Overview

To support your health and financial wellness, Green Dot Public Schools provides valuable benefits that help you and your family stay healthy and pay for care in the event of illness or injury.

Important: Effective January 1, 2020, all charter schools in Washington State are required to participate in the state-sponsored benefits plan. You will receive information about how to enroll in 2020 benefits through the School Employees’ Benefits Board (SEBB) later this year. The benefits you elect for 2020 through SEBB will take effect January 1, 2020, and last through December 31, 2020. For more information about the SEBB benefits, please visit the SEBB website.

Learn about your Washington Green Dot benefits:

Enroll on Workday.

Medical

Green Dot Public Schools offers a choice of medical plans with different coverage levels and costs, so you have the flexibility to select the option that’s best for you.

2019 – 2020 medical plan options for WA employees:

  • Aetna EPO Plan
  • Aetna PPO Plan

Compare the plans below and see your contribution rates for coverage.

announcement
Opt-out credit for electing “no coverage”

You can receive a $150 monthly payment if you waive Green Dot medical coverage because you and your covered tax dependents have other coverage that is not through the individual market — for example:

  • You are covered by your spouse or domestic partner’s employer group health plan.
  • You are covered by your parent or guardian’s employer group health plan.

To receive the payment, you must actively log in to Workday, elect “decline medical plan,” and complete the Opt-Out Payment Attestation Form to certify that you meet the above requirements. You will not receive the payment if you miss the enrollment deadline and default to “no coverage.”

Please note: If a family member is a Green Dot employee covered under any Green Dot medical plans and you are covered as a dependent under their plan, the waive incentive does not apply.

Plan documents and legal notices

For a PDF of the Summary of Benefits and Coverage (SBC) for each of your benefit plans, click on the plan names below:

Washington plans

For more information about the dental and vision plans, see the Dental and Vision pages or the documents posted on the left side of the page.

Key features

Both medical plans offer:

  • Comprehensive, affordable coverage that exceeds the requirements of the healthcare reform law — see your contribution rates. Tip: If you need extra protection from large or unexpected medical expenses, you may also choose to enroll in Aflac supplemental medical coverage.
  • Free in-network preventive care, with services such as annual physicals, recommended immunizations, and routine cancer screenings covered at 100%. See more covered preventive services.
  • Prescription drug coverage included with each medical plan. Prescription benefits are provided by Aetna, our medical plan carrier. Learn more.
  • Large network of providers that have agreed to negotiated rates, which saves you money. Both medical plans cover the same services, but each plan’s network is a little different, so be sure to find in-network providers for your specific plan.
  • Choice of four coverage levels:
    • Employee Only
    • Employee + Spouse/Domestic Partner
    • Employee + Child(ren) up to age 26
    • Employee + Family

Compare the medical plans

The following chart provides an overview of coverage under the WA medical plans. For complete details, please review the plan documents in the left menu.

Medical Plan Comparison Chart
Washington employees

Plan Details Aetna EPO Plan
In-Network
Aetna EPO Plan
Out-of-Network*
Aetna PPO Plan
In-Network
Aetna PPO Plan
Out-of-Network*
Annual Deductible
(Individual/Family)
$250/$500 $3,000/$6,000 $500/$1,000 $750/$1,500
Out-of-Pocket Maximum
(Individual/Family)
$1,500/$4,500 $9,000/$18,000 $2,000/$4,000 $6,000/$12,000
PCP Required

No

No

Preventive Care Covered in full 50% after deductible Covered in full 40% after deductible
Office Visits
Primary Care/
Specialist
$10 copay / $20 copay 50% after deductible $10 copay / $20 copay 40% after deductible
Urgent Care $10 copay 50% after deductible $10 copay 40% after deductible
Emergency Room $100 copay $100 copay $100 copay $100 copay
Maternity Care (Inpatient) $100 copay after deductible 50% after deductible 20% after deductible 40% after deductible
Inpatient Hospital $100 copay after deductible 50% after deductible 20% after deductible 40% after deductible
Outpatient Surgery Covered in full after deductible 50% after deductible 20% after deductible 40% after deductible
Prescription Drugs
Retail (30-day supply)
  • Tier 1
  • Tier 2
  • Tier 3
  • Tier 4

