Medical Insurance Update June 15, 2017 We are sharing some information now to ensure you get this information here, but please know that there will be much more information at open enrollment in August.
PAISBOA Health Benefit Trust has hired Aetna to provide medical network services to HBT participants starting November 1, 2017 for the 2017-18 and 2018-19 health plan years. We are leaving Independence Blue Cross. The Trustees made this decision in April – 6 months before the transition date - in order to guarantee a smooth transition. The Trustees unanimously decided that claims management and cost control, customer service and satisfaction, and network access will be superior with Aetna. This was not a decision to be taken lightly. IBC has done well for the Trust for the past 50 years. While many meetings were had with both vendors, and much in-depth research and comparison were done, the final decision was based on four primary factors
Why Claims Cost Control and Claims Target Guarantee Innovative, value-based approaches on population health management to better accomplish the Triple Aim of high quality services, increased patient satisfaction and well-being, and lower overall costs of care. The trust is looking for a carrier whose networks can provide excellent care while managing costs.
Why Customer Service and Dedicated Service Team Network Access (local and national) Administrative Services Only (ASO) Fees
So what is changing and what is staying the same? Let’s start with what is staying the same.
What is staying the same? Your doctors (over 98% of them) If you are currently in the Keystone HMO Custom 515 What is staying the same are the things that we want, such as doctor selection. Over 98% of doctors in the IBC plan also participate in Aetna, and some doctors that do not participate in the IBC plan do participate in Aetna. You can take a look at this now. You can click on this link and this screen will come up. Pick Aetna Select if you are currently in the school’s HMO plan. Pick Aetna Choice POSII if you are currently in the Personal Choice or Personal Choice High Deductible plan. If you are currently in the Personal Choice 20/30/70 or the High Deductible Plan https://www.aetnaresource.com/18381/paisboa-health-benefit-trust
What is staying the same? Your premiums Due to expected savings, we are looking at a 2% to 5% increase in premiums, and TPS intends to absorb that increase through the employer contribution in 2017-18.
What is staying the same? Your prescription card – we will continue to use CVS as your prescription benefit carrier. Keep your CVS prescription cards, because the pharmacy vendor, which is CVS Caremark, will not be changing. As a reminder, you can use your CVS card at many participating pharmacies, not just CVS.
What is staying the same? We are keeping the Personal Choice and HD plans exactly the same.
What is staying the same? We are keeping the Personal Choice and HD plans exactly the same.
Now what is changing?
What is changing? New card Like IBC, you will get one card for yourself and each dependent, band, just like the IBC card, the ID number will be the same for yourself and all dependents. You will get your new card before the plan goes into effect on November 1.
What is changing? Aetna mobile Find a doctor or urgent care center Research claims Get an ID card
What is changing? There are a few small changes to the HMO plan. The Inpatient hospital copay goes from $500 to $100 per day, which could mean savings for visits of less than five days. Spinal manipulation (chiropractor) visits – covered 60 days after injury, vs new plan which provides 30 visits per year. These change are minor and mostly positive. I am happy to talk about any concerns regarding these changes with you individually.
Next steps Open enrollment will take place during August inservice You will select your medical plans in September Aetna ID cards will be issued by November 1 The Aetna plans go into effect November 1 The Trust continues due diligence to ensure that Aetna lives up to its commitments
Questions?