HomeMy WebLinkAbout04-18-07 WS Minutes-Health Plan
MINUTES
CITY OF OCOEE
WORKSHOP ON HEALTH INSURANCE PLAN
April 18, 2007, at 6:00 P.M.
I A. CALL TO ORDER
Mayor Vandergrift called the workshop session to order at 6:00 p.m. in the Commission
Chambers of City Hall. City Clerk Eikenberry called roll and declared a quorum present.
Roll Call: Commissioner Hood, Commissioner Anderson, Mayor Vandergrift,
Commissioner Keller, and Commissioner Johnson.
Also Present: City Attorney Rosenthal, City Manager Frank, City Clerk Eikenberry,
Human Resources Director Camicella; Mackie Branham, Ray Tomlinson, and Tina
Wittman from Crown Consulting; and several interested employees.
B. DISCUSSION REGARDING OPTIONS FOR RESOLVING THE
CURRENT HEALTH INSURANCE PRICE INCREASE.
Human Resources Director Carnicella said that our current health care plan is
following the trend in health care and anticipated to increase by 18%. It is currently a
$2,523,540 million dollar plan that would increase to $2,977,777.
He stated the options were; 1) for the City to come up with the additional money, 2) for
the employees to absorb the cost 2 approximately $125/month increase, or 3) to change
the plan and/or funding arrangement.
Human Resources Director Carnicella reviewed the current plan stating that 87% of
employees are on the HMO "free" plan, and 13% have opted for the PPO plan. He stated
that there are 119 employees on the "employee only" plan and 155 employees that have
the "family" plan. He said the last time we kept the plan the same the 155 employees
with dependant coverage had an increase from $187/month to $210/month. He said he is
proposing the HRA plan, which was introduced during the budget cycle, because if an
employee ended up with a catastrophic illness they would have to pay a maximum out-of-
pocket of $3500. He said if we would have changed to this plan last year, 27 people
would have reached the $3500 maximum, and the City would have saved $458,157.
Human Resources Director Carnicella said the HRA plan actually shifts the cost to
those employees who have to use it the most. He added that most jurisdictions are
shifting the cost of the plan to all of the employees, and some are shifting it to those who
use it the most. He made comparisons between current plans, the HRA Plan, and an "in
between plan. He said the in between plan would have saved the City $85,176 if it had
been proposed at budget time.
Ray Tomlinson of Crown Consulting introduced other members of his company; Tina
Wittman, the Account Executive assigned to Ocoee, and Mackie Branham, his business
partner.
Varian Brandon-Boles, Strategic Accountant Executive from United Health Care, was
also present to answer questions.
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Mr. Branham said he would like to assist the City in long term planning for health
insurance. He gave a PowerPoint presentation and reviewed cost projections for
increases of 7%, 11 % and 15% over the next five years. He stated the City is currently
under a fully insured contract and the following two components are controlled by the
carrier:
Pooling Levels - amount of exposure per member inside of a group health plan. The city
currently we has $125,000 risk exposure per member inside of the group plan. By having
a high pooling level, the carriers control what your loss ratio is going to be. The
catastrophic exposures in the Exposure's Claims Experience determine that loss ratio.
Blended Rate Factors- combination of your group plan claims experience in combination
with their manual rates to project a blended rate and determine your costs in that given
year.
Mayor Vandergrift asked if not paying the higher premium wouldn't raise the pooling
level. Mr. Branham said they are designing a little self insured plan inside of the fully
insured product, called a Health Reimbursement Account (HRA) which takes on more
exposures as a City, in form of the deductible, and we will be rewarded in a lesser
premium paid out to United. An HRA is part of a fully insured contract, it just takes on
more risk exposure under the deductible, and the City would have to choose how that
deductible will be paid out by City and the employees.
Human Resources Director Carnicella said the savings in premium cost is over
700,000, but the City has to fund the pool of $1000 exposure for each employee, leaving
a difference of $458,000 in savings to the City. That figure is based on having a $1500
deductible with City funding the first $1000 and the employee funding the next $500 of
the deductible. Mr. Branham said you are creating a little self insured bucket inside of
your fully insured plan, thus lowering your premium. He then reviewed a chart showing
estimated HRA Utilization for the plan year using a model of a plan that is similar to the
plan the City would have. Out-of-pocket expenditures ranged from 375 of 681 members
paying from $1 - $99 on the low end, up to 120 of 681 members paying $1000 - $3500 on
the high end, with the remaining members falling in the middle of the ranges between
$100 - $1,000.
Human Resources Director Carnicella said that it is possible to structure the plan so
the employee's unused money in the bucket could roll over to their plan for the next year,
increasing the City contribution from $1000 to $2000. The plan proposed $2000 credit in
the bucket for family plans.
Commissioner Keller said he is on an HRA plan and was part of the committed who
designed it. He said most people who don't suffer serious illness in the first year have a
chance to build up that bucket, and it is the build up that makes that plan work.
Human Resources Director Carnicella said if the City decides to open a clinic for one
or two days, those services would be free to the City. The services and some
prescriptions would be free to the employee and would not cut into their out-of-pocket
expenses. There still could be an opportunity to work closely with United (or their
competitors) to come up with a way to meld various plans that we spoke of and come
back with a plan that will be good for everyone. We need to find a way to reduce the cost
of the plan and reduce the amount of burden that we shift to the employees. Hopefully, if
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most employees stay healthy long enough to build a large bank to take care of you,
should there be some catastrophic event. The only problem is the employee who has that
catastrophic event right after the plan starts. He stated he and the City Manager have
discussed the option of using saved money in the bucket, if we had a good plan year, to
reduce the burden to those employees who had a serious illness. The problem with this
type of plan is that there is no way to guarantee that, because you cannot predict what
will happen.
