Staff Benefits

Medical Insurance - Anthem Blue Access PPO HSA

Worthington Schools offer a High Deductible Health Care Plan with Anthem.  Anthem will send new identification cards to employees newly enrolled in the plan via mail within 7-10 business days of January 1, 2024.  It should be noted that ID cards will come in plain white envelopes and will only contain up to 4 cards per envelope.  If you have a larger family, your ID cards will arrive in two separate envelopes.  If your ID cards are not received by January 1, 2024, and you need to see a doctor or pick up a prescription, you can email Beth Hohenstein to obtain a temporary ID card.  

Once you receive your ID card, new enrollees should consider downloading the Anthem Sydney app or create an account on the Anthem website to be able to track deductible amounts met, find network physicians, compare costs of services, view Explanations of Benefits, utilize virtual care options, and find important information on other available programs, services and discounts.  

After your deductible is met, the only item that would apply to the Out of Pocket Maximum is the $250 emergency room copayment per ER visit, which is waived if you are admitted.  The out of pocket maximum is $2500 for single and $5000 for family for emergency room visit purposes.

The monthly premium for health care coverage is split into two equal deductions withheld on the first and second pay of each month.

2024 Medical Insurance Premiums:

• Certified Staff & Administrators
• Classified Staff & Other Administrators

Annual Network Deductibles:                                   

• Single Deductible: $1,750
• Family Deductible: $3,500

Annual Out-of-Network Deductibles:

• Single Deductible: $3,500
• Family Deductible: $7,000

The Certificate of Coverage is a description of benefits and coverage under the plan and provides more in-depth detail about covered services and exclusions. 

High Deductible Health Plans provide the opportunity for you to open a Health Savings Account to help you to save to pay for eligible medical, dental, vision and prescription drug expenses if you meet eligibility requirements.  The Board of Education provides a flat dollar amount of funding to an HSA opened by you through CME Federal Credit Union.  See additional information under Health Savings Accounts.    

Dependent Eligibility:  Dependent children can be covered under the plan up to age 26 regardless of financial dependence, student status, residence or marital status.  Dependents are automatically dropped from health insurance coverage at the end of the month in which the dependent turns 26.

New enrollees in the Medical Plan are required to send the following documentation to enroll a spouse and dependents: 

• Birth Certificates (Children) 
• Marriage Certificate (Spouse) 

Please send to WEC, Attn:  Beth Hohenstein before December 31, 2023 

Searching the Provider Network

If you are not currently enrolled in the district's medical coverage through Anthem, but are considering it, you can search Anthem's network as a guest. You can search as a guest on Anthem.com using the Blue Access PPO network until your coverage begins on January 1, 2024.  If you wish to search for network providers you and/or your dependents can use for out of state care, please be sure to search the National PPO (Blue Card PPO) network. 

Once benefits become effective, you will be able to easily search for network providers by creating a user account on the Anthem website or downloading the Sydney Health App.

If you are traveling out of the country or have an insured dependent traveling abroad, please contact Beth Hohenstein for more details on international coverage.  

Prescription Drug Information

The formulary for prescription drugs can be viewed through your online Anthem account OR on the Anthem Sydney app.  In the meantime, click here for a searchable formulary to determine which tier of coverage your medication falls in and if a prior authorization is needed.  If your prior authorization has expired or if you have been newly prescribed a medication requiring prior authorization, your physician will need to provide the required information to Anthem before your prescription can be obtained.  

While members are welcome to use Anthem's mail order pharmacy, Carelon, for prescription services, it is not required.  Maintenance medications can be obtained at a network retail pharmacy as long as the prescription is written for a 90-day supply.  In addition, we are pleased to announce that many preventive medications for conditions such as asthma, diabetes, heart issues, cholesterol, and osteoporosis may be obtained at no cost.  Click here for a complete listing of those preventive medications. Please note that formularies do change throughout the year to comply with the Food & Drug Administration recommendations.  

