whirlpool corporation: 2011 u.s. benefits...whirlpool corportation confidential active flexforce...
TRANSCRIPT
WHIRLPOOL CORPORTATION CONFIDENTIAL
WHIRLPOOL CORPORATION
2011 US Benefits
Susan PavlopoulosSenior ManagerGlobal Benefits
November 17 2010
WHIRLPOOL CORPORTATION CONFIDENTIAL
2011 ACTIVE amp RETIREE MEDICAL PLANS
WHIRLPOOL CORPORTATION CONFIDENTIAL
2011 ACTIVE REWARDS AND SAVINGS PLANS
WHIRLPOOL CORPORTATION CONFIDENTIAL
2011 ACTIVE AMANA HOURLY PLANS
Presentation title 4
WHIRLPOOL CORPORTATION CONFIDENTIAL
2011 ACTIVE FT SMITH HOURLY PLANS
Presentation title 5
WHIRLPOOL CORPORTATION CONFIDENTIAL
ACTIVE FLEXFORCE LIMITED PLAN
Limited Plan
in-network out-of-network
EMP
LOY
EE
PA
YS
Deductible
Per Person3 $1800 $3600
Out-of-Pocket Limit
Per Person none none
Benefit DescriptionW
HIR
LPO
OL
PAY
SPrimary Care Physician (PCP) Office Visits
70 50
Specialist Office Visits 70 50
Hospital (Inpatient amp Outpatient)2 70 50
Surgery (Inpatient amp Outpatient) 2 70 50
Adult Routine Wellness 100 Not covered
Well Child Care 100 Not covered
Emergency Room70 70
50 if non-emergency
Mental and Nervous (inpatient amp outpatient)
70 50
Chiropractic Care
70 50
limited to 20 visits per calendar year (combined limit)
Home Health Care
70 50
limited to 120 visits per calendar year (combined limit)
Annual Maximum na
Lifetime Maximum na
Prescription Benefit Highlights
Retail or Mail Order 70 coinsurance
Indicates no deductible applies
Corporate StandardSample PowerPoint 6
WHIRLPOOL CORPORTATION CONFIDENTIAL
WHIRLPOOL WELLNESS PREVENTIVE CARE BENEFITS
Preventive Care Adults Actives amp Pre Medicare Retirees
bull 100 no deductible in network
bullBill with routinepreventive V-code
Well-adult care includes one routine office visit and examination each Plan Year after age 18 years and one OBGYN office visit and examination after age 18 years of age each Plan Year
Included immunizations and screenings associated with the above routine office visits are as follows bull Immunizations
1Tetanus Diphtheria (Td) Booster once every 10 years 2Influenza Vaccination (flu shot) one shot each Plan Year
3Pneumococcal Vaccination (Pneumovaz) one dose for persons 65 years and over
4Meningococcal conjugated vaccine (MCV4) one dose for college freshmen living in dormitories 5bull Screenings
6Cholesterol screening including triglycerides LDL HDL or lipid panel once every 5 years beginning at age 20 years
7Baseline Mammogram one between 30 and 40 years of age and one Mammogram each Plan Year starting at age 40 years of age
8Pap Smear and Routine Pelvic Exam one each Plan Year beginning at age 18 years
9Bone density test for osteoporosis every two years for women age 50 years and over
Colorectal Cancer Screenings 1048707 Fecal occult blood test (FOBT) or Colonoscopy or Double contrast barium enema 1048707 Digital rectal examination (DRE) and prostate specific antigen (PSA) test
bull Pathologies labs chest x-rays and EKGs that are ordered as part of your preventive care visit due to age andor family history and are considered preventive care by your Physician
WHIRLPOOL CORPORTATION CONFIDENTIAL
WHIRLPOOL WELLNESS PREVENTIVE CARE BENEFITS
Preventive Care
Children
bull 100 no
deductible in
network
bullBill with
routinepreventive
V-code
Well-child care includes routine office visits and examination as follows 1 Six visits 0 ndash 12 months 2 Three visits 12 ndash 24 months 3 Annual visits from 24 months through age 18 years of age4 GYN exam for children at age 18
When associated with routine office visits the following immunizations and screenings are covered
bull Immunizations o Two doses of Hepatitis A Three doses of Hepatitis B
o Six doses of Diphtheria Tetanus Pertussis (DtaP) Four doses of Haemophilus
Influenza type b Four doses of Polio Four doses of Pnuemococcal Conjugate
Two doses of Varicella wo doses of Measles Mumps Rubella
o One dose of Influenza vaccine (flu shot) one dose each Plan Year for children over
the age of 8 years two doses (administered separately by at least 4 weeks)
each Plan Year for children up through 8 years of age
o Human papilloma virus (HPV) vaccine for girls ages 9 through 18 years of age at the
following intervals
1048707 One complete dosage per lifetime consisting of 3 shots given within a 6 month
timeframe
1048707 Women over the age of 18 years but under the age of 26 years who have not yet
received the HPV may also receive the vaccine
bull Meningococcal conjugated vaccine (MCV4) at the following intervals
One dose between the ages of 11 and 12 years or
One dose before high school entry or at age 15 years whichever
occurs first for children who have not previously received the
MCV4 vaccine
bull Screenings and Exams Lead level testing one between ages 9 to 12 months and one at 24 months or after Vision screening conducted as part of Well-child care visit at ages 3 4 5 6 8 10
12 15 and 18 years Hearing screening conducted as part of Well-Child care Visit at ages 4 5 6 8 10 12
15 and 18 years Pap smear and routine pelvic exam one each Plan Year beginning at age 18 years or
the onset of sexual activity whichever comes first
Pathologies labs chest x-rays and EKGs that are ordered as part of your preventive
care visit and are considered preventive care by your Physician
WHIRLPOOL CORPORTATION CONFIDENTIAL
WHATrsquoS CHANGING
Active Medical
Dependents up to age 26 may be added to plans student and marital status no longer apply
Lifetime maximums on active plans have been removed
Over the counter medications will no longer be reimbursable through an FSA (or HSA) without a prescription
Retiree Medical
Most Pre-65 retirees moving to Rewards and Savings plans
No I-account for pre-65 Rewards and Savings plans
Most Post-65 retirees moving to stipend as of 1111
Pre and post-65 plans offered thru Whirlpool have LTM
WHIRLPOOL CORPORTATION CONFIDENTIAL
2011 PHARMACY BENEFIT
WHIRLPOOL CORPORTATION CONFIDENTIAL
2011 PHARMACY BENEFIT FOR ACTIVES amp PRE-65 RETIREES
Tier 0 $0 or 0 Coinsurance
Tier 1 10 Coinsurance30-day supply
Min $5 Max $1290-day supply
Min $1250 Max $30
Tier 2 20 Coinsurance
30-day supplyMin $20 Max $100
90-day supplyMin $50 Max $250
Tier 3 50 Coinsurance
30-day supplyMin $50 Max $250
90-day supplyMin $125 Max $625
Tier 4 100 Coinsurance
INCREASED VALUE TO MEMBERS amp PLAN
Encourage the
utilization of clinically
and cost effective
therapies
Primarily Generics
Encourage the
utilization of cost
effective therapies that
donrsquot qualify for $0 tier
Primarily Generics
Encourage the
utilization of cost
effective therapies
relative to other agents
therapies
Primarily Preferred
Brands
Products that are not as
clinically or cost
effective relative to
other available agents
therapies
Primarily Non-Preferred
Brands
Products
considered to have
minimal or no
clinical or cost
effectiveness
relative to other
available agents
therapies
Primarily Non-
Preferred Brands
90-day supply available thru
Walgreens network
pharmacies or mail order only
WHIRLPOOL CORPORTATION CONFIDENTIAL
WHATrsquoS CHANGINGActive amp Pre-65 Pharmacy
Walgreens Health Initiatives (WHI) selected to replace Medco as pharmacy benefit manager (PBM)
30-day fills use the WHI network for discounted pricing
90-day fills maintenance medications may be filled at Walgreens retail or thru Walgreens mail order
WHI network includes independent pharmacies as well as chains such as CVS Rite Aid Wal-Mart amp Target
Post-65 Retirees
Moving to stipend
WHIRLPOOL CORPORTATION CONFIDENTIAL
Q Will prescriptions automatically be transferred to Walgreens
A 30-day prescriptions will not be transferred to Walgreens
90-day mail maintenance medications will be automatically transferred to
Walgreens Mail Service as of January
NOTE 90-day prescriptions not filled using mail service any 30-day
prescription as well as narcotics and compound medications will not be
transferred and will require a new prescription from your physician
Q Will the tier of drugs change
A No the tiers in the benefit plan design are not changing
However the price that members pay for medication may change due to the
special discount pricing being offered by WHI
WHI QampA
WHIRLPOOL CORPORTATION CONFIDENTIAL
Q Will there be two ID cards for next year
A No active and pre-65 members will continue to have one card for
medical and pharmacy
14
ID CARDS
WHIRLPOOL CORPORTATION CONFIDENTIAL
PHONE 1-877-WHIRL50 (877-944-1550)
FAX 1-800-736-8270
WEB wwwwalgreenshealthcom
Click on Healthcare Professionals tab
15
WHI Contact Information
WHIRLPOOL CORPORTATION CONFIDENTIAL
HEALTHSCOPE BENEFITS
WHIRLPOOL CORPORTATION CONFIDENTIAL
17
HealthSCOPE Benefits
Pre-certificationPre-authorization
Claim Status
Eligibility
Benefit Information
Provider Network verification
IVR- Available 247
1st Level Appeals
1-800-660-6212CUSTOMER CARE
REPRESENTATIVES
Whirlpool Service Line
1-800-660-6212
M-F 800 am ndash 600 pm EST
WHIRLPOOL CORPORTATION CONFIDENTIAL
18
HSB Whirlpool Customer Care Web Tools
Click on Providero Check on
o Claim Status
o Eligibility
o Benefit Information
o Precert Information
o Copies of EOBs
wwwhealthscopebenefitscom
WHIRLPOOL CORPORTATION CONFIDENTIAL
19
HealthSCOPE Benefits
Copy of provider EOB
WHIRLPOOL CORPORTATION CONFIDENTIAL
20
PRE-CERTIFICATION PROCEDURES
All members along with their providers will be required to pre-certify all Non-emergency inpatient admissions Major outpatient surgical procedures Non-stat MRI amp CT Scans Outpatient mental health facility admits or visits
Contact HealthSCOPE Benefits for pre-certification at 1-800-660-212
Member ID card has reminder statement regarding pre-certification
20
WHIRLPOOL CORPORTATION CONFIDENTIAL
WHIRLPOOL PROVIDER UPDATES
COMMUNICATIONS THROUGHOUT THE YEAR
Quarterly Newsletters
Quarterly Teleconferences
Join the mailing list Send an email to susan_a_pavlopouloswhirlpoolcom
HealthSCOPE Benefits websitewwwhealthscopebenefitscom
Walgreens website
wwwwalgreenshealthcom
21
WHIRLPOOL CORPORTATION CONFIDENTIAL
QUESTIONS
WHIRLPOOL CORPORTATION CONFIDENTIAL
2011 ACTIVE amp RETIREE MEDICAL PLANS
WHIRLPOOL CORPORTATION CONFIDENTIAL
2011 ACTIVE REWARDS AND SAVINGS PLANS
WHIRLPOOL CORPORTATION CONFIDENTIAL
2011 ACTIVE AMANA HOURLY PLANS
Presentation title 4
WHIRLPOOL CORPORTATION CONFIDENTIAL
2011 ACTIVE FT SMITH HOURLY PLANS
Presentation title 5
WHIRLPOOL CORPORTATION CONFIDENTIAL
ACTIVE FLEXFORCE LIMITED PLAN
Limited Plan
in-network out-of-network
EMP
LOY
EE
PA
YS
Deductible
Per Person3 $1800 $3600
Out-of-Pocket Limit
Per Person none none
Benefit DescriptionW
HIR
LPO
OL
PAY
SPrimary Care Physician (PCP) Office Visits
70 50
Specialist Office Visits 70 50
Hospital (Inpatient amp Outpatient)2 70 50
Surgery (Inpatient amp Outpatient) 2 70 50
Adult Routine Wellness 100 Not covered
Well Child Care 100 Not covered
Emergency Room70 70
50 if non-emergency
Mental and Nervous (inpatient amp outpatient)
70 50
Chiropractic Care
70 50
limited to 20 visits per calendar year (combined limit)
Home Health Care
70 50
limited to 120 visits per calendar year (combined limit)
Annual Maximum na
Lifetime Maximum na
Prescription Benefit Highlights
Retail or Mail Order 70 coinsurance
Indicates no deductible applies
Corporate StandardSample PowerPoint 6
WHIRLPOOL CORPORTATION CONFIDENTIAL
WHIRLPOOL WELLNESS PREVENTIVE CARE BENEFITS
Preventive Care Adults Actives amp Pre Medicare Retirees
bull 100 no deductible in network
bullBill with routinepreventive V-code
Well-adult care includes one routine office visit and examination each Plan Year after age 18 years and one OBGYN office visit and examination after age 18 years of age each Plan Year
Included immunizations and screenings associated with the above routine office visits are as follows bull Immunizations
1Tetanus Diphtheria (Td) Booster once every 10 years 2Influenza Vaccination (flu shot) one shot each Plan Year
3Pneumococcal Vaccination (Pneumovaz) one dose for persons 65 years and over
4Meningococcal conjugated vaccine (MCV4) one dose for college freshmen living in dormitories 5bull Screenings
6Cholesterol screening including triglycerides LDL HDL or lipid panel once every 5 years beginning at age 20 years
7Baseline Mammogram one between 30 and 40 years of age and one Mammogram each Plan Year starting at age 40 years of age
8Pap Smear and Routine Pelvic Exam one each Plan Year beginning at age 18 years
9Bone density test for osteoporosis every two years for women age 50 years and over
Colorectal Cancer Screenings 1048707 Fecal occult blood test (FOBT) or Colonoscopy or Double contrast barium enema 1048707 Digital rectal examination (DRE) and prostate specific antigen (PSA) test
