2021 U.S. Benefits Enrollment Guide - Student Success - CareFirst
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2021 U.S. Benefits Enrollment Guide Student Success
Table of Contents
How to Enroll 2 This Enrollment Guide contains
information regarding Blackboard-
Important Reminders 3 sponsored benefit plans. Blackboard
makes every efort to accurately report
the coverage, benefits and limitations
Eligibility 5
of these plans. If there is any diference
between this publication and the
Medical Plan 7 Summary Plan Descriptions (SPDs), the
SPDs will govern. For a more detailed
Medical Benefits-at-a-Glance 11 description of these plans and plan
information required by the Employee
CareFirst BlueCross BlueShield Resources 12 Retirement Income Security Act (ERISA),
please refer to the SPDs. To access the
Dental Plan 15 SPDs, visit www.blackboard.bswif.com
and click on the Library Tab. Blackboard
reserves the right to amend, modify or
Vision Plan Options 16
terminate all or part of its benefit
plans at any time.
Life and Disability Insurance Plans 18
Please note that Blackboard places the
Other Voluntary Pre-Tax Benefits 20 highest importance on your personal
privacy and the confidentiality of your
Additional Benefits 22 personal information. All personal
information that is collected through
Per Pay Period Deductions 27 Blackboard-sponsored benefit plans and
our benefit partners will be safeguarded
and will never be shared without your
Required Federal Notices 28 consent. Your personal information is
100% confidential.
Vendor Contact Information 30
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2021 U.S. Benefits Enrollment Guide 1
Welcome to the Benefits Guide for
Blackboard Student Success Employees
Blackboard ofers you a valuable benefits package, including medical, dental,
vision, health savings account, flexible spending account and more to support
good health for you and those who depend on you. This benefits guide contains
the information you need to help make informed decisions about your benefits.
How to Enroll
You can view, change or
Sign in using SSO, or enter your User ID and password
enroll for benefits by logging STEP 1 directly on the bswif enrollment site. Your User ID is the
in to the Blackboard online same as your Blackboard network ID.
benefits system, bswif, at
Go to the My Profile page and review your personal and
www.blackboard.bswif.com, family information for accuracy. If any of your personal
or via Single Sign On (SSO) at STEP 2
demographic information needs to be updated, please
portal.ofice.com/myapps, go to Oracle Fusion HR.
and following these steps:
Within the My Profile page, click on Family Information
and enter all family information before beginning
STEP 3
enrollment. If you are not covering dependents, you
may skip this step.
Go back to the homepage and click on Get Started
and follow the instructions to enroll in or change your
benefits. Be sure to review each benefit category. Each
STEP 4
category will have a check mark in the box on the lef
margin when you have completed your elections.
Save all changes.
Click on Go to Confirmation Statement and print a copy
STEP 5
for your personal records.
2021 U.S. Benefits Enrollment Guide 2
Important Reminders
As a Blackboard Student Success employee, you have access to valuable benefit
plan options and providers. You can find more information on these plans and
providers by reviewing this benefits enrollment guide.
Medical Plan Cost-Sharing
Charges Accumulate for Your Benefits
Out-of-Pocket Maximum Enrollment Checklist
The Blackboard medical plan includes This checklist will help guide you through enrollment.
an annual out-of-pocket maximum (OOP) ☐ Review the information enclosed in this enrollment guide
cap that is intended to limit how much ☐ Go to www.blackboard.bswif.com
you have to spend on health care. Not
☐ Enroll, drop or make changes to your medical, dental, vision,
all health care charges will contribute to supplemental life, FSA, Aflac, HSA, legal and identity thef benefits
this OOP maximum, but all cost-sharing ☐ Save all changes
charges such as deductibles, copays and
☐ Print or email a copy of your benefits confirmation statement
coinsurance payments (for doctor’s ofice
visits, prescription drugs, etc.) will contribute
toward your OOP maximum.
Dependent Verification Process
Blackboard employees who enroll their
spouse or dependent children for the first
time are reminded that they will need to
provide supporting documentation—a
copy of the marriage certificate for spouse
and birth certificate for child(ren)—to
the Blackboard benefits enrollment
center (blackboard@bswif.com) in order
for benefits elections to be approved.
Employees who enroll a domestic partner
will need to complete the domestic
partner certification process via the
Blackboard online benefits system
at www.blackboard.bswif.com.
2021 U.S. Benefits Enrollment Guide 3
Want to Save Money Year-Round?
Follow These Money Saving Tips:
1. Stay in-network and be sure to use your free preventive care visits.
2. Shop around when you need a provider. The www.carefirst.com/myaccount member site
will have the tools you need to cost out diferent options afer you enroll.
3. Ask for alternate options for care—there could be other treatments that are less costly and
just as efective. Be sure to bring this up with your provider.
4. Choose generic medications whenever possible.
2021 U.S. Benefits Enrollment Guide 4
Eligibility
All Blackboard Student Success active, non- Please see the last page of this enrollment
seasonal employees who work at least 30 hours guide for contact information for benefit
per week are eligible for the following benefits: partners.
• Medical and prescription drug (CareFirst Benefits-eligible employees may also provide
BlueCross BlueShield) coverage for eligible family members including:
• Health savings account (ConnectYourCare)
• Employee’s spouse or eligible domestic
• Dental (Delta Dental) partner
• Vision (Vision Service Plan) • Children up to age 26 (medical, dental
• Basic life and AD&D insurance (Cigna) and vision only)
• Supplemental term life, spousal, child
and AD&D insurance (Cigna) Domestic Partner Benefits
• Short Term Disability (Cigna) Student Success contact centers provide benefit
• Long term disability insurance (Cigna) coverage for eligible same sex or opposite sex
• Flexible spending accounts (HealthEquity/ domestic partners. Please be aware that under
Wageworks) federal tax law some benefits (such as health
• Legal insurance plan (ARAG) insurance) are not taxable for employees,
• Employee Assistance Program (Cigna) spouses and dependents. Because a domestic
partner is not considered a dependent under IRS
• Identity Thef Protection (Allstate/
guidelines, benefits for domestic partners and
InfoArmor)
their children are taxable. For more information,
• Accident, Critical Illness, Hospital
please visit the Blackboard online benefits
Indemnity (Aflac)
system at bswif.
All active, non-seasonal, salaried employees
are also eligible for the 401(k) Plan (Fidelity).
2021 U.S. Benefits Enrollment Guide 5
Qualified Life Events If you experience a qualified life event,
(Making Changes During the Year) you will have 30 days from the date of the
life event to change your benefit elections
Once you complete your benefits enrollment (provided the change is consistent with the
process, you will not be able to make life event). You will be required to provide the
changes during the year unless you Blackboard benefits enrollment center with
experience a qualified life event, such as: supporting documentation of the qualified
• Marriage or divorce life event and its efective date (send to
• Birth or adoption of an eligible child blackboard@bswif.com).
