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BENEFITS PRESENTATION
BONNER SPRINGS SCHOOL DISTRICT
Welcome!
The benefits you elect now are effective January 1, 2021 –
December 31, 2021
• Your deductible/out-pocket maximums will re-set to zero on January 1, 2021
• Remember to review all your plan options and networks to determine what best fits your needs
• No changes to medical plans except 90-day maintenance medications can now be filled at retail pharmacies
2
Qualifying Life Event
Unless you have a qualified change in status, you cannot make changes to the benefits you elect until the next annual enrollment period.• Qualified changes in status include:
• Birth of a child, adoption, marriage, death, divorce, loss of coverage (if you or your spouse/dependents are covered under another plan and then lose that coverage)
Should you wish to make changes to your elections due to a qualifying event, you have 31 days from the event to notify Stormi Vitt, Benefit Coordinator andcomplete/turn in the appropriate paperwork. Otherwise you will have to wait untilthe next annual enrollment to make any changes to your benefit elections.
Adding a NewbornIf you have Single Coverage or are currently covering Dependents:
• Request coverage for the newborn within 31 days following the birth• The baby WILL NOT be automatically enrolled for you• After you complete the enrollment request, the child will be added
retroactive to his/her birth date• The member could be responsible for additional Premium
3
USD 204 Wellness Vision Statement: To empower and reward employees for
living sustainable healthy lives both in and out of the workplace
Wellness Champions:
BSHS Crystal Coleman-Richardson
CMS Melissa Mitchell
BSE Tammy Dooley
DRE Kristi Flack
EDW Kevin Riley
District Kaela Williams
Wellbeing
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Wellbeing Program Highlights
Programming and Challenges – offered to staff; focus on physical, emotional, financial, and social wellbeing
Prizes – opportunities to earn prizes and awards!
Communications – wellbeing communication sent out every month
Community Activities – opportunities to participate in community wellness activities
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Copay – a fixed dollar amount you pay for covered services. Such services include but are not limited to physician office visits, urgent care, and prescriptions.
Insurance Terms
Out-of-Pocket Maximum – is the most you will pay in a given plan year for your benefits, not including your premium. Your deductible, copays, and coinsurance all accumulate towards this maximum amount. Once this is met, all covered services will be paid at 100% for the remainder of the plan year.
Deductible – is the amount of money you pay for services before coinsurance applies. This does not apply to preventive services required under the Affordable Care Act.
Coinsurance – is the percentage you pay for certain services based on the allowed amount charged. Generally, the insurance company pays the larger portion of the percentage and you pay the smaller portion. Coinsurance applies after the deductible has been met.
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NetworkAvailability & Differences
The network of providers available to you depends on the Blue KC plan you choose:
Visit www.bluekc.com to find a provider
Preferred-Care Blue (PCB)
Preferred Provider Organization (PPO)
Blue Select Plus (BSP)Exclusive Provider Organization
(EPO)
Blue CareHealth Maintenance Organization
(HMO)
• Applies to Option 2: QHDHPand Option 3: PPO
• Larger network in Greater KC area
• Provides in and out-of-network coverage
• Emergencies are covered at the in-network level
• Provides access to the national Blue Card network when traveling outside the Blue KC area
• Applies to Option 1: Spira Care EPO
• Smaller network, limited to 10 hospitals, Spira Care Centers, and approximately 3,900 providers
• Provides in-network coverage only
• Emergencies are covered at the in-network level
• Provides access to the national Blue Card network when traveling outside the Blue KC service area
• Applies to Option 5: HMO
• Smallest network; local coverage only
• Provides in-network coverage only
• Emergencies are covered at the in-network level
• No coverage outside of the KC Metro. Only Johnson and Wyandotte counties are in-network in Kansas
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KC METRO NETWORK HOSPITALS
KC Metro Hospitals Preferred-Care Blue Blue Select Plus Blue Care
AdventHealth (Shawnee Mission)
Belton Regional Medical Center Cameron Regional Medical Center Cass Regional Medical Center
Center Point Medical Center
Children’s Mercy Hospital
Children’s Mercy Hospital—South
KU Medical Centers
Lee’s Summit Hospital
Liberty Hospital
Menorah Medical Center
North Kansas City Hospital
Olathe Medical Center
Overland Park Regional
Providence Medical Center
Research Medical Center
St. Joseph Medical Center
St. Luke’s (All Locations)
St. Mary’s Medical Center
Truman Medical Center - Hospital Hill
Truman Medical Center—Lee’s Summit 8
Blue Select Plus Network
Visit www.bluekc.com to find a provider
If you are in the 32 county BlueKC service area and receive care from a hospital or provider that does not participate in the BlueSelect Plus Network, you will not have any coverage.
