Annual Change 2013 MT Employees

STATE OF MONTANAAnnual Change 2013

Employees

What Are My Choices?• The Choice or Classic Plan for Medical • The Premium or Basic Plan for Dental – choose a plan• I can use PPO and Premier dentists with both plans • Wellness Programs• Prescriptions I Take• Providers I See

(In- or Out-of-Network)

As a member, the choices I make determine my

out-of-pocket costs

Read the Book!

Chances are the book has your answers.

• Every State employee and every retiree gets an Annual Change book.

• If you are an employee and have not received a book, contact your HR or Payroll person. They distribute the books. Employees make their elections online.

• Retirees books were mailed 9/14.

How To Do Elections Online

• Needed: MINE site login (ask payroll for help)

• Go to Employee Self Service

• Click on Benefits Enrollment• You must say YES or NO to

Vision, Medical Flex, and Dependent Flex

• Read the email you receive after hitting SUBMIT.

Rates for 2013

• State share stays at $733• Choice rates (formerly

Managed Care) went up

a little• Classic rates (formerly

Traditional) went up more than Choice

• Save $5 - $10/month for attending a health screening

• In 2014 you can save more by being tobacco-free!

If I Make the Right Choices…

Classic PlanRupert + spouse and kids $987

No health screenings - $0

State share $733

Rupert’s monthly payment $254

Choice PlanRupert + spouse and kids $947

Health screenings for Rupert and spouse - $10

State share $733

Rupert’s monthly payment $204

Benefits Changes

• Medical Flexible Spending max drops to $2,500 (federal law)

• Office copays still $15 for the Choice plan

• Coinsurance for both plans is 25% in-network and 35% out-of-network

• Discontinued benefits include bariatric surgery, infertility treatment, and foot orthotics

• Increased wellness options

WellnessWe have wellness options from:• HCBD – EAP, Lunch ‘N’ Learn,

Weight Watchers;• Cigna – Management for

weight, stress, and disease; tobacco cessation, prenatal support; and

• CareHere – Dietitian, RN, Exercise Physiologist, Coaches for Behavioral Health and Tobacco Cessation

Cigna, CareHere, and two of the HCBD wellness programs have no out-of-pocket cost to the member.

URx• We still have Urx • Some Specialty drug copays

will increase • Your best deal on a drug may

be through mail order• Need help finding the most

cost effective drug? Call and talk to our Benefits Specialists or Nurses.

Call HCBD if you have trouble paying for your specialty drugs – help may be available

Our Health Plan• Our benefit plan is SELF-FUNDED!

HCBD – sets rates, determines benefits, & oversees the plan• Rates NOT set by Cigna or Delta• Benefits NOT set by Cigna or Delta

Rates are increasing because of the rising

cost of healthcare and, in part, lifestyle choices.

YOUR MEDICAL PLAN OPTIONS

Plan year: 2013

STATE OF MONTANA

12Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2012 Cigna

WHAT IS CHANGING?

OOP = Out-of-Pocket

• Select Preventive Services covered at 100% on both plans when provided in-network

Choice: Classic:

Individual Family Individual FamilyIn-network deductible $500 $1,000 $1,000 $2,250

Out-of-network deductible

$750 + balance billing

$1,750 + balance billing



In-network OOP Max $2,500 $5,000 $5,000 $11,250

Out-of-network OOP Max






IS MY DOCTOR IN THE NETWORK?

Cigna’s Open Access Plus network of physicians and hospitals will replace our current provider network. To verify your doctor is in the network check

www.cigna.com/stateofmontana Or call the pre-enrollment support line at (855) 692-0131

http://www.cigna.com/stateofmontana


WHEN ARE YOU AVAILABLE TO HELP ME?

• Find a doctor, hospital or health facility when you need one – online, by phone, or on the go with any web-enabled device

• 24 hours a day, 7 days a week • Talk to a nurse for information when you can’t reach your

doctor – day or night

If your doctor is not in-network and you are in the middle of treatment for certain conditions, ask about

Transition of Care


• Self-service through myCigna.com lets you:

– Check your coverage

– View, print, and download your Explanation of Benefits

– Access articles and health education resources, and sign up for online coaching programs

– Keep track of your health history and records with a secure online Personal Health Record

MyCigna.com


CIGNA ID CARDS

Scheduled to be mailed December 17, 2012

Does SABHRS have your correct mailing

address?


HOW DO YOU HELP ME UNDERSTAND AND TRACK MY HEALTH CARE EXPENSES?

