19- 20 E mploye e Be ne fits Ope n E nr ollme nt for L ic e - PowerPoint PPT Presentation

19- 20 E mploye e Be ne fits Ope n E nr ollme nt for L ic e nse d E duc ator s

Ma nda to ry Ope n E nro llme nt  Distric t’ s OE BB o pe n e nro llme nt pe rio d  Starts August 15 and c lose s August 30  E nro ll in me dic a l, de nta l a nd visio n pla ns a nd/ o r a F le xib le Spe nding Ac c o unt  2019-20 pla n ye a r sta rts Oc tobe r 1 BBe nroll.c om - Whe re yo u lo g into the MyOE BB syste m to ma ke  OE yo ur e nro llme nt se le c tio ns, e nro ll yo ur de pe nde nts, se t up yo ur a c c o unt, o r ve rify/ re se t yo ur use rna me a nd pa sswo rd. Yo u c a n a lso se e whic h pla ns yo u a re c urre ntly e nro lle d. BB - Whe re Mo da me mb e rs lo g in to se a rc h fo r  Modahe alth.c om/ OE he a lth pla n pro vide rs, re q ue st Mo da I D c a rds a nd g e t a me mb e r ha ndb o o k.

T e rmino lo g y  I n Ne two rk  Mo da Co nne xus ne two rk pro vide rs  Co insura nc e T he pe rc e nta g e o f e lig ib le he a lth c a re e xpe nse s yo ur pla n pa ys a fte r yo u me e t a ny re q uire d a nnua l de duc tib le . Yo u a re re spo nsib le fo r pa ying the re ma ining diffe re nc e .  Co pa yme nt T he fixe d do lla r a mo unt yo u pa y fo r c e rta in se rvic e s.

T e rmino lo g y  De duc tib le T he a mo unt yo u must pa y e a c h ye a r b e fo re yo ur pla n b e g ins to pa y fo r c o ve re d he a lth c a re e xpe nse s yo u use .  Out-o f-po c ke t Ma ximum  T he mo st yo u will pa y o ut o f yo ur po c ke t in a ye a r b e fo re yo ur pla n b e g ins pa ying 100% o f e lig ib le e xpe nse s.  I nc lude s the de duc tib le a nd a ny c o pa yme nts fo r me dic a l (no n- pha rma c y) se rvic e s.  De duc tib le s a re c a lc ula te d individua lly b ut limite d to thre e pe r fa mily  Co o rdina te d Ca re  Prima ry Ca re Pro vide r (PCP 360)

E mplo ye e Be ne fits Ope n E nro llme nt  L e ar n about your plan options  OE BB 2019-20 Be ne fits Ope n E nrollme nt Guide  Ava ila b le o nline a t www.OE BBplandoc s.c om  Re g iste r fo r a we b ina r a t OE BBwe binars.c om  No Cha ng e s to Mo da He a lth De nta l a nd Visio n Pla ns  Mo da De lta De nta l Pre mie r Pla n 5  Mo da Qua rtz Visio n Pla n  Ne w Mo da He a lth Me dic a l Pla ns  Co o rdina te d Ca re vs No n-Co o rdina te d Ca re  Prima ry Ca re Pro vide r “PCP 360”  Pla n 5 fo r L ic e nse d E duc a to rs  Ne w Be ne fit: Mo da is a dding c o ve ra g e fo r infe rtility se rvic e s

Mo da He a lth la unc he s Ne w Me dic a l Pla ns  All Mo da pla ns will use the Sta te -wide Conne xus ne two rk  Co o rdina te d a nd no n-c o o rdina te d-c a re o ptio ns fo r yo u, a nd fo r e a c h me mb e r o f yo ur fa mily  Co nta c t Mo da Me dic a l Custo me r Se rvic e to find in-ne two rk pro vide rs fo r de pe nde nts, re tire e s & COBRA me mb e rs living o ut o f Ore g o n  Me mb e rs re siding o utside o f the Co nne xus se rvic e a re a a re o nly e lig ib le fo r the no n-c o o rdina te d b e ne fit le ve l.  Mo da ha s c re a te d a spe c ia l link fo r OE BB me mb e rs: https:/ / www.modahe alth.c om/ oe bb/ F ro m this link, yo u'll b e a b le to use F ind Ca re to se a rc h fo r PCP 360s tha t q ua lify fo r e nha nc e d b e ne fits.

