This year’s annual Open Enrollment for 2014 benefits occurs from October 1 to December 2, 2013. If you wish to make any changes to your existing coverage, you must complete the Enrollment Form and return it to the District Benefits Office no later than December 2, 2013. All changes will be effective January 1, 2014. Please review the following brief highlights to understand changes that may affect you in 2014.
[button href=”https://www.jhmbhealthconnect.com/2582″ bg_color=”#59969B” text_color=”#fff”]COBRA & ED Code Participants – Click Here For Your Open Enrollment Information [/button]
[tabs tab1=”Actives/Non-Medicare Retirees” tab2=”Part-Time Employees” tab3=”Medicare Retirees”]
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[togg title=”No Rate Contribution Increases for 2014″]
The Joint Health Management Board (JHMB) is pleased to announce that, thanks to the improved program usage by our employees and retirees, and the efforts of the Fresno Unified School District and the JHMB, there are no rate contribution increases for any of the benefits for the second straight year. In addition, there are no changes to your Vision and Dental providers or plan benefits in 2014. It will require continued efforts by all of us to manage our overall healthcare expenses to help minimize increases in the coming years.[/togg]
[togg title=”Plan Option A and Option B (PPO) Updates”]
New Prescription Benefit Manager: On January 1, 2014, Citizens Rx will replace EnvisionRx as the Prescription Benefits Manager (PBM) for the two PPO Plans. The JHMB has made this change for 2014 to curb the rising cost of healthcare and maintain existing copays. There will not be any changes in benefits or a reduction in your current pharmacy network as a result of this change. This move is intended to mirror your current plan design with minimal disruption. In addition, any of your current, active prescriptions on file with a participating network pharmacy will remain in effect.
The JHMB is proud that this change will provide participants with enhanced customer service. Citizens Rx is dedicated to delivering safe, high-quality pharmacy care at optimal cost and offers participant-centered service features such as:
– A dedicated call center line with extended hours, live call support and operations
– Mobile Virtual Pharmacy Card App that provides dosage reminders, refill alerts, and GPS functions to locate the nearest pharmacies
– Mail order pharmacy where 99% of all prescriptions ship out within 24 hours
– Acceptance at more than 63,000 retail pharmacies nationwide
In December, you will receive new ID cards and detailed information about Citizens’ network, mail order pharmacy, and other services.
$1,000 Cap for Non-Network Outpatient Surgical Facilities: In addition, as of January 1, 2014, the maximum benefit for non-network outpatient surgical facilities will be $1,000 per incident. This means, if you wish to receive an outpatient surgery from a non-network ambulatory surgical center, hospital or other facility on or after January 1, 2014, you will be responsible for facility charges above the $1,000 benefit. If you currently have surgeries scheduled on or after January 1, 2014, be sure to check whether the surgery will be performed at a network facility. Delta Health Systems is available to assist you in determining whether a particular provider is an Anthem Blue Cross network provider or a non-network provider. You may contact Delta Health Systems at (800) 807-0820.
New 24/7 NurseLine Service: Lastly, the WellPATH Employee Wellness Program is now sponsoring the Anthem Blue Cross 24/7 NurseLine for all Plan participants enrolled in the PPO plans. The 24/7 NurseLine is there for you (at no cost) whenever you need to consult a health professional regarding your health concerns. At home, on vacation, or on a business trip, this service provides you with direct access to a registered nurse (English or Spanish) to answer questions about allergies, fevers, types of preventive care, or any other topic to help you along your path to better health. Be sure to review the flyer enclosed in the packet sent to your home for more details on this new program. This service becomes available on October 1, 2013, so if you are an existing PPO participant, you can start to use this service at that time.[/togg]
[togg title=”Plan Option C (Kaiser Permanente)”]
You can only enroll in Kaiser Permanente Health Plan if you live or work in a zip code on the attached Kaiser zip code range list. Also, Kaiser Permanente Health Plan coverage is only available to participants not eligible for Medicare (under age 65). If you are a retiree eligible for Medicare, effective January 1, 2014, you have the option to enroll in the Kaiser Permanente Senior Advantage Plan. Please contact the District Benefits Office for more information on the Senior Advantage Plan.
