For Your &IRI¿X - Conroe ISD · 2019-07-31 · TRS-ActiveCare for similar benefits. The following...

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In this issue: Annual enrollment Changes for the 2016-17 plan year Preventive care Onsite mammograms CISD Wellness Center Live Healthy America summer challenges Aetna dental plans Life insurance options Summer smarts Conroe ISD summer hours The Benefits Office is here for you from June 6 through July 29, 2016 Monday through Thursday, 7:30 a.m. to 5:30 p.m. Closed on Friday Regular hours resume August 1, 2016 Monday through Friday, 8:00 a.m. to 4:30 p.m. Call us at 936-709-7808 or email us at [email protected] with any benefits-related questions. Reminder for family status changes and other qualified life events When certain life events occur (marriage, birth, etc.), you may make changes to your benefits that are related to the event. For example, you may add health insurance coverage for a new dependent. Be sure to contact the Conroe ISD Benefits Office no later than 30 calendar days after the event date to request a change; otherwise, you can only make changes during annual enrollment. Summer 2016 Get ready for annual enrollment Each year during annual enrollment, you have the opportunity to add or make changes to your benefits. Conroe ISD has an active enrollment period, so all employees are required to submit elections by July 31, 2016, for the new plan year that begins September 1, 2016. There are two ways to enroll: 1. Online: Enroll on your own from any computer with Internet access. Visit www.conroeisd.net and click “Employees.” Under “Employee Logins,” you will see the “Insurance Enrollment” link. 2. Onsite: First Financial Administrators, Inc. provides benefits counselors to help you make informed enrollment decisions and complete the enrollment process. You will be able to schedule an appointment or walk in to meet with a counselor. Location Date/Time Conroe High School Library July 5-28; Monday – Thursday, 7:30 a.m. to 5:30 p.m. The Woodlands College Park High School Library July 5-28; Monday – Thursday, 7:30 a.m. to 5:30 p.m. 2SX QEOMRK GLERKIW SV [EMZMRK FIRI¿XW# %GXMSR MW WXMPP VIUYMVIH If you are not making any changes or you are declining all coverage, you still need to submit your selection using the online enrollment system (see the enrollment instructions above). ;LEX·W RI[ JSV XLI TPER ]IEV# Conroe ISD works hard to offer outstanding, competitive benefits for you and your family. Rising medical and pharmacy costs continue to challenge the health care market, making it necessary to adjust our plan design and cost structure. Even with these changes, we are pleased to be able to maintain a self-funded health plan at rates below those charged by TRS-ActiveCare for similar benefits. The following changes will take effect September 1, 2016: Medical premiums will increase for all coverage tiers. See the next page for the chart displaying the current and new rates. The District contribution will also increase from $428 per month to $440 per month. A prescription deductible will be added to the medical plan, and prescription copays for brand and specialty medications will increase. The prescription deductible will be waived for generics. New drug exclusions will be implemented for medications for which a generic is available. If you have a current prescription for a medication on this list, Aetna will contact you separately by mail. Deductibles, office/specialist visit copays, and out-of-pocket maximums will increase for the Tier 2 (Aetna Select SM ) medical plan network. Spousal coverage: A new eligibility provision in the medical plan will make spouses ineligible if they have access to other medical coverage through their employer. Employees will need to provide information about their spouse’s eligibility for other medical plan coverage during the enrollment process in order to include them as a covered individual. The Dental Maintenance Organization (DMO®) premiums will increase slightly for all coverage tiers. The supplemental Humana critical illness plan is being replaced with an Aflac critical illness plan, which offers better benefits at lower costs. For Your &IRI¿X )QTPS]II &IRI¿XW 2I[WPIXXIV

Transcript of For Your &IRI¿X - Conroe ISD · 2019-07-31 · TRS-ActiveCare for similar benefits. The following...

