BSSD 2021 OE Presentation v5:HOFRPH 7KH EHQHILWV\RX HOHFW QRZ DUH HIIHFWLYH -DQXDU\ ² 'HFHPEHU

BENEFITS PRESENTATION

BONNER SPRINGS SCHOOL DISTRICT

Welcome!

The benefits you elect now are effective January 1, 2021 –

December 31, 2021

• Your deductible/out-pocket maximums will re-set to zero on January 1, 2021

• Remember to review all your plan options and networks to determine what best fits your needs

• No changes to medical plans except 90-day maintenance medications can now be filled at retail pharmacies

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Qualifying Life Event

Unless you have a qualified change in status, you cannot make changes to the benefits you elect until the next annual enrollment period.• Qualified changes in status include:

• Birth of a child, adoption, marriage, death, divorce, loss of coverage (if you or your spouse/dependents are covered under another plan and then lose that coverage)

Should you wish to make changes to your elections due to a qualifying event, you have 31 days from the event to notify Stormi Vitt, Benefit Coordinator andcomplete/turn in the appropriate paperwork. Otherwise you will have to wait untilthe next annual enrollment to make any changes to your benefit elections.

Adding a NewbornIf you have Single Coverage or are currently covering Dependents:

• Request coverage for the newborn within 31 days following the birth• The baby WILL NOT be automatically enrolled for you• After you complete the enrollment request, the child will be added

retroactive to his/her birth date• The member could be responsible for additional Premium

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USD 204 Wellness Vision Statement: To empower and reward employees for

living sustainable healthy lives both in and out of the workplace

Wellness Champions:

BSHS Crystal Coleman-Richardson

CMS Melissa Mitchell

BSE Tammy Dooley

DRE Kristi Flack

EDW Kevin Riley

District Kaela Williams

Wellbeing

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Wellbeing Program Highlights

Programming and Challenges – offered to staff; focus on physical, emotional, financial, and social wellbeing

Prizes – opportunities to earn prizes and awards!

Communications – wellbeing communication sent out every month

Community Activities – opportunities to participate in community wellness activities

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Copay – a fixed dollar amount you pay for covered services. Such services include but are not limited to physician office visits, urgent care, and prescriptions.

Insurance Terms

Out-of-Pocket Maximum – is the most you will pay in a given plan year for your benefits, not including your premium. Your deductible, copays, and coinsurance all accumulate towards this maximum amount. Once this is met, all covered services will be paid at 100% for the remainder of the plan year.

Deductible – is the amount of money you pay for services before coinsurance applies. This does not apply to preventive services required under the Affordable Care Act.

Coinsurance – is the percentage you pay for certain services based on the allowed amount charged. Generally, the insurance company pays the larger portion of the percentage and you pay the smaller portion. Coinsurance applies after the deductible has been met.

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NetworkAvailability & Differences

The network of providers available to you depends on the Blue KC plan you choose:

Visit www.bluekc.com to find a provider

Preferred-Care Blue (PCB)

Preferred Provider Organization (PPO)

Blue Select Plus (BSP)Exclusive Provider Organization

(EPO)

Blue CareHealth Maintenance Organization

(HMO)

• Applies to Option 2: QHDHPand Option 3: PPO

• Larger network in Greater KC area

• Provides in and out-of-network coverage

• Emergencies are covered at the in-network level

• Provides access to the national Blue Card network when traveling outside the Blue KC area

• Applies to Option 1: Spira Care EPO

• Smaller network, limited to 10 hospitals, Spira Care Centers, and approximately 3,900 providers

• Provides in-network coverage only


• Provides access to the national Blue Card network when traveling outside the Blue KC service area

• Applies to Option 5: HMO

• Smallest network; local coverage only

• Provides in-network coverage only


• No coverage outside of the KC Metro. Only Johnson and Wyandotte counties are in-network in Kansas

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KC METRO NETWORK HOSPITALS

KC Metro Hospitals Preferred-Care Blue Blue Select Plus Blue Care

AdventHealth (Shawnee Mission)

Belton Regional Medical Center Cameron Regional Medical Center Cass Regional Medical Center

Center Point Medical Center

Children’s Mercy Hospital

Children’s Mercy Hospital—South

KU Medical Centers

Lee’s Summit Hospital

Liberty Hospital

Menorah Medical Center

North Kansas City Hospital

Olathe Medical Center

Overland Park Regional

Providence Medical Center

Research Medical Center

St. Joseph Medical Center

St. Luke’s (All Locations)

St. Mary’s Medical Center

Truman Medical Center - Hospital Hill

Truman Medical Center—Lee’s Summit 8

Blue Select Plus Network

Visit www.bluekc.com to find a provider

If you are in the 32 county BlueKC service area and receive care from a hospital or provider that does not participate in the BlueSelect Plus Network, you will not have any coverage.

