2023 Benefits Plan Year

03 Introduction
04 YOSS Platform
05 Accessing Your Portal
06 Your OneSource Solution
07 Important Notes
09 Benefits Checklist
10 State Health Insurance
11 Retirement
13 Disability
14 Life Insurance
17 Dental
18 Vision
19 Critical Illness/Cancer
20 Cancer
21 Accident
22 Hospital Indemnity
23 Medical Spending Accounts
24 Telemedicine
26 Carrier Information
27 FAQ’s
28 General Notices
30 Notes
 Benefits are an integral part of the overall compensation package provided by the Ben Hill County
School District. We understand that your benefits package is important to you and your family.
Our package is designed to provide the best possible coverage, at the best possible price with the goal
of securing your family’s financial security. Please take time to review each item carefully and
discuss questions you may have with a benefits counselor.

Who is eligible?
All active full-time employees are eligible for coverage the first day of the month following one month of
continuous full-time service.
How do I enroll?
• Plan Year: Core Benefits Jan 1 - Dec 31 | State Health Jan 1—Dec 31
• Can enroll online through HR & Benefits Portal or ONE-ON-ONE with a benefits counselor
• New hire enrollment must take place within 30 days of first day of service
Can I make changes?
Changes to Cafeteria Plan Deductions may only be made during the plan year due to a qualifying life event
(such as marriage, child birth, etc.) and must be completed through the HR & Benefits portal within thirty
(30) days of the event.

Your benefits included in this guide:

• State Health Insurance • Critical Illness/Cancer

• Retirement (TRS, PSERS) • Cancer
• 403(b)/457 Supplemental Retirement Plan Options • Accident
• Short & Long Term Disability • Hospital Indemnity
• Group Term Life • Medical Spending Accounts
• Permanent Life • Telemedicine
• Dental & Vision

Your OneSource Solution, nor its associates represent Teachers Retirement System of Georgia, PSERS, Social Security, or State Health (SHBP).

To discuss your personal situation with a benefits counselor at Your OneSource Solution,
please call (229) 896-3436 to set up an appointment or email
[email protected]

For illustrative purposes only. Refer to full plan documents. 3 Ben Hill County Schools
The YOSS Platform is an online HR & Finance Software available 24/7 via any web browser or mobile device.
Your employer may use the platform for items like electronic pay stubs, W2s, and more. Once logged into
the platform you can click on Benefits Portal which will direct you to the benefits platform, Employee
Navigator. Below are instructions on registering and logging into the benefits platform.

Step 1: Accessing the platform

Go to :https://yossplatform.com/login.aspx
Step 2: Registration
Click on “Register a New User”
Users have two choices when registering:
I) Email & Date of Birth
II) Company Code,
Employee Id, and Date of Birth

Step 3: Two Factor Security

When you login from a new device
you will be prompted to complete a
Two-Factor Security check.
You can verify using your email on
file or your mobile SMS number if al-
so verified.
Do not refresh your page or you will
have to restart.

Please note the benefits portal is a separate website therefore if unregistered

you will need to register again.
Also, your username and password may differ from your YOSS platform login.

4 Ben Hill County Schools

For illustrative purposes only. Refer to full plan documents.
You can access your Employee Benefits information provided through Your OneSource Solution 24/7 365
days a year by accessing the Benefits Portal!

Please note the benefits portal is a separate website

therefore if unregistered you will need to register again.
Also, your username and password may differ.

Step 1: Login using the credentials you set from

your registration email or click new user
registration!

Your company identifier

is Ben-Hill

Step 2: COMPLETE!
Once logged into your
portal you can access
many features such as:
• View and edit your profile
• See your current elections
• Adjust coverage due to a life event
• View common documents

Need technical assistance? Give us a call at (229) 896-3436 or

email us at [email protected]!

5 Ben Hill County Schools

For illustrative purposes only. Refer to full plan documents.
 We have partnered with Your OneSource Solution, a local financial services firm, to serve as a
resource for our employees in one-on-one benefit counseling! Your OneSource Solution has an
experienced team of counselors available to discuss all areas of your financial needs!

Life Insurance Dental & Vision Retirement

TRS, Social Security, 403b/457

Supplemental Health Disability Much More!

We are real people who offer real solutions to real problems.

We want to partner in your success!

(229) 896-3436 | www.YourOneSourceSolution.com | 125 S. Burwell Ave | Adel, Georgia 31620

[email protected]

Your OneSource Solution, nor its associates represent Teachers Retirement System of Georgia, Social Security, or State Health (SHBP).

Securities and Advisory Services offered through GWN Securities, Inc. 11440 N. Jog Road, Palm Beach Gardens, FL 33418, 561-472-2700, Member
FINRA, SIPC. Your OneSource Solution is not a subsidiary of nor controlled by GWN Securities, Inc.