bull Pathologies labs chest x-rays and EKGs that are ordered as part of your preventive care visit due to age andor family history and are considered preventive care by your Physician
WHIRLPOOL CORPORTATION CONFIDENTIAL
WHIRLPOOL WELLNESS PREVENTIVE CARE BENEFITS
Preventive Care
Children
bull 100 no
deductible in
network
bullBill with
routinepreventive
V-code
Well-child care includes routine office visits and examination as follows 1 Six visits 0 ndash 12 months 2 Three visits 12 ndash 24 months 3 Annual visits from 24 months through age 18 years of age4 GYN exam for children at age 18
When associated with routine office visits the following immunizations and screenings are covered
bull Immunizations o Two doses of Hepatitis A Three doses of Hepatitis B
o Six doses of Diphtheria Tetanus Pertussis (DtaP) Four doses of Haemophilus
Influenza type b Four doses of Polio Four doses of Pnuemococcal Conjugate
Two doses of Varicella wo doses of Measles Mumps Rubella
o One dose of Influenza vaccine (flu shot) one dose each Plan Year for children over
the age of 8 years two doses (administered separately by at least 4 weeks)
each Plan Year for children up through 8 years of age
o Human papilloma virus (HPV) vaccine for girls ages 9 through 18 years of age at the
following intervals
1048707 One complete dosage per lifetime consisting of 3 shots given within a 6 month
timeframe
1048707 Women over the age of 18 years but under the age of 26 years who have not yet
received the HPV may also receive the vaccine
bull Meningococcal conjugated vaccine (MCV4) at the following intervals
One dose between the ages of 11 and 12 years or
One dose before high school entry or at age 15 years whichever
occurs first for children who have not previously received the
MCV4 vaccine
bull Screenings and Exams Lead level testing one between ages 9 to 12 months and one at 24 months or after Vision screening conducted as part of Well-child care visit at ages 3 4 5 6 8 10
12 15 and 18 years Hearing screening conducted as part of Well-Child care Visit at ages 4 5 6 8 10 12
15 and 18 years Pap smear and routine pelvic exam one each Plan Year beginning at age 18 years or
the onset of sexual activity whichever comes first
Pathologies labs chest x-rays and EKGs that are ordered as part of your preventive
care visit and are considered preventive care by your Physician
WHIRLPOOL CORPORTATION CONFIDENTIAL
WHATrsquoS CHANGING
Active Medical
Dependents up to age 26 may be added to plans student and marital status no longer apply
Lifetime maximums on active plans have been removed
Over the counter medications will no longer be reimbursable through an FSA (or HSA) without a prescription
Retiree Medical
Most Pre-65 retirees moving to Rewards and Savings plans
No I-account for pre-65 Rewards and Savings plans
Most Post-65 retirees moving to stipend as of 1111
Pre and post-65 plans offered thru Whirlpool have LTM
WHIRLPOOL CORPORTATION CONFIDENTIAL
2011 PHARMACY BENEFIT
WHIRLPOOL CORPORTATION CONFIDENTIAL
2011 PHARMACY BENEFIT FOR ACTIVES amp PRE-65 RETIREES
Tier 0 $0 or 0 Coinsurance
Tier 1 10 Coinsurance30-day supply
Min $5 Max $1290-day supply
Min $1250 Max $30
Tier 2 20 Coinsurance
30-day supplyMin $20 Max $100
90-day supplyMin $50 Max $250
Tier 3 50 Coinsurance
30-day supplyMin $50 Max $250
90-day supplyMin $125 Max $625
Tier 4 100 Coinsurance
INCREASED VALUE TO MEMBERS amp PLAN
Encourage the
utilization of clinically
and cost effective
therapies
Primarily Generics
Encourage the
utilization of cost
effective therapies that
donrsquot qualify for $0 tier
Primarily Generics
Encourage the
utilization of cost
effective therapies
relative to other agents
therapies
Primarily Preferred
Brands
Products that are not as
clinically or cost
effective relative to
other available agents
therapies
Primarily Non-Preferred
Brands
Products
considered to have
minimal or no
clinical or cost
effectiveness
relative to other
available agents
therapies
Primarily Non-
Preferred Brands
90-day supply available thru
Walgreens network
pharmacies or mail order only
WHIRLPOOL CORPORTATION CONFIDENTIAL
WHATrsquoS CHANGINGActive amp Pre-65 Pharmacy
Walgreens Health Initiatives (WHI) selected to replace Medco as pharmacy benefit manager (PBM)
30-day fills use the WHI network for discounted pricing
90-day fills maintenance medications may be filled at Walgreens retail or thru Walgreens mail order
WHI network includes independent pharmacies as well as chains such as CVS Rite Aid Wal-Mart amp Target
Post-65 Retirees
Moving to stipend
WHIRLPOOL CORPORTATION CONFIDENTIAL
Q Will prescriptions automatically be transferred to Walgreens
A 30-day prescriptions will not be transferred to Walgreens
90-day mail maintenance medications will be automatically transferred to
Walgreens Mail Service as of January
NOTE 90-day prescriptions not filled using mail service any 30-day
prescription as well as narcotics and compound medications will not be
transferred and will require a new prescription from your physician
Q Will the tier of drugs change
A No the tiers in the benefit plan design are not changing
However the price that members pay for medication may change due to the
special discount pricing being offered by WHI
WHI QampA
WHIRLPOOL CORPORTATION CONFIDENTIAL
Q Will there be two ID cards for next year
A No active and pre-65 members will continue to have one card for
medical and pharmacy
14
ID CARDS
WHIRLPOOL CORPORTATION CONFIDENTIAL
PHONE 1-877-WHIRL50 (877-944-1550)
FAX 1-800-736-8270
WEB wwwwalgreenshealthcom
Click on Healthcare Professionals tab
15
WHI Contact Information
WHIRLPOOL CORPORTATION CONFIDENTIAL
HEALTHSCOPE BENEFITS
WHIRLPOOL CORPORTATION CONFIDENTIAL
17
HealthSCOPE Benefits
Pre-certificationPre-authorization
Claim Status
Eligibility
Benefit Information
Provider Network verification
IVR- Available 247
1st Level Appeals
1-800-660-6212CUSTOMER CARE
REPRESENTATIVES
Whirlpool Service Line
1-800-660-6212
M-F 800 am ndash 600 pm EST
WHIRLPOOL CORPORTATION CONFIDENTIAL
18
HSB Whirlpool Customer Care Web Tools
Click on Providero Check on
o Claim Status
o Eligibility
o Benefit Information
o Precert Information
o Copies of EOBs
wwwhealthscopebenefitscom
WHIRLPOOL CORPORTATION CONFIDENTIAL
19
HealthSCOPE Benefits
Copy of provider EOB
WHIRLPOOL CORPORTATION CONFIDENTIAL
20
PRE-CERTIFICATION PROCEDURES
All members along with their providers will be required to pre-certify all Non-emergency inpatient admissions Major outpatient surgical procedures Non-stat MRI amp CT Scans Outpatient mental health facility admits or visits
Contact HealthSCOPE Benefits for pre-certification at 1-800-660-212
Member ID card has reminder statement regarding pre-certification
20
WHIRLPOOL CORPORTATION CONFIDENTIAL
WHIRLPOOL PROVIDER UPDATES
COMMUNICATIONS THROUGHOUT THE YEAR
Quarterly Newsletters
Quarterly Teleconferences
Join the mailing list Send an email to susan_a_pavlopouloswhirlpoolcom
HealthSCOPE Benefits websitewwwhealthscopebenefitscom
Walgreens website
wwwwalgreenshealthcom
21
WHIRLPOOL CORPORTATION CONFIDENTIAL
QUESTIONS
WHIRLPOOL CORPORTATION CONFIDENTIAL
2011 ACTIVE REWARDS AND SAVINGS PLANS
WHIRLPOOL CORPORTATION CONFIDENTIAL
2011 ACTIVE AMANA HOURLY PLANS
Presentation title 4
WHIRLPOOL CORPORTATION CONFIDENTIAL
2011 ACTIVE FT SMITH HOURLY PLANS
Presentation title 5
WHIRLPOOL CORPORTATION CONFIDENTIAL
ACTIVE FLEXFORCE LIMITED PLAN
Limited Plan
in-network out-of-network
EMP
LOY
EE
PA
YS
Deductible
Per Person3 $1800 $3600
Out-of-Pocket Limit
Per Person none none
Benefit DescriptionW
HIR
LPO
OL
PAY
SPrimary Care Physician (PCP) Office Visits
70 50
Specialist Office Visits 70 50
Hospital (Inpatient amp Outpatient)2 70 50
Surgery (Inpatient amp Outpatient) 2 70 50
Adult Routine Wellness 100 Not covered
Well Child Care 100 Not covered
Emergency Room70 70
50 if non-emergency
Mental and Nervous (inpatient amp outpatient)
70 50
Chiropractic Care
70 50
limited to 20 visits per calendar year (combined limit)
Home Health Care
70 50
limited to 120 visits per calendar year (combined limit)
Annual Maximum na
Lifetime Maximum na
Prescription Benefit Highlights
Retail or Mail Order 70 coinsurance
Indicates no deductible applies
Corporate StandardSample PowerPoint 6
WHIRLPOOL CORPORTATION CONFIDENTIAL
WHIRLPOOL WELLNESS PREVENTIVE CARE BENEFITS
Preventive Care Adults Actives amp Pre Medicare Retirees
bull 100 no deductible in network
bullBill with routinepreventive V-code
Well-adult care includes one routine office visit and examination each Plan Year after age 18 years and one OBGYN office visit and examination after age 18 years of age each Plan Year
Included immunizations and screenings associated with the above routine office visits are as follows bull Immunizations
1Tetanus Diphtheria (Td) Booster once every 10 years 2Influenza Vaccination (flu shot) one shot each Plan Year
3Pneumococcal Vaccination (Pneumovaz) one dose for persons 65 years and over
4Meningococcal conjugated vaccine (MCV4) one dose for college freshmen living in dormitories 5bull Screenings
6Cholesterol screening including triglycerides LDL HDL or lipid panel once every 5 years beginning at age 20 years
7Baseline Mammogram one between 30 and 40 years of age and one Mammogram each Plan Year starting at age 40 years of age
8Pap Smear and Routine Pelvic Exam one each Plan Year beginning at age 18 years
9Bone density test for osteoporosis every two years for women age 50 years and over
Colorectal Cancer Screenings 1048707 Fecal occult blood test (FOBT) or Colonoscopy or Double contrast barium enema 1048707 Digital rectal examination (DRE) and prostate specific antigen (PSA) test
bull Pathologies labs chest x-rays and EKGs that are ordered as part of your preventive care visit due to age andor family history and are considered preventive care by your Physician
WHIRLPOOL CORPORTATION CONFIDENTIAL
WHIRLPOOL WELLNESS PREVENTIVE CARE BENEFITS
Preventive Care
Children
bull 100 no
deductible in
network
bullBill with
routinepreventive
V-code
Well-child care includes routine office visits and examination as follows 1 Six visits 0 ndash 12 months 2 Three visits 12 ndash 24 months 3 Annual visits from 24 months through age 18 years of age4 GYN exam for children at age 18
When associated with routine office visits the following immunizations and screenings are covered
bull Immunizations o Two doses of Hepatitis A Three doses of Hepatitis B
o Six doses of Diphtheria Tetanus Pertussis (DtaP) Four doses of Haemophilus
Influenza type b Four doses of Polio Four doses of Pnuemococcal Conjugate
Two doses of Varicella wo doses of Measles Mumps Rubella
o One dose of Influenza vaccine (flu shot) one dose each Plan Year for children over
the age of 8 years two doses (administered separately by at least 4 weeks)
each Plan Year for children up through 8 years of age
o Human papilloma virus (HPV) vaccine for girls ages 9 through 18 years of age at the
following intervals
1048707 One complete dosage per lifetime consisting of 3 shots given within a 6 month
timeframe
1048707 Women over the age of 18 years but under the age of 26 years who have not yet
received the HPV may also receive the vaccine
bull Meningococcal conjugated vaccine (MCV4) at the following intervals
One dose between the ages of 11 and 12 years or
One dose before high school entry or at age 15 years whichever
occurs first for children who have not previously received the
MCV4 vaccine
bull Screenings and Exams Lead level testing one between ages 9 to 12 months and one at 24 months or after Vision screening conducted as part of Well-child care visit at ages 3 4 5 6 8 10
12 15 and 18 years Hearing screening conducted as part of Well-Child care Visit at ages 4 5 6 8 10 12
15 and 18 years Pap smear and routine pelvic exam one each Plan Year beginning at age 18 years or
the onset of sexual activity whichever comes first
Pathologies labs chest x-rays and EKGs that are ordered as part of your preventive
care visit and are considered preventive care by your Physician
WHIRLPOOL CORPORTATION CONFIDENTIAL
WHATrsquoS CHANGING
Active Medical
Dependents up to age 26 may be added to plans student and marital status no longer apply
Lifetime maximums on active plans have been removed
Over the counter medications will no longer be reimbursable through an FSA (or HSA) without a prescription
Retiree Medical
Most Pre-65 retirees moving to Rewards and Savings plans
No I-account for pre-65 Rewards and Savings plans
Most Post-65 retirees moving to stipend as of 1111
Pre and post-65 plans offered thru Whirlpool have LTM
WHIRLPOOL CORPORTATION CONFIDENTIAL
2011 PHARMACY BENEFIT
WHIRLPOOL CORPORTATION CONFIDENTIAL
