Do You Want The Tax And Savings Advantages Of A Health Savings Account .
GoldBlue Cross Blue Shield Health Savings 1800,a Multi-State PlanBenefit Period: January 1, 2015 to December 31, 2015Do you want the tax and savings advantages of a HealthSavings Account (HSA)?Health Savings are our only qualified high-deductible health plans that offer the tax andsavings advantages of Health Savings Accounts (HSA). You pay all costs until your deductibleis met. Then you pay a percentage of costs until you meet your out-of-pocket max.This Health Savings Plan is a Qualified High Deductible Health Plan that may be coupledwith a Health Savings Account (HSA). However, certain cost-sharing reductions (CSR) or planvariations of this plan that are offered through the Health Insurance Marketplace are notintended to be used with an HSA. If you have questions, please check with your financialadvisor.If you are looking for additional plan details, each plan’s Summary of Benefits and Coverageis available online at HighmarkBCBSDE.com/SBC/BCBSDE. With this information, you’ll beable to shop and compare with confidence. If you do not have online access, you can get apaper copy of any Summary of Benefits free of charge by calling toll-free 1-855-329-3007.?QuestionsHighmark Blue Cross Blue Shield Delaware is an independent licensee of the Blue Cross and Blue Shield Association. Blue Cross, Blue Shield and the Crossand Shield symbols are registered service marks of the Blue Cross and Blue Shield Association. Highmark is a registered mark of Highmark Inc. Informationregarding the Patient Protection and Affordable Care Act of 2010 (a.k.a. “PPACA”, “Affordable Care Act”, “ACA”, and/or “Health Care Reform”), as amended, and/or any other law, does not constitute legal or tax advice and is subject to change based upon the issuance of new guidance and/or change in laws. State lawsmay be applicable. Any review of materials, request for information, or application does not obligate you to enroll for coverage. Please request the Outlineof Coverage for details on benefits, conditions and exclusions. Providing your information is voluntary. We are committed to providing outstanding servicesfor our applicants and members. If you require special assistance, including accommodations for disabilities or limited English proficiency, please call us at1-877-959-2563 to request these free services (TTY/TDD users may call 711).Highmark Blue Cross Blue Shield Delaware does not discriminate on the basis of race, color, national origin, disability, age, sex, gender identity, sexualorientation, or health status in the administration of the plan, including enrollment and benefit determinations.Highmark Blue Cross Blue Shield Delaware is a Qualified Health Plan issuer in the Health Insurance Marketplace.26642 (11/14)HighmarkBCBSDE.com
Blue Cross Blue Shield Health Savings 1800,a Multi-State Plan ExplainedPlan DetailsYou Pay1You PayDeductible – Individual 1,800N/AOut-of-Pocket Limit – Individual 1,800N/ADeductible – Family2 3,600N/AOut-of-Pocket Limit – Family 3,600N/ACoinsuranceafter deductible0%N/APreventive Care3 – Annual deductible and coinsurance do not apply to the Preventive Care services listed belowRoutine Annual Physical Exam,Routine Annual Gynecological Exam,Immunizations (Adult & Pediatric),Routine Mammogram Screenings, andPreventive Medications40%100%Illness or Injury CarePrimary Care Office/Clinic Visit0% after deductible100%Specialist Office Visit0% after deductible100%Emergency Room Visit0% after deductible0% after deductiblePrescription Drugs50% after deductible100%Maternity Services0% after deductible100%Inpatient Hospital Services0% after deductible100%Medical/Surgical