2. Enrollment
New vendor, Chard Snyder, will handle enrollment and premium collection
Online:
Phone:
Coverage does not rollover, so every retiree must enroll
Open Enrollment is October 29th -November 18th

3. 2019 HEALTH ASSESSMENT CHANGES
New DEDUCTIBLE CREDIT
To qualify for the deductible credit, employees and their covered dependents should receive a preventative wellness exam with their primary care physician in Once complete, the credit will automatically apply to the 2019 deductible.

5. Plan Changes 2019 Telemedicine Bariatric Surgery Mental Health Copays
All 6 medical plans will offer telemedicine
Plans 1-4 will have access to a Primary Care Physician
Plans 5 & 6 will have access to Primary Care Physician and Mental Health Specialists
Bariatric Surgery
No longer covered under any medical plan or The Zero Card
Mental Health Copays
Access to mental health professionals will be available for a copayment, if applicable by plan, rather than subject to deductible and coinsurance
Emergency Room Copays
Visits to the ER now come with an additional deductible of $250 unless admitted

6. RX Changes 2019 $0 Drug List 90 Day Supply Weight Loss Prescriptions
Preferred generics available on plans 1-4 at any in-network pharmacy
Replaces RXnGo benefit through Zero Card
90 Day Supply
Cost is 2.5 co-pays mail order or 3 co-pays in retail pharmacy
Weight Loss Prescriptions
Covered after pre-authorization
Fertility Prescriptions
Coverage now includes initial diagnosis and injections

8. Preventative Coverage
Recommended routine gender and age-specific care and screenings
Health Counseling
Weight loss, depression, tobacco cessation
Immunizations
Flu, HPV, shingles, Tdap, Pneumoccocal, Heptatitus A and B
Cancer Screenings
Mammogram, colonoscopy, PSA, pap smear
Preventative RX
Folic acid, single agent statins, aspirin

9. Benefits Value Advisor
Only Available on Plans 5 and 6
Concierge-style customer service from Blue Cross and Blue Shield
BVA offers the following services:
Education about coverage options
Appointment scheduling
Price comparison and shopping assistance
This service empowers members to make more cost- effective, high quality choices

10. 2019 Zero Card Changes

11. BCBS Plan 1 Blue Choice PPO; Zero Card Eligible; Not Eligible for HSA
Benefit
In-Network Payment Level
Individual/ Family Deductible
$2,000/$6,000
Individual/ Family Out-of-Pocket Max (Includes deductible, copays and RX)
$5,600/$13,500
Office Visit Co-pay
Primary Care- $35; Specialist- $50; Telemedicine- $15
Emergency Room Copay
$250
Coinsurance
80%
RX Deductible
$150 Individual/ $450 Family
Preferred Generics $0
Non-Preferred Generic
$40
Preferred Brand
$75
Non-Preferred Brand
$125
Specialty
$200

12. BCBS Plan 1 Blue Choice PPO; Zero Card Eligible; Not Eligible for HSA
Plan 1 PPO, Blue Choice
2019 Monthly Retiree Cost
Retiree Only
$110.00
Retiree + Spouse
$810.00
Retiree + Child
$400.00
Retiree + Children
$660.00
Retiree + Family
$1,330.00
Plan 1 PPO, Blue Choice
2019 Monthly Cost WITHOUT UCO Contribution
Retiree Only
$578.02
Spouse Only
Child Only
Children Only
$860.45
Family Only
$1,142.89

13. BCBS Plan 2 Blue Preferred PPO; Zero Card Eligible; Not Eligible for HSA
Benefit
In-Network Payment Level
Individual/ Family Deductible
$1,250/$3,750
Individual/ Family Out-of-Pocket Max (Includes deductible, copays and RX)
$3,500/$10,500
Office Visit Co-pay
Primary Care- $25; Specialist- $50; Telemedicine- $15
Emergency Room Copay
$250
Coinsurance
80%
RX Deductible
$150 Individual/ $450 Family
Preferred Generics $0
Non-Preferred Generic
$40
Preferred Brand
$75
Non-Preferred Brand
$125
Specialty
$200

14. BCBS Plan 2 Blue Preferred PPO; Zero Card Eligible; Not Eligible for HSA
Plan 2 PPO, Blue Preferred
2019 Monthly Retiree Cost
Retiree Only
$40.00
Retiree + Spouse
$670.00
Retiree + Child
$300.00
Retiree + Children
$530.00
Retiree + Family
$1,150.00
Plan 2 PPO, Blue Preferred
2019 Monthly Cost WITHOUT UCO Contribution
Retiree Only
$576.08
Spouse Only
Child Only
Children Only
$857.56
Family Only
$1,139.05

