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HomeMy WebLinkAboutRES.2230.12-18-2006BILL NO. 06-266 RESOLUTION NO. A RESOLUTION AUTHORIZING THE CITY MANAGER TO EXECUTE A CONTRACT WITH DELTA DENTAL FOR EMPLOYEE DENTAL INSURANCE SERVICES, IN THE CITY OF CAPE GIRARDEAU, MISSOURI BE IT RESOLVED BY THE COUNCIL OF THE CITY OF CAPE GIRARDEAU, MISSOURI, AS FOLLOWS: ARTICLE 1. The City Manager, for and on behalf of the City of Cape Girardeau, Missouri, is hereby authorized to execute a Contract with Delta Dental for employee dental insurance services, in the City of Cape Girardeau. Said Contract shall contain no changes in plan design or premium structure from the current city plan with Delta Dental. A copy of the proposal is attached hereto and made a part hereof. PASSED AND ADOPTED THIS DAY OF )ffetaj , 20 Gayle L.Abnrad, City Clerk oe Jay Knudtson, Mayor CBIZ Benefits & Insurance Services, Inc. 11440 Tomahawk Creek Parkway Leawood, Kansas 66211 Main: (913) 234-1000 Toll Free: (800) 530-5866 Fax: (913) 234-1100 December 7, 2006 Mr. David Milam Human Resources and Risk Manager City of Cape Girardeau 401 Independence Street P.O. Box 617 Cape Girardeau, MO 63702 Re: Dental and Medical Plan Renewal Dear David: Your dental and medical plan renewals will renew effective January 1, 2007. The following information will discuss those plans. Dental Plan As you know, the City's dental plan is self funded with Delta Dental Plan of Missouri. As such, you set your own conventional equivalent rates to gather enough premiums to cover administrative costs and claims. The expenses for the past year on this plan have been within those projected at renewal last year. Delta has requested a slight increase in administrative costs for the next year. Even with a slight increase, and the projected claims for 2007, your current rates should provide adequate funding for the plan. We would recommend renewing the plan with Delta Dental with no increase in premium rates. Medical Plan Your paid claims have increased by 23% over the prior 12 month period, from $1,882,170 for 10/01/04 — 09/30/05 to $2,315,716 for 10/01/05 — 09/30/06. In the last 12 months, there were 20 claims over $25,000 for a total of $1,092,790.68. This is equivalent to 47% of your claims on 3% of your members. 11440 TOMAHAWK CREEK PARKWAY . LEAWOOD, KANSAS 66211 •913-234-1000 • FAx: 913-234-1100 Mr. David Milam City of Cape Girardeau December 7, 2006 Page Two The contract in place with Anthem (in place prior to the City contracting with CBIZ) is a hybrid self- funded plan. As such, while there is potential to realize savings if claims are lower than expected, any deficits developed are carried forward, and are funds owed to Anthem, regardless of the City's actions (termination, etc.). Additionally, if there is a deficit carried forward, Anthem will include a specific component in the renewal rating formula for deficit recovery. 2007 Plan Year Renewal As discussed, your claim experience has deteriorated this year. However, Anthem's renewal philosophy is to utilize the past three years of claims experience in the rating formula. As such, you have benefited from your positive claims experience from 2005. As part of the renewal process, Anthem would normally increase all fixed expenses, increase claim maximums and include a component for deficit recovery. After negotiations, Anthem has agreed not to increase individual stop loss costs, administrative costs, nor include a specific component for reduction of the deficit. After these reductions, Anthem proposed an overall increase of 43% on the Enriched Plan and 41.6% on the Base (City paid) plan. These increases would develop about $3,146,086 in premium for 2007, vs. an approximate collected' premium of $2,183,027, based on current enrollment, and rates charged by the City to employees. Possible Plan Changes Anthem has developed some possible plan design options to mitigate this increase. The first suggested change is to remove the two plans and keep one plan in place. This develops a credit of approximately 3%. The plan that would be provided to all employees and retirees will include benefit changes. Some of those changes are as follows: Deductible: Coinsurance limit: Maximum Out-of-pocket: Office Visit Copay: Prescription Drugs: Mr. David