E mplo ye e Be ne fits Ope n E nro llme nt  Choose Coordina te d- Ca re or Non- c oordina te d Ca re Option  I f yo u a nd/ o r yo ur fa mily me mb e rs c ho o se c o o rdina te d c a re , yo u will c ho o se a prima ry c a re pro vide r o r "PCP 360" who will b e a c c o unta b le fo r yo ur he a lth. E a c h c o ve re d fa mily me mb e r c a n c ho o se if the y wa nt c o o rdina te d c a re , a nd if so , the ir o wn PCP 360. Re g a rdle ss, no ne o f yo u will ne e d a re fe rra l to se e a spe c ia list.  Cho o sing c o o rdina te d c a re me a ns tha t yo u will re c e ive e nha nc e d b e ne fits like :  A lo we r de duc tib le  A lo we r o ut-o f-po c ke t ma ximum  L o we r c o st fo r o ffic e visits, spe c ia list visits a nd a lte rna tive c a re visits

How to Choose a PCP 360  Me mb e rs must c ho o se a PCP 360 with Mo da to pa rtic ipa te in c o o rdina te d c a re a nd re c e ive e nha nc e d b e ne fits.  Use MyMo da F ind Ca re to find a PCP 360  Me mb e rs c a n c ho o se the ir PCP 360 in o ne o f two wa ys  Online thro ug h MyMo da b e g inning in Se pte mb e r  Ca ll Mo da Custo me r Se rvic e a t 866.923.0409  Me mb e rs who c ho o se the ir PCP 360 b y Oc to b e r 25 will re c e ive the c o o rdina te d c a re e nha nc e d b e ne fit e ffe c tive Oc to b e r 1.  Me mb e rs c a n c ho o se a PCP 360 a t a ny time during the ye a r. E nha nc e d b e ne fits will b e c o me e ffe c tive the first o f the mo nth.  Me mb e rs who a re pa rtic ipa ting in c o o rdina te d c a re will ne e d to utilize the ir c ho se n PCP 360 fo r a ll o f the ir prima ry c a re se rvic e s.

Yo ur Me dic a l Pla n  Moda He alth Me dic al Plan 5 inte gr ate d with the Gr oup HRA plan with $500/ $2,000 de duc tib le pe r pe rso n/ fa mily c o o rdina te d c a re a nd ma ximum o ut-o f-po c ke t pe r pe rso n/ fa mily o f $3,300/ $9,900 (in ne two rk c o o rd. c a re )  Me mb e rs pa y 25% c o -insura nc e .  Of the $1,594 to ta l pre mium fo r he a lth insura nc e , the Distric t pa ys $1,477/ mo . a nd yo u pa y $117/ mo pre -ta x. (@ 1.0 F T E )  Pa rt time lic e nse d ha ve a pro ra te d Distric t c o ntrib utio n  Me dic a l Opt o ut to HRA VE BA is a va ila b le $300/ mo .

