Fridley 2024 Benefits Guide : simplebooklet.com

Enroll now!Making benefit selectionsGetting startedYou must request a change to your benefitswithin 30 days of your life event (60 days forchanges involving Medicaid eligibility). Documentation may be required.Your benefit plans are in effect July 1, 2024 – June 30, 2025. EligibilityEnrolling in coverageYour Spouse Open Enrollment is your one chance each year toreview your coverage options and make changes toyour benefits.Your choices are in effect from July - June of thefollowing year unless you have a qualifying lifeevent.Open EnrollmentQualifying life events allow you to change yourcoverage during the year outside of OpenEnrollment. These include:marriage or divorce, birth or adoption, death of a covered dependent, and a change in eligibility through Medicare,Medicaid, or a spouse or parent's coverage.If you have a qualifying life eventYou may also cover your eligible dependents whenyou elect coverage for yourself.Covering your familyDependent children are eligible until age 26regardless of student or marital status.You may cover your legal spouse.Your childrenHow to EnrollRead your materials and make sure youunderstand all of the options available.Login to PlanSource to add or dropdependents, change plans, waive coverage.Come prepared with dates of birth, socialsecurity numbers, and legal names of anydependents you live with to enroll in benefits.Remember to review your beneficiaries.Complete and submit your EOI form if yourenrollment requires it.IneligibleDivorced or Legally separated spouseCommon law spouse, even if recognized byyour stateDomestic partners, unless your employer statesotherwiseFoster childrenSisters, brothers, parents or in-laws, etc.

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Balance billingWhen you use an out-of-networkmedical or dental provider, theymay bill you the difference betweenwhat they charge and the amountyour insurance pays.Medical: balance billing is inaddition to – and does not counttowards – your out-of-pocketmaximum.CoinsuranceAfter you’ve met your deductible,you’re sometimes responsible for apercentage of the cost of themedical care, dental care, orprescription medication youreceived. This percentage iscoinsurance.CopayA flat fee you pay each time youreceive a copay-eligible medical,dental, or vision service orprescription medication. DeductibleThe amount you’re responsible forpaying in care expenses before themedical or dental plan starts payingdeductible-eligible expenses.In-networkIn-network care is always yourlowest-cost option. Networks aregroups of medical, dental, andvision providers, pharmacies, andfacilities that agree to discount thecost of their care or service.Out-of-pocket maximumThe most you’ll pay for covered in-network medical care in a year. Thisincludes your deductible, anycoinsurance or copays, andprescription drugs. The out-of-pocket maximum doesnot include your premium (theamount you pay for coverage), non-covered expenses, or out-of-network care that’s been balancebilled.Primary care physicianA primary care physician (PCP) isyour main medical doctor – usuallya general practitioner (GP), familydoctor, internist, OB/GYN, orpediatrician (for children).Referral/pre-authorizationSome specialty medical providersand services require a referral froma primary doctor. These may include- but are not limited to -cardiology, psychiatry, orthopedicsurgeons, rheumatology, surgery,and imaging (CT or MRI).How to handle medicalbills (4:46)Helpful terms & resourcesGetting startedWe've removed as much jargon as possible.But you’ll probably still encounter some terms as you enroll in and use your benefits, and wewant you to be prepared!

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MedicalDentalHealthPartnersCustomer Service:952-883-5000VisionVSPCustomer Service:800-877-7195Life & AD&DLong-Term DisabilityMadison NationalCustomer Service:1-800-356-9601VEBA AccountFlexible Spending AccountWexCustomer Service:1-833-225-5939View Your NoticesClient PortalClient PortalClient PortalClient PortalContact informationGetting startedPlease reach out to HR with any questions!HR Department:hrdepartment@fridley.12.mn.usAnnual NoticesWe’re required to tell you about certainrights and responsibilities you have as anemployee of Fridley Public Schools

