Retiree Health Plan Advisory Board(RHPAB) Modernization Committee .
Retiree Health Plan Advisory Board(RHPAB)Modernization CommitteeMeeting AgendaMeeting:Date:Time:Location:Modernization CommitteeWednesday March 20th, 20199:00am ‐3:30pmAnchorage: Atwood Building, 550 W 7th, 19th Floor Conf. RoomJuneau: State Office Building, 10th Floor Conf. RoomTeleconference:1-650-479-3207 / 805 836 400WebEx /onstage/g.php?MTID edf9c6703e6214784139fe42e7d24dc19Committee Members:Cammy Taylor (chair), Joelle Hall, Judy Salo, Mauri Long9:00amCall to Order Cammy Taylor Approve Agenda Approve previous Meeting Minutes Introductions9:10amPublic Comment Read the Oral Public Comment Script9:30amDiscuss Modernization Topics Analysis – DRB Presentations Enhanced Clinical Review Teladoc Out of Network Reimbursement Wellness11:15 amSecureCare Presentation – Bharon Hoag11:45amMeeting Adjournment
Retiree Health Plan Advisory BoardPublic Comment GuidelinePublic CommentPurposeProtocolThe public comment period allows individuals to inform andadvise the Retiree Health Plan Advisory Board about policyrelated issues, problems or concerns. It is not a hearing andcannot be used to address health benefit claim appeals. Theprotected health information of an identified individual willnot be addressed during public comment.Individuals are invited to speak for up to three minutes. A speaker may be granted the latitude to speaklonger than the 3-minute time limit only by theChair or by a motion adopted by the Full AdvisoryBoard. Anyone providing comment should do so in amanner that is respectful of the Advisory Board andall meeting attendees.The Chair maintains the right to stop public comments thatcontains Private Health Information, inappropriate and/orinflammatory language or behavior.Members providing testimony will be reminded they arewaiving their statutory right to keep confidential thecontents of the retirement records about which they aretestifying. See AS 40.25.151.Protected Health InformationProtected Health Information (PHI) submitted to the Board in writing will beredacted to remove all identifying information, for example, name, address,date of birth, Social Security number, phone numbers, health insurancemember numbers.If the Board requests records containing protected health information, theDivision will redact all identifying information from the records beforeproviding them to the Board.1
Retiree Health Plan Advisory BoardPublic Comment GuidelineFrequently Asked QuestionsHow can someone IN PERSON - please sign up for public comment using theclipboard provided during the meeting.providecomments?VIA TELECONFERENCE – please call the meeting teleconferencenumber on a telephone hard line. To prevent audio feedback, donot call on a speaker phone or cell phone. You may use the mutefeature on your phone until you are called to speak, but do notput the call on hold because hold music disrupts the meeting. Ifthis occurs, we will mute or disconnect your line.IN WRITING – send comments to the address or fax number belowor email AlaskaRHPAB@alaska.gov. For written comments to bedistributed to the Advisory Board prior to a board meeting theymust be received thirty days prior to the meeting to allow time fordistribution and identifying information will be redacted (see“Protected Health Information”).PRIVATE HEALTH INFORMATION: The state must comply withfederal laws regarding Private Health Information. Writteninformation submitted for public comment which containsidentifying information will be redacted to ensure compliancewith privacy laws.Address: Department of Administration, Attn: RHPAB, 550 W 7thAvenue, Ste 1970, Anchorage, AK 99501 Fax: (907) 465-2135Can I bring myquestions orconcerns about aclaim or medicalissue to theBoard?For additionalinformation:The Board does not have authority to decide health benefit claimappeals. Members should call Aetna at 1-855-784-8646 to addresstheir question and/or concern. After contacting Aetna, memberscan also contact the Division of Retirement and Benefits at 1- 800821-2251 or 907-465-8600 if in Juneau.For additional information please call 907-269-6293 or emailAlaskaRHPAB@alaska.gov if you have additional question.2
