Iberville Parish School Board
Arthur M. Joffrion, Jr., Ed.D. Polly Higdon Chris Daigle Superintendent President Vice-President Secretary/Treasurer
September 24, 2018
To: Iberville Parish School Board Retirees From: Benefits Department RE: 2019 Open Enrollment and Wellness Program Iberville Parish School Board (IPSB) will begin open enrollment for benefits in October 2018. The 2019 Wellness Program will run simultaneously with open enrollment. As our organization grows, we adapt to ensure that we offer a comprehensive benefit package and we look for benefits that support our employees and retirees. Rates for health, dental and life insurance coverage will not change for 2019.
OPEN ENROLLMENT If you do not wish to make any changes to your health, dental or life insurance, there is no action needed on your part. We have provided you with a Retiree Benefit Guide to help you understand the plans and benefits offered to you in retirement. You will only need to see an open enrollment representative if you want to make a change to your coverage. Should you wish to speak to an open enrollment representative, please see the attached sheet showing dates and times a representative will be available. There are two changes to the health plans for 2019. The first plan change will be the use of Accredo Specialty Pharmacy to fill orders for all specialty drugs. Doctors will be required to order specialty drugs (those that treat chronic or rare health problems) directly from Accredo. The second plan change will allow for quantity per dispensing limits on certain medications based on manufacturer's recommended dosage. Representatives from Blue Cross Blue Shield of Louisiana will be on site to explain the above changes and answer any questions you may have regarding the changes or any other plan benefits. Per IPSB policy, effective January 1, 2018, any IPSB retiree or their spouse who becomes eligible for Medicare parts A & B, must enroll in the Humana Medicare Advantage health coverage offered by the IPSB. It is the responsibility of the retiree to notify the IPSB when becoming Medicare eligible.
WELLNESS PROGRAM The health and wellness of our employees and retirees is very important to us at Iberville Parish Schools. We have exhibited this in our strong support of employee health and our partnership with Ochsner for our Wellness Program. Participation in the Wellness Program is voluntary, however, in order to qualify for the Preferred Wellness Premium, you must complete the requirements of the Wellness Program every year. Please see the included Preferred Wellness Premium Document for further information.
In order to qualify for the Preferred Wellness Health Premium for 2019,
all three of the following requirements must be completed:
1. Complete the online Personal Health Assessment (PHA) at www.bluewellnessla.com If you are a first time user, your location code is 78C88ERCR
2. Have an Onsite Wellness Exam (exam must be performed onsite at an IPSB location) You need to preregister for your exam at https://ochsner.vitalogyinc.com A schedule of clinic dates and times is included for your reference.
3. Complete Any TWO of the following activities and log them in at www.bluewellnessla.com
Dental Visit Eye Exam Skin Cancer Screening Age or Gender Appropriate Screening (pap test, colonoscopy, etc) Get a Flu Shot (offered at all Onsite Wellness Clinics) Be Tobacco Free or Participate in Smoking Cessation Program Complete an Online Workshop at www.bluewellnessla.com Participate in one 5K Walk/Run Attend a Hello Health Seminar and take a quiz Attend a Community Health Fair Please contact Frank Lee at 504-842-6017 should you have any questions relating to the Wellness Program. Please review the enclosed "Retiree Benefit Guide”. No changes to your benefits will be accepted after November 15, 2018. November 15, 2018 is also the last day to complete and enter requirements to qualify for the 2019 Preferred Wellness Premium. You must re-qualify every year to receive the Preferred Wellness Premium. If you are not making any changes to your coverage, then you do not have to contact us or see any of the open enrollment representatives. Should you have any questions, please contact Cassie Dupree in the IPSB Benefits Department at 225-687-4341, ext 2126.
2019 Retiree Benefit Guide
IBERVILLE PARISH SCHOOL BOARDInnovate, Invigorate, Inspire
CoverageLimitation
PREFERRED WELLNESS PREMIUM
MEDICARE ELIGIBLEPer IPSB policy, any retiree and/or their covered spouse is required to move to the Humana Medicare Advantage medical plan at the time they become Medicare Part A and B eligible. Please contact the Benefits Department at least 3 months prior to becoming Medicare eligible.
All IPSB retirees who retained health insurance coverage are encouraged to participate in the annual wellness program. Retirees that have insurance coverage through IPSB are eligible to earn a preferred wellness premium for 2019. Retirees that complete the four requirements and log required activities in to the portal no later than 11/15/2018 will be eligible for the preferred wellness premium.
