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.
Welcome to the Bexar Health Care Connection
The Bexar Health Care Connection is an employee health care resource, designed to provide answers to employee questions regarding Bexar County health care benefits. Here are compiled specific details about the health insurance plans offered by Bexar County, upcoming policy changes, and additional employee health care resources.
- New Health Insurance Marketplace Coverage
- Bexar County 2015 Benefits Guide
The same Bexar County 2015 Benefits Guide that was mailed to individual employee homes may also be viewed here in PDF format.
- Bexar County 2016 Benefits Guide
- Benefits and Coverage Summary/Explanation
- Plus One Qualifying Adult
A Plus One Qualifying Adult tier has been added to the County's Medical, Dental, Vision and Life Insurance plans. The new tier is available to all employees provided that certain criteria are met, as outlined below:
- The Bexar County Employee and Plus One Qualifying Adult must have resided together in the same residence for at least 12 months, and must continue to do so fro the Plus One Qualifying Adult to remain eligible for benefits;
- Plus One Qualifying Adult must be 18 years of age or older;
- Plus One Qualifying Adult must be financially interdependent with the Bexar County employee, sharing common financial obligations as evidenced by 3 or more of the following documents:
ALL 3 Evidenced Items MUST be turned in and Certified before Benefits are Effective
- Joint Deed or mortgage agreement to demonstrate common ownership of real property or a common leasehold interest in real property;
- A title or vehicle registration showing common ownership of a motor vehicle;
- Proof of joint bank accounts or credit accounts;
- Proof of designation as the primary beneficiary for life insurance or retirement benefits;
- Assignment of a durable property power of attorney or health care power of attorney.
Employees who wish to enroll in the new tier may do so during the Special Open Enrollment Period starting Wednesday, February 19, 2014 and ending March 30, 2014. Enrollment must be completed in person at Human Resources in order to obtain certification.
Coverage starts March 1, 2014 or the date of enrollment, whichever is later. All 3 evidenced items must be turned in before the benefits become effective.
Please note that the following individuals are not eligible for designation as a Plus One Qualifying Adult:
- Parents' other descendants
- Grandparents and other descendants
- Step relatives
- Renters, boarders, tenants
- Employees of the Bexar County employee
If you have any questions, please contact Human Resources at 210.335.2545
- Enrolling in Your Bexar County Health Care Benefits
Annual Open Enrollment
Open enrollment occurs at the end of each year, and is the only time during the year that changes can be made, with the exception of a change in family status.
You can enroll for coverage within 31 days of your eligibility date or during the Annual Enrollment period. If you do not enroll for coverage within 31 days of your eligibility date or during Annual Enrollment, you may not receive health coverage during the plan year unless you experience a qualified change in family status (see Making Changes During the Year for details). The benefit choices you make during your enrollment will remain in effect for the entire plan year (January 1 - December 31). You will have the opportunity to change your benefit selections once a year during the Annual Enrollment period or during the year if you experience a family status change (within 31 days).
Making Changes During the Year
If you experience a qualified change in family status, you will have the opportunity to make mid-year changes to your benefit elections. Changes must be made within 31 days of the event date. Examples of a qualified change in family status include, but are not limited to, the following:
- Marriage, divorce, legal separation, or annulment
- Birth or adoption of a child
- Change in employment for you or your spouse that affects your benefit eligibility
- Loss of other health coverage
- Death of spouse or dependent
- Court Order
- Active Duty Military Leave
- Leave without pay
It is your responsibility to notify Bexar County within 31 days after a qualifying event. Any benefit changes must be directly related to the qualified change in family status. You will need to submit an Insurance Change form to Human Resources and provide documentation of the event, such as a marriage license or birth certificate. Failure to do so will cause you and/or your dependents to wait until the next annual enrollment period to make any changes. Special time frames that apply to Medicaid/CHIP enrollments can be found in the Bexar County 2014 Employee Benefits Guide.
Complete Your EOI Online
If you have elected to increase your group live insurance coverage, you must submit satisfactory Evidence of Insurability (EOI) to the Minnesota Life Insurance Company before the coverage becomes active.
Before you begin:
- Your spouse must be present if you elected spouse coverage that requires EOI (electronic signature required)
- An email address is required
- The process takes 10-30 minutes to complete
- You will not be able to save your work to return later
- Have your medical records available, specifically:
- Name/address of physicians, hospitals, and clinics by whom you've been treated
- Details regarding diagnosis and treatment
To Submit Your EOI visit LifeBenefits.com/SubmitEOI
- AETNA Dental Benefits
Read about your Aetna Dental Plan . Use the bookmarks to navigate to your plan.
Looking for a dentist on Aetna's Dental PPO Plan?
