GROUP HEALTH PLAN (pre-tax or post-tax benefit)
 
Notice: The Ashland School District Group Health Plan
follows the requirements of the Affordable Care Act.

Eligibility:

• All certified employees working 20 hours or more per week and a minimum of ten months per calendar year qualify for medical/dental/vision.

• All classified, confidential and supervisor employees working 20-29.99 hours per week and a minimum of ten months per calendar year qualify for medical only.

• All classified, confidential and supervisor employees working 30 hours or more per week and a minimum of ten months per calendar year qualify for medical/dental/vision.

• All classified, confidential and supervisor employees working 30 hours or more per week and a minimum of ten months per calendar year qualify to add spouse, children and/or family coverage.

• Classified employees only - may opt-out of the group health plan and receive a $200 per month cash incentive with proof of coverage through another plan. Opt Out Form

 
Medical coverage is provided by HMA (Healthcare Management Administrators). HMA provides access to claims and benefit information through our member portal, myHMA. Upon receipt of your ID card you can access HMA by going to www.accesshma.com and selecting the myHMA Member login button and then clicking on the “register now” link. For step by step directions on how to register in the member portal, CLICK HERE. For step by step directions on how to find a provider, CLICK HERE.

Medical Coverage Changes for 2021

• Effective January 1, 2021, we are pleased to announce our new health administrator, HMA (Healthcare Management Administrators). HMA uses the Blue Cross Blue Shield network which will allow greater access to more providers and facilities at a cost savings to employees and to the district health plan.

• The $300 individual & $900 family deductibles for 2021 will now be eliminated due to the cost savings by changing to HMA.

• All members will  receive 2 new ID cards via US Postal Service in the later part of December to be used beginning January 1, 2021. All members will have a single card that is shared between their dependents. If you need extra cards, you may order, print or download them online via the HMA website once you register at www.accesshma.com.

• You do not have to complete new enrollment paperwork, as we have already provided HMA with your current information.

•  Only complete the HMA Enrollment Form and the Pre-Tax Benefits Deduction Authorization Form if you are enrolling or making any changes to your current benefits.

•  Benefit summaries and plan descriptions will be posted at a later date. Benefits for 2021 will be covered at the same in and out-of-network levels as 2020.

  • HMA website

  • 2021 Medical/Dental/Vision/Pharmacy Summary Plan Description

  • 2021 Benefits Summary

  • As required by Health Care Reform, a Glossary of Health Coverage and Medical Terms is provided.

• ​You will notice a slight decrease in premiums for 2021. There will be a $4 increase in out-of -pocket premiums for family coverage only, beginning January 1, 2021, for the Classified, Confidential and Supervisor groups. Family coverage will increase from $249 to $253 per month. Please click on link below for details on premium decreases/increases  for each classification.

  • Certified Premiums

  • Classified, Confidential and Supervisor Premiums

 
Dental Coverage: 

• There are  changes to dental benefits for 2021.

• Benefits will be administered by HMA.

• HMA has a network of dental providers. Out of network dental providers will be reimbursed at 85% of the usual and customary rates. To find an in-network dentist go to www.accesshma.com. View the In-Network Dental Providers Guide

Vision Coverage:

• There are no changes to vision benefits for 2021 Benefits will be administered by HMA.

• To find an in-network provider www.accesshma.com. View the In-Network Vision Provider Guide. 

 
Pharmacy Coverage:

• Effective September 1, 2021, Navitus Health Solutions will be our new pharmacy provider. Member Brochure

• Once you receive your new health insurance card from HMA you can register online with Navitus Health Solutions  https://members.navitus.com

• Navitus also has a mobile app for your convenience

Mail Order Program and Copays:

Mail Order Pharmacy

Please send mail order prescriptions to Costco Pharmacy starting on September 1, 2021. It is easy to begin using Costco Pharmacy. You can register online at pharmacy.costco.com. Please allow 10 to 14 calendar days from the day you submit your order to receive your medication(s). You do not need to be a Costco member to use Costco Pharmacy.

Specialty Pharmacy

Navitus SpecialtyRx serves members who are taking medication(s) for certain chronic illnesses or complex diseases such as rheumatoid arthritis, multiple sclerosis, cancer and hepatitis C. To receive specialty medications through the pharmacy benefit, you will need to fill these prescriptions at Lumicera Health Services. Ordering new prescriptions through our specialty pharmacy partner, Lumicera Health Services is simple. Just call a patient care specialist at 1.855.847.3553 to get started. They will work with you and your prescriber to get your prescription set up. 

• $30 for generic products (90 day supply)

• $80 for preferred brand products (90 day supply)

• $120 for non-preferred brand products (90 day supply)

• $160 for specialty products (90 day supply)