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2. Agenda. IntroductionsChange for the BetterCoverage AvailableOpen EnrollmentResources to Help You Make Your DecisionQuestions?. 3. Health Care Statistics. Obesity in US is epidemicAdults and ChildrenKansas = 25%
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1. 1 State of KansasOpen Enrollment 2008 Good morning (afternoon), everyone. My name is ____________________ with Kansas Health Policy Authority (KHPA) and I’m here to tell you about the new and improved health plan options available to those enrolled in the State Employee Health Benefits Plan for Plan Year 2008.
Good morning (afternoon), everyone. My name is ____________________ with Kansas Health Policy Authority (KHPA) and I’m here to tell you about the new and improved health plan options available to those enrolled in the State Employee Health Benefits Plan for Plan Year 2008.
2. 2 Agenda Introductions
Change for the Better
Coverage Available
Open Enrollment
Resources to Help You Make Your Decision
Questions? Here’s our agenda for today’s presentation. [READ SLIDE]
Here’s our agenda for today’s presentation. [READ SLIDE]
3. 3 Health Care Statistics Obesity in US is epidemic
Adults and Children
Kansas = 25% – 29%
Contributes to serious health issues like diabetes and heart disease
Diabetes
US = more than 21 million people
Kansas = 141,000 of adults have been diagnosed
Smoking is the number one cause of preventable death in the US
US = 1 in 4 adults smoke
Kansas = 1 in 5 adults smoke
Kansas = 30 percent of adults use tobacco in some form
Before we begin talking about this year’s benefit options, I’d like to share some statistics with you that will help you to understand why we have made some changes to our health plan. Given these health care statistics, it should come as no surprise that obesity, diabetes and tobacco control are three major focuses for the State of Kansas. We have made changes to our health plan that target these issues, which we’ll be discussing momentarily. I’d like to point out that in addition to these three issues, we are also focusing on nutrition and self leadership.
According to the Centers for Disease Control and Prevention, obesity in the United States has increased sharply for both adults and children during the past 20 years. In the State of Kansas, 25 to 29 percent of our residents are obese. Unfortunately, this trend affects many aspects of our overall health and can contribute to serious conditions like heart disease and diabetes.
Speaking of diabetes, more than 21 million people in the US have diabetes. In Kansas, 141,000 adults have been diagnosed with this condition. Diabetes is associated with an increased risk for a number of serious, sometimes life-threatening complications, including blindness, end stage renal disease, and cardiovascular disease.
Another alarming health statistic is that smoking is the number one cause of preventable death in the US. In the US, one in four adults smoke. In Kansas, one in five smokes, and nearly 30 percent use tobacco in some form. The health risks associated with smoking are considerable, and significant health benefits from quitting begin almost immediately.
Before we begin talking about this year’s benefit options, I’d like to share some statistics with you that will help you to understand why we have made some changes to our health plan. Given these health care statistics, it should come as no surprise that obesity, diabetes and tobacco control are three major focuses for the State of Kansas. We have made changes to our health plan that target these issues, which we’ll be discussing momentarily. I’d like to point out that in addition to these three issues, we are also focusing on nutrition and self leadership.
According to the Centers for Disease Control and Prevention, obesity in the United States has increased sharply for both adults and children during the past 20 years. In the State of Kansas, 25 to 29 percent of our residents are obese. Unfortunately, this trend affects many aspects of our overall health and can contribute to serious conditions like heart disease and diabetes.
Speaking of diabetes, more than 21 million people in the US have diabetes. In Kansas, 141,000 adults have been diagnosed with this condition. Diabetes is associated with an increased risk for a number of serious, sometimes life-threatening complications, including blindness, end stage renal disease, and cardiovascular disease.
Another alarming health statistic is that smoking is the number one cause of preventable death in the US. In the US, one in four adults smoke. In Kansas, one in five smokes, and nearly 30 percent use tobacco in some form. The health risks associated with smoking are considerable, and significant health benefits from quitting begin almost immediately.
4. 4 It’s All Good News! Improved Health Coverage for 2008
New Health plan option
Easier Access
Enhanced preventive care
Increased employer contributions 95/55
Improved prescription drug coverage
Healthy lifestyle programs coming soon Employees are a valued resource for the state of Kansas. The focus of our health plans is on preventive care and wellness.
There are a number of changes for 2008. Here are the five most notable:
There will be three health plan options. We have replaced our health maintenance organization (HMO) options and our PPO options with two new plans—Plan A and Plan B. This will provide greater access to care. We will continue to offer the same Qualified High-Deductible Health Plan with a Health Savings Account (HSA).
Preventive care benefits have increased. Our new health plan options place significant attention on preventive health care to help you and your family live a healthier and happier life. Enhancements to preventive care benefits include coverage for medically appropriate colonoscopies and mammograms from a network provider whether they are routine preventive screens or in connection with a diagnosis.
