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Benefits GuideEffective July 1st, 2024 - June 30th, 2025Click Here If You Would Like To View A Voice OverRecording Walking You Through This Guide.
This year’s open enrollment will be passive. Thismeans if you wish to keep your current benefitsthe same, you do not need to take any action for2024. If you wish to enroll or make a change, youneed to complete the enrollment/change form.Open enrollment runs from June 3rd throughJune 21st. Make your benefit elections bycompleting the forms, and returning them toChristine Eaton by June 21st, 2024. Elections orchanges will take effect on July 1st, 2024.Legally Married SpouseDomestic PartnerBiological ChildrenStep-childrenAdopted ChildrenChildren in your custody for adoptionChildren under your legal guardianshipPermanently disabled children over plan age restrictionsNote: You, the employee, must be enrolled in the coverageyou wish to enroll a dependent in. You may only enroll in benefits when you are firsteligible (New Hire enrollment period) or make changesto your benefits during Open Enrollment. However, youcan make changes/enroll during the plan year if youexperience a qualifying life event:MarriageDivorceNew Baby/AdoptionDeath of DependentYour Dependent's Open EnrollmentYou/Dependent lose other coverageYou/Dependent gain other coverageYou/Dependent lose Medicaid coverageYou/Dependent gain Medicaid/Medicare coverageSee Full Event List HereGetting StartedMaking benefit selectionsMid Year Changes l Qualifying Life EventsNeed Help? Contact ChristineEaton (ceaton@hfmboces.org)New HiresNew Hires are eligible for coverage with the effectivedate being their date of hire.2024 Open EnrollmentWho can I add to my coverage?Enrollment Forms: MVP, UCM, Delta Dental, Waiver
Out-of-pocket maximumThe most you’ll pay for covered in-network medical care in aplan year. This includes your deductible, any coinsurance orcopays, and prescription drugs. The out-of-pocket maximumdoes not include your premium (the amount you pay forcoverage), non-covered expenses, or out-of-network carethat’s been balance billed. HFM plan has matching deductibleand out-of-pocket values, therefore once deductible has beenmet, no further medical or RX costs will apply for the planyear. CoinsuranceAfter you’ve met your deductible, you’re sometimes responsiblefor a percentage of the cost of the medical care, dental care, orprescription medication you received. This percentage iscoinsurance. The HFM policy does not include this feature. CopayA flat fee you pay each time you receive a copay-eligiblemedical, dental, or vision service or prescription medication. In-networkIn-network care is always your lowest-cost option. Networks aregroups of medical, dental, and vision providers, pharmacies, andfacilities that agree to discount the cost of their care or service.Deductible (HDHP Plan)The amount of first dollar responsibility attributed to eachindividual participating in the plan. For family enrollmentthe amount is an aggregate combination of all familymembers. Embedded DeductibleThe amount any one person from the family must meet tofulfill their deductible requirement. This value generallymatches the single deductible. Primary care physicianA primary care physician (PCP) is your main medical doctor –usually a general practitioner (GP), family doctor, internist, OB/GYN,or pediatrician (for children).How to handlemedical bills (4:46)Getting StartedHelpful Terms & ResourcesWe've removed as much jargon as possible.But you’ll probably still encounter some terms as you enroll in and use your benefits, and we want you to be prepared!
In-network careHigh Deductible PlanBenefit SummariesNetwork name:NY EPO HDHP NetworkAnnual Deductible$4,000 individual (embedded) $8,000 family (embedded)Coinsurance0% Out-of-pocket maximum$4,000 individual (embedded) $8,000 family (embedded)Preventive carePrimary care visitSpecialist visit100% coveredDeductible then, 0% coinsurance Deductible then, 0% coinsuranceUrgent careEmergency roomInpatient hospital careDeductible then, 0% coinsurance Deductible then, 0% coinsuranceDeductible then, 0% coinsurancePrescription drugsGeneric Preferred brand Non-preferred brandDeductible then, $0Deductible then, $0Deductible then, $0Your cost for coverageEmployee onlyEmployee + Child(ren)Employee + SpouseEmployee + FamilyPer paycheck (12 month / 10 month)$22.17 / $28.81$39.89 / $51.86$44.33 / $57.62$66.49 / $86.44Medical InsuranceThe information shown in this presentation is an illustrative summary only. The underlying plan contract or document governs all aspects of the plan. Final rates 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.You'll get in-network preventive care at 100%, prescription drug coverage, and anannual limit on your expenses.Your medical plan choices are throughMVP Health Care .Benefit SummaryMail Order FormAdditional InformationHFM BOCES covers 94% of the premiums for this plan.
