2021-2022 Benefit Guide - Open Enrollment: May 12-26, 2021 Benefits Effective: September 1, 2021 - August 31, 2022 - Wicomico County Public Schools
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2021-2022 Benefit Guide
Open Enrollment: May 12-26, 2021
Benefits Effective: September 1, 2021 - August 31, 2022
Questions and What’s Inside
Questions
We are here to help with any issues that may arise.
If you require assistance with your benefits:
Call the appropriate insurance carrier. You will need your ID number or Social Security number along with date of
service and provider name.
If you still need assistance, contact the Human Resources Department at 410-677-4595.
If you have questions about... Contact Phone Number Website or Email
wcps.benelogic.com
Benelogic 1-866-263-1779
info@wcps.benelogic.com
Medical Claims CareFirst 1-877-691-5856 www.carefirst.com
CareFirst District Office CareFirst 1-410-742-3274 Salisbury.do@carefirst.com
Prescription Claims Retail CVS Caremark 1-800-241-3371
Prescription Mail Order CVS Caremark 1-800-241-3371
Dental Claims CareFirst 1-866-891-2802
Vision Claims Davis Vision 1-800-783-5602
Vince Reagan,
www.lfg.com
403(b) and 457(b) Plan Lincoln Financial 1-703-254-8715
Vincent.Reagan@LFG.com
Retirement Consultant
www.naviabenefits.com
Flexible Spending Account Navia Benefit Solutions 1-800-669-3539 customerservice@
naviabenefits.com
Long Term Disability Insurance The Standard 1-800-348-3226
General Human Resources and 1-410-677-4595
Bunnie Stanley, WCPS bstanley@wcboe.org
Benefit Questions ext. 65316
Voluntary Benefits The Warner Companies 1-866-870-5093 service@lwarner.com
WellAware - Employee wellness.wcboe.org
US Wellness 1-844-542-9699
Wellness Program wellaware@uswellness.com
What’s Inside
Questions...................................................................2 Dental.......................................................................15
Welcome.....................................................................3 Vision........................................................................16
Voluntary Benefits....................................................17
Eligibility and Enrollment.........................................4 Basic Life and AD&D................................................19
Health Insurance Rates.............................................5 Dependent Term Life................................................19
Voluntary Supplemental Term Life............................20
Online Enrollment (Benelogic).................................6
Flexible Spending Accounts.....................................21
WellAware - Wellness Program................................7 Long Term Disability.................................................22
Benefits......................................................................9 Employee Assistance Program................................23
Medical.....................................................................9 403(b) and 457(b) Plans..........................................25
Pharmacy.................................................................12 Important Notices......................................................26
Retiree Health Insurance.........................................14
2 | WICOMICO COUNTY PUBLIC SCHOOLS 2021-2022 BENEFIT GUIDE
Welcome
Options for Completing Open Enrollment:
Option 1: Use Benelogic, the online portal, to elect your benefits (see page 6). Two ways to log on:
» Launch the Benelogic icon from the XIA Links
» Enter wcps.benelogic.com into a web browser and log in with your WCPS computer login and password
Option 2: New! Telephonic Enrollment – call 1-866-263-1779 to make your benefit elections over the phone.
Hours: 8:30 a.m. to 5:00 p.m., Monday through Friday.
Note: Contact the Voluntary Benefits Call Center at 1-866-870-5093, same hours as above, for assistance with Life
insurance, Critical Illness, Short Term Disability and Accident coverage. You can elect new coverage/increase/change
current coverage, for certain amounts, with no medical questions asked. The Call Center can also assist with cancellation
of benefits. For Accident coverage, you can cancel your coverage in Benelogic.
Wicomico County Public Schools (WCPS) is proud to offer a comprehensive and competitive benefits package to its employees.
Whether you are a new employee enrolling in benefits for the first time or considering your benefit options during open enrollment,
this guide is designed to help you through the process. Please take the time to review this information and ask questions so you can
make the best decisions for you and your family.
Open Enrollment is from May 12 to May 26, 2021. This is your once a year opportunity to make benefit changes.
Benefit changes must be submitted through Benelogic and will be effective for the September 1, 2021 to August 31, 2022 plan
year. If you are adding a dependent to your health insurance coverage during Open Enrollment, dependent documentation
must be submitted to Human Resources by June 4, 2021.
If you have questions about voluntary benefits, or how they fit with your medical benefits, schedule with a benefit counselor at
www.eznetscheduler.com/calendar/wcps. Win raffle prizes for scheduling your appointment!
Your Lincoln Financial Retirement Consultant will be available for one-on-one help with WCPS’s 403(b) and 457(b) plans.
Schedule an appointment up until 7:00 p.m. using the online scheduler. Win raffle prizes!
Benelogic is the employee benefits portal where you will make your benefit elections. A link to Benelogic can be found in the
XIA Links or log into Benelogic at wcps.benelogic.com. Your login for Benelogic is the same username and password as your
WCPS computer login. More information on page 6.
The following voluntary benefits cannot be canceled on Benelogic: Life Insurance with Accelerated Death Benefits, Critical
Illness Insurance and Short-Term Disability Insurance. To cancel these benefits, contact the Voluntary Benefits Call Center at
1-866-870-5093.
Earn a wellness incentive valued at up to $240 by participating in the WCPS employee wellness program called WellAware.
A link to WellAware is in the XIA Links or log on at wellness.wbcoe.org with your WCPS computer username and password.
More information on page 7.
Flexible Spending Account (FSA) enrollments do not carry forward from one plan year to the next. You must make an
FSA election during Open Enrollment to enroll for the next school year.
For this plan year only, the Healthcare and Dependent Care Flexible Spending Accounts (FSAs) have an unrestricted carryover.
You can carryover all unused amounts from plan year ending August 31, 2021 to the next plan year (September 1, 2021 –
August 31, 2022) as long as you enroll in the FSA for next year. To enroll in a Flexible Spending Account you must make an
annual election of at least $20 during Open Enrollment.
Benefit elections stay in place until the next Open Enrollment period unless you have a Qualifying Life Status Event (QLE) as
defined by the IRS. If you have a QLE, benefit changes must be completed within 30 days of the QLE by submitting the request
through Benelogic and providing documentation to support the change request to Human Resources.
Health insurance rates are projected to increase 0% for FY 2022.
WCPS continues to evaluate ways to improve the quality of your health care, keep our health plans competitively priced, and
control costs for you and WCPS. We encourage staff to become and remain engaged in these efforts by being educated on the
plans and using them wisely. Participate in Employee Wellness programs and activities and partner with your physician to get
appropriate preventative screenings. Also, consider programs like First Help (free 24-hour nurse advice line), CareFirst Video
Visit with a doctor, mail order pharmacy and generic prescriptions to lower your copays and overall plan costs.
