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DoD NAF HBP Open Enrollment Overview November 4 – November 29.

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Presentation on theme: "DoD NAF HBP Open Enrollment Overview November 4 – November 29."— Presentation transcript:

1 DoD NAF HBP Open Enrollment Overview November 4 – November 29

2 Agenda Open Enrollment Overview Medical Benefit Overview Health and Wellness Programs Dental Benefits Member Tools and Discount Programs www.nafhealthplans.com

3 Open Enrollment Overview The Open Enrollment Period allows eligible employees to: –Join the DoD NAF HBP or another available NAF health plan if not already enrolled –Switch plans –Add or remove eligible dependents –Add or drop dental –Drop coverage altogether –Do nothing and keep current medical/dental coverage If you are making an enrollment change, complete and return the enrollment forms to your local Human Resources Office no later than November 29, 2013 www.nafhealthplans.com

4 DoD NAF HBP Medical Benefits Review www.nafhealthplans.com

5 2014 HBP Contributions PlanIndividual CoverageFamily Coverage 2013201420132014 Medical Plan$69.65$72.09$162.04$167.71 Dental Plan$4.36 $10.32 Medical and Dental$74.01$76.45$172.36$178.03 Stand Alone Dental$17.98$18.44$42.52$43.62 www.nafhealthplans.com

6 2014 Benefit Changes Annual Medical Deductible Increase: You will have the opportunity to earn additional Health Incentive Credits to offset the increase to the deductible. Aetna Open Choice PPO Plan If you elect coverage for:Your 2014 deductible will be: Individual$400 in-network; $1,000 out-of-network Family of 2$800 in-network; $2,000 out-of-network Family of 3 or more$1,200 in-network; $3,000 out-of-network Aetna Traditional Choice Plan, including Aetna International If you elect coverage for:Your 2014 deductible will be: Individual$400 Family of 2$800 Family of 3 or more$1,200 www.nafhealthplans.com

7 2014 Benefit Changes Earn more Health Incentive Credits in 2014! The maximum an individual can earn will increase from $100 to $150, the family maximum will increase from $300 to $450 You now have seven ways to earn the Health Incentive Credit in 2014: ActivityHealth Incentive Credit Earned Have a preventive care exam (dependents under 18)$100 – one per year Have a preventive care exam (employees, retirees and dependents over 18) $50 – one per year Complete/Update Health Assessment$50 – one per year Complete a Simple Steps online wellness program$50 – one per year Complete the Personal Health Record Walk-Me-Through Tool$50 – one per lifetime Make entries into the Personal Health Record Health Tracker$50 – one per year Make entries into the Personal Health Record Physical Activity Tracker$50 – one per year Respond to items on the Member Health Engagement Plan “to-do” list$50 – one per year www.nafhealthplans.com

8 2014 Benefit Changes Out-of-Pocket Maximum Effective January 1, 2014, all in-network medical, behavioral health and pharmacy member cost-sharing will apply towards the out-of- pocket (OOP) maximum. This means that the following costs will now count toward your OOP limit: PCP and specialist copays, emergency room copays, inpatient per confinement fees, pharmacy copays and 3 rd tier pharmacy coinsurance. You will still be responsible for the deductible, copays and confinement fees, but the costs will go toward your annual OOP maximum. Once your share of the cost for in-network deductible, copays, coinsurance and per confinement fees reach the applicable OOP maximum, the plan pays the covered expenses at 100% for the remainder of the calendar year. Please note that the $150 prescription eyewear allowance, bariatric surgery coinsurance, premiums, out-of-network deductible, coinsurance, and balance billing, and non-covered services do not count towards your OOP maximum. www.nafhealthplans.com

9 Health Incentive Credit These credits will be placed in an account and applied towards the first family member’s claim where the deductible and/or coinsurance would be applied. Employees can earn a maximum of $150 per year per person, up to $450 per family per year. Health Incentive Credit features: Applied to the medical deductible and/or coinsurance as claims are processed. The Credit cannot be applied to copayments such as PCP, Specialist, Emergency Room, Urgent Care copays, Hospital confinement fees, or pharmacy copays. The credit will roll over every year until used, up to 3 years. Credits are displayed on Explanation of Benefits and in Aetna Navigator *Preventive exams eligible for the incentive: annual routine physical, well woman exam or well child exam. www.nafhealthplans.com

10 2014 Benefit Changes Pediatric Vision Effective January 1, 2014, prescription eyewear for children up to age 22 will be covered at 100% with no copay (in and out of network). This includes one pair of basic frames and lenses, which have specific vision codes associated with them called V codes, which indicate what is covered. The V codes that are payable at 100% are limited to (V2020, V2100- 2199, V2200-2299, V2300—2399, V2121, V2221, V2321) In order to have this benefit paid at 100%, you may have to pay for the frames and lenses out-of-pocket and submit a claim to Aetna for reimbursement of the covered charges. www.nafhealthplans.com

