2020 Health Benefits Open Enrollment Open Enrollment Period August - PowerPoint PPT Presentation

2020 Health Benefits Open Enrollment Open Enrollment Period August 14, 2020 to September 14, 2020 Plan Year October 1, 2020- September 30, 2021

Agenda • Open Enrollment, Eligibility, Benefit Offerings and Costs • Medical Plans • Dental Plan • Vision Plan • Employee Assistance Program • Life and AD&D Insurance • Long-Term Disability Insurance • Section 125 Flexible Spending Accounts • Dependent Verification Review

Open E en Enrollmen ent, Eligib ibili lity, B , Benefit fit Offerings ngs & & Costs

What is Ben Benef efits Open pen Enrollm llment? It’s the one time each year you can make changes to the following health benefits: • Medical plan selection • Dependent enrollment changes without a qualified event • Section 125 Flexible spending accounts (IRS requires new elections each year) • Voluntary long-term disability plan participation All open enrollment information, forms and resources can be found at www.scccd.edu/openenrollment Remem ember er - ch changes m made d durin ring t the o ope pen enroll llment pe peri riod w will be ill beco come effective O October 1, 1, 2020. 2020.

Emplo loyee E Elig igibilit lity All regular, full-time management, confidential, classified, and faculty employees, as well as their eligible dependents. Eligibility guidelines can be found in the bargaining unit agreements or Board Policy/Administrative Regulations.

Dependent E Elig igib ibili lity ty Elig ligib ible depe pendents in inclu lude: Legally married spouse • Registered Domestic Partner • Child(ren)* – A “child” includes a natural biological child, adopted child, step-child, a child you • have legal guardianship over (such as foster child) and a child for whom coverage is required due to a medical support order. *Dependent children are eligible to continue on the health plans up until the age of 26. Elig ligib ible d depe pendents do not in inclu lude: • a spouse (and stepchildren) following legal separation or a final decree of dissolution of marriage or divorce; • any person who is on active duty in a military service, to the extent permitted by law. It is is the emplo loyee’s r respo ponsibi bility t to notif ify the Dis District Human R Resources O Offic ice – benefi efits s staff ff and m make c changes t to t the h healt lth in insurance pla plans wit within in 3 30-days f from t the q quali lifying e event date.

Depende dent E Eligi gibilit lity S Suppo porting ing Do Docum ument ents To enroll your eligible dependent(s), the following documentation must accompany the enrollment form. Dependent Type Official Document SSN Verification Spouse Certified copy of the marriage certificate Copy of the Social Security Card Registered Domestic Partner Copy of Declaration of Domestic Partnership Copy of the Social Security Card with the California Secretary of State Biological Child(ren) Certified copy of the birth certificate naming Copy of the Social Security Card employee as child’s biological parent Step-Child(ren) Certified copy of the birth certificate(s) Copy of the Social Security Card naming current legally, married spouse as the child’s biological parent. Applicable spouse documentation required as well. Foster Child, Legal Certified copy of the birth certificate(s), Copy of the Social Security Card Guardianship or Adopted Child along with legal court documentation showing adoption, legal responsibility and/or guardianship of the child(ren).

Mid-year changes (outside of Open Enrollment) If you have a qualifying life event during the plan year and you wish to make a change to your health insurance plans, you must take action within 30-days from the qualifying event date. Examples of qualifying life events: Examples of qualifying life events: • Marriage • Divorce • Birth of a child • Adoption of a child • Eligible dependent loses their health care coverage (not currently enrolled on your plans) You will be required to submit: You will be required to submit: • Health Insurance Plan Change Enrollment Form • Supporting documentation (marriage certificate, birth certificate, court order, final judgment for divorce)

Dependent Eligibility Review Reminder • The District, as part of the EdCare Group, conducts a dependent eligibility review every three (3) years. • The next review will take place in 2022. • A Dependent Eligibility Review allows the EdCare group make sure the health benefit plans are compliant with state law, are competitive, and cost effective for our members (you). • The review also helps the EdCare Group manage overall plan costs which benefits all members.

