Virginia Office of Group Insurance

2. Virginia Office of Group Insurance Open Enrollment Department of Environmental Quality Second Floor Conference Room Meetings: Monday 10:00 – 11:30 am Thursday 2:00 – 3:30 pm Facilitator: Burt Krebs, Manager (703) 555-1212 bkrebs@vaogi.gov Open Enrollment: April 1 - May 28

3. AGENDA • Insurance Carrier Selection: Traditional or PPO All Employees Must Re-enroll in Health Insurance Includes an Employee Health Insurance Survey • FY 2012 Appropriation: Type of Coverage Transition of Care • FY 2012 Plan Design: Flexible Spending Account (FSA) • Open Enrollment Procedures Online and Paper Applications – Deadline: 5:00 pm May 28 • Office of Group Insurance Resources Open Enrollment: April 1 - May 28

4. Insurance Carrier Selection: Traditional or PPO • Traditional Plan – Insurance carrier pays 80% of the allowable charges and the employee pays the remaining 20%. • Preferred Provider Organization Plan – The co-payment is $20 for physician office visits (in-network physicians) The carrier pays 85% of allowable charges and the employee pays the remaining 15% (in-network) and 70/30 out-of-network. • A PPO is not a Health Maintenance Organization (HMO). • A Preferred Provider Organization (PPO) is a health plan with an established provider network (physicians, hospitals, labs, etc.) that has agreed to accept specific payment levels for specific services. • In a PPO, you are free to select any healthcare provider. • Referrals are not required. Patients can “self-refer” themselves to specialists without having to get a referral from their primary care physician (PCP). Open Enrollment: April 1 - May 28

5. FY 2012 Appropriation: Type of Coverage Note: The above rates detail the bimonthly premium rates for employees employed at least 26 hours per week. Premiums are deducted from the employee’s first and second paychecks each month. No separate premiums for vision benefits for all members (and dependents) enrolled in medical coverage. Open Enrollment: April 1 - May 28

6. FY 2012 Appropriation: Plan Design • Pharmacy benefits as well as Dental and Vision are unchanged from FY’11. • New for FY ’12 is a premium category The Flexible Spending Account (FSA) limit has been increased from $2,500 to $3,000 • The Integrated Behavioral Health Plan (IBHP) In-Patient Co-payment has been increased to $15, and Outpatient Co-payment has been increased to $25. • Enhanced Wellness Benefits and Well Baby Nursery Benefit are part of both plans Open Enrollment: April 1 - May 28

7. Health Insurance Application Procedures • All Employees Must Re-enroll in Health Insurance -Make a Choice between Traditional or PPO • Review PPO Provider Directories located on the website www.ogi.gov. If your Preferred Provider is not on PPO List, compare and decide if the PPO Plan is appropriate vs. Traditional coverage . • Agency Payroll Offices prefer you complete your application online by visiting www.ogi.gov. • Agency Payroll Offices will accept a “limited number” of paper applications, but supplies are limited. Download and print a PDF - Application for Insurance on the website. • Completed Paper Applications must be turned in to Agency Payroll Office by 5:00 PM May 28. Open Enrollment: April 1 - May 28

8. RESOURCESOFFICE OF GROUP INSURANCE For all questions and concerns, please contact a member of the Office of Group Insurance Services Team according to the first letter of your last name: Monday – Friday 8am – 5pm • Liana Anderson, Benefits Assistant (L-R) (703) 378-3170 landerson@ogi.gov Abbey McLean, Benefits Assistant (A-K) (703) 378-3739 amclean@ogi.gov Trey Summerfield, Benefits Assistant (S-Z) (703) 378-2044tsummerfield@ogi.gov Open Enrollment: April 1 - May 28