Hello, I am Donna Cassario, one of your Benefits Specialists here at - - PDF document

SLIDE 1

Hello, I am Donna Cassario, one of your Benefits Specialists here at Brevard Public Schools. I am going to spend the next 15 minutes going over the Annual Open Enrollment presentation for 2013 Employee Benefits. I will outline the key components and changes to your benefits offered through Brevard Public Schools AND focus on how to maximize the value of these plans... Remember, these are your benefits, and we want you to receive the highest quality and value possible. As a respected employee

• f this district, your optimal health and well-being are important to
• us. We encourage you and your family members to take charge of

your health by taking advantage of your scheduled Preventive Care screenings! Now, let’s get started…

1

SLIDE 2

Once again, we’ve got you covered with the BPS Health Plan and benefits offered by Brevard Public Schools. Open enrollment for 2013 will start on October 22nd and end on November 1st this year. If you would like to make any changes to your current benefits elections, this will be the only time to log-on to the enrollment Website and make changes. If you are newly hired and have recently made your selections for current benefits for this calendar year 2012, those benefits will remain in effect for 2013, unless you wish to start or continue with Flexible Spending Accounts or you wish to make any changes for 2013, then you will need to go on-line and enroll. It’s easy, and I’ll show you how in just a few minutes. But now, let’s begin to go through some of the key highlights of your benefits program options.

2

SLIDE 3

We want to make you aware of upcoming changes based upon legislation from Health Care Reform for 2013.

• The Maximum Contribution

to medical Flexible Spending Account (FSA) is now $2,500

• Employees will receive a new Summary of Benefits and

Coverage (SBC)

• Your board paid contribution toward the BPS Health Plan

will now be listed on your W-2 for calendar year 2012. This amount will not be taxed, it is simply being listed for information purposes.

3

SLIDE 4

Preventive Care Services are services provided to help you prevent a disease. These screenings are based on guidelines established for your age and gender. Some good examples are Annual Physicals, Annual Well- Woman Exams, Mammograms, Immunizations, and PSA screenings. A list of covered services is available on the district benefits website and is titled “Understanding Your Preventive Care Benefits.” The good news is that the covered Preventive Care Services are provided at NO COST to you when visiting an In-network provider. Through preventive exams and routine health screenings, your doctor can detect early warning signs of more serious conditions. As you know, the earlier a condition is discovered, the sooner it can be treated, and your chance of a better prognosis and healthier life is greatly increased! These services could literally end up saving your life!

4

SLIDE 5 As you know, these economic times have created many challenges for all of us. Based on employee survey feedback and efforts by the Superintendent’s Insurance Advisory Committee, we implemented the BPS Preferred Health Centers on January 1st, 2012. These Preferred Health Centers provide employees, retirees, and their covered dependents with lower-cost treatment alternatives for urgent and/or convenient care without disruption

• f

your Primary Care Provider relationship. We listened to your concerns and needs, and worked on developing a solution. We continue to seek additional feedback from you, but so far, the response has been

• verwhelmingly positive!

Additionally, preliminary claims data show a decline in the number of Emergency Room Visits while still providing an option for optimal care, which results in lower

• ut-of-pocket costs to both you and to the BPS Health Plan!

5

Slide 6

From Titusville to Palm Bay, we’ve got you covered with the BPS Preferred Health Centers conveniently located throughout Brevard County. BPS’ Preferred Health Center network now has 13 facilities, including the newest beachside location in Indialantic --Surfside Urgent Care. These community health-care partners are committed to providing you with an alternative treatment option and extended hours of operation all at a lower cost to you. We will continually monitor the network and make any adjustments necessary to ensure the highest quality and most convenient access for you and your covered family members. Of course, you will continue to have access to your other CIGNA network providers at the current benefit plan levels. Remember, using the CIGNA network always saves you money – and now – using the BPS Preferred Health Centers saves you even more!

6

SLIDE 7

• Each of the centers has high quality staff to assist you, often an

M.D.

• The

centers provide necessary labs, basic x-rays, and prescriptions for medically necessary medications.

