2022 PRIEST BENEFITS GUIDE - Archdiocese of Galveston-Houston
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Your 2022 Medical Pharmacy Dental Vision Life, AD&D Additional Benefits Benefits Benefits Benefits Benefits Disability Benefits If you have Medicare or will become eligible for Medicare in the next 12 months, a federal law gives you more choices about your prescription drug coverage. Please see the separate legal disclosure booklet for more details. 2022 Priest Benefits Guide 2
Your 2022 Medical Pharmacy Dental Vision Life, AD&D Additional Benefits Benefits Benefits Benefits Benefits Disability Benefits YOUR 2022 BENEFITS The benefits described in this guide are effective January 1—December 31, 2022. Welcome! The Archdiocese of Galveston-Houston is proud to offer a comprehensive benefits package that has been customized to meet your needs. We are committed to promoting better health for our priests. This means you have access to annual physicals and more—all at no cost to you. Please review this guide carefully and consider your options so that you can make the best choices for your situation. This benefits guide has been prepared to summarize the many benefit programs and plans available to our priests. Please read this information carefully. This benefit guide is a summary and not intended to be comprehensive, so please refer to the plan documents pertaining to each plan for more information. Open Enrollment Open Enrollment will begin October 1st and end November 5th, 2021. Any changes you make to your benefit elections during Open Enrollment will become effective on January 1, 2022. To enroll or make changes to your benefit elections, you must log on to the ADP web portal. Detailed instructions on how to complete your enrollment in ADP are available on the Archdiocese of Galveston-Houston Human Resources website: www.archgh.org/hr. If you do not take action during open enrollment, your Priest Benefits will automatically roll over to the 2022 plan year. What’s New for 2022? New Provider: Life, Disability and FMLA Effective January 1, 2022, Voya will administer our Life and Disability plans. There are no changes to the benefits under these plans. However, if you need to make a claim or report a leave of absence on or after January 1, 2022, you must contact Voya. Please see page 3 for contact information and policy numbers. OptumRx Formulary Change The formulary (or “drug list”) for the Medical/Rx plans will change effective January 1, 2022. This means some drugs that are currently covered may be excluded from coverage beginning January 1st. If you are taking a drug that will be impacted by this change, you will receive notification in the mail from OptumRx, and we encourage you to review this information and discuss your treatment options with your doctor. 2022 Priest Benefits Guide 1
Your 2022 Medical Pharmacy Dental Vision Life, AD&D Additional Benefits Benefits Benefits Benefits Benefits Disability Benefits Enrolling in Benefits You can complete your enrollment quickly and easily online by logging onto ADP. Follow these steps to get started: 1 Go to www.workforcenow.adp.com Log into ADP using your username and password. For login help or 2 to reset your password, click on “Forgot Your User ID/Password?” Detailed instructions are available on the Human Resources website: 3 www.archgh.org/hr Your Benefit Premiums Benefit Who Pays the Cost? Medical & Prescription Drug Coverage The Archdiocese of Galveston-Houston pays the entire cost Dental Coverage The Archdiocese of Galveston-Houston pays the entire cost Vision Coverage You pay the full premium amount Basic Life/AD&D Insurance The Archdiocese of Galveston-Houston pays the entire cost Supplemental Life Insurance You pay the full premium amount Employee Assistance Program The Archdiocese of Galveston-Houston pays the entire cost Important Reminders Free Preventive Care Your Archdiocese of Galveston-Houston Medical Plan covers in-network preventive care at 100%. This means you can receive your annual physical, prostate exams, immunizations, and other routine preventive services on an annual basis at no cost to you! Remember to ask your doctor if the services are classified as preventive— you may have to pay for services received during your visit if they are not classified as preventive. Virtual Visits with MDLive