It's important to understand your health insurance plan so that you feel comfortable that you've made the best decision for your specific needs and budget. You can start by reviewing the Health Plan Premium Chart to see the amount you pay for your health insurance premiums. Employees have deductions taken January-June, then again September-December (October-December for biweekly-paid employees).

While FCPS health plans all offer comprehensive coverage, keep in mind that health plans differ in which providers you can see and how much you may need to pay beyond your premium. Knowing the terms used in talking about health insurance will help you feel more comfortable when choosing a plan. Please take a moment to review the terms below:

• A copay is a fixed amount you pay for a covered health care service (like a doctor’s visit, hospital outpatient visit, or prescription drugs).
  For example, you might pay a $20 copay for primary care visits and a $40 copay for specialty care visits.

• A deductible is the amount you pay for covered health care services before your insurance starts to pay. The Cigna Open Access Plus (OAP) plan has a deductible.
  For example, a plan with a $300 deductible means that you pay the first $300 of covered services before the plan benefits begin to pay. FCPS health plans cover certain preventive services without charging you a copay or coinsurance, even if you haven’t yet met your yearly deductible.

• Coinsurance is the percentage of a covered in-network health care service you pay. This often applies after you’ve paid your deductible.
  For example, if the plan’s allowed amount for an office visit is $100 and you’ve met your deductible, your 10% coinsurance payment would be $10. The plan pays the rest.

• Out-of-pocket Maximum is the most you have to pay for covered services in a plan year. After you spend this amount on deductibles, copays, and coinsurance, your health plan pays 100% of the costs of covered benefits for the remainder of the plan year. The out-of-pocket limit doesn’t include your monthly premiums. It also doesn’t include anything you may spend for services your plan doesn’t cover.

Let ALEX help!
Watch this short video for a quick rundown of these health plan terms: www.myalex.com/fcps/home#review-basics.

Important Reminders:

• Deductibles and maximum out-of-pocket limits are based on a calendar year. These amounts will reset every January 1.
• You can choose to change health plans during Open Enrollment (typically held in the fall) or if you experience a qualifying life event. Changes made during Open Enrollment will be effective on January 1.
• Refer to the Employee Benefits Briefing for any important announcements, updates, and reminders related to FCPS benefits in the upcoming calendar year.