Transcript Slide 1

Health Care Coverage for You
and Your Family!
2009-2010 Plan Year
Welcome
Agenda
 TRS-ActiveCare Program Highlights
– Enrollment Summary
– Facts and Figures
 What’s New for 2009-2010
– ActiveCare 1, 2 and 3, plus new 1-HD option
– HMOs
 How to Enroll
– Who is Eligible to Enroll
– Cost of Coverage
– Enrollment Support
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Enrollment Summary
Percentage of Employees by Plan • February 2009
ActiveCare 3
15,062
7%
HMO Plans
10,488
5%
ActiveCare 1
39,841
18%
ActiveCare 2
151,505
70%
216,896 Employees • 361,918 Members
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Facts and Figures
2006-2007
2007-2008
Percent
Increase
Billed Charges
$2.1 billion
$2.5 billion
19%
Medical Claims
Transactions
2.9 million
3.2 million
10%
Pharmacy Claims
Transactions
2.7 million
3.0 million
11%
Paid Claims—
Medical
$656 million
$783 million
19%
Paid Claims—
Prescription Drugs
$151 million
$176 million
17%
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What’s New for 2009-2010?
ActiveCare 1, 2 and 3
 4.5 percent premium increase
 Continued emphasis on health and
wellness
 One benefit change: Bariatric surgery
New Option! ActiveCare 1-HD
 Basically same as ActiveCare 1, but
– Higher deductible (meets IRS definition
of a high deductible health plan—all
coverage categories)
– Slightly lower premium cost (for most
coverage categories)
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PPO Network for ActiveCare 1-HD, 1, 2 and 3
Largest PPO network
in the state
 Includes over 50,000 physicians and
over 400 hospitals in Texas
 Available in all 254 Texas counties
 Advantages to using network
Need to locate a
Provider?
www.trs.state.tx.us/trs-activecare
www.bcbstx.com/trs
providers
 Receive highest level of benefits
 No claims to file
 No balance billing
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Plan Overview – Network Level of Benefits
Plan Features
ActiveCare 1-HD
ActiveCare 1
ActiveCare 2
ActiveCare 3
Deductible
(individual/family)
$2,300/$2,300
$1,150/$3,000
$500/$1,500
None
$3,000/$5,000
$2,000/$6,000
$2,000/$6,000
$1,000 per
individual
80% / 20%
80% / 20%
80% / 20%
80% / 20%
Out-of-Pocket
Maximum
(does not include
deductibles)
Coinsurance
(Plan pays/participant
pays)
Illustrates benefits when network providers are used. Non-network benefits are also available; see
Enrollment Guide for more information.
Plan Overview – Network Level of Benefits
Services
Office Visit Copay
Preventive Care
 Routine physicals*
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Well-woman exams*
Routine mammograms*
Eye exams*
Well-baby exams
Immunizations
Hearing exams
PSA screenings
Colorectal screenings
Osteoporosis
screenings
* Services
limited to one per
person per plan year
ActiveCare
1-HD
ActiveCare 1
ActiveCare 2
ActiveCare 3
20% after deductible
$25 for primary
$35 for specialist
$20 for primary
$30 for specialist
$0 copay up to $500
per person, per plan year
$25 for primary
$35 for specialist
$20 for primary
$30 for specialist
Remaining charges subject to
deductible and coinsurance
Includes all
preventive care
services billed with
an office visit by a
network doctor
Includes all
preventive care
services billed with
an office visit by a
network doctor
Coinsurance
applies when no
office visit is billed
or when services
are performed
outside the office
(deductible waived)
Coinsurance applies
when no office visit
is billed or when
services are
performed outside
the office
(no deductible)
Non-network benefits are also available; see Enrollment Guide for more information.
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Plan Overview – ActiveCare 1-HD vs. ActiveCare 1
Plan Features
ActiveCare 1-HD
ActiveCare 1
Meets IRS definition of High
Deductible Health Plan
and offers opportunity to
contribute pretax dollars into
a Health Savings Account
(HSA)
Yes, for all coverage categories
(employee only, employee and
spouse, employee and child(ren)
and employee and family)
Yes, for employee-only coverage
No, for other coverage categories
Deductible
$2,300 for employee only
$2,300 for family
$1,150 per individual
$3,000 per family
Maximum Coinsurance
$3,000 for employee only
$5,000 for family
$2,000 per individual
$6,000 per family
Out-of-Pocket Maximum
(includes deductibles)
$5,300 for employee only
$7,300 for family
$3,150 per individual
$9,000 per family
Monthly Premium Cost
Less expensive than ActiveCare 1
in all coverage categories
except employee and family
More expensive than ActiveCare
1-HD in all coverage categories
except employee and family
Note: The amounts shown for “family” refer to the coverage categories for employee and spouse,
employee and child(ren) and employee and family.