You have access to virtual visits through MDLive. Whether you’re at home or traveling, access to a board- certified doctor is available 24 hours a day, 7 days a week through the phone, online video, or the BCBSTX Mobile App. You can speak to a doctor immediately or schedule an appointment based on your availability. Please see page 8 for more details about this service. BCBSTX 24/7 Nurseline The BCBSTX 24/7 Nurseline gives you access to a team of registered nurses available to answer your health questions and help you decide whether you should go to the emergency room, urgent care center, or make an appointment with your doctor. Nurses are available 24 hours a day, 7 days a week. This valuable resource can help you learn about health conditions and enable you to make smart health care decisions. 2 Archdiocese of Galveston-Houston
Your 2022 Medical Pharmacy Dental Vision Life, AD&D Additional Benefits Benefits Benefits Benefits Benefits Disability Benefits The Benefits Help Line The Archdiocese of Galveston-Houston Benefits Help Line is a valuable resource for your health, welfare, and insurance benefits. Talk to a personal benefits advocate about your eligibility, enrollment, benefit questions, finding a provider, billing or claim questions, and more! The Benefits Help Line is available Monday through Friday, 7:00 AM to 6:00 PM Central Time. 855-664-8164 agh_benefits@ajg.com Important Contacts Benefit Vendor Phone Website/Email Archdiocese of Human Resources 713-652-8265 www.archgh.org/hr Galveston-Houston Medical Blue Cross Blue Shield 800-521-2227 www.bcbstx.com (Group #274679) of Texas (BCBSTX) Prescription Drugs OptumRx 1-855-524-0381 www.optumrx.com Virtual Visits MDLive 888-680-8646 www.mdlive.com/bcbstx Blue Cross Blue Shield Nurseline 800-581-0393 N/A of Texas (BCBSTX) Diabetes & Hypertension Support Livongo 800-945-4355 join.livongo.com/ARCHGH (Registration Code: ARCHGH) Dental Blue Cross Blue Shield 800-521-2227 www.bcbstx.com (Group #274852) of Texas (BCBSTX) Vision VSP 1-800-877-7195 www.vsp.com (Group #12001362) Life and AD&D Voya 1-888-238-4840 www.voya.com/claims (Group #723517) Employee Assistance www.guidanceresources.com Voya 877-533-2363 Program Web ID: MY5848i (ComPsych) TTY: 800-697-0353 (Group #723517) Mobile App: GuidanceNow℠ travelsecurity.garda.com Travel Assistance Voya In the US: 800-859-2821 Email: ops@europassistance-usa.com (Group #723517) (Europ Assistance) Worldwide: +1-202-296-8355 Contract Number: 17372020 Funeral Planning, Will Prep Everest Funeral 1-800-913-8318 everestfuneral.com/voya & Concierge Concierge 2022 Priest Benefits Guide 3
Your 2022 Medical Pharmacy Dental Vision Life, AD&D Additional Benefits Benefits Benefits Benefits Benefits Disability Benefits MEDICAL BENEFITS The Archdiocese of Galveston-Houston offers two medical plans through Blue Cross Blue Shield of Texas (BCBSTX). With a PPO plan, you have the ability to see the doctor of your choice. However, you will pay less out -of-pocket if you choose doctors, hospitals, and other healthcare providers in the Blue Choice PPO Network. To find an in-network provider, go to www.bcbstx.com and click on “Find a Doctor or Hospital” or contact the Benefits Help Line by emailing agh_benefits@ajg.com or call 1-855-664-8164. Medical Services Priest Plan BCBSTX Blue Choice Network In-Network Out-of-Network Annual Deductible $400 $800 Coinsurance You pay 10% after deductible You pay 40% after deductible Out-of-Pocket Maximum $1,500 $3,000 Preventive Care Plan pays 100% 40% after deductible Primary Care Office Visit $15 copay 40% after deductible Specialist Office Visit $25 copay 40% after deductible MDLive Virtual Visit $15 copay Not Covered Urgent Care Center $25 copay 40% after deductible Emergency Room $100 copay $100 copay (copay waived if admitted) (copay waived if admitted) Diagnostic Tests Plan pays 100% 40% after deductible X-ray, labs, blood work (LabCorp or Quest Diagnostics) Imaging 10% after deductible 40% after deductible MRI, CT/PET Scan Inpatient Services 10% after deductible 40% after deductible Outpatient Services 10% after deductible 40% after deductible The Archdiocese of Galveston-Houston believes its Medical and Pharmacy Plan as described in this guide is a “grandfathered health plan” under the Patient Protection and Affordable Care Act (PPACA). As permitted by PPACA, a