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Page 1. Pasadena ISD Page 2 PISD Benefits Contact Numbers Cecilia Beltran713-740-0110 Nancy Silvestre 713-740-0120 Vonnie Conde713-740-0121 Page 3 1515.

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Presentation on theme: "Page 1. Pasadena ISD Page 2 PISD Benefits Contact Numbers Cecilia Beltran713-740-0110 Nancy Silvestre 713-740-0120 Vonnie Conde713-740-0121 Page 3 1515."— Presentation transcript:

1 Page 1

2 Pasadena ISD Page 2

3 PISD Benefits Contact Numbers Cecilia Beltran713-740-0110 Nancy Silvestre 713-740-0120 Vonnie Conde713-740-0121 Page 3 1515 Cherrybrook – Pasadena 77502 Summer Hours: Monday – Thursday 7:00a.m. – 5:30p.m.

4 Page 4  Your health coverage begins the first day you are on duty. However … o If you choose to have coverage beginning in August, you must write out a check for the August premium. o If you choose coverage to begin Sept 1, you do not need to do anything. Your premium will come out of Sept checks.  “Voluntary plans” ( Disability, Dental, Cancer etc.) coverage begins the first day of following month  Elections you choose now (at your Human Resources appt.) carry you through December 31,2013. o Annual Enrollment (to make changes to your elections) begins in the fall. Those changes go into effect 01/01/2014. Coverage is from Jan 1 – Dec 31. Enrollment and Coverage

5 Page 5 Payroll Information (refer to sheet in packet)  Premiums are taken out of both checks equally. o Check dates are 1 st of the month, and 15 th of the month.  Health Insurance Options are: o Medical Plan I - Aexcel Aetna Choice POS II o Medical Plan II – Aetna CPOS II Healthfund o Plan III - Alternate Plan (no health insurance with us) o Medical Plan IV – Aetna CPOS II HRA - ACD

6 Page 6 Medical Plan I – Aexcel Aetna CPOSII ---------- $4,000

7 Medical Plan I – Aexcel Aetna CPOSII Cont’d Page 7

8 Medical Plan I – Aexcel Aetna CPOS II Monthly Premiums District’s Contribution Employee’s Cost Employee Only Employee & Spouse Employee & Child(ren) Family $245 $250 $245 $650 $245 $510 $245 $895 Page 8

9 Medical Plan II – Aetna CPOSII AHF-HRA Page 9

10 Medical Plan II – Aetna CPOSII AHF-HRA (cont’d) Page 10

11 District’s Contribution Employee’s Cost Employee Only Employee & Spouse Employee & Child(ren) Family $245 $135 $245 $335 $245 $260 $245 $495 Page 11 Medical Plan II – Aetna CPOS II AHF-HRA Monthly Premiums

12 Medical Plan III – Alternate Plan I. Hospital Income Inpatient Hospital Days$150 per day/Benefit Maximum180 Days per Calendar Year II. Life and Accidental Death and Dismemberment Insurance Employee covered under the Alternate Plan receive an additional $10,000 in life insurance III. Dental Coverage – Sun Life Financial Deductible per year - $50 Calendar Year Max. Benefits - $1,000 * Preventative & Diagnostic Dental Services – 100% of Usual & Customary Charges Periodic Oral Exam, Bite0Wing X-Rays, Dental Prophylaxis Cleaning, Complete Series or Panorex * Basic Dental Services ( Minor Restorative, Endodontic, and Oral Surgery ) – 80% of Usual & Customary Charges Fillings, Root Canal Treatment, Root Planning, Periodontal Surgery, Simple Extraction, Surgical Extraction * Major Dental Services – 50% of Usual & Customary Charges Crowns, Fixed Bridges, Full Dentures, Inlay & On lays, Partial Dentures, Relining Dentures, Repairs to Full Dentures, Partial Dentures, Bridges Page 12

13 Medical Plan IV – Aetna Select Page 13 $500 Employee/yr ($41.66/mo for Aug newhires) $1,000 EE+S, Ch or F ($83.33/mo for Aug newhires)

