This year’s annual Open Enrollment for 2018 benefits occurs from October 2 to December 1, 2017. 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 December 1, 2017. All changes will be effective January 1, 2018. Please review the following brief highlights to understand changes that may affect you in 2018.
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.
[button href=”https://www.jhmbhealthconnect.com/7118″ bg_color=”#59969B” text_color=”#fff”]COBRA & ED Code Participants – Click Here For Your Open Enrollment Information [/button]
[tabs tab1=”Actives” tab2=”Non-Medicare Retirees” tab3=”Part-Time Employees” tab4=”Medicare Retirees”]
[tab]
[togg title=”2018 Open Enrollment Benefits Information Guide”]
The Joint Health Management Board strives to ensure its members are informed and responsible health care consumers, in the most cost-effective and efficient manner. To that end, we have streamlined the benefits information we provide to both active employees and new hires to the District.
The 2018 Open Enrollment Benefits Information Guide is your supplemental Open Enrollment resource to understanding and selecting the best benefit options for you and your family. In the guide, you’ll find information about:
[checklist]
- Eligibility and Enrollment Requirements
- Benefit Summaries, Cost Information, and Comparison Charts
- Vendor Information (including contact details)
- Annual Notices & Legal Information
[/checklist]
We encourage you to reference this new resource as you review your benefit options for 2018.
Download the 2018 Open Enrollment Benefits Information Guide
[/togg]
[togg title=”Plan Option A and Option B (PPO) Updates”]
NEW: Envision Rx “Select Formulary” in 2018
In 2016, the JHMB introduced 3 copay tiers for Generic Drugs ($10), Preferred Brand-name Drugs ($35), and Non-preferred Brand-name Drugs ($50). This original change was made in the interest of ensuring that our members have access to generic drugs and preferred brand-name drugs at affordable rates. Earlier this year, the JHMB added a fourth tier to provide members with access to generic drugs treating targeted health conditions (high cholesterol, high blood pressure, diabetes, and depression) at $0 copay. Each of these changes was made after careful consideration by the JHMB and its partners to manage the rising costs of prescription drugs while ensuring that our members have access to quality medications at affordable rates.
In these continuing efforts, the JHMB has approved the implementation of Envision Rx’s Select Formulary for Plan Options A and B effective January 1, 2018. Under the Select Formulary program, the JHMB’s existing 4 copay tiers remain, however the drugs available within those tiers may change based on the latest Envision Rx standards. Currently, Envision’s research indicates that as many as 1100 members in Plan Options A and B may be impacted by the implementation of the Select Formulary drug list.
What You Need to Do
In early November, Envision Rx will send more detailed communications to impacted plan participants only regarding which drugs are affected by the Select Formulary drug list. If your spouse or dependent(s) receives the letter from Envision, we recommend reviewing the drug list and identifying if any of the current prescription drugs will be excluded. Until then, should you have additional questions regarding your prescription drug benefit, please contact the EnvisionRxOptions Customer Service Help Desk at (800) 361-4542. The Help Desk is here to assist you with prescription questions 24 hours a day/7 days a week.
NEW: Planned Surgery Benefit through BridgeHealth
In recent years, the JHMB has worked hard to find innovative solutions to manage and maintain the highest quality and most cost-effective benefits for our active employees and retirees. In 2018, we are partnering with BridgeHealth to offer a new planned surgery benefit that covers 100% of the costs for non-emergency surgeries – no deductible, no coinsurance! BridgeHealth partners with top-rated providers to help improve surgical outcomes (such as fewer complications and lower infection rates) and reduce costs for procedures such as:
- – Bariatric: Gastric bypass, gastric sleeve, lap band removal
- – Cardiac: Coronary artery bypass graft, valve repair and replacement
- – General: Gall bladder removal, ENT, hernia repair
- – Orthopedic: Carpal tunnel release, ACL repair, hip and knee replacement
- – Spine: Spinal fusion, artificial disc replacement
- – Women’s Health: Hysterectomy
This new service launches January 1, 2018. You should consider contacting BridgeHealth if your doctor recommends scheduling a surgery in February 2018 or later. A dedicated care coordinator will help you select a top-rated provider for your type of procedure and will handle all the administrative work, approvals, billing and scheduling. If travel is required, BridgeHealth arranges transportation and lodging for the patient and a companion.