grandfathered health plan must preserve certain basic health coverage that was already in the Plan when that law was enacted. Being a grandfathered health plan means that your Plan may not include certain consumer protections (health and pharmaceutical coverages) of PPACA that apply to other (non-grandfathered) plans, for example, the requirement for the provision of preventive health services without any cost sharing. However, the grandfathered plans must comply with certain other consumer protections in PPACA, for example, the elimination of lifetime limits on benefits. As a grandfathered plan, this Plan, self-funded by the Archdiocese of Galveston-Houston, does not provide medical and pharmaceutical coverage that contravenes with Catholic teachings. Questions regarding which protections (Medical and Pharmaceutical coverages) apply and which protections (Medical and Pharmaceutical coverages) do not apply to our grandfathered health plan status can be directed to the plan administrator, Charlie Pavlovsky, at 713-652-8261. 4 Archdiocese of Galveston-Houston
Your 2022 Medical Pharmacy Dental Vision Life, AD&D Additional Benefits Benefits Benefits Benefits Benefits Disability Benefits TELEHEALTH BENEFITS Get Care When and Where You Need It MDLive provides you with access to board-certified doctors anytime and anywhere it’s most convenient for you—at home, work, or on the go. MDLive has the nation’s largest telehealth network of doctors ready to provide convenient, quality care by phone or secure video. Doctors can diagnose a wide range of non- emergency medical issues and even send prescribed medications to your pharmacy of choice. MDLive physicians can treat the following: Flu Sore throat Headache Rash Allergies Fever Nausea/vomiting Ear problems Cough Sinus infection Pink eye UTI ON YOUR PLAN: $15 COPAY How to Get Started www.mdlive.com/bcbstx To register, go to www.mdlive.com/bcbstx. Enter your first and last name, date of birth, and BCBSTX member ID number. Once you have an account, you 888-680-8646 can browse doctor profiles, view available appointment times, and schedule an appointment with the doctor of your choice. www.mdlive.com/getapp 2022 Priest Benefits Guide 5
Your 2022 Medical Pharmacy Dental Vision Life, AD&D Additional Benefits Benefits Benefits Benefits Benefits Disability Benefits 24/7 Nurseline Health happens—good or bad, 24 hours a day, 7 days a week. That is why BCBSTX has registered nurses waiting to talk to you whenever you call the 24/7 Nurseline. Registered nurses are available to answer health questions and to help you decide whether you should go to the emergency room, urgent care, or make an appointment with your doctor. Plus when you call, you can also access an audio library of more than 1,000 health topics—from allergies to surgeries—with more than 500 topics available in Spanish. Call the 24/7 Nurseline anytime at 800-581-0393. Blue Access For Members Get information about your health benefits anytime, anywhere. Use your computer, phone or tablet to access the Blue Cross Blue Shield of Texas (BCBSTX) secure member website, Blue Access for Members. With Blue Access for Members, you can: Provider Finder Locate a doctor, hospital or facility in the BCBSTX Blue Choice PPO Network ID Cards Request a new ID card, or print a temporary one Wellness Tools & Resources Access handy tools like Well onTarget, which has fitness trackers, food diaries, and more Claims View or print Explanation of Benefits statements, and check the status or history of a claim My Coverage See your benefits at a glance or in detail Customer Service Use secure messaging to get in touch with helpful customer service representatives It’s easy to get started! Visit www.bcbstx.com/member and click on “Register Now” under the blue Member Login button. You will need the information on your BCBSTX ID card to complete your registration. If you do not have this information, you can call the BCBSTX Help Desk at 888-706-0583 for assistance. BCBSTX Mobile App Many of the services and resources available through Blue Access for Members can also be found right in the palm of your hand! With the IT’S EASY TO GET BCBSTX Mobile App, you can access your important health plan information wherever you are. Text* BCBSTXAPP to 33633 to get the app, or download it directly from the App Store or Google Play. CONNECTED *Message and data rates may apply. Terms and conditions and privacy policy at bcbstx.com/mobile/text-messaging. 6 Archdiocese of Galveston-Houston
