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Independent School District #492 Austin Public Schools March 1, 2012 Health Insurance Plan 2/21/2012

Independent School District #492 Austin Public Schools March 1, 2012 Health Insurance Plan 2/21/2012. Benefits effective March 1, 2012. The Austin Public School health plan went out for bid for coverage effective 3/1/2012

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Independent School District #492 Austin Public Schools March 1, 2012 Health Insurance Plan 2/21/2012

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  1. Independent School District #492 Austin Public Schools March 1, 2012 Health Insurance Plan 2/21/2012

  2. Benefits effective March 1, 2012 The Austin Public School health plan went out for bid for coverage effective 3/1/2012 Why – Renewal from UMR (TPA -Third Party Administrator) was not affordable Recommendation to change TPA’s to CCStpa based on capabilities and cost Management & Insurance Committee recommended changes in carriers at renewal time Board of Directors approved recommended changes

  3. Austin Independent School District #4922012 Benefit Plan Comparison (In-Network)

  4. Austin Independent School District #4922012 Benefit Plan Comparison (In-Network)

  5. CCStpa: The right partner for you • Founded in 1982 — 30 years experience • Purchased by Blue Cross Blue Shield of Minnesota in 1985 • Headquartered in Eagan • Outstanding service and responsiveness of a top notch TPA • dedicated claims, service, and account management to Austin Public Schools • Integrated resources and industry expertise of a large health plan • Compliance, Contracts, Legal departments

  6. Large provider network means access to your choice of care

  7. CCStpa, not your average tpa. • Access to Minnesota’s broadest network • Access to virtually all doctors, hospitals and other health care providers in the state • Strong negotiations produce deep discounts • Relationships with national networks ensure access and savings anywhere in the country for people traveling or dependants residing outside of MN. • PHCS

  8. Services and support that help you manage your health

  9. Coordinated, personalized support for you Customer service and connections • Check claims status, order ID cards, view membership, view benefits, print forms, search for providers • Answers benefits coverage and other questions • Provides information about available services and tools • May connect you to a nurse or other health specialists

  10. Were here to help • Customer Service (651)-662-5425 or (866) 356-2425 • Monday – Thursday 8a.m.– 5p.m. Friday 9a.m. -5p.m. • Find a doctor online: • Go to www.ccstpa.com • Click on member tab • Click on “Find a doctor” • Choose the EPNI network to match network listed on ID card, or the PHCS travel network when traveling • Check drug list online: • Go to www.ccstpa.com • Click on member tab • Click on “prescription drugs” • Click on “myprime.com”

  11. More support for your health • Health Assessment and Online Coaching • Stop-Smoking Support • CCS Member Center • Online Wellness Center • General health information • Tips for nutrition, fitness, safety, etc. • Stay on track with health goals

  12. Prescription drugs

  13. Prime Therapeutics and CCStpa • Prime Therapeutics network of pharmacies includes over 60,000 pharmacies nationwide. • Cub, CVS, Target, Walgreens, Walmart • Independent and local drug stores • Access information at: • www.myprime.com • 1-800-509-0545 • Prime Therapeutics telephone number is located on the back of your ID card

  14. 2012 Prescription drug benefit250/500 Plan *For eligible drugs available at participating 90dayRx pharmacies.

  15. 2012 Prescription drug benefit 1200/2400 plan Member cost-share after deductible is met *For eligible drugs available at participating 90dayRx pharmacies.

  16. $20 $xx Generic equivalent Co-pay Generic equivalent Ask for generics and saveGenerics work the same as brand name drugs, but cost less $xx Brand name co-pay Member cost $120 Brand name Actual Cost

  17. Order 90-day supplies* 90dayRx program: • Home delivery or pharmacy pick-up • Less expensive • More convenient * For eligible drugs available at participating 90dayRx pharmacies.

  18. Specialty Rx • Available for specific chronic conditions • Often the prescriptions require special handling • Order from a specialty network pharmacy • Fairview Specialty Pharmacy, LLC*1-800-595-7140(612) 672-5262 faxwww.fairviewspecialtyrx.org • Triessent 1-888-216-6710 1-866-203-6010 fax • Contact customer service with questions regarding Specialty Rx

  19. Step Therapy • Step Therapy is based on FDA guidelines, clinical evidence and research to ensure you are taking the most appropriate medication • Physicians and pharmacists review medications to determine which is appropriate and lower-cost alternative medications • Previously qualified Step Therapy participants will be grandfathered and will not have to re-qualify

  20. Questions?

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