Health Savings Accounts - CME Federal Credit Union

High Deductible Health Plans are coupled with the opportunity to open a Health Savings Account (HSA) to help you to save to pay for eligible medical, dental, vision and prescription drug expenses.  For more information on HSA rules and eligibility requirements, please see the 2024 Benefit Summary booklet.  The Board of Education provides a flat dollar amount of funding to an HSA opened by you through CME Federal Credit Union.  You can apply for your HSA online by following these step-by-step instructions. 

Eligible CLASSIFIED employees AND OTHER ADMINISTRATORS enrolled in a single medical plan will receive $250 in January in their HSA, while those enrolled in the family medical plan will receive $500. Those employees have the opportunity to earn an additional $250 and $500, respectively, by completing specific wellness activities. Any Board HSA funds earned through completing wellness activities in 2023 will be deposited in February 2024. Employees can see wellness points accumulated on Anthem.com or on the Anthem Sydney app by clicking on "My Health Dashboard", and then "My Rewards".   

Classified employees and Other Administrators hired mid-calendar year who elect to enroll in the district medical plan, are eligible for HSA and choose to open an HSA, will receive a prorated portion of the Board HSA "enrollment" contribution for the number of months enrolled in the plan during that calendar year.  It is also possible for a mid-year hire to receive the Board HSA "wellness" contribution by submitting documentation to Beth Hohenstein of wellness activities you may have completed under a prior employer for the prior calendar year.  

Eligible CERTIFIED employees and ADMINISTRATORS enrolled in a single medical plan will receive $200 in January in their HSA, while those enrolled in the family medical plan will receive $400. Those employees have the opportunity to earn an additional $200 and $400, respectively, by completing specific wellness activities. Any Board HSA funds earned through completing wellness activities in 2023 will be deposited in February 2024. Employees see wellness points accumulated on Anthem.com or on the Anthem Sydney app by clicking on "My Health Dashboard", then "My Rewards".

Certified employees hired mid-calendar year who elect to enroll in the district medical plan, are eligible for an HSA and choose to open an HSA, are eligible for a new hire Board HSA contribution of $1,000 for those enrolled in the single plan and $2,000 for those enrolled in the family plan.

Administrators should refer to their Compensation & Fringe Benefit package document for details on Board HSA contribution amounts when hired mid-calendar year.  

Employees have the option to deposit pre-tax dollars into a Health Savings Account as long as the total amount contributed by the employee and the Board of Education does not exceed the contribution limit set forth by the IRS (see below).  Employees can choose to have their personal HSA contributions deducted over 2, 12 or 24 pay periods.  This option is available to you when completing your online enrollment during open enrollment. 

2024 HSA Contribution Limits:

• Single Plan = $4,150
• Family Plan = $8,300
• Additional catch-up contribution (age 55 or older) = $1,000

*Please note, these are annual limits.  If you are joining or leaving the plan mid-year, these limits should be prorated by the number of months you were enrolled in the medical plan. The negotiated agreement also requires employees leaving the plan prior to the end of the calendar year to pay back a prorated portion of the Board HSA contribution granted in January. It is also the employee's responsibility to ensure he or she does not overcontribute to their HSA

Dental Insurance - Delta Dental (PPO)

Worthington City Schools offers a comprehensive dental plan administered by Delta Dental of Ohio.  See Benefit Summary for details of the plan. If enrolling for the first time, Delta Dental will mail your ID card prior to January 1, 2024.  Your ID card can also be obtained online by creating an account on Delta Dental's website. 

2024 Dental Insurance Premiums: 

• Certified Staff
• Classified Staff & Other Administrators

The monthly premium for dental is withheld on the second pay of each month. 

Dependent eligibility: Unmarried dependent children may be covered up to age 26 regardless of financial dependence, student status, or residence.  Dependents are automatically dropped from dental insurance coverage at the end of the month in which the dependent turns 26.

