Use this link for access to the Blue Cross Blue Shield Member Guide

The member guide provides an understanding to the services and benefits though Blue Cross Blue Shield including:

• Health Insurance Terms
• Your Member Account on MYBlueKC.com
• What to Expect on your Explanation of Benefits (EOB)
• MyBlueKC Mobile App
• Opt-In to Text Messaging

Finding Care

• Knowing Where to Go for Care
• Find a Doctor or Hospital
• Blue KC Community Support Tool
• Total Care Primary Care Providers
• Virtual Care
• Blue Card
• Blue Cross Blue Shield Global Solutions
• How Prior Authorization Works

Living Healthy

• Getting the Most Out of Your Preventive Care
• Behavioral Health Services
• A Healthier You
• Maternity Support Right from the Start
• Blue 365
• Lifestyle Program Benefit
• Diabetes Self Management
• Chronic Condition Management
• Complex Medical Case Management
• Transitions of Care Program
• Advanced Illness Program
• Blue KC Care Management App
   

 

Use this link to access the MY Blue KC Portal

By using the member portal, you can find care, review your plan and browse their Knowledge Hub. 

The portal can also assist you with contacting a Blue Cross Blue Shield represenative for assistance. 

 UMB Customer Service - 866-520-4472

Please contact the Benefits Department if you need to make changes to your HSA contribution amount. We will send you the necessary form. 

Click here to be directed to UMB where you can find valuable resources such as:

• A Quick Guide to HSAs
• Top Questions about HSAs
• Saving and Spending HSA dollars
• HSA Contribution Rules Married
• HSAs and Medicare
• and many more... 

Need to make changes to your personal contribution? Contact the Benefits Department to request the form. 

Making the most of your Pharmacy Benefits
Blue KC, together with the pharmacy benefit manager (OptumRx), provides safe, easy and cost-effective ways for you to get the medication you need. 

You have several ways to fill prescriptions. Each option offers convenient services to help you make the most of your pharmacy plan. 

Retail Network
You can fill prescriptions at thousands of retail pharmacies and many national drug stores, supermarkets and large retailers. 

Home Delivery
Home delivery program can save you time and money by delivering maintenance medications directly to your home.  Log into your pharmacy benefits account by following these easy steps:

1. Log into MyBlueKC.com
2. Click Plan Benefits on the left and then select Pharmacy
3. From that screen select Manage Prescriptions & Track Home Deliveries to be redirected to the OptumRx site.  Once you're redirected to the OptumRx Homepage, you can:

• Enroll in home delivery
• Find a network pharmacy
• Check medication coverage

 

Optum RX Effective 1/1/2020

Blue Cross Blue Shield 2025 Premium Drug List

Click here for MyBlueKC.com to Find a Doctor or Hospital

At MyBlueKC.com, members have access to Find Care, a cost-sharing estimate and price comparison platform that empowers member to see and compare costs for healthcare.

With Find Care, members can better understand healthcare expenses before visiting a doctor or scheduling care. 

• Find providers in your network
• Narrow search using filters
• Estimate Costs
• Read and write provide reviews
• Compare providers
• Review doctor quality information

To Search as a New Member or Guest

1. Visit BlueKC.com
2. Select Find Care in the upper right corner of the page
3. Click Find Care As a Guest
4. Select Your Network under the Select a Medical Network dropdown
5. Explore your Options
   *Searching as a guest will not allow you to estimate costs, research condition information or view treatment timelines

Get More from your Search
Use categories to expand your search and feel more empowered with your healthcare decisions:

Search by Location
Search by city or Zip code.

Search by Plan
For current members, your plan's network will display

Search by Category:

• Name of doctor or specialty: Search by first or last name, or a specialty, such as general practice or OB/GYM.
• Facility name or type of facility: Enter the name of the hospital or clinic, or types of facilities near you and the support you might need.

Search by Costs for Procedures
Find Care enables members to search for procedures and estimate their out-of-pocket costs for medical procedures, such as a knee replacement or MRI

Search by Condition
Search conditions such as deviated septum or lumbar (low back pain). Read medical information to find treatment options and doctors, which can provide insights into how you can lower your total costs and find the support you might need.

  

Save and Earn with Smart Shopper
Compare in-network sites for care and earn Cash rewards for shopping healthcare.

