2020-2021 Plan Sponsors and Third Party Administrators Medical - - PowerPoint PPT Presentation

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2020 2021 plan sponsors and third party administrators
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2020-2021 Plan Sponsors and Third Party Administrators Medical - - PowerPoint PPT Presentation

Jun 01, 2023 598 likes •882 views

DSISD Employee BenefitsPackage 2020-2021 Plan Sponsors and Third Party Administrators Medical Benefits Provided through the Teacher Retirement System of Texas(TRS) Medical Benefits Provided through the Texas Schools Health Benefits Program

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DSISD Employee BenefitsPackage 2020-2021

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SLIDE 2

Financial Services administered by National Benefit Services(NBS)

Plan Sponsors and Third Party Administrators

Medical Benefits Provided through the Teacher Retirement System of Texas(TRS) Medical Benefits Provided through the Texas Schools Health Benefits Program Supplemental Benefits Provided through the Region 20 Benefits Cooperative Supplemental Benefits Administered by Financial Benefit Services (FBS)

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This presentation provides general information about

  • pen enrollment and highlights of available benefits.

Benefit plan details are available in the

– FBS Benefits Guide – FBS Benefits Portal – TRS ActiveCare Enrollment Guide – TSHBP Enrollment Guide

and through other links on the DSISD DSISD’s Open Enrollment 2020 webpage.

2020 – 2021 Benefits

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SLIDE 4

Open Enrollment for 2020 - 2021

  • July 15 through August 21
  • Passive Enrollment for existing employees –

Only Employees with FSAs, Dependent Care Accounts, or those wishing to make selection changes must re-enroll.

  • It is a good idea to log in and review your benefit choices, and verify

that your address, contact information, dependents, and beneficiaries are up-to-date.

  • All new employees must enroll or decline benefits.
  • Keep your ID Cards for non-medical plans if you are not making

plan changes. New Medical ID cards will be sent to all participants at the address on file in the DSISD Benefits Hub.

  • If your NBS debit card for HSA/HRA or FSA expires on 9/1/2020,

you will get a new card in early September. Your current card will work until the first time you use the new card. ALL enrollments are completed online through the Benefits Hub. www.mybenefitshub.com/drippingspringsisd

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Benefits for 2020 - 2021

DSISD Benefits

  • $10,000 life insurance paid by DSISD
  • District-paid Employee Assistance Program

(EAP) for all employees

  • $300 per month District contribution to Health

Insurance premium

  • $75 per month District contribution to a Health

Savings Account (HSA)

  • For ActiveCare HD and TSHBP HD participants
  • $900 per year District contribution to a Health

Reimbursement Arrangement (HRA)

  • For ActiveCare 2, ActiveCare Primary or Primary +,

TSHBP Co-Pay, or Scott & White HMO participants

www.deeroakseap.com 5

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Cafeteria Plan - Overview

  • Menu of Benefits for a Customized Benefit

Package

  • All Benefits operate independently.
  • Benefits paid with pre-tax dollars can reduce

your taxes

  • Changes can be made to plan selections
  • utside of Open Enrollment only if you have a

Qualified Family Status Change, and if you request the change within 30 days.

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SLIDE 7

Medical Plan Options

CafeteriaPlan Options Pre- Tax 7

TRS ActiveCare Plans

Blue Cross and Blue Shield of Texas & Caremark RX https://www.bcbstx.com/trsactivecare 866-355-5999

TRS ActiveCare Primary TRS ActiveCare Primary + TRS ActiveCare HD TRS ActiveCare 2

Scott & White HMO https://trs.swhp.org/ 800-321-7947

TSHBP Alternative Medical

https://tshbp.org/ 888-803-0081 Care Coordinator (July 2020) Care Coordinator and Care Connect Program- https://tshbp.info/CCVideo Physician Directory tool https://tshbp.info/HSNetwork Pharmaceutical Drug Look-up tool https://tshbp.info/DrugPham https://tshbp.info/EGuide2020 https://tshbp.info/PlanFlyer20-21

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SLIDE 8

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2020-2021 Monthly Medical Plan Premiums

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SLIDE 9

Networks

BCBSTX Plans

https://www.bcbstx.com/trsactivecare

ActiveCare HD Nationwide Network Plan ActiveCare 2 Nationwide Network Plan ActiveCare Primary or Primary + (Must choose a Primary Care Physician and get a referral for any Specialist. Must use Network Doctors and Facilities) Statewide Network Plans

