Open Enrollment

Open Enrollment

Dates to Remember:
Open Enrollment Period:     October 16 – November 20, 2012
Benefit Effective Date:         January 1, 2013
Meeting Schedule:               Please plan on attending one of the following meetings.
       Date         Time   School Room
16-Oct 2:30   Wayne Hills Center art room
17-Oct 3:20   William Perry library
22-Oct 3:30   High School library
23-Oct 3:30   Kate Collins library
24-Oct 3:00   Berkeley Glenn library
29-Oct 10:00   Central Office board room
29-Oct 2:50   Wenonah library
31-Oct 3:00   Westwood library

 

All Forms are Due:                          November 20, 2012 by 4:00 p.m.

Open enrollment is coming for Waynesboro Public Schools employees. This packet contains important information you need to make an informed decision about your health plan, dental plan, and flexible spending account selections.  I encourage you to review your coverage options and choose the plans that are right for you. Open Enrollment is your once-a-year opportunity to enroll, make changes, or terminate coverage on yourself and/or your dependents without a change in your family status.

  •  Payroll deductions for insurance (health and dental) changes made during open enrollment will be reflected in the December 19, 2012 paycheck. 
  • Employees enrolling in a flexible spending account during open enrollment will have the first contribution amount deducted from the January 31, 2013 paycheck.
  • Members enrolling in new insurance plans should receive their ID cards no later than January 1, 2013.

 

Medical and Dependent Care Reimbursement Accounts (the “Benny” card)

• You must complete an enrollment form for 2013.  Even if you choose not to participate you need to sign the “If You Decide to Decline Participation” line.

  • Medical Expenses Annual Limit:           $2,500.  This is a change from the 2012 maximum of $5,000.
  • Dependent Care Annual Limit:              $5,000.
  • Plan Year:                                                       January 1 – December 31, 2013
  • Plan Administrator:                                    LDB Insurance Agency, Inc.
  • LDB Representative:                                  Stephanie Van Meter
  • LDB Telephone Number:                          (800) 366-3846 or (540) 433-2796

 

  • Direct Deposit Authorization Form does not need to be completed again if it has been submitted in previous years, unless your bank information has changed.
  • Your annual election for the new plan year will automatically be loaded on your existing Benny Card. Your card is good for five (5) years, so please do not destroy it. There is a $10 fee for two replacement/additional cards.
  • Save all your receipts, including those for Benny Card purchases.
  • You can check your account balance, activate your Benny Card, begin the claims process, and find more information about the flexible spending accounts at www.ldbinsurance.com.

 Health Insurance Benefit

• No health enrollment application is necessary if you wish to maintain your current coverage.

• You must complete an application for new enrollments, plan terminations, to add or remove dependents or to switch between the high and low plan.

 The SAW Consortium has renewed the health insurance contract with Coventry Health Care of Virginia (formerly Southern Health) for the 2013 plan year. The following changes have been made to the benefit structure.  These changes will be effective January 1, 2013. 

High Plan

Current

Changes Effective 1-1-13
Specialist Co-pay

$45

$50
Deductible

$250/$500

$500/$1,000
Prescription: Tier 3 Co-pay

$50

$60
Low Plan

 

 
Specialist Co-pay

$45

$50
Deductible

$750/$1,500

$1,000/$2,000
Prescription: Tier 3 Co-pay

$50

$60

In accordance with Health Care Reform laws two benefits will change.

  1. Coverage for enhanced women’s preventive services and contraceptive coverage will begin.
  2. A new 4 page Summary of Benefits will be distributed. 

 Note for 2013:

Beginning in 2013, Coventry Health Care of Virginia will introduce PersonalCare: Pharmacy Savings!

Coventry members who must manage asthma, COPD, CAD, diabetes or heart failure can live better and pay less for drug treatments.  Those who join Coventry’s “PersonalCare” will pay less for prescriptions related to their condition.  PersonalCare members pay $0 for Tier 1 drugs, and 50% copayment for Tier 2 drugs.  To remain eligible for these discounts, follow the program’s medically-approved guidelines for your condition for 12 months. Your status will be reviewed each year on January 1st. 

Note for 2014:

SAW Consortium will implement a premium differential for wellness compliance.  The plan details are:

  • You must be enrolled in the health insurance program with Waynesboro Public Schools.
  • Starting in December 2013 employees that meet the criteria will pay $25 less per month than employees that do not meet the criteria.  This will total a $300 savings per year for their health insurance coverage.
  • To be eligible an employee must have a routine physical between 09-01-2012 and 08-31-2013.  The physical can be with your Primary Care Physician, or for women a well woman exam at OB/GYN, or a mammogram – all qualify.  Occupational physicals (for bus drivers) also qualify.
  • Coventry HealthCare of Virginia will report the employees eligible for the benefit.

 Rates for 2013 (starting with your December 19, 2012 paycheck)

High Plan

2013 Monthly Premium

School Board Share

Employee Share
Subscriber Only

516

461

55
+ one minor

777

581

196
+ children

1,041

681

360
+ spouse

1,089

714

375
+ family

1,468

905

563
+ 2ee family

1,468

1,175

293

 

Low Plan

2013 Monthly Premium

School Board Share

Employee Share
Subscriber Only

460

450

10
+ one minor

692

581

111
+ children

926

681

245
+ spouse

969

714

255
+ family

1,305

905

400
+ 2ee family

1,305

1,164

141

 

High vs Low plan comparisons:

Differences

High Plan

Low Plan

Employee Monthly Premium Cost

See rate tables

See rate tables

In-Network Deductible (Individual/Family)

$500/$1,000

$1,000/$2,000

Annual Out-of-Pocket Maximum (Individual/Family)

$2,500/$5,000

$3,500/$7,000

Co-Insurance Member Percentage

20%

30%

 

Similarities

High Plan

Low Plan
Preventive Care Office Co-pay

$0

$0
Colonoscopies/Mammograms/ Laboratory Services

$0

$0
PCP Office Visit Co-pay

$25

$25
Specialist Office Visit Co-pay

$50

$50
Prescription Drug Benefit

$10/$30/$60

$10/$30/$60
Mail Order Prescription Benefit

$10/$60/$150

$10/$60/$150
Vision Benefit – Spectacle Eye Exam Co-Pay

$15

$15

 

Dental Insurance Benefit

• No dental enrollment application is necessary if you wish to maintain your current coverage.

• You must complete an application for new enrollments, plan terminations, to add or remove dependents or to switch between the high and low plan.

 Rates for 2013 (no change from 2012)

 

Low plan

High plan
Subscriber Only

21.51

39.29
+ one minor

43.04

78.59
+ spouse

43.04

78.59
+ family

72.75

132.85

 High vs Low plan comparisons:

Differences

High Plan

Low Plan
Employee Monthly Premium Cost

See rate table

See rate table
Annual Benefit Maximum

$1,250

$1,000
Orthodontic Lifetime Maximum

$1,250

n/a
Major Dental Care

50% paid after 12- month waiting period

n/a
Orthodontic Benefits

50% paid after 12-month waiting period, subject to lifetime maximum

n/a

 

Similarities

High Plan

Low Plan
Annual Deductible

$50

$50
Diagnostic and Preventive Care

100% paid

100% paid
Basic Dental Care

80% paid, after deductible

80% paid, after deductible