2021 2022 PLAN YEAR - Emmett Independent School District #221
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Emmett Independent School District #221
2021 - 2022 PLAN YEAR
Emmett School District
119 N Wardwell Avenue
Emmett, ID 83617
(208) 365-6301
At the Emmett Independent School District, we strive to Contact Information:
provide high-quality, competitive benefits to our
employees. Cindy Spaulding
This guide is an overview of the benefits available to you. Please
read it carefully in order to make the best choices for you and
Human Resource Officer
your family. cspaulding@isd221.net
If you have questions about any of the benefits mentioned in this
guide, please don’t hesitate to reach out to Cindy Spaulding at 208-365-6301
the District Office.
CONTENTS PAGE
PREMIUMS……………………………………………………………………………………………………………………………………………… 3
MEDICAL…………………………………………………………………………………………………………………………………………………. 4
HEALTHCARE EXPENSE ACCOUNTS……………..………………………………………………………………………………………….. 5
DENTAL……………………………………………………..……………………………………………………………………………………………. 6
VISION…………………………………………………………………………………………………………………………………….……………... 7
GROUP LIFE & VOLUNTARY LIFE……………..………………………………………………………………………………………………. 8
DISABILITY………………………………………………………………………………………………………………………………………………. 9
VOLUNTARY BENEFITS……………………………………………………………………………………………………………………………. 10
REGENCE INFORMATIONAL FLYERS………………………………………………………………………………………………………… 12-23
MONT HLY DIST RICT CONT RIBUT ION: $795.08 per employee
QUALIFYING EVENTS:
Unless you experience a life-changing qualifying event, you cannot make changes to your benefits until the next open
enrollment period. Qualifying events include things like: Marriage, divorce or legal separation; Birth or adoption of a child;
Change in child’s dependent status; Death of a spouse, child or other qualified dependent; Change in residence; Change in
employment status or a change in coverage under another employer-sponsored plan.
Insurance Premiums *District will pay $795.08 per employee
Medical – Regence $1,500 Deductible PPO Plan
*total cost varies based on dental plan choice Total Cost to Employees
Full Premium Delta Dental Willamette Dental
Employee Only $838.10 $97.94 $105.02
Employee & Spouse $1,842.20 $1,102.04 $1,109.12
Employee & 1 Child $1,289.90 $549.74 $556.82
Employee & 2+ Children $1,499.00 $758.84 $765.92
Family $2,135.00 $1,394.84 $1,401.92
DBL CPL $2,135.00 $654.68 $668.84
Medical – Regence $2,800 Deductible HSA Plan
Full Premium Delta Dental Willamette Dental
Employee Only $707.97 $0.00 $0.00
Employee & Spouse $1,556.20 $815.96 $823.04
Employee & 1 Child $1,089.70 $349.42 $356.50
Employee & 2+ Children $1,266.30 $525.91 $532.99
Family $1,803.60 $1,063.25 $1,070.33
DBL CPL $1,803.60 $323.09 $337.25
Delta Dental
Full Premium Total Cost to Employee
Employee Only $37.00 $0.00
Employee & Spouse $82.20 $45.20
Employee & 1 Child $71.25 $34.25
Employee & 2+ Children $106.00 $69.00
Family $141.85 $104.85
DBL CPL $141.85 $67.85
Willamette Dental Dental Blue Connect
Full Premium Total Cost to Employees
Employee Only $44.08 $0.00
Employee & Spouse $95.39 $51.31
Employee & 1 Child $84.73 $40.65
Employee & 2+ Children $126.15 $82.07
Family $168.95 $124.87
DBL CPL $168.95 $80.79
Vision
Full Premium Total Cost to Employees
Employee Only $7.83 $0.00
Employee & Spouse $15.69 $7.86
Employee & Child(ren) $16.78 $8.95
Family
. $26.81 $18.98
DBL CPL $26.81 $11.15
This booklet provides only a summary of your benefits. All services described within
3 2021-2022Employee Benefit Guide
are subject to the definitions, limitations, and exclusions set forth in each insurance
carrier or provider’s contract.
