1. 2016 Faculty & Exempt Open Enrollment Monday, November 2, 2015 - Wednesday, November 25, 2015

2. What’s New in 2016 Four Medical Plans to chose from
4 Tiered Premium Rates for Medical, Dental and Vision
New Vision Vendor
New Flexible Spending Account Vendor

3. CHEIBA Tiered Premium Structure
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family

4. Anthem Blue Cross Blue Shield Medical Plans
Blue Advantage HMO/Point of Service
Prime Blue Priority PPO
Blue Priority HMO
Lumenos HDHP

5. Anthem Blue Cross Blue Shield Medical Plans Blue Advantage HMO/POS
This is an existing plan with no changes other than the addition of the annual eye exam.

6. Blue Advantage Point of Service POS/HMO
PCP Required
Yes
Individual /Family Deductible
$0/$0
Out-of-Pocket Max Individual/ Family
$2,000/$4,000
Preventative Care Visits
100% Covered
Primary Care Office Visits
$20 Copayment
Specialist Office Visits
Emergency Room
$100 Copayment
Inpatient Hospital
$400 Copayment per admission
Outpatient Ambulatory surgery
$60 Copayment

7. Anthem Blue Cross Blue Shield Medical Plan Prime Blue Priority PPO
Formerly known as the Prime Plan.
Plan option has been modified to include an additional tier of coverage.
If you or a family member utilize a Designated Primary Care Physician (PCP) or Specialist, your out-of-pocket cost will be lower.
Designated Provider are located in the following counties: Adams , Arapahoe, Boulder (including Longmont), Broomfield, Denver, Douglas, Elbert, El Paso, Fremont, Jefferson, La Plata, Montezuma, Pueblo, Summit and Teller.
If you do not reside in these counties, you can access these providers while traveling.

8. Prime Blue Priority PPO
Tier 1 (limited Network)
Tier 2
Out of Network
PCP Required
Yes
Individual /Family Deductible
$400/$800
$960/$1,920
Out-of-Pocket Max Individual/ Family
$750/$1,500
$2,000/$6,000
Preventative Care Visits
100% covered
Primary Care Office Visits
$10 Copay
15% After Ded
35% After Ded
Specialist Office Visits
Emergency Room
Inpatient Hospital
Outpatient Ambulatory surgery
10% After Ded

9. CHEIBA Tiered Premium Structure
Blue Advantage Point of Service Plan (HMO/POS) & Blue Prime PPO Plan & Custom Plus Health Plan
Total Cost
Your
monthly Cost
Employee Only
$637.52
$147.00
Employee + Spouse
$1,528.84
$352.00
Employee + Child(ren)
$1,401.84
$323.00
Employee and Family
$1,759.13
$405.00

10. Anthem Blue Cross Blue Shield Medical Plans Lumenos HDHP
HDHP = High Deductible Health Plan
Features a plan year deductible that applies to medical or prescription drug benefits
Health Savings Account eligible plan.
Health Savings Account (HSA)is an account that allows you to pay for qualified out-of-pocket medical expenses.
HSA is a personal, portable account and remains in your control regardless of your employment.
Contact your financial institution for more information about setting up a HSA.

11. Lumenos HDHP PCP Required No Individual /Family Deductible
$2,500/$5,000
Out-of-Pocket Max Individual/ Family
$2,5000/$5,000
Preventative Care Visits
100% covered
Primary Care Office Visits
$0 After Ded
Specialist Office Visits
Emergency Room
Inpatient Hospital
Outpatient Ambulatory surgery

12. CHEIBA Tiered Premium Structure
Lumenos 2500 HDHP
Total Cost
Your Monthly Cost
Employee Only
$573.52
$132.00
Employee + Spouse
$1,376.84
$317.00
Employee + Child(ren)
$1,261.84
$291.00
Employee and Family
$1,584.13
$365.00

13. Anthem Blue Cross Blue Shield Medical Plans Blue Priority HMO (Limited Network)
NEW Plan for 2016.
In-Network Only Plan.
Network is limited to providers in Denver metro area, which includes Adams, Arapahoe, Boulder, Broomfield, Denver, Douglas, and Jefferson, counties as well as Elbert, El Paso, Teller, Fremont, La Plata, Montezuma, Pueblo, and Summit counties.
Most ASU employees are not eligible unless you live in the counties listed.
Your PCP will coordinate your care within the Blue Priority HMO Network.
Referrals are required.

14. CHEIBA Tiered Premium Structure
Blue Priority HMO Plan
(Limited Network)
Total Cost
Your Monthly Cost
Employee Only
$586.52
$137.00
Employee + Spouse
$1,406.84
$325.00
Employee + Child(ren)
$1,289.84
$298.00
Employee and Family
$1,619.13
$374.00

15. Finding / Selecting Providers (Primary Care Providers = PCP)
Go to anthem.com
Select Find a Doctor
Select type of care – Search as a member
Select State – Colorado
Select Plan/Network (i.e. Prime Blue Priority PPO)
Select type of physician
Select specialty
Select location
Click Search
Visit HR website for more information and instructions on selecting a PCP.

