Medical Benefits Options

Preferred Provider Organization (PPO) Plan

This plan requires a $20 copay for office visits and pays 90 - 100 percent of most other eligible expenses once the deductible is met. The deductible is $300 for an individual and $900 for a family. The full family deductible must be met before expenses are paid for any one individual. Wellness is covered at 100 percent for in-network providers and is not subject to the deductible. A copay is not required for wellness visits.

Pharmacy benefits are offered through the Medco Pharmacy Program which uses a large network of retail pharmacies, and there is no additional cost for this program. The copay is $10 for generic drugs, $30 for preferred brand name drugs, and a 20 percent coinsurance for non-preferred brand name drugs. The plan also offers a voluntary mail order prescription plan for maintenance medication which can be ordered up to a 90 day supply. The cost of a 90 day supply is 2 ½ times the monthly premium ($25 for generic, $75 for name brand, 20 percent of copay for non-preferred brand name with minimum cost being $100 and maximum of $250).

Health Savings Account Preferred Provider Organization (HSA PPO)

This HSA PPO is a High Deductible Health Plan (HDHP). Employees are required to satisfy a $1,500 individual deductible or $3,000 family deductible before eligible expenses are covered at 90 percent. The full family deductible must be met before expenses are paid for any one individual. Wellness is covered at 100 percent for in-network providers and is not subject to the deductible. Pharmacy costs are covered like any other expense (subject to the deductible and then paid at 90 percent). The advantage to this plan is that the monthly employee premium is very low in exchange for a higher out-of-pocket liability.

HDHP members are encouraged to open a Health Savings Account (HSA), which is an individually owned, portable pre-tax savings account. You may contribute to this account on a pre-tax basis and then use this money to satisfy the deductible or any other qualified medical expenses. For 2011, employees may contribution up to $3,050 for individual coverage and $6,150 for family coverage.

The advantages to an HSA are:

You own the funds; they roll over from year to year and grow through investment earnings.
Flexibility in the use of funds including use for medical expenses not covered by insurance, long-term care expenses and insurance, medical premiums if unemployed, and out-of-pocket medical expenses when covered by Medicare.*
Triple tax savings: (1) tax-free deductions when you contribute, (2) tax-free earning through investment, and (3) tax-free withdrawals for qualified expenses.
You may adjust the contribution levels during the year.
Penalty-free withdrawals for any reason at age 65 (taxed as ordinary income).

To open an HSA, you will need to sign up for automatic payroll deduction with U.S. Bank during the online election process.

*Health Savings Account regulations have changed effective January 2011 due to the Healthcare Reform. For more information on these changes, click here.

Additional HSA Information:

Alternative Network- Blue Open Access POS

There are two networks to choose from when selecting health care coverage. The traditional network is called Blue Choice PPO, and it provides in-state, national, and international coverage. The second network is a new alternative network, called Blue Open Access POS, which is a voluntary option for both the PPO and the High Deductible plans. This network still offers state, national, and international coverage, but it is more limited than the Blue Choice PPO network. The alternative network is of lesser cost in premiums than the traditional network.

This alternative network might not include the same providers as the Blue Choice PPO network. You can check to see if your providers are included in this network by going to www.bcbsga.com and selecting "Find a Doctor." Make sure to select "Blue Open Access POS" from the drop down menu to begin your search.

Additional information on the alternative network can be found in the 2011 Comparison Guide and Rate Guide; however, the summary plan documents are not yet available.

Tobacco Use Surcharge

A $50 surcharge will be added to the monthly medical plan premium for the use of tobacco products. This charge applies to both active employees and retirees but not COBRA participants. The surcharge is designed to encourage tobacco users to adopt a healthier lifestyle. If a tobacco cessation program is successfully completed and the use of tobacco is discontinued, the surcharge will be removed.

There are many resources available to employees who need assistance with stopping the use of tobacco. To access this information, click here.