2022 Retiree Benefits Briefing

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RetireeBenefits BriefingAn Open Enrollment Newsletter about 2022 Benefits for FCPS RetireesMonday, October 11 – Friday, November 5, 2021Mark Your Calendars!What’s New for '22?Open enrollment is your annualopportunity to review and make changesto your plan elections. Open enrollment forretiree benefits will start on Monday, Oct.11, and end on Friday, Nov. 5, 2021.As occurred last year, benefits openhouses will be held virtually. Therewill be many opportunities to chat withvendors and Benefits staff; see page 5 formore information.Premiums are set by expected planexpenses for the upcoming year andany reserves from the prior year. Due toreduced health and dental care claimsover the past year, premium increases arelow for 2022.OctoberMT1112OE starts!WT1314F15VIRTUALOpen House1 - 3 p.m.181920VIRTUALOpen House212228291 - 3 p.m.252627VIRTUALOpen House1 - 3 p.m.November112VIRTUALOpen House345OE ends!1 - 3 p.m.We encourage you to read this Briefingthoroughly to review changes occurringfor 2022. If you need further information,refer to the resources listed in this Briefingor plan to attend a virtual open enrollmentevent.For more information, please visit theRetirees Open Enrollment website(www.fcps.edu, search keywords “retireeopen enrollment”).2022 Plans & Premium ChangesMedicalMedicare-eligible retirees/dependentsAetna Medicare AdvantageKaiser Permanente MedicareNon-Medicare retirees/dependentsAetna/Innovation HealthCareFirst BlueChoice AdvantageKaiser Permanente Signature HMODentalAll retireesAetna DPPOAetna DNO 5.2% 1.3% 2.3% 2.3% 0% 0% 0%Medical/Dental/Pharmacy Benefits Premium Holiday!Medical/dental premiums will besuppressed in December in order torebate this plan year's funds to retirees. New Diabetes Management ProgramEffective January 1, participantsenrolled in the Livongo diabetesmanagement program will transition toa CVS administered program; lancetsand diabetic test strips will be coveredat 0 copay for all participants.Applies to pre-65 retirees. Program notyet available to Medicare retirees. Increased Dental MaximumThe annual benefit maximum under theAetna Dental PPO plan will increasefrom 1,750 to 2,000.OfficeOfficce offioff BeBBenefitenefifitt Services · FaFFairfaxair fax CoCCountyounty PuPPublicublic ScSSchoolsc ho o ls1

Benefit AnnouncementsMedical/Dental/PharmacyBenefitsNew Health Plan ID CardsComing to Some RetireesHealth/Dental Premium Holiday inDecemberOver the last 18 months, many individualspostponed elective medical and dentaltreatment as result of the pandemic.This delay created a surplus of reserveswhich are being returned to retirees.Retirees will not have medical and dentalpremiums deducted in December.Recent legislation and carrier systemupgrades mean some retirees will receivenew ID cards this fall. New cards areexpected to be issued to:Increased Dental MaximumThe annual benefit maximum for in-network services under the Dental PPO planwill increase from 1,750 to 2,000 effective January 1, 2022.New Diabetes Management ProgramEffective January 1, CVS will transitionparticipants enrolled in the Livongodiabetes management program toa new program. If you are enrolledin the program, look for upcomingcommunications from CVS, as theexisting Livongo meters will no longerbe connected as of January 1. Alsobeginning in 2022, lancets and diabetictest strips will be covered at 0 copayfor all CVS participants. Applies to pre65 retirees. Program not yet available toMedicare retirees.Formulary Drug ChangesChanges to the list of covered medications (formulary) occur periodically. It isimportant to check your plan’s drug formulary to see if changes will occur to yourcoverage or copays. You can view yourplan’s formulary by visiting the plan’s website: 2CVS Caremark: info.caremark.com/fcpsSilverScript: FairfaxPS.silverscript.comKaiser Permanente: my.kp.org/fcpsOffice of Benefit Services · Fairfax County Public Schools Aetna Medicare Advantage membersby mid-DecemberCareFirst members during the month ofDecemberKaiser members will not receive newID cards in the mail, but can access anupdated electronic version through theirmember account.New ID cards may be issued to Aetna/Innovation Health and Aetna dentalmembers later in 2022. Questions aboutyour ID cards should be directed to themember services department of yourinsurance plan.Benefit Contracts ReviewLike all public sector employers, FCPSmust periodically “compete” benefit plancontracts to ensure the programs providethe best value to both employees andFCPS. This Request for Proposal (RFP)process sometimes results in changes tothe plans or vendors offered.In 2021, RFPs were issued for the lifeinsurance benefits for employees covered under the Fairfax County Employees’ Retirement System (FCERS) andthe FCPS deferred compensation plans.Negotiations for these contracts continueand changes could occur in 2022. Oncefinalized, extensive communications willbe issued to impacted employees.Later this year, an RFP will be issued foremployee and retiree health insuranceplans, with changes expected in 2023.

