Retiree

Benefits Briefing An Annual Newsletter About Open Enrollment for FCPS Retirees

Fall 2016

Open Enrollment: Tuesday, October 11 – Friday, November 11, 2016

Mark Your Calendars!

What’s New for 2017?

It’s hard to believe that the summer is already over! Now that fall is here, it’s time to begin thinking about your plan elections for the 2017 calendar year.

Pharmacy Benefit Manager Change

Open Enrollment for 2017 benefits will run from October 11 through November 11, 2016. The changes you make during this period will become effective January 1, 2017. This Briefing contains important information about changes occurring in 2017 as well as considerations for the future. Please take the time to read thoroughly.

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OE starts!

Open House: Hayfield

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Open House: Chantilly

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7 Open House: Annandale

Dental Re-Entry for Eligible Retirees For this open enrollment period only, eligible retirees who did not maintain dental coverage upon retirement will be afforded a one-time opportunity to elect coverage under the FCPS plan. You must take action if you do not have dental coverage and wish to enroll. See page 3 for more details about this re-entry period.

2017 Plans & Premium Increases Medical

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CVS Caremark® will replace Express Scripts, effective January 1, 2017. For Medicare retirees, coverage will be provided through SilverScript, a subsidiary of CVS Caremark. Virtually every retail pharmacy used by retirees will continue to be in-network. Copay and coinsurance levels will remain the same. See page 2 for more details about this transition.

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Ext. Hours: Gatehouse

Ext. Hours: Gatehouse

OE ends!

Aetna/Innovation Health CareFirst BlueChoice Advantage Kaiser Permanente Signature HMO Kaiser Permanente Medicare

Dental

Aetna DPPO Aetna DMO/DNO

+ 3.9% + 3.3% - 2.7% + 4.0% + 5.9% + 0%

2017 premiums can be found on pages 4-5.

Office of Benefit Services · Fairfax County Public Schools

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Introducing CVS Caremark®! Beginning January 1, 2017, Aetna/Innovation Health and CareFirst members will transition to CVS Caremark for management of prescription benefits. For Medicare retirees, your pharmacy benefits will be provided through SilverScript, a subsidiary of CVS Caremark. This change will provide members additional convenience and savings options, while providing access to a broad network that includes thousands of retail pharmacies nationwide. In addition to CVS Pharmacy®, members will continue to have access to major retail pharmacy chains, such as Walgreens, Giant, Safeway, Wegmans, and many others. Copayment levels will remain the same, and new savings options are available for members who take maintenance medications. • New cost-saving options for maintenance medications o Beginning January 1, you have the option of filling maintenance medications at a CVS Pharmacy and enjoying the savings previously available only through mail order. Members will be able to fill up to a 90-day supply of maintenance medications at a CVS Pharmacy and pay only 2 copayments. You may also continue to receive up to a 90-day supply of maintenance medications through mail order and pay 2 copayments, or use a non-CVS retail Pharmacy and pay 3 copayments. • Additional convenience o Employees who take specialty medications will transition to CVS Specialty Pharmacy. While you will continue to receive these medications through mail order, you will also have the option of confidential and convenient delivery of your specialty medications to CVS pharmacies at no additional charge. o Diabetes supplies (including glucose meters, lancets, and test strips) will be available through your prescription benefit instead of your medical benefits. Some diabetes equipment, such as insulin pumps, will continue to be covered under your medical plan. Except where prohibited by law, your medication history, remaining refills and existing mailorder prescriptions will be transferred from Express Scripts to CVS Caremark/SilverScript. You will receive a new pharmacy ID card from CVS Caremark/SilverScript in mid-December. Please make sure you provide this card to your pharmacy in the new year. Look for more communications later this fall on how to begin accessing your benefits under CVS Caremark/SilverScript. You may also visit www.info.caremark.com/fcps (nonMedicare retirees) or http://FairfaxPS.silverscript.com (Medicare retirees) for more information. Please note: Express Scripts will continue to provide pharmacy benefits for Aetna/Innovation Health and CareFirst members through December 31, 2016. No change in pharmacy benefits will occur for Kaiser Permanente participants.