If you are traveling and are outside of the the 32 county BlueKC service area, you still have access to the national Blue Card PPO Network and can receive in-network benefits.

All life or limb threatening emergent care is covered at the in-network level, regardless if you are in- or out-of-network.

Blue KC 32 county service areaKansas: Johnson and Wyandotte Missouri: Andrew, Atchison, Caldwell, Carroll, Cass, Bates, Benton, Buchanan, Clay, Clinton, Davies, Dekalb, Gentry, Grundy, Harrison, Henry, Holt, Jackson, Johnson, Lafayette, Livingston, Mercer, Nodaway, Pettis, Platte, Ray, Saline, St.Clair, Vernon, Worth

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Care Centers + Hospitals In-Network

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Take a virtual tour at

SpiraCare.com/TourGuide

Plans to expand based on membership demand

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COMPREHENSIVE SERVICES CONVENIENT BENEFITS

Adult and Pediatric Primary and Preventive Care

Sick Care Common Prescriptions Filled On-Site**

Specialist Referrals & Scheduling

Chronic ConditionManagement

Behavioral Health Consultations

Patient WellnessFollow-Ups

Support in Understanding your Plan’s Network

DigitalX-Rays*

LabDraws

Access to A Healthier You Platform

Extended Full-Service Hours

Patient Wellness Follow-ups

Health Coaches On-Site

On-line Scheduling for most appointment types, call for

sick care needs

Virtual Care and Online Communications

*X-rays are available at select locations only, but are at no additional cost to members.** Select prescriptions will be offered on-site at your regular copay or deductible level.

Option 1 Spira Care EPO: Up to a $60 allowable charge for services

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2021 Medical Rates

Option 1: Spira Care

EPO

Option 2: QHDHP

Option 3: PPO

Option 4*: Buy-Up PPO

Option 5*: HMO

EMPLOYEE ONLY $0 $0 $0 $121 $54

DISTRICT FUNDED HSA(EMPLOYEE ONLY)

$107 $12 N/A N/A N/A

FAMILY $619 $865 $911 $1,197 $1,027

*Grandfathered plans – no new enrollment

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Employee Monthly Medical Plan Premium / Member Responsibility

Total Exposure = Above Rate Annualized + Out-of-Pocket Maximum

2021 Individual Exposure

EMPLOYEE ONLY

COVERAGE

Option 1: Spira Care

EPO

Option 2: QHDHP

Option 3: PPO


Option 5*: HMO

Annual Premium $0 $0 $0 $1,452 $648

Out-of-Pocket Maximum $2,800 $2,800 $4,000 $2,750 $3,000

Annual District Funded HSA $1,284 $144 N/A N/A N/A

Total Exposure $1,516 $2,656 $4,000 $4,202 $3,648

*Grandfathered plans – no new enrollment 13

Total Medical Insurance Exposure = Premium + Out-of-Pocket Maximum

2021 Medical PlansOption 1: Spira Care EPO

BlueSelect Plus

Option 2: QHDHP

Preferred Care Blue

Option 3: PPO

Preferred Care Blue

Deductible

Individual

Family

In Network

$2,800

$5,600

In Network

$2,800

$5,600

In Network

$1,000

$2,000

Member Coinsurance 0% 0% 20%

Out-of-Pocket Maximum

Individual

Family

$2,800

$5,600

$2,800

$5,600

$4,000

$8,000

Office Visit

Primary Care Physician

Specialist

Spira Center

Deductible

Deductible

$60 Maximum allowable charge

Deductible

Deductible

N/A

$40

$80

N/A

Preventive Care Covered 100% Covered 100% Covered 100%

Urgent Care Deductible Deductible $80

Emergency Room Deductible Deductible $200 then deductible then 20%

Outpatient Surgery / Inpatient Hospital Services Deductible Deductible Deductible then 20%