• A change in your covered dependent’s
eligibility for benefits through his or
Pre-Tax Benefit Contributions
her employer Several of your benefit plan deductions,
• You or a dependent become enrolled including those for medical, dental, vision,
in Medicare, Medicaid or CHIPRA HSA, FSA, 401(k) and legal are made on a
pre-tax basis. This means that you will not
• Your dependent ceases to meet
pay federal, state and social security taxes
Blackboard’s dependent eligibility
on the premiums you pay for these plans
requirements
through per pay period deductions. Paying
• Significant changes in the cost
for these premiums on a pre-tax basis helps
of coverage
reduce your taxable income and puts more
money back in your pocket.
See the Per Pay Period Deductions section
for premium information.
2021 U.S. Benefits Enrollment Guide 6Medical Plan
Benefit eligible employees can elect medical coverage under the HealthyBlue
Advantage plan through CareFirst BlueCross BlueShield. The HealthyBlue
Advantage plan is a high deductible health plan that provides eligible in-network
preventive care covered at 100% and includes prescription drug coverage. The
plan also ofers access to a tax-advantaged health savings account (HSA) that
you can use to help cover your annual deductible and out-of-pocket expenses.
Or, pay for health care expenses with other funds (not your HSA) and use your
HSA to save for future health care expenses or as an additional retirement
savings account. See page 9 for details.
About CareFirst
BlueCross BlueShield Quick Tip About Prescription
CareFirst BlueCross BlueShield is part Drugs
of the National BlueCross BlueShield
(BCBS) network, giving you access Blackboard’s medical plan comes with prescription drug
coverage. There are two ways to fill your prescriptions— either at
to the broad BCBS national network of
a retail pharmacy or through mail order. If you have maintenance
health care providers. If you are enrolled medications (something you take on an ongoing basis), mail
(or planning to enroll) in the HealthyBlue order is a time and a money saver. You’ll save money because
Advantage plan, go to the Blackboard you’ll only be responsible for paying two copays for a 90 - day
Student Success-specific microsite at supply when getting medications through mail order instead
of three copays. You’ll save time by receiving your maintenance
www.carefirst.com/blackboardss medications through the mail instead of having to pick them up at
to find a provider in the National the pharmacy.
BCBS network.
HealthyBlue Advantage Plan
Check out some of the medical plan’s
key features: The Importance of Choosing
• The plan pays benefits for eligible care In-Network Providers
received— in-and out-of-network—afer
you pay an annual deductible. The plan You can maximize your benefits by using National BlueCross
BlueShield network providers—including doctors, labs, hospitals
pays more for care received in-network.
and other facilities:
• Preventive care is covered at 100% when
• The plan pays a higher percentage of the cost of your care,
received in-network. and you pay less
• For most eligible services (including • Network providers have been contracted to ofer services
prescription drugs), you pay a copay to you at discounted rates
(afer deductible). To find in-network providers, go to
https://member.carefirst.com/mos/#/fadpublic/search/home
• The plan ofers access to a tax-advantaged
or call 866.399.9509.
health savings account (HSA) you can use
to help cover your annual deductible and
other eligible out-of-pocket costs.
2021 U.S. Benefits Enrollment Guide 7How the Family Deductible
Works for the HealthyBlue
Advantage Plan
If you enroll in Employee + Spouse,
Employee + Children, or Employee + Family
coverage under the HealthyBlue Advantage With an aggregate deductible, a
plan, you will have an aggregate family combination of one or more family
deductible. This means the expenses of members’ expenses must satisfy the
either one family member or all family family deductible of $5,000 for the
members must meet the total family plan to start paying benefits.
deductible before the plan pays benefits.
It is important to note that the deductible
may be satisfied through either medical or
prescription drug expenses that you incur,
or a combination of the two—there are
not separate deductibles for medical and
prescription drugs.
2021 U.S. Benefits Enrollment Guide 8Health Savings Account
If you enroll in HealthyBlue Advantage plan, you can open a health savings account (HSA)
through ConnectYourCare—our HSA administrator—and use it to pay current and/or future
qualified medical, prescription drug, dental and vision expenses.
Health Savings Account (HSA)
What is it? A tax-advantaged, interest-bearing savings account you use in conjunction with a high deductible health plan.
Employees who enroll in the HealthyBlue Advantage plan, and:
• Have a zero balance in a health care flexible spending account (FSA);
Who is • Are not covered under any other non-high deductible health plan, including a spouse’s plan;
eligible? • Are not covered under Medicare, Medicaid or Tricare; or
• Are not claimed as a dependent on someone else’s tax return.
If not eligible, consider opening an FSA.
How do You can enroll in and select your annual contribution amount through bswif at any time, provided you are
I enroll? enrolled in the HealthyBlue Advantage plan.
• Eligible medical, dental and vision care services
What can • Prescription medications
it be used • Future health needs, including those in retirement
for? For a full list of qualified medical expenses, visit the Internal Revenue Service website at www.irs.gov and see
publication 502 titled Medical and Dental Expenses.
From you, via payroll deductions, up to annual IRS limits
Where does • IRS limits for 2021 are $3,600 for an individual and $7,200 for a family
the money • If your spouse is enrolled in his or her own HSA, your combined contributions cannot exceed the annual
come from? family maximum contribution amount
• If you are age 55 and over, you can make additional catch-up contributions of up to $1,000 per year
• You enroll in the HealthyBlue Advantage plan and open an HSA with ConnectYourCare via bswif
• You make contributions to your HSA through pre-tax, paycheck deductions.
— You can change your contribution elections at any time, via bswif
• You can pay for eligible expenses four ways:
How does it — Pay directly using your HSA debit card; or
work? — Pay electronically using your online ConnectYourCare account at https://www.connectyourcare.com/; or
— Pay out-of-pocket and reimburse yourself with HSA funds; or
— Pay the expense out of pocket and save your HSA funds for later use, even afer retirement.
• You can also elect to contribute to a limited purpose HSA-compatible FSA to pay for eligible dental
and vision expenses.
You own it. You decide whether to spend or save your HSA funds. If you leave Blackboard, the money is still
yours; you can use it now and/or in the future.
Increase your tax savings. HSAs ofer you three times the tax savings: your payroll contributions are
tax-free, the money you take out to pay for qualified expenses is tax-free, and interest and investment
savings are tax-free.
Why use it? Savings for medical expenses afer retirement. Your HSA funds can be a key component of your retirement
savings strategy; you can use your HSA as a vehicle to help you begin saving now for medical expenses in
retirement.
