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Raytown School District Open Enrollment 2010-2011. All Active Employees Must Enroll or Waive. Health Benefits Dental Benefits Vision Benefits Basic Life (must designate beneficiary) Flex Spending/Cafeteria 125 Benefits (Active Employees Includes Individuals Retiring 2010)
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All Active Employees Must Enroll or Waive • Health Benefits • Dental Benefits • Vision Benefits • Basic Life (must designate beneficiary) • Flex Spending/Cafeteria 125 Benefits • (Active Employees Includes Individuals Retiring 2010) • Retirees prior to 2010 will be provided Enrollment Packet via United States Mail • Retirees or Individuals on Cobra are not to complete the electronic version for Open Enrollment. • If you have not received your packet by April 23, please contact Benefits Office/Payroll Office, (816) 268-7066
ALL EMPLOYEES MUST COMPLETE ONLINE ENROLLMENT EVEN IF WAIVING COVERAGE, RETIREES MUST COMPLETE PAPER ENROLLMENT FORMS,ALL ENROLLMENTS MUST BE COMPLETED BY MAY 9TH.
New Medical Insurance Carrier BlueCross BlueShield of Kansas City
Welcome to Blue Cross and Blue Shield of Kansas City! • Welcome to your new Blue Cross and Blue Shield health benefit program! • Your new coverage will be effective July 1, 2010. Please be sure to show your new Blue Cross ID card for services received on or after July 1, 2010. • You should receive your Blue Cross ID card towards the end of June. Each enrolled family member will receive their own ID card. Your SSN is not used as an identifying number on the ID card. • Show your BCBSKC ID card to your provider and at the pharmacy each time you receive services on or after July 1, 2010.
Before We Get Started…. • Health Care Reform What’s covered now? And what’s covered in the future? • The health care reform bill that passed is very complex, and full of moving parts, however, some elements have become clearer. In the next several months, some changes will occur, and we will be ready to make these changes for plan years after September 23, 2010. In the meantime – your Blue Cross plans are consistent and secure and you will receive exceptional service. • BlueKC.com will provide current information and Frequently Asked Questions • Pre-Existing Waiting Period • Pre-Existing Waiting Period will not apply: • Members currently enrolled in Humana • Members currently enrolled in another Group Health Plan • Deductible Credit • You will receive credit for the Deductible/OOP Maximum expenses you have incurred on your Humana plan from January 1st, 2010 through June 30th, 2010.
2010 Medical Plans • PPO Health Plans • Preferred-Care Blue – PPO (Preferred Provider Organization) • No selection of PCP (Primary Care Physician) • No referrals to Specialists • In and Out of Network Coverage • Pay lower out of pocket expenses by using network Providers • National and International Coverage • Three PPO Plan Options • $2,000 Deductible Base Plan • $1,000 Deductible Buy-Up Plan • $500 Deductible Buy-Up Plan
Preferred-Care Blue PPO Visit www.BlueKC.com for a complete list of Providers 53 Hospitals, 4,858 Physicians (Liberty, St. Joseph, St. Mary’s and Truman Hospitals are not in the Preferred-Care Blue Network)
Travel with Your PPO Health Plans As a Blue Cross Blue Shield Member, you can take your healthcare benefits with you across the country and around the world. The BlueCard PPO Program gives you access to over 6,000 hospitals and 800,000 physicians around the country, giving you the peace of mind that you can take charge of your health, wherever you are. Visit our website at www.BlueKC.com click BlueCard Provider Directory, click Continue. Login using the ID number on the front of your BCBSKC ID Card. or call (800) 810-BLUE (2583) to receive a complete list of network of hospitals and physicians.
Preferred-Care Blue PPO$2,000 Deductible Base Plan Emergency Services received in a network facility – Copay + Network Deductible and Network Coinsurance. Emergency Services received in a non-network facility – Copay + Non-network Deductible and Non-network Coinsurance.
Preferred-Care Blue PPO$1,000 Deductible Buy-Up Plan Emergency Services received in a network facility – Copay + Network Deductible and Network Coinsurance. Emergency Services received in a non-network facility – Copay+ Non-network Deductible and Non-network Coinsurance.
Preferred-Care Blue PPO$500 Deductible Buy-Up Plan Emergency Services received in a network facility – Copay + Network Deductible and Network Coinsurance. Emergency Services received in a non-network facility – Copay + Non-network Deductible and Non-network Coinsurance.
