Inside this issue: Deductibles and Copays Page 1 Cost Saving Tip Page 2 Unum: More Benefits Page 3 Benefit Spotlight: Perfect Attendance Page 4 FSA Medical Cards Page 4 Announcements Page 5 DHR Community Health Fair Page 6 IRS Notice Page 7 Department Contacts Page 7 2020 MEDICAL DEDUCTIBLE & COPAYS PLAN PROVISIONS IN-NETWORK BENEFITS OUT OF NETWORK BENEFITS MEDICAL BENEFITS DEDUCTIBLES: Per Hospital Admission $300 per admission $900 per admission Calendar Year Deductible $1,000 per member $3,000 per family $3,000 per member $9,000 per family ***Last Quarter of the Year deductible will carry over and applies to all medical eligible expenses CO-PAYMENT AMOUNTS: Physician office visit $30 per office visit Not Applicable Outpatient Hospital Emergency $150 treatment room visit $150 treatment room visit Urgent Care Center $75 per Urgent Care visit Not Applicable Night Clinic office visit $30 per office visit Not Applicable Co-Insurance Stop-Loss Includes annual deductible and co-pay amounts $5,000 per individual $14,700 per family Unlimited per individual Unlimited per family RX BENEFITS DEDUCTIBLES : Brand Name Drugs $50 per member Generic Drugs No deductible CO-PAY AMOUNTS: Generic $10 - 30 day supply Preferred Brand $45 - 30 day supply Non-Preferred Brand $65 - 30 day supply January starts a new year for our medical and Rx plan deductibles. Please see ECISD’s scheduled deductible and co-pay provisions. Office visit co-payments are not applied towards meeting the annual $1,000 per member medical deductible.
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ediNbuRG cisd Benefit neWsletteR · Cynthia Vela Family Medical Leave Specialist Extension 2030 Miranda Gallo Workers' Comp Specialist Extension 2029 Leticia Marin Leaves & Absences
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Transcript
Inside this issue:
Deductiblesand Copays
Page 1
Cost Saving TipPage 2
Unum:More Benefits
Page 3
Benefit Spotlight:
Perfect Attendance
Page 4
FSAMedical Cards
Page 4
AnnouncementsPage 5
DHR Community Health Fair
Page 6
IRS NoticePage 7
Department Contacts
Page 7
January 2020
2020 Medical deductible & copays
PLAN PROVISIONS
IN-NETWORKBENEFITS
OUT OF NETWORK BENEFITS
Medical Benefits
deductiBles:
Per Hospital Admission $300 per admission $900 per admission
Calendar Year Deductible $1,000 per member$3,000 per family
$3,000 per member$9,000 per family
***Last Quarter of the Year deductible will carry over and applies to all medical eligible expenses
co-PayMent aMounts:
Physician office visit $30 per office visit Not Applicable
Urgent Care Center $75 per Urgent Care visit Not Applicable
Night Clinic office visit $30 per office visit Not Applicable
Co-Insurance Stop-LossIncludes annual deductible and co-pay amounts
$5,000 per individual$14,700 per family
Unlimited per individualUnlimited per family
Rx Benefits
deductiBles :
Brand Name Drugs $50 per member
Generic Drugs No deductible
co-Pay aMounts:
Generic $10 - 30 day supply
Preferred Brand $45 - 30 day supply
Non-Preferred Brand $65 - 30 day supply
January starts a new year for our medical and Rx plan deductibles. Please see ECISD’s scheduled deductible and co-pay provisions. Office visit co-payments are not applied towards meeting the annual $1,000 per member medical deductible.
Edinburg CiSdBENEFIT NEWSLETTER
2 | Cost Saving Tip
There are times when a health issue needs an Emergency Room (ER) visit. Such times
when an ER is necessary are when there is a life-threatening or disabling health problem, such as loss of consciousness, broken bones, or severe shortness of breath.Reserving the use of the ER for emergencies only helps keep your out-of-pocket costs to a minimum. However, in many cases, people choose to visit the ER for issues like a cold, sprained ankle, or toothache. At times like this, one should consider visiting an Urgent Care facility to experience a shorter wait time and pay less out of pocket. Even more costly are freestanding ER facilities. What is a freestanding ER?A freestanding Emergency Room (ER) looks and feels like an Urgent Care center. It functions equally to a hospital ER except that it is not physically attached to a hospital. Freestanding ERs can be found close to residential neighborhoods. Because they are ERs, they charge a facility fee just like a
Cost Saving TipUrgent Care vs. Freestanding ER
conventional hospital ER, causing you to end up with a much higher bill. Here are a few ways to tell the difference between freestanding ERs and Urgent Care centers.
