2021 Plan Year Benefits Booklet - Jefferson Parish School ...
←
→
Page content transcription
If your browser does not render page correctly, please read the page content below
2021 Plan Year Benefits Booklet
Dr. James Gray
Superintendent
Donna W. Joseph
Chief Human Resources Officer
TO: All Employees
FROM: Donna W. Joseph
Chief Human Resources Officer
Jefferson Parish Schools continue to provide our employees with high quality and affordable healthcare
options. We want to make sure you are getting the most out of your benefits and understand all of the plans
available to you. JP Schools' 2021 Plan Year Open and Annual Enrollment period provide employees with the
opportunity to review, elect, cancel, and make changes to their health and supplemental insurance coverage.
Employees who work 20 or more hours per week should complete the open enrollment process.
We are pleased to offer employees the option of completing Open and Annual Enrollment with three options to
capture benefit elections:
1. On line- Employees can go to the JP Schools' secure on-line benefits portal
2. By phone-Employees may contact an enroller via telephone
3. Face-to Face- employees can meet with an enroller at either administrative office site
Instructions to navigate annual enrollment are attached.
Open and Annual Enrollment will continue to take place from Thursday, October 1st - Monday, November
16th. During this time, eligible employees may elect or make changes to all of their benefit options (medical,
dental, vision, life, accident, cancer, supplemental retirement, flexible spending account, Identity theft
protection etc.). Additionally, if an employee would like to move any of their coverage from pre-tax to post-tax
status, this can be done during Open Enrollment.
Additional documentation will be required for employees who are enrolling in medical coverage for the first
time or making changes to an 0GB health plan, electing a 2021 health savings account contribution amount
(Pelican HSA 775 plan), or requesting voluntary life insurance above the guarantee issue amount.
All elections and changes made during Open and Annual Enrollment will be effective Friday, January 1,
2021. Employees' current insurance elections will continue until Thursday, December 31, 2020.
For more information about the Open and Annual Enrollment periods, please visit the following link:
http://www.jpschools.org/insurance.
If you have any questions, please email OpenEnrollment@jpschools.org or call our insurance team at 504-349-
8564.
Thank you for your commitment towards providing the students of Jefferson Parish with the highest quality
education and preparing them for a brighter future.
Sincerely, 1AJ
Q:;;oseph11�
Chief Human Resources Officer
Human Resources 501 Manhattan Boulevard. Harvey, Suite 1200, Louisiana 70058 • 504-349-7866 · jpschools.org
Jefferson Parish Schools Benefit Plan 2021
Welcome to your Open Enrollment
Jefferson Parish Schools benefit plan allows you to customize your benefits to meet your individual and family needs.
The benefits plan let you choose the benefits that are right for you so that you can build your personal benefit program
your way—it’s your choice!
Not all of us have the same benefit needs. As your family situation and responsibilities change, you will be able to change
your benefit elections each year as long as the plan continues.
Each JP Schools location will be scheduled for one or more days to conduct one-on-one sessions for changes to your
benefits elections.
Core Insurance Benefits for Jefferson Parish Schools
Medical Insurance
- Blue Cross Blue Shield Pelican HRA 1000
- Blue Cross Blue Shield HSA 775
- Blue Cross Blue Shield Magnolia Local
- Blue Cross Blue Shield Magnolia Local Plus
- Blue Cross Blue Shield Magnolia Open Access
- Vantage Medical Home HMO
Flexible Spending Plan
- National Plan Administrators Medical Reimbursement Flexible Spending Account (FSA)
- National Plan Administrators Dependent Care Reimbursement Flexible Spending Account
Dental and Vision Insurance
-�uardian Dental
-Davis Vision
Disability Insurance
- Cigna Long Term Disability
- Cigna Short Term Disability
Life Insurance
- Cigna Basic Life – Employer Paid
- Cigna Voluntary Life (For Employees and Dependents)
- State of Louisiana Basic Life (For Employees Pre Tax or Post Tax and Dependents Post Tax only)
- Chubb Life Time Benefit Term with Long Term Care rider
5
�efferson Parish Schools Benefit Plan (continue�)
�oluntary �enefits from Colonial Life �ccident �nsurance Company
Acci�ent �nsurance
Cancer �nsurance
Critical �llness �nsurance
�ospital Confinement �n�emnity �nsurance
�hole Life �nsurance
*Employees with existing Colonial Life coverage should meet with a Colonial Life benefits counselor to
discuss which version they currently have in place.
Choosing �our �enefits
There are t�o �ays that the money can be ta�en out� Pre Tax or Post Tax�
Eligible benefits for the �re�ax are the follo�ing�
�e�ical
�ental
Flexible Spen�ing Plan (FSA)
Vision
Cancer �nsurance
�ospital Confinement �n�emnity �nsurance
State of Louisiana Basic Life - Pretax Employee Only
This is a choice that you can ma�e �uring your one-to-one session �ith an Open Enrollment agent�
�ou may also choose to ha�e these �e�uctions ma�e Post Tax�
Eligible benefits for the �ost �ax Only�
�on� Colonial Life
- Cigna Short Term �isability Cigna Voluntary Employee Life
Cigna Voluntary Spouse Life
- Cigna Long Term �isability Cigna Voluntary �epen�ent Life
- Cigna Voluntary Life
- Chubb LBT
Colonial Life
- �hole Life �nsurance
- Acci�ent �nsurance
- Critical �llness �nsurance
6
Je��e�so� Pa��sh Schools �e�e��t Pla� �co�t���e��
������ �������
�o� P�e��a� �e��ct�o�s� o�ce �o� elect a� ��s��a�ce o�t�o�� �o� ca� o�l� cha��e that o�t�o�������� ��� ������
���������� �� ���� ���������� ���������less �o� meet a ��al������ e�e�t��am�l� stat�s cha��e�� �o� m�st co�tact the
JP Schools ��s��a�ce �eam a�� com�lete the �e�e��t cha��e �a�e��o�� ��th�� th��t� �����cale��a� �a�s o� the ��al������
