Raytown School District Open Enrollment 2010-2011

Raytown School DistrictOpen Enrollment 2010-2011

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Health Benefits Dental Benefits Vision Benefits Basic Life (must designate beneficiary) Flex Spending/Cafeteria 125 Benefits (Active Employees Includes Individuals

Retiring 2010) Retirees prior to 2010 will be provided

Enrollment Packet via United States Mail Retirees or Individuals on Cobra are not

to complete the electronic version for Open Enrollment.

If you have not received your packet by April 23, please contact Benefits Office/Payroll Office, (816) 268-7066

All Active Employees Must Enroll or Waive

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ALL EMPLOYEES MUST COMPLETE ONLINE ENROLLMENT EVEN IF WAIVING COVERAGE,

RETIREES MUST COMPLETE PAPER ENROLLMENT FORMS,

ALL ENROLLMENTS MUST BE COMPLETED BY MAY 9TH.

New Medical Insurance Carrier

BlueCross BlueShield of Kansas City

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Welcome to Blue Cross and Blue Shield of Kansas City!

Welcome to your new Blue Cross and Blue Shield health benefit program!

Your new coverage will be effective July 1, 2010. Please be sure to show your new Blue Cross ID card for services received on or after July 1, 2010.

You should receive your Blue Cross ID card towards the end of June. Each enrolled family member will receive their own ID card. Your SSN is not used as an identifying number on the ID card.

Show your BCBSKC ID card to your provider and at the pharmacy each time you receive services on or after July 1, 2010.

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Before We Get Started….

Health Care ReformWhat’s covered now? And what’s covered in the future?– The health care reform bill that passed is very complex, and full

of moving parts, however, some elements have become clearer. In the next several months, some changes will occur, and we will be ready to make these changes for plan years after September 23, 2010. In the meantime – your Blue Cross plans are consistent and secure and you will receive exceptional service.

– BlueKC.com will provide current information and Frequently Asked Questions

Pre-Existing Waiting Period– Pre-Existing Waiting Period will not apply:– Members currently enrolled in Humana– Members currently enrolled in another Group Health Plan

Deductible Credit– You will receive credit for the Deductible/OOP Maximum

expenses you have incurred on your Humana plan from January 1st, 2010 through June 30th, 2010.

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2010 Medical Plans

• PPO Health PlansPreferred-Care Blue – PPO (Preferred Provider

Organization)

• No selection of PCP (Primary Care Physician)

- No referrals to Specialists• In and Out of Network Coverage

– Pay lower out of pocket expenses by using network Providers

• National and International Coverage• Three PPO Plan Options

• $2,000 Deductible Base Plan• $1,000 Deductible Buy-Up Plan• $500 Deductible Buy-Up Plan

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Medical Premiums Effective July 1, 2010

* RATES EFFECTIVE 07/01/2010 BEGINNING WITH JUNE, 2010 PAYCHECK

TOTAL COST EMPLOYEE WORKS: EMPLOYEE WORKS: EMPLOYEE WORKS: EMPLOYEE WORKS:$2,000 30 HRS OR MORE 20 HRS & UNDER 30 15 HRS & UNDER 20 10 HRS & UNDER 15

Base Plan DISTRICT EMPLOYEE DISTRICT EMPLOYEE DISTRICT EMPLOYEE DISTRICT EMPLOYEE DEDUCTION CODE PAYS PAYS PAYS PAYS PAYS PAYS PAYS PAYS

EMPLOYEE ONLY $ 316.42 $ 306.70 $ 9.72 $ 205.49 $ 110.93 $ 153.35 $ 163.07 $ 101.21 $ 215.21 EMPLOYEE / SPOUSE $ 727.73 $ 306.70 $ 421.03 $ 205.49 $ 522.24 $ 153.35 $ 574.38 $ 101.21 $ 626.52 EMPLOYEE / CHILDREN $ 591.68 $ 306.70 $ 284.98 $ 205.49 $ 386.19 $ 153.35 $ 438.33 $ 101.21 $ 490.47 FAMILY $ 996.65 $ 306.70 $ 689.95 $ 205.49 $ 791.16 $ 153.35 $ 843.30 $ 101.21 $ 895.44

EMPLOYEE WORKS: EMPLOYEE WORKS: EMPLOYEE WORKS: EMPLOYEE WORKS:$1,000 30 HRS OR MORE 20 HRS & UNDER 30 15 HRS & UNDER 20 10 HRS & UNDER 15

Buy Up Plan DISTRICT EMPLOYEE DISTRICT EMPLOYEE DISTRICT EMPLOYEE DISTRICT EMPLOYEE DEDUCTION CODE PAYS PAYS PAYS PAYS PAYS PAYS PAYS PAYS

EMPLOYEE ONLY $ 340.48 $ 306.70 $ 33.78 $ 205.49 $ 134.99 $ 153.35 $ 187.13 $ 101.21 $ 239.27 EMPLOYEE / SPOUSE $ 783.07 $ 306.70 $ 476.37 $ 205.49 $ 577.58 $ 153.35 $ 629.72 $ 101.21 $ 681.86 EMPLOYEE / CHILDREN $ 636.68 $ 306.70 $ 329.98 $ 205.49 $ 431.19 $ 153.35 $ 483.33 $ 101.21 $ 535.47 FAMILY $ 1,072.44 $ 306.70 $ 765.74 $ 205.49 $ 866.95 $ 153.35 $ 919.09 $ 101.21 $ 971.23

EMPLOYEE WORKS: EMPLOYEE WORKS: EMPLOYEE WORKS: EMPLOYEE WORKS:$500 30 HRS OR MORE 20 HRS & UNDER 30 15 HRS & UNDER 20 10 HRS & UNDER 15

Buy Up Plan DISTRICT EMPLOYEE DISTRICT EMPLOYEE DISTRICT EMPLOYEE DISTRICT EMPLOYEE DEDUCTION CODE PAYS PAYS PAYS PAYS PAYS PAYS PAYS PAYS

EMPLOYEE ONLY $ 363.50 $ 306.70 $ 56.80 $ 205.49 $ 158.01 $ 153.35 $ 210.15 $ 101.21 $ 262.29 EMPLOYEE / SPOUSE $ 836.00 $ 306.70 $ 529.30 $ 205.49 $ 630.51 $ 153.35 $ 682.65 $ 101.21 $ 734.79 EMPLOYEE / CHILDREN $ 679.71 $ 306.70 $ 373.01 $ 205.49 $ 474.22 $ 153.35 $ 526.36 $ 101.21 $ 578.50 FAMILY $ 1,144.94 $ 306.70 $ 838.24 $ 205.49 $ 939.45 $ 153.35 $ 991.59 $ 101.21 $1,043.73

NOTE TO COBRA PARTICIPANTS:

YOU WILL PAY THE MONTHLY AMOUNT LISTED IN THE "TOTAL COST" COLUMN

PLUS AN ADDITIONAL 2% OF YOUR HEALTH PREMIUM ADMINISTRATION FEE

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Preferred-Care Blue PPO

Visit www.BlueKC.com for a complete list of Providers

53 Hospitals, 4,858 Physicians

Centerpoint Medical CenterChildren’s MercyKU HospitalLee’s Summit HospitalMenorah Medical CenterNorth Kansas City Hospital

Olathe Medical CenterOverland Park RegionalResearch HospitalsSaint Luke’s HospitalsShawnee Mission Medical Center

(Liberty, St. Joseph, St. Mary’s and Truman Hospitals are not in the Preferred-Care Blue Network)

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Travel with Your PPO Health Plans

As a Blue Cross Blue Shield Member, you can take your

healthcare benefits with you across the country and around the

world.

The BlueCard PPO Program gives you access to over 6,000 hospitals and

800,000 physicians around the country, giving you the peace of mind

that you can take charge of your health, wherever you are.

Visit our website at www.BlueKC.com click BlueCard Provider Directory, click Continue. Login using the ID

number on the front of your BCBSKC ID Card.

or call (800) 810-BLUE (2583) to receive a complete list of network of hospitals and physicians.

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Preferred-Care Blue PPO$2,000 Deductible Base Plan

In-Network Out-of-Network

Deductible: The portion the covered person must pay each calendar year before BCBSKC will provide benefits.

Individual Deductible

Family Deductible

$2,000

$6,000

$2,750

$8,250

Coinsurance: Portion of covered charges paid by BCBSKC after you satisfy your deductible.

