The Advisor Open Enrollment
for January 1, 2011
Important information about your group health benefits.
What is the Oxford Plan B (Base)
Wagner College is pleased to announce Freedom Access medical benefits
important news concerning our medical and plan?
dental insurance programs. The purpose of
this newsletter is to update our employees on The Plan B program includes the
the changes to our benefit programs effective
following benefits:
January 1, 2011. As we are sure you are
aware, the cost of providing high quality
In-Network / Approved Services
benefit programs has been steadily rising. For
the second year in a row, Wagner’s healthcare o Office Visit Copay: $30
insurer is requesting a cost increase of 15% to
o Specialist Copay: $50
20%. We, through our benefit consultants at
o Deductible: None
Bollinger, have been analyzing program
o Coinsurance: 100% after copay
alternatives that would allow us to continue to
o Emergency Room Visit Copay:
offer a high quality plan at an affordable cost.
$100
Effective January 1, 2011 we are changing o In-Patient Hospital: $500 Per Admit
some of the provisions of our medical and o Outpatient Hosp.: $250 Copay / visit
dental plans. We will continue to use Oxford
Healthcare (“Oxford”) as the insurer for the o Drug Card Deductible:$100 / person
Medical Plan and United Healthcare (“UHC”) **Note: This deductible does
for the Dental Plan. not apply to Tier 1 drugs.
o Drug Card Copays: Tier 1:$15
Copay; Tier 2: $25 Copay; Tier
MEDICAL 3:$50 Copay
o
What medical programs are being offered Out-of-Network/
as of January 1, 2011? Non-Approved Services
o Initial Deductible:
We will offer one medical plan, the Plan B $3,000/person; $9,000/ family).
(Base) Freedom Access plan. The old Plan A
o Coinsurance: After deductible, the
(Buy-Up) Plan will no longer be offered to
plan pays 70% of the next $10,500 of
employees.
claims per member ($31,500 per
family), and 100% thereafter.
The Oxford Freedom Access plan does
not require the selection of a Primary
Care Physician or referrals to see
specialists.
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The above is a summary; additional
benefits and limitations apply.
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Is the network of providers changing? No, Medical Flexible Spending Account
you will need to continue to utilize providers • Allows you to defer up to $2,500 of your
from the Oxford Freedom Network to get the annual salary into an account that will
most out of the plan reimburse you on a tax-favored basis for
qualified health expenses including:
Will I have to select a Primary Care o deductibles
Physician? No, you do not need to select a o co-payments/coinsurance
Primary Care Provider nor will you need a o amounts above UCR
referral to see a specialist o Health/dental care not covered under
any insurance plans
o over the counter medications used to
How can I locate “In-Network” providers? treat illness/injury IF PRESCRIBED IN
You may call the toll free phone number of, WRITING BY A DOCTOR
(800)444-6222 or access the Oxford network o over the counter medical supplies
provider directories via their website to obtain used to treat illness/injury
the most current provider information. The o vision/contact lens supplies and
website is located at www.oxhp.com Click on services
“Members” and then on “Find a Physician or
Facility”. When asked “What network?”, click Dependent Care Spending Account
on the “Freedom Network”.
• Allows you to defer up to $5,000 of your
Who should medical claims be submitted annual salary ($2,500 if married, filing
to? separately; maximum under all plans) into an
All claims must be submitted to Oxford at the account that will reimburse you on a tax-
address appearing on the back of your favored basis for qualified dependent care
identification card. expenses
These benefits can be elected by any
Can I add my natural or adopted child who is employee. Enrollment in a Wagner health
less than age 26 to the medical plan at this plan is not required.
time?
Yes, you will be able to enroll your natural or
adopted child(ren) who are less than age 26 for
coverage effective January 1, 2011. You must
have medical coverage under the Wagner plan
as a pre-requisite to add the child(ren). If you do
not enroll them now, you must wait until next
year for your next opportunity unless you
experience a qualified life event that creates
special enrollment rights for you. (if you think
you have experienced one of these event,
please contact Human Resources.)
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DENTAL How can I locate “In-Network”
providers?
What are the PPO Dental benefits? You may call the toll free phone number on
The dental plan benefits for the PPO are the back of your identification card, or
payable for services from dentists participating access the UHC dental network provider
in the UHC PPO dental network or from any directory via their website to obtain the
non-PPO dentist of your choice. most current provider information. The
website is located at
Deductible: $50 ($150 per family)
www.myuhcdental.com. Click on “Locate
Preventive: 80%, no deductible a Dentist”. When asked “What network?”,
Basic: 80%, after deductible click on the “Dental Options PPO”.
Major: 50%, after deductible
Orthodontia: Not Covered
Annual Max. Benefit: $1,000 per person What will the Oxford Medical / UHC
Dental program cost participants?
Your out of pocket expenses are generally
lower when participating providers are used. Effective January 1, 2011 the Oxford
Members may be balanced billed when using Medical / UHC Dental programs will cost
non-participating providers. enrolled employees the following Monthly
payroll deductions:
What are the In-Network PPO Only Dental
benefits? Oxford Plan B ( Base):
The dental plan benefits for the In-Network PPO Employee Only: $137.00
are payable only if you use a PPO dentist: Employee + Spouse: $300.00
Deductible: $25 ($75 per family) Employee + Child(ren): $270.00
Family: $410.00
Preventive: 100%
UHC Dental PPO Plan:
Basic: 80% after deductible Employee Only: $ 35.70
Major: 50% after deductible Employee & Spouse: $102.67
Annual Maximum Benefit (Non-Ortho): Employee + Child(ren): $106.08
$1,500 per person Family: $109.30
Orthodontia (child): $1,500 Lifetime Max UHC Dental In-Network PPO Plan:
Employee Only: $ 4.10
These services must be accessed from dentists Employee & Spouse: $20.53
participating in the UHC dental network. Employee + Child(ren): $22.35
Family: $34.22
The above are summaries only; additional
benefits and limitations apply. Only those employees making a change in
their benefit election or covered
dependents as of January 1, 2011 will be
To whom should dental claims be required to complete a new medical and
submitted? dental Premium election form. All forms
All claims must be submitted to UHC at the must be completed and returned to
address appearing on the back of your Linda Cosentino by December 10, 2010.
identification card.
Will I receive new Dental Identification Card?
You will be not be receiving new identification
cards from UHC.
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