Ways to Stay Healthy in 2022Get Your Flu Shot!This year, it's more important than everto get your flu shot! Retirees and theircovered dependents enrolled in FCPShealth plans can receive free1 flu vaccinesthrough a number of different sources.Aetna/Innovation Health and CareFirstmembers can receive a free flu vaccineat: Any CVS retail pharmacy nationwide In-network Primary Care Physicians Participating Pharmacies, RetailClinics and Urgent Care Centers(Carefirst members may access onlythose in the metro Washington D.C.area).Aetna Medicare Advantage memberscan receive a free flu vaccine at: Participating retail pharmaciesnationwide (i.e., CVS, Harris TeeterPharmacy, Wegmans Pharmacy, etc.) Any Primary Care Physicians, RetailClinics and Urgent Care Centers (i.e.,Minute Clinic, Patient First, etc.) thataccepts Medicare and accepts yourplan.Kaiser Permanente members can obtaina no-cost flu shot at Kaiser MedicalCenters, and at drive-thru and walk-upclinics. Go to http://my.kp.org/fcps forinformation on flu shot clinics.Don't forget! When obtaining a flu shotat a retail pharmacy, make sure youbring both your health plan and CVSCaremark/SilverScript ID cards.With all plans, your provider may choose to applyan office visit copay in conjunction with administeringthe vaccine, or your provider administers the vaccineduring an office visit for other services.1Take Advantage of Your Plan’sFitness Benefits!It’s easier than ever to stay healthy andmaintain an active lifestyle! If you are inan FCPS Medicare plan, you have fitnessbenefits available to you at 0 cost. Aetna Medicare Advantage’s SilverSneakers Program provides members access to thousands of participating fitness locations. You can alsodownload the app SilverSneakers Go.For more information, visit the AetnaMedicare website at www.aetnamedicare.com/fcps/en/index.html, click onthe "Live Well" dropdown menu andthen click on "Gym Memberships & Fitness Classes". Kaiser Permanente Medicare Advantage’s Silver&Fit Exercise andHealthy Aging Program lets members choose between two convenientoptions - a Fitness Center Membershipor a Home Fitness Program. To learnmore, visit the Kaiser website atmy.kp.org/fcps, click on "Plans andServices", and then click on "Silver &Fit Program".Medicare ID Card Needed forCOVID-19 Booster ShotsRetirees who will be obtaining a boosterimmunization for COVID-19 should bringboth their medical and pharmacy plan IDcards as well as their ‘original Medicare’card (the red, white, and blue card) tothe pharmacy or provider’s office. Whileall other medical services are billedthrough the insurance plan, the Centersfor Medicare and Medicaid Services hasindicated the booster vaccines are to bebilled directly to Medicare until furthernotice.Office of Benefit Services · Fairfax County Public Schools3

Get the Most of Your Health Plan!Understanding Your Health Insurance CostsWhen choosing the right health insurance plan for your specific needs and budget,it’s important to consider all the options available to you. Start by reviewing the 2022Premium Charts on pages 6-7 to see the amount you pay for your health insuranceeach month. While FCPS health plans all offer comprehensive coverage, keep in mindthat health plans can differ in which providers you can see and how much you mayneed to pay beyond your premium. Knowing the terms used in talking about healthinsurance will help you feel more comfortable when choosing a plan. Please take amoment to review the terms below.What is a Copay? What is a Deductible?Copaypaid byinsuredindividualMEDICAL BILLA fixed amount you payfor a covered health careservice (like a doctor’s visit,hospital outpatient visit, orprescription drugs).For example, you might paya 20 copay for primary carevisits and a 40 copay forspecialty care visits.Please note: the AetnaMedicare Advantage Plandoes not have copays formost services. The amount you pay forcovered health care servicesbefore your insurance starts topay.For example, a plan with a 250 deductible would meanthat you pay the first 250 ofcovered services yourself.All FCPS health plans covercertain preventive serviceswithout charging you a copayor coinsurance, even if youhaven’t yet met your yearlydeductible.Please note: the AetnaMedicare Advantage, KaiserPermanente SignatureHMO, and Kaiser MedicareAdvantage plans do notdeductibles.What is Coinsurance?%%The percentage of a coveredin-network health careservice you pay. This oftenapplies after you’ve paid yourdeductible.For example, if the healthinsurance plan’s allowedamount for an office visitis 100 and you’ve metyour deductible, your 10%coinsurance payment wouldbe 10. The health insuranceplan pays the rest.Out-of-pocket maximumThe most you have to pay for covered services in a plan year. Afteryou spend this amount on deductibles, copays, and coinsurance,your health plan pays 100% of the costs of covered benefits.The out-of-pocket limit doesn’t include your monthly premiums. It also doesn’t includeanything you may spend for services your plan doesn’t cover.4Office of Benefit Services · Fairfax County Public Schools

Your Open Enrollment ResourcesFCPS encourages you to utilize the many available resources to aid you in makingimportant benefits decisions. These resources include the FCPS and vendor websites,member service centers, and virtual support from FCPS staff and benefits vendorsduring Open EnrollmentFCPS ResourcesVisit our websitewww.fcps.edu(Search keyword “Benefits”)Send us an emailHRConnection@fcps.eduSpeak with a representativeBenefit Services: 571-423-3200Hours: 8 a.m. - 4:30 p.m., Mon. - Fri.Virtual Open HousesThe Office of Benefit Services (OBS) willbe hosting virtual sessions to discuss2022 benefits for retirees. Chat with benefit vendors and OBS staff to get answersto your questions. Virtual informationalsessions will be held on:How to Sign Up for a Virtual Open House Friday, October 15, 1 - 3 p.m. Wednesday, October 20, 1 - 3 p.m. Thursday, October 28, 1 - 3 p.m. Tuesday, November 2, 1 - 3 p.m.You will be asked to create an accountusing your preferred email and password.Then, you will complete registration for theevent by entering your name and employment status. A confirmation email with thesession link will be sent to the email address you provided.To register for a virtual open house, visitthe Retiree Open Enrollment website (www.fcps.edu, search “open enrollment”). Clickon the session link posted for the openhouse you would like to attend.Accessing the Open House EventOn the day of the event, you will use the session link that was emailed to you to accessthe virtual open house "lobby". You can move around the lobby and choose to enter“booths”. When you enter a booth, you have the opportunity to review posted materials and/or chat one-on-one with a representative. View the sample lobby below, so youknow what to expect!Please note: Retirees are encouraged to pre-register before the day of the event to ensure they can access.Office of Benefit Services · Fairfax County Public Schools5