Explanation of Benefits (EOB)

• Clearly shows how and when claims were paid

• Available in print or online at myCigna.com

• Choose if you would like to go paperless with myCigna.com


Flexible Spending Account Joint Processing

More choices coming soon…• For now you can continue to submit medical flex claim

forms as you always have• We are working on the joint processing capability and will

update you as we work through this process


We help you

be well and live well.


Lifestyle Management – On the phone, online, or both

Weight managementGet support to help build your confidence, become more active, eat healthier and change your habits.

Tobacco cessationOur helps you get and stay tobacco free. Develop a personal quit plan that’s right for you.

Stress managementOur program helps you understand the sources of your stress and learn coping techniques to manage stress both on and off the job.


YOUR HEALTH FIRST

Connect with one dedicated contact.A health advocate may be calling you to get things started, or you can call any time.

They can help you:

• Manage a chronic health condition;

• Make educated decisions;

• Know what to expect if you need to spend time in the hospital;

Get support for these (and more) chronic healthconditions:• Asthma• Heart Disease• COPD (Emphysema and

Chronic Bronchitis)• Diabetes Types 1 & 2, • Peripheral Arterial Disease• Low Back Pain• Osteoarthritis• Mental health conditions


HEALTHY PREGNACIES HEALTHY BABIES

Stay healthy !

Get live support 24/7

Call Cigna for tips on: • How to handle your discomfort

during pregnancy; • What foods to enjoy and which to

avoid; and • Information on delivery options,

birthing classes, maternity benefits.

Get rewarded for a good decisionWhen you participate and complete the program you’ll be eligible to receive:• $250 if you enroll by the end of your first trimester; or• $125 if you enroll by the end of your second trimester.


For help during Annual Change, call

Cigna’s toll free pre-enrollment line:

(855) 692-0131

This service is available 24 hours a day,

7 days a week.

Annual Change News for State of Montana Dental Benefits

Delta Dental Dual Network Offering

Two dentist networks – You don’t have to select just one!

Freedom of Choice – State of Montana members may visit:

A Delta Dental PPOSM dentist (most savings)

A Delta Dental Premier® dentist (some savings), or

A non-participating dentist (no savings)

Statewide Network Growth 38 new PPO dentists in 2012 13 new Premier dentists in 2012

Overall Network Counts(Unique Dentists)

Jan 2012

May 2012

Sept 2012

PPO 123 127 148

Premier 256 257 276

Additional contracts received but not processed

PPO 5

Premier 0

State of Montana Dental Benefit Options

Effective January 1, 2013Benefits and Covered Services Basic Plan Premium Plan

Who’s Eligible Primary member, spouse, and eligible dependent children up to age 26

Deductibles - Per Calendar Year - Applies only to Type B and C Services

No Deductible $50 per person /

$150 per family

Annual Maximum – Type A Services $600 per calendar year

$600 per calendar year

Annual Maximum – Type B & C Services Not Covered $1,200 per calendar year

Type A Services -- Oral examinations, cleanings, x-rays, fluoride treatment, sealants, and amalgam fillings

100% 100%

Type B Services– Extractions, endodontics, periodontics, oral surgery, non-amalgam fillings

Not Covered 80%

Type C Services – Crowns, bridges, initial dentures Not Covered 50%

See the HCBD website or the SPD for a full list of Type A, B, and C services, limitations, and exclusions

Benefits illustrated above are not intended for use as a comprehensive description of the Plan. Please consult your benefit booklet for complete details, including limitations and exclusions.

Pre-treatment estimate /Pre-determination of benefits

Lets a member to find out in advance what the member will have to pay

Recommended for any treatment expected to be $300 or more in cost

State of Montana Dental Plan ID Card

Two ID cards mailed to each employee/retiree Attached to bottom of letter Separate ID card for dental plan ID cards will be in name of employee/retiree

Claims address

State of MT Customer Service toll-free phone number

Delta Dental specific alternate ID number

Custom State of MT web site

deltadentalins.com/stateofmontana

Web Capabilities Dentist directory Member online

services Benefits and eligibility

information Claim status Fee finder Printable ID card Electronic EOB’s MySmileKids Extensive dental health

section and videos

Mobile Apps View the website Find a dentist Log in to view

eligibility, benefits, claims, ID cards

Socialize with Us Facebook

Twitter

YouTube.com

Google+

SmileWaySM Wellness Program

Includes a three-part Oral Health Challenge:

Review habits: Take a quiz and sign up for targeted email messages

Get educated: Take advantage of our dental health library, videos, and children’s oral health site

Stay informed: Subscribe to our e-newsletter, connect through Facebook, or follow us on Twitter

We keep you smiling®

Thank you!

www.deltadentalins.com/stateofmontana

Customer Service – (866) 496-2370

What can I receive at the Health Center?• Primary care• Same day services by appointment• Health screenings• Health coaching

Open now in Helena, coming to more towns in Montana soon!