• Any care provided, or referrals, will be coordinated with your

primary care provider.

• And because we’ve negotiated special provider reimbursements,

when you visit a BPS Preferred Health Center, your co-pay is only $15, with all claims managed by our current BPS Health Plan administrator—CIGNA.

7

SLIDE 8

A common question that is asked regarding the Urgent Care Centers is: “What conditions should I go to the Urgent Care Center versus the Emergency Room?” The short answer is that anything life or limb threatening should always be treated at an Emergency Room. The Urgent Care Centers provide treatment options for non-life threatening conditions. Urgent Care Centers are great facilities for conditions which could be treated by a doctor’s office visit, but are somewhat urgent in

• nature. Some good examples are: Minor burns or injuries, sprains
• r strains, colds, sore throats, fever, flu symptoms, ear infections,

rashes or skin irritations, mild asthma, and animal bites. Always utilize the Emergency Room for chest pain, difficulty breathing, severe bleeding, head

• r

face trauma, loss

• f

consciousness, sudden loss of vision, and blurred vision.

8

SLIDE 9 Now let’s discuss some ways to maximize the value of your benefit plan by being a good health care consumer. Remember to always utilize In-network providers for all

• services. For Routine Laboratory Services, make sure to utilize Quest or LabCorp

as your In-network lab provider. There is no Copayment at LabCorp or Quest labs, and negotiated rates lower costs to the BPS Health Plan. Did you know that the cost for Outpatient Diagnostic Procedures like X-rays, MRI’s,

• r CAT Scans varies depending upon where you receive these services?

If you have an MRI at an Outpatient Imaging Center, the cost could be up to 50% less than the cost for that same procedure at a hospital… In this example, your responsibility is 20% of the contracted rate of $500 for an MRI at an Outpatient Imaging Center versus the contracted rate of $1,000 at a Hospital, your 20% out-of-pocket cost would only be $100 compared to $200 at the Hospital. Plus the cost to the BPS Health Plan is then $400 at the Outpatient Center, as

• pposed to $800 at the Hospital.

9

SLIDE 10

Talk to your doctor about the lower-cost medication alternatives, such as generic or preferred-brand alternatives that may be available which can save you significantly

• n your out-of-pocket costs.

If you are taking any Maintenance Medications, you can utilize the Cigna Home Delivery program to get a 90-day supply for only 2 30-day copayments as opposed to 3 copayments, saving you a third of the cost. Maintenance Medications are those that you are taking on an ongoing basis like blood pressure or cholesterol medications. Another way to be a good health care consumer is to look at the $4 Medication Lists at retail pharmacies, and talk with your pharmacist or doctor to see if one of those may work for you! In addition, some pharmacies will fill the prescriptions for certain antibiotics for FREE. Our BPS Health Plan pharmacy program, administered by CIGNA, is detailed on their website at www.mycigna.com .

10

SLIDE 11 When there are several equally effective medication choices available, it makes sense to use the least expensive options whenever possible. The Pharmacy Step Therapy program could save both you and your benefits trust fund substantial cost, which saves all of us money. The program requires that individuals use one or more lower-cost medications first before moving to higher- cost, non-preferred brand-name drugs in certain therapeutic categories. CIGNA will work with you and your doctor to be sure that you are using the best drug for your care. This program targets only 14 categories of non-preferred brand- name medications, so if you are currently taking generic or preferred brand name drugs, you will not be affected by this new program. If you want to see a list of the drug categories or check to see if a drug is on the step therapy, non-preferred brand-name list, you can do this by visiting www.mycigna.com

11

SLIDE 12 Our goal is to hold your costs down as much as possible while providing quality benefits. The Delta Dental Plans, Humana Vision Plan, and The Hartford’s Short and Long-Term Disability and AD&D products rates are actually decreasing. By visiting the district Benefits website, http://benefits.brevardschools.org/Benefits.htm you can also find a link to a video presentation which provides a detailed description of the Dental plans and benefits. The video will explain the differences in the plans and help you to make an informed decision regarding what option is best for you and your family… If you are adding Hartford’s Short-Term or Long-Term Disability plans for the first time, you will need to complete an Evidence of Insurance application to be approved for this coverage. This application will be sent to you by The Hartford.

