Benefits

Benefits

Your 2022 Benefits

Healthy employees are the heart of a great organization and we appreciate our employee’s contributions to our success. It is our privilege to offer you the wide range of valuable health and wellness benefits, including affordable options for everything from medical, prescription drug and dental, to life insurance and disability benefits. EBRPSS is proud to offer the following comprehensive benefits package to all full-time employees. Participants share the costs of some benefits (medical) and EBRPSS provides other benefits at no cost to the participant (life, accidental death & dismemberment). In additional, there are voluntary benefits with reasonable group rates that can be purchased through payroll deductions (dental, vision, supplemental life insurance, disability, accident and critical illness coverage). Participants and their dependents are eligible for EBRPSS’s health plan on date of hire. All other benefits are effective the first of the month following 30 days of continuous full-time employment. 

Benefit Advocate Center – bac.ebrpschools@ajg.com | (833) 940-3885

How do I enroll?

Visit the Benefits Department to complete required paperwork. 

For more information, please call (225) 922-5680 Monday thru Friday 8:30am – 4:00pm.

Eligibility and Participation

Any regular, full-time employee working a minimum of 30 hours per week is eligible for the benefits mentioned in this guide. You are eligible for East Baton Rouge Parish School System’s health plan upon date of hire. All other benefits are effective the first of the month following 30 days of continuous full-time employment.

Eligible Dependents

Dependents include: your spouse, children under the age of 26, and disabled dependents of any age.

Certain documentation must be provided to EBRPSS before dependents can be added to your health plan. You MUST bring the required documentation in to the Benefits Department, or your dependent(s) will not be added. 

-Documentation required for spouses (one piece of documentation required): Marriage Certificate

-Documentation required for children (two pieces of documentation required): Current or prior year tax return, birth certificate, final court order, legal adoption papers, legal guardianship papers, or a qualified medical child support order

Please visit the Benefits Department if you have any other special circumstances.

Qualifying Life Events

By law, elections made now will remain in effect until the next open enrollment period unless you or your family members experience a qualifying event. If you experience one of these qualifying events, you must contact your group leader within 30 days.

    • Marriage Divorce
    • Death of a spouse or dependent
    • Loss or gain of dependent’s eligibility
    • Loss or gain of a spouse’s/dependents medical or dental coverage through another employer
    • Birth
    • Adoption

Medical Insurance

BCBS of LA - HMO/PPO

Highlights

Medical insurance represents the largest component of the East Baton Rouge Parish School System benefits program. If you want to enroll in the medical and prescription plan, you can choose from three medical plans administered by BlueCross BlueShield of Louisiana (BCBSLA) – two traditional HMO/POS plans and one with a smaller network of providers. The chart below shows the amount you will pay for the medical services listed. to find a network provider associated with your benefit choice, visit www.bcbsla.com/find-a-doctor/louisiana-medical.

Details

If you are a Blue Cross Blue Shield of Louisiana or HMO Louisiana member age 18 or older, you can register for AccessBlue and review your claims. In our effort to safeguard your personal health information as much as possible, all members age 18 and older have restricted access to ONLY their personal claims information. for members under 18, the primary cardholder (also known as the subscriber) can view their claims in accordance with federal and state regulation and Blue Cross company policy. 

AccessBlueMember Maintenance services such as address changes, etc., are available to primary cardholders only. Please note: members under an employer-sponsored plan cannot access this service unless your employer has elected to participate. Primary cardholders can access member maintenance information for themselves and those covered under their plan.

Community Blue Summary of Benefits
Core HMO Summary of Benefits
Core PPO Summary of Benefits
Buy-Up HMO Summary of Benefits
Buy-Up PPO Summary of Benefits

How do I know which plan is right for me?

Community Blue Select

By choosing the Community Blue Select Plan, you’ll obtain coordinated, focused care with preferred in-network access to the Baton Rouge Clinic, Baton Rouge General Physicians Group, Baton Rouge General Medical Center and its providers/facilities. You still have out-of network coverage, but at lower benefits levels. Your deductibles and out-of-pocket amounts in this plan are the same as the Core plan, but higher than the Buy-up plan. This option may be right for you and your family if:

• You will utilize a more defined, high-quality network size
• To save money on medical premiums, you will utilize a more defined, preferred network to seek quality care
• You want a one-stop shop for cost-effective healthcare
• You are willing to pay the lowest premiums available for the same level of plan benefits as the Core Plan, but use a smaller-sized, preferred network of quality health providers through the Baton Rouge General System
• Go to www.bcbsla.com/community-blue to view participating providers in a preferred network

Core HMO/PPO

By choosing the Core Plan, you’ll get competitive coverage that costs less than what’s offered by most employers. Under the Core Plan, deductibles and copayments are slightly higher than the Buy-Up Plan, and you pay a higher rate of coinsurance after you meet your deductible. This option may be right for you if:

• You want lower paycheck deductions, but do not want a limited provider network
• You want coverage that is similar to coverage offered by most other employers
• You want to pay a smaller amount up front
• You don’t mind paying a higher deductible or higher costs for medical services at the time of services being rendered
• You don’t use your medical benefits often

Buy-Up HMO/PPO

By choosing the Buy-up Plan, you’ll get maximum security, but at a higher premium cost than the Core Plan. However, your deductibles, copayments and coinsurance are all lower than the Core Plan. This option may be right for you if:

• You want maximum protection against the high costs of healthcare
• You are willing to pay more premium up front
• You want to avoid unexpected out-of-pocket expenses
• You use your medical benefits often

Humana Medicare Advantage Plan

Frequently Asked Questions

What is a Medicare Advantage Plan?

A Medicare Advantage Plan is an alternative to Medicare Parts A and B. It is offered through private insurance companies but approved by Medicare.  Most Medicare Advantage Plans have enhanced benefits, limits on out-of-pocket expenses, and worldwide coverage for emergency and urgently needed care. Some even have extra services, fixed costs, and prescription drug benefits. You’ll still have Medicare, but Part A (Hospital Insurance) and Part B (Medical Insurance) coverage will come from the Medicare Advantage Plan instead of Original Medicare. To enroll in a Medicare Advantage plan you must have both Medicare Part A and Part B.

Can I enroll in more than one Medicare Advantage Plan?

No.  You may only be enrolled in one Medicare Advantage plan at a time. Enrolling in a second Medicare Advantage Plan will disenroll you from the first.

