Coatesville Area School District

Question: Am I eligible for insurance?

Answer: Eligibility for insurance is determined by the Collective Bargaining Contract or Employee Group Agreement for each employee group. Please ask the Benefits Specialist whether you specifically are eligible for insurance.

Question: What kinds of insurance does the district offer?

Answer: CASD offers medical, hospitalization, dental, vision and prescription insurance coverage in addition to Workers’ Compensation for on-the-job injuries and illnesses. The district provides life and disability insurance to all full-time employees at no cost to the employee.

Question: Who is our insurance carrier?

Answer: The district’s medical insurance is provided by Independence Blue Cross, vision insurance is through Davis Vision, dental insurance is through United Concordia, prescription drug coverage is through IBX Rx and specialty prescription drugs are provided by Future Scripts.

Question: When does my insurance begin?

Answer: The starting date for your insurance is determined by your Collective Bargaining Contract or Employee Group Agreement. For members of Teamsters, there is a 60-day waiting period. For members of the Federation, coverage begins on the 1st day of the month after the hiring date. For all other eligible employees (such as teachers), coverage begins on the first day of employment.

Question: How much does the insurance cost?

Answer: The district pays most of the cost of the insurance. Employees are asked to pay a small portion of the cost of insurance. This employee contribution varies with each Collective Bargaining Group (union contract) or Employee Group Agreement and varies from year to year. You should speak to the Benefits Specialist to find your specific costs.

Question: Does the health insurance cover my family?

Answer: Eligible Dependents: If you are enrolling in the Coatesville Area School District’s health benefits, you may cover your eligible dependents (proof of eligibility will be required). Spousal coverage may be restricted based on the conditions outlined in the Collective Bargaining Group or Employee Agreement. Please refer to your contract/bargaining agreement. Eligible dependents for the Medical and Prescription Plan are defined as: - Legal spouse (as recognized under both applicable state law and the Internal Revenue Code). - Dependent children who are your natural, adopted children, children legally placed with you for adoption, a child for whom legal guardianship has been awarded to you or your spouse, and stepchildren who are in each case, under age 26. Eligible dependents for the Dental and Vision plans are defined as: -Legal spouse (as recognized under both applicable state law and the Internal Revenue Code). - Dependent children as defined above, up to age 19, or up to age 23 if unmarried, a full-time student and dependent on you for principal support. For dependents aged 19 to 23, you must complete a student verification form for the CASD’s Human Resources Department each year to continue coverage. The Dental provider United Concordia also confirms student status annually. A disabled child aged 26 or older may continue to be eligible if s/he is incapable of self-support because of any mental or physical condition. The child must be unmarried and dependent on you for principal support. An Application for Handicapped Status must be approved by the insurance carrier.

Question: Do I have the district’s insurance?

Answer: If you are a full-time employee, you must either elect the CASD coverage or provide proof that you have current coverage from another source.

Question: Is there a “network"?

Answer: Yes, for medical and hospitalization, we use the Blue Cross/Blue Shield network of health care providers. There is also an optional network of dental providers through United Concordia at www.UCCI.com and an optional network through Davis Vision at www.davisvision.com.

Question: How do I know if my doctor/hospital is in the network?

Answer: You can check two ways. You can check on online at www.myibxtpa.com and click “find network hospitals and doctors” under the Online Services section. You may want to also call your doctor or hospital to confirm that they are participating in the Blue Cross/Blue Shield network. For out- of network medical and hospitalization claims, you must first pay the out-of network deductible. After the out-of-network deductible is met, the plan will pay a percentage of the usual, customary and reasonable charges. You will be billed for the difference between the plan’s allowance and the actual charge of the provider.

Question: What happens if I don’t use the network dental or vision provider?

Answer: There is no penalty to you for not using the dental and/or vision provider network, however you will not get network discounts. Using a network provider will reduce your costs, therefore allowing you to receive more services before meeting your annual program maximum.

Question: How much are the co-pays for doctor visits and pharmacy?

Answer: Co-pays are determined by the current Collective Bargaining Agreement for each employee group. You should speak to the Benefits Specialist or refer to your union contract or employee agreement for your specific co-pays. There is also a mail order option for a 3-month supply; the cost is less than buying medication monthly.

Question: When can I make changes to my insurance?

Answer: You may make changes within 30 days of a “Qualifying Event.” These “Qualifying Events” are listed by the federal government as birth, death, marriage, divorce, birth or adoption of a child, substantial change in insurance coverage of spouse, termination of spouse’s employment, court ordered addition, change from full time to part time, dependent ceases to be an eligible dependent, unpaid leave of absence, termination of employment and COBRA. You may also make changes during open enrollment for your employee group each year.

Question: How do I make changes to my insurance?

Answer: You need to complete a new health insurance application that indicates the changes you wish to make.

Question: If I resign, how long will my insurance remain in effect?

Answer: Typically, you are covered until the end of the month in which you resign. If the academic-calendar employee resigns on the last day of school or thereafter, coverage continues until the last day in August after the school year ends. For all other employees, coverage runs through the end of the month. You will be offered the option to continue your coverage under the COBRA Provision.

Question: If I have a problem with my insurance, who do I contact?

Answer: If your question is related to medical, prescription drug and or vision coverage, you or your provider can call Independence Blue Cross’ Customer Service at 1-800-275-2583.

If your question is related to a “Specialty Prescription,” you should contact Future Scripts at 1-855-427-4682 from 8:30 a.m. to 5:00 p.m. Monday through Friday.

If your question is related to dental care, you should contact United Concordia’s Customer Service Monday through Friday, 8 a.m. to 8 p.m. ET at 1-800-322-0366.

The Reschini Group’s Customer Service Team can also assist you with medical, prescription drug, dental and vision claim issues at 800-442-8047.

Question: If I have a problem with my Health Savings or Health Reimbursement Account, who do I contact?

Answer: Contact Health Equity’s customer service at 866-346-5800 or go online at HealthEquity.com. You may also call Human Resources at 610-466-2400 after you have contacted the above providers.