2022 Dental Rates for ERFC and FCERS RetireesAetna DPPOAetna DNOCoverage LevelPre-65 Retirees/DependentsAge 65 andOlder Retirees/Dependents1Monthly Total RateMonthly Total RateIndividual 53.62Retiree 1 91.14Family 129.24 61.08Coverage LevelAll Age GroupsMonthly Total RateIndividual 21.25 103.82 Retiree 1 147.21 36.15Family 51.142022 Medical Rates for ERFC Retirees(Subsidy applies to age 55 and older)Medical PlanMonthly Total RateERFC Subsidy Appliesto Age 55 & OlderMonthly Total RateMinus SubsidyAetna/Innovation Health (Non-Medicare retirees)Aetna Group Medicare Advantage PPO (Medicare-eligible retirees)Individual 884.77 100.00 784.77Retiree 1 (no Medicare) 1,769.53 100.00 1,669.53Family 2,211.91 100.00 2,111.91Medicare Individual 410.71 100.00 310.71Double Medicare 821.42 100.00 721.421 Medicare 1 Individual 1,295.48 100.00 1,195.481 Medicare 2 Individuals 2,180.25 100.00 2,080.25Family (one or more has Medicare) 2,211.90 100.00 2,111.90 661.16 100.00 561.16Retiree 1 (no Medicare) 1,322.33 100.00 1,222.33Family 1,652.93 100.00 1,552.93CareFirst BlueChoice Advantage(Available to all retirees not eligible for Medicare)IndividualKaiser Permanente HMO (Non-Medicare retirees who live in the local KP HMO service area)Kaiser Permanente Medicare Advantage (Medicare retirees who live in the local KPMA service area)Individual 706.60 100.00 606.60Retiree 1 (no Medicare) 1,413.20 100.00 1,313.20Family 1,766.51 100.00 1,666.51Medicare Individual 251.22 100.00 151.22Double Medicare 502.44 100.00 402.441 Medicare 1 Individual 957.82 100.00 857.821 Medicare 2 Individuals 1,664.42 100.00 1,564.42Family (one or more has Medicare) 1,766.51 100.00 1,666.51The pre-65 premium is assessed if all covered individuals are under 65 or not covered by Medicare. The Age 65 and Older premium is assessed if one or moreindividuals are age 65 or older (or covered by Medicare).16Office of Benefit Services · Fairfax County Public Schools

2022 Medical Rates for FCERS Retirees(Subsidy applies to age 55 and older)Your medical rate will be the monthly total rate for your plan and coverage MINUS a subsidy based on your years ofservice (see Retiree Benefits Handbook).Medical PlanMonthlyTotal Rate 15Subsidy 25Subsidy 50Subsidy 100Subsidy 125Subsidy 150Subsidy 175SubsidyAetna/Innovation Health (Non-Medicare retirees)Aetna Group Medicare Advantage PPO (Medicare-eligible retirees)Individual 884.77 869.77 859.77 834.77 784.77 759.77 734.77 709.77Retiree 1 (no Medicare) 1,769.53 1,754.53 1,744.53 1,719.53 1,669.53 1,644.53 1,619.53 1,594.53Family 2,211.91 2,196.91 2,186.91 2,161.91 2,111.91 2,086.91 2,061.91 2,036.91Medicare Individual 410.71 395.71 385.71 360.71 310.71 285.71 260.71 235.71Double Medicare 821.42 806.42 796.42 771.42 721.42 696.42 671.42 646.421 Medicare 1 Ind. 1,295.48 1,280.48 1,270.48 1,245.48 1,195.48 1,170.48 1,145.48 1,120.481 Medicare 2 Ind. 2,180.25 2,165.25 2,155.25 2,130.25 2,080.25 2,055.25 2,030.25 2,005.25Family (w/Medicare) 2,211.90 2,196.90 2,186.90 2,161.90 2,111.90 2,086.90 2,061.90 2,036.90CareFirst BlueChoice Advantage(Available to all retirees/dependents not eligible for Medicare)Individual 661.16 646.16 636.16 611.16 561.16 536.16 511.16 486.16Retiree 1 (no Medicare) 1,322.33 1,307.33 1,297.33 1,272.33 1,222.33 1,197.33 1,172.33 1,147.33Family 1,652.93 1,637.93 1,627.93 1,602.93 1,552.93 1,527.93 1,502.93 1,477.93Kaiser Permanente HMO (Non-Medicare retirees who live in the local KP HMO service area)Kaiser Permanente Medicare Advantage (Medicare retirees who live in the local KPMA service area)Individual 706.60 691.60 681.60 656.60 606.60 581.60 556.60 531.60Retiree 1 (no Medicare) 