12

13

Slide 13

Dental coverage for 2013 is the same with 4 different plan options: Two DHMO products provided by DeltaCare USA and Two PPO products provided by Delta Dental. All the premiums are paid by the employee through payroll deductions using pre-tax dollars, and there are no design changes with any of the BPS dental plans. There will be no increase in cost for the DHMO dental products in

• 2013. As a matter of fact, there will be a decrease in rates for you!

This chart shows the premiums for the two DHMO DeltaCare plans.

Draft

14

Slide 14

There will also be a decrease in premiums for the two PPO plans! This chart shows the premiums for the two Delta Dental PPO plans. For complete descriptions of all dental plan designs and how they work, please refer to our Benefits Website.

Draft

Slide 15

As you recall, BPS introduced the spousal surcharge a couple of years ago for medical coverage only, and this will continue to be in place after January 1, 2013. This surcharge will not apply to you if your spouse does not work, works for an employer who does not offer medical insurance for its employees, works for Brevard Public Schools, or if your spouse is eligible for a government-sponsored medical plan such as Medicare. Also, the surcharge will not apply if your spouse elects medical coverage through his or her employer, and is also enrolled in medical coverage under your plan. In that instance, your spouse’s plan will be utilized as primary coverage, and the BPS Health Plan will be secondary coverage. Again, this is only for MEDICAL coverage, not dental, vision, or other benefit options.

15

SLIDE 16

If you have previously completed an affidavit, the determination of whether or not you currently pay a spousal surcharge will remain in place, but ONLY if you update your Affidavit during Open Enrollment. This can be done easily by going to the enrollment website and clicking the AFFIDAVIT AFFIRMED button. Everyone who newly enrolls his or her spouse in medical coverage during this open enrollment will be assessed the monthly surcharge – unless you complete an affidavit stating the surcharge does not apply to your spouse’s situation. The affidavit will pop up if you are enrolling your spouse for the first time. It must be printed, completed, and signed, and the ORIGINAL affidavit must be returned to the Compensation and Benefits Office no later than November 15, 2012. You must send the original document; no faxes or scanned copies will be accepted.

16

SLIDE 17

Health Care Reform extended the maximum age for dependent coverage to age 26. The child has to be your natural child, step child, or adopted child, and not have insurance available through other group

• coverage. The child’s coverage will terminate, however, at MIDNIGHT on the child’s 26th birthday.

Do not confuse this with the Florida Statute, which provides coverage for your children between the ages

• f 26 and 30. This coverage requires a child to:
• Be your financial dependent;
• Be unmarried with no dependents of his or her own;
• Reside in the state of Florida OR is a full or part-time student;
• Not have medical insurance available through his or her employer,
• Not covered under any other medical insurance plan.

If this child remains eligible, coverage will terminate on December 31st of the year the child turns 30. Please note: Children are automatically dropped from medical, dental and vision when they turn 26 UNLESS you add them as an Overage Dependent. If your dependent child is between the ages of 26 and 30 and qualifies for coverage, you must complete the Dependent Age 26 - 30 Affidavit to receive coverage. Children are automatically dropped from Accidental Death & Disability (AD&D) when they turn 22 and Dependent Life insurance when they turn 26. On a separate note, grandchildren can only be covered until they are 18 months old as long as their parent, your child, is being covered on the BPS Health Plan or you become their legal guardian.