This benefit guide describes the highlights of our benefits in non-technical language. Your specific rights to benefits under the plan are governed solely, and in every respect, by
the official documents and not the information in this summary. If there is any discrepancy between the descriptions of the programs as contained in this brochure and the official
plan documents, the language of the official document shall prevail as accurate. Please refer to the plan-specific documents for detailed plan information. Any plan benefits may
be modified in the future to meet Internal Revenue Service rules or otherwise as decided by Wicomico County Public Schools.
WICOMICO COUNTY PUBLIC SCHOOLS 2021-2022 BENEFIT GUIDE | 3
Eligibility and Enrollment
Who is an Eligible Dependent and What Documentation is Required?
Your legal spouse – a copy of the marriage certificate and the spouse’s social security card.
Dependent children – a copy of the official birth certificate and their social security card. Children may be covered on
the health insurance plan up to age 26.
Disabled adult child (special rules apply – contact HR)
When Does Coverage Begin for New Hires?
New hires have 30 days from their date of hire to make their benefit elections and if no
election is made then the benefit(s) is waived
Coverage begins on date of hire for Basic Life and Accidental Death and
Dismemberment Insurance
Coverage begins on the first of the month following date of hire for Medical, Prescription,
Vision, Dental
Coverage begins on the first of the month following thirty (30) days after date of hire for
Flexible Spending Accounts, Supplemental Life, Dependent Life, Long Term Disability,
Life Insurance with Accelerated Death Benefits, Critical Illness, Short-Term Disability
and Accident Insurance
403(b) and 457(b) Retirement Plan – You are eligible to enroll immediately upon your date of hire or any time thereafter.
Deductions begin on the first pay period following completion of the enrollment process.
CareFirst My Account
Set up an account today! Go to carefirst.com/myaccount to create a username and password.
1. Home 4. Doctors
Quickly view plan information including effective date, Find in-network providers and facilities nationwide, including
copays, deductible, out-of-pocket status and recent claims specialists, urgent care centers and labs
activity Select or change your primary care provider (PCP)
Manage your personal profile details including password, Locate nearby pharmacies
username and email, or choose to receive materials
5. My Health
electronically
Send a secure message via the Message Center Access health and wellness discounts through Blue365
Check Alerts for important notifications Learn about your wellness program options
Track your Blue Rewards progress
2. Coverage
6. Documents
Access your plan information—plus, see who is covered
Update your other health insurance information, if applicable Look up plan forms and documentation
View, order or print member ID cards Download Vitality, your annual member resource guide
Order and refill prescriptions
7. Tools
View prescription drug claims
Access the Treatment Cost Estimator to calculate costs for
3. Claims services and procedures
Check your claims activity, status and history Use the drug pricing tool to determine prescription costs
Review your Explanation of Benefits (EOBs)
8. Help
Track your remaining deductible and out‑of‑pocket total
Submit out-of-network claims Find answers to many frequently asked questions
Review your year-end claims summary Send a secure message or locate important phone numbers
4 | WICOMICO COUNTY PUBLIC SCHOOLS 2021-2022 BENEFIT GUIDE
2021-2022 Estimated Health Insurance Rates
Includes Medical, Prescription, Vision and Dental Coverage
These rates are tentative subject to final adoption of the FY 2022 budget by WCPS.
EPO Plan PPO Plan
Coverage Level Employee Cost Board Cost Employee Cost Board Cost
Per Pay Per Pay Per Pay Per Pay
Employee Only $40.00 $329.00 $45.00 $357.00
Employee + One Child $123.00 $549.00 $135.00 $594.00
Employee + Spouse $174.00 $684.60 $190.00 $740.00
Family Coverage $212.00 $786.40 $232.00 $848.60
Two Earner Family* $80.00 $918.40 $90.00 $990.60
*Two Earner Family = Both the employee and spouse work for WCPS, are both benefit eligible and have dependents.
How to Locate In-Network Providers
Go to www.carefirst.com/doctor
Log in as a CareFirst Member then your search will display on providers for the plans that you are enrolled in
Wellbeats
You have exclusive access to on-demand fitness by Wellbeats! This includes:
600+ fitness classes including yoga, cycling, running, HIIT, and strength training
Nutrition education and recipes
Mindfulness classes Logging in (3 ways):
1-5 minute office breaks 1. Launch Wellbeats from XIA Links on a WCPS
Goal-based challenges computer
Kid-friendly activities and pre/post-natal classes 2. Website portal - https://portal.wellbeats.com -
Beginner-level and no equipment options recommend Google Chrome, Safari, or Microsoft
Edge
Login Credentials: 3. Download the mobile app - available on iOS and
Username = WCBOE email address Android
Password = Employee ID number (ex. E012345)
WICOMICO COUNTY PUBLIC SCHOOLS 2021-2022 BENEFIT GUIDE | 5
Online Enrollment (Benelogic)
Benelogic is an online portal for benefits enrollment and information. Here you can learn about programs, choose your
benefits and beneficiaries, and access tools and resources.
Open Enrollment 2021 – At a WCPS computer, launch the Benelogic icon from the XIA Links. You will land on the Home
page of the Employee Portal which has detailed information about Employee Benefits and a WCPS Library of documents
and forms.
Begin your 2021 Open Enrollment event by clicking ‘Go’ in the Attention box on the Home page.
Choose which enrollment path you prefer: Quick Enroll (this option takes you directly to the summary of benefits where
you can quickly access only those plans you want to elect or change) or Step-by-Step (leads you through the benefit
election wizard where you can review, elect, or change your benefits).
Please note: any changes or cancellations of the TransAmerica/Unum plans MUST be completed by calling the The
Warner Companies at 1-866-870-5093.
After reviewing your elections, click the Submit button at the top or the bottom of the page in order to commit your
enrollment event.
Once you have completed your enrollment event, click View Confirmation to display and then print your Enrollment
Summary. This Enrollment Summary is always accessible from the Employee Portal.
New Hires – Benefits Enrollment
You’ve been issued a WCPS username and temporary password. You must reset your password before you can access
Benelogic. Follow these steps to reset your password:
Go to reset.wcboe.org using any web browser
Enter username and temporary password
» USERNAME: enter in your assigned Username (xxxxx@wcboe.org)
» PASSWORD: enter in Temporary Password (password is case sensitive)
» New Password
» Confirm New Password
Password requirements:
» 8 characters in length (can be more but not less)
» 1 number
» Must include 1 upper and 1 lower case letter
» Password can not include any part of your name
Click Submit
Now, you may log into Benelogic to make your benefit elections
Enter wcps.benelogic.com into a web browser. Login with your WCPS username (ex. mworkema – drop the
“@wcboe.org”) and the password that you just created.