Page 1: For Your &IRI¿X - Conroe ISD · 2019-07-31 · TRS-ActiveCare for similar benefits. The following changes will take effect September 1, 2016: Medical premiums will increase for all

In this issue: Annual enrollment Changes for the 2016-17 plan year Preventive care Onsite mammograms CISD Wellness Center Live Healthy America summer challenges

Aetna dental plans Life insurance options Summer smarts

Conroe ISD summer hoursThe Benefits Office is here for you from June 6 through July 29, 2016 Monday through Thursday, 7:30 a.m. to 5:30 p.m. Closed on Friday

Regular hours resume August 1, 2016 Monday through Friday, 8:00 a.m. to 4:30 p.m.

Call us at 936-709-7808 or email us at [email protected] with any benefits-related questions.

Reminder for family status changes and other qualified life eventsWhen certain life events occur (marriage, birth, etc.), you may make changes to your benefits that are related to the event. For example, you may add health insurance coverage for a new dependent. Be sure to contact the Conroe ISD Benefits Office no later than 30 calendar days after the event date to request a change; otherwise, you can only make changes during annual enrollment.

Summer 2016Get ready for annual enrollmentEach year during annual enrollment, you have the opportunity to add or make changes to your benefits. Conroe ISD has an active enrollment period, so all employees are required to submit elections by July 31, 2016, for the new plan year that begins September 1, 2016.

There are two ways to enroll:

1. Online: Enroll on your own from any computer with Internet access. Visit www.conroeisd.net and click “Employees.” Under “Employee Logins,” you will see the “Insurance Enrollment” link.

2. Onsite: First Financial Administrators, Inc. provides benefits counselors to help you make informed enrollment decisions and complete the enrollment process. You will be able to schedule an appointment or walk in to meet with a counselor.

Location Date/Time

Conroe High School Library July 5-28; Monday – Thursday, 7:30 a.m. to 5:30 p.m.

The Woodlands College Park High School Library July 5-28; Monday – Thursday, 7:30 a.m. to 5:30 p.m.

If you are not making any changes or you are declining all coverage, you still need to submit your selection using the online enrollment system (see the enrollment instructions above).

Conroe ISD works hard to offer outstanding, competitive benefits for you and your family. Rising medical and pharmacy costs continue to challenge the health care market, making it necessary to adjust our plan design and cost structure. Even with these changes, we are pleased to be able to maintain a self-funded health plan at rates below those charged by TRS-ActiveCare for similar benefits. The following changes will take effect September 1, 2016:

Medical premiums will increase for all coverage tiers. See the next page for the chart displaying the current and new rates. The District contribution will also increase from $428 per month to $440 per month.

A prescription deductible will be added to the medical plan, and prescription copays for brand and specialty medications will increase. The prescription deductible will be waived for generics.

New drug exclusions will be implemented for medications for which a generic is available. If you have a current prescription for a medication on this list, Aetna will contact you separately by mail.

Deductibles, office/specialist visit copays, and out-of-pocket maximums will increase for the Tier 2 (Aetna SelectSM) medical plan network.

Spousal coverage: A new eligibility provision in the medical plan will make spouses ineligible if they have access to other medical coverage through their employer. Employees will need to provide information about their spouse’s eligibility for other medical plan coverage during the enrollment process in order to include them as a covered individual.

The Dental Maintenance Organization (DMO®) premiums will increase slightly for all coverage tiers.

The supplemental Humana critical illness plan is being replaced with an Aflac critical illness plan, which offers better benefits at lower costs.

For Your

Page 2: For Your &IRI¿X - Conroe ISD · 2019-07-31 · TRS-ActiveCare for similar benefits. The following changes will take effect September 1, 2016: Medical premiums will increase for all

Women 35 years of age and older

Women who have not had a mammogram in the last 12 months

Women who have a documented referring physician willing to accept the results of the screening (Mammosafe)

Women who have a history of breast cancer – these women may be screened on the Mammosafe Mobile Coach if they have been in remission for at least five years, and they provide Mammosafe with at least two years of prior mammograms that were obtained after all treatment for breast cancer was completed

Women who are experiencing any breast symptoms or problems

Women who are pregnant or breastfeeding

Women who have been diagnosed with breast cancer in the last two years (The Rose)

Screenings are free for members of a Conroe ISD Aetna medical plan. Covia Health, Mammosafe, and The Rose all accept major medical plans. If you are not enrolled in a Conroe ISD medical plan, please contact your insurance carrier to find out how these services are covered.

