New Plan Addresses Employee Concerns, Increases Access, and Waives Fees
ANNAPOLIS, MD - Maryland Department of Budget and Management Secretary David Brinkley today announced changes to the wellness plan under the State Employee and Retiree Health and Welfare Benefits Program, a plan designed to make healthcare more affordable for state employees while improving overall health. The changes to this plan will reward those employees who have already completed the 2015 healthy activities and give those who have not yet completed the activities a second chance to do so in 2016. Surcharges will also be waived through 2017.
“These changes to the Wellness Plan address the concerns of state employees and will help many more take advantage of the program,” Secretary Brinkley said. “We are happy to announce these changes in an effort to improve customer service, improve the health of our workers, and provide savings.”
Employees who completed requirements by the Dec. 31, 2015 deadline will see their primary care physician copays waived through the end of 2016 and will not be required to complete requirements again in 2016. Employees who did not complete requirements by the end of last year will begin seeing their primary care physician copays waived as soon as they complete the activities.
State employees who did not complete the requirements by the December 31, 2015 deadline must take the following steps to take advantage of the program in 2016:
Additionally, employees now have a choice of health risk assessments – the state’s Health Risk Assessment (available online), or an assessment from an employee’s own medical plan.
Evidence shows that an employer-sponsored wellness program reduces escalating healthcare costs and improves the health, well-being, and overall quality of life for participants. The State of Maryland’s Wellness Plan is designed to increase self-awareness and help state employees better understand their current health status by providing examples on how to stay healthy or become healthier. It also provides information on the benefits to becoming a more informed medical consumer.
Even though healthcare reform may be repealed, the tax forms still have to be produced for 2016 (just like last year). Similar to last year, you are not required to include the form 1095-Cs with your tax filing. Instead you are asked to simply keep a copy for your records.
The forms are due to you by March 2nd so start watching your mail in the next week or so. If you have questions, visit the IRS site: https://www.irs.gov/affordable-care-act/questions-and-answers-about-health-care-information-forms-for-individuals.
There are just 7 days left of Open Enrollment 2017! Do you need to re-enroll in a flexible spending account? If so, you must call the IVR or return the form from your Open Enrollment packet by November 15th!
If you don't need to change plans, add or remove a dependent, or re-enroll in an FSA, you don't have to do anything! But if you do - time is running out! Don't wait until the last day - the high call volume could mean you miss your chance to make those changes!
Greetings and Salutations! Open Enrollment for Maryland State employee and retiree health benefits starts TOMORROW: October 13th!
Open Enrollment will run from October 13th until midnight on November 15th.
Open Enrollment packets for employees have been distributed by the agencies and retiree and direct pay packets have been mailed to your homes.
Important Reminder for Retirees and Direct Pay/COBRA participants: If you want your current benefits to continue for 2017, you do not have to do anything! Your coverage elections will roll over on January 1, 2017 and continue for the rest of the year.
Important Reminder for Active Employees: If you want your current benefits to continue for 2017, you do not have to do anything! Your coverage elections will roll over on January 1, 2017 and continue for the rest of the year. EXCEPT FOR FLEXIBLE SPENDING ACCOUNT (FSA) enrollment. If you are enrolled in either the healthcare or dependent daycare FSA plans and wish to continue that plan for 2017, YOU MUST CALL THE IVR AND RE-ENROLL. These plans do not automatically roll over to the next plan year.
If you need to make changes to your benefit elections, please refer to the instruction sheet found in your Open Enrollment packet.
Also included in your Open Enrollment packet are 2017 rates, the new benefits guide, and the 2017 wellness activities!
Check back for more Benefits News!
We know that fall brings cooler weather, football, and....health benefits Open Enrollment! Open Enrollment is fast-approaching! Expect to receive your enrollment packets by mid-October. If you are an active employee, your packet will come from your agency benefits office. If you are a retiree, your packet will come from the Employee Benefits Division.
Keep checking back to this site for more details!
Now that we know the difference between an EPO and a PPO, let's talk about an IHM, or Integrated Health Model.
