2023 Open Enrollment

This year’s annual Open Enrollment for 2023 benefits occurs from October 1 to November 30, 2022. Please review the following highlights below to understand changes that may affect you in 2023.

[button href=”https://www.jhmbhealthconnect.com/11653″ 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]

This year’s annual Open Enrollment for 2023 benefits occurs from October 1 to November 30, 2022. If you wish to make any changes to your existing coverage, you must complete the Enrollment Form online or return it to the District Benefits Office by no later than Wednesday, November 30, 2022. All changes will be effective January 1, 2023. Please review the following brief highlights in this letter to understand changes that may affect you in 2023. In addition, the Benefit Information Guide is your supplemental Open Enrollment resource to help you understand and select the best benefit options for you and your family. 

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 online. 

Please note, if you currently participate in the District’s Section 125 Flexible Spending Account (FSA) plan and wish to use this plan in 2023, you must re-enroll and set your annual contribution amount for the upcoming year. 

[togg title=”Open Enrollment is Online This Year for Full-Time Employees”]

 The Fresno Unified School District Benefits Department is excited to announce a simpler way to enroll in your benefits for the upcoming plan year (2023). Over the last year, we have piloted our new online benefits enrollment system for new hires and now it’s ready for primetime – during this year’s Open Enrollment period. The new system has been designed to walk you through each of your enrollment decisions for the upcoming year, including selecting/adding your dependents and electing your medical, dental and vision coverage. You can start and finish when it’s convenient for you using the unique hyperlink that we will send to your District email address once enrollment begins on October 1, 2022. 

NOTE: It may take up to 2 days from October 1st for you to receive your enrollment email due to system limitations. 

If you wish to make changes during this annual enrollment period, it may take 15-30 minutes to complete the online enrollment form. If at any time you need to take a break, you can save your progress, and return at a later time to complete the form. However, you must complete your enrollment online by no later than Wednesday, November 30, 2022. If you have any questions, please contact the Benefits Department at (559) 457-3520. 

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[togg title=”2023 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 2023 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 2023.

Download the 2023 Open Enrollment Benefits Information Guide

Download

[/togg]

[togg title=”Plan Option A and Option B (PPO) Participants”]

NEW: Annual Coordination of Benefits (COB) Form Required Starting January 2023 

Beginning 2023, all Plan Option A and Option B (PPO) participants with one or more covered dependent(s) will be required to complete an annual Coordination of Benefits (COB) Form with Delta Health Systems (DHS). The District’s plans contain a “Coordination of Benefits” provision to ensure coordination of coverage between payors. For billing purposes, when a patient is covered under more than one group plan, one payor becomes the “primary carrier” and the other becomes the “secondary carrier.” The primary carrier must pay benefits before the secondary carrier can determine what benefits it will pay. This applies if you have more than one medical plan, including Medicare coverage. 

In January 2023, DHS will mail the annual COB form to all Plan Option A and Option B (PPO) participants with one or more covered dependent(s) – including Medicare-eligible retirees. Be sure to review your form and make any necessary changes to ensure your information is up-to-date. Sign all pages and return the complete COB form to DHS within 90 days of the date of the mailed letter. Failure to complete and/or return the form within the 90-day period may result in any pending claims being denied. For more information, contact DHS Customer Service at (800) 807-0820. 


 

Telehealth: You’ve Got Teladoc – Talk to a Doctor Anywhere, Anytime by Phone or Video 

Teladoc provides telehealth services for PPO Plan Options A & B. With Teladoc, you can connect with leading board-certified physicians in your state through the internet or telephone, helping you avoid emergency rooms and urgent care centers. Teladoc can also assist with prescription medications and with many non-emergency illnesses, including: 

• Allergies

• Arthritic pain

• Asthma

• Bronchitis

• Colds and flu

• Diarrhea

• Insect bites

• Pharyngitis

• Conjunctivitis (pink eye)

• Rash

• Respiratory infection

• Sinusitis

• Skin inflammation

• Sore throat

• Sprains & strains

• Urinary tract infection

• Sports injuries

• Vomiting

Telehealth services are available at $0 cost and no deductible applies when using Teladoc. For more information regarding this service, please visit  www.JHMBHealthConnect.com/telehealth-at-your-fingertips.


