Northern Michigan University Summary of 2017 Benefit Enhancements. Kristen Bjorne Associate Director of Human Resources Benefits

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1 Northern Michigan University Summary of 2017 Benefit Enhancements Kristen Bjorne Associate Director of Human Resources Benefits

2 What s new for Plan Year 2017? There are three new benefit enhancement beginning January 1, 2017: CVS Caremark will manage the prescription drug benefit, 24/7 online doctor s visits will be available through Blue Cross (Amwell), and EyeMed will administer our vision benefits. 2

3 Why did NMU make changes? A bid process was conducted for our prescription drug and vision lines of business. Both CVS Caremark and EyeMed provide enhanced member programs as well as cost savings. Savings experienced will help offset future cost increases. 24/7 online doctor s visits were added to the current Blue Cross/Blue Shield Plan to provide employees with quality health care anytime and anywhere within the U.S. at a reduced office visit co-pay ($10 vs. $20 in-office visit). 3

4 Are there changes to existing deductibles, co-pays, and co-insurance? No. There are no changes to benefit plan designs. The Blue Cross medical plan deductible remains at $500 for one member; and $1,000 two or more (In-Network). Flat-dollar co-pays remain at: $20 for in-office doctor visit, $10 online visit (new), $20 chiropractic $150 Emergency Room Co-insurance of 20% remains with annual co-insurance maximum of $2,000/$4,000. 4

5 Are there changes to existing deductibles, co-pays, and co-insurance? The triple tier in-network retail pharmacy co-pays remain at $15/$30/$60 (generic/preferred brand/non-preferred brand). NMU Health Center Pharmacy co-pay remains at $10/$20 (generic/brand). Some members may see changes in co-pays for certain prescription drugs, with some co-pay amounts decreasing and others increasing. These are changes that employees may have already experienced within our current Rx plan (Express Scripts) based on formulary changes. 5

6 Will I receive new health care cards? Yes. New ID cards will be issued from: Blue Cross/Blue Shield for the medical/dental plan, CVS Caremark for the prescription drug plan, and EyeMed for the vision plan. Helpful Hint: Use the Mobile App from our partners above to obtain a virtual ID card and eliminate wallet clutter. CVS Caremark and EyeMed will mail a welcome kit which will include ID cards. Effective January 1 st, it is important that you show your new cards to your service providers and destroy your old cards. 6

7 When will I receive the new ID cards? Blue Cross cards were mailed. Note, your Enrollee ID number remains the same. The Rx symbol on the front was removed and customer service information on the back was updated. CVS Caremark cards are scheduled to mail on December 20 th. If you do not have your card on January 1 st and you need a script filled, you have several options to obtain your script: Visit caremark.com to print a temporary card. You will need to first register on the site and substitute your SSN when prompted for your benefit ID card number. Call Customer Care at to obtain your ID number and use it at the pharmacy. Visit your pharmacy and ask that they call the CVS Caremark Pharmacy Help Desk to verify your benefits. Your pharmacy will have the number. 7

8 When will I receive the new ID cards? EyeMed Vision cards are scheduled to mail later this month. If you do not have your EyeMed card on January 1 st and need services, you will need to give your name and date of birth to your vision provider and they will look you up in the EyeMed system. Pay attention to the mail you receive at home this month! 8

9 Do I need to use a CVS Caremark pharmacy? No. You may continue to get scripts filled at the NMU Health Center or other retail providers such as: Peninsula Pharmacy Shopko Snyder Target (now CVS Caremark) Walgreens Walmart See Caremark.com and do a ZIP code search for additional pharmacies. 9

10 Can I still use Rx Mail Order? Yes. CVS Caremark offers a convenient option for receiving maintenance-type drugs. You can have a 90-day supply of medication sent directly to your home or other location. Members requiring specialty medication must use CVS Specialty to obtain their prescription. Specialty medication is obtained via mail order but certain specialty meds may be available at the CVS Caremark pharmacy located within Target in Marquette. A letter with specific actions to be taken for members requiring specialty pharmacy will be mailed to home address. 10

11 What is different about the vision plan? In terms of co-pays and plan allowances, nothing. The benefit plan design with EyeMed is the same as the current plan. Additional discounts are available through EyeMed such as: 20% off remaining balance on frames beyond plan coverage, 20% off non-prescription sunglasses, and 15% off retail price or 5% off promotional price for Lasik surgery using the U.S. Laser Network. 11

12 How do I know if my vision provider is included in the EyeMed network? You may access current providers on the EyeMed website (eyemed.com) by choosing the Insight Network. NMU is currently working with EyeMed to invite additional providers to become part of the Insight Network. Note: Network participation is the provider s choice. If provider is not part of the Insight Network, the out-of-network reimbursement schedule still applies. 12

13 What s 24/7 online health care? When your regular doctor isn t available, you may see a U.S. board-certified doctor anytime. No appointment needed. You can either use your mobile device to log into the Amwell app, or use a computer to log into bcbsm.amwell.com. You may want to use 24/7 online visits when: Your primary care doctor is not available, You can t leave your home or workplace, You re on vacation or traveling for work, You re caring for children or a family member who can t leave home, You re looking for affordable after-hours care. Specific account registration is found on the HR website. Plan to register for the Amwell services before you actually need to make the online appointment. 13

14 What can be treated online? Minor illnesses for you and your family members can be treated such as: Sinus and respiratory infections, colds, flu, vomiting; Minor burns, cuts, scrapes, skin rash; Sore throat, earache, eye irritation, seasonal allergies. Prescriptions may be written at the Amwell doctor s discretion and the doctor will send an electronic script to a pharmacy of your choosing. Doctors won t prescribe controlled substances. If an Amwell doctor determines that an online visit is not appropriate for your illness, he/she will advise you to see your primary care physician. 14

15 Where do I find more specific details about the health plans? Some NMU-specific website functionality may not be available until January 1 st but general information is currently available by visiting: Caremark.com Eyemed.com Bcbsm.amwell.com (24/7 online visits) Bcbsm.com (site registration is currently available) Plan design information is available by visiting: Nmu.edu/hr. Click on Benefits, Insurance Plans, and scroll to the various plans. 15

16 Thank you! QUESTIONS? Please reserve your personal health-related questions for a phone call or appointment with: Kristen Bjorne x1030 Kimberly Hongisto x2470 Never send personal health information in an . Keep Calm and Call HR We are here to assist you! 16

For employers. See a doctor online anytime. Confidence comes with every card. 24/7 online health care POWERED BY AMERICAN WELL

For employers. See a doctor online anytime. Confidence comes with every card. 24/7 online health care POWERED BY AMERICAN WELL For employers See a doctor online anytime. Confidence comes with every card. 24/7 online health care POWERED BY AMERICAN WELL 24/7 online health care 7 % of employers 28 % 70 % 2012 2014 2016 In the U.S.,