For More Information
Review the enclosed Benefits Information Guide for more details on this new benefit and coverage. In January 2018, BridgeHealth will begin sending materials to eligible plan participants with more details about how to use the service. Until then, if you have any questions feel free to contact BridgeHealth at (844) 567-2970 or visit their website at www.bridgehealth.com. Register with the company code, FUSD2, for full access to their website.
[/togg]
[togg title=”No Rate Contribution Changes for 2018″]
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 sixth straight year.
[/togg]
[togg title=”Telehealth Services at Your Fingertips – Only a $5 Copay”]
The Joint Health Management Board (JHMB), in partnership with TeamCare, provides you with access to Plushcare’s network of telehealth physicians available to you and your covered family members. For both PPO Plans, Plan Options A and B, the Plan covers all but $5 of the cost for each appointment. No deductible applies when using PlushCare! As a reminder, Plan Option A has a $250 deductible and $15 copayment, and Plan Option B has a $1,000 deductible and $25 copayment. But when you use the PlushCare telehealth service, you only pay a $5 copay!
PlushCare’s physician network consists of board certified physicians in internal medicine or pediatrics that trained at a top-25 medical school in the United States. Their physicians provide the same level of care as in-person visits, including electronic prescriptions to your pharmacy in seconds. Fresno Unified plan participants have most commonly used PlushCare for respiratory conditions, urinary conditions and skin conditions. In fact, over one-third of the appointments were scheduled for respiratory conditions. Most plan participants using PlushCare call the service 3-5 times per year.
Go online at anytime to schedule an appointment! You call or video chat with a physician and he or she will diagnose you or your family member’s health issue. Your PlushCare physician will then provide recommended treatments based on your symptoms. If appropriate, the physician can write a prescription and have it sent immediately to the pharmacy of your choice.
How to Use Plushcare
-
- 1. Call (866) 460-6205, go online at www.plushcare.com, or download the PlushCare app. First time users will need to register. You will need to provide your name, date of birth, email address, and create a password. It only takes a couple of minutes. Register today!
-
- 2. Select “Book Appointment” and choose which physician you wish to talk with at a time that is convenient for you.
-
- 3. The doctor will call or video chat with you at your scheduled appointment time.
- 4. If necessary, prescriptions will be sent to your pharmacy in seconds!
If you’re not one of the several hundreds of plan participants that have begun to use this service this year, we recommend it as your first option the next time you need access to a physician. For more information, visit www.JHMBHealthConnect.com/telehealth-at-your-fingertips.
[/togg]
[togg title=”Attend a Benefits Workshop – Nov 15, 2017″]
The JHMB, in collaboration with EnvisionRx and BridgeHealth will conduct a 1-hour benefits workshop specifically to provide information and address your questions regarding EnvisionRx’s new Select Formulary and the new planned surgery benefit offered by BridgeHealth. Mark your calendars!
Wednesday, November 15th
5:00 – 6:30 p.m.
Bullard High School | Theatre
5445 N. Palm Avenue
Fresno, CA 9370
[/togg]
[togg title=”Plan Option C (Kaiser Permanente®)”]
SPECIAL NOTE: At this time, the Joint Health Management Board is deadlocked in their decision to renew or terminate Kaiser for the upcoming year. Please see the Special Notice for details on “things you should consider for open enrollment” as a result of this deadlock.
Download the Kaiser Special Notice
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. 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”]
WellPATH, the Employee Wellness Program for Fresno Unified School District, is pleased to offer a variety of wellness services throughout the year. The suite of free or low-cost services includes: preventative wellness screenings, group fitness classes, annual flu shot clinics, monthly health education, and wellness coaching.