e�e�t o� �am�l� stat�s cha��e� ��al������ e�e�ts��am�l� stat�s cha��es ��cl��e�
�ett��� ma���e�� ���o�ce�� o� le�all� se�a�ate�
���th� a�o�t�o�� o� �laceme�t o� a�o�t�o� o� a� el����le ch�l�
�eath o� �o�� co�e�e� s�o�se o� ch�l�
�ha��e �� �o�� o� �o�� s�o�se�s �o�� stat�s that a��ects �e�e��ts el�����l�t�
��o� e�am�le� sta�t��� a �e� �o� o� lea���� a �o��
� cha��e �� �o�� ch�l��s el�����l�t� �o� �e�e��ts
�ecom��� el����le �o� �e��ca�e o� �e��ca��
� s������ca�t cha��e �� �o�� s�o�se�s health co�e�a�e att����ta�le to �o�� s�o�se�s em�lo�me�t
�e�e����� o� the t��e o� cha��e� �o� ma� �ee� to ��o���e ��oo� o� the cha��e ��o� e�am�le� a co�� o� a ma���a�e
l�ce�se o� ���th ce�t���cate�� �� �o� �o �ot �ot��� �o�� ��s��a�ce �e�a�tme�t a�� Pa��oll �e�a�tme�t ��th��
cale��a� �a�s� �o� ��ll ha�e to �a�t ��t�l the �e�t ��e� a�� ����al ���ollme�t �e��o� to ma�e �e�e��ts cha��es
��less �o� ha�e a�othe� �am�l� stat�s cha��e�
IMPORTANT: Adding Newborns and Adopted Children to Insurance Coverage
�o a�� a �e��o�� as a �e�e��e�t o� �o�� me��cal ��s��a�ce co�e�a�e� �o� m�st ��o���e the JP Schools ��s��a�ce
�e�a�tme�t ��th a ���th ce�t���cate o� a co�� o� the ���th lette� ��th�� da�s o� the ch�l��s ���th �ate� �he
���th lette� ��ll s����ce as ��oo� o� �a�e�ta�e o�l� �� �t co�ta��s the �elat�o�sh�� o� the ch�l� to the JP Schools
em�lo�ee ��th the me��cal ��s��a�ce� �� the ���th ce�t���cate o� ���th lette� �s �ot �ece��e� ��th�� �a�s� the
ch�l� ca��ot �e a��e� ��t�l the �e�t a���al e��ollme�t �e��o�� �o sche��le a� a��o��tme�t ��th the JP Schools
��s��a�ce team� �lease�call �������������
�o a�� a� a�o�te� ch�l�� �o� m�st ��o���e the ��s��a�ce �e�a�tme�t ��th le�al a�o�t�o� �a�e�s ��th��
�a�s o� the ch�l��s a�o�t�o� �ate� �o a�� a ch�l� �lace� �o� a�o�t�o� ��th �o�� �o� m�st ��o���e the ��s��a�ce
�e�a�tme�t ��th the a�o�t�o� �laceme�t a��eeme�t o� a� act o� s���e��e� a�� �le�� o� �o��t ce�t���cat�o� ��
com�l�a�ce ��th �a���S� ������� ��th�� �a�s o� the ch�l��s �laceme�t �o� a�o�t�o� ��th �o�� �� these le�al
a�o�t�o� �a�e�s a�e �ot �ece��e� ��th�� the �a� t�me ��ame� e��ollme�t ca��ot ta�e �lace ��t�l the �e�t a���al
e��ollme�t �e��o�� ��less �o� e��e��e�ce a�othe� ��al���e� l��e e�e�t that s���o�ts the a���t�o� o� the ch�l� to the
�la�� �o sche��le a� a��o��tme�t ��th the JP Schools ��s��a�ce team� �lease�call �������������
�h�le ��� ��ll �ee� the soc�al sec���t� ca�� �o� e�e�� �e�so� o� the �la�� the soc�al sec���t� ca�� �s �ot a
�e����eme�t �o� ���t�al e��ollme�t �o� a �e��o�� o� a�o�te���lace� ch�l��� Please �emem�e� to se�� the JP Schools
��s��a�ce team the soc�al sec���t� ca�� ��o� �ece��t� ��e�e�a�l� ��th�� �� �a�s o� the ���th�a�o�t�o�� ��� �������
��� ���� �� ���� ������� ������� ���� �� �������� ������� �� ��� ������ ������ ������� ��� ������� ���� ������
���� ��� ������ ���������� ���� ������ ��������� ������� 1� 2�21�
7
�efferson �arish Schools �enefit �lan �contin�ed�
�ol������ JP Schools ���������� Pl��s
��� � ���������� Pl�� ������
���� �inancial �d�isors���� �den�orn ��e� Ste ����etairie� �� ������
��stomer Ser�ice �epresentati�es are a�aila�le to assist �onday � �riday� � a.m. � � p.m. ��entral �ime� at
��������������.
�lease log onto http://jpschools.org/departments/finance/payroll to locate a�thori�ed ��� � �epresentati�es.
��� � ���������� Pl��
�ational �lan �dministrators
�������������� �ffice
�S���at�lan.com
�o��s���� P��l�c ���lo���s �������� �o����s���o� Pl��
���� �l�e�onnet �entre �o�le�ard� S�ite ���
�aton �o�ge� �� �����
����� �������� or ����� ��������
�a� ����� ��������
https://lo�isianadcpretire.g�rs.com
�o�isiana �eferred �ompensation �lan ��reat��est �inancial�
�� ����� ���������So�theastern �egion/�e� �rleans�
�ey �etirement �lan �o�nselor
����� ��������
c.arria�a�empo�er�retirement.com
Ser�ice ho�rs:��o���� � ������� � ���� �o � ���� ������l ����
Jefferson Parish School Insurance Office
504-349-8564
8
Jefferson Parish Schools Benefit Plan (continued)
Your Colonial Life Contacts:
Rita White
Account Coordinator
(504) 457-2010 Ext 22 Office
(504) 457-2017 Fax
Rita.White@Coloniallifesales.com
Servicing Agents for Jefferson Parish School System
For Eastbank Employees please call:
Cathy O’Neal
(504) 457-2010 Ext 38 Office
(504) 457-2017 Fax
Catherine.Oneal@coloniallifesales.com
For Westbank Employees please call:
Linda Gibbs
(504) 457-2010 Ext 20 Office
(504) 457-2017 Fax
Linda.Gibbs@Coloniallifesales.com
9
JEFFERSON PARISH SCHOOLS
HEALTH PREMIUM ANALYSIS
EFFECTIVE 1/1/2021
MAGNOLIA OPEN ACCESS
ACTIVE EMPLOYEE ACTIVE RETIREE
24 20 24 20
PAYS PAYS PAYS PAYS
SINGLE 73.82 88.58 97.24 116.69
WITH SPOUSE 292.48 350.97 315.90 379.08
WITH CHILDREN 116.56 139.88 139.98 167.99
FAMILY 315.06 378.07 317.98 381.58
MAGNOLIA LOCAL
ACTIVE EMPLOYEE ACTIVE RETIREE
24 20 24 20
PAYS PAYS PAYS PAYS
SINGLE 55.86 67.03 79.28 95.14
WITH SPOUSE 234.15 280.97 257.57 309.08
WITH CHILDREN 90.61 108.74 114.10 136.92
FAMILY 252.57 303.09 259.25 311.10
MAGNOLIA LOCAL PLUS
ACTIVE EMPLOYEE ACTIVE RETIREE
24 20 24 20
PAYS PAYS PAYS PAYS
SINGLE 70.12 84.15 93.54 112.26
WITH SPOUSE 280.40 336.48 303.82 364.59
WITH CHILDREN 111.21 133.46 134.63 161.57
FAMILY 302.11 362.53 306.84 368.22
JEFFERSON PARISH SCHOOLS
HEALTH PREMIUM ANALYSIS (Cont'd)
EFFECTIVE 1/1/2021
PELICAN H.S.A 775
ACTIVE EMPLOYEE ACTIVE RETIREE
24 20 24 20
PAYS PAYS PAYS PAYS
SINGLE 10.37 12.45 N/A N/A
WITH SPOUSE 86.41 103.70 N/A N/A
WITH CHILDREN 25.28 30.34 N/A N/A
FAMILY 94.23 113.07 N/A N/A
PELICAN HRA 1000
ACTIVE EMPLOYEE ACTIVE RETIREE
24 20 24 20
PAYS PAYS PAYS PAYS
SINGLE 35.03 42.04 58.45 70.15
WITH SPOUSE 166.44 199.73 189.86 227.84
WITH CHILDREN 60.75 72.90 84.17 101.01
FAMILY 179.98 215.97 191.09 229.32
VANTAGE MEDICAL HOME HMO
ACTIVE EMPLOYEE ACTIVE RETIREE
24 20 24 20
PAYS PAYS PAYS PAYS
SINGLE 69.91 83.90 93.33 112.01
WITH SPOUSE 279.74 335.69 303.16 363.80
WITH CHILDREN 110.90 133.08 134.32 161.19
FAMILY 301.40 361.67 306.17 367.41
PLEASE NOTE: INSURANCE DEDUCTIONS WILL BE DEDUCTED