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Health Savings Account (HSA)
 What is an HSA?
– Special account owned by an individual and used to pay out-of-pocket
expenses (such as deductibles) or to grow as savings
– May be funded by the employee, the employer or both
– Portable, meaning the HSA funds always belong to the individual
 Who is eligible?
Per IRS rules, any adult can contribute to an HSA if he/she:
– Has coverage under an HSA-qualified high deductible health plan
– Has no other first-dollar medical coverage
– Is not enrolled in Medicare
– Cannot be claimed as a dependent on someone else’s tax return
 Does TRS offer an HSA?
– No! But ActiveCare 1-HD qualifies as an HDHP for all coverage
categories and ActiveCare 1 qualifies for employee-only coverage
– Employees are not required to have an HSA to enroll in these plans
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What You Need to Know
 Participating districts/entities in TRS-ActiveCare are not
expected or required to offer HSAs
– You may seek an HSA administrator on your own
– No integration with Blue Cross or Medco systems
– No tax or legal advice available from TRS or TRS-ActiveCare
customer service; HSA inquiries should be directed to your
tax or legal counsel and/or your HSA administrator
 ActiveCare 1-HD is not for everyone
– You need to look beyond the premium cost
– Premium savings may not be enough to justify the additional
deductible and out-of-pocket expenses
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Benefit Change – Bariatric (Weight Loss) Surgery
Important:
Effective
September 1, 2009,
coverage for
bariatric surgery
will be available
only when
performed at one of
the Blue Distinction
Centers for
Bariatric Surgery
List is subject to change:
Check online or call Customer Service for most current list
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Health and Wellness
Programs
ActiveCare 1-HD, 1, 2 & 3 Plans
Wellness Coaches
Personalized
Support.
Motivational
and lifestyle
coaching by
clinical
professionals
Lifestyle and condition
management can be challenging
Our Wellness Coaches are here to help
• Personalized telephonic support
• Motivational and behavioral coaching
• Personalized and coordinated goal-setting with
action plans
• Communications via US mail
• Monitoring compliance and tracking outcomes
1-800-462-3275
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Condition Management Programs
 Voluntary programs designed for those diagnosed
with: asthma, diabetes, congestive heart failure, coronary
artery disease, chronic obstructive pulmonary disorder,
metabolic syndrome (high blood pressure, high
cholesterol and obesity), lower back pain, rare conditions
or depression
 Enrolling in a program can help:
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Decrease the intensity and frequency of symptoms
Enhance self-management skills
Minimize missed days at work
Enrich quality of life
 Call to enroll or ask questions
– Condition management telephone
number is also listed on ID cards
1-800-462-3275
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Weight Management and Tobacco Cessation
Tobacco Cessation
Program
Support for members
who want to quit
Self-Paced Approach
• Online tools and
resources via the
Personal Health Manager
• Secure e-mail outreach to
keep members on track
Personalized Lifestyle
Management Support
• Counseling and coaching
with licensed Wellness
Coaches
• Motivational toolkit
• 24/7 Nurseline
• Referrals when
appropriate
Weight Management
Program
Support for a
Healthier
You
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Special Beginnings®
Special Beginnings helps expectant mothers and
their babies get off to a healthy start by providing
prenatal and postnatal health education, and
guidance from pregnancy to six weeks after delivery
Once enrolled in the program, plan participants receive:
• Pregnancy risk assessment by an experienced obstetric
registered nurse to determine risk level of pregnancy and
level of outreach needed
• A welcome packet full of product samples, coupons and
magazines
• Educational materials on a variety of topics