6 Ben Hill County Schools

For illustrative purposes only. Refer to full plan documents.
 Open Enrollment

1. Confirm your access to the enrollment portal in advance of the start of the Open Enrollment dates.
2. If applicable attend educational sessions and then enroll either online or with a benefits counselor.
3. After Open Enrollment check your payroll deductions to verify that the correct amount was withheld.
Contact your payroll department immediately if your deductions are not correct.

During Open Enrollment you may:

• Enroll in the benefits coverage • Decrease/Increase coverage

• Change plan options • Discontinue enrolled coverage
• Enroll eligible dependents • Make demographic changes
• Drop covered dependents • And much more...

IMPORTANT NOTE:
The elections made during Open Enrollment will be the coverage you will have
for the entire plan year, unless you have a qualifying life event that allows a
change to your coverage.

7 Ben Hill County Schools

For illustrative purposes only. Refer to full plan documents.
 Confirming your choices:
It is important that you verify your elections prior to the end of your enrollment
period. The benefits elected will be in effect for the entire plan year.
Review and print your “Benefits Summary” page within the portal. Report any
discrepancies immediately to your Payroll department.

The Internal Revenue Service (IRS) prohibits you from changing coverage elections,
enrolling in or cancelling coverage outside of Open Enrollment. However, the IRS does
permit you to change coverage, enroll or cancel coverage in certain limited circumstances.
Those circumstances include but are not exclusively : marriage, divorce, birth,
adoption, death of a dependent or gain/loss coverage under spouse’s
employer.

If you have a life event, the IRS

generally only allows 30 days to make
changes to your available benefit plans!

Additional Information:
This benefits guide summarizes the benefits you can elect for the plan year. A more detailed
explanation of benefit provisions is provided in each benefit summary plan document. Every attempt
has been made to ensure that the information in this booklet is accurate.

Your benefits offered through your employer in partnership with Your OneSource Solution is
governed by legal documentation and insurance contracts. In the event of conflict between this
benefits guide and the official plan documents and/or contracts, the terms of the official
plan documents and contracts shall prevail.

8 Ben Hill County Schools

For illustrative purposes only. Refer to full plan documents.
 Confirm your access to the benefits portal

Update/Confirm your beneficiaries and dependents within the Benefits

Portal

Complete Enrollment within the Benefits Portal with a benefits counselor

or online

Review & Print your benefits summary page—Review 24/7 within the
benefits portal.

Compare your paystub to the benefits shown within the Benefits Portal

9 Ben Hill County Schools

For illustrative purposes only. Refer to full plan documents.
State Health Benefit Plan

As a full time employee, the State Health Benefit Plan available to you represents a significant component of your
compensation package. Your employer pays $945 per month towards your state health insurance!

Enroll during the Fall at:

https://myshbpga.adp.com
Registration Code: SHBP-GA

All qualifying life events & enrollment

must be submitted through the SHBP
Portal or via phone with SHBP!

SHBP Wellness Portal

https://bewellshbp.com

SHBP Phone Number

(800) 610-1863

Member Rates:

SHBP Decision Guide

https://shbp.georgia.gov Your OneSource Solution, nor its associates represent Teachers Retirement System
of Georgia, Social Security, or State Health (SHBP).

10 Ben Hill County Schools

For illustrative purposes only. Refer to full plan documents.
As a benefits eligible employee, you may be eligible to receive a pension from TRS/PSERS (if vested), Social Security
(Review Windfall Elimination Provision with a Financial Consultant), and the money you save for
yourself in a Supplemental Retirement Plan (403(b)/457). After retirement, you can potentially receive income
from at least three places.

TRS/
PSERS SS 403B/457

TRS offers a defined benefit plan, guaranteeing a monthly benefit - based on a member's highest two consecutive
years of salary and service - which is payable for the life of the member, and when applicable, transferable to a
member's spouse or beneficiary(ies). 6% of your salary is contributed to your TRS Pension from your
check. In addition, your employer contributes approximately 20% of your salary to TRS on your
behalf. However, even if you participate in TRS over a 30 year career, TRS will only provide a pension equal to 60%
of your pre-retirement salary. TRS is a wonderful benefit public educators have in Georgia but supplementing your
Retirement Plan is recommended.

Public School Employees Retirement System (PSERS) members include bus drivers, food service workers,
and maintenance or custodial personnel. Some managers in these positions are members of TRS. Each member
contributes $4 each month (or $10 per month if membership started on our after July 1, 2012). These contributions
are deducted from your paycheck nine months of the year - from September through May. This means each member
only contributes only $36 per year ($90 if after July 1, 2012). To receive a benefit, you must have at least ten years of
credible service and you must be age 65 for Normal Retirement or Age 60 for Early Retirement (you will receive a
reduced benefit). To calculate your benefit amount, you multiply your years of Creditable Service by a Specific Dollar
Amount set by the Georgia General Assembly. The current dollar amount is $15.50.