To enroll in Kaiser, you must complete the Kaiser enrollment form along with the FUSD benefits enrollment form. For more information about Kaiser Permanente plan benefits and service areas, review the supplemental information enclosed in Open Enrollment packet sent to your home.[/togg]
[togg title=”WellPATH Program Expansion”]
The WellPATH Program has expanded its reach to now offer support for covered spouses, domestic partners, and early retirees along their path to better health. These individuals are eligible to participate in the program so long as they meet the following requirements:
– The individual is a legal spouse or domestic partner enrolled in the district’s medical plan; or
– The individual is an early retiree (defined as a retired individual under age 65 and not eligible for Medicare) enrolled in the district’s medical plan; and
– The individual can provide proof of enrollment such as a healthcare member ID number
Please note that while spouses, domestic partners and early retirees are eligible to participate in the program, they are not eligible for any rewards or incentives. Additionally, retirees age 65 and over and dependents remain excluded from the WellPATH program at this time.
In addition, starting in 2014 WellPATH will begin offering new services to help you along your path to better health, including:
– Personal Wellness Reports
– Wellness Screenings
– Wellness Coaching
More information will be provided on these new programs later this fall. Until then, visit www.JHMBHealthConnect.com/wellpath for upcoming health/wellness events, including WellPATH classes and events, Health Talk Webinars, and your chance at the monthly $25 gift card giveaway.[/togg]
[togg title=”Tax Savings Opportunities Through Section 125 Plans”]
If you enrolled in the Section 125 flexible spending account (FSA) administered by American Fidelity Assurance Company (AFA) for the 2013 plan year, be sure to review your medical spending throughout the year to ensure you are maximizing your benefits. You may reimburse yourself for eligible healthcare expenses incurred by you, your spouse, eligible dependents, and/or adult children up to age 26. You may also reimburse yourself for eligible dependent day care expenses provided that they fall within the special rules outlined by the plan.
The JHMB recommends that you review your FSA on a quarterly basis to ensure that you are maximizing your benefits and reimbursements. Remember, if you don’t use your money by the end of the calendar year, you lose it. Use it, don’t lose it!
As reminder, if you wish to utilize the Section 125 flexible spending account in 2014, you must re-enroll with AFA. Please review the AFA site schedule available below details regarding AFA’s on-site enrollment sessions this Fall. [/togg]
[togg title=”Group Additional Life Insurance From The Standard”]
The District provides basic life insurance, but active employees are also eligible to sign-up for Additional Life Insurance. Standard Insurance Company is one of the District’s insurance providers and we have included Standard’s Life Insurance Needs Calculator in this year’s Open Enrollment packet. We have also included a copy of Standard’s Group Additional Life Insurance Information flyer below for you to download and review:
[button href=”https://www.jhmbhealthconnect.com/wp-content/uploads/2013/10/GroupAdditionalLife_BenefitsAtAGlance.pdf” bg_color=”#59969B” text_color=”#fff”]DOWNLOAD: Group Additional Life Insurance – Benefits At-a-Glance[/button]
Be sure to review this information to help assess whether this additional life insurance is right for you and your family. For more information on additional coverage options and rate, visit www.JHMBHealthConnect.com/your-benefits.[/togg]
[togg title=”No Action Required”]
If you do not wish to make any changes to your existing coverage for the upcoming year, no action is required on your part during this Open Enrollment period. However, if you wish to make changes to your existing coverage you must complete the Benefits Open Enrollment form.[/togg]
[togg title=”Review the Materials”]
To assist you in making the best decisions for you and your family, the following information is available for your review:
Summary of Benefits & Coverage (Plan A | Plan B | Plan C)
Summary of Medical, Dental, and Vision Rates
American Fidelity Assurance Site Schedule for Section 125 Appointments
Standard Group Additional Life Insurance – Benefits At-a-Glance
Summary of Zip Code Ranges For Kaiser Permanente Service Areas
For additional plan information and/or provider contact information view the following pages:
www.JHMBHealthConnect.com/your-benefits
www.JHMBHealthConnect.com/using-plans[/togg]
[/tab]
[tab]
