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2017 Annual Benefit Enrollment Review

START HERE

Important Things To Know

IT'S TIME TO START THINKING ABOUT:

How much did you have to pay towards your health expenses this last year?

Do you know how much you might have to pay toward your health expenses for this upcoming year?

How much will you have to pay out-of-pocket when it comes to your health (doctor's office visits, ER, surgeries, co-pays, etc.)?

What benefits does your school offer to help with out-of-pocket costs?

Things to Remember...

Benefits will become effective September 1st and will remain in effect until August 31, 2018.

You must enroll or decline coverage on yourself AND your eligible dependents (even if you aren't taking coverage).

You can only change your benefits during open enrollment. You will not be allowed to change your benefits after August 18th unless you experience and IRS defined Qualifying Event.

Want to receive text notifications about your enrollment and other helpful information?

SEND A TEXT TO 313131

TEXT "FBS ETX"

Website Stuff Here

How to Login

1. Visit www.etxebc.com and select your district.

2. Click the Login Button

3. Type in your Username and Password

Your Username is:

THE FIRST SIX LETTERS OF YOUR LAST NAME, THE FIRST LETTER OF YOUR FIRST NAME, AND THE LAST FOUR DIGITS OF YOUR SOCIAL SECURITY NUMBER.

Username and Password Instructions

Your Username is:

THE FIRST SIX LETTERS OF YOUR LAST NAME, THE FIRST LETTER OF YOUR FIRST NAME, AND THE LAST FOUR DIGITS OF YOUR SOCIAL SECURITY NUMBER. (I.E. John Smith ***-**-0081 is smithj0081)

Your Password is:

YOUR ENTIRE LAST NAME AND THE LAST FOUR DIGITS OF YOUR SOCIAL SECURITY NUMBER. (I.E. John Smith's password is: smith0081)

If your last name has hypens, spaces, dashes, apostrophes or any other punctuations, EXCLUDE the punctuation. Full last name, letters only.

Call Center

Help is just a phone call away with the FBS Call Center!

  • Call 866-914-5202
  • Available 8 AM TO 5 PM, Monday through Friday
  • English or Spanish Enrollers available to answer questions or to enroll via the phone.

Medical

TRS Medical

  • ActiveCare 1-HD
  • ActiveCare Select
  • ActiveCare 2

Deductibles, Co-Insurance, and Out-of-Pocket Maximums

The deductible is the amount you have pay first toward your medical expenses (non-preventive). If you have family coverage, the family deductible must be met before benefits are paid for any covered member. (Copays do not apply toward the deductible).

*In-Network Preventive Services are covered at 100%

Once you've met the deductible, Aetna pays 80% of covered expenses, and you pay 20% (coinsurance) until you meet your OUT-OF-POCKET MAXIMUM.

*An H.S.A and/or Medical Supplemental plan can help with your out-of-pocket costs.

Once you've met your OUT-OF-POCKET MAXIMUM (deductible and coinsurance), Aetna pays 100% of covered expenses for the rest of the year.

Active Care 1-HD

ActiveCare 1-HD is currently the High Deductible Plan with lower premiums and is H.S.A. Qualified

In-Network:

$2,500 Deductible/$6,550 Out-of-Pocket Maximum for Employee Only

$5,000 Deductible/$13,100 Out-of-Pocket Maximum for Family

Out-of-Network:

$5,000 Deductible/$13,100 Out-of-Pocket Maximum for Employee Only

$10,000 Deductible/$26,200 Out-of-Pocket Maximum for Family

Only in-network expenses will apply towards the in-network out-of-pocket maximum, and only out-of-network expenses will apply towards out-of-network out-of-pocket-maximum!

ActiveCare Select

If you do NOT live in the counties above, pick "ActiveCare Select" plan in the "ActiveCare Select/Aetna Whole Health Plan Options"

MD Anderson and Texas Children’s Hospital are NOT part

of this network.

Baylor Scott and White Quality Alliance: Collin, Dallas, Denton, Ellis, Parker, Rockwall, Tarrant Counties

Memorial Hermann Accountable Care Network: Ft. Bend, Harris, Montgomery Counties

Kelsey Select: Ft. Bend, Harris, Montgomery, Galveston, and Brazoria Counties...These zipcodes only: 77511, 77512, 77578, 77581, 77583, 77584,77588

$1,200 Deductible/$6,850 Out-of-Pocket Maximum for Employee Only

$3,600 Deductible/$13,700 Out-of-Pocket Maximum for Family

*This plan does not cover out-of-network services except for emergencies.

