Employee Benefits Open Enrollment 2016 Alaska
Agenda Employee Benefits Update � 2016 Medical Plans � 2016 Ancillary Benefit Plans � Additional Benefits � Next Steps � 2
Healthcare Cost Management What is exp doing to help manage rising healthcare costs? � Exp has designed a program that provides a comprehensive level of benefits that promotes wellness and offers choice to our employees � Exp currently pays a large portion of health care coverage premiums for eligible employees and dependents � Exp offers tools and incentives to empower members to be responsible healthcare consumers 3
2016 Open Enrollment There will be no changes in the benefit plans. � Exp will continue to offer a Medical/Rx plan; administered by Premera/Blue Cross and Blue Shield for all employees located in Alaska � Payroll deductions will increase slightly = 5% � Exp will continue to offer Dental, Vision, Life and AD&D, Short-term and Long-term Disability; administered by Guardian. 4
What Can You Do? � Become better healthcare consumers � Be proactive with your health – get your annual exams and preventive screenings � Go to your doctor or a convenience care clinic when ill; don’t wait � Use urgent care for non-emergencies instead of the emergency room � Use generic medications when possible � Follow Rx dosage instructions 5
2015 Benefit Overview Carrier Coverage Premera Medical, Prescription Drugs Guardian Dental, Vision, Life and AD&D, Short- term and Long-term Disability Trustmark Accident and Critical Illness Plans Allstate Cancer Plans myCafeteriaPlan Flexible Spending Accounts Health Advocate Assists employees and families navigate the healthcare system Guardian Employee Assistance Program 6
Premera Medical Options Medical Plan Highlights � Premera will continue to be the insurance carrier for exp in Alaska � Preventive is covered at 100% with no co-pays on all plans for preferred or participating providers � A preferred provider is a provider that has a preferred status with Premera. Most providers in the network have a preferred designation � There are a few providers that may be participating providers , meaning they accept Premera, and you will not be balanced billed for any services, however these services will be subject to a higher cost share � Out of network, non-preferred providers may be subject to balance billing � Balanced Billing is when the member is responsible for paying the difference between what the carrier pays based on the allowed amount and what the provider charges, since the provider is not under contract with the carrier 7
Heritage Plus Envoy PLAN TYPE OF SERVICE YOU PAY: 8
Heritage Plus Envoy PLAN TYPE OF SERVICE YOU PAY: 9
Heritage Plus Envoy PLAN TYPE OF SERVICE YOU PAY: 10
Additional Benefits Premera Benefits • Preventive benefits are covered at 100% for preferred and participating providers – this includes immunizations • Spinal manipulations (chiropractic care) is covered for a $25 copay for preferred providers and does not count towards the 6 visits • Virtual care (Teledoc) is available for a $25 copay. This does not count towards the 6 visits that are covered under a copay. This allows you to talk to a doctor from the convenience of your home with phone or video consultations • Medical Travel Support is available. When you need to travel in or outside of Alaska for medical care, Premera Blue Cross Blue Shield of Alaska may reimburse you for your travel expenses. 11
Premera.com Look up network doctors / hospitals � Estimate costs � Look up drug tier and search for generic alternatives or equivalents � Track claims status � Health improvement programs � Health product discounts � Review plan details � 12
Saving money on Prescriptions Mail Order Prescription Benefits: � You can order a 3 month supply of medicine to be shipped to you for only the cost of 2.5 co-pays. � This saves you time and money for medicines you take on a routine basis. Generic Medications: � Several pharmacies now offer special prescription programs, including $4 generic drugs and free antibiotics. � Generic drugs contain the same active ingredients and are available in the same strength and dosage form as their brand- name counterparts but could cost up to 50% less. 13
Health Advocate Information & Service Support •Assist with eldercare issues Clinical Services •Obtain health information to help make •Find qualified healthcare providers informed decisions •Schedule appointments •Assist with finding qualified wellness •Locate and research the newest programs treatments •Help arrange transportation •Assist with complex medical condition •Assist with understanding test results Administrative Health Coaching Services •Obtain unbiased health information •Navigate within an insurance company •Help prepare patients for You will be •Assist with correcting billing healthcare appointments assigned a mistakes •Help members become active Personal participants in their healthcare Health Advocate (PHA ) � 24/7 Toll-free telephone support � Your privacy is protected 14
Dental Benefits � Guardian is the provider for dental insurance. � There are 2 plans to choose from: a low and a high PPO option. � Please visit www.guardiananytime.com to look up dentists in the network. Dental Insurance - Guardian Life Insurance Company Low Plan High Plan Benefit Details You Pay: You Pay: Deductible waived for preventative Deductible waived for preventative Preventive & Diagnostic Services In-Network Covered in Full, no deductible Covered in Full, no deductible Out-of-Network Covered in Full @ R&C*; no deductible Covered in Full @ R&C*; no deductible Basic Services In-Network 20% after deductible 20% after deductible Out-of-Network 20% after deductible** 20% after deductible** Major Services In-Network 50% after deductible 50% after deductible Out-of-Network 50% after deductible** 50% after deductible** Orthodontic Services In-Network & Out-of-Network 50% to $1,500 lifetime max, 50% to $1,500 lifetime max, No Deductible No Deductible Dependent Child Only up to age 19 Dependent Child Only up to age 19 Individual / Family Individual / Family Calendar Year Deductible In-Network $50/$150 $50/$150 Out-of-Network $50/$150 $50/$150 Annual Maximum Benefit $1,000 Combined $2,000 Combined In-Network & Out-of-Network *R&C = Reasonable and Customary: the amount that your health plan determines is the normal range of payment for a specific service within a given geographic area ** Important: When using an out-of-network provider, you may be balanced billed for amounts over the reasonable and customary charges 15
Vision Benefits � Guardian is the provider for vision insurance, using the Davis Vision network. � Please visit www.davisvision.com to look up a provider in the network. Vision Insurance - Guardian Life Insurance Company Choice Plan Benefit Details You Pay: Benefit Frequency Exams Once every 12 months Lenses Once every 12 months Frames Once every 24 months Exam Co-pays In-Network $10 Co-pay Out-of-Network Up to $50 Allowance Lenses Co-pay Single Vision: In-Network $25 Co-pay Out-of-Network Up to $48 Allowance Bifocal: In-Network $25 Co-pay Out-of-Network Up to $67 Allowance Trifocal: In-Network $25 Co-pay Out-of-Network Up to $86 Allowance Lenticular: In-Network $25 Co-pay Out-of-Network Up to $86 Allowance Frames In-Network $130 Allowance Out-of-Network Up to $48 Allowance Contact Lenses Conventional: In-Network Up to $130 Allowance Out-of-Network Up to $105 Allowance Medically Necessary: In-Network $25 Co-pay Out-of-Network Up to $210 Allowance 16
Employee Life and AD&D Insurance � Exp provides all full-time employees with Basic Term Life Insurance with Accidental Death & Dismemberment (AD&D.) � The benefit amount is two times your annual earnings to a maximum of $200,000. Supplemental Employee Coverage � AD&D Coverage included at no additional cost. � Elect coverage in units of $10,000. � Maximum is the lesser of $500,000 or 5 times basic annual earnings. � If you are already enrolled in EE Supplemental Life, the amount of your life insurance will automatically increase 5% each year, up to 5 years, with premium remaining at the lower elected amount. You do not need to do anything in order for the automatic increase to take effect. � If you would like increase the amount of Spouse coverage you currently have OR enroll for the first time, you will need to fill out an Evidence Of Insurability form (available during the enrollment process). 17
Recommend
More recommend