Deductible and Out-of-Pocket Maximum Credit • Deductible Credit You will receive credit for the Deductible/OOP Maximum expenses you incur from January 1st, 2010 through June 30th , 2010. • If you have satisfied all or a portion of your Deductible with Humana, you will receive credit for the Deductible with BCBSKC. • If you have satisfied all or a portion of your OOP Maximum with Humana, you will receive credit for the OOP Maximum with BCBSKC. • If you receive your EOB after July 1, 2010 and if you have any BCBSKC claims – we will reprocess your claim to give you credit for the deductible/out-of-pocket maximum on your BCBSKC plan. January 1 , 2011 – December 31, 2011 The full Deductible and Out-of-Pocket Maximum will apply January 1, 2011.
Preferred-Care Blue PPO Lab services performed in a Hospital or Outpatient setting and all Radiology Services subject to Coinsurance
Routine Preventive Care Vision Care (Applicable Office Visit Copay) One routine eye exam per calendar year
Prescription DrugsRetail and Mail-Order Consistent with your previous plans, Rx Copays DO NOT go towards Deductible or Out-of-Pocket Maximum To get started on EXPRESS SCRIPTS get a NEW Prescription from your Doctor! Please see Benefits/Payroll for Rx Prior Authorization Forms
Prescription Drug CoverageGenerics First Program For some medication classes, multiple generic medication alternatives now exist. Members will be required to try a generic medication before initiating therapy with a brand name medication. This will apply to the following medication classes: • NSAIDs: (Anti-Inflammatory medications for Arthritis and pain) • Calcium Channel Blockers:(CCB for hypertension) • ACE Inhibitors/ARBs:(Medications for hypertension) • Statins: (Medications for cholesterol) • SSRIs/NDRIs:(Medications for Depression) • Nasal Steroids: (Medications for Allergies) • Sedative Hypnotics: (Medications for Sleep) • Proton Pump Inhibitors (PPIs):(Medications for gastroesophageal reflux disease [GERD] or stomach acid) The Generics First Program will be implemented 90 days after July 1, 2010. Any member currently taking a Name Brand drug can continue. Any new prescription request after the 90-day waiting period will be subject to the Generics First Program. Generics First Program is Effective 10/1/10
Key Differences (In-Network Services) *Copays do not apply to deductible or OOP maximum
General Information • Transition of Care • If you or a covered dependent is under the care of a physician that is NOT a BCBSKC provider for a continuing medical condition, we can provide assistance in your transition to network providers. • Pregnancy in third trimester • Current confinement in hospital or treatment facility • Scheduled surgery • Ongoing treatment of illness Each transition of care is evaluated on a case by case basis. Please see Benefits/Payroll for Transition of Care Assistance Forms or Rx Prior Authorization Forms
Finding a Provider is Easy…. • Kansas City Metro Area • www.BlueKC.com • Find Blue KC Doctors, Hospitals, Pharmacies • SELECT A PROVIDER DIRECTORY • Local BlueKC Provider Directory MY INSURANCE PLAN • Select Your Plan Preferred-Care Blue Network SELECT A PROVIDER TYPE • Doctors • Hospitals • Pharmacies, Facilities, Labs • Dental • Urgent Care and Retail Health Centers • Mental Health • Other Providers • Click CONTINUE • All Other Areas • www.BlueKC.com • Find Blue KC Doctors, Hospitals, Pharmacies • SELECT A PROVIDER DIRECTORY • BlueCard Provider Directory CONTINUE • Select Guest Tab • Choose Product PPO/EPO • FIND PROVIDERS • Physicians • Hospitals • Behavioral Health • All Types
Enrollment Process For Medical, Dental, Vision and Life Your BluesEnroll Account will be active Monday, April 26th 2010. On the Internet, go to www.bluesenroll.com • Login ID is (your first name) (First initial of your last name) (last four digits of your SSN) ValerieS0570 • Password is your nine-digit SSN without spaces or dashes • You will be asked to change your password • Call BluesEnrolltoll free help line at 877-336-8083 Monday through Friday, 8:00 AM to 5:00 PM CST On-line Enrollment must be completed by 11:59 p.m. on Sunday, May 9, 2010
BluesEnroll On-Line Instructions • Complete step-by-step on-line instructions are available on the district’s intranet and web site. • www.raytownschools.org
AFTER BENEFIT “Open” ENROLLMENT MAY 9TH NO CHANGES WILL BE ALLOWED UNLESS YOU HAVE A “QUALIFYING EVENT” IN YOUR LIFE AS DEFINED BY INSURANCE REGULATIONS. QUALIFYING EVENT CATEGORIES: • CHANGE IN MARITAL STATUS • CHANGE IN NUMBER OF DEPENDENTS • CHANGE IN EMPLOYMENT STATUS • CHANGE IN ELIGIBILITY STATUS
New Voluntary Dental Carrier Assurant Employee Benefits
Dental Insurance • Premiums are 100% Employee Paid • 3 Plans Offered • Prepayment Plan • Freedom Basic Low PPO Plan • Freedom Preferred High PPO Plan • Freedom Preferred High PPO increase in benefits from 80% to 100% for Type II In-Network Services • If you are currently enrolled in the Humana dental plans, there are no waiting periods for services in the Assurant plans • You must re-enroll or you will lose coverage • To locate a provider: www.assurantemployeebenefits.com