Milam City of Cape Girardeau December 7, 2006 Page Three $2,500 / person (3x family) In -network $2,500 (2x family) In -network $5,000 (2x family) In -network $30 Primary Care / $50 Specialist $10 Generic / $35 Tier 2 / $75 Tier 3 / Specialty Drugs (Tier 4) 25% Copay to Annual Max of $2,500 11440 TOMAHAWK CREEK PARKWAY . LEAWOOD, KANSAS 66211 •913-234-1000 • FAx: 913-234-1100 While these are changes from your current plans, Physician office visits and Prescription Drugs remain covered subject to copays. Additionally, you will see some enhancements to benefits as illustrated in the side by side comparison which is attached. One of those enhancements is that office surgery is now covered under the office visit copay, where it was covered subject to deductible and coinsurance. Also, emergency room visits were subject to deductible and coinsurance, where now they are covered at 80% after a $150 copay, no deductible. Preventive care services, which were covered at a maximum of $150, will now have no limit. This develops an increase of 25% over last years Base Plan Rates. Those rates are attached. If we can provide any further information, please let us know. Sincerely, David J. Johnson, CEBS Senior Benefits Consultant /dlr Enc. 11440 TOMAHAWK CREEK PARKWAY 9 LEAWOOD, KANSAS 66211 .913-234-1000 9 FAx: 913-234-1100 Physician Home and Network Non -Network Network Non -Network Lifetime Maximum Unlimited Unlimited Deductible (Single/Family) $1,000 $2,000 $2,000 $2,500 $2,500 Charges applied to the Network deductible will office -visit copay. It was deductible and $4,000 $7,500 $7,500 not apply towards the Non -network deductible coinsurance. Office visit $30 PCP/ Deductible/ 50% $30 PCP/ and vice versa. There is a $5 allergy injection copayment per $30 SPC $50 SPC 4th quarter deductible carry over credit is no visit in the network office setting only if billed longer standard, The deductible is included in out-of-pocket Out-of-pocket Maximums (Single/Family) $2,000 $4,000 $5,000 $10,000 $5,000 $10,000 $10,000 Deductible/ 50% office -visit charge with the injection charge, $20,000 maximum. This was tracked as coinsurance (deductible not (deductible not (deductible (deductible maximums without the deductible. Deductible/ 50% included) Included) included) included) Network and non -network maximums do not network office visit, the member pays Allergyinjections i Deductible/ 20% Deductible/ 50% cross apply. Cost Share 20% 50% 20% 50% Physician Home and Office Services (includes Office surgery is now covered under the PCP and SCP) office -visit copay. It was deductible and coinsurance. Office visit $30 PCP/ Deductible/ 50% $30 PCP/ Deductible/ 50% There is a $5 allergy injection copayment per $30 SPC $50 SPC visit in the network office setting only if billed without an office visit charge. If there is an Office Surgery Deductible/ 20% Deductible/ 50% $30 Deductible/ 50% office -visit charge with the injection charge, the member pays the office -visit copay and Allergy serum Deductible/ 20% Deductible/ 50% Deductible/ 20% Deductible/ 50% not the allergy injection copay. If allergy serum is the only charge as a result of a network office visit, the member pays Allergyinjections i Deductible/ 20% Deductible/ 50% $5 Deductible/ 50% deductible/ cost share instead of a copay. WAS, MRIs, CT -scans, PETS, nuclear cardiology imaging studies, stress tests, and Allergy testing Deductible/ 20% Deductible/ 50% Deductible/ 20% Deductible/ 50% non -routine maternity ultrasounds now are subject to the Other Outpatient Services cost Routine and non routine Covered in full Deductible/ 50% $30 Deductible/ 50% share regardless of where services are received. mammograms Other Outpatient Services cost share will apply to all DME, DME vendor medical Diabetic education Deductible/ 20% ° Deductible/ 50% $30 Deductible/ 50% supplies, and prosthetic devices/appliances obtained in the office visit, urgent care, other outpatient setting, or home care setting. WAS, MRIs, PETS, Covered in full Deductible/ 50% Deductible/ 20% Deductible/ 50% CT -scans, nuclear cardiology imaging studies and non -maternity related ultrasounds The information included here is simply an overview of key benefit changes in our standard product lines. It is not an exhaustive list of changes