Active Health Plan Open Enrollment March 1 – 22, 2013
Table of Contents Your Guide to Open Enrollment For 2013 .......................................................................................... 1 Key Facts ......................................................................................................................................... 1 What’s Included with This Guide ...................................................................................................... 1 What’s New in 2013? ............................................................................................................................ 2 All Participants Must Enroll .............................................................................................................. 2 Premier and Ultra Plans ................................................................................................................... 2 Standard Plan .................................................................................................................................. 3 Other Important Benefit Changes .................................................................................................... 3 2013 Benefits Enrollment Reminders .............................................................................................. 4 Choose a Medical Plan Option ........................................................................................................ 5 Choose a Dental Plan Option .......................................................................................................... 5 What to Expect After Open Enrollment ............................................................................................ 5 How to Enroll .................................................................................................................................... 6 Eligibility .............................................................................................................................................. 10 Spouse/Domestic Partner Will Be Required To Enroll In Other Available Plans .......................... 10 Take action now ............................................................................................................................. 11 Paying for Dependent Coverage .................................................................................................... 11 Coordination of Benefits (COB) Changes ........................................................................................ 12 Non-Duplication of Benefits ........................................................................................................... 12 Coordination of Benefits (COB) Credit Banks Eliminated .............................................................. 12 Dual Coverage ............................................................................................................................... 12 Action Steps to Enroll in the PPO Health Care Partnership Option (Premier & Ultra Plans) ..... 14 What You and Your Spouse/Domestic Partner Must Do— At-A-Glance ....................................... 14 What Happens if I Do Not Complete the HCP Requirements by the Deadlines?......................... 14 More Details about Steps 1 – 4 for Health Care Partnership........................................................ 15 Enrolling for the Standard Plan ...................................................................................................... 17 Medical Plan Option Comparisons ................................................................................................... 18 Premier Plan Option Comparison .................................................................................................. 18 Ultra Plan Option Comparison ....................................................................................................... 20 Standard Plan Option Highlights .................................................................................................... 21 Dental Plan Option Comparisons ..................................................................................................... 22 Changes to Prescription Drug Benefits – Market Priced Drug Program (MPD) .......................... 23 About the MPD Program ................................................................................................................ 23 What You Need to Do .................................................................................................................... 23 Important Resources .......................................................................................................................... 25
This guide is a Summary of Material Modifications that describes changes to the UEBT Active Health Plan. Please read it carefully and keep it with your Summary Plan Description and other Plan information. The Trustees reserve the right to amend, modify or terminate the Plan at any time. i
UEBT Active Open Enrollment
Your Guide to Open Enrollment For 2013 This Open Enrollment Guide contains information about important changes to your health care benefits beginning May 1, 2013. These changes are a result of the new Collective Bargaining Agreements (CBAs) that provide a new health plan design for the UEBT. A newsletter recently mailed to your home highlighted a few of the changes. You will find more detail on benefit changes that are effective May 1, 2013 in this guide. Because of the changes to your benefits, UEBT is providing this special Open Enrollment opportunity for you to elect coverage effective May 1, 2013 through December 31, 2013. The next Open Enrollment period will be in the fall for benefits effective January 1, 2014 through December 31, 2014. Please read this guide carefully to understand the changes to your benefits and your enrollment choices. There are certain steps you must complete in order to participate in PPO Health Care Partnership—the option with the highest level of benefits and lowest out-of-pocket costs for you.
Key Facts Enrollment is March 1 through March 22, 2013 for coverage beginning May 1, 2013 through December 31, 2013.
You must enroll online by March 22, 2013 to get the medical coverage you want. If you do not enroll, you and your dependents will lose coverage May 1.
To enroll, go online at www.ufcwtrust.com and make your elections by March 22. See page 6 for details.
What’s Included with This Guide Summaries of Benefit Coverage (SBCs) are provided to you as required by the Affordable Care Act (ACA, also known as Health Care Reform). They summarize your health care benefits and coverage, using a uniform glossary of terms commonly used in the health insurance industry. See pages 18 – 22 for a comparison of your medical plan options and dental benefits.
1
UEBT Active Open Enrollment
What’s New in 2013? All Participants Must Enroll If you don’t complete Open Enrollment, coverage for you and your dependents will terminate on May 1, 2013. Premier and Ultra Plans New design for PPO medical coverage—Health Care Partnership (HCP) + Personal Direction (PD) The new plan design is structured to improve efficiency and eliminate unnecessary costs wherever possible. It also enables participants to take a more active role in their health care and reduce out-ofpocket expenses by engaging in activities that promote wellness. Both options provide comprehensive health care coverage, but you can minimize your out-of-pocket expenses if you select Health Care Partnership (HCP). If you elect the PPO (Indemnity) Health Care Partnership option, you need to complete the Action Steps. The Action Steps will help promote your health awareness and education. By completing the required HCP Action Steps, you become eligible for the highest level of medical benefits (with minimal changes to your current coverage) and the lowest level of premiums for your dependents. The Action Steps, as they may be modified by the Trustees from time to time, will be a requirement of the HCP option each year. For this Open Enrollment, you must complete Open Enrollment and the 3 required Action Steps by the deadlines shown on page 14. If either you or your enrolled spouse/domestic partner does not complete Open Enrollment and the 3 required Action Steps in any year, you will be placed in the PPO Personal Direction (PD) option, which has higher premiums, no Health Reimbursement Account credit (HRA), and higher out-of-pocket expenses for you. For this Open Enrollment, if you enroll in the PD option, your HRA balance will be reduced by the pro-rated portion (for May 1-December 31) of the amount that was added in January 2013.
Premier Plan Modified HMO Options Premier Plan Health Net Eliminated. The Health Net option will be eliminated on May 1, 2013. If you are currently enrolled in Health Net, you will need to enroll in either the PPO or Kaiser option. It is possible that some of your doctors belong to the Blue Shield PPO network. You can search the network provider list by going online at www.ufcwtrust.com and clicking on Open Enrollment UEBT Actives. If you choose Kaiser, you will have to select a primary care physician from within the Kaiser plan. Your current doctors are not Kaiser providers. Premier Plan Changes to Kaiser HMO Benefits. The Kaiser HMO option will include a deductible and coinsurance for hospital services, as well as premiums for enrolled dependents. In addition, the HMO plan’s supplemental coverage for chiropractic, acupuncture, EMAP, MedExpert, and hearing aid services will end beginning May 1, 2013. Most of these services are generally available under the HMO plan. See page 18 for details.
