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Insurance Benefits

2011 Benefits Changes

Related Documents:
High School Programs of Study
DCS Vision Plan Info

Karla Hallmark, Benefits Manager
Christine Wheeler, Benefits Assistant
Phone: 662-449-7100
Fax: 662-449-7236

For information regarding your benefits contact us at benefits@dcsms.org

Announcing Tela-Health Open Enrollment November 1 - 30, 2012

"Talk to a Doctor Any Time!"

www.DeSotoCoSchools.getlbc.com



Insurance/Retirement Benefits

The Employee Services Department is responsible for all aspects of insurance and benefits for DeSoto County Employees. Feel free to contact us if you have any questions.  We are here to serve you!

HOT NEWS!

Open Enrollment
Available October 1st through October 31st for Health Insurance
Available August 1st through August 31st for Dental and Vision


Benefits Online

State and School Employees can now view your benefits online. Please visit http://knowyourbenefits.dfa.state.ms.us

Wellness Benefits
Have you heard?  You can get up to $1000.00 in free wellness benefits in 2010!
Complete your Succeed Health Risk Assessment (HRA).  
Go to http://knowyourbenefits.dfa.state.ms.us/
  or https://www.webmdhealth.com/Mississippi/

Blue Cross Blue Shield Representative
Phone: 1-800-709-7881

AlwaysCare Benefits, Inc. -- Dental and Vision Insurance
Call 662-449-7262 or 662-42-7112  today for information about Dental and Vision Coverage for you and your family.

Other Benefits
DeSoto County Schools also offers benefits through American Fidelity Assurance Company, such as Cancer, Salary Protection (Disability), Accident, Long Term Care, GAP Insurance as well as Life Insurance that may include your spouse and/or children. These benefits are optional.  An American Fidelity Representative will offer these benefits at each school. 

 2011 Benefit Changes

Effective January 1, 2011 is the requirement that all employees enrolled in the Select Coverage pay a portion of their active employee premiums.

  • Legacy employees enrolled in Select Coverage will pay $20 per month
  • Horizon employees enrolled in Select Coverage will pay $38 per month
  • The State will continue to pay 100% of the active employee premium for employees (both Legacy and Horizon) enrolled in Base Coverage
  • Premiums for dependents and retirees have been increased generally across the board

    Health Insurance Open Enrollment

  • October 1st to 31st
  • Employees may change coverage options during Open Enrollment
  • Effective date of coverage will be January 1, 2011

Participants can go to http://knowyourbenefits.dfa.state.ms.us for information on the differences between Base and Select Coverage.

 Select Coverage Deductibles and Coinsurance Maximums

The 2011 calendar year deductibles and coinsurance maximums under Select Coverage will be as follows:

Select Coverage In-Network Out-of-Network
Calendar Year Deductible- Individual Coverage $1,000  $2,000
Calendar Year Deductible- Family Coverage  $2,000  $4,000
Individual Medical Coinsurance Maximum  $2,500 $3,500
Individual Prescription Drug Deductible     $75 $75

  Base Coverage Deductibles and Coinsurance/Co-payment Maximums

The 2011 calendar year deductibles and coinsurance/co-payment maximum amounts under Base Coverage will be as follows:

Base Coverage In-Network Out-of-Network
Calendar Year Deductible - Individual Coverage $1,800  $1,800
Calendar Year Deductible - Family Coverage  $3,000  $3,000
Coinsurance/Co-payment Maximum - Individual Coverage  $2,500 $4,000
Coinsurance/Co-payment Maximum - Family Coverage     $5,000 $5,000

 Base Coverage will continue to qualify as a high deductible plan under federal tax regulations

DCS Education Platinum & Gold Plans Info

DCS Vision Plan Info

 

2011 Benefit Changes Part II

Benefit Changes as required by The Patient Protection and Affordable Care Act

The following changes are made as a requirement under The Patient Protection and Affordable Care Act:

  • The pre-existing condition exclusion period will be eliminated for dependent children under the age of 19.
  • The lifetime maximum limit for all participants will be eliminated.

NOTE:  Individuals whose coverage under the Plan ended because they reached the lifetime maximum limit, and who otherwise are still eligible under the Plan, may re-enroll in the Plan.  Individuals may apply for coverage during the October Enrollment Plan for an effective date of January 1, 2011.


Expanded Wellness Benefits
The Plan’s annual wellness benefits will be expanded to include services recommended by the U.S. Preventative Services Task Force.  For a list of covered wellness services, please visit the Plan’s website at http://knowyourbenefits.dfa.state.ms.us  or call BCBSMS at 800-709-7881 to request a copy.  Please remember that participants age 18 and older must complete the HealthQuotient(HQ) health risk assessment each calendar year prior to receiving wellness benefits. 

Diabetic Self-Management Training and Education
The calendar year limit for diabetic self-management training and education will be eliminated. Participant in ActiveHealth’s Informed Care Management Program and certification of medical necessity will be a requirement for receiving this benefit. More information about this program will be provided by ActiveHealth later this year.

Home Health and Private Duty Nursing Services
The calendar year limit for home health and private duty nursing services will be eliminated. Prior to receiving these services, certification necessity by ActiveHealth will be required.

Pulmonary Rehabilitation Services
The annual visit limit for pulmonary rehabilitation services will be eliminated. Prior to receiving these services, certification of medical necessity by BCBSMS will be required.

Cardiac Rehabilitation Services

The session limit for cardiac rehabilitation services will be eliminated. These services will continue to require prior approval by BCBSMS. Participants must use a cardiac rehabilitation program that is certified by the American Association of Cardiovascular and Pulmonary Rehabilitation. Participants can contact BCBSMS at 800-709-7881 to locate a certified provider.

Emergency Room Co-Payment
A $100 co-payment will apply to each emergency room visit after the first emergency visit in a calendar year.  Base Coverage participants who have met their coinsurance/co-payment maximum for the year will not be charged the emergency room co-payment.

Smoking Cessation Prescriptions Drugs
Coverage for smoking cessation prescription drugs will be subject to the participant's enrollment in the Plan's online tobacco cessation program through WebMD at www.webhealth.com/mississippi.  Coverage will also continue to be subject to the participant's applicable deductible and the appropriate prescription drug co-payment amount, and will be limited to a lifetime maximum of $350.  Over the counter smoking cessation products will not be covered.  Plan participants residing in Mississippi may utilize the services of the ACT Center and the Mississippi Tobacco Quitline free of charge.

The Act Center:  601-815-1180 or www.act@quit.com
The Quitline:       1-800.QUIT.NOW (800-781-8669) or www.quitlinems.com

New Medical Management Administrator
ActiveHealth Management, Inc. (ActiveHealth) has been selected as the new medical management administrator for the Plan.  Beginning January 1, 2011, ActiveHealth will provide medical management, disease management, and utilization review services such as certification of inpatient hospital admissions, outpatient MRI and CAT scans, and other services that require certification of medical necessity.  More information resources, and other programs will be mailed to participants later this year.

New Mail Order Services
On January 1, 2011, the participants drug mail order will transition from Walgreens Mail Service to Catalyst Rx's mail service pharmacy, Immediate Pharmaceutical Services, Inc. (IPS). Participants will receive more information on IPS and mail order later this year.

 

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5 E. South Street • Hernando, MS 38632
Phone: (662) 429-5271 • Fax: (662) 429-4198
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