medical plans available
Doyon offers medical plans through the Federal Employee Health Benefits (FEHB) program for tribal employees. Employees at Doyon and many of subsidiaries can buy the same health insurance offered to U.S. federal government employees.
The FEHB plans give you and your family choices so you can choose the plan that works best for healthcare needs.
Open enrollment begins November 13, 2023, and concludes December 11, 2023. Enrollment for all benefits is available through PlanSource.
During open enrollment, you can add or change dependents, and enroll (or decline coverage) for the following benefits:
Medical plans through FEHB
Dental and vision coverage
Health care flexible spending account
Dependent care flexible spending account
Voluntary employee life insurance
Voluntary spouse life insurance
Voluntary child life insurance
Voluntary critical illness
Hospital indemnity and accident insurance
You can add or change dependents and enroll (or decline) for the following benefits during your initial enrollment period and annual open enrollment period:
• FEHB Medical Plan
• Dental and Vision Coverage
• Health and Dependent Care Flexible Spending Accounts
• Voluntary Life Insurance for Self, Spouse, and Child
• Basic Life Insurance
• Voluntary Critical Illness
• Hospital Indemnity and Accident Insurance
You must re-enroll in your flexible spending accounts each year.
Choosing a plan
Every family’s needs are different. Choose a plan that matches the way you use medical services. For example, if you have a lot of doctor visits, you may want a plan with lower out-of-pocket expenses. Or, if you have a prescription drug you take every day, choose a plan that covers those drugs at the lowest cost.
Decide who to cover
The FEHB plans are available for:
Employee + 1
Employee + family
Look at provider networks
Your costs are lower when you use providers who are part of the plan; these are “in-network” providers. If you have doctors or other health care providers that you like, call their office to see if they are in-network for the plans you are considering. This means that they have an agreement with that plan’s insurance company to provide service to you at a lower price.
In general, plans with a bigger network of healthcare providers will give you more choices. If you use providers that are not in your plan’s network, you may pay much more.
Some of the FEHB plan providers use the same networks as Aetna and Cigna:
• APWU – 471 plan uses Cigna/ 474 plan uses United Healthcare
• GEHA – uses United Healthcare’s network
• MHBP – uses Aetna’s network
• NALC – uses Cigna’s network
• SAMBA – uses Cigna’s network
Think about your budget
With many health plan choices, you can find a premium cost that fits your budget. Your total cost of health care also includes out-of-pocket expenses, so you need to compare those costs as well as the premium cost.
Some FEHB plans put part of your premium in a medical reimbursement account (HSA or HRA) for your use – consider this when comparing plan premium costs.
You can choose a plan in the state where you live OR the state where you work. Use the tool to compare features of the plans available to you. You can compare up to three plans at a time.
COMPARE FEHB PLANS
The Compare Plans Tool shows a monthly premium cost for each plan. This is the employee premium most tribal employees pay for each FEHB plan. However, Doyon has chosen a different contribution strategy. Please use this chart for your premium cost for each FEHB plan available to you.
health care definitions
The amount paid for your health insurance every month. You and Doyon share in the cost of this premium, with Doyon paying the majority of the cost.
The amount you pay for health care services before your insurance plan starts to pay.
A fixed payment for a service, paid at the time of service. Not usually subject to a deductible.
The percentage of the cost you pay for health services after you have paid your deductible.
Out of Pocket Costs
Costs for medical care that are not paid by insurance. This includes deductibles, co-payments and coinsurance for covered services and all costs for services that are not covered. Once you reach your out-of-pocket maximum, the insurance plan will pay 100% of eligible costs for the rest of the calendar year.
Services covered by your health insurance plan, listed in the plan’s Summary of Benefits.
Frequently asked questions
All regular full-time and part-time employees.
• Variable Hour Employees who are not expected to work 130 hours per month
• Seasonal Employees
• Contract Employees
• Tribal Retirees
• Non-Citizens working outside of the US
If you are unsure of your employment status, check with your manager.
You will enroll for an FEHB medical plan, and other benefits, through PlanSource.
Your Username is the first letter of your first name, up to six letters of your last name and the last four numbers of your social security number. Example: If your name is Jane Anderson and the last four of your SSN is 1234, your Username would be janders1234.
The FEHB plans offer three different types of enrollment: Self only, Self Plus One, and Self Plus Family Coverage is available for the employee, spouse, and children under the age of 26.
Yes, with some exceptions. You are not eligible for an FEHB plan if you have existing Federal Employee Health Benefits (FEHB) coverage. This does not include other federally managed/funded plans like Medicare, VA, or Indian Health Services. However, if you have Tricare Reserve Select (not TriCare or TriCare Prime – only Tricare Reserve Select), you are no longer eligible for that coverage now that you are eligible for FEHB. If you want to enroll for an FEHB plan, you must immediately notify Tricare to terminate your Tricare Reserve Select coverage.
