Medical Coverage

CSEBO is an organization that makes affordable health care coverage its primary goal, and CSEBO includes employee membership at the Board level.

CSEBO is committed to offering School District Employees quality and affordable health care coverage. We regularly review our health care programs in order to insure they are meeting employees' needs.

Each year at open enrollment, employees decide whether they want to enroll in the Preferred Provider Organization (PPO), a Health Maintenance Organization (HMO) or a Health Savings Account (HSA). At that time they also select which insurance company they prefer, Anthem Blue Cross or Kaiser Permenante.

CSEBO currently offers 11 plans for active employees and early retirees, 7 plans administered through Anthem Blue Cross (5 of which are self-insured PPO's) and 4 HMO's offered through Kaiser Permanente. CSEBO also offers its Members ancillary coverages: 6 self-insured Delta Dental PPO Plans, 2 self-insured vision plans (administered through VSP), an Employee Assistance Program through Optum, as well as Basic and Voluntary coverages through The Hartford for life insurance.

CSEBO also utilizes an online platform, BeneTrac, for handling enrollments by District staff, with the ability for employees to self-enroll in plan offerings. BeneTrac allows CSEBO and District staff to effectively and efficiently manage enrollments, with built-in reporting for billing and enrollment tracking. Additionally, BeneTrac can mass update by Member to streamline enrollments and mid-year demographic updates (addresses, phone numbers, etc.) to ensure carriers have the most up-to-date information.

Medical Carriers

CSEBO contracts with both Anthem Blue Cross and Kaiser Permanente. For contact information for both insurance companies, please click below.

Anthem Blue Cross

Kaiser Permanente

How CSEBO's Plans Work

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How the PPO Works

The PPO offers employees a flexible choice for care he or she receives. Employees still have a Primary Care Physician (PCP) with their PPO, but can see any specialist or provider of their choice, without a referral from his or her PCP. CSEBO offers a variety of PPO options to its Members, each offering varying copays, coinsurance and out-of-pocket maximums. When comparing CSEBO’s PPO plans, here are a few terms to keep in mind:

Medical Expense Terms Defined

Deductible

Copays & Coinsurance

Out-of-Pocket Maximum

The amount you pay in full for services before the plan can pay for your costs. Deductibles run calendar year, January 1st to December 31st of each year.

Please note: All CSEBO’s PPO plans waive the deductible for primary and specialist office visits.

Copays are the fees you pay when you go to the doctor or fill a prescription.
Coinsurance is the percentage you pay for care for services beyond the scope of your copay after your deductible is met.

The plan pays the rest.

The maximum you will pay for medical or prescription expenses in a calendar year. If the maximum is reached, you will be covered at 100% for the remainder of the calendar year.

Please note: All CSEBO’s PPO plans have separate medical and prescription out-of-pocket maximums.

Employees see the greatest cost-savings when using providers that are considered in-network, or participating. Participating providers in the Anthem Blue Cross network have agreed to a rate that they will accept as reimbursement for covered services. Non-participating, or out-of-network providers, on the other hand, are non-contracted with Anthem Blue Cross and will result in a greater cost share for the plan and the member. For a list of participating providers, please use the “Find a Doctor” link.

How the HMO Works

Under the HMO, employees and eligible dependents must choose a PCP to coordinate and manage their care. This PCP must be chosen from a special list of doctors and medical group who are part of the HMO network. PCP’s can be a family practitioner, general practitioner, internal medicine specialist, pediatrician, or OB-GYN. If the employee needs specialty care, his or her PCP will refer them to the appropriate source. Most services and supplies are provided to members at no cost or for a very small co-pay.

For a list of participating providers, please use the following links:

Anthem Blue Cross:
"Provider Finder" link.
Search with "Identification Number or Alpha Prefix (first three values)": "NCF"

Kaiser Permanente:
"Provider Finder" link.

How CDHP's Work

A Consumer-Directed Helath Plan (CDHP) is an IRS-qualified High-Deductible Health Plan (HDHP) paired with a financial account, most commonly a Health Savings Account (HSA), that you can deposit money in to pay for any qualified medical, dental or vision expense as defined by the IRS. Examples of qualified medical expenses include primary and/or specialty care visits, hospital visits, prescription drugs, dental and vision care. For a full list of IRS-qualified expenses, please refer to the IRS website and the annual IRS Publication 502.

CDHP’s allow employees to save in the present with lower monthly premiums than traditional plans and utilize the same doctors, networks and pricing as their traditional counterparts. Employees do not pay federal taxes on money deposited into the account through payroll deductions, and it can be used at any time to pay for care. The account grows with tax-free interest, and the money will go with the employee if they change jobs or retire.

CSEBO currently utilizes two different HSA administrators for Anthem Blue Cross and Kaiser Permanente members. Both administrators offer automatic medical and prescription claims integration, balance trackers and comprehensive and easy investment options for employees to invest their funds.

CSEBO HSA Frequently Asked Questions (FAQ)

Carrier	HSA Vendor	Website	Contact Information	Investment Options
Anthem Blue Cross	HealthEquity	http://www.healthequity.com/	1-866-346-5800	HealthEquity Investments
Kaiser Permanente	HealthcareBank	https://www.kp.org/healthpayment	1-877-761-3399	HealthcareBank Investments

Who can contribute to an HSA?

Both employees and employers can contribute to an HSA.

How much can employees and employers contribute into an HSA annually?

2022 Maximum Annual Contributions

Age Band	Individual HDHP Coverage	Family HDHP Coverage
55 & Under:	$3,650	$7,300
55 & Over:	$4,650	$8,300

You can contribute funds to your account in the prior tax year until April 15th following the start of a new tax year. Please note, the IRS annually adjusts the maximums. For detailed information on HSA contributions and qualifications, please see IRS Publication 969.

Who should consider a CDHP?

CDHPs and HSAs are like personal savings accounts, but the money is used only for qualified medical, dental and vision expenses. Employees completely own and control the money in their account.

Like any health care plan option, CDHPs have both advantages and disadvantages. For those that are familiar with their medical plan and carrier who want to save for future health care costs, a CDHP is a good option. However, those who are heavy utilizers of their medical plan, especially those on brand or specialty prescriptions, may find it difficult to meet the higher deductibles and coinsurance required with a CDHP.