WELCOME TO YOUR BENEFITS!
AT GREATER CLARK COUNTY SCHOOLS, WE UNDERSTAND THE IMPORTANT ROLE THAT OUR BENEFIT PROGRAMS PLAY IN THE LIVES OF OUR EMPLOYEES AND THEIR FAMILIES.
Please take time to learn about these benefits so you can make an educated decision. When you make well-informed decisions, you can best manage your out-of-pocket expenses and also help control the rising cost of healthcare.
At Greater Clark County Schools, we offer the following benefits: Anthem HSA Medical Plan, three dental plans, a vision plan, disability insurance, life insurance, and several other voluntary benefits.
WHAT DOES THAT WORD EVEN MEAN?
We admit it, benefits can be hard to understand. Here are some common benefit words and their definitions to help you as you read through this guide.
(JAN 1 THROUGH DEC 31)
The amount you are required to pay per calendar year before certain benefits are paid for by the plan. Once you meet the deductible amount, expenses are covered by the plan based on the coinsurance percentage. This deductible starts over every January 1st.
ANNUAL OUT-OF-POCKET MAXIMUM
(JAN 1 THROUGH DEC 31)
The most you pay in a calendar year for covered services that are subject to coinsurance/copays. The deductible is included in this amount. If you reach the annual out-of-pocket maximum, the plan pays 100% of covered in-network eligible expenses for the remainder of the plan year. Office visits and prescription copays are included in the annual out-of-pocket maximum for our medical plans. This maximum starts over every January 1st.
When you are billed for the difference between the provider’s actual charge and the amount reimbursed under the medical or dental plan. This occurs when you go outside of the preferred provider network. Balance billing does not apply towards out-of-pocket maximum.
COPAYMENTS OR COPAYS
EXPLANATION OF BENEFITS (EOB)
HEALTH SAVINGS ACCOUNT (HSA)
The percentage you pay for covered expenses.
The flat dollar amount you pay for certain in-network services.
Provides information about how your claim was processed by the insurance company. The EOB details what portion of the claim was paid by the insurance company and what portion is your responsibility.
A special, tax-advantaged, interest bearing account to help plan and pay for qualified health care expenses (including plan deductible) while covered by a qualified high deductible health plan.
A group of doctors, hospitals and other healthcare providers that contract with a plan vendor to provide quality healthcare services at favorable rates.
PREFERRED PROVIDER ORGANIZATION (PPO)
A healthcare arrangement designed to provide healthcare services at a discounted cost for members to use designated providers (the network), but which also provides coverage (at a lower level) for services received from providers that are not part of the network.
USUAL, CUSTOMARY, AND REASONABLE (UCR) CHARGES
UCR charges are determined by your health plan vendor and are based on the range of fees charged by doctors with comparable training and experience for the same or similar service in your area. When you receive in-network care, UCR charges do not apply. You are responsible for amounts over UCR for out-of-network care.
COVERING YOU AND YOUR FAMILY
WHO IS ELIGIBLE
Greater Clark County Schools is proud to offer a comprehensive benefits package to eligible, full-time employees who work at least 30 hours per week and/or meet the requirements for continuing eligibility during an approved leave of absence. Our company benefits package is briefly summarized in this booklet.
Health Savings Account
Basic Life and AD&D Insurance
Voluntary Life and AD&D Insurance
Long Term Disability
Voluntary Short Term Disability
TIPSON HEALTHCARE COSTS
Visit the Emergency Room only in the case of a true emergency. Check your area for an Urgent Care location or utilize our FREE clinic.
Use Generic prescriptions, if available. Ask your doctor for a Generic or request the Generic equivalent when having your prescription filled. Call TrueScripts to find where to purchase your prescriptions at the lowest cost and use their mobile app for information about those drugs. More about this app on page 7.
Utilize In-Network Providers. Your medical costs increase greatly when you visit a provider who is not in the network. Always confirm your provider is in the Anthem Blue Access PPO Network, especially when being referred to another provider or facility for services.
Be sure you and your dependents receive routine annual physical exams and immunizations. Adults and children should have preventive health screenings recommended for their age for early detection of health conditions. All of these preventive services are covered at 100% on each of our plans.
MEDICAL, DENTAL & VISION
1. Select Find a Doctor
Log in with
3. Select a specialization
4. You can then narrow your search event further and/or review
cost of certain procedures and if they are accepting new patients.
WHERE TO FIND CARE
The more you know about the cost and quality of doctors and hospitals, the easier it is to make the best choices for you and your family. The online directory has plenty to offer, starting with simplified search tools that give you the results you need. You’ll also see integrated cost and quality information, helping you compare doctors and control health care spending.
