Return to flip book view

YourBenefitsEffective July 2025 - June 2026Genoa-Hugo School District

Making benefit selectionsEligibilityYou must request a change to your benefits within 30days of your life event (60 days for changes involvingMedicaid eligibility). Documentation may be required.Your benefit plans are in effect July 1 – June 30 eachyear. In general, there are three times you can makebenefit selections:Enrolling in coverage123Qualifying life events allow you to change your coverageduring the year outside of Open Enrollment. Theseinclude: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 eventOpen Enrollment is your one chance each year to reviewyour coverage options and make changes to yourbenefits.Your choices are in effect from July 1 – June 30 of thefollowing year unless you have a qualifying life event.Your benefits begin on the first day of the monthfollowing or coincident with date of hire; this is youreffective date. Be sure to submit your selections withinyour first 30 days of employment. Your benefit selections will be in effect through June 30. When you're first eligibleAt Open EnrollmentYou may also cover your eligible dependents when youelect coverage for yourself.Your Spouse or PartnerYou may cover your legal spouse.Your ChildrenDependent children are eligible: Medical, dental and vision: until age 26 regardlessof student or marital statusChild life insurance: until age 21, or 26 if a full-timestudentAll Genoa-Hugo School District employees who work 28hours or more per week are eligible for benefits. Benefitcoverage for you and/or your dependent(s) begins onthe first day of the month following or coincident withdate of hire. For non-continuing contracts, coverage willbe terminated at the end of August when an employeeworks through the end of their contract year; otherwise,coverage ends the last day of the month in whichemployment is terminated.For YouCovering your familyEmployer & EmployeeContributionsGenoa-Hugo School District contributes toward the costof your benefits. Benefit eligible employees receive$1,147.23 per month to spend on their own benefitelections. This allowance will cover employee onlycoverage for the Base medical plan, dental, vision, andlife. It can only be used for benefits offered throughGenoa Hugo School District. The costs to participate arelisted separately throughout the enrollment guide bytype of enrollment. Premiums will be deducted from yourpaycheck on a pre-tax basis.

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.Pre/Prior-authorizationSome specialty medical providers,services and prescriptions requireprior authorization from yourinsurance company. These mayinclude - but are not limited to -surgery, imaging (CT, MRI) andcertain prescription medications.Primary care physicianA primary care physician (PCP) isyour main medical doctor – usuallya general practitioner (GP), familydoctor, internist, OB/GYN, orpediatrician (for children).Have questions? Your advocate is here to help youwith all things benefits. See theircontact information on the nextpage.How to handle medical bills(2:04)We’re required to tell you about certainrights and responsibilities you have as anemployee of Genoa-Hugo School District. You can request a paper copy at no chargefrom:McKinze Vaughn719-743-2428mvaughn@genoahugo.orgDownload nowHelpful terms & resourcesAnnual NoticesWe've removed as much jargon as possible.But you’ll probably still encounter some terms as you enroll in and use yourbenefits, and we want you to be prepared!Learn more

Medical insuranceAnthemGroup: H604671-855-837-8536www.anthem.comNurseline (24/7): 800-337-4770Dental insuranceAnthemGroup: H604671-855-837-8536www.anthem.comVision insuranceAnthemGroup: H604671-866-723-0515www.anthem.comLife and AD&D insuranceUnumGroup: 438383 1-866-679-3057www.unum.comSTD, Cancer, AccidentAflacKevin Nuamannkevin_nuamann@us.aflac.comFirst National AgencyMike O’Dwyer719-775-2848mikeod@qwestoffice.netGenoa-Hugo SDMcKinze Vaughn Business Manager719-743-2428mvaughn@genoahugo.orgOneDigitalJen ReigelKristi Phillips720-212-2039; jreigel@onedigital.com720-452-2601; kphillips@onedigital.comContact information

