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2012-2013 Plan Year . Effective September 1, 2012. PPO Plan Overview. ActiveCare 1-HD, 1, 2 and 3 Plans 2012-2013 Plan Year. Enrollment Summary (Employees by Plan, Feb. 2012). FirstCare Health Plans 2.5% Scott & White Health Plan 2.5% Valley Baptist Health Plans 0.3%.
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2012-2013 Plan Year Effective September 1, 2012
PPO Plan Overview ActiveCare 1-HD, 1, 2 and 3 Plans2012-2013 Plan Year
Enrollment Summary (Employees by Plan, Feb. 2012) FirstCare Health Plans 2.5% Scott & White Health Plan 2.5% Valley Baptist Health Plans 0.3% 280,753 Employees • 477,346 Members (Employees and Dependents)
Cost Of Coverage Cost of Coverage (Active Care 1-HD, 1,2,3) • Rate increase effective September 1, 2012 ActiveCare 1-HD ActiveCare1 ActiveCare2 ActiveCare 3 4% 4% 6% 9% • Increases are driven by rising health care costs and higher use of medical and prescription drug services.
PPO Plan Overview (Network Level of Benefits) • No Medical Plan Changes for 2012-2013 Primary means care provided by family practitioners, internists, OB/GYNsandpediatricians.All other physicians are specialists.
PPO Plan Overview (Network Level of Benefits) • Sample services include: annual physical exams, well-woman and well-child care, routine mammograms, immunizations, routine colonoscopies, and more • Refer to Plan Highlights on the website or see Enrollment Guide for a list of covered services when using network providers • Covered services under this benefit must be billedby the provider as “preventive care”
Prescription Drugs ActiveCare 1-HD,1, 2 & 32012-2013 Plan Year
Medco administers your prescription drug plans on behalf of TRS • ActiveCare 1-HD, 1, 2, and 3 plans • Benefit includes both a retail and mail component • Medco has its own mail-order pharmacy – Medco By Mail – where specialist pharmacists focus on compliance and lower cost options for the patient, and the automated filling system ensures the prescription is filled accurately.* Medco only buys medication from the most reputable suppliers Your Medco Prescription Drug Plan *Medco’s mail-order pharmacies fill about 2 million prescriptions per week through a highly automated process that is 99.9997% accurate and is 23 times more accurate than a retail pharmacy “Dispensing Error Rate in a Highly Automated Mail-Service Pharmacy Practice”; Nov. 2007, Pharmacology, a peer-reviewedjournal of the American College of Clinical Pharmacy
Prescription Drug Benefits – Network Level * If you obtain a brand-name drug when a generic equivalent is available, you are responsible for the generic copayment plus the cost difference between the brand-name drug and the generic drug. Chart illustrates benefits when network pharmacies are used. Non-network benefits are also available; see Enrollment Guide for more information.
Premiums vary by age Purchase Age Cost Per Month Coverage for a 45-year old Age 50 $23.49 Under this program can be Age 55 $32.91 as low as $17.95 per month— Age 60 $47.52 Less than a dollar a day Age 65 $75.50 Long Term Care Insurance
Program Sources Benefits Administrator Website Only: http://genworth.com/trs Username: TRSADMIN Password: groupltc Apply online or call Customer Service 1-866-659-1970 Program Sources
Enrollment • Open Enrollment Periods for 2012-2013 Plan Year: • April 23 - May 25 (Spring Enrollment) • August 1 - August 31 (Summer Enrollment) • No pre-existing condition exclusion applies except for those who previously declined coverage (may be reduced by prior creditable coverage) • Passive enrollment – If no plan or coverage changes, then no form required • Premium adjusted to reflect any rate change, effective September 1
ID Cards (mailed to your home) • PPO plans (ActiveCare 1-HD, 1, 2 and 3) • Separate cards for medical and prescription drugs • Blue Cross and Blue Shield of Texas • Medco • No medical plan changes; BCBSTX will NOT reissue ID cards to existing plan participants (medical plan ID cards do not expire) • Prescription drug ID cards will be reissued by Medco for ActiveCare 2 and ActiveCare 3 plan participants
What if I Have Questions? Call TRS-ActiveCare customer service for: Claim questions/status Network provider information Membership and eligibility Medical and prescription drug coverage questions Inquiries (telephone and e-mail) ID card requests Transition of care information Help with online tools! Personalized Service Customer Service1-866-355-5999
Proposed 2012-2013 RISD Health Plan Rates Heath Plans District Employee Total Contribution Contribution TRS Premium TRS-ActiveCare 1HD $287.00 $11.00 $298.00 TRS-ActiveCare 1 $287.00 $51.00 $338.00 TRS-ActiveCare 2 $287.00 $173.00 $460.00 TRS-ActiveCare 3 $287.00 $350.00 $637.00 EXAMPLE ONLY NOT APPROVED BY RISD
Voluntary Benefit Review- 2012-2013 • Annual Open Enrollment- April 23- May 25 ONLY. • Dental and Vision Carriers will be Changing. • New Critical Illness Offering for 2012 with Guaranteed issue Opportunities. • Every Employee should login to InRoll to Double Check and Confirm Benefit Selections for 2012- 2013. • Please Update Beneficiary Designations and Dependent Information if Needed. • Take Advantage of Open Enrollment Opportunities- Remember, you are responsible for the benefit elections you make. Make Sure they are correct to avoid eligibility problems in the future.
Dental • New Carrier for 2012-13 • Lincoln Financial Group • Full Take Over of Currently Insured Employees • 3 Options Still Available- High, Medium, Low • PPO Plan Design- You can use any dentist • Benefit Structure will Remain the Same • Rates Guaranteed for 2 years High OptionMiddle OptionLow Option E/O $37.18 $31.55 $17.74 E+1 $72.36 $61.39 $34.52 E/F $126.07 $106.97 $60.15
Long Term Disability • Standard Insurance • Same Carrier as last Year • 8 plan Options to Choose From- 4 short term, 4 long term • Insures Against a Loss of Income Due to Sickness or Accident • Insures up to 66 2/3% of Income • Guaranteed issue, Open Enrollment
Supplemental Term Life • Standard Insurance • Rockwall ISD Provides $15,000 Coverage on all Employees • Employees can Purchase Additional Coverage • Very Affordable Group rates • Coverage amounts up to $200,000 or 5 Times Annual Salary on Employee • Coverage Amounts up to 50% of Employee Amount on Spouse • Coverage Available on Children • Easy Underwriting Process- simple to complete/evidence of insurability form is required for all enrollments.
Permanent Life Insurance • Fidelity Life • $25,000 - $150,000 Benefit Amounts. • Premiums will Never Change. • Take the Coverage with You When You Leave Portable. • Simple Underwriting Process. • Coverage for Employee, Spouse, Children.
Accidental Death and Dismemberment- AD&D • Standard Insurance • Same Carrier as last Year • Coverage amounts up to $500,000 • Very Affordable Group Rates- $500,000 coverage for only $10.00 • Coverage Amounts up to 50% of Employee Amount on Spouse • Coverage Available on Children • Guaranteed Issue. No Health Questions
Critical Illness- New for 2012-13 • Lincoln Financial Group • Provides Lump Sum Benefit for Critical Illnesses • Cancer, Heart Attack, Stroke, Quality of Life, etc. • Coverage amounts up to $20,000 • Very Affordable Group Rates • Available for Employee, Spouse, Children • Guaranteed Issue. No Health Questions
Vision • New Carrier for 2012-13 • Block Vision • Full Take Over of Currently Insured Employees • Much Improved Benefits • Premiums Remain the same • Very Large Provider Network, Including Walmart • Benefits for Exams, lenses, Frames, Contacts E/O $7.88 E+1 $14.18 E/F $21.86
Legal Plan/ Identity Theft • Legal Plan of America • Provides Free and Discounted Legal Care • Tax Preparation and Advice • Financial Education & Credit Counseling Services • Identity Theft Solutions • Life Events Counseling One Low Rate- $14.00
Questions Thank you for attending Presentation will be on the District Benefits Website next week. www.rockwallisd.com Click on Staff Link Click on Employee Benefits Click on Benefits Information/Education Session