1. 2018 Benefit meetings
Sturgeon Bay School District

2. Agenda Open Enrollment Medical Insurance Dental Insurance
Voluntary Vision Insurance
Voluntary Accident & Critical Illness
Next Steps/Questions/Answers

3. 2018 Open Enrollment Open Enrollment is: May 2nd through May 31st
Employees/Dependents may enroll or make changes to their insurance elections during open enrollment period.
All eligible employee’s are required to complete a 2018/2019 enrollment form.
Change Forms must be turned in to the business office by May 31st
Late enrollments will not be accepted without a qualifying event.
Insurance changes will go into effect 7/1/2018

4. Benefit highlights Network Health medical benefits
No plan design changes for 2018
slight increase in premium
New ID Cards will be sent
Delta Dental benefits will remain the same with a slight increase to premium
No change to Voluntary Vision benefits
No change to Voluntary Accident and Critical Illness benefit

5. Select Services Covered in Full
Base Plan - $2000/$4000 HMO
Network Health
In-Network
Out of Network
Deductible
Split Deductible HRA
Single: $2,000
Family: $4,000
First $1,000 Employee Pays
Second $1,000 HRA Pays
(Maximum 2 per family)
n/a
Coinsurance 0%
Out-of-Pocket Maximum
(Medical Deductible & Coinsurance)
Office Visits
Primary Care Physician:
Specialty Care Physician:
MDLive: $0 copay
$20 copay
$50 copay
Not Covered
Routine/Preventive Care
Select Services Covered in Full
Urgent Care – Door County Medical Center
Emergency Room
$200 copay
ACA Out-of-Pocket Maximum
(Medical Deductible, Coinsurance, Medical Copays, & Rx Copays)
Single: $6,850
Family: $13,700
Hospital Services
Retail Prescription Coverage
$20/ $40 / $60 / $60

6. Buy Up Plan - $1000/$2000 POS Network Health In-Network Out of Network
Deductible
HRA Out of Network Deductible:
Single: $1,000
Family: $2,000
Single: $1,500
Family: $3,000
First $500 Employee pays
Second $1000 HRA pays
(Maximum 2 per family)
Coinsurance 0%
20%
Out-of-Pocket Maximum
(Medical Deductible & Coinsurance)
Single: $2,750
Family: $5,500
Office Visits
Primary Care Physician:
Specialty Care Physician:
MDLive: $0 copay
$20 copay
$50 copay
MDLive: $0 copay
Deductible & Coinsurance
Routine/Preventive Care
Select Services Covered in Full
Urgent Care – Door County Medical Center
Emergency Room
$200 copay
ACA Out-of-Pocket Maximum
(Medical Deductible, Coinsurance, Medical Copays, & Rx Copays)
Single: $6,850
Family: $13,700
n/a
Hospital Services
Deductible & Coinsurance
Retail Prescription Coverage
$20/ $40 / $60 / $60

7. Buy Down Plan - $2000/$4000 HDHP HMO
Network Health
In-Network
Out of Network
Deductible (Non-Embedded)
District H.S.A. Contribution
Single: $2,000
Family: $4,000
$350 Single / $700 Family
n/a
Coinsurance 0%
Out-of-Pocket Maximum
(Medical Deductible & Coinsurance)
Office Visits
Primary Care Physician:
Specialty Care Physician:
MDLive: $41 fee
Deductible
MDLive: $41 fee
Not Covered
Routine/Preventive Care
Select Services Covered in Full
Urgent Care
Emergency Room
In-Network Deductible
ACA Out-of-Pocket Maximum
(Medical Deductible, Coinsurance, Medical Copays, & Rx Copays)
Hospital Services
Retail Prescription Coverage
Deductible & Coinsurance

8. Buy Down Plan - $3000/$4000 HDHP HMO
Network Health
In-Network
Out of Network
Deductible (Embedded)
District H.S.A. Contribution
Single: $3,000
Family: $6,000
$1,000 Single/$2,000 Family
n/a
Coinsurance 0%
Out-of-Pocket Maximum
(Medical Deductible & Coinsurance)
Office Visits
Primary Care Physician:
Specialty Care Physician:
MDLive: $41 fee
Deductible
MDLive: $41 fee
Not Covered
Routine/Preventive Care
Select Services Covered in Full
Urgent Care
Emergency Room
In-Network Deductible
ACA Out-of-Pocket Maximum
(Medical Deductible, Coinsurance, Medical Copays, & Rx Copays)
Hospital Services
Retail Prescription Coverage
Deductible & Coinsurance

9. Co-owned by Froedtert Health and Ministry Health Care, a part of Ascension, Network Health is able to offer access to a large network of high-quality providers. Across 22 Wisconsin counties, they have negotiated deep discounts for the benefit of the District.
Live & Work in Wisconsin – no across country service calls

