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Choosing Your Medical Plan Columbia Public Schools PLUS PLAN BASIC PLAN.

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Presentation on theme: "Choosing Your Medical Plan Columbia Public Schools PLUS PLAN BASIC PLAN."— Presentation transcript:

1 Choosing Your Medical Plan Columbia Public Schools PLUS PLAN BASIC PLAN

2 MEDICAL PLAN: BASIC VS. PLUS Part 1 Columbia Public Schools

3 Medical Plan Options Columbia Public Schools Basic Plan Plus Plan with Health Savings Account

4 Changes for 2013 Basic Plan No plan changes New premium rates for 2013 Plus Plan No plan changes New premium rates for 2013 Health Savings Account (HSA) District contribution: $400 to be deposited on 1/30/13 $200 to be deposited on 9/30/13 $600 annual total for 2013* Columbia Public Schools *Prorated amounts for the part-time employee

5 What You Need to Do Columbia Public Schools If you are a Basic Plan participant and want to keep the Basic Plan No action is required; your Basic Plan choice will roll to 2013 If you want to participate in the Traditional Flex Plan for 2013 (unreimbursed medical and dental expenses), make your election on the green ASI Traditional Flex Plan enrollment form and return by November 30, 2012 If you want to add a dependent, complete the green Basic Choice Add Dependent form If you are a Plus Plan participant and want to keep the Plus Plan with HSA Go to the yellow Plus Plan enrollment form to review the HSA eligibility questions and follow instructions ReminderMake your 2013 HSA payroll deduction election now, as current deductions do not roll. Decide how much you want to contribute to your HSA through payroll deductions, and enter your election for 2013 on the yellow Plus Plan form; return the election form by November 30, 2012 If you want to participate in the Limited Flex Plan for 2013 (dental and vision reimbursement only), complete the yellow ASI Limited Flex Plan enrollment form and return by November 30, 2012 If you want to add a dependent, complete the yellow Plus Plan Choice Add Dependent form If you want to switch plans Complete the green Basic Plan enrollment form, or the yellow Plus Plan enrollment form If you want to flex your day care Complete the ASI election form for 2013 Open Enrollment election forms are due in Business Services on November 30, 2012

6 What is the Basic Plan? $500 deductible (individual)$500 deductible (individual) $1,500 maximum out-of-pocket limit (individual)$1,500 maximum out-of-pocket limit (individual) $15, $30, and $45 prescription drug copays$15, $30, and $45 prescription drug copays Mail order copays: $25, $55, and $90 for 90-day supplyMail order copays: $25, $55, and $90 for 90-day supply Columbia Public Schools The Basic Plan is our traditional health plan, with:

7 What is the Plus Plan? $1,400 deductible (individual)/$2,800 deductible (family)$1,400 deductible (individual)/$2,800 deductible (family) Prescription costs and other eligible expenses count toward the deductiblePrescription costs and other eligible expenses count toward the deductible 100% coverage after deductible is met, for in-network services100% coverage after deductible is met, for in-network services Maximum out-of-pocket for individual coverage is $1,400; family maximum is $2,800, for in-network servicesMaximum out-of-pocket for individual coverage is $1,400; family maximum is $2,800, for in-network services If eligible, employee opens a Health Savings AccountIf eligible, employee opens a Health Savings Account District contributes $600 annually to the employees Health Savings Account, lowering the total out-of-pocket maximum to $800 per yearDistrict contributes $600 annually to the employees Health Savings Account, lowering the total out-of-pocket maximum to $800 per year Employee makes pre-tax contributions to the Health Savings AccountEmployee makes pre-tax contributions to the Health Savings Account Use the Health Savings Account to pay for qualified medical expensesUse the Health Savings Account to pay for qualified medical expenses Columbia Public Schools

8 What is the Plus Plan? A qualified high deductible health plan (QHDHP) that satisfies Internal Revenue Service requirements regarding deductibles, contributions, and out-of-pocket expensesA qualified high deductible health plan (QHDHP) that satisfies Internal Revenue Service requirements regarding deductibles, contributions, and out-of-pocket expenses The deductible on the Plus Plan meets the IRS guidelines for QHDHPsThe deductible on the Plus Plan meets the IRS guidelines for QHDHPs Columbia Public Schools