Become a WellPATH Champion
This year, the program is looking for WellPATH Champions who are willing and able to spread the WellPATH message and encourage their peers to take an active role in leading a healthy lifestyle. If you are interested in becoming a WellPATH Champion, please contact WellPATH by email at WellPATH@delapro.com.
Personalized Programs to Support Your Path to Better Health
WellPATH continues to search for ways to support you along your path to better health. If you commit to improving your overall wellbeing, we will commit to making it easier for you. Complete ALL of your Behavior Modification Coaching and/or Personal Training Program sessions and you may be eligible to have WellPATH REIMBURSE YOUR PROGRAM FEES. Review the program details below and contact a Pinnacle Training Systems Wellness Coach at (559) 515-3578 for more details about this special offer.
To be eligible for the following programs you must first complete the personal wellness screening.
Behavior Modification Coaching
This program focuses on sustainable nutrition and healthy lifestyle behaviors. Participants learn the skills and tools they need to incorporate life-long changes to undesirable habits and how to adopt healthy behaviors to reduce their risk of chronic disease.
During the initial consultation, participants work with the Pinnacle Training Systems Behavior Modification Coaches to establish their customized wellness goals. Thereafter, participants have 8, 30-minute sessions (in-person or by phone) to address barriers and achievements to meeting their goals. The coaching program also consists of 8 educational webinars, a nutritional workbook, nutritional analysis, and body composition tracking.
Personal Training Program
This program provides accountability to individuals having a hard time committing to a regular exercise program. Sessions focus on teaching individual’s proper techniques and exercise regimes that can be mimicked at home or another facility.
During the initial consultation, participants work with Pinnacle Training Systems to determine goals and current level of fitness, assessment of strengths and weaknesses, and body composition tracking, as well as the design of a custom workout based on principles of exercise science.
For more information about these programs and and other WellPATH offerings, visit www.JHMBHealthConnect.com/wellpath.
[/togg]
[togg title=”Take a Healthy Minute and Schedule a Preventive Cancer Screening”]
Under the District’s health plan, all participants are eligible for FREE preventive cancer screenings. Take a Healthy Minute and schedule an appointment with your physician today to get up-to-date with your routine cancer screenings.
[/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 2017 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 2018, 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.
Download AFA Information & Schedule
[/togg]
[togg title=”Employee Assistance Program (EAP)”]
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=”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:
[checklist]
- 2018 Open Enrollment Benefits Information Guide
- American Fidelity Section 125 Open Enrollment Announcement including a list of scheduled sites and dates
- Annual Participant Notices
- Benefits Enrollment Form – which must be completed and returned to the Benefits Office no later than December 1, 2017.
- Kaiser Commercial Zip Code Master Listing
[/checklist]
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=”Plan Option A and Option B (PPO) Updates”]
NEW: Envision Rx “Select Formulary” in 2018
This does NOT apply to the EnvisionRx Plus Medicare Part D Prescription Plan, however it does apply to those enrolled in the EnvisionRx prescription plan. If you and/or your dependent are enrolled in the EnvisionRx Plus Medicare Part D Prescription Plan, Envision will mail you a summary of benefits outlining changes, if any, to the EnvisionRx Plus plan.
In 2016, the JHMB introduced 3 copay tiers for Generic Drugs ($10), Preferred Brand-name Drugs ($35), and Non-preferred Brand-name Drugs ($50). This original change was made in the interest of ensuring that our members have access to generic drugs and preferred brand-name drugs at affordable rates. Earlier this year, the JHMB added a fourth tier to provide members with access to generic drugs treating targeted health conditions (high cholesterol, high blood pressure, diabetes, and depression) at $0 copay. Each of these changes was made after careful consideration by the JHMB and its partners to manage the rising costs of prescription drugs while ensuring that our members have access to quality medications at affordable rates.
