2013-14 INSURANCE (c) 2013 CareOperative, LLC - Confidential - - PowerPoint PPT Presentation

2013-14 INSURANCE

10/30/2013 (c) 2013 CareOperative, LLC - Confidential and Proprietary 1

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Open Enrollment Online

November 1-30

This includes: Our Plan Flex VSP Vision (Form available online) UNUM (Contact Shannon for forms) Long Term Care and Disability Paynewest Beth Glover 721-1000 ex. 6427 On District website HR-Health and other benefits

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Thanksgiving Break Crazy Days

x

$0 $2,000,000 $4,000,000 $6,000,000 $8,000,000 $10,000,000 $12,000,000 $14,000,000 99-00 00-01 01-02 02-03 03-04 04-05 05-06 06-07 07-08 08-09 09-10 10-11 11-12 12-13

Expenditures 00/01 - 11/13

7.41%

FLEX Changes

• Since January 1, 2013, you have only been

allowed to FLEX $2500 per year on medical. Dependent care remains at $5000.

• This is an IRS rule that we had nothing to do

with.

• There is an option to you, although the
• ption may contain an element of risk.

Health Savings Accounts

• With an HSA, you can put up to $3300 per

year into your account or $6550 if your spouse/dependent is on your plan. If you are

• ver age 55, you can put up to $1000 more

per year into the account.

• You select to withdraw any amount up to

that and the deposits would be automatically made to an account we set up with Health Equity.

• You are free to use the funds as you need

them for health care related expenses.

Introduction To Healthcare Blue Book

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Healthcare Blue Book

• An independent online service that helps people find

Fair Prices for hundreds of healthcare services

• Designed to provide price information that is available

in other industries

• Provided by the MCPS Health Insurance Committee for

you and your family

• Available through your Allegiance website

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Why A Transparency Solution Is Needed

• In-network prices can vary by

300% to 500% or more

• Most people don’t know

how to find providers that

• ffer Fair Prices
• Employers and employees

CAN cut healthcare costs if they have the right information, tools and incentives

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In-Network Provider Prices Vary Dramatically

$0 $200 $400 $600 $800 $1,000 $1,200 $1,400 $1,600 $1,800

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Fair Price – Knee MRI

Shows distribution of claims amounts paid in-network for knee MRI procedures in same market

How To Use Healthcare Blue Book

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• Search for procedures using common

language

• 1. What Do You Need?
• Learn what the fair price is for the

procedure in your area

• 2. What Should It

Cost?

• Compare providers on cost and quality
• 3. Where Can I Get

The Fair Price?

Healthcare Blue Book Terminology

19

Color Coding System

• Green = at or below the Fair Price
• Yellow = somewhat above the Fair Price
• Red = among the most expensive providers

ShopSmartTM Procedures

Category Examples

Surgery & Procedures Cataract, urology, ENT, general General Diagnostics Colonoscopy, sleep, cardiology Bone & Joint Knee, shoulder, hip Women’s Health Mammography, hysterectomy High Tech Imaging CT, MRI Traditional Imaging X-ray, ultrasound Labs Top 30 tests

• High volume
• Med/high price
• High price variance
• “Consumer Choice”

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Outpatient >$500

Accessing Healthcare Blue Book

• Allegiance

website

– Log in with your

credentials

• Mobile app

– iPhone or

Android

– Mobile browser – Individual

access code

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Login

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What Do I Need? Search By Procedure

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Keyword Search Menu Search Zip Code Driven Mobile Code

What Should It Cost? Knee Arthroscopy

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Fair Prices

Where Can I Get It? Provider Listing

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Detailed Provider Information

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Detailed Facility Info Physician Listing Quality Ratings

Summary

• For ShopSmart procedures, Healthcare Blue Book

displays Fair Price, price ranges, facility lists and physician information for:

♦ Most outpatient procedures over $500

• For other procedures, use Healthcare Blue Book to

find Fair Price information to help you shop for a Fair Price provider

• Either way - save hundreds or thousands of dollars

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• We have contracted with Broadway

Pharmacy inside St. Patrick’s Hospital to provide excellent discounts on prescription drugs.

• They will sell to us for the actual

procurement cost plus $7.00.

• They also match Wal-Mart and other’s low

cost generics.

• They will do 90 day supplies and mail order.
• Their hours are M-F 7-5:30
• It is easy to switch. Just call them or visit

them and tell them where you currently have your prescriptions. They do all the rest.

CostCare

We will continue our relationship with CostCare by continuing in-school blood draws with follow-up consults. They will also do flu shots this fall. We will also continue the $10 co- insurance payment for CostCare treatments at their three locations for those on our traditional plan.

• Remember to show proof to Shannon if your

spouse is secondary on our plan and has

• ther coverage.

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