9 What is a Health Savings Account? A Health Savings Account is a tax-free opportunity to save and pay for your qualified out-of-pocket health expensesA Health Savings Account is a tax-free opportunity to save and pay for your qualified out-of-pocket health expenses A Health Savings Account is associated only with a Qualified High Deductible Health Plan (our Plus Plan)A Health Savings Account is associated only with a Qualified High Deductible Health Plan (our Plus Plan) A Health Savings Account is similar to, but different from, a Flexible Spending AccountA Health Savings Account is similar to, but different from, a Flexible Spending Account Columbia Public Schools

10 Comparison of Basic and Plus Plans Effective January 1, 2013 Columbia Public Schools Basic Plan In-networkOut-of-network Deductible (per calendar year) $500 single $1,000 family $600 single $1,200 family Coinsurance80% after deductible70% after deductible Out-of-pocket maximum (single/family) $1,500/$3,000 (excludes prescription copays) $2,100/$4,200 (excludes prescription copays) Prescription drugsRetailMail Order Generic$15 copay$25 copay Preferred$30 copay$55 copay Non-preferred$45 copay$90 copay District contribution to Health Savings Account None Plus Plan In-networkOut-of-network Deductible (per calendar year) $1,400 individual $2,800 family $1,400 individual $2,800 family Coinsurance100% after deductible70% after deductible Out-of-pocket maximum (single/family) $1,200/$2,400 (includes prescription costs) $4,200/$8,400 (includes prescription costs) Prescription drugs Prescription costs apply toward deductible, similar to other eligible medical expenses Generic Preferred Non-preferred District contribution to Health Savings Account $600 for 2013 Basic PlanPlus Plan In-networkOut-of-networkIn-networkOut-of-network Deductible (per calendar year) $500 single $1,000 family $600 single $1,200 family $1,400 individual $2,800 family $1,400 individual $2,800 family Coinsurance80% after deductible70% after deductible100% after deductible70% after deductible Out-of-pocket maximum (single/family) $1,500/$3,000 (excludes prescription copays) $2,100/$4,200 (excludes prescription copays) $1,200/$2,400 (includes prescription costs) $4,200/$8,400 (includes prescription costs) Prescription drugsRetailMail Order Prescription costs apply toward deductible, similar to other eligible medical expenses Generic$15 copay$25 copay Preferred$30 copay$55 copay Non-preferred$45 copay$90 copay District contribution to Health Savings Account None$600 for 2013

11 Deductible Notes Basic Plan Family Deductible Note The Basic Plan family deductible is $1,000 per year. The $1,000 can be a combined deductible of all of the covered family members. Remember that if one individual in the family meets the $500 deductible, insurance will begin to pay on that one individual. Columbia Public Schools Plus Plan Family Deductible Note The Plus Plan family deductible is $2,800 per year. This means that if you have more than one person on the Plus Plan, you will need to reach the $2,800 deductible before ANY eligible expense will be covered by insurance. Once the deductible is met, insurance pays 100% of eligible expenses.

12 Health Savings Account Enrollment Eligibility Columbia Public Schools To be eligible to contribute to a Health Savings Account, you must: Be covered by the Plus PlanBe covered by the Plus Plan Not be covered by another health plan that is not a high deductible health planNot be covered by another health plan that is not a high deductible health plan –Not be covered by Medicare –Not be covered by a spouses plan that has a deductible of less than $1,200 for a single plan, or $2,400 for a family plan –Not be covered by another plan that covers first dollar expenses, like prescription copays or office visit copays Not be covered as a dependent on anothers tax planNot be covered as a dependent on anothers tax plan

13 Health Savings Account Enrollment Eligibility Columbia Public Schools The IRS does not allow you to double-dip on saving taxes on medical expenses! This means: If you are married and your spouse has a traditional flexible benefits plan, you would not be eligible to contribute to a Health Savings AccountIf you are married and your spouse has a traditional flexible benefits plan, you would not be eligible to contribute to a Health Savings Account