You will land on the Home page of the Employee Portal.
Begin making your benefit elections by clicking Go in the Attention box on the Home page.
Benelogic’s enrollment wizard will now take you through each benefit by displaying the plans and coverage levels
available for you to elect.
After you review and submit your elections for Medical, Rx, Dental, Vision and Basic Life/AD&D, click Go again to take
you through the enrollment wizard for the Voluntary products and Flexible Spending Accounts.
Once you have completed both sets of enrollments, click View Confirmation to display and then print your Enrollment
Summary. This Enrollment Summary is always accessible from the Employee Portal.
For technical assistance with the Benelogic Employee Portal, contact Benelogic Client Services at 1-866-263-1779 or
info@wcps.benelogic.com.
6 | WICOMICO COUNTY PUBLIC SCHOOLS 2021-2022 BENEFIT GUIDE
WellAware - Wellness Program (5/1/2021−4/30/2022)
We are committed to giving you easy access to a variety of tools and activities to help you improve your health and
happiness. We look forward to supporting you in your ongoing wellness journey!
LEARN SOMETHING NEW - Enroll in interactive online workshops including stress management, goal setting, and
physical health.
INSPIRE OTHERS - Share your wellness story and inspire others on the path to better wellness.
EARN WELLNESS INCENTIVES - Earn up to $240 in rewards by participating in the WellAware program.
TRACK YOUR PROGRESS - Use the online health portal and Healthy Path app to see your results and track your
goals.
Getting Started
Getting started in the wellness program is easy! Launch the WellAware icon from a WCPS computer or visit wellness.wcboe.
org and log in using your WCPS computer login credentials.
Navigating WellAware
We have a variety of wellness areas to explore on WellAware. Let’s take a tour:
1 2 3 4 5 6 7
Check here regularly to see new links and tips and see your
dashboard for challenges, resources, information and reminders!
1 HEALTH: Enter your own measurements and 4 EXERCISE: You want it, you got it! See exercise
track your results over time or complete a Health plans, log your reps, get ideas and stay fit here!
Assessment here.
5 NEWS: Find our latest (or your favorite oldies but
2 WELLNESS: Choose from over 30 online wellness goodies) newsletter and blog posts here.
learning modules! Enroll or cancel your workshops
and see your workshop history. 6 INCENTIVE: Check your status toward your wellness
incentive here! Enough said!
3 NUTRITION: Calling all foodies! Log your food
intake, track your calories, vitamins and minerals, 7 REFERENCE: Search the vast knowledge of the
see recipes and so much more. Dig in. health and video library, change your profile and
contact us.
WICOMICO COUNTY PUBLIC SCHOOLS 2021-2022 BENEFIT GUIDE | 7
WellAware - Wellness Program (5/1/2021−4/30/2022)
Wellness Incentives
The resources on WellAware will help you maintain a healthy lifestyle and earn points toward your wellness incentives. By
submitting your physician form and completing wellness activities throughout the year, you can earn rewards valued up to
$240. The amount of your wellness incentive depends on your participation in the program.
Important Dates:
Complete physician form by April 30, 2022
Earn 50 points for Period 1 by October 31, 2021, and/or 50 points for Period 2 by April 30, 2022
Requirements Physician Form 50 Points in Period 1 50 Points in Period 2
Due by 4/30/2022 (5/1/2021 - 10/31/2021) (11/1/2021 - 4/30/2022)
$120 wellness rewards
OR
$240 wellness rewards
How do I earn points?
The WellAware program includes a variety of activities such as reducing your debt, cooking a healthy dinner, or reading
a self-help/development book as ways to earn points. Activities in the program are worth between 5-25 points. Visit the
WellAware portal and view the “Incentive” section to see the full list of activities and their point value.
How do I qualify for rewards?
Once you meet the point goal and qualify for rewards, you may choose from the following incentive: a wearable fitness
device, reimbursement for a wellness-related item such as a gym membership, or lower health insurance premiums.
More information about incentives and their distribution can be found on the WellAware portal.
Who can participate?
All benefit eligible employees may participate in the wellness program.
Is the program mandatory?
No. The wellness program is a completely voluntary program. The program is administered according to federal rules
permitting employer-sponsored wellness programs that seek to improve associate health or prevent disease, including
the Americans with Disabilities Act of 1990, the Genetic Information Nondiscrimination Act of 2008, and the Health
Insurance Portability and Accountability Act, as applicable, among others.
What if I am unable to participate in the wellness program due to a medical condition?
Contact US Wellness at 844-542-9699 or wellaware@uswellness.com to discuss alternative options that may be
available. Please do not contact the HR department to discuss health matters related to the wellness program.
Will my personal health information be shared with my employer?
No. WCPS does not have access to your personal health information. US Wellness, WCPS’ wellness vendor, provides
WCPS with aggregate health reports to understand the population as a whole and to determine future programs and
resources to offer. For more information, please refer to the US Wellness Terms of Use on the WellAware portal or
contact US Wellness at privacy@uswellness.com.
Have another question? We are glad to help!
Contact US Wellness at wellaware@uswellness.com or 844-542-9699.
8 | WICOMICO COUNTY PUBLIC SCHOOLS 2021-2022 BENEFIT GUIDE
Medical
You have a choice between two medical options: a Preferred Provider Organization (PPO) and an Exclusive Provider
Organization (EPO). Both give you access to a quality network of practitioners and hospitals in Maryland along with access
to a national network. You may receive services from any provider. The benefit you receive will be based upon the network
status of the provider as well as the plan you are enrolled in.
An EPO is a PPO Plan that does not provide coverage if you visit an out-of-network provider. If you do incur costs with
an out-of-network provider, you will be responsible for 100% of the costs. In-network benefits are provided when you use
Preferred Providers or In-Network Providers.
PPO covers care provided both inside and outside the plan’s provider network. You will pay more out of your own pocket
when you use practitioners who do not belong to the Preferred Provider Network. You may be required to pay a deductible
and a greater portion of the cost of medical treatment. You may also need to file a claim.
EPO Option PPO Option
Name
In-Network You Pay 1,2
In-Network You Pay1,2 Out-of-Network You Pay1,3
24 HOUR NURSE ADVICE LINE
Registered nurses are available 24/7 to discuss
your symptoms with you and recommend the most Call 1-800-535-9700 anytime to speak with a registered nurse.
appropriate care.
