PEEHIP

Public Education Employees’ Health Insurance Plan

The Alabama Association of School Business Officials (AASBO) Conference

February 11, 2014

PEEHIP Premium Rates October 1, 2013 – September 30, 2014

Allocation per active employee - $714

Hospital medical premium for active employees:

Single - $ 15

Family - $ 177

Optional plans –

Cancer, Indemnity, Vision, single dental - $38

Family dental - $45

Tobacco surcharge = $28

There were premium increases for Cobra/Leave of Absence and Surviving

Spouses rates shown on next slide.

PEEHIP Premium Rates October 1, 2013-September 30, 2014

COBRA and LOA

Premiums

Monthly Premium

FY14

Increase

Over FY13

Individual $ 403 $ 9

Family $ 997 $ 16

Supplemental $ 154 $ 6

Surviving Spouse

Premiums

Monthly Premium

FY14

Increase

Over FY13

SS<65 $ 679 $ 8

SS<65, Depend<65 $ 870 $ 10

SS<65, Depend>65 $ 839 $ 10

SS>65 $ 318 $ 1

SS>65, Depend <65 $ 516 $ 10

SS>65, Depend >65 $ 485 $ 10

BENEFIT CHANGES to Optional Plans effective October 1, 2013

PEEHIP Cancer Plan (administered by Southland)

Added a limit of $5000 for blood and plasma per year for leukemia. Added new cancer surgical procedures to the cancer schedule. Allow any physician recommended observation period that is

greater than 24 hours to qualify as an inpatient stay.

PEEHIP Indemnity Plan (administered by Southland) Allow any physician recommended observation period that is

greater than 24 hours to qualify as an inpatient stay.

PEEHIP Vision Plan (administered by Southland) Southland will provide at no cost its Vision Choice plan to all PEEHIP

members who participate in any of the PEEHIP optional plans. Estimated savings of 20% for members who use Vision choice providers

VIVA Health Plan Changes

Primary Care Physician Copay increase from $20 to $30 Inpatient Hospital Stays—adding a $25 copay for days 2-5

Adding Calendar Year deductibles and coinsurance limits.

No changes to the VIVA dental plan.

Changes in PEEHIP Benefits and Policies

Certified Registered Nurse Anesthesiologists (CRNA) and Anesthesiologist Assistants (AA)

January 1, 2014, the PEEHIP Hospital Medical Plan began covering in-network CRNA’s and AA’s to the extent these providers are acting under appropriate supervision and within their state license.

Changes in PEEHIP Benefits and Policies

PEEHIP Supplemental Hospital Medical Plan

An annual maximum amount paid from the PEEHIP Supplemental Hospital Medical Plan will be limited to $6,250 for individual and $12,500 for family coverage.

Members who enroll in Marketplace (Exchange) plan for their primary coverage cannot enroll in PEEHIP’s Supplemental Plan.

Changes in PEEHIP Benefits and Policies

PEEHIP Supplemental Hospital Medical Plan

Members enrolled in high deductible plans with deductibles greater than $1,250 for individual or $2,500 for family are also not eligible for the PEEHIP Supplemental Plan

Changes to Healthcare Flexible Spending Account

• Members enrolled in the Health Flexible Spending Accounts (FSAs) are now allowed to carryover $500 of unused funds remaining in a health FSA at the end of a plan year to be used in the following plan year for covered health FSA eligible expenses.

• Any unused amounts in excess of $500 remaining in your health FSA at the end of the plan year will be lost.

ALLKIDS Changes

The three month waiting period before a child can be enrolled in ALL Kids if previously covered by other health insurance under an employer sponsored group health insurance plan and is voluntarily terminated will be eliminated.

A child will continue to be ineligible for ALL Kids if they are currently covered by other health insurance.

The Wellness Program will continue. (ADPH)

Health screenings

Osteoporosis screenings

-Age and medical criteria must be met.

Flu vaccines -Available @ school for children of PEEHIP members

Colorectal Screening Kit -Over 99% accurate and almost as effective as a colonoscopy

Flu Shots

Flu Shots are given and covered at: • PEEHIP Worksite Wellness Locations (no copay)

• Doctor’s Offices

Flu Shots given at pharmacies are not covered by PEEHIP.

Coordination Of Benefits (COB) Update

• SECOVA is no longer processing the COB forms, you must submit your COB Audit information directly to PEEHIP to complete your audit.

• There are approximately 1,584 accounts on Claims Hold

• To complete your audit and have the claim hold removed from your account you must provide the COB information online through PEEHIP’s Member Online Services (MOS) at https://mso.rsa-al.gov/ or fax a completed form to

1-877-517-0021.

Retiree Employment Verification

All members who retired on or after 10/1/2005 are required to verify Retiree Employment Information yearly

– Under PEEHIP Law, if a member retired on or after October 1, 2005, and is employed by another employer that provides at least 50% of the cost of single health insurance coverage, the retiree cannot be insured on the PEEHIP hospital medical plan.

READ the PEEHIP ADVISOR

• Important information is always included in the PEEHIP Advisor.

• The PEEHIP Advisor is a part of the RSA Advisor.

Open Enrollment (OE) www.rsa-al.gov/PEEHIP/open-enroll.html

Begins July 1. Paper form deadline is August 31. Online enrollment deadline is September 10 -

Coverage is effective on October 1. Members can download the OE packet or call to have one

mailed to them.

If there are no changes, DO NOT complete the forms.

If using paper forms to enroll in Medical and cancel Optional Plans, the cancellation request must be indicated on the Status Change form.