Expenses0% after deductible100%Diagnostic Services6(Lab, X-ray and other services)0% after deductible100%Therapy and Rehabilitation Services70% after deductible100%Mental Health/Substance Abuse Services0% after deductible100%Routine Eye Exam (Every 24 months)0%100%Pediatric DentalPediatric Vision1Exam/Cleaning: 0%; All otherbenefits: 0% after deductibleExam: 0%; Frames/Lenses:0% after deductible100%100%You are responsible for out-of-pocket costs each Benefit Period up to a maximum amount shown. Thereafter, the Plan pays 100% of the Provider’s AllowableCharge during the remainder of the Benefit Period. This amount does not include amounts in excess of the Provider’s Allowable Charge.2Health Savings Family Deductible: For an Agreement covering more than one (1) family member, the ENTIRE family deductible must be met (within a benefitperiod) before Highmark will pay for covered services for ANY family member. The family deductible can be satisfied by an individual family member or acombination of one or more family members.3The Highmark Delaware Preventive Service Schedule is reviewed and updated periodically based on the requirements of the Patient Protection and AffordableCare Act of 2010, as amended, and the advice of the American Academy of Pediatrics, U.S. Preventive Service Task Force, the Blue Cross and Blue ShieldAssociation and Medical Consultants. Accordingly, the frequency and eligibility of services is subject to change.4Certain limited prescriptions and over-the-counter drugs prescribed for preventive purposes.5The plan utilizes the HCR Comprehensive Formulary on the Premier network. Mail order available.6Laboratory and Diagnostic Services require one copay per date of service and type of service. Advanced Imaging includes but is not limited to CAT Scan, CTA,MRI, MRA, PET Scan and PET/CT Scan.7Therapy visit limits include in and out-of-network visits. Speech therapy is limited to 30 visits per contract year each for Rehabilitative and Habilitative services(60 visits total per contract year). Physical therapy and occupational therapy are a combined 30 visit limit per contract year each for Rehabilitative andHabilitative services (60 visits total per contract year).
2015 HEALTH INSURANCEPLAN COMPARISONFOR INDIVIDUALS AND FAMILIESThe coverage you need and the options you want fromHighmark Blue Cross Blue Shield Delaware5504D-1114
BETTER WITH BLUEFor over 75 years, Highmark Blue Cross Blue Shield Delaware has worked to offer our community the bestpossible health care experience.The future of health care is about youOur goal is to transform your health care experience. We’re making it simpler to access smart new ideas like: Health care programs that reward doctors for better patient results Member tools that make it easy for you to track what you’re spending Live support from myCare NavigatorSM, a personal guide to help youand your family better navigate the health care systemWith so many great reasons to be a member, it’s easy to see why we were rated #1 for plan satisfaction,*and why we are the health insurance brand chosen by more Americans than any other.**Here’s what you need to make an informed choice:How health insuranceplans work pg 2How to enroll pg 9Compare your Highmarkplan options pg 4Important dates pg 10Real-worldexamples pg 5Glossary pg 11The Highmarkdifference pg 6Contact us back cover2015 Highmark planoptions pg 7*Based on the 2013 Highmark Member Satisfaction Study — conducted with DSS Research.**Based on Atlantic Information Services’ (AIS) Directory of Health Plans: 2013, total national Blue Cross Blue Shield companies medical enrollment (YE 2012).pg 1Questions? Please call 1-855-329-3007 (TTY/TDD users may dial 711).