- Go to www.aetna.com
- Highlight "individuals and Families" tab
- Click "Find a Doctor" in Blue Box
- Click "A plan offered by my employer or organization"
- Click Dentist (Primary Care)
- Enter in your zip code, city or state
- Highlight "Dental PPO/PDN with PPO II" network
- AETNA Health Care Resources
- Aetna Navigator
- Aetna 2016 Formulary - 2016 Aetna Pharmacy Plan Drug List - This is a general formulary listing. Members get most accurate plan coverage information by logging into/registering at Aetna.com
- Aetna 2016 Formulary Changes - Aetna 2016 Formulary Updates
- Aetna Choice POS II Plans (Premium and Base PPOs) - Read about the benefits that come with Aetna's Choice POS II Plans (equivalent to the Premium and Base PPO plans).
- Open Access Aetna Select Plan (Executive/EPO) - Read about the benefits that come with Aetna's Open Access Aetna Select Plan (equivalent to the Executive/EPO plan).
- Aetna CVS ExtraCare Health Card - Learn about the discounts offered with the CVS HealthCare card
- Aetna Dental Plans - Learn about Aetna's dental plans.
- Aetna Discount Programs - Aetna's members also get the benefit of discounts on other health-related services.
- Aetna Navigator Secure Member Website - Read about the resources and tools available on Aetna Navigator, the website for Aetna's members.
- Disease Management Program - Learn about the support you get with Aetna's Disease Management Program.
- DocFind Online Directory - Use Aetna's DocFind Online Directory to search for doctors on Aetna's medical plans.
- Informed Health Line - Learn about Aetna's 24-hour nurse line, audio library, and website resources to help with your medical choices.
- Reimbursement Accounts - Quick Reference Guide for PayFlex reimbursement accounts
- Phone Support by a Registered Nurse - Learn about the support you receive from Aetna's nurse line.
- Simple Steps Health Assessment - Learn how the Simple Steps Health Assessment can help you with your health-related goals.
- Understanding Aexcel - Understand how the Aexcel system helps identify doctors who meet certain standards set by Aetna.
- AETNA and Medical Forms
The Medical Benefits Request form allows employees to file a claim for reimbursement. The form needs to be filled out as directed and either mailed to Aetna or faxed to 859.455.8650. If faxed, a cover sheet is encouraged for faster processing, but not necessary. When mailed or faxed, please be sure to include your Aetna ID number and full name.
1) Complete items one (1) through nineteen (19) in full.
2) Complete items twenty (20) through twenty-four (24) only if other medical coverage exists.
3) Be certain to sign the authorization to release information in block twenty-five (25).
4) If you wish to have your benefits for this claim paid directly to your physician or supplier, sign block twenty-six (26).
5) If you have submitted a request for benefits to another plan, including Medicare, attach a copy of the bills you submitted to the other plan and the explanation of benefits you received from the other plan.
6) Attach itemized bills or ask your health care provider to complete the applicable section on the reverse side. The bills must include:
- Patient's name
- Date(s) of service(s)
- Condition being treated
- Relationship to employee
- Type of service(s) rendered
If this information is missing, write it on the bill and sign your name.
7) If prescription drugs are covered under your plan, submit receipts or a Prescription Drug Record form. Receipt must contain:
- Drug name
- Dose per day
- Purchasing Date
- Nature of illness or injury
- Prescription number
- Physician's name
- Pharmacy name and address
8) Retain copies of your bills for your record.
9) Send the completed benefits request and the bills to:
Aetna Life Insurance Company
PO Box 981106
El Paso, TX 79998-1106
- Quest Health Screenings
The primary focus of Bexar County and Aetna in 2013 is on employee wellness and disease management. In order to optimize employee health, Bexar County has instituted a Health Screening requirement.
- What is a Health Screening?
What is a Health Screening?
A Health Screening is a valuable tool that provides an assessment of an individual's basic health status and offers insights into the individual's possible health risks. The Health Screening includes a Finger Stick technique that will measure LDL/HDL cholesterol levels, a triglyceride level, a glucose (blood sugar) level, and a BMI (Body Mass Index) assessment which includes height and weight. You will be asked if you were fasting or not fasting at the time of the test, to know how best to interpret the glucose level.
- How are Health Screening Results Used?
How are Health Screening Results Used?
It is normal to be concerned about the privacy of your health care data. All information from an employee Health Screening is kept completely private and is viewable only by AETNA, in accordance with the federal Health Insurance Portability and Accountability Act (HIPAA) of 1996. Bexar County will never see an employee's individual Health Screening results.
What Bexar County will see is an aggregate report provided by AETNA listing overall health risk factor percentages that were identified by the Health Screening Results. The aggregate report will never list an employee by name, employee number, or any other identifying features. It is the goal of Bexar County to work together with Aetna to create employee workshops and seminars focused on the health and wellness issues most relevant to Bexar County employees.
