BROWARD HEALTH BENEFITS 2013

The Broward Health Notice of Privacy Practice describes

how medical information about you may be used and

disclosed and your rights regarding this information.

You will be asked to sign the

acknowledgement form at Orientation.

Notice of Privacy Practices

• Medical plans cover medical, pharmacy and vision care.

• No pre-existing limitations.

• Hospitalization requires pre-certification.

Medical Coverage

• In- and out-of-network benefits.

• Broward Health facilities for in-network benefits.

• No primary care physician needed.

• Referrals are not required for physician office visits or outpatient diagnostic procedures; however hospitalization requires pre-certification.

• Can use out-of-network physicians and hospitals, but at a greater cost.

• 911 emergencies covered at in-network level.

Best Choice Plus

• In-network benefits only; except emergency.

• Referrals are not required for physician office visits or outpatient diagnostic procedures; however hospitalization requires pre-certification.

• Primary care physician coordinates your care.

• Nationwide coverage.

• Over 50 hospitals in tri-county area.

Open Access Aetna Select

• High Deductible Health Plan (HDHP) = comprehensive medical coverage + Health Savings Account (HSA).

• Nationwide coverage.

• Over 50 hospitals in tri-county area.

• In-network hospital benefits paid at 80% after deductible.

• Out-of-network benefits paid at 60% after deductible.

• Pre-certification required for hospital admission.

• Specialist referrals and diagnostic authorizations not required.

• $1,500 single deductible, $3,000 family deductible.

• Deductible must be met before claims are paid, except for preventive.

Aetna Choice

• Covers in- and out-of-network dental treatment.

• Pays 50-80% of eligible expenses up to plan allowable for in-network dental services.

• $1,000 maximum benefit per person per year.

• Can carry over up to $350 per year up to $1,000.

• Nationwide coverage.

Reliance Standard Dental – PPO

• In-network benefits only.

• No waiting periods, calendar year maximums or deductibles.

• Co-pays required for root canal, crowns, etc.

• No out-of-network benefits.

Safeguard Dental (MetLife)

• Health and Dental benefits effective 1st of the month following hire date.

• Required documentation such as marriage and birth certificates.

• If you miss the new hire deadline, you may only enroll at annual enrollment, or if you experience a life qualifying event.

Don’t Delay Enrollment!

Medical Plans

Best Choice Plus* Open AccessAetna Select* Aetna Choice*

Office Visit • $20 co-pay/office visit• $20 co-pay/office visit

• $30 co-pay/specialist visit• Covered at 80% after

deductible

Inpatient Hospital

• Hospital charges paid 100% at Broward Health facilities after $100 co-pay

• Hospital charges paid 100% at Aetna facilities after $500 co-pay

• Covered at 80% after deductible

Out of Network

• 60% after annual deductible

• Emergency covered as in-network

• Emergency covered as in-network

• No out-of-network

• Covered at 60% after deductible

Outpatient Services

• Hospital charges paid 100% at Broward Health facilities. Lab services covered at 100% after $5 co-pay. Imaging / diagnostic covered at 100% after $10 co-pay. Surgery covered at 100% after $50 co-pay.

• Diagnostic covered at 90% after deductible and surgery covered at 100% after $200 co-pay

• Covered at 80% after deductible

Prescription Drugs

• $10 Generic

• $25 Brand Formulary

• $40 Brand Non-formulary

• $50 Specialty

• $10 Generic

• $30 Brand Formulary

• $50 Brand Non-formulary

• $75 Specialty

• Covered at 80% after deductible. Deductible waived for preventive Rx.

*All plans include vision care

Please note: This is a partial listing of benefits. Other co-pays, co-insurance and deductibles may apply. There is no co-payment, co-insurance or deductible for in-network preventive services.

