MEDICAL PLAN OPTIONS
PWCS offers a health and vision insurance package through Anthem BlueCross and BlueShield to all permanent full-time and part-time employees who work at least 17 1/2 hours per week. We continue to offer the KeyCare Enhanced (PPO), KeyCare Core (PPO)and the Healthkeeper (HMO/POS) plans. The medical plan comparison chart may be useful in determining which plan will best fit your family’s needs. In some circumstances, employees who are in a temporary or substitute position may be eligible for medical insurance due to the Affordable Care Act (ACA) regulations. Employees who become eligible for coverage under ACA will be notified by the Office of Benefits and Retirement Services when they meet specific criteria as established by the ACA regulations.
The KeyCare Enhanced (PPO),andKeyCare Core (PPO)plans allow you the freedom to see any participating physician without the need for a specific primary care physician and with no referral required for specialist visits. There is no deductible for in-network services on any of our plans. You may see out-of-network providers at a higher cost. The Enhanced PPO plan is the most expensive option on a per-paycheck basis, but you pay a simple co-payment at the time of medical services. The Core PPO plan allows you to save on your per-paycheck premiums. but pay slightly higher co-pays and incur an additional 20% co-insurance on certain services.
The Healthkeeper (HMO/POS) requires an assigned Primary Care Physician for each member of your plan and does require a referral to see a specialist, though you do still have the option of visiting out-of-network specialists at a higher cost. Please refer to the plan comparison chart, and SBC for each plan to determine which plan is the right fit for your family.
All plan members enrolled in a PWCS medical plan receive the Anthem Blue View Vision benefits as part of their coverage.
All plan members enrolled in a PWCS health insurance plan receive prescription services from WelldyneRX. You will receive a separate insurance card to present to the pharmacy for your prescription benefits. Once you receive your WellDyneRX card, you can visit their registration site at www.mywdrx.com
ESS enrollment or Enrollment Foms must be received by the Office of Benefits & Retirement Services by May 15, 2017.
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DENTAL PLAN OPTIONS
All full-time and part-time employees working 17 1/2 hours per week are eligible to enroll in either Delta Premier, Delta Dental PPO or both plans. The Delta PPO plan can be added as a supplement to the Delta Premier dental plan. Employees not interested in the medical package can enroll in dental benefits separately.
Delta Dental Premier Plan
The Premier Plan allows you to receive a benefit for in-network or out-of-network services. Select a dentist from the Premier Dental Network to receive the greatest level of savings on your out-of-pocket costs. Participating dentists have agreed to accept Delta Dental’s payment and any patient coinsurance and/or deductible as payment in full for covered benefits. You may also receive care from an out-of-network dentist; however, that dentist may charge more than Delta Dental’s plan allowance. You are responsible for any charges above the plan allowance, plus any required coinsurance and applicable deductible. There is NO ORTHODONTIC coverage in this plan.
Delta Dental PPO Plan
The PPO Dental Network has an extensive provider base in Northern Virginia. To receive a benefit you must use a contracted PPO Dental Network provider. This plan provides orthodontic benefits for children to age 19 (up to $2,000 lifetime per child) and a $2,000 calendar year maximum benefit per individual. There is no out-of-network coverage for services performed by non-participating PPO dentists. A 6-month waiting period for major services and a 12-month waiting period for orthodontic coverage applies. Prince William County Schools does not contribute toward the cost; however, payment of the premium through pre-tax payroll deduction is available.
Enrollment forms or ESS enrollment must be received by the Office of Benefits & Retirement Services by May 15, 2017.
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FLEXIBLE BENEFITS PROGRAM
A Flexible Spending Account is a program that the Federal Government allows an employer to sponsor. It enables you (the employee) to save Federal, state and Social Security (FICA) taxes on the money you use to pay for eligible expenses. The tax savings will increase your take home pay. If you choose to participate in this valuable benefit, you and your eligible dependents can pay for medical, dental and vision expenses, and/or dependent day care expenses on a tax-free basis. Under the plan, only the expenses of a participant, a participant’s spouse or a participant’s dependent(s) qualify for pre-tax treatment. If you are unsure if a person qualifies as an eligible dependent, please refer to the P&A website for a more detailed definition, www.padmin.com.
The PWCS Flexible Spending Accounts will be administered by P & A Group effective July 1, 2017. Annual re-enrollment is required for every Flexible Spending Participant. This year, participants will enroll online using the P & A Group Online Enrollment functionality at www.padmin.com . Click here for instructions for the enrollment process. There will be NO PAPER ENROLLMENT FORMS for the 2017-2018 Flexible Benefits Plan Year. IRS maximums for the 2017-18 plan year are $2600 for health flexible spending and $5000 dependent care flexible spending (for child care).
Any claims incurred against July 1, 2016 - June 30, 2017 plan year funds (including claims incurred between June 30 and September 15, 2017), will be administered by Sheakley until September 30, 2017. Any claims incurred for the new plan year July 1, 2017 – June 30, 2018 will be administered by P & A Group.