2013-14 INSURANCE (c) 2013 CareOperative, LLC - Confidential - PowerPoint PPT Presentation

2013-14 INSURANCE (c) 2013 CareOperative, LLC - Confidential 10/30/2013 1 and Proprietary

Open Enrollment Online On District website HR-Health and other benefits November 1-30 This includes: Our Plan Flex VSP Vision (Form available online) UNUM (Contact Shannon for forms) Long Term Care and Disability Paynewest Beth Glover 721-1000 ex. 6427 (c) 2013 CareOperative, LLC - Confidential 10/30/2013 3 and Proprietary

x Crazy Days Thanksgiving Break (c) 2013 CareOperative, LLC - Confidential 10/30/2013 4 and Proprietary

Expenditures 00/01 - 11/13 $14,000,000 $12,000,000 $10,000,000 $8,000,000 7.41% $6,000,000 $4,000,000 $2,000,000 $0 99-00 00-01 01-02 02-03 03-04 04-05 05-06 06-07 07-08 08-09 09-10 10-11 11-12 12-13

FLEX Changes • Since January 1, 2013, you have only been allowed to FLEX $2500 per year on medical. Dependent care remains at $5000. • This is an IRS rule that we had nothing to do with. • There is an option to you, although the option may contain an element of risk.

Health Savings Accounts • With an HSA, you can put up to $3300 per year into your account or $6550 if your spouse/dependent is on your plan. If you are over age 55, you can put up to $1000 more per year into the account. • You select to withdraw any amount up to that and the deposits would be automatically made to an account we set up with Health Equity. • You are free to use the funds as you need them for health care related expenses.

Introduction To Healthcare Blue Book (c) 2013 CareOperative, LLC - Confidential 10/30/2013 14 and Proprietary

Healthcare Blue Book • An independent online service that helps people find Fair Prices for hundreds of healthcare services • Designed to provide price information that is available in other industries • Provided by the MCPS Health Insurance Committee for you and your family • Available through your Allegiance website (c) 2013 CareOperative, LLC - Confidential 10/30/2013 15 and Proprietary

Why A Transparency Solution Is Needed • In-network prices can vary by 300% to 500% or more • Most people don’t know how to find providers that offer Fair Prices • Employers and employees CAN cut healthcare costs if they have the right information, tools and incentives (c) 2013 CareOperative, LLC - Confidential 10/30/2013 16 and Proprietary

In-Network Provider Prices Vary Dramatically $1,800 $1,600 $1,400 $1,200 $1,000 $800 $600 Fair Price – Knee MRI $400 $200 $0 Shows distribution of claims amounts paid in-network for knee MRI procedures in same market (c) 2013 CareOperative, LLC - Confidential 10/30/2013 17 and Proprietary

How To Use Healthcare Blue Book • Search for procedures using common 1. What Do You Need? language 2. What Should It • Learn what the fair price is for the Cost? procedure in your area 3. Where Can I Get • Compare providers on cost and quality The Fair Price? (c) 2013 CareOperative, LLC - Confidential 10/30/2013 18 and Proprietary

Healthcare Blue Book Terminology Color Coding System • Green = at or below the Fair Price • Yellow = somewhat above the Fair Price • Red = among the most expensive providers 19

ShopSmart TM Procedures • High volume • Med/high price Outpatient >$500 • High price variance • “Consumer Choice” Category Examples Surgery & Procedures Cataract, urology, ENT, general General Diagnostics Colonoscopy, sleep, cardiology Bone & Joint Knee, shoulder, hip Women’s Health Mammography, hysterectomy High Tech Imaging CT, MRI Traditional Imaging X-ray, ultrasound Labs Top 30 tests (c) 2013 CareOperative, LLC - Confidential 10/30/2013 20 and Proprietary

Accessing Healthcare Blue Book • Allegiance website – Log in with your credentials • Mobile app – iPhone or Android – Mobile browser – Individual access code (c) 2013 CareOperative, LLC - Confidential 10/30/2013 21 and Proprietary

Login (c) 2013 CareOperative, LLC - Confidential 10/30/2013 22 and Proprietary

What Do I Need? Search By Procedure Menu Keyword Search Search Zip Code Driven Mobile Code (c) 2013 CareOperative, LLC - Confidential 10/30/2013 23 and Proprietary

What Should It Cost? Knee Arthroscopy Fair Prices (c) 2013 CareOperative, LLC - Confidential 10/30/2013 24 and Proprietary

Where Can I Get It? Provider Listing (c) 2013 CareOperative, LLC - Confidential 10/30/2013 25 and Proprietary

Detailed Provider Information Physician Detailed Listing Facility Info Quality Ratings (c) 2013 CareOperative, LLC - Confidential 10/30/2013 26 and Proprietary

Summary • For ShopSmart procedures, Healthcare Blue Book displays Fair Price, price ranges, facility lists and physician information for: ♦ Most outpatient procedures over $500 • For other procedures, use Healthcare Blue Book to find Fair Price information to help you shop for a Fair Price provider • Either way - save hundreds or thousands of dollars (c) 2013 CareOperative, LLC - Confidential 10/30/2013 27 and Proprietary

• We have contracted with Broadway Pharmacy inside St. Patrick’s Hospital to provide excellent discounts on prescription drugs. • They will sell to us for the actual procurement cost plus $7.00.

• They also match Wal-Mart and other’s low cost generics. • They will do 90 day supplies and mail order. • Their hours are M-F 7-5:30 • It is easy to switch. Just call them or visit them and tell them where you currently have your prescriptions. They do all the rest.

CostCare We will continue our relationship with CostCare by continuing in-school blood draws with follow-up consults. They will also do flu shots this fall. We will also continue the $10 co- insurance payment for CostCare treatments at their three locations for those on our traditional plan.

• Remember to show proof to Shannon if your spouse is secondary on our plan and has other coverage. (c) 2013 CareOperative, LLC - Confidential 10/30/2013 31 and Proprietary