 

  • $10 copay
  • $20 copay
  • $35 copay
  • 20% coinsurance; maximum $150

 

  • 20% coinsurance; maximum $250
  • 20% coinsurance; maximum $250
  • 20% coinsurance; maximum $250
  • N/A

 

  • $10 copay
  • $20 copay
  • $35 copay
  • 20% coinsurance; maximum $150

 

  • 20% coinsurance; maximum $250
  • 20% coinsurance; maximum $250
  • 20% coinsurance; maximum $250
  • N/A
Mail Order (90-day supply)
  • Tier 1
  • Tier 2
  • Tier 3

 

  • $20 copay
  • $40 copay
  • $70 copay

 

  • N/A
  • N/A
  • N/A

 

  • $20 copay
  • $40 copay
  • $70 copay

 

  • N/A
  • N/A
  • N/A

*Out-of-network coverage is based on the negotiated rate. If your provider's rate is higher, you will be responsible for paying the difference.

announcement
Use Aetna Navigator to get the most from your plan

When you enroll in an Aetna medical or dental plan, you have many tools and resources available to you through Aetna Navigator. By logging in through Aetna, you can access a personalized, secure account where you can:

  • Access claim forms and information
  • Search for a doctor, dentist, hospital, or pharmacy using DocFind®
  • Join health and wellness programs
  • Use medical and drug cost calculators
  • View or print an ID card
  • Speak with a registered nurse 24/7

How the EPO plan works

  • Provides both in-network and out-of-network coverage. However, you’ll pay less out of pocket when you use Aetna network providers.
  • For in-network care, you must first satisfy a deductible and you’ll pay a $10 copay for most office visits and other services.
  • For most out-of-network care, you must first satisfy a deductible before benefits begin. After you meet the deductible, you pay 50% coinsurance for care.

How the PPO plan works

  • Provides both in-network and out-of-network coverage. However, you’ll pay less out of pocket when you use Aetna network providers.
  • You pay copays for office visits and urgent care when you stay in network. For other types of in-network care, you must first meet a deductible and then you pay 20% coinsurance.
  • For most out-of-network services, you must first satisfy a deductible before benefits begin. After you meet the deductible, you pay 40% coinsurance for care.
announcement
Use your EPO or PPO plan wisely

Here are ways to make the most of your Aetna medical plan all year long.

  • Track your stats. Log in to Aetna’s website to see how much of your deductible you’ve met, review claims, use helpful tools, and more.
  • Pair it with a Healthcare Reimbursement Account. During a separate enrollment in November, you may choose to enroll in the Healthcare Reimbursement Account, which allows you to set aside before-tax dollars to help pay for your eligible medical, prescription, dental, and vision expenses. Keep in mind, you can only carry over up to $500 of unused money in your FSA to the next calendar year; amounts over $500 will be forfeited.
  • Be cost-conscious. Visit Aetna’s website, where you can search for in-network providers and use cost comparison tools to estimate and compare costs of many common medical services according to your specific plan.

Prescription Drugs

Both of the medical plans include retail and mail order prescription drug coverage through Aetna. See how drugs are covered by Aetna.

Paying for prescriptions

There is no annual deductible for prescription drugs, so you begin paying copays with your first prescription purchase. The category, or tier, your drug is in determines the amount you pay. See the Medical Plan Comparison Chart for coverage amounts.

Save money

The cost of prescription drugs is rising faster than many other healthcare services and supplies. But, there are ways for you to save:

  • Ask your doctor about generics. Generic medications are generally just as effective as brand-name medications, but they cost between 30% and 75% less.
  • Use mail order. If you regularly take medication to treat a chronic condition — such as an allergy, heart disease, high blood pressure, or diabetes — using the mail order prescription service will save you time and money. Visit your medical plan carrier’s website or call the number on the back of your insurance ID card to use this service.

