Health Benefits Frequently Asked Questions

Frequently Asked Questions

1. Why are we making this change?

  • At least two-thirds of our employees are currently enrolled in Aetna
  • Aetna offers a variety of methods to contact a representative from self-service to live chats for questions or concerns
  • Aetna has a strong network in South Jersey as well as a national network for all products
  • One benefit card will give access to medical and vision benefits, and hopefully prescription benefits in the future

2. I have many questions about how this change will impact me personally; who can I talk to?

  • Aetna will visit each school by October 18 to answer any questions that you have. Your school principal and operations manager will soon provide you with your school’s site visit date and instructions on how you can register for time with Aetna representatives.

3. What does exiting the SEHBP mean to me if I am with Horizon and not with Aetna?

  • Your current medical coverage will end 12/31/2017. You will be mapped to a comparable medical coverage plan with Aetna and your new medical benefits will be effective 1/1/2018.

4. What will happen to my prescription coverage?

  • Your prescription coverage will remain with Benecard through 6/30/2018. No changes will occur with prescription for the 2017-2018 school year.

      5. May I waive medical coverage and take prescription coverage only?

  • No. You must either take these two coverages together or waive both coverages.

6. How do I waive coverage?

  • To waive coverage, you must submit a Waiver of Coverage Form for medical/prescription, dental or vision benefits on or before November 22, 2017. Submit this form to Laura Davis.

7. Who will be the carrier for vision?

  • Your coverage for vision will be with Aetna effective 1/1/2018.

8. Who will be the carrier for dental?

  • Your coverage for dental will be with Delta Dental effective 1/1/2018.

9. When will this change be effective?

  • Benefits with Aetna will be effective January 1, 2018.

10. How can I confirm my physician is in the network of the new carrier?

  • Any employee can look up his/her provider(s) on the chosen carrier website to see provider participation status at any time. You do not need to be a registered member to get this information. Additionally, CCSD in partnership with Aetna will be holding information sessions for staff. Representatives from Aetna will be onsite to answer any questions you may have.

11. How will I determine what my employee contribution will be effective January 1, 2018?

  • A calculator was added to the CCSD website to assist you in determining your estimated employee contribution. During your school’s site visit, you can have an Aetna representative guide you through figuring out your employee contribution.

12. What if I want to change the plan I am automatically mapped to?

  • During Open Enrollment you will have the option to make changes to your coverage.You must complete an enrollment form to submit this change.

13. When will I receive notice of the plan I am automatically mapped to?

  • This information was mailed to your home address indicated on file on October 13, 2017. Instructions to determine what plan you will be automatically mapped to are available here.

14. How will I know what plans are available?

  • A listing of the available plans through Aetna will be listed on the CCSD website starting the month of October.

15. What is a Qualifying Life Event?

  • Qualifying Life Events include involuntary loss of coverage due to one or more of the following: loss of coverage by spouse or partner, marriage, divorce, legal separation, birth, adoption and/or death.

16. When will Open Enrollment occur for the 2018-2019 school year?

  • Open Enrollment is scheduled to occur in May 2018. The effective date for benefits coverage in the 2018-2019 school year will be July 1, 2018.

17. Why is Open Enrolment changing from October to May?

  • The District is ensuring the benefit period runs parallel with the school year. Going forward, benefits will be active effective July 1 of each year.

18. Is Aetna the only option there is for medical coverage?

  • Yes, Aetna is the approved provider for medical coverage for all CCSD employees starting January 1, 2018.

19. Will ID cards be issued for all carriers?

  • Yes. ID cards will be issued for medical and vision from Aetna and dental will be issued from Delta Dental.  All cards will be effective starting January 1, 2018.

20. How many ID cards will I receive?

  • You and your covered dependents will receive three (3) ID cards.  Two (2) from Aetna for medical and vision and one (1) from Delta Dental for dental.

21. When will I receive my new ID cards?

  • ID cards will be issued on or before Monday, December 19, 2017.

22. What does Open Access Managed Care (OAMC) mean?

  • In the OAMC plan, no primary care provider (PCP) is required and no referral is required.  You can go to any doctor within the network you choose.

23. How do I know the name of my current medical plan?

There are a few ways to identify your current plan:

  • You can view your current ID card. On the upper right hand side, the plan name will be indicated.
  • You can access the Employee Self Service Portal and view the demographics screen to view a summary of all benefits located in the lower left hand section.
  • You can access MBOS and view your Personal Benefit Statement.  The name of your plan and level of coverage is indicated in the lower right hand section.

24. What is MBOS?

  • Member Benefit Online System. It is a set of internet based applications that allows registered members access to their pension and, if applicable, health benefits account information.

25. How do I get access to MBOS?

  • To use MBOS, you must be registered with both MBOS and the myNewJersey website. For additional instructions on how to register for MBOS click here. 

26. What will happen to my prescription coverage?

  • Your prescription coverage will remain with Benecard through 6/30/2018.  No changes will occur with prescription for the 2017-2018 school year.

27. Will I receive a new ID card for prescription?

  • No. You can continue to use your existing card.

28. I currently do not have an ID card for prescription. What do I do?

  • Contact Benecard at 877-723-6005 and request a new card.  This is a 24 hour service.

29. How do I select a primary care provider (PCP)?

  • During the transition to Aetna, a PCP will be assigned for you if you select one of the HMO plans.  You may access the Aetna website at any time during Open Enrollment to select a different PCP. If you are already in an Aetna HMO and choose to remain in a HMO, your current PCP will be assigned to your new Aetna plan.

30. Does everyone have to select a primary care provider (PCP)?

  • No. Only employees who choose to participate in an HMO are required to select a primary care provider (PCP).

31. How and when can I attend a site visit session?

  • Site visits will occur during Open Enrollment. Each district building will have Aetna representatives visit to support employees navigate the Open Enrollment process.

32. I am planning to retire soon and have 25 years or more of service.  What will happen to my medical coverage since we are no longer in SEHBP?

  • You will return to a SEHBP plan after retirement. Contact SEHBP at 609-292-7524 to arrange a counseling session with a representative from the state.

33. What is a Flexible Spending Account?

  • Flexible Spending Accounts (FSA) let you use pre-tax dollars to pay for eligible health care expenses for you, your spouse, and your eligible dependents. For additional information, view the educational videos provide by TASC here.

34. What Flexible Spending Account benefits can I enroll?

TASC offers a wide variety of flexible spending benefits; however, Camden City School District only offers the following:

  • Medical FSA
  • Dependent care
  • Transit & Parking



 

 

    

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