 

Elixir Member Portal – Easier Management of Your Pharmacy Benefits 

Have you ever been in your doctor’s office wondering if the drug being prescribed would be covered by your insurance plan? Now, you don’t have to wonder because it is easier than ever to keep an eye on your prescription benefits with the newest release of the Elixir Member Portal and mobile app. 

Prescription Benefits at Your Fingertips 

Whether or not you have used Elixir’s Member Portal or mobile app, you will gain some helpful new features that will make managing your prescription benefits much easier. Here’s a quick snapshot of what you can do. 

  • – Complete benefits information, so you can easily determine copays, accumulated max out of pocket amounts, and more 
  • – Personalized savings offers that will alert you when there is a savings opportunity, such as a lower cost alternative 
  • – Dynamic pharmacy search filters that will help you find pharmacies based on specific needs, such as those with drive-thru pick-up windows or those that are open 24 hours a day 
  • – Ask-a-Pharmacist and enhanced contact options, so you can send messages to ask pharmacists questions about your medications 
  • – Refill reminders that will alert you when any of your prescriptions are ready to be refilled 
  • – Complete list of current medications, which can be printed or easily accessed for referencing as needed 
  • – Biometric sign-on, enabling you to quickly and securely access your information with your unique fingerprint 
  • – Glossary and forms to help you understand and get the most from your pharmacy benefit 

 

Get Started Today 

If you aren’t already using Elixir’s handy Member Portal and/or mobile app to access your prescription benefits, we recommend you start now. Check out the full article online for details on how to get started at www.JHMBHealthConnect.com/11514. 

[/togg]

[togg title=”Elixir Customer Service Survey – Just 9 Quick Questions”]

We Need Your Feedback: Survey Open from October 1 – 31, 2022

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. 

For the past four years, we conducted a customer service survey for our prescription drug program and received valuable feedback from hundreds 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 Elixir prescription drug benefits within the last year, we ask that you take a moment to answer 9 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: 

  • – Retail Pharmacy – Rite Aid | Walgreens | CVS | Costco 
  • – Specialty Pharmacy – Elixir Specialty 
  • – Elixir Website and Member Portal 
  • – Elixir Overall Customer Service 

This is your chance to provide feedback on the services you’ve received from Elixir 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 $50 Gift Card 

You may complete the survey 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. 

We look forward to your feedback and thank you for helping us manage the highest quality benefits for you and your family.  

[/togg]

[togg title=”Plan Option C (Kaiser Permanente)”]

You can only enroll in the 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 group enrollment form along with the District’s benefits enrollment form. For more information about Kaiser Permanente plan benefits and service areas, review the information enclosed in this Open Enrollment packet. We also invite you to review their online informational portal, complete with an overview video and additional details about Kaiser’s services and resources at the “Watch Video” link provided below. 

[/togg]

[togg title=”No Rate Contribution Changes for 2023″]

In addition, the JHMB is pleased to announce that for the 11th straight year, there are no rate contribution increases for any of the District’s benefits. This is primarily a result of the efficient program usage by our employees and retirees, and the efforts of the Fresno Unified School District and the collective efforts of the labor groups, management, and professional staff of the Joint Health Management Board. 

[/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=”Dependents Eligibility Reminder”]

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=”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. Below are some highlights of the WellPATH program. If you have not signed up to receive the monthly newsletter informing you of current program offerings, benefit updates, and educational material for your health, please reach out to WellPATH@delapro.com or visit our Staying Connected page to sign up (www.JHMBHealthConnect.com/staying-connected.) 

Participate in Wellness Challenges – Improve Your Health and Win Prizes! Throughout the year, the WellPATH Program serves up wellness challenges to jumpstart and/or cultivate healthy habits among its members. These challenges typically run 6-8 weeks and offer individual and work site incentives based on healthy eating, exercising, and educational activities. 

Become a WellPATH Champion! WellPATH Champions are on-site ambassadors for the WellPATH program who are committed to creating a workplace culture of health and wellness. They share wellness-related information with coworkers and help them connect with wellness programs and activities. WellPATH Champions receive program benefits and incentives. Contact WellPATH if you would like to receive information about becoming a WellPATH Champion. 

