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Benefits Open Enrollment May 7-27, 2014 Health Care Enterprises - HCE

Benefits Open Enrollment May 7-27, 2014 Health Care Enterprises - HCE. Medical Plan Guiding Principles. Low-cost and market-competitive Decisions based on best practices and evidence-based medicine When possible, drive care to the AAMC medical community

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Benefits Open Enrollment May 7-27, 2014 Health Care Enterprises - HCE

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  1. Benefits Open EnrollmentMay 7-27, 2014Health Care Enterprises - HCE

  2. Medical Plan Guiding Principles Low-cost and market-competitive Decisions based on best practices and evidence-based medicine When possible, drive care to the AAMC medical community Align with Vision 2020: Living Healthier Together and population health management Steering Group:

  3. HealthCare EnterprisesChanges Effective July 1, 2014 Medical Plan Premium Increase Per pay cost under each medical plan • Core: $1.89 (Individual) - $12.06 (Family) • WellChoice: $3.63 (Individual) - $25.02 (Family) • VitalChoice: $5.49 (Individual) - $37.36 (Family No Premium Increase in Dental and Vision Plans

  4. How Do We Manage Health? • Focus on prevention, early detection and management of risk factors that are major causes of chronic illness and death • Heart disease is the #1 health problem locally, regionally and nationally • This year we are helping our employees know your numbers: your own risk factors for developing heart disease

  5. You and Your Doctor • A primary care doctor helps you prevent, detect and treat risk factors for heart disease: • High Body Mass Index • High Blood Pressure • High Cholesterol • Diabetes or Pre-Diabetes • Smoking

  6. Changes Effective July 1, 2014 Healthy Equation This year, we are launching a new initiative for our adult health plan members. It focuses on the importance of our members: • building a relationship with a primary care physician and • getting screened for conditions that increase the risk of developing heart disease and diabetes.

  7. Healthy Equation • See your doctor and get your cholesterol and diabetes screenings in calendar year 2014 (Jan. 1 – Dec. 31, 2014) • If all three components aren’t completed by Dec. 31, 2014, members will have a $30 per pay surcharge, in effect from Jan. 30, 2015 through June 30, 2015. • Applies to employees with our medical plan and their covered spouses; it does not apply to children.

  8. What’s the Healthy Equation?

  9. Healthy Equation Any time during calendar year 2014: many have done it already! Visit does NOT have to be a physical or “check-up” Screening is ordered by your primary care doctor and results go to that doctor Screening can be done before, during or after the visit; it’s up to you and your doctor to decide No reporting needed by doctor or patient No primary care doctor? We’ll help find you one.

  10. Combined Leave Benefit No further reduction to the standard CLB accrual rate Part time Employees: Employment status up to .9 will accrue CLB based on their employment status. If you are a .5 employee & work more than 40 hours in a pay period, your pay period CLB accrual will max out at the .5 status.

  11. Combined Leave Benefit In addition the maximum carry over amount will be relative to the updated part-time accrual amounts, (currently the part time carry over is no different than Full time employees).

  12. Changes Effective July 1, 2014 Copays and Deductible updates: • PCP visits will remain at $15 • Annual Well Exam/GYN visits continue to be covered in full without a copay • Visits to a Specialty provider will increase to $40 • Inpatient Hospital Deductibles will increase to $500. for AAMC and $1,000. for all other CHP/PPO hospitals. AAMC FastCare Clinics • Bowie • Coming Soon: Clinics in Annapolis & Other Location

  13. Changes Effective July 1, 2014 Medical Flexible Spending Accounts • $500 Carryover under the General-Purpose Medical and Limited-Purpose FSA • FSA must be re-elected for 7/1/14 to rollover current year funds or any remaining funds will be forfeited • Carryover is in addition to the $2,500 maximum

  14. Changes Effective July 1, 2014 CareFirst will replace NCAS as the Plan Administrator of the VitalChoice II Dental Indemnity Plan Benefits will continue to be covered through any Dental provider. Additionally there will be several enhancements to the plan: • If you seek care from a CareFirst dentist, you will benefit from the CareFirst provider discount • There will be NO balance billing when receiving care from a CareFirst provider Services received from a non-CareFirst dental provider will continue to be reimbursed based on Usual, Reasonable and Customary

  15. Changes Effective July 1, 2014 United HealthCare Vision Plan • The United Optical stores are now EyeFit Vision Centers – Upgraded diagnostic equipment, better selection, and more locations. • Benefit increase in contact lenses from $105 to $125 • Polycarbonate lenses are now covered

  16. Changes Effective July 1, 2014 Prescription Drug Program • While oral contraceptives will continue to be available for $0 copay, applicable coinsurance will apply to the brand name. • The initial, first fill of maintenance medications will be available for a 30-day supply only. • Following the first fill, maintenance medications may be filled for a 90-day supply.

  17. Questions?

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