FROM EACH PAYCHECK
JEFFERSON PARISH SCHOOLS
DENTAL/VISION PREMIUM ANALYSIS
EFFECTIVE 1/1/2021
GUARDIAN DENTAL JPPSS PAY/CONTRIB
ACTIVE EMPLOYEE ACTIVE RETIREE ACTIVE EMPLOYEE
24 20 24 20 24 20
PAYS PAYS PAYS PAYS PAYS PAYS
EMPLOYEE ONLY 0.00 0.00 0.00 0.00 12.52 10.44
WITH SPOUSE 18.46 22.16 18.46 22.15
WITH CHILDREN 28.12 33.74 28.12 33.74
FAMILY 45.00 53.98 45.00 53.98
DAVIS VISION JPPSS PAY/CONTRIB
ACTIVE EMPLOYEE ACTIVE RETIREE ACTIVE EMPLOYEE
24 20 24 20 24 20
PAYS PAYS PAYS PAYS PAYS PAYS
EMPLOYEE ONLY 0.00 0.00 0.00 0.00 1.96 2.34
WITH SPOUSE 3.16 3.78 3.16 3.78
WITH CHILDREN 5.30 6.36 5.30 6.36
FAMILY 7.98 9.58 7.98 9.58
1213
14
15
16
17
18
19
20
OGB offers two fully-insured life insurance plans for employees and
retirees through The Prudential Insurance Company of America
(Prudential). The state pays half of the life insurance premium for
covered employees and retirees.
The two plans of life insurance available, along with the corresponding
amounts of dependent life insurance offered under each plan, are
noted below.
The policy through Prudential is Term insurance. Term Life insurance is
a pure transference of risk in exchange for the payment of premium.
Prudential, and prior carriers, have been providing coverage and
assuming risk for the payment of premium. In the event a covered
person were to pass, Prudential would honor their obligation/contract
and pay the benefit. Absent that event, the insurer has earned the
premium for the assumption of risk of the insurance.
The Term Life policy has no cash value or paid up provision and to return
premium at a later date would mean that Prudential provided free
insurance coverage during the time they assumed the risk of the insured
passing away.
https://info.groupbenefits.org/life-insurance/ 1/5
21Life Insurance | Office of Group Benefits
BASIC LIFE
OPTION 1 OPTION 2
Employee $5,000 Employee $5,000
Spouse $1,000 Spouse $2,000
Each child $500 Each child $1,000
DependentEmployee DependentEmployee
life pays life pays
$1.36/month $2.72/month
BASIC PLUS SUPPLEMENTAL PLAN
OPTION 1 OPTION 2 Contact
Employee Schedule to Employee Schedule to Information
a max of a max of
$50,000* $50,000*
OGB Customer
*Amount based on *Amount based on Service
employee’s annual employee’s annual 1-800-272-8451
salary salary 8:00 AM – 4:30
PM CT Monday –
Spouse $2,000 Spouse $4,000 Friday
Each child $1,000 Each child $2,000
DependentEmployee DependentEmployee
Prudential Life
life pays life pays Claim Customer
$2.72/month $5.44/month Service
1-800-524-0542
Important Notes 8:00 AM – 8:00
PM ET Monday –
Friday
Newly hired employees who enroll
within 30 days of employment are
eligible for life insurance without Prudential Life
providing evidence of insurability. Medical
Employees who enroll in the life Underwriting
insurance plan after 30 days are 1-888-257-0412
8:00 AM – 8:00
22Life Insurance | Office of Group Benefits
Plan members currently enrolled who
wish to add dependent life coverage for Prudential Life
a spouse can do so by providing Conversion
evidence of insurability. Eligible 1-877-889-2070
dependent children can be added 8:00 AM – 8:00
without providing evidence of PM ET Monday –
insurability to the insurer. Friday
Employee pays 100 percent of
dependent life premiums. Prudential Life
Portability
1-800-778-3827
Accidental Death and 8:00 AM – 8:00
PM ET Monday –
Dismemberment Friday
Who is eligible?
Death
Basic and Basic Plus Supplemental Notification
Plans
Full-Time Employees
Eligible Retirees Please notify the
human resources
office at the plan
If retired, coverage for AD&D automatically member’s
terminates on January 1 following the covered agency (or
person’s 70th birthday. If the plan member is still former agency, if
actively employed at age 70, coverage terminates retired) when a
at midnight on the last day of the month in which plan member or
covered
retirement occurs. dependent dies.
A certified copy
Plan Changes at Age 65 and 70 of the death
certificate must
Plan members enrolled in life insurance coverage be provided to
will automatically have a 25 percent reduction in the plan
life coverage on January 1 following their 65th member’s
agency.
birthday. Another automatic 25 percent reduction
in coverage will take effect on January 1 following
their 70th birthday. Premium rates will be reduced
accordingly.
https://info.groupbenefits.org/life-insurance/ 3/5
23Life Insurance | Office of Group Benefits
Continued Coverage for Dependent Children A
coverred child under the age of 26 who is incapable
of self-sustaining employment is eligible to
continue coverage as an overage dependent if
OGB receives required medical documents
verifying his or her incapacity before he or she
reaches age 26. The definition of incapacity has
been broadened to include mental and physical
incapacity.
This coverage is not health insurance coverage (often referred to as
“Major Medical Coverage”). This type of plan is NOT considered
“minimum essential coverage” under the Affordable Care Act and
therefore does NOT satisfy the individual mandate that you have health
insurance coverage. If you do not have other health insurance coverage,
you may be subject to a federal tax penalty.
This policy provides ACCIDENT insurance only. It does NOT provide basic
hospital, basic medical, or major medical insurance as defined by the New
York State Department of Financial Services.
IMPORTANT NOTICE – THIS POLICY DOES NOT PROVIDE COVERAGE FOR
SICKNESS.
Group Insurance coverages are issued by The Prudential Insurance
Company of America, a Prudential Financial Company, Newark, NJ. The
Booklet-Certificate contains all details, including any policy exclusions,
limitations, and restrictions, which may apply. Contract Series: 83500.
©2018 Prudential Financial, Inc. and its related entities. Prudential, the
Prudential logo, the Rock symbol, and Bring Your Challenges are service
marks of Prudential Financial, Inc. and its related entities, registered in
many jurisdictions worldwide.