Prescription Copayment Levels

Short-Term Medications

Maintenance Medications

(max. 30-day supply)

Where Obtained Generic Brand Name

Participating retail pharmacies $7 20%, max $50

Specialty Medications

(max. 90-day supply)

CVS retail Pharmacy

CVS Caremark Mail Service

$14

$14

20%, max $100 20%, max $100

(max. 30-day supply)

Participating non-CVS Pharmacy

CVS Caremark Specialty Pharmacy

$21

$7

20%, max $150

20%, max $50

Preventive medications covered by the Affordable Care Act remain available for $0 copay.

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Office of Benefit Services · Fairfax County Public Schools

Plan Updates for 2017 Retirees Eligible for One-Time Re-entry in FCPS Dental Plan For the fall 2016 Open Enrollment period only, retirees who did not maintain FCPS dental coverage upon retirement will be afforded a one-time opportunity to elect coverage under the plan. Coverage elected during Open Enrollment will be effective January 1, 2017. To be eligible to elect coverage, you must meet the definition of retiree, which means: •• You terminated employment with FCPS and immediately began drawing retirement benefits, and, •• you are currently receiving pension benefits from VRS, ERFC and/or FCERS that are directly related to your former employment with FCPS. Also, for this Open Enrollment period only, the 5-year enrollment requirement to join the dental plan will be waived. This year, eligible retirees may enroll in the dental plan if they did not meet the 5-year requirement at retirement. You are eligible to re-enter the FCPS dental plan if: You meet the definition of retiree*, and 1. You did not re-enter the plan in 2007 when eligible, or 2. You did not elect coverage at time of retirement, or 3. You were not eligible to elect coverage at retirement, because you did not have dental coverage in place for 5 or more years. You may also add coverage for your eligible dependents. Current DHO participants are also eligible to elect coverage during Open Enrollment. *Former employees who are deferred vested annuitants (did not begin drawing a benefit at retirement), COBRA participants, and surviving spouses who did not retain coverage at time of initial eligibility do not meet the definition of retiree and remain ineligible to elect coverage.

Once coverage is elected, continuous coverage must be maintained. If coverage is voluntarily cancelled - or terminated due to non-payment - the retiree will not be eligible to reinstate. Retirees who are eligible to elect dental coverage will receive a separate mailing with the enrollment form and instructions. Look for this mailing to arrive by the end of October.

Enhanced Vision Benefits for Kaiser Permanente Participants Starting January 1, Kaiser Permanente participants will be eligible for a 25% discount on frames and lenses, and a 15% discount on contact lenses, when obtained at a Kaiser Permanente optical facility. This discount is now available to Medicare retirees and will be available to all retirees in 2017. This discount provides greater savings for vision hardware, and is in addition to the $150 vision benefit allowance currently provided to all participants. Visit https:// my.kp.org/fcps/ for more information.

Dental Enhancements Each year, FCPS evaluates coverage under the medical and dental programs to ensure the benefits remain market relevant. As part of this review, some enhancements will occur to the Aetna DPPO plan in 2017. Starting next year, coverage levels will be enhanced for periapical x-rays and re-cementation of crowns and dentures. Additionally, orthodontia for dependent children remains a covered benefit if work began prior to age 20 (currently age 19). Visit www.ih-aetna.com/fcps, and click on Dental Plan Information for more details.

