Mark Bercheni Don Poulson and Matt Bill September 1 2022 2 Agenda Why are we making the change Gold PPO and Blue CDHP plan design Prescriptions HSA FSA Dental EAP Timing of actions Quick video view the website and app ID: 1044056
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1. MEDICAL PLAN CARRIER CHANGEMark Bercheni, Don Poulson and Matt BillSeptember 1, 2022
2. 2AgendaWhy are we making the changeGold PPO and Blue CDHP plan designPrescriptions, HSA, FSA, Dental, EAPTiming of actionsQuick video - view the website and appNew IDs branded with RX on it. Be sure to use current until 12/31.Transition for those in care across the year change. Q&A time
3. 3RFP ProcessWith the help of Gallagher Consulting, Human Resources initiated a national Request for Proposal(RFP) for medical plan carriers.It had been several years since an RFP was done to explore opportunities for improved service options.We evaluated the carriers with a wide range of criteria.We appreciate our relationship with Paramount, which has been one of our vendors over the past 20 years.
4. Carriers were ranked and the best overall was:MEDICAL MUTUAL OF OHIO4
5. 5DECISIONMedical Mutual’s (MM) advantages include:Better network strength across all of Ohio. Search the Medical Mutual page for providers. A best-in-class national Cigna PPO NetworkEnhanced customer service and employee experience with more user-friendly web pages and mobile appLower administration fees Improved discounts with in-network doctors and hospitalsExcellent reporting and technologyMore emphasis on integrated wellness programsEmail: benefits@utoledo.edu with questions
6. 6WHAT IS NOT CHANGINGPrescription coverage and administrator (CerpassRx)UTMC will remain the in-network Tier 1 provider Employer/Employee premium split remains 80/20Co-pay amountsDeductiblesCo-insurance percentagesMax out of pocketsEmail: benefits@utoledo.edu with questions
7. 7What is changingMoving to one Preferred Provider Organization (PPO) and one Consumer Directed Health Plan (CDHP)Gold (PPO) and Blue (CDHP) to be consistent with dental and vision naming convention. (Not a duplicate of the Gold Plan of the past)Both plans will have greater in-network coverage than current plans Improved plan design coverage for the members.Urgent care versus a primary care physicianProMedica facilities and doctors will be in-network at Tier 2Required open enrollment due to selection of PPO for those eligibleEmail: benefits@utoledo.edu with questions
8. 8Tier DefinitionsTier 1 = UTMC In-NetworkUTMC In-Network includes all services rendered at UTMC & UTP facilities and by UTMC & UTP providers. Lowest deductibles, co-pays, co-insurance, and max out of pocket. Tier 2 = In-NetworkIn-Network includes all services rendered within the Medical Mutual SuperMed network in Ohio and the Cigna PPO network outside of Ohio. Standard in-network deductibles, co-pays, co-insurance, and max out of pocket. Tier 3 = Out-of-NetworkOut-of-Network includes services rendered outside of either network. Highest deductibles, co-pays, co-insurance, and max out of pocket. Email: benefits@utoledo.edu with questions
9. 9timeline8/18 UToledo News article to announce change to Medical Mutual for medical insurance carrier and WebEx Q&A planned for 9/19/1 Provide WebEx presentation to employees9/29 Postcard on Open Enrollment to homes 10/1 Updated 2023 open enrollment web pages10/3 Open Enrollment begins10/3 UToledo News article with open enrollment details10/10 Benefits announcement on Benefits Fair and Open Enrollment is underway10/12-13 Benefits Fairs10/24 Targeted email final reminder to those who haven’t participated12/5 Medical Mutual welcome email letter and personalized video to employees12/13 HR/Medical Mutual WebEx tutorials of the website and app12/15 ID Cards go out1/10 HR/Medical Mutual WebEx tutorials of the website and app again Note: Dates are subject to changeEmail: benefits@utoledo.edu with questions
10. MEDICAL MUTUAL10
11. 11EMPLOYEE EXPERIENCE Postal MailemailText MessagingSocial MediaTelephoneProvider and Health System IntegrationMember PortalsWellnessProgramLocate Providers in the MedMutual SuperMed Network: MedMutual SuperMed Provider Link
12. New Carrier Combined ID cards for 2023 Can also use the MM app as your ID card!12Sample Front of ID CardSample Back of ID Card
13. 13Final ReminderOpen EnrollmentOctober 3rd through the 31stBenefits Fairs:Main Campus on 10/12 Health Science Campus on 10/13 Time will be from 10am until 2pm on both daysEmail: benefits@utoledo.edu with questions
14. Questions?