Investment performance. Your HSA funds are automatically deposited in an FDIC-insured, interest-bearing
account through UMB, ConnectYourCare’s banking partner; you can choose from a number of investment
options once your account balance reaches $1,000, and grow the dollars you don’t use over time so you have
more to spend on future eligible expenses.
2021 U.S. Benefits Enrollment Guide 9HSAs and Taxes Enroll in the Limited Purpose
You must complete IRS Form 8889 with your HSA-Compatible FSA to Pay
tax return each year to report total deposits for Eligible Dental and Vision
and withdrawals from your health savings Expenses
account. You do not have to file an itemized
If you open an HSA, you are not allowed to
return to use this form.
enroll in a traditional health care flexible
Please be sure to save all your receipts for spending account (FSA). However, you are
health care services when using your HSA. allowed to enroll in a limited purpose
Saving your receipts will assist you with your HSA-compatible FSA to help pay for eligible
tax filing if you are ever audited by the IRS. dental and vision expenses only. See page 21
for more information.
Download the myCYC mobile app to manage your
account on the go or visit connectyourcare.com for
the following HSA resources:
• HSA Information Guide
• Eligible HSA Expenses
• How to File an HSA Claim
2021 U.S. Benefits Enrollment Guide 10Medical Benefits-at-a-Glance
Plan HealthyBlue Advantage Plan
Features In-Network You Pay: Out-of-Network1 You Pay:
Yearly Deductible
Individual $2,500 $4,500
Family $5,000 $9,000
Out-of-Pocket Maximum2
Individual $4,500 $6,000
Family $6,550 $12,000
PCP: Deductible; then $0 copay per visit
PCP/Specialist Ofice Visit Deductible; then $50 copay per visit
Specialist: Deductible; then $30 copay per visit
Preventive Care
Well-Child Visits Covered at 100% Deductible; then covered at 100%
Routine Physicals/Immunizations
Well Woman Care/Pap Test
Covered at 100% $50 copay per visit
Mammograms
Maternity Services
Ofice Visits Covered at 100% Deductible; then $50 copay per visit
Childbirth/Delivery/Professional Services Deductible; then $30 copay per visit Deductible; then $50 copay per visit
Facility Professional Services Deductible; then $300 copay per day Deductible; then $500 copay per day
Inpatient Hospital Services3
Facility Fee (e.g., hospital room) Deductible; then $300 copay per day Deductible; then $500 copay per day
Physician/Surgeon Fee Deductible; then $30 copay per visit Deductible; then $50 copay per visit
Non-Hospital: Deductible; then $100 copay per visit Non-Hospital & Hospital:
Outpatient Services or Surgeries
Hospital: Deductible; then $300 copay per visit Deductible; then $500 copay per visit
Emergency Care
Deductible; then $200 copay per visit
Hospital Emergency Room
Urgent Care Facility Deductible; then $50 copay per visit Deductible; then $50 copay per visit
Ambulance In-Network Deductible; then $50 copay per service
Diagnostic Tests (Non-Hospital)
Lab Tests Deductible; then covered at 100% Deductible; then $50 copay per visit
X-rays Deductible; then $50 copay per visit Deductible; then $50 copay per visit
Imaging (CT/PET scans, MRIs) Deductible; then $100 copay per visit Deductible; then $200 copay per visit
Prescription Drug
Generic Drugs: Deductible; then $0 copay
Retail (up to a 30-day supply) Preferred Brand Drugs: Deductible; then $25 copay
Non-Preferred Brand Drugs: Deductible; then $45 copay
Generic Drugs: Deductible; then $0 copay
Mail Order (up to 90-day supply) Preferred Brand Drugs: Deductible; then $50 copay
Non-Preferred Brand Drugs: Deductible; then $90 copay
1
Reimbursement is based on CareFirst BlueCross BlueShield’s Allowed Amount. You may be responsible for filing claims and/or paying any charges that
exceed the Allowed Amount.
2
Out-of-pocket limit (includes all covered expenses) accumulates toward both the in- and out-of-network payment limit.
3
All inpatient hospital services must be pre-certified. 10% penalty applied to out-of-network without pre-certification.
2021 U.S. Benefits Enrollment Guide 11CareFirst BlueCross BlueShield Resources
CareFirst BlueCross You’ll discover the lifestyle behaviors helping
you stay younger or making you age faster
BlueShield Microsite
and receive insightful recommendations
Before you enroll, visit the microsite, created based on your results.
exclusively for Blackboard employees, at
www.carefirst.com/blackboardss where Health Coaching
you can access member tools, health and
wellness resources and plan information. You may receive a call or email inviting
you to participate in health coaching.
Or, call 877.260.3253 and press option 7
Manage Your Medical Plan to enroll in the coaching program.
Coaches are registered nurses and trained
Information with My Account professionals who provide one-on-one
Set up an account at www.carefirst.com/myaccount to track support to help you reach your wellness
your personal information on your laptop, or on your mobile
goals. Take advantage of this voluntary and
device via the CareFirst mobile app.
confidential program that can help you
With your online account, you can check your claims, view your
ID card, find a doctor or urgent care center, manage your health
achieve your best possible health.
plan, and more!
Diabetes Prevention Program
Participate in an interactive, telemedicine-
Enhanced Health and based lifestyle change program developed
Wellness Programs by the Center for Disease Control and
CareFirst gives you access to a highly Prevention (CDC). This 12-month program
personalized wellness program through can help you lose weight and significantly
Sharecare, Inc.* You’ll find motivating digital reduce the risk of developing type 2 diabetes.
resources—accessible anytime—that support You’ll have support from a personal health
your unique health and wellness goals and coach or registered dietician and tools and
help you live a healthier life. Once you become resources at your fingertips. Note: There are
a member, visit carefirst.com/sharecare to qualifying factors—be sure to check out the
get started. Enter your CareFirst account Prevent Diabetes section of carefirst.com/
username and password and complete the sharecare to see if you are eligible.
one-time registration with Sharecare to link
your CareFirst account information.
RealAge® Health Assessment
Find out if your healthy habits are truly Download the CareFirst BlueCross
making an impact. In just a few minutes, BlueShield mobile app from your app
RealAge will help you determine the physical store, or visit the mobile website on your
age of your body versus your calendar age. device at https://member.carefirst.com/.
* Sharecare, Inc. is an independent company that provides health
improvement management services to CareFirst members.
2021 U.S. Benefits Enrollment Guide 12Tobacco Cessation Program FirstHelp—Free 24-Hour
Expert guidance, support and tools make Nurse Advice Line
quitting easier than you think. Quitting Call 800.535.9700 anytime to speak with a
smoking and other forms of tobacco can registered nurse. Nurses will discuss your
lower your risk for many serious conditions symptoms with you and recommend the
from heart disease and stroke to lung cancer. most appropriate care.