Prescription Drug

Retail (30-day supply)

Tier 1 – Generic

Tier 2 – Preferred

Tier 3 – Non-Preferred

Mail Order or Retail (90-day supply)

Deductible Deductible

N/A

$12

$35

$60

$24 / $70 / $120

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2021 Medical PlansOption 4: Buy-Up PPO

Preferred Care Blue

Option 5: HMO

Blue Care

Deductible

Individual

Family

In Network

$500

$1,000

In Network

None

None

Member Coinsurance 20% 0%

Out-of-Pocket Maximum

Individual

Family

$2,750

$5,500

$3,000

$7,500

Office Visit

Primary Care Physician

Specialist

Spira Center

$20

$40

N/A

$40

$80

N/A

Preventive Care Covered 100% Covered 100%

Urgent Care $40 $80

Emergency Room $150 then deductible then 20% $200

Outpatient Surgery / Inpatient Hospital Services Deductible then 20%

$500 per day, up to $2,500 per calendar year per person

Prescription Drug

Retail (30-day supply)

Tier 1 – Generic

Tier 2 – Preferred

Tier 3 – Non-Preferred

Mail Order or Retail (90-day supply)

N/A

$12

$35

$60

$24 / $70 / $120

N/A

$12

$35

$60

$24 / $70 / $120

GRANDFATHERED PLANSNO NEW ENROLLMENT

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Claim Example #1

Based on January – December 2021Employee in good health with single coverage. Sally has a Preventive exam & lab services, one diagnostic office visit, a Tier 1 Rx filled monthly and one additional Tier 2 Rx filled just once. Option 1:

Spira Care EPO

Option 2:QHDHP

Option 3: PPO


Option 5*: HMO

Premium $0 $0 $0 $1,452 $648

Preventive Exam ($75) $0 $0 $0 $0 $0

One PCP Diagnostic Exam ($125)

$60 at a Spira

Center$125 $40 $20 $40

Tier 1 Rx ($15/month) $180 $180 $144 $144 $144

Tier 2 Rx ($60) $60 $60 $35 $35 $35

District HSA Contribution ($1,284) ($144) N/A N/A N/A

Total Employee Cost ($984) $221 $219 $1,651 $86716*Grandfathered plans – no new enrollment

Claim Example #2

Based on January – December 2021Employee with single coverage. John has a car accident in September and is in the hospital for six days, four follow up specialist visits, two Tier 2 Rx’s for 3 months.

Option 1:Spira Care

EPO

Option 2:QHDHP

Option 3: PPO


Option 5*: HMO

Premium $0 $0 $0 $1,452 $648

Hospital Stay ($50,000) $2,800 $2,800 $4,000 $2,750 $2,500

Four Specialist Visits ($150 each)

$0 $0 $0 $0 $320

Tier 2 Rx ($80/month) $0 $0 $0 $0 $105

Tier 2 Rx ($135/month) $0 $0 $0 $0 $75

District HSA Contribution ($1,284) ($144) N/A N/A N/A

Total Employee Cost $1,516 $2,656 $4,000 $4,202 $3,648

17*Grandfathered plans – no new enrollment

Claim Example #3

Based on January – December 2021Employee + Family Plan. Mary is in fair health with a monthly cholesterol medication. Her spouse is on a $3,000 prescription drug, and their child receives a well child care exam and one urgent care visit for the flu with a tier 1 prescription.

Option 1:Spira Care

EPO

Option 2:QHDHP

Option 3: PPO


Option 5*: HMO

Annual Premium $7,428 $10,380 $10,932 $14,364 $12,324

Employee Tier 2 Cholesterol Rx ($200/month)

$2,400 $2,400 $420 $420 $420

Spouse Tier 3 Rx ($3,000/ month)

$2,800 $2,800 $720 $720 $720

Well-Child visit ($180) $0 $0 $0 $0 $0

Child Urgent Care ($90) $90 $90 $80 $40 $80

Child Tier 1 Rx ($35) $35 $35 $12 $12 $12

District HSA Contribution N/A N/A N/A N/A N/A

Total Employee Cost $12,753 $15,705 $12,164 $15,556 $13,55618*Grandfathered plans – no new enrollment

Here are a few things you can do on the BlueKC member portal:

My Information

Quickly print/email your ID card

View Plan Benefits

View coverage & pharmacy info

Review Claims

View claims, EOB’s, deductibles, and out-of-pocket maximums

Find Care

Find doctors, hospitals, and pharmacies

Ask Us

Get answers to your questions

MYBLUEKC.COM

Register at mybluekc.com

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VIRTUAL CARE

Affordable access to treat your urgent, sick and behavioral health needs 24/7 through the BlueKC Virtual Care App!

