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Open Enrollment: Tuesday, October 11 – Friday, November 11, 2016 An Annual Newsletter About Open Enrollment for FCPS Retirees Fall 2016 Retiree Benefits Briefing Office of Benefit Services · Fairfax County Public Schools 1 Mark Your Calendars! It’s hard to believe that the summer is already over! Now that fall is here, it’s time to begin thinking about your plan elections for the 2017 calendar year. Open Enrollment for 2017 benefits will run from October 11 through November 11, 2016. The changes you make during this period will become effective January 1, 2017. This Briefing contains important information about changes occurring in 2017 as well as considerations for the future. Please take the time to read thoroughly. October M T W T F 11 12 13 14 17 18 19 20 21 24 25 26 27 28 31 November M T W T F 1 2 3 4 7 8 9 10 11 Open House: Chantilly OE starts! OE ends! Open House: Hayfield Open House: Annandale Ext. Hours: Gatehouse What’s New for 2017? Pharmacy Benefit Manager Change CVS Caremark ® will replace Express Scripts, effective January 1, 2017. For Medicare retirees, coverage will be provided through SilverScript, a subsidiary of CVS Caremark. Virtually every retail pharmacy used by retirees will continue to be in-network. Copay and coinsurance levels will remain the same. See page 2 for more details about this transition. Dental Re-Entry for Eligible Retirees For this open enrollment period only, eligible retirees who did not maintain dental coverage upon retirement will be afforded a one-time opportunity to elect coverage under the FCPS plan. You must take action if you do not have dental coverage and wish to enroll. See page 3 for more details about this re-entry period. 2017 premiums can be found on pages 4-5. 2017 Plans & Premium Increases Medical Aetna/Innovation Health + 3.9% CareFirst BlueChoice Advantage + 3.3% Kaiser Permanente Signature HMO - 2.7% Kaiser Permanente Medicare + 4.0% Dental Aetna DPPO + 5.9% Aetna DMO/DNO + 0% Ext. Hours: Gatehouse

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  • Open Enrollment: Tuesday, October 11 Friday, November 11, 2016An Annual Newsletter About Open Enrollment for FCPS Retirees Fall 2016

    RetireeBenefits Briefing

    Office of Benefit Services Fairfax County Public Schools 1

    Mark Your Calendars! Its hard to believe that the summer is already over! Now that fall is here, its time to begin thinking about your plan elections for the 2017 calendar year.

    Open Enrollment for 2017 benefits will run from October 11 through November 11, 2016. The changes you make during this period will become effective January 1, 2017.

    This Briefing contains important information about changes occurring in 2017 as well as considerations for the future. Please take the time to read thoroughly.

    OctoberM T W T F

    11 12 13 14

    17 18 19 20 21

    24 25 26 27 28

    31

    NovemberM T W T F

    1 2 3 4

    7 8 9 10 11

    Open House:Chantilly

    OE starts!

    OE ends!

    Open House:Hayfield

    Open House:Annandale

    Ext. Hours: Gatehouse

    Whats New for 2017?Pharmacy Benefit Manager ChangeCVS Caremark will replace Express Scripts, effective January 1, 2017. For Medicare retirees, coverage will be provided through SilverScript, a subsidiary of CVS Caremark. Virtually every retail pharmacy used by retirees will continue to be in-network. Copay and coinsurance levels will remain the same. See page 2 for more details about this transition.

    Dental Re-Entry for Eligible RetireesFor this open enrollment period only, eligible retirees who did not maintain dental coverage upon retirement will be afforded a one-time opportunity to elect coverage under the FCPS plan. You must take action if you do not have dental coverage and wish to enroll. See page 3 for more details about this re-entry period.

    2017 premiums can be found on pages 4-5.