2011 PHARMACY BENEFIT FOR ACTIVES amp PRE-65 RETIREES
Tier 0 $0 or 0 Coinsurance
Tier 1 10 Coinsurance30-day supply
Min $5 Max $1290-day supply
Min $1250 Max $30
Tier 2 20 Coinsurance
30-day supplyMin $20 Max $100
90-day supplyMin $50 Max $250
Tier 3 50 Coinsurance
30-day supplyMin $50 Max $250
90-day supplyMin $125 Max $625
Tier 4 100 Coinsurance
INCREASED VALUE TO MEMBERS amp PLAN
Encourage the
utilization of clinically
and cost effective
therapies
Primarily Generics
Encourage the
utilization of cost
effective therapies that
donrsquot qualify for $0 tier
Primarily Generics
Encourage the
utilization of cost
effective therapies
relative to other agents
therapies
Primarily Preferred
Brands
Products that are not as
clinically or cost
effective relative to
other available agents
therapies
Primarily Non-Preferred
Brands
Products
considered to have
minimal or no
clinical or cost
effectiveness
relative to other
available agents
therapies
Primarily Non-
Preferred Brands
90-day supply available thru
Walgreens network
pharmacies or mail order only
WHIRLPOOL CORPORTATION CONFIDENTIAL
WHATrsquoS CHANGINGActive amp Pre-65 Pharmacy
Walgreens Health Initiatives (WHI) selected to replace Medco as pharmacy benefit manager (PBM)
30-day fills use the WHI network for discounted pricing
90-day fills maintenance medications may be filled at Walgreens retail or thru Walgreens mail order
WHI network includes independent pharmacies as well as chains such as CVS Rite Aid Wal-Mart amp Target
Post-65 Retirees
Moving to stipend
WHIRLPOOL CORPORTATION CONFIDENTIAL
Q Will prescriptions automatically be transferred to Walgreens
A 30-day prescriptions will not be transferred to Walgreens
90-day mail maintenance medications will be automatically transferred to
Walgreens Mail Service as of January
NOTE 90-day prescriptions not filled using mail service any 30-day
prescription as well as narcotics and compound medications will not be
transferred and will require a new prescription from your physician
Q Will the tier of drugs change
A No the tiers in the benefit plan design are not changing
However the price that members pay for medication may change due to the
special discount pricing being offered by WHI
WHI QampA
WHIRLPOOL CORPORTATION CONFIDENTIAL
Q Will there be two ID cards for next year
A No active and pre-65 members will continue to have one card for
medical and pharmacy
14
ID CARDS
WHIRLPOOL CORPORTATION CONFIDENTIAL
PHONE 1-877-WHIRL50 (877-944-1550)
FAX 1-800-736-8270
WEB wwwwalgreenshealthcom
Click on Healthcare Professionals tab
15
WHI Contact Information
WHIRLPOOL CORPORTATION CONFIDENTIAL
HEALTHSCOPE BENEFITS
WHIRLPOOL CORPORTATION CONFIDENTIAL
17
HealthSCOPE Benefits
Pre-certificationPre-authorization
Claim Status
Eligibility
Benefit Information
Provider Network verification
IVR- Available 247
1st Level Appeals
1-800-660-6212CUSTOMER CARE
REPRESENTATIVES
Whirlpool Service Line
1-800-660-6212
M-F 800 am ndash 600 pm EST
WHIRLPOOL CORPORTATION CONFIDENTIAL
18
HSB Whirlpool Customer Care Web Tools
Click on Providero Check on
o Claim Status
o Eligibility
o Benefit Information
o Precert Information
o Copies of EOBs
wwwhealthscopebenefitscom
WHIRLPOOL CORPORTATION CONFIDENTIAL
19
HealthSCOPE Benefits
Copy of provider EOB
WHIRLPOOL CORPORTATION CONFIDENTIAL
20
PRE-CERTIFICATION PROCEDURES
All members along with their providers will be required to pre-certify all Non-emergency inpatient admissions Major outpatient surgical procedures Non-stat MRI amp CT Scans Outpatient mental health facility admits or visits
Contact HealthSCOPE Benefits for pre-certification at 1-800-660-212
Member ID card has reminder statement regarding pre-certification
20
WHIRLPOOL CORPORTATION CONFIDENTIAL
WHIRLPOOL PROVIDER UPDATES
COMMUNICATIONS THROUGHOUT THE YEAR
Quarterly Newsletters
Quarterly Teleconferences
Join the mailing list Send an email to susan_a_pavlopouloswhirlpoolcom
HealthSCOPE Benefits websitewwwhealthscopebenefitscom
Walgreens website
wwwwalgreenshealthcom
21
WHIRLPOOL CORPORTATION CONFIDENTIAL
QUESTIONS
WHIRLPOOL CORPORTATION CONFIDENTIAL
2011 ACTIVE AMANA HOURLY PLANS
Presentation title 4
WHIRLPOOL CORPORTATION CONFIDENTIAL
2011 ACTIVE FT SMITH HOURLY PLANS
Presentation title 5
WHIRLPOOL CORPORTATION CONFIDENTIAL
ACTIVE FLEXFORCE LIMITED PLAN
Limited Plan
in-network out-of-network
EMP
LOY
EE
PA
YS
Deductible
Per Person3 $1800 $3600
Out-of-Pocket Limit
Per Person none none
Benefit DescriptionW
HIR
LPO
OL
PAY
SPrimary Care Physician (PCP) Office Visits
70 50
Specialist Office Visits 70 50
Hospital (Inpatient amp Outpatient)2 70 50
Surgery (Inpatient amp Outpatient) 2 70 50
Adult Routine Wellness 100 Not covered
Well Child Care 100 Not covered
Emergency Room70 70
50 if non-emergency
Mental and Nervous (inpatient amp outpatient)
70 50
Chiropractic Care
70 50
limited to 20 visits per calendar year (combined limit)
Home Health Care
70 50
limited to 120 visits per calendar year (combined limit)
Annual Maximum na
Lifetime Maximum na
Prescription Benefit Highlights
Retail or Mail Order 70 coinsurance
Indicates no deductible applies
Corporate StandardSample PowerPoint 6
WHIRLPOOL CORPORTATION CONFIDENTIAL
WHIRLPOOL WELLNESS PREVENTIVE CARE BENEFITS
Preventive Care Adults Actives amp Pre Medicare Retirees
bull 100 no deductible in network
bullBill with routinepreventive V-code
Well-adult care includes one routine office visit and examination each Plan Year after age 18 years and one OBGYN office visit and examination after age 18 years of age each Plan Year
Included immunizations and screenings associated with the above routine office visits are as follows bull Immunizations
1Tetanus Diphtheria (Td) Booster once every 10 years 2Influenza Vaccination (flu shot) one shot each Plan Year
3Pneumococcal Vaccination (Pneumovaz) one dose for persons 65 years and over
4Meningococcal conjugated vaccine (MCV4) one dose for college freshmen living in dormitories 5bull Screenings
6Cholesterol screening including triglycerides LDL HDL or lipid panel once every 5 years beginning at age 20 years
7Baseline Mammogram one between 30 and 40 years of age and one Mammogram each Plan Year starting at age 40 years of age
8Pap Smear and Routine Pelvic Exam one each Plan Year beginning at age 18 years
9Bone density test for osteoporosis every two years for women age 50 years and over
Colorectal Cancer Screenings 1048707 Fecal occult blood test (FOBT) or Colonoscopy or Double contrast barium enema 1048707 Digital rectal examination (DRE) and prostate specific antigen (PSA) test
bull Pathologies labs chest x-rays and EKGs that are ordered as part of your preventive care visit due to age andor family history and are considered preventive care by your Physician
WHIRLPOOL CORPORTATION CONFIDENTIAL
WHIRLPOOL WELLNESS PREVENTIVE CARE BENEFITS
Preventive Care
Children
bull 100 no
deductible in
network
bullBill with
routinepreventive
V-code
Well-child care includes routine office visits and examination as follows 1 Six visits 0 ndash 12 months 2 Three visits 12 ndash 24 months 3 Annual visits from 24 months through age 18 years of age4 GYN exam for children at age 18
When associated with routine office visits the following immunizations and screenings are covered
bull Immunizations o Two doses of Hepatitis A Three doses of Hepatitis B
o Six doses of Diphtheria Tetanus Pertussis (DtaP) Four doses of Haemophilus
Influenza type b Four doses of Polio Four doses of Pnuemococcal Conjugate
Two doses of Varicella wo doses of Measles Mumps Rubella
o One dose of Influenza vaccine (flu shot) one dose each Plan Year for children over
the age of 8 years two doses (administered separately by at least 4 weeks)
each Plan Year for children up through 8 years of age
o Human papilloma virus (HPV) vaccine for girls ages 9 through 18 years of age at the
following intervals
1048707 One complete dosage per lifetime consisting of 3 shots given within a 6 month
timeframe
1048707 Women over the age of 18 years but under the age of 26 years who have not yet
received the HPV may also receive the vaccine
bull Meningococcal conjugated vaccine (MCV4) at the following intervals
One dose between the ages of 11 and 12 years or
One dose before high school entry or at age 15 years whichever
occurs first for children who have not previously received the
MCV4 vaccine
bull Screenings and Exams Lead level testing one between ages 9 to 12 months and one at 24 months or after Vision screening conducted as part of Well-child care visit at ages 3 4 5 6 8 10
12 15 and 18 years Hearing screening conducted as part of Well-Child care Visit at ages 4 5 6 8 10 12
15 and 18 years Pap smear and routine pelvic exam one each Plan Year beginning at age 18 years or
the onset of sexual activity whichever comes first
Pathologies labs chest x-rays and EKGs that are ordered as part of your preventive
care visit and are considered preventive care by your Physician
WHIRLPOOL CORPORTATION CONFIDENTIAL
WHATrsquoS CHANGING
Active Medical
Dependents up to age 26 may be added to plans student and marital status no longer apply
Lifetime maximums on active plans have been removed
Over the counter medications will no longer be reimbursable through an FSA (or HSA) without a prescription
Retiree Medical
Most Pre-65 retirees moving to Rewards and Savings plans
No I-account for pre-65 Rewards and Savings plans
Most Post-65 retirees moving to stipend as of 1111
Pre and post-65 plans offered thru Whirlpool have LTM
WHIRLPOOL CORPORTATION CONFIDENTIAL
2011 PHARMACY BENEFIT
WHIRLPOOL CORPORTATION CONFIDENTIAL
2011 PHARMACY BENEFIT FOR ACTIVES amp PRE-65 RETIREES
Tier 0 $0 or 0 Coinsurance
Tier 1 10 Coinsurance30-day supply
Min $5 Max $1290-day supply
Min $1250 Max $30
Tier 2 20 Coinsurance
30-day supplyMin $20 Max $100
90-day supplyMin $50 Max $250
Tier 3 50 Coinsurance
30-day supplyMin $50 Max $250
90-day supplyMin $125 Max $625
Tier 4 100 Coinsurance
INCREASED VALUE TO MEMBERS amp PLAN
Encourage the
utilization of clinically
and cost effective
therapies
Primarily Generics
Encourage the
utilization of cost
effective therapies that
donrsquot qualify for $0 tier
Primarily Generics
Encourage the
utilization of cost
effective therapies
relative to other agents
therapies
Primarily Preferred
Brands
Products that are not as
clinically or cost
effective relative to
other available agents
therapies
Primarily Non-Preferred
Brands
Products
considered to have
minimal or no
clinical or cost
effectiveness
relative to other
available agents
therapies
Primarily Non-
Preferred Brands
90-day supply available thru
Walgreens network
pharmacies or mail order only
WHIRLPOOL CORPORTATION CONFIDENTIAL
WHATrsquoS CHANGINGActive amp Pre-65 Pharmacy
Walgreens Health Initiatives (WHI) selected to replace Medco as pharmacy benefit manager (PBM)
30-day fills use the WHI network for discounted pricing
90-day fills maintenance medications may be filled at Walgreens retail or thru Walgreens mail order
WHI network includes independent pharmacies as well as chains such as CVS Rite Aid Wal-Mart amp Target
Post-65 Retirees
Moving to stipend
WHIRLPOOL CORPORTATION CONFIDENTIAL
Q Will prescriptions automatically be transferred to Walgreens
A 30-day prescriptions will not be transferred to Walgreens
90-day mail maintenance medications will be automatically transferred to
Walgreens Mail Service as of January
NOTE 90-day prescriptions not filled using mail service any 30-day
prescription as well as narcotics and compound medications will not be
transferred and will require a new prescription from your physician
Q Will the tier of drugs change
A No the tiers in the benefit plan design are not changing
However the price that members pay for medication may change due to the
special discount pricing being offered by WHI
WHI QampA
WHIRLPOOL CORPORTATION CONFIDENTIAL
Q Will there be two ID cards for next year
A No active and pre-65 members will continue to have one card for
medical and pharmacy
14
ID CARDS
WHIRLPOOL CORPORTATION CONFIDENTIAL
PHONE 1-877-WHIRL50 (877-944-1550)
FAX 1-800-736-8270
WEB wwwwalgreenshealthcom
Click on Healthcare Professionals tab
15
WHI Contact Information
WHIRLPOOL CORPORTATION CONFIDENTIAL
HEALTHSCOPE BENEFITS
WHIRLPOOL CORPORTATION CONFIDENTIAL
17
HealthSCOPE Benefits
Pre-certificationPre-authorization
Claim Status
Eligibility
Benefit Information
Provider Network verification
IVR- Available 247
1st Level Appeals
1-800-660-6212CUSTOMER CARE
REPRESENTATIVES
Whirlpool Service Line
1-800-660-6212
M-F 800 am ndash 600 pm EST
WHIRLPOOL CORPORTATION CONFIDENTIAL
18
HSB Whirlpool Customer Care Web Tools
Click on Providero Check on
o Claim Status