Participate in a WellPATH Wellness Screening – “Know Your Numbers” and Receive a $25 Gift Card! There are important numbers that we all need to know in order to safeguard our health. Cholesterol, blood pressure, waist size, body mass index, and blood sugar are key indicators of our risk for major 

illness. By knowing these numbers, we can take action to reduce our chances of developing heart disease, diabetes, and other major illnesses. It is very important to get these numbers checked on a regular basis and you can learn this information by attending a WellPATH Know Your Numbers wellness screening. 

Additional Services Offered by WellPATH The suite of free services includes: 

  • – Annual preventative wellness screenings ($25 gift card for participating) 
  • – Wellness challenges (Gift Card Prizes for qualifying participants) 
  • – Group fitness classes 
  • – Annual flu shot clinics 
  • – Monthly health education 
  • – Wellness coaching 
  • – Personal training (member must qualify) 
  • – Behavior modification (member must qualify) 

For more information about these programs and other WellPATH offerings, visit www.JHMBHealthConnect.com/wellpath or contact the WellPATH Program at (833) Well-PATH. 

[/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”]

Enrollment Period Open Through December 2, 2022

The District, in partnership with American Fidelity, offers flexible spending account plans that let you use pre-tax dollars to cover eligible healthcare and dependent care expenses. If you enrolled in the Section 125 flexible spending account (FSA) administered by American Fidelity for the 2022 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 they fall within the special rules outlined by the plan. 

The District 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! 

Schedule Your Appointment to Re-Enroll 

As reminder, if you wish to utilize the Section 125 flexible spending account in 2023, you must re-enroll with American Fidelity. Upon enrollment in the FSA Plan, you will have the option to request a Healthcare FSA Plan Debit Card through American Fidelity. Please review the enclosed American Fidelity Section 125 Open Enrollment Announcement for more details regarding their Section 125 plan offerings and scheduling an appointment with them to complete your FSA enrollment. 

The Healthcare FSA Plan and Termination 

If you are a participant in your Healthcare FSA plan and you are terminated, your funds may be preserved and you may have other options available to you. Please note that your termination date becomes the last day of your FSA plan year. You can only submit reimbursement for eligible expenses that are incurred prior to your termination date. 

It is important that you contact American Fidelity at (866) 504-0010 ext. 1, if you have any further questions regarding your FSA healthcare plan fund at the time of termination. Your failure to act in conjunction with your Healthcare FSA plan may cause your funds to be permanently forfeited after your termination. If you have a balance in your Healthcare FSA plan approaching the end of the plan year or upon termination, you may purchase eligible healthcare FSA plan items through the FSA Store: www.fsastore.com. 

Download AFA Information & Schedule

Download

[/togg]

[togg title=”Employee Assistance Program (EAP)”]

Available to All Benefit-eligible Employees, Retirees, and Dependents Including Kaiser Permanente (Plan C) Members

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=”Fresno Unified School District’s Health and Welfare Benefits Annual Notices”]

The Benefits Information Guide provides a list of notices and disclosures that pertain to your employer-sponsored health and welfare plans, as required by federal law. These are listed in the section of the booklet titled, “Required Notices.” 

Download the 2023 Open Enrollment Benefits Information Guide

Download

[/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]

[/checklist] For additional plan information and/or provider contact information view the following pages: www.JHMBHealthConnect.com/your-benefits | www.JHMBHealthConnect.com/using-plans

* Do not mail original birth or marriage certificates to the District. 

[/togg]

[/tab]

[tab]

This year’s annual Open Enrollment for 2023 benefits occurs from October 1 to November 30, 2022. 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 Wednesday, November 30, 2022 (or November 18, 2022 if you wish to enroll in Kaiser Senior Advantage, see page 4). All changes will be effective January 1, 2023. Please review the following brief highlights in this letter to understand changes that may affect you in 2023. 

