Partnersh nership Plan 2.0 Unite tedHe dHealth thcare - PowerPoint PPT Presentation

Partnersh nership Plan 2.0 Unite tedHe dHealth thcare are/Oxford Oxford welcomes es You to the State te of Connecticut ecticut Partne ners rship hip Plan 2.0 Benef efits its: The Partnership Plan 2.0 offers a rich plan design, featuring the same no no-referral ferral Point-of-Service (POS) plan design offered to state employees, providing: o In- and Out-of-Network coverage o 100% coverage for In-Network preventive care o Coverage for naturopaths, chiropractic care and acupuncture o An extensive local and national network through UnitedHealthcare/Oxford o Health Enhancement Program (HEP) o Dedicated Service Team • The Healt alth h Enhancem emen ent Program am (HEP) is a program designed to promote preventive screenings, wellness visits and chronic disease education and counseling for employees and, as a result, saves money on health care in the long term by focusing health care dollars on prevention • The Partnership Plan 2.0 has a dedicated team of individuals who are your point of contact throughout the process. You will not be lost in the shuffle with questions or concerns about enrollment, billing, or claims 1 Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

Most t Que uest stione ioned d Benefi nefits ts Benef efit it In In-Netw twork Cover erage age Out-of of-Ne Netw twor ork Cover erage age Preventive Care: No Copay Deductible Plus Coinsurance Adult and Pediatric Immunizations/Vaccines No Copay Deductible Plus Coinsurance Primary Care and Specialist Sick $15 Copay Deductible Plus Coinsurance Visits Naturopathic Physician Visits $15 Copay Deductible Plus Coinsurance $35 Copay $35 Copay Emergency Room *Waived if Admitted *Waived if Admitted Urgent Care Center $15 Copay Deductible Plus Coinsurance Routine Vision Exam & $15 Copay Deductible Plus 50% Coinsurance Refraction - 1 Exam Per Calendar Year - 1 Exam Per Calendar Year $15 Copay Office Infertility Services No Copay Inpatient and Deductible Plus Coinsurance Outpatient Hospital No Copay Deductible Plus Coinsurance Outpatient PT/OT - Unlimited Visits - 30 Visits Per Calendar Year No Copay Deductible Plus Coinsurance Speech Therapy - Unlimited Visits - 30 Visits Per Calendar Year 2 Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

Most t Que uest stione ioned d Benefi nefits ts – Continued ntinued Benef efit it In In-Netw twork k Cover erag age Out-of of-Ne Netw twor ork Cover erag age Deductible Plus Coinsurance No Copay Chiropractic - 30 Visits Per Calendar Year; - Unlimited Visits *Medical necessity required Acupuncture $15 Copay Deductible Plus Coinsurance - 20 Visits Per Calendar Year Combined In- and Out-of-Network Durable Medical Equipment No Copay Deductible Plus Coinsurance Foot Orthotics No Copay Deductible Plus Coinsurance Nutritional Counseling No Copay Deductible Plus Coinsurance - 3 Visits per person per calendar year  Out-of-Network Deductible: $300 (individual) / $900 (family) Out-of-Network Coinsurance: 80/20  Out-of-Network Out-of-Pocket Maximum: $2,300 / $4,900 (includes deductible)   In-Network Out-of-Pocket Maximum: $2,000 / $4,000 *For a complete listing of covered services, please review the Summary Plan Description (SPD), available on the State Comptroller’s website for the Partnership Plan. See page 10 for website information. 3 Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

Provide vider r Netw twork ork Inform formati tion on – Loc ocal al Local Network rk : “Oxford Freedom” As a UnitedHealthcare/Oxford member, you will have access to one of the largest networks in the Connecticut, New York* and New Jersey tri-state area. In the tri-state, you will utilize the Oxfor ord d Freed eedom om network. Oxford members can seek services from any participating Oxfor ord d Freed eedom om provider in Connecticut, New York * and New Jersey without a referral .  Note: When speaking to your physician about their participation status, please use “ Oxford ord Freed eedom om ,”, not “the State Plan” *The following counties in New York are considered within the Oxford Freedom network area: New York, Bronx, Dutchess, Kings, Nassau, Orange, Putnam, Queens, Richmond, Rockland, Suffolk, Sullivan, Ulster and Westchester. All other counties in New York would be considered out of the Oxford Freedom area, so members would utilize the United tedHea ealt lthcare e Choic oice e Plus us national network. Searching hing for Local Providers ders To search for your physician, or any participating physician, online: – Visit https://www.oxhp.com/Member/MemberPortal/ – In the upper right- hand corner, click on “Find a Physician or Facility” – Select “Freedom” from the list of Oxford Networks – You can search for Physicians or Facilities, and search for both by Location, Name or Oxford Provider ID by clicking on the appropriate radio button – Complete the required fields marked with an asterisk - at minimum - and click “Search” 4 Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

Provi vide der r Netw twork ork Inform formati tion on – Nationa ional Nationa nal Network rk: : “UnitedHealthcare Choice ce Plus” When traveling outside of the tri-state area, if you live out of the area, or if you have a child attending school out of the area, you also have seamless access to the United edHe Healthc althcar are e Choi oice Plus national network. By finding one of our UnitedHe tedHealthc althcare Choice ice Plus physicians, your services will be treated just as if you were still at home.  Please note only those providers located outside the tri-state service area are considered participating Choice Plus providers for Oxford members *The following counties in New York are considered within the Oxford rd Freedom dom network area: New York, Bronx, Dutchess, Kings, Nassau, Orange, Putnam, Queens, Richmond, Rockland, Suffolk, Sullivan, Ulster and Westchester. All other counties in New York would be considered out of the Oxfor ord d Freedom dom area, so members would utilize the United tedHea ealt lthcare e Choic oice e Plus us national network. Sear arching ing for Prov ovide iders s Out of the Area ea To search for a Choice Plus physician online: – Visit https://connect.werally.com/?showBackButton=true – You can search by provider name or provider specialty by entering your search criteria in the rectangular box and hitting “Search” *You can narrow your search by changing the zip code – You can also search a list of providers by specialty, service type, condition, etc. by selecting one of the blue boxes 5 Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

Clinica ical l Programs rams • All Partnership Plan 2.0 members have access to the following programs: UnitedHealthcare/Oxford Clinical Programs PHS 2.0: Personal Health Support Nurse Team CKS: Comprehensive Kidney Solutions NL: Oxford On-Call Nurse Line TRS: Transplant Resource Services WC: Telephonic Wellness Coaching UBH: Full Care Management TDS: Treatment Decision Support HPP: Healthy Pregnancy Program CHD: Congenital Heart Disease MIP: Managed Infertility Program CSP: Cancer Support Program NRS: Neonatal Resource Services CRS: Cancer Resource Services HeN: HealtheNotes *For more in- depth information on any of these programs, please see the enclosed “State of Connecticut Partnership Plan Health, Wellness and Clinical Management Programs” handout All Partnership Plan 2.0 members also have access to the Rally ly Web b Porta tal on oxfordhealth.com • – For additional information on Rally please visit http://partnershipstateofct.welcometouhc.com and put your cursor over “Online Tools & Resources”, then click on “Your Member Website” – Additionally, after your effective date, you may log into your account, then click on the “Health and Wellness” tab 6 Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.