Office of Benefit Services · Fairfax County Public Schools

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2017 Dental Rates Aetna DPPO

Aetna DNO

Individual

$46.37

Individual

$19.95

Minifamily

$78.83

Minifamily

$33.93

Family

$48.01

Family

$111.76

2017 Medical Rates for ERFC Retirees MEDICAL PLAN

AGE 55 & OLDER MONTHLY TOTAL RATE ERFC SUBSIDY

MONTHLY TOTAL RATE MINUS SUBSIDY

Aetna/Innovation Health (available to all retirees) Individual

$709.84

$100.00

$609.84

Minifamily (you + 1 other; no one has Medicare)

$1,419.67

$100.00

$1,319.67

Family (you + 2 or more others; no one has Medicare)

$1,774.58

$100.00

$1,674.58

Medicare Individual

$422.21

$100.00

$322.21

Medicare Minifamily

$844.42

$100.00

$744.42

Individual + Medicare

$1,132.04

$100.00

$1,032.04

Minifamily + Medicare

$1,774.58

$100.00

$1,674.58

Family + Medicare

$1,774.58

$100.00

$1,674.58

CareFirst BlueChoice Advantage (available to all retirees not eligible for Medicare) Individual

$564.53

$100.00

$464.53

Minifamily

$1,129.06

$100.00

$1,029.06

Family

$1,411.33

$100.00

$1,311.33

Kaiser Permanente (available to retirees who live in the local Kaiser Permanente/KP Medicare service area) Individual

$600.46

$100.00

$500.46

$1,200.91

$100.00

$1,100.91

$1,501.13

$100.00

$1,401.13

$236.75

$100.00

$136.75

Medicare Minifamily

$473.50

$100.00

$373.50

Individual + Medicare

$837.21

$100.00

$737.21

Minifamily + Medicare

$1,437.66

$100.00

$1,337.66

Family + Medicare

$1,501.13

$100.00

$1,401.13

Minifamily (you + 1 other; no one has Medicare) Family (you + 2 or more others; no one has Medicare) Medicare Individual

Key to Medicare Coverage Rates Medicare Individual: You (the individual) have Medicare coverage. Medicare Minifamily: You + 1 dependent. Both you and your dependent have Medicare coverage. Individual + Medicare: You + 1 dependent. One individual does not have Medicare coverage and one individual does. Minifamily + Medicare: You + 2 dependents. Two individuals do not have Medicare coverage and one individual does. Family + Medicare: You + 3 or more dependents. Three or more individuals do not have Medicare coverage and one individual does.

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Office of Benefit Services · Fairfax County Public Schools

2017 Medical Rates for FCERS Retirees (Subsidy applies to age 55 and older) Your 2017 medical rate will be the monthly total rate for your plan and coverage MINUS a subsidy based on your years of retirement (see Retiree Benefits Handbook). MEDICAL PLAN

MONTHLY TOTAL RATE

$ 15 SUBSIDY

$ 25 SUBSIDY

$ 50 SUBSIDY

$ 100 SUBSIDY

$ 125 SUBSIDY

$ 150 SUBSIDY

$ 175 SUBSIDY

Aetna/Innovation Health (available to all retirees) Individual

$709.84

$694.84

$684.84

$659.84

$609.84

$584.84

$559.84

$534.84

Minifamily

$1,419.67

$1,404.67

$1,394.67

$1,369.67

$1,319.67

$1,294.67

$1,269.67

$1,244.67

Family

$1,774.58

$1,759.58

$1,749.58

$1,724.58

$1,674.58

$1,649.58

$1,624.58

$1,599.58

Medicare Individual

$422.21

$407.21

$397.21

$372.21

$322.21

$297.21

$272.21

$247.21

Medicare Minifamily

$844.42

$829.42

$819.42

$794.42

$744.42

$719.42

$694.42

$669.42

Individual + Medicare

$1,132.04

$1,117.04

$1,107.04

$1,082.04

$1,032.04

$1,007.04

$982.04

$957.04

Minifamily + Medicare

$1,774.58

$1,759.58

$1,749.58

$1,724.58

$1,674.58

$1,649.58

$1,624.58

$1,599.58

Family + Medicare

$1,774.58

$1,759.58

$1,749.58

$1,724.58

$1,649.58

$1,649.58

$1,624.58

$1,599.58

CareFirst BlueChoice Advantage (available to all retirees not eligible for Medicare) Individual

