Nurses Etc. Staffing SCA Benefits Funding
• NES has contracted with FCE Benefits to administer
the Service Contract Act (SCA) employee Health &
Welfare Benefit Plan (the Plan)
– FCE is a specialist in the management of benefits
programs for government contractors
• NES employees working on an SCA-covered contract
are eligible for a benefits program valued at the SCA
fringe hour rate as stipulated in the Area Wage
Determination applicable to the worksite you are
assigned
Nurses Etc. Staffing SCA Benefits Funding
• For each hour you are paid, up to 40 hours per
week, including paid holidays and vacation, a
matching fringe hour amount will be deposited by
the Plan Trust for the purchase and administration
of your benefits
• The maximum fringe paid hours per year is 2,080
Nurses Etc. Staffing SCA Benefits Formula
• After your fringe paid hours are reported and funded
into the Plan, those hours are posted to your account
and FCE calculates which of the four benefit classes
you qualify for based on your 13-week rolling average
• Your class is recalculated with each cycle of fringe
paid hours reported and funded into the Plan using the
most recent 13 weeks of hours in the system.
• The Plan utilizes a 13-week rolling
average to provide stability in your
level of class of benefits
Nurses Etc. Staffing SCA Benefits Employee Classes
• Class I If you average 1 to 15 fringe paid hours per week
• Class II If you average 16 to 22 fringe paid hours per week
• Class III If you average 23 to 29 fringe paid hours per week
• Class IV If you average 30 to 40 fringe paid hours per week
The NES SCA Benefits Program has four classes to
provide all employees a set of Core and Medical Benefits
regardless of their average weekly work schedule:
Nurses Etc. Staffing SCA Benefits Core Benefits
• Group Term Life
• Accidental Death & Dismemberment
• Dental Care (orthodontia for children under 19)
• Vision Care
• Weekly Disability
• Outpatient Diagnostic Studies
• Retirement Plan Contribution
• Employee Assistance Program (EAP)
All SCA employees will have a core set of NES-paid
benefits based on your class. Please refer to your SCA
Health & Welfare Benefit Plan Summary for details.
The Core Benefits Plan includes:
Nurses Etc. Staffing SCA Benefits Medical & Rx Benefits
All employees will have one of two types of NES-paid
Medical Benefits based on your class:
• Classes I through III Indemnity Medical Benefits
• Class IV Major Medical Benefits
Nurses Etc. Staffing SCA Benefits Indemnity Benefits
The First Health PPO medical plan provides coverage for:
• Office visits and outpatient care
• Inpatient hospitalization, emergency care and
surgical services
• Prescription drugs
Indemnity Medical Plan for employees in Classes I through III
The Indemnity plan pays a scheduled, fixed dollar amount
per covered service, regardless of expenses incurred. For
example, if the benefit plan pays $1,000 per event, it will pay
this amount regardless of whether the bill is $500 or $1,500
Nurses Etc. Staffing SCA Benefits Major Medical Benefits
The Cigna PPO medical plan provides coverage for:
• Office visits and outpatient care
• Inpatient hospitalization, surgical services,
emergency care and urgent care
• Prescription drug copayments and discount mail
order service
Major Medical Plan for Class IV employees
The plan includes an in- and out-of-network annual plan
deductible, $30 copay for in-network office visit with
doctors and specialists, and employee coinsurance for
specific services
Nurses Etc. Staffing SCA Benefits Waiving Coverage
• Employees with qualifying medical coverage may elect
to waive or decline medical coverage and have the
portion that would have been used to pay for medical
coverage allocated into their 401(k)
• In order to waive medical coverage you must complete
the medical waiver form and provide evidence you
have current and effective coverage through another
qualified medical plan
• Qualified medical coverage is limited to
employer-sponsored group health plans
and TRICARE
Nurses Etc. Staffing SCA Benefits Waiving Coverage (cont’d)
• Medicare, Medicaid and VA medical plans are not considered qualified medical plans
• Individually secured medical insurance plans are not considered qualified medical plans
• Medical discount plans are not considered qualified medical plans
• You cannot waive the Core Benefits plan (group term life, AD&D, vision, dental, disability, etc.)
• You may add your eligible dependents to the Core Benefits plan at no additional cost to you
• If you add your eligible dependents to the Core Benefits plan, you will receive a lower level of coverage for your family
Nurses Etc. Staffing SCA Benefits Dependent Benefits
Dependent Benefits for Part-Time employees
• All employees in classes I through III may elect to
have their fringe hour amounts used to purchase
benefits for both themselves and their eligible
dependents
• In exchange for this option, the employee will have a
lesser degree of coverage for him or herself, but enjoy
coverage for the entire family
• Some Core Benefits provide coverage for
employees only this includes, but is not
limited to, the Weekly Disability Benefit
Nurses Etc. Staffing SCA Benefits Dependent Benefits
Dependent Benefits for Full-Time employees
• All class IV employees may choose to add their
eligible dependents to one of two types of medical
coverage, but must pay for it through payroll
deductions
• The regular-cost coverage plan includes only Major
Medical and Prescription Drug coverage for your
eligible dependents
• The low-cost coverage plan includes a level of Core
Benefits plus Indemnity Medical and Prescription Drug
coverage
Nurses Etc. Staffing SCA Benefits Eligibility
Who is Eligible to Enroll
• All NES employees who work on an SCA contract
are eligible for the SCA employee Health & Welfare
Benefit Plan
• SCA-covered positions include both part-time and
full-time employees
• Who else is eligible? Eligible dependents of NES
employees working on SCA-covered positions
Nurses Etc. Staffing SCA Benefits Eligibility
Which Dependents are Eligible to Enroll
• Legal spouse Documentation required if last name is different
• Common law spouse Documentation required
• Domestic partners and their children Documentation required
• Dependent children Up to age 26 and uninsured;
documentation required if last name is different
Please note: Life insurance coverage requirements are
different from the other Core and Medical coverage limits in
that dependents 21 years or older will have to prove enrollment
in a college or university on a full-time basis.