Financial Wellness Program Get Great Deals—and Better
Take small steps toward big improvements Health—with Blue365
in your financial situation. Whether you want Blue365 is CareFirst BlueCross BlueShield’s
to stop living paycheck to paycheck, get out member discount program. Get discounts
of debt, or send a child to college, financial from a variety of national retailers, including
wellness resources are here to help. Jenny Craig, Reebok, Healthways and
Fairmont Hotels & Resorts. To register, go to
Tailored Resources and Tools www.carefirst.com/wellnessdiscounts and
Access these exclusive features online or via have your CareFirst BlueCross BlueShield
the CareFirst mobile app: member ID card ready.
• Personalized timeline: Receive content
Staying Healthy During Pregnancy
based on your health and well-being
goals, along with your motivation and Have a healthy pregnancy and a healthy baby
interests. with these planning tools and programs:
• Trackers: Connect your wearable devices • Online pregnancy center: Go to
or enter your own data to monitor daily www.carefirst.com/pregnancy to
habits like stress, sleep, steps, nutrition access interactive tools and a wealth
and more. of information about pregnancy, labor
• Challenges: Stay motivated to achieve and delivery, and newborn care.
your health goals by joining a challenge. • 24-hour health care advice line: Call
• Health Profile: Access your health data 800.535.9700 to speak with a registered
like biometric and lab results, vaccine nurse who can answer your questions
information and medications, all in or guide you to appropriate care.
one place. • Text4baby messages: Get text
• Stress Management: With Inspirations & messages with health tips and
Relax 360, access relaxation and wellness information throughout your pregnancy
videos to help you find freedom from and your baby’s first year. Go to
stress, unwind, or ease into a restful night www.text4baby.org to begin.
of sleep. • High-risk pregnancy support: Call
888.264.8648 for support if you
are at risk for a premature delivery
or for pregnancy-related medical
complications.
2021 U.S. Benefits Enrollment Guide 13See a Doctor 24/7/365 with CareFirst Video Visit
CareFirst BlueCross BlueShield Video Visit allows you to see a doctor whenever and wherever you want, via your
smartphone, tablet or computer, and typically costs less than a traditional doctor visit. Use Video Visit for treatment
of common, non- emergency health issues like the flu. You can get care for other needs like behavioral health support
from a therapist or psychiatrist, guidance from a certified nutritionist or breastfeeding support from a lactation
consultant. Visit carefirstvideovisit.com to learn more and to register.
Blue Rewards: Your Reward for Living Healthier
Blue Rewards ofers you incentives for taking steps to get and stay healthy. You decide
which healthy activities interest you and get rewarded for completing them. Both you and
your enrolled spouse or domestic partner can earn rewards for completing one or all of the
following activities:
Earn $100: Select a primary care provider (PCP) and complete a health screening
You can visit your PCP or visit a CVS MinuteClinic® to complete your screening.
Must complete within 120 days of when your benefits go into efect.
Earn $50: Consent to receive wellness emails and take the RealAge® Health Assessment
Must complete within 120 days of when your benefits go into efect.
Earn $25: Retake the RealAge® Health Assessment
If you earned the reward for taking the assessment initially, you can earn an additional reward
for retaking it afer six months. Must complete before the end of your benefits plan year.
Completing a Health Screening Receiving Your CareFirst Blue
Health screenings help you understand Rewards Visa® Incentive Card
your current health status, so you can take You’ll receive an incentive card about 10–14
steps to improve it. You can complete days afer completing one or more activities.
a health screening with your PCP or at Put it toward your annual deductible or other
a CVS MinuteClinic.® eligible out-of-pocket costs like copays or
coinsurance for medical, prescription drug,
Choosing a Primary Care Physician dental and vision benefits. Make sure to
Be sure to choose a PCP* who participates in always save your receipts as proof of the
our Patient-Centered Medical Home (PCMH) expense. As long as you remain a CareFirst
program to earn your reward. The PCMH member, any future incentives you earn will
program is designed to provide your PCP be automatically added to the same card.
with a more complete view of your health You have until the end of your benefit plan
needs and the care you receive from other year to use your reward, plus an additional
providers. 90 days to reimburse yourself for any eligible
* If you have a PPO or Advantage plan, and you live outside MD,
DC or Northern VA, you can select a provider from the BlueCard expense that occurred during the year. You’ll
PPO network who specializes in general practice, family practice, receive only one incentive card, but it can be
internal medicine, pediatrics or geriatrics.
used by everyone covered under your plan
(including dependent children).
2021 U.S. Benefits Enrollment Guide 14Dental Plan
Dental benefits are provided through our dental partner, Delta Dental. You do
not have to elect medical coverage in order to elect dental coverage.
The Delta Dental plan ofers a choice of in-network or out-of-network providers. The in-
network providers are in the PPO network. Please note that you may be required to pay out-
of-network providers at the time of service and may incur higher out-of-pocket costs
and balance billing. Below is a description of the benefits and coverage levels for the Delta
Dental plan.
Delta Dental Plan
PPO Network Premier and Out-of-Network
Yearly Deductible
Individual $50 $50
Family $100 $100
Preventive & Diagnostic Care
Covered at 100% Deductible; then covered at 100%
Exams, Cleanings & X-rays
Basic Care Services
Fillings, Extractions, Posterior Deductible; then covered at 80% Deductible; then covered at 50%
Composite Fillings
Major Services
Inlays, Onlays, Crowns & Bridges, Deductible; then covered at 50% Deductible; then covered at 50%
Oral Surgery
Orthodontia
50% 50%
Adults and Children
Orthodontia Lifetime Maximum
$1,500 $1,500
Adults and Children
Calendar Year Maximum Benefit
$1,000 $1,000
Per covered person
Check out the Delta Dental mobile app
or visit the Delta Dental web portal
for more information.
2021 U.S. Benefits Enrollment Guide 15Vision Plan Options
You will have a choice of vision coverage options. You may choose to enroll in the Vision
Service Plan (VSP) or, if you enroll in the medical plan, you automatically have access to
a discount plan called BlueVision provided by CareFirst BlueCross BlueShield and ofered
through the Davis Vision, Inc. national network of providers. Read this section to determine
which vision coverage option is right for you and your family.