DRAFT-Summary of Responses to Proposed Plan Design ChangeProposed change: Enhanced Clinical Review for High-Tech ImagingPlans affected:DB Retiree PlanReviewed by:Retiree Health Plan Advisory Board Modernization SubcommitteeProposed implementation date: January 1, 2020Review Date:March 20, 2019Table 1. Plan Design ChangesMember ActuarialNo impactXMinimalXimpactHighimpactNeed InfoDRB Ops Financial ClinicalXXTPAProviderXXXDescription of proposed change:The proposed change would require in-network providers to seek prior authorization ofcertain outpatient radiology and cardiology services, sleep studies, interventional painmanagement programs, and musculoskeletal procedures (hip/knee replacements) for nonMedicare eligible members. This proposed change would not apply to services obtainedthrough a non-network provider.BackgroundThe plan currently covers diagnostic high-tech imaging and testing including radiology,cardiology services, musculoskeletal imaging, sleep management studies, and cardiacrhythm implant devices if a member has specific symptoms. Generally, these tests andservices are not covered if performed as part of a routine physical examination. Even so,utilization and the per member per month cost associated with high-cost, high-techimaging and testing services has risen over time, and is currently significantly higher inAlaskaCare plans than across Aetna “book of business” comparisons.Not only does increased usage affect the plan financially, but this growth in utilization ofenhanced imaging techniques can create other unintended impacts and consequences.Unnecessary imaging applications bring additional costs to the member and the plan, andcan result in members receiving needless exposure to radiation during the imagingprocess, without measurable contribution to positive health outcomes or more accuratediagnoses.March 20, 2019Page 1 of 7
DRAFT-Summary of Responses to Proposed Plan Design ChangeUnder this proposal, the AlaskaCare retiree health plan would adopt Aetna’s EnhancedClinical Review (ECR) program. Under this program, network providers submitprecertification requests to a vendor contracted by Aetna to review such requests inadvance of administering services or conducting tests. After review, the precertificationdetermination would be sent in a letter to the member and by fax to both the providerwho ordered the service and the provider who would perform the service (if differentfrom the ordering provider).If a precertification request is denied, providers have the option to request a peer-to-peerreview within 14 days from the date of denial. Another physician will review and discussthe necessity of the service with the provider at a mutually agreed-upon time. Mostdisputes are resolved at this level, but if a disagreement about the necessity of the servicepersists, the provider can appeal directly to Aetna through the standard Provider Appealprocess.When providers agree to join Aetna’s network, they agree to conform to Aetna’spublished clinical policy bulletins regarding the medical necessity of services, includinghigh-tech imaging and testing. Aetna has implemented enhanced clinical reviewprograms with other clients, so network providers are already familiar with the process.This initiative would largely operate behind the scenes; network providers (not patients)would be responsible for obtaining preauthorization in advance of administering servicesand seeking reimbursement. The extra scrutiny assists in ensuring that evidence-basedguidelines of appropriate care are being followed prior to the administration of high-costimaging and/or testing.Table 2: Comparison of Current to Proposed ChangeCURRENT: 2019 Retiree Insurance Information BookletCurrentRadiation, X-rays, and Laboratory Tests(Page 44-45 The Medical Plan pays normal benefits for X-rays, radium treatments, andof 2019radioactive isotope treatments if you have specific symptoms. This includesRetireediagnostic X-rays, lab tests, TENS therapy, and analyses performed while youInsuranceare an inpatient. Charges for these services are not paid if related to a routineInformation physical examination except as noted below.Booklet)The plan provides coverage for the following routine lab tests: One pap smear per year for all women age 18 and older. Charges for a limited office visit to collect the pap smear are alsocovered. Prostate specific antigen (PSA) tests as follows:o One annual screening PSA test for men between ages 35 and 50with a personal or family history of prostate cancer, andMarch 20, 2019Page 2 of 7
