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Benefits Summary

This summary is designed to give you an outline of the health benefit programs. Contained in the summary are tips for you on using the plans.

Summary of Benefit Coverage Notices 9/1/2018

Insurance Premiums

Prescription Benefits

Express Scripts administers prescription benefits for the PPO 750, 1200 and 2500 Plans. Prescriptions can be purchased through your local pharmacy or through mail order. Prescription co-pays range from $10.00 - $50.00 depending on your prescription and/or plan. For more information regarding prescription coverage, visit the Express Scripts website at www.express-scripts.com or call (800) 627-9799.

Prime Therapeutics is the plan administrator for prescription beneifts for the HDHP 1500 with HSA and HMO plan. Please refer to the Benefit Summary Booklet for co-pay or member responsibility. Additional information regarding your prescription coverage through Prime Therapeutics can be accessed through the Blue Access for Members (BAM) portal at www. bcbsil.com or call (800) 423-1973.

Employee Medical Benefit Booklet

The Blue Cross/Blue Shield PPO & HMO Plans are offered to employees who are eligible for medical benefits. Please refer to the eligibility section of the booklet on page 7.

Plan Comparison Overview 9/01/19

Health Care Benefit Program - PPO Plan
Option 750 with HRA - Deductible $750
Option 2500 – Deductible $2,500
Option HDHP 1500 with HSA- Deductible $1,500

Health Care Benefit Program - HMO Plan

Option HMO20 - Deductible N/A

Employee Dental Benefit Summary

MetLife PPO plan and Blue Cross Blue Shield HMO plans are offered to employees who are eligible for dental benefits. Eligibility is the same as for medical benefits.

Employee Life Insurance Policy Booklets

Basic term Life insurance is a District paid benefit for those employees who are scheduled to work a minimum of 17 1/2 hours per week. Supplemental Life and AD&D Insurance is also available to employees to purchase. The provider is Reliance Standard Life Insurance Company.

Employee Long Term Disability Insurance Booklet (Certified Staff Only)

LTD insurance provides income replacement for designated employee groups. In the event you become disabled from a non-work related injury or sickness, disability income benefits are provided as a source of income. This is a board paid benefit for eligible employees and is provided by Met Life Insurance.

Additional Benefits

Enrollment Forms


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