This year’s annual Open Enrollment for 2019 benefits occurs from October 1 to November 30, 2018. 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, 2018. All changes will be effective January 1, 2019. Please review the following brief highlights to understand changes that may affect you in 2019.
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.
[tabs tab1=”COBRA Participants” tab2=”ED Code Participants” ]
[tab]
[togg title=”Important Reminder for All Plan Participants”]
Notify the District When Your Ex-Spouses & Dependents are No Longer Eligible for Benefits
As a reminder, you are required to notify the District within 60 days following the date on which any dependent no longer meets the eligibility criteria for dependent coverage (including divorce or legal separation; and the termination, dissolution or nullification of Domestic Partnership). Failure to notify the District within the adequate time period may cause you to be responsible for the reimbursement of any claims paid for ineligible dependents.
[/togg]
[togg title=”Plan Option A and Option B (PPO) Updates”]
The EnvisionRx Customer Service Survey
We Need Your Feedback: Survey Open from October 1 – November 2, 2018
One of the JHMB’s core missions is to manage and maintain the highest quality health benefits possible on behalf of active and retired employees. From time to time, we reach out to you (as plan participants) to help us understand and manage the service you receive from our benefits vendors. This year, we are conducting a very brief survey regarding our prescription drug program to evaluate the level of service you receive. The survey does not require you to provide your name or any identifying information.
If you have used your EnvisionRx prescription drug benefits within the last year, we ask that you take a moment to answer 10 simple questions to help us assess and improve your customer experience. The survey asks brief questions regarding the following aspects of the prescription drug program:
- – Overall Customer Service
- – Retail Pharmacy
- – Mail Order Pharmacy
- – Specialty Pharmacy
- – Website and Member Portal
This is your chance to provide feedback on the services you’ve received from EnvisionRx and its partners over the last year. You may also add written comments to provide more details regarding your experience(s).
Take the Survey & Enter to Win a $25 Gift Card
You may complete the survey either using the paper survey enclosed in this packet or online at www.JHMBHealthConnect.com/rxsurvey. If you wish to enter into a raffle for a $25 Visa Gift Card, complete the survey and bring either the completed paper version or a print out of the confirmation page of the online survey to a Wellness Screening or Flu Shot Clinic from October 1 – November 2, 2018. Only surveys handed in at the screenings or flu shot clinics will be eligible for the raffle.
We look forward to your feedback and thank you for helping us manage the highest quality benefits for you and your family.
Considering Surgery? Understand Your Options – BridgeHealth Planned Surgery Program
Fresno Unified School District partners with BridgeHealth to ensure you receive high quality care when you need non-emergency surgery. BridgeHealth connects you with top-rated facilities and surgeons, and you’ll pay less out of pocket.
Comparing your provider options and costs can help you get the best care. The District’s health plan provides you with options when you need non-emergency surgery. In addition to the Anthem Blue Cross provider network, the District’s health plan also includes a supplemental planned surgery program through BridgeHealth. The program covers 100% of your surgery costs and gives you and your enrolled family members access to top-rated hospitals, surgery centers and doctors nationwide – 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
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
For more details on this benefit and coverage, review the enclosed Benefits Information Guide or visit www.JHMBHealthConnect.com/bridgehealth. If you have any additional 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=”Rate Contribution Changes for 2019″]
The Joint Health Management Board (JHMB) continuously strives to manage and maintain the highest quality and most cost-effective benefits for our active employees and retirees. Medical, dental, and vision premiums depend on the plan option(s) you select. Please review the rates included on the enclosed Benefits Enrollment form for more details.
Thanks to the improved program usage by our employees and retirees, and the efforts of the Fresno Unified School District and the JHMB, these rate changes are not as large as the healthcare industry average increases in recent years. However, 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 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. 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=”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=”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=”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
- EnvisionRx Customer Service Survey – which must be completed online or returned (to the Benefits Office or at a wellness screening or flu shot clinic) no later than November 2, 2018.
- Benefits Enrollment Form – which must be completed and returned to the Benefits Office no later than November 30, 2018.
- 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=”Action Required”]
This year’s annual Open Enrollment for 2019 benefits occurs from October 1 to November 30, 2018. 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, 2018 (or November 6, 2018 if you wish to enroll in Kaiser Senior Advantage, see page 4). All changes will be effective January 1, 2019. Please review the following brief highlights in this letter to understand changes that may affect you in 2019.
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, or add/remove eligible dependents, you must complete the Benefits Open Enrollment form enclosed in this packet.
