plan year ‘08/09 benefits presentation
DESCRIPTION
WELCOME!. Benefits begin July 1, 2008 By Paul Bogumill, Director of Benefits, Montana University System (406) 444 - 0329. Plan year ‘08/09 benefits presentation. How’d That Happen……………………. 1) Our Plan Projectory had sharply increased. - PowerPoint PPT PresentationTRANSCRIPT
Benefits begin July 1, 2008By Paul Bogumill, Director of Benefits, Montana University System(406) 444 - 0329
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WELCOME!
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How’d That Happen……………………..
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1) Our Plan Projectory had sharply increased.
2) We attacked the problem by identifying cost drivers and implementing more aggressive risk management activities.
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DeductibleCo-insuranceCo-paymentCo-insurance
Max
No Change
All Plans “Managed” by MUS
Plan A Plan B New West Allegiance MC PEAK Blue Choice
Traditional
Managed Care
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Pg 7-12
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Continue to perform “Well” Large movement into managed care last
year6,682 Traditional Plan Policy
Holders 3,153 shift to Managed Care
Last Year
Good outcomes / satisfaction
Prenatal $0 co-pay if enrolled in StarBaby
Program Clarification of $15 Office Visit
Professional services onlyLabs / x-ray / apply to deductible and
coinsurance
Preventative Labs through Well Checks
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New West Health Services New West Health Services THE choice for the Montana University THE choice for the Montana University
System EmployeesSystem Employees
In state customer service to give you personal In state customer service to give you personal attentionattention
Expanded Network – Facilities and ProvidersExpanded Network – Facilities and Providers
High Quality HealthcareHigh Quality Healthcare– Preventive CarePreventive Care– Local Nurse Case ManagersLocal Nurse Case Managers
Consistently competitive rates year after yearConsistently competitive rates year after year
Out-of-State NetworkOut-of-State Network
Locally based and ownedLocally based and owned
Full service health plan with proven Full service health plan with proven recordrecord
Extensive provider participationExtensive provider participation
Self referral to any PEAK providerSelf referral to any PEAK provider
Extended statewide and national network Extended statewide and national network with referral by any PEAK physicianwith referral by any PEAK physician
NEW! Healthy AIM health improvement NEW! Healthy AIM health improvement assistance servicesassistance services
ALLEGIANCEFA M I L Y O F C O M P A N I E S
Spring 2008
Allegiance MeansValue
Allegiance MeansService• Access to a broad provider
network that serves all MUS campuses & affiliated centers.
• Access to superior national provider network & centers of excellence
• Access to knowledgeable medical staff to help you manage your health care.
• A Customer Service Team dedicated to the needs of MUS.
• Quick and accurate claims turnaround.
• Responsive customer service.• Claims access and Eligibility
information available 24/7 via the web or IVR (phone based).
• Knowledgeable & helpful professionals.
Why Choose Blue?An advanced degree of savings, service, and
security.
We’re proud to offer you:
•The lowest rates. • A comprehensive benefits package.• The second largest national provider network.• Unparalleled stability. As Montana’s oldest and largest health insurance provider, we can give you the kind of security you won’t find elsewhere. And we’re right next-door.
There’s never been a better time to go Blue.
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Scheduled Benefit Design
You Choose the Provider Use Delta Dental providers - if you want “pre-negotiated fees”
No Change
All Plans “Managed” by MUS
Basic
Premium
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Enhanced Out of Network Benefit for members in
areas without access (50 mile radius) to a network
provider.
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OLD DEDUCTIBLESOLD DEDUCTIBLES NEW DEDUCTIBLESNEW DEDUCTIBLES
No matter what Medical Plan you choose
We are all on ONE Prescription Plan
Administered by CVS/Caremark
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Coverage Reminder
Coverage for Proton Pump Inhibitors (PPI) such as Aciphex, Nexium, Prevacid, and Protonix are available under the prescription drug plan as long as they are filled at a retail pharmacy. Because of the availability of an over-the-counter alternative (Prilosec and its generic Omeprazole), PPI drugs are not available through the mail order facilities.
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Two mailing notices of account balances per year.
NO ADMIN FEE to employee.
*Reminder – Flex Plan choices need to be re-elected every yearPg 26
• Introducing WellAwardsWellAwards
• Reward program for those currently practicing healthy lifestyle behaviors and to encourage those who wish to improve
• Participants get credit for healthy activities earn a $100 cash award
• Available Fall 2008 – employees and spouses
• See May Wellness Newsletter for more details…
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• Employee Assistance Program (EAP) – counseling services (previously APS Healthcare)
• Recovering from Depression Program
• Online Work-Life documents and tools
• Legal Services
• Financial Services
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Please have your change forms Please have your change forms filled out byfilled out by
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Thank You For
Coming!