Health insurance
You must be considered 80% or above in order to qualify for health insurance.
Health insurance is available to the employee, their spouse and dependents under the age of 26. There is a waiting period of 60 days. (insurance starts the 1st day of the month after the waiting period).
Update on benefits for 2022-2023
You will now have the option of choosing a PPO or HMO plan.
Both plans have the same coverage as you have now in terms of deductibles, coinsurance, out of pocket medical and services.
However, with the HMO plan we are able to maintain the same level of employee contribution as you have now. If you choose to stay with the current PPO plan we will need to increase your employee contribution for the coverage.
So, what is the difference between PPO and HMO plans?
- PPO (Preferred Provider Organization) allows you to use providers in or out of the PHP network without referrals.
- HMO (Health Maintenance Organization) requires you to use providers in the PHP network and have referrals from your designated primary care physician to see other doctors.
The HMO option is allowing LCS to deliver the same benefits we currently have at the same cost to you by utilizing PHP HMO member doctors. This is the first change or adjustment to health insurance at LCS in several years. However, we understand that some of you (or your family members) may be utilizing doctors that are not part of the HMO and therefore we wanted to continue the PPO option.
Below are the per pay amounts deducted for the employees' portion:
HMO PPO
Single $80 $105
Double $170 $225
Family $190 $270
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The LCS insurance is a high deductible plan. In order to minimize out of pocket costs for employees the school has an Health Reimbursement Agreement (HRA) that reimburses employees for the medical expenses incurred up to the deductible. The only co-pays are for prescriptions if you remain in the PHP network of providers. The plan year is from January 1 thru Dec 31.
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LCS makes a copay debit card available to their employees as part of their Medical Reimbursement or FSA Program. Rather than paying the full amount due to the provider and submitting for reimbursement, members and their covered dependents may use their debit card for any of the following services when the services are covered by their medical benefit plan*.
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Office visit copay
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Pharmacy copay
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Chiropractic care copay
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FSA eligible expense
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Urgent care copay
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ER copay
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Deductible
To use the debit card, members should wait until receiving their EOB from PHP to make sure the amount is correct before using the debit card to pay. Debit cards can only be used at approved providers that accept MasterCard for services specific to your plan*. If you are not able to use your debit card, you will need to pay the copay at the time of service. You can submit a reimbursement request by completing the EHIM Medical Reimbursement Form.
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