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 title=”Plan Option A and Option B (PPO) Participants”]

NEW: Annual Coordination of Benefits (COB) Form Required Starting January 2023

Beginning 2023, all Plan Option A and Option B (PPO) participants with one or more covered dependent(s) will be required to complete an annual Coordination of Benefits (COB) Form with Delta Health Systems (DHS). The District’s plans contain a “Coordination of Benefits” provision to ensure coordination of coverage between payors. For billing purposes, when a patient is covered under more than one group plan, one payor becomes the “primary carrier” and the other becomes the “secondary carrier.” The primary carrier must pay benefits before the secondary carrier can determine what benefits it will pay. This applies if you have more than one medical plan, including Medicare coverage.

In January 2023, DHS will mail the annual COB form to all Plan Option A and Option B (PPO) participants with one or more covered dependent(s) – including Medicare-eligible retirees. Be sure to review your form and make any necessary changes to ensure your information is up-to-date. Sign all pages and return the complete COB form to DHS within 90 days of the date of the mailed letter. Failure to complete and/or return the form within the 90-day period may result in any pending claims being denied. For more information, contact DHS Customer Service at (800) 807-0820.


 

Telehealth: You’ve Got Teladoc – Talk to a Doctor Anywhere, Anytime by Phone or Video

Teladoc provides telehealth services for PPO Plan Options A & B. With Teladoc, you can connect with leading board-certified physicians in your state through the internet or telephone, helping you avoid emergency rooms and urgent care centers. Teladoc can also assist with prescription medications and with many non-emergency illnesses, including:

• Allergies

• Arthritic pain

• Asthma

• Bronchitis

• Colds and flu

• Diarrhea

• Insect bites

• Pharyngitis

• Conjunctivitis (pink eye)

• Rash

• Respiratory infection

• Sinusitis

• Skin inflammation

• Sore throat

• Sprains & strains

• Urinary tract infection

• Sports injuries

• Vomiting

Telehealth services are available at $0 cost and no deductible applies when using Teladoc. For more information regarding this service, please visit  www.JHMBHealthConnect.com/telehealth-at-your-fingertips.


Elixir Member Portal – Easier Management of Your Pharmacy Benefits

Have you ever been in your doctor’s office wondering if the drug being prescribed would be covered by your insurance plan? Now, you don’t have to wonder because it is easier than ever to keep an eye on your prescription benefits with the newest release of the Elixir Member Portal and mobile app.

Prescription Benefits at Your Fingertips

Whether or not you have used Elixir’s Member Portal or mobile app, you will gain some helpful

new features that will make managing your prescription benefits much easier. Here’s a quick snapshot of what you can do.

  • – Complete benefits information, so you can easily determine copays, accumulated max out of pocket amounts, and more
  • – Personalized savings offers that will alert you when there is a savings opportunity, such as a lower cost alternative
  • – Dynamic pharmacy search filters that will help you find pharmacies based on specific needs, such as those with drive-thru pick-up windows or those that are open 24 hours a day
  • – Ask-a-Pharmacist and enhanced contact options, so you can send messages to ask pharmacists questions about your medications
  • – Refill reminders that will alert you when any of your prescriptions are ready to be refilled
  • – Complete list of current medications, which can be printed or easily accessed for referencing as needed
  • – Biometric sign-on, enabling you to quickly and securely access your information with your unique fingerprint
  • – Glossary and forms to help you understand and get the most from your pharmacy benefit

Get Started Today

If you aren’t already using Elixir’s handy Member Portal and/or mobile app to access your prescription benefits, we recommend you start now. Check out the full article online for details on how to get started at www.JHMBHealthConnect.com/11514.

[/togg]

[togg title=”Elixir Customer Service Survey – Just 9 Quick Questions”]

We Need Your Feedback: Survey Open from October 1 – 31, 2022

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.

For the past four years, we conducted a customer service survey for our prescription drug program and received valuable feedback from hundreds 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 Elixir prescription drug benefits within the last year, we ask that you take a moment to answer 9 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:

  • – Retail Pharmacy – Rite Aid | Walgreens | CVS | Costco
  • – Specialty Pharmacy – Elixir Specialty
  • – Elixir Website and Member Portal
  • – Elixir Overall Customer Service

This is your chance to provide feedback on the services you’ve received from Elixir 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 $50 Gift Card

You may complete the survey 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.

We look forward to your feedback and thank you for helping us manage the highest quality benefits for you and your family.  