2021 – 2022 Medical Plans
Option 1: Option 2:
Plan Highlights:
Regence $1,500 PPO Regence $2,800 HSA
Deductible (Calendar Year)
Individual $1,500 $2,800
Family $5,000 $5,000
Coinsurance (In-Network)
Plan pays 70% / You pay 30% Plan pays 80% / You pay 20%
Cost-sharing after deductible is met
Out-of-Pocket Maximum (Includes Deductible + Coinsurance + Copays) (Includes Deductible + Coinsurance)
(Once member reaches this, plan will pay 100%
for remainder of calendar year)
Individual $5,500 $5,500
Family $11,000 $11,000
No Deductible
Physician Office Visit
Primary Care: $30 copay Primary Care: $15 (after deductible)
Specialist: $45 copay Specialist: $40 (after deductible)
Preventive Care Covered 100% Covered 100%
No deductible up to $400, then
Diagnostic Labs / Imaging Applied to deductible + coinsurance
applied to deductible + coinsurance
Hospitalization/Maternity Applied to deductible + coinsurance Applied to deductible + coinsurance
Emergency Room 30% after $300 copay per visit (waive if admitted) Applied to deductible + coinsurance
Pharmacy / RX Deductible & OOP combined w/Medical
Preferred Generic: $10 (deductible waived) $10 (deductible waived)
Preferred Brand Name: 25% $30 (after ded)
Non-Preferred Brand Name: 50% $60 (after ded)
N/A $150 (after ded)
Specialty:
Monthly Employee Costs Delta Dental Willamette Dental Delta Dental Willamette Dental
Employee Only $97.94 $105.02 $0.00 $0.00
Employee & Spouse $1,102.04 $1,109.12 $815.96 $823.04
Employee & 1 Child $549.74 $556.82 $349.42 $356.50
Employee & 2+ Children $758.84 $765.92 $525.91 $532.99
Family $1,394.84 $1,401.92 $1,063.25 $1,070.33
Regence PPO vs. Regence HSA
Regence PPO Regence HSA
✓ Members pay flat copays for physician office visits and most prescriptions. ✓ The Regence HSA is a high-deductible health plan. Members
receive coverage for medical services once they reach their
✓ Great choice for members who have ongoing medical costs and prefer deductible.
copays and upfront coverage for services. ✓ Members who participate on the HSA Medical Plan will also have a
health savings account which can be used to pay for medical
expenses that are applied to their plan’s deductible.
✓ Great choice for members with minimal medical expenses each year
who want to save money on health insurance premiums.
➢ Both plans include 100% coverage for Preventive Care Services with no copay and no deductible.
4 This booklet provides only a summary of your benefits. All services described within
2021-2022Employee Benefit Guide
are subject to the definitions, limitations, and exclusions set forth in each insurance
carrier or provider’s contract.
Healthcare Expense Accounts
*FSA/HSA vendor changing to Ameriflex – effective 9/1/2021
The medical plan you choose to enroll on determines which healthcare expense accounts you are eligible for.
Option 1: Regence $1,500 PPO Option 2: Regence $2,800 HSA
FLEXIBLE SPENDING ACCOUNT HEALTH SAVINGS ACCOUNT
You can contribute pre-tax funds to your FSA and use the Emmett School District will contribute $25.00 per month to the
money to pay for your out-of-pocket healthcare expenses employee’s Health Savings Account (if you have one open). Funds can be
including: used for eligible healthcare expenses or saved. Unused HSA funds roll
- Deductibles, Copays & Prescription Drugs over year after year. Employees may also elect to contribute to HSA with
- Dental & Vision Expenses pre-tax payroll deductions. The maximum HSA contributions that an
- Prescribed Supplements and over-the-counter employee can elect for 2021 are based on your enrollment:
items (with prescription)
IRS FSA Contribution Annual Per Month 2021 HSA Employee Annual Contribution
Limits for 2021 Amount Deduction Contribution Limits: Maximum
Single Coverage $3,600.00
Annual Maximum $2,750.00 $229.16
Family Coverage $5,444.12
Age 55+ Additional $1,000 Per Year
Participants have until November 30, 2022, to submit
for expenses incurred during the plan year. Employee pays $1.50 account admin fee.
Any unused funds will be forfeit and will not rollover to
the next plan year. Eligibility Requirements
Once you’re covered by a qualified HDHP, you can contribute to an
Employee pays $3.25 account admin fee. HSA if you:
› Are not covered by any non-HSA eligible health plan including a
general purpose Health Flexible Spending Account (Health FSA) or a
Health Reimbursement Arrangement (HRA). If your spouse has a
DEPENDENT CARE FSA
General Purpose Health FSA that allows reimbursements for your
expenses, you may not participate.
(Optional & Available Regardless of Medical Plan Participation) › Are not enrolled in Medicare or Tricare. If you are over 65, as long
as you have not enrolled in Medicare or Tricare, you can continue to
Employees may contribute to the Dependent Care FSA to
make contributions and use your funds. Once you are enrolled in
pay for eligible dependent care expenses using pre-tax Medicare or Tricare, you can no longer make contributions, but you
contributions. may still continue to use funds you have previously saved.
The IRS Maximum for 2021: $5,000 per year › Are not being claimed as a dependent on someone else’s tax
Eligible expenses for Dependent Care FSA: return.
› If you become no longer covered by a qualified HDHP, you may
› Care for your child who is under age 13
still use your HSA funds, however, you may not continue to contribute
› Before and after-school care
to your account.
› Baby sitting and nanny expenses
› Day care, nursery school, and preschool
› Summer day camp
CONTACT AMERIFLEX
› Care for a relative who is physically or mentally
incapable of self-care and lives in your home Phone: 888.868.3539
Web: myameriflex.com
5 This booklet provides only a summary of your benefits. All services described within
2021-2022Employee Benefit Guide
are subject to the definitions, limitations, and exclusions set forth in each insurance
carrier or provider’s contract.
