HEALTH CARE PLANS 2015

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Transcription:

HEALTH CARE PLANS 2015

A New Way to Provide Health Insurance to Entertainment Industry Employees Media Services Health Care Plan Choice of 9 Medical Plans plus options for dental and vision coverage Competitive price points with premium rates as low as $244.87 per month Flexible employer funding options: Minimum employer contribution is 122.44 per month (50% of the lowest cost single employee rate) All plans are ACA compliant. Cutting edge employee support including online decision tools and a call center to assist employees with enrollment Benefits administration for entertainment industry employers through Media Services and Bloom Health Media Services provides entertainment industry employers with benefits eligibility tracking to eliminate risk of ACA employer mandate penalties 1

Media Services: 2015 Healthcare Plan Features for Entertainment Industry Employers & Employees Benefit Plans Offered Carrier Medical Plan Types Media Services Benefit Medical, Dental & Vision Anthem HMO (4), PPO (2), HSA (2), HIA/HRA Medical Networks Anthem PPO Nationally Anthem HMO Network (CA) Anthem Priority Select HMO (CA) Price Points (single employee) Total monthly premium: $244.87 to $518 Employer Defined Contribution Minimum Employer Contribution Benefit Range Enrollment Method Enrollment Assistance Benefits Administration Production company employers set a defined contribution to the employees monthly insurance premiums. Minimum employer contribution as low as $122.44 or 50% of the lowest cost single plan available Bronze and Silver Employees shop for coverage on an Exchange operated by Bloom Health. The Bloom Health Exchange includes decision support tools to help guide employees to the best plan for their needs. A call center is also available to assist employees as they enroll. Coordinated by Media Services and the Bloom Health Marketplace 2

Media Services: 2015Healthcare Plan HMO Options (California Only) Proposed Media Services Value HMO 30/40 Elements Choice HMO Priority Select Value HMO Priority Select Elements Healthcare Plans In-Network Only In-Network Only In-Network Only In-Network Only Network Used Anthem HMO Anthem HMO Priority Select HMO Priority Select HMO Health Reimbursement Account None None None None Deductible (Individual / Family) None $1,500/member None $1,500/member OOP Max (Individual / Family) $3,500 / $7,000 $6,350 / $12,700 $3,000 / $6,000 $6,350 / $12,700 Coinsurance N/A 30% N/A N/A Office Visit Copay (PCP/Specialist) $30/$40 Copay $50/$70 Copay $20/$40 Copay $50/$70 Copay Preventive Care Covered in Full Covered in Full Covered in Full Covered in Full Inpatient Copay $750 / day (max 3) 30% $250 / day (max 3) 30% Outpatient Surgery Copay $350 / admit 30% $125 / admit 30% Emergency Room Copay $150 Copay $250 Copay $150 Copay $250 Copay Rx Deductible $150/member (x3 family max) $500/member (x3 family max) None $500/member (x3 family max) Rx Generic Copay $15 Copay (Rx ded waived) $15 Copay (Rx ded waived) $15 Copay $15 Copay (Rx ded waived) Rx Brand Copay $30 Copay $35 Copay $30 Copay $35 Copay Rx Non-Formulary Copay $50 Copay Not Applicable $50 Copay Not Applicable Rx Specialty Copay 30% (Max $150/Rx) 30% (Max $150/Rx) 30% (Max $150/Rx) 30% (Max $150/Rx) Metal Tier Silver Bronze Silver Bronze Preliminary 2015 Rates The Rates asssume the employer will pay for 50% of the Lowest Cost EE Rate Single $433.52 $347.23 $350.36 $244.87 Two Party $877.40 $696.18 $702.75 $508.72 Family $1,240.57 $981.69 $991.07 $724.60 3

