1. EMPLOYEE BENEFITS

2. PPO Plan, EPO Plan, QHDHP/HSA
MEDICAL COVERAGE Claims are paid by funds contributed by the District, its employees, and retirees.
PPO Plan, EPO Plan, QHDHP/HSA

3. SELF FUNDED Hometown Health (HTH) – Processes the Claims
Hometown Health Network – Preferred Provider Panel website is located in the Question/Answers & Highlights Handout
Preferred Provider Hospitals – Renown Medical Center, Renown South Meadows, Carson Tahoe Regional Medical Center & Northern Nevada Medical Center

4. Preferred Provider Organization Plan (PPO)
District covers employee’s premium
No referral required on file for specialist office visits
Comprehensive Major Medical Plan

5. PPO PLAN Deductibles Preferred Provider:
- $500 per employee - $1,000 per family
Non-Preferred Provider:
$1,500 per employee
$3,000 per family

6. Non-Preferred Provider:
PPO PLAN
Eligible Expenses
Preferred Provider:
After deductible has been met,
eligible expenses covered at 80%
Non-Preferred Provider:
After deductible has been met, in most cases eligible expenses covered at 60% for usual and customary costs

7. Non-Preferred Provider:
PPO PLAN
Annual Out-of-Pocket Maximums
Preferred Provider:
$3,500 per employee
$7,000 per family
Non-Preferred Provider:
$7,500 per employee
$15,000 per family

8. PPO PLAN Office Visit Co-payments for Preferred Providers
Primary Care Physician - $35
Specialists / Urgent Care- $50
No deductible & No Claim Forms

9. Exclusive Provider Organization Plan (EPO)
Employee pays a portion of the full premium*
Must reside in the Northern Nevada or North Lake Tahoe service area
Referral required for specialist or no coverage
No referral required for annual Gynecologist exam or Chiropractic services
* Check schedule of premiums in the Questions/Answers and Highlights

10. EPO PLAN
No deductible
No claim forms
Make Co-payments

11. EPO PLAN Co- Payments for Service Listed
$35 Physician Visits/Lab and X-ray
$50 Specialist/ Urgent Care Visits
$200 Emergency Services; $300 Non-Emergency
$200 Outpatient Surgery Facility
$1,250 Inpatient Hospital

12. Qualified High Deductible Health Plan Health Savings Account (QHDHP/HSA)
Used in conjunction with Health Savings Account (HSA)
You pay 100% of medical and prescription drugs until Deductible is met, and then you share only a portion of the cost
You pay nothing once the Out-of-Pocket max is met (Preferred Providers)

13. CALENDAR YEAR DEDUCTIBLE Individual Deductible: $2,700
QHDHP/HSA
CALENDAR YEAR DEDUCTIBLE
Individual Deductible: $2,700
Family Deductible: $5,000

14. Preferred Provider: Non-Preferred Provider:
QHDHP/HSA
Eligible Expenses
Preferred Provider: Non-Preferred Provider:
After deductible has been met, After deductible has been met, in most
eligible expenses covered at 80% cases eligible expenses covered at 60%
for usual and customary costs

15. Annual Out-of-Pocket Maximums
QHDHP/HSA
Annual Out-of-Pocket Maximums
Preferred Provider: Non-Preferred Provider: $6,550 per employee $6,550 per employee
- $13,100 per family $ 13,100 per family

16. QHDHP/HSA District will fund a portion of the Employee’s HSA
2019 Annual contribution is $1,805
District contributions made two times a year of $902.50; once in the beginning of the year and once in the middle of the year.
The amount that the District funds will be determined by your insurance eligibility effective date.
There are no “Use It or Lose It“ requirements - You own it!
Most out-of-pocket expenses can be paid with the HSA. (Check IRS guidelines.)