Dental

Healthy teeth and gums are important to your overall health. That’s why it’s important to have regular dental checkups and maintain good oral hygiene. Green Dot Public Schools offers a choice of dental plans through Aetna so you can select the level of coverage that best fits your needs.

2019 – 2020 dental plan options for WA employees:

  • Aetna DMO Plan
  • Aetna Low Plan
  • Aetna High Plan

Compare the plans below and see your contribution rates for coverage.

Under the DMO plan, you choose a primary care dentist and receive all of your care within the plan’s network — there is no out-of-network coverage. There is also no deductible or annual maximum benefit under the DMO plan.

Under both the High and Low plans, you can see any dentist you want, but you must first meet a deductible before coverage begins. These plans also include an annual maximum benefit. The difference between the two is in the deductibles, out-of-network coverage, and orthodontic lifetime maximums.

Key features

All the dental plans include:

  • Affordable coverage that helps you manage the cost of dental treatment — see your contribution rates
  • Wide network of providers that have agreed to negotiated rates, which helps you save money (reminder: the DMO plan only pays benefits for care received in-network)
  • Choice of four coverage levels:
    • Employee Only
    • Employee + Spouse/Domestic Partner
    • Employee + Child(ren) up to age 26
    • Employee + Family
search
Find a network dentist

You’ll generally pay less when you use a dentist in Aetna’s network. Visit Aetna’s website to locate in-network providers:

  • To find DMO plan providers, click “DMO®/DNO” within the DMO®/DNO/Managed Dental section.
  • To find Low plan or High plan PPO providers, select “Dental PPO/PDN with PPO II” within the Dental PPO/PDN with PPO II network section.

Compare the dental plans

The following chart provides an overview of coverage under the WA dental plans. For complete details, please review the plan documents in the left menu.

Dental Plan Comparison Chart
Washington employees

Plan Details Aetna DMO Plan
In-Network
Aetna Low Plan
In-Network
Aetna Low Plan
Out-of-Network
Aetna High Plan
In-Network
Aetna High Plan
Out-of-Network
Primary Care Dentist Yes No No No No
Annual Deductible
(Individual/Family)
None $50/$150 $75/$225 $25/$75 $50/$150
Annual Maximum Benefit None $1,500 $1,000 $1,500 $1,500
Diagnostic and Preventive Care Services Fee schedule Covered in full You pay 20%, no deductible Covered in full Covered in full
Basic Services Fee schedule 20% after deductible 50% after deductible 20% after deductible 20% after deductible
Major Services Fee schedule 50% after deductible 50% after deductible 50% after deductible 50% after deductible
Orthodontics
(adults and children)
Fee schedule 40% after deductible 40% after deductible 40% after deductible 40% after deductible
Orthodontic Lifetime Benefits
(adults and children)
Fee schedule $1,000 $1,000 $2,500 $2,500

Use your dental benefits wisely

Here’s how to make the most of your dental benefits:

  • Choose a provider – Each time you need dental care, you have a choice of providers. Selecting a participating dentist in the Aetna network will ensure you receive the highest benefits from your plan.
  • If your service will exceed $300, submit for a pretreatment estimate. You should always submit a request for a pretreatment estimate for procedures and services your dentist believes will exceed $300 (such as crowns, inlays, bridges, and periodontics). For more information about pretreatment estimates, call your dental carrier.
  • Check your claim status and other information on Aetna’s website. You can review Explanation of Benefits (EOB) statements, check if claims have been paid, and more.

Vision

Having an annual eye exam is one of the best ways to make sure you’re keeping your eyes healthy. Green Dot Public Schools offers vision coverage through VSP to save you money on expenses such as eye exams, glasses, and contact lenses.

