PLYMOUTH CANTON EDUCATIONAL ASSOCIATION
BENEFITS PAGE
WHAT'S NEW
Ulliance Employee Assistance Program
Legal and Financial Information
PCCS HEALTH PLAN OFFERINGS AS OF SEPTEMBER 1, 2024
Plans available for 1/1/25
Plans 7&8 Special Enrollment Form
Healthcare claims incurred during the new plan year 9/1/24-8/31/25 must be filed for reimbursement 90 days from the end of the plan year.
It was negotiated in the new contract that Cash In Lieu would be given to teachers who do not take health insurance. The following are the amounts:
$1,000 cash in lieu up to 290 members
$2,000 cash in lieu 291 - 320 members
$3,000 cash in lieu 321 + members
IMPORTANT DATES
The cost of the BCBS Health plan runs from Sept. 1- August 31st.
The deductible for BCBS Health accrues from January 1- December 31st.
If your deductible is not met in the calendar year, deductible expenses from October - December can be applied to the next year.
BCBS Dental plan runs from Sept. 1st - Aug. 31st.
NVA Vision plan runs from January 1st - December 31st
YOUR BENEFITS
Register on the Blue Cross Blue Shield and HealthEquity FSA. It is a great way to see a history of your health expenditures, get a new ID card, see your FSA balance, fill out reimbursement forms directly, and more! Get online and check these sites out.
Cigna Employee Assistance/Life Support Program: An employee assistance program is available through Cigna. They have an array of services available from a 30 minute free legal consultation to an array of resources from child care to pet care. Cigna Assistance Program.
AUTO INSURANCE:
Beginning in July 2020, you will now have more options with your automobile insurance coverage. To make a decision you need to know if your health insurance is primary or secondary when you are in an auto accident. Our health insurance, BCBS, pays primary in this case. Attached is a communication with information for you to use when working with your automobile carriers to make your decision on coverage.
Automotive Communication Letter 2020
Beginning May 1, 2014, Blue Cross Blue Shield will be the primary payor for health services if you are in an auto accident. If in the past you added the rider to your auto policy which made auto the primary payor, you can cancel this rider as of this date. This will likely reduce your auto insurance rates. If your insurance carrier requests a letter verifying this change, it can be found in the PCCS Memos section of this website, titled “5-13-14 Auto letter”.
HEALTH ENROLLMENT LAW CHANGE:
Due to a change in the law, effective 9-1-14 Employee + Child is no longer considered family coverage. As of this date Employee + Child will now be at the 2-Person rate.
AFFORDABLE CARE ACT:
The Affordable Care Act does not affect teachers who carry the district’s health insurance.3
BENEFITS COMMITTEE
The PCEA Benefits Committee consists of teacher representatives from each building in the Plymouth–Canton School District. Vanessa Smolenski and Tiffany Gartner are the Benefits Committee Co-Chairs and can be reached at Vanessa.Smolenski@pccsk12.com or tiffany.gartner@pccsk12.com. The purpose of this committee is to gather information regarding all employee benefits (health, dental, vision, long term disability, short term disability, flexible spending accounts, employee assistance plan, family medical leave, and HIPPA privacy practices) and make it available to PCEA members. PCEA Benefit Committee representatives are available to all PCEA members to answer questions and/or assist members in getting benefit questions answered. If you wish to contact a member of this committee regarding your employee benefits, feel free to contact them.
Dawn Schaller is the P-CCS Employee Benefits Coordinator. She is available to teachers who have questions and/or concerns regarding their benefits. She can be reached at (734) 416-4834 or dawn.schaller@pccsk12.com. Dawn is also willing to come to individual buildings to meet with staff to talk about benefits and/or answer questions. She is available before or after school or even during the lunch hour. Do not hesitate to invite her to your building.
CONTACT INFORMATION
HEALTH INSURANCE
Blue Cross Blue Shield of Michigan Website
Blue Cross Community Blue Medical Claim Form
Fax social worker reimbursement claims to:
1-866-571-3746 FAX
Attach a cover sheet with request indicating that you are from Plymouth-Canton Community Schools.
OR mail social worker reimbursement claims to:
BCBSM
27000 West 11 Mile Road
Mail Code B 530
Southfield, MI 48034-2200
Definitions of Health Insurance Terms
Federal Notices as of May 1st, 2020
Dependent Eligibility for 19-25 year-olds for Health coverage only
The dependent child can be covered until the last day of their 26th birthday for medical coverage.