and is not a legal document. For complete details on all benefits, limitations and exclusions, please refer to the benefit contract. In the event of a conflict between this document and the contract, the contract will control. Anthem Blue Cross and Blue Shield is the trade name RightCHOICE° Managed Care, Inc. (RIT), Healthy Alliance°Life Insurance Companyy (HALIC) and HMO Missouri, Inc. use to do business PPO Product Comparison - Pt/6 (4106) in most of Missouri. RIT and certain affliates administer non•HMO benefits underwritten by HALIC and HMO benefits by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. RIT, HMO Missouri, Inc, and HALIC are independent licensees of the Blue Cross Blue Shield Association. Benefit Blue CrossAnthem New Change Preventive Care Services There is no caiendar-year benefit maximum. Services include but are not : There was a $150 calendar -year maximum for limited to: routine exams, well adult. pelvic exams, Pap testing, Vision Exams/Refractions covered under new PSA tests, immunizations, plan. annual diabetic eye exam, routine vision and hearing exams Physician home and office $30 Deductible/ 50% $30 Deductible/ 50% visits Other outpatient services at Deductible/ 20% Deductible/ 50% Deductible/ 20% Deductible/ 50% hospital/altemative care facility Immunizations Covered in full Covered in full Covered in full Covered in full through age 5 Emergency and Urgent ER charges are paid at dopay and now Care include separately billed doctor charges. Emergency room services at Deductible! 20% Deductible/ 50% $150/20% $150120% There now is an urgent care center copay hospital (facility/other covered services) copayment waived if admitted Urgent care center services Deductible/ 20% Deductible/ 50% $50 Deductible/ 50% Emergency ambulance Deductible/ 20% Network Deductible/ 20% In Network services Deductible/ 20% Deductible/ 20% Inpatient and Outpatient Professional Services Included but are not limited to: Medical care visits (1 per Deductible/ 20% Deductible/ 50% Deductible/ 20% Deductible/ 50% day) intensive medical care, concurrent care, consultation, surgery, administration of general anesthesia and newborn exams PPO Product Compariso • P2/6 (4/06) Benefit Inpatient Facility Services Unlimited days except for: 60 days Network/Non- network combined for physical medicine/rehab (limit includes day rehabilitation therapy services on an outpatient basis) 90 days Network/Non- network combined for skilled nursing facility Blue Cross AnthemChange Deductible/ 20% Deductible/ 50% Deductible/ 20% Deductible/ 50% Deductible/ 20% Deductible/ 50% Deductible/ 20% Deductible/ 50% Now there is a 60-day limit per benefit.period for inpatient physical medicine/rehab, Previously we did not track inpatient physical medicine/rehab. Skilled Nursing now has a 90-day limit per benefit period. The limit was 100 day. Outpatient Surgery Deductible/ 20% Deductible/ 50% Deductible/ 20% Deductible/ 50% (Hospital/Alternative Care Facility) Other Outpatient Services Breast prosthesis is covered whether internal (including but not limited to): or external following a mastectomy and four surgical bras per benefit period. Breast Non-surgical outpatient Deductible/ 20%' Deductible/ 50% Deductible/ 20% Deductible/ 50% prosthesis is not subject to the maximum for prosthetic devices. services such MRIs, CT-scans, chemotherapy, Foot orthotics now are covered under the ultrasounds, and other PIan, diagnostic outpatient HHC now is limited to 90 visits per benefit services period vs. 100 visits current plan. Home health care services Deductible/ 20% Deductible/ 50% Deductible/ 20% Deductible/ 50% Private duty nursing is covered under home care and has a separate limit of $50,000 per (Network and Non-network benefit period and $100,000 per lifetime. The combined) 90 visits per dollar limits are combined Network and Non- benefit series (excludes IV network. therapy) When provided in the home, Durable medical equipment, Deductible/ 20% Deductible/ 50% Deductible/ 20% Deductible/ 50% physical/manipulation therapy (excluding chiropractic services), occupational therapy, orthotics (Network and Non- network combined $4,000 and speech therapy will accumulate towards benefit period maximum) the home care services limit only. DME & orthotics now have