1. Health Plan Options Open Enrollment 2019

2. Health Plan Options: Open Enrollment 2019
Open Enrollment Overview
Choosing a Plan – Health Plan Overviews
New Plan – Optima Health HMO
Participating in Open Enrollment
Making Changes Later

3. Open Enrollment Overview
Make health plan changes
Enroll in Flexible Spending
2019 Open Enrollment Dates:
Plan Coverage: July 1, 2019 – June 30, 2020
May 1-15,
Use edirect this year. Be sure to use a Chrome browser. Enter date of birth as mm/dd/yyyy. There will be computers available for you. If you add dependents, documentation will be required.

4. Open Enrollment Overview
No Action is Required if You:
Have no health plan-related changes
Are not enrolling in a Flex Spending Account
Do not plan to participate in Premium Rewards

5. Open Enrollment Overview
Make any plan changes
Flexible Spending Account (FSA) – ANNUAL
Continue Premium Rewards - ANNUAL
Dental – Basic/Expanded
Vision – Basic/Expanded

6. Open Enrollment Overview
Flexible Spending Accounts (FSAs)
Health FSA
Dependent Care FSA
Must enroll every year

7. Open Enrollment Overview
Flexible Spending Accounts (FSAs) - NEW this Year
Limit for FSA = $2,700
Monthly Flex Fee =$2.10 (Reduced fee!)
PAYFLEX MasterCard

8. OPEN ENROLLMENT 2019
Choosing a plan

9. Factors in Choosing a Plan
If you have small children
If you or someone on your plan has a chronic illness
If you or someone on your plan take(s) prescription medications
If you tend to be very healthy
If your physicians are in the network

10. Factors in Choosing a Plan
Frequently travel outside of coverage area
Travel internationally
Tight budget
Have experienced increase in out-of-pocket expenses

11. Factors in Choosing a Plan
All Plans Include – Wellness
Free Office Visits – Children up to age 6
Free Annual Check-ups – Children age 7 & older
Free Routine Screenings & Exams – Adults
Free EAP Plans

12. Choosing a Plan Health Plan Choices Available COVA Care
Statewide and elsewhere
COVA HealthAware
COVA HDHP
Optima Health HMO (NEW!)
Regional, mostly in Hampton Roads
Kaiser Permanente HMO*
Regional, mostly N. Virginia
TRICARE Supplement*
Eligible Military Retirees
DHRM Spotlight on Your Benefits provides more details than will be covered in this presentation. We are providing some highlights.
*Not covered in this presentation

13. COVA Care Deductible – Per plan year Out of Pocket Max
One Person - $300
One Person - $1500
Two or More - $600
Two or More - $3000
Deductible is for diagnostic laboratory tests, x-rays, shots, durable medical equipment and ambulance service.

14. COVA Care International Travel – Blue Cross Blue Shield Global Core
Domestic Travel – BlueCard PPO Program
Out-of-Network Option

15. COVA Care Vision Basic – Blue View Vision Vision & Hearing Options
Routine exam once per year
$15 co-pay
Vision & Hearing Options
Expanded vision
Routine hearing exams - $40 co-pay
Hearing aids and other services
More detailed information available in spotlight or on the Anthem web site (or on our site?)

16. COVA HealthAware Deductible - Per plan year Out of Pocket Max
One Person - $1,500
One Person - $3,000
Two or More - $3,000
Two or More - $6,000

17. COVA HealthAware Consume-driven health plan
Includes a Health Reimbursement Account (HRA) fund
Up to $600 for employee
Up to $1,200 for employee and spouse

18. COVA HealthAware Earn HRA funds – Healthy Activities $150 maximum
“Do Rights”
$150 maximum
“Do Rights” include:
Routine exams
Use MyActiveHealth Tracker
Flu Shot
Completing Coaching Module
Unused funds roll over to the next plan year as long as you work at the university
May also contribute to a Flexible Spending Account

19. COVA HealthAware BIG CHANGES this year
Health Reimbursement Account (HRA) – Used FIRST for medical and prescription before FSA
PAYFLEX MasterCard
Dental Now Delta Dental

20. COVA HealthAware Pharmacy Vision & Hearing – basic
HRA covers pharmacy expenses
Retail and Mail Order
Some free generic and preferred brands
Vision & Hearing – basic
Out-of-Network Coverage

21. COVA HealthAware – New this Year
HRA funded on PAYFLEX MasterCard
FSA funded on PAYFLEX MasterCard
Aetna Health App
Delta Dental

22. COVA HDHP Deductible – Per plan year Out of Pocket Max
One Person - $1,750
One Person - $5,000
Two or More - $5,000
Two or More - $10,000

23. COVA HDHP Pharmacy Vision Not Available Mandatory generic
Retail & Mail Order
Vision
Not Available
Hearing
Out of Network

24. COVA PLANS – SUMMARY OF CHANGES, OPTIONS
OPEN ENROLLMENT 2019
COVA PLANS – SUMMARY OF CHANGES, OPTIONS

25. COVA Health Plans – New this Year
Drug Program – IngenioRX
Dental Program – Delta Dental
Medication and Health Coaching
Free Health & Wellness Programs
Maternity: $300 Co-pay Waived
Health Assessment

26. COVA Care & HDHP – New this Year
Enhanced Member Services
Engage Mobile App
Activate SmartShopper

27. COVA Care & HealthAware Only – Premium Rewards
Earn $17 off monthly premiums ($34 couple)
Complete online assessment
Must be completed during Open Enrollment

28. COVA Health Plans: Dental Open Enrollment Options
Basic – Diagnostic & Preventative
2 free cleanings per year
Expanded Dental – Dental work, Orthodontic
Deductible per person
Different levels of co-insurance based on procedure

29. NEW THIS YEAR!
Optima health hmo

30. OPTIMA HEALTH HMO Deductible – Per plan year Out-of-Pocket Max
One Person - $150
One Person - $1,500
Two or More - $300
Two or More - $3,000

31. OPTIMA HEALTH HMO Regional – Hampton Roads coverage area
26,000 providers
Sentara Quality Care Network & Riverside Health Systems
Referral-less HMO/No Out-of-Network except Children

32. OPTIMA HEALTH HMO – Coverage Area
17 County Service Areas
Chesapeake, Franklin, Gloucester, Hampton, Isle of Wight, James City, Mathews, Newport News, Norfolk, Poquoson, Portsmouth, Southampton, Suffolk, Surry, Virginia Beach, Williamsburg, York
If traveling 100 miles from area, pay for emergency care and submit for reimbursement. Exceptions for covered children living out of the area.

33. OPTIMA HEALTH HMO Includes Expanded Dental Includes Vision
Dominion National
Includes Vision
Eyemed

34. OPTIMA HEALTH HMO
MDLIVE *Virtual Care Anywhere 24/7/365