Recommended Screenings and Vaccinations for men Ages 18 – 39 Ages 40 – 49 Ages 50+

Blood pressure, weight/body mass index (BMI) Yearly Yearly Yearly

Cholesterol Yearly Yearly Yearly

Colorectal screening N/A N/A Varies

Influenza Yearly Yearly Yearly

Tetanus, diphtheria and pertussis (Td/Tdap) Every 10 years Every 10 years Every 10 years

Recommended Screenings and Vaccinations for women Ages 18 – 34 Ages 35 – 49 Ages 50+

Blood pressure, weight/body mass index (BMI) Yearly Yearly Yearly

Cholesterol Yearly Yearly Yearly

Colorectal screening N/A N/A Varies

Cervical cancer screening (Pap test) Yearly Yearly Yearly

Mammogram N/A Yearly Yearly

Influenza Yearly Yearly Yearly

Tetanus, diphtheria and pertussis (Td/Tdap) Every 10 years Every 10 years Every 10 years

Medical Plan Premiums per Paycheck*Aetna Whole HealthSM Aetna HDHP

(closed to new enrollment)

Coverage Tier 2015-16 2016-17 2015-16 2016-17

Employee Only $52 $64 $95 $107.50

Employee+Child(ren) $192 $242 $272 $325

Employee+Spouse $248 $395 $445 $462.50

Employee+Family $404 $454 $540 $545

*An additional $5 is added for tobacco users.

Note: The District contributed an additional $214 per paycheck for eligible employees in 2015-16. This amount will increase to $220 for 2016-17.

Part-time, substitute, and temporary employees are not eligible for the District contribution.

Preventive care remindersSummer break is a great time to catch up on your wellness exams. If you are due for a preventive screening or vaccination, consider taking care of it before you head back to school in August.

Onsite mammogramsWe are pleased to announce Covia Health, Mammosafe, and The Rose will provide onsite screening mammograms during the month of July.

Recommended Screenings and Vaccinations Here are some important services recommended for men and women.

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How to prepare for your appointment: Do not wear lotions, ointments, powders, perfumes, or deodorants on the day of your appointment.

Please wear two-piece clothing for your convenience and comfort.

Please take the following to your appointment: insurance card, photo ID, and prior mammography records, if possible. If your appointment is with Mammosafe, be sure to also take your completed patient forms.

Covia HealthWill be at The Woodlands College Park High School on July 6, July 7, July 20, and July 21 from 7:00 a.m. to 5:00 p.m.

Covia Health is the only luxury 3D mobile mammography and bone density screening provider in Texas. Please visit www.coviahealth.org to learn more.

To schedule your appointment with Covia Health:

1. For July 6 and 7, please visit https://cisdjul6-7.coviahealth.org (PIN is 7741259). For July 20 and 21, please visit https://cisdjul20-21.coviahealth.org (PIN is 8863722).

2. If you have questions, please contact Katie McDonald via email at [email protected] or call 832-476-9660, extension 129.

3. You do not need to have a doctor’s order to obtain a screening mammogram, but you must have your doctor’s contact information so Covia Health can send results to your doctor.

4. If you meet the requirements for a bone density screening, you will need to take a doctor’s order for the bone density test. You may schedule your bone density exam at the same time as your screening mammogram.

MammosafeWill be at Conroe High School on July 11, July 18, and July 25 from 8:00 a.m. to 3:00 p.m.

