Blet the new health  welfare 12 9-11
Upcoming SlideShare
Loading in...5
×
 

Blet the new health welfare 12 9-11

on

  • 3,409 views

 

Statistics

Views

Total Views
3,409
Views on SlideShare
2,651
Embed Views
758

Actions

Likes
0
Downloads
8
Comments
0

4 Embeds 758

http://blet34.com 597
http://app5.websitetonight.com 74
http://www.blet34.com 58
http://app6.websitetonight.com 29

Accessibility

Upload Details

Uploaded via as Microsoft PowerPoint

Usage Rights

© All Rights Reserved

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Processing…
Post Comment
Edit your comment

Blet the new health  welfare 12 9-11 Blet the new health welfare 12 9-11 Presentation Transcript

  • THE NEW HEALTH & WELFARE For Active Employees Covered by GA 23000 By Steve Young Designated Legal Counsel
  • HEALTH & WELFARE Member Contribution• Member contribution reduced to $200. per month January 1, 2012• Remains $200. through June 30, 2016 – Four years frozen – Frozen into first full year of next negotiations• July 1, 2016 can be increased to a maximum of $230.
  • HEALTH & WELFARE Annual Deductible• $200. annual deductible for in network, non co-pay services for a member• $400. Annual deductible for in network, non co-pay services for a member’s family• Applies to NON Co-Pay: – MRI’s – Surgery – X-Rays – Etc. View slide
  • HEALTH & WELFARE Annual Deductible BLET• $200. annual deductible – Begins July 1, 2012 at 50% $100. – January 1, 2013 75% $150. – January 1, 2014 100% $200.00• $400. Annual deductible – Begins July 1, 2012 at 50% $200 – January 1, 2013 75% $300. – January 1, 2014 100% $400. View slide
  • HEALTH & WELFARE Co-Insurance• Applies only to Non Co-Pay procedures only• Plan pays 95% of a Non Co- pay in network procedure with a $1,000. annual cap for the member and a $2,000. annual cap for the member’s family
  • HEALTH & WELFARE Co-Insurance BLET• July 1, 2012 50% – $500. member – $1,000. family• January 1, 2013 75% – $750. member – $1,500. family• January 1, 2014 100% – $1,000. member – $2,000. family
  • HEALTH & WELFARE Example• Member goes to the doctor with arm pain. Doctor prescribes medication and rest• Member pays $20. co-pay and no more• No deductible or co- insurance payment as this is a co-pay visit
  • HEALTH & WELFARE Example• Member goes to the doctor with arm pain. Doctor prescribes medication and an MRI that costs $1,000• Member pays co-pay- office visit• Member pays deductible of $200. – Member’s deductible for the year is met• Member pays 5% of the remaining $800. which is $40.
  • HEALTH & WELFARE Example• Member meets annual deductible of $200. and co- insurance of $1000• Member’s family incurs non co-pays bills of $22,000. Member then pays a $200. deductible and an additional $1,000. co-insurance• Gets credit towards family deductible and co-insurance• Member only has co-pays for remainder of the year
  • HEALTH & WELFARE Co-Pays• Emergency Room Co-pay will be $75. UNLESS the visit results in an admission• $20. Co-pay for urgent care facilities• $10. Co-pay for convenient care clinic – health care facility typically located in a high traffic retail store, supermarket or pharmacy that provides affordable treatment for uncomplicated minor illness and/or preventative care to consumers
  • HEALTH & WELFARE Example• Member goes to ER with skin rash and is treated and released for poison ivy.• Total charges are $625.• Member pays $75. co-pay• Member pays $200. deductible• Member pays 5% of remaining balance of $375. of $17.50• Convenient Care clinic would only require $10. Co-pay
  • HEALTH & WELFARE Co-Pays for Prescription Drugs• $5. Co-pay for in network GENERIC drugs• $25. Co-pay for in network BRAND name drugs• $45. Co-pay for in network drug not on the plan’s formulary list of drugs
  • HEALTH & WELFARE Co-Pays for Mail Order Drugs• $5. Co-pay for in network GENERIC drugs• $50. Co-pay for in network BRAND name drugs• $90. Co-pay for in network drug not on the plan’s formulary list of drugs
  • HEALTH & WELFARE Generic v. Brand Name Drugs• Generic prescription plan to encourage transfer from brand name to generic drug – Voluntary program• Prior authorization, step therapy, quantity & duration, Generic prescription program will be applicable to GA 46000 (retiree plan) on January 1, 2012