27
1 ANNUAL OPEN ENROLLMENT for Retiree Benefits Benefits Selections are Effective January 1, 2022
1
ANNUAL OPEN ENROLLMENTfor
Retiree BenefitsBenefits Selections are
Effective January 1, 2022
2
BPS Retiree Benefit Options
BPS Medical/Rx Plans Dental Vision
Life Insurance
3
New in 2022
Humana• Dental carrier
The Standard • Retiree Term Life and Dependent Life Insurance carrier
Benefits Call Center (opens Oct. 18th, 9 am; available year-round)• Phone: 321-800-4490 Hours: 9 am to 9 pm M-F & 9 am to 3 pm Saturday• Be sure to inform the representative that you have retiree coverage
Employee Benefits Mailbox• [email protected]
4
The Gold plan accesses Cigna’s nation-wide network of providers
For a lower In-network office visit copay, look for physicians with the “Tier 1 Provider” logo -in Cigna’s provider directory
Both plans share the same pharmacy benefits
TYPE OF SERVICE
In-Network Out-of-Network Schedule 1 Schedule 2Wellness: $1,500/$3,000 Wellness: $3,000/$6,000 Wellness: $750/$1,500 Wellness: $1,250/$2,500
1/2 Wellness: $2,000/$4,000 1/2 Wellness: $4,000/$8,000 1/2 Wellness: $1,250/$2,500 1/2 Wellness: $2,250/$4,500Non-Wellness:$2,500/$5,000 Non-Wellness:$5,000/$10,000 Non-Wellness: $1,750/$3,500 Non-Wellness: $3,250/$6,500
COINSURANCE (mbr paid) 20% 50% 20% 40%
$5,500/$11,000 $12,500/$25,000 $4,500/$9,000 $6,500/$13,000
(Medical) (Medical) (Medical) (Medical)
OFFICE VISITS
Primary Care office visit Tier 1*: $30 / Non-Tier 1: $45 50% AD3$30 40% AD 3
Specialist office visit Tier 1*: $50 / Non-Tier 1: $75 50% AD $50 40% AD
BPS Employee Well-Care Centers $0 Not Covered $0 Not Covered
Preferred Health Center $30 Not Covered $30 Not Covered
Advanced Radiology/ Outpatient Surgery at a Preferred Facility $200 50% AD $125 40% AD
HOSPITAL SERVICESInpatient Hospital $900 copay + 20% AD 50% AD $600 copay + 20% AD 40% ADOutpatient Surgery 20% AD 50% AD 20% AD 40% ADEMERGENCY & LAB Emergency RoomUrgent Care $75 $75 $50 $50 Major Diagnostics (CT/PET scans, MRI) Outpt/ Non-preferred 20% AD 50% AD 20% AD 40% AD
PHARMACY BENEFITS In-Network Out-of-Network In-Network Out-of-NetworkSeparate Out-of-Pocket Maximum (OOPM) Indiv /Family: $2,200 /$4,400 Not Covered Indiv /Family: $2,200 /$4,400 Not Covered
Generic $20 Not Covered $20 Not CoveredPreferred Brand $50 Not Covered $50 Not CoveredNon-Preferred Brand $150 Not Covered $150 Not CoveredMail Order Pharmacy 2x 30-day Retail Not Covered 2x 30-day Retail Not Covered
NOTES: * Tier 1 = For lower copay, provider must have the Tier 1 symbol -- -- next to their name in Cigna's provider directory. 1 Ancillary Providers, e.g., labs, imaging centers, and outpatient surgical facilities
2 "Non-contracted" means has no contract with Cigna 3 AD = After Deductible
ANNUAL OUT OF POCKET MAXIMUM (Indiv/Fam)
ANNUAL DEDUCTIBLE (Individual/Family)
$450 copay + 20% AD $300 copay+ 20% AD
2022 PLAN YEAR
Network = Cigna's Open Access Plan Parrish & Steward Hospital Systems & their Affiliates
plus Independent Physicians in
Brevard County and all Cigna Ancillary1 Providers
Health First Physicians, Hospitals & Affiliates
plus Non-Contracted2 Out-of-
Network Providers
GOLD PLAN SILVER PLAN
5
• On the Silver Plan, Schedule 1 has better pricing with the provider network limited to Parrish & Steward Hospital Systems and their Affiliates plus independent physicians in Brevard County and Cigna Ancillary providers
• Schedule 2 includes Health First and non-contracted providers with higher pricing than on Schedule 1
