow you to make plan changes at any time during the year in which they occur. For any allowable changes, you must enroll online within 30 calendar days of the event (60 days for the birth of a child, CHIP/ Medicaid eligibility or loss of eligibility) to avoid a lapse in coverage. The following include reasons you may change your benefits during the year.

Comprehensive information about MMSD’s benefits is available online!

1. Find benefit information on line at MMSD’s Benefits Website (https://www.madison.k12.wi.us/human-resources/employee-benefits)

2. Enroll in benefits at MMSD’s Benefits Enrollment Website (https://standard.benselect.com)
   TO LOG IN AND ENROLL:

   • Your username is your b number without the “b”

   • Your PIN is the last 4 digits of your SSN followed by the last 2 digits of your year of birth. Note, you may be required to reset your PIN. Please be sure to save your new password for future logins.

   • If you have not previously logged in, your default PIN is the last 4 digits of your SSN followed by the last 2 digits of your year of birth. You will be required to create a more secure PIN. Please be sure to save your new password for future logins. If you do not remember your PIN, email benefits@madison.k12.wi.us for assistance.

   • Once logged in, click the “Next” button on the top right portion of the page to navigate through your benefit elections. Continue to click “Next” until all benefit elections have been made.

   • To save and submit your benefit elections, you must click “I Agree” on the Submit Your Enrollment page. Once submitted, a confirmation page will be displayed. Save or print this page for your records.

   • Step-by-step directions can be found here

3. There’s an app for that! Scan the QR code below or go to mmsd-benefits.com on your mobile device.

Carriers

You have the opportunity to enroll in health insurance through Dean Health Plan or Group Health Cooperative of South Central Wisconsin. These carriers provide you with a diverse range of networks and providers, yet have the exact same type of coverage (copays, etc.). They do have slightly different employee premiums (what you pay per pay period for your coverage).

Plan Options

Each carrier provides a Health Maintenance Plan (HMO), Point-of-Service Plan (POS) or Preferred Provider Organization Plan (PPO). The PPO plan is only available to employees who do not live in South Central Wisconsin.

The HMO plan allows you to use in-network providers only. GHC uses GHC Clinics, UW Hospital and Meriter Hospital. Dean Health Plan uses SSM Health/Dean Clinics and SSM Hospital for Dean. If you need to see an out-of-network provider, such as provider at Mayo Clinic or a specialty care provider, your doctor will request a referral to these providers. The referral will be approved if there are no in-network providers that can treat the condition. The HMO plans have an annual deductible of $100 per person ($200 per family). The annual deductible resents every January 1. They have $20 office visit copays (this does not apply to preventive care visits and visits for children age 18 and younger). They also have a $150 emergency room copay.

Under the POS plan, you have the option to use in-network providers, but you are also able to use out-of-network providers without pre-approval or a referral. With out-of- network providers, you have an additional $250 individual annual deductible ($500/family) and an 80/20 co-insurance cost -- you pay the first $250/$500 of services and then 20% of the costs once the annual deductible has been met.

Some employees elect the POS plan for the flexibility to see out-of-network providers, even if it may never happen. As a reminder, if you needed a referral to an out-of-network provider due to a medical condition that an in-network provider cannot treat, you can request a referral to a specialist that can treat that condition, although it is not guaranteed to be approved. Other employees have selected the POS plan due to dependents who live outside of the area, such as college students, or due to significant family travel needs. The HMO plan covers urgent care and emergency care anywhere within the USA. If you or a family member needs urgent or emergency care, the HMO plan will cover those costs as if it was in network. By enrolling the POS plan and not using out- of-network providers, you are incurring additional costs (higher premiums out of your paycheck and district resources) and you may be enrolled in a plan that doesn’t meet your medical needs.

There are circumstances where the POS plan may be the best plan to be enrolled in. That’s ok, you can enroll in the POS plan. But, be mindful that the premium contribution difference between the HMO and POS plan may be more than what it would cost you to pay for the out-of-network medical care out of your pocket.

Additional Benefits

Listed below are some of the programs in place to help you utilize all of the benefits available through the health insurance plan. Wellness benefits are provided through both Dean and GHC.

• Dean’s Living Healthy program allows you to earn up to $150 in wellness rewards ($100 for covered spouses and adult children 18 & older) for completing a heath assessment, having a MyChart account, and more! More information can be found at: https://www.deancare.com/wellness/health-and-wellness

• GHC’s ManageWell rewards program provides you and your family an opportunity to earn points on a quarterly basis. Visit https://ghcscw.com/wellness/wellness-reimbursement for details.

• GHC Care OnDemand provides 24/7/365 virtual access to providers and therapists.

• My Chart and mobile phone applications are provided to access your benefit and claim information.

Health Insurance Premiums

The health insurance premium contributions – the amount you pay for your coverage – is based on which carrier you choose, which plan you enroll in, the coverage tier (single vs family) and your payroll frequency.