$564.53

$549.53

$539.53

$514.53

$464.53

$439.53

$414.53

$389.53

Minifamily

$1,129.06

$1,114.06

$1,104.06

$1,079.06

$1,029.06

$1,004.06

$979.06

$954.06

Family

$1,411.33

$1,396.33

$1,386.33

$1,361.33

$1,311.33

$1,286.33

$1,261.33

$1,236.33

Kaiser Permanente (available to retirees who live in the local Kaiser Permanente/KP Medicare service area) Individual

$600.46

$585.46

$575.46

$550.46

$500.46

$475.46

$450.46

$425.46

Minifamily

$1,200.91

$1,185.91

$1,175.91

$1,150.91

$1,100.91

$1,075.91

$1,050.91

$1,025.91

Family

$1,501.13

$1,486.13

$1,476.13

$1,451.13

$1,401.13

$1,376.13

$1,351.13

$1,326.13

Medicare Individual

$236.75

$221.75

$211.75

$186.75

$136.75

$111.75

$86.75

$61.75

Medicare Minifamily

$473.50

$458.50

$448.50

$423.50

$373.50

$348.50

$323.50

$298.50

Individual + Medicare

$837.21

$822.21

$812.21

$787.21

$737.21

$712.21

$687.21

$662.21

Minifamily + Medicare

$1,437.66

$1,422.66

$1,412.66

$1,387.66

$1,337.66

$1,312.66

$1,287.66

$1,262.66

Family + Medicare

$1,501.13

$1,486.13

$1,476.13

$1,451.13

$1,401.13

$1,376.13

$1,351.13

$1,326.13

Key to Medicare Coverage Rates Medicare Individual: You (the individual) have Medicare coverage. Medicare Minifamily: You + 1 dependent. Both you and your dependent have Medicare coverage. Individual + Medicare: You + 1 dependent. One individual does not have Medicare coverage and one individual does. Minifamily + Medicare: You + 2 dependents. Two individuals do not have Medicare coverage and one individual does. Family + Medicare: You + 3 or more dependents. Three or more individuals do not have Medicare coverage and one individual does. Office of Benefit Services · Fairfax County Public Schools

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Planning for the Future Health Plan Task Force Earlier this year, Superintendent Garza convened a Health Plan Task Force to review and evaluate current FCPS health programming options and develop recommendations for plan structures to be implemented in calendar year 2017 and beyond. Task Force Members included representatives from a variety of groups, including representatives from the two retiree associations. A well-deserved thank you to the members of the Task Force for the many hours they devoted to these meetings.

Becoming Eligible for Medicare in 2017? If you or your spouse will become Medicareeligible during 2017, it’s important to consider the following during Open Enrollment: • FCPS health plans require that retirees (and dependents of retirees) enroll with Medicare Parts A&B when first eligible. Failure to enroll in Medicare could result in significant expense, as claims will pay as if Medicare were in place. Aetna/Innovation Health and Kaiser Permanente are the two FCPS plans available to Medicare retirees. • If you anticipate changing plans during the calendar year, consider any potential impact of meeting your deductible and out-of-pocket maximums. You may want to change plans during the Open Enrollment prior to becoming eligible for Medicare, as deductibles and out-of-pocket maximums do not transfer from one plan to another. Transferring plans mid-year may mean additional out-of-pocket expense, which must be weighed against plan and premium differences. For more information, visit www.fcps.edu and search keyword “Medicare”.

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Office of Benefit Services · Fairfax County Public Schools

Health Plan Changes Being Evaluated for 2018 Looking forward to calendar year 2018, FCPS is evaluating common practices of other large employers, along with recommendations of the FCPS Health Plan Task Force that was formed last spring. Currently, the following changes are being evaluated for implementation in 2018:

Tobacco-free Discount In addition to the negative impact to individual health, use of tobacco products is widely documented to create thousands of dollars additional in health care costs. Many employers offer discounts to employees who do not use tobacco products in any form, and FCPS is evaluating adding this incentive to health plan premiums for 2018. The amount of the discount is yet to be determined. If you currently use tobacco products, there are many resources available to help you quit. Next fall, employees/retirees may be asked to attest that they have not used tobacco products for at least the previous 6 months in order to receive the discount. See page 7 for resources on tobacco cessation programs. For more information, search keywords “tobacco cessation” on the intranet.

