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Plan changes and new plans

The Employee Benefit Trust Board of Trustees approved plan changes that take effect January 1. This includes a Telehealth program, changes to pharmacy tier and copay, and increase to the basic life maximum. The Trust is also offering new Group Health and Delta Dental plans and new dependent life options. See information on these changes and new plan offerings.

Plan changes

Regence/Asuris – Telehealth (MDLive)

A telehealth benefit is added to the Regence/Asuris plans as listed below. This is through MDLive and will allow participants access to a doctor via phone or secure video to treat non-emergent conditions. We will provide you more information on this exciting benefit soon.

  • HealthFirst 250 – $10 copay, paid at 100%. Deductible waived, does not go towards first 4 office visits covered outside of deductible.
  • HealthFirst 500 – $10 copay, paid at 100%. Deductible waived, does not go towards first 4 office visits covered outside of deductible.
  • High Deductible Health Plan – $38 consult fee until deductible is satisfied, then paid at 100%.
  • LEOFF 1 Plan A – Paid at 100%

Group Health High Deductible Health Plan – Pharmacy and copay

A non-formulary co-pay tier will be added to the GH High Deductible Health Plan, and the deductible, co-pay and co-insurance will be waived for preventive care drugs.

 

Current

Effective 1/1/2017

Generic formulary

$15

$15

Name brand formulary

$30

$30

Non-formulary

Not covered

$50

Preventive

$15 or $30

Covered in full, deductible co-pay, co-insurance waived

Willamette Dental – Copay reduction

Resin based composite (white) fillings will be covered with a $0 copay on all teeth regardless of where they are located in the mouth, or the number of surfaces impacted.

Standard Basic Life Insurance – Increase maximum

The basic life insurance maximum increases from $300,000 to $500,000 which better aligns with what is available out in the market. This could increase premium costs for an employer with higher paid employees, offering coverage based on salary.

Standard Basic Life Insurance – Remove limitation

Currently, employers covering a total of 10 or fewer employees must go through Standard’s underwriting review for coverage in excess of $20,000. This limitation is removed effective 1/1/17.


New plan options available 1/1/2017

Group Health – New $500 deductible plan

A new HMO plan with a $500 deductible is being added. This plan is similar to the Regence/Asuris HealthFirst $500 plan offering with matching deductible, co-insurance and co-insurance maximum. A plan summary will be available by November 1.

Delta Dental – New incentive level plan

A new incentive level plan (Plan J) is being added that provides preventive care which does not count toward the annual plan maximum of $1,500. This plan is modeled after the existing Plan F with Class 1 benefits being exempt from the annual maximum. A plan summary will be available by November 1.

Standard Dependent Life – New options

Two new options with higher benefit amounts will be available as outlined below. This is a benefit that is 100% employer paid and requires 100% participation of all eligible employees.

Option 1 (existing) – $1,000

Option 2 (existing) – $2,000

Option 3 (new) – $5,000

Option 4 (new) – $10,000

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