EMPLOYEE MEETING OPEN ENROLLMENT APRIL 22, 2016 · Your personal health ally, offering the same great services as Anthem Anywhere, plus new features like custom content, personalized

GOOD, SMART PEOPLE EFFECTIVELY MANAGING

THE ENTIRE HEALTH CARE DOLLAR.

EMPLOYEE MEETINGAPRIL 22, 2016OPEN ENROLLMENT

January 1st, 2020

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TODAY’S PRESENTATION

OPEN ENROLLMENT

EBC / BENEFIT ENROLLMENT

DEPENDENT AUDIT

BENEFIT REVIEW

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5 OVERVIEW OF ALL PLANS – QUESTIONS & CLARIFICATIONS

EAP Announcement

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OPEN ENROLLMENT

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MONDAY, OCTOBER 21ST – FRIDAY, NOVEMBER 1ST

Benefits effective January 1, 2020 All employees must make new elections for the 2020 plan year

Make any changes you want to your benefits Waived previously & want to enroll for 2020 Don’t want to change anything? You must still complete open enrollment.

The only time benefit changes can be made outside of Open Enrollment is in the case of a QUALIFYING EVENT: (within 30 days from date of the event)

Marriage Birth Death Divorce Adoption/Custody Involuntary loss of coverage

Employees must actively engage in enrollment or benefits will be lost!

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OPEN ENROLLMENT – EASY & CONVENIENT

ENROLLMENT PARTNER: EBC – Enrollment Benefit Concepts

THREE ways to enroll (ONLY ONE IS REQUIRED):

CALL CENTER

(937) 401-3739 Monday-Thursday: 8:30 am to 5:30 pm

Friday: 8:30 am to 5:00 pm

SELF-SERVE

www.aflacatwork.comLog in using SS # and PIN

(last 4 digits of SSN and

last 2 digits of birth year)

APPOINTMENT

Benefit Specialists Reserve your slot at:

www.ebcoh.com/enroll

http://www.aflacatwork.com/

http://www.ebcoh.com/enroll

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OPEN ENROLLMENT – HOW TO BE PREPARED

Date of Birth Social Security Number

IF YOU ARE NEWLY ENROLLING A SPOUSE AND/OR DEPENDENTS:

Date of Birth for each dependent Social Security Number for each dependent

Expect to spend about 30 minutes to enroll, no matter how you decide to enroll.

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DEPENDENT AUDIT – CONSOVA

Any employee adding a new spouse or dependent to the medical, dental, or vision plan, at any time, will be audited.

“Open Enrollment” does not secure coverage for your dependents.

Following enrollment, you will receive a letter in the mail from Consova with instructions on how to complete the required audit.

Failure to respond to the audit will result in termination of coverage for dependents!

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OPTING OUT OF THE MEDICAL / RX PLAN

THE FOLLOWING OPTIONS ARE AVAILABLE IF YOU CHOOSE TO OPT OUT OF THE MEDICAL / RX PLAN:

1. $600 CASH Taxable (paid $150 per quarter).

2. $600 deposited into a Healthcare Flexible Spending Account – Tax Free!!

IN ORDER TO RECEIVE OPT OUT FUNDS YOU AND ELIGIBLE DEPENDENTS / SPOUSE MUST BE COVERED UNDER OTHER GROUP HEALTH INSURANCE, MEDICARE, MEDICAID OR TRICARE.

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2020 BENEFIT UPDATE

WHAT IS STAYING THE SAME?

Medical Anthem

PharmacyRx Benefits /

Express Scripts

DentalSuperior Dental

Care

Life/Vol Life/AD&D Voya

Worksite Aflac / Trustmark

Wellness Incentive Wellvibe

WHAT IS NEW?

Employee Assistance Program

Anthem

WHAT IS CHANGING?

