Alaska Chapter
June 2012
Renewal Meeting
April 10th and 11th, 2012
Meeting Agenda
• What’s New for 2012‐13?
• Premera BCBS of Alaska
• Value‐Added Benefits
• Ancillary Products
• Benefit Solutions, Inc. (BSI) – Intro to SIMON
• Renewal Information
• Q & A
• Renewal Packet Handout
What’s New for 2012‐13?
• Premera 3‐Tier Benefit Change for non‐grandfathered plans
• New Online User Interface for accessing Benefit Solutions, Inc (BSI) ‐ SIMON
Premera Blue Cross Blue Shield of Alaska
Group Product Update
4Confidential & Proprietary – Premera
Premera Medical Plan Line‐Up
Deductible Choices:– Classic: $250, $500
– Frontier: $750, $1000, $1500, $2000, $2500
– Envoy: $3000, $5000
– HSA: $2500, $5000
All plans (except HSA plans) waive the deductible for office visits, as well as lab and diagnostic imaging.
All plans include Rx coverage, with an option for 90 day mail‐order supply.
All plans are available to Grandfathered and Non‐Grandfathered Groups.
Current Structure
Alaska 2‐Tier Network: Heritage Select and Envoy
What’s Heritage Select Functions similarly to a PPO, however applies to hospitals only
Members receive the highest benefit at preferred hospitals and hospital based chemical dependency facilities
Members may use any professional provider and receive benefits on a constant level of allowable charges
What is EnvoySubset within Select and Plus
The member’s first six preferred provider office visits, shared among certain professional and alternative care benefits, are subject only to the plan’s Copay, with subsequent visits subject to
the deductible and coinsuranceWhen a member needs care in a hospital setting, in‐network facilities are where they will get
the highest benefit levels
Plan Selection
If you are a… You can…
Renewing Grandfathered Fully Insured • Renew as‐is on the 2 tier plan design
• Renew on the 3 tier plan design (lose GF status)
New Grandfathered Fully Insured Groups • Accommodate GF status and enroll on “like” GF 2 tier plan design
• Enroll on 3 tier plan design (lose GF status)
Renewing Non‐Grandfathered Fully Insured Groups
• Required to renew onto 3 tier plan design
New Non‐Grandfathered Fully Insured Groups • Required to enroll on 3 tier plan design
7Confidential & Proprietary – Premera
Key Messages
• Premera is implementing solutions to address unsustainable rising cost of healthcare
• The three‐tier network structure allows members more affordable options inpreferred and participating providers
• Premera is proud to have such a vast provider network
• Premera Blue Cross Blue Shield of Alaska is committed to playing its part in building a more sustainable healthcare system. We encouraging members to use in‐network providers. These providers offer high quality care and services while giving our members lower out‐of‐pocket costs.
• This change does not apply to grandfathered plans.
8Confidential & Proprietary – Premera
Association Grandfather Matrix
Classic 250
Classic 500
Frontier 750
Frontier 1000
Frontier 1500
Frontier 2000
Frontier 2500
Envoy 3000
Envoy 5000
HSA 2500
HSA 5000
Classic 250 Yes No No No No No No No No No No
Classic 500 Yes Yes No No No No No No No No No
Frontier 750 Yes Yes Yes No No No No No No No No
Frontier 1000 Yes Yes Yes Yes No No No No No No No
Frontier 1500 Yes Yes Yes Yes Yes No No No No No No
Frontier 2000 Yes Yes Yes Yes Yes Yes No No No No No
Frontier 2500 Yes Yes Yes Yes Yes Yes Yes No No Yes No
Envoy 3000 Yes Yes No No No No No Yes No Yes No
Envoy 5000 Yes Yes No No No No No No Yes Yes Yes
HSA 2500 No No No No No No No No No Yes No
HSA 5000 No No No No No No No No No Yes Yes
“If my business renews on Plan X from my current benefit plan, will I remain eligible to be grandfathered?”
Move To ‐ ‐ ‐ ‐ ‐ ‐ ‐ ‐ ‐ ‐ ‐ ‐ ‐ ‐ ‐ ‐ ‐ ‐ ‐ ‐ ‐ ‐ ‐ ‐ ‐ ‐ ‐ ‐ ‐ ‐ ‐ ‐ ‐ ‐ ‐ ‐ ‐ ‐ ‐ ‐ >
Move
From
Premera Member Portal Update
Medical Membership Portal
WorldDoc controls entire UI once member has logged into portal, creating limitations on how quickly changes can be made to content, features, etc.
What Can You Do Today?
• Short member‐centric videos to provide helpful information about popular topics.
• Spending activity report‐ summarizes your healthcare spending over time in a downloadable pie chart.
• Premera Mobile – New on the go technology. Utilize the app to show proof of coverage, on the go “find a doctor”, connect to customer service or Nurseline.