Spousal Surcharge In order to keep coverage affordable, FCPS will be evaluating a “surcharge” for spouses who have access to other health coverage, but are enrolled under the FCPS health plan. Spousal surcharges are common components of large employer plans as a way to minimize costs and keep participant premiums low. Surcharge amounts, and a definition of what constitutes other coverage, are still being evaluated. 

Focus on Wellness Resources to Become Tobacco-Free

Continued Focus on Disease Management

FCPS Health Plans • $0 copay for tobacco cessation • $0 copay for prescribed smoking cessation medications Refer to your health plan's website for more details: • Aetna: www.ih-aetna.com/fcps • CareFirst: www.carefirst.com/fcps • Kaiser: https://my.kp.org/fcps/

In 2017, there will be an increased focus on disease management programs (DM) through all of the health plans. DM programs are designed to help people with certain chronic disease conditions better manage their health and decrease complications by coordinating the delivery of high quality care. DM programs do not replace your doctor’s care or advice. Since chronic disease conditions are one of the highest drivers of health care costs for FCPS, these programs can also help to save you and the plan money.

Quit Now Virginia Phone: 1-800-QUIT-NOW Call toll free 24/7 to receive free expert counseling from a trained Quit Coach, a personalized quit plan, and self-help materials. National Cancer Institute Phone: 877-44U-QUIT or 877-448-7848 Website: www.smokefree.gov • Trained counselors provide information and support (Spanish speakers available) • Available Mon. - Fri. 8 a.m. to 11:00 p.m.

Seasonal Flu Immunizations Flu shots continue to be available at Benefits Open Houses for retirees for a nominal charge. FCPS retirees and family members of employees and retirees (18 and older) may receive a seasonal flu immunization at any FCPS clinic for $28.* Please email [email protected] for questions.

Your insurance plan may identify you to participate in a DM program through a physician referral, medical claims or when you take your annual health assessment survey. If identified, a registered nurse or other health professional would contact you by phone or mail to engage in one-on-one support telephonically or to participate in online health coaching programs. They can help you monitor your condition, answer your questions and provide personalized care. You will choose whether you want to access the program and/or how often you would like to be contacted. There is no cost to you for accessing resources through the DM program. Participation in DM programs is confidential and is done strictly through your insurance plan. FCPS does not receive any identifiable health information in accordance with state and federal privacy laws. We hope you will take advantage of this opportunity to obtain these valuable health resources.

Large flu clinics will be held at: • Benefits Open Houses (Hayfield, Chantilly, and Annandale) • Tuesday, October 11, 2:30 - 6 p.m. Willow Oaks Administrative Center • Thursday, December 8, 3 - 6 p.m. Gatehouse Administration Center For more information, visit www.fcps.edu and search keywords “flu shots”. *Medicare Part B is accepted as long as the person is not in an HMO. Please bring your Medicare card and your photo ID. Office of Benefit Services · Fairfax County Public Schools

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Resources Available During Open Enrollment Many factors impact the decision of which health plan is best for you. FCPS encourages you to utilize the available resources to aid you in making this important decision. These resources include the FCPS website along with vendor websites, member service centers, and on-site support from both FCPS and benefits vendors during Open Houses and on select dates at Gatehouse Administration Center.

Open Houses

Extended Hours

Wednesday, October 12 4:00 – 7:00 p.m. Hayfield Secondary School Cafeteria 7630 Telegraph Road, Alexandria

Wednesday, November 9 Thursday, November 10 4:30 p.m. – 7:30 p.m. 8115 Gatehouse Road, Falls Church • Health vendors and Benefits staff assistance only • No flu shots will be available

Thursday, October 27 4:00 – 7:00 p.m. Chantilly High School Cafeteria 4201 Stringfellow Road, Chantilly

FCPS Resources

Monday, November 7 10:00 a.m. – 5:00 p.m. Annandale High School Cafeteria 4700 Medford Drive, Annandale

HR Client Services: 571-423-3000 [email protected] Hours: Monday - Friday, 8 a.m. - 4:30 p.m.