Plan Benefits and FeaturesGenoa-Hugo School District offers you, our valued employee and your family, quality health care coverage throughAnthem®. You have the option to choose from a Base and a Buy Up plan. The medical plans covers services withinAnthems PPO national network. Go to www.Anthem.com for more information.MedicalThe information shown in this presentation is an illustrative summary only. The underlying plan contract or document governs all aspects of the plan. Final ratesare dependent on actual enrollment, insurance carrier or plan rules, plan selection, and eligibility criteria. Please refer to the plan document, contract, and othernotices contained in this document, applications, and other corresponding communications for additional information.Both plans cover services within a network ofcontracted hospitals, doctors, specialists, clinics,and therapists and non-network as well. Benefitsreceived from network providers are payable at ahigher level than those benefits received from non-network providers.PharmacyVisit Anthem.com, choose Order and ManagePrescriptions and log on. On the pharmacy page,choose Find a Pharmacy. Enter your zip code andhow far you want to search near you. Call thepharmacy member servicesnumber on the back of your id if you need furtherassistance.24/7 NurselineYour first line of defense against unexpectedhealth issues or for advice on where to go forcare.Help you find doctors, hospitals, and specialistsin your area.Give you referrals to LiveHealth Online, an optionfor care that allows you to have a video visit witha board- certified doctor.Enroll in health management programs for certainhealth conditions.Sydney Health Mobile AppSydney Health serves as their fully integrated digitalplatform, fostering the most personalized, optimalAnthem experience. Have a live video visit with aboard-certified doctor, therapist, or well beingcoach on your smartphone, tablet, or computer witha camera.EAP with myStrengthUp to 3 visits per issueFace to Face counseling or online visits viaLiveHealth OnlineLegal Consultation with a 30 minute phone or inperson meeting. Discounted fees to retain alawyer. Free legal forms online and additionalonline resources.Financial Consultation with professionals.Dependent care and daily living resources withinformation around child care, adoption, summercamps and elder care.Call 800-999-7222 , use the Sydney Health appor go to anthemeap.com. Enter company code:My EAP CO.

In-NetworkOut-of-NetworkCalendar Year Deductible Individual Family$1,500$3,000$4,500$9,000Out-of-pocket Maximum Individual Family$5,500$11,000 $16,500$33,000Lifetime MaximumUnlimitedUnlimitedCopays Preventive Primary care visit Specialist visitCovered at 100%$40 copay$80 copayDED then you pay 50%DED then you pay 50%DED then you pay 50%Diagnostics Lab & Xray MRI, CT, PET ScansDED then 20%$250 DED then you pay 50%DED then you pay 50%Hospital Inpatient Outpatient$500 then Deductible then 20%$500 then Deductible then 20%DED then you pay 50%DED then you pay 50%Prescription drugs Generic Preferred brand Non-preferred brand Specialty Mail Order (90-day supply)$0; $10$60$125$458Generic 2.5x, All others 3x copay50%Not CoveredEmergency$300 then Deductible then 20%AmbulanceDeductible then 20%Urgent Care$80Deductible then 50%Chiropractic$40Not Covered20-visit max per calendar yearPhysical Therapy$40Deductible then 50%20-visit max per calendar yearYour cost for coverageEmployee onlyEmployee + spouseEmployee + child(ren)Employee + familyEmployee Rates$1,099.44$2,198.88$2,033.96$3,133.40See plan detailsFind an in-network providerMedical Base PlanThe information shown in this presentation is an illustrative summary only. The underlying plan contract or document governs all aspects of the plan. Final ratesare dependent on actual enrollment, insurance carrier or plan rules, plan selection, and eligibility criteria. Please refer to the plan document, contract, and othernotices contained in this document, applications, and other corresponding communications for additional information.

