This year’s annual Open Enrollment for 2020 benefits occurs from October 1 to Friday, November 29, 2019. 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 29, 2019. All changes will be effective January 1, 2020. Please review the following brief highlights to understand changes that may affect you in 2020.
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=”Plan Option A and Option B (PPO) Updates”]Halcyon Behavioral Health To Replace Avante Health Effective January 1, 2020
Beginning in January 2020, Halcyon Behavioral Health will administer the mental health and substance abuse services for Plan A and Plan B participants of the District’s medical plans. There will be no change in benefits coverage once this change is made. The JHMB will provide more detailed information about the new vendor, including contact information and any continuity of care provisions prior to the change. Stay tuned for further details in the latter months of 2019.The EnvisionRx Customer Service Survey
We Need Your Feedback: Survey Open from October 1 – November 1, 2019
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. Last year, we conducted a customer service survey for our prescription drug program and received valuable feedback from more than 800 of our plan participants. Your feedback was essential in helping us identify and improve gaps in service. Now it’s time to assess our progress over this past year. 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
Take the Survey & Enter to Win a $50 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 $50 Visa Gift Card, please provide your employee/retiree ID number when you complete the survey. It will help us identify you if you win the raffle.
We look forward to your feedback and thank you for helping us manage the highest quality benefits for you and your family.
Know Before You Go: Location Still Impacts How Much You Pay for Imaging Services
In 2018, the JHMB provided our Plan A and Plan B participants with a detailed cost analysis of the imaging costs at local facilities for x-rays and CT scans. At that time, we noted that the costs for those services at “free-standing” radiology centers or physician offices were generally 3-6 times less expensive than those at hospitals and medical centers. Now, we’ve updated the data for 2019 and have included the updated handout in this open enrollment packet. Review the enclosed handout for actual member costs at local facilities in the recent plan year, as well as tips to advocate for your wallet before your next imaging procedure. [/togg] [togg title=”Rate Contribution Changes for 2020″] 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, family medicine, emergency 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!
- Annual Participant Notices
- EnvisionRx Customer Service Survey – which must be completed online or returned to the District Benefits Office no later than November 1, 2019.
- Benefits Enrollment Form – which must be completed and returned to the Benefits Office no later than November 29, 2019.
- California Region Group (Kaiser) Enrollment/Change Form
- Kaiser Commercial Zip Code Master Listing
- 2019 Imaging Costs Update
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”]Halcyon Behavioral Health To Replace Avante Health Effective January 1, 2020
Beginning in January 2020, Halcyon Behavioral Health will administer the mental health and substance abuse services for Plan A and Plan B participants of the District’s medical plans. There will be no change in benefits coverage once this change is made. The JHMB will provide more detailed information about the new vendor, including contact information and any continuity of care provisions prior to the change. Stay tuned for further details in the latter months of 2019.The EnvisionRx Customer Service Survey
We Need Your Feedback: Survey Open from October 1 – November 1, 2019
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. Last year, we conducted a customer service survey for our prescription drug program and received valuable feedback from more than 800 of our plan participants. Your feedback was essential in helping us identify and improve gaps in service. Now it’s time to assess our progress over this past year. 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
Take the Survey & Enter to Win a $50 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 $50 Visa Gift Card, please provide your employee/retiree ID number when you complete the survey. It will help us identify you if you win the raffle.
We look forward to your feedback and thank you for helping us manage the highest quality benefits for you and your family.
Know Before You Go: Location Still Impacts How Much You Pay for Imaging Services
In 2018, the JHMB provided our Plan A and Plan B participants with a detailed cost analysis of the imaging costs at local facilities for x-rays and CT scans. At that time, we noted that the costs for those services at “free-standing” radiology centers or physician offices were generally 3-6 times less expensive than those at hospitals and medical centers. Now, we’ve updated the data for 2019 and have included the updated handout in this open enrollment packet. Review the enclosed handout for actual member costs at local facilities in the recent plan year, as well as tips to advocate for your wallet before your next imaging procedure. [/togg] [togg title=”Kaiser Permanente® Senior Advantage Plan Option”]Special Enrollment Ends November 5, 2019
As a reminder, from October 1 – November 5, 2019, 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, 2020, 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 5, 2019. Any other changes you wish to make to your existing coverage can be made during the Annual Open Enrollment period from October 1 – November 29, 2019. 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, 2020, you will have to make this change by November 5, 2019. 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 29, 2019. [/togg] [togg title=”Rate Contribution Changes for 2020″] 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=”Attend the Fall 2019 Benefits Workshop “]Mark Your Calendars – November 13, 2019
The JHMB, in collaboration with Halcyon Behavioral Health (our new mental health and substance abuse vendor), Claremont EAP, and the WellPATH program, will conduct a 2-hour benefits workshop. The topics will include information about our new vendor, Halcyon Behavioral Health, new Customer Service contacts for EnvisionRx, and the District’s WellPATH program offerings. There will also be time allotted to address any open questions. Wednesday, November 13, 2019 4:30 – 6:30 PM Bullard High School | Theatre 5445 N. Palm Avenue Fresno, CA 93704 [/togg] [togg title=”Stay Connected – Sign Up for Monthly Updates & Benefit Alerts”] Every month, the JHMB provides our plan participants with healthful information to help them along their path to better health. This includes benefits alerts and key reminders, upcoming events, healthful news and local activities, wellness offerings, healthy recipes, and even a new Healthy Aging Corner for our age 55+ plan participants. If you are not currently receiving these healthful email updates, visit www.JHMBHealthConnect.com/staying-connected to review past announcements and to sign up for our email list. [/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, family medicine, emergency 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 any time 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!
Become a WellPATH Champion
WellPATH is always 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, visit www.JHMBHealthConnect.com/wellpath/wellpath-champions 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) 548-3260 for more details about this special offer. 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
- Annual Participant Notices
- EnvisionRx Customer Service Survey – which must be completed online or returned to the District Benefits Office no later than November 1, 2019.
- Benefits Enrollment Form – which must be completed and returned to the Benefits Office no later than November 29, 2019.
- California Region Group (Kaiser) Enrollment/Change Form
- Kaiser Commercial Zip Code Master Listing
- 2019 Imaging Costs Update