Employer contributions are higher. The State of Kansas will continue to pay the majority of your health and dental expenses—on average 95 percent contribution for employee coverage, and increase the contribution for dependent coverage from 45 to 55 percent. This means that most employees will not see a change in their premium deductions.
Improvements have been made to prescription drug coverage. The co-insurance you pay for generic and preferred brand diabetic and asthma medications have been reduced. We’ve added coverage for smoking-control products and weight-loss medications and our wellness initiative coming in January will also provide health and lifestyle coaching.
Healthy lifestyle programs are coming soon. We will be introducing new healthy lifestyle programs designed to help you make wellness a priority in your everyday life. You will be receiving more information on these programs in the coming months.
This presentation will provide you with an overview of your 2008 options as well as important enrollment information.
Employees are a valued resource for the state of Kansas. The focus of our health plans is on preventive care and wellness.
There are a number of changes for 2008. Here are the five most notable:
There will be three health plan options. We have replaced our health maintenance organization (HMO) options and our PPO options with two new plans—Plan A and Plan B. This will provide greater access to care. We will continue to offer the same Qualified High-Deductible Health Plan with a Health Savings Account (HSA).
Preventive care benefits have increased. Our new health plan options place significant attention on preventive health care to help you and your family live a healthier and happier life. Enhancements to preventive care benefits include coverage for medically appropriate colonoscopies and mammograms from a network provider whether they are routine preventive screens or in connection with a diagnosis.
Employer contributions are higher. The State of Kansas will continue to pay the majority of your health and dental expenses—on average 95 percent contribution for employee coverage, and increase the contribution for dependent coverage from 45 to 55 percent. This means that most employees will not see a change in their premium deductions.
Improvements have been made to prescription drug coverage. The co-insurance you pay for generic and preferred brand diabetic and asthma medications have been reduced. We’ve added coverage for smoking-control products and weight-loss medications and our wellness initiative coming in January will also provide health and lifestyle coaching.
Healthy lifestyle programs are coming soon. We will be introducing new healthy lifestyle programs designed to help you make wellness a priority in your everyday life. You will be receiving more information on these programs in the coming months.
This presentation will provide you with an overview of your 2008 options as well as important enrollment information.
5. 5 Coverage Available Health
Prescription Drug
Dental
Vision
Hearing
KanElect Flexible Spending Accounts (FSAs)
Health Care FSA
Dependent Care FSA We are offering a complete healthcare package for our employees:
Health coverage. You may enroll yourself and your eligible family members in any of the health plans. Eligible employees with lower incomes may enroll in the HealthyKIDS program, which we’ll discuss a little later in this presentation.
Prescription drug coverage. When you choose and enroll in a health plan, you are automatically enrolled in our prescription drug plan administered separately by Caremark.
Dental coverage. You are automatically enrolled in single dental coverage when you enroll in one of our health plans. You may purchase dental coverage for your dependents enrolled in the health plan.
Vision coverage. You may choose vision coverage regardless of whether you are enrolled in a health plan. However, if you enroll your dependent children in the vision plan, they must be the same dependent children who are enrolled in your health plan.
KanElect Flexible spending accounts (FSAs). These include a Health Care FSA to help you pay, with pre-taxed dollars, expenses not covered by your health, dental and vision plans and a Dependent Care FSA to help you pay, with pre-tax dollars, day care expenses for your dependents under age thirteen or legally dependent elder care.
Selecting the coverage that’s right for you will depend on a variety of factors, like whether you will cover dependent children or a spouse. No matter what your unique circumstances, you are sure to find a plan that will fit your needs. But first, a little background.
We are offering a complete healthcare package for our employees:
Health coverage. You may enroll yourself and your eligible family members in any of the health plans. Eligible employees with lower incomes may enroll in the HealthyKIDS program, which we’ll discuss a little later in this presentation.
Prescription drug coverage. When you choose and enroll in a health plan, you are automatically enrolled in our prescription drug plan administered separately by Caremark.
Dental coverage. You are automatically enrolled in single dental coverage when you enroll in one of our health plans. You may purchase dental coverage for your dependents enrolled in the health plan.
Vision coverage. You may choose vision coverage regardless of whether you are enrolled in a health plan. However, if you enroll your dependent children in the vision plan, they must be the same dependent children who are enrolled in your health plan.
KanElect Flexible spending accounts (FSAs). These include a Health Care FSA to help you pay, with pre-taxed dollars, expenses not covered by your health, dental and vision plans and a Dependent Care FSA to help you pay, with pre-tax dollars, day care expenses for your dependents under age thirteen or legally dependent elder care.
Selecting the coverage that’s right for you will depend on a variety of factors, like whether you will cover dependent children or a spouse. No matter what your unique circumstances, you are sure to find a plan that will fit your needs. But first, a little background.