HOW HEALTH INSURANCE PLANS WORKMost health insurance plans have three different stages that determine how much you and yourhealth insurance company pay for health care services:1 Before you meet your deductible2 After you meet your deductible3 When you reach your out-of-pocket maximumBefore you meet your deductible 1,000 DEDUCTIBLEEach plan year begins with a new deductible. Youpersonally pay out of pocket for your medicalYOU PAY:services until your expenses total the amount ofyour deductible. Then, your plan pays for its shareof covered services. Remember that your insurancecompany pays 100% of many preventive care services,which are not subject to your deductible as long asyou visit an in-network provider. And many plans100 % ( copays)0%PLAN PAYS:For example: If your plan has a 1,000 deductible and you pay 800 in coveredmedical costs, you must spend 200 more in medical fees to meet your 1,000deductible (copays do not go toward meeting your deductible).have copays for common services in advance ofthe deductible.20% COINSURANCEAfter you meet your deductibleOnce you have paid your deductible, you only payYOU PAY:20 %( copays)for part of your care. During this stage, you pay apercentage (coinsurance) of some medical costs80 %PLAN PAYS:and/or a flat fee (copay) for others. Your healthinsurance company pays for 100% of the planallowance for covered in-network care. You’llcontinue to pay coinsurance and copays until youreach your out-of-pocket maximum for the year.When you reach your out-of-pocket maximumFor example: Let’s say you visit the doctor after you’ve met your deductible, andyour plan has a 20 office visit copay and 20% coinsurance. That means you pay afixed 20 fee (your copay) for your appointment. If your doctor performs a specialservice, such as a blood test, you may also pay 20% of that cost (your coinsurance).OUT OF POCKET MAXIMUMYour out-of-pocket maximum is the most you will beasked to pay from your own pocket during any givenYOU PAY:plan year. After that, your health insurance companypays 100% of the plan allowance for covered in-networkcare. Your deductible, coinsurance and copays all gotoward meeting your out-of-pocket maximum.PLAN PAYS: 0100 %For example: If your plan has a 6,350 out-of-pocket maximum and you spend 6,350 in covered medical services, your plan pays for 100% of your coveredin-network care for the rest of the plan year. You’ll still need to keep paying yourmonthly premium after you meet your out-of-pocket maximum.Visit DiscoverHighmark.com to learn more and enroll.pg 2
HOW HEALTH INSURANCE PLANS WORKUsing your health insurance planIt’s important to think about how you use your medical benefits — it could have a big effect on your health carecosts and your plan decision. Factoring in how often you receive care makes it easier to anticipate future healthcare costs — and what you may be able to afford in case of an emergency.When choosing aplan, consider:How often youand your familyvisit a doctor,including primarycare physicians (PCP)and specialistsHow manyprescriptionsyou takeHighmark lets you choose from a wide variety of affordable plan options that have different levels of monthlypremiums, deductibles, copays and coinsurance. When you start to compare plans, it’s also important that yougain a good understanding of what services are covered