1013266-00001-00
246 Guardian"
JEFFERSON FEDERATION OF TEACHERS HEALTH AND
Group Number: 00517225
A Dental insurance plan through Guardian:
Provides coverage for key preventive services such as regular checkups and cleanings to keep you and your family healthy
Helps offset potentially expensive dental procedures, such as crowns and fillings
Gives you access to one of the nation's largest dental networks so care is convenient to you
Makes it easy to find a high quality certified network dentist by accessing guardiananytime.com or Guardian's find a provider
mobile app
Fast and easy claim payments
About Your Benefits:
PPO plan, you can visit any dentist; but you pay less out-of-pocket when you choose a PPO dentist. Out-of-network benefits are
based on a percentile of the prevailing fee data for the dentist's zip code.
Your Dental Plan PPO
Your Network is DentalGuard Preferred
Calendar year deductible In-Network Out-of-Network
Individual $50 $50
Family limit Not Applicable
Waived for None None
Charges covered for you (co-insurance) In-Network Out-of-Network
Preventive Care 100% 100%
Basic Care 80% apro
Major Care 50% 50%
Orthodontia 50% 50%
Annual Maximum Benefit $1500 $1500
Maximum Rollover Yes
Rollover Threshold $500
Rollover Amount $250
Rollover Account Limit $1000
Lifetime Orthodontia Maximum $1000
Dependent Age Limits 26
Penalty for Late Entrants:
During the first 12 months that a late entrant is covered by this plan, we won't pay for the following services:
• All Group II, G,roup Ill and Group IV Services.
Charges for the services we don't cover under this provision are not considered to be covered charges under this plan,
and therefore can't be used to meet this plan's deductibles.
We don't apply a late entrant penalty to covered charges incurred for services needed solely due to an injury suffered by
a covered person while insured by this plan.
A late entrant is a person who: (a) becomes covered by this dental plan more than 31 days after he or she is eligible; or
(b) becomes covered again, after his or her coverage lapsed because he or she did not make required payments.
Benefit information illustrated within this material reflects the plan covered by Guardian as of 06/ I 0/2019
JEFFERSON FEDERATION OF TEACHERS HEALTH AND WELFARE ALL ELIGIBLE EMPLOYEES Benefit Summary
The Guardian Life Insurance Company of America, New York, NY
25A �ample of �erv1ces Covered by Your t'lan:
PPO
Plan pays (on average)
In-network Out-of-network
Preventive Care Cleaning (prophylaxis) 100% 100%
Frequency: Once Every 6 Months
Fluoride Treatments 100% 100%
Limits: No Age Limits
, O1·al Exams 100% 100%
Periodontal Maintenance 100% 100%
Frequency: Once Every 6 Months
Sealants (per tooth) 100% 100%
X-rays 100% 100%
Basic Care Anesthesia* 80% 80%
Fillingst 80% 80%
Perio Surgery 80% 80%
Repair & Maintenance of
Crowns, Bridges & Dentures 80% 80%
Root Canal 80% 80%
Scaling & Root Planing (per quadrant) , 80% 80%
,
Simple Extractions 80% 80%
Surgical Extractions 80% 80%
Major Care Bridges and Dentures 50% 50%
Dental Implants 50% 50%
Inlays, Onlays, Veneers*'1' 50% 50%
Single Crowns 50% 50%
Orthodontia Orthodontia 50% 50%
Limits: Adults & Child(i-en)'
This is only a partial list of dental services. Your certificate of benefits will show exactly what is covered and excluded. **For PPO and
or Indemnity members. Crowns, Inlays, Onlays and Labial Veneers are covered only when needed because of decay or injury or other
pathology when the tooth cannot be restored with amalgam or composite filing material. When Orthodontia coverage is for
"Child(ren)" only, the orthodontic appliance must be placed prior to the age limit set by your plan: If full-time status is required by
your plan in order to remain insured after a certain age; then orthodontic maintenance may continue as long as full-time student status
is maintained. If Orthodontia coverage is for "Adults and Child(ren)" this limitation does not apply. *General Anesthesia - restrictions
apply. tFor PPO and or Indemnity members, Fillings - restrictions may apply to composite fillings.
This document is a summary of the major features of the referenced insurance coverage. It is intended for illustrative
purposes only and does not constitute a contract. The insurance plan documents, including the policy and certificate,
comprise the contract for coverage. The full plan description, including the benefits and all terms, limitations and exclusions
that apply will be contained in your insurance certificate. The plan documents are the final arbiter of coverage. Coverage
terms may vary by state and actual sold plan. The premium amounts reflected in this summary are an approximation; if
there is a discrepancy between this amount and the premium actually billed, the latter prevails.
Manage Your Benefits: Need Assistance?
Go to www.GuardianAnytime.com to access secure information Call the Guardian Helpline (888) 600-1600, weekdays,
about your Guardian benefits including access to an image of your 8:00 AM to 8:30 PM, EST. Refer to your member ID (social
ID Card. Your on-line account will be set up within 30 days after security number) and your plan number: 00517225
your plan effective date.. Please call the Guardian Helpline if you need to use
your benefits within 30 days of plan effective date.
Please note, self-serve options over the phone or
Find A Dentist: online at Guardian Anytime are not available until the
case is fully implemented, please wait to speak to a
Visit www.GuardianAnycime.com live agent when calling the Guardian Helpline.
Click on "Find A Prnvider"; You will need to know your plan, which
can be found on the first page of your dental benefit summary.
EXCLUSIONS AND LIMITATIONS
■ Important Information ;,bout Guardian's DencalGuard Indemnity ;md consultations ;md for preventive, restorative, endodontic, periodontic. and
DcntalGuard Preferred Network PPO plans: This policy provides dental prosthodontic services. The services, exclusions and limitations listed ilbovc do
insurance only. Coverage is limited to those charges that are necessary to not constitute a contri\ct and arc a summary only. The Guardian plan
prevent, diagnose or treat dental disease, def�ct, or injury. Deductibles apply. documents are the final arbiter of coverage. Contract# GP-1-DG2000 et al.