However, even if you participate in PSERS over a 30 year career, PSERS will only provide $465/month. PSERS is not
intended to serve as your sole retirement plan. As such a supplemental retirement plan is highly recommended.

OneSource/Orion
[email protected] | (229) 896-3436
Your OneSource Solution offers a 403b/457 utilizing an open architecture mutual fund platform.
The platform is fully liquid meaning there are never any surrender charges.

Please note you may be eligible for a 1% employer match on your 403b account.
Please inquire with your payroll department.

Your OneSource Solution, nor its associates represent Teachers Retirement System
of Georgia, Social Security, or State Health (SHBP).
11 Ben Hill County Schools
For illustrative purposes only. Refer to full plan documents.
For illustrative purposes only. Refer to full plan documents. 12 Ben Hill County Schools
Disability insurance provides a source of income to people who are unable to work and who lose income due to
an accident or illness.

14 Days - Benefits begin on day 30 Days - Benefits begin on day

Elimination Period (How long before benefits start?)
15 31

Up until your Long-Term Up until your Long-Term

Benefit Duration (How long will it pay?) Disability starts; 11 weeks (90 Disability starts; 9 weeks (90
days) days)

Benefit Amount (How much will it pay?) 60% of your gross weekly salary 60% of your gross weekly salary

Maximum Benefit Amount (What is the cap?) $1,000 (Weekly) $1,000 (Weekly)

Pre-Existing Condition (What isn’t covered?) 3 months / 6 months 3 months / 6 months

Elimination Period (How long before benefits start?) 90 Days - Benefits begin on day 91

Benefit Duration (How long will it pay?) Up until normal Social Security retirement age

Benefit Amount (How much will it pay?) 60% of your gross monthly salary

Maximum Benefit Amount (What is the cap?) $6,000 (Monthly)

Pre-Existing Condition (What isn’t covered?) 3 months / 12 months

Short-Term Disability Monthly Rates

Long-Term Disability Monthly
Age Category 14/14 Monthly Rate 30/30 Monthly Rate Rates
All Ages $0.49 $0.32 Monthly Payroll
Age Category
Rate
Rate Calculator:
<20 $0.11
Short-Term Disability Long-Term Disability
20 - 24 $0.12
1. Divide Annual Salary by
1. Divide Annual Salary by 52 25 - 29 $0.17
12
2. Multiply by Benefit Percentage 30 - 34 $0.26
2. Divide by 100
(60%) 35 - 39 $0.32
3. Multiply by Rate 40 - 44 $0.37
3. Divide by 10 and Multiply by Rate
(Based on Age)
45 - 49 $0.51
50 - 54 $0.72
To receive disability benefits a person must generally:
55 - 59 $0.84
1) Be Disabled as certified medical physician
60 - 64 $0.91
2) Experience a loss of income
65 - 69 $0.95
3) Not receive income from other sources (Verify with your HR department to see if applicable )
70 - 99 $1.00

13 Ben Hill County Schools Coverage Carrier:

For illustrative purposes only. Refer to full plan documents.
 Life insurance is a pillar of financial advising as an untimely death can be
catastrophic to your family - not only emotionally but financially. Additionally, life
insurance is the only asset not currently taxed when passed to your heirs - making it a
strong planning tool.

$20K Board Paid Voluntary Term Permanent

Term Life Insurance Life Insurance Life Insurance

OneSource recommends combining the power of inexpensive group term life insurance
with a permanent life insurance policy to ensure coverage upon retirement/separation of
service and to lock in low rates at an earlier age!

14 Ben Hill County Schools

For illustrative purposes only. Refer to full plan documents.
 Group Term Life is an inexpensive way for you to protect you and your family from an untimely
death during your working years. It is a good idea to partner your term insurance with a permanent
solution. When considering how much coverage you need, consider your outstanding debts and at
least two to three years of your salary.

Life Insurance Amounts - Plan Includes Accidental Death and Dismemberment

In increments of $10,000 up to the lesser of $300,000 or 5x

Employee
Salary

Spouse $5,000 increments for up to 50% of Employee Option

Dependent Children $10,000

Guarantee Issue - First Time Eligible (New Hire)

Employee Up to $100,000

Dependent Spouse Up to $25,000

Dependent Children $10,000

During Open Enrollment the Employee Can Elect an additional $10K not
Additional Coverage exceeding the Guaranteed Issued Amount

Employee & Spouse

Life and AD&D Rates What happens to my term life insurance when I separate from service?
A 55-year-old who is still employed who has $100K term that costs $17.70 per month
Rates per
Age The same 55-year-old retires and “ports” this term coverage. They would immediately
$1,000
begin paying $134.00 per month for the same $100K of term coverage. At age 65 it costs
$386/mo, at age 70 it costs $541.00/mo, and at age 80 it costs $1,753.00/mo!
All Ages $0.177

