2011-2012 Benefit Changes

Health Plan
Heartland will again be offering the Wellmark Blue Cross/Blue Shield health plan for the 2011-2012 year. The overall increase in rates will be 10.15%.

This is an open enrollment year. This means that you may bring on eligible family members to both your health and dental coverage, to be effective July 1, 2011. We do not plan to have another open enrollment year for three years.

Changes:
• One routine/preventive colonoscopy ordered by your doctor will be paid at 100% regardless of whether a medical diagnosis is made during the colonoscopy. Currently, if a medical condition is diagnosed during the procedure, it goes towards your deductible.
• Due to changes in health care reform, in-network chiropractic care (now paid at $10 per visit) will be paid at 85%, as any other in-network office visit.
• Routine vision exam done at an in-network doctor (now paid at $10 per visit) will be paid at 85%, as any other in-network office visit.
• We have added a Tier 4 for convenience drugs. Convenience drugs are those that combine two drugs to make an expensive convenience drug. Wellmark is trying to discourage the use of these costly alternatives, and in fact, have eliminated them altogether for their own employees. However, they’ll be available to you, but at a higher co-pay. All Tier 4 drugs have a $75 co-pay, after you have met your $100 prescription deductible. Click here for a list of drugs that are currently on the Tier 4 drug list. We will continue to offer Tier 1 generics at $5 with no deductible. Tier 2 and 3 will be offered at $20 and $35, respectively, after an annual $100 deductible per person has been met. No individual should ever pay more than one prescription deductible of $100 per calendar year. There is a maximum of two deductibles per family or $200 total.

If you are currently taking a prescription for a Tier 4 drug, you may want to talk to your doctor now about trying a less expensive alternative.

• Due to changes in health care reform, the $5 million lifetime limit per person will be changed to unlimited.
• Smoking cessation consultation will be covered at 100% under preventive care (only with your PCP).

Delta Dental
• No changes in rates or coverage.

EyeMed Vision
• The insurance survey reflected three years of dissatisfaction with the EyeMed vision coverage. Feedback indicated you could get similar benefits without paying premiums by using a coupon or taking advantage of a sale. You also told us you were unhappy with the network of doctors and the difficulty you had coordinating a Wellmark provider for your routine vision exam and an EyeMed provider for your glasses or contacts. Because of this, our voluntary vision coverage through EyeMed will be discontinued June 30.
• If you currently carry the EyeMed voluntary vision insurance and are eligible for new lenses or frames (24 months since you purchased frames under the plan, 12 months since you purchased lenses under the plan, and 12 months since you purchased contact lenses under the plan), be sure to look into getting your vision hardware before June 30.
• The Insurance Committee will be searching for a vision plan with richer benefits that is accessible to all our employees. In the meantime, a vision discount plan will be offered this year. This plan uses EyeMed providers and is offered through our dental plan. It is free of charge to any full-time employee. There is no limit on the frequency of purchasing lenses or frames, and discounts such as 30% off of all frames and single vision lenses for $75 are some of the benefits that will be available after July 1. More information on how to take advantage of these discounts will be coming soon.

Take advantage of the in-person benefit meetings, benefit videos and other benefit materials available on the Intranet under the Benefits tab to learn more about your benefits. If you have any questions please contact Kathy Martin, Benefits Specialist, at kmartin@aea11.k12.ia.us or ext. 14385.