Coinsurance Member pays: 10%

BCBSKC pays: 90%

Member pays: 30%

BCBSKC pays: 70%

Out-of-Pocket Maximum


Individual Maximum

Family Maximum

$3,000

$9,000

$6,000

$18,000

Out-of Pocket Maximum: Total of deductible and coinsurance that members pay each calendar year toward covered services before BCBSKC pays 100%.

Emergency Services received in a network facility – Copay + Network Deductible and Network Coinsurance.

Emergency Services received in a non-network facility – Copay + Non-network Deductible and Non-network Coinsurance.

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Preferred-Care Blue PPO$1,000 Deductible Buy-Up Plan




Family Deductible

$1,000

$3,000

$1,250

$3,750



BCBSKC pays: 90%

Member pays: 40%

BCBSKC pays: 60%

Out-of-Pocket Maximum In-Network Out-of-Network

Individual Maximum

Family Maximum

$4,000

$12,000

$12,000

$24,000



Emergency Services received in a non-network facility – Copay+ Non-network Deductible and Non-network Coinsurance.

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Preferred-Care Blue PPO$500 Deductible Buy-Up Plan




Family Deductible

$500

$1,500

$750

$2,250



BCBSKC pays: 80%

Member pays: 40%

BCBSKC pays: 60%

Out-of-Pocket Maximum In-Network Out-of-Network

Individual Maximum

Family Maximum

$3,500

$10,500

$7,000

$21,000



Emergency Services received in a non-network facility – Copay + Non-network Deductible and Non-network Coinsurance.

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Deductible and Out-of-Pocket Maximum Credit

Deductible Credit

You will receive credit for the Deductible/OOP Maximum expenses you incur from January 1st,

2010 through June 30th , 2010.

January 1 , 2011 – December 31, 2011

The full Deductible and Out-of-Pocket Maximum will apply January 1, 2011.

If you have satisfied all or a portion of your Deductible with Humana, you will receive credit for the Deductible with BCBSKC.

If you have satisfied all or a portion of your OOP Maximum with Humana, you will receive credit for the OOP Maximum with BCBSKC.

If you receive your EOB after July 1, 2010 and if you have any BCBSKC claims – we will reprocess your claim to give you credit for the deductible/out-of-pocket maximum on your BCBSKC plan.

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Preferred-Care Blue PPO

Lab services performed in a Hospital or Outpatient setting and all Radiology Services subject to Coinsurance

$2,000 Base Plan

$1,000 Buy-Up Plan

$500 Buy-Up Plan

Physicians Office Visits

PCP (Internal Medicine, General Practitioner, Family Practitioner, Pediatrician)

Specialists (Allergists, OB/Gyn, ENT)

$25* copay

$50* copay

$20* copay

$40* copay

$25* copay

$50* copay

*Office Visit Copay includes Office Charge and Lab services in Physician’s office, or Independent Lab

Consistent with your previous plans, copays do not apply to deductible or OOP Max

Chiropractic Care Applicable Specialist Copay

(Includes office visit, lab and x-ray)

Skeletal manipulations are subject to deductible and coinsurance

Urgent Care

(includes CVS Minute Clinics; Walgreen’s Take-Care Centers)

$50* copay $40* Copay $50* copay

Emergency Services

(Copay waived if admitted to a network hospital)

$100 copay then Deductible then Coinsurance

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Routine Preventive Care

Mandated Routine Services

Paid at 100%

PSA Tests

Pelvic Exams and Pap Smears

Mammograms

Childhood Immunizations

Lead Testing

Colorectal Cancer Exams

Newborn Hearing Screening

Other Covered Routine Services

Paid at 100%

$50O Calendar Year Maximum (applies to network and non-network services)

Physician Examinations

CBC Metabolic Screening

Urinalysis

Glucose Screening

Thyroid Stimulating Hormone Screening

Lipid Cholesterol Panel

HIV Screening

HPV Screening

Chest X-ray

EKGVision Care

(Applicable Office Visit Copay)

One routine eye exam per calendar year

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Prescription DrugsRetail and Mail-Order

Frequently Used Pharmacies Include:

Costco, CVS, Hen House, Hy-Vee, K-Mart, Price Chopper, Sam’s Club, Sun Fresh,

Target, Walgreen’s, Wal-Mart

Retail (up to a 34-day supply)

Tier 1 $10 copay

Tier 2 $25 copay

Tier 3 $50 copay

Express Scripts - Mail Order Prescription Program

Long Term Maintenance Drugs

Mail-Order (up to a 102-day supply)

Tier 1 $30 copay

Tier 2 $75 copay

Tier 3 $150 copay

To get started on EXPRESS

SCRIPTS

get a NEW Prescription from your Doctor!