14 Enrollment Eligibility Columbia Public Schools Anyone can enroll Must be eligible to contribute Plus Plan Health Savings Account

15 Health Savings Account District Contribution Columbia Public Schools Amount of district contribution will be determined each year; cost is the difference between the Basic Plan premium and the Plus Plan premiumAmount of district contribution will be determined each year; cost is the difference between the Basic Plan premium and the Plus Plan premium If you are eligible for a Health Savings Account, the district will contribute $600 to the Health Savings Account over the course of the year for the full-time employeeIf you are eligible for a Health Savings Account, the district will contribute $600 to the Health Savings Account over the course of the year for the full-time employee Example:Example: Deductible$1,400 District contribution-600 Your total out-of-pocket expense $800 Employee Basic Plan premium$480 Employee Plus Plan premium-430 Difference$50 $50 x 12 = $600

16 Health Savings Account District Contribution Columbia Public Schools January$50 February$50 March$50 April$50 May$50 June$50 July$50 August$50 September$50 October$50 November$50 December$50 $50 x 12 = $600 } $400 deposited to Health Savings Account on January 31, 2013 $50 deposited to HSA $200 on September 30, 2013

17 Health Savings Account Benefits Columbia Public Schools You can: Contribute pre-tax money to your Health Savings Account through payroll deduction, based on your health care needs; use the money in the Health Savings Account to pay for your health care expensesContribute pre-tax money to your Health Savings Account through payroll deduction, based on your health care needs; use the money in the Health Savings Account to pay for your health care expenses –Maximum contribution: Single coverage: $3,250 per year (max includes districts amount)Single coverage: $3,250 per year (max includes districts amount) Family coverage: $6,450 per year (max includes districts amount)Family coverage: $6,450 per year (max includes districts amount) Contribute an extra $1,000 into the Health Savings Account if you are over 55Contribute an extra $1,000 into the Health Savings Account if you are over 55 Contribute by making deposits in person at Landmark BankContribute by making deposits in person at Landmark Bank Elect in November how much you want deducted from your paycheckElect in November how much you want deducted from your paycheck Cannot change payroll deduction amount in 2013Cannot change payroll deduction amount in 2013

18 Whose expenses can you pay for with your Health Savings Account? Columbia Public Schools Dependents expenses count if you claim them on your income tax returneven if dependents arent on CPS insurance plansDependents expenses count if you claim them on your income tax returneven if dependents arent on CPS insurance plans Health Savings Account qualified expenses include:Health Savings Account qualified expenses include: –Over-the-counter drugs must be prescribed by a doctor –Glasses, contact lenses, eye exams –Dental expenses –Deductible (remember, you pay 100% of expenses up to first $1,400, including prescription costsless $600 annual district contribution) Reminder

19 What other expenses are reimbursable from your Health Savings Account? Columbia Public Schools Services not covered by the medical plan that do not count toward the deductible, such as:Services not covered by the medical plan that do not count toward the deductible, such as: –Well visits –Sports physical costs –Hearing aids –Lasik eye surgery

20 Things to Remember About Health Savings Accounts Columbia Public Schools The districts contribution helps offset your deductible and out-of- pocket maximumThe districts contribution helps offset your deductible and out-of- pocket maximum Payroll contributions (and other contributions) are tax-freePayroll contributions (and other contributions) are tax-free The money in your Health Savings Account is always your moneyThe money in your Health Savings Account is always your money If you leave employment or retire, the Health Savings Account is still yoursit is portableIf you leave employment or retire, the Health Savings Account is still yoursit is portable Earnings in your account grow tax-freeEarnings in your account grow tax-free If you use this money for non-qualified expenses, you will be taxed on the amounts spent plus 20% penaltyIf you use this money for non-qualified expenses, you will be taxed on the amounts spent plus 20% penalty You can use the Health Savings Account for medical expenses after employment ends, as the money is always yoursYou can use the Health Savings Account for medical expenses after employment ends, as the money is always yours After age 65, you can pay CPS retiree premiums with your Health Savings AccountAfter age 65, you can pay CPS retiree premiums with your Health Savings Account The balance in your account rolls from year to yearThe balance in your account rolls from year to year You will have to plan on how you will pay for expenses during the first part of the year when your Health Savings Account balance hasnt had time to accumulateYou will have to plan on how you will pay for expenses during the first part of the year when your Health Savings Account balance hasnt had time to accumulate