For example, an MRI can cost anywhere from $400 to $1,400, depending on where you go.
Where you go for medical services can make a big difference in how much you pay and how long you wait to see a health care provider. Use the chart below to help you choose where to go for care.
Your employee clinic is usually the best choice for many primary and acute care services like labwork, minor injuries, pink eye, the flu, specialist recommendations and some prescriptions. www.proactive.md
See page 10 for more info!
If your primary care doctor isn’t available, and you have a routine issue such as a sinus problem, rash, or pink eye, then choose the another inexpensive option — telemedicine.
If you do not have a lifeor limb-threatening medical emergency, then go to your primary care doctor (PCP) if available.
If you do not have a life- or limb- threatening medical emergency, nor have a PCP available, and don’t have a routine issue, then visit a local urgent care center.
If you do have a lifeor limb- threatening medical emergency then go to the emergency room.
An appointment with a physician is available from your phone or computer.
It’s a great idea to build a relationship with your PCP, especially for longterm care needs. They can provide follow-up care and refer you to a specialist, if needed.
Urgent care centers typically don’t require an appointment and are often open in the evenings and on weekends. Plus, innetwork urgent care centers are faster and much less expensive than the ER.
In the case of a true medical emergency, go to the ER. At the ER, true emergencies are treated first, and other cases must wait — sometimes for hours. And, it will cost you a lot more to get care at the ER.
See page 11 for more info!
SAVING ON PRESCRIPTIONS
PRESCRIPTIONS ARE SO EXPENSIVE!
Unless you have TrueScripts...
Greater Clark County Schools is partnered with TrueScripts as their Pharmacy Benefit Manager, or PBM. A PBM works as the middle man, passing down discount from the manufacturer to your employer and you. Did you know there are many drugs out there that you’re OVER paying for? They might even be free as a member of the Greater Clark sponsored health plan.
Don’t overpay for another minute! The next time you’re prescribed a medication, call Greater Clark's dedicated TrueScripts Member Care staff at (844) 257-1955.
Have a question AT the pharmacy? Your pharmacist can contact your TrueScripts Member Care staff at (855) 326-2159.
TRUESCRIPTS MOBILE APP MyDrugBenefit
MyDrugBenefit is a web portal that empowers you and your family to get the greatest return on your pharmacy benefits. This includes getting the right therapy at the right time, from the right source, based on the help and considerations of a real person in real time!
With MyDrugBenefit you can…
• Manage your medications
• Look up your medications when at a doctor’s visit
• Review doctor’s visit prep questions
• Track immunizations
• Review your refill history, doctor’s name, supply and quantity
• Review details of your healthcare plan
• Find potential savings with alternative medicines
• Review labels and warning signs, common brand names and consumption instructions
WHAT IS THE MOST I WILL PAY?
In-Network Deductible Individual | Family Out-of-Network Deductible Individual | Family
In-Network Out-of-Pocket Maximum Individual | Family Out-of-Network Out-of-Pocket Maximum Individual | Family
HOW DOES IT WORK AT THE HOSPITAL?
$1,500 | $3,000 $4,500 | $9,000
$1,500 | $3,000 $15,000 | $30,000
You pay 0% after deductibleOut-patient Surgery
Major Imaging (Ex: MRI, CT, PET scan)
HOW DOES IT WORK AT THE DOCTOR’S OFFICE?
Preventive Care LiveHealth Online No Charge $59
Primary Care Physician Specialist
WHAT IF I NEED EMERGENCY CARE?
You pay 0% after deductible
You pay 0% after deductibleEmergency Room
HOW MUCH DOES IT COST FOR PRESCRIPTIONS?
RX Out-of-Pocket Max
Retail (30-day supply)
Retail (90-day supply)
YOUR MEDICAL COST PER PAY (24)
pay 0% after deductible
pay 0% after deductible
HEALTH SAVINGS ACCOUNT
IF YOU ARE ENROLLED
THE HSA PLAN
YOU HAVE CONTROL:
• Unused money rolls over from year to year in an interest bearing savings account.
• You can use the funds on medical, dental and vision expenses for you and your family.
• You can even invest your funds for the future.
• There is no “use it or lose it” rule.
YOU SAVE ON TAXES:
• All money deposited is not taxed.
• Withdrawals for eligible expenses are exempt from federal income tax.
• You can earn interest tax free.
WHO IS ELIGIBLE FOR AN HSA?
Anyone who is:
• Enrolled in the HSA Plan which is a qualified High Deductible Health Plan (HSA $1,500 plan).