The premium contribution is a percentage of the total monthly cost of the coverage. The amount owed is based on a sliding scale for the various employee groups. The percentages are 2.50%, 6.0%, 10.0%, or 12.0% depending upon your employment unit. If you are paid monthly, premiums are withheld from each monthly check. If you are paid bi-weekly, premiums are withheld from the first two checks in each month, half from each check (in months where there are 3 checks, premiums will only be deducted from the first two).

Premiums for health insurance are paid a month in advance. For example, the January health insurance premiums will be taken from your December paycheck(s). You may notice an adjustment on your paycheck after enrolling or changing coverage to catch-up on premiums.

The charts below show the employment groups and the corresponding premiums and pre-tax employee contributions.

Dependent Care (such as daycare) FSA

A dependent care FSA allows you to save for daycare expenses for your child (up to age 13) or a disabled dependent/spouse. To be eligible for dependent care FSA, you must work or be a full-time student. Expenses include preschool, after-school care, daycare and summer day camps and are not for medical expenses for dependents. The maximum annual amount you can deposit into a dependent care FSA is $5,000.

Planning and Considerations

The FSA plan runs on a calendar year therefore you’ll want to plan ahead. Because the plan is “use it or lose it”, you will want to make sure to spend all of your funds by the end of the calendar year. The plan does have a 2 1⁄2 month grace period built in, allowing for additional spending of remaining funds for up to 2 1⁄2 months following the end of the calendar year.

To plan ahead, you’ll want to estimate how much you think you’ll spend on qualified expenses. For the medical FSA, consider any deductibles, trips to the doctor or emergency room, prescription drug refills, dental expenses and vision expenses. You can also visit the FSA Store (https://fsastore.com/) for over-the-counter qualified expenses.

Dental Coverage

Delta Dental of Wisconsin is the Dental Insurance carrier for MMSD. Delta Dental has a nation-wide network, and covers more than 75% of the area and nation’s dentists. Your lowest out-of-pocket costs will come from seeing a Delta Dental PPO dentist, but you will also receive cost advantages if you see a Premier dentist. Dental expenses are all eligible expenses for Health Care Flexible Spending. Consider enrolling in an FSA to help reduce expenses.

Plan Options

The District offers two plan options: The Base Dental Plan offers an annual maximum of $1,200 per year whereas the Buy-Up Plan offers a $1,500 annual maximum. The other differences:

• The Base Plan has a $25/individual ($75/family) annual deductible for Basic Restorative or Major Restorative Care services. The annual deductible will not be applied to any Preventive services.
• The Base Plan has a lower premium than the Buy-up Plan.

Vision Coverage

This insurance plan is provided by Delta Dental, in conjunction with EyeMed. The EyeMed network gives you access to a national network of both independent providers along with the nation’s most respected optical retail brands such as Target Optical, LensCrafters, and Pearl Vision. You can elect this benefit to cover yourself and your eligible family members. The EyeMed plan allows for materials to be obtained once every 12 months. See the chart below for benefit details.

The benefit is simple to understand and easy to use. Each member enrolled in the plan (either single or family coverage) will receive up to $250 towards the purchase of frames, lenses and/or contacts. Additionally, any expenses above the benefit maximum are discounted!

Madison Metropolitan School District provides you with basic life insurance, basic accidental death & dismemberment (AD&D), voluntary life insurance and AD&D, short-term disability, long-term disability and long-term care insurance.

Life Insurance

You are automatically enrolled in Basic Life and AD&D Insurance. Coverage is 1x your salary, rounded up to the next thousand. MMSD pays 100% of the cost of this plan.

The Basic + Retirement Plan is only available for employees hired prior to 7/1/2018 and who were already enrolled in the coverage prior to 7/1/2018. Coverage is 1x your salary, rounded up to the next thousand. MMSD pays 85% of this coverage.

Disability Insurance

You are automatically enrolled in Long Term Disability Insurance. The benefit level is 80% of your pre-disability earnings after a 75 calendar day wait period. The benefit will continue as long as you’re disabled, through the standard Social Security full retirement age.

Voluntary Short Term Disability Insurance is available to all employees who work 19+ hours per week, except those in the Teacher Unit. The benefit level is 66.67% of your pre-disability earnings, after a 2 week waiting period. If you enroll in coverage during Open Enrollment, you will have a 12-month exclusion period for certain conditions before benefits are available. Premiums can be found in the Standard Enrollment System when electing the coverage.

Long Term Care Insurance

Voluntary Long Term Care Insurance is available for you, your spouse/domestic partner and parents. Long Term Care Insurance helps pay for long-term nursing home stays, assisted living facilities, home modification and care coordination for services not covered by health insurance. Premiums are based on the coverage level and additional options.

More information about the coverage options and premiums can be found at: http://unuminfo.com/MadisonMetroSD74under/index.aspx