17. QHDHP/HSA Not Eligible If:
Enrolled in a secondary health insurance that is non-HSA eligible, including a general purpose Health Flexible Spending Account (FSA) or a Health Reimbursement Account (HRA)
Enrolled in Medicare, Tricare, or other insurance, such as a spouse’s employer plan
Claimed as a dependent on someone else's tax return
Other exclusions may apply

18. How much can I contribute?
QHDHP/HSA
How much can I contribute?
HSA Annual Contribution Limits (Set by the IRS)
Single: $3,450
Family: $6,900
HSA Catch-Up Contribution
$1,000 per individual age 55 and over

19. DENTAL PLAN The Preferred Provider Dental Network is Guardian
Deductibles:
-$50 per employee
- $100 per family
Calendar Year Benefit maximum - $2,000
Children under age 19 have unlimited calendar year benefits
No orthodontia coverage

20. DENTAL PLAN If using Preferred Provider Network Dentist:
Preventive: 100% - No Deductible
Restorative: 80%
Major: 80%

21. Vision Service Plan (VSP)
VISION PLAN
Vision Service Plan (VSP)
Premiums paid by District
Dependents covered at no additional expense even if they are not enrolled on your medical coverage
Eye exam once every 12 months
$10 co-payment per eye exam
Lenses/Frames or contacts once every 24 months

22. PREMIUMS
Schedule of premiums are located in the Questions/Answer and Highlights packet
Please review the rates in the PPO,EPO, and QHDHP plans as there could be a difference in cost to the employee
Part-Time Certified – Premiums Prorated based on FTE
Certified – Monthly
Classified (12 Month) – Bi-Weekly
Classified (9/10/11 Month) – 18 Bi-Weekly

23. LIFE INSURANCE District-Paid Term Life and AD&D
Certified/Classified - $40,000
Confidential - $50,000
Admin / Pro-tech’s / Psychologist - $250,000

24. Premium Conversion Plan
SECTION 125 PROGRAM
Premium Conversion Plan
Allows dependent medical/health and cancer insurance premiums to be paid on a pretax basis
If on the QHDHP, you cannot have a general purpose FSA (Flexible Spending Account) in the household, however, you may have a Limited Purpose Health FSA for dental and vision.

25. Flexible Spending Accounts
SECTION 125 PROGRAM
Flexible Spending Accounts
Debit Card available
Dependent Day Care
$5,000 per year
Children under 13
Non-Reimbursed Medical Expenses
- $2,550 per year
- deductibles, co-payments, and orthodontia

26. SECTION 125 PROGRAM Example: Salary: $2,000 Insurance Premiums: $200
Taxable Salary: $1,800
25% Tax Bracket: $450 instead of $500
$1,800 x 25% = $450
$2,000 x 25% =$500
Extra $50 in Take-Home Pay

27. DOCTOR ON DEMAND Board Certified Doctors
365 Days A Year – 24 Hours a Day
Connect instantly from phone, tablet, or computer
Treat variety of health conditions, order lab work and prescriptions, get prescription refills
PPO/EPO members: $24.50 per visit
HDHP members: $49.00 per visit until deductible is met

28. GRAND ROUNDS Second opinions from World-Leading Experts
Offers medical advice, assistance, and support to ensure employees and their families receive the best possible medical care
Learn about a diagnosis, condition, or treatment plan
Free to all employees and dependents who are currently enrolled in a WCSD Health Plan
No copay, deductible, or coinsurance
Can be accessed by phone or online

29. VOLUNTARY BENEFITS Group Legal Supplemental Life Insurance
Disability Insurance
Long-Term Care
Cancer Insurance
Accident Benefit Insurance

30. WELLNESS PROGRAM
To promote and improve employee wellness and reduce health risks through education and wellness activities, goal setting and outreach events.

31. YOU
AN OWNER’S MANUAL
WELLNESS PROGRAM

32. HEALTH MANAGEMENT Healthy Tracks Online Health Management Tools
Health Insurance Premium Discount Opportunity

33. HEALTHY TRACKS WELLNESS PROGRAM

34. ComPsych GuidanceResources
Confidential consultation on personal issues
Legal information and resources
Information, referrals and resources for work-life needs
Financial information, resources and tools
Tobacco cessation
Online information, resources and tools

35. Thank You for Attending
Your single source for confidential support, expert information and valuable resources, when you need it the most.
Available 24 hours a day, 7 days a week
Call: WCSD (9273)
TDD:
Online: guidanceresources.com Your company web ID: WCSDEAP

36. IMPORTANT! 90 days to complete forms and add dependents
It is your responsibility to enroll within the required time frame
Risk Management Office
425 East Ninth Street
Reno, NV 89512
(775)