Presentation on theme: "1 ISD 15 St Francis 2012 Retiree/COBRA Open Enrollment Meeting April 2012."— Presentation transcript:
1 ISD 15 St Francis 2012 Retiree/COBRA Open Enrollment Meeting April 2012
Highlights No changes in plans The 3 medical plans offered by the District for Early Retirees and COBRA Participants Freedom 65+ Plan The dental plan offered by the District NeoPath On-Site Health Clinic Where to go for more resources Who to call if you have questions 2
Plan Options Three Medical Plan Options $30 Co-Pay Plan $2,000 Deductible Plan $5,000 Deductible - 3 for Free Plan No Change in rates or plans 3
4 2012 - 2013 Plan Highlights 2012 - 2013 Plan Highlights $30 Copay Plan Highest monthly premium contributions but less out-of pocket costs at the time of service. $2,000 Deductible Plan Moderate monthly premium contributions with moderate out-of-pocket costs at the time of service. More “consumerism” than the $30 copay plan. Opportunity for employees to accumulate dollars for future healthcare needs, including retirement. $5,000 Deductible 3-for-Free Plan Lowest monthly premium contribution with more out-of-pocket costs at the time of service. The Physician costs (only) for your first three visits are covered at 100%.
5 Plan Differences $30 Copay Plan$2,000 Deductible Plan$5,000 Deductible 3-for-Free Plan Annual DeductibleNone$2,000 Per Person $4,000 Per Family $5,000 Per Person $10,000 Per Family Annual Out-of-Pocket Maximum$2,000 Per Person $5,000 Per Family $2,500 Per Person $5,000 Per Family $5,000 Per Person $10,000 Per Family Office Visits$30 CopayDeductible, then 20%First 3 visits: Physician Charges are Free! Add’l charges/visits: Deductible Hospital Care Outpatient Inpatient Convenience Care Urgent Care Emergency Care You pay nothing $15 Copay $30 Copay $50 Copay Deductible, then 20% Deductible Retail Pharmacy Generic Brand Non-Formulary $12 Copay $35 Copay $50 Copay $12 Copay $35 Copay $50 Copay $12 Copay $35 Copay $50 Copay Mail Order Pharmacy Generic Brand Non-Formulary $24 Copay $70 Copay $100 Copay $24 Copay $70 Copay $100 Copay $24 Copay $70 Copay $100 Copay 5
Freedom Plan – Supplement to Medicare Open Access, no referral Preventive Care – 100% Coverage Copay $15 office visit copay Hospital Services 100% Coverage Prescription Drug Copay $12 generic, $24 brand Out-of-Pocket (OOP) Maximum $3,000 6
NeoPath On-Site Health Clinic The NeoPath On-Site Health Clinic is available for former employee retirees and COBRA participants under age 65 who are enrolled in a Health Partners medical plan with ISD 15. No charge for services provided at the on-site health clinic 30 + generic prescriptions available for free 7
Examples to keep your out of pocket expenses down: Use of Convenience Care Clinics or eVisits Use www.virtuwell.com for 24/7 online diagnosis and prescriptions from HealthPartners Calling HealthPartners Nurseline for advice Call or Email your Clinic before you visit Utilize generic drugs when possible Utilize the NeoPath On-site health clinic, if eligible 8
9 Get the Most From Your Plan Member Services 952-883-5000 or 800-883-2177 Monday – Friday 7:00 a.m. – 7:00 p.m. www.healthpartners.com 9
10 www.healthpartners.com View your benefits, claims and your Deductible and Out of pocket maximums Order new ID cards Refill a prescription Print EOB’s (Details for each claim received, insurance- covered portion of claim, and insured’s responsibility.) Healthy discounts Drug interaction checker, cost calculator, medicine library
New Wellness Program We are currently developing a new wellness program with Health Partners. More information to follow. 13
14 Dental Benefits Delta Preferred Network Preventative care - 100% Basic Services - 100% Major Services - 60% $1,000 annual (plan year) benefit maximum per member No annual deductible per member Delta Premier Network or Out of Network** Preventative care - 100% Basic Services - 80% Major Services - 50% $1,000 annual (plan year) benefit maximum per member $50 annual deductible per member / $150 per family Delta Dental – No Increase ** Difference between billed charges and “allowable” is Members Responsibility
Qualifying Life Event Changes Generally, you can make certain changes to your health and dental plans if you experience any of the following: Marriage / divorce Birth, adoption or death of your dependent Change in job status for either you or your dependent (new job, loss of job, change if full/part-time status, strike, lockout, etc.) Consult with Wendy Carlberg, to determine if you experience a Qualified Life Event Change 15
Enrollment Forms Election/Change forms can be found on the District website: www.stfrancis.k12.mn.us Select Departments Select Human Resources Select Open Retiree/COBRA Benefits 16
Billing Information Your billing cycle for 2012-2013 will remain on the same schedule unless you notify Lori Davis. There is no change in administrative fees. Annual payments are not charged a fee, quarterly payments are charged a 1% fee and monthly payments are charged a 2% administrative fee. 17
18 Questions after today's meetings can be directed to: Insurance/Benefits Wendy Carlberg Wendy.Carlberg@stfrancis.k12.mn.us (763) 753-7043 Billing/Invoices Lori Davis Lori.Davis@stfrancis.k12.mn.us (763) 753-7051 All Forms are due back to Wendy Carlberg @ the District Office by 4:00 pm on Tuesday, May 15 th, 2012.
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