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HealthChoice Medical Plan

HealthChoice Medical Plan. HealthChoice offers a “3 tier” plan design to give members greater control over their health choices. Deductibles vary depending on where you choose to receive medical services. Tier 1 = WDH Network of Providers*

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HealthChoice Medical Plan

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  1. HealthChoice Medical Plan • HealthChoice offers a “3 tier” plan design to give members greater control over their health choices. • Deductibles vary depending on where you choose to receive medical services. • Tier 1 = WDH Network of Providers* • *if you live greater than 35 miles from WDH, all care except same day surgery at the hospital closest to your home will be considered as tier 1. • Tier 2 = Harvard Pilgrim Health Care (HPHC) Network Providers • Tier 3 = All Non-Participating Providers

  2. HealthChoice Medical Plan Annual deductibles are as follows: Deductibles co-accumulate between the tiers, meaning that if you’ve paid $500 toward tier 1 services, that $500 is also credited toward your tier 2 and tier 3 deductibles. Once a deductible has been met, services will be covered at different rates, depending on the tier, by way of co-payments and co-insurance.

  3. HealthChoice Medical Plan Health Reimbursement Account (HRA) As part of your medical benefit, WDH provides you and your covered dependents with an HRA to help offset a portion of your deductible. These funds may be used throughout the plan year for eligible medical expenses that apply to your deductible. You will want to use these funds before paying any expenses out-of-pocket.

  4. HealthChoice Medical Plan Benny Cards You may access your HRA funds with your Benny Card. The Benny Card will be pre-loaded with your initial HRA funds for you and your covered dependents to use to pay for any qualifying medical expenses as if it were a Visa credit card. When you receive a medical bill or pick up a prescription, simply use your Benny Card for payment. Please be sure to keep all receipts in the event that Health Plans asks for documentation to support a charge.

  5. HealthChoice Medical Plan Health Reimbursement Account (HRA) HRA Funds are as follows: *In addition to these initial HRA funds, you will have opportunities throughout the year to earn additional HRA funds if you choose to participate in TakingCare, WDH’s optional Wellness Program.

  6. HealthChoice Medical Plan TakingCare Wellness Program WDH is pleased to support your wellness efforts by offering the TakingCare Wellness Program to all employees who enroll in the HealthChoice Medical Plan. If you choose to participate in TakingCare, you will have opportunities throughout the year to earn additional HRA funds for simply making healthier choices. Your first opportunity to earn an additional $250 in HRA funds is during the month you are initially eligible for medical benefits by participating in an optional Health Assessment. There are 2 components to the Health Assessment; a biometrics screening and an online health questionnaire.

  7. HealthChoice Medical Plan TakingCare Wellness Program • Biometrics Screening • Employee Health will read the following biometrics: • Blood pressure • Height • Weight • Waist circumference • Cholesterol (non-fasting glucose reading) • Your results will be forwarded to CGI Benefits Group, the third party administrator of TakingCare. NO individual results will be recorded or kept by WDH.

  8. HealthChoice Medical Plan TakingCare Wellness Program Health Questionnaire As a newly benefit-eligible employee, you will receive an e-mail from CGI Benefits Group (wellness@cgibenefitsgroup.com) at your WDH e-mail address. The e-mail will include a link to the health questionnaire as well as your initial password. Your answers will remain confidential and you will receive a “personal wellness score” along with health-related information and articles for your reference. You will have until the end of the month in which you are newly eligible for benefits to complete BOTH components of the Health Assessment. Once you have successfully completed both components, an additional $250 will be deposited into your HRA.

  9. Obtaining Balances and Questions HRA Fund Balance • There are 3 ways for you to obtain your HRA balance: • Visit the Health Plans website at: www.healthplansinc.com • Visit the Benny Card website at: www.mybenny.com • Call Health Plans Customer Service at: 1 (877) 490-3636

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