DRAFT-Summary of Responses to Proposed Plan Design Changeo One annual screening PSA test for men 50 years and older. Mammograms as follows:o One baseline mammogram between age 35 and 40,o One mammogram every two years between age 40 and 50, ando An annual mammogram at age 50 and above and for those with apersonal or family history of breast cancer.These tests will be paid at normal plan benefits following the deductible. Otherincidental lab procedures in connection with pap smears, PSA tests, andmammograms are not covered.Services Requiring Pre-certificationThe following list identifies those services and supplies requiringprecertification under the medical plan. Language set forth in parenthesis inthe precertification list is provided for descriptive purposes only and does notserve as a limitation on when precertification is required.Current(Page 44-45of ation is required for the following types of medical expenses: Stays in a hospital Stays in a skilled nursing facility Stays in a rehabilitation facility Stays in a hospice facility Outpatient hospice care Stays in a residential treatment facility for treatment of mental disordersand substance abuse Partial confinement treatment for treatment of mental disorders andsubstance abuse Home health care Private duty nursing care Transportation (non-emergent) by fixed wing aircraft (plane) Transportation (non-emergent) by ground ambulance Applied Behavioral Analysis (early intensive behavioral interventionfor children with pervasive developmental delays) Autologous chondrocyte implantation, Carticel (injection into the kneeof cartilage cells grown from tissue cultures) Cochlear implant (surgical implant of a device into the ear to try toimprove hearing) Cognitive skills development Customized braces (physical – i.e., non-orthodontic braces) Dental implants and oral appliances Dialysis visits Dorsal column (lumbar) neurostimulators: trial or implantation (forrelief of severe pain)March 20, 2019Page 3 of 7
DRAFT-Summary of Responses to Proposed Plan Design ChangeElectric or motorized wheelchairs and scootersGastrointestinal tract imaging through capsule endoscopyHyperbaric oxygen therapyLimb prostheticsOncotype DX (a method for testing for genes that are in cancer cells)Orthognathic surgery procedures, bone grafts, osteotomies and surgicalmanagement of the temporomandibular joint (reconstructive surgeriesto attempt to correct structural abnormalities of the jaw bones) Organ transplants Osseointegrated implant Osteochondral allograft/knee (grafting of cartilage and bone from acadaver to the knee joint) Proton beam radiotherapy Reconstruction or other procedures that may be considered cosmetic Surgical spinal procedures Uvulopalatopharyngoplasty, including laser-assisted procedures(surgery to reconfigure the soft palate to try to help with sleep apnea) Ventricular assist devices MRI-knee MRI-spine Intensive outpatient programs for treatment of mental disorders andsubstance abuse, including:o Psychological testingo Neuropsychological testingo Outpatient detoxificationo Psychiatric home care services TravelWhen receiving services from a network provider, precertification must beobtained by the provider from the Third Party Administrator for the followingtypes of medical expenses: High-tech radiology (MRI/CT Scans) Diagnostic cardiology Sleep management studies Cardiac rhythm implant devices Interventional pain management Hip and Knee replacements (arthroplasties) ProposedChangeMember Impact:Under the current benefits, some patients may be undergoing costly and potentiallyduplicative procedures that expose them unnecessarily to elevated levels of radiation. TheMarch 20, 2019Page 4 of 7
DRAFT-Summary of Responses to Proposed Plan Design Changeproposed change would help ensure that the high-tech imaging and diagnostic testingmember receive from network providers is medically necessary and follows appropriateevidence-based guidelines.This proposed initiative would provide members with an additional measure ofconfidence that the care they are receiving is medically necessary and essential to theircourse of care. Furthermore, enhanced clinical review will help protect members againstunnecessary medical expenses.Because the precertification process would occur between the network provider and theThird Party Administrator, if the precertification is granted members should anticipateminimal, if any, interaction with this policy. If a service is denied, the provider mayconsult with a peer to discuss the need for the procedure, but the member will beinformed of the denial and will need to consider next steps or other options with theirprovider.Actuarial ImpactNeutral / Enhancement / DiminishmentTable 3: Actuarial ImpactCurrentActuarial ImpactN/ANotesN/AThis initiative is not anticipated to have an actuarial impact on the plan. 1 The plan willcontinue to cover high-tech imaging and diagnostic testing when medically necessary.DRB operational impacts:The Division will work to educate members and increase familiarity with the enhancedclinical review process. The Division will also work to educate staff members about theinitiative to ensure members are provided with accurate information regarding theprocess and staff are prepared to assist members.Financial Impact to the plan:Table 4, Estimated SavingsProposed ChangeEnhanced clinical review for high-techimaging and diagnostic testingEstimated Annual Financial Impact 250,000 net savings to the planSegal Memo Implementation of Enhanced Clinical Review (ECR) Program for High Tech Radiology Services datedMarch 15, 2019.1March 20, 2019Page 5 of 7