Mammosafe provides mobile mammography screenings in a warm and inviting environment by a dedicated female staff. In addition to preventive screenings, Mammosafe offers diagnostic mammogram and breast ultrasound follow-up for women whose screening mammograms are interpreted as needing additional imaging evaluation. Please visit www.mammosafe.com to learn more.

To schedule your appointment with Mammosafe:

1. Schedule online at http://mammosafe.com/conroe-isd/ or call 832-977-7213.

2. Download, complete, and take your patient forms to your appointment. These can be found at www.mammosafe.com under the “Appointments” tab.

3. Take your prior imaging, if possible. Dr. Roubein will be on board and may be able to provide preliminary results before you depart the mobile breast imaging center if your prior imaging is available.

The RoseWill be at the Conroe ISD Employee Health and Wellness Center on July 6 from 11:00 a.m. to 4:30 p.m., July 14 from 9:00 a.m. to 3:30 p.m., July 21 from 9:00 a.m. to 3:30 p.m. and July 27 from 11:00 a.m. to 4:30 p.m.

The Rose provides advanced breast cancer screening and diagnostic services to more than 35,000 women annually and is now the leading nonprofit breast health care organization in southeast Texas. For every three insured women who receive a mammogram, The Rose is able to provide a mammogram for one uninsured woman. Please visit www.therose.org to learn more.

To schedule your appointment with The Rose:

1. Schedule online at www.therose.org/mobile (company code is CISD) or call 281-464-5136.

2. Answer the prescreening questions and enter your personal information.

3. Select your appointment time.

Please note: Conroe ISD Aetna medical plan members have the freedom to choose any provider in the Aetna Memorial Hermann Accountable Care Network or Aetna Select network to receive free routine screening mammograms at no cost, per plan criteria. If you have questions about this benefit, please call Aetna Member Services at 1-866-381-8933 or log in to your secure member website, Aetna Navigator® at www.aetna.com.

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Live Healthy America summer challengesWellness is more than just physical – it includes mental, emotional, financial, and social aspects as well. Conroe ISD, in partnership with Live Healthy America, is pleased to offer some fun, optional wellness challenges for summer that will help you grow in multiple areas of your life.

Power of 8Power of 8 consists of unique, individual challenges that provide two different programs for eight well-being focal points:

Purpose – set goals and develop a plan to get there

Physical – fit your workout in each day with fun challenges

Brainy – keep your brain active with quizzes and games

Peer to Peer – develop your relationships with family and friends

Balance – take time for yourself

Nutrition – eat and live well

Financial – learn how to improve your financial well-being

Community – get involved and give back

Ready to get started? You can sign up for any of the Power of 8 challenges beginning June 15, 2016 at www.livehealthyconroeisd.com. If you’ve logged in before, enter your username and password on this screen. If you need to sign up, click “Sign Up” on the right side of the screen. If you need help, call Live Healthy at 1-888-282-0822 or email [email protected]. The program will end August 31, 2016.

Conroe ISD Employee Health & Wellness CenterSummer hours June 6-August 14, 2016Monday/Tuesday/Thursday 8:00 a.m. to 5:00 p.m.

Wednesday 10:00 a.m. to 6:00 p.m.

Friday/Saturday 8:00 a.m. to 12:00 p.m.

Regular hours resume August 15, 2016Monday 8:00 a.m. to 5:00 p.m.

Tuesday/Wednesday/Thursday 10:00 a.m. to 6:00 p.m.

Friday/Saturday 8:00 a.m. to 12:00 p.m.

Aetna dental plansThe network-only Dental Maintenance Organization (DMO) plan offers predictable out-of-pocket costs, and the Participating Dental Network (PDN) plan allows you to see any licensed dentist. Use the chart below to compare the plans and decide which one is best for you.

