Ingham County HRA Benefit Presentation (Powerpoint)
24
Ingham County HRA/ Bundled Products
Transcript of Ingham County HRA Benefit Presentation (Powerpoint)
Ingham CountyHRA/ Bundled Products
Purchase PlanPHP
HRAStandard Plan
DeductibleSingle/Family
$5,000/$10,000 $500/$1,000
Coinsurance % 20% 20%
Max Out of PocketSingle/Family
$6,350/$12,700 $2,000/$4,000
Office Visit $20 $20
Chiro Copay/18 Visit Max $20 $20
Urgent Care Copay/ER $50/$100 $50/$100
Rx $5/$30/$60/40%MOPD 2x
$5/$30/$60/40%MOPD 2x
($1200 OOP Max per person)
*2015 Standard Plan
Purchase PlanPHP HRA High Plan
DeductibleSingle/Family
$5,000/$10,000 $0
Coinsurance % 0% 0%
Max Out of PocketSingle/Family
$6,350/$12,700 $1,000/$2,000
Office Visit $20 $20
Chiro Copay/18 Visit Max $20 $20
Urgent Care Copay/ER $50/$100 $50/$100
Rx $5/$30/$60/40%MOPD 2x
$5/$30/$60/40%MOPD 2x
($1200 OOP Max per person)
*2015 High Plan
Subscriber1. Present PHP ID Card & CIC HRA Promise Card to the provider to explain the HRA process.
2. Provider will submit claim to Physicians Health Plan (PHP).
3. After CIC receives your claim from PHP, CIC claims specialists will ensure the processing of your medical provider claim within 7 to 10 days.
4. You will then receive by mail a CIC explanation of benefits (EOB), showing the medical provider’s bill has been processed.
CIC/ABS
Participating Provider
Participating Provider5. DON’T FORGET TO PAY
PROVIDER FOR ANY REMAINING CHARGES IF
ANY (Copay, etc).
Participating ProviderClaims Process
PHP
0%Coinsurance
$0Deductible
$5,000Deductible
0%Coinsurance
PHP
High Plan HRASurgeryDiagnostic TestLab TestHospital StayPathologyPhysical Therapy
The following are a few examples of medical procedures that are subject to deductible and
coinsurance
HRA
PHP w/ High Plan HRA
$5,000 Deductible
20%Coinsurance
PHP
Standard HRASurgeryDiagnostic TestLab TestHospital StayPathology
The following are a few examples of medical procedures that are subject to deductible and
coinsurance
PHP w/ Standard HRA
20%$1,500
Coinsurance
$500DeductibleHR
A
*Frequently Asked QuestionsQ: I received an invoice, should I just pay it?A: Before you pay any invoice, please make sure that you have received PHP and CIC/ABS Explanation of Benefits. This way you can be sure the claims had been processed.
Q: I received an invoice and it looks really high, is it correct?A: If you have any questions regarding your claims, please contact CIC/ABS to double check that the claims were processed properly. When in doubt, give CIC/ABS a call.
Q: My provider requested pre-payment before surgery? Would CIC/ABS pre-pay the provider?A: Unfortunately the IRS requires that services are received before any reimbursement is made. If your provider asks for a pre-payment, contact CIC/ABS to see if we can make an arrangement and explain the HRA process.
1
1
22
2
3
3 3
4
4
3
5
5
6 7
7
8 9 10
10
1. Employer Info2. Member Info3. Provider Info4. Date of Service5. PHP Approved Amount6. Purchased Plan Deductible7. PHP Paid8. HRA Deductible
9. HRA Coinsurance10.Reimbursed Amount to Pay
to Provider11.Amount Employee Must Pay
Provider
How to Read Your EOBs
6
PHP Purchased Plan EOB CIC Reimbursed Plan
EOB
11
*Save $$ on Prescriptions!
It’s as easy as
Enter The Name of Your Prescription
Select your Medication from the list that appears
Select the Correct Dosage for Your Medication
Enter Your Zip Code
Click “Find Pharmacy”
The Website Will Give you a List of Preferred Pharmacies
Show Your Medtipster ID Card at a Preferred Pharmacy, and you pay $0!
Cost Transparency Program
*$10 Gift Card per call for elective procedure pricing information
*25% of the service savings if you go to one of the lower cost providers within 75 miles of Lansing
* Does not need to be the lowest cost option, just one of the lower cost options!
*Includes Providers in Grand Rapids, Mount Pleasant, and Lansing*
Common non-emergent procedures eligible for comparisons: •• MRIs
•• Ultrasounds•• CT Scans
•• Mammograms•• Colonoscopies
Contact an analyst to see if yours can be quoted!
A2CT
A²CT Recommended
Physician Referred
Transparency:Knee MRI w/o contrast
Facility Location CostMcLaren – Central Michigan Community Hospital
South DriveMt. Pleasant $2,183.50
Open MRI Crapo StreetMt. Pleasant $843.00
Mecosta County Medical Center
Oak StreetBig Rapids $1,067.00
MidMichigan –Midland
Wellness DriveMidland $1,762.00
MidMichigan – Clare
McEwan StreetClare $1,966.00
Same PhysiciansSame NeighborhoodSavings of $1,340.50
A2CT
A²CT Recommended
Transparency:Lung Cancer Screenings
Facility Location CostMcLaren – Central Michigan Community Hospital
South DriveMt. Pleasant $1,423
Mid Michigan Health – Gratiot Cancer Center
Warwick DriveAlma $1,549
Mercy Health Grand Rapids – Lacks Cancer Center
Jefferson AveGrand Rapids $99
McLaren Health– Greater Lansing
Greenlawn AveLansing Charter Twp FREE
Savings of $1,549!
24/7/365 Access to U.S. Board-Certified Doctors & PediatriciansWhen should you use: Instead of going to Urgent Care or ER; When you are on vacation.
24/7/365 Access to U.S. Board-Certified Doctors & Pediatricians
24/7/365 Access to U.S. Board-Certified Doctors & Pediatricians
Adddepende
nts
TRY IT ONCE.YOU’LL LOVE IT.
Amanda LutkeClaims AnalystExt. 1011
Your Personally Dedicated CIC Team
Automated OptionsOperator Dial 0Claims Questions, inc. HRA Claims
Dial 1Employer Benefit Administration Questions
Dial 2Individual Coverage Questions Dial 3COBRA Questions Dial 4
855-306-1099 Phone855-306.1098 Fax
Brian CoteGroup Benefit ConsultantExt. 1007
Lise HoppeAccount ManagerExt. 1000
Lynda RobyCustomer Service RepExt. 1022
Rachel ParsonsWellness CoordinatorExt. 1088
Call or click to speak with a licensed professional any time of
the day or night.
1-855-306-1099 or www.cicbcg.com
Thank You!
(855) 306-1099 ( (855) 306-1098 6
www.cicbcg.com 8
Questions or Comments?Our team is here to help!
