ISD 15 St Francis 2012 Retiree/COBRA Open Enrollment Meeting

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ISD 15 St Francis

2012 Retiree/COBRA

Open Enrollment Meeting

April 2012

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

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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

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2012 - 2013 Plan Highlights $30 Copay Plan

Highest monthly premium contributions but less out-ofpocket costs at the time of service.

$2,000 Deductible Plan Moderate monthly premium contributions with moderate out-of-pocketcosts at the time of service. More “consumerism” than the $30 copayplan. Opportunity for employees to accumulate dollars for future healthcare needs, including retirement.

$5,000 Deductible 3-for-Free PlanLowest monthly premium contribution with more out-of-pocketcosts at the time of service. The Physician costs (only) for your first threevisits are covered at 100%.

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Plan Differences

$30 Copay Plan $2,000 Deductible Plan $5,000 Deductible3-for-Free Plan

Annual Deductible None $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 Copay Deductible, then 20% First 3 visits: Physician Charges are Free!

Add’l charges/visits: Deductible

Hospital CareOutpatientInpatientConvenience CareUrgent CareEmergency Care

You pay nothingYou pay nothing

$15 Copay$30 Copay$50 Copay

Deductible, then 20%Deductible, then 20%Deductible, then 20%Deductible, then 20%Deductible, then 20%

DeductibleDeductibleDeductibleDeductibleDeductible

Retail PharmacyGenericBrandNon-Formulary

$12 Copay$35 Copay$50 Copay

$12 Copay$35 Copay$50 Copay

$12 Copay$35 Copay$50 Copay

Mail Order PharmacyGenericBrandNon-Formulary

$24 Copay$70 Copay

$100 Copay

$24 Copay$70 Copay

$100 Copay

$24 Copay$70 Copay

$100 Copay

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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

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NeoPath On-Site Health ClinicThe 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

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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

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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

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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

Plan Comparison Tool

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Plan Comparison Tool

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New Wellness Program We are currently developing a

new wellness program with Health Partners. More information to follow.

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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

Qualifying Life Event ChangesGenerally, you can make certain changes to your health and dental plans ifyou 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

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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

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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.

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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 15th, 2012.