1. Puyallup School District: 2018-2019 Benefits Depot Benefit Year: November 1, 2018 – October 31, 2019
Presented by Tony Ciez

2. 2018 Benefit Fair and Depot Schedule
Effective Date: November 1, 2018 to October 31, 2019
Open Enrollment Deadline: September 30, 2018
 FSA Plan Year: September 1, 2018 to August 31, 2019
FSA Open Enrollment Deadline: August 27, 2018
Benefit Fair
Ferrucci Jr. High School
Tuesday, September 11th from 3:00 - 6:00 pm
Benefit Depot Schedule
ESC, 302 Second St. SE Puyallup WA 98371
Monday, August 27th 4-6pm
Saturday, September 8th 9am-noon
Thursday, September 13th 4-7pm
Saturday, September 15th 9am-noon
Wednesday, September 19th 10am-1pm
Thursday, September 20th 4-7pm
Wednesday, September 26th 4-7pm
Friday, September 28th 4-8pm
Kaiser Permanente Open Houses
Puyallup Medical Center, th Ave SE Puyallup WA 98374
Main Event:
Thursday, August 23rd 5-7pm
Mini Sessions:
Wednesday, August 29th 4-7pm
Tuesday, September 25th 4-7pm
Thursday, September 27th 4-7pm BL

3. What are my Medical Plan Options for 2018-2019?
Medical plans available
November 1, 2018:
Medical plans NOT renewing
Kaiser HMO
Kaiser Access PPO - $350 Plan
*NEW* Kaiser Access PPO - $750 Plan
*NEW* Kaiser Access PPO - $2,500
*NEW* Kaiser QHDHP with HSA
Regence Innova A PPO
Regence Innova B PPO
Regence Innova $2500 PPO
Regence QHDHP with HSA
All employees will need to complete an enrollment form and Cigna’s beneficiary form! If you do not turn in a form, the Benefit Office will contact you. The arrows indicate the plan that is most similar. Be sure to consider all the plans before making a selection.

4. Transition of Care For those moving from Regence to Kaiser

5. What is my Cost of Coverage. I am a full-time employee (1
What is my Cost of Coverage? I am a full-time employee (1.0 Benefit FTE)
If you work full time (1.0 fte) you will find your pre-calculated monthly cost for medical on your employee group’s calculation worksheet.
Includes cost of mandatory benefits.
Rate assumes enrollment in Delta Dental. Additional savings for those that select the Willamette Dental Plan
Pooling is not included in these calculations. BL
Find this Worksheet and all other benefits information at this llink:

6. What is my Cost of Coverage. I am a part-time employee (less than a 1
What is my Cost of Coverage? I am a part-time employee (less than a 1.0 Benefit FTE)
Calculate or Identify your Benefit FTE
Multiply your average number of hours/day by how many days you are contracted to work/year.
Then divide that number by 1,440. This is your “Allocation Factor,” it cannot be greater than 1.0.
Example Calculation: 5 hrs per day X 190 days per year ÷ 1440 = .6597
Calculate your Benefit Allocation
Multiply your “Allocation Factor” by $ This provides you with your monthly amount of State Allocation that you are entitled to based on your allocation factor.
In the example above: x $ = $556.77
Calculate amount available for medical coverage
The cost of mandatory benefits depends for each employee group (in example below, cost is reflective of dental, Life and LTD). Subtract this cost from your calculated State Allocation amount This is the monthly amount of allocation you have available for the cost of medical coverage.
You can deduct this amount from the total premium to calculate your total out-of-pocket cost.
In the example above for a teacher: $ $ = $341.59 BL

7. What is my Cost of Coverage. I am a part-time employee (less than a 1
What is my Cost of Coverage? I am a part-time employee (less than a 1.0 Benefit FTE)
From the example on the previous page, you can reduce the total premiums below by $
Total Monthly Premiums for each plan and carrier
Medical Plan Option
Core HMO Plan
Access PPO $350
Access PPO $750
Access PPO $2,500
QHDHP with HSA Option
Employee
$767.03
$777.28
$700.57
$671.70
$679.44
Employee + Spouse
$1,426.18
$1,445.23
$1,302.61
$1,248.93
$1,263.32
Employee + Child
$1,048.27
$1,062.28
$957.45
$917.99
$928.57
Employee + Children
$1,099.38
$1,114.07
$1,004.13
$962.75
$973.84
Employee + Spouse & Child
$1,707.42
$1,730.24
$1,559.49
$1,495.22
$1,512.45
Employee + Spouse & Children
$1,758.53
$1,782.02
$1,606.16
$1,539.98
$1,557.73 BL
The back of your calculation worksheet also walks you through this calculation.