Vision Service Plan (VSP) Option VSP Copays, Discounts & Services
The VSP vision plan is a separate election (not Product/Service Details
bundled with the medical plan) and you will WellVision Exam® $15 copay every calendar year
pay for coverage through bi-weekly pay period Frame/Lenses $20 copay every calendar year
deductions. Employees and dependents
Contacts
$125 allowance every calendar year
enrolled in the VSP vision plan have access to (instead of glasses)
VSP EasyOptions, which ofers the flexibility Glasses/Sunglasses
30% discount on lens options such as scratch
resistance and anti-reflective coatings
to choose your vision benefits coverage
30% discount on additional glasses, sunglasses
while at the doctor’s ofice. Review the VSP® Glasses/Sunglasses
and lens options
EasyOptions table on the right to learn more. Laser Vision Correction
15% discount on regular price or
(applies only to contracted
5% discount on promotion price
facilities)
VSP Vision Plan Highlights
Discounts on designer brand frames,
VSP® EasyOptions
including bebe®, ck Calvin Klein, Flexon®,
Lacoste, Michael Kors, Nike and Nine West. If you enroll in VSP, EasyOptions is included, and you and your
dependents get to personalize the coverage that works best for
Discounts on brand-specific contacts, you at the time you visit your in-network doctor.
glasses, and LASIK You and each of your dependents can choose a diferent
• Contacts: Mail-in rebates on eligible customizable benefit at the time of your appointment to
best meet your vision needs. For plan details, visit vsp.com
ACUVUE and Bausch & Lomb brand contacts
or call 800.877.7195.
• Glasses: Savings from 40%–50% Crizal
No-Glare technology, Nike prescription
sunglasses, Transitions® Adaptive lenses,
$250 Frame Progressive Photochromic
UNITY® digital lenses and more Allowance
OR
Lenses
OR
Lenses
• Lasik: Additional savings up to $500 from
NVISION Eye Centers and $400 savings OR
from TLC Eye Centers® IN LIEU OF GLASSES
$200 Elective Contact Lenses Allowance
Download the VSP mobile app
from your app store or visit vsp.com
for easy access to plan information.
2021 U.S. Benefits Enrollment Guide 16TruHearing MemberPlus® Program BlueVision Option
A free membership for VSP members and their If you enroll in the medical plan, BlueVision,
dependents that provides access to a national provided by CareFirst BlueCross BlueShield,
network of more than 4,500 licensed hearing is bundled with your medical plan coverage,
aid professionals and discounts on hearing which means your per pay period deductions
aid purchases including hearing aid units, for medical coverage also pay for your
batteries and more. BlueVision coverage. BlueVision ofers vision
Go to www.VSP.com for more information. care discounts through the Davis Vision, Inc.
national network of providers.
BlueVision Highlights
BlueVision BlueVision helps you save on exams, eyeglasses,
In-Network Services You Pay sunglasses, contact lenses, LASIK procedures
Eye Examinations and more. Here’s how BlueVision works:
Routine Eye Exam with Dilation $10
(per benefit period)
• To get started, find a participating provider
Frames1
Priced up to $70 retail $40 by visiting https://member.carefirst.com/
Priced above $70 retail $40, plus 90%
of the amount over and using the Find a Provider feature, or
$70 by calling Davis Vision at 800.783.5602.
Spectacle Lenses1
Single Vision $35
Be sure to ask the provider if he or she
Bifocal $55 participates in the Davis Vision network.
Trifocal $65
Lenticular $110 • When you schedule your appointment,
Lens Options1, 2 identify yourself as a CareFirst BlueCross
(add to spectacle lens prices above)
Standard Progressive Lenses $75 BlueShield member and provide your
Premium Progressive Lenses (Varillux®, etc.)
Ultra Progressive Lenses (digital)
$125
$140
identification number and date of birth.
Polarized Lenses $75 There are no claim forms to file if you use
High Index Lenses $55
Glass Lenses $18 a network provider.
Polycarbonate Lenses $30
Blended Invisible Bifocals $20 • BlueVision also ofers a benefit for a
Intermediate Vision Lenses $30 routine eye exam at a non-Davis Vision
Photochromic Lenses $35
Scratch-Resistant Coating $20 provider. You will have to pay the entire
Standard Anti-Reflective Coating $45
Ultraviolet (UV Coating) $15 cost of the service up-front, then submit a
Solid Tint $10 claim to Davis Vision for reimbursement.
Gradient Tint $12
Plastic Photosensitive Lenses $65 • You can receive one pair of eyeglasses or a
Contact Lenses2 supply of contact lenses per benefit period,
Contact Lens Evaluation and Fitting 85% of retail price
Conventional 80% of retail price at a discounted price (limits may apply).
Disposable/Planned Replacement 90% of retail price
DavisVisionContacts.com, Mail Order Discounted prices • For more information, visit
Contact Lens, Replacement Online
https://member.carefirst.com/
Up to 25% of
allowed amount
or call 800.783.5602.
Contact Lenses1
or 5% of any
advertised special3
1
CareFirst BlueCross BlueShield does not underwrite lenses, frames,
and contact lenses in this program. This portion of the Plan is not an
Out-of-Network Services You Pay insurance product. Some providers in Maryland and Virginia may not
provide these discounts.
Routine Eye Examination with Dilation Plan pays $33, you 2
Special lens designs, materials, powers and frames may require
(per benefit period) pay balance
additional cost.
3
Some providers have flat fees that are equivalent to these discounts.
2021 U.S. Benefits Enrollment Guide 17Life and Disability Insurance Plans
Blackboard provides Basic Life and Accidental Death & Dismemberment
(AD&D) insurance coverage for you and your family in the event of a serious
accident or death. In addition, Blackboard ofers the opportunity to purchase
additional life insurance and AD&D coverage for yourself and your family
members. Blackboard also provides company-paid short term disability (STD)
and long term disability (LTD) insurance coverage that replaces a portion of
your base pay should you need it.
Basic Life and AD&D Coverage
COMPANY-PAID
Blackboard automatically provides benefits-eligible employees with basic life and AD&D
insurance through Cigna at no cost to you. Coverage is provided in the amount of one times
your total annual compensation* (minimum $50,000; maximum $500,000). If the insurance
company deems your death to be the result of an accident, an additional amount equal to the
amount described above will be payable to your beneficiary.
* Your annual earnings are calculated based on your regular pay including overtime, bonuses and commissions calculated as of December 31
of the previous year or at current base salary, whichever is greater.
Supplemental Life and AD&D Coverage
Supplemental Employee Life Insurance
EMPLOYEE-PAID
You may elect supplemental employee life insurance coverage, up to the guaranteed issue limit
of $300,000, when initially eligible for benefits as a new hire. You may choose to elect up to
$1,000,000 in supplemental coverage. Requests for amounts greater than the Guaranteed Issue
Limit and/or outside your initial period as a new hire will require Evidence of Insurability (EOI).
