Welcome to Open Enrollment for your Benefits!

April 9, 2015

USD 475 Geary County Schools offers you and your eligible family members a comprehensive and valuable benefits program. We encourage you to take the time to educate yourself about your options and choose the best coverage for you and your family. There are several nice changes to our benefit package which will be highlighted on the following pages. Please review the changes carefully before making your elections for the new plan year. Once you have made your elections, you will not be able to change them until the next open enrollment period unless you have a qualified change in family status.

When to Enroll Our open enrollment is now open and will close on the last day of school - May 22, 2015. The health and dental insurance benefits you elect during open enrollment will be effective from July 1, 2015 through June 30, 2016. Other insurance coverages, like disability, life, vision, flex, dependent care spending accounts will be effective June 1, 2015 through May 31, 2016.

Who must go through the Open Enrollment Process?  ALL full-time employees o Those who want insurance o Those who don’t want insurance  Teachers leaving at the end of the school year Design © 2008-2013 Zywave, Inc. All rights reserved. Group Benefit Specialists, Inc.KR 11 2014

What’s New for

2015

 NEW OPEN ENROLLMENT PROCEDURES! o STEP 1:

Review your benefit options!



A Benefits Video is linked to the new enrollment portal on your USD 475 Employee Intranet. It will provide additional information about our new plans and how they compare to our previous plans.

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Group presentations will be made by our new BC/BS of KS representatives. Feel free to bring your spouse to one of these informational meetings!  Monday, April 13th 4:00 p.m. City Middle School  Tuesday, April 14th 4:00 p.m. Fort Riley Middle School

o STEP 2: 

Enroll or Waive Medical and Dental On-line!

Medical and Dental elections MUST be completed on-line PRIOR to the Open Enrollment meeting scheduled in your building!  Log in to your USD 475 Employee Intranet www.usd475.org; Click on “Staff”; Quick Links on right hand side for “New Benefits and Insurance Information”. Here is where all of your benefit information is located!  Click on the EasyAppsOnline link (technical issues call EAO at 1-888-5634474 ext 5, M-F 7am – 5 pm)  Enter your Last Name, Year of Birth, and Month of Birth to find your file.  Elect or Waive the BC/BS Medical option o

 

Be prepared to provide details about other health insurance you will carry in addition to the USD 475 health plan so benefits can be coordinated. But DO NOT show your prior PHS/Coventry plan information as that will not be considered duplicate coverage.

Elect or Waive the Delta Dental option Print your medical and dental enrollment choices or bring your electronic device to show confirmation of your elections as you proceed to Step 3.

o STEP 3: Finalize your Benefit Package  Finish your other benefit elections during your building open enrollment meetings. Watch for the building schedule to be posted on the Intranet.  If you miss your building’s meeting or if you want to talk personally with HR or our Insurance representatives about the new plans, plan to complete your enrollment during the following catch up dates at the Devin Center:  Monday, May 18th and Friday, May 22nd - all day  Thursday, May 21st – 3:00 pm – 6:00 pm  Note: the enrollment team at your building meeting WILL NOT be able to answer your questions about our medical or dental insurance options.

Medical and Prescription Drugs At the start of this school year, an insurance committee was formed with employee representation from around the district, including administration and board representation. Because our claims utilization was stable, we were able to get health insurance carriers competing for our business this year! All of this savings will be passed on to employees! We are able to significantly reduce payroll deductions for all Design © 2008-2013 Zywave, Inc. All rights reserved. Group Benefit Specialists, Inc.KR 11 2014

employees and offer plans that will provide attractive features to meet a wide variety of coverage needs expressed by our employees. A new BC/BS of Kansas package will take effect July 1st, 2015. Watch the Benefit Video prepared by our insurance consultants from Group Benefit Specialists and attend the BC/BS group presentations to learn more about the new plans. We are now offering a high deductible health plan (HDHP) which allows you to establish a Health Savings Account to maximize tax savings available to individual enrolled in HDHP’s. .

