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2016 BCBSGa

Open Enrollment

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Agenda

What’s new in 2016?

BCBSGa Plan Options and Benefits

Personal Health Programs

Online Tools

Questions

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What’s new in 2016?

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LiveHealth Online

• What is LiveHealth Online?

− LiveHealth Online is BCBSGa’s telemedicine offering. This allows members to have a virtual visit with an in-network doctor, providing an alternative method to access quality care.

− When your own doctor isn’t available or you are short on time, LiveHealth Online can help. LiveHealth Online gives you access to quality medical care 24/7 with no appointments or long wait times

• With LiveHealth Online you get:

− Immediate access to in-network, board-certified doctors 24/7

− Secure and private two-way video chats with doctors

− Prescriptions sent directly to your pharmacy, if needed*

• When to use LiveHealth Online?

− As always, you should call 911 with any emergency

− Use LiveHealth Online for common health concerns such as colds, the flu, fevers, rashes, infections, allergies, and family health questions

HMO Plan: Subject to $35 co-payHRA Plan: In-network co-insurance applies; member does not have to meet the deductible first

*In certain states, prescriptions cannot be issued as a result of an online interaction with a doctor. For state telehealth availability, check the map on livehealthonline.com.

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Roll Over Credits

• In 2015, members were only allowed to roll over their unused well-being incentive credits between the three BCBSGa HRA plans

• Beginning in 2016, members can roll over unused well-being incentive credits if they decide to move from plan to plan, regardless of plan type (HRA or HMO) or insurance carrier

− Example #1: Member moves from the BCBSGa Bronze HRA plan in 2015 to a BCBSGa HMO plan in 2016

− Example #2: Member moves from the UnitedHealthcare HMO in 2015 to a BCBSGa HMO plan in 2016

BCBSGa

Kaiser Permanente

UnitedHealthcare

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BCBSGa Plan Options & Benefits

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BCBSGa HRA Plans

Active and Early Retirees

Gold HRASilver HRABronze HRAProvider Network:SHBP network (Open Access POS) Outside of GA use BlueCard Nat ional PPO networkNo referrals required for specialists

Out-of -net work benef its available

• HRA = Health Reimbursement Arrangement

• No co-pays

• Benefits are subject to deductible/co-insurance

• Our BCBSGa HRA plans offer members true consumerism

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How the HRA plans work

Health Reimbursement Arrangement (HRA) Account• SHBP contributes base HRA well-

being incentive credits to your Health Reimbursement Arrangement (HRA) account.

• These well-being incentive credits are used to help pay for your covered major medical expenses, such as inpatient or outpatient procedures.

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Annual Deductible• Once your HRA well-being

incentive credits are exhausted, you are responsible for meeting an annual deductible before the plan begins to pay a percentage of your covered expenses, called co-insurance.

• You can use the well-being incentive credits in your HRA account to help meet your deductible.

Out-of-Pocket

• After you meet your annual deductible, you pay a percentage of the cost of your covered expenses, called co-insurance.

• If you still have well-being incentive credits in your HRA account after you've met your annual deductible, you can use them to pay your share of co-insurance.

• Once you reach your annual out-of-pocket maximum, the plan pays 100 percent of any of your remaining in-network covered expenses for the rest of the plan year.

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BCBSGa HMO Plan

Active and Early Retirees

• BCBSGa Statewide HMO• Provider Network:

• SHBP network (Open Access POS) • Outside of GA use BlueCard National PPO network• No referrals required for specialists

• No out-of-network benefits available

• HMO = Health Maintenance Organization

• Care is guided by your doctor, but unlike most HMOs, you don’t need referrals to see a specialist.

• Budget friendly

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Benefits at a Glance

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Personal Health Programs

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Online Tools

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Questions?