    2017 Plans & Premium Increases

    MedicalAetna/Innovation Health + 3.9%CareFirst BlueChoice Advantage + 3.3%Kaiser Permanente Signature HMO - 2.7%Kaiser Permanente Medicare + 4.0%

    DentalAetna DPPO + 5.9%Aetna DMO/DNO + 0%

    Ext. Hours: Gatehouse

  • Office of Benefit Services Fairfax County Public Schools2

    Introducing CVS Caremark!Beginning January 1, 2017, Aetna/Innovation Health and CareFirst members will transition to CVS Caremark for management of prescription benefits. For Medicare retirees, your pharmacy benefits will be provided through SilverScript, a subsidiary of CVS Caremark. This change will provide members additional convenience and savings options, while providing access to a broad network that includes thousands of retail pharmacies nationwide. In addition to CVS Pharmacy, members will continue to have access to major retail pharmacy chains, such as Walgreens, Giant, Safeway, Wegmans, and many others. Copayment levels will remain the same, and new savings options are available for members who take maintenance medications. New cost-saving options for maintenance medications

    o Beginning January 1, you have the option of filling maintenance medications at a CVS Pharmacy and enjoying the savings previously available only through mail order. Members will be able to fill up to a 90-day supply of maintenance medications at a CVS Pharmacy and pay only 2 copayments. You may also continue to receive up to a 90-day supply of maintenance medications through mail order and pay 2 copayments, or use a non-CVS retail Pharmacy and pay 3 copayments.

    Additional convenienceo Employees who take specialty medications will transition to CVS Specialty Pharmacy.

    While you will continue to receive these medications through mail order, you will also have the option of confidential and convenient delivery of your specialty medications to CVS pharmacies at no additional charge.

    o Diabetes supplies (including glucose meters, lancets, and test strips) will be available through your prescription benefit instead of your medical benefits. Some diabetes equipment, such as insulin pumps, will continue to be covered under your medical plan.

    Except where prohibited by law, your medication history, remaining refills and existing mail-order prescriptions will be transferred from Express Scripts to CVS Caremark/SilverScript. You will receive a new pharmacy ID card from CVS Caremark/SilverScript in mid-December. Please make sure you provide this card to your pharmacy in the new year. Look for more communications later this fall on how to begin accessing your benefits under CVS Caremark/SilverScript. You may also visit www.info.caremark.com/fcps (non-Medicare retirees) or http://FairfaxPS.silverscript.com (Medicare retirees) for more infor-mation.Please note: Express Scripts will continue to provide pharmacy benefits for Aetna/Innovation Health and CareFirst members through December 31, 2016. No change in pharmacy benefits will occur for Kaiser Permanente participants.

    Prescription Copayment Levels Short-Term Medications

    (max. 30-day supply)

    Maintenance Medications(max. 90-day supply)

    Specialty Medications (max. 30-day supply)

    Where Obtained

    Participating retail pharmacies

    CVS retail Pharmacy

    CVS Caremark Mail Service

    Participating non-CVS Pharmacy

    CVS Caremark Specialty Pharmacy

    Generic $7 $14 $14 $21 $7Brand Name 20%, max $50 20%, max $100 20%, max $100 20%, max $150 20%, max $50

    Preventive medications covered by the Affordable Care Act remain available for $0 copay.

  • Office of Benefit Services Fairfax County Public Schools 3

    Plan Updates for 2017

    Dental EnhancementsEach year, FCPS evaluates coverage under the medical and dental programs to ensure the benefits remain market relevant. As part of this review, some enhancements will occur to the Aetna DPPO plan in 2017. Starting next year, coverage levels will be enhanced for periapical x-rays and re-cementation of crowns and dentures. Additionally, orthodontia for dependent children remains a covered benefit if work began prior to age 20 (currently age 19). Visit www.ih-aetna.com/fcps, and click on Dental Plan Information for more details.

    Enhanced Vision Benefits for Kaiser Permanente ParticipantsStarting January 1, Kaiser Permanente participants will be eligible for a 25% discount on frames and lenses, and a 15% discount on contact lenses, when obtained at a Kaiser Permanente optical facility. This discount is now available to Medicare retirees and will be available to all retirees in 2017. This discount provides greater savings for vision hardware, and is in addition to the $150 vision benefit allowance currently provided to all participants. Visit https://my.kp.org/fcps/ for more information.

