Everything you Need to know about Your Benefit Plan

Transcription

1 HDHP/100% Preventive Care Plan Enrollment Guide Everything you Need to know about Your Benefit Plan Administrated by: Hawaii Mainland Administrators, LLC az.com/members PPO Network: To locate a PHCS Provider: or

2 Medical Benefits Intro to your plan PPO Network: HDHP/100% Preventive Care Plan Medical Benefits Membership in National Consumers Benefits Association Annual Deductible Included $3,000 Ind / $6,000 Fam Coinsurance 80% Annual Out of Pocket Covered Medical Expenses Health Savings Account (HSA) with Health Equity $6,650 Ind / $13,300 Family Limited to Primary Care, Urgent Care and Lab Services Included Enrollment Limitation Can only enroll in HDHP/100% Preventive Plan when also enrolling in Sedera Health Access Plan DISCLAIMER: The HDHP/Basic MEC is not a conventional HDHP that provides catastrophic and comprehensive benefits. It s purpose is to provide the framework to allow HSA compatibility. Preventive Benefits: For a full listing of covered preventive services please visit: benefits/ Prescription Drugs 100% of Preventive Care benefits under PPACA Pharmacy Benefit Manager (PBM): Prescription Drugs Discount Plan Only Discount Plan Only Discounts vary from 40 to 80% off retail level

3 HDHP/100 % Preventive Care Plan Contribution Schedule Monthly Contribution Schedule EE Only $95.31 EE + Child(ren) $ EE + Spouse $ EE + Family $ Click on Find a Provider In the top right hand corner Click OK at the bottom right corner Click Select network On left hand side in middle Find a PHCS Provider Visit us at: multiplan.com Click on PHCS Click on Preventive Services Only Inside the pop up box Enter type of Provider (Urgent Care, Primary Care, Specialists, etc..) in the search box Enter Zip Code and click on search icon For Additional Help: Call:

4 Sample ID Card Be Prepared Carry your Card Front of Card Back of Card Deductible Per Person $3,000 Per Family $6,000 Expect to receive your ID Card within 5 to 10 days from your requested effective date Register your account online. Go to: az.com/members Click on: Enter your information. From there you will have access to request ID Cards, view claims, etc.

5 Your prescription drug discount plan Fill a prescription at a Pharmacy or Online You can trust our high level of commitment in finding the right solution for you every time. Let WellDyneRx help you achieve your health care goals. WellDyneRx is an innovative, fullservice prescription benefit manager, servicing its health plan members through a retail network of over 65,000 pharmacies nationwide. Our full-service mail order facilities utilize advanced robotics to accurately fill more than 1-million prescriptions per year. As an industry leader, WellDyneRx excels at developing innovative and integrated health care solutions that enhance value for employers, health plans and members. Our unique approach to plan management enables us to provide our clients with the strategic business advantages they require to excel in today s dynamic health care environment. We take an active interest in understanding our clients and members health care goals, anticipating their needs and exceeding their expectations. Set Up Your Account Welldynerx.com For member Services: