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2021 NORTH EAST ISD - BENEFITS REVIEWOpen Enrollment - October 5-26, 2020

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2021 NORTH EAST ISD - BENEFITS REVIEWOpen Enrollment - October 5-26, 2020

GREAT NEWS! No rate changes for 2021

WHAT’S NEW?

- Livongo – Diabetes & Hypertension

- Low and High PPO Plans

- Deductibles and Out-of-Pocket Maximums Increased

- Airrosti – Added Copay - $35

- https://vimeo.com/airrosti/review/382192797/970c8000b8

- Healthy Living Rewards

- Member Rewards

- NEISD will continue the HDHP/HSA District annual contribution

▪ $500 (Employee only medical coverage)

▪ $1,000 (Employee + child/spouse/family)

NO CHANGES TO:

Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association

2021 Benefits Review

NORTH EAST ISD

Benefit

In-Network Comparisons

PPO – Low PPO – High BlueEdgeSM

/HSA

Preventive Services 100% 100% 100%

Wellness Exams 100% 100% 100%

MD Live/Telemedicine $15 $15 100% After deductible

Retail Health Clinic $25 $25 100% After deductible

PCP Office Visit $25 $25 100% After deductible

Specialist & AirrostiOffice Visit $35 $35 100% After deductible

Urgent Care Clinic $45 $45 100% After deductible

Your 2021 North East ISD Benefits

Comparing Office Visit Copays Only

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*After deductible

**After $100 inpatient Copay and Deductible

2021 North East ISD Benefits Comparison

Benefit

High PPO Plan Low PPO Plan

In-NetworkOut-of-

NetworkIn-Network

Out-of-

Network

Individual Deductible $1,500 $3,000 $2,000 $4,000

Family Deductible $4,500 $9,000 $6,000 $12,000

Employer HCA/HSA Contribution N/A N/A

Individual Out-of-Pocket Max $4,000 $8,000 $6,500 $13,000

Family Out-of-Pocket Max $11,250 $22,500 $15,000 $30,000

Office Visit

PCP/Specialist & Airrosti/Urgent Care$25/$35/$45 70%* $25/$35/$45 60%*

Preventive Care 100% 70%* 100% 60%*

Inpatient Admission 90%** 70%** 80%** 60%**

Emergency Room 90%* 80%*

All Other Covered Services 90%* 70%* 80%* 60%*

MDLive – Medical & Behavioral Health $15 N/A $15 N/A

No RX Benefit Changes.

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*After deductible

**Preventive Drug List applies

Your 2021 North East ISD Benefits

Benefit

BlueEdgeSM

High Deductible Health Plan

In-Network Out-of-Network

Individual Deductible $2,800 $5,200

Family Deductible $8,400 $15,600

Individual Out-of-Pocket Max $2,800 $5,200

Family Out-of-Pocket Max $8,400 $15,600

Office Visit 100%* 60%*

Preventive Care 100% 60%*

Inpatient Admission 100%* 60%*

Emergency Room 100%*

All Other Covered Services 100%* 60%*

Retail Rx – Generic/Preferred/Non-Preferred Ded/Coins** N/A

Mail Order Rx – Generic/Preferred/Non-Preferred Ded/Coins** N/A

HEALTHY LIVING REWARDS

Healthy Activity* Who is Eligible Award Amount

Health Assessment Employee Only $25.00 premium credit

Diabetes Management Program

Employee and/or Spouse/Dependent

$50.00 gift card

Weight Management Program

Employee and/or Spouse/Dependents

$25.00 gift card

Women’s and Family

Health –formerly

Special Beginnings®

Employee and/or Spouse/Dependent

• Enroll in 1st

trimester - $100 gift

card

• Enroll in 2nd

trimester - $75 gift card

- No Changes

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Hospitals may all look the same, but there are often differences

in the quality of care you receive depending on the facility you choose.

The choices you make matter when it comes to your health care.

Blue Distinction® Specialty Care Program

Hospitals and medical facilities with superior expertise in delivering

higher-quality health care in at least one of the following specialties:

Knee and HipReplacement

Spine Surgery

Cardiac Care

Bariatric Surgery

TransplantsMaternity Care

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Blue Distinction® Centers and Blue Distinction® Centers+ have a proven history of delivering exceptional care and results.

With two levels of recognition, you and your doctor can choose the option that best meets your needs.

Two Distinct Recognitions

Blue Distinction CentersDemonstrate quality care, treatment expertise and better overall patient results

Blue Distinction Centers+Demonstrate more affordable care in addition to quality care, treatment expertise and better overall patient results

National access across the top 100 metropolitan areas

Livongo is an independent company that provides chronic condition management for Blue Cross and Blue Shield of Texas. Livongo is solely responsible for the products and services that it provides.

Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association

LIVONGO®

Expanded Condition Coaching Servicesfor Diabetes and Hypertension

748207.0519

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Not available with HMO networks

Diabetes Management

and Hypertension

Management Solutions

Livongo®

Livongo is an independent company that provides chronic condition management solutions for Blue Cross and Blue Shield of Texas. Livongo is solely responsible for the products and services that it provides.

• Welcome kit with smart glucose meter or connected blood

pressure cuff

• Digital and live coaching through meter, phone and the

Livongo mobile app

• Services covered as preventive with no out-of-pocket costs

If you are eligible, Livongo will contact you

about how to sign up for this program.

14Livongo is an independent company that provides chronic condition management for Blue Cross and Blue Shield of Texas.

Livongo is solely responsible for the products and services that it provides.

LIVONGO®

Diabetes Management Features

• Real-time personalized

messaging on the Livongo

connected blood glucose meter

• Certified diabetes educators

available 24/7/365

• Instant interventions when

blood glucose readings are out

of range

• Optional notifications for high

and low readings to give loved

ones and providers insight

• Test strips and lancets at

no extra cost, delivered right

to the member’s door

• Member-initiated reports (with

blood glucose readings and

trends) enable more focused

conversations with a clinician

• Business reports on enrollment,

activation and clinical outcomes

15Livongo is an independent company that provides chronic condition management for Blue Cross and Blue Shield of Texas.

Livongo is solely responsible for the products and services that it provides.

LIVONGO®

Hypertension Management Features

• Easy remote monitoring via

wireless-connected blood

pressure cuff

• Licensed professionals provide

live coaching and 24/7 digital

alerts

• Notifications for high blood

pressure readings and

reminders to check blood

pressure

• Intuitive mobile experience to

track progress and receive

personalized, clinically-

grounded coaching and

educational content

• Member-initiated reports (with

blood pressure readings and

trends) enable more focused

conversations with a clinician

• Business reports on enrollment,

activation and clinical outcomes

Brought to you by North East ISD Benefit Plan

VALUABLE MEMBER RESOURCES

17Screen images are for illustrative purposes only.

Blue365 is a discount program only for BCBSTX members. This is NOT insurance. Some of the services offered through this program may be

covered under your health plan. Employees should check their benefit booklet or call the Customer Service number on the back of their ID card for

specific benefit facts. Use of Blue365 does not change monthly payments, nor do costs of the services or products count toward any maximums

and/or plan deductibles. Discounts are only given through vendors that take part in this program and are subject to change. BCBSTX does not

guarantee or make any claims or recommendations about the program’s services or products. Members should consult their doctor before using

these services and products. BCBSTX reserves the right to stop or change this program at any time without notice.

Member discounts

simply for being a

BCBSTX member

• Exclusive health and wellness deals

from national and local retailers

• Save money on fitness gear, family

activities, gym memberships, healthy

eating, dental, vision, hearing aids

and more from top national and local

retailers

• Log in to Blue Access for MembersSM

and click “Member Discount Program”

in Quick Links to view your available

discounts and to register for weekly

emails

Blue365®

Member Discount Program

18*Blue Points program rules are subject to change without prior notice. Member agrees to comply with all applicable federal,

state and local laws, including making all disclosures and paying all taxes with respect to their receipt of any reward.

The Fitness Program is provided by Tivity Health™ Services, LLC, an independent contractor which administers the Prime® Network of fitness centers.

The Prime Network is made up of independently-owned and managed fitness centers. Prime is a registered trademark of Tivity Health, Inc. Tivity Health

is a trademark of Tivity Health, Inc.

Blue Cross®, Blue Shield® and the Cross and Shield Symbols are registered service marks of the Blue Cross and Blue Shield Association,

an association of independent Blue Cross and Blue Shield Plans.

The portal includes

recommended activities that

make up your Personal

Member Journey.

Well onTarget®

Highlights• Health Assessment

• Member dashboard

• Digital self-management programs

• Trackers and tools

• Interactive symptom checker

• Health and wellness content

• Secured messaging

• Blue PointsSM

rewards*

• Fitness Program

• Tracking for fitness and nutrition

and also device integration

• Personal wellness challenges

• Mobile app (AlwaysOn)

Member Wellness Portal

Screen images are for illustrative purposes only.

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Answer! Your health advisor’s

goal is to help you get the

care you need to get better.

IF A HEALTH ADVISOR REACHES OUT …

A HEALTH ADVISOR:

• Can help to coordinate your and your family’s serious health concerns

• Gives you one person you can

count on when you need help

the most

• Works with a team of specialists to help make sure you have the right care for your unique circumstances

20Screen images are for illustrative purposes only.

*Message and data rates may apply.

To download

the app, go to

Google Play,

the App Store

or text*

BCBSTXAPP

to 33633

• Find an in-network doctor,

hospital or urgent care facility

or search for Spanish-speaking

doctors

• Access your claims, coverage

and deductible information

• Access temporary digital

member ID card

• Secure login with Face ID

(iOS only) and Fingerprint ID

• Let us know your

communication preferences

BCBSTX App for Mobile Devices

• Find medicines – see cost and coverage information

– Search for medicines to find: cost estimates, formulary status, therapeutic alternatives, utilization management (UM) requirements and medicine interactions.

– Find and compare pricing for a generic version of the brand name medicine searched, or a 90-day supply at a retail pharmacy.

– Find ways to save money with low-cost generic drugs.

– Learn about drug interactions, possible side effects, and therapeutic alternatives.

• Find a pharmacy

– Search for in-network pharmacies by location and pharmacy name.

– Compare medicine prices across in-network pharmacies.

• Prescription history

– Providing a summary of paid pharmacy claims including member cost, plan paid amount, HSA/FSA paid amount and total cost of medicines.

MyPrime.com – Prime Therapeutics’ member tool for managing medicinesKeeping track of prescriptions, covered drugs, and preferred pharmacies

can be time consuming and complicated. MyPrime.com is Prime’s safe,

convenient website offering members quick access to their pharmacy

benefit information.

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Stay Engaged

in Your Health Care

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• Use in-network providers

• Research costs in Provider Finder®

• Review EOBs and bills sent

by your providers

• Use wellness benefits

• See your physician regularly

for preventive care or illness

• Ask your health care provider questions

about prescribed medications and treatment

• Ask your doctor if lower-cost

drug options are right for you

• Log into BlueAccess for Members

bcbstx.com for more health

and wellness information

• Text NEISD to 33633 – provide email & phone

number

How You Can Be a Smarter Consumer