Your 2022 Medical Pharmacy Dental Vision Life, AD&D Additional Benefits Benefits Benefits Benefits Benefits Disability Benefits Blue365 Discounts Blue365 is just one more advantage you have by being a Blue Cross Blue Shield of Texas (BCBSTX) member! With this program, you may save money on health and wellness products and services from top retailers that are not covered by insurance. There are no claims to file and no referrals or preauthorizations. Once you sign up for Blue365 at blue365deals.com/bcbstx, weekly “Featured Deals” will be emailed to you. These deals offer special savings for a short period of time. Below are some of the ongoing deals you can access on the Blue365 website: EyeMed | Davis Vision You can save on eye exams, eyeglasses, contact lenses and accessories. You have access to national and regional retail stores and local eye doctors. You may also get possible savings on laser vision correction. TruHearing® | Beltone™ | American Hearing Benefits Receive exclusive access to low pricing on today’s latest hearing aid technology. You could get savings on hearing tests, evaluations and hearing aids. Sun Basket | Nutrisystem® | Farmbox Direct Help reach your weight loss goals with savings from leading programs. You may save on healthy meals, membership fees (where applicable), and nutritional products and services. Fitbit® You can customize your workout routine with Fitbit’s family of trackers and smartwatches that can be employed seamlessly with your lifestyle, your budget, and your goals. You’ll get a 20% discount on Fitbit devices plus free shipping. Reebok | SKECHERS® Reebok makes top athletic equipment for all people. Get 20% off select models. SKECHERS, a leader in the footwear industry, offers exclusive pricing on select styles— get 30% off plus free shipping online. Gympass Gympass gives you access to 12,000+ gyms and studios nationwide, virtual personal training, and online therapy for as low as $19.99 per month. Partner gyms include Life Time Fitness, F45, Barry’s, Gold’s Gym, SoulCycle, and more! 2022 Priest Benefits Guide 7
Your 2022 Medical Pharmacy Dental Vision Life, AD&D Additional Benefits Benefits Benefits Benefits Benefits Disability Benefits PHARMACY BENEFITS The Archdiocese of Galveston-Houston Medical/Rx plans include comprehensive prescription drug coverage. You are automatically enrolled in prescription drug coverage as part of the Priest Medical/Rx Plan. Our prescription drug benefits administered by OptumRx. Prescription Drug Benefits Priest Plan OptumRx In-Network Retail Pharmacy 30-day supply Generic $5 copay * Preferred Brand $30 copay * Non-Preferred Brand $55 copay OptumRx Home Delivery 90-day supply Generic $0 copay * Preferred Brand $60 copay * Non-Preferred Brand $110 copay * For certain preferred brand and non-preferred brand drugs, you may be required to try a generic equivalent first. See below for more details. About Step Therapy The Step Therapy Program encourages safe and cost-effective medication use. The program is designed to keep members safe and save money when possible. To receive coverage for certain medications, you may need to first try a proven, generic equivalent before using a more costly treatment, if needed. For a complete list of drugs covered by your plan, as well as a list of Step Therapy drugs, visit www.optumrx.com. Generic Drugs Non-Preferred Brand Drug Preferred Brand Drug You can save on your out-of-pocket A name brand drug that may have a Preferred brand drugs are commonly TERMS TO costs by choosing generic drugs. Brand and generic drugs are regulated by the FDA and are therapeutic alternative available as either a generic or preferred brand drug. These drugs will generally be prescribed name-brand drugs that has been selected based on its clinical effectiveness, safety, and KNOW chemically and medically the same. the most expensive. cost. Preferred brand drugs will However, generic drugs typically generally be more expensive than cost significantly less. Talk to your Formulary generic drugs, but less expensive doctor to find out if generic drugs The list of prescription drugs covered than non-preferred brand drugs. are right for you. by the plan. Also called a “drug list.” 8 Archdiocese of Galveston-Houston
