ROCKFORD PUBLIC SCHOOLS 2018 OPEN ENROLLMENT 3 Plans PPO500 (RBMA, - - PowerPoint PPT Presentation

ROCKFORD PUBLIC SCHOOLS 2018 OPEN ENROLLMENT

3 Plans

 PPO500 (RBMA, HI)

 $500 Individual Deductible

 PPO1000

 $1000 Individual Deductible

 High Deductible Health Plan (HDHP)

 $2500 Individual Deductible  Health Savings Account Component

3 Plan Designs

PPO 500 PPO 1000 HDHP

In Out In Out In Out Office Visit $15 50% $15 50% Ded/Coins Ded/Coins Specialist $25 50% $25 50% Ded/Coins Ded/Coins Deductible Single $500 $1,000 $1,000 $2,000 $2,500 $5,000 Family $1,500 $3,000 $2,000 $4,000 $5,000 $10,000 Out of Pocket Max Single $3,500 $7,000 $4,000 $8,000 $3,500 $7,000 Family $7,500 $15,000 $8,000 $16,000 $7,000 $14,000 Coinsurance 80% 50% 80% 50% 80% 50% The Out of Pocket Maximum Includes the Deductible

• In Network - 100% covered with no cost sharing (not subject to

deductible)

• Out of network – 50% covered (not subject to deductible)
• Preventative services include:
• Adults:
• Cholesterol screening, immunizations, mammography,

pap smear, colonoscopy, routine annual physical

• Children:
• Immunizations, routine annual physical

Preventive Care is Subject to Federal Guidelines as Laid Out by HHS Including Age and Frequency Limits.

Preventive Care – All Plans

Prescription Coverage - Express-Scripts

PPO 500 PPO 1000 HDHP

Rx Co-pays- Retail*

(30 Day Supply)

15/40/60* NA 15/40/60* NA NA NA Rx Co-pay – Mail

(90 Day Supply)

30/80/120 NA 30/80/120

*Prescriptions filled at Walgreens and CVS will cost an additional $10.

• Mail order for maintenance drugs is mandatory after 3 fills at the

local pharmacy.

• Can access information on-line to:

www.express-scripts.com

• Check whether medication is covered.
• Compare mail order vs pharmacy cost.
• Check for generic equivalent or formulary alternatives.

Prescription Co-pays

• Prescriptions purchased at CVS or Walgreens

will cost an additional $10 each.

• Possible less expensive alternatives:
• Wal-Mart
• K-Mart
• Meijer
• Sam’s Club
• Schnucks

Mail order for maintenance drugs if mandatory. 90- day supply through mail order vs. 30-day supply at local pharmacy.

BlueCross Network Provider Options

 Physicians

 Per Online Directory  www.BCBSIL.com

 In-Network Hospitals

 OSF St. Anthony  Swedish American  Mercy/Rockford Memorial Hospital

The Humana Network Will No Longer Be An Option As Of July 1st 2018.

1 Dental Plan

 Annual Deductible:

 $50 Individual, $150 Family  N/A to preventive /diagnostic

 Services paid at:

 Preventive

100%

 Basic

80%

 Major

50%

 Orthodontia

50%

 Annual Benefit Limit:

 $1,500

 Orthodontia Lifetime Limit (children up to age 19):

 $1,500

 Out of network is paid based on usual and customary.

Deductible and Annual Benefit Limit will reset as of July 1, 2018

Health Savings Accounts (H.S.A)

 Those who elect the HDHP are eligible to open a Health

Savings Account (H.S.A.).

 You can contribute pre-tax dollars:  $3,450 Individual annually per household  $6,850 family annually per household  District will make a contribution to YOUR account.  “Use it and keep it” - $$$ belongs to you.  Debit Card, Checkbook to pay co-pays, deductibles and other

• ut-of-pocket healthcare expenses.

 Additional information on the H.S.A is available on Employee

Online.

RPS Annual HSA Funding

• Those enrolling in the HDHP need to complete an application for an HSA

account with Associated Bank (no fees).

• RPS will transfer the amounts below into your Associated HSA bank

account based on medical enrollment status.

• Funds are available to you on day one of the plan year.
• Pretax payroll deductions are allowed – contact HR for information.
• Interest earned grows tax free.
• Mutual fund options are available at a nominal fee.