1,413.20 1,398.20 1,388.20 1,363.20 1,313.20 1,288.20 1,263.20 1,238.20Family 1,766.51 1,751.51 1,741.51 1,716.51 1,666.51 1,641.51 1,616.51 1,591.51Medicare Individual 251.22 236.22 226.22 201.22 151.22 126.22 101.22 76.22Double Medicare 502.44 487.44 477.44 452.44 402.44 377.44 352.44 327.441 Medicare 1 Ind. 957.82 942.82 932.82 907.82 857.82 832.82 807.82 782.821 Medicare 2 Ind. 1,664.42 1,649.42 1,639.42 1,614.42 1,564.42 1,539.42 1,514.42 1,489.42Family (w/Medicare) 1,766.51 1,751.51 1,741.51 1,716.51 1,666.51 1,641.51 1,616.51 1,591.51Individual: You (the individual)Key to Coverage Level RatesRetiree 1 (no Medicare): You 1 dependent; no one hasMedicare coverage.Family (Retiree 2 or more): You 2 or more dependents;no one has MedicareMedicare Individual: You (the individual) have Medicarecoverage.Double Medicare: You 1 dependent. Both you and yourdependent have Medicare coverage.1 Medicare 1 Individual: You 1 dependent. Oneindividual has Medicare coverage and one individual doesnot.1 Medicare 2 Individuals: You 2 dependents. Oneindividual has Medicare coverage and two individuals donot.Family (with Medicare): You 3 or more dependents. Oneor more dependents have Medicare.Office of Benefit Services · Fairfax County Public Schools7

Your Open Enrollment ChecklistBefore Open Enrollment:Review your pre-open enrollment statement to ensure your plan and covereddependent(s) information is correct.If you will be requesting coverage for your spouse and/or dependent children whoare not currently enrolled, begin gathering legal documentation needed to addthem to the plan.If you are a direct bill participant (i.e. paying premiums to Optum), look for updatedmailings from Optum. If you are paying premiums using your bank's bill payservice, make sure to update your premiums before January.During Open Enrollment:Review this Benefits Briefing carefully as you consider your plan choices.Take advantage of the many open enrollment resources available to you. Attend avirtual FCPS or vendor session, review information on both the FCPS and benefitvendor websites, or contact the Department of Human Resources.If you wish to change your plan or covered dependent(s), complete Form HR-461and return to the Office of Benefit Services no later than November 5. The formcan be found online at www.fcps.edu, search keywords “Retiree benefits forms”You do not need to take action if you are not making any coverage changes.Af ter Open Enrollment:If you changed plans during Open Enrollment, look for new ID cards in lateDecember.Retirees adding their spouse ordependent children, please note –8 FCPS requests your spouse/dependentchild(ren)'s SSN for reporting healthplan enrollment to the IRS. If you are requesting coverage for yourspouse and/or dependent children notcurrently enrolled, you must supplythe appropriate legal documents tosupport eligibility for coverage underthe plan. Documents are not requiredfor dependents currently covered bythe plan.Your dependent’s coverage cannotbe made effective until the Office ofBenefit Services receives appropriatelegal documentation.Office of Benefit Services · Fairfax County Public SchoolsEligible for Medicare? Retirees andDependents Required to Enroll WhenFirst Eligible All FCPS retiree medical plansrequire retirees, spouses, and theirdependents to enroll in Medicare PartsA and B when they become eligible forMedicare, including eligibility due todisability. Retirees who retained FCPS healthcoverage must elect Medicare wheneligible even if they are working foranother employer.

