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 of 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 22 nd and end on November 1 st 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 1 st , 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 of 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 overwhelmingly 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 out-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 or 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 or face trauma, loss of 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, or 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 opposed 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 on 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
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