Costs for medical procedures are unpredictable. In fact, the same test or procedure can vary by hundreds or even thousands of dollars, depending on where you go. Blue KC’s Smart Shopper program allows you to research your options and earn cash rewards for scheduling your procedures at lower cost options in your network. Going to a cost-effective site for your care saves money. Through Smart Shopper, we are able to pass on a percentage of these savings directly to you. 

Smart Shopper will display providers and costs, which you can compare side by side. 

The program leverages the existing local and national network of providers and facilities that you trust today. Taking care of your health is important, and so is your budget. This innovation is part of Blue KC’s commitment to cost transparency and cost savings. For additional support, call Blue KC Customer Service at the number on the back of your member ID card.

Smart Shopper on the Blue KC Member Portal

The program leverages the existing local and national network of providers and facilities that you trust today. Taking care of your health is important, and so is your budget. This innovation is part of Blue KC’s commitment to cost transparency and cost savings. For additional support, call Blue KC Customer Service at the number on the back of your member ID card.

Smart Shopper on the Blue KC Member Portal

• Log into MyBlueKC.com and select Find Care
.• Click Find Doctors, Specialists & Hospitals.
• Click the Find Care button in the pop-up and select the Smart Shopper rewards tile to begin your search.

It Pays to Shop 

Smart Shopper pays eligible members cash rewards for choosing a Smart Shopper-eligible provider for certain routine procedures, preventive exams, imaging scans and scheduled surgeries. The reward you receive will vary depending on the procedure you need.

Get Started

Step 1: When your doctor recommends a medical test or procedure, evaluate your options for care by logging in at MyBlueKC.com and selecting Find Care.

• Choose Find Doctors, Specialists and Hospitals
• Click the Find Care button in the pop-up
• Select the Smart Shopper Rewards tile for  your search

Step 2: Receive care at a reward-eligible site of your choice, in your plan’s network.

Step 3: After your claim is paid, Smart Shopper will mail you a reward check.

Click here to be directed directly to BlueKC - Maternity Resources

Resources Include:

• Pregnancy Benefits
• Breastfeeding Support
• Breast Pump Coverage
• Extra Support for high-risk pregnancies
• Mindful - 24/7 mindful advocate - Call 833-302-6463

Important reminder

Once your little one arrives, you’ll need to add your baby to your health plan within 30 days of birth.

If you have employer-provided coverage, contact your HR department.

If you purchase your own plan, notify the Healthcare Marketplace to ensure continuous coverage for your newest family member.

Newborn Coverage – Blue Cross Blue Shield 

This important notice defines how newborns may be added to your SMSD BCBSKC health plan. Please note that the process differs depending on whether you currently have any dependents (including a spouse) covered under your health plan.  

How to add a newborn if you are currently enrolled for “EMPLOYEE ONLY” coverage: Effective immediately, upon the birth of a child, you must submit an application for the newborn within 31 days following the birth. If an application is submitted within 31 days following birth, the child will be added to your SMSD health plan retroactive to his/her birth date and additional premium will be charged (if applicable). IMPORTANT: If an enrollment application for the newborn is not received within 31 days following birth, the newborn child may not be added to the SMSD BCBSKC health plan until the next open enrollment period. This means covered services will only include an inpatient stay of at least 48 hours for a covered newborn child following any vaginal delivery or 96 hours following a cesarean section delivery. NO COVERAGE for the newborn will be provided after the initial 48 or 96 hour period unless an application is received for the newborn.  

How to add a newborn if you are currently enrolled for “EMPLOYEE+ 1” or “FAMILY” coverage: BCBSKC will provide automatic coverage of a newborn child for the first 31 days following birth. NO premium is required for the newborn for the first 31 days after birth. To add the newborn to your SMSD health plan as an ongoing, covered dependent past the first 31 days of birth, an application is necessary if your current coverage does not provide for dependent children. The application must be completed and returned within 31 days of the newborn’s birth for coverage to continue beyond the first 31 days.  

Contact Jennifer Lumley for the directions on the required documentation to add your infant to your plan.

New Health Insurance Marketplace Coverage Options and Your Health Coverage

When key parts of the health care law take effect in 2014, there will be a new way to buy health insurance: the Health Insurance Marketplace. To assist you as you evaluate options for you and your family, this notice provides some basic information about the new Marketplace and employment-based health coverage offered by your employer.

