This year’s annual Open Enrollment for 2016 benefits occurs from October 1 to November 30, 2015. If you wish to make any changes to your existing coverage, you must complete the enclosed Enrollment Form and return it to the District Benefits Office no later than November 30, 2015. All changes will be effective January 1, 2016. Please review the following brief highlights to understand changes that may affect you in 2016.
[button href=”https://www.jhmbhealthconnect.com/5524″ 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” ]
[tab]
[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 enclosed in this packet.[/togg]
[togg title=”Plan Option A and Option B (PPO) Updates”]
New Telehealth Offering from PlushCare: The Joint Health Management Board (JHMB) is pleased to announce that effective January 1, 2016 the PlushCare network of telehealth physicians will be available to all PPO medical plan participants and covered family members. For both PPO Plans, Plan Options A and B, the Plan will cover all but $5 of the cost for each appointment, and no deductible applies when using PlushCare!
Telehealth is a convenient service for the diagnosis and treatment of many non-acute medical conditions. This service will be offered through PlushCare, and provides you with on-demand access to U.S. Board certified physicians via secure video or by phone. PlushCare physicians provide the same level of care as in-person visits, including electronic prescriptions to your pharmacy in seconds. Appointments are available 24 hours a day, 7 days a week.
Over the coming weeks, you’ll be provided with more information regarding PlushCare and the telehealth service. In addition, be sure to attend a Benefits Workshop this Fall, as the JHMB will be providing more detailed information and answering questions regarding this new offering.
Introducing a Prescription Drug Formulary: EnvisionRx Options and the JHMB are always working together to find ways to provide better prescription coverage while managing the rising costs of prescription medications. Currently, the Plan offers co-pays at $10 and $35 for generic and brand name drugs, respectively. Effective January 1, 2016, Plan Options A and B will begin using a prescription drug formulary list, which creates a new “Non-preferred Brand-name Drugs” tier and co-pay.
As a result of this plan change, brand-name drugs that have a generic alternative or an equivalent acting brand name available will be placed on the non-preferred brand tier with a $50 copayment, while their generic alternative will be available on the generic tier at a $10 copayment. Brand-name drugs without a generic alternative or an equivalent acting brand name available will continue to be available as preferred brand-name drugs with a $35 copayment.
- – Generic Drugs: $10
- – Preferred Brand-name Drugs: $35
- – Non-preferred Brand-name drugs: $50
NOTE: These changes in tier level may impact your current copay if you choose to continue to receive a Non-preferred Brand-name medication.
Over the coming weeks, you’ll be provided with more information regarding this prescription drug benefit change. In addition, be sure to attend a Benefits Workshop this fall, as the JHMB will be providing more detailed information and answering questions regarding this plan change.
Attend a Benefits Workshop: The JHMB, in collaboration with Delta Health Systems and EnvisionRx, will conduct two 1.5-hour benefits workshops specifically to provide information and address your questions regarding the new PlushCare telehealth offering and prescription drug formulary change. Review the dates below and mark your calendars.
- Wednesday, October 28, 2015 at 5:00 PM – 6:30 PM
Bullard High School | Theatre
5445 N. Palm Ave
Fresno, CA 93704 - Wednesday, November 4, 2015 at 5:00 PM – 6:30 PM
Sunnyside High School | Theater
1019 S. Peach Ave
Fresno, CA 93727
[/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, 2016, 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 this Open Enrollment packet.[/togg]
[togg title=”WellPATH Program Update”]
Introducing 3 New Wellness Services: In support of its efforts to help you along your path to better health, the WellPATH Program is unveiling 3 new services this Fall; 1) Massage Therapy, 2) Personal Training, and 3) Behavior Modification Consulting. The Massage Therapy Program is incentive-based, while the Personal Training services and Behavior Modification Consulting will be by invitation-only.
Massage Therapy Program
All massage therapy services will be held at school sites and district locations as a reward for reaching participation minimums at their respective on-site personal wellness screening events. The minimums for sites will be as follows:
- – Sites with 10 – 50 employees require a 50% participation minimum
- – Sites with 51 – 100 employees require a 47% participation minimum
- – Sites 101 – 150+ employees require a 45% participation minimum
Once a school site or district location reaches their participation minimums they will get to select the day and time they would like to have a (chair) massage therapist onsite. Massages will only be offered to members who participated in the screening event.
Personal Training Services
This new offering will be offered by invitation-only to selected personal wellness screening participants. The program will provide accountability to individuals having a hard time committing to a regular exercise program. Sessions will focus on teaching individuals proper techniques and exercise regimes that can be mimicked at home or another facility.
Behavior Modification Consulting
This new offering will also be offered by invitation-only to selected personal wellness screening participants. The program will focus on sustainable nutrition and healthy lifestyle behaviors. Participants will learn the skills and tools they need to incorporate life-long changes to undesirable habits and how to adopt healthy behaviors that reduce their risk of chronic disease.