Will I lose my Original Medicare if I join the Humana Medicare Advantage plan?

No. While on this plan, Humana replaces your Original Medicare benefits. However, you must continue to be enrolled in Medicare Part A and B and must still pay your Part B premium to Medicare. If at any time you lose or cancel coverage from the Humana Medicare Advantage Plan, you will return to Original Medicare. Please notify your benefits administrator if you decide to cancel your coverage.

I am eligible for Medicare, but have not yet applied for Medicare Part B. When can I enroll in the Humana plan?

To join this plan you must have Medicare Part A and B. Once you receive your Medicare effective dates, you may enroll into this plan.

What plans can I choose from with Humana?

East Baton Rouge Parish School System worked with Humana to create benefit packages to meet your needs. You’ll have the choice between a Humana Medicare Advantage Employer HMO (Health Maintenance Organization) and PPO (Preferred Provider Organization) Plan.

What is the difference between the Medicare Advantage HMO and PPO Plan?

An HMO (Health Maintenance Organization) Plan features a specific list of doctors, hospitals and other providers that you must use to receive benefits, except in emergency situations. You will choose a primary care doctor and may need a referral from your primary care doctor for certain benefits and services. With a PPO (Preferred Provider Organization) Plan you may use both in and out of network doctors and hospitals as long as the out of network doctor or hospital accepts Medicare and agrees to bill Humana.  The amount you pay may be higher when services are received from an out of network doctor or hospital. Referrals are not needed and you’re not required to choose a primary care doctor.

How much will it cost for the for the Humana Medicare Advantage plan?

For premium information, please see the Employee Rates section of this website.

Will I have to pay a copayment when I see my doctor or go to the hospital?

No. You will not be responsible for copayments on any medical benefit or service received as part of the Humana Medicare Advantage Plan.

How do I know which plan is right for me?

You will receive an informational kit in the mail from Humana. This kit will include plan benefits, covered services and other plan details which will help you choose the right plan. You will also be given the opportunity to attend seminars in late August and early September at the IRC (Instructional Resource Center). Humana Representatives will be at the seminars to help you choose the right plan for and answer questions you have about the plan or your specific needs.

How can I find out if my doctors are in Humana’s network?

A provider directory (listing of doctors near you in Humana’s network) will be mailed to you shortly after you receive your informational kit from Humana.  You can search for your doctors in the directory to see if they are in-network. You may also find Humana providers online at humana.com.

How do I enroll in the plan?

East Baton Rouge School System will enroll you in the Humana Medicare Advantage Employer PPO Plan. If you would like to keep the Humana Medicare Advantage Employer PPO Plan there is nothing you need to do. If you do not want the Humana Medicare Advantage Employer PPO Plan, you will have the choice to “buy down” to the Humana Medicare Advantage Employer HMO Plan or “buy up” to the Blue Cross Blue Shield Plan you are currently enrolled in. Details including how to “buy up” or “buy down” will be sent with the informational packet from Humana.

When can I enroll in the Humana Medicare Advantage Plan?

You will be able to choose your plan during the initial Open Enrollment Period. An Open Enrollment Period is a range of dates when you are able to select, waive or change your Medicare Advantage Plan. The dates of your Open Enrollment Period for this year are October 14th through November 14th.

I am not Medicare eligible but my spouse/dependent is. Will my spouse/dependent be allowed to join The Humana Medicare Advantage plan?

Yes.  If your spouse/dependent is enrolled in Medicare Parts A and B they may join this plan.  You will remain with Blue Cross Blue Shield on your current coverage until you are Medicare eligible.

I am Medicare eligible but my spouse/dependent is not. Who will provide coverage to my spouse/dependent when I join Humana?

When you move to the Humana Medicare Advantage Plan, your spouse/dependent will remain with Blue Cross Blue Shield on their current plan until they are also Medicare eligible.

I am a Medicare eligible surviving spouse/ dependent. May I join the Humana Medicare Advantage Plan through EBRPSS?

Yes.  If you are a surviving spouse/dependent and currently have coverage through EBRPSS, you may join this plan.

If I receive “extra help” from Medicare to pay for my prescription drugs can I still join the Humana Medicare Advantage Plan?

Yes.  If you receive “extra help” from Medicare (also known as low-income subsidy) you can still enroll in this plan.  Humana and Medicare will work together to make sure you receive prescription drugs at the lowest cost possible.

To see if you qualify for getting extra help, call:

1-800-MEDICARE (1-800-633-4227). TTY/TDD users should call 1-877-486-2048, 24 hours a day/7 days a week; and see http://www.medicare.gov ‘Programs for People with Limited Income and Resources’ in the publication Medicare & You.

The Social Security Administration at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY/TDD users should call 1-800-325-0778 or Your State Medicaid Office.

What if I need more information or have a question that I need answered before the seminar?

You may contact Humana at 1-800-824-8242 (TTY: 711). When you call be sure to mention that you are eligible through East Baton Rouge Parish School System.

Medical Coverage (In-Network Coverage Only)

Plan Choices Community Blue Select Network Core HMO/PPO Buy-Up HMO/PPO
Annual Deductible
Individual Deductible $1,000 $1,000 $600
Per Member Deductible in Family $1,000 $1,000 $600
Annual Out-Of-Pocket (OOP) Max
Individual OOP Max $6,900 $6,900 $5,850
Family OOP Max $13,800 $13,800 $11,700
Per Member OOP Max in a Family $6,900 $6,900 $5,850
Office Visits
Primary Care (PCP) $30 Copay $30 Copay $25 Copay
Specialist $60 Copay $60 Copay $50 Copay
Pregnancy $30 Copay $30 Copay $30 Copay
Mental & Nervous/Alchol & Drug $30 Copay $25 Copay $25 Copay
Urgent Care $60 Copay $60 Copay $50 Copay
Lab & Low Tech Imaging Fully Covered Fully Covered Fully Covered
High Tech Imaging (Free Standing) 20% after Deductible 20% after Deductible 15% after Deductible
Preventative & Wellness Fully Covered Fully Covered Fully Covered
Outpatient Services
Emergency Room 20% after Deductible 20% after Deductible 15% after Deductible
Outpatient Facility $100 Copay, then 20% $100 Copay, then 20% $50 Copay, then 15%
Outpatient Professional Services 20% after Deductible 20% after Deductible 15% after Deductible
Lab Low & High Tech Imaging 20% after Deductible 20% after Deductible 15% after Deductible
Inpatient Services
Inpatient Hospital Admission (Copay n addition to the deductible amount) $600 Copay per Admission, then 20% after Deductible $600 Copay per Admission, then 20% after Deductible $400 Copay per Admission, then 15% after Deductible
Inpatient Professional Services 20% after Deductible 20% after Deductible 15% after Deductible

