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

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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

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SLIDE 1

19- 20 E mploye e Be ne fits Ope n E nr

  • llme nt for

L ic e nse d E duc ator s

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SLIDE 2

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

 OE

BBe nroll.c om - Whe re yo u lo g into the MyOE

BB syste m to ma ke 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.

 Modahe alth.c om/ OE

BB - Whe re Mo da me mb e rs lo g in to se a rc h fo r

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.

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SLIDE 3

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.

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SLIDE 4

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)

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SLIDE 5

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

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SLIDE 6

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.

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SLIDE 7

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

  • 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
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SLIDE 8
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SLIDE 9

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.

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SLIDE 10

Yo ur Me dic a l Pla n

 Moda He alth Me dic al Plan 5 inte gr

ate d with the Gr

  • up

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 .

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SLIDE 11

Pha rma c y Be ne fits

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SLIDE 12

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

  • 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

  • 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

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SLIDE 13

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

  • 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

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SLIDE 14

Gro up He a lth Re imb urse me nt Arra ng e me nt

 T

  • 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

  • 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

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SLIDE 15
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SLIDE 16
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SLIDE 17
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SLIDE 18
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SLIDE 19

L

  • 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

  • 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

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SLIDE 20

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)

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SLIDE 21

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

 Busine ss Se r

vic e s Payr

  • ll and E

mploye e Be ne fits we b site

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SLIDE 22

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

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SLIDE 23

L ic e nse d E duc a to rs 403(b ) Be ne fits

 F

  • r e lig ib le lic e nse d e duc a to rs, fo r 2019-20 the a nnua l

403(b ) Distric t c o ntrib utio n e ithe r $50 o r $75 DOE pe r mo nth with no e mplo ye e ma tc h re q uire me nt. Yo u must se le c t a 403(b ) pro vide r a nd c o mple te the sa la ry re duc tio n a g re e me nt b e fo re Distric t c o ntrib utio ns c a n b e g in.

 E

mplo ye e 403(b ) o r 457(b ) de fe rre d c o mpe nsa tio n pla ns a va ila b le thro ug h Ca rruth Co mplia nc e Co nsulting http:/ / www.nc o mplia nc e .c o m/ g ue st_e mplo ye e s.a spx? E mplo ye rI D=130

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SLIDE 24

Moda He a lth Re sourc e s

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SLIDE 25
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SLIDE 26
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SLIDE 27

Moda

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SLIDE 28

 Co nta c t info

 OE

BB 1-888-469-6322

 Be ne fit q ue stio ns  Ne e d a ssista nc e with re g iste ring , lo g g ing in o r e nro lling in

MyOE BB https:/ / myo e b b .o rg / o e b b / !p b .ma in

 HRCSD Busine ss Se rvic e s

 Pa yro ll & E

mplo ye e Be ne fits we b pa g e

 Be ne fit e lig ib ility q ue stio ns  Co nta c t info fo r pa yro ll & b e ne fits spe c ia list

 Gre tc he n Wina ns 387-5019

 Nue Syne rg y 855.890.7239

 Gro up HRA e nro llme nt & c usto me r se rvic e

 www.nue syne rg y.c o m

 Que stio ns?