Your Cost Per Pay Cycle – Full-time Eligible Employees

Best Choice Plus

(Preferred Provider Organization) – PPO

Open AccessAetna Select

(Exclusive Provider Organization) – EPO

Aetna Choice (POS II)

(High Deductible Health Plan) – HDHP

Employee $51.23 $57.36 $11.26

Employee & Spouse/DP

$117.12 $129.87 $34.05

EE & Child(ren) $82.30 $91.69 $21.15

Family/DP $159.44 $176.81 $46.35

Medical Bi-Weekly Payroll Deductions

Note: Part-time rates and domestic partner benefits also available

Medical Premium Rate and Tobacco Use

• Two medical premium rates for employees and spouses/domestic partners: tobacco and non-tobacco.

• Submit a tobacco attestation form for non-tobacco rate, otherwise tobacco rate will apply.

• Tobacco rate is $23.07 higher per person biweekly, $600 per year. That’s $1,200 per year for employee + spouse/domestic partner.

• Tobacco users can qualify for non-tobacco rate by participating in a tobacco cessation program.

• Call EAP at 954-847-4327 if you can’t qualify due to a medical reason.

Reliance Standard Dental Plan Safeguard Dental Plan

Maximum Plan Benefit

• $1,000 / person (per Calendar Year) • No maximum

Preventive Care • 100% covered • 100% covered

Services• Services paid at 50-80% of Plan Allowance

maximum

• Co-pays are required for many procedures such as root canal, crowns, etc.

Orthodontia• 50% of billable charges, up to $1,500 lifetime

maximum• $1,850 co-pay

In-Network Benefit

• Yes • Yes

Out-of-Network Benefit

• Yes • No

Dental Plans

Dental Bi-Weekly Payroll Deductions

Your Cost Per Pay Cycle – Full-time Eligible Employees

Reliance Standard Dental Safeguard Dental

Employee $3.34 $2.74

Employee & Spouse/DP

$6.93 $5.20

EE & Child(ren) $6.49 $4.92

Family/DP $11.01 $6.06

Note: Part-time rates also available

Voluntary Short-Term Disability

• Pays up to 60% of your basic weekly earnings.

• Maximum benefit $2,000 per week.

• Maximum of 9 weeks.

• Pre-existing condition limitation.

• 29-day elimination period.

• Employee pays full cost.

• If you do not enroll at time of hire, evidence of insurability may be required at open enrollment.

Voluntary Long-Term Disability

• Pays up to 60% of your basic weekly earnings.

• Maximum benefit $8,000 per month.

• 90-day elimination period.

• Pre-existing condition limitation.

• BH pays ½ of premium.

• If you do not enroll at time of hire, evidence of insurability may be required at open enrollment.

• Management and Physicians subject to other plan criteria.

• 1x base salary life insurance at no cost.

• Additional voluntary insurance for employees and dependents available via payroll deduction.

• Call 1-800-553-1209 to enroll.

Life Insurance

Flexible Spending Accounts

• Medical Expenses- Pre-tax dollars to pay for out-of-pocket expenses, such as

prescription drug co-pays, over-the-counter medications and medical, dental and vision expenses.

- Up to $2,500/year.

• Dependent Expenses- Pre-tax dollars to pay for day care expenses.

- Up to $5,000/year.

• Use It or Lose It- Any monies remaining in a flexible spending account after

the end of the year will be forfeited.

Retirement Plans

• Pension Plan

- 5% of base pay contributed by Broward Health.

- Automatically enrolled after one year of employment.

• Star Plus 403(b) Plan / 457(b) Plan

- VALIC & Fidelity.

- Match (403b) up to 2.4% of base pay after one year of employment.

- You must enroll in the plan.

• Retiree health insurance plans also available

Thank you!

This presentation has been prepared as a guide and reference for the use of North Broward Hospital District’s employees. It explains the Medical, Dental and Prescription Plan Programs.

If there are any discrepancies between the information stated in this presentation and the plan documents, company policy or health care provider contracts, the plan documents, company policy and healthcare provider contracts will supersede. The North Broward Hospital District reserves the right to be the final authority in any matters concerning these programs. The District also reserves the right to change these policies or discontinue this program at any time without notice.

Welcome to Broward Health!

For more information, please visit:

www.BrowardHealth.org