1 Wayne County Government 2020Enrollment Meeting
2 Administrator Claims Questions please contact: Kerilyn Lepper, Benefit Analyst klepper@dunnbenefit.com Tammy Shaw, Claims Manager tshaw@dunnbenefit.com Nikki Malott, Flex Benefits nmalott@dunnbenefit.com (800) 880-9960 www.dunnbenefit.com
3 Precertification Please call Clinix prior to receiving services (see ID Card or SPD for a list required services) to receive the maximum benefit payable. (800) 227-2298 www.clinixhealthcare.com
Eligibility – Working Spouse Rule 4 If the spouse of the Employee is employed and eligible for coverage under their own employer, benefits under this Plan will continue to be coordinated as described in the Coordination of Benefits section of this document. The spouse’s plan will be primary on the spouse’s claims and this Plan will pay as secondary if family coverage is elected and the appropriate premium/contribution is paid. However, if the spouse elects not to take coverage that is available through his/her employment (without regard to cost), this Plan will not provide any coverage for that spouse. The Working Spouse Rule does not apply when both husband and wife are employees of this Employer. However, no person may be both an employee and a dependent of this Plan. The Working Spouse Rule applies to medical, dental and vision coverages.
Preferred Provider Organization 5 (PPO) To check the status of a provider, you can call Encore Health Network or visit their website. (888) 446-5844 www.encoreconnect.com
6 Prescription Drugs • True Rx will administer your prescription drug program starting 1/1/20. Information will be found on your NEW ID CARD . • Plan A – Traditional Plan - rx copays apply. • Plan B- Traditional Plan – rx copays apply. • Plan C – High Deductible Plan – pays 100% AFTER deductible is met. If you have any questions or need assistance with a prescription drug, please call True Rx. • Member Services (866) 921-4047 • www.truerx.com • RxGrp#-TRUE0891 Bin#-020958 PCN:07960000
Benefit Summary 7
Contributions 8
9 Value Added Programs Diagnostic Testing Lab Testing An enhanced out-patient This is an optional benefit Diagnostic Testing benefit, designed to save you money on including X-rays, MRI, CT and PET outpatient laboratory needs. scans, will be available to help you save money. Plan A, B, and C Plan A+B: 80% no deductible 100% no deductible Plan C: 100% no deductible At preferred facilities ONLY At preferred facilities ONLY (A list of facilities will be provided)
10 Value Added Programs - Telemedicine NO COST TO YOU! Talk to a Doctor 24/7/365 access Avoid unnecessary ER/Urgent Care visits Avoid long waits www.swiftmd.com Online Passcode: WAYNEGVT17
Voluntary Products 11 Voluntary Term Life Dental Flexible Benefit Plan VTL Benefits are Dental Benefits are FSA: available to elect under available to elect under Health Reimbursement: OneAmerica. Delta Dental. Annual Maximum $2,700 Rollover maximum $500 • Dependent Care: Annual Maximum $5,000 Debit Cards Available www.oneamerica.com www.deltadentalin.com
Dunn Online 12 CHECK OUT OUR NEW MEMBER PORTAL Register Today! • Mobile Access • Print ID Card • New User-Friendly Design • Personal Health Record • Online Enrollment www.dunnbenefit.com BECAUSE OF DUNN ONLINE, YOU CAN NOW “ENROLL” ONLINE!
13 Open Enrollment • Dates for Open Enrollment: starts October 21 st and ends November 1st • Change elections for Medical/Dental/Life/Flex • Add or remove dependents ONLINE ENROLLMENT DEMO
14 Questions
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