Hea Health Insurance Ben Benef efit Offerin ings The District is part of a joint powers authority (JPA) known as EdCare. All of the health insurance plan offerings are self-funded, except for the Kaiser HMO plans. Our insurance broker is Barthuli & Associates. Our broker team assists the District with the health plans and is available to assist members with general questions, claims, etc. Phone: (559) 385-7510 Website: http://www.edcaregroup.com/

Health Insurance Ben Hea Benef efit Offerin ings Four (4) Medical Plan Options • Modern Care PPO • Bronze PPO • Kaiser HMO High Plan • Kaiser DHMO Low Plan • PPO Dental Plan • Vision Plan • Employee Assistance Program (EAP) • Group Life & AD&D Insurance • Voluntary Long-Term Disability Insurance • Voluntary benefits (such as AFLAC & American Fidelity) •

2020 2020-2021 2021 H Health P Plan C Cost osts • The District pays the premiums in full for dental, life, vision and EAP insurances. • There is no additional cost to add dependents to your medical, dental, vision, life and EAP plans. Medica cal I l Insurance ce Pla lans for for C CSEA, SCFT a and nd Mana nagement & & Con onfident ntial Plan Monthly Employee Payroll Deduction Bronze PPO Medical Insurance Plan $194 Modern Care PPO Medical Insurance Plan $381 Kaiser Low DHMO Medical Insurance Plan $0 Kaiser High HMO Medical Insurance Plan $619.54 All voluntary products are paid for by the employee.

2020 2020-2021 2021 H Health P Plan C Cost osts • The District pays the premiums in full for dental, life, vision and EAP insurances. • There is no additional cost to add dependents to your medical, dental, vision, life and EAP plans. Medica cal I l Insurance ce Pla lans for for POA OA Plan Monthly Employee Payroll Deduction Bronze PPO Medical Insurance Plan $158 Modern Care PPO Medical Insurance Plan $345 Kaiser Low DHMO Medical Insurance Plan $0 Kaiser High HMO Medical Insurance Plan $583.54 All voluntary products are paid for by the employee.

Medi dical P Plans ns

Ka Kaiser H r HMO P Plans Ben Benefit Sum ummary BENEFITS HIGH HMO LOW DHMO Lifetime Maximum None None $1,500 One-party $4,000 One-party Annual Copay Maximum $3,000 Two or more members $8,000 Two or more members Calendar Year Deductible None *$2,000 One-party/$4,000 Two or more Coinsurance Paid in full except copayments as indicated *20% after deductible Office Visit $25 copay/visit $20 copay/visit Chiropractic Not Covered Not Covered Well Baby Care No Charge No Charge Physical Exams No Charge No Charge Hospital Inpatient Benefits $500 per admit *20% after deductible Hospital Outpatient Surgery $100 copay per procedure *20% after deductible Emergency Room $100 copay per visit (waived if admitted) *20% after deductible Urgent Care $25 copay/visit $20 copay/visit

Ka Kaiser H r HMO P Plans Ben Benefit Sum ummary - Cont ntinued ued BENEFITS HIGH HMO LOW DHMO Paid in full. Limited to 100 days per benefit Skilled Nursing Facility *20% after deductible period. Paid in full. Limited to 100 days per Paid in full. Limited to 100 days per calendar Home Health Care calendar year. year. Local Ground or Air Ambulance $100 copay *$150 copay after deductible Surgeon & Surgeon Assistant Paid in full Paid in full Anesthesiologist Paid in full Paid in full Physician Consultations Paid in full Paid in full Radiation Therapy Paid in full Paid in full Physician Hospital & Skilled Nursing Paid in full Paid in full Facility Visits Diagnostic Lab and X-Ray $10 *$10 after deductible

Ka Kaiser H r HMO P Plans Ben Benefit Sum ummary - Cont ntinued ued BENEFITS HIGH HMO LOW DHMO Durable Medical Equipment Paid in full 20% Maternity No charge and $500 copay/admit hospital No charge and *20% after deductible for hospital services services Mental/Nervous Outpatient $25 copay/visit $20 copay/visit Mental/Nervous Inpatient $500 per admit *20% after deductible Alcoholism and Substance Abuse – $25 copay/visit. No limits. $20 copay/visit. No limits. Outpatient Alcoholism and Substance Abuse – Detox: $500 per admit *20% after deductible Inpatient Retail: $10 Generic, $30 Brand Name. Up to Retail: $10 Generic, $30 Brand Name. Up to 30- 30-day supply. day supply. Prescription Drugs (oral contraceptives MAIL ORDER: $20 Generic, $60 Brand. Up to MAIL ORDER: $20 Generic, $60 Brand. Up to 100- are covered) 100-day supply. day supply. SPECIALTY DRUGS: 20% not to exceed $150. SPECIALTY DRUGS: 20% not to exceed $150. 30- 30-day supply. day supply.