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Employee Benefits

Jump to: Medical | Prescriptions | Dental | Vision | Well-Being Program | Legal Notices

2020 Open Enrollment

The Annual Open Enrollment will be held October 14 – November 11, 2019, and will not be extended. HCPSS will continue to offer the same comprehensive benefits program, with some changes to the prescription plan offered through Express-Scripts.

See below for the Benefits Enrollment Guide. Employees may enroll or make changes beginning October 14 via Workday.

Benefits open house events will be held in the Ascend One Susquehanna Room, 8939 Stanford Blvd., Columbia.

  • Monday, October 14, 10 a.m.-5 p.m.
  • Tuesday, October 29, 10 a.m.-5 p.m.
  • Wednesday, November 6, 12:30-5 p.m.

Details regarding Open Enrollment and Benefits Offerings:

Previous Open Enrollment Guide for Active Employees – 2019

Annual Medical Costs

Medical (prescriptions included), Dental, and Vision Plan Breakdowns

Medical Plans – CareFirst and Aetna

CareFirst BlueChoice HMO Open Access

With CareFirst BlueChoice HMO Open Access, you can select your doctor from a regional network of physicians, specialists and hospitals located throughout Maryland, Washington, D.C. and Northern Virginia. CareFirst aims to keep you healthy by emphasizing prevention, early detection and early treatment.

Other Resources

Open Access Aetna Select HMO

There’s no requirement to select a PCP, or obtain referrals for specialty care. The network of medical providers and facilities is nationwide, offering a full range of primary care doctors and specialists. When you visit a network provider, you will pay a flat copay for your care. Network providers will handle all of the claims paperwork for you. In order to receive benefits from this plan, you must see network providers.

Aetna Open Choice PPO

You can receive care within the network and pay less for your care. Or, you can choose to receive care outside the network and still receive benefits, but at a higher cost. There are no referral requirements.

Aetna’s nationwide Open Choice PPO network includes 934,260 health care providers; 159,100 of whom are Primary Care Providers (PCPs). This makes it easy to find a network doctor or a hospital, whether you are at home, work or traveling.

Other Member Resources (Open Access Aetna Select HMO and Open Choice PPO)

Prescriptions Plan – Express Scripts

Included in employee benefits packages, express scripts handles services related to prescriptions. They are supported by a national network of over 50,000 pharmacies and a 24-hour, 365-day-a-year Patient Care Contact Center. Home delivery is available for employee medications from express.

On or after 01/01/2020, please call Express Scripts member services at (877) 866-5859 to verify if your pharmacy will allow a 90-day fill, or for assistance in locating a SMART90 participating pharmacy. You may also log in or register at www.Express-Scripts.com/90day to locate SMART90 participating pharmacies in your area.

Dental Plans – Delta Dental and Cigna

Delta Dental PPO

The Delta Dental PPO has a national network of dentists with no need to select a primary dentist. With this plan each enrolled family member receives up to $2,000 for PPO and Premier providers in paid benefits per calendar year. When you use a provider within the PPO network, you receive the highest level of coverage with the least amount of out-of-pocket expenses.

You may choose to use dentists outside of the network, but your costs may be higher.

CIGNA Dental Care HMO

This plan provides low out-of-pocket costs and no claim forms. You can get up to two free dental cleanings a year, and two more at a minimal co-pay. You’ll also receive a Patient Charge Schedule, which lists all of the dental procedures covered by your plan, and any out-of-pocket costs you may run into. CIGNA has a National Network of DHMO providers.

You will need to select a primary care dentist (PCD). If no PCD is selected one will be chosen for you. You are responsible for staying in the network.

Vision Plan- Vision Service Plan (VSP)

Flexible Spending Accounts (FSA) – Navia Benefit Solutions (formerly Flex Plan Services, Inc.)

Questions?

HCPSS Benefits Support Center (BSC) representatives are available to help with online enrollment and questions: Monday–Friday 8:30 a.m.–5:30 p.m. Phone: (443) 589-1940, Toll Free: (855) 245-9479.

Employee Well-Being Program

Women’s Health and Cancer Rights Act

The Women’s Health and Cancer Rights Act (WHCRA) of 1998 requires group health plans to make certain benefits available to participants who have undergone a mastectomy. In particular, a plan must offer mastectomy patients benefits for:

  • All stages of reconstruction of the breast on which the mastectomy was performed
  • Surgery and reconstruction of the other breast to produce a symmetrical appearance
  • Prostheses
  • Treatment of physical complications of the mastectomy, including lymphedema

Our plans comply with these requirements. Benefits for these items generally are comparable to those provided under our plans for similar types of medical services and supplies. Of course, the extent to which any of the items is appropriate following mastectomy is a matter to be determined by the patient and her physician.

Our plans neither impose penalties (for example, reducing or limiting reimbursements) nor do they provide incentives to induce attending providers to provide care inconsistent with these requirements. For more information about WHCRA coverage, contact your health plan administrator.

Newborns’ and Mothers’ Health Protection Act

The Newborns’ and Mothers’ Health Protection Act (NMHPA) of 1996 is a federal law that addresses the length of time a mother and newborn child are covered for a hospital stay in connection with childbirth. In general, benefits for a hospital stay in connection with childbirth cannot restrict benefits:

  • to less than 48 hours for a normal vaginal delivery
  • to less than 96 hours following a delivery by cesarean section

The 48 and 96 hour period starts at the time of delivery. It is important to note that coverage subject to NMHPA guidelines is the mother’s coverage. Newborns must be added to the Employee’s health plan within 30 days of the date of birth.