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1 ISD 15 St Francis 2012 Retiree/COBRA Open Enrollment Meeting April 2012
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Highlights No changes in plans The 3 medical plans offered by the District for Early Retirees and COBRA Participants Freedom 65+ Plan The dental plan offered by the District NeoPath On-Site Health Clinic Where to go for more resources Who to call if you have questions 2
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Plan Options Three Medical Plan Options $30 Co-Pay Plan $2,000 Deductible Plan $5,000 Deductible - 3 for Free Plan No Change in rates or plans 3
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4 2012 - 2013 Plan Highlights 2012 - 2013 Plan Highlights $30 Copay Plan Highest monthly premium contributions but less out-of pocket costs at the time of service. $2,000 Deductible Plan Moderate monthly premium contributions with moderate out-of-pocket costs at the time of service. More “consumerism” than the $30 copay plan. Opportunity for employees to accumulate dollars for future healthcare needs, including retirement. $5,000 Deductible 3-for-Free Plan Lowest monthly premium contribution with more out-of-pocket costs at the time of service. The Physician costs (only) for your first three visits are covered at 100%.
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5 Plan Differences $30 Copay Plan$2,000 Deductible Plan$5,000 Deductible 3-for-Free Plan Annual DeductibleNone$2,000 Per Person $4,000 Per Family $5,000 Per Person $10,000 Per Family Annual Out-of-Pocket Maximum$2,000 Per Person $5,000 Per Family $2,500 Per Person $5,000 Per Family $5,000 Per Person $10,000 Per Family Office Visits$30 CopayDeductible, then 20%First 3 visits: Physician Charges are Free! Add’l charges/visits: Deductible Hospital Care Outpatient Inpatient Convenience Care Urgent Care Emergency Care You pay nothing $15 Copay $30 Copay $50 Copay Deductible, then 20% Deductible Retail Pharmacy Generic Brand Non-Formulary $12 Copay $35 Copay $50 Copay $12 Copay $35 Copay $50 Copay $12 Copay $35 Copay $50 Copay Mail Order Pharmacy Generic Brand Non-Formulary $24 Copay $70 Copay $100 Copay $24 Copay $70 Copay $100 Copay $24 Copay $70 Copay $100 Copay 5
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Freedom Plan – Supplement to Medicare Open Access, no referral Preventive Care – 100% Coverage Copay $15 office visit copay Hospital Services 100% Coverage Prescription Drug Copay $12 generic, $24 brand Out-of-Pocket (OOP) Maximum $3,000 6
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NeoPath On-Site Health Clinic The NeoPath On-Site Health Clinic is available for former employee retirees and COBRA participants under age 65 who are enrolled in a Health Partners medical plan with ISD 15. No charge for services provided at the on-site health clinic 30 + generic prescriptions available for free 7
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Examples to keep your out of pocket expenses down: Use of Convenience Care Clinics or eVisits Use www.virtuwell.com for 24/7 online diagnosis and prescriptions from HealthPartners Calling HealthPartners Nurseline for advice Call or Email your Clinic before you visit Utilize generic drugs when possible Utilize the NeoPath On-site health clinic, if eligible 8
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9 Get the Most From Your Plan Member Services 952-883-5000 or 800-883-2177 Monday – Friday 7:00 a.m. – 7:00 p.m. www.healthpartners.com 9
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10 www.healthpartners.com View your benefits, claims and your Deductible and Out of pocket maximums Order new ID cards Refill a prescription Print EOB’s (Details for each claim received, insurance- covered portion of claim, and insured’s responsibility.) Healthy discounts Drug interaction checker, cost calculator, medicine library
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Plan Comparison Tool 11
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Plan Comparison Tool 12
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New Wellness Program We are currently developing a new wellness program with Health Partners. More information to follow. 13
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14 Dental Benefits Delta Preferred Network Preventative care - 100% Basic Services - 100% Major Services - 60% $1,000 annual (plan year) benefit maximum per member No annual deductible per member Delta Premier Network or Out of Network** Preventative care - 100% Basic Services - 80% Major Services - 50% $1,000 annual (plan year) benefit maximum per member $50 annual deductible per member / $150 per family Delta Dental – No Increase ** Difference between billed charges and “allowable” is Members Responsibility
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Qualifying Life Event Changes Generally, you can make certain changes to your health and dental plans if you experience any of the following: Marriage / divorce Birth, adoption or death of your dependent Change in job status for either you or your dependent (new job, loss of job, change if full/part-time status, strike, lockout, etc.) Consult with Wendy Carlberg, to determine if you experience a Qualified Life Event Change 15
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Enrollment Forms Election/Change forms can be found on the District website: www.stfrancis.k12.mn.us Select Departments Select Human Resources Select Open Retiree/COBRA Benefits 16
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Billing Information Your billing cycle for 2012-2013 will remain on the same schedule unless you notify Lori Davis. There is no change in administrative fees. Annual payments are not charged a fee, quarterly payments are charged a 1% fee and monthly payments are charged a 2% administrative fee. 17
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18 Questions after today's meetings can be directed to: Insurance/Benefits Wendy Carlberg Wendy.Carlberg@stfrancis.k12.mn.us (763) 753-7043 Billing/Invoices Lori Davis Lori.Davis@stfrancis.k12.mn.us (763) 753-7051 All Forms are due back to Wendy Carlberg @ the District Office by 4:00 pm on Tuesday, May 15 th, 2012.
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