Presentation on theme: "2015 Plans. Plans offered ARBenefits offers 3 plans to Active, COBRA and Non-Medicare members through Health Advantage. ARBenefits offers 1 plan to the."— Presentation transcript:
Plans offered ARBenefits offers 3 plans to Active, COBRA and Non-Medicare members through Health Advantage. ARBenefits offers 1 plan to the Medicare retiree members through Qualchoice.
ARBenefits Plans ARBenefits Premium - is a Point Of Service (POS) plan. It has a deductible, co-insurance and co- pays. ARBenefits Classic - is the equivalent of a High Deductible PPO Plan. It has a deductible and co- insurance. ARBenefits Basic - is also the equivalent of a High Deductible PPO Plan with the highest deductible. ARBenefits Premium Medicare Primary Retirees - pays what Medicare doesn’t pay according to plan benefits. Pays the same as the active ARBenefits Premium plan for Non-Medicare spouses &dependents.
What is a deductible? A deductible is a specific amount that a member must pay out of pocket each year before the plan begins to pay its portion.
What is a co-payment or co-pay? A co-payment, also known as a co-pay, is a set amount you must pay when you receive a particular service, such as an office visit, a trip to the emergency room or a prescription filled. These do count toward your out of pocket expenses. They do not count toward your deductible.
What is co-insurance? Co-insurance is the amount you pay after the insurance company has paid their portion. Co-insurance is often expressed as a percentage of the allowable charges. You must satisfy your deductible before your co-insurance will begin. This counts toward your yearly maximum out of pocket expenses.
Out of Pocket Expense Out of Pocket expense is the amount of money a member will have to pay for services that are not paid by your insurance. This may be a co-pay, deductible or co- insurance.
Annual Out of Pocket Limit The maximum amount of money you are required to pay for covered services, medical, pharmacy or supplies in a contract year. There are charges you may be required to pay that do not count toward this annual limit.
In Network Services Services you obtain or request from providers that are participating in your chosen benefit coordinator’s network.
Out of Network Services Services you obtain or request from a provider that is not participating in your chosen benefit coordinator’s network.
Health Savings Account (HSA) Health Savings Account (HSA) – is required for all eligible active employees on the Classic and Basic plans. Due to this requirement, active employees on the Classic and Basic plans are only eligible for the Limited and Dependent Flexible Spending Account. HSA funds may be used for all medical services. Unused funds will roll over to the next plan year.