Human Resources Director Carnicella said if we have a good year, and United Health
Care is drawing down on an account that we set up with our money, there is an
opportunity to get a substantial premium break. He discussed other ways to the plan to
get premium breaks by passing minor costs off to employees such as raising the co-pays,
the hospital visit, the urgent care visit, or using a clinic.
Ray Tomlinson described the Administrative Services Only (ASO) model. The only
thing that changes with this model is the why we fund the program. They first need to
look at size and claims history of an organization. Under these self funded arrangements
the City would set the Pooling Level (for example $50,000) where the City would pay
any claims that fall under $50,000 plus the administrative costs to United Way or other
carrier. The funding would be transparent to employees. The city would pay the first
dollars up to an aggregate so that the City would be protected by capping your exposure;
you would know what the worst case scenario would be on individual claims and
aggregate claims. The maximum claims exposure that you would have in a horrible
claims year generally runs about 10% over a fully funded plan. Under an ASO the
maximum claims exposure would be capped at that level, which would be less then the
trend for increases in other types of insurance. On a good claims year, you would not
have to payout claims and on a bad claims year you would know what the cap is.
Commissioner Anderson asked where the numbers in the estimated HRA Utilization
came from. Mr. Tomlinson said it is a model based on an account very similar to the
City of Ocoee's. Commissioner Anderson said that he wants to make sure employees
are paying a negotiated rate for health care and not the published inflated rate. Mr.
Tomlinson said they are still obligated to honor the contracted rates from United Health
Care. Commissioner Anderson said if we did well and beat the model; can we come
back and reimburse employees some of the deductible? Commissioner Keller said that
would not build a larger bank which would roll over into next year and that is how the
plan works. Human Resources Director Carnicella said it is possible to reimburse the
employees some portion of their out-of-pocket expenses, but the plan would have to be
designed that way. Mayor Vandergrift asked if we could pool the money long enough
to use it to self insure? Mr. Tomlinson said if the City wants to self insure, the model
that works best is to use an ASO carrier like United because the have done the
contracting and discounting, and do it better than TP As who negotiate rental networks,
and they could get better discounts. Mayor Vandergrift said he believed it would be a
good idea to move toward being self insured.
Human Resources Director Carnicella said we are not done looking at ways to tweak
the plan and put together several different options. He also said Mr. Tomlinson is also
looking at the possibility of sharing the clinic with surrounding cities and have it remain
open for five days. Mayor Vandergrift asked where the clinic would be, who would run
it, choose the staff, etc. Mr. Tomlinson said the City would have an agreement with a
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third party provider with experience in clinic operations that would handle administrative
duties and hire doctors, etc., but the City would set the hours of operation. The City
would have to provide the facility for the clinic. The City of Port St. Lucie is using a
house they obtained through eminent domain. The clinic would benefit the City because
more than half of your claims dollars are being spent on office visits and prescriptions. It
would have a long term impact through wellness programs and good disease management
programs. He said medical services provided in a clinic area better and less costly than in
the open marketplace.
Commissioner Anderson asked about evening hours of operation for the clinic. Mr.
Tomlinson said some cities do that, but most want their clinic open during the day and
encourage employees to go to the clinic by not docking them for time off.
Commissioner Anderson asked if the funding mechanism for the clinic would come
from reduced premiums. Mr. Tomlinson said that is how most organizations do it, but
they would like to look into other creative ways to find savings not add an additional
budgetary item. One form of savings from the clinic would come from Worker's Comp
injuries. If other communities would like to use the clinic, it may be able to be opened
for five days.
Commissioner Johnson asked if there are a set number of visits they will pay for before
we have to pay? Mr. Tomlinson said it is priced out on a per-employee/per-month basis,
so an increase in employees would increase the cost, or conversely decrease the cost if
there were fewer employees. Commissioner Johnson asked about prescriptions. Mr.
Tomlinson said they look at historic usage of pharmaceuticals and decide what to stock,
but it is the City's call on what will be stocked in the clinic. He said he thinks it is a good
idea to go with generic pharmaceuticals, but that would be decided by the City.
Human Resources Director Carnicella said as part of the proposal for the budget we
would like to include more self funding in other areas such as general liability and
worker's compo He said he hopes to bring back a comprehensive package that will allow
substantial savings. We would have to put money in reserves in case of catastrophic
events, but if we have a good statistical year similar to the last 8 to 10 years, the savings
would more than pay for the clinic. He said we have to use a long term strategy and
move toward a more self funded program without shifting the burden to the employees.
If we create steerage by building up the "bucket," we may decide how to play with the
co-pays, or give more options to employees, etc.
Commissioner Keller asked if we are only look at one HRA plan, or can we give options
to employees to stay in a similar plan to what they have. What happens if there is a clinic
and employees do not want to use it? Mr. Branham said to get the maximum premium
break from this it is much better to have a one plan model. Human Resources Director
Carnicella said employees have demonstrated what they would want to do because 87%
are in the HMO plan that has the low deductibles, so we would not get much of a
premium break because no one would move to the HRA. He added that we have to come
back with the very best model, probably a one-plan HRA model with a clinic. The
employees still have choices, they can go to their specialist or primary care provider, but
it would cost a little more.
Commissioner Keller said the clinic then becomes the "in network" and going outside of
that would raise their deductible to the maximum out-of-pocket of $3500. Are we taking
away their share of the "bucket" if they do not use the clinic?