[/togg]

[togg title=”Plan Option C (Kaiser Permanente)”]

You can only enroll in the 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 group enrollment form along with the District’s benefits enrollment form. For more information about Kaiser Permanente plan benefits and service areas, review the information enclosed in this Open Enrollment packet. We also invite you to review their online informational portal, complete with an overview video and additional details about Kaiser’s services and resources at the “Watch Video” link provided below.

In addition, if you and/or your spouse are currently in Medicare, you may be eligible to participate in the Kaiser Permanente Senior Advantage Plan. Contact the District Benefits Department for more information about this plan offering at (559) 457-3520. Please note that if you wish to enroll in the Kaiser Permanente Senior Advantage Plan, you must complete the enrollment form by November 18, 2022. 

[/togg]

[togg title=”No Rate Contribution Changes for 2023″]

In addition, the JHMB is pleased to announce that for the 11th straight year, there are no rate contribution increases for any of the District’s benefits. This is primarily a result of the efficient program usage by our employees and retirees, and the efforts of the Fresno Unified School District and the collective efforts of the labor groups, management, and professional staff of the Joint Health Management Board.

[/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=”Dependents Eligibility Reminder”]

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=”Medicare Enrollment Reminder”]

Enroll In Medicare When You and/or Your Spouse Become an Eligible Retiree to Minimize Your Payments 

The Joint Health Management Board wants to remind you of the importance of enrolling in Medicare once you are eligible. The District’s Health Care Plan indicates that you must enroll in Medicare Parts A & B as soon as you and/or your spouse become eligible for Medicare as a retiree. 

Your specific Coordination of Benefits (COB) changes once you become eligible for Medicare as a retiree, which may result in reductions of Plan payments and increases in your payments if you fail to enroll in Medicare. This requirement only applies to retirees in the Fresno Unified School District Employee Health Care Plan. Active employees age 65 or over are not required to enroll in Medicare. For more information, review the JHMB’s notice available at www.JHMBHealthConnect.com/5665. 

[/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. Below are some highlights of the WellPATH program. If you have not signed up to receive the monthly newsletter informing you of current program offerings, benefit updates, and educational material for your health, please reach out to WellPATH@delapro.com or visit our Staying Connected page to sign up (www.JHMBHealthConnect.com/staying-connected.)

Participate in Wellness Challenges – Improve Your Health and Win Prizes! Throughout the year, the WellPATH Program serves up wellness challenges to jumpstart and/or cultivate healthy habits among its members. These challenges typically run 6-8 weeks and offer individual and work site incentives based on healthy eating, exercising, and educational activities.

Become a WellPATH Champion! WellPATH Champions are on-site ambassadors for the WellPATH program who are committed to creating a workplace culture of health and wellness. They share wellness-related information with coworkers and help them connect with wellness programs and activities. WellPATH Champions receive program benefits and incentives. Contact WellPATH if you would like to receive information about becoming a WellPATH Champion.

Participate in a WellPATH Wellness Screening – “Know Your Numbers” and Receive a $25 Gift Card! There are important numbers that we all need to know in order to safeguard our health. Cholesterol, blood pressure, waist size, body mass index, and blood sugar are key indicators of our risk for major

illness. By knowing these numbers, we can take action to reduce our chances of developing heart disease, diabetes, and other major illnesses. It is very important to get these numbers checked on a regular basis and you can learn this information by attending a WellPATH Know Your Numbers wellness screening.

Additional Services Offered by WellPATH The suite of free services includes:

  • – Annual preventative wellness screenings ($25 gift card for participating)
  • – Wellness challenges (Gift Card Prizes for qualifying participants)
  • – Group fitness classes
  • – Annual flu shot clinics
  • – Monthly health education
  • – Wellness coaching
  • – Personal training (member must qualify)
  • – Behavior modification (member must qualify)

For more information about these programs and other WellPATH offerings, visit www.JHMBHealthConnect.com/wellpath or contact the WellPATH Program at (833) Well-PATH.

[/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]

[/checklist] For additional plan information and/or provider contact information view the following pages: www.JHMBHealthConnect.com/your-benefits | www.JHMBHealthConnect.com/using-plans

* Do not mail original birth or marriage certificates to the District.