What is the Health Insurance Marketplace?

The Marketplace is designed to help you find health insurance that meets your needs and fits your budget. The Marketplace offers "one-stop shopping" to find and compare private health insurance options. You may also be eligible for a new kind of tax credit that lowers your monthly premium right away. Open enrollment for health insurance coverage through the Marketplace begins in October 2013 for coverage starting as early as January 1, 2014.

Can I Save Money on my Health Insurance Premiums in the Marketplace?

You may qualify to save money and lower your monthly premium, but only if your employer does not offer coverage, or offers coverage that doesn't meet certain standards. The savings on your premium that you're eligible for depends on your household income.

Does Employer Health Coverage Affect Eligibility for Premium Savings through the Marketplace?

Yes. If you have an offer of health coverage from your employer that meets certain standards, you will not be eligible for a tax credit through the Marketplace and may wish to enroll in your employer's health plan. However, you may be eligible for a tax credit that lowers your monthly premium, or a reduction in certain cost-sharing if your employer does not offer coverage to you at all or does not offer coverage that meets certain standards. If the cost of a plan from your employer that would cover you (and not any other members of your family) is more than 9.5% of your household income for the year, or if the coverage your employer provides does not meet the "minimum value" standard set by the Affordable Care Act, you may be eligible for a tax credit.¹

Note: If you purchase a health plan through the Marketplace instead of accepting health coverage offered by your employer, then you may lose the employer contribution (if any) to the employer-offered coverage. Also, this employer contribution -as well as your employee contribution to employer-offered coverage- is often excluded from income for Federal and State income tax purposes. Your payments for coverage through the Marketplace are made on an after- tax basis.

How Can I Get More Information?

For more information about your coverage offered by your employer, please check your summary plan description or contact Andrew Staum, Benefits Coordinator, 913-993-6354.

The Marketplace can help you evaluate your coverage options, including your eligibility for coverage through the Marketplace and its cost. Please visit HealthCare.gov for more information, including an online application for health insurance coverage and contact information for a Health Insurance Marketplace in your area.

 

 

Videos
Presentation of your Medical Plan Options
Smart Shopper Demonstration Video
Blue Select Plus Network

Annual Legal Notices 

Special Enrollment Rights
If you are declining enrollment for yourself or your dependents (including your spouse) because of other health insurance or group health plan coverage, you may be able to enroll yourself and your dependents in this plan if you or your dependents lose eligibility for that other coverage (or if the employer stops contributing towards your or your dependents’ other coverage). However you must request enrollment 30 Days (depending on your carrier plan document) days after you or your dependents’ other coverage ends (or after the employer stops contributing toward the other coverage.) This Special Enrollment opportunity is available only if you indicated (or otherwise as required) information regarding your or your dependents’ other coverage on your initial enrollment form/waiver. 

In addition, if you acquire a new dependent as a result of marriage, birth, adoption or placement for adoption, you may be able to enroll yourself and your dependents. However, you must request enrollment 30 Days after the marriage, birth, adoption, or placement for adoption. 

You may also be eligible for a Special Enrollment Period if you and/or your dependents are determined to be eligible for premium assistance under a state Medicaid plan or state child health plan. You must request enrollment within 60 days of the date you are determined to be eligible for this premium assistance.  

Women’s Health and Cancer Rights Act 

Did you know that your plan, as required by the Women’s Health and Cancer Rights Act of 1998, provides benefits for mastectomy-related services including reconstruction and surgery to achieve symmetry between the breasts, prostheses, and complications resulting from a mastectomy (including lymphedema)?  Call your Plan Administrator 913-993-6354 for more information. 

Your Right to Receive a Notice of Privacy Practices 

Your Information. Your Rights. Our Responsibilities. This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.
YOUR RIGHTS

You have the right to:

• Get a copy of your health and claims records
• Correct your health and claims records
• Request confidential communication 
• Ask us to limit the information we share
• Get a list of those with whom we’ve shared your information
• Get a copy of this privacy notice  Choose someone to act for you
• File a complaint if you believe your privacy rights have been violated 

YOUR CHOICES

You have some choices in the way that we use and share information as we:  

• Answer coverage questions from your family and friends
• Provide disaster relief
• Market our services and sell your information 

OUR USES AND DISCLOSURES 

We may use and share your information as we:  

• Help manage the health care treatment you receive
• Run our organization
• Pay for your health services
• Administer your health plan
• Help with public health and safety issues
• Do research  Comply with the law
• Respond to organ and tissue donation requests and work with a medical examiner or funeral director
• Address workers’ compensation, law enforcement, and other government requests
• Respond to lawsuits and legal actions 

YOUR RIGHTS 
When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you. 

