Your 2018 Benefits Understanding Annual Enrollment

Transcription

1 Your 2018 Benefits Understanding Annual Enrollment

2 Eligibility At least 30 hours per week Eligible dependents include: Your legal spouse/domestic Partner Dependents up to age 26

3 Your Medica Medical Benefits HSA Plan Plan Provisions Annual Deductible (Single/Family) Out-of-Pocket Maximum (Includes Deductible) Lifetime Maximum Preventive Care Primary Physician Office Visit Hospital Services In- Network Single: $6,350 Family: $12,700 Out-of- Network Single: $10,500 Family: $21,000 $6,350/ $12,700 $30,500/ $61, % 0% after deductible 0% after deductible Unlimited 50% after deductible 50% after deductible 50% after deductible

4 Virtual Care Overview Access Services Process Computer Smartphone Tablet Diagnosis Treatment plan Prescriptions or phone consultation Symptoms are discussed and diagnosed Course of treatment is put into place Note: Virtual care providers must be in plan s network.

5 Virtual Care Treatment of Common Medical Conditions Allergies Bladder infections Cold & flu Ear infections Fevers Migraines Pinkeye Stomach pain Other, non-urgent common health conditions

6 Convenient and Cost Effective Online Treatment Virtual Care Options CLINIC-BASED AMWELL VIRTUWELL Many clinics offer virtual care, online care or e-visits 24/7 online clinic available in every state (except Arkansas) Includes coverage for behavioral health care services 24/7 online clinic available in select states Each visit is $39 or less Each visit is $45 or less Mobile, web and phone visits with a board-certified doctor Online visits with a certified nurse practitioner Amwell.com Virtuwell.com

7 Know Your Care Options Cost Differences FREE CallLInk nurse line $ Virtual Care e-visits Convenience Care Retail Clinics $$ Office Visit $$$ Urgent Care $$$$ Emergency Room Low Cost High Cost

8 Your Prescription Drug Many preventive medications are covered at no charge to you see drug list HSA Plan Plan Provisions Retail (30-day supply) Generic Preventative Brand Preventative All Other Drugs Specialty Drugs In- Network 100% coverage 100% coverage 100% after deductible Limited to drug list* Out-of- Network 50% of charges incurred

9 Pharmacy Benefits Filling Prescriptions 90-day refill option Up to 3-month supply per refill 0nline ordering is available fm many pharmacies Mail order Medications delivered to your home (Fairview Mail Pharmacy) Up to three-month supply Copays and coinsurance apply *Ask your doctor if a 60- or 90-day Rx is appropriate

10 What are the HSA contributions limits? IRS bases contribution limits on calendar year 2018 Single Contract $3,450 Family Contract $6,900 Over 55 Catch-up $1,000

11 Medica Medical Plan Contributions Tiers 2018 Employee Premium 2018 Employer Premium Employee Only $ $ Employee + Spouse $1, $ Employee + Child(ren) $1, $ Employee + Family $2, $815.50

12 Learn About Your Medical Network Medica Choice Passport National open access network Co-branded ID cards Overview See any network provider without a referral 100% Pass-through of negotiated provider discounts Strength 27K Primary care physicians* >4K Clinics, offices and hospitals* >680K National providers >5,300K National hospitals >60K National pharmacies Medica Contracted Service Area Seamless benefit administration 12,000+ employer groups and over 2 million members nationwide via Medica and UnitedHealthcare Fully integrated Rx through CVS 60,000+ pharmacies including 24-hour pharmacies Convenience and urgent care Virtual Care UnitedHealthcare Contracted Service Area

13 Member Resources Available mymedica.com Find out what s covered in your plan Track your claims Check to see if your doctor is in your network See which drugs are covered Order ID cards

14 HEALTH AND WELLNESS

15 Health Club Reimbursement Fit Choices SM by Medica Health & Wellness 240 Reasons to get fit with Fit Choices SM by Medica 12 Visits per month $20 Credit toward monthly dues 8K Health clubs to choose from (national and regional)

16 My Health Rewards by Medica Introduction Our exclusive online health and wellness program focuses on engagement and personalization Help members understand and improve their health Engage members in their health Motivate members through incentives and rewards

17 My Health Rewards by Medica Personalized Homepage

18 My Health Rewards by Medica Completed your on line health risk assessment - Compass

19 My Health Rewards by Medica Compass Examples

20 My Health Rewards by Medica Health Assessment Results

21 My Health Rewards by Medica HealthMap

22 My Health Rewards by Medica HealthMap Directions and Activities

23 My Health Rewards by Medica Journey Example Good Fat, Bad Fat SAM SAM

24 My Health Rewards by Medica Track

25 My Health Rewards by Medica Sync Directions Click on the tile related to your wearable device or app to sync.

26 My Health Rewards 2017 Rewards Points Available by Completing Health Actions My Health Rewards (Standard) Action Compass TM Next Steps Consult TM Journeys TM Track TM Care Support Points per action each 1 per day Health action Once per year Once per year Up to 300 per year Up to 200 per year 200 once per year (if identified) Points earned Reward First $20 giftcard Second $20 gift-card Third $20 gift-card Fourth $20 gift-card Fifth $20 gift-card Members 18 years old + can earn up to $100 in gift cards funded by Medica

27 My Health Rewards by Medica Next-Steps Consult Health Guides provide education on Compass health assessment and biometric screening results: Personalized phone consultation Raise health awareness and reinforce positive results Identify small steps toward healthier changes Recommend programs

28 My Health Rewards by Medica Rewards We ve added the ability to allow members to toggle between Available Activities and Completed Activities. *Please note some activities will show in both categories.