ANNUAL DEDUCTIBLE (Benefit period)4
Individual None None $200
Family None None $600
ANNUAL OUT-OF-POCKET MAXIMUM (Benefit period)5
Medical6 $1,200 Individual/$3,600 Family $1,200 Individual/$3,600 Family
Prescription Drug 6
$5,400 Individual/$9,600 Family $5,400 Individual/$9,600 Family
LIFETIME MAXIMUM BENEFIT
Lifetime Maximum None None
PREVENTIVE SERVICES
Well-Child Care (incl. exams & immunizations) No charge* No charge* 20% of AB
Adult Physical Examination (incl. routine GYN visit) No charge* No charge* Deductible, then 20% of AB
Breast Cancer Screening No charge* No charge* Deductible, then 20% of AB
Pap Test No charge* No charge* Deductible, then 20% of AB
Prostate Cancer Screening No charge* No charge* Deductible, then 20% of AB
Colorectal Cancer Screening No charge* No charge* Deductible, then 20% of AB
OFFICE VISITS, LABS AND TESTING
Office Visits for Illness $20 PCP/$30 Specialist per visit $20 PCP/$30 Specialist per visit Deductible, then 20% of AB
Outpatient Facility—$5 per visit Outpatient Facility—$20 per visit
Outpatient Facility Physician—$20 Outpatient Facility Physician—$20
Imaging (MRA/MRS, MRI, PET, CAT scans) & X-ray PCP/$30 Specialist per visit Deductible, then 20% of AB
PCP/$30 Specialist
Office—$20 PCP/$30 Specialist Office—$20 PCP/$30 Specialist
per visit
Outpatient Facility—$20 per visit
Outpatient Facility Physician—$0
Lab No charge* Deductible, then 20% of AB
Office—$20 PCP/$30 Specialist
Individual Lab—$30 per visit
Allergy Testing/Allergy Shots $5 per visit $5 per visit Deductible, then 20% of AB
Allergy Serum $45 per visit $45 per visit Deductible, then 20% of AB
Outpatient Facility—$50 per visit Outpatient Facility—$50 per visit
Outpatient Physician—$30 per visit Outpatient Physician—$30 per visit
Outpatient Surgical Services Deductible, then 20% of AB
Outpatient Office—$20 PCP/$30 Outpatient Office—$20 PCP/$30
Specialist Specialist
Outpatient Facility—$40 per visit
Outpatient Physician—$0 per visit Outpatient Facility—$40 per visit
Physical, Speech and Occupational Therapy Outpatient Office—$30 per visit Outpatient Physician—$0 per visit Deductible, then 20% of AB
(limited to 50 visits/calendar for each Outpatient Office—$30 per visit
type of therapy)
Outpatient Facility-$40 per visit
Radiation, Chemotherapy and Renal Dialysis No charge* Deductible, then 20% of AB
Outpatient Physician/Office-$0 per visit
$30 per visit (limited to 20
Chiropractic/Acupuncture $30 per visit Deductible, then 20% of AB
visits/calendar year)
AB = Allowed Benefit
This summary is for comparison purposes only and does not create rights not given through the benefits contract.
WICOMICO COUNTY PUBLIC SCHOOLS 2021-2022 BENEFIT GUIDE | 9
Medical
EPO Option PPO Option
Name
In-Network You Pay1,2 In-Network You Pay1,2 Out-of-Network You Pay1,3
EMERGENCY SERVICES
Urgent Care Center $20 per visit $20 per visit Deductible, then 20% of AB
Emergency Room—Facility Services $150 per visit $150 per visit
Emergency Room—Physician Services $30 per visit $30 per visit
Ambulance (if medically necessary) No charge* No charge*
HOSPITALIZATION (Members are responsible for applicable physician and facility fees)
Outpatient Facility Services $40 per visit $40 per visit Deductible, then 20% of AB
Outpatient Physician Services $20 PCP/$30 Specialist per visit $20 PCP/$30 Specialist per visit Deductible, then 20% of AB
Deductible, then $100 per
Inpatient Facility Services $100 per admission $100 per admission
admission, then 20% of AB
Inpatient Physician Services No charge* No charge* Deductible, then 20% of AB
HOSPITAL ALTERNATIVES
Home Health Care No charge* No charge* 20% of AB
$100 per admission, then 20%
Hospice $100 per admission $100 per admission
of AB
Deductible, then $100 per
Skilled Nursing Facility $100 per admission $100 per admission
admission, then 20% of AB
MATERNITY
Preventive Prenatal and Postnatal Office Visits No charge* No charge* Deductible, then 20% of AB
Deductible, then $100 per
Delivery and Facility Services $100 per admission $100 per admission
admission, then 20% of AB
Nursery Care of Newborn No charge* No charge* Deductible, then 20% of AB
Artificial and Intrauterine Insemination No charge* No charge* Deductible, then 20% of AB
In Vitro Fertilization Procedures7 (limited to 3
attempts per live birth up to $100,000 lifetime No charge* No charge* Deductible, then 20% of AB
maximum)
MENTAL HEALTH AND SUBSTANCE ABUSE (Members are responsible for applicable physician and facility fees)
Deductible, then $100 per
Inpatient Facility Services $100 per admission $100 per admission
admission, then 20% of AB
Inpatient Physician Services No charge* No charge* Deductible, then 20% of AB
Outpatient Facility Services $30 per visit $30 per visit Deductible, then 20% of AB
Outpatient Physician Services $30 per visit $30 per visit Deductible, then 20% of AB
Office Visits $20 per visit $20 per visit Deductible, then 20% of AB
Medication Management $20 per visit $20 per visit Deductible, then 20% of AB
MEDICAL DEVICES AND SUPPLIES
Durable Medical Equipment No charge* No charge* Deductible, then 20% of AB
Hearing Aids for ages 0-18 (limited to 1 hearing aid
No charge* No charge* Deductible, then 20% of AB
per hearing impaired ear every 3 years)
Outpatient Physician-$30 per visit Outpatient Physician-$30 per visit
Adult Hearing Exam Deductible, then 20% of AB
Office-$20 per visit Office-$20 per visit
Adult Hearing Aid (limited to 1 hearing aid per
hearing impaired ear every 3 years; benefit limited to No charge* No charge* Deductible, then 20% of AB
$1,000 maximum/hearing aid device)
Hair Prosthesis (one per benefit period; not to
No charge* No charge* Deductible, then 20% of AB
exceed $350 maximum)
AB = Allowed Benefit
* No copayment or coinsurance.
1 When multiple services are rendered on the same day by more than one provider, Member payments are required for each provider.
2 In-network: When covered services are rendered by a provider in the Preferred Provider network, care is reimbursed at the in-network level. In-network coinsurances are based on a percentage of the Allowed Benefit. The Allowed Benefit is
generally the contracted rates or fee schedules that Preferred Providers have agreed to accept as payment for covered services. These payments are established by CareFirst BlueCross BlueShield (CareFirst), however, in certain circumstances,
the Allowed Benefit for a Preferred Provider may be established by law.