Your 2022 Medical Pharmacy Dental Vision Life, AD&D Additional Benefits Benefits Benefits Benefits Benefits Disability Benefits Save with Generic Drugs Both prescription and over-the-counter generic drugs can be less costly than brand name drugs. You can save on your out-of-pocket costs by choosing generic medications. Both brand and generic drugs are regulated by the Food and Drug Administration (FDA) and are chemically and medically the same. However, generic drugs tend to cost significantly less than their brand name equivalents! We encourage you to talk to your doctor to find out if generic drugs are right for you. OptumRx Mail Saver Do you take medicine every day for diabetes, asthma, or another condition? These are called maintenance medications. Mail Service Saver is a program that helps you better manage your maintenance medications on an ongoing basis. You can save both time and money by filling your prescriptions for maintenance medications through OptumRx Home Delivery. Not only is home delivery safe and reliable, it also offers some advantages: Cost Savings — You may pay less for your medication with a 90-day supply from OptumRx Home Delivery. Convenience — Get free standard shipping on medications delivered to your mailbox. 24/7 Access & Reminders — Speak to a licensed pharmacist who can answer your questions any time, any day. You can even set up text reminders to help you remember to take or refill your medications. Home Delivery is optional, but highly encouraged. Get started with OptumRx Home Delivery by visiting www.optumrx.com or call 1-855-524-0381. OptumRx Member Website & Mobile App From the OptumRx member website and mobile app, you can easily refill a medication, transfer a retail prescription to home delivery, IT’S EASY TO GET access the most current drug coverage information, compare potential cost savings, and more! To register, visit www.optumrx.com or download the OptumRx Mobile App from the App Store or Google Play. CONNECTED 2022 Priest Benefits Guide 9
Your 2022 Medical Pharmacy Dental Vision Life, AD&D Additional Benefits Benefits Benefits Benefits Benefits Disability Benefits LIVONGO DIABETES & HYPERTENSION The Simpler Way to a Healthier You Testing and tracking your blood glucose levels and blood pressure are critical steps to successfully manage diabetes and hypertension, but they can be a time-consuming, manual process. Now, there’s a better way! Livongo provides you with an advanced blood pressure monitor, blood glucose meter, unlimited test strips, and on-demand coaching anytime, 100% paid for by the Archdiocese of Galveston-Houston. Join Livongo and You’ll Get: FREE advanced blood pressure monitor and/or Real-time support from Personalized tips & articles blood glucose meter coaches when you need it picked just for you Send health summary Automatic uploads mean Optional family alerts keep reports to your doctor no more logbooks everyone in the loop directly from your meter A more helpful meter Get advice on what to do next. Livongo’s advanced devices give you a personalized tip right after each blood glucose or blood pressure check. Unlimited test strips, no cost to you With Livongo, test strips are ordered directly from your meter and delivered for free right to your door. Register at join.livongo.com/ARCHGH or call 800-945-4355 with code: ARCHGH 10 Archdiocese of Galveston-Houston
Your 2022 Medical Pharmacy Dental Vision Life, AD&D Additional Benefits Benefits Benefits Benefits Benefits Disability Benefits DENTAL BENEFITS Dental coverage is important to your overall health and wellness. The Archdiocese of Galveston-Houston provides Dental coverage for our priests through Blue Cross Blue Shield of Texas (BCBSTX). The Dental PPO Plan helps you with the cost of preventive, basic, and major dental services. This plan gives you the freedom to select any dentist, but you will pay less out-of-pocket when you choose a provider in the BCBSTX Dental Network. To find an in-network provider, go to www.bcbstx.com and click on “Find a Doctor.” Next scroll to the bottom of the page and select “Find a Dentist.” Enter your search criteria to find in-network dentists near you. Dental Services Dental PPO Plan BCBSTX Dental PPO Network In-Network and Out-of-Network Annual Deductible $50 