21 How to Get Money Out of Your Health Savings Account Columbia Public Schools Pay the doctor/provider directly from your Health Savings Account debit card or checkPay the doctor/provider directly from your Health Savings Account debit card or checkOR Pay the doctor/provider directly with your own cash, check, or credit card, then later write a check to yourself from your Health Savings Account for expensesPay the doctor/provider directly with your own cash, check, or credit card, then later write a check to yourself from your Health Savings Account for expenses Keep documentation of the expenses for your records, in the event of an auditKeep documentation of the expenses for your records, in the event of an audit Its simple:

22 Tax Reporting Recordkeeping Requirements Columbia Public Schools W-2 will show your payroll contributionsW-2 will show your payroll contributions Bank issues Form 5498 each year in May, which reports employer and employee contributionsBank issues Form 5498 each year in May, which reports employer and employee contributions Form 8889 is completed with your income tax return to determine any excess contributions or taxable distributions. Form 8889 is simple:Form 8889 is completed with your income tax return to determine any excess contributions or taxable distributions. Form 8889 is simple: –Report your contributions –Report your expenses (keep your documentation of expenses) –Report any taxable distributions Its simple:

23 Example: Minimal User Columbia Public Schools * $75 toward deductible plus $30 Rx copay = $105 ** $285 toward deductible Anticipated expenses after PPO and Rx discounts Basic Plan ($500 deductible) Doctor visits (assume $75 per visit)$75 Prescription drugs (retail): Generic Preferred Non-preferred $30 Total medical cost$105 Deductible$500 Coinsurance (plan pays) after deductible80% Out-of-pocket cost for health care expenses$100* District contribution to HSA Net out-of-pocket$105 cost Anticipated expenses after PPO and Rx discounts Plus Plan ($1,400 deductible) Doctor visits (assume $75 per visit)$75 Prescription drugs (retail): Generic Preferred Non-preferred $210 Total medical cost$285 Deductible$1,400 Coinsurance (plan pays) after deductible100% Out-of-pocket cost for health care expenses$285** District contribution to HSA$600 Net out-of-pocket$315 savings Anticipated expenses after PPO and Rx discounts Basic Plan ($500 deductible) Plus Plan ($1,400 deductible) Doctor visits (assume $75 per visit)$75 Prescription drugs (retail): Generic Preferred Non-preferred $30$210 Total medical cost$105$285 Deductible$500$1,400 Coinsurance (plan pays) after deductible80%100% Out-of-pocket cost for health care expenses$100*$285** District contribution to HSA$600 Net out-of-pocket$105 cost$315 savings

24 Example: Average User Columbia Public Schools * $450 toward deductible plus $150 Rx copay = $600 ** $1,078 toward deductible Anticipated expenses after PPO and Rx discounts Basic Plan ($500 deductible) Doctor visits (assume $75 per visit)$450 Prescription drugs (retail): Generic Preferred Non-preferred $40 $120 Total medical cost$610 Deductible$500 Coinsurance (plan pays) after deductible80% Out-of-pocket cost for health care expenses$610* District contribution to HSA Net out-of-pocket$610 cost Anticipated expenses after PPO and Rx discounts Plus Plan ($1,400 deductible) Doctor visits (assume $75 per visit)$450 Prescription drugs (retail): Generic Preferred Non-preferred $200 $644 Total medical cost$1,294 Deductible$1,400 Coinsurance (plan pays) after deductible100% Out-of-pocket cost for health care expenses$1,294** District contribution to HSA$600 Net out-of-pocket$694 cost Anticipated expenses after PPO and Rx discounts Basic Plan ($500 deductible) Plus Plan ($1,400 deductible) Doctor visits (assume $75 per visit)$450 Prescription drugs (retail): Generic Preferred Non-preferred $40 $120 $200 $644 Total medical cost$610$1,294 Deductible$500$1,400 Coinsurance (plan pays) after deductible80%100% Out-of-pocket cost for health care expenses$610*$1,294** District contribution to HSA$600 Net out-of-pocket$610 cost$694 cost * $450 toward deductible plus $160 Rx copay = $610 ** $1,294 toward deductible

