open enrollment department of environmental quality second floor conference room meetings: monday...

From: Kym Thomas

To: Burt Kregs

Subject: Design Presentations Slides – Open Enrollment Meetings

Hello Burt,

Upon reviewing the printouts of the slides you provided, I have decided on an effective design that includes a shortened version of the available Plans. On the Opening slide, I included the meetings time and place available for the Virginia Office of Group Insurance. I included bullet points on the Agenda slide and added information about the plans to be discussed and resources for the employees to contact the Benefit Services Team of OGI Since the paper application are limited in supply, I made the point to first list the information to complete the application online by including the direct link to the website. There is a slide that gives a brief overview of the what to expect from the Traditional Plan vs. The New PPO Plan along with the expected premiums depending on type of coverage. The last slide has resource information of the Benefits Services Team phone numbers and emails. Take a look at my suggestions and respond at your convenience with your comments, suggestions, questions or concerns. Please do not hesitate to contact me at (513) 555-1212.

Thanks

Kym Thomas Documentation and Training Specialist

Virginia Office of Group Insurance

Open EnrollmentDepartment of Environmental Quality

Second Floor Conference RoomMeetings:

Monday 10:00 – 11:30 amThursday 2:00 – 3:30 pm

Facilitator: Burt Krebs, Manager(703) 555-1212

[email protected]

Open Enrollment: April 1 - May 28

AGENDAInsurance Carrier Selection: Traditional or PPO

All Employees Must Re-enroll in Health Insurance Includes an Employee Health Insurance Survey

FY 2012 Appropriation: Type of CoverageTransition of Care

FY 2012 Plan Design: Flexible Spending Account (FSA)

Open Enrollment ProceduresOnline and Paper Applications – Deadline: 5:00 pm May 28

Office of Group Insurance Resources


Insurance Carrier Selection: Traditional or PPO


• Traditional Plan – Insurance carrier pays 80% of the allowable charges and the employee pays the remaining 20%.

• Preferred Provider Organization Plan – The co-payment is $20 for physician office visits (in-network physicians) The carrier pays 85% of allowable charges and the employee pays the remaining 15% (in-network) and 70/30 out-of-network.• A PPO is not a Health Maintenance Organization (HMO). • A Preferred Provider Organization (PPO) is a health plan with

an established provider network (physicians, hospitals, labs, etc.) that has agreed to accept specific payment levels for specific services.

• In a PPO, you are free to select any healthcare provider. • Referrals are not required. Patients can “self-refer” themselves

to specialists without having to get a referral from their primary care physician (PCP).

FY 2012 Appropriation: Type of Coverage


Note: The above rates detail the bimonthly premium rates for employees employed at least 26 hours per week. Premiums are deducted from the employee’s first and second paychecks each month. No separate premiums for vision benefits for all members (and dependents) enrolled in medical coverage.

Type of Coverage Traditional P P OEmployee Only 18.50 15.00 Employee and Spouse 47.00 38.50 Employee and Child 32.50 26.00 Employee and Children 43.00 35.50 Employee Spouse and Child 58.50 48.00 Employee Spouse and Children 65.50 54.50

FY 2012 Appropriation: Plan Design


• Pharmacy benefits as well as Dental and Vision are unchanged from FY’11.

• New for FY ’12 is a premium category The Flexible Spending Account (FSA) limit has been increased from $2,500 to $3,000

• The Integrated Behavioral Health Plan (IBHP) In-Patient Co-payment has been increased to $15, and Outpatient Co-payment has been increased to $25.

• Enhanced Wellness Benefits and Well Baby Nursery Benefit are part of both plans

Health Insurance Application ProceduresAll Employees Must Re-enroll in Health Insurance

-Make a Choice between Traditional or PPOReview PPO Provider Directories located on the website

www.ogi.gov . If your Preferred Provider is not on PPO List, compare and decide if the PPO Plan is appropriate vs. Traditional coverage .

Agency Payroll Offices prefer you complete your application online by visiting www.ogi.gov.

Agency Payroll Offices will accept a “limited number” of paper applications, but supplies are limited. Download and print a PDF - Application for Insurance on the website.

Completed Paper Applications must be turned in to Agency Payroll Office by 5:00 PM May 28.


RESOURCESOFFICE OF GROUP INSURANCE


For all questions and concerns, please contact a member of the Office of Group Insurance Services

Team according to the first letter of your last name:

Monday – Friday 8am – 5pm

Liana Anderson, Benefits Assistant (L-R) (703) 378-3170 [email protected]

Abbey McLean, Benefits Assistant (A-K) (703) [email protected]

Trey Summerfield, Benefits Assistant (S-Z) (703) 378-2044 [email protected]

open enrollment department of environmental quality second floor conference room meetings: monday...

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