Blue Cross Online Visits
Not feeling well? Just need to talk to someone? Video conference with a U.S. Board certified doctor or nurse practitioner wherever and whenever you need one. Create a Blue Cross Online account; you will need your BCBS health card to get your Enrollee ID number. You must have video capability for visits through your smartphone or your computer. If your camera isn't working, please call 1-844-606-1608 to speak with a service rep. Copays apply. This includes behavioral health (therapy and psychiatry) as well.
Go to: Blue Cross Online Visits
*Blue Cross will be switching to Virtual Care by Teladoc instead of Online Visits on January 1st, 2024.*
Please see the information below regarding this switch.
Insurance Cards
To request new, additional or replacement insurance cards, go online at www.BCBSM.com and register as a user. There is an option GET AN ID CARD. This is for health and dental insurance
Prescriptions & Pharmacies
Did you know some prescriptions are actually no cost to you at some pharmacies? To find the lowest price for your prescription, go to www.goodrx.com(link)
Pharmacy Initiatives - Plans 3-6 only
OptumRX
Use OptumRX to order your prescriptions by mail at lower cost and to order more than one refill of drugs you must take every day. Your subscriber ID on your BCBS card is your member ID for the OptumRX site.
OptumRx Home Delivery Prescription Form
Autism coverage FAQ | bcbsm.com
Find your plan’s autism coverage:
The easiest way is to log in to your member account. You can do that using our website or the Blue Cross mobile app.
After logging in, go to My Coverage, select Medical and then What’s Covered. Look for autism. In that section you’ll get information about:
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Plan requirements for getting services
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The kinds of services your plan will help pay for
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How much you pay and your plan pays
BCSBM and BCN offers coverage for autism spectrum disorder (ASD) for underwritten groups and multi-state self-funded ASC groups. Benefits include:
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Applied Behavior Analysis (ABA)
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Physical Therapy, Speech Therapy, Occupational Therapy as part of ASD Treatment
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Nutritional Counseling as part of ASD Treatment
Dental Insurance
Log in for claims and coverage information.
Vision Insurance
RX Optical Vision Advantage Program
Dependent Eligibility for 19-25 year-olds for Dental & Vision coverage only.
The dependent must:
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Be a member of the employee’s household AND
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Be a full time college student 5 months of the calendar year OR earn less than four times the current personal exemption amount allowed by the IRS.
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College students may live away from home.
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The end of the calendar year, for 25 year-olds, is the maximum length of time they can remain on your coverage.
Flexible Spending Account
For the 2020-2021 plan year, there is unlimited rollover from last year in to the new year for unspent funds. Additionally, this year's health plan ended 8/31 but receipts for services received prior to that can be turned in until 11/30. If there are any additional funds they will show up in Health Equity accounts in mid-December once everything has been processed.
Effective September 1, 2015 The vendor for the Flexible spending account (FSA) is HealthEquity. HealthEquity is partnered with Blue Cross Blue Shield. You can set up an account at http://healthequity.com or download the HealthEquity desktop app to print out reimbursement forms, monitor your FSA and find other important information.
Eligible FSA health care expenses can include but are not limited to: deductibles- co-pays-office visit co-pays-well baby care- physical therapy-chiropractor-orthodontics- immunizations- psychologists- orthodontics- eye exams- glasses/contacts- hearing exam/hearing aids- Rx co-pay
Flexible Spending Account Receipts should be kept for 7 years. An Explanation of Benefits (paper and online copies available on bcbs.com) is the best way to document FSA expenditures.
If your Healthequity FSA card has been lost or stolen, contact HealthEquity Member Services at 1-877-284-9840.
Health Equity Health reimbursement form
HealthEquity Dependent Care reimbursement - To access, log into your Health Equity member portal. It is located under "Docs & Forms"
HealthEquity Dependent Care Information
Life Insurance
The district provides each member $40,000 dollars in life insurance free of charge.
Additional voluntary life insurance can be purchased through MetLife. Additional information on purchasing voluntary life insurance can be found at https://www.metlife.com/or you can contact Dawn Schaller.
Life Insurance Change of Beneficiary &/OR Name Form (CIGNA)
MetLife Group Life Insurance Brochure
Disability Insurance
P-CCS Long Term Disability Certificate
P-CCS Short-Term Disability Insurance Brochure
P-CCS Aflac Short-Term Disability Insurance Rates Chart
Family Medical Leave Act(FMLA)
PCCS Family / Medical Leave Summary Sheet
PCCS Family / Medical Leave Request Form
Request for Family/Medical Leave
HIPPA Information
PCCS / HIPPA Notice of Privacy Practices
PCCS Memos