During the initial consultation participants will work with the Pinnacle Training Systems Behavior Modification Coaches to establish their customized wellness goals. Thereafter, participants will have 7, 30-minute sessions (in-person or by phone) to address barriers and achievements to meeting their goals. Participants will be held accountable for being engaged and completing tasks requested by the Pinnacle staff in an effort to be successful.
For more information about these programs and other WellPATH offerings, visit www.JHMBHealthConnect.com/wellpath.
[/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 2015 plan year, be sure to review your 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.
As reminder, if you wish to utilize the Section 125 flexible spending account in 2016, you must re-enroll with AFA. Please review the AFA information enclosed in this open enrollment packet for more details regarding AFA’s on-site enrollment sessions this fall and their Section 125 plan offerings.[/togg]
[togg title=”Employee Assistance Program (EAP) Reminder”]
Personal concerns can impact your work performance and overall functioning. The Employee Assistance Program, offered through Claremont EAP, helps you resolve personal issues before they become more serious and difficult to manage. Claremont will support you quickly and confidentially in dealing with the stresses and challenges of everyday life. You and your family members can receive the following professional, confidential counseling services:
- – 5 Free Counseling Visits per Incident
- – Legal Consultations
- – Financial Services
- – Child/Elder Care Referrals
- – School/College Assistance
- – Adoption Assistance
- – Pet Care Referrals
- – Daily Living/Convenience Referrals
- – Wellness Referrals
The EAP also provides access to resources that can help you address virtually any personal concern or question. Visit www.ClaremontEAP.com for more information or call Claremont EAP at (800) 834-3773 to discuss your question or issue with an experienced counselor who will refer you to the resources most appropriate for your needs.[/togg]
[togg title=”No Rate Contribution Increases for 2016″]
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 fourth straight year. In addition, there are no changes to your Vision and Dental providers or plan benefits in 2016. 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=”Review/Download the Materials”]
To assist you in making the best decisions for you and your family, the following information is available for your review:
American Fidelity Assurance Section 125 Information
Benefits Enrollment Form – which must be completed and returned to the Benefits Office no later than November 30, 2015.
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 2016″]
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 fourth straight year. In addition, there are no changes to your Vision and Dental providers or plan benefits in 2016. 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 benefit elections 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 benefit elections you must complete the Benefits Open Enrollment form enclosed in this packet. [/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 2015 plan year, be sure to review your 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.
As reminder, if you wish to utilize the Section 125 flexible spending account in 2016, you must re-enroll with AFA. Please review the AFA information enclosed in this open enrollment packet for more details regarding AFA’s on-site enrollment sessions this fall and their Section 125 plan offerings.[/togg]
[togg title=”Review/Download 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
Benefits Open Enrollment Form – which must be completed and returned to the Benefits Office no later than November 30, 2015.
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 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 enclosed in this packet.[/togg]
[togg title=”Plan Option A and Option B (PPO) Updates”]
New Telehealth Offering from PlushCare: The Joint Health Management Board (JHMB) is pleased to announce that effective January 1, 2016 the PlushCare network of telehealth physicians will be available to all PPO medical plan participants and covered family members. For both PPO Plans, Plan Options A and B, the Plan will cover all but $5 of the cost for each appointment, and no deductible applies when using PlushCare!
Telehealth is a convenient service for the diagnosis and treatment of many non-acute medical conditions. This service will be offered through PlushCare, and provides you with on-demand access to U.S. Board certified physicians via secure video or by phone. PlushCare physicians provide the same level of care as in-person visits, including electronic prescriptions to your pharmacy in seconds. Appointments are available 24 hours a day, 7 days a week.
Over the coming weeks, you’ll be provided with more information regarding PlushCare and the telehealth service. In addition, be sure to attend a Benefits Workshop this Fall, as the JHMB will be providing more detailed information and answering questions regarding this new offering.
Introducing a Prescription Drug Formulary: EnvisionRx Options and the JHMB are always working together to find ways to provide better prescription coverage while managing the rising costs of prescription medications. Currently, the Plan offers co-pays at $10 and $35 for generic and brand name drugs, respectively. Effective January 1, 2016, Plan Options A and B will begin using a prescription drug formulary list, which creates a new “Non-preferred Brand-name Drugs” tier and co-pay.
As a result of this plan change, brand-name drugs that have a generic alternative or an equivalent acting brand name available will be placed on the non-preferred brand tier with a $50 copayment, while their generic alternative will be available on the generic tier at a $10 copayment. Brand-name drugs without a generic alternative or an equivalent acting brand name available will continue to be available as preferred brand-name drugs with a $35 copayment.
- – Generic Drugs: $10
- – Preferred Brand-name Drugs: $35
- – Non-preferred Brand-name drugs: $50
NOTE: These changes in tier level may impact your current copay if you choose to continue to receive a Non-preferred Brand-name medication.