Get a copy of health and claims records

• You can ask to see or get a copy of your health and claims records and other health information we have about you. Ask us how to do this.
• We will provide a copy or a summary of your health and claims records, usually within 30 days of your request. 

Ask us to correct health and claims records

• You can ask us to correct your health and claims records if you think they are incorrect or incomplete. Ask us how to do this.
• We may say “no” to your request, but we’ll tell you why in writing within 60 days.

Request confidential communications

• You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address.
• We will consider all reasonable requests, and must say “yes” if you tell us you would be in danger if we do not.

Ask us to limit what we use or share

• You can ask us not to use or share certain health information for treatment, payment, or our operations. 
• We are not required to agree to your request, and we may say “no” if it would affect your care. Get a list of those with whom we’ve shared information 

Get a list of those with whom we’ve shared information 

• You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why.
• We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months. 

Get a copy of this privacy notice 

• You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly. 

Choose someone to act for you

• If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
• We will make sure the person has this authority and can act for you before we take any action.

File a complaint if you feel your rights are violated

• You can complain if you feel we have violated your rights by contacting us using the information on page 1.
• You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/.
• We will not retaliate against you for filing a complaint. 

YOUR CHOICES

For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.

In these cases, you have both the right and choice to tell us to:

• Share information with your family, close friends, or others involved in payment for your care
• Share information in a disaster relief situation

If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.

In these cases we never share your information unless you give us written permission:

• Marketing purposes
• Sale of your information 

OUR USES AND DISCLOSURES

How do we typically use or share your health information?   We typically use or share your health information in the following ways.

Help manage the health care treatment you receive

• We can use your health information and share it with professionals who are treating you. Example: A doctor sends us information about your diagnosis and treatment plan so we can arrange additional services.

Run our organization

• We can use and disclose your information to run our organization and contact you when necessary.
• We are not allowed to use genetic information to decide whether we will give you coverage and the price of that coverage. This does not apply to long term care plans. Example: We use health information about you to develop better services for you.

Pay for your health services 

• We can use and disclose your health information as we pay for your health services.  Example: We share information about you with your dental plan to coordinate payment for your dental work. 

Administer your plan

• We may disclose your health information to your health plan sponsor for plan administration.  Example: Your company contracts with us to provide a health plan, and we provide your company with certain statistics to explain the premiums we charge. 

HOW ELSE CAN WE USE OR SHARE YOUR HEALTH INFORMATION?  

We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html. 

Help with public health and safety issues.
We can share health information about you for certain situations such as:

• Preventing disease
• Helping with product recalls
• Reporting adverse reactions to medications
• Reporting suspected abuse, neglect, or domestic violence
• Preventing or reducing a serious threat to anyone’s health or safety

Do research
We can use or share your information for health research.

Comply with the law
We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.  

Respond to organ and tissue donation requests and work with a medical examiner or funeral director

• We can share health information about you with organ procurement organizations.
• We can share health information with a coroner, medical examiner, or funeral director when an individual dies.

Address workers’ compensation, law enforcement, and other government requests
We can use or share health information about you:

• For workers’ compensation claims
• For law enforcement purposes or with a law enforcement official. With health oversight agencies for activities authorized by law
• For special government functions such as military, national security, and presidential protective services

Respond to lawsuits and legal actions.

• We can share health information about you in response to a court or administrative order, or in response to a subpoena.

OUR RESPONSIBILITIES

• We are required by law to maintain the privacy and security of your protected health information.
•  We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
• We must follow the duties and privacy practices described in this notice and give you a copy of it.
•  We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.  
• For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.

CHANGES TO THE TERMS OF THIS NOTICE
We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, on our web site, and we will mail a copy to you. 

