Health Committee Report

The following information is designed to help you manage your Benefits. We (The Insurance Committee) are trying to educate the teachers of VUSD on what our Benefits consist of for the year.
Thank you for letting us serve you…

The Insurance Committee.

Medical Benefits

CERTIFICATED EMPLOYEE BENEFITS HEALTH INSURANCE - Self Insured Schools of California (SISC) Anthem Blue Cross Prudent Buyer Plan 2014-15

ϖ Group plan revisions effective October 1, 2014.

ϖ Anthem Blue Cross Prudent Buyer Plan Participating Physicians and Hospitals.

ϖ Includes coverage for spouse/registered domestic partner; eligible dependents up to age 26.

ϖ Pre-authorization required for all surgeries (inpatient and outpatient). Covered benefits - Insurance year starts January 1 - Annually:

► Office Visits - $30 co-pay per visit (not subject to deductible)

► Emergency Room Services NOT resulting in direct hospital admission will be responsible for ER deductible of $200

► Subject to $200 individual or $500 family deductible} 80/20% of first $5,000; max out of pocket

* Outpatient Diagnostic X-ray and Lab} $1000 per person/$3000 per family of Anthem

* Hospitalization} approved charges; 100% of approved

* Annual Physical (for employee and spouse)} charges thereafter per calendar year

Prescription drug – Navitus Health Solutions Local Pharmacy (Eff. 4/1/14) - co-pays: $5/generic - $20/brand name for 30 day supply and Costco Mail Service Pharmacy Services for– co-pays: $10/generic - $50/brand name mail order for 90 day supply for maintenance drugs. Brand Name must meet a $100-individual/$300 family annual deductible before co pay applies.

*MENTAL HEALTH SERVICES - Provided and payable under the Anthem Blue Cross medical plan