o Eligibility
o Benefit Information
o Precert Information
o Copies of EOBs
wwwhealthscopebenefitscom
WHIRLPOOL CORPORTATION CONFIDENTIAL
19
HealthSCOPE Benefits
Copy of provider EOB
WHIRLPOOL CORPORTATION CONFIDENTIAL
20
PRE-CERTIFICATION PROCEDURES
All members along with their providers will be required to pre-certify all Non-emergency inpatient admissions Major outpatient surgical procedures Non-stat MRI amp CT Scans Outpatient mental health facility admits or visits
Contact HealthSCOPE Benefits for pre-certification at 1-800-660-212
Member ID card has reminder statement regarding pre-certification
20
WHIRLPOOL CORPORTATION CONFIDENTIAL
WHIRLPOOL PROVIDER UPDATES
COMMUNICATIONS THROUGHOUT THE YEAR
Quarterly Newsletters
Quarterly Teleconferences
Join the mailing list Send an email to susan_a_pavlopouloswhirlpoolcom
HealthSCOPE Benefits websitewwwhealthscopebenefitscom
Walgreens website
wwwwalgreenshealthcom
21
WHIRLPOOL CORPORTATION CONFIDENTIAL
QUESTIONS
WHIRLPOOL CORPORTATION CONFIDENTIAL
2011 ACTIVE FT SMITH HOURLY PLANS
Presentation title 5
WHIRLPOOL CORPORTATION CONFIDENTIAL
ACTIVE FLEXFORCE LIMITED PLAN
Limited Plan
in-network out-of-network
EMP
LOY
EE
PA
YS
Deductible
Per Person3 $1800 $3600
Out-of-Pocket Limit
Per Person none none
Benefit DescriptionW
HIR
LPO
OL
PAY
SPrimary Care Physician (PCP) Office Visits
70 50
Specialist Office Visits 70 50
Hospital (Inpatient amp Outpatient)2 70 50
Surgery (Inpatient amp Outpatient) 2 70 50
Adult Routine Wellness 100 Not covered
Well Child Care 100 Not covered
Emergency Room70 70
50 if non-emergency
Mental and Nervous (inpatient amp outpatient)
70 50
Chiropractic Care
70 50
limited to 20 visits per calendar year (combined limit)
Home Health Care
70 50
limited to 120 visits per calendar year (combined limit)
Annual Maximum na
Lifetime Maximum na
Prescription Benefit Highlights
Retail or Mail Order 70 coinsurance
Indicates no deductible applies
Corporate StandardSample PowerPoint 6
WHIRLPOOL CORPORTATION CONFIDENTIAL
WHIRLPOOL WELLNESS PREVENTIVE CARE BENEFITS
Preventive Care Adults Actives amp Pre Medicare Retirees
bull 100 no deductible in network
bullBill with routinepreventive V-code
Well-adult care includes one routine office visit and examination each Plan Year after age 18 years and one OBGYN office visit and examination after age 18 years of age each Plan Year
Included immunizations and screenings associated with the above routine office visits are as follows bull Immunizations
1Tetanus Diphtheria (Td) Booster once every 10 years 2Influenza Vaccination (flu shot) one shot each Plan Year
3Pneumococcal Vaccination (Pneumovaz) one dose for persons 65 years and over
4Meningococcal conjugated vaccine (MCV4) one dose for college freshmen living in dormitories 5bull Screenings
6Cholesterol screening including triglycerides LDL HDL or lipid panel once every 5 years beginning at age 20 years
7Baseline Mammogram one between 30 and 40 years of age and one Mammogram each Plan Year starting at age 40 years of age
8Pap Smear and Routine Pelvic Exam one each Plan Year beginning at age 18 years
9Bone density test for osteoporosis every two years for women age 50 years and over
Colorectal Cancer Screenings 1048707 Fecal occult blood test (FOBT) or Colonoscopy or Double contrast barium enema 1048707 Digital rectal examination (DRE) and prostate specific antigen (PSA) test
bull Pathologies labs chest x-rays and EKGs that are ordered as part of your preventive care visit due to age andor family history and are considered preventive care by your Physician
WHIRLPOOL CORPORTATION CONFIDENTIAL
WHIRLPOOL WELLNESS PREVENTIVE CARE BENEFITS
Preventive Care
Children
bull 100 no
deductible in
network
bullBill with
routinepreventive
V-code
Well-child care includes routine office visits and examination as follows 1 Six visits 0 ndash 12 months 2 Three visits 12 ndash 24 months 3 Annual visits from 24 months through age 18 years of age4 GYN exam for children at age 18
When associated with routine office visits the following immunizations and screenings are covered
bull Immunizations o Two doses of Hepatitis A Three doses of Hepatitis B
o Six doses of Diphtheria Tetanus Pertussis (DtaP) Four doses of Haemophilus
Influenza type b Four doses of Polio Four doses of Pnuemococcal Conjugate
Two doses of Varicella wo doses of Measles Mumps Rubella
o One dose of Influenza vaccine (flu shot) one dose each Plan Year for children over
the age of 8 years two doses (administered separately by at least 4 weeks)
each Plan Year for children up through 8 years of age
o Human papilloma virus (HPV) vaccine for girls ages 9 through 18 years of age at the
following intervals
1048707 One complete dosage per lifetime consisting of 3 shots given within a 6 month
timeframe
1048707 Women over the age of 18 years but under the age of 26 years who have not yet
received the HPV may also receive the vaccine
bull Meningococcal conjugated vaccine (MCV4) at the following intervals
One dose between the ages of 11 and 12 years or
One dose before high school entry or at age 15 years whichever
occurs first for children who have not previously received the
MCV4 vaccine
bull Screenings and Exams Lead level testing one between ages 9 to 12 months and one at 24 months or after Vision screening conducted as part of Well-child care visit at ages 3 4 5 6 8 10
12 15 and 18 years Hearing screening conducted as part of Well-Child care Visit at ages 4 5 6 8 10 12
15 and 18 years Pap smear and routine pelvic exam one each Plan Year beginning at age 18 years or
the onset of sexual activity whichever comes first
Pathologies labs chest x-rays and EKGs that are ordered as part of your preventive
care visit and are considered preventive care by your Physician
WHIRLPOOL CORPORTATION CONFIDENTIAL
WHATrsquoS CHANGING
Active Medical
Dependents up to age 26 may be added to plans student and marital status no longer apply
Lifetime maximums on active plans have been removed
Over the counter medications will no longer be reimbursable through an FSA (or HSA) without a prescription
Retiree Medical
Most Pre-65 retirees moving to Rewards and Savings plans
No I-account for pre-65 Rewards and Savings plans
Most Post-65 retirees moving to stipend as of 1111
Pre and post-65 plans offered thru Whirlpool have LTM
WHIRLPOOL CORPORTATION CONFIDENTIAL
2011 PHARMACY BENEFIT
WHIRLPOOL CORPORTATION CONFIDENTIAL
2011 PHARMACY BENEFIT FOR ACTIVES amp PRE-65 RETIREES
Tier 0 $0 or 0 Coinsurance
Tier 1 10 Coinsurance30-day supply
Min $5 Max $1290-day supply
Min $1250 Max $30
Tier 2 20 Coinsurance
30-day supplyMin $20 Max $100
90-day supplyMin $50 Max $250
Tier 3 50 Coinsurance
30-day supplyMin $50 Max $250
90-day supplyMin $125 Max $625
Tier 4 100 Coinsurance
INCREASED VALUE TO MEMBERS amp PLAN
Encourage the
utilization of clinically
and cost effective
therapies
Primarily Generics
Encourage the
utilization of cost
effective therapies that
donrsquot qualify for $0 tier
Primarily Generics
Encourage the
utilization of cost
effective therapies
relative to other agents
therapies
Primarily Preferred
Brands
Products that are not as
clinically or cost
effective relative to
other available agents
therapies
Primarily Non-Preferred
Brands
Products
considered to have
minimal or no
clinical or cost
effectiveness
relative to other
available agents
therapies
Primarily Non-
Preferred Brands
90-day supply available thru
Walgreens network
pharmacies or mail order only
WHIRLPOOL CORPORTATION CONFIDENTIAL
WHATrsquoS CHANGINGActive amp Pre-65 Pharmacy
Walgreens Health Initiatives (WHI) selected to replace Medco as pharmacy benefit manager (PBM)
30-day fills use the WHI network for discounted pricing
90-day fills maintenance medications may be filled at Walgreens retail or thru Walgreens mail order
WHI network includes independent pharmacies as well as chains such as CVS Rite Aid Wal-Mart amp Target
Post-65 Retirees
Moving to stipend
WHIRLPOOL CORPORTATION CONFIDENTIAL
Q Will prescriptions automatically be transferred to Walgreens
A 30-day prescriptions will not be transferred to Walgreens
90-day mail maintenance medications will be automatically transferred to
Walgreens Mail Service as of January
NOTE 90-day prescriptions not filled using mail service any 30-day
prescription as well as narcotics and compound medications will not be
transferred and will require a new prescription from your physician
Q Will the tier of drugs change
A No the tiers in the benefit plan design are not changing
However the price that members pay for medication may change due to the
special discount pricing being offered by WHI
WHI QampA
WHIRLPOOL CORPORTATION CONFIDENTIAL
Q Will there be two ID cards for next year
A No active and pre-65 members will continue to have one card for
medical and pharmacy
14
ID CARDS
WHIRLPOOL CORPORTATION CONFIDENTIAL
PHONE 1-877-WHIRL50 (877-944-1550)
FAX 1-800-736-8270
WEB wwwwalgreenshealthcom
Click on Healthcare Professionals tab
15
WHI Contact Information
WHIRLPOOL CORPORTATION CONFIDENTIAL
HEALTHSCOPE BENEFITS
WHIRLPOOL CORPORTATION CONFIDENTIAL
17
HealthSCOPE Benefits
Pre-certificationPre-authorization
Claim Status
Eligibility
Benefit Information
Provider Network verification
IVR- Available 247
1st Level Appeals
1-800-660-6212CUSTOMER CARE
REPRESENTATIVES
Whirlpool Service Line
1-800-660-6212
M-F 800 am ndash 600 pm EST
WHIRLPOOL CORPORTATION CONFIDENTIAL
18
HSB Whirlpool Customer Care Web Tools
Click on Providero Check on
o Claim Status
o Eligibility
o Benefit Information
o Precert Information
o Copies of EOBs
wwwhealthscopebenefitscom
WHIRLPOOL CORPORTATION CONFIDENTIAL
19
HealthSCOPE Benefits
Copy of provider EOB
WHIRLPOOL CORPORTATION CONFIDENTIAL
20
PRE-CERTIFICATION PROCEDURES
All members along with their providers will be required to pre-certify all Non-emergency inpatient admissions Major outpatient surgical procedures Non-stat MRI amp CT Scans Outpatient mental health facility admits or visits
Contact HealthSCOPE Benefits for pre-certification at 1-800-660-212
Member ID card has reminder statement regarding pre-certification
20
WHIRLPOOL CORPORTATION CONFIDENTIAL
WHIRLPOOL PROVIDER UPDATES
COMMUNICATIONS THROUGHOUT THE YEAR
Quarterly Newsletters
Quarterly Teleconferences
Join the mailing list Send an email to susan_a_pavlopouloswhirlpoolcom
HealthSCOPE Benefits websitewwwhealthscopebenefitscom
Walgreens website
wwwwalgreenshealthcom
21
WHIRLPOOL CORPORTATION CONFIDENTIAL
QUESTIONS
WHIRLPOOL CORPORTATION CONFIDENTIAL
ACTIVE FLEXFORCE LIMITED PLAN
Limited Plan
in-network out-of-network
EMP
LOY
EE
PA
YS
Deductible
Per Person3 $1800 $3600
Out-of-Pocket Limit
Per Person none none
Benefit DescriptionW
HIR
LPO
OL
PAY
SPrimary Care Physician (PCP) Office Visits
70 50
Specialist Office Visits 70 50
Hospital (Inpatient amp Outpatient)2 70 50
Surgery (Inpatient amp Outpatient) 2 70 50
Adult Routine Wellness 100 Not covered
Well Child Care 100 Not covered
Emergency Room70 70
50 if non-emergency
Mental and Nervous (inpatient amp outpatient)
70 50
Chiropractic Care
70 50
limited to 20 visits per calendar year (combined limit)
Home Health Care
70 50
limited to 120 visits per calendar year (combined limit)
Annual Maximum na
Lifetime Maximum na
Prescription Benefit Highlights
Retail or Mail Order 70 coinsurance
Indicates no deductible applies
Corporate StandardSample PowerPoint 6
WHIRLPOOL CORPORTATION CONFIDENTIAL
WHIRLPOOL WELLNESS PREVENTIVE CARE BENEFITS
Preventive Care Adults Actives amp Pre Medicare Retirees
bull 100 no deductible in network
bullBill with routinepreventive V-code
Well-adult care includes one routine office visit and examination each Plan Year after age 18 years and one OBGYN office visit and examination after age 18 years of age each Plan Year
Included immunizations and screenings associated with the above routine office visits are as follows bull Immunizations
1Tetanus Diphtheria (Td) Booster once every 10 years 2Influenza Vaccination (flu shot) one shot each Plan Year
3Pneumococcal Vaccination (Pneumovaz) one dose for persons 65 years and over
4Meningococcal conjugated vaccine (MCV4) one dose for college freshmen living in dormitories 5bull Screenings
6Cholesterol screening including triglycerides LDL HDL or lipid panel once every 5 years beginning at age 20 years
7Baseline Mammogram one between 30 and 40 years of age and one Mammogram each Plan Year starting at age 40 years of age
8Pap Smear and Routine Pelvic Exam one each Plan Year beginning at age 18 years
9Bone density test for osteoporosis every two years for women age 50 years and over