Human Resources Director Carnicella said don't assume it is gong to be the HRA
model, it may be a melding between the current HMO and the HRA model merged into
one plan that may have an out-of-pocket of$1500 or $2000.
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Commissioner Anderson confirmed that if you go to your own doctors you would still
get the first $1000 money from the "bucket" as part of your $1500 deductible.
Human Resources Director Carnicella said the incentive to use the clinic is that the
City would save more money and may be able to pay co-pays if a specialist is necessary.
Mayor Vandergrift said he would like to see a hotline set up for employees so all of
their questions would be answered.
Commissioner Anderson asked the monthly cost to insure a family. HR Analyst
Bertling advised it was $1072.72 per month.
Commissioner Anderson said he has a concept that he would like the Commission to
consider that is being done right now outside the United States. He asked if we could
negotiate a family group health insurance price that we could also offer to residents of the
City of Ocoee. Could we firewall it to where a high risk scenario would not affect the
City employee's premium? Human Resources Director Carnicella said the only
people who can be covered by the current plan are employees, or independent contractors
who work for us.
Mr. Tomlinson said that Congress has been trying to pass a plan of that concept called
an Association Plan, where there is a commonality of people. That has not been
approved yet, and at this time there has to be an employment relationship. The group
products out there are not able to do that yet. You could allow citizens to use the medical
clinic since it is not insurance and does not fall under the regulatory agencies that prohibit
it. The City would have to determine cost for citizens as opposed to free clinic for
employees. You would have to determine an eligibility list of those who could use the
clinic. Commissioner Johnson said employees would have to wait too long to use the
clinic if it were also opened to the residents. Mr. Tomlinson said there would be a lot of
details that would have to be worked out.
Commissioner Anderson asked how the state offers insurance to people. Mr.
Tomlinson said that is a MEW A - Multiple Employer Welfare Association, which is
more of an association plan that the City cannot do.
Commissioner Anderson said he would like us to consider the idea of the clinic being
available idea to residents on a non-priority basis.
QUESTIONS FROM EMPLOYEES:
Nancy Cox asked if the deductibles cover the amount the doctor charges or just the co-
pay. Mr. Branham said under the co-pay arrangement, the $15 would be your out-of-
pocket exposure for that event. Other exposure such as in patient stay, surgical events,
and diagnostic events such as MRIs are covered by your deductible; anything else done in
the office is covered under the co-pay and the deductible exposure does not apply.
Mr. Lipton - did the City check to see if the state or county had a health insurance
program that we could join with them to save money? Mr. Tomlinson said there are
Interlocal or Consortium Plans such as the one with Marion County, Ocala, Dunedin, and
two other small cities. They came together to get a better leveraging power through a
purchasing alliance. They are self insured. Human Resources Director Carnicella said
they have not looked into that option. Mayor Vandergrift said it would be a good idea
to research that or contact Florida League of Cities to see if they have information.
Ricky Waldrop said he understands the City is trying to save money, but there are not
many employees that could handle $3500 out-of-pocket if they had a serious illness.
Mayor Vandergrift said he does have a problem with putting the burden on the one who
needs the insurance most due to a serious illness. He would also like the City to look into
pooling money to give to others who become seriously ill. Commissioner Johnson said
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we have to find a way to give the employees good insurance, but cut the costs to the City
to cover the plan so that we can keep other benefits where they need to be such as raises
and pensions.
Commissioner Anderson - said we changed to United Last year. Where would Blue
Cross be this year, now that United is so high? Have we looked into that to see if they
offer us last year's rate? Mr. Tomlinson said they looked at Blue Cross at last renewal
and they were a little higher, but we can look at it again.
Mayor Vandergrift said he wants a newsletter and hotline set up to discuss this issue.
Commissioner Johnson said we also have to keep in mind what is going to happen with
the state legislature and what impact it will have on the City. City Manager Frank said
the House proposal, as it stands right now, would have between a three and five million
dollar impact on the city's revenue.
Commissioner Anderson asked what the out-of-pocket expense would be on the current
HMO plan, as opposed to the HRA plan. Human Resources Director Carnicella said
less that $1000 maximum.
Mayor Vandergrift said we need to keep the employees involved in the process. He
asked City Clerk Eikenberry to put together a newsletter to inform the employees what
was discussed with a telephone hotline and an FAQ section.
Kathy Lipton asked if they have surveyed the employees to see if they would even use a
clinic before they spend money to open one, and what about liability of a clinic and the
fact that they have no history on you. Mayor Vandergrift said the liability will be taken
on by the clinic provider. The usage of the clinic should fall under the FAQs that will be
answered.
Human Resources Director Carnicella said you may still go to your regular doctor, but
the clinic has the capability of getting your records from other doctors should you decide
to go there.
Jean Grafton, retiree, said asked if the future plan will include retirees. Human
Resources Director Carnicella said the retirees will remain on our insurance as they
always have. There is no recommendation to remove coverage for retirees. There is an
unfunded liability issue that will have to be answered through the Finance Department in
the next year. Ms. Grafton asked if the cost of the plan will go down. Human
Resources Director Carnicella said if we do nothing to change the existing plan, those
that have to pay for the plan such as retirees and dependent coverage, will suffer the
increased every year. Ms. Grafton said, retirees who are on a fixed income, must absorb
all of the insurance increase, while employees with dependant coverage only absorb a
small portion of the increase; will that change? Human Resources Director Carnicella
said the Pension Board needs to look at those issues and if the fund is doing better they
can build in that type of protection for retirees. Mayor Vandergrift said he would like
to see the retirees included in the insurance newsletter that is going out. How will this
affect retirees not living in this area that cannot use the clinic? Commissioners consented
they would lose that privilege and have to go their regular physicians. Ms. Grafton
asked if the fund for the catastrophic medical loss has started already, is the City prepared
to absorb the costs in the worst case scenario. Human Resources Director Carnicella
said we are currently still under the old plan and in the planning stages for the new plan.