16. New for 2016 LiveHealth Online
See a doctor 24 / 7 on your computer or mobile device.
No waiting for a callback. Wait time – 2-3 minutes.
Available anywhere you have a computer or mobile device with Internet access.
Access to in-network board-certified Physicians.
Allows doctors to ePrescribe medications.
Members may pay via Visa, MasterCard, American Express and Discover.
Cost is lower than or equal to a doctor’s visit.
More Information or to sign up

17. Anthem Blue Cross Blue Shield Dental Plans
Two Dental plans offered
1. Anthem Blue Dental PPO Plus
2. Anthem Blue Dental PPO
No changes to the plans

18. Anthem Blue Cross Blue Shield Dental Plans
Anthem Blue Dental PPO Plus
Anthem Blue Dental PPO
In Network
Out of Network
Annual Maximum
$1,500
Annual Deductible
$25/$75
$50/$150
Diagnostic & Preventive Services*
(No Deductible)
100%
Restorative/General Services (Fillings, Composites,
Anesthesia, Emergency, Oral Surgery)
80%
60%
Endodontic Services (root canal therapy, etc.)
Periodontal Services* (gingivectomy, osseous surgery,
periodontal scaling & root planing and maintenance)
Major Services (Crowns, Bridges,
Dentures, Approved Implants)
50%
40%
Orthodontia Lifetime Maximum for Eligible
Dependent children to age 19
50% up to $1,000
40% up to $1,000

19. Anthem Blue Cross Blue Shield Dental Plans – Premium Tier
Anthem Blue Dental PPO Plus or Anthem Blue Dental PPO
Total Cost
Your
monthly Cost
Employee Only
$39.00
$13.00
Employee + Spouse
$90.00
$31.50
Employee + Child(ren)
$86.00
$30.00
Employee and Family
$102.00
$36.00

20. Anthem Blue Cross Blue Shield Vision Plans
Anthem Blue View Vision Plan replaces VSP
Enrollment in any of the Anthem medical plans will automatically include an annual eye exam.
Access to vast network of both private doctors as well as retail locations such as: Sears Optical, Pearle Vision, JCPenney Optical, Target optical and LensCrafters. Also local providers Rocky Mountain Eye Center and Abba Eye Center.

21. Anthem Blue View Vision
Employees enrolled in an Anthem Medical plan & would like to cover material and hardware can elect the
Blue View Vision Materials Only Benefit
Employee Only
$6.36
Employee + Spouse
$11.92
Employee + Child(ren)
Employee and Family
$17.31

22. Blue View Vision Materials Only
Description
Level of Coverage from an Anthem Provider
Non-Anthem Provider
Eyeglass Frames (once every 12 months)
$130 allowance, the 20% off any remaining balance
Reimbursed up to 70%
Standard plastic single vision lenses
$15 Copay, then covered in full
Reimbursed up to $50
Standard plastic lined bifocal lenses
Reimbursed up to $75
Standard plastic lined trifocal lenses
Reimbursed up to $100
Contact Lenses (once every 12 months
$130 allowance, then 15% off any remaining balance

23. Anthem Blue View Vision
Employees who are not enrolled in the Anthem medical plans but would like vision coverage can elect
Voluntary Exam & Materials (Full-Service) Plan
Employee Only
$8.80
Employee + Spouse
$16.49
Employee + Child(ren)
Employee and Family
$23.95

24. Supplemental Programs
24 Hour Nurse Line – Reach a RN 24 hours a day, 7 Days a week.
Audio Health Library – More than 300 prerecorded health topics.
Future Moms – Manage a healthy pregnancy.
MyHealth Advantage – Home mailings from Anthem.
Condition Care – Support for Chronic conditions.
Colorado Quitline – Support for helping to quit smoking or tobacco use.
PAL Program – Independent consultant who can help you navigate the Anthem system or claims issues
Health Fairs – Yearly blood draws, flu shots and biometric screenings.

25. Flexible Spending Account – 24 Hour Flex
24 Hour Flex is replacing PayFlex as new vendor.
Claims for expenses incurred 2015 to PayFlex. (Deadline is April 15, 2016).
I will be in touch with anyone who currently has a Flex that might be impacted by the roll-over
Maximum amount for Health Account is $2,550.00
Maximum amount for Dependent Account is $5,000.00
Pre-tax deductions & pre-retirement. Use it or lose it.
24 Hour Flex Debit Card is available.
Sign up for direct deposit.
Must enroll yearly

26. ASU CHEIBA Health Fair Wednesday, November 11, 2015
Free blood draws, flu shots and biometric screens.
SUB 309 7:00am until 11:00 am.
Vendors from Anthem, 24 Hour Flex, TIAA- CREF, Valic and Fidelity.

27. 2016 Faculty & Exempt Open Enrollment
For more information or to print forms
Questions….