1. Health Care Presentation
Benefits Coordinator: Brandi Wehner
(907) x11382
Benefits Technician: Sara McBride
(907) x11311

2. Presentation Overview
- Overview of our Health Plan
- Health Care Changes
- Open Enrollment
- Resources available

3. (Self-funded health plan)
Health Plan Overview
Health Care Committee
Works together to provide a sustainable health care plan for employees within the constraints of the budget and the negotiated agreements
Made up of 3 representatives each from ESSA, FEA, & Administration, and 1 representative from FPA
(Self-funded health plan)
FNSB School District
WPAS
FNSB (Borough)
Aetna
-Adjudicates all claims
- Provides EOBs & customer service to employees relating to coverage/claims
-First level appeal
HR/Benefits Team
Enrolls/dis-enrolls employees
Educates employees on the plan
Administers open enrollment
Provides the resources to review the plan documentation
Administers optional benefits through Navia
Administratively supports the Health Care Committee
- Administers the plan and verifies eligibility
- Second level appeal
Payroll /Accounting Team
Processes contributions
Determines employer and employee costs
Collects payment if necessary (LWOP)
-Medical Preferred Provider Network
-Works directly with providers & WPAS for pre-certifications & claims processing

4. Health Plan Overview

5. $0 Copay for preventive/$10 for all other services
Health Plan Overview
For Plans A and C
$0 Copay for preventive/$10 for all other services
By Appointment Mon - Fri: 7:30am – 6:30pm Walk-Ins Mon - Fri 8:30am - 4:30pm Acute injury & illness only

6. Health Plan Overview
Medical and Prescription Drug Benefits

7. Health Plan Overview
Welfare and Pension Administration Services (WPAS):
This is the customer service number on your health insurance card
May view Explanation of Benefits (EOBs)
May request website PINs for yourself or dependents
May provide feedback through a Customer Service Survey
WPAS has a new website that includes all plan documentation, claims forms, links to providers, and paid claims information.
If unable to reach by phone, you may by clicking on the contact us link at the bottom of the webpage:

8. Health Plan Overview Medical PPO – Aetna: www.aetna.com
Find a Provider:

9. Health Plan Overview
Benefits Available with Teladoc:

10. Health Plan Overview
Benefits Available with BridgeHealth
Employer Code: FBNSB

11. Health Plan Overview
Prescription Drug Copay Plan (Plans A & C)

12. Health Plan Overview To manage your prescriptions, register at:
Plan Summary will show you the details of your plan and how much you’ve spent towards your out-of-pocket maximum

13. DENTAL VISION AND AUDIO (DVA) BENEFITS
Health Plan Overview
Dental, Vision and Audio (DVA) Plan
DENTAL VISION AND AUDIO (DVA) BENEFITS
Employee pay period contributions
(for full-time employees over 19 pay periods)
Employee Only
Employee + Spouse or Child
Family
$6.31
$12.63
$15.79
Deductible
Dental
Vision & Audio
$50.00, waived for preventive/diagnostic
N/A
Reimbursement Percentage
Vision
Audio
Preventative & Diagnostic
Routine
Major
Exam & Lenses
Frames
Contacts
Exam and Hearing Aid devices
100% of allowable charges
80% of allowable charges
50% of allowable charges
Annually, at 100% at VSP providers
Every 2 years, up to $120 at VSP providers
Annually, to $200 at VSP providers (in lieu of frames and lenses)
Annually, 80% of allowable charges, up to $600, then 50% to maximum benefit
Maximum Benefit
$3,000 per person
$2,500 per ear in any consecutive 3 years

14. Health Plan Overview
Our Vision provider has been VSP Vision Care since the 2016 plan year
You may find a provider through the VSP.com search engine
If you register on the site, you are able to view your benefits with VSP providers and out-of-network providers, review claims, print a member card, and receive education and special offers.

15. Health Plan Overview Optional Benefits Available
Flexible Spending Arrangement - FSA
Health Savings Account - HSA
Health Reimbursement - HRA
Available with all Plans or Waived
Available with Plan B only
Available with Plan C only
- Pre-taxed, lowers your taxable income
-Must enroll annually at open enrollment
- Use it or lose it at the end of the year
Medical FSA
- can use funds immediately and pay over the year with payroll deductions
Dependent Care FSA
– use for daycare or elder care expenses
Pre-taxed, lowers your taxable income
Must enroll annually at open enrollment
Is your money and you may keep it even after employment ends
IRS restrictions on who may contribute to an HSA
*May not contribute to a medical FSA and an HSA in the same calendar year.
Employer contribution only
Funds carry over while enrolled in Plan C
*May enroll in both a medical FSA and an HRA.
These benefits are through
Navia Benefit Solutions

16. Health Plan Overview Optional Benefits Available at:
Employer Code: FSS
Your debit card may be good for up to 3 years. As you enroll, the funds will be loaded to the card. You can select the below icon on Navia’s website to view the status of your card.
You may go to the app store or find the app link on Navia’s website

17. Health Care Deductibles/Limits
*Plan A
Plan B
Plan C
DVA
Medical & Rx
Dental, Vision & Audio
Deductible
$1000/$3000
Preventive care: 100%; no deductible
$2500/$5000
$3000/$6000
Deductible for dental: $50 per person
Out-of-Pocket limits
$2000/$6000
$2000/$8000
$2000/$4000
No changes to theses benefits from this year
For 2018, the annual deductible is increasing for Plans A and B. The medical out-of-pocket limit is also increasing for Plan A. there are no changes to Plan C or DVA.

18. October 15th through November 15th
Open Enrollment
October 15th through November 15th
Enrollment will be on-line through Employee Self-Service (ESS)
Paper forms will be available on our website and accepted in lieu of online enrollment for those unable to access ESS, they must be submitted by November 15th.
Supporting documentation for newly enrolled dependents must be submitted to the HR office no later than 5:00 p.m. on November 30, 2018.
Online enrollment through ESS will end on November 15, 5:00 p.m.
Supporting documentation includes a marriage license if enrolling a spouse, birth certificates, legal guardianship documents, and/or adoption papers if enrolling children.

19. Open Enrollment Open Enrollment Packets
- Will be mailed out on September 24, 2018
- Will include the 2019 Enrollment Guide, online enrollment
instruction sheet, links to enrollment forms and documents.
Open Enrollment Site (
- Will have all forms, plan documents, plan costs, education materials
posted by October 15, 2018.
Enrollment workshops
- Available October 16th & 17th and November 6th & 7th from 3:00 p.m. to
6:00 p.m. in the Technology Learning Center (TLC), Rm 236 of the ADC Building.

20. Open Enrollment Online enrollment tutorial (YouTube video):

21. Resources Available The School District Benefit Page is located at:
Open enrollment information is located at:
Navia Benefits (FSA, HSA, HRA) information is located at: