Benefit Basics Webinar Series How To Choose A MCHCP Medical Plan For Non-Medicare Retirees Online www.mchcp.org Phone 800-487-0771 573-751-0771 Address 832 Weathered Rock Court Jefferson City, MO 65101 Questions after Viewing? •Submit personal questions to MCHCP for response –myMCHCP  Log in to myMCHCP  Select myMessages tab  Compose message –MCHCP Member Services  800-487-0771 2 Today’s Presenter Lisa Campbell Communication Specialist Missouri Consolidated Health Care Plan www.mchcp.org 800-487-0771 3 Agenda Things to Consider Calculations Informed Enrollment Tool Open Enrollment Things to Consider 5 Things to Consider Medical Claims - Past - Future Prescriptions - Generic - Brand - Non-Formulary - Health Savings Account (HSA) - Spouse - Children Incentives Available Funds - Personal Dependents Enrolled Plan Premiums - Tobacco Free - Partnership - Disease Management 6 Medical Claims Preventive: 100% covered Major Services: Well Child Hospitalization Well Woman Surgery Immunizations Radiology Cancer Screenings Routine Services: Office Visits Labs 7 Medical Claims Procedure Total # You Child Total Outpatient Surgery 1 $350 $0 $350 Office Visits 6 $240 $80 $320 Radiology 6 $125 $50 $175 Preventive 2 $0 $0 $0 Chiropractor 10 $400 $0 $400 Therapy 5 $200 $0 $200 List anticipated services for upcoming year 8 Medical Claims Log in to myMCHCP Select UMR or Coventry logo Claims 9 Medical Claims Select individual whose claims you want to view The individual’s information will appear at the top of the screen Select claim that you would like to view to determine what the billed amount, allowed amount, and what you paid. 10 Prescriptions Prescription Tier Network Discounted Rate Co-Pay Amoxicillin Generic $18.21 $8 *Sertraline Generic $1,290.64 $8 *Montelukast Generic $25.66 $8 Assumptions: All costs are based on generic alternative. All prescriptions are for 30 day supply at retail. *Generic alternatives for Zoloft and Singulair. 11 Prescriptions Log in to myMCHCP Select Express Scripts logo Manage Prescriptions Price a Medication 12 Prescriptions 13 Prescriptions 14 Prescriptions 15 Prescriptions 16 Dependents Enrolled Who will be covered on your plan? 17 Available Funds 18 Available Funds Contributions Subscriber Only Subscriber + Dependent(s) MCHCP $300 $600 Employee has option to add personal funds pre-tax to HSA. 19 Premiums *Partnership Premium for Employee Only Coverage PPO 300 PPO 600 • $70 month* • $840 year • $41 month* • $492 year HDHP • $0 month* • $0 year 20 Annual Premiums PPO 300 PPO 600 $840 HDHP $492 $0 $492 difference $792 with HSA contribution $348 difference $840 difference $1140 with HSA contribution 21 Incentives Disease Management Rx Reduced Copayment $55 vs $100 $110 vs $200 $137.50 vs $300 Partnership $25 subscriber only 22 Calculations Service Allowed Amount PPO 300 PPO 600 HDHP Annual Physical $0 $0 $0 $0 *Office Visit -Sinus $100 $25 $100 $100 Generic Antibiotic $12 $8 $8 $12 **Annual Premium ---- $840 $492 $0 State HSA Contributions ---- ----- ----- ($300) Total Member Cost ---- $873 $600 $+188 *Office visit is with primary care physician with no lab work. **Member earns incentives. 23 Calculations Service Allowed Amount PPO 300 PPO 600 HDHP $0 $0 $0 $0 *Office Visit -Sinus -Influenza -Psychiatrist $100 $150 $125 $25 $25 + $50 = $75 $40 $100 $150 $125 $100 $150 $125 Prescriptions -2 Generic -Brand Name $12 + 10 = $22 $40 $16 $35 $16 $35 $22 $40 $150 $20 x 3 = $60 $150 $150 **Annual Premium ---- $840 $492 $0 State HSA Contributions ---- ----- ----- ($300) Annual Physical Chiropractor x 3 Total Member ---$1,091 $1,068 $587 - $300 = Cost $287 *Office visit is with primary care physician with one lab work. **Member earns incentives. 24 Informed Enrollment Tool myMCHCP Informed Enrollment Adjust utilization Medical and Pharmacy Claims loaded Adjust dependents 25 Open Enrollment Plan Options Premiums Incentives 26 Contact Information MCHCP 800-487-0771 www.mchcp.org myMCHCP • • • • • Eligibility/Enrollment Premiums Change of address Name change General benefit questions Other Contact UMR 888-200-1167 www.umr.com Coventry 855-234-6191 www.chckansas.com ESI 866-544-6963 www.express-scripts.com • • • • Benefits Claims Providers ID Cards 27