• Both plans share the same pharmacy benefits
TYPE OF SERVICE
In-Network Out-of-Network Schedule 1 Schedule 2Wellness: $1,500/$3,000 Wellness: $3,000/$6,000 Wellness: $750/$1,500 Wellness: $1,250/$2,500
1/2 Wellness: $2,000/$4,000 1/2 Wellness: $4,000/$8,000 1/2 Wellness: $1,250/$2,500 1/2 Wellness: $2,250/$4,500Non-Wellness:$2,500/$5,000 Non-Wellness:$5,000/$10,000 Non-Wellness: $1,750/$3,500 Non-Wellness: $3,250/$6,500
COINSURANCE (mbr paid) 20% 50% 20% 40%
$5,500/$11,000 $12,500/$25,000 $4,500/$9,000 $6,500/$13,000
(Medical) (Medical) (Medical) (Medical)
OFFICE VISITS
Primary Care office visit Tier 1*: $30 / Non-Tier 1: $45 50% AD3$30 40% AD 3
Specialist office visit Tier 1*: $50 / Non-Tier 1: $75 50% AD $50 40% AD
BPS Employee Well-Care Centers $0 Not Covered $0 Not Covered
Preferred Health Center $30 Not Covered $30 Not Covered
Advanced Radiology/ Outpatient Surgery at a Preferred Facility $200 50% AD $125 40% AD
HOSPITAL SERVICESInpatient Hospital $900 copay + 20% AD 50% AD $600 copay + 20% AD 40% ADOutpatient Surgery 20% AD 50% AD 20% AD 40% ADEMERGENCY & LAB Emergency RoomUrgent Care $75 $75 $50 $50 Major Diagnostics (CT/PET scans, MRI) Outpt/ Non-preferred 20% AD 50% AD 20% AD 40% AD
PHARMACY BENEFITS In-Network Out-of-Network In-Network Out-of-NetworkSeparate Out-of-Pocket Maximum (OOPM) Indiv /Family: $2,200 /$4,400 Not Covered Indiv /Family: $2,200 /$4,400 Not Covered
Generic $20 Not Covered $20 Not CoveredPreferred Brand $50 Not Covered $50 Not CoveredNon-Preferred Brand $150 Not Covered $150 Not CoveredMail Order Pharmacy 2x 30-day Retail Not Covered 2x 30-day Retail Not Covered
NOTES: * Tier 1 = For lower copay, provider must have the Tier 1 symbol -- -- next to their name in Cigna's provider directory. 1 Ancillary Providers, e.g., labs, imaging centers, and outpatient surgical facilities
2 "Non-contracted" means has no contract with Cigna 3 AD = After Deductible
ANNUAL OUT OF POCKET MAXIMUM (Indiv/Fam)
ANNUAL DEDUCTIBLE (Individual/Family)
$450 copay + 20% AD $300 copay+ 20% AD
2022 PLAN YEAR
Network = Cigna's Open Access Plan Parrish & Steward Hospital Systems & their Affiliates
plus Independent Physicians in
Brevard County and all Cigna Ancillary1 Providers
Health First Physicians, Hospitals & Affiliates
plus Non-Contracted2 Out-of-
Network Providers
GOLD PLAN SILVER PLAN
68
BPS Health PlanTobacco-use Surcharge This program will continue in 2022. A $50/month tobacco-use surcharge will be
added to the medical plan premiums of tobacco users Use of any tobacco product is subject to the surcharge. This includes vaporizers, e-
cigarettes, pipes, cigars, and smokeless tobacco.
Retirees enrolled for BPS medical coverage must complete the Medical Plan Affidavit which asks about their own tobacco use and their covered spouse, if applicable
Retirees affirming tobacco use on the Affidavit will be subject to the surcharge*. The surcharge will be refunded if the tobacco user(s): Complete Cigna’s Tobacco Cessation Program by September 30, 2022 with either a
Cigna telephonic coach: 800-244-6224 OR Cigna’s onsite health coach, Joni Deblecourt-Whelen: 321-338-5955 (call or text)
Both coaching options have a similar average of 6 sessions and include Nicotine Replacement Therapy
If an individual completes their Cigna program by the deadline, any applied surcharge will be refunded by January 1 of the following calendar year.