14 Medical Plan IV – Aetna Select Cont’d Page 14

15 District’s Contribution Employee’s Cost Employee Only Employee & Spouse Employee & Child(ren) Family $245 $100 $245 $251 $245 $210 $245 $395 Page 15 Medical Plan IV – Aetna Select Monthly Premiums

16 Aetna Member Resources  Group Plan Number: 838899  Member Services Toll Free Number 1-800-841-3541  Claims Address: P.O. Box 981106, El Paso TX 79998-1106  Remember to Register on Aetna Navigator o How to Register - Registration is an easy process: o Go to www.aetna.com and click on "Register" under "Aetna Navigator ® Member Log In" o Complete the requested information Page 16

17 17 What is Aexcel*? Aexcel is a designation for specialty doctors who are some of the high performers in their specialty areas. It’s easy to find Aexcel-designated doctors - just look for the star  next to their names in DocFind ® *Aexcel is not available with HMO plans. Are part of the existing Aetna network of health care providers See enough Aetna patients to allow us sufficient data to review their performance Have met industry-accepted practices for clinical performance Have met Aetna’s efficiency standards As the final step, we make sure there are enough specialists for members to choose from How do specialist qualify for the Aexcel designation?

18 18 Aexcel-designated doctors are in 12 specialty areas  Cardiology  Cardiothoracic Surgery  Gastroenterology  General Surgery  Neurology  Neurosurgery  Obstetrics / Gynecology*  Orthopedics  Otolaryngology/ENT  Plastic Surgery  Urology  Vascular Surgery *Ob/Gyns are classified as specialists in the Aetna plan.

19 How to Find a PCP  DocFind – o Go to www.aetna.com and click on doc find. o Select your provider category. You can search by city, state, zip, specialty, hospital affiliation, provider name, gender, language and education. o Select the “Aexcel Choice POSII Open Access” network for Medical I o Select the “Aetna Choice POSII (Aetna Health Fund)” network Medical II o Select the “Open Access Aetna Select (Aetna Health Fund)” network Medical IV o Click on search to find a provider Page 19 www.aetna.com/docfind/custom/pasadenaisd

20 20 Custom DocFind makes it easier for you to find an Aexcel-designated specialist 999 Shore Rd. Suite N999 Anywhere, CT, 06457 (860)123-3456 Allan, Michael, MD

21 Page 21 Docfind Provider View Details

22 Page 22 Express Script Pharmacy Benefits Participating Pharmacy – up to 30 days supply Tier 1: Generic Drug$15 Co-Pay Tier 2: Preferred Brand Drug$40 Co-Pay Tier 3: Non-Preferred Drug$70 Co-Pay Home Delivery – up to 90 days supply Tier 1: Generic Drug$30 Co-pay Tier 2: Preferred brand drug$80 Co-pay Tier 3: Non-preferred brand drug$140 Co-Pay **Plan 1 includes the following deductible (combined Tier 2 & Tier 3 drugs only) $100 deductible per person $150 deductible for family

23 Page 23 Other P.I.S.D Employee Benefits Resources:  Monthly Newsletter  Website o Insurance Contact phone numbers and web links o FAQ’s o Documents and claim forms for download o Information on your health plan

24 Pasadena ISD Wellness Center Page 24 1850 E. Sam Houston Parkway, Pasadena TX 77503 Clinic Hours are Monday, Wednesday, Friday: 8 am—4 pm Tuesday and Thursday: 1pm—8pm Saturday: 8am—1pm Call 713-740-5300 for an appointment or visit www.pasadenaisdclinic.comwww.pasadenaisdclinic.com  Employees on our health plan can receive services at the clinic at no cost. (Family members eligible also)  Employees not on our health plan will pay the copay based on their insurance plan.  Employees with NO INSURANCE will have $50 copay.

25 QUESTIONS … Page 25

26 Mr. Whitney Miller 1-800-876-9070


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