Paulding County Board of Commissioners 2020 Open Enrollment - - PowerPoint PPT Presentation
Confidential Paulding County Board of Commissioners 2020 Open Enrollment Employees Responsibility Review Open Enrollment Materials Review your personal information and update if necessary Assign beneficiaries Complete your
Confidential
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Benefit HRA 2 HRA 1 POS Health Reimbursement Arrangement (HRA)
You have a first dollar Health Reimbursement Account (HRA) and receive funds based on the following plan entry dates: 1/1 to 3/31 $1,000 for individual or $2,000 for family. 4/1 to 6/30 $750 for individual or $1,500 for family. 7/1 to 9/30 $500 for individual or $1,000 for family. 10/1 to 12/31 $250 for individual or $500 for family.
Calendar Year Deductible
$3,000 $6,000 $2,000 $4,000 $1,500 $3,000 Out Of Pocket Maximum
$7,000 $14,000 $5,000 $10,000 $4,000 $8,000 Coinsurance 90% 90% 80% Preventive Care 100% 100% 100% Office Visit Copay
Deductible + 10% Deductible + 10% Deductible + 10% Deductible + 10% $25 $50 Hospital/Inpatient Services Deductible + 10% Deductible + 10% Deductible + 20% Emergency Room Deductible + 10% Deductible + 10% $300 Urgent Care Deductible + 10% Deductible + 10% $75 Pharmacy
$15 $40 $60 20% to $150 $15 $40 $60 20% to $150 $15 $40 $60 20% to $150
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Log on to www,anthem.com/find-care/ to locate an in-network provider for medical and dental. Employees enrolled in family coverage for medical and dental also receive a Basic Dependent Life policy in the amount of $5,000 for spouses and $2,500 for each eligible child. Cost of coverage is included in the deduction above.
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Benefit In-Network Member Cost Out-of-network Reimbursement Frequency Exam with Dilation as Necessary $10 Copay Up to $50 Once every calendar year Frames $0 Copay; $130 Allowance Up to $48 Once every other calendar year Standard Plastic Lenses Single Vision Bifocal Trifocal $25 Copay $25 Copay $25 Copay Up to $48 Up to $67 Up to $86 Once every calendar year Lens Options (paid by the member and added to the base price of the lens) UV Treatment Tint (Solid and Gradient) Standard Plastic Scratch Coating Standard Polycarbonate $10 $12 $0 $40 N/A N/A N/A N/A Contact Lens Conventional Disposable Medically Necessary $130 allowance $130 allowance Paid in Full Up to $105 Up to $105 Up to $210 Once every calendar year Laser Vision Correction Lasik or PRK from U.S. Laser Network Save $800 on LASIK when you choose any Premier LASIK Network
when you choose any other in-network provider. N/A Once per lifetime
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Log on to www,anthem.com/find-care/ to locate an in-network provider for vision.
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Call Health Advocate at 866-695-8622 if you have any of these needs:
healthcare-related issues
Visit Health Advocate at www.HealthAdvocate.com/Paulding to:
provide
benefit
allows Health Advocate to work on your behalf with providers and insurance companies
* Register for the site by clicking “Register” and then entering your first name, last name, date of birth and home zip code.
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Medical Bill Saver is a money-saving benefit from Health Advocate.
providers to lower the balance on any uncovered medical or dental bill of $400 or more.
providers on your behalf
significant savings
healthcare consumer
your provider
with a personal Savings Result Statement
parents, and parents-in-law can all use the service.
call Health Advocate at 866-695-8622 MedChoice Support is an online, self- directed, resource that providers you access to independently developed and widely accepted medical information to help you share in the decision-making process with your healthcare provider. Over 150 topics are currently available, examples include:
angiogram?
mammograms?
surgery?
buildup in the middle ear?
ADHD?
chemotherapy for early-stage breast cancer?
www.HealthAdvocate.com/Paulding
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Voluntary Life Benefit Coverage Employee Coverage Amount: You can purchase coverage in increments of $25,000 up to the lesser of $500,000 or 7 x your annual salary. Guarantee Issue (New Hires): You will have a guaranteed issue amount of up to $250,000. Spouse Coverage Amount: If you elect Supplemental Life Insurance for yourself, you can purchase Spouse coverage in increments of $12,500 to a maximum of $250,000 not to exceed 100% of the employee’s coverage amount. Guarantee Issue (New Hires): Your spouse will have a guaranteed issue amount of up to $62,500. Child(ren) Coverage Amount: If you elect Supplemental Life Insurance for yourself, you can purchase $10,000 in coverage for eligible child(ren) ages 15 days to 26. Guarantee Issue (New Hires): All coverage amounts. Annual Enrollment/Evidence of Insurability Guidelines: If you are currently participating in the Voluntary Life coverage you may increase your current coverage amount by one increment, not to exceed the Guarantee Issue amounts of $250,000 for yourself and $62,500 for your spouse, without providing Evidence of Insurability (EOI). Additional coverage amounts will require EOI that is satisfactory to Anthem BCBS before the excess can become effective. If you are electing coverage for the first time for yourself or spouse, EOI that is satisfactory to Anthem BCBS will be required before any coverage can be effective.
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Percentage of Income 60% of your weekly pre-disability earnings Benefit Maximum $830 Benefits Begin After (Elimination Period) Injury Sickness 14 days 14 days Maximum Benefit Duration *** 24 weeks Short Term Disability if provided to you by Paulding County Board of Commissioners at no cost to you.
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Percentage of Income 60% of your monthly pre-disability earnings Benefit Maximum $6,000 Benefits Begin After (Elimination Period) Injury Sickness 180 days 180 days Maximum Benefit Duration *** Social Security Retirement Age Long Term Disability is provided to you by Paulding County Board of Commissioners at no cost to you. Pre-Existing Condition Exclusion: Any sickness or injury for which you received medical treatment, consultation, care, or services (including diagnostic measures or the taking of prescribed medications) during the specified months (3 months) prior to your coverage effective date. A disability arising from any such sickness or injury will be covered only if it begins after you have performed your regular occupation on a full-time basis for the specified months (12 months) following the coverage effective date.
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The Employee Assistance Program is provided to you, at no cost, by Paulding County Board of Commissioners and is offered through Anthem BCBS. Resource Advisor offers support for employees, family members and beneficiaries including:
finder, child development, elder care resources, wellness and mental health topics, will preparation and legal library. Beneficiary Support Program provides beneficiaries with the following services:
important estate matters
Advantage account that gives them immediate access to funds Travel Assistance providers members support while traveling, including: emergency medical services, language assistance, legal assistance and much more. Call 1-888-209-7840 Visit www.ResourceAdvisor.Anthem.com
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