• Frequent, personal contact with a nurse case manager
who helps coordinate care with the mom’s physician
• Immunization schedules
Program components are available in English and Spanish
1-800-462-3275
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Personal Health Manager (PHM)
Your online wellness experience begins
with the Personal Health Manager
Features include:
 Lifestyle Management tools:
 Weight Management
 Tobacco Cessation
 Fitness and Nutrition Plans
 Stress Reduction
 Health Risk Assessment
 “For Your Health” features
 Blue PointsSM Rewards
 “Ask-A” feature – health and
wellness questions via
secure e-mail
 Online health encyclopedia
 Interactive symptom checker
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Personal Health Manager – Home Page
Read secure
messages
Take a Health Risk
Assessment
Review
member
alerts
Access Member
Care Profile
Use the
Interactive
Symptom
Checker
Explore
topics in the
Health
Information
and Care
Center
Ask a Question to a
certified Nurse,
Trainer, Dietitian or
Life Coach
Read the latest
health news, search
for specific health
topics or explore the
prescription drug
index
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Health Risk Assessment (HRA)
Be informed about your
overall health and well-being
A Health Risk Assessment helps
assess your health risks, interests
and readiness to change
 Examines your overall health
and well-being
 Provides a detailed report with overall
health and well-being score and
sub-scores for:
 Medical health, job satisfaction,
life load, risk and lifestyle, mood, nutrition,
sleep, stress, pain and body weight
 Recommends areas for improvement
 Confidential and secure
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“Ask-A” Online Advisor
Expert advice at your fingertips.
Ask the experts.
Expert advice from
licensed professionals
via the Personal Health
Manager
Our “Ask-A” feature is here to help.
Ask a Nurse:
Interact online with a
Blue Care Advisor on
non-emergency,
health-related
questions using the
secure “Ask a Nurse”
feature.
Ask a Trainer,
Dietitian or
Life Coach:
Send questions
about fitness,
nutrition, or
managing stress.
CONFIDENTIAL AND SECURE
Receive a response within one business day
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Blue PointsSM Incentives
Stay motivated.
Earn Blue Points in the
Personal Health Manager
TRS-ActiveCare PPO plan
participants and their covered
dependents accumulate Blue Points
in the Personal Health Manager
 Complete designated health and
wellness activities
 Report completed activities in the
Personal Health Manager
 Track your available balance
 Redeem earned Blue Points for
a variety of items!
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24/7 Nurseline
Advice anytime.
Round-the-clock health
and the wellness advice
from licensed
professionals
Advice isn’t just needed
from 9 to 5.
24/7 Nurseline is here to help.
 Nurses provide health advice and
information about high fevers, earaches,
cuts and bruises and more
 Audio health library on topics such as
kicking the smoking habit and ways
to get a good night’s rest
24/7
1-800-581-0368
Available in English and Spanish
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Learn more about the
Blue Care Connection
health and wellness
programs online
www.bcbstx.com/trs
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Blue Access® for Members
Online member management tool
 Check claim status, view
and download EOBs
(Explanations of Benefits)
 Order additional ID cards,
and print temporary ID
 Monthly health articles
 Links to health information
and wellness tools and
resources, including the
Personal Health Manager
Send secure e-mail messages to BCBS Customer Advocates
available Monday thru Friday, 7 a.m. to 10 p.m. (CT)
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What if I Have Questions?
Personalized Service
 Call TRS-ActiveCare customer service for:
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Claim questions/status
Network provider information
Membership and eligibility
Medical coverage questions
Inquiries (telephone and e-mail)
ID card requests
Transition of care information
Help with online tools!