and at what level and cost.Things to keep in mindWhenever you’re shopping for health insurance coverage, here are a few extra things to remember:pg 3NoReferralsEmergencyCoverageNationalCoverageAll Highmark plans let you see aspecialist without needinga referral from your primarycare doctor, so you can get thecare that you need when youneed it.No matter which Highmarkplan you choose, emergency careis covered at in-network rates atany emergency room.Highmark is part of the BlueCross Blue Shield network, so youhave access to over 92% of allphysicians and more than 97% ofall hospitals across the country.Questions? Please call 1-855-329-3007 (TTY/TDD users may dial 711).
COMPARE YOUR HIGHMARK PLAN OPTIONSHighmark has the plan options you needWe have a wide variety of affordable plan options that can work for any budget — including our most popularplans with copays for many services, even before you meet your deductible. All of the plans include EssentialHealth Benefits from the Affordable Care Act, and many plans are available across all metal levels.Does this sound like you?Then this plan might be a good choice.Metal levels:I want the tax and savingsadvantages of a HealthSavings Account (HSA).Health Savings Blue EPO is our only qualified high-deductiblehealth plan that offers the tax and savings advantages of aHealth Savings Account (HSA). You pay all costs until yourdeductible is met. Then you pay a percentage of costs until youmeet your out-of-pocket maximum.Bronze, Silver and GoldI want some copayswith coverage rightfrom the start.Shared Cost Blue PPO and EPO plans have copays withcoverage for some services right from the start. For other services,you need to meet your deductible before we pay for your care.These plans have a wide range of deductibles.Bronze, Silver, Gold and PlatinumI am under 30 andlooking for some of thelowest cost coverage.If you are under 30 (or if you meet financial hardshiprequirements), Major Events Blue EPO plans providebasic coverage. And you get the protection you need in caseof an emergency.CatastrophicVisit DiscoverHighmark.com to learn more and enroll.pg 4
REAL WORLD EXAMPLESThese scenarios may help you better understand which plan option mightwork best for you:Jeri is in her 40s, has three kidsand lots of doctor visits. She islooking for a plan that gives her“the most copays,”so she isn’t surprised later.JeriShe is considering Shared CostBlue PPO or Shared Cost Blue EPO.Josh is 35 and healthy butvery budget-conscious. Hewants a plan with“low premiums andcopays”for services he uses most.JoshHe is considering Shared Cost BluePPO or Shared Cost Blue EPO.Paul and Anna are in their40s. They are pretty healthyand like to find ways toPaul & Anna“keep their taxes lowevery year.”They are consideringHealth Savings Blue EPO.Kelly is 28 and in good health.She doesn’t get sick often andis only looking for coverage“in case of an emergency.”KellyShe is consideringMajor Events Blue EPO.**Major Events plans are only available for individuals and families under 30 years of age or are based on a financial hardship.This information is for illustrative purposes only and is intended to provide general information and does not attempt to give you advice based on yourspecific circumstances.pg 5Questions? Please call 1-855-329-3007 (TTY/TDD users may dial 711).