If you retain benefits, you cannot change your elections until the following open enrollment period unless a qualifying event occurs. Qualifying events include termination of employment, marriage, death, divorce, birth of a child, adoption, change in employment status or a change in coverage under another employer-sponsored plan. You have 30 days to report a qualifying event.
If you are a retiree from the Iberville Parish School Board (IPSB), you are eligible to enroll in the benefits outlined in this guide. In addition, the following family members are eligible for coverage: your spouse, your children through the end of the month during which they turn 26.
In order to elect medical and dental benefits for your dependents, birth certificates and/or marriage licenses are required. Please remember to deliver this information to the Benefits Department or email them at [email protected].
A retiree declining coverage under the IPSB health insurance plan shall not be allowed to return to the plan at any time in the future. Careful consideration to possible future circumstances should be given prior to electing to decline coverage. Retirees who do not elect coverage at the time of the retirement or drop coverage at any time after retirement, are not eligible to rejoin the IPSB plan thereafter.
Failure to pay all premiums timely, included Medicare premiums, will result in cancellation of coverage and coverage will not be reinstated.
Open enrollment will be conducted on-site by IPSB's enrollment vendor AGM Benefit Solutions. Enrollment counselors will be on-site to explain your benefit options and to help you enroll or waive coverage for the 2019 plan year.
If you do not want to make any changes to your coverage, no action is required on your part. No changes will be accepted after November 15, 2018. Benefit elections will be effective January 1, 2019.
The surviving spouse of a retiree will be eligible to continue health insurance benefits at the rate prescribed at the time of death of the retiree. When the surviving spouse reaches age 65, he/she will convert to retiree rates. Should a surviving spouse remarry, they are no longer eligible to remain on the IPSB Benefit Plans (health and dental).
To retain current benefits in retirement, contact AGM Benefit Solutions at 844-880-6774. Health and life insurance will be deducted from your monthly retirement check. Dental premiums will be deducted by bank draft from your checking account. Voluntary deductions must be maintained directly with the carrier.
WHO IS ELIGIBLE?
IMPORTANT
HOW TO ENROLL AT TIME OF
RETIREMENT:
2019 OPEN ENROLLMENT:
MAKING CHANGES
OVERVIEW
Coverage
Limitation
Benefit
Network
Individual Deductible
Family Deductible
Coinsurance
Out-of-Pocket
Family Out-of-Pocket
Preventative/Wellness
Primary Care Copayment
Specialist Copayment
Urgent Care Copayment
Hospital Admission
Inpatient Physician Services
Outpatient Facility
Outpatient Facility Services
Physical, Speech or Occupational Therapy
X-Ray/ Labs/ Other Imaging
Ambulance
Emergency Room
Hospice Care
Organ & Tissue Transplant
Outpatient Mental, Nervous and Substance Abuse
Skilled Nursing Facility
Inpatient Mental, Nervous and Substance Abuse
Pharmacy Deductible
Prescriptions: Tier1
Tier 2
Tier 3
Monthly Premium
Retiree Only
Two-Party
FamilyPlease note that the above benefits description is a brief summary and may not include all policy details.
------ --- --- --- ---
$499.98 $474.98 $750.74 $725.74 $428.90 $403.90
$431.26 $406.26 $638.38 $613.38 $389.62 $364.62
$303.52 $278.52 $407.70 $382.70 $256.80 $231.80
Non-Wellness Premium Wellness Preferred Non-Wellness Premium Wellness Preferred Employee Premium Wellness Preferred
Option 1 Option 2 Option 3
$55 Copay N/A $55 Copay N/A 100% after Ded. 50%/50% after Ded.
$40 Copay N/A $40 Copay N/A 100% after Ded. 60%/40% after Ded.
$15 Copay N/A $15 Copay N/A 100% after Ded. 80%/20% after Ded.
$50 N/A $50 N/A Medical and Pharmacy Ded. Combined
80%/20% after Ded. N/A 90%/10% after Ded. 70%/30% after Ded. 100% after Ded. 60%/40% after Ded.
100% (Ded. Waived) N/A 100% (Ded. Waived) 70%/30% after Ded. 100% (Ded. Waived) 60%/40% after Ded.
80%/20% after Ded. N/A 90%/10% after Ded. 70%/30% after Ded. 100% after Ded. 60%/40% after Ded.
80%/20% after Ded. N/A 90%/10% after Ded. 70%/30% after Ded. 100% after Ded. 60%/40% after Ded.
80%/20% after Ded. 80%/20% after Ded. 90%/10% after Ded. 90%/10% after Ded. 100% after Ded. 100% after Ded.