In these continuing efforts, the JHMB has approved the implementation of Envision Rx’s Select Formulary for Plan Options A and B effective January 1, 2018. Under the Select Formulary program, the JHMB’s existing 4 copay tiers remain, however the drugs available within those tiers may change based on the latest Envision Rx standards. Currently, Envision’s research indicates that as many as 1100 members in Plan Options A and B may be impacted by the implementation of the Select Formulary drug list.
What You Need to Do
In early November, Envision Rx will send more detailed communications to impacted plan participants only regarding which drugs are affected by the Select Formulary drug list. If your spouse or dependent(s) receives the letter from Envision, we recommend reviewing the drug list and identifying if any of the current prescription drugs will be excluded. Until then, should you have additional questions regarding your prescription drug benefit, please contact the EnvisionRxOptions Customer Service Help Desk at (800) 361-4542. The Help Desk is here to assist you with prescription questions 24 hours a day/7 days a week.
NEW: Planned Surgery Benefit through BridgeHealth
In recent years, the JHMB has worked hard to find innovative solutions to manage and maintain the highest quality and most cost-effective benefits for our active employees and retirees. In 2018, we are partnering with BridgeHealth to offer a new planned surgery benefit that covers 100% of the costs for non-emergency surgeries – no deductible, no coinsurance! BridgeHealth partners with top-rated providers to help improve surgical outcomes (such as fewer complications and lower infection rates) and reduce costs for procedures such as:
- – Bariatric: Gastric bypass, gastric sleeve, lap band removal
- – Cardiac: Coronary artery bypass graft, valve repair and replacement
- – General: Gall bladder removal, ENT, hernia repair
- – Orthopedic: Carpal tunnel release, ACL repair, hip and knee replacement
- – Spine: Spinal fusion, artificial disc replacement
- – Women’s Health: Hysterectomy
This new service launches January 1, 2018. You should consider contacting BridgeHealth if your doctor recommends scheduling a surgery in February 2018 or later. A dedicated care coordinator will help you select a top-rated provider for your type of procedure and will handle all the administrative work, approvals, billing and scheduling. If travel is required, BridgeHealth arranges transportation and lodging for the patient and a companion.
For More Information
In January 2018, BridgeHealth will begin sending materials to eligible plan participants with more details about how to use the service. Until then, if you have any questions feel free to contact BridgeHealth at (844) 567-2970 or visit their website at www.bridgehealth.com. Register with the company code, FUSD2, for full access to their website.
[/togg]
[togg title=”No Rate Contribution Changes for 2018″]
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 sixth straight year.
[/togg]
[togg title=”Telehealth Services at Your Fingertips – Only a $5 Copay”]
The Joint Health Management Board (JHMB), in partnership with TeamCare, provides you with access to Plushcare’s network of telehealth physicians available to you and your covered family members. For both PPO Plans, Plan Options A and B, the Plan covers all but $5 of the cost for each appointment. No deductible applies when using PlushCare! As a reminder, Plan Option A has a $250 deductible and $15 copayment, and Plan Option B has a $1,000 deductible and $25 copayment. But when you use the PlushCare telehealth service, you only pay a $5 copay!
PlushCare’s physician network consists of board certified physicians in internal medicine or pediatrics that trained at a top-25 medical school in the United States. Their physicians provide the same level of care as in-person visits, including electronic prescriptions to your pharmacy in seconds. Fresno Unified plan participants have most commonly used PlushCare for respiratory conditions, urinary conditions and skin conditions. In fact, over one-third of the appointments were scheduled for respiratory conditions. Most plan participants using PlushCare call the service 3-5 times per year.
Go online at anytime to schedule an appointment! You call or video chat with a physician and he or she will diagnose you or your family member’s health issue. Your PlushCare physician will then provide recommended treatments based on your symptoms. If appropriate, the physician can write a prescription and have it sent immediately to the pharmacy of your choice.