Plan Features DMO PDN Low PDN High

Plan BasicsEmployee-Only Premium per Paycheck

$7.97

$12.14

$20.42

Maximum Benefit Amount per Plan Year Unlimited $800 $1,200

Primary Care Dentist Required Yes No No

Referrals to Specialists Required Yes No No

Out-of-Network Coverage No Yes Yes

Plan BenefitsPreventive Services

100%

100%

100%

Basic Services Based on Copay Schedule 80% 80%

Major Services Based on Copay Schedule 50% 50%

Orthodontic Services Based on Copay Schedule 50%* 50%*

Plan Waiting Periods (for new CISD Aetna dentalplan participants only, where applicable)Preventive Services (e.g., cleanings, exams, x-rays) None None None

Basic Services (e.g., fillings, scaling, root planing) None 6 months 6 months

Major Services (e.g., crowns, dentures, root canals) None 6 months 6 months

Orthodontic Services None 12 months* 12 months*

*Children under age 19 (no coverage for adults).The plans do not cover dental work, including orthodontic treatment, that began before a member is covered under the plan.

Page 5: For Your &IRI¿X - Conroe ISD · 2019-07-31 · TRS-ActiveCare for similar benefits. The following changes will take effect September 1, 2016: Medical premiums will increase for all

Life insurance optionsWhen choosing life insurance coverage, it’s important to know the differences among the policies offered through Conroe ISD. That way, you can make the best decision for you and your family during annual enrollment. Here are the highlights for each policy:

Group Term Life – Unum Life Insurance Company of America Choose coverage for you (up to five times your salary, not to exceed $500,000), your spouse (up to 100% of employee amount), and your children (up to $10,000).

Premiums are based on your age as of September 1 each year.

During annual enrollment, if you and your eligible dependents are currently enrolled in the plan, you may increase the coverage amount up to $200,000 for yourself and up to $25,000 for your spouse. Any coverage over these amounts will be subject to answers to health questions.

During annual enrollment, if you and your eligible dependents are not currently enrolled in the plan, you may apply for coverage up to the maximum amounts, and all coverage will be subject to answers to health questions.

If you retire, reduce your hours, or leave CISD, you can continue your coverage at the group rate for as long as the group policy is in place.

Term Life – American Fidelity Assurance Company Choose coverage for you (up to $200,000), your spouse (up to $50,000), and your children (up to $20,000).

Premiums are based on the length of the policy (10, 20, or 30 years), age, and tobacco usage at the time of issue. Premiums are guaranteed not to increase during your initial term period.

You are required to answer a short health and work questionnaire to obtain a policy.

You own the policy. If you leave CISD, you can take the policy with you at the same rate you paid as an employee.

You may renew the policy at the end of the term period until you reach age 90.

Summer smartsSaving your skinSkin cancer is the most common cancer in the United States. Help stay safe by wearing sunscreen, limiting your sun exposure, and avoiding indoor tanning. Also, remember to schedule your annual preventive skin check!

Don’t let bug bites bug youSummer is fun, but it’s also bug season. Some of them can give you West Nile virus, Lyme disease, or other serious diseases. To help keep those critters from really bugging you:

Use an insect or tick repellent.

Keep your grass mowed and remove any leaves from your yard.

Check yourself, your kids, and your pets for ticks after you have been outside.

Never leave infants, children, older adults, or pets in a locked car!

Page 6: For Your &IRI¿X - Conroe ISD · 2019-07-31 · TRS-ActiveCare for similar benefits. The following changes will take effect September 1, 2016: Medical premiums will increase for all

Universal Permanent Life – Texas Life Insurance Company Choose coverage for you and your spouse. An individual policy for $25,000 is also available on each of your minor children and grandchildren.

Premiums are based on age and tobacco usage at the time of issue, and they are guaranteed for a significant period of time.

You are required to answer a short health and work questionnaire to obtain a policy.

You own the policy. If you leave CISD, you can take the policy with you at the same rate you paid as an employee.

You may renew the policy at the end of the guaranteed period for a guaranteed death benefit up to age 121.

If your death is accidental, the death benefit is doubled, up to age 65.

All of the policies contain an accelerated death benefit, which allows you to request a percentage of the benefit amount if you become terminally ill.

CCG CONROEISD-0013 (5/16)