Prescription Coverage (In-Network Coverage Only)

Plan Choices Community Blue Select Network Core HMO/PPO Buy-Up HMO/PPO
Pharmacy Deductible $50 per Person / $100 per Family $50 per Person / $100 per Family $50 per Person / $100 per Family
Pharmacy Out-of-Pocket Maximum $1,000 per Person / $2,000 per Family $1,000 per Person / $2,000 per Family $1,000 per Person / $2,000 per Family
Retail Pharmacy (30 Day Supply) Generic/Preferred Brand/Non-Preferred Brand $10 / $25 / $45 *Mail Order rates will apply after 4th fill (original + 3 refills) $10 / $25 / $45 *Mail Order rates will apply after 4th fill (original + 3 refills) $10 / $25 / $45 *Mail Order rates will apply after 4th fill (original + 3 refills)
Mail Order (90 Day Supply) Generic/Preferred Brand/Non-Preferred Brand $25 / $65 / $100 $25 / $65 / $100 $25 / $65 / $100

Your Cost for Medical and Prescription Coverage (Active Employees)

Community Blue Select Network

Monthly Premium 9, 10, and 11 Month Employees Per Payroll Deduction (20 per year) 12 Month Employees Per Payroll Deduction (26 per year)
Employee Only $46.12 $27.67 $21.29
Employee + Spouse $310.33 $186.20 $143.23
Employee + Child(ren) $234.54 $140.72 $108.25
Family $483.38 $290.33 $223.33

Core HMO/PPO

Monthly Premium 9, 10, and 11 Month Employees Per Payroll Deduction (20 per year) 12 Month Employees Per Payroll Deduction (26 per year)
Employee Only $95.71 $57.43 $44.17
Employee + Spouse $424.39 $254.63 $195.87
Employee + Child(ren) $333.72 $200.23 $154.02
Family $662.40 $397.44 $305.72

Buy-Up HMO/PPO

Monthly Premium 9, 10, and 11 Month Employees Per Payroll Deduction (20 per year) 12 Month Employees Per Payroll Deduction (26 per year)
Employee Only $209.05 $125.43 $96.48
Employee + Spouse $624.61 $374.77 $288.28
Employee + Child(ren) $512.51 $307.51 $236.54
Family $924.34 $554.60 $426.62

Your Cost for Medical and Prescription Coverage (Non-Medicare Retirees)

Community Blue (Monthly Rate) CORE HMO/PPO (Monthly Rate) Buy-Up HMO/PPO (Monthly Rate)
Employee Only $191.11 $277.05 $458.39
Employee + Spouse $401.77 $599.43 $945.74
Employee + Child(ren) $369.62 $541.50 $788.32
Family $535.61 $844.99 $1,245.46

Wellness

Employee Rates - Medical Plan

Employee Rates

2021 Medical Rates

 

 

Per Paycheck Deductions for Active Employees

 9, 10, and 11 Month Employees:
Monthly Rate X 12 months / 20 = Per Paycheck Deduction 

12 Month Employees:
Monthly Rate X 12 months / 26 = Per Paycheck Deduction

flex spending account

What is a flex Spending Account?

You can save money on your health care and/or dependent day care expenses with a Flexible Spending Account (FSA). You set aside funds each pay period on a pre-tax basis and use them tax-free for qualified expenses. You pay no federal income or Social Security taxes on your contributions to an FSA. (That’s where the savings comes in.) Your FSA contributions are deducted from your paycheck before taxes are withheld, so you save on income taxes and have more disposable income. You can contribute to your FSA through pre-tax payroll deduction up to $2,600 for Healthcare/Medical spending or up to $5,000 for Dependent Care spending. For the health plan FSA, any unused portion leftover at the end of the year will rollover to the next year. For the Dependent Care, this will not rollover. If you do not use the full amount by the end of the plan year, you will forfeit those dollars. Refer to IRS Guidelines for more information on reimbursement procedures and qualified expense specifications. During the year, participants have access to this account for reimbursement of expenses that insurance does not cover, for example:

-Deductibles, co-pays, and other eligible expenses not covered by insurance
-Prescription drugs and medical supplies
-Dietary supplements and vitamins with a doctor’s letter of medical necessity
-Dental services, orthodontics, and dentures
-Eyeglasses, contacts, solutions, and eye surgery
-Weight-loss programs (associated with a specific disease)
-Weight-loss over-the-counter drugs with doctor’s letter of medical necessity
-Chiropractic services
-Vitamins with doctor’s letter of medical necessity
-Psychiatric care and psychologist’s fees
-Smoking-cessation programs
-Smoking-cessation over-the-counter drugs
-Adult and child daycare services
-Adoption expenses

When you use tax-free dollars to pay for these expenses, you realize an increase in your spending power and substantial tax savings.

Click here for a list of additional expenses that qualify for reimbursement.

Wageworks (formally Conexis) Resources

Using your FSA
Helpful Hints
Website Navigational Guide
Enrollment Form
Dependent Care Information
Request for Reimbursement Claim Form
Request for Reimbursement Dependent Care Claim Form

Employer paid basic life & ad&d insurance

Eligibility

Employee Class One – All full-time, active employees hired prior to July 1, 2022, and working 30 or more hours per week in an eligible class are eligible for coverage on the policy effective date. A delayed effective date will apply if the employee is not actively at work.

Employee Class Two – All full-time, active employees hired after July 1, 2022, and working 30 or more hours per week in an eligible class are eligible for coverage on policy effective date. A delayed effective date will apply if the employee is not actively at work.

