BREMEN PUBLIC SCHOOLS HEALTH AND WELLNESS PROGRAMS OCTOBER 19, 2017
ENROLLMENT OPPORTUNITIES 1. Hire Date A new hire has 31 days from the first working day to enroll. 2. Open Enrollment All full-time employees have the opportunity to enroll or add dependents during the open enrollment period. The open enrollment period occurs during October or November of each year. 3. HIPAA Qualifying Event A full-time employee that has a HIPAA Qualifying Event has 31 days from the event date to enroll. HIPAA Qualifying events include but are not limited to: 1. Birth or adoption of a child 2. Marriage 3. Loss of eligibility due to divorce, legal separation, death, job loss 4. Involuntary termination of Medicaid
MASE INSURANCE TRUST PLAN OPTIONS 1. PPO Option 1 1. Dr. Visit Co-Pay - $20.00 2. Hospital ER Co-Pay - $150 3. Deductible - $750 per individual or $1500 per family (can be a combination of family members, each family member is limited to the individual deductible) 4. Co-insurance for other services 20% 5. Maximum Out-of-Pocket - $1,650 per individual or $3,300 per family (can be a combination of family members, each family member is limited to the individual out-of-pocket maximum) 6. Prescription Drugs Co-Pay - $10, $25 or $50 depending upon the Tier
MASE INSURANCE PLAN OPTIONS 1. PPO Option 2 High Deductible Health Plan 1. Dr. Visit Co-Pay None, subject to deductible 2. Hospital ER Co-Pay None, subject to deductible 3. Deductible - $3,000 per individual or $6,000 per family (can be a combination of family members, each family member is limited to the individual deductible) 4. Co-insurance for other services 0% 5. Maximum Out-of-Pocket - $3,000 per individual or $6,000 per family (can be a combination of family members, each family member is limited to the individual out-of-pocket maximum) 6. Prescription Drugs Co-Pay None, subject to deductible 7. All services (except MASE Clinic services) are subject to the deductible
MASE INSURANCE PLAN OPTIONS 1. PPO Option 3 High Deductible Health Plan 1. Dr. Visit Co-Pay None, subject to deductible 2. Hospital ER Co-Pay None, subject to deductible 3. Deductible - $6,000 per individual or $12,000 per family (can be a combination of family members, each family member is limited to the individual deductible) 4. Co-insurance for other services 0% 5. Maximum Out-of-Pocket - $6,000 per individual or $12,000 per family (can be a combination of family members, each family member is limited to the individual out-of-pocket maximum) 6. Prescription Drugs Co-Pay None, subject to deductible 7. All services (except MASE Clinic services) are subject to the deductible
COMMON BENEFITS OF ALL 3 PLANS 1. Preventive Benefits Preventive benefits are covered at 100%. Examples of preventive services are well baby checks, annual physicals, mammograms, colonoscopies. 2. MASE Clinic All plan participants have access to the MASE Clinic. The MASE Clinic provides minor acute care, wellness screenings, bloodwork and some medications. There is no cost to the employee to use the Clinic. 3. Web Access All plan participants have access to a variety of websites: mybensite, Anthem, MASE Clinic. 4. LiveHealthOnline Online access to doctors that can assess your condition, provide treatment options and even send a prescription to the pharmacy of your choice.
UNIQUE BENEFITS TO PLANS 2 AND 3 1. Health Savings Account High Deductible Health Plans are compatible with Health Savings Accounts. Health Savings Accounts are tax-free accounts that can be used for expenses not reimbursed by your medical plan. There are annual limits on contributions but the account rolls over into the next year. There is not a use it or lose it provision. Payroll deduction is available.
CHANGES FOR 2018 Castlight The MASE Trust is no longer contracting with Castlight. You can still shop for services on the Anthem website. Critical Illness Plan The MASE Trust is no longer purchasing a critical illness policy for all members on Plan 2 or Plan 3. Emergency Room Coverage Anthem will no longer cover non-emergency services provided in an emergency room. You will be responsible for the full cost of the service. Obviously if it is an emergency go to the emergency room!