    Retirees Eligible for One-Time Re-entry in FCPS Dental Plan For the fall 2016 Open Enrollment period only, retirees who did not maintain FCPS dental coverage upon retirement will be afforded a one-time opportunity to elect coverage under the plan. Coverage elected during Open Enrollment will be effective January 1, 2017.To be eligible to elect coverage, you must meet the definition of retiree, which means: You terminated employment with

    FCPS and immediately began drawing retirement benefits, and,

    you are currently receiving pension benefits from VRS, ERFC and/or FCERS that are directly related to your former employment with FCPS.

    Also, for this Open Enrollment period only, the 5-year enrollment requirement to join the dental plan will be waived. This year, eligible retirees may enroll in the dental plan if they did not meet the 5-year requirement at retirement.

    You are eligible to re-enter the FCPS dental plan if:You meet the definition of retiree*, and

    1. You did not re-enter the plan in 2007 when eligible, or

    2. You did not elect coverage at time of retirement, or

    3. You were not eligible to elect coverage at retirement, because you did not have dental coverage in place for 5 or more years.

    You may also add coverage for your eligible dependents. Current DHO participants are also eligible to elect coverage during Open Enrollment. *Former employees who are deferred vested annuitants (did not begin drawing a benefit at retirement), COBRA participants, and surviving spouses who did not retain coverage at time of initial eligibility do not meet the definition of retiree and remain ineligible to elect coverage.

    Once coverage is elected, continuous coverage must be maintained. If coverage is voluntarily cancelled - or terminated due to non-payment - the retiree will not be eligible to reinstate.

    Retirees who are eligible to elect dental coverage will receive a separate mailing with the enrollment form and instructions. Look for this mailing to arrive by the end of October.

  • Office of Benefit Services Fairfax County Public Schools4

    2017 Medical Rates for ERFC Retirees

    MEDICAL PLAN MONTHLY TOTAL RATE ERFC AGE 55 & OLDER SUBSIDYMONTHLY TOTAL RATE MINUS SUBSIDY

    Aetna/Innovation Health (available to all retirees)Individual $709.84 $100.00 $609.84Minifamily (you + 1 other; no one has Medicare) $1,419.67 $100.00 $1,319.67

    Family (you + 2 or more others; no one has Medicare) $1,774.58 $100.00 $1,674.58

    Medicare Individual $422.21 $100.00 $322.21Medicare Minifamily $844.42 $100.00 $744.42Individual + Medicare $1,132.04 $100.00 $1,032.04Minifamily + Medicare $1,774.58 $100.00 $1,674.58Family + Medicare $1,774.58 $100.00 $1,674.58

    CareFirst BlueChoice Advantage (available to all retirees not eligible for Medicare)Individual $564.53 $100.00 $464.53Minifamily $1,129.06 $100.00 $1,029.06Family $1,411.33 $100.00 $1,311.33

    Kaiser Permanente (available to retirees who live in the local Kaiser Permanente/KP Medicare service area)Individual $600.46 $100.00 $500.46Minifamily (you + 1 other; no one has Medicare) $1,200.91 $100.00 $1,100.91

    Family (you + 2 or more others; no one has Medicare) $1,501.13 $100.00 $1,401.13

    Medicare Individual $236.75 $100.00 $136.75Medicare Minifamily $473.50 $100.00 $373.50Individual + Medicare $837.21 $100.00 $737.21Minifamily + Medicare $1,437.66 $100.00 $1,337.66Family + Medicare $1,501.13 $100.00 $1,401.13

    Key to Medicare Coverage RatesMedicare Individual: You (the individual) have Medicare coverage.Medicare Minifamily: You + 1 dependent. Both you and your dependent have Medicare coverage.Individual + Medicare: You + 1 dependent. One individual does not have Medicare coverage and one individual does.Minifamily + Medicare: You + 2 dependents. Two individuals do not have Medicare coverage and one individual does.Family + Medicare: You + 3 or more dependents. Three or more individuals do not have Medicare coverage and one individual does.