If you are traveling and are outside of the the 32 county BlueKC service area, you still have access to the national Blue Card PPO Network and can receive in-network benefits.
All life or limb threatening emergent care is covered at the in-network level, regardless if you are in- or out-of-network.
Blue KC 32 county service areaKansas: Johnson and Wyandotte Missouri: Andrew, Atchison, Caldwell, Carroll, Cass, Bates, Benton, Buchanan, Clay, Clinton, Davies, Dekalb, Gentry, Grundy, Harrison, Henry, Holt, Jackson, Johnson, Lafayette, Livingston, Mercer, Nodaway, Pettis, Platte, Ray, Saline, St.Clair, Vernon, Worth
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Care Centers + Hospitals In-Network
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Take a virtual tour at
SpiraCare.com/TourGuide
Plans to expand based on membership demand
10
COMPREHENSIVE SERVICES CONVENIENT BENEFITS
Adult and Pediatric Primary and Preventive Care
Sick Care Common Prescriptions Filled On-Site**
Specialist Referrals & Scheduling
Chronic ConditionManagement
Behavioral Health Consultations
Patient WellnessFollow-Ups
Support in Understanding your Plan’s Network
DigitalX-Rays*
LabDraws
Access to A Healthier You Platform
Extended Full-Service Hours
Patient Wellness Follow-ups
Health Coaches On-Site
On-line Scheduling for most appointment types, call for
sick care needs
Virtual Care and Online Communications
*X-rays are available at select locations only, but are at no additional cost to members.** Select prescriptions will be offered on-site at your regular copay or deductible level.
Option 1 Spira Care EPO: Up to a $60 allowable charge for services
11
2021 Medical Rates
Option 1: Spira Care
EPO
Option 2: QHDHP
Option 3: PPO
Option 4*: Buy-Up PPO
Option 5*: HMO
EMPLOYEE ONLY $0 $0 $0 $121 $54
DISTRICT FUNDED HSA(EMPLOYEE ONLY)
$107 $12 N/A N/A N/A
FAMILY $619 $865 $911 $1,197 $1,027
*Grandfathered plans – no new enrollment
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Employee Monthly Medical Plan Premium / Member Responsibility
Total Exposure = Above Rate Annualized + Out-of-Pocket Maximum
2021 Individual Exposure
EMPLOYEE ONLY
COVERAGE
Option 1: Spira Care
EPO
Option 2: QHDHP
Option 3: PPO
Option 4*: Buy-Up PPO
Option 5*: HMO
Annual Premium $0 $0 $0 $1,452 $648
Out-of-Pocket Maximum $2,800 $2,800 $4,000 $2,750 $3,000
Annual District Funded HSA $1,284 $144 N/A N/A N/A
Total Exposure $1,516 $2,656 $4,000 $4,202 $3,648
*Grandfathered plans – no new enrollment 13
Total Medical Insurance Exposure = Premium + Out-of-Pocket Maximum
2021 Medical PlansOption 1: Spira Care EPO
BlueSelect Plus
Option 2: QHDHP
Preferred Care Blue
Option 3: PPO
Preferred Care Blue
Deductible
Individual
Family
In Network
$2,800
$5,600
In Network
$2,800
$5,600
In Network
$1,000
$2,000
Member Coinsurance 0% 0% 20%
Out-of-Pocket Maximum
Individual
Family
$2,800
$5,600
$2,800
$5,600
$4,000
$8,000
Office Visit
Primary Care Physician
Specialist
Spira Center
Deductible
Deductible
$60 Maximum allowable charge
Deductible
Deductible
N/A