USD 475 Geary County Schools Health Insurance Blue Cross and Blue Shield of Kansas – July 1, 2015 – June 30, 2016 Option 1 - $500

Option 2 - $1,500

Option 3 - $3,000 HDHP

This chart will highlight some of the common features of the plans, WHEN CARE IS RECEIVED FROM CONTRACTING PROVIDERS. Care from non-contracting providers will be subject to additional out of pocket requirements. Please refer to the BC/BS Benefit Summaries for further details. DEDUCTIBLE Per Person Maximum Per Family COINSURANCE Deductible + Coinsurance Per Person Maximum Per Family COPAYS (count towards annual maximums below)

Preventive Care Rider

Benefit Year runs July 1 - June 30

$500

$1,500

$3,000

$1,000

$3,000

$6,000

80% Insurance / 20% Patient to $2,500/$5,000 $3,000 $6,000

$4,000 $8,000

$35 per Dr. Office Visit and eye exam $200 Emergency Room Copay then Ded & Coins

100% Insurance / 0% Patient $3,000 $6,000 Subject to Deductible

Certain services, when coded as preventive by the doctor, are covered 100% by insurance. Covered services are determined by the ACA and include certain immunizations, well-child wellwoman well-man exams, screenings including breast cancer, cervical cancer, colorectal cancer, PSA, osteoporosis. There are certain approval criteria, such as age and gender.

Diagnostic and Routine Screening Mammograms and Colonoscopy's

1 Diagnostic Colonoscopy per year, regardless of diagnosis 1 Diagnostic Mammogram per year, regardless of diagnosis

Subject to Deductible

Lab & X-ray Services

First $500 Outpatient Lab/X-ray Paid at 100% by Insurance. Additional expense subject to Deductible & Coinsurance

Subject to Deductible

PRESCRIPTION DRUGS:

34 day supply (100 unit dosage for maintenance drugs)

Subject to Deductible First, then:

Copays count towards annual maximums below

$15 Generic Copay

$15 Generic Copay

$30 Formulary Brand Copay

$50 Formulary Copay $75 Non-Formulary Copay

Quantity limits, step therapy, prior authorization, and some drug exclusions may apply.

* Illustrative Copay Cap Per Person Maximum Per Family

$45 Non-Formulary Brand Copay Mailorder Copays by Tier - $37.50 / $75 / $112.50

$2,000 $4,000

$1,000 $2,000

Mailorder Copays by Tier $37.50 / $125 / $187.50

$2,000 $4,000

MAXIMUM OUT OF POCKET per benefit year: Combines Deductible, Coinsurance, Copayments, RX Copays. Once reached, Insurance will pay 100% of covered expenses, including prescriptions, for the remainder of the benefit year.

$5,000 $10,000

$5,000 $10,000

* Illustrative Copay Cap- While there isn't a 'separate' cap on copays, this will illustrate the accumulation of copays it would take in order for you to reach the 'Maximum Out of Pocket' limits.

Member may select any option at open enrollment effective 7/1/2015. At future open enrollments, the only move that cannot be made is from Option 3 to Option 1.

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$5,000 $10,000

Page

Annual Per Person Annual Max Per Family

The USD 475 health plans are in compliance with the ACA Health Care laws applicable to large employers. Our plans meet the minimum value and affordability guidelines. This means our full time benefit eligible employees and dependents may not qualify for tax credits or subsidies on the Marketplace / Exchanges. Options 1 and 2 are consider “creditable” for Medicare Part D Prescription Drug purposes. The HDHP Option 3 is “non-creditable”. If you are considering leaving our plan in the near future and are Medicare eligible, please visit with a representative about this topic.

Health Savings Accounts (HSA) We encourage you to review the long term advantages of participating in a Health Savings Account to pay the out of pocket share of your medical bills. If you participate in our Option 3, $3,000 High Deductible Health Plan, you can set aside money in a Health Savings Account (HSA) to pay for eligible medical, dental and vision expenses. It can even help you with long term care expenses in the future. We have posted an HSA Guide on our Intranet. The Guide will illustrate how you can take advantage of the tax saving features by enrolling in our Option 3 HDHP and establishing a Health Savings Account. The IRS provides the rules that govern this tax saving opportunity, so review the guidelines carefully. In order to take advantage of the HSA tax savings opportunity, you must create an HSA account BEFORE you incur a medical or prescription expense. If you chose not to fund your HSA on a regular basis, we suggest that you open the account with the minimum balance required. Then, before you pay for a medical bill or prescription, deposit the money into your HSA and use your HSA checks or debit card to pay your medical bill.