    2017 Dental RatesAetna DPPO Aetna DNO

    Individual $46.37 Individual $19.95

    Minifamily $78.83 Minifamily $33.93

    Family $111.76 Family $48.01

  • Office of Benefit Services Fairfax County Public Schools 5

    2017 Medical Rates for FCERS Retirees (Subsidy applies to age 55 and older)Your 2017 medical rate will be the monthly total rate for your plan and coverage MINUS a subsidy based on your years of retirement (see Retiree Benefits Handbook).

    MEDICAL PLAN

    MONTHLY TOTAL RATE

    $ 15 SUBSIDY

    $ 25 SUBSIDY

    $ 50 SUBSIDY

    $ 100 SUBSIDY

    $ 125 SUBSIDY

    $ 150 SUBSIDY

    $ 175 SUBSIDY

    Aetna/Innovation Health (available to all retirees)Individual $709.84 $694.84 $684.84 $659.84 $609.84 $584.84 $559.84 $534.84

    Minifamily $1,419.67 $1,404.67 $1,394.67 $1,369.67 $1,319.67 $1,294.67 $1,269.67 $1,244.67

    Family $1,774.58 $1,759.58 $1,749.58 $1,724.58 $1,674.58 $1,649.58 $1,624.58 $1,599.58

    Medicare Individual $422.21 $407.21 $397.21 $372.21 $322.21 $297.21 $272.21 $247.21

    Medicare Minifamily $844.42 $829.42 $819.42 $794.42 $744.42 $719.42 $694.42 $669.42

    Individual + Medicare $1,132.04 $1,117.04 $1,107.04 $1,082.04 $1,032.04 $1,007.04 $982.04 $957.04

    Minifamily + Medicare $1,774.58 $1,759.58 $1,749.58 $1,724.58 $1,674.58 $1,649.58 $1,624.58 $1,599.58

    Family + Medicare $1,774.58 $1,759.58 $1,749.58 $1,724.58 $1,649.58 $1,649.58 $1,624.58 $1,599.58

    CareFirst BlueChoice Advantage (available to all retirees not eligible for Medicare)Individual $564.53 $549.53 $539.53 $514.53 $464.53 $439.53 $414.53 $389.53

    Minifamily $1,129.06 $1,114.06 $1,104.06 $1,079.06 $1,029.06 $1,004.06 $979.06 $954.06

    Family $1,411.33 $1,396.33 $1,386.33 $1,361.33 $1,311.33 $1,286.33 $1,261.33 $1,236.33

    Kaiser Permanente (available to retirees who live in the local Kaiser Permanente/KP Medicare service area)

    Individual $600.46 $585.46 $575.46 $550.46 $500.46 $475.46 $450.46 $425.46

    Minifamily $1,200.91 $1,185.91 $1,175.91 $1,150.91 $1,100.91 $1,075.91 $1,050.91 $1,025.91

    Family $1,501.13 $1,486.13 $1,476.13 $1,451.13 $1,401.13 $1,376.13 $1,351.13 $1,326.13

    Medicare Individual $236.75 $221.75 $211.75 $186.75 $136.75 $111.75 $86.75 $61.75

    Medicare Minifamily $473.50 $458.50 $448.50 $423.50 $373.50 $348.50 $323.50 $298.50

    Individual + Medicare $837.21 $822.21 $812.21 $787.21 $737.21 $712.21 $687.21 $662.21

    Minifamily + Medicare $1,437.66 $1,422.66 $1,412.66 $1,387.66 $1,337.66 $1,312.66 $1,287.66 $1,262.66

    Family + Medicare $1,501.13 $1,486.13 $1,476.13 $1,451.13 $1,401.13 $1,376.13 $1,351.13 $1,326.13

    Key to Medicare Coverage RatesMedicare Individual: You (the individual) have Medicare coverage.Medicare Minifamily: You + 1 dependent. Both you and your dependent have Medicare coverage.Individual + Medicare: You + 1 dependent. One individual does not have Medicare coverage and one individual does.Minifamily + Medicare: You + 2 dependents. Two individuals do not have Medicare coverage and one individual does.Family + Medicare: You + 3 or more dependents. Three or more individuals do not have Medicare coverage and one individual does.