Customer Service
1-866-355-5999
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Prescription
Drugs
ActiveCare 1-HD,1, 2 & 3
Your Medco Prescription Drug Plan
 Medco administers your prescription
drug plans on behalf of TRS
– ActiveCare 1, 2, and 3 and now the
new 1-HD plan
 Benefit includes both a retail and mail
component
 Medco has its own mail-order
pharmacy – Medco By Mail – where
specialist pharmacist focus on
compliance and lower cost options for
the patient, and the automated filling
system ensures the prescription is
filled accurately.*
• Medco’s mail-order pharmacies fill about 2 million prescriptions per week through a highly automated process that is 99.9997% accurate and is 23
times more accurate than a retail pharmacy
“Dispensing Error Rate in a Highly Automated Mail-Service Pharmacy Practice”; Nov. 2007, Pharmacology, a peer-reviewed journal of the American
College of Clinical Pharmacy
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Prescription Drug Benefits - Network Level
Features
Drug Deductible
(per person, per plan year)
ActiveCare
1-HD
ActiveCare 1
ActiveCare 2
ActiveCare 3
Subject to
$2,300 plan
year deductible
Subject to
$1,150 plan
year deductible
$50
$50
$10
$25*
$45*
$10
$25*
$40*
$15
$35*
$60*
$15
$35*
$55*
$20
$62.50*
$112.50*
$20
$62.50*
$100*
Retail Short-Term
(up to 30-day supply)
Generic/Preferred Brand/NonPreferred Brand
Retail Maintenance
(after second fill, up to 30-day
supply)
Generic/Preferred Brand/NonPreferred Brand
Medco by Mail
(up to 90-day supply)
Generic/Preferred Brand/NonPreferred Brand
20% coinsurance
after deductible
* If you obtain a brand-name drug when a generic equivalent is available, you are responsible for the generic copayment plus the cost difference between
the brand-name drug and the generic drug. Chart illustrates benefits when network pharmacies are used. Non-network benefits are also available; see
Enrollment Guide for more information.
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Specific Rx Benefit Information
 Retail pharmacies are ideal for acute (short-term) and new medication
you may be trying for the first time
 If you are taking a long-term medication, filling your prescriptions
through Medco’s mail-order pharmacy provides several benefits:
– You receive a 90-day supply of your medication at a lower copay
– Prescriptions are delivered directly to you and you can order refills online
and check the status of your orders
– You have access to specialist pharmacists
• Specifically trained in specific conditions
• Review all of your incoming prescriptions for potential safety issues and will
contact you and your doctor to discuss any issue
– Medco only buys medication from the most reputable suppliers
 You have access to specialist pharmacists whether you fill your
prescription at a retail pharmacy or at Medco By Mail
• Your medication questions can be answered by calling
1-866-355-5999
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Patient Centric Care
Different members have different needs
Well
Acute
Chronic
Complex
Wrinkles,
baldness,
contraception,
vitamins
Colds and flu,
strep throat,
ear infection,
headache,
sprains
Heart disease,
diabetes,
arthritis,
high blood pressure,
high cholesterol,
dementia,
chronic back pain
Cancer, AIDS,
pulmonary
hypertension,
multiple chronic
conditions such as
heart failure and
diabetes
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Specialist Pharmacists
An industry leading platform to better care
Rare &
Specialty
Oncology
Immunology
Diabetes
Cardiovascular
Pulmonary
Neurology
Psychiatry
Gastrointestinal
 Specialist pharmacists have special training and unparalleled experience
 A unique model and scale that enables each Medco pharmacy to specialize
in a particular disease
 Proprietary data capabilities bring specialist services to members
Medco’s specialist pharmacists create a patient experience which improves
the quality of member care and increases savings for our clients
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Medco’s Therapeutic Resource Centers provide
specialized pharmacy services
• > 59% of TRS-AC members have chronic & complex needs
• > 96% of Rx cost is for members with chronic & complex conditions
Complex
9.1% of members and
41.3% of FY08 costs
9%
41%
Chronic
49.8% of members and
55.1% of FY08 costs
Well
19.2% of members and
<1% of FY08 costs
817
patients
1,832
patients
13.5%RxRxcost
cost
4.9%
Oncology
Immunology
3,668 patients
6.4% Rx cost
Diabetes
16,109 patients
18.0% Rx cost
Cardiovascular
39,091 patients
25.3% Rx cost
Pulmonary
39,465 patients
15.1% Rx cost
Neurology
Psychiatry
54,353 patients
17.0% Rx cost
Gastrointestinal
5,539 patients
1.2% Rx cost
50%
Acute
21.9% of members and
3.1% of FY08 costs
Rare &
Specialty
22%
55%
19%
% Members
% Rx Cost
FY’08 TRS data
Complex & Chronic patients
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Focus on right drug at right time for the right person
The future of medicine lies in specialization:
 Specialist Pharmacist
 Personalized Medicine offering
 My Rx Choices®
 Other Available Resources
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Personalized Medicine
 What is it?
