Health plans are not just for sick people by zll14065

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									Perspective…
                                                                                                                   April 2008


                      P E B B
                                                                                                                      Washington State
                                                                                                                   Health Care Authority
                                                                                                        Public Employees Benefits Board




Health plans are not just for sick people

I      f you’ve been
       relying on your
health insurance only
                                  your overall health online.
                                  A health risk assessment
                                  lets you get immediate,
                                                                   always done on the secure
                                                                   side of your health plan’s
                                                                   Web site, so be prepared
                                                                                                   annual physicals, and
                                                                                                   vaccinations are available,
                                                                                                   too—often at little or no
when you’re sick, then            customized information           to create a log-in and          cost to you.
you’ve been missing out           on your potential health         password if you don’t           Below are some of the
on some great benefits            risks. You will also find        already have one.               resources offered by our
offered by your health            out what actions you             And don’t forget                health plans.
plan.                             can take to reduce those         about preventive care
Each of the health plans          risks. This assessment is        benefits. Flu shots,
offers resources to help
you stay healthy and                Personalized Health Risk Assessment (online)
increase your health
knowledge. You might use            If you are a member of
your health plan to sign            Aetna:           Go to www.aetnahca.com and select Health Risk Assessment.
up for an exercise class,
lose weight, quit smoking,          Group Health: Go to www.ghc.org and sign up for the health profile.
or manage a chronic
condition such as diabetes          Kaiser:          Go to www.kaiserpermanente.org under My Health Manager
or asthma.                                           (bottom of web page), and select total health assessment.

An excellent feature                UMP:             Go to www.ump.hca.wa.gov and take the eHealth survey from the
available through all plans                          Health Counts! page.
is the ability to assess

  Health Information
  Aetna:                           Group Health:                    Kaiser:                        Uniform Medical Plan
  Anyone visiting the Aetna        Whether you’re looking for a     The Health and Wellness        (UMP):
  InteliHealth® Web site can       support group, a description     section of Kaiser              From its Health Counts!
  tap into their information       of a medical test, or details    Permanente’s Web site          page, the UMP site offers
  library and search for           about an illness, try the        offers tools and resources     quick links to weight
  information on drugs,            Healthwise Knowledgebase         on nutrition, fitness, child   management resources
  health terms, ailments, and      offered on Group Health’s        and teen health, as well       (including a body mass
  recipes. Content comes           Web site. Members can also       as a variety of fun health     index calculator), and the
  from an in-house editorial       visit the Classes and Events     calculators.                   Free and Clear smoking
  staff and a relationship with    page to take advantage of                                       cessation program.
                                                                                                   Members can also find a
  Harvard Medical School.          activities offered.
                                                                                                   list of preventative care
                                                                                                   services covered by the
                                                                                                   health plan.



HCA 50-658 (4/08)
                         PEBB’s Web site | www.pebb.hca.wa.gov


                        Pilot project to test wellness ideas
                        at state agencies

                        S      tarting this spring,
                               employees at
                        nine state agencies will
                        determine which activities
                        work best at improving
                        or maintaining employee
                        health.
                        Wellness coordinators
                        in each agency will lead       In general, a “culture of     Show your support for
                        the pilot project, called      health” means employees       the wellness activities
                        the Healthy Worksite           feel supported in             that are most meaningful
                        Initiative. Coordinators       maintaining or improving      to you. Your involvement
                        will create wellness           their health while at         will help guide future
                        policies and test employee     work. The Healthy             wellness initiatives at
                        activities at their agencies   Worksite Initiative will      your state agency, and
                        through June 2009. The         find out what it takes to     for all state employees.
                        Health Care Authority’s        create a culture of health    Information is available
                        Washington Wellness            in different state agency     on the Web site
                        program will sponsor the       environments (small and       www.wellness.wa.gov.
                        initiative.                    large agencies with diverse   Successful activities and
                        “Although most state           job types) and how that       processes will be shared
                        agencies and higher-           might be replicated across    among the nine agencies
                        education institutions are     all state agencies.           and when possible, with
                        working towards worksite       Agencies participating        other agencies. Well-
                        wellness, most have done       in the Healthy Worksite       documented activities,
                        this with few resources        Initiative include:           processes, and tools will
                        (staff or budget) formally                                   provide the blueprint for
                        dedicated to wellness,”        • Attorney General’s
                                                         Office                      other agencies that choose
                        said Washington Wellness                                     to become a health-
                        Director Scott Pritchard.      • Department of               promoting worksite.
                        “Research over the past          Financial Institutions      In 2010, Washington
                        10 years and evidence in       • Department of Health        Wellness will submit
                        the private sector suggests                                  a final report to the
                        investing in employee          • Department of Natural
                                                         Resources                   Legislature.
                        health provides a positive
                        return on investment           • Department of Social        For more information
  Washington State                                                                   and updates on the
Health Care Authority   and leads to a ‘culture of       and Health Services
                        health’ at the worksite.                                     Healthy Worksite
     Steve Hill,                                       • Employment Security
                        We want to find out                                          Initiative, contact your
   Administrator                                         Department
                        what a culture of health                                     organization’s wellness
  Public Employees      looks like for Washington      • Health Care Authority       coordinator. If you’re not
    Benefits Board      State agencies and their       • Higher Education            sure who your wellness
   1-800-200-1004       employees.”                      Coordinating Board          coordinator is, contact
    360-412-4200                                                                     your Human Resources
www.pebb.hca.wa.gov                                    • Labor and Industries        department.