Delta Dental
PROVIDER NETWORK PPO PREMIER
Annual Deductible
None None
(Individual / Family)
Plan Pays: Plan Pays: Delta Dental
Monthly Employee Cost
Preventive Care
70-100% 70-100%
(Exam, cleanings, x-rays) Employee Only $0.00
Basic Procedures Employee & Spouse $45.20
70-100% 70-100%
(Fillings, extractions, root canal) Employee & 1 Child $34.25
Major Procedures
50% 50% Employee & 2+Children $69.00
(Crowns, bridges, dentures)
Annual Maximum Benefit Family $104.85
$1,000 $1,000
(Per Member)
Visit www.deltadentalid.com to view network providers, claims, and member discounts
Willamette Dental (Dental Blue Connect)
BENEFITS COPAY
General Office Visit $15 Copay
Annual Benefit Maximum No Annual Maximum
**Must go to the Willamette Dental Clinic for services**
Willamette Dental
Preventive (Cleanings, X-Rays, Exam) Covered 100% after Copay Monthly Employee Cost
Fillings $15 Copay Employee Only $0.00
Employee & Spouse $51.31
Extraction / Surgical Extraction $15 Copay / $75 Copay
Employee & 1 Child $40.65
Root Canal $50 Copay
Employee & 2+Children $82.07
Crowns & Bridges $150 Copay (each service)
Family $124.87
Dentures $200 Copay
Orthodontia $1,500 Copay
Nitrous Oxide $20 Copay
Dental Implant N/A
6 This booklet provides only a summary of your benefits. All services described within
2021-2022Employee Benefit Guide
are subject to the definitions, limitations, and exclusions set forth in each insurance
carrier or provider’s contract.
Vision
LifeMap Choice Vision Insurance
In Partnership with VSP®
PROVIDER NETWORK VSP Provider
Annual Eye Exam $0 copay
Lenses
$25 materials copay
(every 12 months)
Single vision, lined bifocal, lined trifocal
Covered in Full Monthly Employee Cost
lenses; polycarbonate lenses for children
Employee Only $0.00
Frames
$150 Allowance
(every 12 months) Employee & Spouse $7.86
Contact Lenses (instead of frames)
$150 Allowance Employee & 1 Child $8.95
(every 12 months)
Family $18.98
• Retinal Screening: Guaranteed price as an
Other VSP Benefits: enhancement to your WellVision Exam
• Laser Vision Correction: 15% discount at
contracted facilities
You do not need a card to access your VSP benefits. Simply give your Eye Clinic
your Name and DOB. Dependents covered on vision will be accessed under the
Employee’s Information.
FIND VSP PROVIDERS AT: WWW.VSP.COM
7 This booklet provides only a summary of your benefits. All services described within
2021-2022Employee Benefit Guide
are subject to the definitions, limitations, and exclusions set forth in each insurance
carrier or provider’s contract.
Group Life Insurance
Basic Life Insurance
Employer Paid Life Insurance Reduction in Coverage Due to Age – Benefits reduce to
the following percentage and terminate at retirement. If you are
Employee still working the required number of hours to be eligible for this
insurance at age 65, your benefits will reduce to 65% at age
70, to 50% at age 75.
Death Benefit: $50,000
Accidental Death & Dismemberment: (AD&D)
AD&D Benefit: Equal to Life Benefit Payable when an insured employee suffers a loss as a
result of an accidental bodily injury or death sustained
in an accident.
Supplemental Life and AD&D Insurance (Optional)
Employees may elect to purchase additional life insurance for themselves and their dependents. Employees may elect up to the
Guaranteed Issue amounts without an evidence of insurability when they are initially eligible for coverage. Any amounts over the
Guaranteed Issue, or any increases in coverage will require a questionnaire to be completed and approved by LifeMap prior to
the coverage going into effect.
Rate Chart
Supplemental Life w/ AD&D Insurance
Employee: Spouse: Child(ren):
Employee Age Rate per $1000
Elect up to: 0 – 29 $0.07
Elect up to: Elect up to:
$300,000 $300,000 $10,000 30 – 34 $0.08
Not to exceed 100% of the
In $10,000 increments, in $2,000 increments 35 – 39 $0.10
Employee’s Supplemental
not to exceed 3x your basic (6 mo - age 26)
Life election 40 – 44 $0.18
annual earnings.
45 – 49 $0.33
Guarantee Issue: Guarantee Issue: Guarantee Issue: 50 – 54 $0.55
$50,000 $20,000 $2,000
55 – 59 $0.96
60 – 64 $1.11
Use this chart to estimate your monthly cost for additional life insurance:
65 – 69 $1.95
x ÷ 1000 = 70 – 74 $3.42
75 & Over $5.22
Elected Life Amount x Rate from chart Divided by Monthly Cost
Child(ren) Per Unit Per
1,000 $0.25
$2,000
Employee/Spouse/Child
$0.018
Vol AD&D Rate per
Reduction in Coverage Due to Age: Benefits reduce to the following percentages and $1000
terminate at retirement. Benefits reduce to 65% at age 70 and to 50% at age 75. The *Supplemental Spouse rates and premiums are based
percentage reduction is based on original coverage prior to any reductions at each policy on the Employee's age, not the Spouse's age.
anniversary.
