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St. Tammany Parish School Board
Group Health Plan


Health Plan Notices

2020 Open Enrollment

Medicare Part D Model Creditable Coverage Disclosure Notice

Medicare Part D Creditable Coverage FAQ

Vesting Schedule for Health Insurance

Women’s Health and Cancer Rights Act

Premium Assistance Under Medicaid and the Children's Health Insurance Program (CHIP)

Availability of HIPAA Notice of Privacy Practices

Special Enrollment Rights


Summary of Benefits and Coverage

Active Employees

Retired Employees

Prescription Benefit Summary


Active and Retired Employees (Express Scripts)

Prescription Exclusions

 

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Premiums Effective August 1, 2019


 
EMPLOYEE
EMPLOYER
TOTAL

Active Employees:

Single

87.08

571.94

659.02

w/ Spouse

404.30

1,082.75

1,487.05

Both Employees

99.52

1,387.53

1,487.05

w/ Child(ren)

248.80

617.32

866.12

Family

447.84

1,148.85

1,596.69

Both Employees

124.40

1,472.29

1,596.69

Retirees w/ No Medicare:

Single

87.08
1,107.34
1,194.42

w/ Spouse

404.30
1,843.24
2,247.54

Both Employees

99.52
2,148.02
2,247.54

w/ Child(ren)

248.80
1,171.30
1,420.10

Family

447.84
1,822.42
2,270.26

Both Employees

124.40
2,145.86
2,270.26

Retirees w/ 1 Medicare Eligible

Single

31.10
360.69
391.79

w/ Spouse

149.28
1,401.55
1,550.83

Both Employees

55.98
1,494.85
1,550.83

w/ Child(ren)

74.64
673.44
748.08

Family

248.80
1,849.58
2,098.38

Both Employees

62.20
2,036,18
2,098.38

Retirees w/ 2 Medicare Eligible

w/ Spouse

87.08
692.91
779.99

Both Employees

43.54
736.45
779.99

Family

155.50
806.90
962.40

Both Employees

62.20
900.20
962.40