80%/20% after Ded. 80%/20% after Ded. 90%/10% after Ded. 90%/10% after Ded. 100% after Ded. 100% after Ded.
80%/20% after Ded. N/A 90%/10% after Ded. 70%/30% after Ded. 100% after Ded. 60%/40% after Ded.
80%/20% after Ded. N/A 90%/10% after Ded. 70%/30% after Ded. 100% after Ded. 60%/40% after Ded.
80%/20% after Ded. N/A 90%/10% after Ded. 70%/30% after Ded. 100% after Ded. 60%/40% after Ded.
80%/20% after Ded. N/A 90%/10% after Ded. 70%/30% after Ded. 100% after Ded. 60%/40% after Ded.
80%/20% after Ded. N/A 90%/10% after Ded. 70%/30% after Ded. 100% after Ded. 60%/40% after Ded.
80%/20% after Ded. N/A 90%/10% after Ded. 70%/30% after Ded. 100% after Ded. 60%/40% after Ded.
$55 Copay N/A $45 Copay 70%/30% after Ded. 100% after Ded. 60%/40% after Ded.
$55 Copay N/A $45 Copay 70%/30% after Ded. 100% after Ded. 60%/40% after Ded.
$40 Copay N/A $30 Copay 70%/30% after Ded. 100% after Ded. 60%/40% after Ded.
100% (Ded. Waived) N/A 100% (Ded. Waived) N/A 100% (Ded. Waived) 60%/40% (Ded. Waived)
$6,000 N/A $3,000 Unlimited $3,000 Unlimited
$3,000 N/A $1,500 Unlimited $1,500 Unlimited
80%/20% N/A 90%/10% 70%/30% 100%/0% 60%/40%
$3,000 N/A $1,500 $3,000 $3,000 $3,000
$1,000 N/A $500 $500 $1,500 $1,500
Option 1: IPSB Standard PPO Plan (SPPO) Option 2: IPSB Enhanced PPO Plan (EPPO) Option 3: IPSB High Deductible Health Plan (HDHP)
PPO PPO PPOIn-Network Out of Network In-Network Out of Network In-Network Out of Network
Comprehensive and preventative healthcare coverage is important in protecting you and your family from the financial risks of unexpected illness and injury. A little prevention goes a long way – especially in healthcare. Routine exams and regular preventative care provide an inexpensive review of your health. Small problems can potentially develop into large expenses. By identifying the problems early, often they can be treated at little cost. Consider your medical situation and choose what works best for you and your family. Monthly payroll deductions are shown below.
MEDICAL (WITHOUT MEDICARE)
Benefit
Network
Individual Deductible
Family Deductible
Coinsurance
Out-of-Pocket
Family Out-of-Pocket
Preventative/Wellness
Primary Care Copayment
Specialist Copayment
Urgent Care Copayment
Hospital Admission
Inpatient Physician Services
Outpatient Facility
Outpatient Facility Services
Physical, Speech or Occupational Therapy
X-Ray/ Labs/ Other Imaging
Ambulance
Emergency Room
Hospice Care
Organ & Tissue Transplant
Outpatient Mental, Nervous and Substance Abuse
Skilled Nursing Facility
Inpatient Mental, Nervous and Substance Abuse
Pharmacy Deductible
Prescriptions: Tier1: Primarily Generic, although some Brand-Name drugs may be included
Tier 2: Brand-Name Drugs
Tier 3: Brand-Name or Generic Drug that may have a theraputic alternative. Multisource & Compound Drugs
Tier 4: Specialty Drugs
Monthly Premium
Retiree and Dependents
The Humana Medicare Advantage medical plan pays 100% of covered costs with a $0 deductible and a $1,000 out-of-pocket maximum. The $1,000 out-of-pocket is a statement required by regulatory agencies, in almost all instances the out-of-pocket cost for Humana is $0 since Medicare eligible providers' claims costs are covered at 100%.
Please note that the above benefits description is a brief summary and may not include all policy details.