8 This booklet provides only a summary of your benefits. All services described within
2021-2022Employee Benefit Guide
are subject to the definitions, limitations, and exclusions set forth in each insurance
carrier or provider’s contract.
Group Disability Insurance
Long Term Disability (Optional)
Long Term Disability insurance, offered through LifeMap is coverage that provides you help in times of need. You get a
monthly check if you can’t do your regular job because of illness or injury, whether it’s work-related or not.* This benefit is only
available to employees in the benefit class described below:
Employer-Paid LTD Benefits
Benefit Class: Active employees working 20+ hours per week
Benefit Percentage: 66 & 2/3% of monthly earnings
Maximum Monthly Benefit: $5,000 per month
Elimination Period: 180 days
Maximum Benefit Duration: If you become disabled prior to age 60, the maximum benefit period will be to age 65. If
you become disabled at age 60 or above, the maximum benefit period will be based on
you age at the time of disability.**
* Pre-existing conditions may be excluded.
** Please refer to the certificate of coverage for details.
Short Term Disability (Optional)
Short Term Disability insurance is coverage that provides you with income protection should you become disabled from a covered
injury, illness, or pregnancy and you are unable to work for a short period of time. This is a voluntary benefit, meaning employees
must enroll on the coverage when initially eligible for benefits and the monthly premium is deducted from your paycheck. These
benefits are offered through Colonial Life. The benefit amount is dependent on the insured’s benefit class as outlined
below:
Elimination
Options Benefit % Up to a Maximum of: Payable for up to:
Period
Options available depending on 60% of weekly gross Payable for up to 7/7, 0/14, 14/14
Up to $4,000 per week
the elimination period earnings 26 weeks
Electing Coverage During Open Enrollment: Pre-Existing Condition(s):
If you did not elect this coverage when you were initially Benefits are not payable for pre-existing condition(s) unless
hired, and want to sign up during open enrollment, you you have been continuously enrolled on this policy for 12
must complete the required Evidence of Insurability consecutive months. A pre-existing condition is an injury,
Form along with your application. Colonial Life will illness or pregnancy that you have received medical care or
review your form and determine if you qualify to enroll treatment for within a 90-day period before you signed up for
on the plan. this plan.
9 This booklet provides only a summary of your benefits. All services described within
2021-2022Employee Benefit Guide
are subject to the definitions, limitations, and exclusions set forth in each insurance
carrier or provider’s contract.
Other Voluntary Benefits
The Kuna School District offers additional voluntary benefits through Colonial Life. Voluntary benefits can help protect your
income and provide financial security for you and your family. For assistance these benefits please contact the Murray Group at
(208) 765-2620.
This booklet provides only a summary of your benefits. All services described within
10 2021-2022 Employee Benefit Guide
are subject to the definitions, limitations, and exclusions set forth in each insurance
carrier or provider’s contract.Employee Assistance Program (EAP)
What is the EAP? Schedule an Appointment:
The Employee Assistance Program (EAP) offers free, confidential counseling
& Life-Balance Resources to Emmett School District Employees and eligible In-person Counseling – 866-750-1327
family members by seasoned, licensed professionals.
Online Consultations – www.myRBH.com
What does the EAP provide?
• Up to 4 confidential face-to-face counseling sessions for all
employees, dependents and members of your household per issue. 24-hour Crisis Help – 888-750-1327
Counseling is available for almost any issue, such as:
• marital and relationship conflict
MyRBH Access Code: LIFEMAP
• stress related difficulties
• emotional and psychological problems
• career concerns
• substance abuse issues and bereavement
Important Benefit Information
• These visits are at $0 cost to you
• Appointments are confidential
Benefit Contact Information
Benefit Plan Carrier Name Website Phone Number
Benefit Advocates The Murray Group murraygr.com 877.765.2620
Medical Regence regence.com 888.494.2583
Dental Willamette Dental willamettedental.com 855.433.6825
Dental Delta Dental of Idaho deltadentalid.com 800.356.7586
Vision VSP Vision Plan vsp.com 800.877.7195
Life /LTD LifeMap lifemapco.com 1.800.794.5390
FSA Ameriflex myameriflex.com 888.868.3539
HSA Ameriflex myameriflex.com 888.868.3539
Additional Voluntary Plans Colonial Life coloniallife.com 800.325.4368
Access Plan Information and
Benefit Notices Online
› Go to http://books.murraygr.com/bookcase/ykrnk
Emmett School District is required to provide employees with access to
important notices such as the Summary of Benefits and Coverage (SBC), or
Plan Documents, and Special Plan Notices. All of these documents are › Scan the QR Code on your smartphone
available in the company’s employee benefit library. A free printed
copy of all your plan documents and notices may be obtained by calling
The Murray Group at 208.765.2620.
11 2021-2022 Employee Benefit Guide This booklet provides only a summary of your benefits. All services described within
are subject to the definitions, limitations, and exclusions set forth in each insurance
carrier or provider’s contract.Regence Advantages
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Regence BlueShield of Idaho
is an Independent Licensee of the Blue Cross REG-128866-20/08-ID
and Blue Shield Association © 2020 Regence BlueShield of Idaho
1211West Myrtle Street | Suite 200 | Boise, ID 83702
Regence complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.