11 DoD NAF HBP Health and Wellness Programs www.nafhealthplans.com

12 Aetna Health Connections Disease Management What is it: Personal support to help you manage your ongoing health conditions Support for 34 health conditions including Diabetes, High Cholesterol, High Blood Pressure, etc. How it can help you: Telephone outreach on how to manage your health conditions Support for working with your doctors Notification about potential medical errors and opportunities to improve care Information about your health conditions www.nafhealthplans.com

13 Simple Steps To A Healthier Life What is it: Online guide to health and wellness How it can help you: Identify potential health issues with a health assessment Get personalized reports to help you set goals Participate in online wellness programs You can visit the website as often as you like. Simple Steps is more than just the health assessment. You can use site features such as articles, quizzes, recipes and other tools to learn more about the health topics that mean the most to you. Eligible for Health Incentive Credit Earn $50 for completing/updating Health Assessment Earn $50 for completing online wellness program www.nafhealthplans.com

14 Personal Health Record The Personal Health Record (PHR) is an online service, accessed through Aetna Navigator, that provides a secure place for all your health information gathered from: –Medical claims –The Health Assessment at Simple Steps To A Healthier Life –Personal medical data you provide, such as over- the-counter drugs, family history and health problems you may not necessarily see a doctor for (like back pain). –Your PHR also provides health alerts and reminders from MedQuery, a health monitoring system. Eligible for Health Incentive Credit Earn $50 per lifetime for completing PHR Walk-Me- Through Tool Earn $50 for updating PHR Physical Activity Trackers Earn $50 for updating PHR Health Trackers www.nafhealthplans.com

15 Member Health Engagement Plan What is it: Provides you with a personalized list of recommended actions to help improve your health and wellness How it can help you: Site offers personalized action plans based upon your specific health status Includes reminders on core health activities, such as completing health assessment, to health screenings Eligible for Health Incentive Credit Earn $50 for completing item on “to-do” list. www.nafhealthplans.com

16 Pharmacy Advisor ® - 1-877-418-4128 What is it: Proactive outreach to members to help manage medication and health conditions One-on-One support by phone or mail How it can help you: It’s staffed with registered pharmacists and technicians that are available to help you manage your medicine and condition. Rely on: –Quick, secure advice that’s planned around your schedule. –Information about medicines and how they work in your body. –Guidance to help you stay on track with your prescription medicine. www.nafhealthplans.com

17 Informed Health Line (1-800-556-1555) What is it: 24-hour nurse helpline for your health questions Online health resource How it can help you: Get answers to your health questions from registered nurses day or night Make decisions about when to call your doctor Learn about medical tests and procedures Go online for health information, tools and resources www.nafhealthplans.com

18 DoD NAF HBP Dental Benefits Review www.nafhealthplans.com

19 Dental Options for 2014 Passive PPO Dental Plan For members enrolled in a DoD NAF HBP Stand Alone Dental Plan For members who are not enrolled in a NAF medical plan under the DoD HBP through your employer www.nafhealthplans.com

20 Your dentist...your choice Choice #1 - Visit an Aetna PPO dentist and receive services at negotiated rates Choice #2 - Visit any licensed dentist of your choice for maximum flexibility under your plan www.nafhealthplans.com

21 How both options work Option #1 - When you visit a dentist in our dental PPO network… – Meet your deductible – Coinsurance – No claim forms Option #2 - When you see any other licensed dentist … – Meet your deductible – Coinsurance – Out-of-pocket expenses may be higher – You may have to file claim forms – You may be subject to balance billing www.nafhealthplans.com

22 Member Tools and Discount Programs www.nafhealthplans.com

23 Member Tools – Aetna Navigator Transactions, Decision Support and Health Information Health History Report Check claims, balances, enrollment DocFind ® Hospital Comparison Tool Member Payment Estimator Price-A-Drug SM Rate Your Medical Professional Aetna InteliHealth ® Healthwise ® Knowledgebase www.nafhealthplans.com

24 Stay well, get fit and save money Discount Programs & Services:  Vision related discounts  Hearing  Fitness  Alternative health care  Dietetic counseling  Weight management  Natural products  And more…. Discount information can be found on Aetna Navigator, by calling Aetna Member Services or at www.nafhealthplans.com. These valuable discounts are not insurance. www.nafhealthplans.com

25 Questions? More information can be found at www.nafhealthplans.com www.nafhealthplans.com


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