total lives covered: 51,371
DESCRIPTION
2005 State Health Plan Enrollment. 25,232. 20,435. 4,189. 1,515. Total Lives Covered: 51,371. Total Lives Covered: 51,371. Employee Survey Concerns. Salary Issues. Picking a Plan Design. Pharmaceuticals. Salary Issues. - PowerPoint PPT PresentationTRANSCRIPT
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Active Dependents
Active Employees
Retiree Dependents
Retirees
Total Lives Covered: 51,371
25,232
20,435
1,515
4,189
Total Lives Covered: 51,371
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Salary Issues. Picking a Plan Design. Pharmaceuticals.
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Respondents pointed to no across-the-board pay increases for the past three years and felt that their take-home pay has been reduced as a result of premium increases each year.
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Respondents feel they have limited choices and many don’t want to pay for services they don’t use.
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There was a great deal of concern about the significant increase in out-of-pocket expenses if we switched from a co-payment plan to a “co-insurance” plan. Participants pay a percentage of the cost
of medication each time a prescription is filled rather than a co-pay (e.g., $14 generic).
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Plan pays 80% of allowable charges after you meet your deductible.
The benefit is limited to $800 per insured per benefit period.
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Plan pays 80% of allowable charges after you meet your deductible.
The benefit is limited to $15,000 per insured per benefit period.
Within the network the plan pays 85% of allowable charges after you meet your deductible.
There is a $150,000 lifetime benefit limit.
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Plan pays 80% of allowable charges after you meet your deductible.
The benefit is limited to $2000 per lifetime.
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Plan pays 80% of allowable charges after you meet your deductible.
The benefit is limited to $350,000 lifetime maximum per insured.
Within the network the plan pays 85% of allowable charges after you meet your deductible
Outside of the network the plan pays 70% of allowable charges after you meet your deductible.
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All plans have a $350,000 lifetime maximum per insured in-network and out-of-network combined.