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and earn rewards for healthy activities. to get care via phone, video or secure
chat. This way, you can get quality,
routine care fromthe comfort of home.
Visit your Member Dashboard to see
your options.
To create an account, have your member ID card handy and go to regence.com.
Learn more on regence.com. Or call us at 1(888) 367-2117(TTY: 711). 3Get the medications
you need at the right G O TO R E GE NCE . CO M TO :
price
We’re here to help you find safe, effective
and affordable medications, with a Get up to a 90-day supply of prescriptions
network that includes convenient home shipped right to your doorstep with
our Home Delivery program. Standard
delivery options, PillPack by Amazon
shipping is free, online ordering is easy,
Pharmacy and 65,000 pharmacies and you’ll get 24/7/365 support from our
across the country, such as Walgreens, expert pharmacy team. (You can also register &
Albertsons, Kroger and Rite Aid. access home delivery at alliancerxwp.com).
HOW WE MAKE SURE YOUR MEDICATIONS
ARE SAFE AND EFFECTIVE
A committee of doctors and Use our powerful search tool to locate
pharmacists creates and in-network pharmacies near you.
reviews our covered-drug list.
They choose medications
based on effectiveness and
safety, not just price.
Access MedSavvy® for side-by-side
The list includes brand and medication and cost comparisons, with
generic drugs. Both have the pharmacist-assigned grades for safety and
same strength, quality and effectiveness. Build a virtual medicine cabinet
purity, but generics usually cost so you can manage your medications and
20–60% less. Ask your doctor receive customized safety and recall alerts.
if a generic will work for you. And ask a registered MedSavvy pharmacist
your medication questions.
You pay a copay (flat dollar
amount) or coinsurance
(percentage of the cost)
depending on the tier your
medication falls into.
Get help managing chronic conditions and
sticking to your treatment plan with our
Care Management program, available
at no extra cost.
MedSa vvy and PillPack by Amazon Pharmacy are separate and independent
companies that provide services for Regence BlueShield of Idaho members. Learn more on regence.com. Or call us at 1(888) 367-2117 (TTY: 711). 7Know before you g o
Get the care that best fits your needs and your budget.
When you need immediate care and your regular doctor is unavailable, it can be
difficult to know whether to choose the emergency room, an urgent care facility
or convenient telehealth options to meet your medical needs.
By choosing wisely, you’ll not only find the best care for your condition—you could
save hours on wait time and avoid higher costs.
When to go to the When to go to urgent care When to use telehealth
emergency room Consider urgent care for: Consider telehealth for:
Here’s when the ER Strains, sprains or bruises Allergies
may be the best choice:
Asthma attacks Cold and flu
Serious accidents or
broken bones Flu-like symptoms; if you suspect Rashes
you might have COVID-19, call Sore throat
Uncontrollable bleeding ahead to ask for instructions
Symptoms of a heart attack Ear infections
Stomach pain or diarrhea
or stroke Pink eye
Bronchial infections such as
Severe shortness of breath Sinus infections
a bad cough
or dizziness
Fevers, adult or pediatric Urinary tract infections (UTI)
$ Physician fee
$ Facility fee
$ Treatment costs
$$$ Higher copay
Plan ahead EMERGENCY ROOM
$$$$$$
When you need care in a hurry, the
last thing you want to think about is
your plan’s network or registering
$ Treatment costs
on a new website. $$ Regular copay
Locate nearby in-network hospitals URGENT CARE
$$$
with ERs and in-network urgent care
centers ahead of time using our
Find a Doctor tool on regence.com.
$ Treatment costs
$ Lower copay
TELEHEALTH
$$
8 Learn more on regence.com. Or call us at 1(888) 367-2117 (TTY: 711).PHARMACY QUICK GUIDE:
FINDING E F F E C T I V E AND AFFORD ABLE MEDICATIONS
Get the most from your pharmacy benefit
Have a prescription to fill? Wondering if you should switch to a generic or use
our home delivery service? Here are some quick tips and programs you need
to know about.
How to fill your prescription
Whether you have a new prescription or need to refill an existing one, our network of more than 65,000
participating pharmacies has you covered—across the country and around your corner.
Show your member ID card to your pharmacist so they can file your claim with us online and tell you how
much you owe.
Programs to stretch your pharmacy dollar
Our programs are designed to put valuable medication and health support into your hands, while also
saving you money.
Covered-drug list Home delivery
When it comes to choosing medications, it’s important to You can get some medications—like the ones you
know how the list of covered drugs—or formulary—works. take for a chronic condition—mailed to you at the
location of your choice. That means fewer trips to the
The covered-drug list divides medications into multiple
pharmacy, and it can even save you a copay or lower
tiers, each with its own cost share. Before we add
your out-of-pocket costs if you have coinsurance.
a medication to the list, our team of doctors and
pharmacists carefully evaluate how safe and effective it 90-day fills
is while assessing whether it will improve health. You can pick up 90-day supplies of most long-term
medications at one of our Extended Supply Network
To see if your medication is covered and how much it
(ESN) retail pharmacies or have our Home Delivery
will cost, visit regence.com/pharmacy, sign in or select
Program ship it to the location of your choice.
your type of coverage, and click on Find a Drug.