How to Use Plushcare
-
- 1. Call (866) 460-6205, go online at www.plushcare.com, or download the PlushCare app. First time users will need to register. You will need to provide your name, date of birth, email address, and create a password. It only takes a couple of minutes. Register today!
-
- 2. Select “Book Appointment” and choose which physician you wish to talk with at a time that is convenient for you.
-
- 3. The doctor will call or video chat with you at your scheduled appointment time.
- 4. If necessary, prescriptions will be sent to your pharmacy in seconds!
If you’re not one of the several hundreds of plan participants that have begun to use this service this year, we recommend it as your first option the next time you need access to a physician. For more information, visit www.JHMBHealthConnect.com/telehealth-at-your-fingertips.
[/togg]
[togg title=”Attend a Benefits Workshop – Nov 15, 2017″]
The JHMB, in collaboration with EnvisionRx and BridgeHealth will conduct a 1-hour benefits workshop specifically to provide information and address your questions regarding EnvisionRx’s new Select Formulary and the new planned surgery benefit offered by BridgeHealth. Mark your calendars!
Wednesday, November 15th
5:00 – 6:30 p.m.
Bullard High School | Theatre
5445 N. Palm Avenue
Fresno, CA 9370
[/togg]
[togg title=”Kaiser Permanente® Senior Advantage Plan Option”]
SPECIAL NOTE: At this time, the Joint Health Management Board is deadlocked in their decision to renew or terminate Kaiser for the upcoming year. Please see the Special Notice for details on “things you should consider for open enrollment” as a result of this deadlock.
Download the Kaiser Special Notice
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, 2018, 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”]
WellPATH, the Employee Wellness Program for Fresno Unified School District, is pleased to offer a variety of wellness services throughout the year. The suite of free or low-cost services includes: preventative wellness screenings, group fitness classes, annual flu shot clinics, monthly health education, and wellness coaching.
Become a WellPATH Champion
This year, the program is looking for WellPATH Champions who are willing and able to spread the WellPATH message and encourage their peers to take an active role in leading a healthy lifestyle. If you are interested in becoming a WellPATH Champion, please contact WellPATH by email at WellPATH@delapro.com.
Personalized Programs to Support Your Path to Better Health
WellPATH continues to search for ways to support you along your path to better health. If you commit to improving your overall wellbeing, we will commit to making it easier for you. Complete ALL of your Behavior Modification Coaching and/or Personal Training Program sessions and you may be eligible to have WellPATH REIMBURSE YOUR PROGRAM FEES. Review the program details below and contact a Pinnacle Training Systems Wellness Coach at (559) 515-3578 for more details about this special offer.
To be eligible for the following programs you must first complete the personal wellness screening.
Behavior Modification Coaching
This program focuses on sustainable nutrition and healthy lifestyle behaviors. Participants learn the skills and tools they need to incorporate life-long changes to undesirable habits and how to adopt healthy behaviors to reduce their risk of chronic disease.
During the initial consultation, participants work with the Pinnacle Training Systems Behavior Modification Coaches to establish their customized wellness goals. Thereafter, participants have 8, 30-minute sessions (in-person or by phone) to address barriers and achievements to meeting their goals. The coaching program also consists of 8 educational webinars, a nutritional workbook, nutritional analysis, and body composition tracking.
Personal Training Program
This program provides accountability to individuals having a hard time committing to a regular exercise program. Sessions focus on teaching individual’s proper techniques and exercise regimes that can be mimicked at home or another facility.
During the initial consultation, participants work with Pinnacle Training Systems to determine goals and current level of fitness, assessment of strengths and weaknesses, and body composition tracking, as well as the design of a custom workout based on principles of exercise science.
For more information about these programs and and other WellPATH offerings, visit www.JHMBHealthConnect.com/wellpath.