Annual Benefit Maximum $1,500 per person Diagnostic & Preventive Services Plan pays 100%; deductible waived Exams, cleanings, bitewing x-rays, sealants Basic Services You pay 20% after deductible Endodontics, periodontics, root canals, oral surgery Major Services You pay 50% after deductible Crowns, inlays, onlays, prosthodontics, implants Out-of-Network Dental Claims While benefits appear to be the same for in-network and out-of-network dentists, please remember that if you choose an out-of-network dentist, there will be a maximum limit that BCBSTX will reimburse. If an out-of- network provider charges over this amount, you may be balance billed by your dentist for the difference between the provider’s charge and the maximum reimbursement allowed by the plan. Additionally, you must file your own claim to be reimbursed for out-of-network services. You can find the claim form and instructions posted under the “Forms” section of the Archdiocese of Galveston-Houston Human Resources website. 2022 Priest Benefits Guide 11
Your 2022 Medical Pharmacy Dental Vision Life, AD&D Additional Benefits Benefits Benefits Benefits Benefits Disability Benefits VISION BENEFITS The Archdiocese of Galveston-Houston offers all priests vision coverage through VSP. Eye care is a vital component of a healthy lifestyle. Regular eye examinations can not only determine your need for corrective eyewear but also may detect general health problems in their earliest stages. Your vision plan makes regular exams and purchasing contacts or glasses simple and affordable. With your vision coverage, you have access to quality vision care. The plan uses VSP’s network of vision care providers, including retail optical centers, optometrists, and opticians. Although you can see any eye doctor you choose, you’ll save the most money if you choose an eye doctor from VSP’s extensive network of providers. Your plan also offers special pricing for LASIK and PRK correction procedures from contracted providers. To access a list of in-network providers and retail centers, or to see a list of contracted LASIK and PRK correction providers, visit www.vsp.com or call 1-800-877-7195. Vision Services Vision Plan VSP Vision Network In-Network Out-of-Network Eye Examinations $20 copay Reimbursed up to $50 Lenses Single Vision $20 copay Reimbursed up to $50 Lined Bifocal $20 copay Reimbursed up to $75 Lined Trifocal $20 copay Reimbursed up to $100 Lenticular $20 copay Reimbursed up to $125 Photochromic/Transition $20 copay Reimbursed up to $5 * Standard Progressive $20 copay Reimbursed up to $75 Frames $150 allowance Reimbursed up to $70 $150 allowance Elective Contact Lenses Reimbursed up to $105 Applies to materials and exam (fitting & evaluation) Benefit Frequency Examination Once every 12 months Lenses OR Contact Lenses Once every 12 months Frames Once every 12 months * $80—$90 copay for Premium Progressive Lenses, $120—$160 copay for Custom Progressive Lenses. All out-of-network progressive lenses are reimbursed up to $75. 12 Archdiocese of Galveston-Houston
Your 2022 Medical Pharmacy Dental Vision Life, AD&D Additional Benefits Benefits Benefits Benefits Benefits Disability Benefits LIFE/AD&D INSURANCE Life and AD&D The Archdiocese of Galveston-Houston provides all priests with Basic Life and AD&D Insurance at no cost to you, and you also have the option to purchase Supplemental Life Insurance. Please note retired priests are only eligible for the Basic Life Insurance paid for by the Archdiocese, not AD&D Insurance. Review the chart below for details. Effective January 1, 2022, these plans will be administered by Voya. Basic Life/AD&D Insurance Supplemental Life Insurance Priest Benefit Priest Benefit Benefit Amount $12,000 Increments of $25,000 Maximum Benefit $12,000 5x your annual earnings, not to exceed $100,000 2 To 67% at age 65 To 67% at age 65 Age Reduction Schedule To 50% at age 701 To 50% at age 703 Benefit Paid By Archdiocese of Galveston-Houston You (1) Benefit reduces on January 1st following the date you attain age 65 and age 70. (2) If you are newly eligible, you may elect up to the guarantee issue amount without Evidence of Insurability (EOI). If you waived coverage when you were first eligible or were denied coverage, any amount elected will be subject to EOI. If you currently have coverage, any increases in coverage will require EOI. Elections requiring EOI will not become effective until and unless approved by Voya. (3) Benefits reduce on the first of the month following the date of the change, to the noted percentage rounded to the next higher multiple of $500 if not already a multiple of $500. 2022 Priest Benefits Guide 13
