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Health

Insurance (2019)

Annual Enrollment for 2019 Opens 10/1/18 (Ends 10/26/18)

Click Here for the Edison Portal (The site will not be available for insurance selections until enrollment opens on October 1st)

Click Here for Edison Password Reset Instructions

NEED TO MAKE MID-YEAR CHANGES?  Contact us at 787-8008 or luttrellj@gcschools.net for assistance.

Click Here to view the Annual Enrollment Newsletter from Benefits Administration

 

MEDICAL INSURANCE OVERVIEW: 

Employees must choose a Plan and a Network

  • Informational Videos are available in the green area to the right.
  • Premium Rates are located in the green area to the right.
  • 2018 rates are effective through 12/31/18.
  • 2019 rates are effective through 12/31/19. Rates have increased 2.5% (on all plans/tiers)

 

Medical Insurance PLAN Choices (Summaries)

  1. Premier PPO

  • Higher premiums – but lower out-of-pocket costs for deductibles, copays and coinsurance.
  • Check here for prescription costs on this plan.
  • There are no changes to this plan for 2019.
 

  2. Standard PPO

  • Lower premiums than the Premier PPO – but you’ll pay more out-of-pocket for deductibles, copays and coinsurance.
  • Check here for prescription costs on this plan.
  • There are no changes to this plan for 2019.
 

  3. Limited PPO

  • Lower premiums than the other PPOs – but you’ll pay more out-of-pocket for deductibles, copays and coinsurance compared to the other PPOs.
  • Check here for prescription costs on this plan.
  • 2019 Plan changes include increases to the annual deductible and out-of-pocket maximums on all tiers.
 

  4. CDHP (Health Savings Plan)

  • Lowest premiums – but you pay your deductible first before the plan pays anything for most services, and then you pay coinsurance, not copays.
  • Check here for prescription costs on this plan.
  • There are no changes to this plan for 2019.
  • The CDHP Plan comes with the option to contribute to an HSA.  Click here for information on PayFlex

 

 Medical Insurance NETWORK CARRIER Choices

  1. Blue Cross Blue Shield Network S

  2. Cigna Local Plus

  3. Cigna Open Access Plus (an additional surcharge applies) 

Click on the Carrier Network Search (in green box on this page) to complete a doctor or medical facility search.

The carriers' covered services are generally the same whether you choose BlueCross BlueShield or Cigna. For some procedures, different medical criteria may apply based on the carrier you select. For detailed information on covered services, exclusions and how the plans work, view the insurance carriers' member handbooks, available on the Benefits Administration website. If you have questions about medical criteria for a specific service, contact the carriers’ member services.

*NOTE: The information in the online searchable directories is only applicable for the current plan year. Information in printed directories are only 100 percent accurate the day it is sent to print. Providers and facilities in the carriers' networks can change. You can always check network status of your preferred providers by calling BCBS or Cigna member services.

 Benefit Improvements for 2019

  • Physical therapy benefit: PPO members no longer have to meet their deductible first for physical therapy, occupational therapy and speech therapy that is in-network and outpatient. They will only have to pay coinsurance. CDHP/HSA members must meet the deductible first and pay coinsurance.
  • Cardiac rehab benefit: PPO members will not pay any costs for in-network, outpatient cardiac rehab. CDHP/HSA members must meet the deductible first before the coinsurance is waived.
  • Bone anchored hearing devices: Will be covered when deemed medically necessary (subject to plan benefits).
  • Maintenance Medicaitons: Members can work with their pharmacists to coordinate refills for maintenance medications so that multiple medications are filled on the same day. For PPO members, the medications being filled to get you “synced” will have pro-rated copays. This applies to statins for high cholesterol, high blood pressure, coronary artery disease, congestive heart failure, diabetes, depression and asthma/COPD medications.