Transcript Document

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
• Align with Vision 2020: Living Healthier Together and
population health management
Steering Group:
Julie McGovern
Pat Czapp, MD
Nancy Luttrell
Kate Snyder, RN
Tom Pianta
Sherry Perkins, PhD, RN
Mitch Schwartz, MD
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HealthCare Enterprises
Changes 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
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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
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
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:
1) building a relationship with a primary care
physician and
2) getting screened for conditions that increase
the risk of developing heart disease and
diabetes.
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.
What’s the Healthy Equation?
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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.
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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.
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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).
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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
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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
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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
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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
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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.
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Questions?