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The information shown in this presentation is an illustrative summary only. The underlying plan contract or document governs all aspects of the plan. Finalrates are dependent on actual enrollment, insurance carrier or plan rules, plan selection, and eligibility criteria. Please refer to the plan document, contract,and other notices contained in this document, applications, and other corresponding communications for additional information.In-Network BenefitsHP Classic $20 Copay PlanHP NationalOne PlanCalendar Year Deductible (DED)(Non-Embedded)$0 single$0 single + 1$0 Family$1,000 single$1,500 single + 1$2,000 FamilyOut of Pocket Maximum(Non-Embedded)$1,000 single$2,000 single + 1$2,000 Family$2,000 single$2,500 single + 1$3,000 FamilyOffice VisitPrimary Care, Specialist$20 copayDED then 80%Diagnostic TestX-Ray, Blood Work100%DED then 80%Convenience Care$10 CopayDED then 80%Emergency Care (ER)$75 CopayDED then 80%ProceduresInpatient, Outpatient$100 CopayDED then 80%Retail Prescription drugs(Generic / Brand / Non-Formulary)Specialty$10 / $20 / Not CoveredDED then 80% up to $200$10 / $20 / Not CoveredDED then 80% up to $200Mail Order Prescription drugs(Generic / Brand / Non-Formulary)$20 / $40 / Not Covered$20 / $40 / Not CoveredMedical insuranceSee plan detailsFind an In-Network Provider Here:Open Access NetworkSee plan detailsRefer to the carrier benefits summary for the exact benefit levels associatedwith your plan.Select from two Medical options provided throughHealthPartnersPlease Refer to your plan documents for full out-of-network benefitsHealthPartners Open Enrollment Guide:Learn More Here!New Medical benefit:Free Virtuwell for all Members!

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Highlights A VEBA is offered exclusively to enrollees of the VEBA compatible medical plan; the HP NationalOnePlan is compatibleYour employer sets up this account for you and puts money into it. As soon as your employer funds theaccount, the money belongs to you.You are not able to contribute to an HRA, this is done by your employer.Because the money isn’t part of your wages, you won’t pay taxes on it. You can use this money to help pay your health care costs at medical facilities.Once retired, you can use VEBA funds to pay for health insurance premiums like COBRA or Medicare.Eligible expenses2024 maximum contribution$3,200Annual rollover amount$640See plan details2024 maximum contribution$5,000Married filing separately? You can contribute up to $2,500 per person.Dependent care FSASingleEmployee + 1FamilyMonthly EmployerContribution$110.42$79.93$102.24See plan detailsThe information shown in this presentation is an illustrative summary only. The underlying plan contract or document governs all aspects of the plan. Finalrates are dependent on actual enrollment, insurance carrier or plan rules, plan selection, and eligibility criteria. Please refer to the plan document, contract,and other notices contained in this document, applications, and other corresponding communications for additional information.Savings PlansA voluntary employee beneficiary account (VEBA) is a unique, tax-free health care savings plan fundedentirely by your employer. It can pay for qualified medical expenses now or in the future, plus it can be usedto pay health insurance premiums when you retire.Health and dependent care expenses can add up. Paying with tax-free fundscan help. Enroll in one or more flexible spending accounts (FSAs) dependingon your needs.Pay for qualifying expenses with tax-free money using yourFlexible Spending Account through OneBridge.Health care expensesPay for eligible medical, prescription, dental, andvision expenses.Health care FSAPay for eligible child or disabled adult care while youwork or attend school.Only the amount you’ve actually contributed isavailable for use at any one time.Estimate carefully! Unused funds will be forfeited atthe end of the year per IRS regulations.Flexible Spending AccountHealth Reimbursement Arrangement HRA/VEBA