a benefit period Prosthetics (network and Deductible/ 20% Deductible/ 50% Deductible/ 20% Deductible/ 50% maximum. Non-network combined Prosthetics now have a benefit period $4,000 benefit period maximum maximum.) Non-emergency ambulance now subject to network deductible and network cost-share. Physical medicine therapy Deductible/ 20% Deductible/ 50% Deductible/ 20% Deductible/ 50% day rehabilitation programs Hospice care Deductible/ 20% Deductible/ 50% Deductible/ 20% Deductible/ 50% Non-emergency ambulance Deductible/ 20% Deductible/ 50% Deductible/ 20% Deductible/ 50% services PPO Product Cornpadw - P3/6 (4/06) I Benefit Blue Cross Current Anthem New Change Outpatient Therapy Speech therapy visits now are unlimited. Services All occupational therapy, physical therapy and (Combined Network and speech therapy in the office is covered under Non network limits apply) the office -visit copay, It was covered under deductible/coinsurance after the member paid Physician home and office $30 Office and Deductible/ 50% $30/$50 Deductible/ 50% the copay for the office -visit charge. visits (PCP/SCP) Deductible/ 20% for therapy Other outpatient services at Deductible/ 20% Deductible/ 50% Deductible/ 20% Deductible/ 50% hospital/ alternative care facility Limits apply to: Physical/manipulation therapy excluding chiropractic services: 20 visits Occupational therapy: 20 visits Chiropractic services: 26 visits network only Speech therapy unlimited Behavioral Health Services There now is no limit to Non -network services (Network & Non -network) for substance abuse rehabilitation programs. Mental Health There was a $5,000 lifetime maximum for Non -network services for substance abuse. Inpatient facility services Deductible/ 20% Deductible/ 50% Deductible/ 20% Deductible/ 50% Physician home and office $30 Deductible/ 50% $30/$50 Deductible/ 50% visits (PCP/SCP) Other outpatient services Deductible/ 20% Deductible/ 50% Deductible/ 20% Deductible/ 50% (hospital/ alternative care facility) Substance Abuse Inpatient 21 days/6 detox Deductible/ 20% Deductible/ 50% Deductible/ 20% Deductible/ 50% Outpatient facility: 30 days Deductible/ 20% Deductible/ 50% Deductible/ 20% Deductible/ 50% Outpatient office visits: 30 $30 Deductible/ 50% $30/$50 Deductible/ 50% visits (PCP/SCP) (Substance abuse rehab programs are limited to 10 episodes per lifetime Network and Non -network combined.) PPO Product.Comparison - P4/6 (4/06) 4 PPO Product Comparison - P5/6 (4/06). GrossAnthem New Change Human Organ and Tissue Transplants Deductible/ 20% Deductible/ 50% Covered in full Deductible/ 30% Comea and kidney transplants are covered A set list of A set list of the same as any other medical condition; Acquisition and transplant transplant transplant other transplants are included under the procedures, harvest and procedures procedures HOTT benefits. storage (including (including No cost share for HOTT services received comes and cornea and from a Network transplant provider. kidney) and covered kidney) and covered Non-networklnon-participating (not services are services are participating in the transplant Network): the subject to the subject to the HOTT admission is subject to 30% cost share same cost same cost and does not accumulate to the Non - shares as other shares as other network/non-participating OPL. surgeries. surgeries. HOTT benefits do not apply to a covered service (related to a covered transplant procedure) received prior to or after the transplant benefit period. Transplant benefit period is defined as the period starting one day prior to the transplant and covered by the case rate/global fee arrangement for Network transplants, or continuing until the discharge date for Non- network transplants. HOTT services apply to the medical lifetime maximum. Eliminated EPO for ABMT — now treated same as other HOTT Prescription Drugs Self injectables (41� Tier) now are 25% cost Network Retail Pharmacy Tier 1, 2 and 3: Tier 1, 2 and 3: Tier 1, 2 and 3: Tier 1, 2 and 3: share with a $2,500 out-of-pocket maximum per benefit period. <30 -day supply (includes $$/$25/$45 is appropriate $10/$35/$75 50% Diabetic test strips are copay diabetic test strip) Tier 4: 20% up to a $100 tier copay plus 30% of allowed Tier 4: 25% up to $2,500 out -of- cost share with a