DRAFT-Summary of Responses to Proposed Plan Design ChangeThe current per non-Medicare eligible member per month plan spend on radiology isapproximately 82, compared with the per member per month average spend of 53 forthe same services across Aetna’s book of business. 2 It is anticipated that 2-3% of servicesand procedures covered by this proposal would be denied or redirected to an alternateform of care. Savings to the plan are projected to be 350,000 annually, but the total costof the program is projected to be 100,000 annually, resulting in 250,000 annual netsavings. 3Clinical considerations:The proposed changes would require additional clinical review for some high-techimaging and diagnostic testing. These services are currently available to members whenmedically necessary, and under the proposed initiative would continue to be available tomembers. This initiative would provide an extra degree of certainty that the servicesrendered are, in face, medically necessary.Third Party Administrator (TPA) operational impacts:The proposed program is already part of existing network contracts between Aetna andparticipating providers, and has already been put into practice with other accounts.Because the administrative framework for review, determinations, and appeals alreadyexists and has been implemented, the impact to the TPA of applying an enhanced clinicalreview program to the plan would be minimal.The addition of this policy may result in additional appeals processing by the TPA, buttypically the volume of appeals in this program is relatively small. In the month ofOctober 2018, across the Aetna’s book of business, there were 170,000 total enhancedclinical review requests submitted, 667 of which were appealed (.39%). 2% of appealsarose from denials. During that time frame, 261 appeals (39.1%) were overturned. 4Provider considerations:As network providers are already familiar with this policy because it is part of theirnetwork agreement with Aetna, the anticipated impact to those providers is minimal.They are already familiar with the policy and with the process because they are requiredto conform to these procedures for other Aetna-covered patients.Enhanced Clinical Review Program, Aetna Presentation dated December 12, 2018.Segal Memo Implementation of Enhanced Clinical Review (ECR) Program for High Tech Radiology Services datedMarch 15, 2019.4Enhanced Clinical Review Program (Follow-up Q&A for Feb. 6, 2019 RHPAB meeting), Aetna Presentation datedFebruary 6, 2019.23March 20, 2019Page 6 of 7
DRAFT-Summary of Responses to Proposed Plan Design ChangeDocuments attached include:Document NameEnhanced Clinical ReviewProgram, Aetna Presentation datedDecember 12, 2018.Enhanced Clinical Review Program(Follow-up Q&A for Feb 6. 2019RHPAB Meeting), AetnaPresentation dated December 12,2018.Financial Analysis – Segal MemoNotesEnhanced ClinicalReview Program 12.12ECR Follow-up forRHPAB ModernizationSegal ECR Memo20190315.pdfMarch 20, 2019Page 7 of 7
330 North Brand Boulevard Suite 1100 Glendale, CA 91203-2308T 818.956.6700 www.segalco.comMEMORANDUMTo:Ajay Desai, Director, Division of Retirement and BenefitsFrom:Richard Ward, FSA, FCA, MAAADate:March 15, 2019Re:Implementation of Enhanced Clinical Review (ECR) Program for High Tech Radiology ServicesThe AlaskaCare Retiree Plan currently provides coverage for medical treatments and applies thegeneral plan provisions, such as deductible, coinsurance and out-of-pocket limitations, todetermine any portion of the costs that are the member’s responsibility. If the member hasadditional coverage, such as Medicare or other employer provided coverage, any portion of thecosts covered by that plan is also considered. Below is a table outlining the current benefits offeredunder the Plan:DeductiblesAnnual individual / family unit deductible 150 / up to 3x per familyCoinsuranceMost medical expenses80%Most medical expenses after out-of-pocket limit is satisfied100%Second surgical opinions, Preoperative testing, Outpatient100%testing/surgery No deductible appliesOut-of-Pocket LimitAnnual individual out-of-pocket limit 800 Applies after the deductible is satisfied Expenses paid at a coinsurance rate other than 80% do not applyagainst the out-of-pocket limitBenefits, Compensation and HR Consulting. Member of The Segal Group. Offices throughout the United States and Canada