Employee Class Three –  Retired employees

Life Benefit

Employee Class One Employee Class Two Employee Class Three
Amount 1.5 times your annual salary rounded to the next higher $1,000 1.5 times your annual salary rounded to the next higher $1,000 $25,000
Maximum Amount $750,000 $50,000 $25,000
Guarantee Issue $250,000 $50,000 $25,000

AD&D Benefit

Employee Class One Employee Class Two Employee Class Three
Amount 1.5 times your annual salary rounded to the next higher $1,000 1.5 times your annual salary rounded to the next higher $1,000 $25,000
Maximum Amount $750,000 $50,000 $25,000
Guarantee Issue $250,000 $50,000 $25,000

Benefit Reduction

Employee Class One Employee Class Two Employee Class Three
Benefits will reduce: to $7,500 at age 70 to $7,500 at age 70 to $7,500 to age 70

Additional Benefits

Available to all classes –  Accelerated Death Benefit, Seat Belt, Airbag, Common Carrier, Conversion. 

For more information, please see the Glossary.

For assistance or additional information
Contact Lincoln Financial Group at (800) 423-2765 or email clientservices@lfg.com.

NOTE: This is not intended as a complete description of the insurance coverage offered. Controlling provisions are provided in the policy, and this summary does not modify those provisions or the insurance in any way. This is not a binding contract. A certificate of coverage will be made available to you that describes the benefits in greater details. Should there be a difference between this summary and the contract, the contract will govern.
©2008 Lincoln National Corporation

Group Insurance products are issued by The Lincoln National Life Insurance Company (Ft. Wayne, IN), which is not licensed and does not solicit business in New York. In New York, group insurance products are issued by Lincoln Life & Annuity Company of New York (Syracuse, NY). Both are Lincoln Financial Group companies. Product availability and/or features may vary by state. Lincoln Financial Group is the marketing name for Lincoln National Corporation and its affiliates. Each affiliate is solely responsible for its own financial and contractual obligations. 

voluntary life insurance

Sponsored By: East Baton Rouge Parish School System

Effective Date: January 1, 2009

Life Benefit

Choice of Package Employee Spouse Dependent
Option A: $25,000 $10,000 $2,000
Option B: $50,000 $20,000 $4,000
Option C: $100,000 $30,000 $6,000
Option D: $150,000 $40,000 $8,000
Option E: $250,000 $50,000 $10,000
Option F: $500,000 $100,000 $10,000
Employees age 70 and older, maximum benefit is $7,500 Employee must elect coverage for spouse to be eligible Six months to age 19 (to age 25 if full-time student) | $250 Child: 14 days to six months | Newborn children to 14 days are not eligible for a benefit
Guarantee Issue $250,000 under age 70 | over 70 maximum benefit is $7,500 $50,000 under employee age 60 | no guarantee issue if the employee is age 60 or older Not Applicable

Benefit Reduction

Employee Spouse Dependent
Benefits will reduce: to $7,500 at age 70 | benefits terminate at retirement unless eligible for retiree benefits to $3,500 at employee age 70 | benefits terminate at employee retirement unless eligible for retiree benefits to $750 at employee age 70

Additional Benefits

Available to all classes –  Accelerated Death Benefit, Conversion, and Portability.

For more information, please see the Glossary.

Eligibility

Employee – All full-time, active employees hired prior to July 1, 2022, and working 30 or more hours per week in an eligible class are eligible for coverage on the policy effective date. A delayed effective date will apply if the employee is not actively at work.

Spouse – Cannot be in a period of limited activity on the day coverage takes effect.

Dependent –   Cannot be in a period of limited activity on the day coverage takes effect.

Exclusion: Suicide – Benefits will not be paid if the death results from suicide within two years after coverage is effective. May apply if employee contributes toward the premium.

For assistance or additional information
Contact Lincoln Financial Group at (800) 423-2765 or email clientservices@lfg.com.

NOTE: This is not intended as a complete description of the insurance coverage offered. Controlling provisions are provided in the policy, and this summary does not modify those provisions or the insurance in any way. This is not a binding contract. A certificate of coverage will be made available to you that describes the benefits in greater details. Should there be a difference between this summary and the contract, the contract will govern.
©2008 Lincoln National Corporation

Group Insurance products are issued by The Lincoln National Life Insurance Company (Ft. Wayne, IN), which is not licensed and does not solicit business in New York. In New York, group insurance products are issued by Lincoln Life & Annuity Company of New York (Syracuse, NY). Both are Lincoln Financial Group companies. Product availability and/or features may vary by state. Lincoln Financial Group is the marketing name for Lincoln National Corporation and its affiliates. Each affiliate is solely responsible for its own financial and contractual obligations. 

Voluntary accidental death & dismemberment insurance

Benefit

Employee Only Plan Family Plan
Amount Choice of $25,000 increments. Not to exceed ten times annual salary. Choice of $25,000 increments. Not to exceed ten times annual salary. Spouse: 50% of the employee benefit (Spouse and employee covered) Each Child: 15% of employee benefit (Children and employee covered) Spouse + Each Child: Spouse 40% and Child 10% of the employee benefit (Spouse, children and employee covered)
Minimum Amount $25,000 $25,000
Maximum Amount $250,000 $250,000
Guarantee Issue Not applicable Not applicable

Benefit Reduction

Employee Spouse
Benefits will reduce: 35% at age 70. An additional 25% of original amount at age 75; An additional 15% of original amount at age 80 Benefits terminate at retirement. Benefits terminate at Spouse age 70 or Employee retires, whichever occurs first.

Eligibility

Employee – All full-time, active employees hired prior to July 1, 2022, and working 30 or more hours per week in an eligible class are eligible for coverage on the policy effective date. A delayed effective date will apply if the employee is not actively at work.

Spouse – Cannot be in a period of limited activity on the day coverage takes effect.

Dependent –   Cannot be in a period of limited activity on the day coverage takes effect.

Exclusion: Suicide – Benefits will not be paid if the death results from suicide within two years after coverage is effective. May apply if employee contributes toward the premium.

East Baton Rouge Parish School System - Employee Monthly Premium

Accidental Death and Dismemberment premium for sample benefit amounts

Refer to Program Specifications for your maximum benefit amounts.
Benefits and premium amounts reflect age reductions.