Pha rma c y Be ne fits

Yo ur De nta l Pla n Mo da De lta De nta l Pre mie r Pla n 5  $1,700 Be ne fit Ma ximum with $50 De duc tib le  I nc e ntive c a re pla n. As lo ng a s yo u visit the de ntist a t o nc e during the ye a r the le ve l o f b e ne fit fo r c e rta in se rvic e s will inc re a se the fo llo wing ye a r (up to a ma ximum o f 100%)  L a te e nro lle e s sub je c t to 12-mo nth wa iting pe rio d fo r a ll se rvic e s o the r tha n pre ve nta tive c a re  De lta De nta l Pre mie r Ne two rk

Yo ur Visio n Pla n Mo da Qua rtz Visio n Pla n  No plan de sign c hange s  Be ne fit runs o n the pla n ye a r b a sis  Be ne fit ma ximum o f $250 inc lude s e xa m a nd ha rdwa re  Co ve rs c o nta c ts o r o ne pa ir o f le nse s e ve ry pla n ye a r  Co ve rs o ne pa ir o f fra me s e ve ry two ye a rs fo r me mb e rs 17 o r o lde r  L a te e nro lle e s a re sub je c t to a 12-mo nth wa iting pe rio d fo r le nse s a nd fra me s

Gro up He a lth Re imb urse me nt Arra ng e me nt  T o pa rtic ipa te in the Distric t’ s Gro up HRA pla n, yo u must first e nro ll in Moda Me dic al Plan 5 . Afte r tha t, yo u must e nro ll o n the distric t’ s Gro up HRA pla n; this c a n b e do ne o nline thro ug h the Nue Syne rg y we b site . Yo u o nly ne e d to e nro ll o nc e with Nue Syne rg y! Mo re info to fo llo w re g a rding ne w a c c o unt se t-up.  Nue Syne rg y c o nta c t info rma tio n:  Pho ne (c usto me r se rvic e ): 855.890.7239  F a x: 855.890.7238  E ma il fo r c la ims: c usto me rse rvic e @ nue syne rg y.c o m

L o ng T e rm Disa b ility I nsura nc e & Optio na l Sho rt T e rm Disa b ility, L ife , & AD&D Sta nda rd I nsura nc e Co mpa ny  Ma nda to ry e nro llme nt L o ng T e rm Disa b ility Pla n 17  90 da ys b e ne fit wa iting pe rio d  Be ne fit pe rc e nta g e 60% o f mo nthly sa la ry up to $8,000/ mo .  Pre mium ra te $0.00353 x mo nthly sa la ry, e mplo ye e pa id  Optio na l Sho rt T e rm Disa b ility Pla n 16  30 da ys b e ne fit wa iting pe rio d. 90 da y b e ne fit dura tio n  Be ne fit pe rc e nta g e 60% o f mo nthly sa la ry up to $1,500/ we e k  Pre mium ra te $0.00374 x mo nthly sa la ry, e mplo ye e pa id  Optio na l c o ve ra g e fo r L ife a nd/ o r AD&D  Yo u, Spo use / do me stic pa rtne r, Childre n

E mplo ye e Assista nc e Pro g ra m E AP he lps yo u priva te ly so lve pro b le ms tha t ma y inte rfe re with yo ur wo rk, fa mily a nd life in g e ne ra l. E AP se rvic e s a re F RE E to yo u, yo ur de pe nde nts, a nd a ll ho use ho ld me mb e rs. E AP se rvic e s a re a lwa ys c o nfide ntia l a nd pro vide d b y e xpe rts.  Co nfide ntia l Co unse ling  24-ho ur Crisis He lp  I n-pe rso n Co unse ling  Online Co nsulta tio ns  Othe r Se rvic e s  1-866-750-1327  www.MyRBHH.c o m (Ac c e ss c o de : OE BB)

Re so urc e s fo r Ope n E nro llme nt  OE BB 2019- 20 Be ne fits Ope n E nrollme nt Guide  Ava ila b le o nline a t www.OE BBpla ndoc s.c om  Re g iste r fo r a we b ina r a t OE BBwe binar s.c om  MyMo da https:/ / www.modahe alth.c om/ oe bb/  Distric t E ma il mploye e Be ne fits we b site  Busine ss Se r vic e s Payr oll and E

F le xib le Spe nding Se c tio n 125 Ac c o unt  Plus Po int  Ope n e nro llme nt ma te ria ls a va ila b le fro m Busine ss Se rvic e s