15. BCBS Plan 3 Blue Preferred PPO; Zero Card Eligible; Not Eligible for HSA; No RX Deductible
Benefit
In-Network Payment Level
First Dollar Coverage
$500 per person
Individual/ Family Deductible
$500/$1000
Individual/ Family Out-of-Pocket Max (Includes deductible, copays and RX)
$5,500/$11,000
Office Visit Co-pay
No co-pays. Office visits including telemedicine are subject to first dollar coverage, then deductible and coinsurance
Emergency Room Copay
$250
Coinsurance
50%
Preferred Generics $0
Non-Preferred Generic
$25
Preferred Brand
$50
Non-Preferred Brand
$100
Specialty
$150

16. BCBS Plan 3 Blue Preferred PPO; Zero Card Eligible; Not Eligible for HSA; No RX Deductible
Plan 3 PPO, Blue Preferred
2019 Monthly Retiree Cost
Retiree Only
$0.00
Retiree + Spouse
$490.00
Retiree + Child
$200.00
Retiree + Children
$360.00
Retiree + Family
$890.00
Plan 3 PPO, Blue Preferred
2019 Monthly Cost WITHOUT UCO Contribution
Retiree Only
$554.08
Spouse Only
Child Only
Children Only
$824.40
Family Only
$1,094.99

17. Primary Care- $35; Specialist- $60; Telemedicine- $15
BCBS Plan 4 Blue Preferred PPO; Zero Card Eligible; Not Eligible for HSA; No RX Deductible
Benefit
In-Network Payment Level
Individual/ Family Deductible
$5,000/$10,000
Individual/ Family Out-of-Pocket Max (Includes deductible, copays and RX)
$7,900/15,800
Office Visit Co-pay
Primary Care- $35; Specialist- $60; Telemedicine- $15
Emergency Room Copay
$250
Coinsurance
80%
Preferred Generics $0
Non-Preferred Generic
$25
Preferred Brand
$50
Non-Preferred Brand
$100
Specialty
$150

18. BCBS Plan 4 Blue Preferred PPO; Zero Card Eligible; Not Eligible for HSA; No RX Deductible
Plan 4 PPO, Blue Preferred
2019 Monthly Retiree Cost
Retiree Only
$0.00
Retiree + Spouse
$430.00
Retiree + Child
$160.00
Retiree + Children
$310.00
Retiree + Family
$660.00
Plan 4 PPO, Blue Preferred
2019 Monthly Cost WITHOUT UCO Contribution
Retiree Only
$513.47
Spouse Only
Child Only
Children Only
$764.34
Family Only
$1,015.21

19. BCBS Plan 5 Blue Choice PPO; HSA Eligible; Not Eligible for Zero Card
Benefit
In-Network Payment Level
Individual/ Family Deductible
$4,000/$12,000
Individual/ Family Out-of-Pocket Max (Includes deductible, copays and RX)
$6,500/$13,000
Coinsurance
80%
Office Visit Co-pay
No co-pays. Office visits including telemedicine are subject to deductible and coinsurance
Telemedicine
Primary care physicians and mental health specialists are available through telemedicine for substantially less than traditional office visits
All RX
No co-pays, RX subject to deductible and coinsurance

20. BCBS Plan 5 Blue Choice PPO; HSA Eligible; Not Eligible for Zero Card
Plan 5 PPO, Blue Choice
UCO HSA Contribution
2019 Monthly Retiree Cost
Retiree Only
$75.00
$0.00
Retiree + Spouse
$410.00
Retiree + Child
$130.00
Retiree + Children
$90.00
$280.00
Retiree + Family
$630.00
Plan 5 PPO, Blue Choice
No HSA Contribution
2019 Monthly Cost WITHOUT UCO Contribution
Retiree Only
$456.54
Spouse Only
Child Only
Children Only
$678.31
Family Only
$900.08

21. BCBS Plan 6 Blue Preferred PPO; HSA Eligible; Not Eligible for Zero Card
Benefit
In-Network Payment Level
Individual/ Family Deductible
$3,000/$9,000
Individual/ Family Out-of-Pocket Max (Includes deductible, copays and RX)
$5,000/$10,000
Coinsurance
80%
Office Visit Co-pay
No co-pays. Office visits including telemedicine are subject to deductible and coinsurance
Telemedicine
Primary care physicians and mental health specialists are available through telemedicine for substantially less than traditional office visits
All RX
No co-pays, RX subject to deductible and coinsurance