If you do not enroll in an FEHB plan, you will not have medical coverage.
FEHB is the Federal Employee Health Benefits (FEHB) program. This is the same insurance offered to U.S. federal government employees. FEHB is the largest group health insurance program in the world, with more than 8 million members. This health insurance is also available to employees of approved tribal employers.
See “Choosing a Plan” for information about choosing a plan. You need to decide who to cover, think about your medical needs, look at provider networks, and think about your budget.
The FEHB has an online tool, the Compare Plans Tool that can help you narrow down your choices within the plans. The tool allows you to choose specific plans and compare them side by side. Always refer to the plan brochures before making a final decision.
The federal government plans include:
• Fee for Service with Preferred Provider Organization (PPO)
• Health Maintenance Organizations (HMO)
• Consumer Driven High Deductible plans (CDHP)
• High Deductible Plans (HDHP) with a Health Savings Account (HSA) or Health Reimbursement Arrangement (HRA)
Different plans are available in different states. You can enroll in a plan either in the state you live or the state you work. For more information on available plans, see the Compare Plans Tool.
You’ll need to do the comparison using one zip code, and then the other. You can’t compare plans for more than one zip code at a time.
Doyon offers dental coverage through Aetna. Features of the plan include:
• $1,500 annual maximum
• Calendar year deductible $50 for individual or $100 for family
• 100% coverage for diagnostic and preventive care
• 80% coverage for basic restorative care
• 50% coverage for major restorative care
Doyon offers vision coverage through VSP. Features of the VSP plan – if you use a provider in the VSP network – include:
• $10 co-pay for your annual eye exam and prescription glasses
• Up to $300 annual allowance for glasses or contact lenses
• Discounts on special lenses, sunglasses, laser vision correction and more
If you have a “qualifying life event” (QLE), you may be able to add a medical plan or change your coverage. Some examples are:
• Your family changes through marriage, divorce, birth, death or for other reasons
• Your employment changes, for example from on-call to regular
• You lose coverage under a spouse’s insurance plan
• You become entitled to Medicare
You will have coverage for 31 days at no cost. Then you have several options:
• You can enroll in “Temporary Continuation of Coverage” for up to 18 months. You will pay the entire premium and an administrative fee.
• You can convert to an individual medical policy.
• You can get other coverage inside or outside of the health insurance exchanges.
Yes. If you qualify for IHS services, you may still have a separate FEHB medical plan. You are not eligible for a Health Savings Account if you have used IHS services – not including preventive, vision or dental care – in the preceding three months.
Yes. However, you must immediately notify TRICARE to terminate your coverage, or you will have to repay TRS for all monies paid on claims retroactive to your FEHB eligibility date or you may face fines and/or a charge of fraud. Click here to access to Tricare Reserve Select website. Contact phone numbers are listed by coverage region on the right-hand side under “Your Contacts.”
Yes. Each plan’s Summary Plan Description (you can view these using the Compare Plans Tool) has a section about coordination with Medicare. If you plan to include your spouse in your FEHB coverage, refer to those documents for more information.
Yes. Doyon is considered a “tribal employer” under the Federal Employee Health Benefits (FEHB) program. All employees who work for a tribal employer are “tribal employees.”
• A spouse (including a same-sex spouse)
• Children under age 26, including adopted children, recognized natural children or stepchildren (including children of same-sex domestic partners in certain states); or foster children living with the employee in regular parent/child relationship.
• Children age 26 or older incapable of self-support, if the disabling condition began before age 26 (medical documentation required)
Grandchildren, unless foster child requirements are met
HRAs and HSAs are recognized by the IRS as “tax-favored” health plans, because the money used to pay qualified medical expenses is not taxed.
See this link for a brief overview of the key features of HRAs and HSAs.
You and Doyon share in the cost of your medical premiums. Doyon will pay the employer share and make a contribution to the employee share of the premium. For several of the FEHB plans, the cost to insure yourself and your family members – with Doyon’s contribution – will be zero. For other plans, Doyon’s additional contribution will make those plans very affordable.
You can use the “ Compare Plans” tool to see the monthly premium costs for each plan. This is the employee premium that most tribal employees pay for each FEHB plan. However, Doyon has decided to contribute additional money to employees’ premiums, reducing employee cost. Remember that if you choose a plan that puts money into an HSA or HRA for your use, the premium cost includes that money.
The premium structure is dictated by the federal government. In some cases, the employee+1 is more expensive than employee+family.
Doyon will pay the entire premium directly to the insurance company. Doyon will deduct your portion of the premium through a pre-tax payroll deduction.
For more information contact Victoria Aldan at 907-459-2016 or firstname.lastname@example.org or Will Daniels at 907-459-2126 or email@example.com.