Colorectal Cancer Screenings 1048707 Fecal occult blood test (FOBT) or Colonoscopy or Double contrast barium enema 1048707 Digital rectal examination (DRE) and prostate specific antigen (PSA) test
bull Pathologies labs chest x-rays and EKGs that are ordered as part of your preventive care visit due to age andor family history and are considered preventive care by your Physician
WHIRLPOOL CORPORTATION CONFIDENTIAL
WHIRLPOOL WELLNESS PREVENTIVE CARE BENEFITS
Preventive Care
Children
bull 100 no
deductible in
network
bullBill with
routinepreventive
V-code
Well-child care includes routine office visits and examination as follows 1 Six visits 0 ndash 12 months 2 Three visits 12 ndash 24 months 3 Annual visits from 24 months through age 18 years of age4 GYN exam for children at age 18
When associated with routine office visits the following immunizations and screenings are covered
bull Immunizations o Two doses of Hepatitis A Three doses of Hepatitis B
o Six doses of Diphtheria Tetanus Pertussis (DtaP) Four doses of Haemophilus
Influenza type b Four doses of Polio Four doses of Pnuemococcal Conjugate
Two doses of Varicella wo doses of Measles Mumps Rubella
o One dose of Influenza vaccine (flu shot) one dose each Plan Year for children over
the age of 8 years two doses (administered separately by at least 4 weeks)
each Plan Year for children up through 8 years of age
o Human papilloma virus (HPV) vaccine for girls ages 9 through 18 years of age at the
following intervals
1048707 One complete dosage per lifetime consisting of 3 shots given within a 6 month
timeframe
1048707 Women over the age of 18 years but under the age of 26 years who have not yet
received the HPV may also receive the vaccine
bull Meningococcal conjugated vaccine (MCV4) at the following intervals
One dose between the ages of 11 and 12 years or
One dose before high school entry or at age 15 years whichever
occurs first for children who have not previously received the
MCV4 vaccine
bull Screenings and Exams Lead level testing one between ages 9 to 12 months and one at 24 months or after Vision screening conducted as part of Well-child care visit at ages 3 4 5 6 8 10
12 15 and 18 years Hearing screening conducted as part of Well-Child care Visit at ages 4 5 6 8 10 12
15 and 18 years Pap smear and routine pelvic exam one each Plan Year beginning at age 18 years or
the onset of sexual activity whichever comes first
Pathologies labs chest x-rays and EKGs that are ordered as part of your preventive
care visit and are considered preventive care by your Physician
WHIRLPOOL CORPORTATION CONFIDENTIAL
WHATrsquoS CHANGING
Active Medical
Dependents up to age 26 may be added to plans student and marital status no longer apply
Lifetime maximums on active plans have been removed
Over the counter medications will no longer be reimbursable through an FSA (or HSA) without a prescription
Retiree Medical
Most Pre-65 retirees moving to Rewards and Savings plans
No I-account for pre-65 Rewards and Savings plans
Most Post-65 retirees moving to stipend as of 1111
Pre and post-65 plans offered thru Whirlpool have LTM
WHIRLPOOL CORPORTATION CONFIDENTIAL
2011 PHARMACY BENEFIT
WHIRLPOOL CORPORTATION CONFIDENTIAL
2011 PHARMACY BENEFIT FOR ACTIVES amp PRE-65 RETIREES
Tier 0 $0 or 0 Coinsurance
Tier 1 10 Coinsurance30-day supply
Min $5 Max $1290-day supply
Min $1250 Max $30
Tier 2 20 Coinsurance
30-day supplyMin $20 Max $100
90-day supplyMin $50 Max $250
Tier 3 50 Coinsurance
30-day supplyMin $50 Max $250
90-day supplyMin $125 Max $625
Tier 4 100 Coinsurance
INCREASED VALUE TO MEMBERS amp PLAN
Encourage the
utilization of clinically
and cost effective
therapies
Primarily Generics
Encourage the
utilization of cost
effective therapies that
donrsquot qualify for $0 tier
Primarily Generics
Encourage the
utilization of cost
effective therapies
relative to other agents
therapies
Primarily Preferred
Brands
Products that are not as
clinically or cost
effective relative to
other available agents
therapies
Primarily Non-Preferred
Brands
Products
considered to have
minimal or no
clinical or cost
effectiveness
relative to other
available agents
therapies
Primarily Non-
Preferred Brands
90-day supply available thru
Walgreens network
pharmacies or mail order only
WHIRLPOOL CORPORTATION CONFIDENTIAL
WHATrsquoS CHANGINGActive amp Pre-65 Pharmacy
Walgreens Health Initiatives (WHI) selected to replace Medco as pharmacy benefit manager (PBM)
30-day fills use the WHI network for discounted pricing
90-day fills maintenance medications may be filled at Walgreens retail or thru Walgreens mail order
WHI network includes independent pharmacies as well as chains such as CVS Rite Aid Wal-Mart amp Target
Post-65 Retirees
Moving to stipend
WHIRLPOOL CORPORTATION CONFIDENTIAL
Q Will prescriptions automatically be transferred to Walgreens
A 30-day prescriptions will not be transferred to Walgreens
90-day mail maintenance medications will be automatically transferred to
Walgreens Mail Service as of January
NOTE 90-day prescriptions not filled using mail service any 30-day
prescription as well as narcotics and compound medications will not be
transferred and will require a new prescription from your physician
Q Will the tier of drugs change
A No the tiers in the benefit plan design are not changing
However the price that members pay for medication may change due to the
special discount pricing being offered by WHI
WHI QampA
WHIRLPOOL CORPORTATION CONFIDENTIAL
Q Will there be two ID cards for next year
A No active and pre-65 members will continue to have one card for
medical and pharmacy
14
ID CARDS
WHIRLPOOL CORPORTATION CONFIDENTIAL
PHONE 1-877-WHIRL50 (877-944-1550)
FAX 1-800-736-8270
WEB wwwwalgreenshealthcom
Click on Healthcare Professionals tab
15
WHI Contact Information
WHIRLPOOL CORPORTATION CONFIDENTIAL
HEALTHSCOPE BENEFITS
WHIRLPOOL CORPORTATION CONFIDENTIAL
17
HealthSCOPE Benefits
Pre-certificationPre-authorization
Claim Status
Eligibility
Benefit Information
Provider Network verification
IVR- Available 247
1st Level Appeals
1-800-660-6212CUSTOMER CARE
REPRESENTATIVES
Whirlpool Service Line
1-800-660-6212
M-F 800 am ndash 600 pm EST
WHIRLPOOL CORPORTATION CONFIDENTIAL
18
HSB Whirlpool Customer Care Web Tools
Click on Providero Check on
o Claim Status
o Eligibility
o Benefit Information
o Precert Information
o Copies of EOBs
wwwhealthscopebenefitscom
WHIRLPOOL CORPORTATION CONFIDENTIAL
19
HealthSCOPE Benefits
Copy of provider EOB
WHIRLPOOL CORPORTATION CONFIDENTIAL
20
PRE-CERTIFICATION PROCEDURES
All members along with their providers will be required to pre-certify all Non-emergency inpatient admissions Major outpatient surgical procedures Non-stat MRI amp CT Scans Outpatient mental health facility admits or visits
Contact HealthSCOPE Benefits for pre-certification at 1-800-660-212
Member ID card has reminder statement regarding pre-certification
20
WHIRLPOOL CORPORTATION CONFIDENTIAL
WHIRLPOOL PROVIDER UPDATES
COMMUNICATIONS THROUGHOUT THE YEAR
Quarterly Newsletters
Quarterly Teleconferences
Join the mailing list Send an email to susan_a_pavlopouloswhirlpoolcom
HealthSCOPE Benefits websitewwwhealthscopebenefitscom
Walgreens website
wwwwalgreenshealthcom
21
WHIRLPOOL CORPORTATION CONFIDENTIAL
QUESTIONS
WHIRLPOOL CORPORTATION CONFIDENTIAL
WHIRLPOOL WELLNESS PREVENTIVE CARE BENEFITS
Preventive Care Adults Actives amp Pre Medicare Retirees
bull 100 no deductible in network
bullBill with routinepreventive V-code
Well-adult care includes one routine office visit and examination each Plan Year after age 18 years and one OBGYN office visit and examination after age 18 years of age each Plan Year
Included immunizations and screenings associated with the above routine office visits are as follows bull Immunizations
1Tetanus Diphtheria (Td) Booster once every 10 years 2Influenza Vaccination (flu shot) one shot each Plan Year
3Pneumococcal Vaccination (Pneumovaz) one dose for persons 65 years and over
4Meningococcal conjugated vaccine (MCV4) one dose for college freshmen living in dormitories 5bull Screenings
6Cholesterol screening including triglycerides LDL HDL or lipid panel once every 5 years beginning at age 20 years
7Baseline Mammogram one between 30 and 40 years of age and one Mammogram each Plan Year starting at age 40 years of age
8Pap Smear and Routine Pelvic Exam one each Plan Year beginning at age 18 years
9Bone density test for osteoporosis every two years for women age 50 years and over
Colorectal Cancer Screenings 1048707 Fecal occult blood test (FOBT) or Colonoscopy or Double contrast barium enema 1048707 Digital rectal examination (DRE) and prostate specific antigen (PSA) test
bull Pathologies labs chest x-rays and EKGs that are ordered as part of your preventive care visit due to age andor family history and are considered preventive care by your Physician
WHIRLPOOL CORPORTATION CONFIDENTIAL
WHIRLPOOL WELLNESS PREVENTIVE CARE BENEFITS
Preventive Care
Children
bull 100 no
deductible in
network
bullBill with
routinepreventive
V-code
Well-child care includes routine office visits and examination as follows 1 Six visits 0 ndash 12 months 2 Three visits 12 ndash 24 months 3 Annual visits from 24 months through age 18 years of age4 GYN exam for children at age 18
When associated with routine office visits the following immunizations and screenings are covered
bull Immunizations o Two doses of Hepatitis A Three doses of Hepatitis B
o Six doses of Diphtheria Tetanus Pertussis (DtaP) Four doses of Haemophilus
Influenza type b Four doses of Polio Four doses of Pnuemococcal Conjugate
Two doses of Varicella wo doses of Measles Mumps Rubella
o One dose of Influenza vaccine (flu shot) one dose each Plan Year for children over
the age of 8 years two doses (administered separately by at least 4 weeks)
each Plan Year for children up through 8 years of age
o Human papilloma virus (HPV) vaccine for girls ages 9 through 18 years of age at the
following intervals
1048707 One complete dosage per lifetime consisting of 3 shots given within a 6 month
timeframe
1048707 Women over the age of 18 years but under the age of 26 years who have not yet
received the HPV may also receive the vaccine
bull Meningococcal conjugated vaccine (MCV4) at the following intervals
One dose between the ages of 11 and 12 years or
One dose before high school entry or at age 15 years whichever
occurs first for children who have not previously received the
MCV4 vaccine
bull Screenings and Exams Lead level testing one between ages 9 to 12 months and one at 24 months or after Vision screening conducted as part of Well-child care visit at ages 3 4 5 6 8 10
12 15 and 18 years Hearing screening conducted as part of Well-Child care Visit at ages 4 5 6 8 10 12
15 and 18 years Pap smear and routine pelvic exam one each Plan Year beginning at age 18 years or
the onset of sexual activity whichever comes first
Pathologies labs chest x-rays and EKGs that are ordered as part of your preventive
care visit and are considered preventive care by your Physician
WHIRLPOOL CORPORTATION CONFIDENTIAL
WHATrsquoS CHANGING
Active Medical
Dependents up to age 26 may be added to plans student and marital status no longer apply
Lifetime maximums on active plans have been removed
Over the counter medications will no longer be reimbursable through an FSA (or HSA) without a prescription
Retiree Medical
Most Pre-65 retirees moving to Rewards and Savings plans
No I-account for pre-65 Rewards and Savings plans
Most Post-65 retirees moving to stipend as of 1111
Pre and post-65 plans offered thru Whirlpool have LTM
WHIRLPOOL CORPORTATION CONFIDENTIAL
2011 PHARMACY BENEFIT
WHIRLPOOL CORPORTATION CONFIDENTIAL
2011 PHARMACY BENEFIT FOR ACTIVES amp PRE-65 RETIREES
Tier 0 $0 or 0 Coinsurance
Tier 1 10 Coinsurance30-day supply
Min $5 Max $1290-day supply
Min $1250 Max $30
Tier 2 20 Coinsurance
30-day supplyMin $20 Max $100
90-day supplyMin $50 Max $250
Tier 3 50 Coinsurance
30-day supplyMin $50 Max $250
90-day supplyMin $125 Max $625
Tier 4 100 Coinsurance
INCREASED VALUE TO MEMBERS amp PLAN
Encourage the
utilization of clinically
and cost effective
therapies
Primarily Generics
Encourage the
utilization of cost
effective therapies that
donrsquot qualify for $0 tier
Primarily Generics
Encourage the
utilization of cost
effective therapies
relative to other agents
therapies
Primarily Preferred
Brands
Products that are not as
clinically or cost
effective relative to
other available agents
therapies
Primarily Non-Preferred
Brands
Products
considered to have
minimal or no
clinical or cost
effectiveness
relative to other
available agents
therapies
Primarily Non-
Preferred Brands
90-day supply available thru