[/togg]
[togg title=”Take a Healthy Minute and Schedule a Preventive Cancer Screening”]
Under the District’s health plan, all participants are eligible for FREE preventive cancer screenings. Take a Healthy Minute and schedule an appointment with your physician today to get up-to-date with your routine cancer screenings.
[/togg]
[togg title=”Employee Assistance Program (EAP) – Available to Retirees Too!”]
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=”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:
[checklist]
- Annual Participant Notices
- Benefits Enrollment Form – which must be completed and returned to the Benefits Office no later than December 1, 2017.
- Kaiser Commercial Zip Code Master Listing
[/checklist]
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 2018″]
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 sixth straight year. 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=”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 2017 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 2018, 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.
Download AFA Information & Schedule
[/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:
[checklist]
- American Fidelity Section 125 Open Enrollment Announcement including a list of scheduled sites and dates
- Benefits Open Enrollment Form – which must be completed and returned to the Benefits Office no later than December 1, 2017.
- Privacy Notice
[/checklist]
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=”Action Required”]
This year’s annual Open Enrollment for 2018 benefits occurs from October 2 to December 1, 2017. 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 1, 2017 (or November 7, 2017 if you wish to enroll in Kaiser Senior Advantage). All changes will be effective January 1, 2018. Please review the following brief highlights to understand changes that may affect you in 2018.
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: Envision Rx “Select Formulary” in 2018
This does NOT apply to the EnvisionRx Plus Medicare Part D Prescription Plan, however it does apply to those enrolled in the EnvisionRx prescription plan. If you and/or your dependent are enrolled in the EnvisionRx Plus Medicare Part D Prescription Plan, Envision will mail you a summary of benefits outlining changes, if any, to the EnvisionRx Plus plan.
In 2016, the JHMB introduced 3 copay tiers for Generic Drugs ($10), Preferred Brand-name Drugs ($35), and Non-preferred Brand-name Drugs ($50). This original change was made in the interest of ensuring that our members have access to generic drugs and preferred brand-name drugs at affordable rates. Earlier this year, the JHMB added a fourth tier to provide members with access to generic drugs treating targeted health conditions (high cholesterol, high blood pressure, diabetes, and depression) at $0 copay. Each of these changes was made after careful consideration by the JHMB and its partners to manage the rising costs of prescription drugs while ensuring that our members have access to quality medications at affordable rates.
In these continuing efforts, the JHMB has approved the implementation of Envision Rx’s Select Formulary for Plan Options A and B effective January 1, 2018. Under the Select Formulary program, the JHMB’s existing 4 copay tiers remain, however the drugs available within those tiers may change based on the latest Envision Rx standards. Currently, Envision’s research indicates that as many as 1100 members in Plan Options A and B may be impacted by the implementation of the Select Formulary drug list.
What You Need to Do
In early November, Envision Rx will send more detailed communications to impacted plan participants only regarding which drugs are affected by the Select Formulary drug list. If your spouse or dependent(s) receives the letter from Envision, we recommend reviewing the drug list and identifying if any of the current prescription drugs will be excluded. Until then, should you have additional questions regarding your prescription drug benefit, please contact the EnvisionRxOptions Customer Service Help Desk at (800) 361-4542. The Help Desk is here to assist you with prescription questions 24 hours a day/7 days a week.
NEW: Planned Surgery Benefit through BridgeHealth
This benefit is available to non-Medicare eligible spouses or dependents
In recent years, the JHMB has worked hard to find innovative solutions to manage and maintain the highest quality and most cost-effective benefits for our active employees and retirees. In 2018, we are partnering with BridgeHealth to offer a new planned surgery benefit that covers 100% of the costs for non-emergency surgeries – no deductible, no coinsurance! BridgeHealth partners with top-rated providers to help improve surgical outcomes (such as fewer complications and lower infection rates) and reduce costs for procedures such as:
- – Bariatric: Gastric bypass, gastric sleeve, lap band removal
- – Cardiac: Coronary artery bypass graft, valve repair and replacement
- – General: Gall bladder removal, ENT, hernia repair
- – Orthopedic: Carpal tunnel release, ACL repair, hip and knee replacement
- – Spine: Spinal fusion, artificial disc replacement
- – Women’s Health: Hysterectomy
This new service launches January 1, 2018. You should consider contacting BridgeHealth if your doctor recommends scheduling a surgery in February 2018 or later. A dedicated care coordinator will help you select a top-rated provider for your type of procedure and will handle all the administrative work, approvals, billing and scheduling. If travel is required, BridgeHealth arranges transportation and lodging for the patient and a companion.