OTHER INSTRUCTIONS FOR NOTICE

• Effective Date: 1/1/2017
• Benefits Coordinator, 8200 W 71st Street, Shawnee Mission, KS 66204 913-993-6354 

COBRA – Initial (General) COBRA Notice Continuation Coverage Rights under COBRA Introduction

You are receiving this notice because you have recently become covered under a group health plan (the Plan). This notice contains important information about your right to COBRA continuation coverage, which is a temporary extension of coverage under the Plan. This notice generally explains COBRA continuation coverage, when it may become available to you and your family, and what you need to do to protect the right to receive it. The right to COBRA continuation coverage was created by a federal law, the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA). COBRA continuation coverage can become available to you when you would otherwise lose your group health coverage. It can also become available to other members of your family who are covered under the Plan when they would otherwise lose their group health coverage. For additional information about your rights and obligations under the Plan and under federal law, you should review the Plan’s Summary Plan Description or contact the Plan Administrator. What is COBRA Continuation Coverage? COBRA continuation coverage is a continuation of Plan coverage when coverage would otherwise end because of a life event known as a “qualifying event.” Specific qualifying events are listed later in this notice. After a qualifying event, COBRA continuation coverage must be offered to each person who is a “qualified beneficiary.” You, your spouse, and your dependent children could become qualified beneficiaries if coverage under the Plan is lost because of the qualifying event. Under the Plan, qualified beneficiaries who elect COBRA continuation coverage must pay for COBRA continuation coverage. If you are an employee, you will become a qualified beneficiary if you lose your coverage under the Plan because either one of the following qualifying events happens:

• Your hours of employment are reduced, or

Your employment ends for any reason other than your gross misconduct. If you are the spouse of an employee, you will become a qualified beneficiary if you lose your coverage under the Plan because any of the following qualifying events happens:

• Your spouse dies;
• Your spouse’s hours of employment are reduced;
• Your spouse’s employment ends for any reason other than his or her gross misconduct;
• Your spouse becomes entitled to Medicare benefits (under Part A, Part B, or both); or
• You become divorced or legally separated from your spouse. Your dependent children will become qualified beneficiaries if they lose coverage under the Plan because any of the following qualifying events happens: 
• The parent-employee dies;
• The parent-employee’s hours of employment are reduced;
• The parent-employee’s employment ends for any reason other than his or her gross misconduct;
• The parent-employee becomes entitled to Medicare benefits (Part A, Part B, or both);
• The parents become divorced or legally separated; or
• The child stops being eligible for coverage under the plan as a “dependent child.”

Sometimes, filing a proceeding in bankruptcy under title 11 of the United States Code can be a qualifying event. If a proceeding in bankruptcy is filed with respect to Shawnee Mission School District, and that bankruptcy results in the loss of coverage of any retired employee covered under the plan, the retired employee will become a qualified beneficiary with respect to the bankruptcy. The retired employee’s spouse, surviving spouse, and dependent children will also become qualified beneficiaries if bankruptcy results in the loss of their coverage under the Plan.

When is COBRA Coverage Available? The Plan will offer COBRA continuation coverage to qualified beneficiaries only after the Plan Administrator has been notified that a qualifying event has occurred. When the qualifying event is the end of employment or reduction of hours of employment, death of the employee, commencement of a proceeding in bankruptcy with respect to the employer, or the employee's becoming entitled to Medicare benefits (under Part A, Part B, or both), the employer must notify the Plan Administrator of the qualifying event. You Must Give Notice of Some Qualifying Events For the other qualifying events (divorce or legal separation of the employee and spouse or a dependent child’s losing eligibility for coverage as a dependent child), you must notify the Plan Administrator within 60 days after the qualifying event occurs.

You must provide this notice to: Benefits Coordinator, 8200 W 71st Street, Shawnee Mission, KS 66204, 913-993-6354. A written notice is required as well as proof of the qualifying event.

How is COBRA Coverage Provided?