Visit regence.com/pharmacy, select your type
Generics of coverage or simply sign in, and click on Find a
Generic and brand-name medications have the Pharmacy to locate an ES N retail pharmacy or reg ister
same strength, quality and purity. But, generics can for home delivery.
cost up to 80% less. So, ask your doctor if there is a
Clinical programs
generic drug that will work for you.
Our pharmacists work behind the scenes to help you
get the medications you need when you need them.
We also look out for safety concerns, such as potential
drug interactions or duplicate prescriptions, that could
affect you.Specialty Pharmacy
We know that living with a complex health condition can be stressful and sometimes confusing. Our
specialty pharmacy services are here to support you with the care and medications you need, every step of
the way. In some cases, your plan may require that you use our Specialty Pharmacy.
To assist you with the complexities of your condition and its treatment, our Specialty Pharmacy services
will help you coordinate refills, monitor side effects, and give you 24-hour access to clinical specialists. You’ll
even get injectable supplies for free—and everything can be delivered to your home or location
of your choice.
Blood Glucose Meter Program
If you have diabetes, you’re eligible to receive a new LifeScan OneTouch® glucose meter at no cost. Order
your meter directly from LifeScan by calling 1(855) 306-2278.
Understanding pre-authorization
To ensure you’re getting an effective drug at an affordable price, we review prescriptions for some
medications before we cover them. Drugs on the pre-authorization list include many for which equal or
more effective and lower-cost options exist.
If your drug needs pre-authorization, you’ll want to do one of two things:
1.Talk with your doctor to see if there’s an alternative treatment that does not require pre-authorization.
OR
2.Have your doctor or pharmacist request pre-authorization for your medication. You may need to get that
authorization before you can get your prescription filled.
Questions? Call the Customer Service number on your member ID card.
Regence BlueShield of Idaho
is an Independent Licensee of the REG-378412-20/08-IDRxServrep378412-19
Blue Cross and Blue Shield Association © 2020 Regence BlueShield of Idaho
1211West Myrtle Street, Suite 200 | Boise, ID 83702
Regence complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.
ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-888-344-6347 (TTY: 711).
注意：如果您使用繁體中文，您可以免費獲得語言援助服務。請致電 1-888-344-6347 (TTY: 711).Introducing Express Scripts® Pharmacy,
your home delivery pharmacy
Home delivery through Express Scripts® Pharmacy is a safe, convenient way to
get your long-term medicines delivered right to your door. It may even help you
save money. Plus, Express Scripts® Pharmacy gives you more:
• 24/7 access to a team of knowledgeable pharmacists and support staff
• Free standard delivery
•Tamper-proof, unmarked packaging
• Refill reminder notices through your phone or email, whichever you prefer
• Multiple locations across the U.S., for fast processing and dispensing
Express Scripts® • Refill prescriptions
Pharmacy mobile app • Track your order
makes it easy to manage • Make payments
your prescriptions • Set reminders to take medicine and more
It’s easy to get started
If you’re already using home delivery for your medicines1
1 Go to express-scripts.com.
2 Register and create a profile.
3 See your active drugs and/or send your refill order.
If you haven’t used home delivery yet, call 1 (833) 599-0451 to get started.1
Express Scripts® Pharmacy has 30 years of experience helping members get their medicines.
1
Home delivery through Express Scripts® Pharmacy will be available starting April 1, 2021.
Until then, continue using your current pharmacy for home delivery needs.
Regence BlueShield of Idaho is an Independent Licensee of the Blue Cross and Blue Shield Association
Express Scripts® Pharmacy is a separate and independent company that is contracted to provide
01013609
mail pharmacy services for BlueCross BlueShield of Idaho members.
Express Scripts® Pharmacy is a trademark of Express Scripts Strategic Development, Inc.
7062-D ID © Regence BlueShield of Idaho 03/21Telehealth for medical and behavioral health care Doctor On Demand™ provides convenient care 24/7/365 Visit a doctor or therapist via video chat We all have times when we need to see a doctor, but it’s inconvenient—there’s no time, the office is closed, or we’re on the road.You know that feeling: “I wish I could get care without leaving the house!” Now you can. Your health plan includes telehealth powered by Doctor On Demand, a national leader in quality care. You can talk to any of Doctor On Demand’s board-certified physicians, licensed counselors and psychiatrists any time by video chat using your computer or the app—24 hours a day, 7 days a week, 365 days a year.
Telehealth for medical and behavioral health care
Care you can count on
You’ll connect with board-certified doctors and therapists who can diagnose and treat non-emergency
medical conditions, mental and behavioral health needs, prescribe medications, and send prescriptions
to your pharmacy. With specialties including primary care, pediatrics, family medicine and behavioral
health, Doctor On Demand makes it easy to get quality care for every member of your family.