Age Monthly Rate per $1,000 $25,000 $50,000 $75,000 $100,000 $125,000 $150,000 $175,000 $200,000 $225,000 $250,000
<70 $0.017 $0.43 $1.75 $2.63 $3.50 $4.38 $5.25 $6.13 $7.00 $7.88 $8.75
70-74 $0.017 $16,250 $32,500 $48,750 $65,000 $81,250 $97,500 $113,750 $130,000 $146,250 $162,500
$0.28 $0.55 $0.83 $1.11 $1.38 $1.66 $1.93 $2.21 $2.49 $2.76
75-79 $0.017 $10,000 $20,000 $30,000 $40,000 $50,000 $60,000 $70,000 $80,000 $90,000 $100,000
$0.17 $0.34 $0.51 $0.68 $0.85 $1.02 $1.19 $1.36 $1.53 $1.70
80+ $0.017 $6,250 $12,500 $18,750 $25,000 $31,250 $37,500 $43,750 $50,000 $56,250 $62,500
$0.11 $0.21 $0.32 $0.43 $0.53 $0.64 $0.74 $0.85 $0.96 $1.06

East Baton Rouge Parish School System - Family Monthly Premium

Accidental Death and Dismemberment premium for sample benefit amounts

Refer to Program Specifications for your maximum benefit amounts.
Benefits and premium amounts reflect age reductions.

Age Monthly Rate per $1,000 $25,000 $50,000 $75,000 $100,000 $125,000 $150,000 $175,000 $200,000 $225,000 $250,000
<70 $0.037 $0.93 $1.85 $2.78 $3.70 $4.63 $5.25 $6.48 $7.40 $8.33 $9.25
70-74 $0.037 $16,250 $32,500 $48,750 $65,000 $81,250 $97,500 $113,750 $130,000 $146,250 $162,500
$0.60 $1.20 $1.80 $2.41 $3.01 $3.61 $4.21 $4.81 $5.41 $6.01
75-79 $0.037 $10,000 $20,000 $30,000 $40,000 $50,000 $60,000 $70,000 $80,000 $90,000 $100,000
$0.37 $0.74 $1.11 $1.48 $1.85 $2.22 $2.59 $2.96 $3.33 $3.70
80+ $0.037 $6,250 $12,500 $18,750 $25,000 $31,250 $37,500 $43,750 $50,000 $56,250 $62,500
$0.23 $0.46 $0.69 $0.93 $1.16 $1.39 $1.62 $1.85 $2.08 $2.31

This is an estimate of premium cost. Actual deductions may vary slightly due to rounding and payroll frequency.

Example: Use this formula to calculate premium for benefit amounts over $250,000.

Monthly Rate Per $1,000 x Benefit In $1,000’s = Monthly Cost

Example: $0.037 x 300 = $11.10/month

For assistance or additional information
Contact Lincoln Financial Group at (800) 423-2765 or email clientservices@lfg.com.

NOTE: This is not intended as a complete description of the insurance coverage offered. Controlling provisions are provided in the policy, and this summary does not modify those provisions or the insurance in any way. This is not a binding contract. A certificate of coverage will be made available to you that describes the benefits in greater details. Should there be a difference between this summary and the contract, the contract will govern.
©2008 Lincoln National Corporation

Group Insurance products are issued by The Lincoln National Life Insurance Company (Ft. Wayne, IN), which is not licensed and does not solicit business in New York. In New York, group insurance products are issued by Lincoln Life & Annuity Company of New York (Syracuse, NY). Both are Lincoln Financial Group companies. Product availability and/or features may vary by state. Lincoln Financial Group is the marketing name for Lincoln National Corporation and its affiliates. Each affiliate is solely responsible for its own financial and contractual obligations. 

voluntary long-term disability insurance

Summary of Benefits |  Sponsored by: East Baton Rouge Parish School System

Long-term disability is intended to protect your income for a long duration after you have depleted short-term disability or any sick leave your company may offer.

 Eligibility – All full-time active employees working 30 or more hours per week in an eligible class are eligible for coverage.

Maximum Monthly Benefit – 60% of salary up to $10,000 per month rounded to the nearest $1

Maximum Benefit Duration –  Reducing benefit Duration / Age 65

Own Occupation Period –  24 months

Elimination Period – 180 days; the umber of days you must b disable prior to collecting disability benefits

Accumulation of Elimination Days – You can satisfy the days of your elimination period with either total (off work entirely) or partial (working some hours at your current job) disability. If you are  working on a partial basis, you will have 2x the elimination period days to satisfy the total of 180 days.

Pre-Existing Condition – You may not be eligible for benefits if you have received treatment for a condition within the past 12 month until you have been covered under this plan for 24 months or if you remain treatment free for a period of 12 consecutive months.

Waiver of Premium – You will not be required to pay premium during any time of approved total or partial disability.

Survivor Income Benefit – A survivor benefit may be paid to your beneficiary if you should die while receiving qualifying disability payments.

EmployeeConnectSM – Access to an employee assistance program for the employee or an immediate household family member who may be experiencing personal or workplace issues.

Benefit Limitations – Mental illness: 24 months; substance abuse: no limit; specified illness: no limit

Portability – If your employment is terminated for any reason other than retirement, disability, or a leave of absence, you can keep your current LTD coverage at the same rate for up to 12 months. Your current coverage must have been in force for at least 12 months.

Bi-Weekly Rates

Age <30 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-80
Rate 0.00091 0.00108 0.00136 0.00195 0.00289 0.00436 0.00540 0.00549 0.00587 0.00732 0.01049

Rates (Based on 20 Pay Periods)

Age <30 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-80
Rate 0.00119 0.00141 0.00177 0.00254 0.00376 0.00566 0.00703 0.00712 0.00763 0.00951 0.01364

Monthly Premium Calculation

Your Monthly Salary* x Premium Factor = Monthly Cost

*Maximum covered payroll is $16,667 monthly.

This is an estimate of premium cost. Actual deductions may vary slightly due to rounding and payroll frequency.

Understanding Your Benefits

Own Occupation – The occupation trade or profession you were employed in prior to your disability as defined by the US DOL Dictionary of Occupational Titles.

Total Disability – You are considered totally disabled if, due to an injury or illness, you are unable to perform each of the main duties of your own occupation. Your “own” occupation is covered for a specific period of time. Following this, the definition of total disability becomes the inability to perform any occupation for which you are reasonably suited based on your experience, education, or training.

Partial Disability – You are considered partially disabled if you are unable, due to an injury or illness, to perform the main duties of your regular occupation on a full-time basis. Partial disability benefits may be payable if you are earning at least 20% of the income you earned prior to becoming disabled, but not more than 99%. Partial disability benefits allow you to work and earn income from your employer as well as continue to receive benefits, which may enable you to receive 100% of your income during your time of disability.