THE HIGHMARK DIFFERENCEWe are thankful that our members have trusted us with their insurance needs for over 75 years. We areconstantly striving to develop new ways to make their health care experience better and more convenient.As part of our dedication to making our communities healthier, we’ve developed a wide array of helpful tools.Here are just a few of the tools, resources and programs that are available to you as a Highmark member.myCare NavigatorSMBlueCardProvider DirectoryA built-in guide for navigatingthe health care system —whether it’s help with a careclaim or assistance with providerbilling, myCare Navigator helpsmembers understand andmanage their care costs.Wherever you go nationwideas a Highmark member, you’rein the Blue network. Just showyour BlueCard at the thousandsof participating physicians andhospitals across the country, andyou’ll receive in-network accessaway from home.Now Highmark gives you moreways than ever to find a healthcare provider that’s right for you.Our easy-to-use online directorycan help you find doctors,dentists, pharmacies, and evensearch for covered medications.You can schedule your firstappointment and transferyour medical records with justone call.Blues On CallHealth & Wellness ToolsYour medical questions don’tjust come up during office hours.That’s why Blues On Call givesyou a 24/7 hotline to a team ofregistered nurses to help youwith personal health questions.Members get access to today’sleading-edge, online health andwellness tools. With Highmarkyou get what you need tolaunch your journey towardbetter health and wellness. It’sconvenient, easy to use, andbest of all, it’s free.Visit DiscoverHighmark.com to learn more and enroll.pg 6
2015 HIGHMARK PLAN OPTIONSThe chart below shows your costs as a member.EPOPPOSHARED COSTPlan TypeMetal LevelBronzeSilverGoldGoldGoldGoldGoldGoldPlan NameShared Cost BlueEPO 5250Shared Cost BlueEPO 3000Shared Cost BlueEPO 0Shared Cost BlueEPO 750Shared Cost BlueEPO 1000Shared Cost BlueEPO 1350Shared Cost BluePPO 1500Shared Cost BluePPO 1800 RewardsDeductible(Individual) 5,250 3,000 0 750 1,000 1,350In-Network: 1,500Out-of-Network: 3,000In-Network: 1,800Out-of-Network: 3,600Deductible(Family)1,2 10,500 6,000 0 1,500 2,000 2,700In-Network: 3,000Out-of-Network: 6,000In-Network: 3,600Out-of-Network: 7,200Out-of-PocketMaximum(Individual)3 6,250 5,000 5,000 3,000 3,000 2,500In-Network: 3,500Out-of-Network: 7,000In-Network: 3,500Out-of-Network: 7,000Out-of-PocketMaximum (Family) 12,500 10,000 10,000 6,000 6,000 5,000In-Network: 7,000Out-of-Network: 14,000In-Network: 7,000Out-of-Network: 14,000Coinsurance(after deductible)10%25%20%20%20%0%In-Network: 0%Out-of-Network:40%In-Network: 0%Out-of-Network:40%Primary Care Visit 5 copay 30 copay 35 copay 25 copay 25 copay0%after deductible 30 copay 20 copaySpecialist orUrgent Care Visit10% afterdeductible 50 copay 50 copay 35 copay 45 copay0%after deductible 40 copay 40 copayEmergency RoomVisit10% afterdeductible 150 copay 250 copay 250 copay 150 copay0%after deductible 250 copay 150 copayInpatient HospitalServices10% afterdeductible25% afterdeductible 500 copay a dayfor 5 days, 0%thereafter20% afterdeductible20% afterdeductible0%after deductible0%after deductible0%after deductibleDiagnostic X-raysand Lab7X-rays: 10% afterdeductibleLab: 25 copayX-rays: 35 copayLab: 25 copayX-rays: 35 copayLab: 25 copayX-rays: 20% afterdeductibleLab: 25 copayX-rays: 35 copayLab: 25 copay0%after deductibleX-rays: 0% afterdeductibleLab: 25 copayX-rays: 35 copayLab: 25 copayPrescription DrugCoverage50% afterdeductible4Generic: 15 copay;Brand Formularyand Non-Formulary/Specialty: 25% afterdeductible4Generic: 8Brand Formulary: 35; BrandNon-Formulary/Specialty: 506Generic: 8Brand Formulary: 35; BrandNon-Formulary/Specialty: 506Generic: 15 copay;Brand Formularyand Non-Formulary/Specialty: 20% afterdeductible4Generic: 8Brand Formulary: 35; BrandNon-Formulary/Specialty: 506Generic: 8Brand Formulary: 35; BrandNon-Formulary/Specialty: 506Generic: 8Brand Formulary: 35; BrandNon-Formulary/Specialty: 506Wellness Rewards*NoNoNoNoNoNoNoYesPediatric DentalServices5Exam/Cleaning: 0%;All other benefits:50% coinsuranceExam/Cleaning: 0%;All other benefits:50% coinsuranceExam/Cleaning: 0%;All other benefits:50% coinsuranceExam/Cleaning: 0%;All other benefits:50% coinsuranceExam/Cleaning: 0%;All other benefits:50% coinsuranceExam/Cleaning: 0%;All other benefits:50% coinsuranceExam/Cleaning: 0%;All other benefits:50% coinsuranceExam/Cleaning: 0%;All other benefits:50% coinsurancePediatric VisionServices5Exam: 0%;Frames/Lenses: 0%Exam: 0%;Frames/Lenses: 0%Exam: 0%;Frames/Lenses: 0%Exam: 0%;Frames/Lenses: 0%Exam: 0%;Frames/Lenses: 0%Exam: 0%;Frames/Lenses: 0%Exam: 0%;Frames/Lenses: 0%Exam: 0%;Frames/Lenses: 0%*Health plan with a Wellness Program that offers a reward: You or your spouse or domestic partner, or dependents 18 or older, can get a 50 reward by completing theWellness Profile. The online Wellness Profile is a self-assessment of your health.pg 7Questions? Please call 1-855-329-3007 (TTY/TDD users may dial 711).
