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
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 PPO 500 PPO 1000 HDHP Rx Co-pays- Retail* 15/40/60* NA 15/40/60* NA NA NA (30 Day Supply) Rx Co-pay – Mail 30/80/120 NA 30/80/120 (90 Day Supply) *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 Mail order for maintenance drugs if mandatory. 90- day supply through mail order vs. 30-day supply at • Schnucks 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 1 st 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 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 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 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/$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…
Online Open Enrollment April 2 nd , 2018 through April 19 th , 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
Open Enrollment Process 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 “How To”
Open Enrollment “How To”
Points to Remember Open Enrollment needs to be completed through Employee Online by April 19 th , 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. There is only one Open Spousal Coverage Rule. Enrollment period for All medical and dental changes will be Medical and Dental, this effective July 1, 2018. will be your only This is a positive enrollment not opportunity to make participating will jeopardize your benefit elections for coverages for the plan year July 1, 2018 July 1, 2018 through through June 30, 2019. 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!
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