[/togg]

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This year’s annual Open Enrollment for 2023 benefits occurs from October 1 to November 30, 2022. 

Action Required: If you wish to make any changes to your existing coverage, you must complete the Enrollment Form online or return it to the District Benefits Office by no later than Wednesday, November 30, 2022. For those employees who have never enrolled in the dental or vision plans, now is the time. Refer to the enrollment form for additional plan information. All changes will be effective January 1, 2023. Please review the following brief highlights to understand changes that may affect you in 2023. 

If you do not wish to make any changes to your benefit elections for the upcoming year, no action is required on your part during this Open Enrollment period. Please note, if you currently participate in the District’s Section 125 Flexible Spending Account (FSA) plan and wish to use this plan in 2023, you must re-enroll and set your annual contribution amount for the upcoming year. 

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The Fresno Unified School District Benefits Department is excited to announce a simpler way to enroll in your benefits for the upcoming plan year (2023). Over the last year, we have piloted our new online benefits enrollment system for new hires and now it’s ready for primetime – during this year’s Open Enrollment period. The new system has been designed to walk you through each of your enrollment decisions for the upcoming year, including selecting/adding your dependents and electing your dental and vision coverage. You can start and finish when it’s convenient for you using the unique hyperlink that we will send to your District email address once enrollment begins on October 1, 2022. 

NOTE: It may take up to 2 days from October 1st for you to receive your enrollment email due to system limitations. 

If you wish to make changes during this annual enrollment period, it may take 15-30 minutes to complete the online enrollment form. If at any time you need to take a break, you can save your progress, and return at a later time to complete the form. However, you must complete your enrollment online by no later than Wednesday, November 30, 2022. If you have any questions, please contact the Benefits Department at (559) 457-3520. 

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[togg title=”No Benefit Changes/Employee Rate Contribution Increases for 2023″]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 11th 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. 

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Enrollment Period Open Through December 2, 2022

The District, in partnership with American Fidelity, offers flexible spending account plans that let you use pre-tax dollars to cover eligible healthcare and dependent care expenses. If you enrolled in the Section 125 flexible spending account (FSA) administered by American Fidelity for the 2022 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 they fall within the special rules outlined by the plan.

The District 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!

Schedule Your Appointment to Re-Enroll

As reminder, if you wish to utilize the Section 125 flexible spending account in 2023, you must re-enroll with American Fidelity. Upon enrollment in the FSA Plan, you will have the option to request a Healthcare FSA Plan Debit Card through American Fidelity. Please review the enclosed American Fidelity Section 125 Open Enrollment Announcement for more details regarding their Section 125 plan offerings and scheduling an appointment with them to complete your FSA enrollment.

The Healthcare FSA Plan and Termination

If you are a participant in your Healthcare FSA plan and you are terminated, your funds may be preserved and you may have other options available to you. Please note that your termination date becomes the last day of your FSA plan year. You can only submit reimbursement for eligible expenses that are incurred prior to your termination date.

It is important that you contact American Fidelity at (866) 504-0010 ext. 1, if you have any further questions regarding your FSA healthcare plan fund at the time of termination. Your failure to act in conjunction with your Healthcare FSA plan may cause your funds to be permanently forfeited after your termination. If you have a balance in your Healthcare FSA plan approaching the end of the plan year or upon termination, you may purchase eligible healthcare FSA plan items through the FSA Store: www.fsastore.com.

Download AFA Information & Schedule

Download

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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.

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The following is a list of notices and disclosures included this open enrollment packet that pertain to your employer-sponsored health and welfare plans, as required by federal law. 

  • – HIPAA Special Enrollment Rights Notice 
  • – HIPAA Privacy Notice of Availability 

Should you have any questions regarding the content of the notices, please contact the Benefits Department at (559) 457-3520. 

Download the Health and Welfare Annual Notices 

Download

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[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]

[/checklist] For additional plan information and/or provider contact information view the following pages: www.JHMBHealthConnect.com/your-benefits www.JHMBHealthConnect.com/using-plans

* Do not mail original birth or marriage certificates to the District. 