• Send proof of coverage to Provider – Allows members to send secured email proof of coverage to a provider straight from their phones.
• Find a Doctor – Hospital comparison on a single page
• Extras & Discounts – list of all discount programs and extras available to members
But Wait….There’s More!
• Member Website Sign In and Password Reset ‐Members can now recover their web user ID and change their password online instead of contacting the Technical Help desk.
• Website Registration for New Members
• Effective early last year, we successfully removed the limitation that prevented members from registering for the website for the first 20 days following their effective date.
• Modifications to Dependent Visibility Enhance “Paperless EOB”
• Visibility rules are now in place allowing a Subscriber and Spouse/Domestic Partner to view all claims information for dependents under the limiting age (age 13 in WA and OR; age 18 in AK). Subscriber can also view non‐sensitive claim information for Major dependents.
• When a Subscriber elects paperless EOBs, they will automatically receive paperless EOBs for underage dependents.
• Permission granting capability allows members over the limiting age to register and give access to a parent or spouse to view all claims information from a single log in.
Premera Dental Plan Line‐Up
– $1000 Max, $50 Deductible, 80/80/50
– $1500 Max, $50 Deductible, 100/80/50
– $2000 Max, $50 Deductible, 100/80/50
Value‐Added Benefits
In addition to the bundled Premera benefits, all medical plans also include:
– Base $10K Life/AD&D Insurance (underwritten by Lifewise Assurance)
– Health Advocate
– Willis Rewards
– COBRA Administration – provided by BSI at NO COST to COBRA eligible employers (generally companies with 20+ employees)
– Dedicated Service Center
– Online Benefit Services
– Consolidated Billing & Electronic Premium Payment
Health Advocate
An employee advocacy program which helps employees and their family members (including parents and parent‐in‐laws) navigate the healthcare system and maximize their healthcare benefits by:
• Explaining Benefits and Facilitating Access to Appropriate Care• Finding Doctors, Locating and Researching Treatments & Expediting Appointments
• Providing Comparative Health Cost Estimates• Helping Resolve Insurance Claims & Negotiating Billing and Payment Arrangements
• Assisting With Eldercare• And much more…
Willis Rewards
• An exclusive discount program available to your, your family and friends.
• Provides you with access to discounts on brand name products and services from a network of over 28,000 merchants.
www.willisrewards.com
(Instructions to register for Willis Rewards are available within your
group’s renewal packet.)
Vision Plan Line‐Up
AGC HBT offers employers two the choice of two vision plans, both underwritten by Vision Service Plan:
– $0 Exam Co‐pay / $10 Hardware Co‐pay
– $10 Exam Co‐pay / $25 Hardware Co‐pay
Additional Life/AD&D Insurance
Each employee enrolled in the medical plan receives $10K Life/AD&D coverage, however employers can elect the following:– Employers can choose to offer Life/AD&D insurance to ALL Eligible Employees – OR – Medical Enrollees Only
– Employers can elect to purchase additional Life/AD&D coverage for their employees in $10K increments:• Additional $10K ($20K total)• Additional $20K ($30K total)*• Additional $30K ($40K total)*• Additional $40K ($50K total)*
*Available to Groups of 10+ employees only.
Short Term Disability (STD)
AGC HBT also offers employers two the choice of two Short Term Disability (STD) plans, both underwritten by Lifewise Assurance:
– $300/week Benefit*
– $500/week Benefit** Subject to 70% of weekly earnings
Benefits begin on the 1st day of disability due to accident and the 8th day of disability due to sickness. Benefits continue to a maximum
of 26 weeks.
Benefit Solutions, Inc. (BSI)
Intro to SIMON
Renewal Packet Handout
Your 2012‐13 Renewal Packet Includes:
– Renewal Letter – customized for grandfathering as it pertains to your group
– Renewal Rate Comparison
– Renewal Application
– Premera Summary of Contract Changes
– 2012‐13 Renewal Booklet
A duplicate copy of all of the above items will also be given to your AGC HBT appointed broker.
Renewal Timeline
May 1st ‐ Recommended Return Date for Renewal Application– Groups that return their completed renewal applications after this
date may experience delay in receiving employee ID cards.
May 1st – 31st
– Open Enrollment for Your Employees
– Online Enrollment Available for Open Enrollment Changes
June 1 – Changes to benefit elections become effective
Questions on Your 2012‐13 Renewal?
• Do you have specific benefit questions?– Please contact your Agent.
• Do you have general renewal questions?– Please contact the health plan’s General Agent.
E‐mail: [email protected]
Phone: (866) 298‐8262
• Do you have enrollment, eligibility or billing questions?– Please contact BSI.
E‐mail: [email protected]
Phone: (877) 694‐8291
Q & A
Thank you for your time!