Montana Health Center

For employees covered on the health plan and their

dependents age two and older also covered on the plan

No out-of-pocket cost

&Private

You Aren’t Alone on the Path to Better Health & Wellness

Registered Dietitian

Registered Nurse

Exercise Physiologist

Behavioral Health Coach

Tobacco Cessation Coach

Schedule Your Get to Know Me Appointment

CareHere(406) 444-9930(877) 423-1330

www.carehere.com

Montana Health Center in Helena first

time access code: MHA2

http://www.carehere.com/

Better Health Step by Step with CareHere Connect

Vision• No changes for 2013

www.eyemedvisioncare.com

While making online benefits changes, you must ELECT or WAIVE vision – No moving on to the next step until you do…

Honest, we don’t do this just to annoy you.

http://www.eyemedvisioncare.com/

Employee Assistance Program

• Four counseling sessions with no copay or coinsurance with in-network providers

(Choice or Classic)• EAP sessions may include

counseling services not covered under the medical plan

Dependent Changes• As always, add a spouse and/or child to dental and vision

only (to add to medical requires a qualifying event)

• You can change it online during Annual Change

• If you have a Flexible Spending Account (FSA), you must be enrolled in the Pre-Tax plan

• May affect your Social Security if you are close to retirement

"A dog who thinks he is a man's best friend is a dog who obviously has never met a tax lawyer."- Fran Lebowitz

Pre-Tax Plan

Flexible Spending Accounts (FSA)Medical FSA

Like vision, you have to elect or waive medical FSA to move to the next step

The new maximum for medical FSAs is $2,500. This is part of healthcare reform.

Dependent FSA

You have to elect or waive dependent FSA to move to the next step (yes! even if you don’t have a kid!)

The maximum for dependent FSAs is still $5,000.

Cigna will be offering the option of automatic processing of claims

soon for the medical FSA

Long-Term Care

Cost based on: Benefit chosen - care type, monthly benefit, & duration Age at purchase Inflation Protection

Details on UNUM’s website www.unum.com

Important notice regarding Long-Term Care: Unum Life Insurance Company announced it is discontinuing the sales of new group long-term care contracts as of February 7, 2012. While they realize there is a need for this type of product, current economics, pricing, and risk factors make it impossible for them to meet their financial and risk management objectives.

Unum will continue to accept enrollees on existing policies. They will continue to provide high quality service to existing policyholders and claimants throughout the life of the group policy and as long as premiums are paid. This change will not impact Unum’s current relationship with existing customers.

http://www.unum.com/

Life Insurance• Plan A – Basic Life $14,000, part of core benefits• Plan B – Dependent Life $2,000 for spouse, $1,000 for children• Plan C – Optional Life = 1X your salary rounded to the next $5,000 (May choose extra in $5K increments up to $500K)• Plan D – Spouse

Supplemental Life (spouse life amount may not exceed Plan C amount)

• Plan E – AD&D for employee only or employee and dependents

MEDEX Travel AssistRepatriation – Traveling 200 miles+

away from home and die, this will pay…to bring your remains home

Accelerated Benefit – Terminally ill? You may qualify for up to 75% of your life insurance

Portability – Separate from the State, you may port your Life insurance to a Term Life policy

Conversion – separate from the State, you may convert your Life insurance to a Whole Life policy

Call (800) 527-0218 for more information

Long-Term Disability

If you can’t do the work you used to do…

Rehabilitation Plan – May provide vocational or educational training to help you get back to work Survivors Benefit - If you die while receiving this, 3X your benefit goes to your surviving spouse or children

http://benefits.mt.gov/ltd.mcpx

• Choice or Classic medical plan• Deductibles and out-of-pocket max are increasing

• Basic or Premium dental plan • Both plans allow you to use both networks – PPO and Premier

• Say yes or no to Flex • Medical ($2,500 max) and dependent ($5,000 max)

• Say yes or no to Vision• Adding extra life coverage?• Health Care Advocates may be contacting you!• Be ready for Tobacco-free discount in 2014!

Choices MUST Be Made by 10/26!

Thank you!www.benefits.mt.gov

[email protected] (800) 287-8266

TTY (406) 444-1421

http://www.benefits.mt.gov/

mailto:[email protected]

Annual Change 2013 MT Employees

Health & Medicine

Transcript of Annual Change 2013 MT Employees