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Employee Benefits

Find information about 2021 benefits.

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

Visit HCPSS’ Staff Help Site for answers to frequently asked questions about benefits.

2022 Active Employee Benefits

2022 Open Enrollment Newsletter for Active Employees

2022 Benefits Enrollment Guide

Annual Medical, Dental and Vision 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

Cigna PPO (Total Plan)

The Cigna PPO has a national network of dentists with no need to select a primary care dentists. Employees will have the freedom to visit any licensed dentist you wish, but selecting an “in-network” Cigna PPO provider will result in the lowest out-of-pocket costs to the employee.

Aetna DMO

Aetna DMO is a dental maintenance organization (DMO). Aetna DMO offers a list of participating dentists for your care. It is important that you review your choices of Primary Care Dentist (PCD) in your area to make sure that this is the right plan for your dental needs. A PCD selection will not be mandatory during enrollment process. However, in order to use your DMO benefits a PCD is required. Once you enroll, Aetna will send you a “Welcome Kit” in the mail The Welcome Kit will include a reminder of the mandatory PCD election and a sample ID card. Once the Welcome Kit is received, employees should call the Aetna Customer Service line at 877-238-6200 Monday through Friday 8:00am to 6:00pm or login to the member website at https://www.aetnaresource.com/p/HCPSS-Open-Enrollment-2020 to select your PCD and/or for additional assistance. Once a PCD is elected from the Aetna network, employees can set-up a dentist appointment to see their provider. There is no deductible to meet, no annual dollar maximums, and no claim forms for you to file.

Your selection of PCD must be made prior to the 15th of the month, in order to take effect the first of the next month.

Vision Plan- Vision Service Plan (VSP)

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

Questions?

HCPSS Benefits Help Desk representatives are available to help with online enrollment and questions: Monday–Friday 8:30 a.m.–4:30 p.m. Phone: (410) 313-7333. Inquires may always be sent to the Benefits Office via email at benefits@hcpss.org.

Employee Well-Being Program

HCPSS employees have access to professional, free and confidential counseling and support services to manage their needs. Consider this program as your very own personal assistant who can connect you to resources to improve your finances, schedule counseling sessions, develop strategies for navigating stress, and much more.

Employees and family members can receive up to six free counseling sessions (including assessment, follow-up and referral services) per person, per episode, per year. Listed below is information regarding the program and a link to EAP Orientation video.

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.

Machine Readable Files

In late 2020, federal agencies responsible for overseeing the implementation of the Affordable Care Act (ACA)—the Departments of Labor, Health and Human Services (HHS) and Treasury (the Departments)—issued the Transparency in Coverage (TiC) final rule. The rule requires insurers and self-funded plans to post the following machine-readable files (MRF) to a publicly available website:

  • In-Network Rate File: Applicable in-network provider rates, including negotiated rates, derived amounts, and underlying fee schedule rates for all covered items.
  • Out-of-Network Rate File: Historical data outlining the different billed charges and allowed amounts a plan or issuer has paid for covered items or services furnished by out-of-network providers (minimum of 20 entries).

Aetna’s machine-readable files for HCPSS

Carefirst’s machine-readable files for HCPSS