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2009-2010 Health & Dental Insurance Information 
 

For 2009-2010, we have three health care plan options: Kaiser HMO, Great-West Basic Plan, and Great-West Standard Plan. None of the plans have an employee contribution for employee only coverage.

There are some adjustments to the Great-West Plans this year. For example, generic prescriptions will be $5 (decreased from $10) for a 30 day supply. There is no longer a limited vision benefit on the Great-West Standard Plan; in its place the district is offering a voluntary vision plan through VSP. Lab, x-ray, and high tech radiology will be covered at 80% after deductible on the Standard Plan; preventative lab and x-ray will be covered at 100%.

Please feel free to email or phone Susana Aguirre at 720-561-5022, Bob Jamieson at 720-561-5188, or Beth Collins at 720-561-5936 if you have specific questions.  Employees working at least a .5 FTE position are eligible for benefits.  If you do not know whether or not you are eligible for benefits, please contact one of us. 

 GREAT-WEST PHARMACY TRANSITION

To all Great-West Members,

As many of you know, Great-West Healthcare was purchased by CIGNA more than a year ago. BVSD’s health plan is still covered through Great-West (now a part of CIGNA) and is still primarily self-funded by the district. As part of the transition to CIGNA, CIGNA is moving Great-West members’ pharmacy benefit management to CIGNA on November 1, 2009. BVSD conducted a review of CIGNA’s pharmacy benefit and determined that it is better and less disruptive for our members if we stay with our current pharmacy benefit manager, Express Scripts, Inc. (ESI).

ESI has been BVSD’s pharmacy benefit manager (PBM) since we started with Great-West in 2007. This year, the district was able to lower the co-pay to members for generic prescriptions to $5. By staying with ESI we are able keep the same large network of pharmacies and also join a PBM coalition of other public sector organizations with more than 40,000 members. Staying with ESI and joining the coalition helps the district better manage our plan for the benefit of our members. For example, beginning November 1, we are able to lower the preferred brand name drug co-pay to $25 (from $30). We are focused on providing continuity in our benefits and are committed to a smooth transition from ESI through Great-West to ESI directly through the coalition. Beginning November 1, the co-pays for a 30 day supply will be:  $5 for generic; $25 for preferred brand name; $50 for non-preferred brand name.

There will be small changes in the formulary list of preferred and non-preferred drugs. For BVSD, less than 5% of prescriptions are affected. The formulary is reviewed on a periodic basis by all PBM’s as new generic drugs are approved and other drugs are introduced. The link to ESI’s formulary is below. Members with affected prescriptions will receive a letter directly from ESI in a couple of weeks.

We were able to work with Great-West to have the new ESI information added to our Great-West ID cards. Great-West members will receive a new card at the end of October which will replace the current Great-West card beginning November 1. The new card will have the same ID number as your current card along with a new RxGRP code that the pharmacies use to verify coverage. Remember to start using this new card beginning November 1, 2009.

Please contact Bob Jamieson at 720-561-5188 or bob.jamieson@bvsd.org, Susana Aguirre at 720-561-5022 or susana.aguirre@bvsd.org or Beth Collins at 720-561-5936 or beth.collins@bvsd.org if you have any questions. Or, beginning October 26, you can contact ESI customer service at 1-877-531-4918.

Here is link to locate a pharmacy:
 
 

 

 Benefit Related Links

 Great-West (Group 359644)

Great-West offers programs to help you take control of your health.  Our targeted Disease Management Program provides information and support to help you manage certain conditions or simply live a healthier lifestyle.

Disease Management Program
If you or a family member has any of the following:  asthma, chronic obstructive pulmonary disease (COPD), congestive heart failure (CHF), coronary artery disease (CAD), diabetes, oncology, high-risk maternity, neonatology, end-stage renal disease and pain management, you can sign up to receive free information and support materials specific to your condition.  Please contact Member Services at 1-800-663-8081.
 
Program Details:
Direct access to a nurse 24 hours a day, 7 days a week via phone/email
Nurses who specialize in chronic conditions and work in conjunction with your doctor
Customized information to help you effectively manage your condition
Personalized care plans with specific goals and health improvement actions plans
Questions and guidelines to use when meeting with your doctor

Great-West Benefit Summary 2009-2010

Great-West Plan Document 2009

Urgent Care Facilities

Great-West Mail Order Form

 Great-West Medical Claim Form

 Open Access Network Directory

Member Services  1-800-663-8081

To visit the Great-West Web Site, click here.

 Kaiser Permanente (Group 11000)

Kaiser Benefit Summary 2009-2010

Kaiser Plan Document 2009

Kaiser Out-of-Area Student Info

 Kaiser Out-of-Area Student Form

 Walk-In Mammography Services

  Kaiser Flu Shot Clinic 2009

Customer Service  303-338-3800

Appointments & Medical Advice   303-338-4545

To visit the Kaiser Web Site, click here

 

 

 Delta Dental (Group 1996)

Delta Dental Summary 2009-2010

 PPO Directory

Maximize Your Benefits

 Make Good Use of Your PPO Network

 Dental Claim Form  (mail claims to:  Delta Dental CO, PO Box 173803, Denver, CO 80217)

Customer Service  303-741-9305

To visit Delta Dental of Colorado, click here