BCBS Health Insurance Update2013-2014

AKA:What’s different and what effect may

it have on you?

BCBS UpdateCurrent Plan vs. New Plan

Deductible $2,500 $3,500Coinsurance Rate (after deductible) 70/30 or 50/50 70/30Max Out of Pocket $7,500 $8,500Preventive Care 0 0Primary Care Visit $25 $35Specialist Visit 50% After Ded** $70Therapy 50% After Ded** $35 or $70Urgent Care 50% After Ded** $70Emergency Room 50% After Ded** $500Hospital Outpatient 50% After Ded** 30% After Ded**Ambulatory Surgical 50% After Ded** 30% After Ded**Hospital Inpatient 30% After Ded** 30% After Ded**

Hospital Inpatient Copay $250 $0Vision Exam $0 $70Prescription Coverage

Generic Rx $4 $10Name Brand Rx $40/$55/75%* 50%*

BCBS Update• The Down Side to the New Plan–Deductible is $1000 higher (this would have

affected 7 people)–Out of pocket max is $1000 higher (due to the

higher deductible)–Primary care co-pay is $35 instead of $25–Generic drugs have a $10 co-pay ($4 under

current plan)–Non-generic drugs are all co-pays of 50% (max

of $100 per Rx per month)

BCBS Update• The Up Side of the New Plan– Specialist, therapy, urgent care, and emergency

department visits all have co-pays now (current plan paid nothing until deductible met)• Specialist/Therapy/Urgent Care $70• Emergency Room $500

– Hospital outpatient and ambulatory surgery 30/70 after deductible (currently 50/50 after deductible)

– No inpatient hospital co-pay (currently $250)– The new plan is about $10,000 more overall, but

employee premium will remain at $100 per month for this year