Open Enrollment Health Blue Cross Blue Shield of Illinois - - PowerPoint PPT Presentation

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Open Enrollment Health Blue Cross Blue Shield of Illinois - - PowerPoint PPT Presentation

Jun 08, 2023 377 likes •833 views

Open Enrollment Health Blue Cross Blue Shield of Illinois Insurance Dental Delta Dental Insurance Vision Vision Service Plan (VSP) Insurance Flexible Horace Mann - Payflex Spending Account VOYA Life Insurance Employee

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Open Enrollment

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Health Insurance

  • Blue Cross Blue Shield of Illinois

Dental Insurance

  • Delta Dental

Vision Insurance

  • Vision Service Plan (VSP)

Flexible Spending Account

  • Horace Mann - Payflex

Life Insurance

  • VOYA

Employee Assistance Program (EAP)

  • Perspectives

Retirement Planning

  • TransAmerica
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Health Insurance

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4 plans to choose from

HMO of Illinois PPO Plus Blue Choice Select PPO BlueEdge HSA

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HMO of Illinois

  • The HMO plan has the lowest payroll deductions
  • There are no deductibles only co-payments
  • Preventive Care covered at 100%
  • $20 copay per Office or Urgent Care visit
  • $75 copay per Emergency Room visit, waived if admitted
  • You must select a Medical Group and Primary

Care Physician (PCP)

  • Family members may each select there own Medical Group and/or

Primary Care Physician (PCP)

  • Women may also select a Women’s Health Care Provider (WCHP)
  • All services must be provided or referred by a Primary Care

Physician (PCP)

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3 plans have a deductible, coinsurance, and out-of- pocket limit

PPO Plus Blue Choice Select PPO BlueEdge HSA

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PPO Plus

  • Larger Network of Providers
  • In-Network and Out-of-Network Annual

Deductible are combined

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Blue Choice Select PPO

  • Smaller network than PPO Plus
  • In-Network and Out-of-Network Annual Deductibles are not

combined

  • Monthly insurance premiums are less than PPO Plus and HSA

Plan

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BlueEdge HSA

  • Same network as the PPO Plus
  • In-Network and Out-of-Network Annual

Deductibles are not combined

  • Monthly insurance premiums are less than PPO

Plus

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  • District 300 will contribute:
  • Annually $750 Single/$1,500 Family
  • Prorated if enrolled after January 15th
  • You can contribute money into your own account on

a pre-tax basis up to the annual IRS limit

  • HSA participants will need to open an employee
  • wned HSA bank account with First American Bank to

deposit contributions.

  • Funds may be used to pay:
  • Plan deductibles, coinsurance, and co-pays
  • For dental and vision expenses

Blue Edge HSA Savings Account

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PPO and HSA Plans

  • Do not require you to select a Medical Group or

Primary Care Physician (PCP)

  • Preventive Care covered at 100%
  • $150 Emergency Room copay, then 10%

(waived if admitted)

  • Four Tiers
  • Single/Individual
  • Employee + Children
  • Employee + Spouse
  • Family
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Prescriptions

  • 90 Day Supply (for the cost of two months)
  • HMO – Mail In and participating retail pharmacy
  • PPO & HSA - Mail In Only
  • Mandatory Generic Substitute
  • HMO – No, but responsible for difference in

copays

  • PPO & HSA - Yes
  • CVS Pharmacy In-Network
  • HMO – Yes
  • PPO & HSA - No
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Prescription Costs

HMO In-Network PPO Plus Blue Choice PPO HSA

Retail- Generic 34 day supply

$15 $15

($15 + 25% Out of Network)

$15

($15 + 25% Out of Network)

10% after deductible

Retail- Formulary 34 day supply

$30 $30

($30 + 25% Out of Network)

$30

($30 + 25% Out of Network)

10% after deductible

Retail- Non- Formulary 34 day supply

$50 $50

($50 + 25% Out of network)

$50 ($50 + 25% Out of network) 10% after deductible

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Things to Remember

  • Plan year is January 1st to December 31st
  • Fourth quarter rollover (PPO and Blue Choice PPO)
  • October – December
  • Active open enrollment is from October 15 – November 15
  • Wellness Screening Penalty - $20 per month/$240 per year
  • Special Enrollment – (qualifying event) allow you to make

changes to your plan outside open enrollment. Examples are:

  • Loss of coverage
  • Birth or Adoption
  • Marriage or Divorce
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SLIDE 15

BCBS Programs & Tools

  • Blue365
  • Well onTarget
  • Blue Access for Members

(BAM)

  • Provider Finder
  • Summary of Benefits (SBC)
  • Certificate of Coverage
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BAM Mobile - BCBSIL

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1.800MD Telemedicine

  • Telemedicine is available via phone or video

consultation for PPO and HSA participants at no cost to them

  • HMO Members are not eligible to participate

in this program

  • Physicians are Board certified and licensed
  • Prescriptions can be written if warranted
  • Participants must register and fill out a health

history online prior to their consultation

  • Physicians are able to treat common

conditions 24/7/365 which include:

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1.800MD - Telemedicine

  • Allergies
  • Arthritic Pain
  • Bronchitis
  • Certain Rashes
  • Cold/Flu Symptoms
  • Ear Infections
  • Headaches/Migraine
  • Insect Bites
  • And many more non-emergency medical

conditions

  • Sprains/Strains
  • Respiratory Infections
  • Stomach

Ache/Diarrhea

  • Sore Throat
  • Urinary Tract Infection
  • Minor Burns
  • Sinus Infections
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  • BCBS In-network provider
  • First provider in country to offer MRIs for an all-inclusive fee
  • f $600 or less
  • State-of-the art GE technology
  • Expertly trained clinical staff
  • All scans read by subspecialized radiologists from the

Cleveland Clinic

  • Evening & weekend appointments
  • Illinois locations: Schaumburg, Glenview, Skokie, Chicago,

Lombard, Bolingbrook, Oswego, and Vernon Hills

If you are a PPO or HSA participant, District 300 will contribute $100 to your HSA, HRA or FSA account for every Smart Choice MRI

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Dental Insurance

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3 plans to choose from

DHMO PPO Premier PPO

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Delta Dental

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DMO

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Vision Insurance

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Vision Insurance Plan (VSP)

  • Eye Exam
  • $5 copay
  • Every 12 months
  • Prescription Glasses
  • $10 copay
  • $105 - $125 allowance
  • Every 24 months
  • Lenses
  • Copay included in

Prescription Glasses

  • Every 12 months
  • Contacts
  • Copay for exam up to $60
  • $105 allowance for

contacts (instead of glasses)

  • Every 12 months
  • Diabetic Eyecare Plus

Program

  • $20 copay
  • Frequency as needed
  • Ask your VSP doctor for

details.

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Flexible Spending Accounts (FSA)

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Health Care FSA

  • 2019 Maximum contribution is $2,700
  • 2020 Maximum contribution – To be announced
  • Funds can be used for:
  • Medical, dental, and vision deductibles, coinsurance,

and/or copays

  • Glasses, contacts, contact solution, Lasik surgery
  • HSA Participants may also participate in a Limited Health
  • FSA. Funds may by used on vision and dental expenses only
  • Health FSA Carryover - $500 or less can be carried over to

the following plan year for eligible expenses. A $50 minimum enrollment in the new plan year is required.

  • 90 day run out period – A run out period is the additional

time you have to submit eligible claims after the end of the plan year. The last day to submit claims is March 31st

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Dependent Care FSAs

  • Maximum contribution of $5000 per year per family.
  • Dependent care funds can only be reimbursed after

funds have accrued in account and accessed by filing a claim reimbursement form.

  • Dependent Care provider must be declaring income.
  • 90 run out period
  • Example: You have an eligible claim on November

1, 2019 you have until March 31, 2020 to submit for reimbursement

  • No carryover from previous plan year.
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Life Insurance

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Group Life Insurance

  • Automatically enrolled in a Board Paid Term Life

Insurance Policy

  • Refer to your group agreement for coverage amount
  • Age Reductions
  • 67% of covered amount at age 65
  • 50% of covered amount at age 70
  • Accidental Death & Dismemberment and

Personal Loss

  • An additional benefit if you die, lose your hands, feet,
  • r vision as the result of an accident
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Supplemental/Voluntary Life Insurance Available to Employees, Spouses and Children To enroll or change your current coverage submit a VOYA Enrollment Form to HR.Benefits@D300.org AND Must complete a Statement of Health if enrolling in new coverage OR if you enroll increase your current coverage

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Rapid Identity

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Employee Benefits Resource Center

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Employee Assistance Program (EAP)

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Employee Assistance Program

  • Provides Short Term Counseling
  • Further treatment referred to network

providers

  • Available 24/7
  • Call 800-456-6327
  • If emergency, immediately connected with

a counselor

  • Legal and Financial help
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Retirement Planning

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TRANSAMERICA

 Eligibility

 All employees are eligible to enroll in this plan on their date of hire  You can enroll in a retirement plan at anytime

 Create an account with Transamerica and select your contribution amount

 Types

 403(b) – Pre-tax contribution  Roth – After-tax contribution

 Contributions

 Minimum Deferral Amount

 1% of pay

 Maximum Deferral Amount:

 2019 limit is $19,000  Catch Up Contributions (age 50+) limit is $6,000

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D300 Wellness Program Wellness Screenings

Step 1: Log into screening portal nm.chcw.com and enter 4123Com143 in the “New Participants” tab Step 2: Select your screening option:

  • 1. Onsite through Northwestern Medicine
  • 2. Offsite through Northwestern Medicine
  • 3. Your Physician
  • a. CHC Wellbeing Physician Form
  • Penalty waived and earn wellness points
  • b. Premium Discount Only – Physician Screening Form
  • Penalty waived, no wellness points earned

Step 3: Complete the Health & Lifestyle Survey if participating through Northwestern Medicine

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D300 Wellness Program

Information on the Wellness Program may be found on Haiku > D300 Operations Portal > Wellness Program

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D300 Wellness Program

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D300 Wellness Program

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D300 Wellness Program

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D300 Wellness Program – Newsletter

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Need Help?

District contact information:

Lisa Adame Benefits Coordinator

Elizabeth.Adame@d300.org PH: 847-551-8358 FX: 847-551-8493

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