THE POWER BEHIND THE PEHT BENEFIT PLAN

The Public Education Health Trust (PEHT) was developed to assist in the procurement of affordable healthcare options in public school districts in Alaska. PEHT has very low administrative costs and the nimbleness to respond to cost-saving measures as they become available.

PEHT supports local control of health insurance plan decisions, providing districts with choices on plans that meet their budgetary and recruitment needs. This is accomplished by providing plans with low-cost options.

PEHT administration carefully analyzes the various benefit offerings and business relationships to ensure they are maximizing clinical and financial outcomes from every healthcare dollar their members invest. PEHT’s vendors provide valuable assistance in reaching these goals.

PEHT’s office in Anchorage is staffed by Rhonda, Rebecca, and Tia. They all work to help PEHT members with the complex world of healthcare and health insurance. Their toll-free number is (888) 685-7526 or you could also reach them at 907-274-7526, Business hours are Monday – Friday from 8 a.m. to 4:30 p.m.

PEHT’s benefit plans are administered by Employee Benefit Management Services, LLC (EBMS). EBMS is a Montana-based, third-party administrator (TPA) that has been serving clients across the nation for more than 40 years. EBMS utilizes provider networks and direct contracts that reach every city, county, and school district in Alaska to access discounted pricing.

Members who have a question about their medical or dental claims should contact one of EBMS’ knowledgeable, friendly customer service representatives at PEHT’s dedicated toll-free number, (866) 247-1443. They can also log in to the miBenefits portal at miBenefits.ebms.com to obtain answers to most of their benefits questions.

One major benefit PEHT offers members is access to high-quality, lower-cost healthcare through the Aetna Signature Administrator’s (ASA) network of physicians and facilities throughout Alaska and the U.S.

Utilizing the ASA network, PEHT has realized lower healthcare claims expenses for many common healthcare services, while assuring that the quality of services remains strong. In addition to this national network, EBMS on behalf of PEHT has negotiated directly with multiple providers in the Alaska area.

Members who are looking for an in-network provider should access either the Aetna Signature network or the direct contracts directly listed in this newsletter and at pehtak.com/preferred-providers.

PEHT’s focus always has been and remains on its members. Due to their flexibility and ability to partner with vendors that mirror their goals of mitigating rising costs while keeping the health and well-being of every single member in their focus,

PEHT will continue to be the preferred option for Alaska schools in the future.

EVOLVE WITH GO365

Evolve with Go365 is a new feature on the Go365 mobile app and Go365.com where members can complete 10- to 15-minute lessons created to improve their whole-person health.

This Netflix-inspired cinematic content taught by renowned experts will close gaps in knowledge and care while supporting learners to better health outcomes.

Members can unlock personalized learning plans once they complete their self-assessment.

Topics covered are benefits, body, career, community and family, finances, and more!

To sign up, log in to your Go365 mobile app or website and click on the Evolve with Go365 button. One easy step and you are on your way to a virtual classroom where you will learn how to be your best self and do your best work!

GETTING STARTED IS AS EASY AS 1, 2, 3!

STEP 1: Activate your online profile and activate two-factor authentication on Go365.com or on the Go365 mobile app

STEP 2: Move out of Blue Status and unlock your Go365 Mall by completing one of these activities:

• Complete a section of your health assessment
• Submit your biometric screening
• Log a verified workout

  STEP 3: Reach a higher status and earn more Go365 Bucks!

KNOW YOUR NUMBERS AND COMPLETE YOUR BIOMETRIC SCREENING FOR UP TO 4,000 POINTS!

Complete a biometric screening with your primary care physician.
To find more information on completing this, log into your Go365 website page and click on:
→ Activities → Prevention → Biometric Screening

Remember, there is also the at-home biometric kit option as well! Members can also complete their biometric screening by completing the at-home biometric kit options. If you have questions, please contact the Public Education Health Trust.

