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ARCHDIOCESE OF KANSAS CITY
IN KANSAS
2008 EMPLOYEE BENEFIT GUIDE
ELIGIBILITY FOR BENEFITS
Employees who work an average of 30 hours per week for the school or calendar year may apply for Health, Dental,
Voluntary Vision, Life and Disability Insurance benefits. You must elect or decline coverage by completing the necessary
forms within 31 days of hire or eligible change. Health, Dental and Vision coverage is effective the first day of the
following month after the form is completed. Basic Life and Disability Package and Supplemental Life benefits take effect
on the date you sign the enrollment form. The plan year for benefits is the calendar year January 1 - December 31, 2008.
HEALTH CARE PLAN AND PRESCRIPTION DRUGS
Health Care benefits are self-funded by the Archdiocese and claims are administered by The Epoch Group. The Health
Care Plan offers you the flexibility to seek treatment from in-network and out-of-network providers. When you use
in-network providers, you receive the maximum benefits of the plan. The chart below highlights your Health Care benefits
for 2008. Your employer pays a portion of the Health Care cost.
| Services |
In-Network |
Out-of-Network |
| Physician Visits |
$25 copay |
After your deductible, plan pays 60% |
Deductible (in and out-of-network are shared)
Individual
Family |
$400
$800 |
$400
$800 |
| Hospitalization - Catholic Hospitals |
$100 copay, then plan pays 90% after deductible |
| Hospitalization - non-Catholic Hospitals |
$100 copay, then plan pays 80%
after deductible |
$100 copay, then plan pays 60%
after deductible |
| Pre-Admission Review |
Required prior to admission. $200 penalty per occurrence if not obtained. |
| Emergency Room |
$75 copay, then plan pays 80%
after deductible |
$75 copay, then plan pays 60%
after deductible |
| Wellness Benefits - Routine Care |
100% up to $250 per person,
then plan pays 80% after deductible |
100% up to $250 per person,
then plan pays 60% after deductible |
Out of Pocket Maximum (includes deductible)
Individual
Family |
$1,500
$3,000 |
$2,000
$3,500 |
Prescription Drugs (in-network pharmacies)
Generic
Brand Formulary
Brand Name |
Retail (34-day supply)
Lesser of $10 or actual cost
25% of discounted cost or $20 min.
40% of discounted cost or $35 min. |
Mail Order (90-day supply)
$20
$40
$70 |
HEALTH CARE COST IN 2008
You may select Individual or Family Health Care Plan coverage. The chart below shows your share of the monthly cost
compared to the total cost for 2008.
| 2008 Monthly Premium |
| |
Employee
Pays 40% |
Employer
Pays 60% |
Total
Cost |
| Individual Premium |
$215.08 |
$322.64 |
$537.72 |
| Family Premium |
$453.96 |
$680.95 |
$1,134.91 |
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