Walgreens network
pharmacies or mail order only
WHIRLPOOL CORPORTATION CONFIDENTIAL
WHATrsquoS CHANGINGActive amp Pre-65 Pharmacy
Walgreens Health Initiatives (WHI) selected to replace Medco as pharmacy benefit manager (PBM)
30-day fills use the WHI network for discounted pricing
90-day fills maintenance medications may be filled at Walgreens retail or thru Walgreens mail order
WHI network includes independent pharmacies as well as chains such as CVS Rite Aid Wal-Mart amp Target
Post-65 Retirees
Moving to stipend
WHIRLPOOL CORPORTATION CONFIDENTIAL
Q Will prescriptions automatically be transferred to Walgreens
A 30-day prescriptions will not be transferred to Walgreens
90-day mail maintenance medications will be automatically transferred to
Walgreens Mail Service as of January
NOTE 90-day prescriptions not filled using mail service any 30-day
prescription as well as narcotics and compound medications will not be
transferred and will require a new prescription from your physician
Q Will the tier of drugs change
A No the tiers in the benefit plan design are not changing
However the price that members pay for medication may change due to the
special discount pricing being offered by WHI
WHI QampA
WHIRLPOOL CORPORTATION CONFIDENTIAL
Q Will there be two ID cards for next year
A No active and pre-65 members will continue to have one card for
medical and pharmacy
14
ID CARDS
WHIRLPOOL CORPORTATION CONFIDENTIAL
PHONE 1-877-WHIRL50 (877-944-1550)
FAX 1-800-736-8270
WEB wwwwalgreenshealthcom
Click on Healthcare Professionals tab
15
WHI Contact Information
WHIRLPOOL CORPORTATION CONFIDENTIAL
HEALTHSCOPE BENEFITS
WHIRLPOOL CORPORTATION CONFIDENTIAL
17
HealthSCOPE Benefits
Pre-certificationPre-authorization
Claim Status
Eligibility
Benefit Information
Provider Network verification
IVR- Available 247
1st Level Appeals
1-800-660-6212CUSTOMER CARE
REPRESENTATIVES
Whirlpool Service Line
1-800-660-6212
M-F 800 am ndash 600 pm EST
WHIRLPOOL CORPORTATION CONFIDENTIAL
18
HSB Whirlpool Customer Care Web Tools
Click on Providero Check on
o Claim Status
o Eligibility
o Benefit Information
o Precert Information
o Copies of EOBs
wwwhealthscopebenefitscom
WHIRLPOOL CORPORTATION CONFIDENTIAL
19
HealthSCOPE Benefits
Copy of provider EOB
WHIRLPOOL CORPORTATION CONFIDENTIAL
20
PRE-CERTIFICATION PROCEDURES
All members along with their providers will be required to pre-certify all Non-emergency inpatient admissions Major outpatient surgical procedures Non-stat MRI amp CT Scans Outpatient mental health facility admits or visits
Contact HealthSCOPE Benefits for pre-certification at 1-800-660-212
Member ID card has reminder statement regarding pre-certification
20
WHIRLPOOL CORPORTATION CONFIDENTIAL
WHIRLPOOL PROVIDER UPDATES
COMMUNICATIONS THROUGHOUT THE YEAR
Quarterly Newsletters
Quarterly Teleconferences
Join the mailing list Send an email to susan_a_pavlopouloswhirlpoolcom
HealthSCOPE Benefits websitewwwhealthscopebenefitscom
Walgreens website
wwwwalgreenshealthcom
21
WHIRLPOOL CORPORTATION CONFIDENTIAL
QUESTIONS
WHIRLPOOL CORPORTATION CONFIDENTIAL
WHIRLPOOL WELLNESS PREVENTIVE CARE BENEFITS
Preventive Care
Children
bull 100 no
deductible in
network
bullBill with
routinepreventive
V-code
Well-child care includes routine office visits and examination as follows 1 Six visits 0 ndash 12 months 2 Three visits 12 ndash 24 months 3 Annual visits from 24 months through age 18 years of age4 GYN exam for children at age 18
When associated with routine office visits the following immunizations and screenings are covered
bull Immunizations o Two doses of Hepatitis A Three doses of Hepatitis B
o Six doses of Diphtheria Tetanus Pertussis (DtaP) Four doses of Haemophilus
Influenza type b Four doses of Polio Four doses of Pnuemococcal Conjugate
Two doses of Varicella wo doses of Measles Mumps Rubella
o One dose of Influenza vaccine (flu shot) one dose each Plan Year for children over
the age of 8 years two doses (administered separately by at least 4 weeks)
each Plan Year for children up through 8 years of age
o Human papilloma virus (HPV) vaccine for girls ages 9 through 18 years of age at the
following intervals
1048707 One complete dosage per lifetime consisting of 3 shots given within a 6 month
timeframe
1048707 Women over the age of 18 years but under the age of 26 years who have not yet
received the HPV may also receive the vaccine
bull Meningococcal conjugated vaccine (MCV4) at the following intervals
One dose between the ages of 11 and 12 years or
One dose before high school entry or at age 15 years whichever
occurs first for children who have not previously received the
MCV4 vaccine
bull Screenings and Exams Lead level testing one between ages 9 to 12 months and one at 24 months or after Vision screening conducted as part of Well-child care visit at ages 3 4 5 6 8 10
12 15 and 18 years Hearing screening conducted as part of Well-Child care Visit at ages 4 5 6 8 10 12
15 and 18 years Pap smear and routine pelvic exam one each Plan Year beginning at age 18 years or
the onset of sexual activity whichever comes first
Pathologies labs chest x-rays and EKGs that are ordered as part of your preventive
care visit and are considered preventive care by your Physician
WHIRLPOOL CORPORTATION CONFIDENTIAL
WHATrsquoS CHANGING
Active Medical
Dependents up to age 26 may be added to plans student and marital status no longer apply
Lifetime maximums on active plans have been removed
Over the counter medications will no longer be reimbursable through an FSA (or HSA) without a prescription
Retiree Medical
Most Pre-65 retirees moving to Rewards and Savings plans
No I-account for pre-65 Rewards and Savings plans
Most Post-65 retirees moving to stipend as of 1111
Pre and post-65 plans offered thru Whirlpool have LTM
WHIRLPOOL CORPORTATION CONFIDENTIAL
2011 PHARMACY BENEFIT
WHIRLPOOL CORPORTATION CONFIDENTIAL
2011 PHARMACY BENEFIT FOR ACTIVES amp PRE-65 RETIREES
Tier 0 $0 or 0 Coinsurance
Tier 1 10 Coinsurance30-day supply
Min $5 Max $1290-day supply
Min $1250 Max $30
Tier 2 20 Coinsurance
30-day supplyMin $20 Max $100
90-day supplyMin $50 Max $250
Tier 3 50 Coinsurance
30-day supplyMin $50 Max $250
90-day supplyMin $125 Max $625
Tier 4 100 Coinsurance
INCREASED VALUE TO MEMBERS amp PLAN
Encourage the
utilization of clinically
and cost effective
therapies
Primarily Generics
Encourage the
utilization of cost
effective therapies that
donrsquot qualify for $0 tier
Primarily Generics
Encourage the
utilization of cost
effective therapies
relative to other agents
therapies
Primarily Preferred
Brands
Products that are not as
clinically or cost
effective relative to
other available agents
therapies
Primarily Non-Preferred
Brands
Products
considered to have
minimal or no
clinical or cost
effectiveness
relative to other
available agents
therapies
Primarily Non-
Preferred Brands
90-day supply available thru
Walgreens network
pharmacies or mail order only
WHIRLPOOL CORPORTATION CONFIDENTIAL
WHATrsquoS CHANGINGActive amp Pre-65 Pharmacy
Walgreens Health Initiatives (WHI) selected to replace Medco as pharmacy benefit manager (PBM)
30-day fills use the WHI network for discounted pricing
90-day fills maintenance medications may be filled at Walgreens retail or thru Walgreens mail order
WHI network includes independent pharmacies as well as chains such as CVS Rite Aid Wal-Mart amp Target
Post-65 Retirees
Moving to stipend
WHIRLPOOL CORPORTATION CONFIDENTIAL
Q Will prescriptions automatically be transferred to Walgreens
A 30-day prescriptions will not be transferred to Walgreens
90-day mail maintenance medications will be automatically transferred to
Walgreens Mail Service as of January
NOTE 90-day prescriptions not filled using mail service any 30-day
prescription as well as narcotics and compound medications will not be
transferred and will require a new prescription from your physician
Q Will the tier of drugs change
A No the tiers in the benefit plan design are not changing
However the price that members pay for medication may change due to the
special discount pricing being offered by WHI
WHI QampA
WHIRLPOOL CORPORTATION CONFIDENTIAL
Q Will there be two ID cards for next year
A No active and pre-65 members will continue to have one card for
medical and pharmacy
14
ID CARDS
WHIRLPOOL CORPORTATION CONFIDENTIAL
PHONE 1-877-WHIRL50 (877-944-1550)
FAX 1-800-736-8270
WEB wwwwalgreenshealthcom
Click on Healthcare Professionals tab
15
WHI Contact Information
WHIRLPOOL CORPORTATION CONFIDENTIAL
HEALTHSCOPE BENEFITS
WHIRLPOOL CORPORTATION CONFIDENTIAL
17
HealthSCOPE Benefits
Pre-certificationPre-authorization
Claim Status
Eligibility
Benefit Information
Provider Network verification
IVR- Available 247
1st Level Appeals
1-800-660-6212CUSTOMER CARE
REPRESENTATIVES
Whirlpool Service Line
1-800-660-6212
M-F 800 am ndash 600 pm EST
WHIRLPOOL CORPORTATION CONFIDENTIAL
18
HSB Whirlpool Customer Care Web Tools
Click on Providero Check on
o Claim Status
o Eligibility
o Benefit Information
o Precert Information
o Copies of EOBs
wwwhealthscopebenefitscom
WHIRLPOOL CORPORTATION CONFIDENTIAL
19
HealthSCOPE Benefits
Copy of provider EOB
WHIRLPOOL CORPORTATION CONFIDENTIAL
20
PRE-CERTIFICATION PROCEDURES
All members along with their providers will be required to pre-certify all Non-emergency inpatient admissions Major outpatient surgical procedures Non-stat MRI amp CT Scans Outpatient mental health facility admits or visits
Contact HealthSCOPE Benefits for pre-certification at 1-800-660-212
Member ID card has reminder statement regarding pre-certification
20
WHIRLPOOL CORPORTATION CONFIDENTIAL
WHIRLPOOL PROVIDER UPDATES
COMMUNICATIONS THROUGHOUT THE YEAR
Quarterly Newsletters
Quarterly Teleconferences
Join the mailing list Send an email to susan_a_pavlopouloswhirlpoolcom
HealthSCOPE Benefits websitewwwhealthscopebenefitscom
Walgreens website
wwwwalgreenshealthcom
21
WHIRLPOOL CORPORTATION CONFIDENTIAL
QUESTIONS
WHIRLPOOL CORPORTATION CONFIDENTIAL
WHATrsquoS CHANGING
Active Medical
Dependents up to age 26 may be added to plans student and marital status no longer apply
Lifetime maximums on active plans have been removed
Over the counter medications will no longer be reimbursable through an FSA (or HSA) without a prescription
Retiree Medical
Most Pre-65 retirees moving to Rewards and Savings plans
No I-account for pre-65 Rewards and Savings plans
Most Post-65 retirees moving to stipend as of 1111
Pre and post-65 plans offered thru Whirlpool have LTM
WHIRLPOOL CORPORTATION CONFIDENTIAL
2011 PHARMACY BENEFIT
WHIRLPOOL CORPORTATION CONFIDENTIAL
2011 PHARMACY BENEFIT FOR ACTIVES amp PRE-65 RETIREES
Tier 0 $0 or 0 Coinsurance
Tier 1 10 Coinsurance30-day supply
Min $5 Max $1290-day supply
Min $1250 Max $30
Tier 2 20 Coinsurance
30-day supplyMin $20 Max $100
90-day supplyMin $50 Max $250
Tier 3 50 Coinsurance
30-day supplyMin $50 Max $250
90-day supplyMin $125 Max $625
Tier 4 100 Coinsurance
INCREASED VALUE TO MEMBERS amp PLAN
Encourage the
utilization of clinically
and cost effective
therapies
Primarily Generics
Encourage the
utilization of cost
effective therapies that
donrsquot qualify for $0 tier
Primarily Generics
Encourage the
utilization of cost
effective therapies
relative to other agents
therapies
Primarily Preferred
Brands
Products that are not as
clinically or cost
effective relative to
other available agents
therapies
Primarily Non-Preferred
Brands
Products
considered to have
minimal or no
clinical or cost
effectiveness
relative to other
available agents
therapies
Primarily Non-
Preferred Brands
90-day supply available thru
Walgreens network
pharmacies or mail order only
WHIRLPOOL CORPORTATION CONFIDENTIAL
WHATrsquoS CHANGINGActive amp Pre-65 Pharmacy
Walgreens Health Initiatives (WHI) selected to replace Medco as pharmacy benefit manager (PBM)
30-day fills use the WHI network for discounted pricing
90-day fills maintenance medications may be filled at Walgreens retail or thru Walgreens mail order
WHI network includes independent pharmacies as well as chains such as CVS Rite Aid Wal-Mart amp Target
Post-65 Retirees
Moving to stipend
WHIRLPOOL CORPORTATION CONFIDENTIAL
Q Will prescriptions automatically be transferred to Walgreens
A 30-day prescriptions will not be transferred to Walgreens
90-day mail maintenance medications will be automatically transferred to
Walgreens Mail Service as of January
NOTE 90-day prescriptions not filled using mail service any 30-day
prescription as well as narcotics and compound medications will not be
transferred and will require a new prescription from your physician
Q Will the tier of drugs change
A No the tiers in the benefit plan design are not changing