In-NetworkOut-of-NetworkCalendar Year Deductible Individual Family$500$1,500$2,000$4,000Out-of-pocket Maximum Individual Family$2,500$5,000 $7,500$15,000Lifetime MaximumUnlimitedUnlimitedCopays Preventive Primary care visit Specialist visitCovered at 100%$20 copay$50 copayDED then you pay 50%DED then you pay 50%DED then you pay 50%Diagnostics Lab & Xray MRI, CT, PET ScansDED then 10%Deductible then 10%DED then you pay 50%DED then you pay 50%Hospital Inpatient OutpatientDeductible then 10%Deductible then 10%DED then you pay 50%DED then you pay 50%Prescription drugs Generic Preferred brand Non-preferred brand Specialty Mail Order (90-day supply)$0; $10$60$125$200Generic 2.5x, All others 3x copay50%Not CoveredEmergencyDeductible then $300AmbulanceDeductible then 10%Urgent Care$50Deductible then 50%Chiropractic$25Not Covered20-visit max per calendar yearPhysical Therapy$25Deductible then 50%20-visit max per calendar yearYour cost for coverageEmployee onlyEmployee + spouseEmployee + child(ren)Employee + familyEmployee Rates$1,292.84$2,585.68$2,391.75$3,684.59See plan detailsFind an in-network providerMedical Buy UpPlanThe information shown in this presentation is an illustrative summary only. The underlying plan contract or document governs all aspects of the plan. Final ratesare dependent on actual enrollment, insurance carrier or plan rules, plan selection, and eligibility criteria. Please refer to the plan document, contract, and othernotices contained in this document, applications, and other corresponding communications for additional information.

Stay in-network to avoid balance billing (the difference between what an out-of-network provider charges and the amount your insurance pays). Genoa-Hugo School District also offers dental benefits through Anthem®. Thedental plan has in- and out-of- network coverage with the ability to chooseany dentist; however, you will receive the best benefits available on the planby choosing a contracted dentist who participates in the network.The cost to participate in this benefit is provide below as well as a summary ofthe dental benefits. Additional information including FAQs, claim forms, andprovider directories can be found on www.anthem.com.In-networkOut-of-networkDeductible Individual FamilyWaived for Type A - Preventive$50$150Waived for Type A - Preventive$50$150Annual maximum benefit$1,500Preventive care Oral Exams, X-Rays, Cleaning,Fluoride (through age 14)100%100%Basic care Fillings, Simple and SurgicalExtractions, Endodontics, Periodontics,Sealants, Space Maintainers80%80%Major care Crowns, Bridges, Dentures, Implants50%50%Orthodontia (Children to age 18)50% up to $1,000 Lifetime MaximumYour cost for coverageEmployee onlyEmployee + spouseEmployee + child(ren)Employee + familyPer Month$38.49$78.52$89.98$134.56Dental insuranceLearn about dental care categoriesThe information shown in this presentation is an illustrative summary only. The underlying plan contract or document governs all aspects of the plan. Final ratesare dependent on actual enrollment, insurance carrier or plan rules, plan selection, and eligibility criteria. Please refer to the plan document, contract, and othernotices contained in this document, applications, and other corresponding communications for additional information.See plan details

Your vision plan covers either glasses (lenses and frames) or contact lenses each year. If you receive contact lenses, they will be instead of your glasses benefit.In-networkOut-of-networkVision Exam Services$10 Copay then: Eye ExamCovered in full$42 allowance Exam FrequencyOnce every calendar yearVision Care Materials$0 copay then: Eyeglass Lenses (per pair) Single Vision Bifocal Trifocal$0 CopayUp to $40Up to $60Up to $80 Lens FrequencyOnce every calendar yearFrames$130 allowance then 20% discount$45 allowance Frame FrequencyOnce every calendar yearContact Lenses Contact Lens Fitting Medically Necessary Elective (in lieu of eyeglasses)Up to $55Covered in full$130 allowanceApplied to allowance$210 allowance$95 allowance Contact Lenses FrequencyOnce every calendar yearValue Add40% off cost of additional pairs of glassesYour costEmployee onlyEmployee + spouseEmployee + child(ren)Employee + familyMonthly Costs$6.70$13.39$13.43$22.34You'll get an annual exam with coverage for lenses and frames, or contacts inlieu ofGenoa-Hugo School District offers vision benefits through Anthem®.The vision plan is a network-based plan, but your benefit dollars go furtherwhen you stay in network.A summary of the vision benefits is illustrated below. Also, a list of providers,detailed plan descriptions, and FAQs can be found on www.anthem.com.Vision insuranceThe information shown in this presentation is an illustrative summary only. The underlying plan contract or document governs all aspects of the plan. Final ratesare dependent on actual enrollment, insurance carrier or plan rules, plan selection, and eligibility criteria. Please refer to the plan document, contract, and othernotices contained in this document, applications, and other corresponding communications for additional information.See plan details