                                                Page 2
                          For more information, go to www.pebb.hca.wa.gov.



                                                            When can I change my PEBB benefits?
                                                            Generally, you can make changes to your PEBB
                                                            medical and dental plans or enrollment during our
                                                            annual open enrollment. PEBB rules also recognize
                                                            certain events that allow you to make changes
                                                            midyear.
                                                            Below are some of the events that allow you to
                                                            change your or your family’s enrollment or health
                                                            plan selection:
                                                            • When there is a marriage or qualifying domestic
                                                               partnership.
                                                            • After a birth or adopting a child.
                                                            • When there has been a change in your family,
Can I verify my PEBB coverage online?                          such as a new eligible dependent through
                                                               marriage, qualified domestic partnership or legal
Absolutely! From the PEBB home page (www.pebb.                 guardianship.
hca.wa.gov), you can confirm your medical plan              • When there has been a change in your or a
and dental plan (if you have dental) by going to the           dependent’s employment status that could affect
Verify My Coverage link.                                       the cost of your coverage.
                                                            • When you or a dependent loses comprehensive
Helpful tips for signing in to verify your
                                                               group insurance coverage.
coverage
                                                            If these events occur, you are required to update
• You must be a currently enrolled member to access
                                                            or change your benefits:
  your account online.
• If you are a surviving spouse, you must enter the         • When there is a divorce, annulment or
  information of the deceased subscriber’s last name           dissolution of a qualified domestic partnership.
  and your own birth date.                                  • When you lose a dependent or your dependent’s
• If you use a suffix in your name (Jr., Sr., II, etc.)        eligibility changes.
  try including it with your last name.                     • When you move and your health plan is not
• If your last name contains special characters                available in your new location
  (apostrophe, hyphen, etc.), use a space in place of       • When you or an eligible dependent becomes
  the special characters.                                      entitled to Medicare.
Some examples:                                              To make any change in benefits, you must notify
                                                            PEBB within 60 days when one of these events
  If your name is                         Try this
                                                            occurs. Contact your personnel, payroll, or benefits
  D’Angelo ...............................D Angelo
                                                            office to get and submit the correct form.
  Jones-Smith ...........................Jones Smith
  McDougal..............................Mc Dougal
  John Smith, Jr........................Smith Jr                How can I find out more?
  John Smith, III ......................Smith III               The PEBB’s rules are spelled out in Washington
You only have three tries to enter the correct log-in           Administrative Code 182-08-198, 182-12-128,
information before the system locks you out of your             182-12-260, 182-12-262, and found online at
                                                                http://apps.leg.wa.gov/WAC. You also can talk to
account. Contact us via e-mail if your attempts fail.
For faster assistance, be sure to include the sign-in           your personnel, payroll, or benefits office, or visit
information (last name, last 4 digits of subscriber’s           the PEBB Web site at www.pebb.hca.wa.gov. Our
ID number, and birth date).                                     web site’s Info Center also has answers to many
                                                                other commonly asked questions.



                                                       Page 3
                                   PEBB’s Web site | www.pebb.hca.wa.gov


How we’re improving your health care

F       ollowing
        Governor
Gregoire’s five-point
                                  To successfully provide high-quality care at a lower cost involves insurance
                                  companies, providers, employers, and you. Here are some ways you can help:
                                  • Take the online health risk assessment (HRA), available through your health plan
strategy for health care,           or the Washington Wellness web site (www.wellness.wa.gov).
the Health Care Authority         • Participate in wellness activities at your workplace.
(HCA) strives to deliver          • When your doctor prescribes medication, ask if a generic equivalent is appropriate
health insurance that is            for you.
affordable, high-quality,         • Participate in your medical plan’s wellness benefits, such as smoking cessation or
and consistent. These               weight-loss programs.
goals emerged from the            • Use your health plans’ preventive-care benefits to maintain your health and
2007 state Blue Ribbon              detect problems early (when they’re most treatable).
                                  • See your health care provider, rather than visit the emergency room for non-
Commission on Health
                                    emergency situations.
Care Costs and Access.
As a PEBB enrollee, this            How to find more information on these organizations and initiatives
means you can expect an
                                    Governor’s Priorities: Taking Charge of Our Health
affordable menu of health
                                    www.governor.wa.gov/priorities/healthcare/
plans and a standard of
care that promotes best             Governor’s Blue Ribbon Commission on Health Care Costs and Access
practices, chronic care             www1.leg.wa.gov/Joint/Committees/HCCA/
management, and overall             Health Care Authority www.hca.wa.gov
wellness.                           • Health Information Technology and Electronic Medical Records Initiative
                                      www.hca.wa.gov/hit/
Below are some ways we
                                    Washington Health Information Collaborative
are working for you:
                                    www.wahealthinfocollaborative.org/