Dependent Children Rates

(Under Age 26)

$0.291
IMPORTANT: IF YOU AND YOUR SPOUSE ARE BOTH EMPLOYED BY THE SAME EMPLOYER YOU CANNOT COVER ONE
ANOTHER ON SPOUSE LIFE INSURANCE AS A DEPENDENT. IF YOU ELECT SPOUSE COVERAGE YOU DO NOT HAVE
COVERAGE ON YOUR SPOUSE AND ONLY PAID PREMIUMS WOULD BE REFUNDED IN AN EVENT OF A CLAIM.
ADDITIONALLY, IF TWO EMPLOYEES OF THE SAME EMPLOYER HAVE A CHILD(REN) IN COMMON, SAID CHILD(REN)
CANNOT BE COVERED AS A DEPENDENT UNDER TWO SEPARATE POLICIES. IF BOTH PARENTS ELECT DEPEDENT CHILD
LIFE, ONLY ONE CLAIM WOULD BE PAID.

Coverage Carrier:
15 Ben Hill County Schools
For illustrative purposes only. Refer to full plan documents.
Life Insurance, while a pillar of financial consulting, is a commonly misunderstood tool.
Many think the term life insurance will go with them when they retire.
Here is an example of how term life generally works:

What happens to my term life insurance when I separate from service?

A 55-year-old who is still employed who has $100K term that costs $17.70 per month
The same 55-year-old retires and “ports” this term coverage. They would immediately begin paying $134.00 per month for the
same $100K of term coverage. At age 65 it costs $386/mo, at age 70 it costs $541.00/mo, and at age 80 it costs $1,753.00/mo!
AND the Benefit Amount Reduces at age 70 and Terminates at age 100
*Example above is using the Non-Tobacco Rates

What is the solution?

Permanent Life Insurance solves this problem! It may cost a little more at first, but over time
it is much more affordable and is designed to cover you for your entire life!
Once you purchase permanent coverage your rates are designed to never increase!

Plus it solves the long-term care issue

***IMPORTANT: IF YOU AND YOUR SPOUSE ARE BOTH EMPLOYED BY THE SAME EMPLOYER PLEASE NOTE EACH INDIVIUDAL IS ONLY ELIGIBLE FOR
ONE POLICY. THEREFORE IF YOU AND YOUR SPOUSE EACH WANT COVERAGE YOU MUST BE COVERD UNDER YOUR OWN INDIVIDUAL POLICY AND
NOT COVERED UNDER YOUR SPOUSES POLICY. IN THE EVENT THERE ARE TWO POLICIES, ONLY ONE POLICY WOULD BE PAID.***

***ADDITIONALLY, IF TWO EMPLOYEES OF THE SAME EMPLOYER HAVE A CHILD(REN) IN COMMON, SAID CHILD(REN) CANNOT BE COVERED UNDER
TWO SEPARATE POLICIES. IF THE CHILD(REN) HAVE TWO POLICIES, ONLY ONE CLAIM WOULD BE PAID.***

Coverage Carrier:
16 Ben Hill County Schools
For illustrative purposes only. Refer to full plan documents.
 Do you want your smile to look its best? Want to do what you can now, to prevent
expensive dental work later? Our plans help cover the cost of regular dental exams,
cleanings and treatment to help keep your smile healthy for a lifetime.

Benefits Low Plan High Plan Value Plan*

Preventive (Type 1) 100% 100% 100%

Basic (Type 2) 50% 80% 80%

Major (Type 3) N/A 50% 50%

$50 per individu-
$50 per individual $50 per individual
Deductible (Only Type 2 & 3) al
$150 per family $150 per family
$150 per family
Max (per person) $1,000 $1,750 $2,250

Orthodontia (Adult & Child)

Coinsurance N/A 50% 50%

Lifetime Maximum
N/A $2,000 $2,000
(per person)
The above summary assumes in-network provider

Rates Low Plan High Plan Value Plan*

Employee No Cost to you—Paid by the Board!

Employee + 1 Dependent $14.89 $48.73 $31.84

Employee + 2 or more
$47.56 $101.43 $74.51
Dependents
*Designed for in-network use

Ben Hill BOE pays for the employee portion of your dental insurance!

Question about Dental Procedures/Waiting Periods?

Send us an email at [email protected] or
view the listing in the HR & Benefits Portal!

Coverage Carrier:

17 Ben Hill County Schools

For illustrative purposes only. Refer to full plan documents.
 Vision benefits are so much more then an eye exam. They help you
save money, stay healthy, and see everything life has to offer!