While this type of plan is not new, the number of such plans in the marketplace has increased because of healthcare reform (aka the Affordable Care Act or ACA). The ACA included language encouraging the use of "accountable care organizations" which are health plans or health systems that agree to manage a specific group of participants' total healthcare needs. Under the State Employee and Retiree Health and Welfare Program (the Program), Kaiser is the health plan that administers our IHM.
For those enrolled in this plan, your care is provided exclusively by Kaiser practitioners in Kaiser facilities. These facilities often house a multitude of services including x-ray and lab, various specialists, and primary care physicians. IHM's are often referred to as "one-stop shops" for this reason. Participants choosing this type of plan like the convenience of having all of their providers available in one place.
As with the EPO plans, the IHM plan has no coverage for care or services received outside of its facilities (think "out of network"). Care received elsewhere is paid for entirely by the participant.
Now that you know what an EPO is, let's talk about PPO - Preferred Provider Organization. I hinted at its meaning in the EPO discussion so you might havea general idea already.
A PPO plan uses a large national network of providers and facilities, but unlike the EPO, it provides coverage for services you receive from providers who are not in the PPO network. For example, in the PPO plans offered by the State, in network benefits (those provided by a pracitioner in the plan's network) are paid at 90% of the allowed benefit. Except if the service has a copay listed - then the plan pays 100% of the allowed benefit after you pay the copay.
If you receive services from an out of network provider, you pay the deductible of $250, then the plan pays 70% of the in-network allowed benefit; you pay the remaining 30% up to an annual limit of $3,000.
This is an ideal plan choice if you "just need to be sure" you have coverage if you need to receive care from a physician or facility that is not in your plan's network. Beware: because the provider is out of network, you may be billed for the difference between the billed charges and the plan's allowed benefit.
Remember, under the EPO, there is no coverage for out of network services except for medical emergencies.
We get it. "Benefits-speak" can seem like a completely foreign language. That's why we will be offering a word of the day feature - to help make benefits more understandable so you can use your benefits effectively.
Today's word is EPO - Exclusive Provider Organization.
An EPO is a plan in which you must use only providers who are listed in the plan's network (known as in-network providers) for all of your medical care. The only exception is for a medical emergency; in that case you can go to any hospital emergency department.
An EPO typically uses a national network that may be similar to or even identical to the insurance carrier's PPO plan (Preferred Provider Organization). This makes it a lot easier to stay "in-network" and not have to pay for care out of your pocket other than the copays listed in the plan summary found in our Benefits Guide.
FEBRUARY IS HEART HEALTH MONTH!
Your heart is a muscle that acts as a pump to circulate oxygen and nutrients in your blood to the rest of your body. Like other muscles, it needs oxygen and nutrients, too.
But when the arteries in your heart become diseased, the heart can't get the blood it needs to pump efficiently.
You can greatly reduce your risk of heart disease — or slow its progress — by taking prevention "to heart". Making small changes can make a big difference in your health!
LEARN MORE IN THIS UPCOMING HEART HEALTH WEBINAR!
Topic: Keeping A Healthy Heart Webinar
Date: Thursday, February 9, 2017
Time: 11:00 am, Eastern Standard Time
Meeting Number: 804 184 921
Meeting Password: healthyheart
To Join the Online Meeting:
1. Open an Internet Explorer window (copy & paste link).
2. Go to https://kponline.webex.com/kponline/j.php?MTID=m8274d56548ba0ca325133a414e6acb63
3. If requested, enter your name and email address.
4. Enter the meeting password when asked: healthyheart
5. Click "Join".
To Join the Audio Conference Only:
To receive a call back, provide your phone number when you join the meeting, or call the number below and enter the access code.
US Toll: +1-707-256-2401
Access Code: 804 184 921
Having trouble dialing in? Try these backup numbers:
US Toll Free: +1-855-851-8843
45 Calvert Street, Annapolis, MD 21401
300-301 West Preston Street, Baltimore, MD 21201
Toll Free (800) 705-3493