6. 6 New Tool PlanSelect
Decision tools
Series of questions
Helps define your values
Helps determine plan to best meet your needs
Two modules
Health plan
Flexible Spending Account
Recommendation only – it is still YOUR decision
Check provider networks in your area
The state has made available a new tool to assist you in making decisions regarding your health plan participation.
You can access this tool called PlanSelect from the Kansas Self Service Center or from the KHPA web site.
This program will be available beginning October 1, 2007.
This program has two modules to assist you in selecting a health plan as well as planning for KanElect Flexible Spending Account participation.
The tool provides recommendations only – your choice is YOURs. Provider networks are not yet linked to this tool, so they must be checked separately prior to making a plan determination.The state has made available a new tool to assist you in making decisions regarding your health plan participation.
You can access this tool called PlanSelect from the Kansas Self Service Center or from the KHPA web site.
This program will be available beginning October 1, 2007.
This program has two modules to assist you in selecting a health plan as well as planning for KanElect Flexible Spending Account participation.
The tool provides recommendations only – your choice is YOURs. Provider networks are not yet linked to this tool, so they must be checked separately prior to making a plan determination.
7. 7 New Terminology “Medical Home” for primary care
General practice
Family practice
Internal medicine
Pediatrics
Geriatrics
Physician extenders - Physician Assistants and Advance Registered Nurse Practitioners
Preventive Care covered in full when received from your network Medical Home Provider
The medical home is the new terminology for primary care providers. A medical home originates in a primary health care setting where a team of providers work together to provide you and your family with consistent, compassionate care. This could be more than just a family doctor.
We encourage you to seek care from the network “medical home providers.” You do not need to designate a medical home provider nor need a referral for specialty care.
The following network health care providers are considered medical home providers:
General practice
Family practice
Internal medicine
Pediatrics
Geriatrics
Physician extenders (physician assistants and advance registered nurse practitioners)
Preventive care received from a network medical home provider will be covered in full. Other health care services provided by your network medical home provider will be paid at the network benefit level. All other network health care providers will be considered specialists. Network specialists have higher office visit co-pay.The medical home is the new terminology for primary care providers. A medical home originates in a primary health care setting where a team of providers work together to provide you and your family with consistent, compassionate care. This could be more than just a family doctor.
We encourage you to seek care from the network “medical home providers.” You do not need to designate a medical home provider nor need a referral for specialty care.
The following network health care providers are considered medical home providers:
General practice
Family practice
Internal medicine
Pediatrics
Geriatrics
Physician extenders (physician assistants and advance registered nurse practitioners)
Preventive care received from a network medical home provider will be covered in full. Other health care services provided by your network medical home provider will be paid at the network benefit level. All other network health care providers will be considered specialists. Network specialists have higher office visit co-pay.
8. 8 Preventive Care Physical Exams
Well Woman
Well Man
Well Child
Well Baby
Vision Exam
Hearing Exam
Bone Density Screening
Mammogram
Colonoscopy
Immunizations – including allergy shots The Health Plan for 2008 is all about prevention and wellness. The focus is on your health rather than health care. The State has redesigned preventive care to provide easier access.
Health care self-leadership starts with appropriate preventive medical care.
The State is removing the barrier to receiving medically appropriate mammograms and colonoscopies. Services will be covered in full regardless of the diagnosis.
Coverage of immunizations, including allergy shots, has been expanded to all members, regardless of age. Note: Only the immunization is covered in full, if an office visit is billed, the office visit co-pay will apply.
And when you use your network “medical home,” the plans provides preventive care to you at no cost. The Health Plan for 2008 is all about prevention and wellness. The focus is on your health rather than health care. The State has redesigned preventive care to provide easier access.
Health care self-leadership starts with appropriate preventive medical care.
The State is removing the barrier to receiving medically appropriate mammograms and colonoscopies. Services will be covered in full regardless of the diagnosis.
Coverage of immunizations, including allergy shots, has been expanded to all members, regardless of age. Note: Only the immunization is covered in full, if an office visit is billed, the office visit co-pay will apply.
And when you use your network “medical home,” the plans provides preventive care to you at no cost.
9. 9 2008 Health Plans Plan A (NEW)
Plan B (NEW)
QHDHP-HSA (same as last year)
ALL PLANS ARE AVAILABLE STATEWIDE
For 2008, you will have three health plan options:
Plan A
Plan B
and a Qualified High Deductible Health Plan with a Health Savings Account.
Plan A combines the features of the Health Maintenance Organization (HMO) with those of a Preferred Provider Organization (PPO).
Plan B is a replacement to our former PPO options.
There are no changes to the QHDHP-HSA option.
ALL PLANS ARE AVAILABLE STATEWIDE AND NATIONWIDE.
Each plan offers discounts for using health care providers and services that are part of the plans’ preferred provider network. Why the change? We wanted to offer the same plans throughout the State so all employees could choose the plan they wanted. This has eliminated the need for regional pricing as well.
The following slides will explain how each of these plans work.
For 2008, you will have three health plan options:
Plan A
Plan B
and a Qualified High Deductible Health Plan with a Health Savings Account.
Plan A combines the features of the Health Maintenance Organization (HMO) with those of a Preferred Provider Organization (PPO).
Plan B is a replacement to our former PPO options.
There are no changes to the QHDHP-HSA option.
ALL PLANS ARE AVAILABLE STATEWIDE AND NATIONWIDE.
Each plan offers discounts for using health care providers and services that are part of the plans’ preferred provider network. Why the change? We wanted to offer the same plans throughout the State so all employees could choose the plan they wanted. This has eliminated the need for regional pricing as well.
The following slides will explain how each of these plans work.
10. 10 Network Benefit Comparison This is a high level comparison of Plan A and Plan B. The provider networks for Plan A and Plan B are identical within each carrier or Third Party Administrator (TPA). Networks are available through Blue Cross Blue Shield, Coventry or Preferred Health System.
This is a high level comparison of Plan A and Plan B. The provider networks for Plan A and Plan B are identical within each carrier or Third Party Administrator (TPA). Networks are available through Blue Cross Blue Shield, Coventry or Preferred Health System.
11. 11 Non Network Benefits A & B Non Network Providers
$500/$1,500 Deductible
No coverage for preventive care
50% Coinsurance
Coinsurance max $3,650/$7,300
Copays on more services in addition to deductible and coinsurance
Both A&B offer coverage for services received from non network providers. However, there is a front-end deductible and higher coinsurance. In addition, preventive care services are ONLY covered when received from a network Medical Home provider.Both A&B offer coverage for services received from non network providers. However, there is a front-end deductible and higher coinsurance. In addition, preventive care services are ONLY covered when received from a network Medical Home provider.
12. 12 Prescription Drug Coverage Included with Plan A or Plan B
coverage for QHDHP is different
Changes for 2008:
Tobacco control products up to $300
Reduced co-insurance for diabetic and asthma medications
Generics – 10% to a max of $10
Preferred Brands – 20% to a max of $20
Many drugs will go generic in the next year
Watch for savings opportunities
Prescription drug coverage is included in your health plan. (Generic, Preferred Brand, Non Preferred, etc). Prescription drug coverage is provided by Caremark and benefits vary based on the type of drug prescribed. As previously mentioned, there have been some changes to your prescription drug coverage.
Your plan will cover prescription smoking control products, up to $300 per person per calendar year.
Prescription weight loss medications will be covered
Co-insurance for diabetic and asthma medication is reduced to 10 percent, up to a maximum of $10, for generic drugs; and to 20 percent, up to a maximum of $20, for preferred brand name drugs.
Lists of drugs going off patent have been provided in your handouts. Prescription drug coverage is included in your health plan. (Generic, Preferred Brand, Non Preferred, etc). Prescription drug coverage is provided by Caremark and benefits vary based on the type of drug prescribed. As previously mentioned, there have been some changes to your prescription drug coverage.
Your plan will cover prescription smoking control products, up to $300 per person per calendar year.
Prescription weight loss medications will be covered
Co-insurance for diabetic and asthma medication is reduced to 10 percent, up to a maximum of $10, for generic drugs; and to 20 percent, up to a maximum of $20, for preferred brand name drugs.
Lists of drugs going off patent have been provided in your handouts.
13. 13 Why the Change? Offers improved access to care
All employees will have access to the low cost plan
All networks available nationwide
Eliminates pricing differences
No HMO counties
No PPO counties
No Transitional counties
Provides health plan choice
The State offers the same plan designs to all employees regardless of where you reside. By doing so, the State is eliminating the need for HMO, PPO and transitional counties. All employees have access to the same plan options and premiums.
The good news is all employees will have access to the low cost plan!!!The State offers the same plan designs to all employees regardless of where you reside. By doing so, the State is eliminating the need for HMO, PPO and transitional counties. All employees have access to the same plan options and premiums.
The good news is all employees will have access to the low cost plan!!!
14. 14 KanElect Flexible Spending Accounts Two types of accounts:
Health Care FSA and
Dependent Care FSA
Pre-tax contributions
Up to $5,000 per account per year
Extended grace period for Health Care FSA
Annual enrollment is required
Deadline to enroll: October 31 Members enrolled in Plan A or Plan B may elect to contribute to a Health Care Flexible Spending Account. All employees have access to the Dependent Care Flexible Spending Account Program.
Contributions to these accounts are made on a pre-tax basis, which means no taxes are withheld on the money you put into the accounts. That’s like getting a discount equal to your tax bracket, and the funds can be used to pay eligible health care expenses not covered by your health plan, or for dependent care expenses for your children or eligible adults. You can contribute up to $5,000 in each account per year, but is it important to remember that the amounts in your FSA cannot be carried over from year to year; instead, IRS regulations require that any unspent funds must be forfeited. You do have a grace period after the end of the plan year to spend your Health Care FSA funds, but it is limited to the following March 15.