EyeMed Insight Out of

Benefits Frequency
Network Network
Vision Exam $10 Copayment Up to $35
Standard Fit & Follow Up Exam Up to $40 Not Covered Once every 12
months
Premium Fit & Follow Up Exam 10% off Retail Not Covered

Contact Lens Allowance Max Amount

Elective Up to $130 Up to $104
Once every 12
Medically Necessary $0 Copayment; Covered in Up to $200 months
Full

Single Plastic Lenses Co-Payment Max Amount

Single Vision $25 Up to $25
Bifocal $25 Up to $40 Once every 12
Trifocal $25 Up to $55 months

Lenticular 20% Discount Not Covered

Once every 24
Frames $130 Allowance Up to $65
months

Ben Hill BOE pays for your employee portion of Vision!

*If you choose contact lenses, no benefits will be available for covered eyeglass lenses during that period.

Employee Employee + 1 Dependent Family

$0-No cost $4.90 $9.74

Coverage

18 Ben Hill County Schools

For illustrative purposes only. Refer to full plan documents.
 Fully Guaranteed Issue Benefit Amounts

Employee In increments of $5,000 up to $30,000

Spouse In increments of $5,000 up to $30,000 (Not to exceed 100% Employee Election)

Child(ren) Automatically covered at 50% of Employee for no cost

Notes:

Critical Illness provides cash benefits when you’re diagnosed with a covered critical illness. These benefits are paid
directly to you and are intended to help cover your medical out of pocket costs and the living expenses that can
accompany a covered critical illness. This plan is guaranteed issue and has no pre-existing condition other
than a 12 month look back for cancer claims. Also, be sure to fill out your $50 wellness benefit for
getting your health screening!

Premiums based on age! $50 WELLNESS

$16.47 for $10K age 45 non smoker.
BENEFIT
Rates lock in!

Coverage Carrier:
19 Ben Hill County Schools
For illustrative purposes only. Refer to full plan documents.
 Some employees desire a stand alone
traditional cancer plan from AFLAC.

You have this option also!

Cancer treatment is changing—and Aflac is proud to be changing with it. Thanks to advances in
science and treatment, more and more Americans today are living with cancer.1 Aflac Cancer
Protection Assurance helps cover these innovative treatments with benefits
that really care for you as a whole person.
From prevention to recovery, Aflac is with you every step of the way. Our benefits are built to see
you all the way through cancer treatment and they’ll stay with you for life after cancer.2

AFLAC pays cash benefits directly to you, unless you choose

otherwise. This means that you can have added financial
resources with expenses incurred due to medical treatment,
ongoing living expenses or any purpose you choose.

'Progress Against Cancer- 2019 Annual Plan, National Cancer Institute. https://www.cancer.gov/about-nci/budget/plan/progress. Accessed: November 13, 2017. 2Coverage remains in force as long as
premiums are paid. 3Cancer Facts & Figures 2017, American Cancer Society. 'National Cancer Institute, Surveillance, Epidemiology and End Results {SEER) Program. See:https://seer.cancer.gov/
statfacts/html/breast.html and https://seer.cancer.gov/statfacts/html/prost.html. SEER Cancer Statistics Review, 1975-2014, National Cancer Institute. Bethesda, MD, https://seer.cancer.gov/
csr/1975_2014/, based on November 2016 SEER data submission, posted to the SEER web site, April 2017. Accessed: December 13, 2017. 7National Cancer Institute, Cancer Trends Progress Report.
See https://progressreport.cancer.gov/detection. Published: January 2017. Accessed: December 13, 2017.

20 Ben Hill County Schools

For illustrative purposes only. Refer to full plan documents.
An accident insurance policy will pay you a tax-free benefit upon injury from an accident,
which means a sudden, unexpected, and unforeseen event.

Benefit Description Benefit Payout

INJURIES Monthly Premiums
Fractures $200-$5,000
Employee $12.43
Dislocations $160-$4,000
Second & Third Degree Employee + Spouse $20.18
$50 - $10,000
Burns
Concussions $350 Employee + Child $24.20
Cuts/Lacerations $38 - $300 Family $31.95
Eye Injuries $175
MEDICAL SERVICES AND TREATMENT
Ambulance (Ground &
$300 | $900
Air)
Example: Ashley's daughter, Brittany, plays soccer
Accident Follow-Up $35 on the varsity high school team. During a recent
game, she collided with an opposing player, was
knocked unconscious and taken to the local
Therapy Services $35 emergency room by ambulance for treatment with
a broken tooth and concussion.
Medical Appliances $50
Inpatient Surgery $750
HOSPITAL COVERAGE (ACCIDENT)
Benefit
Admission $750 per accident Covered Event
Amount

Ambulance (Ground) $300

$225 a day (non-ICU) up to 365 days
Confinement Emergency Room $125
$450 (ICU) up to 30 days
Accident Follow-Up (2 x $35) $70

Inpatient Rehab $75 a day for up to 31 days Medical Testing $150

Concussion $350

Broken Tooth (Repaired by Crown) $120

Total Benefits Paid by AFLAC $1,115

$50 WELLNESS
BENEFIT
Coverage Carrier:

21 Ben Hill County Schools

For illustrative purposes only. Refer to full plan documents.
Hospital Indemnity Plan provides cash benefits directly to you that help pay for some of the costs - medical and
nonmedical - associated with a covered hospital stay due to a sickness or accidental injury.