Active Care 2

But it is the most expensive plan.

ActiveCare 2 has the lowest deductible compared to ActiveCare 1-HD and ActiveCare Select.

In-Network:

$1,000 Deductible/$6,850 Out-of-Pocket Maximum for Employee Only

$3,000 Deductible/$13,700 Out-of-Pocket Maximum for Family

Out-of-Network:

$2,000 Deductible/$14,300 Out-of-Pocket Maximum for Employee Only

$6,000 Deductible/$28,600 Out-of-Pocket Maximum for Family

Only in-network expenses will apply towards the in-network out-of-pocket maximum, and only out-of-network expenses will apply towards out-of-network out-of-pocket-maxium!

OTHER THINGS TO NOTE:

  • Quest Diagnostics is Aetna's preferred lab testing provider. Using Quest Diagnostics can reduce your out-of-pocket costs. ActiveCare Select and ActiveCare 2 members pay $0 for covered lab tests through Quest Diagnostics.

*If enrolled in ActiveCare Kelsey Select, you must use Kelsey lab services to receive the 100% benefit, not Quest labs.

  • ActiveCare 1-HD lab testing is covered at 80% AFTER the deductible is met.

  • Telehealth through Teledoc is offered for free on the ActiveCare plans, but it's only availble for covered members. There is a $40 consulation fee for each call on the ActiveCare 1-HD plan.

  • Stay IN-NETWORK. Only in-network expenses will apply to the in-network out-of-pocket maximum. If you go out-of-network, then expenses will go toward a SEPARATE out-of-network out-of-pocket maximum! (no coverage on ActiveCare Select if you go out-of-network.)

What Can Help With Your Out-of-Pocket costs?

  • Health Savings Accounts
  • Medical Supplemental (GAP)
  • Flexible Spending Accounts
  • Telehealth
  • Health Savings Accounts
  • Medical Supplement (GAP)
  • Flexible Spending Accounts
  • Telehealth

Health Savings Accounts

Health Savings Accounts

If you are enrolled in the ActiveCare 1-HD medical plan, you are eligible to enroll in a health savings account!

What is a health savings account?

A health savings account (HSA) is a tax-advantaged medical savings account available to employees enrolled in the ActiveCare 1-HD plan. The funds contributed to an account are not subject to federal income tax at the time of deposit.

How much money can I contribute?

Employee Only : Up to $3,400

Family: Up to $6,750

If you are over 55 years old, you can contribute an additional $1,000

Remember: You can only use what has been deducted from your paycheck, but unused funds can accrue in your account year after year.

Funds are for eligible medical expenses as defined by the IRS.

Medical Supplement (GAP)

Medical Supplement (GAP)

Why enroll in a Medical Supplement plan?

Regardless of which plan you choose, you may also want to consider a Medical Supplemental plan to help you meet your deductible.

  • You can choose to enroll in a $1,500 or $2,500 benefit amount for an Inpatient Hospital Stay.

  • 50% of your elect benefit amount can pay towards ER visits, out-patient surgery, physical therapy, Diagnostic testing, MRI, X-rays.

HSA Compatible GAP plan

In order for your GAP plan to be compatible with a Health Savings Account (HSA), it has a deductible amount of $1,300 that must be satisfied before any benefits are payable. When dependent coverage is elected, benefits are payable only after the entire family deductible has been satisfied by one or more insured persons.

Remember, this plan is designed to help you meet your deductible!

The $1500/$2500 benefit is just enough to apply toward the deductibles of the ActiveCare plans (depending on which medical plan you elect.)

Once you meet your Deductible, Co-Insurance begins - Aetna pays 80% and you pay 20% until you reach your Out-of-Pocket Maximum

Also- There are no pre-existing conditions with this plan!

Flexible Spending Accounts

Flexible Spending Accounts

Flexible Spending Accounts (FSA) use pre-tax dollars to help pay toward eligible medical expenses.

It doesn't matter which medical plan you are enrolled in; you don't even have to be enrolled in medical to enroll in an FSA.

