Plan year ‘08/09 benefits presentation

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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 Presentation

Transcript of Plan year ‘08/09 benefits presentation

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

Pg 5

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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

Pg 7-12

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

Pg 15

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Enhanced Out of Network Benefit for members in

areas without access (50 mile radius) to a network

provider.

Pg 21

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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

Pg 13

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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…

Pg 28-29

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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

Pg 30

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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!