Board-certified physicians

Save on drive time oroffice wait time

Pay much less than the emergency room

Care you need--includingprescriptionsPrivate & Secure

Great for traveling when you need care

MAKE AN APPOINTMENTDownload the BlueKC VIRTUAL CARE APP

and register as a new user.

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SELECTIONOnline search tool

so you can discover all optionsavailable

PRICEPersonalized cost

estimates and plan coverage

CONVENIENCEGet email & text alerts if there are

savings

ASSISTANCEExperienced staff can work directly with your

doctor

Rx Savings Solutions helps you decide what’s best for your health and budget

Get Notified How to Save on Prescriptions

DID YOU KNOWA capsule might cost more than a tablet or a drug with

two active ingredients can be split into two for big savings?!

SAME DRUG, DIFFERENT FORM

DIFFERENT DRUG, SAME TREATMENT

SAME ACTIVE INGREDIENT, LOWER PRICE

SAME INGREDIENTS, DIFFERENT PILLS

START SAVING!Go to MyBlueKC.com, access your pharmacy benefits and Rx Savings Solutions

RX SAVINGS SOLUTIONS

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MINDFUL BY BLUEKC

It all starts with the Mindful Advocate In a unique role exclusive to BlueKC, our Mindful Advocates are licensed behavioral health clinicians who match members to services and/or providers and guide care plans.

Just one call away and available 24/7

ENHANCED! Expedited Access Network Team support to find a behavioral health appointment in the earliest window possible for a BlueKC member in crisis

ENHANCED! Virtual CareWith therapists trained and licensed in Virtual Care therapy techniques

ENHANCED! Managed Behavioral HealthHelping members identify in-network providers that best fit their needs by type and specialty

NEW! Online TherapyText and scheduled live chat, phone and video therapy for three sessions to help with conditions like depression, anxiety and stress (for short-term therapy only and accessible as part of your Well-Being Resources)

NEW! Online Self-Guided ToolsResources to manage stress, improve mood and more

NEW! Well-Being ResourcesIncluding three visits per issue for help with major life events (divorce, adoption, loss), stress, financial issues, childcare and other everyday challenges

Mindful by BlueKC is available to health plan

participants.

Normal cost-sharing and out of pocket maximum

limits will apply.

MindfulBlueKC.com 22

EMPLOYEE ASSISTANCE PROGRAM

Our EAP provides you with the tools and resources to help you find your best self

Support & advice to assist you when life

gets overwhelming in areas such as

substance abuse, finding a

daycare, finances, personal stress and

more

Available to all

employees, spouses

anddependents

To get started:Call 800.624.5544Log On to ndbh.com with passcode usd204 23

24/7Confidential

Support

At No Cost to You!

Up to 3 counseling or

coaching sessions per

issue per year for each individual

Health Savings Account (HSA)

• Established for the purpose of paying qualified healthcare expenses of the account owner or dependents.

• The account owner must be covered under a Qualified High Deductible Health Care Plan to contribute to an HSA.

• Portable, it stays with you for life. Even if you change jobs, become unemployed, or retire.

• Unused funds can rollover to use on future expenses.

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• A tax-exempt account • Contributions are tax-deductible (or “pre-tax”)• Earnings on your balance and investments are not taxed• Funds withdrawn for qualified medical expenses are not taxed

• An individually owned, tax-advantaged account that may be used to pay for qualified medical expenses or saved for retirement and certain long-term care expenses.

You CANNOT receive/make contributions to an HSA if…

• You are claimed as a dependent on someone else’s tax return (You are NOT a dependent if you are “married filing jointly” or “married filing single”).