3 Out-of-network: When covered services are rendered by a provider not in the Preferred Provider network, care is reimbursed as out-of-network. Out-of-network coinsurances are based on a percentage of the Allowed Benefit. The Allowed Benefit
is generally the contracted rates or fee schedules that Preferred Providers have agreed to accept as payment of covered services. These payments are established by CareFirst, however, in certain circumstances, the Allowed Benefit for an out-of-
network provider may be established by law. When services are rendered by Non-Preferred Providers, charges in excess of the Allowed Benefit are the member’s responsibility.
4 For family coverage only: When one family member meets the individual deductible, they can start receiving benefits. Each family member cannot contribute more than the individual deductible amount. The family deductible must be met before
the remaining family members can start receiving benefits
5 For Family coverage only: When one family member meets the individual out-of-pocket maximum, their services will be covered at 100% up to the Allowed Benefit. Each family member cannot contribute more than the individual out-of-pocket
maximum amount. The family out-of-pocket maximum must be met before the services for all remaining family members will be covered at 100% up to the Allowed Benefit.
6 Plan has separate out-of-pocket maximums for medical and drug expenses which accumulate independently.
7 Members who are unable to conceive have coverage for the evaluation of infertility services performed to confirm an infertility diagnosis, and some treatment options for infertility. Preauthorization required.
10 | WICOMICO COUNTY PUBLIC SCHOOLS 2021-2022 BENEFIT GUIDEMedical
CareFirst Mobile App
Download the free app to your Apple or Android mobile device by searching for CareFirst in your favorite app store. Or type
www.carefirst.com into your mobile web browser and you will be directed to our mobile site.
CareFirst Video Visit
See a doctor 24/7 without an appointment! You can consult with a board-certified doctor on your smartphone, tablet or
computer. Get treatment for common health issues such as allergies, a sinus infection, a cold or the flu. You can also
schedule video visits for: therapy/psychiatry, diet/nutrition, and breastfeeding support. Visit www.carefirst.com/needcare for
more information.
Free CareFirst Wellness Programs - Sharecare
To get started, visit carefirst.com/sharecare. Enter your CareFirst My Account username and password and complete the
one-time registration with Sharecare to experience the customized CareFirst program. Once you register, you can access
your wellness resources from the web or download the Sharecare app from the App Store or Google Play.
One-on-One Health Coaching
Members have access to personal health coaching. You may also
receive a call inviting you to participate. Lifestyle coaching can assist
with tobacco cessation, weight management, physical activity, stress
management, and healthy eating. Disease management coaching is
available for asthma, diabetes, coronary artery disease, congestive heart
failure, COPD, chronic low back pain, osteoarthritis, atrial fibrillation,
irritable bowel syndrome, and fibromyalgia. We encourage you to take
advantage of this voluntary and confidential phone-based program that
can help you achieve your best possible health by calling 877-260-3253.
Scale Back Lifestyle Change Program
Scale Back is an interactive, telemedicine-based lifestyle change program offered at no cost through our wellness partner,
Sharecare. Scale Back helps participants lose 5-10% of their body weight and significantly reduce the risk of developing
type 2 diabetes and associated chronic diseases. Anyone who has either been identified as having prediabetes or at risk of
developing prediabetes may be eligible to participate.
Craving to Quit
Tobacco use is the leading cause of preventable death and disease in the US. But quitting can be easier than you think
with Craving to Quit, the Sharecare tobacco cessation program. It uses proven methods including the Craving to Quit app,
telephonic support and online education. This voluntary, confidential program is free to health insurance participants.
Financial Well-Being™, powered by Dave Ramsey
Financial expert Dave Ramsey will show you how to take small steps toward big improvements in your financial situation.
Whether you want to stop living paycheck to paycheck, get out of debt, or send a child to college, the Financial Well-Being
program can help.
Inspirations and Relax 360°
Inspirations and Relax 360° can help you take control of stress. Both tools offer relaxation and wellness videos that help
you experience freedom from stress, unwind at the end of the day, or ease into a restful night of sleep. Inspirations provides
soothing video content for stress reduction and ambient white noise for sleep. Or enjoy the scenic sights and sounds of a
360° view of nature with Relax 360°.
To learn more, log in to My Account at carefirst.com/myaccount or call 877-260-3253.
WICOMICO COUNTY PUBLIC SCHOOLS 2021-2022 BENEFIT GUIDE | 11Pharmacy Benefits
Prescription Drug Plan
Your Prescription Benefits
As a CareFirst member, you’ll have access to:
A nationwide network of 69,000 participating pharmacies
Access to thousands of covered prescription drugs
Mail Service Pharmacy, a convenient and fast option to refill your prescriptions through home delivery
Coordinated medical and pharmacy programs to help improve your overall health
Online Tools and Resources
Visit carefirst.com/rxgroup to see if a drug is covered, find a pharmacy, learn how drugs interact with each other and get
more information about medications. You can access even more tools and resources once you’re a member through My
Account (carefirst.com/myaccount) by selecting Drug and Pharmacy Resources under Coverage.
Two Ways to Fill
Retail Pharmacies: With access to 69,000 pharmacies across the country, you can visit carefirst.com/rxgroup and use
our Find a Pharmacy tool to locate a convenient participating pharmacy. Be sure to take your prescription and member
ID card with you when filling prescriptions.
Mail Service Pharmacy: Mail order is a convenient way to fill your prescriptions, especially for refilling drugs taken
frequently. You can register three ways—online through My Account, by phone or by mail. Once you register, you’ll be
able to:
» Refill prescriptions online, by phone or by email
» Choose your delivery location
» Consult with pharmacists by phone 24/7
» Schedule automatic refills
» Receive email notification of order status
» Choose from multiple payment options
Ways to Save
Here are some ways to help you save on your prescription drug costs.
Use generic drugs—generic drugs can cost up to 80% less than their brand-name counterparts. Made with the same
active ingredients as their brand-name counterparts, generics are also equivalent in dosage, safety, strength, quality,
performance and intended use.
Use drugs on the Preferred Drug List—the Preferred Drug List identifies generic and preferred brand drugs that may
save you money.
Use mail order—by using our Mail Service Pharmacy you get the added convenience of having your prescriptions
delivered right to your home. Plus, if you pay a coinsurance for your maintenance drugs, the overall cost of the drug is
less expensive through mail order, reducing your out-of-pocket costs.