22. BCBS Plan 6 Blue Preferred PPO; HSA Eligible; Not Eligible for Zero Card
Plan 6 PPO, Blue Preferred
UCO HSA Contribution
2019 Monthly Retiree Cost
Retiree Only
$100.00
$0.00
Retiree + Spouse
$400.00
Retiree + Child
$120.00
Retiree + Children
$115.00
$270.00
Retiree + Family
$620.00
Plan 6 PPO, Blue Preferred
No HSA Contribution
2019 Monthly Cost WITHOUT UCO Contribution
Retiree Only
$459.29
Spouse Only
Child Only
Children Only
$682.40
Family Only
$905.52

23. Dental Plan Changes 2019
New vendor, Blue Cross and Blue Shield of Oklahoma
Dental plans in 2018 paid 146% of premiums collected, meaning rates were set to increase by almost 60%
To curb the increase, UCO is self-funding claims through BCBS and the plans have new coverage amounts
Two Plans with Orthodontia
New lifetime max on orthodontia services
No Joint Networks
Providers are either in-network or out of network

24. BCBS Plan 1 Benefit In-Network Payment Level $100/$300 100% 80% 50%
No Deductible for Preventative Care
Individual/Family Deductible
$100/$300
Preventative Services Routine cleanings and x-rays
100%
Basic Services
Cavities and fillings
80%
Major Services Crowns, dentures and implants
50%
Orthodontic Services
Orthodontic Lifetime Max
$2,000
Annual Maximum Per Person
Preventative services do not reduce annual maximum
$1,500
Plan 1
2019 Monthly Cost
Retiree Only
$54.00
Retiree + Spouse
$104.00
Retiree + Child
$80.00
Retiree + Children
$106.00
Retiree + Family
$154.00

25. BCBS Plan 2 Benefit In-Network Payment Level $75/$225 100% 75% 50%
No Deductible for Preventative Care
Individual/Family Deductible
$75/$225
Preventative Services Routine cleanings and x-rays
100%
Basic Services
Cavities and fillings
75%
Major Services Crowns, dentures and implants
50%
Orthodontic Services
Orthodontic Lifetime Max
$1,000
Annual Maximum Per Person
Preventative services do not reduce annual maximum
Plan 2
2019 Monthly Cost
Retiree Only
$42.00
Retiree + Spouse
$80.00
Retiree + Child
$62.00
Retiree + Children
$82.00
Retiree + Family
$118.00

26. BCBS Plan 3 Benefit In-Network Payment Level $50/$150 100% 80% N/A
No Deductible for Preventative Care
Individual/Family Deductible
$50/$150
Preventative Services Routine cleanings and x-rays
100%
Basic Services
Cavities and fillings
80%
Major Services Crowns, dentures and implants
N/A
Orthodontic Services
Annual Maximum Per Person
Preventative services do not reduce annual maximum
$750
Plan 3
2019 Monthly Cost
Retiree Only
$19.00
Retiree + Spouse
$38.00
Retiree + Child
$31.00
Retiree + Children
$40.00
Retiree + Family
$61.00

27. Vision Plan Changes 2019 Same vendor (VSP), new plans Two plans
Plan 2 offers the ability for contacts and prescriptions lenses in the same year
No ID Cards
Use SSN to verify eligibility
2019 is the last year to elect vision and keep it. If vision is not elected this year, you will not be able to enroll in vision benefits in the future
This rule will apply every year from now on

28. VSP Vision Plan 1
Benefit
In-Network Payment Level
Well Vision Exam
$10
Frame Allowance
Allowance on contacts OR frames
$150 or $170 for featured brands
Lenses
$25 copay for single vision, lined bifocal/trifocal
Contacts Allowance on contacts OR frames
$150 per year
Plan 1
2019 Monthly Cost
Retiree Only
$7.54
Retiree + Spouse
$15.06
Retiree + Child
$14.74
Retiree + Children
$16.10
Retiree + Family
$25.72
VSP does not issue ID cards, use your SSN to verify eligibility

29. VSP Vision Plan 2
Benefit
In-Network Payment Level
Well Vision Exam
$10
Frame Allowance
$150 or $170 for featured brands
Lenses
$25 copay for single vision, lined bifocal/trifocal
Contacts
$150 per year
Allowance Limit
Allows for purchase of frames and contacts in the same year, or double frame/contact benefit
Plan 2
2019 Monthly Cost
Retiree Only
$12.30
Retiree + Spouse
$24.64
Retiree + Child
$24.10
Retiree + Children
$26.34
Retiree + Family
$42.04
VSP does not issue ID cards, use your SSN to verify eligibility