Scott & White HMO https://portal.swhp.org/#/search?networkC

  • de=TRS&hideOptions=true

(Must use Network Doctors and Facilities. Referrals not needed for Specialist visits.) TRS-ActiveCare Participants Network

9 TSHBP Alternative Medical www.tshbp.info/HSNetwork

TSHBP HD or TSHBP Co-Pay (Must use Network Doctors and Facilities.) TRS-ActiveCare Participants Network

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Medical PlanTips

Preventive Care and Routine Prenatal care – covered at 100% Mail order - for long-term maintenance meds. Initially get two prescriptions from doctor (90 day and 30 day). Brand name drugs will have added costs when generic is available MDLive – the telehealth provider for ActiveCare HD, TSHBP HD, and Scott & White HMO – no charge for phone consultations

888-365-1663

Teladoc – the telehealth provider for ActiveCare 2, and ActiveCare Primary or Primary + - No charge for phone consultations 855-835-2362 ActiveCare Primary and Primary +, and TSHBP HD and TSHBP Co-Pay – Stay in-network – out-of-network services are not covered

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Health Savings Account (HSA)

  • Automatic for ActiveCare HD and TSHBP HD
  • $75 per month contribution by DSISD

($900 annually)

  • Debit card - can be used to pay for qualified medical

expenses

  • HSA funds accumulate from year to year; the money is yours

to keep

  • Employees can also contribute to this account - employee

contributions are pre-tax and can be changed or stopped at any time

  • HSA participants can also choose a Limited Purpose FSA for

vision and dental expenses only

CafeteriaPlan Options Pre- Tax 11

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Health Reimbursement Arrangement(HRA)

  • Automatic for ActiveCare Primary, ActiveCare

Primary +, ActiveCare 2, Scott & White HMO, and TSHBP Co-Pay

  • $900 funded by DSISD at the start of the school

year

  • “Pre-paid” credit card - can be used to pay for

qualified medical expenses

  • “Use it or lose it” – funds do not accumulate or

go with you if you leave the district

CafeteriaPlan Options Pre- Tax 12

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  • Informational Medical Consultations via Telephone (Med information &

advice)

  • Diagnostic Medical Telephone Consultations (Prescriptions, diagnosis etc.)
  • Can be a time and money saver for employees
  • Works with U.S. based doctors and pediatricians – via phone, email, or

video

  • Available 24/7

Teladoc

855-835-2362

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Included in TRS ActiveCare and TSHBP plans

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for ActiveCare Primary and Primary +, ActiveCare 2, and TSHBP Co-Pay

+

  • nly for those covered
  • n the plan.

Telehealth Plans – MDLive orTeladoc

CafeteriaPlan Options Post- Tax

MDLive

888-365-1663

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Provided by DSISD for ActiveCare HD and TSHBP HD (covers employee and all dependents listed with FBS)

+ Also part of Scott &

White HMO coverage (only for those covered by the plan)

+ available on voluntary,

post-tax basis for all others.

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Dental Plans -CIGNA Three CIGNA Plan Options

  • PPO High Plan – most expensive, higher

benefits, more flexibility

  • PPO Low Plan – less expensive, lower benefit

level, will be balance billed for out-of- network care

  • DHMO – lowest cost, must pick a dentist,

in-network care only www.cigna.com 1-800-244-6224 (24/7)

CafeteriaPlan Options Pre- Tax 14

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Dental Plan Premiums 2020-2021

Plan 2020-21 Premium Cigna PPO High Plan Employee Only $35.81 Employee & Spouse $88.20 Employee & Children $96.70 Employee & Family $134.81 Cigna PPO Low Plan Employee Only $17.94 Employee & Spouse $36.45 Employee & Children $41.91 Employee & Family $63.99 Cigna DHMO Employee Only $11.98 Employee & Spouse $22.61 Employee & Children $25.51 Employee & Family $39.41 15

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Vision Plan - SuperiorVision

  • Choose an Approved Provider from

Superior National network

  • $10 Co-pay for Exam
  • $25 Co-pay for Lenses & Frames
  • Exam, Lenses, and Frames – every 12 months
  • $120 Allowance for Contact Lenses
  • $125 Allowance for Frames
  • www.superiorvision.com

CafeteriaPlan Options Pre- Tax 16

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  • Group Term Life (One America) – An

inexpensive way to add life insurance coverage during your working years. DSISD provides $10,000 in life insurance.