Open Houses will include: • Flu shot clinics • Benefit vendors and Benefits staff

Website: https://www.fcps.edu, search keyword "Benefits".

Vendor On-site Support at Gatehouse (Check in at 2nd floor reception)

Aetna/Innovation Health

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CareFirst

CVS Caremark®

Dates

October 19 & November 2

October 19 & November 2

Each Thursday during Open Enrollment October 13, 20. 27; November 3, 10

Walk-in Hours

Mornings: 9:30 a.m. - noon

Mornings: 9:30 a.m. - noon

Afternoons: 1 - 2:30 p.m. on Oct. 27 & Nov. 10 1 - 4 p.m. on Oct. 13, 20, Nov. 3

Appointment Hours

Afternoons: 1 - 4 p.m.

Afternoons: 1 - 4 p.m.

Mornings: 9 - 11:30 a.m.

How to Schedule an Appointment

Call 888-236-6249, or visit www.fcps-aetna-ih.genbook.com

Call 202-680-5958

Email: [email protected]

Office of Benefit Services · Fairfax County Public Schools

Handy Resources at Your Fingertips Cut out the card(s) below, fold it in half, and put it in your wallet or store these numbers to your mobile contacts. That way you’ll always have this important information nearby when you need it.

Aetna/Innovation Health Member Services: 888-236-6249 (Medical) 877-973-3238 (EyeMed Vision) Nurse Advice Line: 800-556-1555 (Informed Health®) Telemedicine: 855-TELADOC (835-2362) (Teladoc®) Website: www.ih-aetna.com/fcps

CareFirst Member Services: 800-296-0724 (Medical) 888-343-3462 (Davis Vision) Nurse Advice Line: 800-535-9700 (FirstHelp™) Telemedicine: www.carefirstvideovisit.com

Pharmacy Benefits CVS Caremark® (non-Medicare retirees): Customer Care: 888-217-4161 Hours: 24 hours a day, 7 days a week Website: http://info.caremark.com/fcps SilverScript (Medicare retirees): Customer Care: 877-321-2597 Hours: 24 hours a day, 7 days a week Website: http://FairfaxPS.silverscript.com

Pharmacy Benefits CVS Caremark® (non-Medicare retirees): Customer Care: 888-217-4161 Hours: 24 hours a day, 7 days a week Website: www.info.caremark.com/fcps

Website: www.carefirst.com/fcps

Kaiser Permanente

(non-Medicare retirees)

Kaiser Permanente (Medicare retirees)

Member Services: 301-468-6000 (D.C. metro area) 1-800-777-7902 (outside D.C. area)

Member Services: 1-888-513-0008

Hours: 8 a.m. - 8 p.m., 7 days a week

Medical Advice Line: 1-800-777-7904 and press "0"

Medical Advice Line: 1-800-777-7904 and press "0" Urgent Care Number: 703-359-7878 (D.C. metro area) 1-800-777-7904 (outside D.C.) Website: http://my.kp.org/fcps/

Hours: 8 a.m. - 8 p.m., 7 days a week Urgent Care Number: 703-359-7878 (D.C. metro area) 1-800-777-7904 (outside D.C.) Website: http://my.kp.org/fcps/

Aetna Dental (DPPO and DNO) Member Services: 877-238-6200 Hours: 8 a.m. - 6:30 p.m., Monday - Friday Website: www.ih-aetna.com/fcps

Office of Benefit Services · Fairfax County Public Schools

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Your Open Enrollment Checklist Before Open Enrollment:

…… Review your pre-open enrollment statement to ensure your plan and covered dependent(s) information is correct. …… If you will be requesting coverage for your spouse and/or dependent children who are not currently enrolled, begin gathering legal documentation needed to add them to the plan. …… Are you eligible for Medicare? Review your statement to ensure you are enrolled in Medicare supplemental coverage with FCPS. Not only is this coverage required for retirees eligible for Medicare, your premiums are lower when Medicare is primary.