25 Example: Above Average User * Out-of-pocket maximum ** $1,400 toward deductible *** $1,500 out-of-pocket max plus $2,600 Rx copays = $4,100 Anticipated expenses after PPO and Rx discounts Basic Plan ($500 deductible) Doctor visits (assume $75 per visit)$1,800 Prescription drugs (retail): Generic Preferred Non-preferred $360 $150 $2,090 Surgery$7,500 Hospital$22,000 Other eligible expenses$5,000 Total medical cost$38,900 Deductible$500 Coinsurance (plan pays) after deductible80% Out-of-pocket cost for health care expenses$1,500* District contribution to HSA$0 Net out-of-pocket cost (savings)$4,100*** cost Columbia Public Schools Anticipated expenses after PPO and Rx discounts Plus Plan ($1,400 deductible) Doctor visits (assume $75 per visit)$1,800 Prescription drugs (retail): Generic Preferred Non-preferred $1,015 $904 $8,721 Surgery$7,500 Hospital$22,000 Other eligible expenses$5,000 Total medical cost$46,940 Deductible$1,400 Coinsurance (plan pays) after deductible100% Out-of-pocket cost for health care expenses$1,400** District contribution to HSA$600 Net out-of-pocket cost (savings)$800 cost Anticipated expenses after PPO and Rx discounts Basic Plan ($500 deductible) Plus Plan ($1,400 deductible) Doctor visits (assume $75 per visit)$1,800 Prescription drugs (retail): Generic Preferred Non-preferred $360 $150 $2,090 $1,015 $904 $8,721 Surgery$7,500 Hospital$22,000 Other eligible expenses$5,000 Total medical cost$38,900$46,940 Deductible$500$1,400 Coinsurance (plan pays) after deductible80%100% Out-of-pocket cost for health care expenses$1,500*$1,400** District contribution to HSA$0$600 Net out-of-pocket cost (savings)$4,100*** cost$800 cost

26 The Big Picture How much can you save over the years by having a Health Savings Account? Account balance rolls over year to year Employer ($600 for 2013)Employer ($600 for 2013) EmployeeEmployee Payroll deductionPayroll deduction In-person deposits at bankIn-person deposits at bank Health Savings Account

27 Plan Costs Effective January 1, 2013 * District-paid Columbia Public Schools CoveringBasic PlanPlus Plan Full-time employee only $480* $430* CoveringBasic PlanPlus Plan Full-time employee only $480* $430* Retiree (non-Medicare)$480$430 Retiree (Medicare)$364$328 CoveringBasic PlanPlus Plan Full-time employee only $480* $430* Retiree (non-Medicare)$480$430 Retiree (Medicare)$364$328 Spouse$472$426 Spouse of retiree (non-Medicare)$472$426 Spouse of retiree (Medicare)$354$318 CoveringBasic PlanPlus Plan Full-time employee only $480* $430* Retiree (non-Medicare)$480$430 Retiree (Medicare)$364$328 Spouse$472$426 Spouse of retiree (non-Medicare)$472$426 Spouse of retiree (Medicare)$354$318 One child$220$194 Children$374$334 CoveringBasic PlanPlus Plan Full-time employee only $480* $430* Retiree (non-Medicare)$480$430 Retiree (Medicare)$364$328 Spouse$472$426 Spouse of retiree (non-Medicare)$472$426 Spouse of retiree (Medicare)$354$318 One child$220$194 Children$374$334 Spouse and one child$692$620 Spouse and children$846$760