Vision Anthem

Educator Voluntary Disability

Voya

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WHAT IS STAYING THE SAME

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MEDICAL PLAN HIGHLIGHTS – ANTHEM

High Deductible Health Plan IN NETWORK OUT OF NETWORK

Annual Deductible : Non-Embedded$1,500 Single$3,000 Family

$4,000 Single$8,000 Family

Co-Insurance (after deductible) 100% 70% / 30%

Preventive Care COVERED IN FULL Deductible

Hospital / Inpatient & Outpatient Deductible Deductible

Professional Services Deductible Deductible

Primary Care Physician (after deductible)$20 PCP /

$40 Specialist Deductible

Emergency Room (after deductible) $150 $150

Urgent Care (after deductible) $50 Deductible

Prescription Drugs (after deductible) $10 / $30 / $50 Deductible

Mail Order (after deductible) $30 / $90 / $150 N/A

Maximum Out-of-Pocket(includes deductible, co-insurance & copays)



ALL OTHER MEDICAL BENEFITS ARE SUBJECT TO DEDUCTIBLE & CO-INSURANCE

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PHARMACY – RX BENEFITS

PHARMACY BENEFIT MANAGER (PBM)

Express Scripts (ESI) You have access to the Members

Services Team 1-800-334-8134

Monday – Friday 7:00 am to 8:00 pm Is my drug covered? Is my Pharmacy in network? Are there lower cost alternatives? Can you assist me with my claim

questions?

MAIL ORDER

ESI HOME DELIVERY: 1-877-503-4073

Mail Order forms can be found at Express-Scripts.com

New Prescriptions: Can be mailed to ESI by using a mail order

form Physicians can phone in ESI Scripts

Physicians can e-scribe ESI Scripts

** NOTE: Mail Order can take up to two weeks for initial order, so members should make sure they have enough medication on hand to last until delivery.

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MEDICAL & PHARMACY PLAN CONTRIBUTIONS

NO CHANGE FROM 2019!!

Weekly Hours

Total Premium

Cost/Month

EmployerCost/Month

EmployeeCost/Month

EmployeeCost Per 20 pay period

EmployeeCost Per 26 pay period

SINGLE

30+25-2920-2415-1910-14

$740.44

$629.37$614.57$496.09$370.22$244.35

$111.07$125.87$244.35$370.22$496.09

$66.64$75.52

$146.61$222.13$297.66

$51.26$58.09

$112.78$170.87$228.96

FAMILY

30+25-2920-2415-1910-14

$1,874.15

$1,593.03$1,555.54$1,255.68$937.08$618.47

$281.12$318.61$618.47$937.08

$1,255.68

$168.67$191.16$371.08$562.25$753.41

$129.75$147.05$285.45$432.50$579.54

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HEALTH SAVINGS ACCOUNT

A health savings account or HSA is an individually-owned account used to save and

pay for eligible medical expenses. Any individual who:

Is NOT covered by any first dollar health coverage

Is NOT enrolled in Medicare

Is NOT claimed as a dependent on someone else’s tax return

Two banking options available :

Who is eligible for an HSA?

AVIDIA WRIGHT-PATT CREDIT

Online only On location services

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HEALTH SAVINGS ACCOUNT

An HSA works with your HDHP The HDHP covers illness or injury after your annual deductible is met,

and certain preventive care services at no cost.

Funds in your HSA can pay for eligible medical expenses (defined by the IRS), before AND after your annual insurance deductible is met.

Funds roll over year to year and earn interest tax free.

Visit flexbank.net for a complete list of eligible expenses

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HEALTH SAVINGS ACCOUNT – FLEXBANK Employees must open an account through FlexBank in order to receive funding into the HSA from Dayton

Board. If you opt for the Wright-Patt account, you will need to submit your paperwork to FlexBank by 12/6/19 or you will be defaulted into an Avidia.

Contributions from Dayton Board into the HSA will be based upon enrollment status for actively working employees as of January 1, 2020.

Dayton Board Contributions will be allocated in January: $750 Single/$1,500 Family

Employee contributions can change on a monthly basis.

Employees who are not eligible to contribute to an HSA will receive the Dayton Board Contribution via a HRA (Health Reimbursement Account).

2020 HSA Contribution Limits: Single: $3,550 $50Family: $7,100 $100

Catch up Contribution: $1,000 No change(age 55 or older)

Maximum contribution limits include Dayton Board Contributions

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FLEXIBLE SPENDING ACCOUNT – FLEXBANK

Healthcare Flexible Spending Account (FSA): Not contributing to an HSA Tax Free General Purpose FSA: Medical, Vision, Dental, and Hearing Expenses Maximum election = $2,700 Can withdraw entire annual election at anytime regardless of year to date deposits Use it or lose it!