[/togg]
[togg title=”Important Reminder for All Plan Participants”]
Notify the District When Your Ex-Spouses & Dependents are No Longer Eligible for Benefits
As a reminder, you are required to notify the District within 60 days following the date on which any dependent no longer meets the eligibility criteria for dependent coverage (including divorce or legal separation; and the termination, dissolution or nullification of Domestic Partnership). Failure to notify the District within the adequate time period may cause you to be responsible for the reimbursement of any claims paid for ineligible dependents.
[/togg]
[togg title=”Plan Option A and Option B (PPO) Updates”]
The EnvisionRx Customer Service Survey
We Need Your Feedback: Survey Open from October 1 – November 2, 2018
One of the JHMB’s core missions is to manage and maintain the highest quality health benefits possible on behalf of active and retired employees. From time to time, we reach out to you (as plan participants) to help us understand and manage the service you receive from our benefits vendors. This year, we are conducting a very brief survey regarding our prescription drug program to evaluate the level of service you receive. The survey does not require you to provide your name or any identifying information.
If you have used your EnvisionRx prescription drug benefits within the last year, we ask that you take a moment to answer 10 simple questions to help us assess and improve your customer experience. The survey asks brief questions regarding the following aspects of the prescription drug program:
- – Overall Customer Service
- – Retail Pharmacy
- – Mail Order Pharmacy
- – Specialty Pharmacy
- – Website and Member Portal
This is your chance to provide feedback on the services you’ve received from EnvisionRx and its partners over the last year. You may also add written comments to provide more details regarding your experience(s).
Take the Survey & Enter to Win a $25 Gift Card
You may complete the survey either using the paper survey enclosed in this packet or online at www.JHMBHealthConnect.com/rxsurvey. If you wish to enter into a raffle for a $25 Visa Gift Card, complete the survey and bring either the completed paper version or a print out of the confirmation page of the online survey to a Wellness Screening or Flu Shot Clinic from October 1 – November 2, 2018. Only surveys handed in at the screenings or flu shot clinics will be eligible for the raffle.
We look forward to your feedback and thank you for helping us manage the highest quality benefits for you and your family.
Considering Surgery? Understand Your Options – BridgeHealth Planned Surgery Program
This benefit is available to non-Medicare eligible spouses or dependents.
Fresno Unified School District partners with BridgeHealth to ensure you receive high quality care when you need non-emergency surgery. BridgeHealth connects you with top-rated facilities and surgeons, and you’ll pay less out of pocket.
Comparing your provider options and costs can help you get the best care. The District’s health plan provides you with options when you need non-emergency surgery. In addition to the Anthem Blue Cross provider network, the District’s health plan also includes a supplemental planned surgery program through BridgeHealth. The program covers 100% of your surgery costs and gives you and your enrolled family members access to top-rated hospitals, surgery centers and doctors nationwide – 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
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
For more details on this benefit and coverage, review the enclosed Benefits Information Guide or visit www.JHMBHealthConnect.com/bridgehealth. If you have any additional 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=”Rate Contribution Changes for 2019″]
The Joint Health Management Board (JHMB) continuously strives to manage and maintain the highest quality and most cost-effective benefits for our active employees and retirees. Medical, dental, and vision premiums depend on the plan option(s) you select. Please review the rates included on the enclosed Benefits Enrollment form for more details.
Thanks to the improved program usage by our employees and retirees, and the efforts of the Fresno Unified School District and the JHMB, these rate changes are not as large as the healthcare industry average increases in recent years. However, 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=”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=”Kaiser Permanente® Senior Advantage Plan Option”]
Special Enrollment Ends November 6, 2018
As a reminder, from October 1 – November 6, 2018, 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 6, 2018. Any other changes you wish to make to your existing coverage can be made during the Annual Open Enrollment period from October 1 – November 30, 2018.
To learn more about the Kaiser Permanente Senior Advantage plan, please contact Kaiser Permanente at the information provided below. Enrollment forms are available for pick up at the District Benefits Office. You may also contact Kaiser Permanente to have an enrollment form mailed to you.
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, 2019, you will have to make this change by November 6, 2018. 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 – November 30, 2018.
[/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
- EnvisionRx Customer Service Survey – which must be completed online or returned (to the Benefits Office or at a wellness screening or flu shot clinic) no later than November 2, 2018.
- Benefits Enrollment Form – which must be completed and returned to the Benefits Office no later than November 30, 2018. As a reminder, if you wish to change to the Kaiser Senior Advantage plan, you will have to make this change by November 6, 2018.
- KPSA 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]
[/tabs]