Non-Wellness Premium Wellness Preferred
$65.75 (per person covered) $40.75 (per person covered)
$40 Copay
$0 $0
$40 Copay
$10 Copay $10 Copay
$20 Copay $20 Copay
$10 Copay $0 Copay
$0 Copay $0 Copay
$0 Copay (Days 1-100) $0 Copay (Days 1-100)
$0 Copay $0 Copay
$0 Copay $0 Copay
$0 Copay $0 Copay
$0 Copay $0 Copay
$0 Copay $0 Copay
$0 Copay $0 Copay
$0 Copay $0 Copay
$0 Copay $0 Copay
$0 Copay $0 Copay
$0 Copay $0 Copay
$0 Copay $0 Copay
$0 Copay $0 Copay
$0 Copay
$1,000 $1,000
--- Unlimited
PPO
Humana Medicare Advantage Plan- Premium (Medicare Eligible Retirees Only)
25% 25%
--- ---
--- ---
In-Network Out of Network $0 $0
$0 Copay $0 Copay
$0 Copay
MEDICAL (WITH MEDICARE)
Coverage
Limitation
Coverage
Limitation
Plan Details
Benefit In-Network Out-of-NetworkIndividual Deductible ($50 per person up to $150 Family Maximum)
$50 (Waived for Preventative) $50 (Waived for Preventative)
Annual Maximum Benefit $2,000 $2,000
Preventative- Cleaning (every 6 months), Fluoride (only for age 19 and under), Oral Exams, Sealants (per tooth), X-Rays
100% 100%
Basic- Anesthesia, Fillings, Perio surgery, Periomaintenance (once every 6 months), Simple & Surgical Extractions, Repair & Maintenance of Crowns, Bridges & Dentures, Scaling & Root Planning (per quadrant)
100% 80%
Orthodontic Maximum (Lifetime) $2,000 $2,000
Rates
Monthly PremiumRetiree Only Retiree + Spouse Retiree + Child(ren) Family
$22.41 $45.83 $49.37 $72.77
Major- Bridges, Dentures, Single Crowns, Dental Implants, Inlays, Onlays & Veneers
60% 50%
Orthodontic % (Adults & Children) 50% 50%
IPSB pays 50% of the cost for Basic Life and AD&D plan up to a benefit of $50,000. Dependent Life ends at age 70 for spouse and age 26 for child(ren).
To search for a provider in your area, please visit www.guardiananytime.com/fpapp/FPWeb/dentalSearch.process.
Benefit Amount 2.5 X your annual earnings up to maximum of $50,000
For retiree after 7/1/97, 2.5 X your annual earnings up to maximum of $50,000
For retiree prior to 7/1/97, 1.5 X your annual earnings up to maximum of $50,000
Class 1: Board Member Retirees Class 2: Retirees
Accidental Death Benefit equals Basic Life equals Basic LifeAccidental Dismemberment Benefit equals Basic Life equals Basic Life
Age Reductions reduces to 75% at age 65, and to 50% at age 70
reduces to 75% at age 65, and to 50% at age 70
Basic Dependents Life Coverage N/A
Option 1: Spouse: $2,000Child(ren): $1,000
Option 2: Spouse: $4,000Child(ren): $2,000
Please note that the above benefits description is a brief summary and may not include all policy details.
Basic Life Retiree Option 1: Dependent Life Option 2: Dependent LifeBasic Life
Monthly Premium
AD&D $0.01 per $1,000 benefit
$0.42 per $1,000 benefit $1.52 per member $3.03 per member
DENTAL
BASIC LIFE & AD&D
Enroll: Enroll: BCBS PPO: BCBS EPO: BCBS HDHP: Humana Medicare
Advantage:
Retiree + SpouseFamily Retiree + Child:
Family:
Notes/Questions:
Coverage
standard.com(888) 937-4783
guardiananytime.com
agmbenefitsolutions.com
bcbsla.com
(844) 707-3769
(800) 495-2583
(800) 627-4200
humana.com
Two-Party:
Basic Employer Paid Life
Carrier EmailPhone
IBERVILLE PARISH SCHOOL BOARD BENEFITS CHECKLISTMedical/Medicare Advantage Dental
Retiree Only: Retiree
Guardian
Guardian
The Standard
IPSB pays 50% of the costs for Basic Life and AD&D plan up to a benefit of $50,000.
