Finding the right plan for you

  • finding the right plan for you It's time to meet your HISD benefits
    If you're looking for information about your 2018 HISD benefits, you've come to the right place. We are here to help you understand the basics. On this site, you'll find videos and other information to explain your options and help you make the best decisions for you and your family. With our help, you'll be able to take charge of your health care, save money, and feel confident in your choices.

Benefits 101

New look, same great care
HISD is switching to Cigna health plans in 2018, but the change will affect you very little.

What’s changing
• Instead of basing provider networks off of the hospitals you go to, we are now basing them off of the doctors that you see.
• We will begin offering Cigna Telehealth Connection, letting you talk to a doctor about minor health issues anywhere you have a phone or a computer.
• The 24/7 Nurse Line will now be run by Cigna.

What’s staying the same
• How your medical plan works and what you will be expected to pay.
• Voluntary benefit options.
• The wellness program.

New Provider Networks
The main change that comes with HISD’s switch to Cigna is there are now two provider networks, LocalPlus and Open Access Plus (OAP).

• If you have a Limited plan: You are only covered to see doctors in the LocalPlus provider network.
• If you have a Choice plan: You can see any doctor in the LocalPlus network—and it’ll be cheaper when you do—but you are also covered to see doctors in our OAP provider network.

Still want more options?
Both the Limited and Choice plans have a Basic or Plus option. You get all of the same doctors and benefits with both options, but you get to choose how you want to pay for your healthcare.
• Choose the Basic option - If you want low monthly payments with a higher deductible.
• Choose the Plus option - If you want a lower deductible with higher premiums.
• Choose an Open Access Plan - If you want everything and are willing to pay for it. It has the biggest provider network and no deductible. The compromise is that your monthly premium payments are going to be significantly more than for any other plan.
All of these plans come with prescription drug coverage and no-cost preventive health visits.

Dental Insurance
Whether you never miss a cleaning or you're not quite sure when you last saw your dentist, there's an HISD plan that will work for you.

First up,let's get to know the two dental insurance plans.

Plan
Employee only
Employee + spouse
Employee + child(ren)
Employee + Family
Low
$1.83
$3.46
$3.62
$6.76
High
$2.75
$5.46
$5.73
$8.79

Dental HMO
• You have to choose a primary care dentist (PCD) who will direct your dental care
• You can only use in-network dentists
• You need a referral from your PCD for any specialty services
• This plan has the lowest premiums and no deductibles

Dental PPO
• You can see any dentist you want, but you'll generally save money by using one that's in network
• You pay a deductible before the plan begins to pay its share of covered expenses
• There is an annual maximum benefit of $1,350 per person

Of course, we want to keep your pearly whites healthy and, well, pearly white, so make sure you get a preventive exam and cleaning every six months. It's free with the HMO plan and free after you've met the deductible on the PPO plan.

Discount Dental
If you want to save money on dental care, there's also the Discount Dental plan. It's not insurance, so there aren't any free exams or cleanings. You'll simply pay as you go for care, with a discount if you see an in-network dentist.
Now that you know about the different plans, it's time to brush up on your options and choose the one that works best for you and your family.

Vision insurance that’s more than meets the eye
If you just think of vision insurance as something to help you pay for eyeglasses, you are missing out on important benefits.

Why visit your eye doctor for a vision exam every year?
• To get a new prescription for your glasses or contacts.
• The visit can uncover common eye diseases like glaucoma and cataracts.
• Your doctor could discover early warning signs for health issues beyond your vision, like diabetes or hypertension – conditions you want to know about as soon as possible.

Two plans: Vision Low and Vision High

Plan
Employee only
Employee + spouse
Employee + child(ren)
Employee + Family
Low
$1.83
$3.46
$3.62
$6.76
High
$2.75
$5.46
$5.73
$8.79

What’s Different
• A Vision High plan means that you can get new frames every year, and your copay for new lenses or contacts is $10.
• A Vision Low plan means you are covered for new frames every two years. Your copay for lenses or contacts is $20, and this benefit renews yearly.

What’s the Same
• Your frame benefit has $150 allowance.
• You can get a 40% discount on a second pair of glasses at most in-network retailers.
• You have access to online ordering tools, including glasses.com and contactsdirect.com.
• Optional additional coverage for premium lens features like UV coating, tint, and anti-reflective lenses.
• $10 copay for your annual eye exam.

FSA
A Flexible Spending Account, or FSA, can save you money on common expenses.

How it works
Before the beginning of the year, you will commit to contributing a certain amount to your FSA. This money will be taken out of your paycheck before you pay taxes on it, but you will have to spend it on eligible expenses.