10. Network Health Local Network
1,842 Primary Care Doctors
10,965 Specialists
51 Hospitals
Large Network Providers:
Affinity Health System
Agnesian Health Care
Bellin Health
Childrens Hospital of Wisconsin
Froedtert Physican Partners
Holy Family Memorial
Prevea Health / HSHS

11. Resources www.networkhealth.com 1-800-826-0940 My Account MDLIVE
Monday, Wednesday-Friday 8 a.m. to 5 p.m.
Tuesday 8 a.m. to 4 p.m.
My Account
View benefit and plan information
Review claim history, claim status and EOB’s
View your ID card, even on the go
Compare prescription costs and specific information about your medications
MDLIVE

12. Resources (continued)
MDLive

13. be a wise consumer ACCESS TO NURSES 24/7
Network Health Nurse Line is offered 24 hours a day, seven days a week for those need-it-right-now situations
Help figuring out where to go for care if it’s not an emergency
Advise on general health issues
Instructions for current or newly prescribed medications
Phone number on back of your I.D. card

14. be a wise consumer Choose the Right Health Care Setting
In addition to access to nurses 24/7, knowing 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.
VIRTUAL - MDLive - $0 copay or $41 fee for HDHP
Walk-in Clinic – Avg. Cost $50-$75
Urgent Care - $200 Copay
Clinical Care - $20 Copay PCP or $50 Copay Specialist
Emergency Room - $200 Copay

15. The Network Health WELLNESS PROGRAM & Incentives
Health Risk Assessments and onsite Biometric Screenings will be provided by NHP/Prevea
participating employee’s will receive a $50 gift card

16. Health Savings Account Product Information
HSAs allow you to deposit money, tax-free into a savings account, to use for qualified health care expenses
Average tax savings is approximately 20%
You can adjust contributions throughout the year
You earn interest on the amounts in your HSA
Unused HSA balance will rollover into future years

17. 2018 HSA Limits & Contribution
Single: $3,450
Family: $6,900
Sturgeon Bay School District will contribute $350/$700 or $1,000/$2,000 annually
HSA funds must be in your account in order to use them
REMINDER: You can adjust your H.S.A. deposits throughout the year, as your needs change.

18. Dental Insurance – Delta Dental
No Changes to your Dental Insurance for 2018
Benefits
Delta Dental
Deductible
$25 Single / $75 Family
Annual Maximum
$1,300 per person
Preventive Services
100%
Basic Services
Major Services
80%
Orthodontics
Lifetime Max.
50% to $2,000
To age 26
Your dental plan options for 2018 are not changing. You have two options to choose from. The Delta Dental option allows you freedom to choose your providers. If you see a provider that is in the Delta PPO or Premier network, it will stretch your dollars further.
You also have the option of the Care Plus plan. This is more restrictive as you need to see a Dental Associates provider in order for there to be coverage.
During open enrollment you can choose to move between plans, so if you are on the Care Plus and would like to move to the Delta Dental plan or the other way around, you can do so during this time.

19. Voluntary Vision– UNited Healthcare
No Changes to your Vision Insurance for 2018
Vision Care Services
In-Network Member Cost
Out-of-Network Cost
Eye Examination
$15 Copay
Up to: $40
Lenses (Once Each 12 Months)
Single
Bifocal
Trifocal
$30 Copay
Up to: $60
Up to: $80
Frames (Once Each 24 Months)
Up to: $130
Up to: $45
Contact Lenses (Once Each 12 Months)
Elective
Up to: $105
Medically Required
$30, then 100%
Up to: $210
Your vision benefits will EyeMed are not changing for During open enrollment you can choose to elect this benefit or you can terminate the coverage if you no longer need this benefit.
This benefit helps to pay for eye exams as well as lenses every 12 months, and frames every 24 months.

20. Voluntary Accident & Critical Illness – United Healthcare
No changes to your Voluntary Accident & Critical Illness coverage
Please refer to the UHC Benefit Summary for a thorough explanation of benefits, including any limitations or exclusions that might apply before enrolling in this coverage
The short term disability is the only plan that is seeing a change this year.
This benefit supplements your income if you are to be off of work due to a non work related injury or illness.
The benefit that is payable in 2018 will be 50% of your weekly wages.
If you are off due to an accident, that benefit will pay on the first day off of work. If it is due to a sickness, you will need to be off for 7 consecutive calendar days and the benefit will start to pay on the 8th day.
This benefit will pay for up to 180 days.

21. Next Steps Review your employee booklet
Talk to your spouse/family about benefits and make a decision
All eligible employee’s need to complete the enrollment form and return to the Business Office by May 31st, 2018
Reminders
Changes to your H.S.A. contribution limits can be made by contacting your Human Resource Department
Calendar year Deductible
Any Deductible and Out of Pocket met in 2018 will be applied to new benefits
If you enroll in the Health Savings Account the plan year will run concurrent with your medical plan year deductible