Order your kit now by visiting participant.solutionsforyourwellness.com/product/peht/

DEVICE SYNC TROUBLESHOOTING TIPS

1. Verify that your device is showing connected under the apps/devices tab

2. Ensure you have the most recent Go365 app update

3. Install the latest software on your smartphone

4. Open the Go365 app frequently to ensure data continues to sync

5. Disconnect the Go365 app then reconnect (this should refresh the step data to your account within 24 hours)

If you tried the above and your steps are still not syncing to your Go365 account, please contact Customer Support for further assistance.

SAVE THE DATE:
OPEN ENROLLMENT BEGINS MAY 1, 2023

Open enrollment is quickly approaching! Every year, you have the opportunity to carefully review your benefits and make changes you’d like to see for the coming plan year (July 1, 2023 – June 30, 2024).

The upcoming May/June newsletter will provide more information on how to enroll.
If you have questions in the meantime, reach out to the Trust office.

NON-EMERGENCY MEDICAL TRAVEL BENEFITS AVAILABLE WITH PRE-APPROVAL

Benefits for non-emergency medical travel may be payable for transportation by a commercial airline (coach class only, with at least a 14-day advanced fare) or ferry from the place where the illness or injury occurred to the nearest area where necessary professional treatment can be obtained unless the plan administrator finds a longer trip is necessary.

For reimbursement consideration, commercial airline flights may only be scheduled for departure 1-2 days in advance of the first appointment or 1-2 days after the last appointment related to the condition being treated. Consideration for additional days may be given upon approval by the plan administrator.

All non-emergency commercial travel must be pre-approved by the plan administrator (or their designate) using the “Public Education Health Trust Non-Emergency Medical Travel Request Form” or no benefits will be provided. The form can be found at pehtak.com/forms.

Contact the Health Trust by phone. In Anchorage call (907) 274- 7526; outside of Anchorage call (888) 685-7526. Business hours are Monday-Friday, 8 a.m.-4:30 p.m. (AKDT).

TRANSPORTATION BENEFITS

Transportation benefits in any one calendar year will be limited to two round trips.

Transportation benefits apply only to the illness or conditions covered under this plan. They do not apply to dental care benefits, vision services, routine care, or preventive care exams unless approved by the plan administrator.

A local physician must certify that needed services are not available locally. Transportation benefits for any foreign healthcare will not be covered, including Canadian healthcare.

Transportation benefits will not be given for diagnostic or second-opinion diagnosis unless diagnostic services cannot be provided locally and are deemed medically necessary by the plan administrator. The physician must provide written certification or detailed medical documentation of the existing condition in advance of the trip.

Non-emergency transportation charges will only be allowed for a patient who is a covered person, except for the following circumstances:

• If the patient is a covered person under 18 years of age, then the transportation charges of a parent or legal guardian accompanying the child will also be allowed.
• If the patient is a covered person over age 18 and has a mental disorder or physical disability that requires the assistance of a caretaker post-procedurally or during travel, the transportation charges of a parent, legal guardian or assigned caretaker accompanying the patient will also be allowed.

After the travel has occurred, a “Public Education Health Trust Non-Emergency Medical Travel Completed Form” must be submitted with the boarding passes and the receipts of the travel, signed off by the attending physician, or no benefits will be provided. All information must be sent to EBMS.

PEHT UPDATES AND NOTICES

EXPLORE WAYS TO LOWER YOUR PRESCRIPTION COSTS

There are some things in life we depend on. Medication is often one of them. Optum Rx® offers simple ways to get the medication you need at an affordable cost.

HERE ARE TIPS TO PREVENT ANY SURPRISES AT THE PHARMACY:

1. Ask your doctor to use real-time benefits check (PreCheck MyScript®). This tool helps doctors check medication coverage and costs before they write a prescription. This makes it easy to compare drug prices, view drug alternatives and helps to:

   • Savetime
   • Check if a prior authorization (PA) is needed
   • Request a PA and receive results quickly

2. Visit optumrx.com to compare medication prices at different pharmacies.
3. You may save money with Optum Home Delivery. Enroll in home delivery at optumrx.com or call the toll-free number on your member ID card.