However the price that members pay for medication may change due to the
special discount pricing being offered by WHI
WHI QampA
WHIRLPOOL CORPORTATION CONFIDENTIAL
Q Will there be two ID cards for next year
A No active and pre-65 members will continue to have one card for
medical and pharmacy
14
ID CARDS
WHIRLPOOL CORPORTATION CONFIDENTIAL
PHONE 1-877-WHIRL50 (877-944-1550)
FAX 1-800-736-8270
WEB wwwwalgreenshealthcom
Click on Healthcare Professionals tab
15
WHI Contact Information
WHIRLPOOL CORPORTATION CONFIDENTIAL
HEALTHSCOPE BENEFITS
WHIRLPOOL CORPORTATION CONFIDENTIAL
17
HealthSCOPE Benefits
Pre-certificationPre-authorization
Claim Status
Eligibility
Benefit Information
Provider Network verification
IVR- Available 247
1st Level Appeals
1-800-660-6212CUSTOMER CARE
REPRESENTATIVES
Whirlpool Service Line
1-800-660-6212
M-F 800 am ndash 600 pm EST
WHIRLPOOL CORPORTATION CONFIDENTIAL
18
HSB Whirlpool Customer Care Web Tools
Click on Providero Check on
o Claim Status
o Eligibility
o Benefit Information
o Precert Information
o Copies of EOBs
wwwhealthscopebenefitscom
WHIRLPOOL CORPORTATION CONFIDENTIAL
19
HealthSCOPE Benefits
Copy of provider EOB
WHIRLPOOL CORPORTATION CONFIDENTIAL
20
PRE-CERTIFICATION PROCEDURES
All members along with their providers will be required to pre-certify all Non-emergency inpatient admissions Major outpatient surgical procedures Non-stat MRI amp CT Scans Outpatient mental health facility admits or visits
Contact HealthSCOPE Benefits for pre-certification at 1-800-660-212
Member ID card has reminder statement regarding pre-certification
20
WHIRLPOOL CORPORTATION CONFIDENTIAL
WHIRLPOOL PROVIDER UPDATES
COMMUNICATIONS THROUGHOUT THE YEAR
Quarterly Newsletters
Quarterly Teleconferences
Join the mailing list Send an email to susan_a_pavlopouloswhirlpoolcom
HealthSCOPE Benefits websitewwwhealthscopebenefitscom
Walgreens website
wwwwalgreenshealthcom
21
WHIRLPOOL CORPORTATION CONFIDENTIAL
QUESTIONS
WHIRLPOOL CORPORTATION CONFIDENTIAL
2011 PHARMACY BENEFIT
WHIRLPOOL CORPORTATION CONFIDENTIAL
2011 PHARMACY BENEFIT FOR ACTIVES amp PRE-65 RETIREES
Tier 0 $0 or 0 Coinsurance
Tier 1 10 Coinsurance30-day supply
Min $5 Max $1290-day supply
Min $1250 Max $30
Tier 2 20 Coinsurance
30-day supplyMin $20 Max $100
90-day supplyMin $50 Max $250
Tier 3 50 Coinsurance
30-day supplyMin $50 Max $250
90-day supplyMin $125 Max $625
Tier 4 100 Coinsurance
INCREASED VALUE TO MEMBERS amp PLAN
Encourage the
utilization of clinically
and cost effective
therapies
Primarily Generics
Encourage the
utilization of cost
effective therapies that
donrsquot qualify for $0 tier
Primarily Generics
Encourage the
utilization of cost
effective therapies
relative to other agents
therapies
Primarily Preferred
Brands
Products that are not as
clinically or cost
effective relative to
other available agents
therapies
Primarily Non-Preferred
Brands
Products
considered to have
minimal or no
clinical or cost
effectiveness
relative to other
available agents
therapies
Primarily Non-
Preferred Brands
90-day supply available thru
Walgreens network
pharmacies or mail order only
WHIRLPOOL CORPORTATION CONFIDENTIAL
WHATrsquoS CHANGINGActive amp Pre-65 Pharmacy
Walgreens Health Initiatives (WHI) selected to replace Medco as pharmacy benefit manager (PBM)
30-day fills use the WHI network for discounted pricing
90-day fills maintenance medications may be filled at Walgreens retail or thru Walgreens mail order
WHI network includes independent pharmacies as well as chains such as CVS Rite Aid Wal-Mart amp Target
Post-65 Retirees
Moving to stipend
WHIRLPOOL CORPORTATION CONFIDENTIAL
Q Will prescriptions automatically be transferred to Walgreens
A 30-day prescriptions will not be transferred to Walgreens
90-day mail maintenance medications will be automatically transferred to
Walgreens Mail Service as of January
NOTE 90-day prescriptions not filled using mail service any 30-day
prescription as well as narcotics and compound medications will not be
transferred and will require a new prescription from your physician
Q Will the tier of drugs change
A No the tiers in the benefit plan design are not changing
However the price that members pay for medication may change due to the
special discount pricing being offered by WHI
WHI QampA
WHIRLPOOL CORPORTATION CONFIDENTIAL
Q Will there be two ID cards for next year
A No active and pre-65 members will continue to have one card for
medical and pharmacy
14
ID CARDS
WHIRLPOOL CORPORTATION CONFIDENTIAL
PHONE 1-877-WHIRL50 (877-944-1550)
FAX 1-800-736-8270
WEB wwwwalgreenshealthcom
Click on Healthcare Professionals tab
15
WHI Contact Information
WHIRLPOOL CORPORTATION CONFIDENTIAL
HEALTHSCOPE BENEFITS
WHIRLPOOL CORPORTATION CONFIDENTIAL
17
HealthSCOPE Benefits
Pre-certificationPre-authorization
Claim Status
Eligibility
Benefit Information
Provider Network verification
IVR- Available 247
1st Level Appeals
1-800-660-6212CUSTOMER CARE
REPRESENTATIVES
Whirlpool Service Line
1-800-660-6212
M-F 800 am ndash 600 pm EST
WHIRLPOOL CORPORTATION CONFIDENTIAL
18
HSB Whirlpool Customer Care Web Tools
Click on Providero Check on
o Claim Status
o Eligibility
o Benefit Information
o Precert Information
o Copies of EOBs
wwwhealthscopebenefitscom
WHIRLPOOL CORPORTATION CONFIDENTIAL
19
HealthSCOPE Benefits
Copy of provider EOB
WHIRLPOOL CORPORTATION CONFIDENTIAL
20
PRE-CERTIFICATION PROCEDURES
All members along with their providers will be required to pre-certify all Non-emergency inpatient admissions Major outpatient surgical procedures Non-stat MRI amp CT Scans Outpatient mental health facility admits or visits
Contact HealthSCOPE Benefits for pre-certification at 1-800-660-212
Member ID card has reminder statement regarding pre-certification
20
WHIRLPOOL CORPORTATION CONFIDENTIAL
WHIRLPOOL PROVIDER UPDATES
COMMUNICATIONS THROUGHOUT THE YEAR
Quarterly Newsletters
Quarterly Teleconferences
Join the mailing list Send an email to susan_a_pavlopouloswhirlpoolcom
HealthSCOPE Benefits websitewwwhealthscopebenefitscom
Walgreens website
wwwwalgreenshealthcom
21
WHIRLPOOL CORPORTATION CONFIDENTIAL
QUESTIONS
WHIRLPOOL CORPORTATION CONFIDENTIAL
2011 PHARMACY BENEFIT FOR ACTIVES amp PRE-65 RETIREES
Tier 0 $0 or 0 Coinsurance
Tier 1 10 Coinsurance30-day supply
Min $5 Max $1290-day supply
Min $1250 Max $30
Tier 2 20 Coinsurance
30-day supplyMin $20 Max $100
90-day supplyMin $50 Max $250
Tier 3 50 Coinsurance
30-day supplyMin $50 Max $250
90-day supplyMin $125 Max $625
Tier 4 100 Coinsurance
INCREASED VALUE TO MEMBERS amp PLAN
Encourage the
utilization of clinically
and cost effective
therapies
Primarily Generics
Encourage the
utilization of cost
effective therapies that
donrsquot qualify for $0 tier
Primarily Generics
Encourage the
utilization of cost
effective therapies
relative to other agents
therapies
Primarily Preferred
Brands
Products that are not as
clinically or cost
effective relative to
other available agents
therapies
Primarily Non-Preferred
Brands
Products
considered to have
minimal or no
clinical or cost
effectiveness
relative to other
available agents
therapies
Primarily Non-
Preferred Brands
90-day supply available thru
Walgreens network
pharmacies or mail order only
WHIRLPOOL CORPORTATION CONFIDENTIAL
WHATrsquoS CHANGINGActive amp Pre-65 Pharmacy
Walgreens Health Initiatives (WHI) selected to replace Medco as pharmacy benefit manager (PBM)
30-day fills use the WHI network for discounted pricing
90-day fills maintenance medications may be filled at Walgreens retail or thru Walgreens mail order
WHI network includes independent pharmacies as well as chains such as CVS Rite Aid Wal-Mart amp Target
Post-65 Retirees
Moving to stipend
WHIRLPOOL CORPORTATION CONFIDENTIAL
Q Will prescriptions automatically be transferred to Walgreens
A 30-day prescriptions will not be transferred to Walgreens
90-day mail maintenance medications will be automatically transferred to
Walgreens Mail Service as of January
NOTE 90-day prescriptions not filled using mail service any 30-day
prescription as well as narcotics and compound medications will not be
transferred and will require a new prescription from your physician
Q Will the tier of drugs change
A No the tiers in the benefit plan design are not changing
However the price that members pay for medication may change due to the
special discount pricing being offered by WHI
WHI QampA
WHIRLPOOL CORPORTATION CONFIDENTIAL
Q Will there be two ID cards for next year
A No active and pre-65 members will continue to have one card for
medical and pharmacy
14
ID CARDS
WHIRLPOOL CORPORTATION CONFIDENTIAL
PHONE 1-877-WHIRL50 (877-944-1550)
FAX 1-800-736-8270
WEB wwwwalgreenshealthcom
Click on Healthcare Professionals tab
15
WHI Contact Information
WHIRLPOOL CORPORTATION CONFIDENTIAL
HEALTHSCOPE BENEFITS
WHIRLPOOL CORPORTATION CONFIDENTIAL
17
HealthSCOPE Benefits
Pre-certificationPre-authorization
Claim Status
Eligibility
Benefit Information
Provider Network verification
IVR- Available 247
1st Level Appeals
1-800-660-6212CUSTOMER CARE
REPRESENTATIVES
Whirlpool Service Line
1-800-660-6212
M-F 800 am ndash 600 pm EST
WHIRLPOOL CORPORTATION CONFIDENTIAL
18
HSB Whirlpool Customer Care Web Tools
Click on Providero Check on
o Claim Status
o Eligibility
o Benefit Information
o Precert Information
o Copies of EOBs
wwwhealthscopebenefitscom
WHIRLPOOL CORPORTATION CONFIDENTIAL
19
HealthSCOPE Benefits
Copy of provider EOB
WHIRLPOOL CORPORTATION CONFIDENTIAL
20
PRE-CERTIFICATION PROCEDURES
All members along with their providers will be required to pre-certify all Non-emergency inpatient admissions Major outpatient surgical procedures Non-stat MRI amp CT Scans Outpatient mental health facility admits or visits
Contact HealthSCOPE Benefits for pre-certification at 1-800-660-212
Member ID card has reminder statement regarding pre-certification
20
WHIRLPOOL CORPORTATION CONFIDENTIAL
WHIRLPOOL PROVIDER UPDATES
COMMUNICATIONS THROUGHOUT THE YEAR
Quarterly Newsletters
Quarterly Teleconferences
Join the mailing list Send an email to susan_a_pavlopouloswhirlpoolcom
HealthSCOPE Benefits websitewwwhealthscopebenefitscom
Walgreens website
wwwwalgreenshealthcom
21
WHIRLPOOL CORPORTATION CONFIDENTIAL
QUESTIONS
WHIRLPOOL CORPORTATION CONFIDENTIAL
WHATrsquoS CHANGINGActive amp Pre-65 Pharmacy
Walgreens Health Initiatives (WHI) selected to replace Medco as pharmacy benefit manager (PBM)
30-day fills use the WHI network for discounted pricing
90-day fills maintenance medications may be filled at Walgreens retail or thru Walgreens mail order
WHI network includes independent pharmacies as well as chains such as CVS Rite Aid Wal-Mart amp Target
Post-65 Retirees
Moving to stipend
WHIRLPOOL CORPORTATION CONFIDENTIAL
Q Will prescriptions automatically be transferred to Walgreens
A 30-day prescriptions will not be transferred to Walgreens
90-day mail maintenance medications will be automatically transferred to
Walgreens Mail Service as of January
NOTE 90-day prescriptions not filled using mail service any 30-day
prescription as well as narcotics and compound medications will not be
transferred and will require a new prescription from your physician
Q Will the tier of drugs change
A No the tiers in the benefit plan design are not changing
However the price that members pay for medication may change due to the
special discount pricing being offered by WHI
WHI QampA
WHIRLPOOL CORPORTATION CONFIDENTIAL
Q Will there be two ID cards for next year
A No active and pre-65 members will continue to have one card for
medical and pharmacy
14
ID CARDS
WHIRLPOOL CORPORTATION CONFIDENTIAL
PHONE 1-877-WHIRL50 (877-944-1550)
FAX 1-800-736-8270
WEB wwwwalgreenshealthcom
Click on Healthcare Professionals tab
15
WHI Contact Information
WHIRLPOOL CORPORTATION CONFIDENTIAL
HEALTHSCOPE BENEFITS
WHIRLPOOL CORPORTATION CONFIDENTIAL
17
HealthSCOPE Benefits
Pre-certificationPre-authorization
Claim Status
Eligibility
Benefit Information
Provider Network verification
IVR- Available 247
1st Level Appeals
1-800-660-6212CUSTOMER CARE
REPRESENTATIVES
Whirlpool Service Line
1-800-660-6212
M-F 800 am ndash 600 pm EST
WHIRLPOOL CORPORTATION CONFIDENTIAL
18
HSB Whirlpool Customer Care Web Tools
Click on Providero Check on
o Claim Status
o Eligibility
o Benefit Information
o Precert Information
o Copies of EOBs
wwwhealthscopebenefitscom
WHIRLPOOL CORPORTATION CONFIDENTIAL
19
HealthSCOPE Benefits
Copy of provider EOB
WHIRLPOOL CORPORTATION CONFIDENTIAL
20
PRE-CERTIFICATION PROCEDURES
All members along with their providers will be required to pre-certify all Non-emergency inpatient admissions Major outpatient surgical procedures Non-stat MRI amp CT Scans Outpatient mental health facility admits or visits