2015 HIGHMARK PLAN OPTIONSThe chart below shows your costs as a member.EPOPlan TypeSHARED COSTHEALTH SAVINGSMAJOR EVENTSMetal dPlan NameShared Cost BlueEPO 300Health Savings BlueEPO 6300 RewardsHealth Savings BlueEPO 3000Health Savings BlueEPO 1800Major Events BlueEPO 6600Blue Cross Blue ShieldShared Cost 3000,a Multi-State PlanBlue Cross Blue ShieldHealth Savings 1800,a Multi-State PlanDeductible(Individual) 300 6,300 3,000 1,800 6,600 3,000 1,800Deductible(Family)1,2 600 12,600 6,000 3,600 13,200 6,000 3,600Out-of-PocketMaximum(Individual)3 1,300 6,300 3,000 1,800 6,600 5,000 1,800Out-of-PocketMaximum (Family) 2,600 12,600 6,000 3,600 13,200 10,000 3,600Coinsurance(after deductible)10%0%0%0%0%25%0%Primary Care Visit 10 copay0% after deductible0% after deductible0% after deductible0% after deductible;Eligible for 3 PCP visitsprior to deductible 30 copay0% after deductibleSpecialist orUrgent Care Visit 20 copay0% after deductible0% after deductible0% after deductible0% after deductible 50 copay0% after deductibleEmergency RoomVisit 250 copay0% after deductible0% after deductible0% after deductible0% after deductible 150 copay0% after deductibleInpatient HospitalServices10% afterdeductible0% after deductible0% after deductible0% after deductible0% after deductible25% after deductible0% after deductibleDiagnostic X-raysand Lab7X-rays: 10% afterdeductibleLab: 10 copay0% after deductible0% after deductible0% after deductible0% after deductibleX-rays: 35 copayLab: 25 copay0% after deductiblePrescription DrugCoverageGeneric: 8Brand Formulary: 35;Brand Non-Formulary/Specialty: 5060% after deductible40% after deductible40% after deductible40% after deductible4Generic: 15 copay;Brand Formulary andNon-Formulary/Specialty:25% after deductible40% after deductible4Wellness Rewards*NoNoNoNoNoNoNoPediatric DentalServices5Exam/Cleaning: 0%;All other benefits: 50%coinsuranceExam/Cleaning: 0%;All other benefits:0% after deductibleExam/Cleaning: 0%;All other benefits:0% after deductibleExam/Cleaning: 0%;All other benefits:0% after deductible0% after deductibleExam/Cleaning: 0%;All other benefits: 50%coinsuranceExam/Cleaning: 0%;All other benefits: 0%after deductiblePediatric VisionServices5Exam: 0%;Frames/Lenses: 0%Exam: 0%;Frames/Lenses: 0%Exam: 0%;Frames/Lenses: 0%Exam: 0%;Frames/Lenses: 0%0% after deductibleExam: 0%Frames/Lenses: 0%after deductibleExam: 0%Frames/Lenses: 0%after deductibleVisit DiscoverHighmark.com to learn more and enroll.MULTI STATEpg 8
HOW TO ENROLLWe make the enrollment process easyHighmark is here to be your health insurance partner, every step of the way.1 Find the plan that works for youIf you need help finding the health insurance plan that fits your needs and budget, a free personal consultationcan give you all the information you need.2 Get financial helpDepending on your household income and other factors, you may be eligible for one or both of these forms offinancial help. Highmark is here to help guide you through the Health Insurance Marketplace to get any financial helpyou may be eligible for, and enroll you with or without financial help. Also, our online Tax Savings Estimator lets youfind out if you might qualify for financial help before you shop. Visit DiscoverHighmark.com/individuals-families touse this helpful tool.Advanced Premium TaxCredits (APTC) can beapplied (in advance) to reduceyour monthly premium.Cost-Sharing Reductions(CSR)* will lower theout-of-pocket costs you maypay at the time of service.To use, you must purchase an individualMarketplace Silver Level plan.To use, you can select an individualMarketplace plan at any metal level.Use the chart below to estimate if you are eligible.NUMBER OF PEOPLE IN YOUR HOUSEHOLD1AdvancedPremiumTax Credits(APTC)You may qualify for lower monthlypremiums if your yearlyincome is between:Cost-SharingReductions(CSR)You may qualify for lower monthlypremiums AND lower out-of-pocket costsif your yearly income is between: 3211,670 46,680 11,670 29,175 15,730 62,92015,730 39,325 19,790 79,160 19,790 49,4754 23,850 95,400 23,850 59,62565 27,910 111,64027,910 69,77531,970 127,88031,970 79,925Eligibility for financial help can only be determined by requesting an eligibility verification through the Health Insurance Marketplace at www.healthcare.gov. Only applicable for coveragein 2015 and in the 48 contiguous states and the District of Columbia. American Indians and Alaska Natives who are members of federally recognized tribes are eligible for cost-sharingreductions at alternative dollar thresholds.*American Indian and Alaska Native cost-sharing reductions apply to individual plans at any Metal Level through the Marketplace.3EnrollWhen you’re ready, you can enroll directly through Highmark with or without financial help. Please seethe back of this brochure for information on how to contact us today. You can also enroll via the HealthInsurance Marketplace.pg 9Questions? Please call 1-855-329-3007 (TTY/TDD users may dial 711).
