Public School Employee Health Insurance Benefit Overview

1. Public School Employee Health Insurance Benefit Overview • Summer/Fall 2006 • For Plan Year Beginning 10-01-2006 www.ARBenefits.org Provided by: Employee Benefits Division (EBD) of Ark. DF&A Ashli Davis, Communications Director

2. Health Insurance Enrollment -Content Overview • Public School Employee health benefits • How to enroll • Plan changes for the new year

3. Look for this booklet in the mail…also available online now! It will contain important health insurance benefit information including rates, contacts and instructions!

4. Summary Plan Description (SPD) This booklet gives details about health insurance coverage, such as exclusions, limitations and plan rules. Coming to your mailbox in the fall. Also available online.

5. Online Info 24/7: • www.ARBenefits.org • Enroll and make changes online! • All health insurance publications, contact information, forms, updates, and more! • Bookmark this site for future reference.

6. Health Maintenance Organization (HMO) • Choice of: • Health Advantage, NovaSys Health or QualChoice/QCA • In-Network benefits provided through Primary Care Physician (PCP) • No out-of-network benefits except in emergencies • Referrals to Specialists must be obtained from PCP to be paid • Office Visits: $20 Co-pay Primary Care Physician (PCP) • (eff. 10-01-06) $25 Co-pay Specialist Care • Hospital Outpatient: $100 Co-pay • Hospital Inpatient: $250 Co-pay + 10% • Out of Pocket Maximum: $1000 Individual / $1,500 Family

7. Point-of-Service (POS) • Choice of: Health Advantage, NovaSys Health, & QualChoice/QCA • Offers wide range of healthcare services. Requires primary care physician referral to maximize the POS benefit. No referrals required if in-network*. Out-of-network benefits are subject to deductible and reimbursed at 70% of approved charges. *Some restrictions apply.

8. Preferred Provider Organization (PPO) • Choice of: Blue Cross Blue Shield & NovaSys Health • More traditional plan with deductible and co-insurance. Offers large network of hospitals, physicians, and other providers. Does not require members to have Primary Care Physician. Offers wide range of comprehensive healthcare services.

9. High Deductible PPO Plan (HD PPO) • Offered by: NovaSys Health • High deductible plan with co-insurance after deductible is met. Offered by NovaSys Health. Does not require members to have Primary Care Physician. Participation in Health Savings Account with minimum $20 contribution required.

10. All plans have Rx benefits • HMO – POS – PPO plans • Three tier co-payment structure for 31-day supply: • $10 for generic medications • $25 for preferred name brand drugs • $50 for non-preferred name brand drugs Find preferred drug listing online at: www.NMHC.com Click on “Member Services” then “State and Public School Employees Preferred Drug List.”

11. All plans have Rx benefits (cont’d) • High Deductible PPO plan (HD PPO) • Prescription costs apply toward deductible • Pay discounted retail cost until deductible is met, then pay 20% co-insurance • Deductible restarts every October 1st • No pre-set co-payments like other plans

12. Included with all plans: • StarEAP (Employee Assistance Program) • Tobacco Cessation program (ARQuit Now) • Health Improvement Programs • Balance (6 weeks, weight management) • Nourish (8 weeks, weight management • Go to www.Corphealth.com/Arwellness Also, 100% coverage for annual wellness exams!

13. How to enroll… • New employees can enroll in health benefits upon hire (have 30 days to enroll) • Existing employees can enroll, drop or make other changes annually during August open enrollment period • Open enrollment changes go into effect on October 1st

14. How to enroll…(cont’d) • Enroll online at: www.ARBenefits.org • Set up individual password security • Enroll, drop, add/delete dependents, change plans, select primary care physician • Print and sign enrollment or change form • Turn into business office by the deadline • Or use paper forms available online or from district business office

15. General Information • May enroll yourself and dependents in any plan with no medical questions, no pre-existing condition limitations • Can change to a different plan or company with no medical questions or limitations

16. Coming in October – New combined Medical and Rx I.D. card! • All plan participants will get new card automatically • Use this card for doctor, hospital and pharmacy visits

17. Health Risk Assessment (HRA) • HRA completed annually for discount next plan year (voluntary participation) • Take HRA August 1-31st • Provides $10 ea/month rate discount per employee and covered spouse • Additional $10 ea/month available based on wellness score HRA available online at www.ARBenefits.org Or by phone 24/7 @ 1-866-456-3950 (Spanish version also available.)

18. Dental and Vision Screenings • For HMO and POS plan participants only: • Preventative dental screenings every 6 months for $25/copayment • Preventative vision screenings every 24 months for $25/copayment • Must be in-network with your benefit coordinator (Health Advantage, NovaSys Health or QualChoice/QCA)

19. Contact us – we can help!We manage your health benefits. • Employee Benefits Division of DF&A Customer Service: Toll Free (877) 815-1017 Little Rock area (501) 682-9656 Email: AskEBD@dfa.state.ar.us On the web: www.ARBenefits.org