17

SLIDE 18 Medical Flexible Spending Accounts, or Medical FSAs, continue to be a great way to increase your buying power and reduce your taxable income. If you wish to continue or start an FSA which begins on January 1, 2013, you must go on-line to enroll and select this option during open enrollment. You can elect up to a total of $2,500 for this plan year. This amount is lower than the previous maximum of $5,000 in compliance with Health Care Reform. You can use these pre-tax dollars to cover additional medical, pharmacy, dental, and vision out-of- pocket expenses; the entire amount you elected is pre-funded and will be available for your use ON January 1st, 2013. The annual amount you choose will be divided by the number of pay periods in the calendar year, and your gross pay will be reduced by that amount each paycheck on a pre-tax basis. As always, your medical, dental, and vision plan premiums are not eligible for reimbursement from your medical FSA. And because of federal healthcare reform, over-the-counter medications are still not reimbursed through the FSA without a written prescription. A complete list of eligible expenses can be found on the Benefits website. Remember – plan carefully when determining how much to put in your medical Flexible Spending

• Account. The IRS imposes the “use it or lose it” rule, which means any account funds not used during

the benefit period will be forfeited and cannot be returned to you by law. If you enrolled in the FSA previously, then your new FSA amount will be loaded onto your existing card. DO NOT THROW OUT YOUR CURRENT YEAR FSA CARD!

18

19

Slide 19

Using the Dependent Care FSA provides another way to use TAX FREE dollars to pay for your eligible dependents’ care expenses. The annual amount is divided by the number of pay periods in the year, and your gross pay is reduced for each paycheck by that amount on a pre-tax

• basis. Your election for the Dependent Care FSA can be up to $5,000 if

you are married filing a joint income tax return or a single parent. If you are married, but file separately, you are limited to $2,500. This kind of FSA is not pre-funded—you can only use the funds that have been withheld each pay period. You cannot be reimbursed for funds that have not yet been withheld. If you wish to continue or start a Dependent Care FSA which begins on January 1st, 2013, you must enroll during this open enrollment. This account will not automatically roll over for plan year 2013.

SLIDE 20

If you do not want to make any changes to your medical, dental, life, STD, LTD, or AD&D coverage's, your current benefits, you do not need to go online to enroll because your current selections will automatically roll over. However, you may have to update one or more of the following:

• 1. The Spouse Medical Plan Affidavit, if your spouse is covered by the

medical plan.

• 2. The Dependent Age 26 to 30 Affidavit, if you want to cover a

dependent child between the ages of 26 and 30.

• 3. The Medical FSA, because enrollment is required each year, if you

want to participate.

• 4. The Dependent Care FSA, because enrollment is required each year,

if you want to participate.

20

SLIDE 21 So, what do you have to do if you need to enroll this year? Actually, the online enrollment process is pretty much unchanged. Here is an example of what you will see when you go

• nline to enroll.

All of your current benefits elections for 2012 (except for any flexible spending accounts you may have) will automatically populate your selections for 2013. These are the elections for medical, dental, vision, short- and long-term disability, additional life insurance, and AD&D that will carry over into 2013, unless you wish to make any changes to this screen and submit your changes during the open enrollment window. Your password to log-on to www.EasyBenefits.com enrollment website has not changed since you last enrolled. You will, however, receive your password letter from your Site Benefits Contact on October 15, about a week before the Open Enrollment begins on October 22. Please read this letter, as very important information regarding your Open Enrollment is included. If you have any questions about the online enrollment process, please first contact your Site Benefits Contact,

• r

you may submit any questions via email to benefits@brevardschools.org If you are a new employee and are just now signing up for 2012 plan year benefits, please note that you will have to enroll again for 2013, but only if you want to make any changes for 2013, or if you want to sign up for a 2013 flexible spending account.

21

SLIDE 22 All of the information we have just reviewed, plus details about all of our other benefits plans, is available

• n

the Benefits Website http://benefits.brevardschools.org/benefits . Each employee is encouraged to utilize this website to more fully understand the District’s benefits package. If you have any further questions, please ask your school or site Benefits Contact,

• r send an email to benefits@brevardschools.org

Brevard Public School’s suite of benefits offerings can make a big difference in the health and well-being for you and your family! Thank you for your time and attention to this important information that affects you. Please remember that online open enrollment starts on Monday, October 22nd and ends at 11:59 pm on Thursday, November 1st. In so many ways, we’ve got you covered!

22