12 | WICOMICO COUNTY PUBLIC SCHOOLS 2021-2022 BENEFIT GUIDEPharmacy Benefits
Prescription Drug Copays
Formulary 2 ■ 5-Tier ■ $50 Deductible ■ $10/35/50 ■ Specialty $35/50
Plan Feature Amount You Pay Description
Individual Deductible $50
Out-of-Pocket Maximum Individual—$5,400
Preventive Drugs A preventive drug is a prescribed medication or item on
$0 (not subject to the deductible)
(up to a 34-day supply) CareFirst’s Preventive Drug List.*
Diabetic Supplies Diabetic supplies include needles, lancets, test strips and alcohol
$0 (not subject to the deductible)
(up to a 34-day supply) swabs.
Generic Drugs (Tier 1)
$10 Generic drugs are covered at this copay level.
(up to a 34-day supply)
Preferred Brand Drugs (Tier 2)
$35 All preferred brand drugs are covered at this copay level.
(up to a 34-day supply)
All non-preferred brand drugs on this copay level are not on the
Non-preferred Brand Drugs (Tier 3)
$50 Preferred Drug List.* Discuss using alternatives with your physician
(up to a 34-day supply)
or pharmacist.
Preferred Specialty Drugs (Tier 4)
$35 Must be filled through Exclusive Specialty Pharmacy Network.
(up to a 34-day supply)
Non-preferred Specialty Drugs
(Tier 5) $50 Must be filled through Exclusive Specialty Pharmacy Network.
(up to a 34-day supply)
Mail order or CVS:
Generic: $10
Preferred Brand: $35 Non-specialty maintenance drugs (Tiers 1, 2 and 3): Up to a 90-day
Non-preferred Brand: $50 supply is available for one monthly copay through Mail Service
Preferred Specialty: $35 Pharmacy or a CVS retail pharmacy. A 90-day supply is available at
Maintenance Drugs Non-preferred Specialty: $50 any pharmacy for three copays.
(up to a 90-day supply) At any other Retail: Specialty maintenance drugs (Tiers 4 and 5): Maintenance specialty
Generic: $30 drugs must be filled through Exclusive Specialty
Preferred Brand: $105 Pharmacy Network. Up to a 90-day supply is available for one
Non-preferred Brand: $150 monthly copay through Exclusive Specialty Pharmacy Network.
Preferred Specialty: N/A
Non-preferred Specialty: N/A
* Visit carefirst.com/rxgroup for the most up-to-date drug lists, including the prescription guidelines. Prescription guidelines indicate drugs that require your
doctor to obtain prior authorization from CareFirst before they can be filled and drugs that can be filled in limited quantities.
This plan summary is for comparison purposes only and does not create rights not given through the benefit plan.
WICOMICO COUNTY PUBLIC SCHOOLS 2021-2022 BENEFIT GUIDE | 13Retiree Health Insurance
The following chart defines eligibility requirements for retiree health insurance. Both the eligibility for retiree health insurance
and the amount of the Board contribution is determined by hire/rehire date and bargaining unit. “Rehire Date” refers to a
benefited employee who separates from employment then is rehired back at a later date as a benefited employee. The “later
date” of re-employment is the rehire date. The rehire date will determine eligibility for retiree health insurance.
An employee must be enrolled in the MD State Retirement System or Aetna Pension Plan and enter retirement directly from
service with WCBOE to be eligible for retiree health insurance. Additionally, the employee must be enrolled in the employee
health insurance plan for at least one full plan year immediately prior to retirement.
Refer to the Board policy titled “Health Insurance Benefit for Retired Employees Policy” for the full list of conditions that apply
to retiree health insurance. This policy is subject to change at the sole discretion of Wicomico County Board of Education.
Retiree health insurance rates can be found at wcboe.org.
Eligibility for Retiree Health Insurance
Board Contribution
Minimum Years of Board Contribution
Bargaining Unit Hire or Rehire Date for Retiree’s
Service for Retiree
Dependents
Unit 1 - Teachers Before 7/1/2016 10 70% 0%
15 to 19.9 50% 0%
Unit 1 - Teachers On or After 7/1/2016 20 to 24.9 60% 0%
25 or more 70% 0%
Unit 2 - Admin. &
All 10 70% 0%
Supervisors
Unit 3 - Classified Before to 7/1/2016 10 70% 0%
15 to 19.9 50% 0%
Unit 3 - Classified On or After 7/1/2016 20 to 24.9 60% 0%
25 or more 70% 0%
14 | WICOMICO COUNTY PUBLIC SCHOOLS 2021-2022 BENEFIT GUIDEDental
A Preferred (PPO) Dental coverage is offered through CareFirst. Reduce your out-of-pocket expenses by visiting a dentist
who participates in our network of preferred and traditional providers. Non-participating providers may bill you the difference
between the CareFirst allowed benefit and the provider’s total charge.
In-Network You Pay Out-of-Network You Pay
(Preferred Dental (Traditional Dental OR
Provider) Non-Participating Dental Provider)
Deductible Applies to All Basic and Major Services $25 Individual $25 Individual
There is a separate deductible for in-and out-of-network services $75 Family $75 Family
Annual Maximum Applies to All Services Except Orthodontic Plan pays $1,000 per member
PREVENTIVE & DIAGNOSTIC SERVICES PLAN PAYMENT
• Oral Exams (two per benefit period) • Fluoride treatments (two per benefit
• Prophylaxis (two cleanings per benefit period per member, until the end of the
period) year the member reaches the age 19)
• Bitewing X-rays • Sealants on permanent molars (once per
• Full mouth X-ray or panograph and tooth per 36 months per member, until 80% of Allowed Benefit1
bitewing X-ray combination and one the end of the year the member reaches
cephalometric X-ray (once per 36 the age 19)
months) • Space maintainers (once per 60 months)
• Palliative emergency treatment
BASIC SERVICES
• Direct placement fillings using approved • Periodontal scaling and root planing
materials (one filling per surface per 12 (once per 24 months, one full mouth
50% of Allowed Benefit after deductible1
months) treatment)
• Simple extractions
MAJOR SERVICES—SURGICAL
• Surgical periodontic services including • Oral surgery (surgical extractions,
osseous surgery, mucogingival surgery treatment for cysts, tumor and
and occlusal adjustments (once per 60 abscesses, apicoectomy and
months) hemi‑section) 50% of Allowed Benefit after deductible1
• Endodontics (treatment as required • General anesthesia rendered for a
involving the root and pulp of the tooth, covered dental service
such as root canal therapy)
MAJOR SERVICES—RESTORATIVE
• Full and/or partial dentures (once per 60 • Recementation of crowns, inlays and/or
months) bridges (once per 12 months)
• Fixed bridges, crowns, inlays and onlays • Repair of prosthetic appliances as
(once per 60 months) required (once in any 12 month period 50% of Allowed Benefit after deductible1
• Denture adjustments and relining per specific area of appliance)
(limits apply for regular and immediate • Dental implants, subject to medical
dentures) necessity review (once per 60 months)
In-Network You Pay Out-of-Network You Pay
ORTHODONTIC SERVICES (Preferred Dental (Traditional Dental OR
Provider) Non-Participating Dental Provider)
• Benefits for orthodontic services may be available for covered members under age 19 50% of 50% of
who meet treatment criteria. Allowed Benefit1 Allowed Benefit1
• Orthodontic Lifetime Maximum Plan pays $1,500 per member
1
NOTE: CareFirst payments are based on the CareFirst Allowed Benefit. Participating and Preferred Dentists accept 100% of the CareFirst Allowed Benefit as payment in full for covered services. Non-participating dentists may bill the member
for the difference between the Allowed Benefit and their charges.