Ajay DesaiMarch 15, 2019Page 2Benefit MaximumsIndividual lifetime maximum Prescription drug expenses do not apply against the lifetimemaximumIndividual limit per benefit year on substance abuse treatmentwithout precertification. Subject to change every three yearsIndividual lifetime maximum on substance abuse treatmentwithout precertification. Subject to change every three yearsPrescription DrugsNetwork pharmacy copaymentMail order copayment 2,000,000 12,715 25,430Up to 90 Day or 100 UnitSupplyGeneric Brand Name 4 8 0 0Some of the benefit coverages provided by the plan require precertification to ensure propermedical protocols and guidelines are followed. These precertification requirements currentlyinclude some high tech imaging such as MRIs for the spine and knee.The change under consideration would add an enhanced level of precertification (orpreauthorization) for all high tech imagining, including, MRI/MRA, CT/CCTA, PET, and NuclearCardiology. This program will require network providers to follow evidenced based guidelines forthese imagining services, and it will also encourage members to seek treatment from networkfacilities and providers. This program would only apply to services and procedures not covered byMedicare.Actuarial ValueThese changes promote efficient utilization of medical services, which helps manage programcosts. However, there are no changes to how the cost share is determined and therefore, the ECRprogram does not affect the actuarial value of the Plan.Financial ImpactWhile the Actuarial Value of the Plan would not be impacted by the implementation of thisprogram, there would be a financial impact to plan costs. Our analysis leverages the analysisconducted by Aetna. Segal has reviewed Aetna’s analysis to determine that all assumptions areappropriate and reasonable.Radiology costs are about 80 per member per month (pmpm) for non-Medicare retirees. It isestimated that approximately 2-3% of network procedures and services covered by the ECRprogram would be denied or redirected to more efficient care. The cost of affected procedures isanticipated to be higher than average. Savings to the plan are estimated to be 350,000 annually.
Ajay DesaiMarch 15, 2019Page 3Based on a 0.70 per retiree per month (prpm) fee for the program, and approximately 11,600 nonMedicare retirees, the total annual cost of the program is approximately 100,000, resulting in 250,000 in annual net savings.It is worth noting that the ECR program currently coordinates exclusively with network providers.Since the Retiree Plan does not have a benefit differential for network and non-network providersand services, there is the possibility that some retirees may “shop” between network and nonnetwork providers if the initial review results in a denial. These instances may be isolated and theoverall impact minimal, but we believe it is worth noting now in order to proactively monitor thePlan for this potential behavior once the ECR program is implemented.This analysis is based on 2016 and 2017 medical and pharmacy claims data, projected to 2019 at3.0% and 6.0% annual trends, respectively. The data was reviewed, but not audited, and found tobe sufficient and credible for this analysis.Please note that the projections in this report are estimates of future costs and are based oninformation available to Segal at the time the projections were made. Segal Consulting has notaudited the information provided. Projections are not a guarantee of future results. Actualexperience may differ due to, but not limited to, such variables as changes in the regulatoryenvironment, local market pressure, trend rates, and claims volatility. The accuracy andreliability of projections decrease as the projection period increases. Unless otherwise noted,these projections do not include any cost or savings impact resulting from The Patient Protectionand Affordable Care Act (PPACA) or other recently passed state or federal regulations.cc:Michele Michaud, Division of Retirement and BenefitsEmily Ricci, Division of Retirement and BenefitsBetsy Wood, Division of Retirement and BenefitsLinda Johnson, SegalNoel Cruse, SegalMichael Macdissi, SegalDan Haar, SegalQuentin Gunn, Segal
Quality health plans & benefitsHealthier livingFinancial well-beingIntelligent solutionsEnhanced ClinicalReview program(Follow-up Q&A forFeb. 6, 2019 RHPAB meeting)