Important RemindersHealth and Dental PremiumPayment RemindersWhile most retirees have their medicaland dental premiums deducted from theirretirement checks, some retirees payvia ‘direct bill’. Optum Financial Services(“Optum”) is FCPS’ billing partner forretirees who do not have their insurancepremiums deducted from their retirementchecks.Sometimes a retiree’s annuity will reduceto a level that will not support medical anddental deductions. If that occurs, be sureto open and read all communications fromOptum as it may contain your premiuminvoice or other important informationabout establishing your payment account.Optum offers safe and convenientpayment options! If you’re a retiree whopays premiums via direct bill, you are ableto pay for your benefits by:1. Setting up monthly recurringAutomated Clearing House (ACH)debits (i.e., automatic deductions fromyour bank account); or2. Making payments by check; or3. Making payments by debit or creditcard.Remember, premiums are due the firstof each month for that month’s coverage.For example, premiums for Decembercoverage are due December 1st. Settingup an automatic, recurring payment isan easy way to ensure your payment isreceived on time.Visit Optum’s website: adminservices.optumhealthfinancial.com to view youraccount information or set up newpayment options. As a reminder, onlythose retirees paying by direct bill willhave an account with Optum.NEW!Designate VRSBeneficiaries OnlineVirginia Retirement System (VRS)members can now designate beneficiariesonline for their Defined Benefit membercontributions and VRS Basic and OptionalGroup Life Insurance. Any changes madeto your beneficiaries online will overrideand revoke previous designations.If you submitted a (VRS-2) paper formbefore July 1, 2021, VRS cannot displaythat information in your myVRS onlineaccount. Beneficiaries designated on thepaper form will remain in effect until youupdate your designations online.If you do not designate beneficiaries,then the order of precedence establishedby law will be followed. VRS membersmay update their beneficiaries by logginginto their VRS account, then select the“Manage My Retirement" tab and then“Manage Beneficiaries” from the dropdown list.As a reminder, major life events such asmarriage, birth/adoption of children, ordivorce may warrant review or updatesto your beneficiary designations.Keep in mind you may have differentbeneficiaries designated for your lifeinsurance, retirement plan, and deferredcompensation benefits. If you are unsureif your beneficiaries are up to date werecommend you place new designationson file. Instructions for updating yourbeneficiaries can be found on the FCPSwebsite (www.fcps.edu, search keyword“beneficiary”).Office of Benefit Services · Fairfax County Public Schools9

FCPS Plans Comply with Non-Discrimination Provisions of the Affordable Care ActFCPS health plans comply with applicable Federal civil rights laws, including Section 1557 of the AffordableCare Act (Nondiscrimination in Health Programs and Activities). In compliance with the Act, FCPS health plansdo not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.FCPS health plans also prohibit denial of health care or health coverage based on an individual’s sex, includingdiscrimination based on pregnancy, gender identity, and sex stereotyping.The Plan also provides important protections for individuals with disabilities and enhances languageassistance for people with limited English proficiency. Each tagline listed below reads, "If you speak [nativelanguage], language assistance services, free of charge, are available to you. Call 571-423-3200."AMHARIC (አማርኛ)ትኩረት፦ አማርኛየምትናገርከሆነ፣ የቋንቋ እርዳታ አገልግሎት፣ በነፃ፣ ለእርስዎ ቀርቧል። 