Employee Benefits Guide - Houston
2020
Employee Benefits Guide
2020
INSIDE THIS GUIDE
YOUR 2020 EMPLOYEE BENEFITS
The Archdiocese of Galveston-Houston is proud to offer a comprehensive benefits package that can be customized to meet the needs of you and your family. We are committed to promoting better health for our Lay personnel and their eligible dependents. This means you have access to annual physicals, cancer screenings, and more--all at no cost to you. Please review this guide and carefully consider your options so that you can make the best choices for you and your dependents.
Have questions about your benefits? The Archdiocese of Galveston-Houston Benefits Help Line is here to help! Simply call 855-664-8164 or email agh_benefits@. Trained advocates are available to help Monday through Friday, 7:00 AM to 6:00 PM CST.
The Summary of Benefits and Coverage (SBC) documents are located on the ADP portal. For hard copy requests, please contact the Human Resources Department by calling 713-652-8265.
TABLE OF CONTENTS
What's New for 2020?
2
2020 Employee Contributions
3
Eligibility and Annual Enrollment
4
How Do I Enroll?
5
The Benefits Help Line
6
Your Medical/Rx Benefits
7
Virtual Visits
10
BCBSTX Resources
11
Your Dental Benefits
12
Your Vision Benefits
13
Life and AD&D Benefits
14
Disability Benefits and FMLA
15
Additional Services from The Standard
16
Important Contact Information
18
If you or your dependents have Medicare or will become eligible for Medicare in the next 12 months, a Federal law gives you more choices about your prescription drug coverage. Please
see the separate legal disclosure booklet for more information.
1
WHAT'S NEW FOR 2020?
2020
MEDICAL & DENTAL COVERAGE
Effective January 1, 2020, your medical and dental coverage will be administered by Blue Cross Blue Shield of Texas (BCBSTX). Your Archdiocese of Galveston-Houston Medical Plans will utilize the Blue Choice PPO Network. Some providers who participate in the Aetna network may not participate in the Blue Choice PPO Network. To verify whether or not your doctor will be in-network, you can navigate to and click on "Find a Doctor or Hospital" to search BCBSTX's provider directory. If you have questions about the transition to BCBSTX or whether or not your provider participates in the Blue Choice PPO Network, please contact the Benefits Help Line at 855-664-8164.
NEW ID CARDS
You will soon receive a welcome packet from BCBSTX in the mail, which will include new medical and dental ID cards. OptumRx will continue to administer our prescription drug coverage in 2020; however, your new BCBSTX medical ID card will display your OptumRx pharmacy information. Please continue to use your current OptumRx ID card at the pharmacy for the remainder of 2019. Effective January 1, 2020, your new BCBSTX medical ID card will be the ONLY ID card you need. On or after January 1, 2020, your current OptumRx ID card will no longer be valid--you will need to have your new BCBSTX medical ID card ready to present at the doctors office or at the pharmacy when filling a prescription. If you have questions about these changes, please contact Human Resources.
VIRTUAL VISITS WITH MDLive
Effective January 1, 2020, you will have access to virtual visits through MDLive. Whether you're at home or traveling, access to a board-certified doctor is available 24 hours a day, 7 days a week via the BCBSTX Mobile App, online video, or telephone service. You can speak to a doctor immediately or schedule an appointment based on your availability. Please see page 10 for more details about this service.
!
QUESTIONS ABOUT YOUR BENEFITS?
The Benefits Help Line is here to help!
The Archdiocese of Galveston-Houston Benefits Help Line is available to answer any questions you and your covered dependents may have. See page 6 for more details.
CALL: 855-664-8164 | EMAIL: agh_benefits@
IMPORTANT REMINDERS
FREE PREVENTIVE CARE
The Archdiocese of Galveston-Houston Medical Plans cover in-network preventive care at 100%. This means you can receive your annual physical, well woman exam, prostate exams, mammograms, immunizations, and other routine preventive services on an annual basis at no cost to you! Remember to ask your doctor if the services are classified as preventive--you may have to pay for services received during your visit if they are not classified as preventive.
MANDATORY MAIL ORDER
If you take a prescription on an ongoing basis, you must fill your prescription through the mail order program. You may fill your prescription at a retail pharmacy for the first two months. For the third prescription, you must fill it through OptumRx Home Delivery.
2
2020
MEDICAL/Rx
COVERAGE TIER Employee Only Employee + Spouse Employee + Child(ren) Employee + Family
2020 EMPLOYEE CONTRIBUTIONS
STANDARD PLAN
Biweekly Premium:
Monthly Premium:
$0.00
$0.00
$210.46
$456.00
$161.54
$350.00
$263.08
$570.00
ECONOMY PLAN
Biweekly Premium:
Monthly Premium:
N/A
N/A
$179.08
$388.00
$104.77
$227.00
$183.23
$397.00
DENTAL AND VISION
COVERAGE TIER
DENTAL PLAN
Biweekly Premium:
Monthly Premium:
Employee Only
$0.00
$0.00
Employee + One Dependent
$25.22
$54.65
Employee + Family
$42.04
$91.08
VISION PLAN
Biweekly Premium:
Monthly Premium:
$4.21
$9.13
$6.08
$13.18
$11.72
$25.40
SUPPLEMENTAL LIFE INSURANCE
EMPLOYEE COVERAGE
Employee Age Bracket ................
................
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