Key features

  • Affordable coverage that helps you manage the cost of vision care and supplies — see your contribution rates
  • Eye exam covered every year, with only a small copay charged to you
  • Coverage for prescription eyeglasses or contact lenses so you can choose the method of correction you prefer
  • Freedom to see any vision provider you want; however, you will get the best value from your plan benefits when you receive care from a VSP network provider
  • Choice of four coverage levels:
    • Employee Only
    • Employee + Spouse/Domestic Partner
    • Employee + Child(ren)
    • Employee + Family
search
Find a network provider

You’ll get the best value by using a provider in the VSP network.

Coverage details

The following chart provides an overview of coverage under the VSP Vision Plan. For complete details, please review the plan documents in the left menu.

VSP Vision Plan
Washington employees

Plan Details In-Network Out-of-Network
WellVision Eye Exam
(every 12 months)
$10 copay Reimbursed up to $45
Prescription Glasses $25 materials copay for frame and lenses combined (lens enhancements have separate copays) See frames, lenses, and lens enhancements
Frames
(every 12 months)
  • $120 allowance for a wide selection of frames
  • $140 allowance for featured frame brands
  • 20% savings on the amount over your allowance
  • $65 Costco® frame allowance
Reimbursed up to $70
Lenses
(every 12 months)
  • Single vision, lined bifocal, and lined trifocal lenses
  • Polycarbonate lenses for dependent children
  • Photochromic/tints/dyes for dependent children covered in full
Single vision:
Reimbursed up to $30
Lined bifocal:
Reimbursed up to $50
Lined trifocal:
Reimbursed up to $65
Lens Enhancements
(every 12 months)
  • Standard progressive: $0 copay
  • Premium progressive: $95$105 copay
  • Custom progressive: $150$175 copay
  • Average savings of 20% – 25% on other lens enhancements
Progressive:
Reimbursed up to $50
Contact Lenses (instead of glasses) (every 12 months)
  • Contact lens exam (fitting and evaluation): up to $60 copay
  • $120 allowance for contacts; copay does not apply
Reimbursed up to $105
Diabetic Eyecare Plus Program $20 copay for services related to diabetic eye disease, glaucoma, and age-related macular degeneration (AMD); retinal screening for eligible members with diabetes. Limitations and coordination with medical coverage may apply. Ask your VSP doctor for details. N/A
Extra savings
Glasses and Sunglasses
  • Extra $20 to spend on featured frame brands (see vsp.com/specialoffers for details)
  • 20% savings on additional glasses and sunglasses, including lens enhancements from any VSP provider within 12 months of your WellVision exam
N/A
Retinal Screening No more than a $39 copay on routine retinal screening as an enhancement to a WellVision exam N/A
Laser Vision Correction Average 15% off regular price or 5% off promotional price; discounts only available from contracted facilities N/A

Contribution Rates

Click on the Contribution Rates Sheet below to view the WA employee contribution amounts by plan and coverage level for the 2019 – 2020 plan year.

WA Contribution Rates Sheet

Teladoc

With our convenient Teladoc benefit, you and your covered family members can see the doctor without leaving the house! It’s an affordable, easy alternative to urgent care and ER visits when you need non-emergency medical care.

Teladoc gives you 24/7/365 access to board-certified physicians who will consult with you by phone or via live video on your mobile phone or computer. Teladoc physicians can provide fast, convenient diagnosis and treatment for many common conditions.

Teladoc: 24/7 virtual doctor visits
Use it for: Use it when:
  • Sinus problems
  • Urinary tract infections
  • Behavioral health needs
  • Pink eye
  • Bronchitis and flu/cough
  • Upper respiratory infection
  • Nasal congestion/allergies
  • Ear infections
  • Much more
  • The doctor’s office is closed
  • Your child has a fever at 2 AM
  • You think you have the flu but feel too ill to leave the house
  • You’re traveling or on vacation
  • It’s after business hours or on weekends
  • Your medical situation is not life-threatening

Access Teladoc

To get started, simply set up an account on the Teladoc website and you’ll be ready the next time you need care in a hurry!