The plan does not pay for; or.1l hygiene services (except as covered under ■ PPO and or Indemnity Special Limitation: Teeth lose or missing before a
preventive services), orthodontia (unless expressly provided for), cosmetic or covered person becomes insured by this pl;m. A covered person m1y have one or
experimental treatments (unless they are expressly p1·ovided for). any more congcnitillly missing teeth or have lost one or more teed1 before he became
treatments to the extent benefits are payable by ;my other payor or for which insured by this plan. We won't pay for a prosthetic device which rcpl.1ccs such teeth
no charge is made, prosthetic devices unless cert.iin conditions are met, ;md unless the device illso replaces one or more natur.ll teeth lost or extr.tcted after the
services ancillary to surgical treatment. The pl;m limits benefits for diagnostic covered person became insured by this plan. R3-DG2000
26�� DavisVision·
Premier Vision Plan IN-NETWORK BENEFITS
Eye Examination
' : . •
;
Every January 1, Covered in full
after $25 copayment
Healthy eyes and clear vision are an Eyeglasses
important part of your overall health and Every January 1, Covered in full
quality of life. Your vision plan helps you care Spectacle Lenses For standard single-vision, lined bifocal, or trifocal
lenses after $25 copayment
for your eyes while saving you money by
Every January 1, Covered in full
offering:
Any Fashion, Designer, or Premier frame from Davis
Vision's Collection'1 (value up to $195)
Paid-in-full eye examinations, eyeglasses and OR
contacts after applicable copayments! $50 retail allowance toward any frame from provider,
Frames
Frame Collection: Your plan includes a selection of plus 20% off balance12
OR
designer, name brand frames that are completely
$100 allowance, plus 20% off balance to go toward
covered in full. 11 any frame from a Visionworks family of store
Contact Lens Collection: Select from the most popular locations.'6
contact lenses on the market today with Davis Vision's Contact Lenses
Contact Lens Collection.'1
Every January 1,
Collection Contacts: Covered in full after $25 copay
One-year eyeglass breakage warranty included on Contact Lens OR
plan eyewear at no additional cost! Evaluation, Fitting
& Follow Up Care Non Collection Contacts:
Standard Contacts: 15% discount
How to locate a Network Provider... Specialty Contacts'3: 15% discount
Just log on to the Open Enrollment section of our
Member site at davisvision.com and click "Find a Every January 1, Covered in full
Provider" to locate a provider near you including: Contact Lenses Any contact lenses from Davis Vision's Contact Lens
Collection11
(in lieu of
OR
eyeglasses)
$115 retail allowance toward provider supplied contact
lenses, plus 15% off balance12
T-Visionworks· ADDITIONAL DISCOUNTED LENS OPTIONS & COATINGS
MOST POPULAR OPTIONS Without With
Savings based on in-network usage and average retail values. Davis Vision Davis Vision
Scratch-Resistant Coating $25 $0
Polycarbonate Lenses $66 $0'4-$30
Standard Anti-Reflective (AR) Coatinq $83 $35
Premium Proqressives (no-line bifocal) $247 $0
Photochromic Lenses (i.e. Transitions®, etc.)'5 $110 $65
For more details about the plan, just log on to the Lower costs and more benefits! See the savings!
Open Enrollment section of our Member site at Service
Without With
davisvision.com or call 1.877.923.2847 and enter Davis Vision Davis Vision
Client Code 7395. Eye Examination $103 $25
Lenses
Bifocals $116 $25
Scratch-Resistant Coating $25 $0
'5
Transitions® $110 $65
Savings up to:
Frame $160 $0
Total $514 $115 $399
'1The Davis Vision Collection is available at most participating independent provider locations. Collection
is subject to change. Collection is inclusive of select toric and muftifoca/ contacts.
11Additional discounts not applicable at Costco locations.
JIIncluding, but not limited to toric, multifoca/ and gas permeable contact lenses.
"For dependent children, monocular patients and patients with prescriptions of 6. 00 diopters or greater.
YTransitions® is a registered trademark of Transitions Optical Inc.
IY Allowance is available at these Vision works family of store locations: Davis Vision, Empire Vision Cen
ters, Total Vision Care, EyeMasters, Cambridge Eye Doctors, Vision World, Dr. Sizer's Vision World,
Eye Dr, Dr. Sizer's Valu Vision, Doctor's Valu Vision, Hour Eyes, Visionworks.
Davis Vision has made every effort lo correctly summarize your vision plan features. In the event of a
conflict between this information and your organization's contract with Davis Vision, the terms of the
contract or insurance policy will prevail.
OE00978 S/21/19
27Here's what
WITHOUT WITH
ADDITIONAL OPTIONS
DAVIS VISION DAVIS VISION
F�MES
we have to Fashion Frame (from the Davis Vision Collection) $100 $0
offer...
Designer Frame (from the Davis Vision Collection) $160 $0
Premier Frame (from the Davis Vision Collection) $195 $0
LENSES
All Ranges of Prescriptions and Sizes $90 $0
Plastic Lenses $78 $0
Oversized Lenses $20 $0
Value for our Members
Tinting of Plastic Lenses $25 $0
A comprehensive benefit ensuring low out-of
pocket cost to members and their families. Our Scratch-Resistant Coating $25 $0
goal is 100% member satisfaction. Polycarbonate Lenses $66 $0' or $30
1
Ultraviolet Coating $25 $12
Convenient Network Locations
Standard Anti-Reflective (AR) Coating $83 $35
A national network of credentialed preferred
providers throughout the 50 states. Premium AR Coating $104 $48
Ultra AR Coating $121 $60
Freedom of Choice
Standard Progressive Addition Lenses $198 $0
Access to care through either our network of
independent, private practice doctors (optometrists Premium Progressive Addition Lenses $247 $0
and ophthalmologists) or select retail partners.
Ultra Progressive Addition Lenses $369 $50
Value-Added Features: High-Index Lenses $120 $55
Mail Order Contact Lenses Polarized Lenses $103 $75
Replacement contacts (after initial benefit)
Photochromic Lenses (i.e. Transitions®, etc.)'2 $110 $65
through DavisVisionContacts.com mail-order
service ensures easy, convenient, purchasing Scratch Protection Plan (Single vision I Multifocal lenses) $20 I $40
online and quick, direct shipping to your door.
Log on to our member Website for details. 11 Polycarbonate lenses are covered in full for dependent children, monocular patients and patients with
prescriptions 6.00 diopters or greater.
Davis Vision provides you and your eligible v Transitions® is a registered trademark of Transitions Optical, Inc.
dependents with the opportunity to receive
discounted laser vision correction, often
referred to as LASIK. For more information,
visit www.davisvision.com.
Out-of-Network Benefits
You may receive services from an out-of-network provider, although you will
receive the greatest value and maximize your benefit dollars if you select a
Contact Info provider who participates in the network. If you choose an out-of-network
For more details about the plan, just log on to the provider, you must pay the provider directly for all charges and then submit
Open Enrollment section of our Member site at a claim for reimbursement to:
davisvision.com or call 1.877.923.2847 and enter Vision Care Processing Unit
Client Code 7395. P.O. Box 1525
Latham, NY 12110
OUT-OF-NETWORK REIMBURSEMENT SCHEDULE
Eye Examination up to $32 I Frame up to $50
Spectacle Lenses (per pair) up to:
Single Vision $32, Bifocal $48, Trifocal $64, Lenticular $80
Elective Contacts up to $92, Visually Required Contacts up to $225
28Offered by Life Insurance Company of North America, a Cigna company
Employer-Paid
TERM LIFE INSURANCE
SUMMARY OF BENEFITS Prepared for: Jefferson Parish School Board
Term Life insurance can help protect your loved ones’ financial health if you are no longer there
to support them.
Who Is Eligible For Coverage?:
You: All active, Full-time Employees of the Employer who are United States citizens or permanent resident aliens regularly working a minimum of 20
hours per week in the United States.
1st of the month following 30 days of Active Service
Available Coverage:
Benefit Amount Maximum Guaranteed Issue Amount
Employee $10,000 $10,000 $10,000
Guaranteed Issue means that you may be able to purchase coverage without medical exams or health questions. See “Guaranteed Issue” below for
more information.