– A science that examines the inherited variations in genes that
dictate drug response (whether a drug will be effective or safe)
– Personalizing drug therapy based on each patient's genetic
variability
 New this year, TRS is providing this service to
TRS-ActiveCare patients if both the doctor and patient
wish to take the test
 Out with the old….drugs aimed at processes or diseases
 In with the new….. drugs designed for specific
interventions based on your genetics
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Your Genes: Which dose is right for you?
Old:
Trial and error
100mg
New:
Pharmacogenomics-driven
500mg
100mg
10mg
Daily dose has been “personalized”
Source: http://www.fda.gov/cder/genomics/presentations.htm; August 26, 2005
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High-level Process Flow
Identification
 Identify pharmacy claim indicating warfarin or
tamoxifen were dispensed
Communication
 Contact physician for approval to test patient
 Contact patient to discuss program and test kit mailing
 800 number provided for questions
Intervention
 Cheek swab completed by patient and mailed to lab
 Lab processes test, sends results and interpretation to
physician and Medco TRC pharmacist
 Therapy change made if applicable
Follow-up
 Monitor lab outcomes and
follow-up as needed
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Personalized Medicine
Patients in Need
 The ability to determine how patients metabolize drugs can have significant
impacts on financial and clinical outcomes
 Avoiding breast cancer re-occurrence, severe bleeding events, and strokes is
possible with a cheek swab test
STOP
49 patients
Tamoxifen
Users
373
New
Warfarin
Users
620
Prevents
Action
$96,000/re-occurrence
estimated to
receiving no
benefit from
Tamoxifen
STOP
Action
Prevents
$13,800/severe bleed
$39,500/stroke
372 patients
estimated to
need dosing
adjustment
The avg. cost/patient tested is $1,000-$1,500 less than those NOT tested
Testing could result in significant quality of life improvement
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My Rx Choices®
Your online savings tool
 Lower your cost for prescriptions with My Rx Choices
– Features include:
• Personal assessment of cost-saving opportunities based on your
prescription plan and the medications you use
• Print a kit to help your doctor better understand the economic
impact of different medication alternatives
• Alternative medications are based upon greatest cost savings to
you presented in order, starting with the highest value
• Brand-to-generic and retail-to-mail comparisons are shown
• The average amount saved by My Rx Choices users is $294!
 Simply visit www.medco.com/save. You’ll to take a
moment to register before using this service. You can
also call 1-866-355-5999
 You have to shop your benefit. Prices can vary at
different retail pharmacies
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My Rx Choices
 Medco can
facilitate on
generic
equivalents
received through
mail order
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Information Resources
 TRS Web site – www.trs.state.tx.us/trs-activecare
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Pharmacy Benefit Highlights
List of maintenance medications
FAQs
Download forms
 Medco Member Web site – www.medco.com
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Prior Authorization List
Formulary Information
Locate a Participating Pharmacy
Health and Wellness Information
My Rx Choices® / Price a Medication
Online Ordering
Order Medco By Mail Refills
Download forms
 Customer Service Number 1-866-355-5999
 Benefits Booklet
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HMO Plan
Options
2009-2010 Plan Year
TRS-ActiveCare
Participating HMOs
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How to Enroll
2009-2010 Plan Year
Who is Eligible to Enroll?
To be eligible for TRS-ActiveCare coverage, you must:
 Be employed by a participating district/entity and
– Be an active, contributing TRS member or
– Be employed 10 or more regularly scheduled hours
each week
Health care coverage for public school employees and their families
45
Employees NOT Eligible to Enroll
 State of Texas employees or retirees
 Higher education employees or retirees
 TRS retirees, receiving or who declined coverage
under TRS-Care
These individuals are not eligible to enroll for TRS-ActiveCare
coverage as employees, but they can be covered as a
dependent of an eligible employee.
