Frequently Asked Questions (FAQs)
1.
When do I need to enroll and how will I know if my enrollment
has been accepted?
2.
How much will I have to pay for health care coverage?
3.
If I have other medical coverage available and choose the
Opt-out credit to get the additional monthly pay (by declining
medical coverage through SLPS), will any of my other benefits
and pension calculation be affected?
4.
Will the monthly opt-out payment be subject to taxes?
5.
Will I be able to qualify for medical coverage if I have
a pre-existing condition?
6.
How can I arrange to see a specialist?
7.
I'm on a prescription drug for an ongoing medical condition.
How do I find out if my drug is covered by PharmaCare and
what my co-pay will be?
8.
There are no co-pays listed for Dental coverage. How do I
find this information?
9.
What type of dental plans are available?
10.
Do I need an ID card to access Dental care?
11.How
do I access Vision services?
12.
How can I arrange to receive a provider directory in the
mail (for Medical, Dental or Vision services)?
13.
What if I need additional information?
1. When do I need to enroll and how
will I know if my enrollment has been accepted?
All employees will receive an enrollment guide and a personalized
worksheet in the mail. You will then be able to go online from
any computer with internet access and enroll on this site.
You can also get immediate help by dialing the SLPS "Benefits
Call Center" Customer Service line at 1-866-345-SLPS
(7577) from 7AM to 7PM CST. Following your enrollment, you
will receive a confirmation statement at your home address.
You will not receive an ID card for dental or vision benefits
- you do not need an ID card to access coverage. Please ensure
that your home address is correct when you enroll so that you
will receive your confirmation statement without any delay.
Top
2. How much will I have to pay for medical coverage?
The District will continue to pay the entire cost of employee
coverage for eligible employees. Employees who have medical
coverage elsewhere and do not wish to be covered by the District’s
plan will be able to “opt-out” of (waive) the District’s
medical coverage and receive a monthly credit. A credit of
$50 per month will be paid to 12-month employees; 10-month
employees receive a $60 monthly credit. This amount will be
included in the last paycheck of each month, as taxable wages.
New employees will be permitted to “opt-out” during
enrollment.
Click here to view Cost of Coverage chart.
Top
3. If I have other medical coverage available and choose
the Opt-out credit to get the additional monthly pay (by declining medical
coverage through SLPS), will any of my other benefits and pension calculation
be affected?
Generally, no. But keep in mind that Pension eligible compensation
includes regular wages plus SLPS' contributions towards medical,
dental and vision benefits. In this case, the value of the
Opt-out credit will be counted as compensation rather than
the value of employee-only medical benefits. The Retirement
System uses the "average final compensation," determined
by the highest average annual compensation for any three consecutive-year
period during the last 10 years of service. You should carefully
consider your situation before making this election.
Remember, the opt-out is for this enrollment only. Reenrolling
in medical coverage will be permitted at the next enrollment
or during the plan year, if you have a qualifying life event.
Top
4. Will the monthly opt-out payment be subject to taxes?
Yes, IRS rules require that this payment be treated as normal
income and thus will be taxed at your normal income tax rate.
Top
5. Will I be able to qualify for medical coverage if
I have a pre-existing condition?
If you are eligible for the District’s medical coverage,
pre-existing condition requirements are waived if you enroll
during the open enrollment period.
Top
6. How can I arrange to see a specialist?
To visit a specialist - you do not need a referral. Each time
you need medical care, you decide the level of benefits by
choosing in - or out of - network provider. If you want in-network
benefits, be sure to confirm that you provider is part of the
UnitedHealthcare network before you receive care, If your provider
is not part of the network, ask if he or she would be willing
to join.
Top
7. I'm on a prescription drug for an ongoing medical
condition. How do I find out if my drug is covered by Pharmacare and what my
copay will be?
You can access PharmaCare’s website at www.PharmaCare.com
or by contacting PharmaCare Customer Service at 1-800-952-4073.
Top
8. There are no co-pays listed for Dental coverage.
How do I find this information?
You can find this information in several ways:
For St. Louis Dental Services (Pre-Paid Dental), you may visit
www.densource.com. When you enter the site, click on "Public
Schools" in the upper right corner. Then click on "St.
Louis Public School Employees." This will take you to
an online provider directory and a plan design document that
lists your costs for a variety of services. If you have questions
or don't have access to a computer, you may call 1-800-369-3485.
For Guardian Dental Insurance (PPO), you may visit www.glic.com
for plan information. If you have questions or don't have access
to a computer, you may call 1-800-541-7846.
Top
9. What type of dental plans are available?
You have access to two types of plans. St. Louis Dental Services
is Pre-Paid Dental - which is like a dental HMO. You must choose
a Primary Care Dentist when you enroll. Guardian Dental Insurance
is an Preferred Provider Organization (PPO) plan. You may see
any provider you choose, but you save money when you visit
network providers.
Top
10. Do I need an ID card to access Dental care?
No. You do not need an ID card. Simply confirm that your provider
is part of the appropriate network when scheduling your appointment.
Top
11. How do I access Vision services?
Before making an eye appointment, you should either call VBA's
Customer Service Department at 1-800-432-4966 or visit www.visionbenefits.com.
VBA will determine if you are eligible for the benefit at that
time. If so, a validated VBA benefit form and a current list
of Participating Providers will be sent to your home, generally
within a week. Select a provider from the list and make an
appointment. Remember in order to take full advantage of the
benefits available, you must present the validated VBA benefit
form to the VBA provider on your first visit. Failure to do
so will result in higher charges.
Top
12. How can I arrange to receive a provider directory
in the mail (for Medical, Dental or Vision services)?
You may call the customer service number (provided on the Contacts
page) for any of the plans to receive a provider directory. You
can always access providers quickly by visiting each plan's
web site (also provided on the Contacts page).
Top
13. What if I need additional information?
You can view the 2007 Enrollment Guide online or call the SLPS
Benefits Call Center Customer Service line at 1-866-345-SLPS(7577).
This guide will provide additional information needed to enroll
in your 2006 benefits.
Top |