Additional Features:
Extended Death Benefit with Waiver of Premium – The extended death benefit continues your coverage without payment of premium, before you’re
eligible to qualify for Waiver of Premium, if you are continuously Disabled for 9 months prior to age 60. “Disabled” means, because of injury or sickness,
you are unable to perform all the material duties of your regular occupation, or you are receiving disability benefits under a program sponsored by your
Employer. Regular Occupation means the occupation you routinely performed at the time your Disability began. We/the insurance company will
consider the duties of your occupations as those that are normally performed in the general labor market in the national economy. If you qualify for
this benefit and have insured your spouse or children, the insurance company will also extend their coverage if applicable.
Waiver of Premium – If you become Disabled prior to age 60, and you remain Disabled continuously for a 9 month period and thereafter, you won’t
need to pay premiums for your life insurance coverage, provided we/the Insurance Company determine(s) you are Disabled. “Disabled” for this
coverage means, because of injury or sickness, you are unable to perform the material duties of your regular occupation, or are receiving disability
benefits under a program sponsored by your employer, for the first 12 months after your Disability began. Thereafter, you must be unable to perform
the material duties of any occupation that you are or may reasonably become qualified based on your education, training or experience. If you qualify
for this coverage and have insured your spouse or children, the insurance company will also waive their premium if applicable.
Accelerated Death Benefit – Terminal Illness – if two unaffiliated doctors diagnose you as terminally ill while the coverage is active, with a life
expectancy of 12 months or less, the benefit for Terminal Illness provides up to:
Employee: 50% of your Term Life Insurance coverage amount or $10,000, whichever is less.
Conversion – To convert, you must apply for the conversion policy and pay the first premium payment within 31 days after your group coverage ends.
Important Definitions and Policy Provisions:
When Your Coverage Begins and Ends – Coverage becomes effective on the later of the program’s effective date, the date you become eligible, the date
your enrollment elections are received if applicable, or the date you authorize any necessary payroll deductions if applicable. Your coverage will not
begin unless you are actively at work on the effective date. Dependent coverage, if applicable, will not begin for any spouse or child who on the
effective date isan inpatient in a facility oris home confined and under the care of a physician. Coverage will end on the earliest of the date you are
eligible for coverage under a plan intended to replace this coverage, you or your dependents if applicable, are no longer eligible, the group policy is no
longer in force, or required premiums are not paid.
Benefit Reductions, Exclusions and Limitations:
Benefit Reduction Schedule - If you are still employed, your benefits will reduce to 75% at age 70.
Limitations - The Accelerated Death Benefit is payable only once. Using this benefit reduces the life insurance death benefit. The amount payable under
the Accelerated Death Benefit may be reduced by the amount of other benefits already paid to the insured under the policy. See your certificate for
details. Benefits will be extended without premium payment until the earlier of the date you are no longer disabled, or the date you fail to qualify for
Waiver of Premium or fail to provide proof of Disability. Waiver of Premium – After premiums have been waived for 12 months, they will be waived for
future periods of 12 months if you remain Disabled. This benefit will remain active until age 65 subject to proof of continuing disability each year.
29Guaranteed Issue:
If you are a new hire and you apply within 31 days after you are eligible to elect coverage for yourself, you are entitled to choose any coverage offered
up to the Guaranteed Issue Amount, without providing proof of good health. If you apply for an amount of coverage greater than the Guaranteed Issue
Amount, coverage in excess of the Guaranteed Issue Amount will not be issued until the insurance company approves acceptable proof of good health.
If you apply for coverage for yourself more than 31 days from the date you become eligible to elect coverage under this plan, the Guaranteed Issue
Amount will not apply, unless Guaranteed Issue has been approved by your employer for a specific period of time. Coverage will not be issued until the
insurance company approves acceptable proof of good health.
These are summarized definitions only. To be eligible for coverage, the covered illness or event must meet the definitions and other terms and
conditions set forth in the group policy.
THIS POLICY PROVIDES LIMITED COVERAGE. IT PAYS A FIXED BENEFIT AND DOES NOT COVER MEDICAL EXPENSES AS INCURRED. THIS IS
NOT A SUBSTITUTE FOR COMPREHENSIVE OR MAJOR MEDICAL HEALTH INSURANCE. THIS COVERAGE DOES NOT SATISFY THE
INDIVIDUAL MANDATE OF THE AFFORDABLE CARE ACT BECAUSE THE COVERAGE DOES NOT MEET THE REQUIREMENTS OF MINIMUM
ESSENTIAL COVERAGE.
Terms and conditions of coverage for Term Life insurance are set forth in Group Policy No. FLX 980448. This is not intended as a complete description of the insurance
coverage offered. This is not a contract. Complete coverage details, including premiums, eligible conditions, their respective payments and policy exclusions and
limitations are contained in the Policy. Please see your Plan Sponsor to obtain a copy of the Policy. If there are any differences between this summary and the group
policy, the information in the group policy takes precedence. Product availability, costs, benefits, riders, covered conditions and/or features may vary by state. Please
keep this material as a reference. Insurance coverage is issued on group policy form number: Policy Form TL-004700. Coverage is underwritten by Life Insurance
Company of North America, 1601 Chestnut St. Philadelphia, PA 19192.
“Cigna” and the “Tree of Life” logo are registered service marks of Cigna Intellectual Property, Inc., licensed for use by Cigna Corporation and its operating subsidiaries.
All products and services are provided by or through such operating subsidiaries, including Life Insurance Company of North America and Cigna Life Insurance
Company of New York, and not by Cigna Corporation.
882860 © 2019 Cigna. Some content provided under license.
30Offered by Life Insurance Company of North America, a Cigna company
Employee-Paid
TERM LIFE INSURANCE
SUMMARY OF BENEFITS Prepared for: Jefferson Parish School Board
Term Life insurance can help protect your loved ones’ financial health if you are no longer there
to support them.
Who Is Eligible For Coverage?:
You: All active, Full-time Employees of the Employer who are United States citizens or permanent resident aliens regularly working a minimum of 20
hours per week in the United States.
1st of the month following 30 days of Active Service
Your Spouse*: Is eligible as long as you apply for and are approved for coverage yourself.
Your Child(ren): Birth to 26, as long as you apply for and are approved for coverage yourself.
*Domestic Partner is defined in the Group Policy. For purposes of this brochure, wherever the term Spouse appears, it shall also include Domestic
Partner registered under any state which legally recognizes Domestic Partnerships or Civil Unions. Additional information is available from your Benefit
Services Representative.
Available Coverage:
Benefit Amount Maximum Guaranteed Issue Amount
Employee 1, 2 or 3 Times Salary Lesser of 3 Times Salary or $250,000 Lesser of 3 Times Salary or $75,000
Spouse Units of $5,000 $250,000 not to exceed 100% of the $30,000
employees benefit
Children Units of $1,000 $10,000; under 6 Months old $500 All amounts
Guaranteed Issue means that you may be able to purchase coverage without medical exams or health questions. See “Guaranteed Issue” below for
more information.