Retiree Only:
Dependent Life Option 1:
Dependent Life Option 2:
Enrollment- AGM Benefit Solutions
Blue Cross Blue Shield of Louisiana
Humana (866) 396-8810
Enroll:
Allstate (800) 521-3535 allstateatwork.com
Transamerica (800) 797-2643 transamericaemployeebenefits.com
CARRIER CONTACTS
Wellness Clinics/Open EnrollmentOctober 2018
DATE
Tuesday, October l-6
Monday, October 22
Wednesday, October 24
Thu rsday, October 25
Thursday, Novem ber 1
Wednesday, November 7
tocATtoN
Retirees at Civic Center
East lberville and Retirees
North/STEM Academy and Retirees
Retirees at Civic Center
Central Office/Op Center and Retirees
Central Office/Op Center and Retirees
Times
9am to 1 pm
8am to 10am
8am to l.1am
9am to 1 pm
7am to 11am
7am to 11am
lberville Ochsner Clinic Makeup Day 8am to noon
8am to noon
Iberville Parish School District - Retirees revised 9/27/18
Annual Health Screenings
SERVICES TO BE OFFERED: • Lipid Panel & Glucose via finger-stick
• Blood Pressure • Height and Weight • Body Mass Index
• Waist Circumference • Results Review with Registered Nurses
• Flu Shots
To pre-register and schedule an appointment go to: https://ochsner.vitalogyinc.com and enter the event code that corresponds with your school.
Ochsner Health Professionals will be performing the screenings and consultations.
**You must attend 1 of the screenings below to be eligible for the Wellness Preferred Premium Health Insurance Rate
Iberville Retiree Screenings at Civic Center Carl F Grant Civic Center Tuesday, 10/16/2018 9:00am-1:00pm Code: 346CAE
East Iberville K-12 Monday, 10/22/18 8:00am-10:00am Code: 350D93 North Iberville Elementary and STEM Academy Wednesday, 10/24/18 8:00am – 11:00am Code:352527
Iberville Retiree Screenings at Civic Center Carl F Grant Civic Center Thursday, 10/25/2018 9:00am-1:00pm Code: 353822
Central Office and OP Center OP Center Auditorium Thursday, 11/01/18 7:00am – 11:00am Code: 35553A Central Office and OP Center OP Center Auditorium Wednesday, 11/07/18 7:00am – 11:00am Code: 35691E
Iberville Ochsner Clinic - Make up Dates 25455 Highway 1, Plaquemine Call (225) 761-5770 to schedule Monday, 10/08/18 8:00am – 12:00pm Or Tuesday, 10/09/18 8:00am – 12:00pm
PREFERRED WELLNESS PREMIUM REQUIREMENTS FOR RETIREES
All lberville Parish School Eoard (IPSB) retirees are encouraged to participate in the annual wellness program. Retirees that haveinsurance covera8e through IPSB are eligible to earn a preferred wellness premium for 20L9. Retirees that complete the pHA. qet
rpremium. All required activities must be completed and logged in the portal no later than November 15, 2018.
PreferredWellnessPremium
lf it is unreasonably difficult due to a medicalcondition for you to achieve the standards for the reward under this program, or if it is medically inadvisable for you toattempt to achieve the standards for the reward under this program, call contact Frank Lee at 504-842 6017) or [email protected] he will work with you to
develop another wav to oualifv for the preferred wellness premrum
STEP ONE
Take a Personal Health Assessment (PHA)
STEP TWOGet an Annual Onsite Wellness Screening
STEP THREE
Complete and *Log TWO Activities from list below(Activities highlighted in yellow must be logged by retiree)
rcet a Flu Shot at an Annual Onsite Wellness Screening*Get a Flu Shot at en outslde locatlonrAttend seminar (onslte or WebEx) and take quiurConplete online workshop (max of two)rAttend Community Health FairrSkln Gncer ScreenlngtDental VisltrEye ExamaAge or Gender Approprlate Screening(i.e,, mammogram, pap test, colonoscopy)tBc Tobacco Free or participate in a smoking cessation program
'Prrtlclpate in 5X Run/Walk
'- ,
taI
*' PREFERRED WELLNESS PREMIUM REQUIREMENTS FOR RETIREES
Log on to www.bluewellnessla.com
Louisiana To take a PHA:
Click "1 - Know Your Health Stdtus" (an incentive point will be given once PHA is
completed)
To take a Workshop:Click "2 -Take a Workshop" to participate in a workshop (an incentive point willbe given once workshop is completed)
bo.co---\--Fr Wor h'|'l''
reElt'a
Alreadv Registered:Enter your username and password and click "GO"
Log on to www.bluewellnessla.com and click "Register New Account". Create username and password. Enterlocation code78C88ERCR l
To loe all other activities:Click "lncentives" tabthen click "Healthy Habit" tab. Click "Complete" and give
activity name and date of activity. Click "Update" then verify information to be
accurate by clicking "OK"
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It is the retiree's resoonsibilitv to track activities and make sure activities are properlv losqed on the wellness oortal.Activities logged after 1,1/1,5/2018 will not be counted.
To track completed activities:Click "lncentives" tab then click "lncentive Summary".