During Open Enrollment:

…… Review this Benefits Briefing carefully as you consider your plan choices. Take advantage of the many open enrollment resources available to you, including information on both the FCPS and benefit vendor websites, attend a Benefits Open House, or visit the Gatehouse Administration Center. …… Eligible retirees have a one-time opportunity to enroll in dental coverage if not currently enrolled. You must take action if you are not currently enrolled and wish to elect dental coverage. …… If you wish to change your plan or covered dependent(s), complete Form HR-461 and return to the Office of Benefit Services. The form can be obtained from: - www.fcps.edu, search keywords "retiree benefits forms" - Benefits Open Houses (see page 8 for complete schedule) - HR Client Services: 571-423-3000 or 800-831-4331 …… You do not need to take action if you are not making any changes.

Af ter Open Enrollment: ……

Aetna Innovation Health and CareFirst participants: - Look for new pharmacy identification cards in the mail by mid-December. - Ensure you provide copies of your cards to your local pharmacy in the new year. - Begin planning for transition to your pharmacy benefits. Make sure you have an appropriate supply of your medication to ensure a smooth transition.

Retirees covering spouse/dependent children, please note –

FCPS must collect your spouse/dependent child(ren)'s SSN for reporting health plan enrollment to the IRS. • If you are requesting coverage for your spouse and/or dependent children not currently enrolled, you must supply the appropriate legal documents to support eligibility for coverage under the plan. Go to www.fcps.edu and search “dependent eligibility” for a list of required documents. • Your dependent’s coverage cannot be made effective until the Office of Benefit Services receives appropriate legal documentation.

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Office of Benefit Services · Fairfax County Public Schools

Your Benefits and the Law FCPS health plans comply with applicable Federal civil rights laws, including Section 1557 of the Affordable Care Act (Nondiscrimination in Health Programs and Activities). In compliance with the Act, FCPS health plans do not exclude people or treat them differently because of race, color, national origin, age, disability, or sex. FCPS health plans also prohibit denial of health care or health coverage based on an individual’s sex, including discrimination based on pregnancy, gender identity, and sex stereotyping.

Language Assistance Services

The Plan also provides important protections for individuals with disabilities and enhances language assistance for people with limited English proficiency. Each tagline listed below reads, "If you speak [native ENGLISH language], language assistance services, free ofservices, charge, available to you.to Call 571-423-3200." ATTENTION: If you speak English, language assistance freeare of charge, are available you. Call 571-423-3200. AMHARIC (አማርኛ) አዳምጥ : አማርኛ, ከክፍያ ነፃ የቋንቋ እርዳታ አገልግሎቶች , የሚናገሩ ከሆነ , ለእርስዎ የሚገኙ ናቸው . 571-423-3200 ይደውሉ . ARABIC (‫)ةيبرعلا‬

.3200-423-571 ‫ ةملاكم‬. ‫ ﺗﺗوﻓر ﻟك‬، ‫ ﻣﺟﺎﻧﺎ‬، ‫ وﺧدﻣﺎت اﻟﻣﺳﺎﻋدة اﻟﻠﻐوﯾﺔ‬، ‫ إذا ﻛﻧت ﺗﺗﻛﻠم اﻟﻌرﺑﯾﺔ‬:‫ﺗﻧﺑﯾﮫ‬

BENGALI (বাংলা)

