DID YOU KNOW?

1. DID YOU KNOW? City of Meridian Wellness Presentation MARCH 21, 2012 Lois MorrisConsultant Boise Mercer

2. Top Ten Things to Know about Health InsuranceGet the most out of your health insurance! 1. Deductible: Set dollar amount you pay each year. Reset every year. • $250 individual / $500 family 2. Coinsurance: Coinsurance applies after your deductible has been met. • 90/10 in network ; 70/30 out of network 3. Copayment: Fixed dollar amount you pay for an office visit. • $20 in network ; deductible/coinsurance out of network

3. Top Ten Things to Know about Health InsuranceGet the most out of your health insurance! 4. Amount charged vs. Allowed amount: In network providers agree to a allowed amount and agree to not bill you the difference between the allowed amount and the charged amount. • Visiting an out of network doctor or facility can cost you more! 5. Out of Pocket Maximum: Once the out of pocket maximum is met (deductibles and coinsurance), most covered services are paid at 100%. • In Network: $1,750 Individual / $3,500 Family • Out of Network: $3,250 Individual / $6,500 Family

4. Top Ten Things to Know about Health InsuranceGet the most out of your health insurance! 6. Generic Drug: Drugs with identical active ingredients as corresponding brand name drugs. Generic drugs on average cost less then one-third of brand name drugs but have the same therapeutic benefit. • $10 Generic • $25 Formulary Brand Name • $40 Non-Formulary Brand Name If you purchase a brand name drug and it has a corresponding generic equivalent, you will pay the different in cost between the generic and brand name drug plus the brand name copayment. • Check to see if your pharmacy’s generic discount program will cost you less than your health plan generic copayment.

5. Top Ten Things to Know about Health InsuranceGet the most out of your health insurance! 7. Preventive Care: Keep yourself healthy and save money on health expenses by following preventive care guidelines for regular check ups, immunizations and tests. In Network • Specifically listed services & immunizations: 100% • Not specifically listed services & immunizations: You pay 10% after deduct Out of network • You pay 30% after deductible • Researchers have estimated that preventable illnesses make up approximately 70% of the burden of illness and the associated costs. Source: New England Journal of Medicine

6. Top Ten Things to Know about Health InsuranceGet the most out of your health insurance! 8. Go to emergency room ONLY for emergencies. • Ask yourself: “am I going to the ER because I have an emergency or because it is open and I don’t need an appointment?” “Can it wait until tomorrow?” • ER visits cost you an additional $100 copay if you are not admitted. • EOB: An explanation of benefits (EOB) form lists the services you received and what BCI paid or applied to your deductible. This is not a bill. • Carefully review the EOB to make sure they only include services you received.

7. Top Ten Things to Know about Health InsuranceGet the most out of your health insurance! 10. Online Tools & Resources: • www.bcidaho.com: • Online cost comparison • Health analysis resources • Health assessments for sleep, stress, nutrition, back & joint health • Find an in network provider • List of covered formulary drugs • www.mercerboise.com (password: Meridian) • Benefit summaries • Summary plan descriptions • Insurance forms • Web links for all insurance vendors/carriers

8. Additional Important Topics!! • Tobacco Cessation Program: $600 per calendar year for smoking cessation prescriptions such as Chantix (brand name) & Bupropion (generic Wellbutrin). • Talk to your doctor – ASK QUESTIONS! Ask your doctor if a recommended service is absolutely necessary. Are there alternatives? • Follow your doctor’s instructions – take any medications exactly as prescribed until completely gone. • Use and get the most out of your flexible spending account. Use pretax dollars to pay for out of pocket medical costs.

9. Thank you for your time today. Questions?