2
UEBT Active Open Enrollment
If you are currently enrolled in the PPO plan or Health Net and wish to enroll in Kaiser (are a new Kaiser enrollee), you and your enrolled spouse/domestic partner are both required to complete the Action Steps outlined on page 14 in order to be eligible for the Kaiser HMO effective May 1, 2013. If you are currently enrolled in Kaiser and wish to stay in Kaiser, there are no Action Steps for this enrollment for 2013; however, you MUST complete Open Enrollment. See page 18 – 20 and the enclosed Summary of Benefit Coverage (SBCs) for highlights of your benefit options in the Premier and Ultra Plans.
Standard Plan Benefits under the Standard Plan are mostly unchanged for 2013. However, you will have to pay a premium to enroll each of your first three children (see page 11 for details) and the PPO non-network outof-pocket maximum will be unlimited. See page 21 of this Guide and the enclosed Summary of Benefit Coverage (SBC) for highlights of the Standard Plan.
Other Important Benefit Changes New requirements for spouses/domestic partners. Any enrolled spouse/domestic partner of a covered employee who has access to an employment-based group health plan must enroll in that plan. For details, see page 10. Premiums for dependent coverage required beginning May 1. Beginning May 1, 2013, you must pay a premium for your enrolled spouse/domestic partner and each enrolled dependent child (per child premium is required on the first three children only). For Premier and Ultra Plan participants, the medical plan option you choose will determine your premium. The Health Care Partnership option offers the lowest cost premium for dependent coverage. See page 11. There is no premium required for your own coverage. Change in coordination of benefits with other plans. When this Plan is the secondary payer (which typically happens when a dependent has health coverage through his/her own employer or Medicare), coordination of benefits between this Plan and the other plan (primary plan) will change to calculate Plan payments on a Non-Duplication of Benefits basis. For details, see page 12. The new Market Priced Drug program will help you and your enrolled dependents, with the advice of your doctors, identify and use lower-cost drugs that produce a similar effect when treating some common health conditions. See page 23. Surrogacy Pregnancy and Related Expenses will not be covered under the Plan. Other Indemnity PPO Plan Changes. The following changes apply to all Plan levels (Premier, Ultra, and Standard):
The PPO network service area increases to 40 miles. If you live more than 40 miles from any Blue Shield PPO provider and receive services from a non-network provider, those services will be covered as out-of-area claims, which have similar deductible and plan coinsurance as PPO claims. However, plan payments will be based on the Blue Shield PPO allowed amount, not the amount the non-PPO provider actually charges.
There will be no out-of-pocket maximum for non-network services.
3
UEBT Active Open Enrollment
Premier and Ultra Plans Disability Extension Benefit Change. Disability Extension will be limited to a maximum of four months in a rolling 36-month period and will run concurrently with FMLA.
The 12-month extension for a Total and Permanent Disability has been eliminated, effective May 1, 2013.
These changes are effective May 1, 2013 and apply to anyone who has not been approved for the disability extension as of that date.
Change in Eligibility Criteria for Disabled Dependent Children. The definition of Total and Permanent Disability includes an added requirement, the inability to engage in Substantial Gainful Activity, which will be determined based on being awarded Social Security disability benefits. Coverage for a disabled child is provided if the child became Total and Permanently disabled before age 19 while covered under this Plan. The New Choice Network through Vision Service Plan (VSP). This new network through VSP includes most of the same VSP providers as you use currently. To find a VSP Choice doctor near you, go to www.vsp.com and type in your zip code under Find a VSP Doctor. If you don’t use a VSP provider, you will have to pay more out-of-pocket. Changes to Retiree Eligibility. Eligibility for the UEBT Retiree Health Plan for members who retire in the future will change as follows:
If you retire on or after January 1, 2014, you will need at least 20 years of credited service under the Joint Pension Plan to be eligible for retiree benefits from the UEBT Retiree Health Plan.
Effective March 1, 2013, a NEW retiree must have at least 25 years of credited service upon retirement to enroll an unmarried dependent child, subject to the eligibility requirements for a dependent child.
If you retire on or after January 1, 2013 and you qualify for retiree benefits based on your employment for an employer that has ceased or ceases participation in the Plan, you may be required to pay additional premiums for your retiree coverage under the UEBT Retiree Health Plan.
Additional information regarding the UEBT Retiree Health Plan and eligibility requirements is available at the Fund Office.
2013 Benefits Enrollment Reminders Open Enrollment for Active Members runs from March 1 – March 22, 2013. You must go online to www.ufcwtrust.com to enroll. You cannot enroll by phone or mail.
Make your choices carefully. Once your election is finalized, you will not be able to make changes until the next open enrollment, unless you have a HIPAA Special Enrollment Event.
When you complete online enrollment, be sure to complete the electronic Authorization for Payroll Deductions, so the premium for your enrolled dependents will be deducted from your paycheck and coverage for your dependents will not be terminated. Be careful to authorize the correct payroll deduction for the number of dependents you are enrolling. If you do not enroll online between March 1 and March 22, 2013, coverage for you and your dependents will terminate on May 1, 2013. If you enroll late, please note the following:
Standard Plan: Your own individual coverage will be reinstated once you complete enrollment.
Ultra Plan: Your own individual coverage will be reinstated once you complete enrollment, but only into the PPO Personal Direction option.
4
UEBT Active Open Enrollment
Premier Plan: Your own individual coverage will be reinstated once you complete enrollment, but only into the PPO Personal Direction option.
Coverage for your dependents will not be reinstated.
Choose a Medical Plan Option
Choose a Dental Plan Option
See pages 18 – 21 for a comparison of benefits.
See page 22 for a comparison of benefits.
These are your options under the Medical Plan.
These are your options under the Dental Plan.
Premier
PPO (Blue Shield) Health Care Partnership (HCP)
Premier
PPO (Blue Shield) Personal Direction (PD)
Premier Access DPO Network
Kaiser HMO
Liberty Dental DMO
Delta Dental Network*
Ultra
PPO (Blue Shield) Health Care Partnership (HCP)
Ultra
PPO (Blue Shield) Personal Direction (PD)
Premier Access DPO Network
Liberty Dental DMO
Delta Dental Network*
Standard
PPO (Blue Shield) Plan
Standard
Premier Access DPO Network
* The Delta Dental Network is only available if you are currently enrolled in this option. This option is not available to new enrollees.