Program DetailsoProgram Summary:o Add preauthorization for participating providers for high tech radiology services – MRI/MRA, CT/CCTA, PET, Nuclear Cardiologyo Providers need to follow evidence-based guidelines of appropriate careo Steerage for members to in-network facilities/physicianoProvider Approval Process:o Requesting provider completes precertificationo Determination is sent in a letter to the member, and by fax to both rendering and orderingprovider.o Alaska Heart Institute feedback (Jan. 2019): Our network team surveyed this provider abouttheir experience with Aetna ECR and they did not report any incidences of member disruption.oDenial Process:o Providers may request a peer-to-peer review within 14 days from the date of the denial.o Providers may choose a convenient time for the peer-to-peer review. It may take 1-2 days tocomplete the peer-to-peer where a discussion and determination is made.o If Precertification denial is upheld after a peer-to-peer review, the provider can appeal directlyto Aetna through the standard Provider Appeal process.oPrecertification Statistics (October 2018 -- Aetna BOB):o 170,000 total requestso 667 appealed (.39%)o 261 were overturned, an overturn rate of 39.1%o 2% of appeals from denials
Savings and FeesoSavings Opportunity: 9.02 PRPMoProgram Fee: 0.70 PRPMo High tech radiology (MRI/CT Scans) 0.35o Diagnostic Cardio 0.10o Sleep Study 0.05o Cardiac Implantable 0.05o Interventional Pain Management 0.10o Hip/Knee Replacements 0.05o Choose a custom bundle or all programso Variable cost via Claim Wire, no fixed costo Implementation: Required 60-day noticeo Aetna Vendor: MedSolutions DBA eviCore Healthcare
Savings ProjectionoMitigate inappropriate utilization due to a multitude of factors including:o New technologies intensify the application of imaging studies for new diagnosticmeanso Greater consumer demando Aging populationo Increased capacity through self-referrals by physicianso New standards of careo Defensive medicineo Aetna Savings Model:o Based on Aetna BOB percentage of services redirected/not authorized due toMedical Necessity Reviewo Aetna BOB Average Cost Per Denied Serviceo Customer-specific data (Census/Network)o Savings reflect the avoided cost of services not authorized
Program ReportingCurrent Period ResultsModalityHi-Tech RadiologyServices Redirected /Not Authorized241Denial Rate9.5%297.9%Diagnos tic CardiologyCardiac Im plantable DeviceSleep StudiesHip & Knee Replacem entPain Managem entTOTAL00.0%9145.7%15.0%176.9%37911.3%Avg Cost per TestGross Program SavingsNet Program Savings 1,122 312,643- 50,197Gross Savings PMPM 0.52Net Savings PMPM- 0.08Prior PeriodModalityHi-Tech RadiologyDiagnostic CardiologyCardiac Implantable DevicePrecertification DecisionsCurrent 138815719910891Hip & Knee Replacement1916320191Pain leep StudiesGrand Total All Procedures
Performance Guarantees Contractual performance guarantees are based upon a two day turnaround timeresponse Performance Guarantee Results: 2nd Quarter of 2018 – BOB PG was 95% met 98% within 5 business days 99% of urgent request completed within 8 hours Real-time peer-to-peer review goal to reach a conclusion
Thank youAetna is the brand name used for products and services provided by one or more of the Aetna group ofsubsidiary companies, including Aetna Health Inc., Aetna Health of California Inc., Aetna Health InsuranceCompany of New York, Aetna Health Insurance Company and/or Aetna Life Insurance Company (Aetna). InFlorida by Aetna Health Inc. and/or Aetna Life Insurance Company. In Maryland, by Aetna Health Inc., 151Farmington Avenue, Hartford, CT 06156. Each insurer has sole financial responsibility for its own products.This material is for information only. Health benefits and health insurance plans contain exclusions andlimitations. Not all health services are covered. See plan documents for a complete description of benefits,exclusions, limitations and conditions of coverage. Plan features and availability may vary by location and aresubject to change. Providers are independent contractors and are not agents of Aetna. Provider participation maychange without notice. Aetna does not provide care or guarantee access to health services. While this material isbelieved to be accurate as of the production date, information is subject to change. For more about Aetna plans,refer to www.aetna.com.Policy forms issued in OK include: HMO OK COC-5 09/07, HMO/OK GA-3 11/01, HMO OK POS RIDER 08/07, GR-23and/or GR-29/GR-29N. 2015 Aetna Inc.00.25.245.1 (11/15)Aetna Inc.