Voluntary Vision Insurance Plan Vision Service Plan (VSP)
Using Your VSP Plan • Locate a VSP Preferred Provider • www.vsp.com or 1-800-877-7195 • Call and make an appointment • Say you have VSP • Provider will handle the rest • Important- no i.d. cards nor prior authorizations
VSP Preferred Provider Network • 40,000 National Access Points • 334 Access Points in Greater KC Area • All have dispensaries on site • 88% of VSP locations offer extended hours
Vision Insurance • Premiums are 100% employee paid • Provides both in and out-of-network coverage • $10 copay for exams
VSP Signature Plan • Frequency • 12 months on Exam • 12 months on Lenses • 24 months on Frame • 12 months on Contact Lenses (in lieu of glasses-lenses and frame) • Copays • $10 copay on exam • $25 copay on glasses
VSP Preferred Provider Coverage • Exam covered after $10 copay • Lenses covered after $25 copay • Single Vision, Lined Bifocal, Lined Trifocal, Lenticular lenses. • Polycarbonate lenses for dependent children • Frame: $130 allowance toward any frame, 20% discount on any overage costs • Non-covered lens options: Cost controlled discounts on all non-covered lens options (i.e. progressives, anti-reflective coating, scratch resistant coating, etc.). Avg. savings 35 to 40%.
VSP Preferred Provider Coverage • Contact Lenses (in lieu of glasses) • $130.00 allowance towards fitting evaluation and materials. • VSP offers a contact lens care program through its providers for additional savings. • Additional VSP Discounts • 30% discount off additional pairs of prescription glasses or non-prescription sunglasses if purchased on same day as exam. Otherwise 20% discount.
VSP Preferred Provider Coverage • Laser Corrective Surgery Discounts • Avg. Savings 15 to 20% • Should VSP contracted surgery center offers a promotional price to public, VSP members receive 5% off the promotional price. • Members who are interested please visit vsp.com or contact VSP at 1-800-877-7195.
Non-Preferred Provider Coverage • Member responsible for payment of services to a non-preferred provider. • Remit itemized paid receipt to VSP within six months from date of service. • Reimbursed the below allowances (copays do apply) • Exam- Up to $45 • Single Lenses- Up to $45 • Bifocals- Up to $65 • Trifocals- Up to $85 • Frame- Up to $47 • Contact Lenses- Up to $105
New Basic Life Insurance Carrier US Able
District Sponsored Basic Life Insurance • No benefit changes • Benefit level based upon hours worked • Must designate a new beneficiary using the BluesEnroll system
Flexible Spending Account / Dependent Care Account Tri-Star Systems
Flexible Spending Accounts Program Highlights • A great way to plan ahead and save money over the course of the year is to participate in the Flexible Spending Account (FSA) program. These accounts allow you to redirect a portion of your salary on a pre-tax basis into reimbursement accounts. Money from these accounts is then used to pay medical expenses, which are not covered by your medical plan. • Services provided by Tri-Star Systems.
Flexible Spending Accounts Program Highlights • Two ways to maximize your pre-tax savings: • Health Care Reimbursement Account: • This account reimburses you for eligible health care expenses not covered by insurance. The maximum amount you can contribute to this account is $2,400. • Dependent Care Reimbursement Account: • Through regular payroll deductions, you can set aside part of your income to pay for daycare expenses for eligible children and adults. Qualified expenses for reimbursement include adult and child daycare centers, preschools and before/after school care. • Employees can make up to $5,000 ($2,500 for married couples filing separately) a year in pre-tax contributions to a dependent care FSA
Flexible Spending Accounts Program Highlights • Important rules: • You are responsible for filing claims for reimbursement. • Carefully review your estimated expenses, as any funds remaining in the account at the end of the year are forfeited. • The money you contribute to each account for the plan year can only be used for eligible expenses you incur during the year. • You must enroll or waive for the 2010 plan year via the Tri-Star Systems web site.
Tri-Star Systems On-Line Enrollment Process MANDATORY ONLINE OPEN ENROLLMENT Enrollment website: www.ezenroll.com Click on the action button
To Login you will need your social security number AND the Open Enrollment letter from Tri-Star that provided you with your password. This is a secure site.
You must click on “I Agree” to continue the Open Enrollment process.
Tri-Star Systems On-Line Enrollment • Complete Tri-Star step-by-step instructions are available on the district’s intranet and web site. • www.raytownschools.org