Having good health and the energy to perform your job life outside ofwork, such as spending time with family, friends, or participating inactivities you enjoy. Think of physical wellbeing as nutrition, stayinghydrated, getting rest, avoiding illness through vaccines, preventivescreenings, and following doctors’ orders!Healthy, supportive relationships with family, friends, and mostimportantly, yourself. Effectively managing feelings and emotions andpracticing healthy ways to manage stress and adapt to challenges.Social & EmotionalThe ability to effectively understand and plan for day-to-day expenses,short-term, and long-term goals, like paying back student loans, savingfor a house, sending children to college, retirement, or caring for agingfamily members.FinancialCreate environments that support well-being at home, work, and in thecommunity.SurroundingsFind purpose, build a support system, and tap into creative abilities.Mind & Spirit Total Wellbeing: Caring For All Of YouSupport for your health, finances, and life.Did you know that MVP offers re-imbursements?Get reimbursed for the things that fit your well-being journey. Click below formore information:The information shown in this presentation is an illustrative summary only. The underlying plan contract or document governs all aspects of the plan. Final rates 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.There are five ingredients to wellbeing — each is just as important as the others:The recipe to living wellPhysicalMake sure you are utilizing Gia by MVP.Gia is your guide to your health & your health plan. Get started and learn moreinformation about Gia by clicking below:Are you getting the most out of your insurance?Click below for more information on how you can get the most out of your MVPHealthcare plan:
Access quality care in the convenience of your own home, on your lunchbreak, or on the way to your child’s soccer game! Whether it's a nagging cough, middle-of-the-night fever, or a suspicious-looking mole or rash — telehealth through UCM Digital Health is here whenyou need it. Connect with a board-certified physician 24 hours a day, 7 daysa week.TelehealthTelehealth: virtual health care that fits yourschedule.See plan detailsThe information shown in this presentation is an illustrative summary only. The underlying plan contract or document governs all aspects of the plan. Final rates 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.Offered through United Concierge Medicine.Do you have a chronic condition? Do you rarely use the plan and could use help navigating the health care system? Do you want to receive care from the comfort of your home, office or classroom? Our virtual health conceirge system can be used for all of the above and more. It is a great way tosave time and money by accessing this valuable resource, fully sponsored by HFM BOCES. Download the app and register early for convenience, this way when you need the coverage it isjust a phone call away. Click here todownloadthe mobileapp!
Dental insuranceYour dental plan is provided through DeltaDentalThe information shown in this presentation is an illustrative summary only. The underlying plan contract or document governs all aspects of the plan. Final rates 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 PlanIn-network careDental PPO PlanAnnual Deductible $25 individual$75 familyAnnual maximum benefit$5,000 per person Preventive care100% coveredBasic care20% after deductible Major care50% after deductible Orthodontic careCoverageLifetime maximum benefit50% covered (adult & dependent child)$4,000 lifetime max benefitYour cost for coverageEmployee onlyEmployee + One DependentEmployee + FamilyPer paycheck (12 month / 10 month)$3.64 / $4.74$7.03 / $9.14$11.10 / $14.43This covers in-network preventive care at 100%!Stay in-network to avoid balance billing (the difference between what an out-of-network provider charges and the amount your insurance pays). Benefit SummaryHFM BOCES covers 85% of the premiums for this plan.
If you cover yourself onlyIf you cover anydependentsHFM BOCEScontributes up to:$1,000$2,000You may also contribute:$$2024 IRS maximumcontribution $4,150$8,300Maximum amount youcan contribute$3,150 or $4,150 if 55years or older$6,300 or $7,300 if 55years or olderSee how an HSA can help yousave for today and tomorrow.Using your moneySpend your HSA balance on health care expenses (medical,prescription, dental, and vision) for you and your tax dependents, ORLet your balance grow for retirement.The money in your HSA is always yours and available for qualifiedhealth care expenses - even if you change jobs or health plans. Beforeretirement, any funds used for non-health care expenses are subject totax penalties. Keep your receipts!Growing your money + tax savingsHSA dollars go in tax-free, grow tax-free and come out tax-free when youuse them for qualified health expenses. You may also be able to investpart of your balance once it meets a certain level.In retirementAt age 65, you can withdraw the funds in your HSA for any use (not justhealth care!) without tax penalties. Health Savings Account (HSA)The information shown in this presentation is an illustrative summary only. The underlying plan contract or document governs all aspects of the plan. Final rates 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.Save pre-tax money for health care expenses – or retirement!An HSA through vendor is paired with a High Deductible Health Plan (HDHP).HFM BOCES contributes to your Health Savings Account (HSA)when you elect the HDHP medical plan and meet IRS eligibilityrequirements. You may also contribute tax-free funds to save for current andfuture health expenses:Contributions HSA fundsIn order to make – or receive – contributions to a Health SavingsAccount (HSA), you must:be enrolled in a qualified High Deductible Health Plan (HDHP),not be covered under any other non-HDHP health coverage,including a full health care FSA through your spouse,not be anyone else’s tax dependent, and not be eligible for or enrolled in Medicare A or B, Tricare, or VAbenefits.EligibilityLearn more about spending accounts with your MVP HDHP byclicking below:
OneDigital Privacy PolicyHIPAA Privacy NoticeNewborns' and Mothers’ Health Protection Act Women’s Health and Cancer Rights Act HIPAA Special Enrollment NoticeContinuation of Coverage Rights Under COBRAMarketplace Coverage OptionsMedicaid and the Children’s Health Insurance Program (CHIP)Medicare D Creditable Coverage NoticeNY DBL Notice Required NoticesFor any addiational assistance pleasecontact:Stacy BlaauboerSenior Account Managerstacy.blaauboer@onedigital.com(518) 720 - 8888 ext. 126Dylan Mather-RichardsonAssociate Account Managerdmatherrichardson@onedigital.com(518) 720 - 8888 ext. 131