The district pays $529.57 per month (2019-2020 school year) to provide medical, vision, life, and dental benefits for you if you qualify as a full-time employee. Each employee pays $10 per month – pretax ($120 per year).
There is a $300 deductible per person, per calendar year for in-network doctors; the plan pays 80% for all allowable services once the deductible has been met. Plan pays 100% after $10,000 total expenses incurred (plus deductible). Thus, the total annual maximum out-of-pocket costs (using in-network providers) would be $2,300.
Deductible increases to $350 per calendar year if out-of-network providers used; employee pays for all services not allowable by the plan and the employee will pay a significantly higher portion of the cost when out of network doctors are used. See the plan document for additional information.
A $100.00 additional fee is charged for each use of the emergency room without being admitted.
Telehealth benefit through MeMD
MeMD’s licensed healthcare providers are available 24 hours a day, 365 days a year. Therapy sessions are scheduled Monday through Friday from 9 am to 7 pm local time.
The first three telehealth visits (whether for medical or mental health services) will be provided to members at no cost for 2019. Thereafter, telehealth benefits will be available for medical and mental health services at cost sharing to members of 20% coinsurance per visit, subject to the medical plan deductible.
$50 yearly deductible applies if purchased at retail in-network pharmacies. Once the deductible is met, you pay the greater of 20% of the cost for generic drugs using in-network pharmacies or $10 minimum, unless the actual cost is less; 20% of the cost for name-brand preferred medications or $20 minimum, whichever is greater.
A mail order Prescription Drug Program from Prescription Mart is also available. There is no deductible; cost is $20.00 for a 90-day supply of generic prescription drugs and $40 for a 90-day supply of name brand preferred drugs. A specialty drug program is also available.
The plan allows $75 for an exam every 12 months with a doctor of your choice. Provides up to $75 for frames; $40 for single vision lenses, $50 for bifocals, $90 for trifocals; and up to $110 for contacts. The plan also pays 10% of expenses incurred in excess of those amounts. You may get contacts OR glasses (not both) in any 12 consecutive month period.
The District provides each employee with $20,000 in term life/AD&D insurance until age 70. After
age 70, coverage is reduced to $10,000.
There is a $50 deductible. The plan provides a maximum of $1,000 coverage each calendar year. Covers two routine cleanings per year with no deductible. Once the deductible has been met, the plan pays 80% for basic and routine services; 50% for major services.
Provides approximately 66 2/3% of salary for up to six months. The waiting period to receive benefits is the greater of 30 days or when sick leave is exhausted.
Six month waiting period; pays approximately 66 2/3% of salary.
Employee Assistance Program (EAP)
After the initial call, provides three outpatient treatment sessions per fiscal year free of charge to all permanent employees and their dependents (up to age 26).