For example, money you put into the Health Care FSA for 2008 must be spent on eligible expenses that you incur no later than March 15, 2009. You have until April 30, 2009, to submit those expenses for reimbursement.
There is NO grace period for Dependent Care Accounts.
You must re-enroll in Flexible Spending Accounts each year. To participate in either the Health Care Flexible Spending Account or the Dependent Care Flexible Spending Account, you must enroll by October 31.Members enrolled in Plan A or Plan B may elect to contribute to a Health Care Flexible Spending Account. All employees have access to the Dependent Care Flexible Spending Account Program.
Contributions to these accounts are made on a pre-tax basis, which means no taxes are withheld on the money you put into the accounts. That’s like getting a discount equal to your tax bracket, and the funds can be used to pay eligible health care expenses not covered by your health plan, or for dependent care expenses for your children or eligible adults. You can contribute up to $5,000 in each account per year, but is it important to remember that the amounts in your FSA cannot be carried over from year to year; instead, IRS regulations require that any unspent funds must be forfeited. You do have a grace period after the end of the plan year to spend your Health Care FSA funds, but it is limited to the following March 15.
For example, money you put into the Health Care FSA for 2008 must be spent on eligible expenses that you incur no later than March 15, 2009. You have until April 30, 2009, to submit those expenses for reimbursement.
There is NO grace period for Dependent Care Accounts.
You must re-enroll in Flexible Spending Accounts each year. To participate in either the Health Care Flexible Spending Account or the Dependent Care Flexible Spending Account, you must enroll by October 31.
15. 15 QHDHP-HSA Qualified High Deductible Health Plan
Preferred Provider Organization (PPO)
Prescription Drug Coverage
Use of Medical Home Encouraged
Health Savings Account (HSA)
Pre-tax or post-tax contributions
Increased maximum contributions allowed
Portable
Balances carry over from year-to-year
$3.50 Monthly management fee
Enrollment Requirements
The QHDHP-HSA option is a PPO, in which you can choose any health care provider but receive a higher level of coverage for using network providers. We recommend you select a “medical home.” Prescription coverage is included with this plan. REMEMBER it is not the same drug plan as is provided with Plans A and B. Prescriptions received with the QHDHP are subject to a deductible and co-insurance. Unlike Plans A and B, the total family out-of-pocket can apply to one member of the family.
The HSA part of the plan allows you to set aside pre-tax money to pay for certain health expenses like deductibles, co-insurance and co-payments that the plan does not cover. Funds contributed to the HSA can be rolled over from year to year. If you stop working for the State of Kansas, you can take your HSA with you.
To participate in the HSA, you must complete a separate form to open the account—this form must be returned to UMB (the plan’s administrator) before December 31.
There is a $3.50 management fee that will be deducted from your account by UMB each month.
Who’s eligible to enroll in a Qualified High Deductible Health Plan HSA? I guess the easiest way to say it is, you cannot have, be on, or be claimed as a dependent on any one else’s health plan or tax return. Nor can you be covered on another health care flexible spending account like our KanElect program.
The QHDHP-HSA option is a PPO, in which you can choose any health care provider but receive a higher level of coverage for using network providers. We recommend you select a “medical home.” Prescription coverage is included with this plan. REMEMBER it is not the same drug plan as is provided with Plans A and B. Prescriptions received with the QHDHP are subject to a deductible and co-insurance. Unlike Plans A and B, the total family out-of-pocket can apply to one member of the family.
The HSA part of the plan allows you to set aside pre-tax money to pay for certain health expenses like deductibles, co-insurance and co-payments that the plan does not cover. Funds contributed to the HSA can be rolled over from year to year. If you stop working for the State of Kansas, you can take your HSA with you.
To participate in the HSA, you must complete a separate form to open the account—this form must be returned to UMB (the plan’s administrator) before December 31.
There is a $3.50 management fee that will be deducted from your account by UMB each month.
Who’s eligible to enroll in a Qualified High Deductible Health Plan HSA? I guess the easiest way to say it is, you cannot have, be on, or be claimed as a dependent on any one else’s health plan or tax return. Nor can you be covered on another health care flexible spending account like our KanElect program.
16. 16 HealthyKIDS Program Dependent Children
200% of poverty level
State of Kansas pays 90% of children’s premium
Same coverage as plan you choose
Must enroll every year
Enrollment ends October 31
Applications available online at:
http://www.khpa.ks.gov/OpenEnrollment07/HealthyKIDS.htm In addition to your health plan options, eligible employees also may qualify for the HealthyKIDS program, which provides an additional employer contribution towards the cost of coverage for dependent children of households with incomes of up to 200 percent of the Federal Poverty Level.
The State of Kansas pays 90 percent of the premiums for children qualifying for this program, and the benefits are the same as the plan you choose for yourself. You must enroll for this program every year, so if you think you may be eligible, please enroll by October 31.