Limited Purpose Flexible Spending Account: Can use if contributing to HSA Dental and vision expenses only Maximum election = $2,700

Work-Related Dependent Care Reimbursement Maximum contribution $5,000 if married/filing jointly or single $2,500 if married/filing separately Can withdraw up to what has been deposited to date….

more like a regular bank account, but tax-free

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ANTHEM BENEFITS OF REGISTERING ONLINE

Blue Access (PPO) Network – anthem.com

Sydney Health

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ANTHEM – MEET SYDNEY

Your personal health ally, offering the same great services as Anthem Anywhere, plus new features like custom content, personalized wellness activities and more. Access Sydney using your online login info, or simply download the app and log in with your Anthem Anywhere username and password.

WHERE TO GET CARE Care Provider Wait & Average Cost When to Go

Board-Certified Doctors10 minutes

$59

• Minor allergic reactions• Minor headaches • Nausea or diarrhea • Cough, cold, or sore throat • Sinus pain or fever • Eye or ear pain/irritation

Physician 30 minutes

$72

• Allergic reactions • Cough, cold, & sore throat • Eye/ear pain• Certain Shots • Minor burns

Family practice Doctors30 minutes

$124

Same as retail clinic & telemedicine plus –• Asthma• Back pain• Preventive visit

Doctors who treat conditions that need immediate attention, but

are not life threatening

30 minutes$143

Same as PCP plus –• Animal bites• Sprains• Stitches• X-rays

Doctors trained in emergency medicine

4 hours$1,500

• Symptoms that feel life threatening or disabling

• Chest pain/severe shortness of breath • Major injury or broken bones• Coughing or vomiting blood • Sudden loss of consciousness

PRIMARY

CARE

PHYSICIAN

TELEMEDICINE

(LiveHealth Online)

RETAIL-BASED

CLINICS

URGENT

CARE

EMERGENCY

ROOM

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ANTHEM – TALK TO A DOCTOR NOWLiveHealth Online

24/7 healthcare when you need it $59 or less per consultant $10 co-pay after deductible ePrescribing to your local pharmacy Integrated with Anthem’s claims

system

LiveHealth Online Psychology

Online non-prescribing licensed psychologist or therapist when you need it

$80 – Social Worker / Therapist$95 – Psychologist$10 co-pay after deductible Available 7am to 11pm 7 days a week Visits last up to 45 minutes Integrated with Anthem’s claims system

Types of Conditions Treated:• Cough• Cold• Flu• Allergies• Suspected Sinus Infection• Pinkeye• etc.

Covers ALL Dependents & Spouses

www.livehealthonline.comCan also download the LiveHealth Online from the app store for your smartphones and iPads.

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Health Management & Engagement

Wellvibe is a health engagement portal designed to

help administer your 2020 Wellness Program

Program is available to all employees enrolled in the medical / Rx plan.

It is VERY easy for you to receive your incentive for 2020! Here is how : Visit your physician for an annual physical

between January 1, 2020 and December 31, 2020.

Create or login into your Wellvibe account You will receive a $75 gift card via the Wellvibe

portal.

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DENTAL PLAN HIGHLIGHTS –SUPERIOR DENTAL CARE

NO CHANGES TO PLAN DESIGN IN NETWORK OUT OF NETWORK

Preventive Services 100% 100%

Basic Services 80% 80%

Major Services 50% 50%

Contract Maximum (per member per contract period) $1,500

DEDUCTIBLE(applies to Basic and Major services and follows the contract period)

$25 Single$75 Family

Copayment(applies to preventive exams) N/A

Orthodontics 50% 50%

Ortho Lifetime Maximum $5,000

Network Access Open Access – same level of coverage in & out of network

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DentalWeekly Hours

Employee Cost Per 20 Pays


Single

30+25-2920-2415-1910-14

$1.39$2.37$4.59$6.96$9.32

$1.07$1.82$3.53$5.35$7.17

Family

30+25-2920-2415-1910-14

$4.40$7.48

$14.53$22.01$22.49

$3.39$5.76

$11.17$16.93$22.69

DENTAL PLAN CONTRIBUTIONS –SUPERIOR DENTAL CARE

NO CHANGES

TO RATES

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VOLUNTARY ACCIDENT / CRITICAL ILLNESS & HOSPITAL INDEMNITY

AFLAC

SUPPLEMENTAL LIFE / AD&D VOYA

UNIVERSAL LIFE WITH LTC TRUSTMARK

OTHER PLANS OFFERED DURING OE

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WHAT IS CHANGING

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VISION PLAN CONTRIBUTIONS – ANTHEM