28 How to Choose Think about your health care expenses; are you a minimum user, average user, or above average user?Think about your health care expenses; are you a minimum user, average user, or above average user? Dont forget to count in the districts Health Savings Account contributionDont forget to count in the districts Health Savings Account contribution If you have family coverage, remember to count premium savings as you weigh your choiceIf you have family coverage, remember to count premium savings as you weigh your choice Consider these factors:Consider these factors: –Deductibles –Out-of-pocket maximums –Prescription costs Plan how you would pay for unexpected expenses early in the year with the high deductible (Plus Plan)Plan how you would pay for unexpected expenses early in the year with the high deductible (Plus Plan) Columbia Public Schools

29 FLEX PLAN: TRADITIONAL VS. LIMITED Part 2 Columbia Public Schools

30 Flex Plan Options Basic Medical Plan Traditional Flex Plan Plus Medical Plan with Health Savings Account Limited Flex Plan Columbia Public Schools

31 Flex Plan Qualified Expenses Traditional Flex Plan Deductibles Prescription copays Glasses, eye exams, contacts Lasik eye surgery Dental expenses Hearing aids Orthodontic expenses Over-the-counter drugs (must be prescribed by a doctor) Other services not covered by the medical plan Limited Flex Plan Dental expenses Glasses, eye exams, contacts Orthodontic expenses Columbia Public Schools NO MEDICAL $2,500 maximum allowed Basic Plan Plus Plan with HSA

32 Enroll in the Plus Plan and Pay Your Out-of-pocket Expenses Like This You can have: Pre-tax payroll deductions to Health Savings Account plus districts contribution to Health Savings Account Health Savings Account Limited Flex You can have: Pre-tax payroll deductions to limited flex Contribution maximum: Single: $3,250 (includes district contribution) Family: $6,450 (includes district contribution) Contribution maximum: $2,500 HSA Qualified Expenses Prescriptions Deductibles Over-the-counter drugs (if prescribed by a doctor) Hearing aids Lasik eye surgery Glasses Vision exams Contacts Dental Limited Flex Qualified Expenses NO MEDICAL Glasses Vision exams Contacts Dental AND Reimbursable under Health Savings Account or Limited Flex

33 HSA and Flex Plan Qualified Expenses The HSA and Flex Plan share the same list of eligible and ineligible expensesThe HSA and Flex Plan share the same list of eligible and ineligible expenses –In your open enrollment packet, see the Frequently Asked Questions about HSAs –On the back of the Frequently Asked Questions page is a list of eligible and ineligible expenses for the HSA –The same list applies to both plans Columbia Public Schools

34 Open Enrollment Employees can add a dependent to the medical plan of their choice Employees can add a dependent to the medical plan of their choice Coverage begins January 1 Coverage begins January 1 Form to add a dependent to the plan must be received by Business Services by November 30 Form to add a dependent to the plan must be received by Business Services by November 30 Deadline for open enrollment is November 30, 2012 Columbia Public Schools

35 Open Enrollment You will be allowed to choose between the plans each year during open enrollment You will be allowed to choose between the plans each year during open enrollment – If you enroll in the Plus Plan for 2013, accumulate a balance in your Health Savings Account, and decide at a subsequent open enrollment that you wish to switch to the Basic Plan, you may do so; once the money is in your Health Savings Account, it belongs to you – However, as long as you are enrolled in the Basic Plan, you will not receive any new Health Savings Account contributions from the district, and you may not put additional money into the Health Savings Account yourself Columbia Public Schools Deadline for open enrollment is November 30, 2012

36 Open Enrollment Columbia Public Schools Deadline for open enrollment is November 30, 2012 November 2012 SundayMondayTuesdayWednesdayThursdayFridaySaturday Thanksgiving

37 Medical Plan Enrollment Choices Basic Plan 1. No action is necessary for employees wanting the Basic Plan, which is similar to the current plan only with a higher deductible and increased prescription copays 2. Can add a dependent to medical plan in November Columbia Public Schools BASIC PLAN