  • Office of Benefit Services Fairfax County Public Schools6

    Planning for the FutureHealth Plan Task ForceEarlier this year, Superintendent Garza convened a Health Plan Task Force to review and evaluate current FCPS health programming options and develop recommendations for plan structures to be implemented in calendar year 2017 and beyond. Task Force Members included representatives from a variety of groups, including representatives from the two retiree associations. A well-deserved thank you to the members of the Task Force for the many hours they devoted to these meetings.

    Health Plan Changes Being Evaluated for 2018Looking forward to calendar year 2018, FCPS is evaluating common practices of other large employers, along with recom-mendations of the FCPS Health Plan Task Force that was formed last spring. Currently, the following changes are being evaluated for implementation in 2018:

    Tobacco-free DiscountIn addition to the negative impact to individ-ual health, use of tobacco products is widely documented to create thousands of dollars additional in health care costs. Many employ-ers offer discounts to employees who do not use tobacco products in any form, and FCPS is evaluating adding this incentive to health plan premiums for 2018. The amount of the discount is yet to be determined. If you currently use tobacco products, there are many resources available to help you quit. Next fall, employees/retirees may be asked to attest that they have not used tobacco products for at least the previous 6 months in order to receive the discount.See page 7 for resources on tobacco cessa-tion programs. For more information, search keywords tobacco cessation on the intranet.

    Spousal SurchargeIn order to keep coverage affordable, FCPS will be evaluating a surcharge for spouses who have access to other health coverage, but are enrolled under the FCPS health plan. Spousal surcharges are common com-ponents of large employer plans as a way to minimize costs and keep participant premi-ums low. Surcharge amounts, and a defini-tion of what constitutes other coverage, are still being evaluated.

    Becoming Eligible for Medicare in 2017?If you or your spouse will become Medicare-eligible during 2017, its important to consider the following during Open Enrollment: FCPS health plans require that retirees

    (and dependents of retirees) enroll with Medicare Parts A&B when first eligible. Failure to enroll in Medicare could result in significant expense, as claims will pay as if Medicare were in place. Aetna/Inno-vation Health and Kaiser Permanente are the two FCPS plans available to Medi-care retirees.

    If you anticipate changing plans during the calendar year, consider any potential impact of meeting your deductible and out-of-pocket maximums. You may want to change plans during the Open Enroll-ment prior to becoming eligible for Medi-care, as deductibles and out-of-pocket maximums do not transfer from one plan to another. Transferring plans mid-year may mean additional out-of-pocket ex-pense, which must be weighed against plan and premium differences.

    For more information, visit www.fcps.edu and search keyword Medicare.

  • Office of Benefit Services Fairfax County Public Schools 7

    Focus on Wellness

    Seasonal Flu ImmunizationsFlu shots continue to be available at Benefits Open Houses for retirees for a nominal charge. FCPS retirees and family members of employees and retirees (18 and older) may receive a seasonal flu immunization at any FCPS clinic for $28.* Please email [email protected] for questions.

    Large flu clinics will be held at: Benefits Open Houses (Hayfield,

    Chantilly, and Annandale) Tuesday, October 11, 2:30 - 6 p.m.

    Willow Oaks Administrative Center Thursday, December 8, 3 - 6 p.m.

    Gatehouse Administration CenterFor more information, visit www.fcps.edu and search keywords flu shots.*Medicare Part B is accepted as long as the person is not in an HMO. Please bring your Medicare card and your photo ID.