Guaranteed Issue! High Low

Hospital Admission (per confinement)

(Once per covered sickness or accident per calendar year) $1,000 $1,000
Hospital Confinement (per day)
(Maximum confinement period: high plan: 10 days per covered sickness or $200 $100
covered accident - low plan:31 days per covered sickness or covered accident)

Hospital Intensive Care (per day)

(Maximum confinement period: $200 $200
10 days per covered sickness or covered accident)

Outpatient Doctor’s Visits (per day)

(Maximum: 1 visit per calendar year)
$50 N/A
Hospital Emergency Room Visit (per day)
$150 N/A
(Maximum: 1 visit per calendar year)

Major Diagnostic Exams

(Once per covered sickness or accident per calendar year)
$200 N/A
Inpatient Surgery Anesthesia (per day) $500 N/A
Outpatient Surgery Anesthesia (per day) $400 N/A
Doctor’s Office Surgery (per day)
(Maximum: 2 visit per calendar year)
$50 N/A

High Low
Employee $40.12 $13.96

Employee + Spouse $77.44 $28.12

Coverage Carrier:
Employee + Child $61.96 $21.98
Family $99.28 $36.14

22 Ben Hill County Schools

For illustrative purposes only. Refer to full plan documents.
 The medical, dental, vision, and dependent care expenses - what you pay out of your own
pocket - doesn’t have to take such a big bite out of your budget. Use a Flexible Spending
Account (FSA) to cover these expenses using PRE-TAX dollars, while also reducing your
taxable income.

Medical Flexible Spending Account (FSA)

Minimum Contribution $300 annually

Maximum Contribution $2,850 annually

Dependent Care Flexible Spending Account (FSA)

Minimum Contribution $300 annually

Maximum Contribution $5,000 annually

Notes: Plan Year is Jan 1—Dec 31 | $570 Carry Over on Medical FSA | Any leftover balance in your
Dependent Care Account is forfeited | Total Medical FSA Contribution is available at the beginning of the year |
Dependent Care election is only available as deposited monthly | Medical FSA has a Visa Debit Card | Dependent
Care Account requires reimbursement submission | See included eligible expenses |

The IRS rules and the rules of your employer designate eligible expenses. Your employer has the responsibility to
interpret these rules and make all decisions as to an expense’s eligibility.

Information About Flexible Spending Accounts:

• Deductions for spending accounts are made on a pre-tax basis every pay period.
• Your spending account elections are binding for the plan year. You may be able to make limited changes if you
have a qualified status change.
• When you enroll in a Medical Flexible Spending Account, you’ll receive a VISA ® spending account card for
purchases of eligible health care with a $2.00 monthly fee
• Remember, you may want to keep your receipts since some transactions may require validation by iSolved.

Important Note:
Please be aware that if you are currently contributing to a Medical Spending Account,
your annual election will not roll over into the new plan year. You must make a new
election during Open Enrollment if you want to contribute to the Medical Spending
Accounts for the next plan year.

$2.00 Flex Fee

23 Ben Hill County Schools
For illustrative purposes only. Refer to full plan documents.
This is a discount benefits program offering significant savings from thousands of providers across the nation.
All of the benefits include the employee and his/her immediate family.
Packages
• Teladoc
• Health Advocacy
• Medical Bill Saver
Advantage • Nurseline
• Doctors Online
• Health Wealth Connection

• Teladoc
• Health Advocacy
• Medical Bill Saver
• Nurseline
• Doctors Online
• Health Wealth Connection
Advantage Plus • Vision
• Dental
• Pharmacy
• Lab Testing
• MRI & CT Scans
• Hearing Aids

• Teladoc
• Health Advocacy
• Medical Bill Saver
• Nurseline
• Doctors Online
• Health Wealth Connection
• Vision
Premier • Dental
• Pharmacy
• Lab Testing
• MRI & CT Scans
• Hearing Aids
• Legal Care Direct
• ID Sanctuary Enhanced
• Roadside Assistance

Packages Pricing

Advantage $10.95
Advantage Plus $14.09
Premier $22.22
Coverage Carrier:

24 Ben Hill County Schools

For illustrative purposes only. Refer to full plan documents.
Teladoc
73% of Americans have trouble receiving timely medical care without having to visit the emergency room. Help employees save time and money with 24/7 access to a doctor by phone
or online video consult - anytime, anywhere in the US with no copay. Doctors offer diagnosis, treatment options and prescription if necessary. By using Teladoc instead of going to an
urgent care clinic or ER, employees cut unnecessary out-of-pocket costs and time wasted in crowded waiting rooms.