$40
$80
N/A
Preventive Care Covered 100% Covered 100% Covered 100%
Urgent Care Deductible Deductible $80
Emergency Room Deductible Deductible $200 then deductible then 20%
Outpatient Surgery / Inpatient Hospital Services Deductible Deductible Deductible then 20%
Prescription Drug
Retail (30-day supply)
Tier 1 – Generic
Tier 2 – Preferred
Tier 3 – Non-Preferred
Mail Order or Retail (90-day supply)
Deductible Deductible
N/A
$12
$35
$60
$24 / $70 / $120
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2021 Medical PlansOption 4: Buy-Up PPO
Preferred Care Blue
Option 5: HMO
Blue Care
Deductible
Individual
Family
In Network
$500
$1,000
In Network
None
None
Member Coinsurance 20% 0%
Out-of-Pocket Maximum
Individual
Family
$2,750
$5,500
$3,000
$7,500
Office Visit
Primary Care Physician
Specialist
Spira Center
$20
$40
N/A
$40
$80
N/A
Preventive Care Covered 100% Covered 100%
Urgent Care $40 $80
Emergency Room $150 then deductible then 20% $200
Outpatient Surgery / Inpatient Hospital Services Deductible then 20%
$500 per day, up to $2,500 per calendar year per person
Prescription Drug
Retail (30-day supply)
Tier 1 – Generic
Tier 2 – Preferred
Tier 3 – Non-Preferred
Mail Order or Retail (90-day supply)
N/A
$12
$35
$60
$24 / $70 / $120
N/A
$12
$35
$60
$24 / $70 / $120
GRANDFATHERED PLANSNO NEW ENROLLMENT
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Claim Example #1
Based on January – December 2021Employee in good health with single coverage. Sally has a Preventive exam & lab services, one diagnostic office visit, a Tier 1 Rx filled monthly and one additional Tier 2 Rx filled just once. Option 1:
Spira Care EPO
Option 2:QHDHP
Option 3: PPO
Option 4*: Buy-Up PPO
Option 5*: HMO
Premium $0 $0 $0 $1,452 $648
Preventive Exam ($75) $0 $0 $0 $0 $0
One PCP Diagnostic Exam ($125)
$60 at a Spira
Center$125 $40 $20 $40
Tier 1 Rx ($15/month) $180 $180 $144 $144 $144
Tier 2 Rx ($60) $60 $60 $35 $35 $35
District HSA Contribution ($1,284) ($144) N/A N/A N/A
Total Employee Cost ($984) $221 $219 $1,651 $86716*Grandfathered plans – no new enrollment
Claim Example #2
Based on January – December 2021Employee with single coverage. John has a car accident in September and is in the hospital for six days, four follow up specialist visits, two Tier 2 Rx’s for 3 months.
Option 1:Spira Care
EPO
Option 2:QHDHP
Option 3: PPO
Option 4*: Buy-Up PPO
Option 5*: HMO
Premium $0 $0 $0 $1,452 $648
Hospital Stay ($50,000) $2,800 $2,800 $4,000 $2,750 $2,500
Four Specialist Visits ($150 each)
$0 $0 $0 $0 $320
Tier 2 Rx ($80/month) $0 $0 $0 $0 $105
Tier 2 Rx ($135/month) $0 $0 $0 $0 $75
District HSA Contribution ($1,284) ($144) N/A N/A N/A
Total Employee Cost $1,516 $2,656 $4,000 $4,202 $3,648
17*Grandfathered plans – no new enrollment
Claim Example #3
Based on January – December 2021Employee + Family Plan. Mary is in fair health with a monthly cholesterol medication. Her spouse is on a $3,000 prescription drug, and their child receives a well child care exam and one urgent care visit for the flu with a tier 1 prescription.