WHEN YOU NEED SURGERY, YOU DESERVE THE BEST

If you’re facing surgery, most of us go with the surgeon that’s referred at our doctor’s appointment because we don’t know that we have or need options. But you always have a choice. In fact, you could be seen by world-renowned specialists at surgical centers of excellence across the nation when you use Transcarent Surgery Care.

WHAT’S INCLUDED?

Transcarent Surgery Care covers your surgery, one pre-operative appointment and one post-operative appointment. This also includes anesthesia, surgical site fees and medications given in the facility for your procedure. Plus, if a local surgeon isn’t available and travel is needed, the travel expenses for the patient and a companion are covered.

WHAT’S THE COST?

As a benefit to you, Public Education Health Trust will cover the cost of your surgery when you use Transcarent! If you have a PPO plan, your surgery costs are covered at 100% and there is no deductible or coinsurance when you choose a Transcarent provider. If you are on a high-deductible health plan, surgery costs are covered at 100% after you meet your deductible.

We know that there’s more to surgery than just the surgery itself. That’s why your dedicated Transcarent Surgery Care Coordinator is there to support you with the logistics before, during and after your procedure, so you can focus on healing.

HOW IT WORKS

1. Call a Care Coordinator at (855) 265-2874
2. Complete a Health History Form
3. Select your provider
4. Show up to your pre-op, surgery and post-op
5. Recover without surprise bills!

And don’t forget... if you’re not yet ready for surgery but need physical therapy for back, joint, or muscle pain, then Virtual Physical Therapy is also available and included in your health plan.

PRO SNOW SHOVELING POINTERS FOR A HEALTHIER, HAPPIER END TO WINTER!

Here in Alaska, we know that wintertime means snow... and this year it has meant a LOT of snow! Yet, while our accumulation may be record-breaking, all that shoveling doesn’t have to be back-breaking as well.

Spring is on the horizon, but we have a few more months of some heavy lifting. Read on for some great tips on how to properly shovel snow in ways to reduce the risk of injury and make the task more manageable.

LET’S DIG INTO IT!

Before bundling up and grabbing the shovel, make sure you:

• Warm up your muscles before you begin. Take a few minutes to walk around, do some light stretches, or even march in place to get your blood flowing and your muscles ready.
• Use a shovel that is the right size for you. A shovel that is too long or too short can put unnecessary strain on your back and joints.
• Bend at your knees, not your back, to lift the snow. Keeping your back straight and using your leg muscles to lift the snow will help to reduce the strain on your lower back and shoulders.
• Push the snow instead of lifting it when at all possible. This will also help to reduce the strain on your back — it’s more efficient and a lot less exhausting!
• Take frequent breaks to stretch your muscles and give your body a rest. This will help to prevent fatigue and reduce the risk of injury.
• Wear boots or shoes with good traction or slip on a pair of ice cleats. It can be slick out there!
• Keep the load you are lifting in close to your body, so you can use your core muscles to support your back.
• Avoid overloading the shovel with too much snow.
• And finally, listen to your body — if you feel pain or discomfort, stop immediately and rest.

Of course, as Alaskans, we know that shoveling snow is a necessary task during the winter months and that it can be painful in more ways than one. But by following these pointers, such as warming up your muscles before you begin, using a shovel that is the right size for you, wearing appropriate footwear, and taking frequent breaks, you can help to reduce the risk of injury and make shoveling snow a safer and more manageable task.

Please, remember that if you have a history of back or joint pain, it's always best to consult with your doctor before undertaking any physically demanding task such as shoveling snow. With the proper precautions and techniques, you can enjoy a snowy winter without worrying about hurting yourself!

DIRECT CONTRACT LIST UPDATES FOR MEMBERS

When a national PPO contract does not meet the needs of providers, they have the option of negotiating a direct contract with the Trust for the benefit of its members. The following providers have responded to their patients’ requests and have completed an in-network contract negotiation directly with the Trust for the benefit of you and your family.

WHERE TO GO WHEN YOU NEED CARE