Anyone who is NOT:
• Covered under any other medical plan that has copays.
• Enrolled in Medicare, Medicaid, or TriCare or have received VA benefits in the last three months.
• Eligible to be claimed as a dependent on someone else’s tax return, such as a person under 26 who is still on their parent’s plan.
Contributions cannot exceed $3,850 for individual coverage and $7,750 for employee with dependent(s) coverage annually on a pre-tax basis for the 2023 tax year.
Individuals age 55 and older are eligible to make catch-up contributions of an additional $1,000 annually.An HSA is a savings account that you can use to pay out-of-pocket health care expenses with pre-tax dollars.
YOUR HEALTH CENTER
Proactive MD has partnered with Greater Clark County Schools to provide an employer-sponsored Health Center. Now you, your spouse, and any dependents enrolled in the health plan can receive exceptional primary care whenever it’s needed, at no cost to you.
Our Health Centers offer services such as family medicine, acute care, medication dispensing and prescriptions, lab work, and more. You can also take advantage of our total wellness solutions, including weight loss programs, diabetes education, stress management, smoking cessation, and wellness coaching.
Our providers and clinical care team practice medicine the way it was meant to be practiced: personally and proactively. We are here to serve you with compassion and transparency, and we promise to always fight for your greatest good. Come see what Care Without Compromise could mean for you!
HEALTH CENTER HOURS & CONTACT
The Health Center should be your first stop for healthcare — whether for routine care, minor illnesses, or injuries. Your Proactive MD Team will assess your symptoms and help you understand the best course of action. Visit: www.proactive-md.com
Greater Clark County Schools Health Center 6200 E. Highway 62, Bldg 2501, Jeffersonville, IN 47130 Phone: 812-214-0460 Fax: 833-638-0118
YOUR HEALTH CENTER
Mon: 8 a.m. to 5 p.m.
Tues: 7 a.m. to 4 p.m. Wed: 8 a.m. to 5 p.m. Thurs: 7 a.m. to 6 p.m.
Fri: 8 a.m. to 4 p.m. Sat: 8-11 a.m.
LIVEHEALTH ONLINE PROVIDED BY ANTHEM
AN AFFORDABLE OPTION FOR QUALITY MEDICAL CARE.
GET THE CARE YOU NEED.
GET STARTED TODAY.
SYDNEY HEALTH APP BY ANTHEM
a video about what you can rely on Sydney to help you with in 2023.
With Sydney, you can find everything you need to know about your Anthem benefits — personalized and all in one place. Sydney makes it easier to get things done, so you can spend more time focused on your health.
WITH JUST ONE CLICK, YOU CAN:
ALREADY USING THE ANTHEM APP?
It’s easy to make
Simply download the Sydney app and log in with your Anthem username and password. When you search “Anthem” in the app store, Sydney Health will be your first option!
Anthem’s app is simple, smart, and ALL ABOUT YOU
HIGH PLAN MID PLAN LOW PLAN BENEFITS
In-Network Calendar Year Deductible (Individual | Family)
$50 | $150
$50 | $150 $50 | $150
Maximum Benefit (Per Person) $1,500 $1,500 $1,000
HOW DOES THE PLAN WORK?
Preventive Services Cleaning and X-rays
Basic Services Fillings and Extractions
Major Services Crowns and Bridgework
Endodontics Root Canals
Periodontics Gum Disease
These services are covered at 100% These services are covered at 100% These services are covered at 100%
You pay 20% of the charges You pay 50% of the charges You pay 50% of the charges
You pay 50% of the charges You pay 70% of the charges You pay 100% of the charges
You pay 50% of the charges You pay 50% of the charges You pay 100% of the charges
You pay 50% of the charges You pay 50% of the charges You pay 100% of the charges
Lifetime Maximum $1,500 $1,500 NA
YOUR DENTAL COST - BI-WEEKLY (24 PAYS)
You pay 50% of the charges
You pay 50% of the charges NA
Employee $15.65 $13.69 $6.94
Employee + 1 $31.22 $24.78 $14.15
Employee + Family $56.08 $41.66 $30.16
WHAT DOES A BALANCE BILL AMOUNT LOOK LIKE?
Dr. Jones charges $750 for a crown.
Anthem Dental Plan
Since Dr. Jones isn’t in the network, he has the right to bill you for the $150 di erence - plus the 50% coinsurance you still have to pay.
The Anthem Dental Plan will only cover $600.
On the other hand, if you visit an in-network dentist, he or she has already agreed to charge the $600 that the plan covers for crowns, so you would only owe 50% of that.