Remember - knowing your Health Screening Results, understanding what they mean and monitoring any changes in them goes a long way toward optimizing your health and feeling GOOD!
- Which Employees Must have a Health Screening?
Which Bexar County Employees Must have a Health Screening?
Bexar County Employees who are on the health plan as the Primary Member. Employee dependents will not have to participate in the screening. The 2013 deadline for completing the Screening is March 31, 2013.
- When Does the Screening Need to be Completed?
When Does the Screening Need to be Completed?
In order to avoid penalties for a particular month, an existing employee who has Aetna coverage who has yet to complete their Health Screening would have to submit their Health Screening information no later than the last day of the previous month. For Example: To avoid June penalties, an employee would have to make sure their Health Screening information was received by May31.
New hires have 60 days from their effective date of coverage to obtain and submit their Health Screening.
- What if an Employee Doesn't Want the Screening?
What if an Employee Doesn't Want to Participate in the Screening?
All Bexar County employees not participating in the Health Screening will be assessed a monthly surcharge each month.
Any employee choosing not to participate in the Screening and not submitting their Health Screening Form prior to the March 31, 2013, deadline will have $25.00 a month deducted from their employee salary, each month until they have completed the Health Screening.
- What is a Health Screening?
- Employee Health & Wellness Clinic
Bexar County provides an Employee Health & Wellness Clinic for the health care and convenience of all Bexar County employees. A Physician or licensed medical provider is on staff daily. Whenever possible, appointments are preferred and may be scheduled by calling 210.335.4WEL (4935). No payment or insurance forms are necessary at the time of service and the $5.00 co-pay charge will be deducted from the employee's following paycheck.
The Employee Health & Wellness Clinic is located at 459 S. Main Street, San Antonio, Texas, 78204. This is two blocks South of the Bexar County Courthouse, on the backside of Main Street.
Services provided by the Employee Health & Wellness Clinic include:
- Pre-employment physicals
- Medical care for minor injuries or illness
- Preventive Health Screenings
- Individualized Wellness Programs
The Clinic is open Monday through Friday from 7:30 am to 11:30 am and from 12:30 pm to 4:30pm. The Clinic is closed on all County Holidays. Questions? Please don't hesitate to call the Clinic at 210.335.4WEL (4935) with ANY health Question!
- University Health System
Bexar County and Aetna are pleased to offer healthcare services for Bexar County employees through Univeristy Health System's network of health centers.
You will receive many benefits, including:
- $5 co-pay for doctor visits and prescriptions
- Primary care, pediatric care and women's health at all locations
- Access to onsite lab and imaging
- Free parking at all loctions
Call 210.358.3488 to select your preferred doctor's office
University Health System and Harlandale Independent School District (HISD) have teamed up to offer the first school-based health center in San Antonio, giving medical care to the students of HISD and their siblings, up to age 18.
Located at 834 W. Southcross San Antonio, TX 78211 on the Collier Elementary Campus! $5 co-pay as part of the Bexar/Aetna/UHS agreement for employees on the Bexar County benefts plan. Clinic is available to everyone!
- Physical exams/Well Child checkups
- Sports physicals
- Minor acute care (ear infections, throat infections, asthma, bronchitis)
- Health education on nutrition, disease and injury prevention
- Medication prescriptions as needed
A parent/guardian must be in attendance at each visit.
Hours of operation:
Monday: 8 a.m. – 6:30 p.m.
Tuesday: 9 a.m. – 6:30 p.m.
Wednesday: 1 p.m. – 6:30 p.m.
Thursday: 9 a.m. – 6:30 p.m.
Friday: 9 a.m. – 4 p.m.
Same day appointments are available!
Contact Us at 358-TALK (8255)
- Wellness Programs for Employees
All employees covered under Bexar County's Medical Plan can now participate in the Quest Diagnostic Simple Health Screening. As part of the Bexar County Wellness Initiative, employees can now complete their 2nd Simple Health Screening or the 1st Simple Health Screening to get their baseline results.
Quest Laboratory will be on site at the Employee Clinic August 27th (8a - 11a).
- Registration period for the on-site event is from July 15 - August 11
- Register at the link below
- You must fast before the screening
Your Simple Health Screening can also be completed at your convenience at any Quest Diagnostics location.
All results are confidential and will be sent to your home address.
Schedule your appointment after your health care benefits effective date. You must be enrolled in one of the Aetna plans before you go on-line to register at We.BlueprintForWellness.com
Heart360® is an online tool which helps you track and manage your heart health and provides helpful advice and information. Visit Heart360 online for more information.