Single Employee Plus Spouse Employee Plus Child(ren) Family Standard $400 $700 $600 $800 Wellness $250 $500 $550 $700 Total (W) $650 $1200 $1150 $1500

Amounts in Purple are additional dollars provided to those who participate in the wellness program

Flexible Spending Account

 You must enroll in Flexible Spending each year through

Employee Online to participate.

 Medical/Dental Flexible Spending Account:

 $2,650 annual maximum contribution per family.

 Limited Flexible Spending Account is for dental/vision

expenses only:

 Must be enrolled in the HDHP with a HSA.  $2,650 annual maximum contribution per family.

 Dependent/Day Care Flexible Spending Account:

 $5,000 annual maximum contribution per family.

Medical Plan - ER Visits PPO500/PPO1000

This is the amount you pay for emergency room visits:

• In-Network
• $200 co-pay
• Co-pay is waived if admitted.
• Deductible and co-insurance apply to

additional services.

A True Emergency Will Always Be considered In-

• Network. Also, Immediate Care is covered at $15

copay

TELADOC

How it works:

 Contact Teladoc



Access via phone, video or mobile app.

 Talk with a physician



Physician will review the medical history.

 Resolve the issue



Physician will diagnose and prescribe medication, if necessary.

 U.S. Board Certified

Physicians in internal medicine, family practice, emergency medicine or pediatrics.

 U.S. residents and state

licensed.

24/7/365 ACCESS TO PHYSICIANS TELADOC PHYSICIANS

Conditions Treated

$15/$40 Co-pay due at time of service.

Wellness

• All new hires (hired after July 1)

automatically receive wellness premiums. HDHP participants receive wellness contribution to a Health Savings Account.

• Must earn 100 points to keep the lower

wellness premiums.

• Points are earned from June 1 – March

31.

• Points must be entered on a website by

the employee.

Wellness – How To Earn Points

• Biometric Screening (free) – 50 points
• Fax results to your doctor – 10 points
• Participate in Challenges – 10 points each (4 challenges

scheduled)

• Participate in a Local Event – 5 points each/30 point max
• Complete preventive exams – 5 points each/20 point max
• Log exercise – 1 point each/30 point max
• And more…

 April 2nd, 2018 through April 19th, 2018 (No later than

4:30pm)

 Changes will take effect July 1, 2018

• Allowed enrollment changes

 Choose Between Available Health Plans  Make/Change Annual FSA Elections  Elect/waive medical/dental coverage  Add/remove dependents from medical/dental coverage

Online Open Enrollment

 Other than during Open Enrollment, you must have a

qualifying event to make changes

Marriage, divorce, legal separation, annulment, death of spouse, birth, adoption, permanent legal guardianship, spouse open enrollment.

 Information regarding Online Enrollment will be distributed

via District email. For IT/email support, contact the Help Desk, M-F 8AM to 5PM at (815) 966-3112, Select Option 1

Online Open Enrollment

 We will use Employee Online (Added Benefits Modules as of 2018)

Open Enrollment.

 You will be able to make the following Changes:  Add or drop dependent(s)  Add or drop your Dental or Health plan(s)  Change health plans  Adjustments to or election of Voluntary Life and AD&D  Elect Flexible Spending Plan (Annual enrollment)  Please note that Employee Online is used to confirm or enroll the

changes to the items listed above. This is a positive enrollment and everyone must re-enroll/enroll. All changes you make in Employee Online will be saved and applied the 7/1/2018 effective date.

Open Enrollment Process

Open Enrollment “How To”

Open Enrollment “How To”

Points to Remember

 Open Enrollment needs to be completed

through Employee Online by April 19th, 2018 at 4:30pm.

 Now is the only time to make changes for

fiscal year July 1, 2018 through June 30, 2019 without a qualifying event.

 You have 30 days after a qualifying event

to make allowed changes to your benefits.

 Spousal Coverage Rule.  All medical and dental changes will be

effective July 1, 2018.

 This

is a positive enrollment not participating will jeopardize your coverages for the plan year July 1, 2018 through June 30, 2019.

There is only one Open Enrollment period for Medical and Dental, this will be your only

• pportunity to make

benefit elections for July 1, 2018 through June 30, 2019!

Additional Open Enrollment Date with labs

 Wednesday, April 4

11:30 Adm Building-Computer Lab

 Thursday, April 12

4:30 Adm Building-Computer Lab

Questions? Thank you for your time!