ENV INSURANCE AGENCY Retiree Dental & Vision Benefits
Introduction ENV Insurance Agency's Call Center 315-641-5848 --- Mon-Fri 8am-5pm CallCenter@InsureWithENV.com All info from presentation will be on district website Presentation Notes Please mute yourself If you have questions, please type them in the chat feature. We will answer them at the end. When using the chat feature be sure to "Send to: Everyone"
Offerings & Eligibility To Be Eligible: Completely optional offering You must have a New York state address Dental plan through Ameritas for at least one High plan (BLUE) and low plan (ORANGE) options month of the year Vision plan through Davis Vision High plan (BLUE) and low plan (ORANGE) options If you do not have a NY address, please contact ENV for alternative options
Dental Plan
Dental Plan Highlights Provides a 25%-35% discount on services before benefit package kicks in $1,500 annual maximum. Per-Person, Per-Year 2 exams/year (100% Covered, In-Network) Out-of-Network claims paid at 80th UCR 80th UCR= 8/10 doctors considered the cost as Usual, Customary & Reasonable in zip code Vision Fusion option $150 vision reimbursement off dental annual maximum
Dental Plan Details Total Deductible for All $75 per-person, per-calendar year. Procedures and Services Annual Maximum Benefit $1,500 per-person, per-calendar year. Preventative: 0 Months Waiting periods waived if member Waiting Periods Basic: 6 Months enrolls before Nov. 1st 2020. Major: 12 Months Option to reduce dental $150 Annual Maximum per- Eye Care (Fusion) Benefit maximum by $150 and apply person, per-calendar year. toward vision services. Once enrolled, must remain If you term at any point, re- Enrollment Rules on plan for 12 months. enrollment is not allowed.
Dental Plan Coverage
Example: Amalgam Filling UCR If you receive a restorative amalgam filling at an out-of-network provider. The BLUE plan covers Amalgam Fillings at 80% of the 80th percentile of what is considered "usual, customary & reasonable" (UCR) for out-of- network providers. In the 14850 zip code (Ithaca), 8 of every 10 dentists (80th UCR) charge $143 for a amalgam procedure. The plan covers 80% of that expense: $114.40 The member is then responsible for the remaining 20%: $28.60 Note that there may be an additional balance bill for out-of- network services if the dentist charges more than the $143 for the amalgam filling procedure. Ask dentist for predetermination before services
Example: Crown UCR If you need an emergency crown but cannot wait to see your in- network provider OR you choose to use an out-of-network provider. Both the BLUE and ORANGE plans cover crowns at 50% of the 80th percentile of what is considered "usual, customary & reasonable" (UCR) for out-of-network providers. In the 14850 zip code (Ithaca), 8 of every 10 dentists (80th UCR) charge $1,125 for a crown procedure. The plan covers 50% of that expense: $562.50 The member is then responsible for the remaining 50%: $562.50 Note that there may be an additional slight balance bill for out-of-network services if the dentist charges more than the $1,125 for the crown procedure. Ask the dentist for predetermination before services
Dental Providers Snapshot of providers just in the City limits of Ithaca Full searchable list is available on the district website
See handout on district website for more results!
Dental Plan Rates Blue Plan Orange Plan EE: $49.82 EE: $45.46 EE+1: $98.80 EE+1: $90.32 EE+Fam: $152.00 EE+Fam: $142.29
Vision Plan
Vision Plan Highlights Broad array of paid-in-full coverage Low member out-of-pocket cost One year breakage warranty Up to a 50% discount on additional pairs of glasses Standard scratch resistant coating on plastic lenses free of charge Once enrolled, must remain on plan for 12 months If you term at any point, re-enrollment is not allowed
Vision Plan Coverage Blue Plan Orange Plan
Vision Plan Coverage Blue Plan Orange Plan
Vision Plan Coverage Blue Plan Orange Plan
Local Vision Providers Ithaca, NY Empire Vision Works 722 S. Meadow St. Optivision of Ithaca 106 E State St. America's Best Contacts & Eyeware 748 S. Meadow St. Walmart Vision Center 135 Fairgrounds Memorial Pkwy
Vision Plan Rates Blue Plan Orange Plan EE: $7.13 EE: $5.06 EE+1: $13.55 EE+1: $9.62 EE+Fam: $20.83 EE+Fam: $14.79
Find a Provider Info on District Website Vision Dental
Find a Provider Info on District Website 3983 3984
Dental Plan Enrollment Forms to be completed Ameritas "Application, Individual Insurance Form" Be sure to list "Ithaca City Schools" under your affiliation ENV Payment Verification Form Pro-Flex Automatic Payment (ACH) Request form How to submit the forms Scan and email forms to: callcenter@insurewithenv.com Mail to: ENV Insurance Agency / ATTN: Call Center, 7789 Oswego, Rd Liverpool, NY 13090 How to waive waiting periods For October 1st 2020 effective date: Submit all forms to ENV by end of September For November 1st 2020 effective date: Submit all forms to ENV by end of October After that point, provide proof of dental coverage within 30 days of enrollment
Vision Plan Enrollment Forms to be completed Davis Vision Enrollment Application ENV Payment Verification Form Pro-Flex Automatic Payment (ACH) Request form How to submit the forms Scan and email forms to: callcenter@insurewithenv.com Mail to: ENV Insurance Agency / ATTN: Call Center, 7789 Oswego, Rd Liverpool, NY 13090 If you would like to enroll in BOTH vision and dental, you do NOT need to submit the Proflex and ENV payment forms twice
Thank you! ENV is here to support the Ithaca CSD Retirees Call us at 315-641-5848, Mon-Fri from 8am-5pm or Email us at: CallCenter@InsureWithENV.com
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