EPO Health Plan - FAQ
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FREQUENTLY ASKED QUESTIONS
EPO
HEALTH PLAN
UnitedHealthcare Choice
What
is the new
annual
deductible and are there
any changes to the
annual coinsurance limits for the EPO Health Plan?
Will I
receive a new
identification card for my
health plan coverage
and prescription drug coverage, and when can I expect to receive them?
Will I be
provided information
on electronic
Coordination of Benefits
for the new three-tier pharmacy benefit with Medco so I understand what
to do?
Is the MPS EPO
Health Plan an
HMO (health maintenance
organization)
with gatekeeper and restrictions to access to specialists?
How can I
find out if my
doctor, hospital, or
therapist is in the
UnitedHealthcare Choice Network for the MPS EPO Health Plan?
Will there be
a special open
enrollment period in 2011
so that I can
change health plans from the PPO to the EPO or from the PPO to the EPO?
Is the
EPO Health Pan a
nationwide plan, or is it
restricted to
southeastern Wisconsin only?
I have a
child who attends
college out-of-state and I
have heard that I
must enroll in the PPO/Indemnity Health Plan to obtain coverage for my
child; is this true?
What are
the new monthly
premium rates for the EPO?
What are
the new annual
deductibles and are there any changes to the annual coinsurance limits
for the EPO Health Plan? Back to top
|
EPO/INDEMNITY HEALTH PLAN
|
ANNUAL DEDUCTIBLE
IN-NETWORK ONLY
|
ANNUAL COINSURANCE
LIMIT IN-NETWORK ONLY
|
|
Single
|
NEW:
$50
|
NEW: No Change $150
|
|
Current:
$ 0
|
Current:
$150
|
|
Family – Two Persons
|
NEW:
$100
|
NEW: No Change
$300
|
|
Current:
$ 0
|
Current:
$300
|
|
Family – Three or More Persons
|
NEW:
$150
|
NEW: No Change $450
|
|
Current:
$ 0
|
Current:
$450
|
Will I
receive a new identification card for my health plan coverage
and prescription drug coverage, and when can I expect to receive them? Back to top
Yes. You will receive a welcome kit and a new card from
UnitedHealthcare for medical claims and a new card from Medco for
prescription drug claims within a day or two in the mail before the
changeover to the new design and the new pharmacy TPA, Medco.
Will I be
provided information on electronic Coordination of Benefits
for the new three-tier pharmacy benefit with Medco so I understand what
to do?
Yes. Information on electronic coordination of benefits or eCOB
will be included in the welcome packet you receive with your new
prescription drug I.D. cards from Medco. eCOB occurs when your
MPS plan is secondary coverage for prescription drugs because you or
any of your covered dependents also have other insurance covering
prescription drugs as primary. To take advantage of eCOB, you
must use a participating retail pharmacy set up for electronic claims
submission. Remember to update MPS with changes to your other
non-MPS insurance coverage for prescription drugs, at any time
throughout the year, for you or your covered dependents under your
health plan. You may contact MPS Benefits and Insurance Services
at (414) 475-8217 to update information on your other non-MPS coverage,
if applicable.
Is the MPS EPO
Health Plan an HMO (health maintenance organization)
with gatekeeper and restrictions to access to specialists? Back to top
No. The EPO health plan is not an HMO and you do not have to go
through a gatekeeper to access in-network specialists.
How can I
find out if my doctor, hospital, or therapist is in the
UnitedHealthcare Choice Network for the MPS EPO Health Plan? Back to top
Will there be
a special open enrollment period in 2011 so that I can
change health plans from the PPO to the EPO or from the PPO to the EPO?
Back to top
No. Switching between plans is permitted only during annual open
enrollment. The next annual open enrollment is in September 2011,
with an effective date of November 1, 2011 for the change.
Is the
EPO Health Plan a nationwide plan, or is it restricted to
southeastern Wisconsin only? Back to top
The EPO network is the UnitedHealthcare CHOICE network that is a broad,
nationwide network. To find out if your doctor or facility is in
the network you can click on the following link: www.myuhc.com
The network for the MPS EPO Health Plan is UnitedHealthcare nationwide
CHOICE network. You can check to see if your child’s medical
providers are in network by clicking on the following link:
www.myuhc.com
|
|
Current
|
New
|
Current
|
New
|
|
HEALTH PLAN
|
Aetna
PPO/Indemnity
Effective
July 1, 2010
Thru
June 30, 2011
|
UnitedHealthcare
PPO/Indemnity
Effective
April 1,
2011
Thru
June 30,
2011
|
UnitedHealthcare
EPO Plan
Effective
July 1, 2010
Thru
June 30, 2011
|
UnitedHealthcare
EPO Plan
Effective
April 1,
2011
Thru
June 30,
2011
|
|
ACTIVE EMPLOYEES
INCLUDING VISION
|
|
Single
|
$ 1,012.15
|
$
882.38
|
$ 560.69
|
$
527.47
|
|
Family
|
$ 2,237.21
|
$
1,950.48
|
$ 1,471.73
|
$
1,384.50
|
|
RETIREES (Does not
Include Vision)
|
|
Single
|
$ 1,008.02
|
$
878.25
|
$ 560.69
|
$
523.34
|
|
Family
|
$ 2,227.19
|
$
1,940.46
|
$ 1,471.73
|
$
1,374.48
|
|
Single, w/Medicare
|
$ 383.44
|
$
343.37
|
$ 415.15
|
$
362.26
|
|
Couple, one w/Medicare
|
$ 1,391.47
|
$
1,221.62
|
$ 977.60
|
$
885.61
|
|
Couple, two w/Medicare
|
$ 766.89
|
$
686.73
|
$ 832.70
|
$
724.52
|
|
Family, one w/Medicare
|
$ 1,602.61
|
$
1,405.58
|
$ 1,326.20
|
$
1,213.40
|
|
Family, two w/Medicare
|
$ 978.03
|
$
870.69
|
$ 1,180.66
|
$
1,052.32
|
|
Family, three w/Medicare
|
$ 1,150.33
|
$
1,030.10
|
$ 1,243.09
|
$
1,086.79
|
|
Note:
Retiree’s Employee
Contribution varies by the amount of the premium in effect as of the
date of retirement.
Retirees who are not
entitled to Board-paid coverage pay the entire premium.
|
