Open Enrollment 2018
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- Amice Barton
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1 Open Enrollment 2018 PLAN YEAR JULY 1, 2018 JUNE 30, 2019 ENROLLMENT SIGN-UP MAY 20 TH MAY 30TH Open Enrollment What do I Need to Know? Significant difference in claims from last year, costs more in line, efforts to save are impactful and we need to stay the course! No plan changes for 2018 NEW items: DayForce - replacing PeopleSoft Wellright - dedicated portal for the Medical Premium Incentive Health Advocate -your own personal health advocate is here to help Enrollment Sign-up in Dayforce May 20 th May 30 th Medical Premium incentive items completed by June 30 th 1
2 NEW: DAYFORCE Enrollment Prior to Open Enrollment Enter/verify your dependents (family members you are enrolling) Use the Form found in Benefits /Forms Enter/verify your beneficiaries (recipients of your life insurance or 403(b) Use the Form found in Benefits /Forms Must enter your PCP ID number in DayForce get this today! Anthem.com / find a doctor Open Enrollment - May Click on Benefits and locate the Open Enrollment link ALL MUST enter benefit selections whether you are enrolling OR waiving Plan Year, July 1, 2018 June 30, 2019 Earning your Medical Premium Incentive NEW this year, a dedicated portal Complete all three steps, in one convenient location by June 30 th Go to Registration code: EASTERSEALS Step 1 Print the PCP Form right from the portal. Once completed, upload completed form to the portal. (Biometric results must have occurred within the past 12 months) Step 2 Complete the Tobacco Affidavit Step 3 - Complete the Health Risk Assessment Complete all three steps to be eligible for the medical premium incentive ($40 per pay period). 2
3 Anthem, what s NEW? New opportunities to SAVE you money NEW: X-rays and Ultrasounds at Participating Independent Providers are subject to a $125 copayment NEW: MRI and High Diagnostic Imaging at Participating Independent Providers are subject to a $250 copayment NEW: Wellness Rewards with Anthem - can earn up to $700 in gift cards and reimbursement: Preventive Wellness Exam and Flu Shot -$100 Tobacco Free Certification-$50 On-line Wellness Tool Kit- up to $150 Gym Reimbursement- up to $400 Solera, a new preventative benefit for Anthem members. It s a lifestyle management program providing you with the tools and resources to lose weight and adopt healthier habits. If you qualify, this program is FREE. Easterseals / Anthem website: Anthem Medical Plan No changes to Plan Design TIER 1 Deductible $3000/$6,000 family max PCP Office Visit $20 copay Specialist $50 Copay RX, $5/$20/$40/$70/$100 OOP Max, $7,150/$14,300 TIER 2 Deductible $5000/$10,000 family max PCP Office Visit $30 copay Specialist $50 Copay RX, $5/$20/$40/$70/$100 OOP Max, $7,150/$14,300 3
4 All the same Ways to Save Preventive Care covered at 100% Routine physicals, Routine screenings, Routine eye exam Lab services covered in Full at Participating Independent Providers Quest, Labcorp, NorDX Live Health Online - $20 copayment Outpatient Surgery at Participating Ambulatory Surgical Center - $125 copay per admission Pharmacy Home Delivery 90 Day Supply (2x s copay) Vitals SmartShopper, earn CASH incentives to use low cost providers, see our expanded list of services! Convenient MD Urgent Care copay co-share program - $25 copayment with Convenient MD ID card ( Easterseals sponsored program) Use urgent care centers instead of Emergency Room, unless you have a life threatening emergency, you can save money by choosing an urgent care setting SAVINGS don t forget!! Using avail. Savings resources Not using all the savings Live Health Online - $20 Urgent Care - $125 Prescription - $5 Prescription - $5 PCP follow up - $20 PCP follow up - $20 Blood work - $0 Blood work - $450 X-Ray - $125 X-Ray - $250 ASC for tonsils - $125 Hospital setting - $3,000 Vitals incentive - $-150 no incentive - $0 Out of Pocket $145 Out of Pocket $3,850 4
5 Vitals SmartShopper This continues to be our biggest opportunity for real savings Call or shop online for cost effective choices of common medical services Avoid paying higher costs and earn cash rewards for being a Smart Shopper Health Advocate Available to you - July 1, 2018 Welcome to your NEW Health Advocate Benefit A service provided at no additional cost to you, courtesy of Easterseals Health Advocate helps you resolve healthcare and insurance related issues; Help finding a doctor Help scheduling an appointment Help in transferring medical records Help resolving benefit issues Help getting your questions answered Help with a provider bill Simply call the toll-free number or visit online HealthAdvocate.com Welcome Kits are available here today 5
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What is the overall deductible? Are there other deductibles for specific services?
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document by calling 1-888-624-6300. Important Questions Answers Why this
Important Questions Answers Why this Matters: For in-network providers Deductible is not applicable innetwork
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.anthem.com or by calling 1-800-922-6621. Important Questions
Important Questions Answers Why this Matters:
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at https://eoc.anthem.com/eocdps/aso or by calling 1-888-650-4047.