  • Additional coverage available up to $500,000
  • Max spouse coverage $500,000
  • Children covered at $10,000
  • AD&D (One America) – Accidental Death &

Dismemberment coverage offers a benefit for bodily injury or death caused by accident

  • Individual Life (5 Star Life) – Portable coverage,

term life up to age 121. Available Terminal Illness & Quality of Life Rider Life Insurance PlanOptions

CafeteriaPlan Options Post- Tax 17

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SLIDE 18
  • Income/ Paycheck Protection - pays you a benefit

should you be unable to work because of an injury, illness, or pregnancy

  • Post-Tax deduction
  • Pre-Existing conditions – 3-month look back,

conditions excluded for one year

  • Six waiting (“elimination”) period options
  • Waiting period waived on 14- or 30-day options if

hospitalized 23 or more hours Disability Plan -UNUM

CafeteriaPlan Options Post- Tax 18

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Reimbursement Plans -NBS Administrator: National Benefit Services - NBS Three Types of Accounts:

  • Healthcare Flexible Spending Account (FSA)
  • Not available for HSA participants
  • Debit Card
  • Limited Purpose FSA for Vision & Dental Only
  • Only for HSA participants
  • Debit Card
  • Dependent Care Reimbursement Account
  • District Childcare direct pre-tax deduction;
  • ther childcare requires reimbursement

process All reimbursement plans are “Use it or Lose it” – no carryover from year to year.

CafeteriaPlan Options Pre- Tax 19

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SLIDE 20
  • Guaranteed Issue, Portable Coverage
  • Pays in Addition to Other Coverage
  • In- and Out-of-Hospital Benefits
  • Wellness Screening Benefits
  • Helps with expenses for: surgical expenses, blood

plasma, platelets, physician & nurse charges, hospital daily charges, radiation & chemotherapy

  • Available riders for ICU and Critical Illness (heart-

attack & stroke) Cancer Plan – American PublicLife

CafeteriaPlan Options Pre- Tax 20

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  • Pays a lump sum benefit if a covered person is

diagnosed with a covered illness or condition

  • Examples of covered illnesses/Conditions:
  • Heart Attack
  • Stroke
  • Coma
  • Organ failure
  • Paralysis
  • Guaranteed Issue

Critical Illness –AFLAC

CafeteriaPlan Options Post- Tax 21

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Hospital Indemnity Plan -Aflac

  • Daily Benefit for Covered Hospital, Critical Care, or

Rehab Facility Stays

  • Hospital Admission (Benefit Per Confinement)
  • $2,000 High Plan / $1,000 Low Plan
  • Hospital Confinement (Benefit Per Day)
  • $200 High Plan / $100 Low Plan
  • Guaranteed Issue
  • No Pre-Existing Condition Limitations

CafeteriaPlan Options Pre- Tax 22

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SLIDE 23
  • Medical Expenses for Injuries
  • $500 per occurrence
  • Daily Hospital
  • Ambulance
  • Accidental Death & Dismemberment

Accident Plan – American PublicLife

CafeteriaPlan Options Pre- Tax 23

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SLIDE 24
  • Provides ground or air medical emergency

transportation solutions

  • Covers out‐of‐pocket medical transport cost

when insurance falls short

  • No network, nationwide coverage (US and

Canada) Emergency Transportation –MASA

CafeteriaPlan Options Post- Tax 24

Two levels of coverage:

  • Emergent Plan covers emergency transportation only
  • Emergent Plus Plan covers emergency transportation, non-emergency

interfacility transportation, and repatriation (when hospitalized more than 100 miles from your residence).

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Identity Theft Protection

  • Identity Monitoring
  • Cyber Monitoring
  • Non-Credit Loan Monitoring
  • Address Monitoring
  • 100% Resolution Guarantee

Identity Theft Plan – IDWatchdog

CafeteriaPlan Options Post- Tax 25

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How to Enroll/Select Benefits

  • Online enrollment system

(www.mybenefitshub.com/drippingspringsisd)

  • New and Returning Employees – 4 Options:
  • Self-enroll online
  • Call FBS at 1-866-914-5202 for assistance
  • Set up a 20-minute appointment on the FBS
  • Scheduler. DSISD Preferred days are July 15th

& 28th and August 5th, 10th, 14th and 17th.

  • Contact Susan Winkler, Local FBS Rep, for

assistance via phone or Zoom.

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FINANCIAL BENEFITSERVICES

Your Total BenefitSolution

Susan Winkler BenefitsConsultant susanw@fbsbenefits.com 512-535-4989

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