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BROWARD HEALTH BENEFITS The Broward Health Notice of Privacy Practice describes how medical information about you may be used and disclosed and your.

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Presentation on theme: "BROWARD HEALTH BENEFITS The Broward Health Notice of Privacy Practice describes how medical information about you may be used and disclosed and your."— Presentation transcript:

1

2 BROWARD HEALTH BENEFITS

3 The Broward Health Notice of Privacy Practice describes how medical information about you may be used and disclosed and your rights regarding this information. You will be asked to sign the acknowledgement form at orientation. Notice of Privacy Practices

4 Medical plans cover medical, pharmacy and vision care. No pre-existing limitations. Hospitalization requires pre-certification. Medical Coverage

5 In- and out-of-network benefits. Broward Health facilities for in-network benefits. No primary care physician needed. No referrals needed. Can use out-of-network physicians and hospitals but at a greater cost. 911/emergencies covered at in-network level. In-network Broward County coverage only. Best Choice Plus

6 In-network benefits only; except emergency. Authorizations not required for diagnostic treatment. Referrals required for specialist visits. Primary care physician coordinates your care. Nationwide coverage. Over 50 hospitals in tri-county area. Aetna Select

7 High Deductible Health Plan (HDHP) = comprehensive medical coverage + Health Savings Account (HSA). Nationwide coverage. Over 50 hospitals in tri-county area. In-network hospital benefits paid at 80% after deductible. Out-of-network benefits paid at 60% after deductible. Pre-certification required for hospital admission. Specialist referrals and diagnostic authorizations not required. $1,500 single deductible, $3,000 family deductible Deductible must be met before claims are paid, except for preventive. Aetna Choice

8 Fee-for-service. Plan pays 80% of eligible expenses. $1,000 maximum benefit per year. “Open panel” of dentists. Nationwide coverage. Basic Dental

9 Family members choose their own dentist. No waiting periods, calendar year maximums or deductibles. No claim forms. No out-of-network benefits. Co-pays required for root canal, crowns, etc. Over 10,700 dentists in California, Florida and Texas. Safeguard Dental

10 Health and Dental benefits effective 1st of the month following hire date. Required documentation such as marriage and birth certificates. If you miss the new hire deadline, you may only enroll at annual enrollment or if you experience a life qualifying event. Don’t Delay Enrollment!

11 Best Choice Plus*Aetna Select*Aetna Choice* Office Visit $15 co-pay/office visit No authorization required for specialist $15 co-pay/office visit Referral required for specialist visit Covered at 80% after deductible Inpatient Hospital Hospital charges paid 100% at Broward Health facilities Hospital charges paid 100% at Aetna facilities after $250 co-pay Covered at 80% after deductible Out of Network Physicians paid at 60% after annual deductible; emergency covered at 100% Emergency only Covered at 60% after deductible Outpatient Services Hospital charges paid 100% at Broward Health facilities Diagnostic cover at 90% after deductible and surgery covered at 100% with $50 co-pay Covered at 80% after deductible Prescription Drugs $10/$20/$30$10/$25/$40 Covered at 80% after deductible. Deductible waived for preventive Rx *All plans include vision care Medical Plans

12 Basic Dental PlanSafeguard Dental Plan Maximum Plan Benefit $1,000 Per person per Calendar YearNo maximum Services Most services paid at 80% of Plan Allowance maximum Co-pays are required for many procedures such as root canal, crowns, etc. Emergency Treatment 80% of Plan Allowance $50 co-pay plus any charges related to service treatment Orthodontia 60% of billable charges, up to $1,500 lifetime maximum $1,850 co-pay Dentist You may select any licensed Dentist who meets plan guidelines You may select any Dentist from provider directory Dental Plans

13 Your Cost Per Pay Cycle Best Choice Plus (Preferred Provider Organization) – PPO Aetna Select (Exclusive Provider Organization) – EPO Aetna Choice (POS II) (High Deductible Health Plan) – HDHP Employee $38.46$40.86$6.32 Employee & Spouse/DP $79.94$84.92$13.13 EE & Child(ren) $58.85$62.52$9.67 Family/DP $108.83$115.61$17.87 Note: Part-time rates and domestic partner benefits also available Medical Bi-Weekly Payroll Deductions

14 Your Cost Per Pay Cycle Basic DentalSafeguard Dental Employee $2.76$1.88 Employee & Spouse/DP $5.71$3.57 EE & Child(ren) $5.35$3.38 Family/DP $9.08$4.16 Dental Bi-Weekly Payroll Deductions Note: Part-time rates also available

15 Voluntary Short-Term Disability Pays up to 60% of your basic weekly earnings. Maximum benefit $1,000 per week. Maximum of 9 weeks. Pre-existing condition limitation. 29-day elimination period. Employee pays full cost. If you do not enroll at time of hire, evidence of insurability is required at open enrollment.

16 Voluntary Long-Term Disability Pays up to 60% of your basic weekly earnings. Maximum benefit $5,000 per month. 90-day elimination period. Pre-existing condition limitation. BH pays ½ of premium. If you do not enroll at time of hire, evidence of insurability is required at open enrollment. Management and Physicians subject to other plan criteria.

17 1x base salary life insurance at no cost. Additional voluntary insurance for employees and dependents available for payroll deduction. Call 1-800-553-1209 to enroll. Life Insurance

18 Flexible Spending Accounts Medical Expenses - Pre-tax dollars to pay for out-of-pocket expenses, such as prescription drug co-pays, over-the-counter medications and medical, dental and vision expenses. - Up to $5,000/year. Dependent Expenses - Pre-tax dollars to pay for day care expenses. - Up to $5,000/year. Use It or Lose It - Any monies remaining in a flexible spending account after the 2009 plan year claim deadline of March 31, 2010 will be forfeited.

19 Retirement Plans Pension Plan - 5% of base pay contributed by Broward Health. - Automatically enrolled after one year of employment. Star Plus 403(b) Plan / 457(b) Plan - AIG VALIC & Fidelity. - Match (403b) up to 2.4% of base pay after one year of employment. - You must enroll in the plan. More Information - Cafeteria, AIGRetirement.com / Fidelity.com or Human Resources.

20 Thank you! This presentation has been prepared as a guide and reference for the use of North Broward Hospital District’s employees. It explains the Medical, Dental and Prescription Plan Programs. If there are any discrepancies between the information stated in this presentation and the plan documents, company policy or health care provider contracts, the plan documents, company policy and healthcare provider contracts will supersede. The North Broward Hospital District reserves the right to be the final authority in any matters concerning these programs. The District also reserves the right to change these policies or discontinue this program at any time without notice. Welcome to Broward Health! For more information, please visit: www.BrowardHealth.org


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