EMERGENCY ROOM EXCEPTIONS Emergency room cost will be covered for the following exceptions: Members under the age of 14 ER visits directed by a health care professional ER visits between the hours of 8:00 pm Saturday through 8:00 am Monday When the closest urgent care center is more than 15 miles away. MedStat, 1001 N Main Street, Nappanee LifePlex Urgent Care, 2855 Miller Drive, Plymouth MedPoint, 1815 Ireland Road, South Bend
SAMPLE COST COMPARISONS SINGLE PLAN MINIMAL USAGE OF INSURANCE 2 DR. VISITS Plan #1 Plan #2 Plan #3 Employee Premium Annual $3,840 $2,160 $1,212 Deductible 0 200 200 Out of Pocket Max 0 0 0 Co pays 40 0 0 Total $3,880 $2,360 $1,412
SAMPLE COST COMPARISONS SINGLE PLAN MODERATE USAGE OF INSURANCE 6 DR. VISITS AND $600 IN OUT-PATIENT SERVICES Plan #1 Plan #2 Plan #3 Employee Premium Annual $3,840 $2,160 $1,212 Deductible 600 1,200 1,200 Out of Pocket Max 0 0 0 Co pays 120 0 0 Total $4,560 $3,360 $2,412
SAMPLE COST COMPARISONS SINGLE PLAN HEAVY USAGE OF INSURANCE 10 DR. VISITS AND $4,500 IN OUT-PATIENT SERVICES Plan #1 Plan #2 Plan #3 Employee Premium Annual $3,840 $2,160 $1,212 Deductible 750 3,000 5,500 Out of Pocket Max 900 0 0 Co pays 200 0 0 Total $5,690 $5,160 $6,712
SAMPLE COST COMPARISONS FAMILY PLAN MINIMAL USAGE OF INSURANCE 5 DR. VISITS Plan #1 Plan #2 Plan #3 Employee Premium Annual $12,144 $7,848 $5,340 Deductible 0 500 500 Out of Pocket Max 0 0 0 Co pays 100 0 0 Total $12,244 $8,348 $5,840
SAMPLE COST COMPARISONS FAMILY PLAN MODERATE USAGE OF INSURANCE 15 DR. VISITS AND $10,000 IN OUT-PATIENT SERVICES (ASSUMING 2 FAMILY MEMBERS USING SERVICES) Plan #1 Plan #2 Plan #3 Employee Premium Annual $12,144 $7,848 $5,340 Deductible 1,500 6,000 11,500 Out of Pocket Max 1,800 0 0 Co pays 300 0 0 Total $15,744 $13,848 $16,840
OPEN ENROLLMENT FOR 2018 OCTOBER 30 THROUGH NOVEMBER 17 NEW THIS YEAR ONLINE ENROLLMENT ALL full-time employees must log onto the MASE website and complete the online enrollment. If you are enrolling for the first time with dependents or adding dependents, you must upload the following documents: For spouses a copy of your marriage certificate and a recent bill or statement with both names, your current address and a current date For children a copy of their birth certificate
OPEN ENROLLMENT FOR 2018 OCTOBER 30 THROUGH NOVEMBER 17 Step 1 Log onto the employee benefits website www.mybensite.com/mase User Name: mase Password: Bremen Step 2 Review the benefits outlined Step 3 Click on the green Enroll Now button in the upper right corner
OPEN ENROLLMENT FOR 2018 OCTOBER 30 THROUGH NOVEMBER 17 Step 4 Log onto your individual site User Name: First four letter of your last name followed by the four digit year of your birth Example: PITT1965 Password: Your social security number Step 5 Select Open Enrollment Plan Election Changes for January 1, 2018 If you need to make changes to your 2017 benefits, select Current Elections for 2017 Step 6 Please review your personal information! It is very important to keep your personal information current with the insurance company and the school corporation.
OPEN ENROLLMENT FOR 2018 OCTOBER 30 THROUGH NOVEMBER 17 Step 7 Follow through the remainder of the screens selecting or waiving the benefits. Step 8 Please designate a life insurance beneficiary. The current paper designations did not transfer over to the online system. Step 9 Confirm your selections and print or email the benefit summary. ALL FULL TIME EMPLOYEES MUST COMPLETE THE ONLINE ENROLLMENT BY MIDNIGHT NOVEMBER 17.