Consistent with your previous

plans, Rx Copays DO NOT go

towards Deductible or Out-

of-Pocket Maximum

Please see Benefits/Payroll for Rx

Prior Authorization Forms

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Prescription Drug CoverageGenerics First Program

For some medication classes, multiple generic medication alternatives now exist. Members will be required to try a generic medication before initiating therapy with a brand name medication. This will apply to the following medication classes:• NSAIDs: (Anti-Inflammatory medications for Arthritis and

pain)• Calcium Channel Blockers: (CCB for hypertension)• ACE Inhibitors/ARBs: (Medications for hypertension) • Statins: (Medications for cholesterol) • SSRIs/NDRIs: (Medications for Depression) • Nasal Steroids: (Medications for Allergies)• Sedative Hypnotics: (Medications for Sleep)• Proton Pump Inhibitors (PPIs): (Medications for

gastroesophageal reflux disease [GERD] or stomach acid)The Generics First Program will be implemented 90 days after July 1, 2010. Any member currently taking a Name Brand drug can continue. Any new prescription request after the 90-day waiting period will be subject to the Generics First Program.

Generics First Program is Effective 10/1/10

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Key Differences (In-Network Services)

*Copays do not apply to deductible or OOP maximum

$2,000 Base Plan $1,000 Buy-Up Plan $500 Buy-Up Plan

Annual Deductible

$2,000 individual

$6,000 family

$1,000 individual

$3,000 family

$500 individual

$1,500 family

Network Coinsurance

Member pays: 10%

BCBSKC pays: 90%

Member pays: 10%

BCBSKC pays: 90%

Member pays: 20%

BCBSKC pays: 80%

Out-of –Pocket Maximum

$3,000 individual /

$9,000 family

(Includes Deductible + Coinsurance)

$4,000 individual /

$12,000 family


$3,500 individual /

$10,500 family


Office Visits $25 PCP copay*

$50 Specialist copay*

$20 PCP copay*


$25 PCP copay*


Chiropractic

Services

$50 copay*

Deductible + Coinsurance

$40 copay*


$50 copay*


Routine Care

$25 PCP copay*


$20 PCP copay*


$25 PCP copay*


Urgent Care

$50 copay*

(office visit/lab only)

$40 copay*


$50 copay*


Emergency Care

$100 copay* then deductible then

coinsurance


coinsurance


coinsurance

Prescription Drugs

$10/$25/$50*

$30/$75/$150*

$10/$25/$50*

$30/$75/$150*

$10/$25/$50*

$30/$75/$150*

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General Information

Transition of CareIf you or a covered dependent is under the care of a physician that is NOT a BCBSKC provider for a continuing medical condition, we can provide assistance in your transition to network providers.

Pregnancy in third trimesterCurrent confinement in hospital or

treatment facilityScheduled surgery Ongoing treatment of illness

Please see Benefits/Payroll for Transition of Care Assistance Forms or Rx Prior

Authorization Forms

Each transition of care is evaluated on a case by case basis.

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Finding a Provider is Easy…. Kansas City Metro Area

www.BlueKC.comFind Blue KC Doctors, Hospitals,

PharmaciesSELECT A PROVIDER

DIRECTORYLocal BlueKC Provider

DirectoryMY INSURANCE PLAN

Select Your PlanPreferred-Care Blue

NetworkSELECT A PROVIDER TYPEo Doctorso Hospitalso Pharmacies, Facilities, Labso Dentalo Urgent Care and Retail Health

Centerso Mental Healtho Other ProvidersClick CONTINUE

All Other Areas www.BlueKC.com

Find Blue KC Doctors, Hospitals, Pharmacies

SELECT A PROVIDER DIRECTORYBlueCard Provider

DirectoryCONTINUE

Select Guest TabChoose Product

PPO/EPOFIND PROVIDERS

o Physicianso Hospitals

o Behavioral Healtho All Types

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Enrollment Process For Medical, Dental, Vision and Life

On-line Enrollment must be completed by 11:59 p.m. on

Sunday, May 9, 2010

Your BluesEnroll Account will be active Monday, April 26th 2010.