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This year’s annual Open Enrollment for 2023 benefits occurs from October 1 to November 30, 2022. 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 Wednesday, November 30, 2022 (or November 18, 2022 if you wish to enroll in Kaiser Senior Advantage, see page 4). All changes will be effective January 1, 2023. Please review the following brief highlights in this letter to understand changes that may affect you in 2023. 

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. 

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NEW: Annual Coordination of Benefits (COB) Form Required Starting January 2023

Beginning 2023, all Plan Option A and Option B (PPO) participants with one or more covered dependent(s) will be required to complete an annual Coordination of Benefits (COB) Form with Delta Health Systems (DHS). The District’s plans contain a “Coordination of Benefits” provision to ensure coordination of coverage between payors. For billing purposes, when a patient is covered under more than one group plan, one payor becomes the “primary carrier” and the other becomes the “secondary carrier.” The primary carrier must pay benefits before the secondary carrier can determine what benefits it will pay. This applies if you have more than one medical plan, including Medicare coverage.

In January 2023, DHS will mail the annual COB form to all Plan Option A and Option B (PPO) participants with one or more covered dependent(s) – including Medicare-eligible retirees. Be sure to review your form and make any necessary changes to ensure your information is up-to-date. Sign all pages and return the complete COB form to DHS within 90 days of the date of the mailed letter. Failure to complete and/or return the form within the 90-day period may result in any pending claims being denied. For more information, contact DHS Customer Service at (800) 807-0820.


 

Telehealth: You’ve Got Teladoc – Talk to a Doctor Anywhere, Anytime by Phone or Video

Teladoc provides telehealth services for PPO Plan Options A & B. With Teladoc, you can connect with leading board-certified physicians in your state through the internet or telephone, helping you avoid emergency rooms and urgent care centers. Teladoc can also assist with prescription medications and with many non-emergency illnesses, including:

• Allergies

• Arthritic pain

• Asthma

• Bronchitis

• Colds and flu

• Diarrhea

• Insect bites

• Pharyngitis

• Conjunctivitis (pink eye)

• Rash

• Respiratory infection

• Sinusitis

• Skin inflammation

• Sore throat

• Sprains & strains

• Urinary tract infection

• Sports injuries

• Vomiting

Telehealth services are available at $0 cost and no deductible applies when using Teladoc. For more information regarding this service, please visit  www.JHMBHealthConnect.com/telehealth-at-your-fingertips.


Elixir Member Portal – Easier Management of Your Pharmacy Benefits

Have you ever been in your doctor’s office wondering if the drug being prescribed would be covered by your insurance plan? Now, you don’t have to wonder because it is easier than ever to keep an eye on your prescription benefits with the newest release of the Elixir Member Portal and mobile app.

Prescription Benefits at Your Fingertips

Whether or not you have used Elixir’s Member Portal or mobile app, you will gain some helpful

new features that will make managing your prescription benefits much easier. Here’s a quick snapshot of what you can do.

  • – Complete benefits information, so you can easily determine copays, accumulated max out of pocket amounts, and more
  • – Personalized savings offers that will alert you when there is a savings opportunity, such as a lower cost alternative
  • – Dynamic pharmacy search filters that will help you find pharmacies based on specific needs, such as those with drive-thru pick-up windows or those that are open 24 hours a day
  • – Ask-a-Pharmacist and enhanced contact options, so you can send messages to ask pharmacists questions about your medications
  • – Refill reminders that will alert you when any of your prescriptions are ready to be refilled
  • – Complete list of current medications, which can be printed or easily accessed for referencing as needed
  • – Biometric sign-on, enabling you to quickly and securely access your information with your unique fingerprint
  • – Glossary and forms to help you understand and get the most from your pharmacy benefit

Get Started Today

If you aren’t already using Elixir’s handy Member Portal and/or mobile app to access your prescription benefits, we recommend you start now. Check out the full article online for details on how to get started at www.JHMBHealthConnect.com/11514.

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We Need Your Feedback: Survey Open from October 1 – 31, 2022

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.