Media Services: 2015 Healthcare Plan PPO Options (Available Nationally) Proposed Media Services Elements Choice PPO Elements Choice H S A Healthcare Plans In-Network Out-of-Network In-Network Out-of-Network Network Used Health Reimbursement Account Anthem PPO None Anthem PPO None Deductible (Individual / Family) $5,900/$11,800 $11,800/ $23,600 $4,500/$9,000 $9,000/ $18,000 OOP Max (Individual / Family) $6,350/$12,700 $12,700/ $25,400 $6,350/$12,700 $12,700/ $25,400 Coinsurance 0% 50% 20% 50% Office Visit Copay (PCP/Specialist) $35 (3 visits) 50% 20% 50% Preventive Care Covered In Full 50% Covered In Full 50% Inpatient Copay No Copay 50% 20% 50% Outpatient Surgery Copay No Copay No Copay 20% 50% Emergency Room Copay Rx Deductible No Copay $500/member (x3 family max) 20% Rx is subject to Deductible Rx Generic Copay $15 Copay (Rx ded waived) Copay + 50% 20% 50% Rx Brand Copay $35 Copay Copay + 50% 20% 50% Rx Non-Formulary Copay Not Applicable Not Applicable 20% 50% Rx Specialty Copay 30% (Max $150/Rx) Copay + 50% 30% (Max $150/Rx) 50% Metal Tier Bronze Bronze Preliminary 2015 Rates The rates assume the employer will pay for 50% of the low cost single rate Single $395.53 $300.59 Two Party $797.62 $625.73 Family $1,126.60 $891.76 4

Media Services: 2015 Healthcare Plan HRA & HSA Options (Available Nationally) Proposed Media Services Lumenos HIA Plus Lumenos HSA Healthcare Plans In-Network Out-of-Network In-Network Out-of-Network Network Used Health Reimbursement Account Anthem PPO $1,000 / $2,000 Anthem PPO None Deductible (Individual / Family) $2,000/$4,000 $4,000/ $8,000 $1,500/$3,000 $3,000/ $6,000 OOP Max (Individual / Family) $5,000/$10,000 $10,000/ $20,000 $3,000/$6,000 $9,000/ $18,000 Coinsurance 20% 40% 20% 40% Office Visit Copay (PCP/Specialist) $30 Copay 40% 20% 40% Preventive Care Covered In Full 40% Covered In Full 40% Inpatient Copay 20% 40% 20% 40% Outpatient Surgery Copay 20% 40% 20% 40% Emergency Room Copay Rx Deductible 20% None 20% Rx is subject to Deductible Rx Generic Copay $10 Copay 40% $10 Copay Copay + 40% Rx Brand Copay $30 Copay 40% $30 Copay Copay + 40% Rx Non-Formulary Copay $50 Copay 40% $50 Copay Copay + 40% Rx Specialty Copay 30% (Max $150/Rx) 40% 30% (Max $150/Rx) Copay + 40% Metal Tier Silver Silver Preliminary 2015 Rates Single Two Party Family The rates assume the employer will pay for 50% of the low cost single rate $486.25 $430.57 $988.12 $871.20 $1,398.74 $1,231.72 5

Media Services: 2015 Healthcare Plan Exclusive Plans (Available Outside of CA) Proposed Media Services Exclusive Value 30/30 Healthcare Plans In-Network Out-of-Network Network Used Health Reimbursement Account None Anthem PPO None Deductible (Individual / Family) None $3,500 / $7,000 OOP Max (Individual / Family) $3,000 / $6,000 $10,000 / $20,000 Coinsurance 30% 50% Office Visit Copay (PCP/Specialist) $30 copay 50% Preventive Care Covered In Full 50% Inpatient Copay 30% 50% Outpatient Surgery Copay 30% 50% Emergency Room Copay $200 Copay $200 Copay Rx Deductible None None Rx Generic Copay $10 Copay Copay + 50% Rx Brand Copay $30 Copay Copay + 50% Rx Non-Formulary Copay $50 Copay Copay + 50% Rx Specialty Copay 30% (Max $150/Rx) Copay + 50% Metal Tier Silver Preliminary 2015 Rates Single Two Party Family The rates assume the employer will pay for 50% of the low cost single rate $518.47 $1,055.79 $1,495.42 6

Media Services 2015 Dental Plan DPPO - HIGH 7

Media Services 2015 Dental Plan DPPO - LOW 8

Media Services 2015 Vision Plan 9