Additional Features:
Extended Death Benefit with Waiver of Premium – The extended death benefit continues your coverage without payment of premium, before you’re
eligible to qualify for Waiver of Premium, if you are continuously Disabled for 9 months prior to age 60. “Disabled” means, because of injury or sickness,
you are unable to perform all the material duties of your regular occupation, or you are receiving disability benefits under a program sponsored by your
Employer. Regular Occupation means the occupation you routinely performed at the time your Disability began. We/the insurance company will
consider the duties of your occupations as those that are normally performed in the general labor market in the national economy. If you qualify for
this benefit and have insured your spouse or children, the insurance company will also extend their coverage if applicable.
Waiver of Premium – If you become Disabled prior to age 60, and you remain Disabled continuously for a 9 month period and thereafter, you won’t
need to pay premiums for your life insurance coverage, provided we/the Insurance Company determine(s) you are Disabled. “Disabled” for this
coverage means, because of injury or sickness, you are unable to perform the material duties of your regular occupation, or are receiving disability
benefits under a program sponsored by your employer, for the first 12 months after your Disability began. Thereafter, you must be unable to perform
the material duties of any occupation that you are or may reasonably become qualified based on your education, training or experience. If you qualify
for this coverage and have insured your spouse or children, the insurance company will also waive their premium if applicable.
Accelerated Death Benefit – Terminal Illness – if two unaffiliated doctors diagnose you or your spouse as terminally ill while the coverage is active, with
a life expectancy of 12 months or less, the benefit for Terminal Illness provides up to:
Employee: 50% of your Term Life Insurance coverage amount or $250,000, whichever is less.
Spouse: 50% of your Term Life Insurance coverage amount or $125,000, whichever is less.
Portability – If your employment is terminated, you can continue your life insurance on a direct-bill basis. Coverage may also be continued for your
spouse/children. Premiums will increase at this time. Coverage can be continued to age 70, unless the insurance company terminates portability for all
insured persons. Refer to your certificate for details.
Conversion – To convert, you must apply for the conversion policy and pay the first premium payment within 31 days after your group coverage ends.
31Employee’s Monthly Cost of Coverage:
Employee Cost Per Spouse Cost Per Age Employee Cost Per Spouse Cost Per
Age
$1,000 $1,000 $1,000 $1,000
0-19 $0.050 $0.102 60-64 $0.780 $1.583
20-24 $0.050 $0.102 65-69 $1.254 $2.546
25-29 $0.049 $0.099 70-74 $2.204 $4.474
30-34 $0.067 $0.136 75-79 $4.014 $8.150
35-39 $0.096 $0.195 80-84 $4.014 $8.150
40-44 $0.146 $0.296 85-89 $4.014 $8.150
45-49 $0.234 $0.475 90-94 $4.014 $8.150
50-54 $0.379 $0.769 95-99 $4.014 $8.150
55-59 $0.589 $1.196
Child Cost Per $1,000 Unit = $0.102
Actual per pay period premiums may differ slightly due to rounding. Rates vary by age and may be subject to change in the future. Benefits will
reduce based on age (see Benefits Reduction Schedule for details).
How to Calculate Your Monthly Cost:
Step 1: Use the chart above to find your Monthly rate based on your age as of your effective date.
Step 2: Multiply this rate by your desired coverage amount, in units. Reference the table above to find the appropriate unit amounts for employee
and/or dependents.
Step 3: The result is the Monthly cost.
Important Definitions and Policy Provisions:
When Your Coverage Begins and Ends – Coverage becomes effective on the later of the program’s effective date, the date you become eligible, the date
your enrollment elections are received if applicable, or the date you authorize any necessary payroll deductions if applicable. Your coverage will not
begin unless you are actively at work on the effective date. Dependent coverage, if applicable, will not begin for any spouse or child who on the
effective date isan inpatient in a facility oris home confined and under the care of a physician. Coverage will end on the earliest of the date you are
eligible for coverage under a plan intended to replace this coverage, you or your dependents if applicable, are no longer eligible, the group policy is no
longer in force, or required premiums are not paid.
Benefit Reductions, Exclusions and Limitations:
Benefit Reduction Schedule - If you are still employed, your benefits will reduce to 75% at age 70.
Exclusions - Voluntary life insurance will not be paid if you commit suicide, while sane or insane, within the first two years of coverage.
Limitations - The Accelerated Death Benefit is payable only once. Using this benefit reduces the life insurance death benefit. The amount payable under
the Accelerated Death Benefit may be reduced by the amount of other benefits already paid to the insured under the policy. See your certificate for
details. Benefits will be extended without premium payment until the earlier of the date you are no longer disabled, or the date you fail to qualify for
Waiver of Premium or fail to provide proof of Disability. Waiver of Premium – After premiums have been waived for 12 months, they will be waived for
future periods of 12 months if you remain Disabled. This benefit will remain active until age 65 subject to proof of continuing disability each year.
Guaranteed Issue:
If you are a new hire and you apply within 31 days after you are eligible to elect coverage for yourself, you are entitled to choose any coverage offered
up to the Guaranteed Issue Amount, without providing proof of good health. If you apply for an amount of coverage greater than the Guaranteed Issue
Amount, coverage in excess of the Guaranteed Issue Amount will not be issued until the insurance company approves acceptable proof of good health.
If you apply for coverage for yourself more than 31 days from the date you become eligible to elect coverage under this plan, the Guaranteed Issue
Amount will not apply, unless Guaranteed Issue has been approved by your employer for a specific period of time. Coverage will not be issued until the
insurance company approves acceptable proof ofgood health.
These are summarized definitions only. To be eligible for coverage, the covered illness or event must meet the definitions and other terms and
conditions set forth in the group policy.
THIS POLICY PROVIDES LIMITED COVERAGE. IT PAYS A FIXED BENEFIT AND DOES NOT COVER MEDICAL EXPENSES AS INCURRED. THIS IS
NOT A SUBSTITUTE FOR COMPREHENSIVE OR MAJOR MEDICAL HEALTH INSURANCE. THIS COVERAGE DOES NOT SATISFY THE
INDIVIDUAL MANDATE OF THE AFFORDABLE CARE ACT BECAUSE THE COVERAGE DOES NOT MEET THE REQUIREMENTS OF MINIMUM
ESSENTIAL COVERAGE.
Terms and conditions of coverage for Term Life insurance are set forth in Group Policy No. FLX 980450. This is not intended as a complete description of the insurance
coverage offered. This is not a contract. Complete coverage details, including premiums, eligible conditions, their respective payments and policy exclusions and
limitations are contained in the Policy. Please see your Plan Sponsor to obtain a copy of the Policy. If there are any differences between this summary and the group
policy, the information in the group policy takes precedence. Product availability, costs, benefits, riders, covered conditions and/or features may vary by state. Please
keep this material as a reference. Insurance coverage is issued on group policy form number: Policy Form TL-004700. Coverage is underwritten by Life Insurance
Company of North America, 1601 Chestnut St. Philadelphia,PA 19192.
“Cigna” and the “Tree of Life” logo are registered service marks of Cigna Intellectual Property, Inc., licensed for use by Cigna Corporation and its operating subsidiaries.
All products and services are provided by or through such operating subsidiaries, including Life Insurance Company of North America and Cigna Life Insurance
Company of New York, and not by Cigna Corporation.
882860 © 2019 Cigna. Some content provided under license.
32Cigna Group Insurance®
PLAN FOR
YOUR FUTURE.