For More Information
In January 2018, BridgeHealth will begin sending materials to eligible plan participants with more details about how to use the service. Until then, if you have any questions feel free to contact BridgeHealth at (844) 567-2970 or visit their website at www.bridgehealth.com. Register with the company code, FUSD2, for full access to their website.
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[togg title=”No Rate Contribution Changes for 2018″]
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 sixth straight year.
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[togg title=”Telehealth Services at Your Fingertips – Only a $5 Copay”]
The Joint Health Management Board (JHMB), in partnership with TeamCare, provides you with access to Plushcare’s network of telehealth physicians available to you and your covered family members. For both PPO Plans, Plan Options A and B, the Plan covers all but $5 of the cost for each appointment. No deductible applies when using PlushCare! As a reminder, Plan Option A has a $250 deductible and $15 copayment, and Plan Option B has a $1,000 deductible and $25 copayment. But when you use the PlushCare telehealth service, you only pay a $5 copay!
PlushCare’s physician network consists of board certified physicians in internal medicine or pediatrics that trained at a top-25 medical school in the United States. Their physicians provide the same level of care as in-person visits, including electronic prescriptions to your pharmacy in seconds. Fresno Unified plan participants have most commonly used PlushCare for respiratory conditions, urinary conditions and skin conditions. In fact, over one-third of the appointments were scheduled for respiratory conditions. Most plan participants using PlushCare call the service 3-5 times per year.
Go online at anytime to schedule an appointment! You call or video chat with a physician and he or she will diagnose you or your family member’s health issue. Your PlushCare physician will then provide recommended treatments based on your symptoms. If appropriate, the physician can write a prescription and have it sent immediately to the pharmacy of your choice.
How to Use Plushcare
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- 1. Call (866) 460-6205, go online at www.plushcare.com, or download the PlushCare app. First time users will need to register. You will need to provide your name, date of birth, email address, and create a password. It only takes a couple of minutes. Register today!
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- 2. Select “Book Appointment” and choose which physician you wish to talk with at a time that is convenient for you.
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- 3. The doctor will call or video chat with you at your scheduled appointment time.
- 4. If necessary, prescriptions will be sent to your pharmacy in seconds!
If you’re not one of the several hundreds of plan participants that have begun to use this service this year, we recommend it as your first option the next time you need access to a physician. For more information, visit www.JHMBHealthConnect.com/telehealth-at-your-fingertips.
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[togg title=”Attend a Benefits Workshop – Nov 15, 2017″]
The JHMB, in collaboration with EnvisionRx and BridgeHealth will conduct a 1-hour benefits workshop specifically to provide information and address your questions regarding EnvisionRx’s new Select Formulary and the new planned surgery benefit offered by BridgeHealth. Mark your calendars!
Wednesday, November 15th
5:00 – 6:30 p.m.
Bullard High School | Theatre
5445 N. Palm Avenue
Fresno, CA 9370
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[togg title=”Kaiser Permanente® Senior Advantage Plan Option”]
SPECIAL NOTE: At this time, the Joint Health Management Board is deadlocked in their decision to renew or terminate Kaiser for the upcoming year. Please see the Special Notice for details on “things you should consider for open enrollment” as a result of this deadlock.
Download the Kaiser Special Notice
As a reminder, from October 2 – November 7, 2017, 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 and spouses.