8. Selecting a Medical Plan Step 1: After reviewing cost, review the basic plan features
Review the cost of each plan and then review the basic plan features. Be sure to look at your monthly premium cost deducted from your paycheck in comparison to the out-of-pocket maximum on the plan:
Benefit Basics for Each Plan
Core HMO Plan
Access PPO $350
Access PPO $750
Access PPO $2,500
QHDHP with HSA Option
Annual Deductible $0
$350
(2x family)
$750
(3x family)
$2,500
$1,500
(2x family agg.)
Annual Out-of-Pocket Max
$2,000
$3,500
$5,000
Coinsurance
100%
90%
80%
Office Visits
$20
$25
$30
80% after deductible

9. Selecting a Medical Plan Step 1: After reviewing cost, review the basic plan features
Don’t forget to review the Prescription Drug Benefits!
Benefit Basics for Each Plan – Retail Drugs
Core HMO Plan
Access PPO $350
Access PPO $750
Access PPO $2,500
QHDHP with HSA Option
Rx Deductible
n/a
Generic
$10 copay
$20 copay
20%
Preferred Brand Name
$35 copay
Non-Preferred Brand Name
$55 copay

10. Selecting a Medical Plan Step 2: Review networks of plans you’re considering
Kaiser Core HMO Network
Plan with deductible, copays, and coinsurance. Selected by PSD to give you a high level of coverage from Kaiser Permanente providers:
More than 1,000 physicians with the Washington Permanente Medical Group at 25 locations
9,000 in-network providers statewide, including 49 hospitals
Visiting member privileges at Kaiser Permanente facilities in other regions while traveling

11. Selecting a Medical Plan Step 2: Review networks of plans you’re considering
Kaiser Access PPO Network
Traditional plans with a deductible, copays, and coinsurance. Selected by PSD to give you a broad choice of providers:
2,600 contracted providers, including major medical groups and hospitals in our service area, and designated pharmacies
First Choice Health network in Oregon, Alaska, Montana, Idaho, and Washington and First Health Network providers in all other states
OptumRx network with 65,000 pharmacies across the country
At your out-of-network benefit level, you can also use any licensed doctor in the U.S., including those at Kaiser Permanente facilities outside of our service area

12. PPO versus HSA - Which plan is best for you and your family?
Consider the following questions:
Would you rather pay more money as you incur services or pay more each pay period?
Are you looking for a tax advantaged savings method?
Do you take expensive or several prescription drugs?
Are you covering a dependent on the medical coverage?
HSA
Which plan is better?
Both are quality plans. It just depends on your financial point of view, medical needs and long term financial goals and objectives. Both plans provide comprehensive coverage and include an out-of-pocket maximum (though the amount varies based on plan selection).

13. Eliminated Plans - What you might consider if you were enrolled on the Regence Innova A or B
My plan is no longer offered, what are my alternative options?
I was on the Regence Innova A or B
Plan with most comparable benefits: Kaiser Access PPO - $750
The Kaiser Access PPO - $750 plan has a moderately lower deductible and out-of-pocket maximum and provides a richer coinsurance percentage then that of the Innova B plan. However, the core features of this plan are very similar to the Innova A plan design.
The Kaiser Access PPO plans have comparable networks to your current Regence plan but you should verify that the doctors you use routinely are in these networks.  
Remember to review all your other plan options as well!

14. Eliminated Plans - What you might consider if you were enrolled on Regence Innova $2500 PPO
My plan is no longer offered, what are my alternative options?
I was on the Regence Innova $2500 PPO plan
Plans with most comparable benefits: Kaiser Access PPO - $2500.
The core features of this plan are very similar to your current Innova $2500 PPO plan design.
The Kaiser Access PPO plans have comparable networks to your current Regence plan but you should verify that the doctors you use routinely are in these networks.  
Remember to review all your other plan options as well!

15. Eliminated Plans - What you might consider if you were enrolled on Regence QHDHP with HSA Option
My plan is no longer offered, what are my alternative options?
I was on the Regence QHDHP with HSA Option
Plans with most comparable benefits: Kaiser QHDHP with HSA Option.
The core features of this plan are very similar to your current QHDHP design in that you will be responsible for the cost of most services except preventive care until you have met your deductible at which point, coinsurance will apply. You can continue to put pre-tax money into a Health Savings Account (HSA) to help offset the high deductible.
. The Kaiser Access PPO plans have comparable networks to your current Regence plan but you should verify that the doctors you use routinely are in these networks.  
Remember to review all your other plan options as well!

16. The Rest of Your Benefit Renewals Mandatory Benefits
Coverage
Renewal
Carrier Partners
Dental
1.8% decrease
5.8% Increase
Delta Dental
Willamette
Vision
14.1% Increase (largely due to benefit enhancements)
Vision Service Plan (VSP)
Group Life / AD&D
0% rate pass
Cigna
Long Term Disability (LTD) BL
Voluntary Benefits:
Medical
Voluntary Life / AD&D
Voluntary Vision Hardware
Voluntary STD and LTD
Voluntary Long Term Care
FSA & HSA

17. Delta Dental of Washington Using Plan A
Get an annual dental exam to increase your plan coinsurance by +10% in the next benefit period. If you don’t go to the dentist in the current benefit period, your benefit level will decrease by -10% in the next benefit period.
70%
80%
90%
100%
3 Networks:
PPO Dentists (highest level of coverage)
Premier Dentists (in-network but may experience more out-of-pocket costs)
Non-Participating Dentists (lowest level of coverage)
In the event you need to have dental work estimated to cost $300 or more, we recommend you have your dentist submit a treatment plan for pre-authorization.

18. Willamette How to use the network
How to schedule an appointment:
Call the Appointment Center: wait-time for an appointment may vary based on your choice of provider, dental office location, appointment type and desired day or time.
Network providers:
If you select the Willamette dental plan, you must receive care from a Willamette Dental Group dentist or specialist.
If you are referred to an outside dentist or specialist by your Willamette provider, you will have coverage per your Willamette plan.