Ms. Grafton asked how this will affect the present and future retirees once they are
eligible for Medicare. Human Resources Director Carnicella we have not given that
too much consideration yet, but that is an issue that will be coming up. We have to figure
out how to handle retirees after they are on Medicare, it may be possible to do a
supplemental plan. Mayor Vandergrift said he thinks there is a standardization of how
to handle Medicare. Ms. Grafton said if they will pay for Medicare Supplement instead
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of the full policy, will the cost be reduced. Human Resources Director Carnicella said
that it should, but it still needs to be researched. Ms. Grafton said there are 37 retirees at
this time who are waiting to hear the answers.
The consensus of the commission was to hold another workshop at the
end of Mav so that we can get numbers together for the budaet.
Mayor Vandergrift said before the next workshop he would like a newsletter to go out
with minutes of this meeting and a hotline for information. An email hotline would be
even better for FAQ's. He thanked the employees for coming here tonight to be involved
in the process.
The meeting adjourned at 8: 11 p.m.
Attest:
APPROVED:
City of Ocoee
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YOUR BENEFITS
UnitedHealthcare
Choice Plus Plan 101
Choice Plus plan gives you the freedom to see any Physician or other
health care professional from our Network, including specialists,
without a referral. With this Qlan, you will receive tlie lii~est level of
benefits when you seek care Tram a network physician, facility or other
health care professional. In addition, you do not have to worry about
any claim forms or bills.
You also may choose to seek care outside the Network, without a
referral. However, you should know that care received from a non-
network physician, facility or other health care p,rofessional means a
higher deductible and Cop!tyment. In addition, If you choose to seek
care outside the Network, UnitedHealthcare only pays a portion of
those charges and it is your responsibility to nay the remainder. This
amount you are required to pay, which coula be significant, does not
apply to the Out-o[..Pocket Maximum. We recommend that you ask the
non-network physician or health care professional about their billed
charges before you receive care.
Some of the Important Benefits of Your Plan:
You have access to a Network of
physicians, facilities and other health care
professionals, including specialists, without
designating a Primary Physician or
obtaining a referral.
Benefits are available for office visits and
hospital care, as well as inpatient and
outpatient surgery.
Care CoordinationSM services are available
to help identify and prevent delays in care
for those who might need specialized help.
FLNOMI0104
Emergencies are covered anywhere in the
world.
Pap smears are covered.
Prenatal care is covered.
Routine check-ups are covered.
Childhood immunizations are covered.
Mammograms are covered.
Vision 'and hearing screenings are covered.
Choice Plus Benefits Sumn'lary
Types ofCovelllge
This Benefit SullU1lJ1l'Y is intended only to highlight your
Benefits nnd should not be relied upon 10 fully
detennine cavcllIge. This benefit plan may not cover 011
of your hcohh core eKpense5. More complete
descriptions of Benefils IInd tbe terms under which
they lire provided lire contained in the Certificate of
Coverage tbat you will receive upon enrolling in the
Pion.
[fthis Benefit Summary conflicts in any way with the
Policy issued to your employer, the Policy sholl prevail.
Tel1Tls thnt ore capitalized in !he Benefit Summwy ore
defined in the Cenificate ofCovernge.
Wherc Benefits ore subject to day. visit and/or dollor
limits, such limits opply 10 the combined use ofBenelits
whether in-Network or oUI-of-Network, except where
mnndated by slllte law.
NetwOlk Benefits are payoble for Covered Helllth
Services provided by or under the direction of your
Network physician.
.Prior Notificntion is ~ired for certain services.
t. Ambulonce Services - Emergency Dilly
2. Dental Services - Accident only
3. Duroble Medienl Equipment
Network and Non-Network Benefits for Durnble
MediClll Equipment are limited to 52,500 per
cnlendar Yllllr. Limits do nOlapply to Dumble
Medicol Equipment classified as dillbetic equipment
or supplies.
4. Emergency Healtb Services
So Eye Examinlltions
RefTllCtive eye examinations are limited to one
evei}' other CllIendar year from a Network Provider.
6. Home Heulth Cllre
Network and Non.Network Benefits ore limited to
60 visits for skilled ente services per clllendoryeor.
7. Hnspice Care
Network and Non-Network Benefits ore limited 10
360 daY5 durinll the entire period of time 1I Covered
Person is covered under the Policy.
8. Hospitnl-Inpntient Stny
9. Injedinns Received in a Pllysiclan's Office
to. Maternity Services
Network Benefits I Copaymem Amounts
a..
Annual Deductible: ~ per Covered Persnn per
calendnr yeor, not to exceed ~ for 011 Covered
Persons in a family. '5CO
Out-of-Pocket Maximum: 52,000 per Covered Person,
per calendaryClU', not to ClCceed 54.000 for nil Covered
Persnns in a fomily. The Out-of-Pockel Ml1Kimum does
not include the Annunl DedUctible. COJlllYments for
some Covered Henhh Services will oever apply to the
Out-of-Pocket Maximum as specified in Seclion I oflhe
COCo
Mnximum Pnlicy Benefit: No Ma...imum Policy
Benefit
Ground Transponation: 10% of Eligible Expenses
Air Transpnnation: 10% ofElillible Expenses
.10% of Eligible Expenses
.Prinr notification is required before follow-up
treatment begins.
