This year's annual Open Enrollment for 2024 benefits occurs from October 1 to November 30, 2023. If you wish to make any changes to your existing coverage, you must complete your Enrollment Form and return it to the District Benefits Office no later than Thursday, November 30, 2023. All changes will be effective January 1, 2024. Please review the following brief highlights to understand changes that may affect you in 2024.
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.
Vision: New Provider and Plan
For Plan Option A and Option B (PPO) participants, vision coverage is now provided by VSP Vision as a PPO plan. The switch to a new provider also comes with additional in-network benefits, including an increased in-network frame allowance to $175/year (up from $130), added calendar year allowance for glasses and contact lenses, and added full coverage for progressive and transition lenses.
To locate an in-network VSP Vision provider, go to www.vsp.com, click on “Find a Doctor.” You can search by location, office or doctor. Any questions pertaining to your vision coverage can be directed to VSP Vision by calling (800) 877-7195, or by visiting the website at www.vsp.com.
Dental Plan Changes
If selecting the Delta Dental Premier® Incentive Plan, you will receive additional benefits including up to 100% coverage for many dental services through in-network and out-of-network providers. The plan is on a new tiered structure designed to increase your benefits as you continue receiving dental care every year. This plan is an enhancement of the existing Delta Dental Dental PPO™ plan.
The new incentive-tiered structure applies to preventive services, restorative services, periodontics, endodontics, oral surgery, and crowns & inlays. There is 100% benefits coverage for participants covered by the plan as of December 31, 2023, otherwise:
- 70% coverage when receiving dental care for the first year enrolled
- 80% coverage when receiving dental care for the second straight year while enrolled
- 90% coverage when receiving dental care for the third straight year while enrolled
- 100% coverage when receiving dental care for the fourth straight year (or longer) while enrolled
Note: Benefits will decrease by 10% if you do not receive dental care each year.
For further assistance or to find an in-network dentist, contact Delta Dental® at (866) 499-3001 or visit www.deltadentalins.com.
Dental Plan Changes
Benefits have been increased for the existing UnitedHealthcare Dental HMO plan:
- Composite fillings and root canals are now no charge.
- All oral surgery, crowns & inlays, and prosthetics & bridges are now no charge.
- The maximum out-of-pocket expense for 24-month orthodontia services have been reduced to $1,250.
You can contact UnitedHealthcare at (800) 999-3367 or find an in-network dentist at www.myuhc.com.
Additional Coverage for Co-insurance
The Joint Health Management Board and Fresno Unified School District have eliminated the percentage co-insurance that you would pay for medical benefits after your deductible has been met if you are enrolled in Plan Option A (PPO) or Plan Option C (Kaiser Permanente®). If you are a Plan Option B (PPO) participant, the percentage co-insurance that you would pay after the deductible has been met has been reduced to 20%.
2024 COBRA/EDCODE Rate Change
Enrollees who are on a monthly bill pay through the bank, bank transfer, or writing checks to FUSD, premium payments must be adjusted accordingly. You will receive a separate notice regarding the rate change for your plan.
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:
- Arthritic Pain
- Colds and Flu
- Insect Bites
- Conjunctivitis (Pink Eye)
- Respiratory Infection
- Skin Inflammation
- Sore Throat
- Sprains & Strains
- Urinary Tract Infection
- Sports Injuries
Telehealth services are available at $0 cost and no deductible applies when using Teladoc. For more information regarding this service, please visit our guide to using your Teledoc benefits.
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 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 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
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.
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 your Open Enrollment packet. We also invite you to review Kaiser’s online informational portal, along with additional details about Kaiser’s services and resources available on the Plan Option C (Kaiser Permanente) page.
Take a Healthy Minute and Schedule a Preventative 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.