We are pleased to provide you with Participate’s 2017-18 Benefits Digest.

This guide
is intended to provide a summary of the benefit programs available to all eligible
employees. It is only an overview. Please review specific plan brochures and plan
documents for full program details, limitations and exclusions.

At Participate, we are confident that our teachers are the reason behind our successes. We truly value you as part of
our professional family. Our goal is to offer the very best healthcare possible to you and your loved ones. With this in
mind, we have developed a comprehensive employee benefit package designed to protect you and your family.

This brochure provides benefit information available July 1, 2017 through June 30, 2018. After July 1st, please visit our
benefits web page at www.hcwbenefits.com . The web page will include information and additional resources available
to you regarding our benefits. Our user name is “Participate” and “teacher” is our password.

Benefit Highlights

Health Plan is through BCBSNC Health Advocate

• IMPORTANT! Our health plan is partnered
with specific doctors and hospitals who will
give you the best care at the best price. If you
do not receive care from one of these
designated places, your costs will be
significantly higher than if you see the
approved physicians.
• Our network of doctors and hospitals is called
BCBS “Blue Value.” (If you are outside of
North Carolina, you may see any BCBS
network physician).
• Please register with BCBSNC’s Member
Services. On “Blue Connect” you can access
your benefit information and view your past
claims. You can also search for the cost of a
prescription and find Blue Value doctors and
hospitals. https://www.bcbsnc.com/members
• Medical tiers have been changed to include a
separate tier for teachers covering a spouse
only, and to combine teachers covering one or
more children.
• IMPORTANT! Please call Health Advocate
for help with finding a Blue Value doctor,
hospital, and a MetLife dentist.
• They will also help you with questions on
your insurance, billing concerns, and even
will schedule appointments for you.
• Health Advocate will help you make good
choices regarding your healthcare.
• This is NOT your insurance; they are simply
here to help you! Just call them to learn
more. Your questions will be confidential.
Our Dental Plan will remain with MetLife
• Your coverage will be better and your costs
will be lower by receiving care from a
MetLife dentist.
Participate also offers Life Insurance, Travel
Assistance and an Employee Assistance
Program
Medical Plan
www.bcbsnc.com | 877-258-3334
Your medical coverage is a “Blue Value” plan. You are encouraged to utilize a BCBS “Blue Value” provider. As long as
you remain in the network, your benefits will be covered at the higher in-network benefit amount.
IN-NETWORK OUT-OF-NETWORK
Office Visit $35/$70 Copay 50%*
Preventive Care Covered at 100% Network Only
Prescription Drugs Retail: $10/75%1 Copay + charge over in-network allowed
Mail Order: 3x Copay amount
Emergency Room $250 Copay $250 Copay
Urgent Care $70 Copay $70 Copay
Annual Deductible $500/$1,000 $1,000/$2,000
Out-of-Pocket Maximum $5,500/$11,0002 $11,000/$22,0002
Inpatient Care 70%* 50%*
Outpatient Care 70%* 50%*
Routine Vision Exam 100% (every benefit period) Network Only
* Coverage provided after deductible
1
There is a $500 Per Drug Maximum for each 30- day supply of Brand Name Drugs
2
Deductible, Coinsurance and copays accumulate toward your out-of-pocket maximum
Preventive Care is covered at 100% with a preventive primary diagnosis code. The service must be a covered preventive
care benefit under healthcare reform. For a list of covered preventive benefits please visit www.bcbsnc.com/preventive

Health Advocate
www.healthadvocate.com| 1-866-695-8622

CALL TO ACTION: Participate is encouraging you to call Health Advocate prior to seeing a new doctor or going to the
hospital. A representative from Health Advocate will help you find the best doctors and hospitals in your area that
participate in the BCBSNC “Blue Value” Network. In addition to finding a physician, they can also assist you with a
variety of services including:
• Answering questions on your health insurance
• Scheduling an appointment for you or a family member
• Assistance with claims or billing concerns regarding your BCBSNC or MetLife coverage
• Direct you to lower cost health and dental services to help keep your costs down

The health advocacy program offers a comprehensive spectrum of programs to help you navigate healthcare and
insurance questions. THIS IS NOT INSURANCE. Health Advocate is here to help you and be your advocate for your
healthcare! All calls are completely confidential in accordance with HIPAA regulations.

