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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 - PowerPoint PPT Presentation
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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
(763) 753-7043
Billing/Invoices
Lori Davis
(763) 753-7051
All Forms are due back to Wendy Carlberg @ the District Office by 4:00 pm on Tuesday, May 15th, 2012.