WHAT IS CHANGING Changing carriers :

EyeMed Anthem Rates are DECREASING

VisionWeekly Hours



Single

30+25-2920-2415-1910-14

$0.31$0.53$1.02$1.55$2.07

$0.24$0.41$0.78$1.19$1.60

Family

30+25-2920-2415-1910-14

$0.79$1.34$2.60$3.94$5.28

$0.60$1.03$2.00$3.03$4.06

NETWORK Same Insight Network

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VISION PLAN HIGHLIGHTS – ANTHEM

IN NETWORK OUT OF NETWORK REIMBURSEMENT UP TO:

EXAM (with dilation as necessary)

$10 Copay $40

FRAMES (any available frame at provider location)

$0 Copay $150 allowance

20% off over $150 $105

CONTACT LENSES(allowance includes materials only)

Conventional DisposableMedically Necessary

$0 Copay | $150 allowance | 15%$0 Copay | $150 allowance | 15%

$0 Copay | paid in full

$120$120$210

STANDARD PLASTIC LENSES Single VisionBifocalTrifocalLenticularStandard ProgressivePremium Progressive Tier 1 Premium Progressive Tier 2Premium Progressive Tier 3

$25$25$25$25$65$85$95

$110

$30$50$70$70$0$0$0$0

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EDUCATOR VOLUNTARY DISABILITY - VOYA

WHAT IS CHANGING Changing carriers | SunLife Voya Rates are DECREASING

SHORT TERM DISABILITY $0.835 per $10 of weekly benefit

LONG TERM DISABILITY $1.68 per $100 of covered benefit

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GOOD, SMART PEOPLE EFFECTIVELY MANAGING

THE ENTIRE HEALTH CARE DOLLAR.

EMPLOYEE MEETINGAPRIL 22, 2016WHAT IS NEW

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EMPLOYEE ASSISTANCE PROGRAM (EAP)

Helps with life’s challenges, including personal, legal, financial and dependent care at NO COST to you!

Available 24/7 by phone or website

Confidential access to customer care specialists and licensed clinicians

Up to 5 face to face visits or video consultations per household member per issue

EAP Member Center available to locate EAP providers and access valuable information

All employees will receive an introductory brochure with a wallet card

More information coming soon!

NEW

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WRAPPING UP

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Sign up by providing RetireMEDiQ with your email address:

www.retiremediq.com/daytonschools

Once you finish this step, you will receive a welcome email. You can complete your online profile by selecting topics of interest, as well as customize how often you’d like communications delivered to your inbox.

You can also call RetireMEDiQ and speak with a licensed benefit advisor 1-866-600-4266

http://www.retiremediq.com/stay-informed

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MCGOHAN BRABENDER ADVOCATE TEAM

At MB, advocacy is more than a department – it’s the foundation of our organization. Our

Knowledgeable problem-solvers are passionately

committed to finding the right solution for every client, every time.

HOW IT WORKS :

If you have contacted your physician or carrier and do were not satisfied with the response, our MB

Advocates team are there to step in on your behalf! We have direct access to senior-level

representatives at our carrier partners. We know how to get to the bottom of issues like :

• Explanation of Benefits (EOB)• Provider Billing Questions• Coordination of Benefits• Pre-Authorization help• Enrollment Status

CONTACT USMonday-Friday 8 a.m. to 5 p.m.P: 937-260-4300 or 877-635-5372F: 937-499-1160E: [email protected]

Have all your paperwork ready

for speedier solutions!

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LET’S REVIEW …

OPEN ENROLLMENT : OCTOBER 21ST – NOVEMBER 1ST

EBC : MAKE APPOINTMENT IN PERSON / CALL / SELF SERVE ONLINE

REVIEW YOUR BENEFIT OPTIONS

DEPENDENT AUDIT

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2

3

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5 QUESTIONS??

TAKE ACTION

Respond quickly!

Documents

EMPLOYEE MEETING OPEN ENROLLMENT APRIL 22, 2016 · Your personal health ally, offering the same great services as Anthem Anywhere, plus new features like custom content, personalized