38 Medical Plan Enrollment Choices Plus Plan 1. Employee completes enrollment form and submits by November Can add a dependent to medical plan at this time 3. Employee completes payroll deduction form for Health Savings Account contribution 4. If employee is a new participant, employee opens account with Landmark Bank – Name the beneficiary for your account – Choose checkbook or debit card or both – No monthly fee – Earnings grow tax-free Columbia Public Schools PLUS PLAN

39 Other Enrollment Options Traditional Flex PlanTraditional Flex Plan –For those enrolled in the Basic Plan –Election form required for 2013 election Limited Flex PlanLimited Flex Plan –For those enrolled in the Plus Plan –Election form required for 2013 election Dependent Care ReimbursementDependent Care Reimbursement –Flexing your day care –Election form required for 2013 election Columbia Public Schools Deadline for open enrollment is November 30, 2012

40 Additional Information on the Employee Benefits Web Site Plan comparisonHow to choosePlan comparisonHow to choose Decision calculatorDecision calculator Prescription drug information Medtrak Pharmacy Web sitePrescription drug information Medtrak Pharmacy Web site FAQ on HSAsFAQ on HSAs Landmark Bank brochure for HSALandmark Bank brochure for HSA Columbia Public Schools Kelly Rich Benefits Assistant Columbia Public Schools 1818 W. Worley Columbia, MO (573) Jane Harmon Benefits Manager Columbia Public Schools 1818 W. Worley Columbia, MO (573)

41 Your Homework Go to the Employee Benefits Web site and click on Plan Comparison Calculator for assistance in making your choice.Go to the Employee Benefits Web site and click on Plan Comparison Calculator for assistance in making your choice. You will need information about your prescription usage for the calculator. An easy way to get your prescription history is to go to the MedTrak Pharmacy Web site.You will need information about your prescription usage for the calculator. An easy way to get your prescription history is to go to the MedTrak Pharmacy Web site. –If you havent already done so, please register at MedTraks online services, to view your prescription history costs. This valuable tool can help you make your enrollment choice. For prescription drug information, go to and click on the Members tab at the top. Go to Need to Register?. For the Cardholder ID entry, enter the number from your medical ID card. Next, log in by creating a user ID and password. You will have access to a history of your prescription drug purchases, your costs, and total cost of your prescriptions. The MedTrak information will help you carefully analyze your prescription drug use and cost. To get the total cost of the drug, add your copays and the plan costs together. –NOTE: If you dont have computer access, contact your pharmacy and ask for a statement of your account for the past year. Be sure to ask for the history of the copay amounts you paid aid the true cost of the drug. This will help you carefully analyze your prescription use and cost. Columbia Public Schools

42 Choosing Your Medical Plan Columbia Public Schools PLUS PLAN BASIC PLAN

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44 Comparison of Basic and Plus Plan 2013 Columbia Public Schools Basic PlanPlus Plan In-networkOut-of-networkIn-networkOut-of-network Deductible (per calendar year) $500 individual $1,000 family $600 individual $1,200 family $1,400 individual $2,800 family $1,400 individual $2,800 family Coinsurance80% after deductible70% after deductible100% after deductible70% after deductible Out-of-pocket maximum (individual/family) $1,500/$3,000 (excludes prescription copays) $2,100/$4,200 (excludes prescription copays) $1,400/$2,800 (includes prescription costs) $4,200/$8,400(includes prescription costs) Childhood immunizations100% Hospitalization (pre- certification required) 80% after deductible70% after deductible100% after deductible70% after deductible Other covered medical services 80% after deductible70% after deductible100% after deductible70% after deductible Mental illness/nervous disorders 80% after deductible; 90 days max/yr 70% after deductible; 90 days max/yr 100% after deductible; 90 days max/yr 70% after deductible; 90 days max/yr Chemical dependency (inpatient) 80% after deductible; 30 days max/yr 70% after deductible; 30 days max/yr 100% after deductible; 30 days max/yr 70% after deductible; 30 days max/yr Prescription drugsRetailMail OrderPrescription costs apply toward deductible, similar to other eligible medical expenses Generic$15 copay$25 copay Preferred$30 copay$55 copay Non-preferred$45 copay$90 copay District contribution to Health Savings Account None$600 annually


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