• You are covered by another health insurance plan that is NOT a QHDHP, such as coverage under a spouse’s traditional PPO or HMO plan.

• You or your spouse have a Flexible Spending Account (FSA), even if the FSA dollars are not used for you.

• You or your spouse are covered by a Health Reimbursement Arrangement (HRA).

• You have medical coverage under TRICARE, or eligible for Medicare, or Medicaid.

• You are in receipt of Veteran Administration (VA) benefits, for a non-service related disability, including prescription drugs, within the previous 3 months you are not eligible to contribute for 3 months following.

• You CAN still have other disability, dental, vision, and long- term care insurance policies & Dependent Care Account through an FSA.

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Is there a limit to how much I can contribute?

ANNUAL MAXIMUMS

The annual contribution is established by law and subject to changeeach calendar year.

If you are between the ages of 55 & 65, you may also be able to make a $1,000 “catch-up” contribution to the HSA each year.

Contribute up to

$3,600Single, or

$7,200Family

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HSA Disbursements

You must retain all receipts in the event of an IRS Audit

Disbursements for qualified healthcare expenses are not subject to taxation

Disbursements for non-qualified expenses are subject to regular taxation plus a 20% penalty. The 20% penalty is waived upon attainment of age 65

Expenses incurred prior to establishing an HSA areNOT eligible for reimbursement

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• Eligible health care expenses include expenses for the individual who opens the account, his or her spouse and dependent children. The spouse and dependent children do not need to be covered under the QHDHP in order to have an eligible HSA expense.

• Hospitalization

• Prescription Drugs

• Over the Counter Drugs

• Doctor Office Visits

• Premiums for Medicare, Long Term Care, COBRA

• Dental expenses (Including Orthodontia)

• Vision (Including Lasik)

• Full list of eligible expenses available on the Treasury website at: www.IRS.GOV

HSA EligibleExpenses

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FLEXIBLE SPENDING ACOUNTS

HEALTH CARE FLEXIBLE SPENDING ACCOUNT

Maximum Contribution: $2,750

• Available regardless of the medical plan you select. If you participate in the HSA, you cannot have this account.

• Enables you to pay medical, dental, vision, orthodontic, and prescription drug expenses for yourself and dependents, regardless if they are covered under your insurance program

• The total amount of your annual election is available to you up front, reducing the chance of having a large out-of-pocket expense early in the plan year

LIMITED FLEXIBLE SPENDING ACCOUNT


• Available only if you elect a QHDHP and participate in the HSA.

• Offers you the same pre-tax savings opportunity for dental, orthodontic, and vision expenses only

• The total amount of your annual election is available to you up front, reducing the chance of having a large out-of-pocket expense early in the plan year

DEPENDENT CARE EXPENSE ACCOUNT


• Available regardless of medical plan selected.

• Gives you the opportunity to redirect a portion of your annual pay on a pre-tax basis to pay for dependent care expenses

• An eligible dependent is any member of your household for whom you can claim expenses on your Federal Income Tax Form

• Children must be under age 13

• Care centers which qualify include dependent care centers, preschool educational institutions, and qualified individuals

• Funds are only available as they are contributed each pay period.

All accounts are Use it or Lose It. Any unused funds on December 31st are forfeited.29

• Eligible health care expenses include expenses for the individual who opens the account, his or her spouse and dependent children. The spouse and dependent children do not need to be covered under the employee’s plan in order to have an eligible FSA expense.

• Hospitalization

• Prescription Drugs

• Over the Counter Drugs

• Doctor Office Visits

• Dental expenses (Including Orthodontia)

• Vision (Including Lasik)

• Full list of eligible expenses available on the Treasury website at: www.IRS.GOV

FSA EligibleExpenses

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Voluntary Dental

DELTA DENTAL OF KANSAS PPO PREMIER Kids 12 & UnderDeductibleIndividual / Family $50 / $150 $0

Annual Maximum $1,500

Preventive Services (unlimited cleanings)