VSP VISION PLAN
Anthem Vision Plan In-Network
Eye Exam $25 Copay
Single | Bifocal | Trifocal $10 Copay for each
Frames $100 allowance
Elective Contacts In lieu of lenses $110 allowance
Medically Necessary Contacts $110 allowance
YOUR VISION COST - BI-WEEKLY (24 PAYS)
Employee + Spouse $2.02
Employee + Child(ren) $2.08
Employee + Family $3.09
Just for being a Anthem member, you are eligible for extra discounts and savings! You can find out more by visiting anthem.com
GLASSES, SUNGLASSES AND CONTACTS
• Save up to 20% on Non-prescription sunglasses
• Additional complete pair of eye-glasses - 40%
• Discounts offered through Anthem's Special Offers Program
Anthem Vision Plan Out-of-Network
Reimbursed up to $35
Reimbursed up to $25 | $40 | $55
Reimbursed up to $45
Reimbursed up to $105
Reimbursed up to $210
LIFE AND AD&D INSURANCE
Greater Clark County Schools offers employer-paid Life Insurance at no cost to you. We also provide all eligible employees the option of purchasing additional Life and AD&D insurance through OneAmerica. These benefits provide valuable peace of mind and give you the option of covering your dependents. If you elect coverage for yourself, you are eligible to elect coverage for your spouse or dependent children as well.
EMPLOYER-PAID LIFE AND AD&D
It’s important that our employees have some level of financial protection. That’s why we provide eligible employees with Basic Life and AD&D coverage through OneAmerica at no cost to you.
All eligible employees receive guaranteed coverage based on employee class. See your OneAmerica schedule of benefits for more information.
LIFE AND AD&D
$10,000 increments up to a maximum of $500,000 Guarantee issue: $150,000 under age 70 $10,000 increments up to a maximum of $500,000 or 100% of employee’s election Guarantee issue: $50,000
Birth to 6 months: $500 Ages 6 months to 26: $5,000 50% at age 70
THINGS TO KNOW
1. A “guarantee issue” amount is the dollar amount of coverage you can be approved for without completing a health questionnaire. Guarantee issue amounts only apply during the 31 days following your initial eligibility period when hired.
2. If you wish to enroll in the Voluntary Life and AD&D plan or increase your coverage after your initial eligibility period, you will be required to complete the Evidence of Insurability Form, which contains questions about your health.
3. Rates are based on your age and the amount of coverage you elect. Spouse rates are also based off of the employee age.
HOW MUCH LIFE INSURANCE DO I NEED?
When it comes to protecting the financial security of you and your family, nothing is more important than planning ahead. Even if you already have a life insurance policy in addition to the company-provided policy, it’s important to ask yourself:
“Do I have the protection I need to cover all of my financial responsibilities?”
You must designate a beneficiary for Basic Life and AD&D and Voluntary Life and AD&D. You have the right to change the beneficiary at any time by written or electronic notice. You can change your beneficiary by contacting Human Resources.
A few categories to consider:
Option 2 BENEFITS
maximum monthly benefit of
Full-Time Certified Employees and Classified Administrators who work more than 18.75 hours per week
maximum monthly benefit
$6,000, as elected
increments of $100, not to exceed 66 2/3% of an
LONG TERM DISABILITY
Greater Clark County Schools offers Long Term Disability coverage at no cost to you! We believe it’s important to provide our employees income protection for those times of life when it’s needed most. The Basic LTD plan will pay 60% of your earning up to $7,000 a month after the 90 day waiting period.
IMPORTANT BENEFIT CONTACTS
Benefit Provider Phone Website
Medical Anthem 800-826-9781 www.anthem.com/find-doctor
Health Savings Account American Fidelity 800-662-1113 www.americanfidelity.com
Proactive MD 877-768-0082 www.proactive-md.com
Dental Anthem 866-947-9398 www.anthem.com/find-doctor
Vision Anthem 866-755-2680 www.anthem.com/find-doctor
Basic / Voluntary Life and AD&D OneAmerica 855-517-6442 www.oneamerica.com
Long Term Disability OneAmerica 855-517-6365 www.oneamerica.com
Director of HR- Tricia Helton
Greater Clark County Schools 812-288-4802 ext. 50146
The information in this Enrollment Guide is presented for illustrative purposes and is based on information provided by the employer. The text contained in this Guide was taken from various summary plan descriptions and benefit information. While every effort was taken to accurately report your benefits, discrepancies or errors are always possible. In case of discrepancy between the Guide and the actual plan documents, the actual plan documents will prevail. All information is confidential pursuant to the Health Insurance Portability and Accountability Act of 1996.