Additional life and AD&D insuranceGenoa-Hugo School District provides basic Life andAccidental Death & Dismemberment (AD&D) Insuranceand is available to eligible employees. This benefit isoffered to all benefit-eligible employees and is providedthrough Unum®. Please note that $2.60 of the GenoaHugo contribution is used toward this benefit and it cannotbe waived.Life and AD&DinsuranceLife and AD&D insuranceThe information shown in this presentation is an illustrative summary only. The underlying plan contract or document governs all aspects of the plan. Final ratesare dependent on actual enrollment, insurance carrier or plan rules, plan selection, and eligibility criteria. Please refer to the plan document, contract, and othernotices contained in this document, applications, and other corresponding communications for additional information.Life insurance can provide added financial protection fornamed beneficiaries in the event the insured individual diesprematurely. Adequate life insurance can help your familymanage expenses and make a difficult transition lesspainful. All employees receive a flat $20,000 benefit with aguarantee issue equal to benefit.AD&D coverage provides a benefit in the event of death ordismemberment resulting from a covered accident. TheAD&D principal sum is equal to the amount of basic lifeinsurance: $20,000.PortabilityConversion PrivilegeAccelerated BenefitReduction Schedule*According to the reduction schedule, benefits reduce to:65% of the original amount at age 6550% of the original amount at age 70 *Coverage may not be increased after a reduction.Important note: It is very important that your beneficiaryinformation is up-to-date; in the event you need tochange your beneficiary, please contact HumanResources.For more details on your Life and AD&D benefits, pleasevisit www.unum.com or contact Human Resources.

Short-Term Disability (STD) offered through Aflac® isavailable to all full-time employees. For manyemployees, a temporary loss of income could have long-term financial consequences. Receive a monthlydisability benefit of up to $6,000 a month. You also havethe option to potentially receive $1,000 for every fiveyears you don’t use the policy. Both 7 and 14 dayselimination periods are offered.Accidents are not planned and they can happen at anymoment. When they do happen, medical bills can startadding up quickly. Aflac® pays cash to help with thefollowing:ER/Doctor/Physical TherapyHospital AdmissionHospital Confinement/ICUDiagnostic Exams (MRI/CT)Ground/Air AmbulanceInjury-specific Cash BenefitsShort-term disabilityThe average out-of-pocket costs for cancer patients can be catastrophic regardless of health care coverage. In manycases, doctors can bring you back to health, but it can be extremely expensive and a lot of treatments are givenwithout discussion for the costs or financial consequence. For rates and additional information, contact HumanResources or the contact information on page 4.CancerSupplementalBenefitsThe information shown in this presentation is an illustrative summary only. The underlying plan contract or document governs all aspects of the plan. Final ratesare dependent on actual enrollment, insurance carrier or plan rules, plan selection, and eligibility criteria. Please refer to the plan document, contract, and othernotices contained in this document, applications, and other corresponding communications for additional information.Accidents are not planned and they can happen at anymoment. When they do happen, medical bills can startadding up fast. Initial doctor / ER / Urgent care visits due to aninjury $160First day in the hospital due to an injury $1,500.00.$300.00 each additional nightFollow up visits due to an injury $55.00, Physicaltherapy visits due to an injury $35.00Ligament damage, torn cartilage, coma, concussion,fracture benefit, sutures, surgeries...$60.00 Wellness benefit once per year for routinewellness check-ups after the policy is in place 12monthsAccidental Death benefit $40,000.00 employeeAccident

2025 benefits