On the Internet, go to www.bluesenroll.com

Login ID is (your first name) (First initial of your last name) (last four digits of your SSN) ValerieS0570

Password is your nine-digit SSN without spaces or dashes

You will be asked to change your password

Call BluesEnroll toll free help line at 877-336-8083 Monday through Friday, 8:00 AM to 5:00 PM CST

http://www.bluesenroll.com/

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BluesEnroll On-Line Instructions

Complete step-by-step on-line instructions are available on the district’s intranet and web site.

www.raytownschools.org

http://www.raytownschools.org/

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AFTER BENEFIT “Open” ENROLLMENT MAY 9TH

NO CHANGES WILL BE ALLOWED

UNLESS YOU HAVE A “QUALIFYING EVENT” IN YOUR LIFE AS DEFINED BY INSURANCE

REGULATIONS.

QUALIFYING EVENT CATEGORIES:

CHANGE IN MARITAL STATUS

CHANGE IN NUMBER OF DEPENDENTS

CHANGE IN EMPLOYMENT STATUS

CHANGE IN ELIGIBILITY STATUS

New Voluntary Dental Carrier

Assurant Employee Benefits

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Dental Insurance

Premiums are 100% Employee Paid

3 Plans Offered– Prepayment Plan– Freedom Basic Low PPO Plan– Freedom Preferred High PPO Plan

Freedom Preferred High PPO increase in benefits from 80% to 100% for Type II In-Network Services

If you are currently enrolled in the Humana dental plans, there are no waiting periods for services in the Assurant plans

You must re-enroll or you will lose coverage

To locate a provider: www.assurantemployeebenefits.com

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Voluntary Dental Benefit Summary

General Plan Information

Assurant PrePaid Plan

Assurant Freedom Basic PPO (Low Plan)

Assurant Freedom Preferred PPO (High

Plan)

Annual Deductible/Individual

N/A $50 $50

Annual Deductible/Family

N/A$50 each family

member$50 each family

member

Waived for Preventive N/A Yes YesWaiting Period for Major Services

N/A N/A 6-12 months

Annual Plan Maximum N/A $1,250 $1,250

Out-of-Network Benefits

Available Available Available

Lifetime Orthodontia Plan Maximum

N/A N/A N/A

Covered Services

Preventive Procedures (In-Network)

$10 office visit copay plus fee schedule

100% 100%

Basic Services (In-Network)


100% 100%

Major Services (In-Network)


N/A 50%

Orthodontia Services

Dependent Children N/A N/A N/A

Adults N/A N/A N/A

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Dental Insurance Premiums

Assurant PrePaid Plan

Assurant Freedom

Basic PPO (Low Plan)

Assurant Freedom

Preferred PPO (High Plan)

Employee: $13.22 $15.09 $28.82Employee + 1:

$25.80 $28.50 $56.15

Family: $41.30 $51.21 $83.55

Voluntary Vision Insurance Plan

Vision Service Plan (VSP)

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Using Your VSP Plan

Locate a VSP Preferred Provider–www.vsp.com or 1-800-877-7195

Call and make an appointment

Say you have VSP–Provider will handle the rest

Important- no i.d. cards nor prior authorizations

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VSP Preferred Provider Network

40,000 National Access Points

334 Access Points in Greater KC Area

All have dispensaries on site

88% of VSP locations offer extended hours

Medical/Office Complex Retail Settings Neighborhood Offices

41% or 7,800 locations



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Vision Insurance

Premiums are 100% employee paid

Provides both in and out-of-network coverage

$10 copay for exams

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VSP Signature Plan

Frequency–12 months on Exam–12 months on Lenses–24 months on Frame–12 months on Contact Lenses (in lieu of glasses-lenses and frame)

Copays–$10 copay on exam–$25 copay on glasses

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VSP Preferred Provider Coverage

Exam covered after $10 copay

Lenses covered after $25 copay–Single Vision, Lined Bifocal, Lined Trifocal,

Lenticular lenses. –Polycarbonate lenses for dependent

children

Frame: $130 allowance toward any frame, 20% discount on any overage costs

Non-covered lens options: Cost controlled discounts on all non-covered lens options (i.e. progressives, anti-reflective coating, scratch resistant coating, etc.). Avg. savings 35 to 40%.