Summary of Exclusions: Not all services and procedures are covered by your benefits contract. This plan summary is for
comparison purposes only and does not create rights not given through the benefit plan.
Frequently Asked Questions
How do I find a preferred dentist? participating dentist, you may be required to pay all costs at
You can access an online directory 24 hours a day at carefirst. the time of care, and then submit a claim form in order to be
com/doctor. Click on Dental and then select Preferred Dental. reimbursed for covered services.
Is there a lot of paperwork? Who can I call with questions about my dental plan?
There is no paperwork when you see a participating dentist, Call Dental Customer Service toll free at: 1-866‑891‑2802
you are free from filing claims. However, if you use a non- between 8:30 a.m. and 5 p.m. ET, Monday–Friday.
WICOMICO COUNTY PUBLIC SCHOOLS 2021-2022 BENEFIT GUIDE | 15Vision
BlueVision Plus
Professional vision services including routine eye examinations, eyeglasses and contact lenses offered by CareFirst
BlueCross BlueShield, through the Davis Vision, Inc. national network of providers.
How the plan works
How do I find a provider?
To find a provider, go to carefirst.com and utilize the Find a Provider feature or call Davis Vision at 800-783-5602 for a list of
network providers closest to you. Be sure to ask your provider if he or she participates with the Davis Vision network before
you receive care.
How do I receive care from a network provider?
Simply call your provider and schedule an appointment. There are no claim forms to file.
What if I go out-of-network?
Staying in-network gives you the best benefit, but BlueVision Plus does offer an out-of-network allowance schedule as
well. You will be responsible for all payments up-front. You will also be responsible for filing the claim with Davis Vision for
reimbursement and paying any balances over the allowed benefit to the non-participating provider.
Can I get contacts and eyeglasses in the same benefit period?
With BlueVision Plus, the benefit covers one pair of eyeglasses or a supply of contact lenses per benefit period.
In-Network You Pay
EYE EXAMINATIONS
Routine Eye Examination with dilation (per benefit period) No copay
FRAMES
$20 copay for Fashion and Designer frames
Davis Vision Frame Collection
$40 copay for Premier frames
Plan pays $45 towards wholesale price (or equivalent allowance at a
Non-Collection Frame
retailer), you pay balance plus $20 frame copay
SPECTACLE LENSES
Basic Single Vision (including lenticular lenses) $20
Basic Bifocal $20
Basic Trifocal $20
CONTACT LENSES (initial supply)
Medically Necessary Contacts No copay with prior approval
Davis Vision Contact Lens Collection $40
Other Single Vision Contact Lenses Plan pays $97, you pay balance
Other Bifocal Contact Lenses Plan pays $127, you pay balance
A more detailed Summary of Vision Benefits is on www.wcboe.org under Benefits for Current Employees then Vision.
Exclusions
The following services are excluded from coverage:
1. Diagnostic services, except as listed in What’s Covered under the Evidence of Coverage.
2. Medical care or surgery. Covered services related to medical conditions of the eye may be covered under the Evidence of Coverage.
3. Prescription drugs obtained and self-administered by the Member for outpatient use unless the prescription drug is specifically covered under the Evidence of Coverage or a rider or endorsement purchased by your Group and attached to the
Evidence of Coverage.
4. Services or supplies not specifically approved by the Vision Care Designee where required in What’s Covered under the Evidence of Coverage.
5. Orthoptics, vision training and low vision aids.
6. Replacement, within the same benefit period of frames, lenses or contact lenses that were lost.
7. Non-prescription glasses, sunglasses or contact lenses.
8. Vision Care services for cosmetic use.
16 | WICOMICO COUNTY PUBLIC SCHOOLS 2021-2022 BENEFIT GUIDEVoluntary Benefits
Life Insurance with Accelerated Death Benefits for Chronic Conditions
Life Insurance will be offered to WCPS employees at very affordable rates through Transamerica Life Insurance Company.
The premiums are based on the death benefit you select, your tobacco status, and your age when the policy is issued. Your
premiums will never increase due to your age.
Coverage is available for you, your spouse, your eligible dependent children and your grandchildren. For new hires,
guaranteed issue underwriting is available. This means there are no medical questions asked for the amounts of coverage
listed below.
Employee – up to $150,000
Spouse – up to $25,000
Child Life – $25,000
During Open Enrollment, employees (other than new hires) choosing coverage for the first time, can elect up to $50,000
and $25,000 for child coverage, without medical questions. Employees who have existing coverage and want additional
coverage can elect coverage in increments of $25,000 ($100,000 maximum including existing coverage) without medical
questions. For spouse coverage, you can enroll by meeting with a Benefit Counselor or contacting the call center at
866-870-5093.
Included coverage at no extra cost:
Chronic Conditions - provides a benefit if you have the inability to perform at least two activities of daily living (ADL)
without substantial assistance or suffer severe cognitive impairment that is expected to be permanent. ADL examples
include eating, bathing, transferring, dressing, etc.
All coverage is portable.
Life insurance that has a guaranteed 3% interest rate.
Convenience of payroll deduction.
Voluntary Critical Illness Insurance
WCPS employees have the opportunity to enroll in the voluntary Critical Illness insurance plan through Transamerica Life
Insurance Company. Critical Illness insurance can help relieve the financial impact of a sudden, life-threatening illness. The
policy provides a lump sum cash benefit upon the diagnosis of a covered critical illness. Covered critical illnesses are limited
to the specific definitions found in the policy. Examples of covered illnesses include:
Heart attack Permanent paralysis
Stroke Major organ transplant surgery
Cancer End-stage renal (kidney) failure
Burns Coronary bypass surgery
A Wellness Benefit of $100 per insured per calendar year is available for
completing certain cancer screening tests.