For Premier and Ultra Participants, the Health Care Partnership (HCP) options require the completion of Action Steps before the deadlines (see page 14). If you already participate in the Kaiser HMO, you will not need to complete the HCP Action Steps in 2013. However, participants who are currently enrolled in the PPO plan or Health Net and want to enroll in the Kaiser HMO during this Open Enrollment must complete the Action Steps within the deadlines to enroll for Kaiser coverage.
What to Expect After Open Enrollment After enrollment, look for these communications:
Confirmation Statement: After the close of Open Enrollment, you will receive a confirmation statement summarizing your elections, dependents you enrolled, and the weekly premium that will be deducted from your paycheck. Review this confirmation statement carefully, submit all the required documentation in a timely manner, and follow the instructions to correct any errors.
5
UEBT Active Open Enrollment
If you are changing plans, you will also receive new medical ID cards from Blue Shield for the PPO or from Kaiser for the HMO plan.
The Medical and Dental plans you selected may also send additional information directly to you.
How to Enroll Information You Need Before Starting Open Enrollment Before you start Open Enrollment online, you will need the following information to request enrollment for your dependents:
Social Security numbers for you and all of your dependent(s) you want to enroll under the Plan.
Dates of birth for all of your dependent(s) you want to enroll under the Plan.
Additional insurance coverage. You will be asked to provide information on other insurance. You will need to have: o
Information on other health insurance that your enrolled spouse/domestic partner has access to (even if your spouse/domestic partner is not enrolled in the other plan).
o
Information on other health insurance that each enrolled child has.
o
Information needed includes the employer’s name, plan’s name, policy number, and contact information for the other employer and/or insurance plan.
6
UEBT Active Open Enrollment
To complete Open Enrollment online, you will be required to read and agree to the following Terms and Conditions: FRAUD NOTICE: I understand that I may be subject to civil and/or criminal penalties for committing a fraudulent insurance act if I knowingly provide any materially false information to, or conceal any material facts from, the Trust Fund with the intent to defraud or mislead the Trust Fund. DISCLOSURE OF CONFIDENTIAL INFORMATION: I understand that a physician, hospital, or other medically designated facility may be requested to furnish an agent, designee or representative of the Health Maintenance Organization (HMO), prepaid plan, or the Trust Fund any and all information or records pertaining to medical history, including services rendered, or treatment given to anyone enrolled now or added later for the purpose of utilization review, quality assurance, surveys, processing of claims, financial audit, or to perform administrative functions and that by participating in the Plan I am allowing such disclosures to be made. I also understand that the Trust Fund, its agents or employees, may need to disclose my, or my dependents’, confidential information to others, including to the business partners, business associates and vendors of the Plan and/or the Trust Fund in order to provide me and my dependents, or inform me and my dependents of, additional benefits and opportunities provided by or made available through the Plan and/or the Trust Fund and/or the business partners, business associates and vendors of the Plan and/or the Trust Fund. I also understand that the Trust Fund, its agents or employees, may disclose my contact and demographic information to the union locals and contributing employers for their internal administrative purposes. Any such disclosures shall be in compliance with all applicable laws. The Trust Fund, its agents or employees, shall use all reasonable safeguards to ensure that any use or disclosure of my confidential information is solely for the purpose of administering benefits under the Plan and/or the other purposes set forth above. ARBITRATION: I understand that any dispute or controversy which may arise between myself or any family member and a prepaid plan or HMO, or any of its providers, shall be settled by the prepaid plan’s or HMO’s final and binding arbitration rules, if any. DECLARATION: I declare under penalty of perjury under the laws of the State of California that the information I provided as part of this enrollment process is true and correct to the best of my knowledge, and I consent to the provisions stated above during this enrollment process, which I have fully read and understand. GO ONLINE at www.ufcwtrust.com from March 1 through March 22 and click on Open Enrollment UEBT Actives.
REMEMBER: Failure to participate in Open Enrollment will result in termination of coverage for yourself and your dependents. Your coverage may be reinstated when you complete enrollment, but you will not be eligible for the highest level of benefits coverage and you will not be able to enroll any dependents until the next Open Enrollment.
7
UEBT Active Open Enrollment
Follow these instructions to enroll online. 1. Open your web browser. 2. At the top left window, in the address bar type: www.ufcwtrust.com Hit the Enter button. 3. Using the left mouse button, click on the Click Here in the banner for UEBT Actives, as shown. This will take you to the Open Enrollment page, which has links to additional information, the online Action Steps, and the link to enroll.
4. Before you can enroll, you must register on this screen if you have not yet done so for this 2013 Open Enrollment. Registering on the Trust Fund website is a different registration and does not apply here. Using the left mouse button, click Register or Reset your Account under the Log In button.
8
UEBT Active Open Enrollment
5. A series of security questions to verify your identity will appear for you to answer.
6. After typing in the security information, you then will be able to establish a Username and Password for the first time. Your Password must contain:
8 – 15 characters At least 1 number At least 1 uppercase and 1 lowercase letter
Your Password cannot contain: More than 2 of the same characters in a row Your Username If you logout to continue Open Enrollment later, you will need to login with the Username and Password that you created. 7. IMPORTANT NOTE: If you experience technical difficulties, please call: 1-855-236-3102, Monday through Friday from 5:30am to 5:30pm PT. This is the support line for technical issues while trying to enroll online. 8. Once you have a Username and Password, you can login to begin Open Enrollment. 9. Once you have completed the Open Enrollment online application, you will see the following screen with the check mark. In addition, you will be sent a Confirmation Statement via mail indicating your enrollment elections.
9
UEBT Active Open Enrollment
Eligibility The Health Plan you are eligible for generally depends on your length of employment.
Standard Plan Participants. New employees first must meet the initial eligibility rule. Then they are covered under the Standard Plan during the first 24 months from the Date of Hire. Courtesy Clerks are covered under the Standard Plan, regardless of length of employment.
Ultra Plan Participants. After 24 months of employment (from Date of Hire), coverage will be provided under the Ultra Plan.
Premier Plan Participants. After 72 months of employment (from Date of Hire), coverage will be provided under the Premier Plan.