    Resources to Become Tobacco-FreeFCPS Health Plans $0 copay for tobacco cessation $0 copay for prescribed smoking

    cessation medicationsRefer to your health plan's website for more details: Aetna: www.ih-aetna.com/fcps CareFirst: www.carefirst.com/fcps Kaiser: https://my.kp.org/fcps/

    Quit Now VirginiaPhone: 1-800-QUIT-NOWCall toll free 24/7 to receive free expert counseling from a trained Quit Coach, a personalized quit plan, and self-help materials.

    National Cancer InstitutePhone: 877-44U-QUIT or 877-448-7848Website: www.smokefree.gov Trained counselors provide information

    and support (Spanish speakers available) Available Mon. - Fri. 8 a.m. to 11:00 p.m.

    Continued Focus on Disease ManagementIn 2017, there will be an increased focus on disease management programs (DM) through all of the health plans. DM programs are designed to help people with certain chronic disease conditions better manage their health and decrease complications by coordinating the delivery of high quality care. DM programs do not replace your doctors care or advice. Since chronic disease condi-tions are one of the highest drivers of health care costs for FCPS, these programs can also help to save you and the plan money.

    Your insurance plan may identify you to par-ticipate in a DM program through a physician referral, medical claims or when you take your annual health assessment survey. If identified, a registered nurse or other health professional would contact you by phone or mail to engage in one-on-one support tele-phonically or to participate in online health coaching programs. They can help you monitor your condition, answer your ques-tions and provide personalized care. You will choose whether you want to access the program and/or how often you would like to be contacted. There is no cost to you for ac-cessing resources through the DM program.

    Participation in DM programs is confidential and is done strictly through your insurance plan. FCPS does not receive any identifiable health information in accordance with state and federal privacy laws.

    We hope you will take advantage of this opportunity to obtain these valuable health resources.

  • Office of Benefit Services Fairfax County Public Schools8

    Resources Available During Open EnrollmentMany factors impact the decision of which health plan is best for you. FCPS encourages you to utilize the available resources to aid you in making this important decision. These resources include the FCPS website along with vendor websites, member service centers, and on-site support from both FCPS and benefits vendors during Open Houses and on select dates at Gatehouse Administration Center.

    Open HousesWednesday, October 12 4:00 7:00 p.m.Hayfield Secondary School Cafeteria 7630 Telegraph Road, Alexandria

    Thursday, October 27 4:00 7:00 p.m.Chantilly High School Cafeteria4201 Stringfellow Road, Chantilly

    Monday, November 7 10:00 a.m. 5:00 p.m.Annandale High School Cafeteria 4700 Medford Drive, Annandale

    Open Houses will include: Flu shot clinics Benefit vendors and Benefits staff

    Vendor On-site Support at Gatehouse (Check in at 2nd floor reception)

    Aetna/Innovation Health CareFirst CVS Caremark

    Dates October 19 & November 2 October 19 & November 2 Each Thursday during Open EnrollmentOctober 13, 20. 27; November 3, 10

    Walk-in Hours Mornings: 9:30 a.m. - noon Mornings: 9:30 a.m. - noon Afternoons: 1 - 2:30 p.m. on Oct. 27 & Nov. 101 - 4 p.m. on Oct. 13, 20, Nov. 3

    Appointment Hours Afternoons: 1 - 4 p.m. Afternoons: 1 - 4 p.m. Mornings: 9 - 11:30 a.m.

    How to Schedule an Appointment

    Call 888-236-6249, or visit www.fcps-aetna-ih.genbook.com

    Call 202-680-5958 Email: [email protected]

    Extended HoursWednesday, November 9Thursday, November 10 4:30 p.m. 7:30 p.m.8115 Gatehouse Road, Falls Church Health vendors and Benefits staff

    assistance only No flu shots will be available

    FCPS ResourcesHR Client Services: 571-423-3000

    [email protected]

    Hours: Monday - Friday, 8 a.m. - 4:30 p.m.