Dental – Delta Dental Plan of Kansas USD 475 will be offer our Delta Dental benefits separately from our BC/BS medical plans starting July 1 st. You will need to make your dental enrollment through the EasyAppsOnline enrollment process. Services

Amount You Pay

Preventive and Diagnostic Services

Exams, cleanings, x-rays – paid at 100%

Basic Services

Fillings, simple extractions – paid at 50%

Major Services

Oral surgery, root canal, crowns – paid at 50%

Annual Maximum

$1,500 per covered person per contract year – July 1 – June 30

Monthly Deductions

Employee only – $26.49 Family – $73.17

Additional Employee Benefit Programs: Vision Coverage Cancer Insurance Term Life Insurance

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Disability Income Insurance Section 125 Flexible Spending Accounts 403(b) Plan Participation

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Refer to your Benefit Guide for details on the following additional insurance plans available to USD 475 Geary County Schools employees.

Your Cost The Monthly Payroll Deduction chart illustrates the employee payroll deduction amounts that will be deducted from your June 2015 paychecks for the coverage beginning July 1, 2015. These figures are subject to change based on the outcome of negotiations for the upcoming contract year.

MONTHLY PAYROLL DEDUCTIONS - USD 475 GEARY COUNTY SCHOOLS July 1, 2015 - June 30, 2016 Plan Year Option 1 $500

Option 2 $1,500

Option 3 $3,000 HDHP

$122.23 26.49 $148.72

$91.77 26.49 $118.26

$45.69 26.49 $72.18

Medical Dental Package Total:

$611.53 73.17 $684.70

$541.17 73.17 $614.34

$434.68 73.17 $507.85

Medical Dental Package Total:

$596.53 73.17 $669.70

$526.17 73.17 $599.34

$419.68 73.17 $492.85

FAMILY - Spouses are bot h Cert ified employees for t he Dist rict Medical $339.78 Dental 73.17 Package Total: $412.95

$269.42 73.17 $342.59

$162.93 73.17 $236.10

FAMILY - Spouses are bot h Adm/Hourly employees for t he Dist rict Medical $309.78 Dental 73.17 Package Total: $382.95

$239.42 73.17 $312.59

$132.93 73.17 $206.10

FAMILY - One Spouse is Cert ified, one is an Adm/Hrly employee for t he Dist rict Medical $324.78 $254.42 Dental 73.17 73.17 Package Total: $397.95 $327.59

$147.93 73.17 $221.10

SINGLE COVERAGE- ALL FULL-TIME Medical Dental Package Total:

FAMILY - CERTIFIED

FAMILY - ADM/HOURLY

DENTAL ONLY - ALL FULL-TIME Single Family

$26.49 $73.17

Medical and Dent al benefit s will be offered separat ely so you can elect t he coverage you need! USD 475 current ly cont ribut es t he following mont hly amount s t owards your healt h insurance premiums:

These figures are subject to change based on the outcome of negotiations for the upcoming contract year. Board contribution towards Single

$330.75

Two Certified

$705.50

Board contribution towards Family Cert

$433.75

Two Adm/Hourly

$735.50

Board contribution towards Family Adm/Hrly

$448.75

1 Cert/1 Adm/Hrly

$720.50

4/7/2015

Design © 2008-2013 Zywave, Inc. All rights reserved. Group Benefit Specialists, Inc.KR 11 2014

Your On-line Enrollment / Waiver Instructions

Page

The information in this Enrollment Guide is presented for illustrative purposes and is based on information provided by the employer and the respective carriers. The text contained in this memo was taken from various summary plan descriptions and benefit information. While every effort was taken to accurately report your benefits, discrepancies or errors are always possible. In case of discrepancy between this memo and the actual plan documents, the actual plan documents will prevail. All information is confidential, pursuant to the Health Insurance Portability and Accountability Act of 1996. If you have any questions about your benefits, contact Human Resources.

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www.usd475.org Click on “Staff”; Quick Links on right hand side for “New Benefits and Insurance Information”; Enroll/Waive by clicking on the http://GBS.EasyAppsOnline.com link.