After you meet the initial eligibility requirement, you must work the following Required Hours each month to maintain your eligibility for continuing medical coverage: Job Classification
Required Hours Per Month
Courtesy Clerks
64 hours
Fuel stations and e-commerce
76 hours
Other employees
92 hours
Spouse/Domestic Partner Will Be Required To Enroll In Other Available Plans Beginning May 1, 2013, if your enrolled spouse/domestic partner has access to health care coverage through his or her own current or former employer, he/she must enroll in that coverage and choose the option that is most comparable to the UEBT Plan, without regard to the cost of the A Spouse or Domestic Partner other plan. If he/she does not enroll in the other coverage, is not eligible for coverage benefits for your spouse/domestic partner under this Plan will be under the Standard Plan. reduced (by 60%) and will not be subject to any out-of-pocket maximum, even if you use a PPO provider. See page 6 for the information you need to provide during Open Enrollment about other insurance coverage available to your dependents. Take a closer look at getting secondary coverage through the UEBT Plan for your dependents. It may not be economical for you to pay to cover your spouse/domestic partner under UEBT when he or she has coverage through employment (which is primary coverage for him/her). This is because beginning May 1, 2013, when the UEBT Plan is secondary, it will coordinate with the primary plan on a Non-Duplication of Benefits basis (explained in detail on page 12 under the section titled Coordination of Benefits (COB) Changes). This Plan will reduce benefit payments for a spouse/domestic partner who does not enroll in a group health plan available through his or her employer (current or former) with benefits most comparable to the benefits under the UEBT Active Health Plan.
10
UEBT Active Open Enrollment
If your spouse/domestic partner is unable to enroll in his/her group health plan until that plan’s next open enrollment, UEBT will allow a one-time grace period until that other plan’s effective date of coverage following the next open enrollment. You are required to provide documentation from that plan or the employer stating that immediate enrollment is not possible, the date of the next open enrollment, and the effective date of coverage. During this grace period, benefit payments through UEBT will not be reduced. Signed certification on the plan’s (or the employer’s) letterhead will be required to certify that a spouse/domestic partner is not eligible for group health insurance coverage from that employer or that the spouse/domestic partner is eligible for coverage under the employer’s plan, but that changes are not allowed outside of the open enrollment period. Benefits will be reduced for claims on or after May 1, 2013, until this documentation is received.
Take action now You can send the certification, on the plan’s or employer’s letterhead, to the Trust Fund office at: UEBT Active Health Plan Employer Certification P.O. Box 8086 Walnut Creek, CA 94596-8086 You will be required to certify, under penalty of perjury, whether your spouse/domestic partner has access to other group health coverage. In addition, you will be responsible for reimbursing the Plan for any amounts paid by the Plan on behalf of a spouse/domestic partner that should not have been paid.
Paying for Dependent Coverage Effective May 1, 2013, you will need to pay a premium to enroll your spouse/domestic partner and dependent children. These weekly premiums are as follows: Premier
PPO Health Care Partnership or Kaiser HMO
PPO Personal Direction
Weekly Premiums
$0 for Member; $20 for Spouse/Domestic Partner; $10 Per Child*
$0 for Member; $30 for Spouse/Domestic Partner; $15 Per Child*
Ultra
PPO Health Care Partnership
PPO Personal Direction
Weekly Premiums
$0 for Member; $20 for Spouse/Domestic Partner; $15 Per Child*
$0 for Member: $35 for Spouse/Domestic Partner; $20 Per Child*
Standard
PPO
Weekly Premiums
$0 for Member; $20 Per Child;* No coverage for Spouse/Domestic Partner
* Premiums are charged on the first three children only; additional children do not require additional premiums.
11
UEBT Active Open Enrollment
Coordination of Benefits (COB) Changes In addition to coverage under the Plan, you and/or your dependents may be covered under another health care plan such as Medicare or another active/retiree group health care plan through current or prior employment. Coordination of benefits operates so that one of these plans will pay its benefits first, called the primary plan. The other plan, called the secondary plan, may then pay additional benefits. Generally, this UEBT Plan will be primary for you as an active employee and secondary for your spouse/domestic partner or dependent child who has active coverage through their own employment or through Medicare in some instances. In addition, UEBT will apply the birthday rule to determine which plan is primary for dependent children who do not have coverage through their own employment. Effective May 1, 2013, the Plan will change the way it calculates its payments as the secondary payer for dependents who have primary coverage through other health plans. Instead of using the current full coordination method, the Plan will coordinate based on a Non-Duplication of Benefits method. In no event will the combined benefits of the primary and secondary plans exceed 100% of the cost for a service. Sometimes, the combined benefit payments will be less than the total expenses.
Non-Duplication of Benefits Under Non-Duplication of Benefits, the Plan will pay benefits only if the primary plan’s payment was less than the amount the UEBT Plan would have paid if UEBT were the only plan providing benefits. For example, if the other plan paid 80% of the allowed amount and this Plan would have paid 75% of this Plan’s allowed amount as the only plan, this Plan will pay nothing additional. The patient will be responsible for the remaining 20%. Another example, if the primary plan paid 70% of the allowed amount and this Plan would have paid 75% of the Plan’s allowed amount as the only plan, this Plan would pay the 5% difference. See the following page for additional examples of non-duplication. This is different from the prior “Full Coordination of Benefits” rule, where in most cases this Plan paid the difference between the allowed amount and the amount paid by the other plan. This meant that a very small amount, if anything, was required to be paid by the patient. For example, if another primary insurer paid 80% of the bill, this Plan would have paid the remaining 20% if the deductible was previously satisfied. The UEBT Plan will not pay for a service that is not a covered expense under the UEBT Plan, even if the service is a covered expense under the primary plan.
Coordination of Benefits (COB) Credit Banks Eliminated Previously, when this Plan was secondary and its payment was reduced in consideration of the primary plan’s payment, a record was kept of the reduction (called a “credit bank”). The amount in the credit bank was used to supplement this Plan’s payments on the patient’s claims later in the same calendar year to the extent that there were allowable expenses that would not otherwise be paid fully by this Plan and the other plan. Effective May 1, 2013, the COB credit bank benefit will be discontinued and all COB credit banks will be eliminated.
Dual Coverage If you and your spouse/domestic partner both work for a contributing employer making contributions into UEBT, are both enrolled in the same medical option and both elect family coverage to cover each other and all of the same dependents by paying the applicable premiums, this Plan will provide Full Coordination of Benefits (see above) rather than Non-Duplication of Benefits.