Continuation of Disability – If you return to work full-time but become disabled from the same disability within six-months of returning to work, you will begin receiving benefits again immediately.

Benefit Duration Reduction – Your benefit duration may be reduce if you become disabled after age 65.

Pre-Existing Condition – Any sickness or injury for which you have received medical treatment, consultation, care, or services (including diagnostic measures or the taking of prescribed medications) during the specified months prior to the coverage effective date. A disability arising from any such sickness or injury will be covered only if it begins after you have performed your regular occupation of a full-time basis for the specified months following the coverage effective date, unless no treatment was received for the specified consecutive months after the coverage effective date.

Benefit Exclusions – You will not receive benefits in the following circumstances:

  • Your disability is the result of a self-inflicted injury
  • You are not under the regular care of a doctor when requesting disability benefits
  • You were involved in a felony commission, act or war, or participation in a riot


Benefit Reductions – 
Your benefits may be reduced if you are receiving benefits from any of the following sources: 

  • Any compulsory benefit act or law (such as state disability plans)
  • Any governmental retirement system earned as a result of working for the current policy holder
  • Any disability or retirement benefit received under a retirement plan
  • Any Social Security or similar plan or act, benefits
  • Earnings the insured earns or receives from any form of employment
  • Workers compensation
  • Salary continuance or employer contributions to an employer sponsored retirement plan


Benefit Termination – 
This coverage will terminate when you terminate employment with this policyholder, or at your retirement.

For assistance or additional information
Contact Lincoln Financial Group at (800) 423-2765 or email clientservices@lfg.com.

NOTE: This is not intended as a complete description of the insurance coverage offered. Controlling provisions are provided in the policy, and this summary does not modify those provisions or the insurance in any way. This is not a binding contract. A certificate of coverage will be made available to you that describes the benefits in greater details. Should there be a difference between this summary and the contract, the contract will govern.
©2008 Lincoln National Corporation

Group Insurance products are issued by The Lincoln National Life Insurance Company (Ft. Wayne, IN), which is not licensed and does not solicit business in New York. In New York, group insurance products are issued by Lincoln Life & Annuity Company of New York (Syracuse, NY). Both are Lincoln Financial Group companies. Product availability and/or features may vary by state. Lincoln Financial Group is the marketing name for Lincoln National Corporation and its affiliates. Each affiliate is solely responsible for its own financial and contractual obligations. 

Voluntary Short-Term Disability Insurance - Specialty Worksite​

Summary of Benefits |  Sponsored by: East Baton Rouge Parish School System |  Effective Date: January 1, 2009

Short-term disability is intended to protect your income for a short duration in case you become ill or injured.

Eligibility – All full-time active employees working 25 or more hours per week in an eligible class are eligible for coverage.

Maximum Monthly Benefit – 60% of weekly salary up to $1,000 per month

Maximum Benefit Duration –  26 weeks

Elimination Period – Benefits begin on the 8th day from an accident or 8th date from an illness

Pre-Existing Condition – You may not be eligible for benefits if you have received treatment for a condition within the past three months until you have been covered under this plan for six months

Waiver of Premium – You will not be required to pay premium during any time of approved total or partial disability.

Enrollment –  You are able to take advantage of this coverage now without a health examination. You may not be offered this opportunity again until your annual open enrollment.

Integration of Benefits – The benefits from this policy will be reduced by benefits you may receive through state disability or your employers sick pay plan.

Understanding Your Benefits

Total Disability – You are considered totally disabled if, due to an injury or illness, you are unable to perform each of the main duties of your own occupation. Your “own” occupation is covered for a specific period of time. Following this, the definition of total disability becomes the inability to perform any occupation for which you are reasonably suited based on your experience, education, or training.

Partial Disability – You are considered partially disabled if you are unable, due to an injury or illness, to perform the main duties of your regular occupation on a full-time basis. Partial disability benefits may be payable if you are earning at least 20% of the income you earned prior to becoming disabled, but not more than 99%. Partial disability benefits allow you to work and earn income from your employer as well as continue to receive benefits, which may enable you to receive 100% of your income during your time of disability.

Continuation of Disability – If you return to work full-time but become disabled from the same disability within six-months of returning to work, you will begin receiving benefits again immediately.

Benefit Duration Reduction – Your benefit duration may be reduce if you become disabled after age 65.

Pre-Existing Condition – Any sickness or injury for which you have received medical treatment, consultation, care, or services (including diagnostic measures or the taking of prescribed medications) during the specified months prior to the coverage effective date. A disability arising from any such sickness or injury will be covered only if it begins after you have performed your regular occupation of a full-time basis for the specified months following the coverage effective date, unless no treatment was received for the specified consecutive months after the coverage effective date.

Benefit Exclusions – You will not receive benefits in the following circumstances:

  • Your disability is the result of a self-inflicted injury
  • You are not under the regular care of a doctor when requesting disability benefits
  • Your disability is covered under a workers compensation plan and/or is due to a job-related sickness or injury
  • You are receiving payment under a salary continuance or retirement plan sponsored by the group policyholder


Benefit Reductions – 
Your benefits may be reduced if you are receiving benefits from any of the following sources: 

  • Any governmental retirement system earned as a result of working for the current policyholder
  • Any disability or retirement benefit received under a retirement plan
  • Any Social Security or similar plan or act, benefits
  • Earnings the insured earns or receives from any form of employment


Benefit Termination – 
This coverage will terminate when you terminate employment with this policyholder, or at your retirement.

For assistance or additional information
Contact Lincoln Financial Group at (800) 423-2765 or email clientservices@lfg.com.

NOTE: This is not intended as a complete description of the insurance coverage offered. Controlling provisions are provided in the policy, and this summary does not modify those provisions or the insurance in any way. This is not a binding contract. A certificate of coverage will be made available to you that describes the benefits in greater details. Should there be a difference between this summary and the contract, the contract will govern.
©2008 Lincoln National Corporation

Group Insurance products are issued by The Lincoln National Life Insurance Company (Ft. Wayne, IN), which is not licensed and does not solicit business in New York. In New York, group insurance products are issued by Lincoln Life & Annuity Company of New York (Syracuse, NY). Both are Lincoln Financial Group companies. Product availability and/or features may vary by state. Lincoln Financial Group is the marketing name for Lincoln National Corporation and its affiliates. Each affiliate is solely responsible for its own financial and contractual obligations. 

dental

Highlights

As a valued employee of East Baton Rouge Parish School system, you have the opportunity to enroll in one of two dental plans: Silver Plan or Gold Plan. This voluntary benefit is offered through AlwaysCare/UNUM and allows you to seek treatment from the dentist of your choice; however, it is always beneficial to use a provider within the network. To find a network provider, visit www.alwayscarebenefits.com or call 1-888-400-9304.