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Stay in-network to avoid balance billing (the difference between what an out-of-network provider charges and the amount your insurance pays). In-Network BenefitsLevel 1Level 2Annual Deductible (DED)NoneNoneAnnual maximum benefitIncludes $500 Implant Maximum$2,000 Per Person$,1500 Per PersonDiagnostic & Preventive CareCleanings, X-rays, Exams, Fluoride, Sealants100% Covered100% CoveredBasic CareSimple Extractions, Endodontics,Periodontics, Complex Oral Surgery100%90%FillingsAmalgam & Anterior Composite100%100%White Fillings80%80%Special CareRestorative Crowns and Onlays90%90%ProstheticsDentures, Bridges, Partial Dentures60%60%Dental Implants50%, up to $500 Maximum(Included in annual maximum)50%, up to $500 Maximum(Included in annual maximum)Find an In-Network Provider Here:Network DirectorySee plan detailsThe information shown in this presentation is an illustrative summary only. The underlying plan contract or document governs all aspects of the plan. Finalrates are dependent on actual enrollment, insurance carrier or plan rules, plan selection, and eligibility criteria. Please refer to the plan document, contract,and other notices contained in this document, applications, and other corresponding communications for additional information.Dental insuranceYou'll get in-network preventive care at 100% along withcoverage for basic and major dental services.Your dental coverage is through HealthPartners.Please Refer to your plan documents for full out-of-network benefits

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The information shown in this presentation is an illustrative summary only. The underlying plan contract or document governs all aspects of the plan. Finalrates are dependent on actual enrollment, insurance carrier or plan rules, plan selection, and eligibility criteria. Please refer to the plan document, contract,and other notices contained in this document, applications, and other corresponding communications for additional information.In-network careStandard PlanPremium PlanBenefit FrequenciesWellvision ExaminationEssential Eye CareLensesFramesContact Lenses12 MonthsAvailable as Needed12 Months24 Months12 Months12 MonthsAvailable as Needed12 Months12 Months12 MonthsExamsWellvision ExamEssential Eye Care$10 Copay$0 per Screening, $20 per Exam$10 Copay for Exam & Glasses$0 per Screening, $20 per ExamPrescription GlassesLensesFrames$25 CopayIncluded in $25 Copay20% off balance over $130 AllowanceCombined with Exam CopayCombined with Exam Copay20% off balance over $130 AllowanceContactsLens Fitting & Exam$130 Lens AllowanceUp to $60 Copay$130 Lens AllowanceUp to $60 CopaySee plan detailsVision insuranceFind an In-Network Provider:Select “Choice Network”Choice NetworkYou'll get coverage for lenses, Frames, and contacts, with an allowance forcontacts and frames.Your vision coverage is through VSP.Please Refer to your plan documents for full out-of-network benefitsand featured brand discountsSee plan details

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Life and AD&D insuranceEmployeeSpouseChild(ren)Election Increments$10,000$5,000$5,000Coverage Amount Maximum5x your annual earnings up to$1,000,000Your (employee) amount up to$500,000$10,000Guarantee Issue (GI)$250,000$50,000Does not applyThe information shown in this presentation is an illustrative summary only. The underlying plan contract or document governs all aspects of the plan. Finalrates are dependent on actual enrollment, insurance carrier or plan rules, plan selection, and eligibility criteria. Please refer to the plan document, contract,and other notices contained in this document, applications, and other corresponding communications for additional information.Financial peace of mind through Madison National.Life insurance pays a benefit if you pass away while you're covered.Accidental Death and Dismemberment (AD&D) insurance offers additionalsupport if you pass away or are seriously injured due to an accident.Employer Paid Basic Life and AD&D insuranceThe district offers basic life and AD&D coverage. Please refer to youremployment contract for plan details.Make sure to designate a beneficiary for your life insurance coverage toensure your family is cared for according to your wishes.Voluntary life and Accident insuranceYou may also purchase additional coverage for you, your spouse, and youreligible child(ren). Long Term Disability insuranceThe district offers long term disability coverage. Please refer to youremployment contract for plan details.

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Fridley 2024 Benefits Guide

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