100% 100% 100%

Basic Services 90% 80% 100%

Major Services 60% 50% 100%

Ortho Services N/A

Monthly Premium

Employee Only $32.00

Employee + Spouse $63.33

Employee + Children $63.58

Employee + Family $107.69

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Voluntary Vision

Surency In-Network

Examination Copay $10 copay

Frequency of ServiceExamLensesFrames

Every 12 monthsEvery 12 monthsEvery 24 months

LensesSingleBifocalTrifocal

$25 copay$25 copay$25 copay

Reimbursement Schedule – Exam 100%

Reimbursement Schedule – Lenses SingleBifocalTrifocal

100%100%100%

Contacts(in lieu of glasses)

$115 allowance; 15% off remaining balance over allowance

Frames $100 allowance

Monthly Premium

Employee Only $8.07

Employee + Spouse $16.93

Employee + Children $14.51

Employee + Family $27.15 32

Voluntary Products

DISABILITY INSURANCE

Disability insurance provides income protection if or when you can’t work because of an illness or injury. It is an additional way to help provide you a source of income should you become disabled from a non-work related injury or sickness.

POLICY FEATURES:• Several different benefit plan

options• Benefit payments deposited

directly into your bank account

• Benefits are payable year round

VOLUNTARY LIFE INSURANCE

Help make sure your family is protected financially in the event of a loved one’s death is an important way of caring for their needs. American Fidelity has several types of individual life insurance plans to choose from, including permanent, term and children’s policies.

POLICY FEATURES:• Death benefit amount that is

generally tax free and paid directly to beneficiaries

• A policy that you own – take with you if you leave employment

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Voluntary Products

CANCER INSURANCE

A cancer diagnosis can change your life, and the expenses associated with a cancer diagnosis can be overwhelming. Limited Benefit Cancer Insurance may offer a solution to help you so you can focus on your treatment and healing.

POLICY FEATURES:• Benefit payments are made

directly to you• Individual, individual and

spouse, individual and child (eligible child as defined in the policy) and family coverage available

CRITICAL ILLNESS INSURANCE

American Fidelity’s Limited Benefit Critical Illness Insurance is an insurance policy that will pay a lump sum if you experience an eligible critical illness, such as a heart attack, permanent damage due to a stroke, major organ failure and/or major burns.

POLICY FEATURES:• Three lump sum benefit

amounts available• Annual health screening test

benefit• Benefits paid directly to you

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Voluntary Products

ACCIDENT COVERAGE

Accidents can bring unexpected costs. An Accident Insurance plan may lessen the impact on your finances by paying benefits to help cover your expenses, regardless of any other coverage you have.

POLICY FEATURES:• Benefit payments are made

directly to you

SECURE ID2

Unexpected problems can have serious influence on your peace of mind. Secure ID2 helps you face those problems with a sense of confidence.

POLICY FEATURES:• ID Sanctuary Enhanced• Legal Services• Roadside Assistance• Global Travel Assistance

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Enrollment

Open Enrollment runs from November 2nd thru November 13th

Two Ways to Enroll:

1. Self Enrollment from November 2nd – 8th

2. Virtual One-on-One Enrollment with an American Fidelity enrollment counselor from November 9th – 13th

Please allow approximately 30 minutes for your enrollment session.

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1 2 3REVIEW INFORMATION

In the meantime, review this presentation and your employee

benefits guide carefully. The benefits you elect now are effective

January 1, 2021 to December 31, 2021.

ASK QUESTIONS

Utilize your CBIZ Representatives and Stormi Vitt, Benefits Coordinator to ask questions to better understand your

benefit options.

Schedule your one-on-one virtual enrollment session to take place

between November 9th thru November 13th, or complete your

online enrollment between November 2nd thru November 8th.

Remember to use the worksheet at the end of your guide to gather all

necessary info in preparation for enrolling.

ENROLL

Next Steps

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Contact InformationIf you have any questions regarding your benefits, please contact one of your CBIZ representatives or your Bonner Springs Benefits Team.

CBIZ Representatives Maggie Knudson, Account [email protected]

Molly Harrison, Senior Account [email protected]

Kate Orr, Associate Account [email protected]

Bonner Springs Benefits TeamEric Hansen, Director of Business913.422.5600 ext. [email protected]

Stormi Vitt, Benefits Coordinator913.422.5600 ext. [email protected]

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BSSD 2021 OE Presentation v5:HOFRPH 7KH EHQHILWV\RX HOHFW QRZ DUH HIIHFWLYH -DQXDU\ ² 'HFHPEHU

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