Once the Plan Administrator receives notice that a qualifying event has occurred, COBRA continuation coverage will be offered to each of the qualified beneficiaries. Each qualified beneficiary will have an independent right to elect COBRA continuation coverage. Covered employees may elect COBRA continuation coverage on behalf of their spouses, and parents may elect COBRA continuation coverage on behalf of their children. COBRA continuation coverage is a temporary continuation of coverage. When the qualifying event is the death of the employee, the employee's becoming entitled to Medicare benefits (under Part A, Part B, or both), your divorce or legal separation, or a dependent child's losing eligibility as a dependent child, COBRA continuation coverage lasts for up to a total of 36 months. When the qualifying event is the end of employment or reduction of the employee's hours of employment, and the employee became entitled to Medicare benefits less than 18 months before the qualifying event, COBRA continuation coverage for qualified beneficiaries other than the employee lasts until 36 months after the date of Medicare entitlement. For example, if a covered employee becomes entitled to Medicare 8 months before the date on which his employment terminates, COBRA continuation coverage for his spouse and children can last up to 36 months after the date of Medicare entitlement, which is equal to 28 months after the date of the qualifying event (36 months minus 8 months). Otherwise, when the qualifying event is the end of employment or reduction of the employee’s hours of employment, COBRA continuation coverage generally lasts for only up to a total 6 1/30/2017 of 18 months. There are two ways in which this 18-month period of COBRA continuation coverage can be extended. Disability extension of 18-month period of continuation coverage If you or anyone in your family covered under the Plan is determined by the Social Security Administration to be disabled and you notify the Plan Administrator in a timely fashion, you and your entire family may be entitled to receive up to an additional 11 months of COBRA continuation coverage, for a total maximum of 29 months. The disability would have to have started at some time before the 60th day of COBRA continuation coverage and must last at least until the end of the 18month period of continuation coverage. You must provide proof of disability to the Plan Administrator (i.e. letter of determination from the Social Security Administration. Second qualifying event extension of 18-month period of continuation coverage If your family experiences another qualifying event while receiving 18 months of COBRA continuation coverage, the spouse and dependent children in your family can get up to 18 additional months of COBRA continuation coverage, for a maximum of 36 months, if notice of the second qualifying event is properly given to the Plan. This extension may be available to the spouse and any dependent children receiving continuation coverage if the employee or former employee dies, becomes entitled to Medicare benefits (under Part A, Part B, or both), or gets divorced or legally separated, or if the dependent child stops being eligible under the Plan as a dependent child, but only if the event would have caused the spouse or dependent child to lose coverage under the Plan had the first qualifying event not occurred. If You Have Questions Questions concerning your Plan or your COBRA continuation coverage rights should be addressed to the contact or contacts identified below. For more information about your rights under ERISA, including COBRA, the Health Insurance Portability and Accountability Act (HIPAA), and other laws affecting group health plans, contact the nearest Regional or District Office of the U.S. Department of Labor’s Employee Benefits Security Administration (EBSA) in your area or visit the EBSA website at www.dol.gov/ebsa. (Addresses and phone numbers of Regional and District EBSA Offices are available through EBSA’s website.) Keep Your Plan Informed of Address Changes In order to protect your family’s rights, you should keep the Plan Administrator informed of any changes in the addresses of family members. You should also keep a copy, for your records, of any notices you send to the Plan Administrator. Plan Contact Information Shawnee Mission School District Benefits Coordinator, 7235 Antioch Road, Shawnee Mission, KS 66204 913-993-6354 Premium Assistance Under Medicaid and the  Children’s Health Insurance Program (CHIP)  If you or your children are eligible for Medicaid or CHIP and you’re eligible for health coverage from your employer, your state may have a premium assistance program that can help pay for coverage, using funds from their Medicaid or CHIP programs.  If you or your children aren’t eligible for Medicaid or CHIP, you won’t be eligible for these premium assistance programs but you may be able to buy 7 1/30/2017   8  1/30/2017  individual insurance coverage through the Health Insurance Marketplace.  For more information, visit www.healthcare.gov.    If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed below, contact your State Medicaid or CHIP office to find out if premium assistance is available.    If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, contact your State Medicaid or CHIP office or dial 1-877-KIDS NOW or www.insurekidsnow.gov to find out how to apply.  If you qualify, ask your state if it has a program that might help you pay the premiums for an employer-sponsored plan.    If you or your dependents are eligible for premium assistance under Medicaid or CHIP, as well as eligible under your employer plan, your employer must allow you to enroll in your employer plan if you aren’t already enrolled.  This is called a “special enrollment” opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance. If you have questions about enrolling in your employer plan, contact the Department of Labor at www.askebsa.dol.gov or call 1-866-444-EBSA (3272).  