Details

Gold Dental Plan | Benefits Summary and Rates Brochure
Gold Dental Plan | Carryover Benefits
Silver Mac Plan | Benefits Summary and Rates Brochure

Forms

Notice of Privacy Practices
Grievance Request Form
Printable Dental Claim Form
Printable Enrollment Form

Vision

Critical Illness and Cancer

Highlights

You may know people who have been affected by a critical illness such as cancer, stroke or heart attack, and witnessed the impact it had on their quality of life. Are you prepared if a critical illness were to happen to you? Critical Illness insurance can help you when you need it the most. It provides a valuable benefit should you or your family be faced with bills resulting from a critical illness. This benefit is in addition to your medical insurance. It helps fill the financial gaps left by deductibles, coinsurance and other out-ofpocket expenses.

Please contact the Benefits Department for more information about this benefit.

Accident expense insurance

Highlights

Even minor accidents can leave you with major expenses. When accidents happen, they are often followed by a number of bills. Are you prepared? Accident Expense insurance plan pays a cash benefit directly to you in addition to any other benefit or insurance you receive. Even with medical insurance, you still have to meet deductibles and pay for coinsurance. There may be additional costs due to emergency room fees, x-rays, follow-up care and other uncovered services. This plan can help you pay for these and other covered expenses. EBR Schools gives you the option of 2 accident policies. For example, accidents as a result of these activities may be covered by this policy: Football, Baseball, Basketball, Soccer, Tennis, Volleyball, Paintball, Mountain Biking, Motorcycle Riding, Cheerleading, Skateboarding, Automobile Accidents, Hunting, and Boxing.

Please contact the Benefits Department for more information about this benefit.

Hospital indemnity

Highlights

A hospital stay can be financially difficult, especially if money is tight and you’re not prepared. Hospital Indemnity coverage will pay you in the event you or a covered family member needs to stay in the hospital. Metlife pays these benefits directly to you and you can use them however you wish — for medical bills, rent or mortgage, living expenses, etc. Hospital Indemnity can help you absorb the financial impact of a hospital stay without busting your budget. You can purchase coverage for you, your spouse, and children. EBR Schools gives you the option of 2 hospital policies.

Please contact the Benefits Department for more information about this benefit.

glossary

Accelerated Death Benefit – Accelerated Death Benefit provides an option to withdraw a percentage of your life insurance when diagnosed as terminally ill (as defined in the policy). The death benefit will be reduced by the amount withdrawn. To qualify, you have satisfied the Active Work rule and have been covered under this policy for the required amount of time as defined by the policy. Check with your tax advisor or attorney before exercising this option.

AD&D – Accidental Death and Dismemberment (AD&D) insurance provides specified benefits for a covered accidental bodily injury that directly causes dismemberment (e.g., the loss of a hand, foot, or eye). In the event that death occurs from a covered accident, both the life and the AD&D benefit would be payable.

Conversion – If you terminate your employment or become ineligible for this coverage, you have the option to convert all or part of the amount of coverage in force to an individual life policy on the date of termination without Evidence of Insurability. Conversion election must be made within 31 days of your date of termination.

Guarantee Issue – For timely entrants enrolled within 31 days of becoming eligible, the Guarantee Issue amount is available without any Evidence of Insurability requirement. Evidence of Insurability will be required for any amounts above this, for late enrollees or increase in insurance and it will be provided at your own expense.

Limited Activity – A period when a spouse or dependent is confined in a health care facility; or, whether confined or not, is unable to perform the regular and usual activities of a healthy person of the same age and sex.

Portability – If coverage has been in force for at least 12 months, you may continue coverage for a specified period of time after your employment by paying the required premium. Portability is available if you cease employment for a reason other than total disability. A written application must be made within 31 days of your termination.

Seat Belt, Airbag, Common Carrier – If you die as a result of a covered auto accident while wearing a seat belt or in a vehicle equipped with an airbag, benefits are payable up to $10,000 or 10% of the principal sum, whichever is less. If loss occurs for you due to an accident while riding as a passenger in a common carrier, benefits will be double the amount that would otherwise apply as outlined in the certificate.

Term Life – Coverage provided to the designated beneficiary upon the death of the insured. Coverage is provided for the time period that you are eligible and premium is paid. There is no cash value associated with this product.

BeneficiaryConnect – Support services for beneficiaries who have experienced a loss.

TravelConnect – Travel assistance services for employees and eligible dependents traveling more than 100 miles from home.

Employee Assistance program (eap)

The Employee Assistance Program (EAP) is a free service to all full time employees of East Baton Rouge Parish School System. The EAP provides confidential assistance to employees who are experiencing difficulty dealing with personal and work related problems that affect their lives. No enrollment is necessary and all contacts with the EAP are strictly confidential.

 

The EAP can provide assistance with problems such as:

    • Stress
    • Depression
    • Substance or alcohol abuse
    • Marital or family problems
    • Problems with children & adolescents
    • Gambling addiction
    • Financial Issues
    • Legal Issues
    • Grief and loss
    • Job performance or work related issues

OptumHealth Behavioral Solutions welcomes your questions and inquiries please contact
OptumHealth Behavioral Solutions 1-866-374-6062
www.liveandworkwell.com
(password: EBRPSS)

Open Enrollment

Each year, employees are allowed to add, remove, or change current benefit elections during the the Annual Open Enrollment Period. This period is during the month of October beginning with the first business day of the month and ending at 4:30pm on the last business day of the month.

retiree information

Life

On August 27, 20212, the Board voted and approved a change to the basic life insurance benefit for retirees. Beginning January 1, 2013, all retiree basic life insurance for those under age 70 will be capped at  $25,000 until the retirees turn age 70. At the age of 70, the benefit reduces to $7,500. For retirees over the age of 70, there is no change to the $7,500 life insurance benefit. Retirees should maintain current beneficiary information with EBRPSS Department of Benefits. 