Your 2022 Medical Pharmacy Dental Vision Life, AD&D Additional Benefits Benefits Benefits Benefits Benefits Disability Benefits WORK-LIFE BALANCE Employee Assistance Program We all experience times when we need a little help preparing for and dealing with the stresses of life. Your Employee Assistance Program (EAP), which is provided to you at no additional cost, gives you the ability to contact master’s-degreed clinicians 24/7 by phone, online, live chat, email, and text. There’s even a mobile app for assistance on the go. Receive referrals to support groups, a network counselor, community resources, or your health plan. If necessary, you’ll be connected to emergency services. Your Employee Assistance Program (EAP) includes up to 3 face-to-face counseling sessions per issue. Assistance is immediate, personal, and available when you need it. EAP services can help you with: Depression, grief, loss, and emotional wellbeing Financial and legal concerns Life improvement and goal setting Stress or anxiety with work or personal life Addictions and substance abuse Hiring movers or home repair contractors To take advantage of the services available to you through your EAP, call 877-533-2363 (TTY 800-697-0353) or visit guidanceresources.com to explore a wealth of information online, including videos, guides, articles, webinars, resources, self-assessments and calculators. ComPsych is the EAP vendor that Voya utilizes for Archdiocese of Galveston-Houston members. Travel Assistance You can get support while traveling 100+ miles from home or internationally, including passport, visa, weather and currency exchange information, help replacing lost passports or credit cards, referrals to medical providers, emergency medical evacuation, legal and interpreter services, and more! Travel assistance is available worldwide 24/7. In the US, toll-free: 800-859-2821 Everywhere else: +1-202-296-8355 Online: travelsecurity.garda.com Contract Number: 17372020 Email: ops@europassistance-usa.com 14 Archdiocese of Galveston-Houston
Your 2022 Medical Pharmacy Dental Vision Life, AD&D Additional Benefits Benefits Benefits Benefits Benefits Disability Benefits Everest Funeral Planning, Will Prep, and Concierge Services Everest is pleased to provide a value-added service that can empower individuals who are dealing with funeral- related issues. Everest, the first nationwide funeral planning and concierge service, is an independent consumer advocate who works on your behalf. Everest’s sole purpose is to provide the information you need to make the most informed decisions about all funeral related issues and then put those wishes into action. Pre-Planning Services At-Need Services 24/7 Advisor Assistance Family Support To discuss funeral planning issues Family assistance and plan implementation Communicate the personal funeral plan to the PriceFinder Research Reports funeral home, removing the family from a sales- The only nationwide database of funeral home focused environment prices Provide 24-hour assistance throughout the Detailed, local funeral home price comparisons funeral process Online Planning Tools Expedited life insurance claim process—eligible Create a personal profile beneficiaries may have access to a portion of “10 key decisions” planner the life insurance funds in as little as two “My Wishes” planning guide business days following receipt of the claim Reference guide form (varies by state law) Information stored and maintained in a secure Negotiation Assistance data warehouse Gather pricing information and present it to the Online Will Prep family in an easy-to-read format Online tool allows users to create customized Negotiate funeral service pricing with local legal documents such as Will, Health Care funeral homes Directive, Power of Attorney, and more Help the family compare prices of caskets and Users are asked a series of easy-to-answer questions with helpful explanations and examples Based on responses, a customized legal document unique to the individual’s situation is created Take advantage of the helpful resources available through Everest everestfuneral.com/voya 1-800-913-8318 2022 Priest Benefits Guide 15
