Choice Plus POS (Point of Service)

Why would I want to enroll in the Choice Plus Point of Service (POS) plan?
It is the most traditional of the 3 plans the County is offering for 2010 and, in fact, works like the current plan.   While you have an active role in your overall wellness, you have limited involvement in the how the plan itself works.  You have a payroll deduction for coverage, you pay copays, deductible and co-insurance for services, and you have access to United Healthcare (UHC) Customer Service and myuhc.com for health and account resources. 

If you want to review more detailed information about the plan, please review the Benefit Summary for the Choice Plus POS . There are changes to this Plan Description that are effective for 1/1/2011 that are defined in the Summary of Material Modifications to the Summary Plan Description (POS) .

We are also providing you with a Comparison Chart of all three plans so that you can look at them all...side by side.

Health Plan Comparison Chart

PAYROLL DEDUCTIONS 
Employees and the County share the total cost of health care coverage.  Your payroll deduction begins one month in advance, in December, for the plan year beginning January 1.

Note: Prescription, EAP and Managed Mental Health and Vision coverage are included in your payroll health contribution deduction.

COPAYS, DEDUCTIBLE, CO-INSURANCE
The health plan is administered by United Healthcare (UHC).  You and your covered family members pay copays, deductibles, and co-insurance. 

• The individual deductible for the POS plan is $600. 
• Once the deductible is met, you pay 20% of the UHC network contracted rate and the plan pays 80%. 
• Your co-insurance amount is applied to an annual out-of-pocket maximum, after which services are covered at 100% by the plan, except for copays. 

PREVENTIVE CARE 
Members pay a copay for preventive office visits.  Additional preventive services related to the preventive office visit, e.g. labwork, x-rays, are covered at 100%.  If you have a diagnosis, labwork and x-ray charges are applied to the deductible and then co-insurance. Preventive Care Flyer

PRESCRIPTION COVERAGE  
This is administered by Walgreens Health Initiatives (WHI).  The copay structure is $15, $30, $45 for up to 30-day retail supply and $30, $60, $90 for up to 90-day retail or mail order supply.

EAP and MANAGED MENTAL HEALTH SERVICES 
These benefits are administered by Unipsych/MHNet. Up to 6 free EAP visits are available for assessment and early intervention.  Managed mental health care has a $10 copay.  There is an in-patient deductible of $100, after which the member pays 10% and the plan pays 90%.

VISION CORRECTION 
These benefits are administered by EyeMed Vision Care.  There is a $10 copay for a basic exam (refraction) and a materials copay of at least $20.

TAX SAVINGS 
You have a tax savings if you elect pre-tax deduction of your health and dental contributions. Enrollment in the Flexible Spending Account (FSA) will allow you to pay for health care expenses and dependent (daycare) expenses on a non-taxable basis.   These options provide dual tax savings.

RESOURCES   You can track health care expenses at myuhc.com or elect to receive a mailed Explanation of Benefits (EOB), indicating the total charge for the service, the UHC contracted rate, and the patient and plan financial responsibility.  One of UHC’s valuable health care resources is the toll-free Nurseline # and online Nurse Chat for your health care concerns. UHC Customer Service answers questions related to all 3 health plans offered by the County.

Participants will receive a new UHC ID card.

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