minimum $45 Non -network pharmacy charges are paid at coinsurance amount plus pocket per prescription , 50% with a minimum dollar amount. maximumer p difference maximum per o Tier 4: 50%cost The mail order vendor will continue to be prescription, between the benefit period share with a precision Rx. with a $2,000 retail charge minimum $45 coinsurance and allowed per prescription maximum per amount calendar year Tier 4 is 30% of allowed amount plus difference between the retail charge and allowed - amount Precision Rx Mail -Order Tier 1, 2 and 3: Not available Tier 1, 2 and 3: Not available Services $16/$30/$50 $20/$90/$190 (90 -day supply (includes Tier 4: 20% up Tier 4: 25% up diabetic test strip) to a $200 to $2,500 out -of - coinsurance pocket maximum per maximum per prescription, benefit period With a $2,000 calendar maximum PPO Product Comparison - P5/6 (4/06). Administrative • -Cross A simple name change. Network Name Changes Alliance Blue Access PPO Pharmacy Vendors Wellpoint Pharmacy WellNextRx for Retail and A simple name change. Management for Retail and Precision Rx for Mail Order Precision Rx for Mail Order Laboratory Services For Alliance, the member No additional cost share for cost share is based on plans with office visit setting and if services are copayment designs if received from an performed during a independent lab in the network, no copayment is Network office visit or at a required. N Network laboratory. For lab services at any other place of service, the applicable Network or Non - network cost shares apply according to the place of service where rendered. E -bill functionality Have the ability to pull up Will not have this Excel -document report with functionality for several current employees enrolled months. on plan. Dependent Child Ages 23/23 end of calendar year 23/23 end of calendar year Pre-existing (PPO products only) Currently have a six month New Hires, Special and Late look back & an 18 month Enrollees: 12 month pre - wait after enrollment for existing wait with a 6 month coverage of pre-existing to look back. Late enrollees late enrollees. must wait until open enrollment to come on the plan. Precertification Currently have a penalty for While precertification is non -participating providers of required; there is no penalty 20% that is the member's to a member when responsibility. precertification is not obtained. Maternity Coverage Employee or spouse Employee or spouse or dependent daughter PPO Product Comparison - P616 (4/06) yam— imurance rates Effectfye Janaary 1, 2006 � Health Ins uranee Monthly Costs Active Employees and Retirees under age 65 Core Plan Employee Onlj Emn & Snause $285.46 $370.16* Ema &` Children Emn & Family $214.10 $499.60 *Paid by the City based on Maximum Claims Premiums Buy -Up Plan Emnlovee Onli Emn &Snouse $107.90* Emu &Children F, &Family $433.02 $350.54 $670.15 *Cost: of Retiree Only Core plan paid by the City. All other tiers paid by employees. COBRA Rates Core PIan mloyee Only EmEmn & p &Snouse $370.67 $668.83 ChildrenFmp &Family $596.05 $887-26 Buy -Up Plan '1 '0 ()niy Ema_ & Spouse Emp &Cdren $487.— 7` $819.35 4. & Family $735.22 $1,061.22 The responsible Party(ies) pays all monthly cost. All monthly Claims premiums, plus 2% administrative fees. premiums based on Maximum Dental Insurance (Monthly Costs) Active Employees and Retirees under age 65 Employee Only Emp &Spouse $23.34* $17.70 Emn &Children Emn & Famih $15.18 $32.38 `Paid by the City includes $5.11 monthly Dependent Tiers aid b Per employee Delta Dental Administration Fee, All P Y employee, no additional Administration Fee. Retirees that retired directly for the City, regardless of age, are treated the same in the Dental plan Tiers as the Health Plan Tiers. COBRA Rates Emnlovee Only Em4 &—Sn $23.80 — Emn & Chflciren EmL& F� $41.86 $39,30 $5694 The responsible pares) pays all monthly costs. The 2% administrative fee is included in listed. above. rates 2007 Health and Dental Insurance Rates Effective January 1, 2007 Health Insurance Monthly Costs Active Employees and Retirees underage 65 Employee Only Employee & Spouse Employee & Child(ren) Employee & Family $462.70* $356.83 $267.63 $624.50 *Cost of Employee Only plan paid by the City. All other tiers paid by employees. COBRA Rates Employee Only