• The word EMERGENCY in the name• It is not attached to a hospital• It is staffed by board-certified ER
doctors and is subject to the same ER copay
The most notable difference between an Urgent Care center and a freestanding ER is the out-of-pocket expense. Employees and dependents with ECISD medical have a $150 emergency room visit copay, are responsible for 30% of the total bill, and are subject to physician out-of-network cost. For those under the same plan, visiting the Urgent Care center may only cost a $75.00 copay.When you have a medical situation, consider if it is wisest to go to the ER or an Urgent Care center.
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If you have a non-emergency medical condition after normal physician hours,you can find an Urgent Care enter by texting "URGENTTX" to "33633"
Unum | 3
Unum Disability InsuranceMore Than Income Replacement
Ifatthetimeofyourdeath,yourdisability had continued for 180consecutive days (6 months),Unum will pay your survivora lump sum benefit equal to 3months of your gross disabilitypayment.
• Paymentcanbemadetoan estate if there are noeligiblesurvivors
• Accelerated SurvivorBenefit can be paid tothememberifdiagnosedwith a terminal illnessand life expectancy isless than 12 months. With written medicalcertification from theattending physician,youmayreceiveyoursurvivor benefit priorto death. No survivorbenefit will be payableto any eligible survivoruponthemember’sdeath.
Employees who began work on the first day of the semester and were not absent for any personal reason from work, are eligible for the $200 Perfect Attenance Stipend on the January 22nd Pay Date. Please see your Payroll Manager to review your 1st Semester Employee Absence Report and complete the form to receive your stipend. Forms are required to be submitted to the Payroll Deparment by Friday, January 10th for pay on January 22, 2020.
FSAFlexible Spending Account
If you elected to have an Flexible Spending Account (FSA) card for 2020, your funds were loaded to your account for use on January 1, 2020. No new cards were issued for the new year if you are continuing with an FSA. Remember your FSA is a "USE IT OR LOSE IT." The “GRACE PERIOD” to exhaust all funds for the 2019 Plan Year is March 15, 2020. Letters with balances were mailed from Bay Bridge to the home address on file as well as from the ECISD Insurance & Benefit Department in November. You can use your card for costs incurred due to medical, dental, & vision (including glasses and contacts) reasons, as well as prescriptions. You can also use your card to purchase anything the IRS deems as an acceptable FSA charge (https://www.healthcare.gov/have-job-based-coverage/f lexible-spending-accounts/). Employees with questions regarding their FSA should feel free to contact the Insurance Department at the ECISD Administration Office or Contact National Plan Administrators (NPA) at 1-800-880-2776.
BCBS Medical CardsEmployees who changed their family status during Open Enrollment received a new medical card from Blue Cross Blue Shield (BCBS) for the 2020 Plan Year. If you elected your coverage to remain the same for the 2020 Plan Year, keep your current medical card for use in 2020. If you misplace or lose your medical card over the break, please contact BCBS at 1-800-521-2227 to order a replacement.
Our specialists can be reached at 956-289-2300Business cell: 956-587-1505
CynthiaVelaFamilyMedicalLeaveSpecialist
Extension2030
MirandaGalloWorkers'CompSpecialist
Extension2029
LeticiaMarinLeaves&AbsencesSpecialist
Extension2146
LindaL.BenavidesLeave&AbsencesSpecialist
Extension2147
IRS PROVIDES TAX INFLATIONADJUSTMENTS FOR TAX YEAR 2020
IR-2019-180WASHINGTON — The Internal Revenue Service announced the tax year 2020 annual inflation adjustments for more than 60 tax provisions, including the tax rate schedules and other tax changes. Revenue Procedure 2019-44 provides details about these annual adjustments.