Supplemental Spouse/Dependent Life Insurance
EMPLOYEE-PAID
You may elect life insurance coverage for your spouse, domestic partner and/or eligible
dependents provided you have also purchased supplemental coverage for yourself:
• Spouse/domestic partner: Up to 50% of employee supplemental coverage, up to a
maximum of $250,000; Guaranteed Issue Limit is $50,000 (if purchased when initially eligible)
• Children: Up to $10,000
Supplemental AD&D Coverage
EMPLOYEE-PAID
You can elect two levels of coverage: for you or for your entire family. Coverage is available in
increments of $10,000 up to a maximum of $1,000,000. Coverage can be purchased at any time
and is not subject to Evidence of Insurability (EOI).
2021 U.S. Benefits Enrollment Guide 18Disability Income Protection Long Term Disability Insurance
Disability insurance is an extremely COMPANY-PAID
important part of the Blackboard benefit The long term disability (LTD) plan through
program. Disability benefits are payable Cigna is a 100% employer-paid program. If
when you are deemed unable to work by the you are unable to work because of an illness
insurer. Benefits are not available because or injury, LTD benefits will start afer 90 days
of the illness or injury of a family member and may cover you up to age 65 if you remain
or for other purposes such as doctor visits. disabled. Long term disability replaces 60%
Disability benefits run concurrent with the of your base pay (maximum coverage of
Family & Medical Leave Act (FMLA) (or state $8,000/month).
equivalent) where applicable.
Short Term Disability Insurance
COMPANY-PAID
More Information
The short term disability (STD) plan through For more information on supplemental life and AD&D insurance
plans, please visit the library section of bswif at
Cigna is a 100% employer-paid program. If www.blackboard.bswif.com.
you can’t perform your job because of an
illness or injury, your STD benefits will start
on the eighth day of your illness or injury and
continue up to 13 weeks. Short term disability
replaces 60% of your base pay (maximum
coverage of $1,500/week). Employees are
eligible afer one year of employment.
2021 U.S. Benefits Enrollment Guide 19Other Voluntary Pre-Tax Benefits
You may elect to participate in any of the following benefits and the funds will
be deducted via pre-tax pay period deductions.
Flexible Spending Accounts (FSAs) Health Care FSA
FSAs allow you to set aside pre-tax money If you are not enrolled in a health savings
from your pay to use throughout the year account (HSA), you can contribute from $100
to reimburse yourself—tax-free—for certain up to $2,700 annually on a pre-tax basis to
health care and dependent care expenses. the health care FSA. You can then use these
Blackboard ofers three FSAs to help you funds throughout the year to pay for eligible
save for eligible health care and dependent health care expenses, such as:
day care expenses, as well as save money on • Out-of-pocket medical and prescription
your taxes. You are not required to elect any drug costs such as copays, deductibles
medical, dental or vision coverage in order and coinsurance
to participate in the FSAs, except the limited
• Out-of-pocket costs for covered dental,
purpose HSA-compatible FSA.
vision and hearing expenses
Go to the HealthEquity/WageWorks
portal to access your FSA(s).
Health Care FSA Debit Card
through HealthEquity/WageWorks
If you enroll in the health care FSA or the limited purpose HSA-
compatible FSA, you will receive a health care FSA debit card to use
to pay for eligible expenses. According to IRS regulations, you may
only use your health care FSA debit card at health care providers,
such as hospitals, doctors, dentists, chiropractors and pharmacies.
When you use your health care FSA debit card at an approved
provider, you may be required to substantiate your transactions with
WageWorks (our FSA benefit partner). If a transaction is not auto-
approved, please provide receipts directly to WageWorks. If a charge
is not substantiated, WageWorks may suspend your health care FSA
debit card until payment is settled.
You may contribute to a health care FSA only if you do not
participate in an HSA. If you are currently enrolled in a health
care FSA, you must reach a zero FSA balance before you can
open an HSA.
2021 U.S. Benefits Enrollment Guide 20Dependent Care FSA Limited Purpose
You can contribute from $100 up to HSA-Compatible FSA
$5,000 annually ($2,500 if married and If you enroll in the HealthyBlue Advantage
filing separately) on a pre-tax basis to the plan and open an HSA, you can also
dependent care FSA if both parents are contribute from $100 to $2,700 on a pre-tax
working. You can then use these funds to pay basis to the limited purpose HSA-compatible
for dependent care expenses, such as: FSA. Please note that you can only use
• Care for your child, through age 12 these funds to pay for eligible dental and
• Care for a covered family member who vision expenses within the plan year.
is physically or mentally disabled and Funds remaining in the limited purpose FSA
unable to care for himself or herself, will be forfeited at the end of the year.
resides in your home for at least eight
hours per day and you claim as a Important FSA Facts and Rules
dependent on your federal tax return Please note the following important
• Preschool or nursery school expenses FSA rules:
• Babysitter in your home • You must re-enroll in the FSAs every year if
• Day care center you wish to contribute funds to the FSAs.
• Summer day camp • You forfeit any money remaining in
• Afer-school care your FSA at the end of the year and
• Adult day care center or in-home care for you cannot carry FSA funds over from
an adult dependent year to year. However, you can submit
receipts for claims incurred in 2021
• And more
through March 31 of the following year.
2021 U.S. Benefits Enrollment Guide 21Additional Benefits
In addition to the benefits in which you enroll during your benefits enrollment
period (such as medical, dental, vision, HSA and FSA benefits), the Student
Success contact centers also provide eligible employees with these additional
valuable benefits.
Adoption Assistance Benefit Allstate Identity Protection
We ofer an adoption assistance benefit Pro Plus
to help employees with adoption-related Allstate Identity Protection delivers a
expenses. The adoption assistance benefit powerful new approach to online privacy,
provides a Federal tax-free benefit of with unique tools and proactive monitoring
$5,000 per child and an additional $1,000 that help you see your personal data, manage
per adopted child with special needs, for it with real time alerts, and protect your
employees who have completed one full year identity. Monitor your financial transactions,
of service with the contact center. You can social media, student loans, retirement
find more information about the adoption accounts, and more. If fraud occurs, Allstate’s
assistance benefit within the library section highly trained in-house experts fully manage
of bswif. and restore your identity, and their $1 million
insurance policy covers any of your associated
Cigna Will Preparation out-of-pocket costs.
You can take advantage of simple, self-
service online tools to help you prepare
for the future.
Services include:
• Last will and testament
• Living will
• Health care and financial power
of attorney
• Estate planning and more
Get more information at
https://www.clclegalforms.com/index?eid=
09C5E843.
2021 U.S. Benefits Enrollment Guide 22Bright Horizons Programs
Benefits for Your Whole Family
When you have work, family and personal responsibilities competing for your
time, there’s no need to stress. Instead, rely on Bright Horizons®. Explore all your
benefits today and start making your life easier.
FULL-TIME CHILD CARE elder caregivers, pet sitters, housekeepers
You can jump ahead on the waitlist at select and more.