Health care FSA
No matter how good your health plan is, you will end up spending money on things like deductibles, coinsurance and uncovered services. Funds in a health care FSA are committed to paying for these qualifying health care expenses.
• You may contribute up to $2,650, pre-tax.
• The full amount you decide to contribute is available Jan. 1, 2018, but the money will be taken out over the course of 24 paychecks.
• You can use the money for your dependent’s health care expenses, even if they are not covered by an Houston ISD plan.
• Learn more about Health Care FSAs here.

What can you use your health care FSA for?
• Doctor visits
• Medical tests
• Dental work
• Eye exams
• Prescriptions
• And more

Dependent day care FSAs
Funds in a dependent day care FSA are committed to paying for day care for your child or other qualifying person.
• You may contribute up to $5,000.
• Unlike the health care FSA, you can only use funds that have already been taken from your paycheck.
• Reenrolling is not automatic, so you must sign up each year that you wish to participate.
• Eligible expenses must meet certain requirements.
• Learn what kind of care is eligible and more about Dependent day care FSAs here.

Planning for any future that happens
Life and Accidental Death & Dismemberment (AD&D) coverage will help make sure you and your loved ones are taken care of in the event you are not able to work.

Life Insurance
Every HISD employee who is eligible for benefits is provided a $10,000 life insurance and AD&D policy at no cost.

AD&D

Optional Disability Coverage
• You choose the percentage (40%, 50% or 66.67%) of your monthly salary that you want to receive each month you collect benefits.
• You can choose to receive benefits for 30, 60, 90 or 180 days.
• The maximum monthly benefit you can receive is $8,000.

Supplemental life and matching AD&D for you:
• You can get coverage for up to eight times your annual base salary, up to $1,000,000.

For your spouse:
• You can get coverage for 1, 2 or 3 times your annual base salary, up to $250,000.

For your child:
• You can get coverage for $5,000, $10,000, $15,000 or $20,000—per child, up to age 26.
• Some benefits may have evidence of insurability requirements or pre existing condition limitations - remember to read the fine print at hisdbenefits.org

Supplemental Insurance could get you cash when you need it most
Sometimes, it’s good to have a little extra beyond your health coverage. Your plan is a great one, but supplemental insurance goes beyond your regular health plan. It will pay you cash for extra medical expenses.

How it works
Even with insurance, a major illness or injury can still cost more than you’d like after you’ve paid deductible and coinsurance costs. You might even end up having to pay these costs – up to the entire amount of your out-of-pocket maximum – in a brief period of time.
• You must be under 70 to enroll or increase your coverage in these plans.
• You must complete your first day of work before these plans take effect.

Cancer & Specified Diseases
There is a high and low coverage option. You do not need to show evidence of good health for either coverage option. A 12-month pre-existing condition applies.

Plan
Employee only
Employee + spouse
Employee + child(ren)
Employee + Family
Low
$5.18
$8.64
$6.63
$8.64
Low+ICU
$8.18
$14.81
$12.48
$17.10
High
$9.42
$17.10
$12.48
$17.10
High+ICU
$12.42
$23.28
$18.66
$23.28

There is a high and low coverage option. You do not need to show evidence of good health for either coverage option. A 12-month pre-existing condition applies.
The plan will pay you $50 for a wellness screening. You will be given a lump sum cash payment when you are first diagnosed with a covered critical illness. There is a high and low coverage option. You do not to provide evidence of good health for either option.

Hospital Indemnity
You’ll receive a lump sum payment for hospital admission and stays up to 365 days. You’ll need to submit a form and receipts after your hospital visit to be reimbursed. Your age does not affect the rate you pay. You do not need to provide evidence of good health to enroll.
Plan
Employee only
Employee + spouse
Employee + child(ren)
Employee + Family
Low
$2.36
$4.42
$4.17
$6.23
High
$4.48
$8.40
$7.79
$11.71

Accident plan
You can only collect benefits for an eligible accident. You’ll receive cash benefits for any expenses that are not fully covered by your medical plan.

Plan
Employee only
Employee + spouse
Employee + child(ren)
Employee + Family
Low
$3.08
$4.95
$5.99
$7.86
High
$5.33
$8.45
$10.10
$13.22

You can find out more about supplemental insurance by calling the HISD Benefits Service Center at 877-780-HISD (4473).

A good lawyer doesn’t have to be hard to find
Your plan’s Personal Legal option makes getting legal help easy and affordable.

Plan
Employee only
Employee + spouse
Rate
$4.77
$6.72

What Personal Legal offers help with
• Creating a will
• Signing a contact
• Dealing with the fallout from identity theft—which affected over 15 million people in the United States in 2016
• Traffic tickets
• Consumer matters
• And more

If you’re lucky, you won’t need a lawyer. But, if you find yourself being one of the many people who could use a lawyer, this coverage is something you will be thankful you purchased.