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Contact Lenses (in lieu of glasses)–$130.00 allowance towards fitting

evaluation and materials.–VSP offers a contact lens care

program through its providers for additional savings.

Additional VSP Discounts–30% discount off additional pairs of

prescription glasses or non-prescription sunglasses if purchased on same day as exam. Otherwise 20% discount.

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Laser Corrective Surgery Discounts–Avg. Savings 15 to 20%–Should VSP contracted surgery center

offers a promotional price to public, VSP members receive 5% off the promotional price.

–Members who are interested please visit vsp.com or contact VSP at 1-800-877-7195.

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Non-Preferred Provider Coverage

Member responsible for payment of services to a non-preferred provider.

Remit itemized paid receipt to VSP within six months from date of service.

Reimbursed the below allowances (copays do apply)–Exam- Up to $45–Single Lenses- Up to $45–Bifocals- Up to $65–Trifocals- Up to $85–Frame- Up to $47–Contact Lenses- Up to $105

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Voluntary Vision Rates

Rates

Employee $8.48

Employee+ One $16.96

Employee + Children $18.14

Family $29.00

New Basic Life Insurance Carrier

US Able

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District Sponsored Basic Life Insurance

No benefit changes–Benefit level based upon hours worked

Must designate a new beneficiary using the BluesEnroll system

Flexible Spending Account / Dependent Care Account

Tri-Star Systems

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Flexible Spending Accounts Program Highlights

A great way to plan ahead and save money over the course of the year is to participate in the Flexible Spending Account (FSA) program. These accounts allow you to redirect a portion of your salary on a pre-tax basis into reimbursement accounts. Money from these accounts is then used to pay medical expenses, which are not covered by your medical plan.

Services provided by Tri-Star Systems.

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Flexible Spending Accounts Program Highlights Two ways to maximize your pre-tax savings:

– Health Care Reimbursement Account:This account reimburses you for eligible health care

expenses not covered by insurance. The maximum amount you can contribute to this account is $2,400.

– Dependent Care Reimbursement Account:Through regular payroll deductions, you can set

aside part of your income to pay for daycare expenses for eligible children and adults. Qualified expenses for reimbursement include adult and child daycare centers, preschools and before/after school care.

Employees can make up to $5,000 ($2,500 for married couples filing separately) a year in pre-tax contributions to a dependent care FSA

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Flexible Spending Accounts Program Highlights

Important rules:–You are responsible for filing claims for

reimbursement.–Carefully review your estimated expenses,

as any funds remaining in the account at the end of the year are forfeited.

–The money you contribute to each account for the plan year can only be used for eligible expenses you incur during the year.

–You must enroll or waive for the 2010 plan year via the Tri-Star Systems web site.

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MANDATORY

ONLINE OPEN ENROLLMENT

Enrollment website:

www.ezenroll.com

Click on the action button

Tri-Star Systems On-Line Enrollment Process

http://www.ezenroll.com/

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To Login you will need your social security number AND the Open Enrollment letter from Tri-Star that provided you with your password. This is a secure site.

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You must click on “I Agree” to continue the Open Enrollment process.

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Tri-Star Systems On-Line Enrollment

Complete Tri-Star step-by-step instructions are available on the district’s intranet and web site.

www.raytownschools.org

http://www.raytownschools.org/

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BluesEnroll, printed confirmation of enrollment in the following:–Blue Cross and Blue Shield of Kansas City

Health Insurance–Assurant Dental Insurance–VSP Vision Care–US Able Life Insurance Beneficiary

Designation

Tri-Star Systems Flexible Spending (FSA)–Printed confirmation of enrolled or waived

Keep for your Records the Above Documents

Completed Enrollment?

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Our Mission

To be the worldwide value and service leader in insurance brokerage, employee benefits, and risk management services

Our Goal

To be the best place to do business and to work

www.lockton.com

© 2010 Lockton, Inc. All rights reserved.Images in this publication © 2010 Jupiterimages Corporation