Worthington City Schools offers vision benefits administered by EyeMed. 

See Benefits Summary for details of the plan. If enrolling for the first time, EyeMed will mail your ID card prior to January 1, 2024.  Your ID card can also be obtained online by creating an account on EyeMed's website. To search for a network provider, search the Insight network at eyemed.com.  EyeMed also offers a hearing aid discount benefit.  Click here for FAQ's related to our vision coverage.  

 2024 Vision Insurance Premiums: 

• Certified Staff Members - Board pays 100% of premium
• Classified Staff

The monthly premium for vision is withheld on the second pay of each month. 

Dependent eligibility: Unmarried dependent children may be covered up to age 26 regardless of financial dependence, student status, or residence.  Dependents are automatically dropped from vision insurance coverage at the end of the month in which the dependent turns 26.

Note: Also, if you are enrolled in the health insurance plan, Anthem covers one eye exam if using an Anthem network provider. 

Life Insurance - MetLife

Worthington City Schools provides employees with a district paid basic term Life and Accidental Death & Dismemberment Insurance policy.  The amount provided depends upon the employee job class as outlined below.  

• Certified: $70,000  
• Classified: $50,000
• Classified PT: $20,000 
• Administrators and Other Administrators: $150,000  

Supplemental Life Insurance - MetLife (Optional)

As an employee, you may elect Supplemental Term Life Insurance up to $100,000.  The cost of the coverage is based on your current age and rates as listed in the above Life Insurance Details. 

Note:  During the current open enrollment period ONLY (October 2023), MetLife is offering a supplemental term life policy up to $100,000 in coverage without providing evidence of insurability to actively working employees, who are not currently enrolled in the plan, or those who are currently enrolled in the plan for less than $100,000. This is a term policy that will end upon resignation or retirement.  Premium is based on age and amount elected.   

Employee Assistance Program (EAP) - Matrix

Worthington City Schools provides employees with an Employee Assistance Program administered by Matrix.  This program provides you with services to help with everyday life challenges that may affect your health and family life.  The EAP may be used to address a broad range of issues including marriage, relationship and family problems, problems at work, legal, elder care and financial issues, stress and anxiety, alcohol and drug dependency, and much more.  This includes up to 8 counseling sessions per family member per event per year at no cost to the employee.  See the Matrix Benefit Summary for details.  Contract Matrix directly at 800.886.1171 to take advantage of this program.  For additional information, go to www.matrixpsych.com.

Voluntary Benefits - American Fidelity

Voluntary benefits such as Accident, Disability, Cancer, Critical Illness, Hospital Indemnity and Life insurance are offered through American Fidelity.  These options allow you to strengthen your overall benefits package and are designed to provide additional cash flow to assist with your out of pocket medical costs and bills.  Employees can enroll in these plans during open enrollment.  Any questions should be directed to Mike Moore at American Fidelity at 877-518-2337 x2731 or their member service center at 800-325-0654.  Employees may also email Mike directly at Mike.Moore@AmericanFidelity.com.

Resigning or retiring employees should contact the American Fidelity Policy Continuation Team at 800-943-2231 to continue those policies once employment is severed.  If you currently hold a Texas Life insurance policy and wish to continue that policy after resignation or retirement, please contact them directly at 800-283-9233.  

Creditable Prescription Coverage

HHS Notice of Privacy Practice - Health

Marketplace Coverage Notice

Newborns Health Protection Act Disclosure

No Surprise Medical Billing Rights

The link below leads to the machine readable files that are made available in response to the federal Transparency in Coverage Rule and includes negotiated service rates and out-of-network allowed amounts between health plans and healthcare providers. The machine-readable files are formatted to allow researchers, regulators, and application developers to more easily access and analyze data.

https://www.anthem.com/machine-readable-file/search

Special Enrollment Notice

State Premium Assistance Notice

Summary of Benefits and Coverage

Wellness Program Notice

Women's Rights under HealthCare Reform