MONTANA UNIVERSITY SYSTEMS Flexible Benefits Program choices

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MONTANA UNIVERSITY SYSTEMSFlexible Benefits
Programchoices

• 2007 2008
• Open Enrollment Information
• For the plan year beginning 7/1/07
• Shelley Murphy 444-0330
• Paul Bogumill 444-0329
• Sue Schmitt 444-0614 (retirees)

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beneFITSHow to make your benefits program
(options) work for you

• Asset
• Protection
• Benefit

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beneFITS keep you whole after a loss

• Checking Account
• Deductibles vs. Copays
• Coinsurance Maximums
• Savings Account
• Long Term Disability
• Property
• Life Insurance/ADD and Long Term Care
• Net Pay
• Reimbursement Accounts
• 1 800 999 - 1077

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Mandated Benefits must choose an option.
PleasePleasePlease review your options and turn
in a new form dont default to prior year
elections - choices will then be made for you.
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Why all the changes..

• Lowest increase in many years.
• 10,11.2,12.2 - 6,6
• Highest trend in many years.

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OPTIONAL VISION BENEFIT

• More standardized benefit design.
• Secured these low rates for 4 years.
• Voluntary benefit.
• Annual benefit option.
• Must re-elect vision if you want to continue the
  benefit.

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Vision Plan Overview
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The EyeMed Panel Composition

• Montana Network Overview
• More than 88 providers at 60 locations across the
  state.
• Ongoing Provider Recruitment
• www.enrollwitheyemed.com/access
• (prior to enrollment)
• www.eyemedvisioncare.com
• (after enrollment)
• Access 7 Days a Week!
  Plan 9690835
• 600AM to 900PM MST Monday - Saturday
• 900AM to 600PM MST - Sunday
• 1-866-723-0513

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Additional Discounts

•  

Savings Example
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MEDICAL PLANS

• TRADITIONAL
• Facility focus
• Self managed
• Offered Everywhere
• (watch Plan A)
• Less first dollar benefit
• Less preventative services

• MANAGED CARE
• Provider Focus
• Managed with the administrator help you stay
  away from the out-of-network benefit.
• Offered in specific locations
• More first dollar benefit
• More preventative services

Compare Schedules rehab, maternity,
acupunture/naturopathic/chiro, for example.
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TRADITIONAL MEDICAL PLANS

• Plan A
• Same Benefits
• More select network
• referred to as a steerage plan.
• 2 Facility Focus.
• St. Patrick's
• St. Vincent's
• Other local facilities elective services will
  pay at 65 (not 75) and do NOT accumulate to
  your Coinsurance Max.
• THIS EFFECTS ALL OF US.

• Plan B
• Same Benefits
• Broadest network.
• Higher Premiums.
• Higher Deductible.
• Higher Coinsurance Max.
• Lower Out-of-Pocket Risk.

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Managed Care Plans

• The largest Managed Care Network in the state
  that offers premium savings, quality claims
  processing, and excellent customer service.
• Our goal at New West continues to offer Montanans
  a secure, quality, customer-driven health
  insurance alternative.

• Blue Card national/international networks. No
  claims to file and No balance billing.
• Dedicated Customer Services reps 7 sites state
  wide for personal contact.

• Any PEAK physician, including specialist, can
  refer members to either an in-network or
  out-of-network physician for in-network benefits.
• PEAK offers a comprehensive provider panel in the
  Butte and Billings area at competitive premium
  rates.

Unsurpassed attention to claims
processing accessible customer service by a
dedicated MUS team.
A customized network that includes a
hospital in every MUS community combined with
an extensive national network.
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Managed Care FAQs

• I have been on a Traditional Plan for a few years
  now, if I switch to a Managed Care Plan do I have
  to start a new pre-existing condition period?
• Do I need a referral to see a network
  specialists?
• In an emergency how am I to coordinate the use of
  network providers and facilities?
• What if the Managed Care Plan doesnt have the
  specialist I need?

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Pharmacy BenefitNo matter what Health Plan
chosen we are all on this one RX plan
administered by PharmaCare.

• NO CHANGES.
• same deductibles/coinsurances and out-of-pocket
  maximum.
• Same use of retail and mail order to purchase
  your medications.
• Ridgeway or Pharmacare for mail-order.
• Added a specialty medication (high end
  biotechs/injectibles/etc) program called
  PROTOCALL.
• These meds are not covered through mail-order,
  and do carry a higher coinsurance if purchased at
  retail.

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ProtoCall Specialty Rx Program

• Free delivery to your home or physicians office
  of up to a 30-day supply of your medication at a
  0 co-payment and no deductibles with
  participation in the ProtoCall program (for
  non-participants, your retail plan design drug
  cost and deductibles will apply)
• 24/7 access to a staff of pharmacists, nurses,
  and care coordinators who are trained specialists
  on your medications and conditions
• Educational materials, support, and home
  instruction
• Ancillary supplies such as syringes and needles
• Better coordination of care with your physician

Please contact PharmaCares ProtoCall program at
1-888-442-9780 (press option 4)
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Dental
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Dental
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Dental
www.WeKeepYouSmiling.com/MUS
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Wellness Assistance Programs

• Wellness Fairs.
• Enhanced Wellness Website.
• Lifestyle Education
• Healthwise Knowledgebase

• Financial counseling
• Legal counseling
• Personal counseling
• For any member of your family.

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Thanks For Comingand protect those assets the
assets you have now and the ones you are working
towards

• HAVE ELECTION FORMS IN BY...

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Retiree Health Plan / Pharmacy Options

• Medicare Retiree
• 400.00 deductible Plan
• 1500 deductible Plan
• Managed Care one rate
• Plan A - 400 deductible
• Plan B - 1500 deductible
• Managed Care one rate

• Non Medicare retiree
• 575.00 deductible Plan
• 1500 deductible Plan
• Managed Care one rate
• Plan A - 600 deductible
• Plan B - 1500 deductible
• Managed Care one rate

?
OLD
NEW
?
You CAN make changes to you MUS Healthplan
choice annually.
Same Pharmacy Plan
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Whats Driving These Rates

• Non Medicare Retirees
• GASB no longer reserve on a pay as you go
  basis.
• Low numbers makes for volatile experience.

• Medicare Retirees
• Medicare is primary payor for medical services.
• MUS offers a true COB type plan.
• Part D subsidy we must maintain equivalency.

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Medicare Retirees B sure

• True COB - not a supplement plan.
• Our benefits on top
• Cardiac rehab
• Skilled Nursing
• 10,000 hospital bill
• Medicare allowed 5000
• Medicare deductible of 992
• Medicare pays 4008
• Then comes to us allow the 5000, satisfies our
  deductible we pay 992.

• Get A
• Buy B
• Dont Buy D

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Retirees Dental Delta Dental
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Retiree Options

• Vision
• Must reenroll/enroll if you want this option.
• Dental Premium Plan
• One time open enrollment.
• Premium plan only.

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Please Please Please

• Turn in a new form
• Dont default to last years options.
• EXPERT MUS HELP FOR RETIREES - Sue
  Schmitt
• 444-0614