Option 1:Spira Care
EPO
Option 2:QHDHP
Option 3: PPO
Option 4*: Buy-Up PPO
Option 5*: HMO
Annual Premium $7,428 $10,380 $10,932 $14,364 $12,324
Employee Tier 2 Cholesterol Rx ($200/month)
$2,400 $2,400 $420 $420 $420
Spouse Tier 3 Rx ($3,000/ month)
$2,800 $2,800 $720 $720 $720
Well-Child visit ($180) $0 $0 $0 $0 $0
Child Urgent Care ($90) $90 $90 $80 $40 $80
Child Tier 1 Rx ($35) $35 $35 $12 $12 $12
District HSA Contribution N/A N/A N/A N/A N/A
Total Employee Cost $12,753 $15,705 $12,164 $15,556 $13,55618*Grandfathered plans – no new enrollment
Here are a few things you can do on the BlueKC member portal:
My Information
Quickly print/email your ID card
View Plan Benefits
View coverage & pharmacy info
Review Claims
View claims, EOB’s, deductibles, and out-of-pocket maximums
Find Care
Find doctors, hospitals, and pharmacies
Ask Us
Get answers to your questions
MYBLUEKC.COM
Register at mybluekc.com
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VIRTUAL CARE
Affordable access to treat your urgent, sick and behavioral health needs 24/7 through the BlueKC Virtual Care App!
Board-certified physicians
Save on drive time oroffice wait time
Pay much less than the emergency room
Care you need--includingprescriptionsPrivate & Secure
Great for traveling when you need care
MAKE AN APPOINTMENTDownload the BlueKC VIRTUAL CARE APP
and register as a new user.
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SELECTIONOnline search tool
so you can discover all optionsavailable
PRICEPersonalized cost
estimates and plan coverage
CONVENIENCEGet email & text alerts if there are
savings
ASSISTANCEExperienced staff can work directly with your
doctor
Rx Savings Solutions helps you decide what’s best for your health and budget
Get Notified How to Save on Prescriptions
DID YOU KNOWA capsule might cost more than a tablet or a drug with
two active ingredients can be split into two for big savings?!
SAME DRUG, DIFFERENT FORM
DIFFERENT DRUG, SAME TREATMENT
SAME ACTIVE INGREDIENT, LOWER PRICE
SAME INGREDIENTS, DIFFERENT PILLS
START SAVING!Go to MyBlueKC.com, access your pharmacy benefits and Rx Savings Solutions
RX SAVINGS SOLUTIONS
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MINDFUL BY BLUEKC
It all starts with the Mindful Advocate In a unique role exclusive to BlueKC, our Mindful Advocates are licensed behavioral health clinicians who match members to services and/or providers and guide care plans.
Just one call away and available 24/7
ENHANCED! Expedited Access Network Team support to find a behavioral health appointment in the earliest window possible for a BlueKC member in crisis
ENHANCED! Virtual CareWith therapists trained and licensed in Virtual Care therapy techniques
ENHANCED! Managed Behavioral HealthHelping members identify in-network providers that best fit their needs by type and specialty
NEW! Online TherapyText and scheduled live chat, phone and video therapy for three sessions to help with conditions like depression, anxiety and stress (for short-term therapy only and accessible as part of your Well-Being Resources)
NEW! Online Self-Guided ToolsResources to manage stress, improve mood and more
NEW! Well-Being ResourcesIncluding three visits per issue for help with major life events (divorce, adoption, loss), stress, financial issues, childcare and other everyday challenges
Mindful by BlueKC is available to health plan
participants.
Normal cost-sharing and out of pocket maximum
limits will apply.
MindfulBlueKC.com 22
EMPLOYEE ASSISTANCE PROGRAM
Our EAP provides you with the tools and resources to help you find your best self
Support & advice to assist you when life
gets overwhelming in areas such as
substance abuse, finding a
daycare, finances, personal stress and
more
Available to all
employees, spouses
anddependents
To get started:Call 800.624.5544Log On to ndbh.com with passcode usd204 23
24/7Confidential
Support
At No Cost to You!
Up to 3 counseling or
coaching sessions per
issue per year for each individual
Health Savings Account (HSA)
• Established for the purpose of paying qualified healthcare expenses of the account owner or dependents.
• The account owner must be covered under a Qualified High Deductible Health Care Plan to contribute to an HSA.
• Portable, it stays with you for life. Even if you change jobs, become unemployed, or retire.
• Unused funds can rollover to use on future expenses.
24
• A tax-exempt account • Contributions are tax-deductible (or “pre-tax”)• Earnings on your balance and investments are not taxed• Funds withdrawn for qualified medical expenses are not taxed
• An individually owned, tax-advantaged account that may be used to pay for qualified medical expenses or saved for retirement and certain long-term care expenses.
You CANNOT receive/make contributions to an HSA if…
• You are claimed as a dependent on someone else’s tax return (You are NOT a dependent if you are “married filing jointly” or “married filing single”).