Retirees and covered spouses must be tobacco free as of April 1, 2021 to be considered a NON-smoker.* If both the retiree and covered spouse use tobacco, only one surcharge will apply. However, both must complete thecoaching in order to have the surcharge refunded.
7
Important Date to Remember To earn a reduced In-network medical plan deductible
November 15, 2021Is the deadline for employees and spouses enrolled/enrolling in a medical plan to complete a biometric screening AND a Health Assessment
Biometric Screening (do this first)• Performed free at any BPS Well-Care Center (WCC)• May be done at employee’s own doctor BUT:
• Must be performed during an annual physical (not at a “sick” visit)• Correct form, available on benefits website, must be used
• Employees must submit their completed form to any Well-Care Center
Health Assessment (HA) at MyCigna.com • If already enrolled in the health plan, visit www.MyCigna.com, register, then click Wellness link to
access HA• If not already enrolled in health plan, a different link must be used:
https://my.cigna.com/?token=3308496.
810
IN-NETWORK DEDUCTIBLES
• If both a Biometric Screening and Health Assessment are not completed by you andyour covered spouse
• Gold plan: $2,500/Individual, $5,000/Family• Silver plan: $1,750/ Individual, $3,500/Family
• If you and your covered spouse each complete a Biometric Screening and Health Assessment by November 15, 2021
• Gold Plan: $1,500/Individual, $3,000/Family• Silver Plan: $ 750/Individual, $1,500/Family
• If only you OR only your covered spouse completes both wellness activities, that’s called “1/2 Wellness”
• Gold Plan: $2,000/Individual, $4,000/Family• Silver Plan: $1,250/Individual, $2,500/Family
BPS Health Plan
911
• Cigna is the plan administrator
• Telehealth services, also called Virtual Care, are free• MDLive is Cigna’s only telehealth partner
• Use preferred providers for outpatient surgery and high-techimaging• Only a $125 copay on the Silver plan; $200 copay on the Gold plan• Lists of preferred providers are available on BPS benefits website
BPS Health Plan
1012
Use In-network providers• $0 copay at Quest and LabCorp for routine lab services• Free annual wellness & preventive services• No cost for services at BPS Well-Care Centers
Cost of treatment varies based on where services are rendered• Outpatient facilities are generally much less expensive than hospital facilities• Find cost of procedures on Cigna’s website www.MyCigna.com
• Find “Estimate Health Care Costs” tab and then use “Medical CostEstimator
Where You Get Treatment Matters
1113
Well-Care Centersfor BPS health plan enrollees
1214
Three Locations• North/Titusville -Jackson Middle School – (321) 222-9070
• Central/Viera -District Office (in overflow parking) – (321) 252-1169
• South/West Melbourne-Central Middle School – (321) 369-9514
Services provided and medications dispensed are at no cost to BPS health plan members. Services include:
• Primary and Acute Care
• Chronic Condition Management
• Health and Wellness Coaching (Access via video, phone and in-person)
• Biometric Screenings
To schedule an appointment, call or go on-line to my.marathon-health.com
BPS Well-Care Centers
13
SPOUSAL SURCHARGEFor Medical Coverage only
• If you are enrolling a spouse for medical (either through BPS or FSRBC), then youMUST complete the Medical Plan Affidavit• On-line: When you enroll your spouse on-line, the affidavit will pop up• Paper: Use the paper form provided in the Open Enrollment mailing. Be sure to
meet the 10/29/21 postmark deadline
• Depending on your affidavit answers, the $250/month surcharge may not apply
• Failure to complete the affidavit* results in an automatic application of the surcharge
• Even if you have PREVIOUSLY completed an Affidavit, you are required to update itevery year during Open Enrollment*
*If spouse is enrolled in the FSRBC, then answer “No” to question 2: I am enrolling my spouse formedical coverage.
14
SPOUSAL SURCHARGE(cont.)