Elect up to $2,600 per year

  • Use it or lose it (check to see if your district offers a Roll-over benefit, Grace Period, or Run-out period)
  • Funds are available upfront on a debit card
  • Can't be enrolled in HSA if enrolling a FSA

The dependent care flexible spending account (DCFSA) enables you to pay for out-of-pocket, work-related dependent daycare costs.

Your can reimburse up to $5,000 (if you are married filing a joint return or you are head of a household) or $2,500 (if you are married filing separate returns).

Reimbursements are made via paper claim form, but payments can be made through direct deposit.

Telehealth

Telehealth

Telehealth is a cost saving benefit allowing you to obtain a diagnosis and prescription over the phone, 24/7/365 (including holidays) for non-emergent care.

$9 for Employee or Family coverage and NO Consultation Fees

You don't have to be enrolled in a medical plan to enroll in the telehealth offered through the East Texas Coop.

Saves money AND time!

Disability/Income Protection

Disability/Income Protection

Disability Insurance pays an income benefit to you should you become sick or injured and unable to work.

Select the Maximum Benefit Period (how long you want your disability to potentially cover you due to sickness or injury).

Premium Plan: To Social Security Normal Retirement Age (SSNRA)

Select Plan: Up to 3 Years if the disability is due to an Illness. Plan pays up to SSNRA if the disability

resulted from an Accident.

*Pregnancy is considered to be an ILLNESS! (not an accident)

How long can you wait until you receive your benefit?

Select the Waiting Period (This is the time in which you must be continuously disabled before filing a claim.)

0/7, 14/14, 30/30, 60/60, 90/90, 180/180

How much money do you need to cover your monthly expenses while you're out on disability?

Select your Monthly Benefit Amount, from $200 up to 66 2/3% of your monthly earnings.

Did you know...

*1st Day Hospital Benefit is available to the 0/7, 14/14,and 30/30 waiting periods. If you are hospitalized as an in-patient for 24 hours or more, the waiting period is waived.

**The pre-existing period is 3/12.

Life Insurance

Life Insurance

BASIC LIFE AND VOLUNTARY LIFE

  • Benefit through Unum
  • All eligible employees will receive at least $10,000 Basic Life Insurance.
  • Employees currently enrolled and New Hires can receive up to $250,000 Life Insurance Guaranteed Issue (No Health Questions Asked!)*
  • Up to $50,000 GI for Spouses, and up to $10,000 for Dependents (to age 26)
  • Employees can get up to $500,000 for Employee and Spouse, but Evidence of Insurability is required for coverage over the GI amount
  • Rates are age banded. This means they can increase as you age.
  • Benefits reduce to 65% at 65; 50% at age 70

*Current employees applying for the first time must complete an Evidence of Insurability

Accidental Death and Dismemberment

AD&D pays a benefit if the cause of death is an ACCIDENT. It also pays toward the loss of a bodily appendage.

Benefit through Unum

Employees can also elect up to $500,000 in AD&D, no health questions asked.

Coverage for spouses and child dependents are available.

Individual Term to 100 Life Insurance

  • Benefit through 5Star
  • You can elect up to $100,000 of Life Insurance Guaranteed Issue for Employees (THIS YEAR ONLY!!!)
  • Up to $30,000 for Spouse, $10K or $20K for Dependents to age 23 (ALSO GI THIS YEAR ONLY!!!)
  • Rates are age banded, but LOCKED to age 100
  • Employees do not have to enroll to obtain coverage for dependents
  • Coverage includes a Quality of Life Rider; up to 4% of the benefit amount can be used toward Home Healthcare, Nursing Home Care, etc (QoL instead of Cash Value)
  • Fully PORTABLE. This coverage BELONGS to the employee.

Dental

Dental

High Plan PPO

Benefit through Cigna

$1500 Calendar Year Maximum; $100 Annual Increase with Preventive Care

100% Preventive & Diagnostic

80% Basic Restorative Care

50% Major Restorative Care

50% Ortho Available for Dependents to age 26 ($1,000 Ortho max)

$50 Deductible for Basic and Major Restorative Care

Monthly Rates

Employee Only: $24.72

Employee/Spouse: $52.53

Employee/Children: $67.98

Family: $92.70

Low Plan PPO

Make sure your dentist is IN-NETWORK if you select this plan option.