10% of Eligible Expenses
Sloo pervisil
SIO per visit
10% of Eligible Expcnses
10% of Eligible E.xpenses
10% of Eligible Expenses
S\O per visit
SlUlIe as 8.11, l:!ond 13
No Copayment npplies to Physician office visits for
prenatal core lifter the first visit
Non-Network Benefits I Copayment Amounts
AnnulII Deduetlble: S\,OOO per Covered Person per
calendar year, nol to exceed S2,OOO fnr all Covered
Persons in a family.
Out-of-Pncket Maximum: S4,000 per Covered Person,
per calendar year, not io exceed 58,000 for 11I1 Covered
Persons in n family. The Out-or-Pocket Maximum does
not include the Annual Deductible. Copayments for
some Covered Health Services will never apply to the
Out-of-Pocket Ma."imum as specified in Section \ of the
COCo
Maximum Policy Benefit: 5\,000.000 per Covered
Person.
Same as Network Benefit
.Same lIS Network Benefit
.Priornotifielllion is required before follow-up
IrClltment begins.
.30% ofElillible E.xpenses
.Prior notilicnlion is required when the cost is more
than 5 \.000.
Same lIS Network Benefit
.Nolificotion is required if results in an Inplltiem Stay.
30% ofElillible Expenses
Eye E.xaminPlions for refmctive errors are not covered.
.30% of Eligible E.xpenses
.30% of Eligible Expenses
030% of Eligible Expenses
30% per injectinn
Sameas8,ll,l:!nnd 13
.Notiliclltion is required ifInpatient Stay ellCeeds 48
hours following n nonna! wginal delivety or 96 hours
following n cl:Sllrcon section delivety.
11. Outpntient Surgery, Dinllnnstic nnd Tberopcutic
Services
Outpatient Surgery
Outpatient Diagnostic Services
Outpatient DingnosticlThempeutic Services - CT
Seons, Pet Scuns, MRI nnd Nuclear Medicine
Outpatient Therapeutic Treaunents
n. Physician's Office Services
Covered Health Services for preventive medical
ClIre.
Cnvered Health Services for ihe dillgnosis and
!reotment nf II Sickness or Injuty received in n
Physician's office.
10% of Eligible E.xpenses
For lob ond llIdiologylXmy:
No Copaymenl
10% of Eligible Expenses
10% of Eligible Expenses
Preventive Mediml Cue - per visit, CKCL'jlt that the
Copayment for II Specialist Physician Office visit is ~
per visil No Copoyment applies when n Physician .5>
charile is not assessed. ';
Sickness or Injury - ~per visit, except that the
Copllyment for II Specialist Physician Office visit is s$
per visil No Copaymenlllpplies when a Physician
clulrlle is not nssessed.
30% of Eligible Expenses
30% of Eligible Expenses
30% ofElil!ible Expenses
30% of Eligible Expenses
No Benefits for preventive Cllre, c.~cept for Child Heolth
Supervision Services.
30% of Eligible Expenses
YOUR BENEFITS
Non-Network Benefits / Copaymcnt Amounts
Types of Covernge Network Benefits / Copayment Amounts
30% of Eligible Expenses
13. Profcssional Fees for Surgical nnd Medical 10% of Eligible Expenses
Services
14. Prosthetic Devices 10"10 of Eligible E~llenses
Network nnd Non-Network Benefits for prosthetic
devices an: limited to S2,5oo per calendnr year.
15. ReCllnstructlve Procedures Some as 8. II, 12, 13 nnd 14
16. Rehabllitntion Services. Outpntlent Thel'llpy S 10 per visit
Nctwork and Non-Network Benefits nn; limited as
follows: 20 visits of physical therapy; 20 visits of
occupational therapy; 20 visits of speech therapy;:m
visits ofpulmoOluy relwbililntion; and 36 visits of
cnrdinc rehnbililntion per calendar year.
17. Skilled Nuning Fncilitynnpotlent Rehnbllltlltion 10% ofElillible Expenses
Fnclllty Scrvlces
Nenvork nod Non-Nenvork Benefits arc limited to
60 dnys per calcndnr year.
18. TronspJnntDtlon Scrvll:es
19. Urgent Cnre Center Scrvlces
30% of Eligible Expenses
.Some as 8, 11,12, 13 nnd 14
30% of Eligible Expenses
.30% of Eligible Expenses
,
"
.10% of Eligible El.-penses
.30% of Eligible Expenses
30% of Eligible Expenses
SSO per visit
Additional Benefits
Bones or Joints of the Jnw ond Fnclul Region
Child Health Supervision Services
Coverage from binh to nge 16.
ClcCt Lip/Cleft Polnte Trcntment
Dcntlll Procedures - Ancsthesioond Hospitnlimtion
Dlohetes Trcntment
Mnmmogruphy
MlI5tcctomy
lUentlll Hcnlth ond Substllnce Abuse Servlces-
Outpotlent
Must receivc prior nuthorization through the Mcnlnl
HClIithlSubSUlnce Abuse Designee. Network nod Non-
Network Bencfits ore limited to 30 visits per cnlendor
yenr.
Mental Rcnlth ond Substnncc Abuse Servlces-
Inpatient ond Intermediate
Must receive prior nuthorization through the Menwl
HC3lthlSubstnnce Abuse Designee. Ncnvork nnd Non-
Nenvork Benefits are limited to 30 days per culendar
year.