Will NOT apply IF your spouse:• Is not employed• Works for an employer which does not offer medical insurance
• Is an employee of Brevard Public Schools and is not benefits eligible
• Is eligible for a government-sponsored plan, such as Medicare
• Elects coverage through his/her own employer and chooses to enroll in the BPS Health Plan as secondary coverage
15
WHEN A DEPENDENT CHILD’S COVERAGE ENDSAt the end of the month in which your child turns 26
However, you may be able to continue his/her coverage* by: completing an enrollment form to add them back to your coverage AND
completing the Over-age Dependent 26-30 (Non-disabled) affidavit
IF they’re eligible for coverage, the Over-age dependent surcharge of $358.88/month,will apply.
* Florida Statute provides for qualified dependent-child coverage until the end of a calendaryear in which a dependent child turns 30 years of age.
16
DentalVision &Life Coverage
17
BPS Benefit Program Partners Dental (Humana Dental – new in 2022)
Four plans: PPO (High & Low); DHMO (High & Low)
Vision (Humana)
Two plans: Basic & Enhanced
Life Insurance (Standard Life Insurance – new in 2022)
Retiree Term Life
Dependent Life Insurance
23
1824
Life Insurance• BPS continues to offer Retiree Life insurance, but as of 1/1/22, the
carrier will be Standard Life Insurance (“The Standard”)
• The Standard will:• maintain your beneficiary designations and
• process retiree life insurance claims
To report a death, update a beneficiary, or check on the status of your account, you can contact The Standard as follows:
By phone: 800-378-4668By email: [email protected]
19
Open Enrollment
20
October 18 to 5:00pm October 29, 2021
Please don’t wait until the last day to reviewyour benefits and make your selections.
If you don’t enroll online, then paper forms mailedto BPS must be post-marked by 10/29/21
OPEN ENROLLMENT DATES
21
Open Enrollment
During Open Enrollment, you MUST:
Complete the Medical Plan affidavit• Addresses tobacco use and• Spouse’s other health plan eligibility
Complete an Over-age dependent affidavit• If covering child(ren) age 26-30, (not handicapped) for medical
Enrollment is accomplished at EasyBenefits.com or by usingcorresponding paper forms and mailing to BPS
22
WelcometoBrevardPublicSchoolsBenefitsOnline
BrevardPublic Schools' employeesandretireesmayentertheir IDnumbersandpasswordstosign in.
AssignedUserID#
Password
Sign In
If youdonothaveapassword,youwill needtoget in touchwithyoursitebenefitscontact.Or youcanresetyourpasswordhere.
If youarearetiree,call 321-633-1000ext. 216withanyquestions.
EasyBenefits.com Log-in page
23
Active Enrollment at EasyBenefits.com (cont.)
Once you login, you arrive at this Welcome & Account Access Page:
Click here to access the Benefits Guide
Click here to begin enrollment
24
Active Enrollment at EasyBenefits.com (cont.)
Star t the Enrollment Process by cl icking where thearrow points
2530
How To Enroll• Open Enrollment materials, including your password, were mailed to your homes
• Logon to www.EasyBenefits.com as often as you like between October 18 to5:00pm on October 29
• As you make elections, watch for applicable Affidavits to pop up• Be sure to complete them• Ensure your computer’s pop-up blocker is turned OFF• At the end of enrolling for BPS benefits, click “ Submit Enrollment,” then. . .• Be sure to print your Confirmation Statement
• If you don’t receive a prompt for your confirmation statement, be sureyour computer’s pop-up blocker is turned off
2631
Medicare-eligible Retirees
• Your medical/dental/vision coverage options will be provided through theFlorida School Retiree Benefits Consortium (FSRBC)
• To learn about the benefits offered, how much they cost, and how youwould enroll, here’s the link to their website: https://myfsrbc.com
27
For more information on all benefit plans offered to Retirees:Visit BPS District Website: brevardschools.orgClick on: Departments Select: Benefits
Contact the new Benefits Call Center• New Call Center: Opens October 18th at 9 am 321 -800 -4490• Available year-round• Hours are 9 am to 9 pm M-F & 9 am to 3 pm Saturday• Be sure to inform the representative that you have retiree coverage
You may also contact the Employee Benefits Office by phone: 321-633-1000 ext. 11216, or
email: [email protected]
ENROLLMENT PERIOD FOR 2022 BENEFITS:October 18 to 5:00pm on October 29