Benefit through Cigna

$1000 Calendar Year Maximum; $100 Annual Increase with Preventative Care

100% Preventive & Diagnostic

50% Basic Restorative Care

50% Major Restorative Care

No Orthodontia on the Low Plan

$50 Deductible for Basic and Major Restorative Care

Monthly Rates

Employee Only: $19.20

Employee/Spouse: $40.80

Employee/Children: $52.80

Family: $72.00

Vision

Vision

Vision Plan Details

Benefit through UHC Vision

$10 Copay for Exam/$25 Copay for Materials

Exam every 12 months

Lenses every 12 months

Frames every 12 months

$130 Frame Allowance

Contacts covered in lieu of glasses/$150 Allowance for contacts

Lens options

Monthly Rates

Employee Only: $7.02

Employee/Spouse: $14.62

Employee/Children: $15.19

Family: $19.47

  • Single Vision
  • Bifocal
  • Trifocal
  • Lenticular
  • Scratch-Coating
  • Poly-Carbonate
  • Progressive

Critical Illness

Critical Illness

Designed to supplement your medical and disability coverage easing the financial impacts by covering some of your additional expenses. It provides a benefit payable directly to the insured upon diagnosis of a covered condition or event, like a heart attack or stroke.

  • Benefit through Unum
  • Lump sum benefit up to $30K for covered conditions such as Heart Attack, Stroke, Coronary Artery Bypass Surgery, End Stage Renal Kidney Failure, Major Organ Failure, Blindness, Benign Brain Tumor, etc.
  • Spouse coverage available in $5K or $10K; Child dependents to age 24 covered 25% of employee benefit

Cancer

Cancer

Cancer insurance offers extra insurance protection if you or a family member are diagnosed with cancer. This benefit is meant to help with costs your medical insurance may not cover.

  • Benefit through Loyal American
  • $50 Annual Wellness Benefit
  • First Occurrence $2,500, $5,000, $7,000
  • Daily Radiation, Chemo, Immunotherapy And Experimental Treatment Benefit Rider
  • Surgical expense
  • Breast reconstruction
  • 38 additional diseases Encephalitis, West Nile, Rabies, Lyme, ALS, MS, Sickle Cell Anemia
  • ICU $500/day any reason, $1000/day cancer

  • 12 Month waiting period for Pre-existing Conditions
  • Guaranteed Issue
  • Fully Portable
  • Benefit pays directly to you

Accident

Accident

Accident insurance is another supplemental benefit that helps reimburse out-of-pocket costs when an accident occurs.

  • Benefit through UHC
  • Coverage for Accidental Injuries.
  • Pays actual charges up to specified benefit amount for:
  • physicians treatment
  • surgery, x-rays
  • reductions of fractures and dislocations,
  • and/or other emergency treatment expenses.
  • Ambulance benefit, Hospital Confinement, and AD&D benefit also available.
  • Gold and Platinum plan options available
  • Emergency Transportation
  • Identity Theft
  • Emergency Transportation
  • Identity Theft

Provides Medical Transportation solutions AND covers out-of-pocket transport cost when your insurance falls short.

Emergent Plan Monthly Rates:

Individual: $9.00

  • Coverage through MASA
  • No Network limitations
  • No dollar limits on ER Transport costs
  • Emergency Helicopter Transport
  • Emergency Ground Ambulance
  • Platinum plan offers Mortal remains transport, return transport, organ retrieval, vehicle return, etc.

Platinum Plan Monthly Rates:

Individual: $24.50

Family: $32.50

Identity theft occurs when someone steals your identity -usually for W4s, traffic violations, etc. Identity theft coverage alerts members when their identity is at riskIdentity theft occurs when someone steals your identity -usually for W4s, traffic violations, etc. Identity theft coverage alerts members when their identity is at risk.

Plus Plan Monthly Rates:

Individual: $7.95

Family: $14.89

  • Benefit through ID Watchdog
  • Identity Theft benefit that conducts monthly ID Advanced Monitoring.
  • Credit report monitoring
  • Full ID Restoration
  • Sexual Offender monitoring
  • Plus plan monitors 1 Credit Bureau
  • Platinum plan monitors all 3 Credit Bureaus and provides annual credit report and scores

Platinum Plan Monthly Rates:

Individual: $11.95

Family: $22.95

Thank You!

It's Time to Enroll!

Got Questions?

Use the CONTACT US link to send us your questions!

That's All!

That's it! you made it! Now get on your computer, smart phone, device and enroll!

The last day to enroll is August 18th!

Thank you for Your Time!

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