Nurses Etc. Staffing SCA Benefits Effective Date
When Benefits Begin
Employee benefits begin on the first of the month following one
month of continuous employment in an SCA-covered position:
July 8:
Employee begins work with NES
August 8:
Employee completes 1 month of service with NES
September 1:
Employee benefit coverage is effective
Nurses Etc. Staffing SCA Benefits Effective Date
When Dependent Benefits Begin
Dependent benefits begin on the first of the month following two full
pay period deductions for coverage, if all documentation is received
by the close of your 31-day enrollment period. Below is an example of
how a dependent can have the same effective date as the employee
July 8: Employee
begins work with NES
July 26:
(at least four business days before
end of month of hire)
Employee completes benefits enrollment
for dependent coverage and
provides FCE with proper dependent
documentation
August 1: First premium payment for dependent coverage (8/1 to 8/15 pay period)
August 16:
Second premium payment for dependent coverage
(8/16 to 8/31 pay period)
Sept 1: Dependent
benefit coverage is
effective
Nurses Etc. Staffing SCA Benefits Effective Date
When Dependent Benefits Have a Different Effective Date
Following is an example of when a dependent will not have the
same effective date as the employee:
July 8: Employee
begins work with NES
July 29:
(three business days before end of month of hire or later thru Day
31)
Employee completes benefits
enrollment for dependent
coverage and provides FCE with proper dependent
documentation
September 1: First premium payment for dependent coverage (9/1 to 9/15 pay period)
September 16:
2nd premium payment for dependent coverage
(9/16 to 9/30 pay period)
October 1: Dependent
benefit coverage is
effective
Nurses Etc. Staffing SCA Benefits Enrollment
The Enrollment Process
• You have a 31-day enrollment period from your date
of hire to complete and submit the Enrollment Form,
Waiver of Medical Benefits Form (if applicable) and
Payroll Deduction Form (if full-time), and selecting
dependent coverage
• If you do not submit the required forms within 31 days
you will be defaulted into employee-only coverage
and an ID card will be issued
• If additional documentation is required to verify
dependent eligibility, it must be submitted within 31
days of your initial enrollment application date or the
coverage is defaulted back to employee-only
Nurses Etc. Staffing SCA Benefits Enrollment
Changes in Enrollment
• You can change your benefits annually during NES’
Open Enrollment period
• Other changes may be allowed if you experience a
qualified life event (QLE) such as marriage, divorce,
birth, or death
– Supporting documentation and forms are required within 31
days of the event
• All QLEs must be reported directly to
FCE within 31 days of the qualified life
event date
Nurses Etc. Staffing SCA Benefits Dependent Coverage
Dependent Coverage for the Low-Cost Indemnity Plan
Employees who work an average of 30 or more hours per week and
who elect Major Medical dependent coverage, may pay for low-cost
Indemnity Medical dependent coverage through payroll deductions.
Following are the rates as of August 1, 2013:
employee + Spouse $70.87 per paycheck
employee + Child(ren) $26.81 per paycheck
employee + Family $80.72 per paycheck
Nurses Etc. Staffing SCA Benefits Dependent Coverage
Dependent Coverage for the Major Medical Plan
Employees who work an average of 30 or more hours per week
and who elect Major Medical dependent coverage, may pay for
regular-cost Major Medical dependent coverage through payroll
deductions.
Following are the rates as of August 1, 2013:
employee + Spouse $196.97 per paycheck
employee + Child(ren) $148.81 per paycheck
employee + Family $340.51 per paycheck
Nurses Etc. Staffing SCA Benefits Employment
Should You Leave NES
• Benefits coverage will continue until the end of the
month during which you terminate employment
• You will be offered COBRA to continue your medical
insurance at premium cost plus a small administrative
fee at your own expense
• Please contact FCE at 800-899-WELL (9355) for
information about COBRA
• Life insurance can either be “ported”
or converted to an individual policy
Nurses Etc. Staffing SCA Benefits Questions
Contact FCE Benefits at 800-899-WELL (9355) with any questions!
You can find Frequently Asked Questions regarding the NES SCA
employee Health & Welfare Benefit Plan by referring to the FAQ
found within your enrollment kit.
? You can get the most complete and detailed
explanation of your benefits by reading the
Summary Plan Description (SPD) Booklet
found within your kit.
Please note that any differences or
conflict between the information in this
presentation and the terms and definitions
of the certificate will be resolved in favor
of the certificate.
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