• You are covered by another health insurance plan that is NOT a QHDHP, such as coverage under a spouse’s traditional PPO or HMO plan.
• You or your spouse have a Flexible Spending Account (FSA), even if the FSA dollars are not used for you.
• You or your spouse are covered by a Health Reimbursement Arrangement (HRA).
• You have medical coverage under TRICARE, or eligible for Medicare, or Medicaid.
• You are in receipt of Veteran Administration (VA) benefits, for a non-service related disability, including prescription drugs, within the previous 3 months you are not eligible to contribute for 3 months following.
• You CAN still have other disability, dental, vision, and long- term care insurance policies & Dependent Care Account through an FSA.
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Is there a limit to how much I can contribute?
ANNUAL MAXIMUMS
The annual contribution is established by law and subject to changeeach calendar year.
If you are between the ages of 55 & 65, you may also be able to make a $1,000 “catch-up” contribution to the HSA each year.
Contribute up to
$3,600Single, or
$7,200Family
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HSA Disbursements
You must retain all receipts in the event of an IRS Audit
Disbursements for qualified healthcare expenses are not subject to taxation
Disbursements for non-qualified expenses are subject to regular taxation plus a 20% penalty. The 20% penalty is waived upon attainment of age 65
Expenses incurred prior to establishing an HSA areNOT eligible for reimbursement
27
• Eligible health care expenses include expenses for the individual who opens the account, his or her spouse and dependent children. The spouse and dependent children do not need to be covered under the QHDHP in order to have an eligible HSA expense.
• Hospitalization
• Prescription Drugs
• Over the Counter Drugs
• Doctor Office Visits
• Premiums for Medicare, Long Term Care, COBRA
• Dental expenses (Including Orthodontia)
• Vision (Including Lasik)
• Full list of eligible expenses available on the Treasury website at: www.IRS.GOV
HSA EligibleExpenses
28
FLEXIBLE SPENDING ACOUNTS
HEALTH CARE FLEXIBLE SPENDING ACCOUNT
Maximum Contribution: $2,750
• Available regardless of the medical plan you select. If you participate in the HSA, you cannot have this account.
• Enables you to pay medical, dental, vision, orthodontic, and prescription drug expenses for yourself and dependents, regardless if they are covered under your insurance program
• The total amount of your annual election is available to you up front, reducing the chance of having a large out-of-pocket expense early in the plan year
LIMITED FLEXIBLE SPENDING ACCOUNT
Maximum Contribution: $2,750
• Available only if you elect a QHDHP and participate in the HSA.
• Offers you the same pre-tax savings opportunity for dental, orthodontic, and vision expenses only
• The total amount of your annual election is available to you up front, reducing the chance of having a large out-of-pocket expense early in the plan year
DEPENDENT CARE EXPENSE ACCOUNT
Maximum Contribution: $5,000
• Available regardless of medical plan selected.
• Gives you the opportunity to redirect a portion of your annual pay on a pre-tax basis to pay for dependent care expenses
• An eligible dependent is any member of your household for whom you can claim expenses on your Federal Income Tax Form
• Children must be under age 13
• Care centers which qualify include dependent care centers, preschool educational institutions, and qualified individuals
• Funds are only available as they are contributed each pay period.
All accounts are Use it or Lose It. Any unused funds on December 31st are forfeited.29
• Eligible health care expenses include expenses for the individual who opens the account, his or her spouse and dependent children. The spouse and dependent children do not need to be covered under the employee’s plan in order to have an eligible FSA expense.
• Hospitalization
• Prescription Drugs
• Over the Counter Drugs
• Doctor Office Visits
• Dental expenses (Including Orthodontia)
• Vision (Including Lasik)
• Full list of eligible expenses available on the Treasury website at: www.IRS.GOV
FSA EligibleExpenses
30
Voluntary Dental
DELTA DENTAL OF KANSAS PPO PREMIER Kids 12 & UnderDeductibleIndividual / Family $50 / $150 $0
Annual Maximum $1,500
Preventive Services (unlimited cleanings)
100% 100% 100%
Basic Services 90% 80% 100%
Major Services 60% 50% 100%
Ortho Services N/A
Monthly Premium
Employee Only $32.00
Employee + Spouse $63.33
Employee + Children $63.58
Employee + Family $107.69
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Voluntary Vision
Surency In-Network
Examination Copay $10 copay
Frequency of ServiceExamLensesFrames
Every 12 monthsEvery 12 monthsEvery 24 months
LensesSingleBifocalTrifocal
$25 copay$25 copay$25 copay
Reimbursement Schedule – Exam 100%
Reimbursement Schedule – Lenses SingleBifocalTrifocal
100%100%100%
Contacts(in lieu of glasses)
$115 allowance; 15% off remaining balance over allowance
Frames $100 allowance
Monthly Premium
Employee Only $8.07
Employee + Spouse $16.93
Employee + Children $14.51
Employee + Family $27.15 32
Voluntary Products
DISABILITY INSURANCE
Disability insurance provides income protection if or when you can’t work because of an illness or injury. It is an additional way to help provide you a source of income should you become disabled from a non-work related injury or sickness.
POLICY FEATURES:• Several different benefit plan
options• Benefit payments deposited
directly into your bank account
• Benefits are payable year round
VOLUNTARY LIFE INSURANCE
Help make sure your family is protected financially in the event of a loved one’s death is an important way of caring for their needs. American Fidelity has several types of individual life insurance plans to choose from, including permanent, term and children’s policies.
POLICY FEATURES:• Death benefit amount that is
generally tax free and paid directly to beneficiaries
• A policy that you own – take with you if you leave employment
33
Voluntary Products
CANCER INSURANCE
A cancer diagnosis can change your life, and the expenses associated with a cancer diagnosis can be overwhelming. Limited Benefit Cancer Insurance may offer a solution to help you so you can focus on your treatment and healing.
POLICY FEATURES:• Benefit payments are made
directly to you• Individual, individual and
spouse, individual and child (eligible child as defined in the policy) and family coverage available
CRITICAL ILLNESS INSURANCE
American Fidelity’s Limited Benefit Critical Illness Insurance is an insurance policy that will pay a lump sum if you experience an eligible critical illness, such as a heart attack, permanent damage due to a stroke, major organ failure and/or major burns.
POLICY FEATURES:• Three lump sum benefit
amounts available• Annual health screening test
benefit• Benefits paid directly to you
34
Voluntary Products
ACCIDENT COVERAGE
Accidents can bring unexpected costs. An Accident Insurance plan may lessen the impact on your finances by paying benefits to help cover your expenses, regardless of any other coverage you have.
POLICY FEATURES:• Benefit payments are made
directly to you
SECURE ID2
Unexpected problems can have serious influence on your peace of mind. Secure ID2 helps you face those problems with a sense of confidence.
POLICY FEATURES:• ID Sanctuary Enhanced• Legal Services• Roadside Assistance• Global Travel Assistance
35
Enrollment
Open Enrollment runs from November 2nd thru November 13th
Two Ways to Enroll:
1. Self Enrollment from November 2nd – 8th
2. Virtual One-on-One Enrollment with an American Fidelity enrollment counselor from November 9th – 13th
Please allow approximately 30 minutes for your enrollment session.
35
1 2 3REVIEW INFORMATION
In the meantime, review this presentation and your employee
benefits guide carefully. The benefits you elect now are effective
January 1, 2021 to December 31, 2021.
ASK QUESTIONS
Utilize your CBIZ Representatives and Stormi Vitt, Benefits Coordinator to ask questions to better understand your
benefit options.
Schedule your one-on-one virtual enrollment session to take place
between November 9th thru November 13th, or complete your
online enrollment between November 2nd thru November 8th.
Remember to use the worksheet at the end of your guide to gather all
necessary info in preparation for enrolling.
ENROLL
Next Steps
37
Contact InformationIf you have any questions regarding your benefits, please contact one of your CBIZ representatives or your Bonner Springs Benefits Team.
CBIZ Representatives Maggie Knudson, Account [email protected]
Molly Harrison, Senior Account [email protected]
Kate Orr, Associate Account [email protected]
Bonner Springs Benefits TeamEric Hansen, Director of Business913.422.5600 ext. [email protected]
Stormi Vitt, Benefits Coordinator913.422.5600 ext. [email protected]
38