Osteoporosis Treatment
Prescription and Non-Prescription Enteral Formulas
Bencfits for low protein food products for Covered
Persons through age 24 nre limited to S2,500 per cnlcndor
year.
Spinal Treatment
Benefits include dingnosis nnd reloted services and nn;
limited to one visit nod trentment per day. Network and
Non-Network Benefits ore limited to 24 visits per
cnlendor year.
Some as 8, II, 12 and 13
Some as II, 12. 13 nod 16
No Anouul Deductible npplies.
Some as B. II, 12, 13,nnd 16
Some as 8, 11, nod 13
Some as 3, II, 12 nnd 13
No Copayment
Snmens 8, II, 12 nod 13
S30 per individunJ visit; S:!S per group visit
.30% of Eligible E.~penses
Some as 11,12,13 nnd 16
No Annunl Deductible npplies.
.Some as 8, II, 12,13, nod 16
.Some as 8, 11 and ]3
Some as 3. 11. 12 and 13
Some as Network Benefit
.Some as B, 11, 12 nod 13
30% of Eligible Expenses
.,
10% of Eligible Expenses
30% of Eligible Expenses
SnmcllS II, 12 nod 13
10% of Eligible Expenses
Some as II, 12 nod 13
30% of Eligible Expenses
530 per visit
30% of Eligible Expenses
,
"
Exclusions
UnitedHealthcare Insurance Company
Excepl nsrrl4Y be'Jl""ilieally provided in Sedian I aftheCcnific:lle afCoV<rillle (COC) arthrnush n
Rider 10 lbe Policy. tl.. fallowinsor. nol covered:
A. Alfcrnntivc Trentments
Acuprelllure; hypnoti.m; rolling; =lle thaupy; lIromJllhornpy; l!l:Upuncture; IlOd aliter fonns of
a1lemnlive treatmenL
B. Comfort Dr Convenience
Personnl comfort or canvmicnce items Dr sen.;ces such ns television; teltphone; bnrbcr Dr beauty
service; ll"est service; .uppli... equipmentllOd similar incidental ..mces DI1d supplies for persannl
comfort including air conditioner>. oir purilicn and filler.. "'ncries and bll11el)' chlllJlen,
dehumidifiers and humidificn; devices or compulersta llSSin in communicalian llOd .peoch.
C. Dentnl
Excepl ns spccifiCll!ly described as covered in Section I ofthc cae under Ihe hcadinl\5 Dental
S"",iccs - Accidenl only. Dental Servic... Ancslhesinlllld Haspilo1i;!ll\ion and Clefl Lip/Clefl Pnlllle
TrcalJl1enl. dentalservic.. are excluded. There is no coverage for services provided for the prevention.
wlIjlI1osis. MIl t"",lment aflheleclh ar 1lUm5 (including exlradian. reslaratian, llOd replncement of
teeth and oeMces 10 improl.e dental clinical outcomes). Dcruo1 implllllIJ and dental bmces DlC
"""Iuded. Dental x....y.. .uppli... MIl opplinnces and a1ll1SsociOled expcn>cs orUiog out ofsuch denUll
services (iocluding ho'pitaliZlllioOlond anesthesin) ore excluded, excepl as miglu otherwise be
required for UlIlIsplonl prcp;ulllian, inidalian ofimmunasupprcssiv... the direct ,"",tm.nt ofllC\ll.
ItlUm\lltic Injul)'. cancer, or cloti p4\nle. or.. described in Section I aflhe COC under tbe heading of
DenIal Procedures - Anesthesin and Haspitalizntian. Trulment for con!lCllitnl1y missins.
mnIpositioned, or .uper numCl1ll)' tcc1h is exclwled. cven ifportofa Congenital Anamnly CX<<pl in
connection with cleft lip orcle/\ paloI. except os dcsoribed in Section 1 of the COC und...1ha heading
Cloti Lip/Cleft PlIlotc TrentmenL
D. Drugs
Prescriptian drug products for olltpnlient use lhnt ore filled by a pre.ocriptian ani... or refill. Self.
injer:lAblc medi""l;aDS extcpt os described in Sectioa I aftll. COC tmdcr tho hending of Diab",es
Tn:l1bl\enL Non-injcctllble mediealions giveo in a Pbysicilln'. office except os required in on
Emersency. O,er-th.-counler drul\5 ond Ireatmen15.
E. Exp.rimentlll, Investigntionnl Dr Unproven Services
Expcrimenlal.lnvestigntiOl1n1 or Unproven Services ore excluded, ex.c:pt (0) bar.., mlllTClwlrnn,plonts
and (b) mediCll!ly approprint. medioalions pre.ocribed fartho IrclIllJl.nt of cnncer. for a particulAr
indicalion. iflhnt druS i. r=gnind for Ihe Ireotment oftllot indication in a .1nndwd reference
compcodiUPl or recommended in medicallilenllUrc. The fua lbalan Experimental, lnveslismionnl or
Unproven S"",i"", 1rcDlmt:ll~ d....;ce or phllflllllCOloSiCll! resimen islbe only avoilnble t=enl for a
porticular ""odilion will DOl result in Benefits iflhe procedure is conlid"",d 10 bo Expcrimental,
10Vcsligntianal nr Unprov.n in th.lreatmonl oftltot particulor condition.
F. Foot Cnre
ROulioo faDl core (indudi"lllbe cuuins or Tm1a,.o1 of corns und Cll!lu,es); noillTimmins. CUlling, or
debriding; bygienic ond pn:vcruive maintCJUll1ce fOOl cure; IfWmem afllm feet or subluxation of the
fool; shoe orthalics.
