NETWORK CHANGE – BENEFITS OPEN FORUM

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Presentation transcript:

NETWORK CHANGE – BENEFITS OPEN FORUM

EVOLUTION OF THE NETWORK Current 2 Separate Networks OSF Direct Access Network – 192 Employees Cottage (HFN) Network – 117 Employees BENEFITS OPEN FORUM

EVOLUTION OF THE NETWORK 2017 One Network – Blue Cross Blue Shield of IL 85% of Doctors and Hospitals Nationwide OSF St Mary’s In-Network Cottage Hospital Billed as if in-network 97-99% Success Rate resolving customer service issues with the first phone call Deeper Hospital Discounts Greater savings for employees BENEFITS OPEN FORUM

COTTAGE HOSPITAL BCBS WAIVER PROGRAM

COTTAGE HOSPITAL BCBS WAIVER PROGRAM If service provided is covered under health plan, Cottage Hospital will waive the difference between in-network and out-of-network benefits. Employee is only responsible for in-network deductibles or co-insurance BENEFITS OPEN FORUM

COTTAGE HOSPITAL BCBS WAIVER PROGRAM Adjustments only include items billed by Cottage Hospital Physicians, anesthesiologists, and ER doctors bill separately Most are in-network with Blue Cross Blue Shield BENEFITS OPEN FORUM

HIGH DEDUCTIBLE EXHIBIT Birth at Cottage Hospital - High Deductible Family Cost Employee Portion Physician $3,000 $2,600 (Family Deductible)+ $40 (10% Coinsurance ) Hospital $4,000 mother $400 (10% coinsurance) $1,000 baby $100 (10% coinsurance) Anesthesiologist $1,000 Total Out of Pocket $3,240 Total In-Network Deductible Met $2,600 Total Out of Network Deductible Met $5,000 Total towards Out of Pocket Max $2,740 BENEFITS OPEN FORUM

HIGH DEDUCTIBLE EXHIBIT Birth at OSF Hospital - High Deductible Family Cost Employee Portion Physician $3,000 $2,600 (Family Deductible)+ $40 (10% Coinsurance ) Hospital $4,000 mother $400 (10% coinsurance) $1,000 baby $100 (10% coinsurance) Anesthesiologist $1,000 Total Out of Pocket $3,240 Total In-Network Deductible Met $2,600 Total Out of Network Deductible Met $0 Total towards Out of Pocket Max BENEFITS OPEN FORUM

Birth at Cottage Hospital – PPO Family PPO EXHIBIT Birth at Cottage Hospital – PPO Family Cost Employee Portion Physician $3,000 $1,500 (Family Deductible)+ $150 (10% Coinsurance ) Hospital $4,000 mother $400 (10% coinsurance) $1,000 baby $100 (10% coinsurance) Anesthesiologist $1,000 Total Out of Pocket $2,250 Total In-Network Deductible Met $1,500 Total Out of Network Deductible Met $5,000 Total towards Out of Pocket Max $1,750 BENEFITS OPEN FORUM

Birth at OSF Hospital – PPO Family PPO EXHIBIT Birth at OSF Hospital – PPO Family Cost Employee Portion Physician $3,000 $1,500 (Family Deductible)+ $150 (10% Coinsurance ) Hospital $4,000 mother $400 (10% coinsurance) $1,000 baby $100 (10% coinsurance) Anesthesiologist $1,000 Total Out of Pocket $2,250 Total In-Network Deductible Met $1,500 Total Out of Network Deductible Met $0 Total towards Out of Pocket Max BENEFITS OPEN FORUM

QUESTIONS?