Lump sum cash benefits are intended to help cover some of the expenses
not covered by medical insurance. Examples include: experimental
treatments, out-of-pocket deductibles and copays, child care, travel
expenses, and anything else you choose. Coverage is portable.
You can purchase coverage for yourself, for yourself and your children, or for your entire family. For new hires, there is
guarantee issue of $40,000 with no medical questions asked. During Open Enrollment, employees other than new hires,
can elect up to $25,000 without medical questions. Employees with existing policies who want to increase their coverage
can increase by one increment of $5,000 ($40,000 maximum including existing coverage).
WICOMICO COUNTY PUBLIC SCHOOLS 2021-2022 BENEFIT GUIDE | 17Voluntary Benefits
Voluntary Short-Term Disability Income Insurance
This type of insurance is designed to help protect your income if you ever get sick or hurt and cannot work. Disability
Income Insurance helps replace up to 60% of your salary if you are unable to work because of a disability. You can select
the benefit amount you want to receive per month in $100 increments. You can elect up to $2,500 per month during this
enrollment without answering any medical questions if you are electing coverage for the first time. For new hires,
coverage is guaranteed issue up to $4,000 with no medical questions asked. Employees with existing policies can increase
their coverage by $300 ($4,000 maximum including existing coverage).
The plan requires you use your sick leave days first and then the elected disability income plan benefits will start.
Premiums will be waived once an insured employee has been totally disabled for 90 days or met the elimination period,
whichever is later. Voluntary Short-Term Disability Income Insurance is offered through Transamerica Life Insurance
Company.
Accident Insurance
Accident insurance is designed to help you with out-of-pocket expenses associated with an off-the-job accidental injury.
Lump sum benefits are paid directly to you based on the amount of coverage listed in the schedule of benefits and are in
addition to any other coverage you may have including health insurance.
All coverage is guaranteed issue, so no health questions are required. This coverage is available for you and your family
through Unum.
Coverage includes lump sum payments for treatment and services as
the result of an accident such as Urgent Care, Hospitalization, Therapy
Services, Burns, Fractures and Dislocations, etc.
This coverage also includes a $100 Wellness Benefit. Unum will pay the
benefit one time per year, per insured, while coverage is in force, if a
covered health test is performed which includes mammography, stress
test, chest x-ray, colonoscopy, blood test and much more.
You can also cover your spouse and children and all coverage is portable
upon employment ending.
Open Enrollment Period: May 12 - May 26, 2021
Licensed Benefit Counselors from The Warner Companies will be available to assist you with your
enrollment. Please contact The Warner Companies Call Center at 866-870-5093 to make changes
to your voluntary benefits coverage. Benefit Counselors are available Monday, Wednesdays and
Fridays from 9:00 a.m. – 5:00 p.m. and Tuesdays and Thursdays from 9:00 a.m. – 7:00 p.m.
This is a summary only. Refer to the policy certificate and riders for complete details.
18 | WICOMICO COUNTY PUBLIC SCHOOLS 2021-2022 BENEFIT GUIDEBasic Life and AD&D and Dependent Term Life
Basic Term Life Insurance and AD&D Benefits
WCPS provides basic group term life insurance and accidental death and dismemberment (AD&D) insurance to all benefit
eligible employees through The Standard. The coverage is automatic and the premiums are 100% employer paid.
Employees enrolled in the Aetna Retirement Plan receive an additional layer of basic term life insurance and AD&D coverage.
The coverage is automatic and the premiums are 100% employer paid.
Life Insurance Description Coverage Coverage Maximum
Basic Group Term Life All Benefit Eligible Employees 1.5 x Annual Salary $150,000
AD&D All Benefit Eligible Employees 1.5 x Annual Salary $150,000
Aetna Plan Participants
Aetna Retirement Plan Participants 1 x Annual Salary $100,000
Additional Basic Life & AD&D
Life and AD&D Benefits reduce to 75% at age 70 and 67% at age 75.
Benefits terminate at retirement or resignation.
Accelerated Benefit Provision - active employees can elect a payment of up to 90% of the Basic Term Life Insurance
coverage if their life expectancy is twelve (12) months or less
Dependent Term Life Insurance
Coverage Requirement (1) amount of insurance on any dependents may not exceed 100% of employee’s basic and
supplemental life insurance combined (2) if both spouses work for WCPS, dependent life insurance will not provide life
insurance coverage for the spouse; only the children will be covered
Spouse Benefit Coverage - $25,000
Dependent Child(ren) Benefit Coverage - your child from live birth to age 25 or your disabled child - $10,000
During Open Enrollment - Evidence of Insurability (EOI) is required for all dependents
Cost for the coverage is $2.82 per pay regardless of the number of eligible dependents
100% employee paid
Portability of Dependent Term Life Insurance and Voluntary Supplemental Term Life Insurance
If employee retires or resigns, the employee can elect to keep their coverage on a direct-billed basis
Premiums remain the same as long as WCPS is an active group with The Standard
Supplemental Term Life benefits will reduce to 60% at age 65; 50% at age 70 and terminate at age 75
WICOMICO COUNTY PUBLIC SCHOOLS 2021-2022 BENEFIT GUIDE | 19Voluntary Supplemental Term Life Insurance
Voluntary Supplemental Term Life Insurance
Term Life Insurance is available in increments of $10,000 up to $200,000 from The Standard
During Open Enrollment:
» For employees who currently do not have Supplemental Life Insurance, you may elect $10,000 in coverage guarantee
issue (no medical review). To elect coverage of more than $10,000, complete the online Evidence of Insurability
(EOI).
» Employees with Supplemental Life Insurance may increase their coverage by $10,000 guarantee issue (no medical
review). To increase coverage by more than $10,000, complete the online Evidence of Insurability (EOI).
Rates are based on your age and the coverage amount elected
Rates each plan year are based on the employee’s age as of September 1st
Age Reduction Formula:
» 75% at age 70
» 66 2/3% at age 75
At initial hire, guarantee issue for any amount up to the $200,000
Accelerated Benefit Provision - active employee can elect a payment of up to 90% of the Supplemental Term Life
Insurance coverage if their life expectancy is twelve (12) months or less
100% employee paid
Employee’s Age: Per Pay Deduction for each $10,000 of coverage
under age 30 $0.19
Age 30 to 34 $0.25
Age 35 to 39 $0.37
Age 40 to 44 $0.62
Age 45 to 49 $1.11
Age 50 to 54 $1.67
Age 55 to 59 $2.41
Age 60 to 64 $3.64
Age 65 to 69 $5.87
Age 70 and higher $19.13
20 | WICOMICO COUNTY PUBLIC SCHOOLS 2021-2022 BENEFIT GUIDEYou can also read
