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Health Plan Options Open Enrollment 2019. Health Plan Options: Open Enrollment 2019. Open Enrollment Overview Choosing a Plan – Health Plan Overviews New Plan – Optima Health HMO Participating in Open Enrollment Making Changes Later. Open Enrollment Overview. Make health plan changes
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Health Plan Options: Open Enrollment 2019 • Open Enrollment Overview • Choosing a Plan – Health Plan Overviews • New Plan – Optima Health HMO • Participating in Open Enrollment • Making Changes Later
Open Enrollment Overview • Make health plan changes • Enroll in Flexible Spending • 2019 Open Enrollment Dates: • Plan Coverage: July 1, 2019 – June 30, 2020 May 1-15, 2019http://edirect.Virginia.gov
Open Enrollment Overview No Action is Required if You: • Have no health plan-related changes • Are not enrolling in a Flex Spending Account • Do not plan to participate in Premium Rewards
Open Enrollment Overview • Make any plan changes • Flexible Spending Account (FSA) – ANNUAL • Continue Premium Rewards - ANNUAL • Dental – Basic/Expanded • Vision – Basic/Expanded
Open Enrollment Overview Flexible Spending Accounts (FSAs) • Health FSA • Dependent Care FSA • Must enroll every year
Open Enrollment Overview Flexible Spending Accounts (FSAs) - NEWthis Year • Limit for FSA = $2,700 • Monthly Flex Fee =$2.10 (Reduced fee!) • PAYFLEX MasterCard
OPEN ENROLLMENT 2019 Choosing a plan
Factors in Choosing a Plan • If you have small children • If you or someone on your plan has a chronic illness • If you or someone on your plan take(s) prescription medications • If you tend to be very healthy • If your physicians are in the network
Factors in Choosing a Plan • Frequently travel outside of coverage area • Travel internationally • Tight budget • Have experienced increase in out-of-pocket expenses
Factors in Choosing a Plan All Plans Include – Wellness • Free Office Visits – Children up to age 6 • Free Annual Check-ups – Children age 7 & older • Free Routine Screenings & Exams – Adults • Free EAP Plans
Choosing a Plan *Not covered in this presentation
COVA Care • International Travel – Blue Cross Blue Shield Global Core • Domestic Travel – BlueCard PPO Program • Out-of-Network Option
COVA Care • Vision Basic – Blue View Vision • Routine exam once per year • $15 co-pay • Vision & Hearing Options • Expanded vision • Routine hearing exams - $40 co-pay • Hearing aids and other services
COVA HealthAware • Consume-driven health plan • Includes a Health Reimbursement Account (HRA) fund • Up to $600 for employee • Up to $1,200 for employee and spouse
COVA HealthAware Earn HRA funds – Healthy Activities “Do Rights” • $150 maximum • “Do Rights” include: • Routine exams • Use MyActiveHealth Tracker • Flu Shot • Completing Coaching Module
COVA HealthAware BIG CHANGES this year Health Reimbursement Account (HRA) – Used FIRST for medical and prescription before FSA PAYFLEX MasterCard Dental Now Delta Dental
COVA HealthAware • Pharmacy • HRA covers pharmacy expenses • Retail and Mail Order • Some free generic and preferred brands • Vision & Hearing – basic • Out-of-Network Coverage
COVA HealthAware – New this Year • HRA funded on PAYFLEX MasterCard • FSA funded on PAYFLEX MasterCard • Aetna Health App • Delta Dental
COVA HDHP • Pharmacy • Mandatory generic • Retail & Mail Order • Vision • Not Available • Hearing • Out of Network
OPEN ENROLLMENT 2019 COVA PLANS – SUMMARY OF CHANGES, OPTIONS
COVA Health Plans –New this Year • Drug Program – IngenioRX • Dental Program – Delta Dental • Medication and Health Coaching • Free Health & Wellness Programs • Maternity: $300 Co-pay Waived • Health Assessment
COVA Care & HDHP – New this Year • Enhanced Member Services • Engage Mobile App • Activate SmartShopper
COVA Care & HealthAware Only – Premium Rewards • Earn $17 off monthly premiums ($34 couple) • Complete online assessment • Must be completed during Open Enrollment
COVA Health Plans: Dental Open Enrollment Options • Basic – Diagnostic & Preventative • 2 free cleanings per year • Expanded Dental – Dental work, Orthodontic • Deductible per person • Different levels of co-insurance based on procedure
NEW THIS YEAR! Optima health hmo
OPTIMA HEALTH HMO • Regional – Hampton Roads coverage area • 26,000 providers • Sentara Quality Care Network & Riverside Health Systems • Referral-less HMO/No Out-of-Network except Children
OPTIMA HEALTH HMO – Coverage Area 17 County Service Areas • Chesapeake, Franklin, Gloucester, Hampton, Isle of Wight, James City, Mathews, Newport News, Norfolk, Poquoson, Portsmouth, Southampton, Suffolk, Surry, Virginia Beach, Williamsburg, York
OPTIMA HEALTH HMO • Includes Expanded Dental • Dominion National • Includes Vision • Eyemed
OPTIMA HEALTH HMO MDLIVE *Virtual Care Anywhere 24/7/365