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Special Open Enrollment for Medical Benefits
(Changes to Plan Options A and B)
TO: Cross (Dual) Covered Medicare Eligible Retired Employees Eligible
For Benefits under the Fresno Unified School District’s Employee Health
RE: Medical Benefit Modifications and Special Open Enrollment Effective
April 1, 2012
DATE: January 27, 2012
In October, 2011, Open Enrollment material mailed to all Plan participants of the Health Care Plan announced that additional changes to the Medical Plans would be forthcoming in order to bring health care spending in line with available income. After careful review, the Joint Health Management Board adopted the medical plan changes noted, in bold, on the attached side-by-side comparison for Plan Options A and B effective April 1, 2012 for all covered Active and Retired Employees.
Dual Covered 100% benefit has been eliminated.
Effective April 1, 2012, if an Employee and/or Retiree is covered under the Plan as an Employee and/or Retiree and as a Dependent spouse or Domestic Partner, standard coordination of benefits provisions will apply (when the required employee contributions are paid). This means the Calendar Year Deductible, Copayments and other possible costs will/may apply. Prescription Benefits do not coordinate and participants will be responsible for the Copayments.
Each employee would have to satisfy their deductible and each would have to pay office visit copayments. The Standard COB process would, in most cases, cover the remaining cost at 100%.
A special Open Enrollment will take place during the period January 27, 2012 through March 9, 2012 as a result of the medical plan changes. In addition to reviewing the enclosed material, you and your family are encouraged to attend an informational meeting where representatives from the Plan (District’s Benefit Office and Delta Health Systems), Anthem Blue Cross (relating Plan Options A and B), and Kaiser Permanente Health Plan (relating Plan Option C) will be available to talk about the available options and to answer your questions concerning coverage differences, coordination of benefits, premium increased your Out-Of-Pocket maximums.
April 1, 2012 will also provide Active Employees and Retirees Not Eligible for Medicare (under age 65) the opportunity to enroll in Kaiser Permanente for the first time; and the Joint Health Management Board (JHMB) is considering a plan for Medicare-Eligible participants at some point in the future, if it is financially feasible. Right now, however, Plan Option C, Kaiser Permanente, is not available to Retirees Eligible for Medicare.
Beverages, light snacks, and giveaways will be provided at the meetings. The meeting dates can be expanded if demand is high. While it is not required in order to attend a meeting, you may sign up for one of the following meetings by logging on to FUSDSpecialOE.org and reserve
a place. By signing up, each health care vendor will be better able to provide you with information, food, and sufficient giveaways!!
|Hoover High School Auditorium||5550 N. First, Fresno 93710|
|Sunnyside High School Auditorium||1019 S. Peach, Fresno 93727|
|Fresno High School Auditorium||1839 N. Echo, Fresno 93704|
If you are considering changing Medical Plan Options (to A or B) effective April 1, 2012, please complete the enclosed District Election Form and return it to the District Office via intra-district mail or regular mail no later than March 9, 2012. Please be advised that any Deductible applied during the January 1, 2012 through March 31, 2012 period under your current Medical Plan Option will be accrued toward the Deductible under any Plan Option (A or B) you enroll in effective April 1, 2012.
If you do not wish to change medical plans, NO action is required on your part and you will automatically remain in your existing Plan A or Plan B. However, since the Medical Plan benefits will change effective April 1, 2012, please review the side-by-side comparison to familiarize yourself with the new benefit changes.
This Special Medical Plan Open Enrollment election does not allow you to change your Dental or Vision benefits. Please be aware that the changes for this Special Open Enrollment are noted in bold-type in the enclosed side-by-side Medical Plan comparison.
Jan 8: PTS Main Office
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