G. Medlenl Supplies aDd Appliances
Devie.. used specifiCll!ly lIS s:Uety items or 10 nfl'ect perf""""",,. primarily in sports-relared nelivilies.
Presc:ribed or nan-prescribed medi.o1liUJ'Pliosand dispoo.:lbl.lUpplies ineluding but not Iimiled 10
e1"lic 5Iockinl\5.1lCC """dages, JlllIWl wuI dressings, ostomy supplies, syrinSesond diabotic test strips.
Ortholic applillllCeslhot straillhlen or re-,lulpc a bndy pan (including =Ial bonding ond IOme types
ofbfnces). Tubings and lIlDSks lUe nOI covered ......pl when used wilh Durable Medical Equipment ..
dcscribed in Section I oflha COCo
H. Mentnl Henlth/Substllnce Abuse
Services performed in connection willt coaditions not clnssified in the C\llTOlIt edidon of the
Dinsnoslic MIl Slati.lit<ll Mnnunl oflh. Ameri""" Psychintric AsrociOlian. S""'i....lluu extand
beyond the period nCCt!5SIUJI for shan-lerm .valUlllian. diogno".. treatment, or crisis inlerventian.
M.nUll Health Ir""lment o!insomnia nnd other sleep dilOfden, neumlogiCll! disonlers.ond other
disorders with a known pbysical ....is.
TrCnlll1ent of conduct ond impulse contra I disoRlcn. pmannlity disorders. plIIlIphiUos lll1d other
Mentallllncsses thut will nol subSlllOlially improve beyond th. culTCtlll.vel offunctianing, or thalore
nol.ubjecllo favorabl. modific:odon or mlUl:lgcmenl occording 10 plllVailing nntiannl stondnrds of
e1iniCll! pn>clia; Il.l reasonably determined by the MenUll HcalthlSubstnnc. Abu.. Designee.
Services ulilizing methadone trcotmenl" mnint.lIllIICC. L.A. A.M. (I-Alplta.Acl:lyl-Methadoll.
Cy~lllZllcine. nr their equivnlenl5. Trentment provided in connectinn with or 10 comply with
involuntary commitments, police ddentions nnd ath.r similM 3mUlsemenIJ. unless aulhorized by lit.
MentoI HcalthlSubstnne. Abu"" Designee. Rcsidontiall=mcnl servi..... Services or supplies Ihnt in
tho reasonabl. judgmenl oflhe Menial HCII!thlSubsuull:. Ab... De:;igno. or. nal. for ...""'ple,
consislent with certain OBlional ,tondortIs orprofessiono1 rescnn:h funher described in Sectinn ~ of tho
cae.
I. Nutrition
Mcsnvilomia ond nulrilian....ed thc:rnpy; nUlridannl counseling for ~ilber individWlls or groups.
Enterol reedings ond other nUlrilional ond electrolyte supplements, including infant fonnulll nnd donor
btcml milk, except.. docribcd in Section I of the cac under the heading Prescriptinn IIlId Non-
prescription Enleral FonnulllS.
J. Physicnl Appenrnnce
Calffletic Procedures including. but notlimitcd 10. pharrrlllcologicolrOSimOllJ; nulriliono1 procedures
or treatments; salabnlSian, chemns"'llcry and nther such slein abrasion procedures lISSCIcioted with lhe
removal of=. tanoos, 8lld/arwhich Me perfanned os nlrcntmCDI fnr 1ICll.. Reploc:emenl ofon
existinll brC<1Sl impl.nl is exeluded if lb. cor\icr breasl implant was a Casmeti. Pn>cedure.
(Repl=ent of on existing b= implanl is considered rocanSINdive if the iaitial brenst imploal
followed OUlSlcclamy.) Physical ""odiliOl1ing progrlUDli such as nlhlctic Irnining. bodybuilding,
. exercise, fimen. fl..ibility. MIl diversion or general moli,ntion. Wcighlloss proJlnllD5 for mediCll!
nod non.medi",,1 renson.. Wil\5. regardless ofthc reason for the hair 10...
K. Providers
Services performed by a pro...;dcr willt your some legol ""iden... or who is a fomily member by birth
or nwrinSe. inelwlins IIpOUSC. brolher. sister. poren! or child This includes nay servi.. lhe provider
mny perfurm 00 him..lfor herself. Services provided 01 a f"'e-stonding Dr Hospital-based e1ingnastie
fneility withoul an order wrinen by a Physician or olher pro\ider lIS further described in Section 2 of
lit. cae (thi. excl~.ion docs not apply 10 mammography testiog).
L. Reproduction
HCII!th 5etviccs nr.d IlSSOCUlled expcIUCS for infertility ttcalmen15. SutnlJlDte parentiag. Th. reversal of
VOIUDtary sterilization.
M. Servie.s Provld.d under Another Plnn
HCII!lb r.crviccs for which "'''ml!le is J"tid under IUTlU\gemen15 required by fedcrnl. "ale or local low.
This ineludes, bUI is nallimiled 10. co'cra&e J"tid by warkers' compemotion, no-fouh nUlamobila
illSUl1lOCO. or similar logislDlion. Health services for tn:lllmcnl nfmilitary service-relnted disabilili...
when you I\fC IesaIly C1ltilled 10 ollter covcrage nnd focililies or. n:asonnbly availabl.ta yau. Heo1111t
services whil. on netiv. miliuuy duty.