[togg title=”No Benefit Changes/Employee Rate Contribution Increases for 2014″]
The Joint Health Management Board (JHMB) is pleased to announce that, thanks to the efforts of the Fresno Unified School District, the JHMB, and the improved program usage by our employees and retirees, there are no employee rate contribution increases for any of the benefits for the second straight year. In addition, there are no changes to your Vision and Dental providers or plan benefits in 2014. It will require continued efforts by all of us to manage our overall healthcare expenses to help minimize increases in the coming years.[/togg]
[togg title=”No Action Required”]
If you do not wish to make any changes to your existing coverage for the upcoming year, no action is required on your part during this Open Enrollment period. However, if you wish to make changes to your existing coverage you must complete the Benefits Open Enrollment form.[/togg]
[togg title=”Review the Materials”]
To assist you in making the best decisions for you and your family, the following information is available for your review:
Summary of Dental and Vision Rates and Benefits
American Fidelity Assurance Site Schedule for Section 125 Appointments
Benefits Enrollment Form – which must be completed and returned to the Benefits Office no later than December 2, 2013.
For additional plan information and/or provider contact information view the following pages:
www.JHMBHealthConnect.com/your-benefits
www.JHMBHealthConnect.com/using-plans[/togg]
[/tab]
[tab]
[togg title=”No Rate Contribution Increases for 2014″]
The Joint Health Management Board (JHMB) is pleased to announce that, thanks to the improved program usage by our employees and retirees, and the efforts of the Fresno Unified School District and the JHMB, there are no rate contribution increases for any of the benefits for the second straight year. In addition, there are no changes to your Vision and Dental providers or plan benefits in 2014. It will require continued efforts by all of us to manage our overall healthcare expenses to help minimize increases in the coming years.[/togg]
[togg title=”Plan Option A and Option B (PPO) Updates”]
New Prescription Benefit Manager: On January 1, 2014, Citizens Rx will replace EnvisionRx as the Prescription Benefits Manager (PBM) for the two PPO Plans. However, this change does not affect participants in the EnvisionRX Plus Medicare Part D plan (see details below).
The JHMB has made this change for 2014 to curb the rising cost of healthcare and maintain existing copays. There will not be any changes in benefits or a reduction in your current pharmacy network as a result of this change. This move is intended to mirror your current plan design with minimal disruption. In addition, any of your current, active prescriptions on file with a participating network pharmacy will remain in effect.
The JHMB is proud that this change will provide participants with enhanced customer service. Citizens Rx is dedicated to delivering safe, high-quality pharmacy care at optimal cost and offers participant-centered service features such as:
– A dedicated call center line with extended hours, live call support and operations
– Mobile Virtual Pharmacy Card App that provides dosage reminders, refill alerts, and GPS functions to locate the nearest pharmacies
– Mail order pharmacy where 99% of all prescriptions ship out within 24 hours
– Acceptance at more than 63,000 retail pharmacies nationwide
In December, you will receive new ID cards and detailed information about Citizens’ network, mail order pharmacy, and other services.
This PBM change does not affect participants in the EnvisionRx Plus Medicare Part D plan. If you currently have an EnvisionRx Plus ID card (as shown below), you will not be affected by this change. If you still have questions regarding your enrollment, please feel free to contact EnvisionRx at (800) 361-4542 for assistance.
$1,000 Cap for Non-Network Outpatient Surgical Facilities: In addition, as of January 1, 2014, the maximum benefit for non-network outpatient surgical facilities will be $1,000 per incident. This means, if you wish to receive an outpatient surgery from a non-network ambulatory surgical center, hospital or other facility on or after January 1, 2014, you will be responsible for facility charges above the $1,000 benefit. If you currently have surgeries scheduled on or after January 1, 2014, be sure to check whether the surgery will be performed at a network facility. Delta Health Systems is available to assist you in determining whether a particular provider is an Anthem Blue Cross network provider or a non-network provider. You may contact Delta Health Systems at (800) 807-0820.
