ROCKFORD PUBLIC SCHOOLS 2019 OPEN ENROLLMENT 3 Plans PPO1000 - PowerPoint PPT Presentation

ROCKFORD PUBLIC SCHOOLS 2019 OPEN ENROLLMENT

3 Plans  PPO1000  $1000 Individual Deductible  High Deductible Health Plan (HDHP)  $2500 Individual Deductible  Health Savings Account Component (Admin Only)  PPO3000  $3000 Individual Deductible

3 Plan Designs PPO 1000 PPO 3000 HDHP In Out In Out In Out Office Visit $15 50% $35 50% Ded/Coins Ded/Coins Specialist $25 50% $50 50% Ded/Coins Ded/Coins Deductible Single $1,000 $1,000 $3,000 $6,000 $2,500 $5,000 Family $2,000 $3,000 $9,000 $18,000 $5,000 $10,000 Out of Pocket Max Single $4,000 $8000 $4,500 $14,000 $3,500 $7,000 Family $8,000 $16,000 $11,250 $30,000 $7,000 $14,000 Coinsurance 80% 50% 70% 50% 80% 50% The Out of Pocket Maximum Includes the Deductible

Preventive Care – All Plans • 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.

Prescription Coverage - Express-Scripts Tier PPO1000* PPO3000* HDHP Tier 1 $15 $10 Ded./Coins. Tier 2 $40 20% (Min. $40) Ded./Coins. Tier 3 $60 30%(Min. $60) Ded./Coins. Mail Order 2x’s for 90 days 2x’s for 90 days Ded./Coins. * 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 • Can use most independent Pharmacies • Prescriptions purchased at CVS or Walgreens will cost an additional $10 each. • Possible less expensive alternatives: • Wal-Mart • Meijer • Sam’s Club Mail order for maintenance drugs is mandatory. • Schnucks 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/Javon Bea Hospitals (Rockton Ave, Riverside Blvd)

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, 2019

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:  $3,500 Individual annually per household  $7,000 family annually per household  District will make a contribution to YOUR account.  “Use it and keep it” - $$$ belongs to you.  Debit Card to pay co-pays, deductibles and other out-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 Employee Plus Family Spouse Child(ren) Standard $400 $700 $600 $800 Wellness $250 $500 $550 $700 Total (W) $650 $1200 $1150 $1500 RBMA, HI and EOPA Funding is Slightly Higher 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 :  $2,700 annual maximum contribution per family.  Dependent/Day Care Flexible Spending Account:  $5,000 annual maximum contribution per family.  Limited Flexible Spending Account: for dental/vision expenses only:  Must be enrolled in the HDHP with a HSA.  $2,700 annual maximum contribution per family.

Medical Plan - ER Visits PPO1000/PPO3000 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 Office Visit copay

TELADOC 24/7/365 ACCESS TO PHYSICIANS TELADOC PHYSICIANS How it works:  U.S. Board Certified  Contact Teladoc Physicians in internal medicine, family practice, Access via phone,  video or mobile app. emergency medicine or  Talk with a physician pediatrics. Physician will review   U.S. residents and state the medical history. licensed.  Resolve the issue Physician will diagnose  and prescribe medication, if necessary.

Conditions Treated $15/$45 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 • Health Assessment – 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 – 30 point max • And more…

Online Open Enrollment  April 1 st , 2019 through April 23 rd , 2019 (No later than 5:00pm)  Changes will take effect July 1, 2019 • 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

Open Enrollment Process  We will use Employee Online for 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  Elect Flexible Spending Plan (Annual enrollment)  Please note that Employee Online is used to confirm or enroll the changes to the items listed above. All changes you make in Employee Online will be saved and applied on the 7/1/2019 effective date.

Open Enrollment “How To”

Open Enrollment “How To”

Points to Remember  Open Enrollment needs to be completed through Employee Online by April 23 rd , 2019 at 5:00pm.  Now is the only time to make changes for fiscal year July 1, 2019 through June 30, 2020 without a qualifying event.  You have 30 days after a qualifying event There is only one Open to make allowed changes to your benefits. Enrollment period for  Spousal Coverage Rule. Medical and Dental, this  All medical and dental changes will be will be your only effective July 1, 2019. opportunity to make benefit elections for July 1, 2019 through June 30, 2020!

Questions? Thank you for your time!