12
UEBT Active Open Enrollment
NON-DUPLICATION EXAMPLES (These examples assume that all deductibles have been met. They are for illustration purposes only and are not intended to reflect every possible benefit plan calculation.) Example 1 Primary Plan (other group health plan)
UEBT Active Health Plan if no other health coverage is available
Billed Amount
$8,600
Billed Amount
$8,600
Plan Allowed Amount
$6,500
UEBT Allowed Amount
$6,500
Plan Pays 80% of allowed amount
$5,200
UEBT Pays 75% of allowed amount
$4,875
Patient Responsibility (without other coverage)
$1,300
Patient Responsibility (without other coverage)
$1,625
Applying Non-Duplication of Benefits
In this case, the benefit paid by the primary plan exceeds the benefit that would have been paid by UEBT if there was no other coverage available.* Therefore, the amount paid by UEBT is $0. The patient is responsible for $1,300. Example 2 Primary Plan (other group health plan)
UEBT Active Health Plan if no other health coverage is available
Billed Amount Plan Allowed Amount Primary Plan pays 70% of allowed amount Patient Responsibility (without other coverage)
Billed Amount UEBT Allowed Amount UEBT Pays 75% of allowed amount Patient Responsibility (without other coverage)
$8,600 $8,100 $5,670 $2,430
$8,600 $7,900 $5,925 $1,975
Applying Non-Duplication of Benefits
In this case, the primary plan paid less than what would have been paid by UEBT if there was no other coverage available.* UEBT will pay $255, which is the difference between what the Primary Plan paid and what UEBT would have paid ($5,925 minus $5,670). The patient is responsible for $2,175 ($2,430 minus the $255 that UEBT paid). Example 3 Primary Plan (other group health plan)
UEBT Active Health Plan if no other health coverage is available
Billed Amount Plan Allowed Amount Primary Plan pays 70% of allowed amount Patient Responsibility (without other coverage)
Billed Amount UEBT Allowed Amount UEBT Pays 75% of allowed amount Patient Responsibility (without other coverage)
$8,600 $4,900 $3,430 $1,470
$8,600 $5,500 $4,125 $1,375
Applying Non-Duplication of Benefits
In this case, the primary plan paid less than what would have been paid by UEBT if there was no other coverage available.* UEBT will pay $695, which is the difference between what the primary plan paid and what UEBT would have paid ($4,125 minus $3,430). The patient is responsible for $775 ($1,470 minus the $695 that UEBT paid). * NOTE: If there is other group health plan coverage available for your spouse/domestic partner, he/she is required to enroll in it or UEBT benefits will be significantly reduced.
13
UEBT Active Open Enrollment
Action Steps to Enroll in the PPO Health Care Partnership Option (Premier & Ultra Plans) The PPO Health Care Partnership (HCP) options provide the highest level of PPO benefits and require the lowest level of premiums. This section explains the Action Steps you and your spouse/domestic partner need to complete by the deadlines shown to qualify for PPO Health Care Partnership (HCP) and the Kaiser HMO (for new Kaiser enrollees only) during May 2013 through December 2013. For future years, you will be required to complete the Action Steps by the applicable deadlines to maintain eligibility for the Health Care Partnership option.
What You and Your Spouse/Domestic Partner Must Do— At-A-Glance You and your enrolled spouse/domestic partner must complete Action Steps 1 – 3 by the deadlines shown on the right. To maintain qualification for HCP in 2014, you and your enrolled spouse/domestic partner must also engage in Action Step 4 on a regular basis in 2013.
What Happens if I Do Not Complete the HCP Requirements by the Deadlines? If either you or your spouse/domestic partner doesn’t complete Action Steps 1 – 3 by the deadlines, you both will be placed into the PPO Personal Direction option effective May 1, 2013, even if you selected the PPO HCP option during Open Enrollment. Your enrolled children do not need to complete theAction Steps, but will be placed in the same plan as you.
What You (and Your Enrolled Spouse/Domestic Partner) Must Do:
Deadline
Step 1. Complete and sign the Health Care Partnership Agreement on behalf of yourself and your enrolled spouse/domestic partner. Go to the Open Enrollment page at www.ufcwtrust.com.
April 15
Step 2. Schedule and obtain a biometric screening either through your doctor, Quest Diagnostics, or a retail pharmacy (see details on pages 15 – 16).
April 15
Step 3. Complete the online Health Risk Questionnaire (HRQ). Go to www.ufcwtrust.com.
April 15
Step 4. Participate in monthly health and lifestyle education coaching through MedExpert to be eligible for Health Care Partnership in 2014
Monthly throughout 2013
Failure to enroll during Open Enrollment will result in coverage termination for you and your dependents on May 1, 2013.
14
UEBT Active Open Enrollment
More Details about Steps 1 – 4 for Health Care Partnership You and your enrolled spouse/domestic partner must complete the following 3 steps by the deadlines provided below to be eligible for the Health Care Partnership option. Step 4 is a health coach call that must be completed on a regular basis throughout the year. NOTE: The Action Steps required for 2013 are described here in this Open Enrollment Guide. For future years, you will be notified again of the required Action Steps and the applicable deadlines during open enrollment for that year. STEP 1. Read, complete and sign the HCP agreement by April 15, 2013. This agreement states your commitment to complete a series of activities to be a health care partner with the Trust Fund. Click on Open Enrollment UEBT Actives at www.ufcwtrust.com. STEP 2. Receive a comprehensive Biometric Screening and provide the results to MedExpert by April 15, 2013. Biometric Screenings measure several aspects of your overall wellness, including blood pressure, cholesterol levels, triglycerides and BMI. Learning about your results will promote your awareness of your health. You can receive a Biometric Screening through your doctor, by going to a Quest Diagnostics® Patient Service Center (PCS) or through participating pharmacies.
Get a Biometric Screening through your doctor:
If you or your enrolled spouse/domestic partner has already had a physical exam with all of the required biometric screening information on or after January 1, 2012, take the Physician Biometric Screening form to your doctor to see if the required information was part of your exam. If so, have your doctor complete and fax the form to MedExpert by April 15. You can find the form at www.ufcwtrust.com once you click on Open Enrollment UEBT Actives.
The Physician Biometric Screening form must be faxed by your doctor to MedExpert at the number listed on the form no later than April 15, 2013.
If you or your enrolled spouse/domestic partner has not had a physical exam and need to get your biometric screening, make an appointment with your doctor as soon as possible. The form must be received by MedExpert by April 15, 2013 via fax from your doctor’s office. Be sure to allow enough time to complete the screening, get test results, for your doctor to fill out the form AND ensure that MedExpert receives the results by the deadline! Your wellness visits including annual biometric screenings are provided at no cost to you when you go to a PPO provider.
NOTE: The Physician Biometric Screening form asks your doctor to certify your nicotine usage. If you receive your biometric screening from a doctor, a test to measure nicotine is not required.