Employees applying for the HealthyKIDS program must make their health plan selection on line during Open Enrollment. AND complete the paper form and provide the requested supporting documentation for the HealthyKIDS program. You and the State Health Plan will be notified of your acceptance.
Applications for the HealthyKIDS program are available online at http://www.khpa.ks.gov/OpenEnrollment07/HealthyKIDS.htm. See your enrollment booklet for more information.In addition to your health plan options, eligible employees also may qualify for the HealthyKIDS program, which provides an additional employer contribution towards the cost of coverage for dependent children of households with incomes of up to 200 percent of the Federal Poverty Level.
The State of Kansas pays 90 percent of the premiums for children qualifying for this program, and the benefits are the same as the plan you choose for yourself. You must enroll for this program every year, so if you think you may be eligible, please enroll by October 31.
Employees applying for the HealthyKIDS program must make their health plan selection on line during Open Enrollment. AND complete the paper form and provide the requested supporting documentation for the HealthyKIDS program. You and the State Health Plan will be notified of your acceptance.
Applications for the HealthyKIDS program are available online at http://www.khpa.ks.gov/OpenEnrollment07/HealthyKIDS.htm. See your enrollment booklet for more information.
17. 17 Dental Coverage Delta Dental
Two networks: Delta Dental PPO and Delta Dental Premier
Two oral exams/cleanings a year
Coverage for restorative, oral surgery, endodontics, periodontics, and prosthodontics
$1,700/person/per year
There are no changes to dental coverage this year.
You continue to have two networks to choose from Delta Dental PPO and Delta Dental Premier. Both networks cover diagnostic and preventive services at 100 percent of the allowed charge, which includes oral examinations with cleanings twice per plan year. Coverage for other benefits such as restorative, oral surgery, endodontics, periodontics, and prosthodontics depend on which network you use.
The maximum benefit is $1,700 per person per year.
There are no changes to dental coverage this year.
You continue to have two networks to choose from Delta Dental PPO and Delta Dental Premier. Both networks cover diagnostic and preventive services at 100 percent of the allowed charge, which includes oral examinations with cleanings twice per plan year. Coverage for other benefits such as restorative, oral surgery, endodontics, periodontics, and prosthodontics depend on which network you use.
The maximum benefit is $1,700 per person per year.
18. 18 Vision Coverage Superior Vision Services
Basic Plan – Network Providers
Exams subject to $50 co-pay
$25 Materials co-pay then:
100% single-vision, standard bifocal, trifocal lenticular lenses
$100 frames
$150 Contact lens allowance
Elective/cosmetic
Enhanced Plan – Network Providers ONLY
Includes Basic Plan Coverage PLUS
Progressive lenses
High index lenses
Poly-carbonate lenses
Scratch and UV coating There are no changes in the Vision Plan this year. You will continue to have the same two choices for vision coverage offered through Superior Vision Services, the basic plan and the enhanced plan.
Remember, eye exams are covered under the preventive benefit of the health plan.
The enhanced plan offers additional coverage. There are no changes in the Vision Plan this year. You will continue to have the same two choices for vision coverage offered through Superior Vision Services, the basic plan and the enhanced plan.
Remember, eye exams are covered under the preventive benefit of the health plan.
The enhanced plan offers additional coverage.
19. 19 Hearing Coverage Kansas State Employees Hearing Improvement Program (K-SHIP)
Regents University
10% discount on hearing exams
Hearing aids available
K-SHIP available at these five Regents Universities
Fort Hays State University
Kansas State University
University of Kansas
University of Kansas Medical Center
Wichita State University
Hearing coverage is provided through the Kansas State Employees Hearing Improvement Program offered by the Hearing and Speech Departments at five of the Regents Universities. A 10% discount is available for hearing exams and the testing required to determine the need for hearing aids.Hearing coverage is provided through the Kansas State Employees Hearing Improvement Program offered by the Hearing and Speech Departments at five of the Regents Universities. A 10% discount is available for hearing exams and the testing required to determine the need for hearing aids.
20. 20 HealthQuest Online health and wellness resources at http://www.khpa.ks.gov/healthquest/default.htm
LIFELINE Employee Assistance Program
1-800-284-7575
Confidential, free, 24/7 personal counseling and referrals
Life coaching services
Healthy Weight Program
5-session, telephonic class
Wellness Newsletters
http://www.khpa.ks.gov/healthquest/newsletter.htm
Wellness Blog
New services coming in 2008! The State of Kansas HealthQuest Wellness Program is designed to improve your health and well-being—and reduce health care costs. You can access HealthQuest at http://www.khpa.ks.gov/healthquest/default.htm (HealthQuest web site).
The HealthQuest site provides links to resources and information on a wide range of health and wellness topics, including: nutrition, physical activity, diseases and conditions, weight control, prevention and more!
This slide provides an overview of some specific programs and features offered by HealthQuest
The LIFELINE Employee Assistance Program provides you with confidential, free, 24/7 personal counseling and referrals as well as life coaching services.
