April 13, 2011 1. July 1, 2011 Administrative & Plan Changes Blue Cross Blue Shield for healthcare...
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Transcript of April 13, 2011 1. July 1, 2011 Administrative & Plan Changes Blue Cross Blue Shield for healthcare...
April 13, 20111
2011 Renewal 2011 Renewal
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2011 – 2012 Renewal 2011 – 2012 Renewal
Primary Physician Care7/10 - 6/11
BCBSNC7/11 - 6/12
Current NEWPrimary Visits $20 $30 Specialist Visits Deductible/80% Deductible/80%Well Baby Care $20 0%Immunizations/Injections $20 0%Physical Exams $20 0%Pap Smears/Mammograms $20 0%Deductible $750 $1,000 Deductible - Family Maximum $1,800 $2,000 Coinsurance Maximum - Individual $2,500 $2,500 Coinsurance Maximum - Family $5,000 $5,000 Hospital Services Deductible/80% Deductible/80%In-Patient Deductible/80% Deductible/80%Out-Patient Deductible/80% Deductible/80%Out-Patient Independent Labs 100%/$500/Deductible/80% 100%Urgent Care $50 Deductible/80%Coinsurance 80% 80%Emergency Room $250 Deductible/80%
Pharmacy$5/$30/$50Mail Order 2x
$4/$45/$60/25%Mail Order 2x
Lifetime Maximum $2,000,000 Unlimited 0%
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2011 – 2012 Budgeted Rates2011 – 2012 Budgeted Rates
Budgeted Rates - 2011 - 2012Monthly
SubscriberCount
CountyMonthly
Contribution
EmployeeMonthly
Contribution
County and EmployeeMonthly
ContributionEmployee Only 441 $670.00 $0.00 $670.00 Employee & Children 102 $670.00 $180.00 $850.00 Employee & Spouse 84 $670.00 $260.00 $930.00 Employee & Family 156 $670.00 $300.00 $970.00
Employee $0.00
Employee & Child (ren) $90.00
Employee & Spouse $130.00
Employee & Family $150.00
New Payroll Deductions as of June 3, 2011New Payroll Deductions as of June 3, 2011
2010 -2011
Over the Counter (OTC) medications will no longer be eligible for FSAs without a physician prescription.
You must file a paper claim with Flexible Benefit Administrators to be reimbursed for Over the Counter (OTC) medications with physician prescription.
Dependent coverage for adult children up to age 26
100% coverage for preventive services in network
No annual limits on certain types of benefits
No pre-existing condition exclusions for children ages 0-19
Impact of Health Reform Impact of Health Reform
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Manage conditions or progress online− With our Online Healthy Living programs
Research prescription drugs− Learn about prescription drug treatments, and their relative costs, for a number of medical conditions
Compare hospitals − Find a hospital that matches unique criteria
Estimate the cost of health care services− With our Health Care Cost Estimator tool
Research more than 200 conditions− Using our online health encyclopedia
Find a provider− Locate providers and research outstanding providers/facilities for certain procedures
Online Tools & Programs(Available through my member services after you are enrolled)
24 hour health information resource Call 1-877-477-2424 Web-based health information & support tools
Audio and video tape library
24/7 access to specially-trained nurses – employees can get quick, personalized answers to health questions
BCBS ID Cards• ID cards will be mailed from BCBSNC to your home• 2 copies of your ID card will be mailed during initial enrollment, if additional cards are
needed call BCBSNC Customer Service.
P.O. Box 8188Virginia Beach, VA 23450
Toll Free (800) 437-3539Fax (757) 431-1155
NEW FLEXIBLE SPENDING ACOUNT ADMINISTRATOR
Your Benefits Card AdministrationYou may elect to use the Benefits Card if you enroll in the
Healthcare Reimbursement Account or Dependent Care
Reimbursement Account
The FBA Benefits Card works like a debit card and allows you
to automatically pay for expenses from your flexible spending
account at the time of service.
The card eliminates your need to pay out-of-pocket at the time
of service.
The Benefits Card is restricted for use only at eligible
merchants and for eligible services as governed by the IRS.
Using the Benefits Card will lessen the paperwork you have to
submit, however, there may be instances where documentation is
requested to substantiate a card swipe.
If requested, documentation must be submitted within 40 days
of the transaction to avoid temporary deactivation of the card.
This ensures the Plan is kept in compliance.
You may elect to order an additional card for any eligible
dependent at no charge.
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Important RemindersImportant Reminders
The BCBS card for medical and prescription use
You will receive 2 cards; extras may be requested online or through customer service.
Transition of Care Forms available if in the middle of treatment (3rd trimester, chemo, etc. )
Explanation of Benefits is only generated and mailed for deductible/coinsurance amounts . View all EOBs on-line.
Call your physician for new prescriptions for mail order:
•Request a 30 day prescription (to fill locally)•Request a 90 day prescription with refills and mail to Medco after 7/1
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Open Enrollment NotesOpen Enrollment Notes
For ALL dependents covered by the Medical Plan, you will need to provide Social Security Numbers during open enrollment process.
BCBS Information Line: 1-877-224 -3305
Open Enrollment: April 18th – 27th to enroll in health plan and make changes to or add all other products as well.
•MANDATORY to meet with an enroller
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