Health Advocacy
Time is money. Personal Health Advocates help employees navigate through insurance and healthcare systems. Advocates can also locate doctors, specialists, hospitals, dentists and
pharmacies. Advocates research treatments, resolve claims and provide medical explanations so employees can make more informed decisions.

Medical Bill Saver

Individuals are responsible for more out-of-pocket medical and dental costs than ever before. Medical Bill Saver provides skilled negotiators who will attempt to negotiate discounts for
your employees, no matter their benefit status. Negotiators can lead to a reduction in their out-of-pocket costs.

Nurseline
Employees have a place to turn to for trusted advice and information when they need it most. Rest assured - highly trained registered nurses are on-call 24/7 to answer questions.

Doctors Online
Employees have access to a team of medical professionals by email or smartphone app. Doctors Online gives employees a trustworthy place to get their healthcare questions answered
through a secure website 24/7. It’s the fast, easy way for employees to get health information from a resource they can trust.

Vision
Our eyes are the windows to our health. Now employees and their family can see better savings at over 20,000 visions providers nationwide including chains and local retailers.
Employees save 10% to 60% on glasses, contacts, laser surgery, exams, and even designer eyewear.

Dental
Help employees smile brighter with big savings at over 158,000 dental practice locations nationwide. In most instances, employees save 15% to 50% per visit* on services from general
dentistry to special procedures. Employees can use their card over and over again to save throughout the year. *Actual costs and savings vary by provider, service and geographical area.

Pharmacy
Our members save 10% to 85% on most prescriptions, reducing their out-of-pocket costs by over $94 million in 2013.

Pet Care
62% of American households have at least one pet. Your employees can keep their pets happy and healthy with discounts on everything from toys and treats to grooming and eats.
They can save on boarding, doggie daycare, training, veterinary services and more.

Lab Testing
Help your employees monitor their health with 10% to 80% off typical costs of routine lab work. Employees can choose from over 1,500 participating locations nationwide and order
online or by phone. Confidential results are available online in as little as 24 hours for most tests.

MRI & CT Scans

A better image leads to a better diagnosis, better treatment, and a better recovery. Your employees save 50% to 75% on usual charges for MRI, CR Scans and Ultrasounds at thousands
of credentialed radiology centers nationwide.

Hearing Aids

55% of seniors cite costs as a reason for not using hearing aids. Your employees receive a free initial screening and save 35% at retail locations nationwide.

Legal Care Direct

With a national average hourly rate of $381, contacting an attorney may seem out of reach. Give employees access to free and discounted rates on services from experienced lawyers.
Attorneys help with traffic tickets, bankruptcy, divorce, spousal and child support. Additional services are also available at no cost.

ID Sanctuary Enhanced - Family

Keep employees one step ahead of identity theft. If they are online, have a bank account or use a credit card, personal information can be stolen at any time. ID Sanctuary provides the
proactive tools and recovery assistance your employees need to quickly respond to an identity or fraud crisis.

25 Ben Hill County Schools

For illustrative purposes only. Refer to full plan documents.
 Plan Carrier Phone Number
Short-Term Disability Mutual of Omaha 800-877-5176
Long-Term Disability Mutual of Omaha 800-877-5176
Voluntary Term Life The Standard 800-628-8600
Permanent Life Trustmark 877-201-8373
Dental Ameritas 800-487-5553
Vision Ameritas 800-487-5553
Accident Aflac 800-433-3036
Critical Illness Aflac 800-433-3036
Hospital Indemnity Aflac 800-433-3036
Health Spending Accounts iSolved 800-796-7910
Telemedicine New Benefits 972-404-8192

26 Ben Hill County Schools

For illustrative purposes only. Refer to full plan documents.
• What do I do if I need technical support?

• Please contact a member from OneSource either at [email protected] or (229) 896-3436.

• How do I request a duplicate dental or vision card?

• Please contact a member from OneSource either at [email protected] or (229) 896-3436.

• If emailing, please indicate if the request is urgent (i.e. your appointment is the same day) and provide the best
mailing address for physical cards to be sent to.

• How do I locate an in-network provider?

• You can find those listed in-network within the portal. Under the “Resources” tab you will find a PDF of dental
and vision providers.
• What is the process of filing a claim?

• Your OneSource Solution is available to assist you in the filing of your claim(s). Each coverage and carrier’s
process differs but generally speaking there will be a claim form to complete including information from your
physician. The insurance carrier, and not OneSource, is responsible for the review, approval/denial, and if
applicable payment of your claim. Our goal is to serve as a resource to you in this process.