The Healthy Weight Program is a five-session class that is conducted over the phone.
HealthQuest wellness newsletters are broadcast to employees via agency human resource offices on a bi-monthly schedule (February, April, June, August, October, December). If you do not have email or miss seeing it, you can always view these newsletters online at the HealthQuest web site at http://www.khpa.ks.gov/healthquest/newsletter.htm.
To help you stay current about wellness topics, you can subscribe to the HealthQuest Wellness Blog. This blog is written by health professionals and includes postings of health and wellness quotes, tips, articles, free resources and participant stories. When you subscribe, you can ask a question or make a comment on any post—instantly at the comments link.
In addition to these programs and services, NEW services are coming in 2008! New services include:
Personal Health Assessment & Health Screening
Personalized, Tailored Health Coaching
Disease and Condition Management
Self-Care Tools
And much more!
Be on the lookout for more information!
The State of Kansas HealthQuest Wellness Program is designed to improve your health and well-being—and reduce health care costs. You can access HealthQuest at http://www.khpa.ks.gov/healthquest/default.htm (HealthQuest web site).
The HealthQuest site provides links to resources and information on a wide range of health and wellness topics, including: nutrition, physical activity, diseases and conditions, weight control, prevention and more!
This slide provides an overview of some specific programs and features offered by HealthQuest
The LIFELINE Employee Assistance Program provides you with confidential, free, 24/7 personal counseling and referrals as well as life coaching services.
The Healthy Weight Program is a five-session class that is conducted over the phone.
HealthQuest wellness newsletters are broadcast to employees via agency human resource offices on a bi-monthly schedule (February, April, June, August, October, December). If you do not have email or miss seeing it, you can always view these newsletters online at the HealthQuest web site at http://www.khpa.ks.gov/healthquest/newsletter.htm.
To help you stay current about wellness topics, you can subscribe to the HealthQuest Wellness Blog. This blog is written by health professionals and includes postings of health and wellness quotes, tips, articles, free resources and participant stories. When you subscribe, you can ask a question or make a comment on any post—instantly at the comments link.
In addition to these programs and services, NEW services are coming in 2008! New services include:
Personal Health Assessment & Health Screening
Personalized, Tailored Health Coaching
Disease and Condition Management
Self-Care Tools
And much more!
Be on the lookout for more information!
21. 21 New HealthQuest Offerings For 2008 Health Screening
Personal Health Assessment
Personalized, tailored wellness resources
Healthy Lifestyle Coaching
Condition and Disease Management Coaching
24/7 Symptoms Support
Health information and web tools
Incentive for participating
Available in early 2008 Health Screening/Personal Health Assessment
January will kick off the state-wide screening program for cholesterol, triglycerides, blood pressure, diabetes, etc. Participants will also take the online Personal Health Assessment and work with health coaches to develop their highly personalized wellness action plans. Whether you’re healthy or managing a health condition or disease, you can work with a health coach to develop a plan, implement it, and stay on track with it. A wide variety of web tools will also be available to support your wellness choices.
Health Coaching – at the Heart of the New Program
In addition to lifestyle and condition/disease management coaching, you can access health coaches 24/7 for Symptom Support. You can call a specially trained healthcare professional -- such as a nurse, dietitian, or respiratory therapist -- any time of the day or night, any day of the week, with any healthcare questions that are important to you, at no cost to you.
Health Coaches can help you understand your health condition, provide reliable information about any treatment options, and help you think through an important health decision. Health Coaches also recognize that there’s a lot of health information out there, some of which may not even be relevant to you. They can help you sort through the pertinent information and understand how it relates to you.
Additional details about program offerings, eligibility, and incentives for participating will be available soon.
Health Screening/Personal Health Assessment
January will kick off the state-wide screening program for cholesterol, triglycerides, blood pressure, diabetes, etc. Participants will also take the online Personal Health Assessment and work with health coaches to develop their highly personalized wellness action plans. Whether you’re healthy or managing a health condition or disease, you can work with a health coach to develop a plan, implement it, and stay on track with it. A wide variety of web tools will also be available to support your wellness choices.
Health Coaching – at the Heart of the New Program
In addition to lifestyle and condition/disease management coaching, you can access health coaches 24/7 for Symptom Support. You can call a specially trained healthcare professional -- such as a nurse, dietitian, or respiratory therapist -- any time of the day or night, any day of the week, with any healthcare questions that are important to you, at no cost to you.
Health Coaches can help you understand your health condition, provide reliable information about any treatment options, and help you think through an important health decision. Health Coaches also recognize that there’s a lot of health information out there, some of which may not even be relevant to you. They can help you sort through the pertinent information and understand how it relates to you.
Additional details about program offerings, eligibility, and incentives for participating will be available soon.