দৃি� আকষর্ণ: আপিন বাংলা , ভাষা সহায়তা েসবা, িনখরচা কথা বলেত পােরন, আপনার জনয্ উপল� . 571-423-3200 কল . CHINESE (繁體中文) 注意：如果你说中国话，语言协助服务，免费的，都可以给你。拨打571-423-3200 。 FRENCH (Français) ATTENTION : Si vous parlez français , les services d'assistance de langues, gratuitement , sont à votre disposition. Appelez 571-4233200 . GERMAN (Deutsch) ACHTUNG: Wenn Sie Deutsch sprechen , Sprachassistenzdienste sind kostenlos, zur Verfügung. Rufen Sie 571-423-3200 . HINDI (�हंद�) ध्यान द� : आप �हंद� , भाषा सहायता सेवाओं, �न: शुल्क बोलते ह�, तो आप के �लए उपलब्ध ह� । 571-423-3200 बुलाओ। IBO (Igbo asusu) Ntị : Ọ bụrụ na ị na-ekwu okwu n'ala Igbo , asụsụ aka ọrụ , n'efu , dị ka gị. Akpọ 571-423-3200 . KOREAN (한국어) 주의 : 당신이 한국어, 무료 언어 지원 서비스를 말하는 경우 사용할 수 있습니다. 571-423-3200 를 호출합니다. KRU (Ɓàsɔ́ɔ̀-wùɖù-po-nyɔ̀) Dè ɖɛ nìà kɛ dyéɖé gbo: Ɔ jǔ ké m̀ Ɓàsɔ́ɔ̀-wùɖù-po-nyɔ̀ jǔ ní, nìí, à wuɖu kà kò ɖò po-poɔ̀ ɓɛ́ìn m̀ gbo kpáa. Ɖá 571-423-3200. PERSIAN FARSI (‫)یسراف‬

. 3200-423-571 ‫ ﭘﺎﺳﺦ‬. ‫ ﺧدﻣﺎت ﮐﻣﮏ زﺑﺎن راﯾﮕﺎن در دﺳﺗرس ﺷﻣﺎ ھﺳﺗﻧد‬، ‫ اﮔر ﺷﻣﺎ ﻓﺎرﺳﯽ ﺻﺣﺑت ﻣﯽ ﮐﻧﻧد‬:‫ﺗوﺟﮫ‬

RUSSIAN (Русский) ВНИМАНИЕ : Если вы говорите России , переводческие услуги , бесплатно , доступны для вас . Звоните 571-423-3200 . SPANISH (Español) ATENCIÓN : Si usted habla español, servicios de asistencia lingüística, de forma gratuita, están disponibles para usted. Llame a 571423-3200. TAGALOG (Tagalog) PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa 571-423-3200. URDU (‫)اُردُو‬

. ‫ ﭘر ﮐﺎل ﮐرﯾں‬3200-423-571 . ‫ ﻣﻔت زﺑﺎن ﮐﯽ ﻣدد ﮐﯽ ﺧدﻣﺎت آپ ﮐو دﺳﺗﯾﺎب ﮨﯾں‬، ‫ اﮔر آپ اردو ﺑوﻟﺗﮯ ﮨﯾں ﺗو‬:‫ﺗوﺟہ‬

VIETNAMESE (Tiếng Việt) Chú ý : Nếu bạn nói tiếng Việt , các dịch vụ hỗ trợ ngôn ngữ , miễn phí, có sẵn cho bạn . Gọi 571-423-3200 . YORUBA (èdè Yorùbá) AKIYESI: Bi o ba nsọ èdè Yorùbú ọfé ni iranlọwọ lori èdè wa fun yin o. Ẹ pe ẹrọ-ibanisọrọ yi 571-423-3200.

Office of Benefit Services · Fairfax County Public Schools

11

Department of Human Resources Office of Benefit Services Gatehouse Administration Center, Suite 2700 8115 Gatehouse Road, Falls Church, Virginia, 22042-1203

Open Enrollment: October 11- November 11 Read inside for information on changes for 2017, and review what you need to do for the future.  CVS Caremark® as pharmacy benefit manager;  New programs to stay healthy; and,  2017 medical and dental premiums Visit www.fcps.edu and search “Open Enrollment” for more details.