    Website: https://www.fcps.edu, search keyword "Benefits".

  • Office of Benefit Services Fairfax County Public Schools 9

    Handy Resources at Your FingertipsCut out the card(s) below, fold it in half, and put it in your wallet or store these numbers to your mobile contacts. That way youll always have this important information nearby when you need it.

    Member Services: 800-296-0724 (Medical) 888-343-3462 (Davis Vision)

    Nurse Advice Line: 800-535-9700 (FirstHelp)Telemedicine: www.carefirstvideovisit.comWebsite: www.carefirst.com/fcps

    CVS Caremark (non-Medicare retirees):Customer Care: 888-217-4161Hours: 24 hours a day, 7 days a weekWebsite: www.info.caremark.com/fcps

    CareFirst

    Member Services: 301-468-6000 (D.C. metro area)1-800-777-7902 (outside D.C. area)

    Hours: 8 a.m. - 8 p.m., 7 days a weekMedical Advice Line: 1-800-777-7904 and press "0"Urgent Care Number: 703-359-7878 (D.C. metro area)

    1-800-777-7904 (outside D.C.)Website: http://my.kp.org/fcps/

    Member Services: 1-888-513-0008Hours: 8 a.m. - 8 p.m., 7 days a weekMedical Advice Line: 1-800-777-7904 and press "0"Urgent Care Number: 703-359-7878 (D.C. metro area)

    1-800-777-7904 (outside D.C.)Website: http://my.kp.org/fcps/

    Kaiser Permanente(non-Medicare retirees)

    Member Services: 888-236-6249 (Medical) 877-973-3238 (EyeMed Vision)

    Nurse Advice Line: 800-556-1555 (Informed Health)Telemedicine: 855-TELADOC (835-2362) (Teladoc)Website: www.ih-aetna.com/fcps

    CVS Caremark (non-Medicare retirees):Customer Care: 888-217-4161Hours: 24 hours a day, 7 days a weekWebsite: http://info.caremark.com/fcps

    SilverScript (Medicare retirees):Customer Care: 877-321-2597Hours: 24 hours a day, 7 days a weekWebsite: http://FairfaxPS.silverscript.com

    Aetna/Innovation Health

    Member Services: 877-238-6200Hours: 8 a.m. - 6:30 p.m., Monday - FridayWebsite: www.ih-aetna.com/fcps

    Aetna Dental (DPPO and DNO)

    Pharmacy Benefits

    Pharmacy Benefits

    Kaiser Permanente(Medicare retirees)

  • Office of Benefit Services Fairfax County Public Schools10

    Your Open Enrollment ChecklistBefore Open Enrollment:

    Review your pre-open enrollment statement to ensure your plan and covered dependent(s) information is correct.

    If you will be requesting coverage for your spouse and/or dependent children who are not currently enrolled, begin gathering legal documentation needed to add them to the plan.

    Are you eligible for Medicare? Review your statement to ensure you are enrolled in Medicare supplemental coverage with FCPS. Not only is this coverage required for retirees eligible for Medicare, your premiums are lower when Medicare is primary.

    During Open Enrollment: Review this Benefits Briefing carefully as you consider your plan choices. Take

    advantage of the many open enrollment resources available to you, including information on both the FCPS and benefit vendor websites, attend a Benefits Open House, or visit the Gatehouse Administration Center.

    Eligible retirees have a one-time opportunity to enroll in dental coverage if not currently enrolled. You must take action if you are not currently enrolled and wish to elect dental coverage.

    If you wish to change your plan or covered dependent(s), complete Form HR-461 and return to the Office of Benefit Services. The form can be obtained from:- www.fcps.edu, search keywords "retiree benefits forms"- Benefits Open Houses (see page 8 for complete schedule)- HR Client Services: 571-423-3000 or 800-831-4331

    You do not need to take action if you are not making any changes.