571-423-3200 ይደውሉ።ARABIC ( )اﻟﻌرﺑﯾﺔ .3200-423-571 اﺗﺻل ﻋﻠﻰ . ﻣﺗﺎﺣﺔ ﻟك ، ﻣﺟﺎﻧﺎ ، ﻓﺈن ﺧدﻣﺎ ت اﻟﻣﺳﺎﻋدة اﻟﻠﻐوﯾﺔ ، إذا ﻛﻧت ﺗﺗﺣدث اﻟﻌرﺑﯾﺔ : اﻧﺗﺑﺎه BENGALI (বাংলা)দৃ আকষণ: আপিন বাংলা , ভাষা সহায়তা েসবা, িনখরচা কথা বলেত পােরন, আপনার জন উপল . 571-423-3200 কল .CHINESE 23-3200。FRENCH (Français)ATTENTION: Si vous parlez Français, des services d’assistance linguistique, gratuits, sont à votre disposition. Composez le 571-4233200.GERMAN (Deutsch)ACHTUNG: Wenn Sie Deutschsprechen, stehen Ihnen kostenlose Sprachassistenzdienste zur Verfügung. Rufen Sie 571-423-3200 an.HINDI ( हंद )ध्यान द : य द आप हंद बोलतेह, भाषा सहायता सेवाएं, न: शल्क,आप के लए उपलब्ध ह । कॉल 571-423-3200 ।ुIBO (Igbo asusu)Ntị : Ọ bụrụ na ị na-ekwu okwu n'ala Igbo , asụsụ aka ọrụ , n'efu , dị ka gị. Akpọ 571-423-3200 .KOREAN (한국어)주의: 한국어를구사하는경우, 무료로 언어 지원 서비스를 이용할 수 있습니다. 571-423-3200으로 전화하십시오.KRU (Ɓàsɔ́ɔ̀-wùɖù-po-nyɔ̀)Dè ɖɛ nìà kɛ dyéɖé gbo: Ɔ jǔ ké m̀ Ɓàsɔ́ɔ̀-wùɖù-po-nyɔ̀ jǔ ní, nìí, à wuɖu kà kò ɖò po-poɔ̀ ɓɛ́ìn m̀ gbo kpáa. Ɖá 571-423-3200.PERSIAN FARSI ( )ﻓﺎرﺳﯽ ﺗﻣﺎس ﺑﮕﯾر 571-423-3200 ﺑﺎ ﺷﻣﺎره . دﺳﺗرسﺷﻣﺎ ھﺳﺗﻧد د ر ، راﯾﮕﺎن ، ﺧدﻣﺎ ت ﮐﻣﮏ ﺑﮫ زﺑﺎن ، اﮔر ﺷﻣﺎ ﺑﮫ زﺑﺎن ﻓﺎرﺳﯽ ﺻﺣﺑت ﻣﯽﮐﻧﻧد : ﺗوﺟﮫ RUSSIAN (Русский)ВНИМАНИЕ: Если вы говорите по-русски,вам доступны бесплатные услуги языковой помощи. Звоните 571-423-3200.SPANISH (Español)ATENCIÓN : Si usted habla español, servicios de asistencia lingüística, de forma gratuita, están disponibles para usted. Llame a 571423-3200.TAGALOG (Tagalog)PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawagsa 571-423-3200.URDU ( )ر ُدوُ ا ﭘر ﮐﺎل ﮐرﯾں۔ 3200-423-571 آپ ﮐو دﺳﺗﯾﺎب ﮨﯾں۔ ، ﻣﻔت ، اﮔر آپ اردوﺑوﻟﺗﮯﮨﯾں ﺗو زﺑﺎن ﮐﯽ ﻣﻌﺎوﻧت ﮐﯽ ﺧدﻣﺎت : ﺗوﺟہ VIETNAMESE (Tiếng Việt)Chú ý : Nếu bạn nói tiếng Việt , các dịch vụ hỗ trợ ngôn ngữ , miễn phí, có sẵn cho bạn . Gọi 571-423-3200 .YORUBA (èdè Yorùbá)AKIYESI: Bi o ba nsọ èdè Yorùbú ọfé ni iranlọwọ lori èdè wa fun yin o. Ẹ pe ẹrọ-ibanisọrọ yi 571-423-3200.10Office of Benefit Services · Fairfax County Public Schools

Your Benefits and the LawMedicare Prescription Drug (Medicare D) PlanAll FCPS medical plans include prescription drugcoverage that is currently more comprehensivethan the Medicare prescription drug plan. Formore information, see “Important Notice fromFairfax County Public Schools about YourPrescription Drug Coverage and Medicare” inthe Retiree Benefits Handbook.Summary of Benefits and CoverageAn updated Summary of Benefits and Coverageor Evidence of Coverage for each medical planis available on each medical vendor’s website.You can find these documents here: Aetna/Innovation Health:www.ih-aetna.com/fcps Aetna Medicare Advantage:www.aetnamedicare.com/fcps/en/index.html CareFirst: www.carefirst.com/fcps Kaiser Permanente and KP Medicare:my.kp.org/fcpsWomen’s Health and Cancer Rights ActIf you have had or are going to have amastectomy, you may be entitled to certainbenefits under the Women’s Health and CancerRights Act of 1998 (WHCRA). For individualsreceiving mastectomy-related benefits, coveragewill be provided (in a manner determined inconsultation with the attending physician and thepatient) for: All stages of reconstruction of the breast onwhich the mastectomy was performed Surgery and