22. 22 Who Can Enroll? Active Employees
Eligible Dependents
Spouse
Dependent children & stepchildren
Not married
Younger than age 23
Receive more than ˝ support from you
US citizen, national or resident
Live with you more than six months/year
No joint tax return So who is eligible to enroll in the state health plan? The answer is easy…you, your lawful spouse, and your dependent children and stepchildren.
To enroll your dependent children or stepchildren, they must:
be unmarried
be younger than 23 years old
receive more than half their financial support from you
be a United States citizen, national, or resident
live with you more than six months per year, and
not file a joint tax return with any other person.
The unmarried child is considered to “reside” with the member even when TEMPORARILY away from home due to special circumstances such as illness or education.So who is eligible to enroll in the state health plan? The answer is easy…you, your lawful spouse, and your dependent children and stepchildren.
To enroll your dependent children or stepchildren, they must:
be unmarried
be younger than 23 years old
receive more than half their financial support from you
be a United States citizen, national, or resident
live with you more than six months per year, and
not file a joint tax return with any other person.
The unmarried child is considered to “reside” with the member even when TEMPORARILY away from home due to special circumstances such as illness or education.
23. 23 Open Enrollment October 1 – October 31, 2007
Enroll online:
Make changes
Add/drop dependents
Enroll in KanElect FSAs
Effective January 1, 2008
Choices binding for 2008 Now that we’ve discussed your options and who can enroll, let’s talk about what you need to do. Open enrollment takes place from October 1 through October 31, 2007.
If you do not select one of the plans by this date, you automatically will be enrolled in the plan that most closely resembles your current plan. Since many of our plan benefits have changed, it is to your advantage to review your options and choose the plan that best fits your needs.
Remember, after October 31, unless you experience a qualifying event, you cannot change your coverage level until the next open enrollment period. The choices you make now will be effective starting January 1, 2008.Now that we’ve discussed your options and who can enroll, let’s talk about what you need to do. Open enrollment takes place from October 1 through October 31, 2007.
If you do not select one of the plans by this date, you automatically will be enrolled in the plan that most closely resembles your current plan. Since many of our plan benefits have changed, it is to your advantage to review your options and choose the plan that best fits your needs.
Remember, after October 31, unless you experience a qualifying event, you cannot change your coverage level until the next open enrollment period. The choices you make now will be effective starting January 1, 2008.
24. 24 Paper Enrollment Forms New employees hired after September 1, 2007
Employees on Leave Without Pay (LWOP)
Employees dropping dependents without changing coverage level status
Employees wishing to enroll in the HealthyKIDS program Employees will need to enroll via paper forms in these situations. Please consult your Human Resource Office in the situation shown.Employees will need to enroll via paper forms in these situations. Please consult your Human Resource Office in the situation shown.
25. 25 Resources to Help You Make Your Decision Enrollment booklet
Review health plan options
Get information about how to enroll
PlanSelect – NEW
Use this suite of tools to help you with your benefits decisions
Look for this button
at http://www.accesskansas.org/employee/ to use the tools!
Interactive CD-ROM
Review benefit and enrollment details
Explore health and wellness information
Link to tools and resources
Because you have new health plan options this year, you should take some time to review your options and determine what is best for you. You have a number of resources available to you.
As usual, you have an enrollment booklet that gives you an overview of your options including comparisons and the cost for coverage as well as information about enrolling.
In addition to this booklet, the State of Kansas is providing you with a special web site called PlanSelect. PlanSelect features a variety of tools to help you select the health plan that best meets your personal and financial needs. It also includes a Savings Account Estimator that helps you estimate your expenses and determine the appropriate FSA or HSA contribution. Choosing your benefits has never been easier! You can access PlanSelect at http://www.accesskansas.org/employee/ (State Employee Service Center web site).
Another cool resource that’s new for 2008 is the Kansas enrollment CD. This CD includes details about your benefits and enrollment as well as general health and wellness information. It even includes links to helpful tools and resources.Because you have new health plan options this year, you should take some time to review your options and determine what is best for you. You have a number of resources available to you.
As usual, you have an enrollment booklet that gives you an overview of your options including comparisons and the cost for coverage as well as information about enrolling.
In addition to this booklet, the State of Kansas is providing you with a special web site called PlanSelect. PlanSelect features a variety of tools to help you select the health plan that best meets your personal and financial needs. It also includes a Savings Account Estimator that helps you estimate your expenses and determine the appropriate FSA or HSA contribution. Choosing your benefits has never been easier! You can access PlanSelect at http://www.accesskansas.org/employee/ (State Employee Service Center web site).
Another cool resource that’s new for 2008 is the Kansas enrollment CD. This CD includes details about your benefits and enrollment as well as general health and wellness information. It even includes links to helpful tools and resources.
26. 26 Questions? We’ve presented a lot of important information today, and I’m sure many of you have questions. I’ll be happy to answer any questions you may have now.We’ve presented a lot of important information today, and I’m sure many of you have questions. I’ll be happy to answer any questions you may have now.