Employee & Spouse Employee & Child(ren) Employee & Family $471.95 $835.92 $744.94 $1,108.94 The responsible party(ies) pays all monthly cost. All monthly premiums based on premiums, plus 2% administrative fees. Dental Insurance (Monthly Costs) Active Employees and Retirees under age 65 Employee Onlv Employee & Spouse Employee & Child(ren) Employee & Family $23.24* $17.70 $15.18 $32.38 *Cost of Employee Only plan paid by the City. All other tiers paid by employees. COBRA Rates Employee Only _Employee & Spouse Employee & Child(ren) Employee & Family $23.80 $41.86 $39.30 $56.84 The responsible party(ies) pays all monthly cost. All monthly premiums based on premiums, plus 2% administrative fees. Cite of Cape Girardeau — Stand Alone Plan Blue AccesssM Suni ntary of Benefits, Effective January 1, 2007 Physician Home and Office Services (PCP/SCF Primary Care Physician (PCP)/Specialty Care Ldn ian (SCP) g Office Surgeries and allergy serum: gy injections (PCP and SCP) gy testing ne and non -routine mammograms rdless of outpatient setting) etic education (regardless of outpatient setting) in medical nutritional therapy (regardless of tient setting) s, MRIs, PETS, C -Scans, Nuclear Cardiology Imaging ies and non-maternit related Ultrasounds reventive Care Services Services include but are not limited to: Routine Exams, Pelvic Exams, Pap testing, PSA tests, Immunizations, Annual diabetic eye exam, Routine Vision and Hearing exams • Physician Home and Office Visits {PCP/SCP) • Other Outpatient Services @ HospitallAltemative Care Fadtity • Immunizations through age 5 • Emergency Room Services @ Hospital (faciifty/other covered services) (copayment waived if admitted) • Urgent Care Center Services • Emerpenc(Ambulance Services Inpatient and Outpatient Professional Services include but are not limited to: • Medical Care visits (1 per day), Intensive Medical Care, Concurrent Care, Consultations, Surgery and administration of general anesthesia and Newborn exams Unlimited days except for: • 60 days Network/Non-Network combined for physical medicine/rehab limit includes Day Rehabilitation Therapy Services on an outpatient basis) • 90 days Network/Non-Network combined for skilled $5 Deductible/20% $30 $30 $30 Deductible/20% $30/$50 Deductible/20% $150/20% $50 Deductible/20% • (ion Surgical Outpatient Services 1111 wl. UwucUDle/LU`, For example: MRIs, C -Scans, Chemotherapy, Ultrasounds, and other diagnostic outpatient services, • Home Care Services ((NetworldNon-network combined) 90 visits (excludes 13herapy) • Durable Medical Equipment and Orthotics 0(Network/Non-network combined) ,000 benefit maximum (excluding Prosthetic Devices and Medical • Prosthetic supplies) $4,000 benefit maximum • Physical Medicine Therapy Day Rehabilitation programs • Hospice Care Deductible/20% • Mn Finarncnnv A -f-1 ..... c--.:___ ANTHEM Deductible/50% Deductible/50% Deductible/50% Deductible/50% Deductible/50% Deductible/50% Deductible/50% Deductible/50% No cooavment/r. $150/20% 50% Deductible/20% Anthem Blue Cross and Blue SWd k the trade nepne Rkh(CHOION Manned care, Inc. (Rrr) Heahhy Manod Lae Insurance Camp (HgLIC) and HMO AUssoui, hrc. use to do business In most of is w. RIT end certain aflillates administer non.NMO benefits under%I*A by 1 0 and MO 9LLE 3.1 PPO LG SOB Rev. 496 HMO benefits underxdden by HMO MssoA Inc, RiT; HMO "Mud, Inc. and WC we krdePendeM kensees of the Blue Cross and Blue ShWdAsaodation. ORepls eW marks Blue Cross and Blue shield AswWon wtpaucuL nrctapy Qt!JVit;@S (Combined Network& Non -Network limits apply) • Physician Home and Office Visits (PCP/SCP) • Other Outpatient Services @ Hospital/Alternative Care Facility Limits apply to: $30/$50 Deductible/20% — Deductible/50% Deductible/50% • Physical/Manipulation therapy excluding Chiropractic Services: 20 visits • Occupational therapy, 20 visits • Chiropractic Services: 26 visits (Network) Non -Network Not Covered • Speech therapy: Unlimited visits Behavioral Health Services: (Network and Non -Network) Mental Health and Substance Abuse • Inpatient Facility Services Deductible/20% Deductible/50% • Physician Home and Office Visits (PCP/SCP) $30/$50 Deductible/50% • Other Outpatient Services @ Hospital/Alternative Care Deductible/20% Deductible/50% Facility Substance Abuse limits • Inpatient: 