reconstruction of the otherbreast to produce a symmetrical appearance Prostheses Treatment of physical complications of themastectomy, including lymphedemaThese benefits are subject to the samedeductible and coinsurance applicable to othermedical and surgical benefits provided underthe plan. Refer to the summary plan documentsavailable on each vendor's website for moreinformation.Medicaid & the Children’s Health InsuranceProgram (CHIP) Offer Premium Assistance forHealth Coverage for Children and FamiliesIf you or your children are eligible for Medicaidor CHIP and you are eligible for health coveragefrom your employer, your state may have apremium assistance program that can help payfor coverage, using funds from their Medicaidor CHIP programs. If you or your children arenot eligible for Medicaid or CHIP, you will not beeligible for these premium assistance programsbut you may be able to buy individual insurancecoverage through the Health InsuranceMarketplace. For more information, visit www.healthcare.gov.If you or your dependents are already enrolledin Medicaid or CHIP and you live in Stateoffering premium assistance, contact your StateMedicaid or CHIP office to find out if premiumassistance is available.If you or your dependents are NOT currentlyenrolled in Medicaid or CHIP, and you think youor any of your dependents might be eligible foreitherof these programs, contact your State Medicaidor CHIP office at 1-877-KIDS NOW or visitwww.insurekidsnow.gov to find out how to apply.If you qualify, ask your state if it has a programthat might help you pay the premiums for anemployer-sponsored plan.If you or your dependents are eligible forpremium assistance under Medicaid or CHIP,as well as eligible under your employer plan,your employer must allow you to enroll in youremployer plan if you are not already enrolled.This is called a “special enrollment” opportunity,and you must request coverage within 60days of being determined eligible for premiumassistance.If you have questions about enrolling in youremployer plan, contact: Department of Labor:www.askebsa.dol.gov or call 1-866-444-EBSA(3272) Medicaid: www.coverva.org/programspremium assistance.cfm or call 800-432-5924 CHIP: www.coverva.org/programs premiumassistance.cfm or call 855-242-8282.Office of Benefit Services · Fairfax County Public Schools11

Department of Human ResourcesOffice of Benefit ServicesGatehouse Administration Center, Suite 27008115 Gatehouse Road, Falls Church, Virginia, 22042-1203FCPS Open Enrollment InformationRetiree Open Enrollment: October 11 - November 5Please read thoroughly to learn more about:Benefit plan updates for 2022;2022 medical and dental premiums; andWays to stay healthy in 2022.Visit www.fcps.edu and search “Retiree Open Enrollment” for more details.Not making changes to your plan?No action required during Open Enrollment.Questions?Contact the FCPS Office of Benefit Services by calling 1-571-423-3200 oremailing HRConnection@fcps.edu.12OfficeOfficce offfiof BeBBenefitenefifitt Services · FaFFairfaxair fax CoCCountyounty PPuPublicublic ScSSchoolsc ho o ls

An Open Enrollment Newsletter about 2022 Benefits for FCPS Retirees O ce of Benefit Services Fairfax County Public Schools 1 VIRTUAL Mark Your Calendars! Open enrollment is your annual opportunity to review and make changes to your plan elections. Open enrollment for retiree benefits will s

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