Common ailments treated via telehealth include:
Medical Behavioral health
Allergy Pink eye Addictions
Cold and flu Rashes Anxiety
Constipation Sinus infection Depression
Ear problems Sore throat Relationship issues
Headache Sunburn Grief and loss
Infections UTI Trauma and PTSD
Nausea Stress managment
What you need to know
Doctor On Demand is simple to use. Here are some basic things to know:
• Doctor On Demand is a great option when your child isn’t feeling well outside business hours,
but dependents will need a parent present during the visit.
• The average wait time to connect with a physician is less than 10 minutes.
• You can use Doctor On Demand as often as you need to.
• We process each visit as a claim, and your costs count toward your deductible.
• Your visit cost is provided up front before you book your visit.You won’t pay more than $54 for a
medical visit; costs for behavioral health visits vary depending on the type of care.
• This is more than a nurse advice line.With Doctor On Demand, a doctor can diagnose, treat and
prescribe medications, as necessary.
• You will work with a Doctor On Demand physician or therapist, not your regular doctor.
• With your permission, the Doctor On Demand physician will share your treatment information
with your regular doctor.
Visit doctorondemand.com/regence-id to register today. You’ll want to create your online account in
advance so when you need care, you’ll already be set up.
Doctor On Demand is a separate and independent company that provides telehealth
services for Regence members.
Regence complies with applicable Federal civil rights laws and does not discriminate on the
basis of race, color, national origin, age, disability, or sex. ATENCIÓN: si habla español, tiene a
su disposición servicios gratuitos de asistencia lingüística. Llame al 1-888-344-6347 (TTY: 711).
注意：如果您使用繁體中文，您可以免費獲得語言援助服務。請致電 1-888-344-6 347 (TTY:
Regence BlueShield of Idaho is an Independent
711).
Licensee of the Blue Cross and Blue Shield Association
REG-199655-19/12-ID
1211 West Myrtle Street, Suite 200 | Boise, ID 83702 © 2019 Regence BlueShield of IdahoEmotional Health and Well-being
Support For You
Recharge, Refresh and Improve Your Mood
with myStrength by Livongo
Now you can use myStrengthʼs web and mobile tools to support your goals and well-being.
Learning to use myStrengthʼs tools can help you overcome the challenges you face
and stay mentally strong. Itʼs all safe, secure and personalized – just for you. And best of
all it's available through your health plan at no extra cost.
What my S t rength
users are saying:
“It’s nice to h ave self-
guided help that is
s o accessible.”
“myStrength gives
me back some of the
‘light’ I h a d lost.”
Go Mobile!
Download the
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myStrength mobile
1. Visit bh.mystrength.com/regenceid1 and click on “Sign Up.” app, log in, and get
2. Enter the access code: "REGENCEID1" started today.
3. Complete the myStrength sign-up process and personal profile.
Regence BlueShield of Idaho is an Independent Licensee of the Blue Cross and Blue Shield Association. Livongo is a separate and independent company that does not provide Blue Cross and Blue Shield products or
services, and is solely responsible for their products or services. Livongo is not insurance, but it is offered in addition to your medical plan to help you get information and support when you need it. Also available
via the myStrength app; use access code REGENCEID1.
Program includes trends and support on your secure account and mobile app but does not include a phone or laptop. The testimonials, statements, and opinions presented are applicable to the member. Each
memberʼs exact results and experience will be unique and individual to each member. The testimonials are voluntarily provided and are not paid. Google Play and the Google Play logo are trademarks of Google LLC.
Apple, the Apple logo, and iPhone are trademarks of Apple Inc., registered in the U.S. and other countries and regions. App Store is a service mark of Apple Inc.
PM04741.B |©2020 myStrength, Inc. All Rights Reserved. |FPF-XXX-0519 |REGENCE EMPOWER
Keep your well-being journey
at your fing ertips
Download the Reg ence Empower mobile app.
You live life on the go. Stay motivated and engage in
your well-being anywhere, anytime by downloading
the Regence Empower app.
Once you’ve created your regence.com account,
download the app and take advantage of these
features while you’re on the go.
Take your health
assessment
Set personal goals and
track progress
Earn and check reward
balances
Participate in challenges
Listen to podcasts
Connect with your Sync your and more
health coach fitness device(s)
Download the Regence Empower app and start
engaging in your well-being journey today!
Use the Regence Empower app to find all your well-being resources.
It is diferent from the Regence app, where you find claims and benefits information.
Regence BlueShield of Idaho Regence BlueShield of Idaho REG-308448-20/02-ID PLUS
is an Independent Licensee of the Blue Cross and Blue Shield Association 1211 West Myrtle Street, Suite 2 0 0 | Boise, ID 83702 © 2 0 2 0 Regence BlueShield of Idaho
Regence complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability,
or sex. ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-888-344-6347 (TTY: 711).