IMPORTANT DATESOpen Enrollment PeriodStarting November 15, 2014, until February 15, 2015, you can enroll in the plan of your choice during what iscalled the Open Enrollment Period. For most people this is the only time when you can enroll in or change yourplan, unless you have a qualifying life event.November15, 2014January1, 2015February15, 2015Open Enrollment BeginsCoverage BeginsOpen Enrollment EndsThis is the first day you can enrollin a plan for coverage beginningJanuary 1, 2015.If you enroll by December 15,2014, this is when your newcoverage will start. Otherwise, youcan use the chart below to findyour start date.The 2015 Open Enrollment Periodends. If you haven’t enrolled in a healthinsurance plan by this date, you can onlyenroll in 2015 coverage if you have aqualifying life event.Coverage start datesIf you enroll:If you enroll:If you enroll:November 15December 16January 16totoDecember 15January 15February 15Your coverage will startYour coverage will startYour coverage will startJanuary 1February 1March 1toSpecial Enrollment PeriodYou can enroll in a new plan outside of Open Enrollment ONLY if you have a qualifying life event, called aSpecial Enrollment Period. If you have one of these events occur, in most cases, you must enroll within 60 daysof the occurrence of the event. It’s important to remember that you can still be eligible for financial help if youenroll during a Special Enrollment Period. You or your spouse loseemployer-provided coverageQualifying life events such as: You have a change in familystatus, such as a marriage,domestic partnership, divorce,or the birth or adoption of a child You have permanently moved You are no longer a dependent onsomeone else’s planVisit DiscoverHighmark.com to learn more and enroll.pg 10
GLOSSARYImportant terms to knowCoinsuranceIn-network providersThe part of a medical bill that you pay after reachingyour deductible. For example, if your medical bill is 100and your coinsurance is 20%, you pay 20. The insurancecompany pays 80.These are health care providers who have anagreement with the health plan pertaining topayment as a network participant.The percentage of coinsurance that you pay can vary betweenplans, and it’s important to realize that the amount you paycould be lower if you qualify for cost-sharing reductions.CopaymentsCopayments (or copays) are fixed, upfront dollaramounts that you pay each time you receive certainhealth care services.Many plans offer copays that give you the security ofknowing your costs in advance. Also, it’s important toremember that all plans cover preventive services withno cost sharing. There are no copays or coinsurance forin-network preventive services like annual check-ups,mammograms and colonoscopies.DeductibleThe dollar amount you must pay each benefit period (usuallya year) for your health care expenses before your plan beginsto pay. For example, if you have a 500 deductible, that’s theamount you will pay before your plan will pay for coveredin-network services.When picking your plan, you should choose the one with thehighest deductible amount that you can comfortably pay ina calendar year. Some services may not require you to meeta deductible before your plan pays. We offer a variety ofdeductibles — so you’re sure to find a plan that fits yourneeds and budget.Out-of-network providersHealth care providers who do not have anagreement with the plan where they can beconsidered a network participant.You usually pay more when you use out-of-networkhealth care providers.Out-of-pocket maximumThe highest amount you will need to pay each benefitperiod (usually a year) for covered in-network carebefore your insurance company pays 100%.For example, if your out-of-pocket maximum is 2,000,once you have paid 2,000 the insurance company pays for100% of the plan allowance for covered in-network care.This does not include any services not covered by your plan.PremiumYour monthly premium is the amount you pay eachmonth for your health insurance.Usually, plans that have a higher deductible have alower monthly premium, while plans with a lowerdeductible will likely have a higher premium.FormularyA formulary is a list of prescription drugs that are coveredby your health insurance plan.A drug’s formulary status affects how much you pay for eachdrug. It’s important to make sure the prescriptions you needare covered in your plan’s formulary.pg 11Questions? Please call 1-855-329-3007 (TTY/TDD users may dial 711).