New 24/7 NurseLine Service: Lastly, the WellPATH Employee Wellness Program is now sponsoring the Anthem Blue Cross 24/7 NurseLine for all Plan participants enrolled in the PPO plans. The 24/7 NurseLine is there for you (at no cost) whenever you need to consult a health professional regarding your health concerns. At home, on vacation, or on a business trip, this service provides you with direct access to a registered nurse (English or Spanish) to answer questions about allergies, fevers, types of preventive care, or any other topic to help you along your path to better health. Be sure to review the flyer enclosed in the packet sent to your home for more details on this new program. This service becomes available on October 1, 2013, so if you are an existing PPO participant, you can start to use this service at that time.[/togg]
[togg title=”New Kaiser Permanente Senior Advantage Plan Option”]
Special Enrollment Ends Oct 31, 2013
As a reminder, from September 1 – October 31, 2013, Fresno Unified School District is offering a Special Enrollment for the new Kaiser Permanente Senior Advantage (HMO) plan. This employer-sponsored group coverage is being offered to Medicare-eligible retirees 65 and older.
Participation in the Senior Advantage plan is not mandatory and is being offered in addition to the current PPO plans. However, if you wish to change to Senior Advantage effective January 1,2014, you will have to make this change during the Special Enrollment period and return your election forms to the District’s Benefit Department by October 31, 2013. Any other changes you wish to make to your existing coverage can be made during the Annual Open Enrollment period from October 1 – December 2, 2013.
If you live in an approved Senior Advantage service area you should have received a detailed information packet regarding the Senior Advantage Special Enrollment in early September. However, if you still have questions regarding this offering, please contact Kaiser Permanente at the information provided below:
Questions about the Senior Advantage (HMO) Plan
Kaiser Permanente
(855) 843-8390
(TTY 711 for the deaf, hard of hearing, or speech impaired)
Seven days a week, 8 a.m. to 8 p.m.
As a reminder, if you wish to change to Senior Advantage effective January 1, 2014, you will have to make this change by October 31, 2013. Any other changes you wish to make to your current health plan offerings can be made during the Annual Open Enrollment period from October 1 – December 2, 2013.[/togg]
[togg title=”WellPATH Program Expansion”]
The WellPATH Program has expanded its reach to now offer support for covered spouses, domestic partners, and early retirees along their path to better health. These individuals are eligible to participate in the program so long as they meet the following requirements:
– The individual is a legal spouse or domestic partner enrolled in the district’s medical plan; or
– The individual is an early retiree (defined as a retired individual under age 65 and not eligible for Medicare) enrolled in the district’s medical plan; and
– The individual can provide proof of enrollment such as a healthcare member ID number
Please note that while spouses, domestic partners and early retirees are eligible to participate in the program, they are not eligible for any rewards or incentives. Additionally, retirees age 65 and over and dependents remain excluded from the WellPATH program at this time.
In addition, starting in 2014 WellPATH will begin offering new services to help you along your path to better health, including:
– Personal Wellness Reports
– Wellness Screenings
– Wellness Coaching
More information will be provided on these new programs later this fall. Until then, visit www.JHMBHealthConnect.com/wellpath for upcoming health/wellness events, including WellPATH classes and events, Health Talk Webinars, and your chance at the monthly $25 gift card giveaway.[/togg]
[togg title=”No Action Required”]
If you do not wish to make any changes to your existing coverage for the upcoming year, no action is required on your part during this Open Enrollment period. However, if you wish to make changes to your existing coverage you must complete the Benefits Open Enrollment form.[/togg]
[togg title=”Review the Materials”]
To assist you in making the best decisions for you and your family, the following information is available for your review:
Summary of Benefits & Coverage (Plan A | Plan B)
Summary of Medical, Dental, and Vision Rates
For additional plan information and/or provider contact information view the following pages:
www.JHMBHealthConnect.com/your-benefits
www.JHMBHealthConnect.com/using-plans[/togg]
[/tab]
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