• How do I confirm my current benefits?

• You may view your current benefit elections provided by Your OneSource Solution 24 hours a day, 7 days a
week, 365 days a year in the online Benefits Portal. You may also contact our office at (229) 896-3436 or
[email protected] to request a paper copy via email or mail.

• What is a life event? How do I process a life event?

• A life event, otherwise known as a qualifying event, occurs under certain events as defined by the IRS under code
125. A life event allows an employee to make changes to their coverages when they otherwise could not. A
common example is the addition of a spouse to your coverage after a recent marriage. It is important to note that
life events must be processed timely as the IRS restricts the amount of time you have from the event to process
the new coverage.
• To process a life event, you can click on the “Life Events” tab within your OneSource benefits portal. You may
also contact our office at (229) 896-3436 or [email protected] and a team member can
assist.

• How do I verify my current beneficiaries?

• You can view your beneficiaries at any time within your OneSource benefits portal. After logging in, click on
enrollment summary and then beneficiaries.

27 Ben Hill County Schools

For illustrative purposes only. Refer to full plan documents.
28 Ben Hill County Schools
For illustrative purposes only. Refer to full plan documents.
The Benefits Plan is offered by your employer. It is governed by the Internal Revenue Code, section 125, and rules issued by your
employer. This section is intended to provide you with general notices and disclosures.

1. This benefits guide summarizes the benefits you can elect. A more detailed explanation of benefit provisions is provided in each benefit summary
plan document. Every attempt has been made to ensure that the information in this booklet is accurate. Coverages are governed by legal
documentation and insurance contracts. In the event of conflict between this benefits guide and the official plan documents and/or contracts,
the terms of the official plan documents and contracts shall prevail.

2. This Notice describes how the Plan(s) may use and disclose your protected health information (PHI) and how you can get access to your
information. The privacy of your protected health information that is created, received, used or disclosed by the Plan(s) is protected by the Health
Insurance Portability and Accountability Act of 1996 (HIPPA). This Notice is available online within your employee benefits portal. A paper copy is
also available, free of charge, by calling your employer or Your OneSource Solution at (229) 896-3436. Please note the participant is responsible for
providing a copy to their dependents covered under the group health plan.

3. Section 125 Pre-Tax Benefit Authorization Notice: Before-tax deductions will lower the amount of income reported to the federal government. This
may result in slightly reduced Social Security benefits. If you do not enroll eligible dependents at this time, you may not enroll them until the next
open enrollment period. You may not drop the coverage you elected until the next open enrollment period. You may only make a change or drop
coverage elections before the next open enrollment period under a qualifying life event.

4. On April 7, 1986, a federal law was enacted (Public Law 99272, Title X) requiring that most employers sponsoring group health plans offer
employees and their families the opportunity for a temporary extension of health coverage (called “continuation coverage”) at group rates in
certain instances where coverage under the plan would otherwise end. If you or your eligible dependents enroll in the group health benefits
available through your Employer you may have access to COBRA continuation coverage under certain circumstances. Therefore, your plan makes
available to you and your dependents the General Notice of COBRA Continuation Coverage Rights. This notice contains important information
about your right to COBRA continuation coverage, when it may become available to you and your family, and what you need to do to protect the
right to receive it. The full Notice is available online within your employee benefits portal. A paper copy is also available, free of charge, by calling
your employer or Your OneSource Solution at (229) 896-3436.

5. For dependent and/or spousal coverage, it is your responsibility to notify Your OneSource Solution if the person is ineligible or ceases to be eligible
to participate in the Plan. There will be no refund of premiums paid into the Plan, when a timely notice is not made.

6. This salary agreement will be terminated if you change the agreement during the next enrollment period. If you do not change the agreement, your
benefit choices will rollover in the next Plan year or default to a specified coverage except for the Flexible Spending Accounts.

7. If you choose not to participate or choose not to continue coverages, your ability to enroll at a later date will be subject to contractual provisions,
which may include medical proof of insurability or limited coverages.

8. If you failed to enroll in options requiring medical underwriting when first eligible and you choose new or increased levels of coverage, you must
complete the medical underwriting process and be approved.

9. If on any policy a beneficiary is not named, the beneficiary will follow the order stated in the policy or the insurance carriers standard protocol.

10. If you have Medicare or will become eligible for Medicare in the next 12 months, a federal law gives you more choices in your prescription drug
plan.

29 Ben Hill County Schools

For illustrative purposes only. Refer to full plan documents.
30 Ben Hill County Schools
For illustrative purposes only. Refer to full plan documents.
31 Ben Hill County Schools
For illustrative purposes only. Refer to full plan documents.
We are real people who offer real solutions to real problems.

32 Ben Hill County Schools

For illustrative purposes only. Refer to full plan documents.