Cigna Term Life Insurance
It’s hard to think about, but what would your family do if something were to happen to you?
Would they be able to make ends meet? For how long?
Cigna Term Life insurance provides your family with How does it work?
additional financial resources if you should pass away Once you select a coverage amount and enroll in
prematurely.* It can help your family: supplemental term life insurance, pending approval if
› Cover final expenses needed, you’ll pay for your selected coverage amount
through convenient payroll deductions.
› Cover your family’s living expenses
You'll be covered for a specific period of time, or “term,”
› Pay off your mortgage and other debts If you pass away during the term, the beneficiary you
› Take care of your children’s education designate will receive a payment for a covered claim.
Please be sure to let your beneficiary know you’ve
Life insurance is an important part of your family’s
designated them, so they can submit a claim for the
financial plan, especially during a time that could be
life insurance.
difficult enough without added financial stress.
Value-added programs and services**
How much life insurance should you buy?
› Cigna Healthy Rewards®. Discounts on health and
Many factors need to be considered, including: wellness services, including vision and hearing care,
› The financial support your family will lose if diet programs, fitness centers, massage, chiropractic
you're gone care and acupuncture.
› Costs associated with final expenses, child care › CignaWillCenter.com. Online tools for you and your
and education spouse to create state-specific legal documents for
› Debts, such as unpaid mortgage, credit cards and
wills and powers of attorney, and valuable resources
for estate and funeral planning.
other loans
› Your spouse’s retirement needs › Cigna Identity Theft Program. Identity theft
prevention and resolution services including personal
assistance and guidance, education and tools to help
prevent identity theft in the future.
Even if you already have some life insurance,
is it enough? Use our insurance needs calculator at › Cignassurance®. Free, interest-bearing account for
Cigna.com/liam to help you find out how much beneficiary payments of $5,000 or more, and support
you might need. from expert resources in financial, legal and
bereavement counseling services.
More than 64% of Americans don't have a will***
Offered by: Life Insurance Company of North America or Cigna Life Insurance Company of New York.
909262 05/17 33How to file a claim Information you’ll need
Claims should be reported within a month of the date of loss or as Make sure you have this information
soon as reasonably possible. Claims can be reported by one of the handy in case you need it.
following methods.
› All beneficiary designations
Complete and file your claim by phone on file
Call toll-free 800.36.Cigna (24462) between › Assignments, court orders or
7:00 am and 7:00 pm, CST. A representative will walk any other documents that may
you through the process. affect payment
› Copy of the death certificate
Complete and file your claim online
Fill out a claim form online at Cigna.com/customer-forms
› Information you saved from
when you enrolled
using the following steps:
› Select “Disability/Accident/Life/Critical Illness/Hospital
› Police or medical examiner
report, if available/applicable
Care Forms”
› Click “Submit a Life and Accidental Death & Dismemberment
Claim” – this will bring you to the Fraud Warning page
› Review the notices, including any notice specific to your state,
and click “Continue”
Questions?
› A pop-up box will appear that says “Hit the continue button
if you have read the above fraud language and wish to Call 800.238.2125 to
continue to file a claim” speak with a customer
› Click “OK” service representative.
› Click “Submit a life, accidental death and dismemberment or
waiver claim online” to begin
Complete and file your claim by fax, email or mail
Blank/fillable claim forms can be found online at
Cigna.com/customer-forms:
› Select and complete the “Life and Accidental Death” claim form
› Print form by clicking “Click to Print” at the bottom of the last
page and send the report by fax, email or mail
- Fax documents to 877.300.6770
- Email scanned documents to claims.pghlif2@Cigna.com
- Mail documents to
Cigna Life and Accident Claim Services
P.O. Box 22328
Pittsburgh, PA 15222-0328
* See your plan materials for details, as exceptions may apply.
** These programs are NOT insurance and do not provide reimbursement for financial losses. Customers are required to pay the entire discounted charge for any discounted products or
services available through these programs. Cignassurance is available to beneficiaries receiving coverage checks over $5,000 from group life and personal accident programs. Counseling, legal
or financial assistance programs are not available under policies insured by Cigna Life Insurance Company of New York. Programs are provided by third party vendors, and not by Cigna. Contact
your Cigna representative for details.
*** Harris Poll, "2015 Rocket Lawyer estate-planning survey." 2015.
Product availability may vary by location and plan type and is subject to change. Group Term Life insurance policies may contain exclusions, limitations, reduction of benefits, and terms under which
the policies may be continued in force or discontinued. For costs and complete details of coverage, contact your Cigna representative. Policy form: TL-004700 et al.
All Cigna products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation, including Life Insurance Company of North America and Cigna Life Insurance
Company of New York (New York, NY). The Cigna name, logo, and other Cigna marks are owned by Cigna Intellectual Property, Inc.
909262 05/17 © 2017 Cigna. Some content provided under license.
34LifeTime Benefit Term
Workplace Benefits
For employees of
CWB-LBT-LTC-LA-0718 Jefferson Parish Schools
35LifeTime Benefit Term
Life Insurance—Valuable protection for
your loved ones
You work hard to provide a good life for
your family. However, what if something
happens to you? Chubb LifeTime Benefit
Term provides the help you and your
family needs to help pay for:
• Mortgage and Rent
• College and Education
• Retirement
• Household Expenses
• Long Term Care
• Childcare
• Family Debt
• Burial
LifeTime Benefit Term provides money
to your family at death, and while you are
living too, if you need home health care,
assisted living or nursing care. For about
the same premium, LifeTime Benefit Term
provides higher benefits than permanent life
insurance and lasts to age 121.
Creative Solutions for Term Life Insurance
Good things happen Guaranteed Premiums Long Term Care (LTC)*
every day, and Life insurance premiums will never If you need LTC, you can access your
increase and are guaranteed to age 100. death benefit while you are living for home
unfortunately hardship Thereafter no additional premium is due health care, assisted living, adult day care
while the coverage can continue to age 121. and nursing home care. You get 4% of
happens too. your death benefit per month while you
Guaranteed Benefits During are living for up to 25 months to help pay
Let us help you protect Working Years for LTC. Insurance premiums are waived
Death Benefit is guaranteed 100% when
everything you value. it is needed most—during your working
while this benefit is being paid.
years when your family is relying on your Extension of Benefits*
income. While the policy is in force, the Extends the monthly Long Term Care
death benefit is 100% guaranteed for the benefit for up to an additional 25 months,
longer of 25 years or age 70. after 100% of the base death benefit has
been used for LTC.
Guaranteed Benefits After Age 70
Even after age 70, when income is less Terminal Illness Benefit
relied upon, the benefit is guaranteed After your coverage has been in force
to never be less than 50% of the original for 30 days, you can receive 50% of your
death benefit. And based on current death benefit, up to $100,000, if you are
interest rates and mortality assumptions, diagnosed as terminally ill.
the full death benefit is designed to last a
lifetime.
Paid-up Benefits
After 10 years, paid up benefits begin
to accrue. At any point thereafter, if
premiums stop, a reduced paid up benefit
is guaranteed. Flexibility is perfect for
retirement.
This product is underwritten by Combined Insurance Company of America, a Chubb company.
36You can also read