Medicare

Retired participants of the EBRPSS medical plans and their covered spouses, who reach age sixty-five (65) on or after June 1, 2005, must enroll in Medicare Parts A and B in order for their claims to be paid under this Plan. If a retired participant or covered spouse is eligible forMedicare, but not enroll for Parts A and B, the claims of the person eligible for Medicare will be denied.

There are three (3) times when retirees can sign up for Medicare Part B:

    1. Initial Enrollment Period (when you turn 65)
    2. General Enrollment Period (January 1st through March 31st each year)
    3. Special Enrollment Period (waited to enroll in Part B because you were still working full-time with EBRPSS)

Retirees not eligible for Medicare may continue the EBRPSS plan. However, the premium structure in future years will reflect a non-Medicare rate. 

Additional information can be obtained at the Medicare Website: Medicare.gov

1095-C

2016 – 1095C Information

1095C FAQs

2015 – 1095C Information

1095C FAQs

Sample 1095C with Definitions

Correction Request Form

403B/457 Plans

If you are a full time employee with EBRPSS, you are eligible to participate in a voluntary 403B or 457 Plan. EBRPSS does not contribute to these plans. It is 100% employee contributions. 

What is a 403B Plan?

A 403B Plan is a tax-deferred retirement plan available to employees of public educational institutions and certain tax-exempt organizations. A 403B Plan allows you to make pre-tax contributions by convenient payroll reduction and save that money for your retirement.

What is a 457 Plan?

A 457 Plan is a type of deferred pay compensation plan. contributions are made on a pre-tax basis. 

Contact Valic

Josh Yankowsky is the account representative for EBRPSS. He can assist with enrolling, making changes, stopping deductions, as well as answering any questions about IRS defined rules and regulations. His contact information can be found below:

Phone: (225) 288-0537
Email: Josh.Yankowsky@valic.com

FAQs

I never received my dental and vision cards, where can I get a copy of them?

Members can print ID cards, locate providers, view claims, and more on www.AlwaysAssist.com

How can I get a copy of my BlueCross BlueShield Louisiana insurance cards?

Members can get a copy of their BCBSLA insurance cards by going to www.BCBSLA.com

What are the qualifying events that allow for benefit changes outside of open enrollment?

Birth, adoption, legal custody, death, marriage, divorce, gain/loss of coverage 

I have a qualifying event and need to add/drop someone to/from my insurance, what do I need to do?

The employee has 30 days to notify EBRPSS of the event. For example, an employee married on November 12, 2022 must notify EBRPSS by December 12, 2022 if they will to add their new spouse to the EBRPSS line of coverage. Any notification beyond thirty days will not be allowed and the employee will have to wait until the next Open Enrollment period to make changes. Please fill out this form and bring any supporting documentation required to the Department of Benefits.

If I resign at the end of the year, when will my insurance coverage end?

In most cases, all active coverage ends in the month in which the employee is terminated. The only exception is if the employee works until the end of the school, then the coverage would remain active until August 31st of the same year.

One of my dependents passed away, what do I need to do?

To submit a Life Insurance claim, please follow these instructions:

1. Notify EBRPSS of the death
2. Submit the employer statement, death certificate, beneficiary statement, and benefits confirmation to Lincoln

If there is no beneficiary listed in either scenario, a preferential beneficiary form may be completed. This form may be used if the beneficiary on file is deceased and proof of death has been received by EBRPSS. 

I need to make a claim for LTD/STD, where can I find the form?

Long-Term Disability Form
Short-Term Disability Form

Contact

I Need To...

  • Enroll in benefits
  • confirm payroll deduction for benefits
  • Verify approval of Evidence of Insurability (EOI) forms I’ve submitted for coverage
  • Change my address
  • Update my personal information

Contact EBR Schools Benefits Department

(225) 922-5680
Monday – Friday | 8:30 AM – 4:00 PM
(excluding holidays)

  • Learn about each benefit plan
  • Find in-network providers
  • Get help with a claim
  • Order ID cards

Contact EBR Schools Benefit Advocate Center 

(883) 940-3885
Monday – Friday | 8:00 AM – 6:00 PM

  • Ask specific questions about services covered by my plan
  • Request an ID card
  • Request a provider directory if my plan includes one
  • Check the status of a claim
  • Pre-authorize certain types of care if my plan requires it

Contact Your Benefit Plan Service Provider
(See List Below)

EBRPSS Benefits Department

Sheila Bradley, Benefits Supervisor – SBradley@ebrschools.org | (225) 922-5441

Anita Williams, Benefit Specialist II – AWilliams25@ebrschools.org | (225) 922-5433

Frenisha Williams, Benefits Specialist I – FWilliams4@ebrschools.org | (225) 922- 5680

Benefit Plan Service Providers

Additional information can be obtained from the Member Services departments of each vendor or from the vendor website.

Benefit Advocate Center bac.ebrpschools@ajg.com | (833) 940-3885

Blue Cross  www.bcbsla.com | (888) 226-2583

Express Scripts (Pharmacy) www.express-scripts.com | (800) 711-0917

Employee Assistance Program (UBH)  www.liveandworkwell.com | (866) 374-6062

Mental Health www.bcbsla.com | (800) 991-5638

AlwaysCare – Dental and Vision www.alwayslife.com | (888) 729-5433

Lincoln Financial  www.lincolnfinancial.com | (800) 423-2765

Joshua Yankowsky (Valic) josh.yankowsy@valic.com | (225) 288-0537

Humana Customer Service www.humana.com | (866) 396-8810

East Baton rouge Enhanced Benefits – Corestream www.EBRPSS.corestream.com | (225) 341-3899

The East Baton Rouge Parish School System and all of its entities (including Career and Technical Education Programs) do not discriminate on the basis of age, race, religion, national origin, disability, or gender in its educational programs and activities (including employment and application for employment), and it is prohibited from discriminating on the basis of gender by Title IX (20 USC 168) and on the basis of disability by Section 504 (42 USC 794). The Title IX Coordinator is Andrew Davis, Director of Risk Management – ADavis6@ebrschools.org, (225) 929-8705, https://ebrschools.org/departments/federal-programs/title-ix/. The Section 504 Coordinator is Danielle Staten – DStaten@ebrschools.org, (225) 326-5668.

Copyright © 2022 East Baton Rouge Parish School System | All Rights Reserved