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Eligible Dependents
 Spouse (including a common law spouse)
 Unmarried children under age 25
– Natural child
– Adopted child
– Stepchild
– Foster child
 Other eligible dependents listed in
Enrollment Guide
– Grandchildren (unmarried)
– Disabled children
(unmarried, of any age)
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Special Eligibility Situations
 If employee and spouse both work for a participating
district/entity:
– A spouse may be covered as an employee or as a
dependent of an employee
– Only one parent can cover dependent children
 A child (under age 25) employed by a district/entity and a
contributing TRS member cannot be covered as a
dependent
 The child must be covered as an employee
 If the child is not a contributing TRS member, the child
may be covered as a dependent
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Enrollment
 Enrollment Periods for 2009-2010 Plan Year:
– April 13 - May 15 (Spring Enrollment)
– August 1 - August 31 (Summer Enrollment)
 Preexisting condition exclusion applies to those that
previously declined coverage; may be reduced by prior
creditable coverage
 Passive enrollment; no need to enroll unless you want to:
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Change TRS-ActiveCare plan option
Add or drop dependents
Cancel and/or decline coverage
Enroll for TRS-ActiveCare coverage with a different
participating district/entity
– Change name or address or correct date of birth or Social Security number
The HMO option from Legacy Health Solutions will not be available for 2009-2010 plan
year. All existing Legacy enrollees must select a new TRS-ActiveCare plan option.
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Cost for Health
Coverage
2009-2010 Plan Year
Monthly Cost
for Coverage
Page 33 of the
Enrollment Guide
51
Cost of Coverage
PPO Plans
ActiveCare 1-HD
ActiveCare 1
Total Cost
Total Cost
Employee Only
$245
$278
Employee and Spouse
$600
$633
Employee and Child(ren)
$382
$443
Employee and Family
$785
$697
Family Deductible
$2,300
$3,000
Family Out-of-Pocket
Maximum
$7,300
$9,000
Coverage Category
Employee and family coverage for ActiveCare 1-HD is more expensive than
ActiveCare 1 because the deductible and out-of-pocket maximum amounts for
family are less and the plan may begin paying benefits sooner
52
Application to
Split Premium
 Married couples
working for different
participating entities
may “pool” funds
 Optional
 Requires an
Application to Split
Premium form to be
completed by both
employees and
employers
 Form available online
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Can Changes in Coverage Be Made After Your
Application Has Been Submitted?
 Changes can be made up to the end of your
enrollment period
 Plan choices will remain in effect through August 31,
2010 unless there’s a special enrollment event such as:
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–
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Marriage or divorce
Birth, adoption or placement for adoption of a child
A child marries or reaches age 25
A court order to provide health coverage for an eligible child
Loss of coverage
 Changes must be made within 31 days after the event
date (special rules apply to newborns)
 New application must be submitted for any change
54
Newborns
 Covered first 31 days if employee has coverage
 Must add newborn within 60 days after the date of
birth or up to one year after the date of birth if:
– Employee has “employee and family” or “employee and
child(ren)” coverage at the time of birth and at the time of
enrollment
 Not necessary to wait for newborn’s Social Security
number
– Submit application without SSN to enroll
– Re-submit another form after SSN is issued
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Cafeteria Plan Vendor(s)
 Making a change through the Section 125 vendor does
not automatically generate a change to coverage
under TRS-ActiveCare
 All changes to TRS-ActiveCare must be signed, dated
and submitted on an Enrollment Application and
Change Form
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Important Notice
Supplemental Coverage
 TRS does not offer or endorse any supplemental
coverage for any of the health coverage plans available
under TRS-ActiveCare
 To obtain information about any coverage that claims to be
a companion or supplement to any TRS-ActiveCare plan,
employees should contact:
– The organization making such offering and/or
– The Texas Department of Insurance (TDI)
http://www.tdi.state.tx.us or the TDI Consumer Helpline (800)
252-3439
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Your TRS-ActiveCare ID card will be
mailed to your home
 Enroll by May 15 to receive ID card by September 1
 ActiveCare 1-HD, 1, 2 and 3
– New ID cards will not be issued to current participants unless
changing plans
– New enrollees will receive new cards
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Enrollment Support
Dedicated Customer Service
 ActiveCare 1-HD,1, 2 or 3
1.866.355.5999
(Blue Cross and Blue Shield of Texas and Medco)
 FirstCare Health Plans
 Mercy Health Plans
 Scott and White Health Plan
 Valley Baptist Health Plans
1.800.884.4901
1.800.617.3433
1.800.321.7947
1.800.829.6440
59
Enrollment Support
Available Online
 Enrollment guide
(English and Spanish)
 Downloadable forms
(enrollment application, split
premium, claim form, etc.)
 Provider locator
 Frequently asked questions
www.trs.state.tx.us/trs-activecare
60
Questions
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