Life Insurance
www.rsli.com | 800-351-7500
Basic Life/ AD&D Insurance
• $15,000 provided at no cost to you by Participate; matching Accidental Death & Dismemberment benefit
• Child: $500 (14 days to 6 months); $5,000 (6 month to age 20/ 26 if full time student); Spouse: $5,000

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Participate| 2017-18 Benefits Digest
Note: The description in this document is intended to provide a general overview of your health & welfare benefit plans. For a complete
description, please consult your policy.
Dental Plan
www.mybenefits.metlife.com | 800-275-4638
Your MetLife dental plan allows you to see the dentist of your choice, but your costs will be lower if you receive care
from an in-network dentist. Also, In-network providers will always file claims on your behalf and cannot balance bill you.
IN-NETWORK OUT-OF-NETWORK
Single/Family Deductible $50/$150
Benefit Maximum $1,250
Preventive Care 100% 90%
Basic Care 80%* 70%*
Major Care 50%* 40%*
* Coverage provided after deductible

Travel Assistance
www.oncallinternational.com | 800-456-3893 (in U.S) 603-328-1966 (worldwide)
Travel Assistance for emergency medical, legal and travel information is provided through On Call International. It is
available 24 hours a day, 365 days a year when you travel 100 miles or more from your U.S. address.
-Pre-Trip Assistance Emergency Personal Services
•• Inoculation requirements
Inoculation requirements Information
information • Urgent message relay
• Passport / Visa requirements • Interpretation / translation services
• Currency exchange rates • Emergency travel arrangements
• Consulate/ embassy referral • Legal assistance and/or bail bond
• Health hazard advisory • Recovery of lost or stolen possessions

Emergency Medical Transportation* Medical Services Include:

• Emergency evacuation • Medical referrals
• Medically necessary repatriation • Medical case monitoring
• Visit by family member or friend • Convalescence arrangements
• Return of dependent children • Prescription assistance & eyeglasses replacement
• Return of vehicle
* Services are subject to a maximum combined single limit of $250,000. Return of vehicle is subject to a $2,500 limit.

Employee Assistance Program

http://rsli.acieap.com| 855-RSL-HELP (855-775-4357) I rsli@acieap.com
EAP and Work-Life Benefits

• Unlimited phone assessment and referral • Unlimited referrals and resources for personal
• Up to 3 counseling sessions for you and your service
family members • Community based resource referrals
• Unlimited child and elder care referrals • Online legal resource
• Legal consultation – unlimited number of issues • Multicultural and multilingual providers
• Unlimited pet care consultation available
• Unlimited education referrals and resources • Mobile App, Website, Text, Chat, Email, and
Video Chat available
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Participate| 2017-18 Benefits Digest
Note: The description in this document is intended to provide a general overview of your health & welfare benefit plans. For a complete
description, please consult your policy.
Additional Information
Health insurance costs in the U.S. typically increase dramatically each year. Participate has continued our commitment
to greatly subsidize teacher health benefits costs and absorb as much of this cost as possible.

During an annual enrollment period, you can remove or make changes to coverage for dependents who are not J visa
holders. For example, a spouse or child who is a U.S. citizen can be added or deleted from the plan. Due to Participate’s
J-1 visa requirements, J-1 teachers cannot remove or change health benefits for themselves or any J-2 spouses or
dependents. Coverage changes are only an option for spouses or dependents that are not in J visa status. For questions
on this restriction please contact Teacher Resources by phone at 1-800-952-4521 or by email at
teacherresources@participate.com.

Monthly Draft Amounts

Bank draft amounts are listed below for your medical and dental plans. Your bank account will be drafted monthly for
the months of September through May each year. You will not be drafted during the summer months of June, July and
August; however, your benefits will remain active throughout the year.

MEDICAL MONTHLY DRAFT AMOUNT

Employee $73.83
Employee + Spouse $370.00
Employee + Child $222.80
Family $398.39

DENTAL MONTHLY DRAFT AMOUNT

Employee $25.00
Employee + Spouse $50.39
Employee + Child(ren) $55.50
Family $81.12

Please contact Human Resources or Teacher Resources with questions on your Participate benefits.

4
Participate| 2017-18 Benefits Digest
Note: The description in this document is intended to provide a general overview of your health & welfare benefit plans. For a complete
description, please consult your policy.