Get a Biometric Screening at no cost to you at Select Retail Pharmacies Participating pharmacies will be conducting the biometric screenings at no cost to you. To see a list of the participating pharmacies, go to the Open Enrollment page at www.ufcwtrust.com and download the list of participating retail pharmacies.
15
UEBT Active Open Enrollment
Get a Biometric Screening at no cost to you through Quest Diagnostics:
Call 1-866-908-9440 now to register and request an appointment, or
Go online at www.ufcwtrust.com, click on Open Enrollment UEBT Actives to register for the Quest biometric screening in 2013. You and your enrolled spouse/domestic partner need to register individually. After your registration, choose a Quest Diagnostic Patient Service Center near you and make the appointment as soon as possible.
When you go online to the Quest Diagnostics Blueprint for Wellness scheduling tool, you will need to enter the registration key: UEBT. Your enrolled spouse/domestic partner will need to login separately and create his/her own account. Then follow the steps to register and schedule your screening at a nearby Quest Diagnostics Patient Service Center. Appointments must be made at least 10 days after the date you scheduled your appointment.
You will receive your individual biometrics screening form in the mail from Quest approximately 10 days after scheduling your appointment. You MUST bring this form with you to your appointment.
IMPORTANT! If you schedule a Biometric Screening through Quest Diagnostics, either by phone or online, you will receive a paper appointment form in the mail approximately 10 days after you schedule your appointment. You MUST bring this form with you to your appointment for your biometric screening. The last date for obtaining an appointment through a Quest Diagnostics Center for a Biometric Screening is April 1, 2013. This allows two weeks to receive your appointment form, which you must bring with you to your appointment. You must complete your screening by April 15.
Prepare for your biometric screening To prepare for your screening, whether you obtain it through your doctor, Quest Diagnostics, or a participating pharmacy, it is important to not eat or drink anything besides water for 10 to 12 hours before your appointment. The most accurate blood test results are obtained when you are “fasting.” Do take all medication normally as prescribed by your physician. You can drink water as you normally do. Also, follow any other instructions you receive from your doctor, Quest, or the retail pharmacy prior to testing. At your appointment, the health professional will draw a small blood sample that will be used to measure:
Glucose (the level of sugar in your blood)
Cholesterol (good, bad and total)
Triglycerides (the types of fats in your blood)
Nicotine usage
16
Getting a biometric screening can help you identify health problems and risk factors for chronic disease early—such as high blood pressure, high cholesterol or high glucose— before they become severe.
UEBT Active Open Enrollment
The health professional will also measure your blood pressure, as well as your height, weight, and waist to calculate your body mass index (BMI). Review your results. MedExpert will provide you access to a secure portal where you can view and print your results. It is a good idea to share your results with your doctor and discuss the best course of action for your health. STEP 3. Complete a Health Risk Questionnaire (HRQ) online by April 15, 2013. You can complete your HRQ anytime—you do not need the results of your biometric screening to take the HRQ. Go to www.ufcwtrust.com and click on Open Enrollment UEBT Actives to take the HRQ. There is no cost to you. It is easy to use and takes only about 15 minutes to complete. You and your enrolled spouse/domestic partner will each have to take the HRQ separately. Once you have finished and submitted the HRQ online, you will be able to immediately print a personalized report from MedExpert that you can take to your doctor to learn whether you’re on track to good health and, if not, how to get there. STEP 4. Talk with a MedExpert health coach each month to meet your health goals. Whether you consider yourself a healthy, fit individual or want to improve your health status, you will be required to work with a health coach from MedExpert as part of the Health Care Partnership (HCP) option. The health coach will contact you by phone on a monthly basis. These calls are excellent opportunities for you to get answers to your questions about healthy lifestyles including diet and exercise, or about your treatment plan for a health condition. If you miss the call, please call the coach back at the call back number he or she provides to you. If the coach is unable to reach you by phone or does not hear back from you within a certain time, you may lose your eligibility for the HCP program in 2014. Please note, if you participate in the Disease Management Program, these coaching calls are in addition to the calls required under that program.
Enrolling for the Standard Plan You must enroll and authorize automatic payroll deductions for your enrolled children. As before, in order to receive the most credit for the HRA, you must complete the HRQ (see Step 3 above).
17
UEBT Active Open Enrollment
Medical Plan Option Comparisons This section provides brief summaries of the plan options available to you and compares the options in the following charts. For specific services, you should review the Summary of Benefits Coverage (SBC) for each option enclosed in this enrollment packet. Please note that all annual deductibles and out-ofpocket maximums include the amounts that you have accumulated since January 1, 2013. If you are currently enrolled in Health Net, you must enroll in one of the options below.
Premier Plan Option Comparison PPO Health Care Partnership
Kaiser HMO
Type of Plan/ Provider Choice
PPO Plan through Blue Shield Any provider; higher benefits with network provider
PPO Plan through Blue Shield Any provider; higher benefits with network provider
HMOMust use Kaiser hospital and physician, except for emergency care
Weekly Member Premiums
Employee: $0; Spouse/Domestic Partner: $20; Per Child: $10*
Employee: $0; Spouse/Domestic Partner: $30; Per Child: $15*
Employee: $0; Spouse/Domestic Partner: $20; Per Child: $10*
No HRA Funding**
No HRA Funding
Health Reimbursement Individual Employee: $700 Account (HRA) Employee with Dependents: $1,250 Funding Network
Non-Network
Network
Calendar Year Deductible
Individual: $900 With 1 Dependent: $1,800 With 2+ Dependents: $1,850
Individual: $1,100 With 1 Dependent: $2,200 With 2+ Dependents: $2,450
Individual: $900 With 1 Dependent: $1,800 With 2+ Dependents: $1,850
Calendar Year Out-ofPocket Maximum
Individual: $2,000 No Maximum With 1 Dependent: (unlimited out-ofpocket) $4,000 With 2+ Dependents: $6,000
Calendar Year Benefit Maximum
*
PPO Personal Direction
Non-Network Individual: $1,100 Individual: $500 With 1 Dependent: With Dependent(s): $1,000 $2,200 With 2+ Dependents: $2,450
Individual: $5,000 No Maximum (unlimited out-ofWith 1 Dependent: pocket) $10,000 With 2+ Dependents: $15,000
$2,000,000 Per Person
Individual: $2,000 With Dependent(s): $6,000
None
ACA Preventive Services
100% of Covered Charges
Not Covered
100% of Covered Charges
Not Covered
100% of Covered Charges
Hospital, Outpatient Surgery and Emergency Room
After Deductible, 85% of Covered Charges
After Deductible, 50% of Covered Charges
After Deductible, 80% of Covered Charges
After Deductible, 50% of Covered Charges
After Deductible, 80% of Covered Charges
Doctor’s Office Visits
After Deductible, 85% of Covered Charges
After Deductible, 50% of Covered Charges
After Deductible, 80% of Covered Charges
After Deductible, 50% of Covered Charges
No Deductible, $20 Copay Per Visit
Premiums are for each of the first three children and then $0 for any additional children. You can continue to use your existing HRA balance from contributions made prior to 2013.
