Your New Employee Health Insurance Plan

1. Virginia Office Of Group Insurance 2012 Your New Employee Health Insurance Plan Traditional Plan vs.PPO |

2. What is a Preferred Provider Organization? A PPO is a health plan with an established provider network (physicians, hospitals, labs, etc.) NOT an HMO! You do not need to choose a Primary Care Physician. You do not need a referral to see a specialist. If your physician is in the PPO network, you will have lower deductibles, a higher reimbursement of expenses, and the lowest possible out-of-pocket expenses. If you are enrolled in the PPO but your physician is not, your deductible will be higher, your reimbursement lower, and higher out-of-pocket expenses. Virginia Office of Group Insurance

3. Unchanged in 2012 Pharmacy, Dental and Vision benefits will be the same! New to the 2012 plan New coverage category: “Employee + Spouse + Single Child.” Flexible Spending account (FSA) has been increased from $2,500 to $3,000. Integrated Behavioral Health Plan (IBHP) In-patient Co-payment has been increased to $15. Outpatient Co-payment has been increased to $25. Wellness Benefits and Well Baby Nursery Benefit are now part of both the traditional plan and the new PPO. Virginia Office of Group Insurance

4. Traditional Plan – 2012 Employee premiums will increase by 15% Plan benefits are unchanged (with the exception of the new addition of Wellness and Well Baby Nursery Benefits.) Co-insurance is unchanged at 80/20. Virginia Office of Group Insurance

5. Preferred Provider Organization (PPO): Network is slightly smaller than the Traditional Plan. Monthly Premiums and deductibles are less than the 2011 Traditional Plan. Co-payment for office visits is $20 (in-network physicians). Co-insurance is 85/15 of allowable charges in-network; 70/30 for out-of-network. Virginia Office of Group Insurance

6. The End Virginia Office of Group Insurance www.vogi.gov1-888-555-1110