Your 2022 Medical Pharmacy Dental Vision Life, AD&D Additional Benefits Benefits Benefits Benefits Benefits Disability Benefits Important Contacts Benefit Vendor Phone Website/Email Archdiocese of Human Resources 713-652-8265 www.archgh.org/hr Galveston-Houston Medical Blue Cross Blue Shield 800-521-2227 www.bcbstx.com (Group #274679) of Texas (BCBSTX) Prescription Drugs OptumRx 1-855-524-0381 www.optumrx.com Virtual Visits MDLive 888-680-8646 www.mdlive.com/bcbstx Blue Cross Blue Shield Nurseline 800-581-0393 N/A of Texas (BCBSTX) Diabetes & Hypertension Support Livongo 800-945-4355 join.livongo.com/ARCHGH (Registration Code: ARCHGH) Dental Blue Cross Blue Shield 800-521-2227 www.bcbstx.com (Group #274852) of Texas (BCBSTX) Vision VSP 1-800-877-7195 www.vsp.com (Group #12001362) Life and AD&D Voya 1-888-238-4840 www.voya.com/claims (Group #723517) Employee Assistance www.guidanceresources.com Voya 877-533-2363 Program Web ID: MY5848i (ComPsych) TTY: 800-697-0353 (Group #723517) Mobile App: GuidanceNow℠ travelsecurity.garda.com Travel Assistance Voya In the US: 800-859-2821 Email: ops@europassistance-usa.com (Group #723517) (Europ Assistance) Worldwide: +1-202-296-8355 Contract Number: 17372020 Funeral Planning, Will Everest Funeral 1-800-913-8318 everestfuneral.com/voya Prep & Concierge Concierge The Archdiocese of Benefits Help Line 855-664-8164 agh_benefits@ajg.com Galveston-Houston Know Your Numbers Use the space below to write in your identification number (located on the front of your BCBSTX ID card) Identification Number: Medical Group Number: 274679 Dental Group Number: 274852 16 Archdiocese of Galveston-Houston
Your 2022 Medical Pharmacy Dental Vision Life, AD&D Additional Benefits Benefits Benefits Benefits Benefits Disability Benefits This Priest Benefits Guide highlights recent plan design changes and is intended to fully comply with the requirements of a self-funded Church Plan Sponsor as a Summary of Material Modifications and should be kept with your most recent Summary Plan Description. This document is an outline of the coverage proposed by the carrier(s), based on information provided by your company. It does not include all of the terms, coverage, exclusions, limitations and conditions of the actual contract language. The policies and contracts themselves must be read for those details. Policy forms for your reference will be made available upon request. The intent of this document is to provide you with general information regarding the status of, and/or potential concerns related to, your current employee benefits environment. It does not necessarily fully address all of your specific issues. It should not be construed as, nor is it intended to provide, legal advice. Questions regarding specific issues should be addressed by your general counsel or an attorney who specializes in this practice area. The Archdiocese of Galveston-Houston believes its Medical and Pharmacy Plan as described in this guide is a “grandfathered health plan” under the Patient Protection and Affordable Care Act (PPACA). As permitted by PPACA, a grandfathered health plan must preserve certain basic health coverage that was already in the Plan when that law was enacted. Being a grandfathered health plan means that your Plan may not include certain consumer protections (health and pharmaceutical coverages) of PPACA that apply to other (non-grandfathered) plans, for example, the requirement for the provision of preventive health services without any cost sharing. However, the grandfathered plans must comply with certain other consumer protections in PPACA, for example, the elimination of lifetime limits on benefits. As a grandfathered plan, this Plan, self-funded by the Archdiocese of Galveston-Houston, does not provide medical and pharmaceutical coverage that contravenes with Catholic teachings. Questions regarding which protections (Medical and Pharmaceutical coverages) apply and which protections (Medical and Pharmaceutical coverages) do not apply to our grandfathered health plan status can be directed to the plan administrator, Charlie Pavlovsky, at 713-652-8261. 2022 Priest Benefits Guide 17
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