**
18
UEBT Active Open Enrollment
Premier Plan Option Comparison Prescription Drugs at Network Pharmacies
Preferred Generic Preferred Brand Non-Preferred
Member Submitted Claims
Maintenance Drugs for Select Maintenance Drugs for Other Other Drugs Conditions Conditions 30-day supply: $7; 30-day supply: $10; 30-day supply: $10; 90-day supply: $14 90-day supply: $20 90-day supply: $30 30-day supply: $15; 30-day supply: $20; 30-day supply: $20; 90-day supply: $30 90-day supply: $40 90-day supply: $60 30-day supply: $25; 30-day supply: $35; 30-day supply: $35; 90-day supply: $50 90-day supply: $70 90-day supply: $105 Costs in excess of the benchmarked drug cost (see Market Priced Drug Program on page 23) are not covered by the Plan. Members pay the excess costs in addition to the above copays. Available only for emergencies and out-of-area users. Lesser of purchase price or AWP less applicable copayment. Vision
Exam, Lenses and Frames
VSP Network Provider: $5 deductible, covered once every 12 months up to wholesale allowance. Non-VSP Provider: Covered up to the Plan Allowances, member pays 100% of costs above Allowance.
19
UEBT Active Open Enrollment
Ultra Plan Option Comparison PPO - Health Care Partnership
PPO - Personal Direction
Type of Plan/Provider Choice
PPO Plan through Blue Shield Any provider; higher benefits with network provider
PPO Plan through Blue Shield Any provider; higher benefits with network provider
Member Weekly Premiums
Employee: $0; Spouse/Domestic Partner: $20; Per Child: $15 (for the first three, $0 for additional children)
Employee: $0; Spouse/Domestic Partner: $35; Per Child: $20 (for the first three, $0 for additional children)
Health Reimbursement Account (HRA) Funding
Individual Employee: $550 Employee with Dependents: $800
No HRA Funding*
Network Calendar Year Deductible
Individual: $950 With 1 Dependent: $1,900 With 2+ Dependents: $2,000
Out-of-Pocket Maximum Individual: $3,000 (in addition to deductible) With 1 Dependent: $6,000 With 2+ Dependents: $9,000
Non-Network
Network
Non-Network
Individual: $1,150 With 1 Dependent: $2,300 With 2+ Dependents: $2,600
Individual: $950 With 1 Dependent: $1,900 With 2+ Dependents: $2,000
Individual: $1,150 With 1 Dependent: $2,300 With 2+ Dependents: $2,600
No Maximum (unlimited out-of-pocket)
Individual: $5,000 With 1 Dependent: $10,000 With 2+ Dependents: $15,000
No Maximum (unlimited out-of-pocket)
Calendar Year Benefit Maximum
$2,000,000 Per Person
ACA Preventive Services
100% of Covered Charges
Not Covered
100% of Covered Charges
Not Covered
Plan Coinsurance
After Deductible, 75% of After Deductible, 50% of After Deductible, 70% of After Deductible, 50% of Covered Charges Covered Charges Covered Charges Covered Charges Prescription Drugs at Network Pharmacies
Preferred Generic Preferred Brand Non-Preferred Member Submitted Claims
Maintenance Drugs for Maintenance Drugs for Other Drugs Select Conditions Other Conditions 30-day supply: $7; 30-day supply: $10; 30-day supply: $10; 90-day supply: $14 90-day supply: $20 90-day supply: $30 30-day supply: $15; 30-day supply: $20; 30-day supply: $20; 90-day supply: $30 90-day supply: $40 90-day supply: $60 30-day supply: $25; 30-day supply: $35; 30-day supply: $35; 90-day supply: $50 90-day supply: $70 90-day supply: $105 Costs in excess of the benchmarked drug cost (see Market Priced Drug Program on page 23) are not covered by the Plan. Members pay the excess costs in addition to the above copays Available only for emergencies and out-of-area users. Lesser of purchase price or AWP less applicable copayment. Vision
Exam, Lenses and Frames
*
VSP Network Provider: $10 deductible, exam is covered once every 12 months; lenses and frames are covered every 24 months, up to wholesale allowance. Non-VSP Provider: Covered up to Plan Allowances, member pays 100% of costs above Allowance.
You can continue to use your existing HRA balance from contributions made prior to 2013.
20
UEBT Active Open Enrollment
Standard Plan Option Highlights PPO Plan through Blue Shield Any provider; higher benefits with network provider
Type of Plan/Provider Choice
Member Weekly Premiums Employee: $0; Spouse/Domestic Partner: $0; Per Child: $20 (for the first three, $0 for additional children) Individual Employee: $400 Employee with Dependents: $500 (Beginning January 1, after meeting the initial eligibility rules)
Health Reimbursement Account (HRA) Funding* (with HRQ completion)
PPO Network
Non-Network
Calendar Year Deductible
Individual: $1,000 With 1 Dependent: $2,000 With 2+ Dependents: $2,300
Individual: $1,200 With 1 Dependent: $2,400 With 2+Dependents: $2,900
Out-of-Pocket Maximum (in addition to Deductible)
Individual: $7,500 With Dependent(s): $15,000
No Maximum (unlimited out-of-pocket) $2,000,000 Per Person
Calendar Year Benefit Maximum ACA Preventive Services
100% of Covered Charges
Not Covered
Plan Coinsurance
After Deductible, 70% of Covered Charges
After Deductible, 50% of Covered Charges
Prescription Drugs at Network Pharmacies
Preferred Generic Preferred Brand Non-Preferred Member Submitted Claims
*
Maintenance Drugs for Maintenance Drugs for Other Drugs Select Conditions Other Conditions 30-day supply: $7; 30-day supply: $10; 30-day supply: $10; 90-day supply: $14 90-day supply: $20 90-day supply: $30 30-day supply: $15; 30-day supply: $20; 30-day supply: $20; 90-day supply: $30 90-day supply: $40 90-day supply: $60 30-day supply: $25; 30-day supply: $35; 30-day supply: $35; 90-day supply: $50 90-day supply: $70 90-day supply: $105 Costs in excess of the benchmarked drug cost (see Market Priced Drug Program on page 23) are not covered by the Plan. Members pay the excess costs in addition to the above copays Available only for emergencies and out-of-area users. Lesser of purchase price or AWP less applicable copayment.