Over the coming weeks, you’ll be provided with more information regarding this prescription drug benefit change. In addition, be sure to attend a Benefits Workshop this fall, as the JHMB will be providing more detailed information and answering questions regarding this plan change.
Attend a Benefits Workshop: The JHMB, in collaboration with Delta Health Systems and EnvisionRx, will conduct two 1.5-hour benefits workshops specifically to provide information and address your questions regarding the new PlushCare telehealth offering and prescription drug formulary change. Review the dates below and mark your calendars.
- Wednesday, October 28, 2015 at 5:00 PM – 6:30 PM
Bullard High School | Theatre
5445 N. Palm Ave
Fresno, CA 93704 - Wednesday, November 4, 2015 at 5:00 PM – 6:30 PM
Sunnyside High School | Theater
1019 S. Peach Ave
Fresno, CA 93727
[/togg]
[togg title=”Kaiser Permanente Senior Advantage Plan Option”]
Special Enrollment Ends November 11, 2015
As a reminder, from October 1 – November 11, 2015, Fresno Unified School District is offering a Special Enrollment for the Kaiser Permanente Senior Advantage 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 this plan is being offered in addition to the current PPO plans. However, if you wish to change to or from Senior Advantage effective January 1, 2016, you will have to make this change during the Special Enrollment period and return your election forms to the District’s Benefit Department by November 11, 2015. Any other changes you wish to make to your current health plan offerings can be made during the District’s Annual Open Enrollment period from October 1 – November 30, 2015.
If you live in an approved Senior Advantage service area you should receive a detailed information packet regarding the Senior Advantage Special Enrollment in early October. 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.[/togg]
[togg title=”WellPATH Program Update”]
Introducing 3 New Wellness Services: In support of its efforts to help you along your path to better health, the WellPATH Program is unveiling 3 new services this Fall; 1) Massage Therapy, 2) Personal Training, and 3) Behavior Modification Consulting. The Massage Therapy Program is incentive-based, while the Personal Training services and Behavior Modification Consulting will be by invitation-only.
Massage Therapy Program
All massage therapy services will be held at school sites and district locations as a reward for reaching participation minimums at their respective on-site personal wellness screening events. The minimums for sites will be as follows:
- – Sites with 10 – 50 employees require a 50% participation minimum
- – Sites with 51 – 100 employees require a 47% participation minimum
- – Sites 101 – 150+ employees require a 45% participation minimum
Once a school site or district location reaches their participation minimums they will get to select the day and time they would like to have a (chair) massage therapist onsite. Massages will only be offered to members who participated in the screening event.
Personal Training Services
This new offering will be offered by invitation-only to selected personal wellness screening participants. The program will provide accountability to individuals having a hard time committing to a regular exercise program. Sessions will focus on teaching individuals proper techniques and exercise regimes that can be mimicked at home or another facility.
Behavior Modification Consulting
This new offering will also be offered by invitation-only to selected personal wellness screening participants. The program will focus on sustainable nutrition and healthy lifestyle behaviors. Participants will learn the skills and tools they need to incorporate life-long changes to undesirable habits and how to adopt healthy behaviors that reduce their risk of chronic disease.
During the initial consultation participants will work with the Pinnacle Training Systems Behavior Modification Coaches to establish their customized wellness goals. Thereafter, participants will have 7, 30-minute sessions (in-person or by phone) to address barriers and achievements to meeting their goals. Participants will be held accountable for being engaged and completing tasks requested by the Pinnacle staff in an effort to be successful.
For more information about these programs and other WellPATH offerings, visit www.JHMBHealthConnect.com/wellpath.
[/togg]
[togg title=”Employee Assistance Program (EAP) Reminder”]
Personal concerns can impact your work performance and overall functioning. The Employee Assistance Program, offered through Claremont EAP, helps you resolve personal issues before they become more serious and difficult to manage. Claremont will support you quickly and confidentially in dealing with the stresses and challenges of everyday life. You and your family members can receive the following professional, confidential counseling services:
- – 5 Free Counseling Visits per Incident
- – Legal Consultations
- – Financial Services
- – Child/Elder Care Referrals
- – School/College Assistance
- – Adoption Assistance
- – Pet Care Referrals
- – Daily Living/Convenience Referrals
- – Wellness Referrals
The EAP also provides access to resources that can help you address virtually any personal concern or question. Visit www.ClaremontEAP.com for more information or call Claremont EAP at (800) 834-3773 to discuss your question or issue with an experienced counselor who will refer you to the resources most appropriate for your needs.[/togg]
[togg title=”No Rate Contribution Increases for 2016″]
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 fourth straight year. In addition, there are no changes to your Vision and Dental providers or plan benefits in 2016. 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=”Review/Download the Materials”]
To assist you in making the best decisions for you and your family, the following information is available for your review:
Benefits Plan Comparison Chart
Benefits Enrollment Form – which must be completed and returned to the Benefits Office no later than November 30, 2015. (Kaiser Senior Advantage due November 11, 2015)
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]
[/tabs]