For the past four years, we conducted a customer service survey for our prescription drug program and received valuable feedback from hundreds 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 Elixir prescription drug benefits within the last year, we ask that you take a moment to answer 9 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:

  • – Retail Pharmacy – Rite Aid | Walgreens | CVS | Costco
  • – Specialty Pharmacy – Elixir Specialty
  • – Elixir Website and Member Portal
  • – Elixir Overall Customer Service

This is your chance to provide feedback on the services you’ve received from Elixir 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 $50 Gift Card

You may complete the survey 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.

We look forward to your feedback and thank you for helping us manage the highest quality benefits for you and your family.  

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Special Enrollment Ends November 18, 2022 

As a reminder, from October 1 – November 18, 2022, Fresno Unified School District is offering a Special Enrollment for the Kaiser Permanente Senior Advantage plan. This employer-sponsored group coverage is available 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, 2023, 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 18, 2022. 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, 2022. 

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. 

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, 2023, you will have to make this change by November 18, 2022. 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, 2022. 

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In addition, the JHMB is pleased to announce that for the 11th straight year, there are no rate contribution increases for any of the District’s benefits. This is primarily a result of the efficient program usage by our employees and retirees, and the efforts of the Fresno Unified School District and the collective efforts of the labor groups, management, and professional staff of the Joint Health Management Board.

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[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.

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[togg title=”Dependents Eligibility Reminder”]

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.

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Enroll In Medicare When You and/or Your Spouse Become an Eligible Retiree to Minimize Your Payments

The Joint Health Management Board wants to remind you of the importance of enrolling in Medicare once you are eligible. The District’s Health Care Plan indicates that you must enroll in Medicare Parts A & B as soon as you and/or your spouse become eligible for Medicare as a retiree.

Your specific Coordination of Benefits (COB) changes once you become eligible for Medicare as a retiree, which may result in reductions of Plan payments and increases in your payments if you fail to enroll in Medicare. This requirement only applies to retirees in the Fresno Unified School District Employee Health Care Plan. Active employees age 65 or over are not required to enroll in Medicare. For more information, review the JHMB’s notice available at www.JHMBHealthConnect.com/5665.

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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. Below are some highlights of the WellPATH program. If you have not signed up to receive the monthly newsletter informing you of current program offerings, benefit updates, and educational material for your health, please reach out to WellPATH@delapro.com or visit our Staying Connected page to sign up (www.JHMBHealthConnect.com/staying-connected.)

Participate in Wellness Challenges – Improve Your Health and Win Prizes! Throughout the year, the WellPATH Program serves up wellness challenges to jumpstart and/or cultivate healthy habits among its members. These challenges typically run 6-8 weeks and offer individual and work site incentives based on healthy eating, exercising, and educational activities.

Become a WellPATH Champion! WellPATH Champions are on-site ambassadors for the WellPATH program who are committed to creating a workplace culture of health and wellness. They share wellness-related information with coworkers and help them connect with wellness programs and activities. WellPATH Champions receive program benefits and incentives. Contact WellPATH if you would like to receive information about becoming a WellPATH Champion.

Participate in a WellPATH Wellness Screening – “Know Your Numbers” and Receive a $25 Gift Card! There are important numbers that we all need to know in order to safeguard our health. Cholesterol, blood pressure, waist size, body mass index, and blood sugar are key indicators of our risk for major

illness. By knowing these numbers, we can take action to reduce our chances of developing heart disease, diabetes, and other major illnesses. It is very important to get these numbers checked on a regular basis and you can learn this information by attending a WellPATH Know Your Numbers wellness screening.

Additional Services Offered by WellPATH The suite of free services includes:

  • – Annual preventative wellness screenings ($25 gift card for participating)
  • – Wellness challenges (Gift Card Prizes for qualifying participants)
  • – Group fitness classes
  • – Annual flu shot clinics
  • – Monthly health education
  • – Wellness coaching
  • – Personal training (member must qualify)
  • – Behavior modification (member must qualify)

For more information about these programs and other WellPATH offerings, visit www.JHMBHealthConnect.com/wellpath or contact the WellPATH Program at (833) Well-PATH.

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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]

[/checklist] For additional plan information and/or provider contact information view the following pages: www.JHMBHealthConnect.com/your-benefits | www.JHMBHealthConnect.com/using-plans

* Do not mail original birth or marriage certificates to the District.

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