You can continue to use your existing HRA balance from contributions made prior to 2013.
21
UEBT Active Open Enrollment
Dental Plan Option Comparisons You must also select your dental option during Open Enrollment. Your dental options are:
Premier & Ultra
Premier Access DPO Network
Delta Dental Network (only available to members currently enrolled in Delta Dental)
Liberty Dental DMO
Standard
Premier Access DPO Network
Dental Plan Options Indemnity Dental with Premier Access DPO Network or Delta Dental Network
Liberty Dental DMO
Choice of Providers
You may select any dentist of your choice. Using a DPO dentist will lower your out-of-pocket expense.
You must use the Liberty DMO providers. If you go to a non-network provider, you will have to pay 100% of the charges incurred.
Calendar Year Deductible
None
None
Calendar Year Benefit Maximum
Premier Plan: $2,500 per person Ultra Plan : $2,000 per person Standard Plan: Preventive and Diagnostic Procedures Only
No maximum
Covered Expenses
Premier Access DPO: Contracted Rates Non-DPO: Plan Scheduled Allowances Delta Dental DPO: Contracted rates Premier: File Fees Non-Delta Dentists: Delta Dental Allowance
See Liberty Dental Schedule of Benefits
Plan Payment Pediatric Dental Care: Preventive & Diagnostic: Basic Restorative: Major Restorative:
Premier Plan 100% of covered expense 100% of covered expense 80% of covered expense 70% of covered expense
Network provider services are provided after you pay the applicable copayment.
Ultra Plan 100% of covered expense 100% of covered expense 60% of covered expense 50% of covered expense
Standard Plan Preventive & Diagnostic ONLY: 100% of covered expense Orthodontic Plan Payment
75% of covered expense, up to $2,000 per person lifetime (Premier & Ultra only)
22
Orthodontic benefit is provided through the Premier Access DPO Plan.
UEBT Active Open Enrollment
Changes to Prescription Drug Benefits – Market Priced Drug Program (MPD) About the MPD Program On May 1, 2013, the UEBT Active Health Plan will implement a Market Priced Drug (MPD) program for prescription drugs for the PPO options. At this time, this program does not apply to you if you are enrolled in the Kaiser HMO option. The new MPD program will help you and your doctor identify lower-cost prescription drugs with the same clinical effectiveness for treating some common health conditions. These drugs are called Preferred Drugs under the MPD program. When you use a Preferred Drug to treat a condition included in the MPD program, you will pay your current co-payment. However, if you use a drug that is not on the Preferred Drug list (known as a NonPreferred Drug), your out-of-pocket cost will be much higher. This is because if you choose to receive a Non-Preferred Drug, you paythe applicable co-payment for the Non-Preferred drug plus the price difference between the Non-Preferred and Preferred Drugs. In some cases, that difference can be hundreds of dollars.
What You Need to Do If you take a prescription drug, be sure to tell your doctor about the MPD program right away. Remind him or her about the program whenever a new prescription is written. If you had a prescription filled for a Non-Preferred Drug, you will receive a special letter from Catamaran, the UEBT Active Health Plan’s pharmacy benefit manager. This letter will be sent to you before the May 1, 2013 effective date and will provide you with the alternative MPD Preferred Drug, its estimated cost, your cost for continuing to use the Non-Preferred Drug and the savings you could realize by switching to the Preferred Drug. It will also explain how to get a new prescription for a Preferred Drug. If you receive one of these letters from Catamaran, share it with your doctor right away.
23
UEBT Active Open Enrollment
MPD Categories Some of the most common drugs and health conditions included in the MPD program are: Acid reflux, heartburn and stomach ulcer Antidepressants Blood thinners Cardiac medications Diabetes High blood pressure High cholesterol
Your doctor knows your full medical history and which drug therapies he or she prefers, but your cost for prescriptions is determined by the Plan’s benefits and rules, including the new MPD program for specific conditions and medications. If you and your doctor decide a Preferred Drug is not right for you, you may call Catamaran, beginning on March 1, 2013, to request an exception, at 1-866-635-6906, 24 hours a day, 7 days a week. Your doctor will be asked to complete an Exception Request form and provide the clinical basis for the request. If approved, you will continue to pay the applicable copayment for the non-preferred medication. For a list of medications affected by the MPD program, please visit the Trust Fund website at www.ufcwtrust.com and click on Open Enrollment UEBT Actives.
Hypnotics and anti-anxiety drugs Nasal steroids and allergy medications Overactive bladder Pain, inflammation and arthritis Parkinson’s disease This list will be continually updated by Catamaran.
24
UEBT Active Open Enrollment
Important Resources Better-informed patients make better health care decisions. That is why the Fund is providing you with resources to learn more about your health and the tools to get healthier.
Resource
Contact Information
Fund Website
www.ufcwtrust.com
Walnut Creek Office
1277 Treat Boulevard, 10th Floor Walnut Creek, CA 94597-8863 [t] 800-552-2400 [f] 925-746-7549
Roseville Office
2200 Professional Drive, Suite 200 Roseville, CA 95661 [t] 800-552-2400 [f] 925-746-7549
Office Hours: Monday through Friday 8:30 a.m. to 4:30 p.m. Phone Hours: Monday through Friday 7:30 a.m. to 5:30 p.m.
Open Enrollment
www.ufcwtrust.com
Indemnity PPO Plan online provider search
www.BlueShiledCA.com
Kaiser HMO Plan
1-866-454-8855
Quest Diagnostics Blueprint for Wellness
1-866-908-9440 Monday – Friday 7:00 a.m. to 8:30 p.m. CST Saturday 7:30 a.m. to 4:00 p.m. CST Online: My.BluePrintforWellness.com (you can also link to Quest Diagnostic’s online scheduling tool through www.ufcwtrust.com)
MedExpert Indemnity HRQ, Medical Decision Support (IMDS) and Health Coaching
1-800-999-1999
Liberty Dental DHMO Plan
1-888-703-6999 www.libertydentalplan.com
25