COMMITTED TO PROVIDING OUTSTANDING SERVICEWe are committed to providing outstanding services for our applicants and members. If you require specialassistance, including accommodations for disabilities or limited English proficiency, please call us at 1-877-9592563 to request these free services. (TTY/TDD: 711)Estamos comprometidos a ofrecer servicios excepcionales a nuestros solicitantes y miembros. Si usted necesitaayuda especial, incluyendo acomodaciones para discapacidades o dominio limitado del inglés, por favor llámenosal 1-877-959-2563 para solicitar estos servicios gratuitos. (TTY/TDD: 711)Wir haben uns verpflichtet, unseren Bewerbern und Mitgliedern außerordentliche Dienstleistungen anzubieten.Falls Sie beispielsweise Unterkünfte für Menschen mit Behinderungen oder aufgrund eingeschränkterEnglischkenntnisse besondere Unterstützung benötigen, kontaktieren Sie uns unter der Rufnummer 1-877-9592563, um unsere kostenlosen Dienstleistungen in Anspruch zu nehmen. (TTY/TDD: 711)Ci impegniamo a fornire sempre servizi all’avanguardia per i nostri candidati e membri. In caso necessitiate diassistenza speciale, compresi alloggi per disabili o supporto per la scarsa padronanza della lingua inglese,contattateci allo 1-877-959-2563 per richiedere gratu
Health Savings are our only quali#ed high-deductible health plans that o"er the tax and savings advantages of Health Savings Accounts (HSA). You pay all costs until your deductible is met. Then you pay a percentage of costs until you meet your out-of-pocket max. This Health Savings Plan is a Quali#ed High Deductible Health Plan that may be coupled
May 02, 2018 · D. Program Evaluation ͟The organization has provided a description of the framework for how each program will be evaluated. The framework should include all the elements below: ͟The evaluation methods are cost-effective for the organization ͟Quantitative and qualitative data is being collected (at Basics tier, data collection must have begun)
Silat is a combative art of self-defense and survival rooted from Matay archipelago. It was traced at thé early of Langkasuka Kingdom (2nd century CE) till thé reign of Melaka (Malaysia) Sultanate era (13th century). Silat has now evolved to become part of social culture and tradition with thé appearance of a fine physical and spiritual .
̶The leading indicator of employee engagement is based on the quality of the relationship between employee and supervisor Empower your managers! ̶Help them understand the impact on the organization ̶Share important changes, plan options, tasks, and deadlines ̶Provide key messages and talking points ̶Prepare them to answer employee questions
On an exceptional basis, Member States may request UNESCO to provide thé candidates with access to thé platform so they can complète thé form by themselves. Thèse requests must be addressed to esd rize unesco. or by 15 A ril 2021 UNESCO will provide thé nomineewith accessto thé platform via their émail address.
Dr. Sunita Bharatwal** Dr. Pawan Garga*** Abstract Customer satisfaction is derived from thè functionalities and values, a product or Service can provide. The current study aims to segregate thè dimensions of ordine Service quality and gather insights on its impact on web shopping. The trends of purchases have
Chính Văn.- Còn đức Thế tôn thì tuệ giác cực kỳ trong sạch 8: hiện hành bất nhị 9, đạt đến vô tướng 10, đứng vào chỗ đứng của các đức Thế tôn 11, thể hiện tính bình đẳng của các Ngài, đến chỗ không còn chướng ngại 12, giáo pháp không thể khuynh đảo, tâm thức không bị cản trở, cái được
More than words-extreme You send me flying -amy winehouse Weather with you -crowded house Moving on and getting over- john mayer Something got me started . Uptown funk-bruno mars Here comes thé sun-the beatles The long And winding road .
Le genou de Lucy. Odile Jacob. 1999. Coppens Y. Pré-textes. L’homme préhistorique en morceaux. Eds Odile Jacob. 2011. Costentin J., Delaveau P. Café, thé, chocolat, les bons effets sur le cerveau et pour le corps. Editions Odile Jacob. 2010. Crawford M., Marsh D. The driving force : food in human evolution and the future.