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, 2018, 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 7, 2017. Any other changes you wish to make to your existing coverage can be made during the Annual Open Enrollment period from October 2 – December 1, 2017.
To learn more about the Kaiser Permanente Senior Advantage plan, please attend the special session offered by Kaiser Permanente or contact Kaiser Permanente at the information provided below. Enrollment forms will be provided at the special session or available for pick up at the District Benefits Office. You may also contact Kaiser Permanente to have an enrollment form mailed to you.
Special Session: Kaiser Senior Advantage (HMO) Plan
Monday, October 16, 2017
2:00 – 6:00 PM
Kaiser Permanente Fresno Medical Center
7300 N. Fresno Street, 3rd Floor
Fresno, CA 93720
Information 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, 2018, you will have to make this change by November 7, 2017. Any other changes you wish to make to your current health plan offerings can be made during the Annual Open Enrollment period from October 2 – December 1, 2017.
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[togg title=”WellPATH Program Update”]
WellPATH, the Employee Wellness Program for Fresno Unified School District, is pleased to offer a variety of wellness services throughout the year. The suite of free or low-cost services includes: preventative wellness screenings, group fitness classes, annual flu shot clinics, monthly health education, and wellness coaching.
Become a WellPATH Champion
This year, the program is looking for WellPATH Champions who are willing and able to spread the WellPATH message and encourage their peers to take an active role in leading a healthy lifestyle. If you are interested in becoming a WellPATH Champion, please contact WellPATH by email at WellPATH@delapro.com.
Personalized Programs to Support Your Path to Better Health
WellPATH continues to search for ways to support you along your path to better health. If you commit to improving your overall wellbeing, we will commit to making it easier for you. Complete ALL of your Behavior Modification Coaching and/or Personal Training Program sessions and you may be eligible to have WellPATH REIMBURSE YOUR PROGRAM FEES. Review the program details below and contact a Pinnacle Training Systems Wellness Coach at (559) 515-3578 for more details about this special offer.
To be eligible for the following programs you must first complete the personal wellness screening.
Behavior Modification Coaching
This program focuses on sustainable nutrition and healthy lifestyle behaviors. Participants learn the skills and tools they need to incorporate life-long changes to undesirable habits and how to adopt healthy behaviors to reduce their risk of chronic disease.
During the initial consultation, participants work with the Pinnacle Training Systems Behavior Modification Coaches to establish their customized wellness goals. Thereafter, participants have 8, 30-minute sessions (in-person or by phone) to address barriers and achievements to meeting their goals. The coaching program also consists of 8 educational webinars, a nutritional workbook, nutritional analysis, and body composition tracking.
Personal Training Program
This program provides accountability to individuals having a hard time committing to a regular exercise program. Sessions focus on teaching individual’s proper techniques and exercise regimes that can be mimicked at home or another facility.
During the initial consultation, participants work with Pinnacle Training Systems to determine goals and current level of fitness, assessment of strengths and weaknesses, and body composition tracking, as well as the design of a custom workout based on principles of exercise science.
For more information about these programs and and other WellPATH offerings, visit www.JHMBHealthConnect.com/wellpath.
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[togg title=”Take a Healthy Minute and Schedule a Preventive Cancer Screening”]
Under the District’s health plan, all participants are eligible for FREE preventive cancer screenings. Take a Healthy Minute and schedule an appointment with your physician today to get up-to-date with your routine cancer screenings.
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[togg title=”Employee Assistance Program (EAP) – Available to Retirees Too!”]
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=”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:
[checklist]
- Annual Participant Notices
- Benefits Enrollment Form – which must be completed and returned to the Benefits Office no later than December 1, 2017. As a reminder, if you wish to change to the Kaiser Senior Advantage plan, you will have to make this change by November 7, 2017.
- KPSA Zip Code Master Listing
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For additional plan information and/or provider contact information view the following pages:
www.JHMBHealthConnect.com/your-benefits
www.JHMBHealthConnect.com/using-plans[/togg]
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