Bright Horizons centers, or enjoy exclusive
EDUCATION AND COLLEGE ADVISING
discounts at participating partner centers that
Take the worry out of your child’s education.
make child care more afordable.
At zero cost to you, this benefit gives you
BACK-UP CHILD CARE access to a team of experts who ofer impartial
Next time school’s closed, the sitter’s on guidance you can trust. 60-90 minute live
vacation or you’re between child care events, guidance from more than 40 experts
arrangements, high-quality back-up care is with 750+ years of experience, and 24/7 online
just a click or call away. Register for free and resources to assist with all-important aspects
Bright Horizons can secure reliable care for of your student’s education are available to
you when and where you need it. Each covered you and your family members.
dependent will receive 20 days of dependent
TUTORING & TEST PREP
care, either at home or at a Bright Horizons
Get a discount on tutoring resources for SATs/
BackUp Care center. Center care costs $15 per
ACTs, standardized tests, Common Core
child or $25 per family; in home costs are $6/hr,
subjects and general help for your student
with a 4 hour minimum requirement.
from Bright Horizons’ partners.
BACK-UP ADULT AND ELDER CARE
SUPPORT FOR CHILDREN
When Mom gets injured, Dad needs help with
WHO NEED EXTRA HELP
meals, your spouse is recovering from surgery
You can be your child’s biggest advocate. Learn
or the regular caregiver calls out sick, Bright
how to understand, advocate for and support
Horizons can arrange high-quality back-up
your child in overcoming hurdles. Through this
care in their home. Each covered dependent
free benefit, you’ll get expert guidance and
will receive 20 days of dependent care at the
learn how to respond to your child’s unique
employee or dependent’s home. You pay $6/hr,
needs via online resources, personalized
and there is a 4 hour minimum requirement.
roadmaps and a webinar series.
ADDITIONAL FAMILY SUPPORT
Do you need a night out of the house? Are
you looking for an aferschool caregiver or
Register Now
someone to watchthe
Download your pet while
Back-Up Careyou’re
app: away Visit clients.brighthorizons.com/blackboard
on vacation? Back-Up Username: blackboard
SearchYou will getcare”
“back-up free membership
in the to
Password: Bbcares
SitterCity.com, where
App Store you can
or Google find support
Play. Education & College Advising Passcode: Bbcares
that meets your needs: nannies, sitters,
Questions? Call: 877.242.2737.
2021 U.S. Benefits Enrollment Guide 23Holidays
Blackboard ofices in the U.S. will be closed in Employee Assistance
observance of the following 2021* holidays: Program (EAP)
• New Year’s Day–January 1, 2021 Life Just Got a Little Bit Easier
• Martin Luther King, Jr. Day– We all face issues at work and home from time to time. When you
January 18, 2021 need a little help, Cigna — Blackboard’s life management partner
— has got you covered. Take advantage of enhanced physical,
• Memorial Day–May 31, 2021 financial and emotional health resources available to you and
• Independence Day–July 5, 2021 anyone in your household. You can access these resources 24/7,
by phone, online or in person, for help with challenges like stress,
• Labor Day–September 6, 2021 work/life balance and financial or legal concerns.
• Thanksgiving Day–November 25, 2021
Take advantage of a wide range of services ofered at no cost
• The Day afer Thanksgiving– to you:
November 26, 2021 · 3 face -to -face counseling sessions with a counselor in your
• Christmas Day–December 24, 2021 area, as well as video -based sessions; per issue/incident.
• New Years Day 2022–December 31, 2021 · Legal assistance: 30 -minute consultation with an attorney, face -
to -face or by phone.*
* Please see your Employee Handbook for more information on
holiday pay policy. · Financial issues: 30 -minute telephone consultation with a
qualified specialist on topics such as debt counseling or planning
for retirement.
· Parenting concerns: Resources and referrals for childcare
providers, before and afer school programs, camps, adoption
organizations, child development, prenatal care and more.
· Eldercare needs: Resources and referrals for home health
agencies, assisted living facilities, social and recreational
programs and long-distance caregiving.
· Pet care: Resources and referrals for pet sitting, obedience
training, veterinarians and pet stores.
· Identity thef: 60 -minute consultation with a fraud
resolution specialist.
To get started, call the Cigna Employee Assistance Program (EAP)
at 877.622.4327 or visit myCigna.com (Employer ID: blackboard).
Helpful webcasts on life management topics are also available.
Watch live or on-demand from a computer, smartphone or tablet
at: www.Cigna.com/EAPWebCasts.
Rest assured that your personal information is 100%
confidential and will not be shared without your consent.
2021 U.S. Benefits Enrollment Guide 24Legal Insurance from ARAG Aflac
Blackboard ofers a legal insurance plan Blackboard ofers Group Accident Insurance,
through ARAG that provides you access to Group Critical Illness Insurance and Group
a range of covered legal services including Hospital Indemnity Insurance plans through
advice and consultation, document Aflac. These plans are meant to supplement
preparation, living trusts/wills and more, existing medical coverage. While major
through a national network of highly medical pays for doctors and hospitals,
experienced attorneys. Aflac is insurance that pays cash benefits
directly to you (unless otherwise assigned).
By enrolling in the ARAG legal plan, you will It provides predetermined benefits that are
have access to in-ofice services, where you paid regardless of any other insurance you
can meet with a network attorney of your have. And it fits most budgets—rates don’t
choice to review the law, discuss your rights go up when you file a claim.
and responsibilities, explore your options
and recommend a course of action. To learn more about your Aflac benefits, please
view the links below:
Most covered legal matters are 100% paid in
full when you work with a network attorney. Accident plan:
You will also have the ability to talk to an https://www.youtube.com/watch?v=Gihl_
ARAG professional over the phone and utilize zxtn4s
ARAG’s robust online resources through their Critical Illness plan:
legal center. Additional covered services https://www.youtube.com/
include caregiving services direct from watch?v=RvdrHxmQ_uM
eldercare experts, identity thef protection
with credit monitoring, ID thef restoration Hospital Indemnity plan:
and identity thef insurance, and more. https://www.youtube.com/
watch?v=7MdNbBIRmMM
For more information call 800.247.4184 or
visit www.ARAGlegal.com/myinfo, access This is a brief product overview only. The
code 18120bla. plan has limitations and exclusions that may
afect benefits payable. Refer to the plans for
complete details, limitations, and exclusions.
Continental American Insurance Company
(CAIC ), a proud member of the Aflac family of
insurers, is a wholly-owned subsidiary of Aflac
Incorporated and underwrites group coverage.
CAIC is not licensed to solicit business in New
York, Guam, Puerto Rico, or the Virgin Islands.