21 days/6 detox • Outpatient Facility: 30 visits • Outpatient Office Visits: 30 visits (Substance Abuse rehabilitation programs are limited to 10 e /sodes el lifetime Network and Non -Network ced. ombin Human Organ and Tissue Transplants' No copaymenticoinsurance 30% • Acquisition and trans lant procedures, harvest and storage, Prescription Drugs Network Tier structure equals 1/2/3 (and 4, If applicable) • Network it Pharmacies: $10/$35/$75 uppRetl Includes 4th Tier is 25% up to an annual OOP maximum 50% minus $75 diabetic test strip Maximum of $2,500 • Anthem Rx Direct Mail Service: day supply) $20/$90/$190 ncl Includes diabetic test strip 4thTier is 25% uP to an annual OOP Maximum Not covered `Member maybe responsible for additional cost when not Of $2500 selecting the available generic drug. Medicare Rx - Wrap fetime Maximum Combined Network and Non -n I Unlimited Unlimited Notes: • Flat dollar copayments and Non Network Human Organ and 114sue Transplants are excluded from the out-of-pocket limits. Also Prescription Drug deducublesleopaymenisl coinsurance are excluded from the out-of-pocket limits. • Deductiblefs) apply only to covered medical services listed with a percentage ("/) coinsurance. However, the deductible does not apply to Emergency Room Services where a copayment and a percentage (%) coinsurance applies. • Network and Non -network deductibles, copayments, coinsurance and out-of-pocket maximums are separate and do not accumulate toward each other. • DgxwdmrAge• to the end of the calendaryear which the child attains age 23 or to the end of the calendar year which the child attains age 23 or if qualifies as a full-time student. • Specialist copayment is applicable to all Specialists excluding General Physicians, Internist Pediatricians, OBIGIN's and Geriatrics or any other Network Provider as allowed bytheplan. • Physicians Home and office visit copayment applies f the office visit is billed with allergy injections. • No copaymenilcoir surance means no deductiblelcopaymenticoinsurance up to the maximum allowable amount. 0116 means no coinsurance up to the maximum allowable amount. However, when choosing a Non-networkprovider, the member is responsible for any balance due after the plan payment. • PCP is a Network Provider who is a practitioner that specializes in familypractice, general practice, internal medicine, pediatrics, obstetrics/gynecology, geriatrics or any other Network provider as allowed by the plan. • SCP is a Network Provider, other than a Primary Care Physician, who provides services within a designated specialty area o(practice. • Certain diabetic and asthmatic supplies have no deductible/copayment/coinsurance uP to the maximum allowable amount at network pharmacies, except diabetic test strips. • Benefit period = calendaryear • Elective abortions are not covered. 'Kidney and cornea are treated the same as any other illness and subject to the medical benefits. IfaPplicaable, all prescription drug expenses except tier 1, (NetworklAron-network RetailMail-service combined) apply to the per individual RXdeductiblc Once the RXdeductible is the appropriate copayment applies. Also ifapplicable, the Prescription Drug out ofpocket maximum applies to Network Retail and Mail,Service combined Ax non-networkdiabetir/asthmatic supplies not covered except diabetic test strips. Prescription Drugs do not accumulate toward the Medical Lifetime Maximum rf applicable). However, once the Medical Lifetime Maximum is stet (f applicable), no additional Prescription Drug claims will be paid. Precertification: • Members are encouraged to always obtain prior approval when using non -network providers. Precertiftcation will help avoid any unnecessary reduction in benefits for non -covered or non -medically necessary services. Angcem Blue Cross and Blue Shield is Bre We name RlghtCHOM Managed Care, Inc. (RIT), Healthy Aliens@ Life Insurance Company �p� IC) and HMO Missouri, Inc. use to do business in nw of Missoud. Rrr and certrdn affllabesadmfdsler non•HMO benefits underwdben by HALIC and HMO benefds underwritten by HMO Missouri, Inc. RR, HMO Missouri, krc. and HAM are Independentkensees ofthe Blue Cross and Blue shield Association, MO BLUE 3.1 NPO LG SOB Rev. 40e ®Registered marks Blue Goss and Blue S%d Association.