KANSAS – Medicaid NEVADA – Medicaid   9  1/30/2017  Website: http://www.kdheks.gov Phone: 1-785-296-3512 

To see if any other states have added a premium assistance program since July 31, 2016, or for more information on special enrollment rights, contact either:  U.S. Department of Labor    U.S. Department of Health and Human Services  

Employee Benefits Security Administration Centers for Medicare & Medicaid Services

www.dol.gov/ebsa    
www.cms.hhs.gov  
                                         1-866-444-EBSA (3272)   1-877-267-2323, Menu Option 4, Ext. 61565  

Notice Regarding Wellness Program Shawnee Mission School District’s wellbeing program is a voluntary wellness program available to all employees. The program is administered according to federal rules permitting employer-sponsored wellness programs that seek to improve employee health or prevent disease, including the Americans with Disabilities Act of 1990, the Genetic Information Nondiscrimination Act of 2008, and the Health Insurance Portability and Accountability Act, as applicable, among others. If you choose to participate in the wellness program you will be asked to complete a voluntary health risk assessment or "HRA" that asks a series of questions about your health-related activities and behaviors and whether you have or had certain medical conditions (e.g., cancer, diabetes, or heart disease). You will also be asked to complete a biometric screening, which will include a blood test for cholesterol and glucose. You are not required to complete the HRA or to participate in the blood test or other medical examinations. However, employees who choose to participate in the wellness program will receive an incentive of a discount on their medical premiums for completing the Health Risk Assessment and Biometric Screening. Although you are not required to complete the HRA or participate in the biometric screening, only employees who do so will receive a discount on their medical premiums. Additional incentives of may be available for employees who participate in certain health-related activities or achieve certain health outcomes.  If you are unable to participate in any of the health related activities or achieve any of the health outcomes required to earn an incentive, you may be entitled to a reasonable accommodation or an alternative standard. You may request a reasonable accommodation or an alternative standard by contacting Danielle Shaw at DanielleShaw@smsd.org or 913-993-6494. The information from your HRA and the results from your biometric screening will be used to provide you with information to help you understand your current health and potential risks, and may also be used to offer you services through the wellness program. You also are encouraged to share your results or concerns with your own doctor. Protections from Disclosure of Medical Information We are required by law to maintain the privacy and security of your personally identifiable health information. Although the wellness program and Shawnee Mission School District may use aggregate 11 1/30/2017 information it collects to design a program based on identified health risks in the workplace, Shawnee Mission School District’s Wellbeing Program will never disclose any of your personal information either publicly or to the employer, except as necessary to respond to a request from you for a reasonable accommodation needed to participate in the wellness program, or as expressly permitted by law. Medical information that personally identifies you that is provided in connection with the wellness program will not be provided to your supervisors or managers and may never be used to make decisions regarding your employment. Your health information will not be sold, exchanged, transferred, or otherwise disclosed except to the extent permitted by law to carry out specific activities related to the wellness program, and you will not be asked or required to waive the confidentiality of your health information as a condition of participating in the wellness program or receiving an incentive. Anyone who receives your information for purposes of providing you services as part of the wellness program will abide by the same confidentiality requirements. The only individual(s) who will receive your personally identifiable health information is (are) [indicate who will receive information such as "a registered nurse," "a doctor," or "a health coach"] in order to provide you with services under the wellness program. In addition, all medical information obtained through the wellness program will be maintained separate from your personnel records, information stored electronically will be encrypted, and no information you provide as part of the wellness program will be used in making any employment decision.  Appropriate precautions will be taken to avoid any data breach, and in the event a data breach occurs involving information you provide in connection with the wellness program, we will notify you immediately. You may not be discriminated against in employment because of the medical information you provide as part of participating in the wellness program, nor may you be subjected to retaliation if you choose not to participate. If you have questions or concerns regarding this notice, or about protections against discrimination and retaliation, please contact Danielle Shaw at DanielleShaw@smsd.org or 913-993-6494. 

There are opportunities to combine the amount the District contributes towards your medical insurance.  In some, but not all, cases this can help reduce your monthly premium amount when enrolled in Family medical coverage. 

Your benefits team is happy to review this with you to see if this is a good option for you and your family.