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  • 2017-2018

    INSURANCE & BENEFITS INFORMATION GUIDE

    The School Board of Nassau County, Florida

    1201 Atlantic Avenue

    Fernandina Beach, Florida 32034

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    DISCLAIMER

    This Insurance & Benefits Information Guide is intended to serve as a guide to the benefits available to employees of the Nassau County School Board. For a complete description of benefits and exclusions, employees are encouraged to examine the materials provided by each insurance company. Employees are responsible for confirming provider participation before receiving treatment or services as some plans bear zero liability if an out-of-network provider is utilized.

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    2017-2018 INSURANCE & BENEFITS INFORMATION GUIDE TABLE OF CONTENTS

    Introduction .................................................................................................................................... 5

    Personnel Department’s Website .................................................................................................. 5

    School Board Contributions ........................................................................................................... 5

    Hospital Benefit Without Group Health Insurance ......................................................................... 5

    Employee Assistance Program (EAP) ........................................................................................... 6

    Trustmark Life Insurance ............................................................................................................... 6

    Florida KidCare .............................................................................................................................. 7

    Wellness Program ......................................................................................................................... 7

    Special Enrollment Notice ............................................................................................................. 7

    Patient Protection & Affordable Care Act (Health Care Reform) ................................................... 7

    Dependent Coverage .................................................................................................................... 8

    Florida Blue Group Health Coverage for Infants .............................................................. 8

    Definition of Eligible Dependents ..................................................................................... 8

    Florida Blue Age Limitations for Dependent Children ...................................................... 9

    Humana Age Limitations for Dependent Children ............................................................ 9

    Required Paperwork ......................................................................................................... 9

    Dependent Eligibility Audits .............................................................................................. 9

    Dependent Addresses ...................................................................................................... 9

    Florida Blue Group Health Insurance ............................................................................................ 9

    Overview ........................................................................................................................... 9

    Pre-Existing Condition Limitations .................................................................................... 9

    Provider Networks & Directories....................................................................................... 9

    Plan Year & Calendar Year .............................................................................................. 9

    Primary Coverage ............................................................................................................. 9

    Online Tools...................................................................................................................... 10

    HMO Primary Care Providers ........................................................................................... 10

    Florida Blue Centers ......................................................................................................... 10

    Blue365® Program ............................................................................................................ 10

    Digital Enrollment Tool .................................................................................................... 10

    Florida Blue Group Health Insurance – Prescription Coverage .................................................... 11

    Prescription Costs ............................................................................................................ 11

    Mail Order Pharmacy Benefits .......................................................................................... 11

    Diabetic Supplies .............................................................................................................. 11

    Medication Guide .............................................................................................................. 11

    Prior Coverage Authorization ........................................................................................... 11

    Responsible Quantity ....................................................................................................... 11

    Responsible Steps ............................................................................................................ 11

    Drugs That Are Not Covered ............................................................................................ 11

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    Prescription Discounts ...................................................................................................... 11

    2017-2018 Benefits Coverage Levels & Rates ............................................................. 12

    2017-2018 Benefit Summary .......................................................................................... 14

    Humana Dental Plan Options ........................................................................................................ 20

    Humana Vision Care Plan ............................................................................................................. 20

    Legal Shield .................................................................................................................................. 21

    AFLAC …………………………………………………………………………………………………… 22

    Section 125 Cafeteria Plan (AFLAC) ............................................................................................. 22

    Flexible Spending Accounts (FSAs) .............................................................................................. 22

    Health Savings Accounts (HSAs) .................................................................................................. 22

    AFLAC Plan Summaries and Rates .............................................................................................. 23

    Liberty National …………………………………………………………………………………………. 25

    Valery Insurance Agency ............................................................................................................... 26

    Employee Leaves ........................................................................................................................... 27

    Employee Rights & Responsibilities Under the Family and Medical Leave Act ........................... 27

    The Deferred Retirement Option Program (DROP) ...................................................................... 28

    Health Insurance Subsidy (HIS) .................................................................................................... 29

    Health Insurance Premium Assistance (CHIP) (Model Notice) ..................................................... 29

    U.S. Department of Labor: Health Insurance Marketplace (Model Notice) ................................... 30

    Women’s Health & Cancer Rights Act (Enrollment Notice) ........................................................... 32

    Women’s Health & Cancer Rights Act (Annual Notice) ................................................................. 32

    Model Newborns’ Act Disclosure ................................................................................................... 32

    Consolidated Omnibus Budget Reconciliation Act (COBRA) ........................................................ 33

    Personnel Department Contact Information .................................................................................. 35

    Benefits & Insurance Contact Information ..................................................................................... 36

    Tax Shelter Annuity Contact Information ....................................................................................... 37

    Nassau County School District Department & School Listings ..................................................... 38

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    INTRODUCTION

    Welcome to the 2017-2018 Insuranc