IDMI Systems

Medical Plan Overview

Why the Change?

• Cost Savings – The change in the plan will save both IDMI and the

employees money.

• Control – The new structure gives us greatly flexibility and makes

changes easier.

• Protection – Depending on the full implementation of the current

health care laws, the Group High Deductible plan may become

overly burdensome for a company our size.

What is the Change?

• Structure – The medical trust account of our current plan will not

change.

• Overall Plan – The group plan will go away with each employee

being issued individual policies.

• Network / Carrier – There will be no change in that the bulk of our

policies will be through Cigna.

• Coverage – No change in coverage, however, there will be certain

advantages and additional coverage.

What are the Disadvantages?

• Applications – Everyone will have to resubmit an application.

• Medical Coverage Cards – The coverage will be implemented using

two cards: One standard medical card from Cigna and one

Supplemental Card.

• Eligibility – Certain employees with conditions may not qualify as an

individual with Cigna.

How will the Two Card Work?

Cigna

• This will be the ‘standard’ medical coverage card you are

used to using.

• It will be a high deductible plan with coverages very

similar to the coverages we have now.

2nd

Card

• This will be the supplemental medical coverage card you

will now use at each visit.

• It will cover a portion of your deductible and any ‘gaps’ in

coverage that the new plan has.

What if I Don’t Qualify?

• For those that do not qualify for the Cigna plan, the application will

be resubmitted to the state assigned plan.

• The state assigned pool is not the respective state version of

Medicare (e.g. PeachCare).

• All insurers by law are required to participate in a state assigned

pool for those individuals that are turned down for coverage and

their employer does not offer a group policy.

• Once submitted, you will be assigned to a medical carrier. It may be

Blue Cross Blue Shield, Aetna, or even Cigna.

What is my coverage on state plan?

• The coverage will be the same.

• As discussed, by using our supplemental coverage card, that we

control, it will augment the plan to make it the same as other

employees.

• Your issued card from the assigned carrier will be the same card as

if you applied individually straight to them.

• The coverages will simply be the state mandated coverage.

Other Points

• Being an individual plan, if you leave the company you can choose

to pay the premiums and take your coverage with you.

• Many doctors are already becoming very familiar with using two

cards, a primary and supplemental.

• If you have claims during a given year, the carrier can not adversely

raise your premiums. The rate will stay the same.

• Certain drug programs and prescriptions will be reduced.

What are the costs?

• Depending your plan (individual, family, etc.) and your length of

service with IDMI, your premiums will be reduced as outlined below:

• For those with less than 3 yrs, your withholdings will stay the same.

Discounts for Length of Employment

Years Premium Reduction Deductible Reduction

3 25%

5 50% 50%

10 75% 100%

Deductible Costs?

• The deductibles / out of pocket will stay the same as they are now.

• Using the supplemental card, this is how we accomplish that.

However, the way you pay your deductible will now be spread out.

• All out of pocket money will be in the form of co-pays:

• So the deductible will not be front end loaded.

30 OP Hospital / Alt Care Facility $500 copay

40 Emergency Room $200 copay

How is it we can save money?

• The plans themselves have very high deductibles.

• While they are ‘Individual Plans’ the law does not allow the insurance

carriers to adversely target an individual because of claims.

• Any increases must be across the board for your particular

demographic category.

• In other words, you and every individual in the state make up a

‘group’

• Our implementation goes direct to the carrier with no agent involved.

Summary

• Your coverage will not be changing.

• Your payroll deductions will not increase and will decrease for many.

• Your out of pocket will be spread out over the year, rather than a

huge amount up front.

• IDMI is maintaining its medical trust account to provide the flexibility

needed.

• Lastly, we are changing TPA providers that implement this plan (i.e.

we will no longer be using Capital Administrators)