注意：如果您使用 繁體中文，您可以免費獲得語言援助服務。請致電 1-888-344-6347 (TTY: 711).• Artificial teeth
• Bandages
• Birth control pills
• Body scan
• Braille books and magazines
• Breast pumps and supplies
• Breast reconstruction surgery
Flexible Spending Account
• Capital expenses (improvements or special
Eligible Expenses equipment installed to a home, if meant to
Which expenses can be reimbursed by an FSA? accommodate a disabled condition)
Your Health Care Reimbursement Flexible Spending
Account lets you pay for medical care expenses not covered • Car modifications or special equipment installed for
a person with a disability
by your insurance plan with pre-tax dollars. The expenses
must be primarily to alleviate a physical or mental defect or • Chiropractor
illness, and be adequately substantiated by a medical
practitioner. The products and services listed below are • Christian Science practitioner
examples of medical expenses eligible for payment under
your FSA, to the extent that such services are not covered • Contact lenses
by your medical and dental insurance plan.
• Crutches
Unfortunately, we cannot provide a definitive list of
“qualified medical expenses.” A determination of whether • Dental treatment (not including teeth whitening)
an expense is for “medical care” is based on all the relevant
• Diagnostic devices
facts and circumstances. To be an expense for medical care,
the expense has to be primarily for the prevention or • Disabled dependent care expenses
alleviation of a physical or mental defect or illness.
• Drug addiction treatment
The following are examples of FSA-eligible expenses:
• Eye exam
• Abortion
• Eye glasses
• Acupuncture
• Eye surgery
• Alcoholism treatment
• Ambulance
• Annual physical examination
• Artificial limb
This Know Your Benefits article is provided by The Murray Group, Inc.
and is to be used for informational purposes only and is not intended
to replace the advice of an insurance professional. © 2020 Zywave,
Inc. All rights reserved.• Fertility enhancement (in vitro fertilization or • Personal protective equipment used for the
surgery) primary purpose of preventing the spread of
COVID-19
• Guide dog or other service animal
• Physical examination
• Health institute fees (if treatment is prescribed by a
physician) • Pregnancy test kit
• Intellectually or developmentally disabled care, • Prosthesis
treatment or special home
• Psychiatric care
• Laboratory fees
• Psychoanalysis
• Lactation expenses
• Psychologist
• Lead-based paint removal (if a child in the home
has lead poisoning) • Special education
• Learning disability care or treatment • Sterilization
• Legal fees associated with medical treatment • Stop-smoking programs
• Lifetime care, advance payments or “founder’s fee” • Surgery
• Lodging at a hospital or similar institution • Special telephone for hearing-impaired individual
• Medical conference expenses, if the conference • Television for hearing-impaired individuals
concerns a chronic illness of yourself, your spouse
• Therapy received as medical treatment
or your dependent
•
• Medical information plan
Transplants
• Medications, if prescribed
• Transportation for medical care
• Nursing services
• Tuition for special education
• Vasectomy
• Operations
• Vision correction surgery
• Optometrist
•
• Organ donors Weight-loss program if it is a treatment for a
specific disease
• Osteopath
• Wheelchair
• Oxygen
• Wig
• X-raySource: www.irs.gov/publications/p502/ar02.html#en_US_publink1 000178947 Plans that do not allow reimbursement of all eligible medical expenses as defined by the IRS and Department of Treasury must customize this article prior to use.
Qualified Medical Expenses
The Internal Revenue Service (IRS) defines qualified medical
care expenses as amounts paid for the diagnosis, cure or
treatment of a disease, and for treatments affecting any
part or function of the body. The expenses must be
primarily to alleviate a physical or mental defect or illness.
The products and services listed below are examples of
medical expenses eligible for payment under your HSA,
when such services are not covered by your high-deductible
health plan. To be an expense for medical care, the expense
has to be primarily for the prevention or alleviation of a
HSA Examples of Eligible physical or mental defect or illness.
Expenses This list is not all-inclusive; additional expenses may qualify,
Your health savings account (HSA) may reimburse: and the items listed below are subject to change in
accordance with IRS regulations. For more information or
• Qualified medical expenses incurred by the account clarification on individual list items, refer to Publication 502
beneficiary and his or her spouse and dependents; or consult a tax professional.
• COBRA premiums; • Abortion
• Health insurance premiums while receiving • Acupuncture
unemployment benefits;
• Alcoholism
• Qualified long-term care premiums*;
• Ambulance
• Any health insurance premiums paid, other than
for a Medicare supplemental policy, by individuals • Annual physical examination
age 65 or older; and
• Artificial limb
• Certain personal protective equipment (PPE)—such
as masks, hand sanitizer and sanitizing wipes— • Artificial teeth
used for the primary purpose of preventing the • Bandages
spread of COVID-19; and
• Birth control pills
• Effective Jan. 1, 2020, qualifying over-the-counter
(OTC) drugs, along with menstrual care products, • Body scan
are also treated as qualified medical expenses.
• Braille books and magazines
Distributions made from an HSA to reimburse the account
beneficiary for eligible expenses are excluded from gross • Breast pumps and supplies
income.
• Breast reconstruction surgery
This Know Your Benefits article is provided by The Murray Group, Inc.
and is to be used for informational purposes only and is not intended
to replace the advice of an insurance professional. © 2020 Zywave,
Inc. All rights reserved.You can also read