    After Open Enrollment: Aetna Innovation Health and CareFirst participants:

    - Look for new pharmacy identification cards in the mail by mid-December. - Ensure you provide copies of your cards to your local pharmacy in the new year. - Begin planning for transition to your pharmacy benefits. Make sure you have an

    appropriate supply of your medication to ensure a smooth transition.

    Retirees covering spouse/dependent children, please note FCPS must collect your spouse/dependent child(ren)'s SSN for reporting health plan enrollment to the IRS. If you are requesting coverage for your spouse and/or dependent children not currently

    enrolled, you must supply the appropriate legal documents to support eligibility for coverage under the plan. Go to www.fcps.edu and search dependent eligibility for a list of required documents.

    Your dependents coverage cannot be made effective until the Office of Benefit Services receives appropriate legal documentation.

  • Office of Benefit Services Fairfax County Public Schools 11

    Your Benefits and the Law

    Language Assistance Services

    ENGLISHATTENTION: If you speak English, language assistance services, free of charge, are available to you. Call 571-423-3200.

    AMHARIC () : , , , . 571-423-3200 .

    ARABIC ().3200-423-571: .

    BENGALI ()

    : , , , . 571-423-3200 .

    CHINESE ()571-423-3200

    FRENCH (Franais)ATTENTION : Si vous parlez franais , les services d'assistance de langues, gratuitement , sont votre disposition. Appelez 571-423-3200 .

    GERMAN (Deutsch)ACHTUNG: Wenn Sie Deutsch sprechen , Sprachassistenzdienste sind kostenlos, zur Verfgung. Rufen Sie 571-423-3200 .

    HINDI ()

    : , , : , 571-423-3200

    IBO (Igbo asusu)Nt : br na na-ekwu okwu n'ala Igbo , ass aka r , n'efu , d ka g. Akp 571-423-3200 .

    KOREAN () :,. 571-423-3200.

    KRU (s-w-po-ny)D n k dy gbo: j k m s-w-po-ny j n, n, wuu k k po-po n m gbo kpa. 571-423-3200.

    PERSIAN FARSI ().3200-423-571: .

    RUSSIAN () : , , , . 571-423-3200 .

    SPANISH (Espaol)ATENCIN : Si usted habla espaol, servicios de asistencia lingstica, de forma gratuita, estn disponibles para usted. Llame a 571-423-3200.

    TAGALOG (Tagalog)PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa 571-423-3200.

    URDU () .3200-423-571: .

    VIETNAMESE (Ting Vit)Ch : Nu bn ni ting Vit , cc dch v h tr ngn ng , min ph, c sn cho bn . Gi 571-423-3200 .

    YORUBA (d Yorb)AKIYESI: Bi o ba ns d Yorb f ni iranlw lori d wa fun yin o. pe r-ibanisr yi 571-423-3200.

    FCPS health plans comply with applicable Federal civil rights laws, including Section 1557 of the Affordable Care Act (Nondiscrimination in Health Programs and Activities). In compliance with the Act, FCPS health plans do not exclude people or treat them differently because of race, color, national origin, age, disability, or sex. FCPS health plans also prohibit denial of health care or health coverage based on an individuals sex, including discrimination based on pregnancy, gender identity, and sex stereotyping.The Plan also provides important protections for individuals with disabilities and enhances language assistance for people with limited English proficiency. Each tagline listed below reads, "If you speak [native language], language assistance services, free of charge, are available to you. Call 571-423-3200."

  • Open Enrollment: October 11- November 11Read inside for information on changes for 2017, and review what you need to do for the future.

    CVS Caremark as pharmacy benefit manager;

    New programs to stay healthy; and,

    2017 medical and dental premiums

    Visit www.fcps.edu and search Open Enrollment for more details.

    Department of Human ResourcesOffice of Benefit ServicesGatehouse Administration Center, Suite 27008115 Gatehouse Road, Falls Church, Virginia, 22042-1203