University of the Incarnate Word

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Presentation transcript:

University of the Incarnate Word Gilsbar, LLC May 1 and May 2, 2018

Why Do I Need Insurance? Insurance is for the unforeseen illnesses in your life. Insurance is to help keep these things from happening by providing you with preventive care at no cost. Insurance is to help offset any cost that might happen if you have an unforeseen illness.

2018 What is Changing? Gilsbar – New TPA for Medical and Dental Three Medical Plan Options Available To You: UIW Bronze, UIW Silver, Cigna PPO PBM – Maxor Plus Dental – no changes Vision – no changes All other benefits – no changes

2018 Medical Benefit Options

Reference-Based Pricing 2018 Networks CIGNA PPO Reference-Based Pricing BRONZE & SILVER National access Large number of national healthcare providers Better in-network benefits Out-of-network benefits available Claims are paid based on Medicare pricing No network & wider provider access Lower premiums & out-of-network costs

2018 Employee Contributions Employer contributes a matching premium

New ID Card Look for a new card in the mail before 6/1. All medical and pharmacy claims on one ID card. Present card to every provider/pharmacy. New claims filing information New pharmacy benefit manager- Maxor Primary Members name on ID card. Each family will receive 2 copies. You can order as many as you like on mygilsbar.com. Claims & Benefit information is listed on the back of ID card. Electronic copies of ID card can be pulled up online or on any mobile device.

MDLive What is MD Live? When should I use MDLIVE? 24/7/365 on-demand access to affordable, quality healthcare. Anytime, Anywhere. With MDLIVE, you can visit with a doctor 24/7 from your home, office or on the go. Our network of Board Certified doctors is available by phone or secure video to assist with non-emergency medical conditions. When should I use MDLIVE? Instead of going to the ER or an urgent care center for a non-emergency issue During or after normal business hours, night, weekends and even holidays If your primary care doctor is not available If traveling and in need of medical care How much does it cost? This service is free of charge for members on the medical plan and their household. Please note, a parent or guardian must be present during any interactions involving minors.

Gilsbar Advocacy Services Benefit Education Concierge for Complex Healthcare Situations Cost & Quality Reviews Appointment Scheduling Parent Care Coordination Prescription Coverage Assistance Review Diagnosis & Treatment Options

How to Contact Gilsbar Phone: 877-301-2988 Should you have questions or need guidance during your open enrollment, call Gilsbar’s Care Advocacy: 877-301-2988. Our friendly and knowledgeable Care Advocates are available to you Monday through Friday from 7 am – 7 pm CST. Phone: 877-301-2988 Email: customerservice@gilsbar.com

Member Experience Check medical plan accumulators & print ID cards Review your claim EOBs and prescriptions history Search the provider directory & view your benefits Questions? Call 877-301-2988 or email customerservice@gilsbar.com

Explanation of Benefits (EOB) An EOB explains how a reimbursement was made or why a claim was not paid or if additional information is needed. When you register on mygilsbar.com you are automatically enrolled to receive electronic EOBs. Outlines claimant, provider & date of services. Shows excluded charges, copay or deductible amounts & covered expenses. Defines amount paid by insurance and patient responsibility. Claim remarks at the bottom of the EOB show an explanation for certain charges being excluded.

Manage Your Account After June 1st, activate your account online or log in: visit www.myGilsbar.com. Register as a “First Time User” as a participant if you have never registered before. Complete the registration form, you will need: Your group number: S2855 A valid, personal email address The last four digits of your social security number You will receive an email confirmation, click the link within it to confirm your registration.

Member Experience Manage your account through the mobile app! Search myGilsbar in Google Play or Apple App Store Download the app and log in using your normal username & password Check medical plan accumulators & print ID cards Review your claim EOBs and prescriptions history Search the provider directory & view your benefits Questions, contact Gilsbar at 877-301-2988 or customerservice@ gilsbar.com

Additional Highlights ID Cards - give to providers and pharmacies HIPAA Authorization through Care Advocates Complete this form in order to discuss dependent/spouse information Other Insurance? Be sure to let Gilsbar know.

Questions?