2021 U.S. Benefits Enrollment Guide 25401(k) Plan
We ofer eligible employees the opportunity to
save money for retirement by participating in the
voluntary 401(k) retirement savings plan. The Plan
Did you know... allows you to make both pre -tax and certain afer-
The health savings account (HSA) you can open with your Blackboard tax (Roth) Deferral Contribution amounts (up to
medical plan can be used as a retirement savings account in addition IRS limits). Blackboard may also make an annual
to your 401(k). The maximum you can contribute to your 401(k) is $19,500 matching contribution to your 401(k) plan. You
(in 2020)*, and the maximum you can contribute to your HSA is $3,600 become fully vested in any matching contributions
for individuals and $7,200 for families (in 2021). That’s thousands of from Blackboard afer you complete three years
additional dollars you save pre -tax for retirement if you choose to wait of service following your initial employment date.
to spend your HSA savings. You will be 33% vested afer your first year of service
and 67% vested afer two years of service.
* Limit is subject to change for 2021 pending IRS guidance.
New hires will be automatically enrolled in 401(k)
pretax at a contribution rate of 3% of eligible salary
afer 30 days of employment. To opt out of the 401(k)
plan go online to www.401k.com or contact Fidelity
representatives at 800.835.5097. Your contributions
to the plan will be automatically increased by 1.00%
annually, based on plan rules, on or about April 1
each year.
The 401(k) plans are administered by Fidelity. To enroll,
make changes to your contributions, investments,
or beneficiaries, or, if you are a new hire, opt out of
automatic enrollment, please visit Fidelity’s website at
www.401k.com or call 800.835.5097. You can also find
more information on the Blackboard Online Benefits
website at www.blackboard.bswif.com in the Library
tab under 401(k).
All active, non-seasonal, salaried employees are
eligible for the 401(k) Plan.
2021 U.S. Benefits Enrollment Guide 26Per Pay Period Deductions
You will pay the following premiums, deducted per pay period, for coverage
under Student Success contact center medical, dental and vision plans.
Employee + Employee + Employee +
Plan Single
Spouse Children Family
HealthyBlue Advantage
$36.92 $365.16 $121.45 $421.90
Medical Plan
Dental Plan $10.44 $20.09 $20.08 $31.86
Vision Plan $4.15 $7.52 $7.91 $12.21
Your Benefit and
Enrollment Resources
The following resources are available to assist
you with open enrollment and any benefits-related questions:
The Blackboard online benefits website, bswif, is available
anytime at www.blackboard.bswif.com or via single sign on
at https://portal.ofice.com/myapps 24 hours a day from any
computer with internet access. You can also download the bswif
benefits app through your app store.
For help completing the online benefits enrollment process,
please call the bswif benefits enrollment center at 877.262.1248
or email blackboard@bswif.com. You can also reach the
Blackboard benefits team by opening a ticket in ServiceNow.
To learn more about the benefits ofered through
CareFirst BlueCross BlueShield please visit
www.carefirst.com/blackboardss or call 866.399.9509.
2021 U.S. Benefits Enrollment Guide 27Required Federal Notices
NEWBORNS’ AND MOTHERS’ HEALTH PROTECTION NOTICE OF PRIVACY PRACTICES
ACT OF 1996 (NMHPA)
The company’s privacy practices describe how medical information
The Newborns’ Act, and its regulations, provides that health plans and about you may be used and disclosed and how you can get access
insurance issuers may not restrict a mother’s or newborn’s benefits to this information. Blackboard may use or disclose your health
for a hospital length of stay that is connected to childbirth to less than information for: treatment, payment, claims assistance, health
48 hours following a vaginal delivery or 96 hours following a delivery care operations, group health plan, required by law, public health,
by cesarean section. However, the attending provider (who may be decedents, health and safety, government functions, and workers’
a physician or nurse midwife) may decide, afer consulting with the compensation. Blackboard is required by law to:
mother, to discharge the mother or newborn child earlier. • Maintain the privacy of protected health information;
The Newborns’ Act, and its regulations, prohibits incentives (either • Provide you with this notice of its legal duties and privacy policies
positive or negative) that could encourage less than the minimum with respect to your health information;
protections under the Act as described above. A mother cannot be • Abide by the terms of our privacy practices;
encouraged to accept less than the minimum protections available
to her under the Newborns’ Act, and an attending provider cannot be
• Notify you if we are unable to agree to a requested restriction on
how your information is used or disclosed;
induced to discharge a mother or newborn earlier than 48 or 96 hours
afer delivery. • Accommodate reasonable requests you may make to
communicate health information by alternative means or at
WOMEN’S HEALTH AND CANCER RIGHTS ACT NOTICE alternative locations.
If you have had or are going to have a mastectomy, you may be Blackboard reserves the right to change its information practices
entitled to certain benefits under the Women’s Health and Cancer and to make the new provisions efective for all protected health
Rights Act of 1998 (WHCRA). For individuals receiving mastectomy- information it maintains.
related benefits, coverage will be provided in a manner determined in The Plan is required by law to provide notice to participants of
consultation with the attending physician and the patient, for: the Plan’s duties and privacy practices with respect to covered
• All stages of reconstruction of the breast on which the individuals’ protected health information, and has done so by
mastectomy was performed; providing to Plan participants a Notice of Privacy Practices, which
• Surgery and reconstruction of the other breast to produce a describes the ways that the Plan uses and discloses protected health
symmetrical appearance; information. To receive a copy of the Plan’s Notice of Privacy Practices
you should contact Stephan Geering, Global Privacy Oficer, Associate
• Prostheses; and
General Counsel, who has been designated as the Plan’s contact
• Treatment of physical complications of the mastectomy, person for all issues regarding the Plan’s privacy practices and
including lymphedema. covered individuals’ privacy rights. You can reach this contact person
These benefits will be provided subject to the same deductibles at: +44.(0)20.7534.6747 or Stephan.Geering@Blackboard.com.
and coinsurance applicable to other medical and surgical benefits
provided under this plan. See Medical benefits at-a-glance for
deductible and coinsurance information. If you would like more
information on WHCRA benefits, call your plan administrator,
Blackboard, Inc., at 202.463.4860.
MEDICARE D Notice ONLY for Medicare Eligible Employees
Blackboard’s Prescription Plan through CareFirst is non-creditable.
This means our existing prescription coverage is, on average, not
as good as standard Medicare prescription drug coverage. You may
keep your coverage through CareFirst; however, since coverage is
non-creditable, depending on how long you go without creditable
coverage you may pay a penalty to join a Medicare drug plan. You can
join a Medicare drug plan when you first become eligible for Medicare
and each year from October 15 through December 7.
2021 U.S. Benefits Enrollment Guide 28You can also read