Quality health plans & benefitsHealthier livingFinancial well-beingIntelligent solutionsEnhanced ClinicalReview program
Enhanced Clinical Review – U65 Retiree Plan WHAT— Lower costs for high tech radiology, certain cardiac and MSK WHY—To mitigate inappropriate utilization by following evidence-basedguidelines of appropriate care Plan Radiology utilization increased 11.5% w/ MRI & CT Scans up 8% Plan PMPM is 82 vs. Aetna BOB at 53 HOW—Add provider preauthorization of certain radiology and cardiologyservices, sleep studies, pain mgmt. and MSK.Network providers only. RESULTS— Estimated Net Annual Savings: U65 Retiree Plan - TBD REPORTING-- AetInfo 2017 Aetna Inc.2
The Enhanced Clinical Review program:a solution to help you contain health care costsCritical touch points of careRepresents 11% of Alaska Care medical costs that you can improveTesting and diagnosisTreatmentHigh-tech radiologyCardiac rhythm implantdevicesDiagnostic cardiologySleep management studiesInterventional painmanagement*Hip and Knee replacements(arthroplasties)** Effective 1/1/20163
Appropriate care leads to better outcomes andproven savings, for the State and membersEvidence-BasedstandardsAetna-preferred providersDetermine appropriate level of careDeliver more cost-effective careResult:Improved health outcomes and maximized savingsAlaska CareMembersConfidence that their health care dollarsare supporting beneficial carePeace of mind that they aregetting the right care, at the highestbenefit level*This is a projection based upon historical claims savings, and actual savings amounts will vary.Aetna Inc.4
Thank youAetna is the brand name used for products and services provided by one or more of the Aetna group ofsubsidiary companies, including Aetna Health Inc., Aetna Health of California Inc., Aetna Health InsuranceCompany of New York, Aetna Health Insurance Company and/or Aetna Life Insurance Company (Aetna). InFlorida by Aetna Health Inc. and/or Aetn
Retiree Health Plan Advisory Board Public Comment Guideline 1 Public Comment Purpose The public comment period allows individuals to inform and advise the Retiree Health Plan Advisory Board about policy-related issues, problems or concerns. It is not a hearing and cannot be used to address health benefit claim appeals. The
Retiree Health Plan Marathon Petroleum Company LP (Company) sponsors and maintains the Marathon Petroleum Retiree Health Plan (the "Plan" or "Retiree Health Plan"). This document amends and restates the Plan effective as of January 1, 2022. This document serves both as the plan document and the Summary Plan Description (SPD) for the Plan.
When Jenny turns 65, she retires with IU Retiree Status. Both elect IU Retiree coverage: ‒ Jenny—IU Anthem Blue Retiree Plan (for 65 ) ‒ Dan—IU Anthem U65 PPO HDHP (for under 65) When Dan turns 65, he can switch to the IU Blue Retiree plan—the same plan as Jenny. Scenario #1 . Jenny & Dan. Dan - Age 63 (Spouse) Jenny .
Retiree Medical Plan (also referred to as the "Retiree Medical Plan" or "Plan"), which is a Component Plan of the Huntington Ingalls Industries, Inc. Retiree Welfare Benefits Plan (the "Welfare Benefits Plan"). If you have questions that are not answered in this SPD, contact
If you are selecting 'Retiree & Children,' 'Retiree & Spouse' or 'Retiree & Family' coverage, you must complete the dependent information in Section 4. Group Legal Plan: You must complete the dependent information in Section 4. Please send the white copy of the form to: FBMC Benefits Management, Inc. Retiree Direct Bill PO Box 10789
Wells Fargo & Company Retiree Plan. Please take the time to read this supplementary information to the Wells Fargo & Company Retiree Plan (Retiree Plan) describing how testing and evaluation for COVID-19 is covered effective January 1, 2021, and keep a copy of it with your
Retiree contributions will decrease for Retiree Only and increase for all other tiers in the Kaiser Northern California Health Plan option. Retiree contributions for Retiree Family coverage will increase and all other tiers will decrease in the Kaiser Southern California option. For more plan information, please call Kaiser at 1-800-278-3296.
documents") briefly describe your Benefits as well as rights and responsibilities, under the CenturyLink Retiree and Inactive Health Plan (the "Health Plan") and make up the official Summary Plan Description for this benefit under the Employee Retirement Income Security Act of 1974, as amended, and the regulations thereunder ("ERISA").
Black holes are predictions of Einstein’s theory of general relativity, which describes gravity, not as a force, but as the curvature of space and time. 2. Black holes act like one-way membranes from which nothing can escape. 3. Although they have several weird properties, observations strongly support their existence. 4. Gravitational waves are vibrations in the gravitational field that .