N. Tntosplllnts
HeallIt !Orviees for alJllUl or lissue IrnnsplllOts ore excluded, CXC1lJIi tho", .pecified .. covered in
Seclion I of lite COCo Any ",lid o'l!lllltrnn'pllUlllhnl is performed 115 nln:Ollnent for c:ulCer. Heallh
services connected wilh the removal ofan organ or ds...e from you for purposes of a lTllnsplant 10
nnotltcr person. HCII!th services for lrnnsplon15 involving mechnniCll! or oniotnl 0lj!llrI5. Any multiple
OlJllUl trnnsplont r.at lisled os a CaYCfCli Health Service in SocliDl1 I oflltc COCo
O. Travel
Heallh services provided in a fon:isa country. unless required as Emergency HCII!tb Services.
Tmvel or lnlrnlpo","ian cxpClUCS, even IMush prescribed by a Physici.... Same travel CXpCtlSCS
rdnted 10 covered UlIlIspllllltl1lion !Orvices may be ",imbursed 8l our discretion.
P. VISion lIud HenrIng
PUrchllSC C05I of eye gl....... coalnet len.... or h..nng oids. Filling charge for bearinS aids. cye
glllSS05 or coulaCllcn,cs. Eye exerciSOlh<rilpy. Surgery thol is inlcr1ded 10 nlla", you to "'" bCller
withaul1l1osses or ollter visi.n carm:tian inclwli.g rndiaI kcrnlalamy.loser, III1d other refractive cye
surgery.
Q. Other Exclusions
HCII!lh services and suppli...thnl do nal mut the definition afa Covered HCII!th Servic.. see
definition in Section ID ofth. COCo
Physical. psycbiat~c or psycholosil:Ol ClUlOlimltionS, IcstinJl, vaccinzllion.. immuni;!ll\ions or
treounents otherwise .overed tmder the Policy. when such .ervices ore: (I) required sulely for
purposes afcorcer. edUc:llion. spans.r comp. unvel. employment, insumnt:e, lllDrTiagc or adaptian;
(2) rei ntingto judicio1 or administrativa proeecdinl\5 or orders; (3) condo<led for purpascs afmediCll!
n:seorcIt; or (4) 10 oblain or mninmin nlicense .fnny type.
Health ."",ie.. recdved 05 a fC5ult of war or any mof....r. whctbcrdeclored arundcclaredorcaus.d
durins ,ervi.., in th. armed forces of oay ""unify.
Health .erviecs recei,ed atier Ih. dole your eoVCf1!lll WIder lite Policy ends. inclwling hCll!lh .ervices
for medical rooditianl ari.ing prior 10 Ih. dnlo your caveras. under lite Policy ends.
HCII!lh services for which you h.ve no IOJlDI ""pansibilily 10 pay. or far which n chora. would nnl
ardiaarily be made in the obsencc of covcrag. under the Policy. 10 Ihe .ventlhnl a Non.NctworIi:
pro...;der ...aives Capaymenl5 nndlor Iha Annual Deductible for a particular hcnllb service, no Ben.fits
ore prooidl>ll for tll. hCll!lh service for which Copaymen15 nndlor the Annual Deductible Dra waived.
Ch"'lles in ""cess afElillible Expen.es or in ex.... of any specified limitation.
Services for Ih. e,a1W1tion wullreotrnonl oftcrDporomnndibular jainl syndmm. OMI). whc1ber lb.
services nte considered to be mediCll! or denlnl in nolure. cxtcpt.. described in Section I afllt. cae
under the heading Ilanes arJoirll5 ofth. Jaw lIOd FlIJ:io1 Region. Upper wullawcr jn", bone sorgcry
..eepl" r.quirod for Ihe direct IrCnlmenl ofacul. trnumnlic lojury ar COIICer. Orthognothic SUlllcry.
jnw o1ignment. ond lreatment for Ibe lemparomwulibulAr joint, except.. a trCOlmenl of obstructiv.
.Ieep apnea.
Surgicalln:nlmcnl MIl non.surWCII! trell1menl of obesity (including morbid obesity).
Growth barmon. th<rilPy; .... trnnsformnlinn aper.uions; l1ClIUlIent afbenign gynecolOll5\ia (abnormal
breast ..,lorgemenl in moles); mediCll! ond SlUI!iCll! treotOl<lll of excessive ....eoting (hypcrltidrosi,);
medical and "''1liCll! _en! for ",aring, I!llUJlt when provided lIS pan of treatment for documenled
ab,lructive sleep apnea. Oml appliances for ...oring. Cll510dial core; domicililu)' core; prhllle dill)'
nursin~ respite Ci1rI:; rest cures.
Psycbosuryel)'. SJlCl'ch tbempy extcpt.. required for trcnuncnl of a spcecb impediment or speccb
dy.functian thet results from Injury. stroke. cl./\ Iip/cloti pnlllle or Congenital Anootnly.
"\
%
This summory af IlcncfIl5 is inlended only to highlight your Benefits and should nal be relied upon to fully deJermine rovctllg.. This pion OIay not cover 011 your heallh cor. expell5OS. Pi.... refer to the
Certificat. afCoveras. for a compleJo listing ofsezvi.... limiUllions. exduaion. and a descriplion of a1llhe 'cm\J end condi.iaos of eovernge. Iftllis desc:riplian eonflict.s in any way with th. Ccrtific:ll. of
c"......g.. the Ccrtificnt. ofCovcra!lO pn:vnils. Terms that ore ..pitnlized in thellen.fll Summery ore defined in the CcrtifiCllle ofc"vcruSe.
021_BS_ChcPls FLNGMlOI04 AAF 213.14SUOO4_revOS
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(absorb the 180/0 increase - this is what every
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(give the employees the 180/0 increase)
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