Contact HealthSCOPE Benefits for pre-certification at 1-800-660-212
Member ID card has reminder statement regarding pre-certification
20
WHIRLPOOL CORPORTATION CONFIDENTIAL
WHIRLPOOL PROVIDER UPDATES
COMMUNICATIONS THROUGHOUT THE YEAR
Quarterly Newsletters
Quarterly Teleconferences
Join the mailing list Send an email to susan_a_pavlopouloswhirlpoolcom
HealthSCOPE Benefits websitewwwhealthscopebenefitscom
Walgreens website
wwwwalgreenshealthcom
21
WHIRLPOOL CORPORTATION CONFIDENTIAL
QUESTIONS
WHIRLPOOL CORPORTATION CONFIDENTIAL
Q Will prescriptions automatically be transferred to Walgreens
A 30-day prescriptions will not be transferred to Walgreens
90-day mail maintenance medications will be automatically transferred to
Walgreens Mail Service as of January
NOTE 90-day prescriptions not filled using mail service any 30-day
prescription as well as narcotics and compound medications will not be
transferred and will require a new prescription from your physician
Q Will the tier of drugs change
A No the tiers in the benefit plan design are not changing
However the price that members pay for medication may change due to the
special discount pricing being offered by WHI
WHI QampA
WHIRLPOOL CORPORTATION CONFIDENTIAL
Q Will there be two ID cards for next year
A No active and pre-65 members will continue to have one card for
medical and pharmacy
14
ID CARDS
WHIRLPOOL CORPORTATION CONFIDENTIAL
PHONE 1-877-WHIRL50 (877-944-1550)
FAX 1-800-736-8270
WEB wwwwalgreenshealthcom
Click on Healthcare Professionals tab
15
WHI Contact Information
WHIRLPOOL CORPORTATION CONFIDENTIAL
HEALTHSCOPE BENEFITS
WHIRLPOOL CORPORTATION CONFIDENTIAL
17
HealthSCOPE Benefits
Pre-certificationPre-authorization
Claim Status
Eligibility
Benefit Information
Provider Network verification
IVR- Available 247
1st Level Appeals
1-800-660-6212CUSTOMER CARE
REPRESENTATIVES
Whirlpool Service Line
1-800-660-6212
M-F 800 am ndash 600 pm EST
WHIRLPOOL CORPORTATION CONFIDENTIAL
18
HSB Whirlpool Customer Care Web Tools
Click on Providero Check on
o Claim Status
o Eligibility
o Benefit Information
o Precert Information
o Copies of EOBs
wwwhealthscopebenefitscom
WHIRLPOOL CORPORTATION CONFIDENTIAL
19
HealthSCOPE Benefits
Copy of provider EOB
WHIRLPOOL CORPORTATION CONFIDENTIAL
20
PRE-CERTIFICATION PROCEDURES
All members along with their providers will be required to pre-certify all Non-emergency inpatient admissions Major outpatient surgical procedures Non-stat MRI amp CT Scans Outpatient mental health facility admits or visits
Contact HealthSCOPE Benefits for pre-certification at 1-800-660-212
Member ID card has reminder statement regarding pre-certification
20
WHIRLPOOL CORPORTATION CONFIDENTIAL
WHIRLPOOL PROVIDER UPDATES
COMMUNICATIONS THROUGHOUT THE YEAR
Quarterly Newsletters
Quarterly Teleconferences
Join the mailing list Send an email to susan_a_pavlopouloswhirlpoolcom
HealthSCOPE Benefits websitewwwhealthscopebenefitscom
Walgreens website
wwwwalgreenshealthcom
21
WHIRLPOOL CORPORTATION CONFIDENTIAL
QUESTIONS
WHIRLPOOL CORPORTATION CONFIDENTIAL
Q Will there be two ID cards for next year
A No active and pre-65 members will continue to have one card for
medical and pharmacy
14
ID CARDS
WHIRLPOOL CORPORTATION CONFIDENTIAL
PHONE 1-877-WHIRL50 (877-944-1550)
FAX 1-800-736-8270
WEB wwwwalgreenshealthcom
Click on Healthcare Professionals tab
15
WHI Contact Information
WHIRLPOOL CORPORTATION CONFIDENTIAL
HEALTHSCOPE BENEFITS
WHIRLPOOL CORPORTATION CONFIDENTIAL
17
HealthSCOPE Benefits
Pre-certificationPre-authorization
Claim Status
Eligibility
Benefit Information
Provider Network verification
IVR- Available 247
1st Level Appeals
1-800-660-6212CUSTOMER CARE
REPRESENTATIVES
Whirlpool Service Line
1-800-660-6212
M-F 800 am ndash 600 pm EST
WHIRLPOOL CORPORTATION CONFIDENTIAL
18
HSB Whirlpool Customer Care Web Tools
Click on Providero Check on
o Claim Status
o Eligibility
o Benefit Information
o Precert Information
o Copies of EOBs
wwwhealthscopebenefitscom
WHIRLPOOL CORPORTATION CONFIDENTIAL
19
HealthSCOPE Benefits
Copy of provider EOB
WHIRLPOOL CORPORTATION CONFIDENTIAL
20
PRE-CERTIFICATION PROCEDURES
All members along with their providers will be required to pre-certify all Non-emergency inpatient admissions Major outpatient surgical procedures Non-stat MRI amp CT Scans Outpatient mental health facility admits or visits
Contact HealthSCOPE Benefits for pre-certification at 1-800-660-212
Member ID card has reminder statement regarding pre-certification
20
WHIRLPOOL CORPORTATION CONFIDENTIAL
WHIRLPOOL PROVIDER UPDATES
COMMUNICATIONS THROUGHOUT THE YEAR
Quarterly Newsletters
Quarterly Teleconferences
Join the mailing list Send an email to susan_a_pavlopouloswhirlpoolcom
HealthSCOPE Benefits websitewwwhealthscopebenefitscom
Walgreens website
wwwwalgreenshealthcom
21
WHIRLPOOL CORPORTATION CONFIDENTIAL
QUESTIONS
WHIRLPOOL CORPORTATION CONFIDENTIAL
PHONE 1-877-WHIRL50 (877-944-1550)
FAX 1-800-736-8270
WEB wwwwalgreenshealthcom
Click on Healthcare Professionals tab
15
WHI Contact Information
WHIRLPOOL CORPORTATION CONFIDENTIAL
HEALTHSCOPE BENEFITS
WHIRLPOOL CORPORTATION CONFIDENTIAL
17
HealthSCOPE Benefits
Pre-certificationPre-authorization
Claim Status
Eligibility
Benefit Information
Provider Network verification
IVR- Available 247
1st Level Appeals
1-800-660-6212CUSTOMER CARE
REPRESENTATIVES
Whirlpool Service Line
1-800-660-6212
M-F 800 am ndash 600 pm EST
WHIRLPOOL CORPORTATION CONFIDENTIAL
18
HSB Whirlpool Customer Care Web Tools
Click on Providero Check on
o Claim Status
o Eligibility
o Benefit Information
o Precert Information
o Copies of EOBs
wwwhealthscopebenefitscom
WHIRLPOOL CORPORTATION CONFIDENTIAL
19
HealthSCOPE Benefits
Copy of provider EOB
WHIRLPOOL CORPORTATION CONFIDENTIAL
20
PRE-CERTIFICATION PROCEDURES
All members along with their providers will be required to pre-certify all Non-emergency inpatient admissions Major outpatient surgical procedures Non-stat MRI amp CT Scans Outpatient mental health facility admits or visits
Contact HealthSCOPE Benefits for pre-certification at 1-800-660-212
Member ID card has reminder statement regarding pre-certification
20
WHIRLPOOL CORPORTATION CONFIDENTIAL
WHIRLPOOL PROVIDER UPDATES
COMMUNICATIONS THROUGHOUT THE YEAR
Quarterly Newsletters
Quarterly Teleconferences
Join the mailing list Send an email to susan_a_pavlopouloswhirlpoolcom
HealthSCOPE Benefits websitewwwhealthscopebenefitscom
Walgreens website
wwwwalgreenshealthcom
21
WHIRLPOOL CORPORTATION CONFIDENTIAL
QUESTIONS
WHIRLPOOL CORPORTATION CONFIDENTIAL
HEALTHSCOPE BENEFITS
WHIRLPOOL CORPORTATION CONFIDENTIAL
17
HealthSCOPE Benefits
Pre-certificationPre-authorization
Claim Status
Eligibility
Benefit Information
Provider Network verification
IVR- Available 247
1st Level Appeals
1-800-660-6212CUSTOMER CARE
REPRESENTATIVES
Whirlpool Service Line
1-800-660-6212
M-F 800 am ndash 600 pm EST
WHIRLPOOL CORPORTATION CONFIDENTIAL
18
HSB Whirlpool Customer Care Web Tools
Click on Providero Check on
o Claim Status
o Eligibility
o Benefit Information
o Precert Information
o Copies of EOBs
wwwhealthscopebenefitscom
WHIRLPOOL CORPORTATION CONFIDENTIAL
19
HealthSCOPE Benefits
Copy of provider EOB
WHIRLPOOL CORPORTATION CONFIDENTIAL
20
PRE-CERTIFICATION PROCEDURES
All members along with their providers will be required to pre-certify all Non-emergency inpatient admissions Major outpatient surgical procedures Non-stat MRI amp CT Scans Outpatient mental health facility admits or visits
Contact HealthSCOPE Benefits for pre-certification at 1-800-660-212
Member ID card has reminder statement regarding pre-certification
20
WHIRLPOOL CORPORTATION CONFIDENTIAL
WHIRLPOOL PROVIDER UPDATES
COMMUNICATIONS THROUGHOUT THE YEAR
Quarterly Newsletters
Quarterly Teleconferences
Join the mailing list Send an email to susan_a_pavlopouloswhirlpoolcom
HealthSCOPE Benefits websitewwwhealthscopebenefitscom
Walgreens website
wwwwalgreenshealthcom
21
WHIRLPOOL CORPORTATION CONFIDENTIAL
QUESTIONS
WHIRLPOOL CORPORTATION CONFIDENTIAL
17
HealthSCOPE Benefits
Pre-certificationPre-authorization
Claim Status
Eligibility
Benefit Information
Provider Network verification
IVR- Available 247
1st Level Appeals
1-800-660-6212CUSTOMER CARE
REPRESENTATIVES
Whirlpool Service Line
1-800-660-6212
M-F 800 am ndash 600 pm EST
WHIRLPOOL CORPORTATION CONFIDENTIAL
18
HSB Whirlpool Customer Care Web Tools
Click on Providero Check on
o Claim Status
o Eligibility
o Benefit Information
o Precert Information
o Copies of EOBs
wwwhealthscopebenefitscom
WHIRLPOOL CORPORTATION CONFIDENTIAL
19
HealthSCOPE Benefits
Copy of provider EOB
WHIRLPOOL CORPORTATION CONFIDENTIAL
20
PRE-CERTIFICATION PROCEDURES
All members along with their providers will be required to pre-certify all Non-emergency inpatient admissions Major outpatient surgical procedures Non-stat MRI amp CT Scans Outpatient mental health facility admits or visits
Contact HealthSCOPE Benefits for pre-certification at 1-800-660-212
Member ID card has reminder statement regarding pre-certification
20
WHIRLPOOL CORPORTATION CONFIDENTIAL
WHIRLPOOL PROVIDER UPDATES
COMMUNICATIONS THROUGHOUT THE YEAR
Quarterly Newsletters
Quarterly Teleconferences
Join the mailing list Send an email to susan_a_pavlopouloswhirlpoolcom
HealthSCOPE Benefits websitewwwhealthscopebenefitscom
Walgreens website
wwwwalgreenshealthcom
21
WHIRLPOOL CORPORTATION CONFIDENTIAL
QUESTIONS
WHIRLPOOL CORPORTATION CONFIDENTIAL
18
HSB Whirlpool Customer Care Web Tools
Click on Providero Check on
o Claim Status
o Eligibility
o Benefit Information
o Precert Information
o Copies of EOBs
wwwhealthscopebenefitscom
WHIRLPOOL CORPORTATION CONFIDENTIAL
19
HealthSCOPE Benefits
Copy of provider EOB
WHIRLPOOL CORPORTATION CONFIDENTIAL
20
PRE-CERTIFICATION PROCEDURES
All members along with their providers will be required to pre-certify all Non-emergency inpatient admissions Major outpatient surgical procedures Non-stat MRI amp CT Scans Outpatient mental health facility admits or visits
Contact HealthSCOPE Benefits for pre-certification at 1-800-660-212
Member ID card has reminder statement regarding pre-certification
20
WHIRLPOOL CORPORTATION CONFIDENTIAL
WHIRLPOOL PROVIDER UPDATES
COMMUNICATIONS THROUGHOUT THE YEAR
Quarterly Newsletters
Quarterly Teleconferences
Join the mailing list Send an email to susan_a_pavlopouloswhirlpoolcom
HealthSCOPE Benefits websitewwwhealthscopebenefitscom
Walgreens website
wwwwalgreenshealthcom
21
WHIRLPOOL CORPORTATION CONFIDENTIAL
QUESTIONS
WHIRLPOOL CORPORTATION CONFIDENTIAL
19
HealthSCOPE Benefits
Copy of provider EOB
WHIRLPOOL CORPORTATION CONFIDENTIAL
20
PRE-CERTIFICATION PROCEDURES
All members along with their providers will be required to pre-certify all Non-emergency inpatient admissions Major outpatient surgical procedures Non-stat MRI amp CT Scans Outpatient mental health facility admits or visits
Contact HealthSCOPE Benefits for pre-certification at 1-800-660-212
Member ID card has reminder statement regarding pre-certification
20
WHIRLPOOL CORPORTATION CONFIDENTIAL
WHIRLPOOL PROVIDER UPDATES
COMMUNICATIONS THROUGHOUT THE YEAR
Quarterly Newsletters
Quarterly Teleconferences
Join the mailing list Send an email to susan_a_pavlopouloswhirlpoolcom
HealthSCOPE Benefits websitewwwhealthscopebenefitscom
Walgreens website
wwwwalgreenshealthcom
21
WHIRLPOOL CORPORTATION CONFIDENTIAL
QUESTIONS
WHIRLPOOL CORPORTATION CONFIDENTIAL
20
PRE-CERTIFICATION PROCEDURES
All members along with their providers will be required to pre-certify all Non-emergency inpatient admissions Major outpatient surgical procedures Non-stat MRI amp CT Scans Outpatient mental health facility admits or visits
Contact HealthSCOPE Benefits for pre-certification at 1-800-660-212
Member ID card has reminder statement regarding pre-certification
20
WHIRLPOOL CORPORTATION CONFIDENTIAL
WHIRLPOOL PROVIDER UPDATES
COMMUNICATIONS THROUGHOUT THE YEAR
Quarterly Newsletters
Quarterly Teleconferences
Join the mailing list Send an email to susan_a_pavlopouloswhirlpoolcom
HealthSCOPE Benefits websitewwwhealthscopebenefitscom
Walgreens website
wwwwalgreenshealthcom
21
WHIRLPOOL CORPORTATION CONFIDENTIAL
QUESTIONS
WHIRLPOOL CORPORTATION CONFIDENTIAL
WHIRLPOOL PROVIDER UPDATES
COMMUNICATIONS THROUGHOUT THE YEAR
Quarterly Newsletters
Quarterly Teleconferences
Join the mailing list Send an email to susan_a_pavlopouloswhirlpoolcom
HealthSCOPE Benefits websitewwwhealthscopebenefitscom
Walgreens website
wwwwalgreenshealthcom
21
WHIRLPOOL CORPORTATION CONFIDENTIAL
QUESTIONS
WHIRLPOOL CORPORTATION CONFIDENTIAL
QUESTIONS