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2005 State Health Plan Enrollment. Total covered: 51,371. Employee Survey Concerns. Salary Issues Respondents pointed to no across-the-board pay increases for the past three years and felt that their take-home pay has been reduced as a result of premium increases each year.
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2005 State Health Plan Enrollment Total covered: 51,371
Employee Survey Concerns • Salary Issues • Respondents pointed to no across-the-board pay increases for the past three years and felt that their take-home pay has been reduced as a result of premium increases each year.
Employee Survey Concerns • Picking a Plan Design • Respondents feel they have limited choices and many don’t want to pay for services they don’t use.
Employee Survey Concerns • Pharmaceuticals. • There was a great deal of concern about the significant increase in out-of-pocket expenses if we switched from a co-payment plan to a “co-insurance”1 plan.
Benefit Provision for Active Employees • Outpatient Physical Therapy • Inpatient Physical Therapy • Temporomandibular Joint Syndrome (TMJ) • Transplant Services All Traditional Plan information pays 80% of allowable charges after deductible is met.
Benefit Provision for Active Employees • Outpatient Physical Therapy • The benefit is limited to $800 per insured per benefit period. • PPO In-Network: • See outpatient therapy services
Benefit Provision for Active Employees • Inpatient Physical Therapy • The benefit is limited to $15,000 per insured per benefit period. • PPO In-Network: • Plan pays 85% of allowable charges after you meet your deductible. • There is a $150,000 lifetime benefit limit
Temporomandibular Joint Syndrome (TMJ) • The benefit is limited to $2000 per lifetime • There are no PPO in-network and PPO out-of-network payment plan options
Transplant Services • Benefit is limited to$350,000 lifetime maximum per insured • An additional $5,000 living expense benefit • PPO in-network plan pays 85% of allowable charges after you meet your deductible • PPO out-of-network plan pays 70% of allowable charges after you meet your deductible