    Governor’s Five-point
    Strategy for Improving                                       What the HCA Does for You
          Health Care
Emphasize health care based on            Works with nationally recognized organizations to improve the quality, safety, and
scientifically proven approaches          affordability of your health care. (See www.leapfroggroup.org and
                                          www.pugetsoundhealthalliance.org.)
                                          Pays for scientific reports to find out if medical devices, procedures, and tests are
                                          safe and work as promoted. These reports are shared with all state agencies that
                                          purchase health care. (See www.hta.hca.wa.gov)
Promote prevention, healthy               Helps you to get information on your health risks and match that information to
lifestyles, and healthy choices           programs and PEBB benefits to improve your health.
                                          (See www.wellness.wa.gov.)
Better manage chronic care                Works with health plans to make it easier to address illnesses common among all
                                          employees and offer the best treatments.
Create more transparency in the           Promotes public reports on providers’ quality of care and health outcomes to help you
health care system                        and employers make decisions about health care.
Make better use of information            Gives grants to individual providers and small hospitals to purchase or upgrade
technology                                electronic medical records systems. The HCA also works with providers, health
                                          plans, hospitals, consumers, and their communities on ways consumers can share
                                          information electronically with their providers and better coordinate care.


                                                          Page 4
                       For more information, go to www.pebb.hca.wa.gov.


How much PEBB coverage costs in 2008
The charts show on average how much your PEBB medical coverage currently costs. You can see the portion the
state contributes and what the average cost is for state and higher-education employees.




                                                        Health care cost trend
                                                       The bar graph shows a history of what the state
                                                       has paid on average toward employees’ medical
                                                       coverage and what employees have paid on
                                                       average.




                                                        * The employees’ average monthly premium is
                                                          based on employees’ medical plan enrollment in
                                                          October 2007. This figure may change.




                                                Page 5
                                PEBB’s Web site | www.pebb.hca.wa.gov


Save money on your health care costs with an FSA

R     obert is one of the
      thousands of PEBB
members who enjoy the
                                                                                       for things like copays,
                                                                                       deductibles, and his
                                                                                       prescription eyewear.
advantage of having a                                                                  When PEBB’s annual open
PEBB Flexible Spending                                                                 enrollment came around,
Account (FSA).                                                                         he knew to contribute at
As a father with three                                                                 least $900 toward his FSA.
young children, he has                                                                 When can you start
recouped expenses that he
                                                                                       an FSA?
usually pays out-of-pocket
for prescriptions, over-the-                                                           • Within the first 31 days
counter medications, and                                                                 of starting your job.
dental visit copays.                                                                   • During the annual open
                                                                                         enrollment.
“I enjoy seeing those                                                                  • Within 31 days of a
reimbursement checks                                                                     qualifying event, such
come in the mail. Each one                                                               as marriage, birth, or
is my pat on the back for                                                                receiving a court order
saving money through my                                                                  regarding coverage of a
FSA,” Robert said.                                                                       dependent.
An FSA is a tax-free                                                                   • When you move and
savings account allowed                                                                  need to change your
by the IRS to help pay for                                                               health plan.
your and your family’s                                                                   If you aren’t eligible to
health-care costs. Your                                                                  start an FSA now, keep
eligible family members
do not have to be enrolled     Can an FSA                 lower those costs by about track of your out-of-
in PEBB coverage to have       help you?                  25 percent. You can find a pocket expenses so you’ll
expenses qualify for FSA       If you’re spending at      full list of eligible expenses know how much to set
reimbursement. This            least $240 each year       at www.asiflex.com/pebb. aside in your FSA for 2009.
                                                                                         ASIFlex provides a
benefit is available if you    in health insurance        The maximum you can            helpful worksheet on
are an employee of a state     copays, coinsurance, and   set aside for your FSA is      their Web site
agency, higher-education       deductibles, and even      $2,400 each year. Robert       www.asiflex.com/pebb.
institution, or community      many over-the-counter      added up his expenses
or technical college.          medications, you can       from previous years
More than 8,000 PEBB
members currently take
advantage of the FSA, a
benefit that saw a 23%            Don’t forget about DCAP
increase in participation         The Dependent Care Assistance Program (DCAP) allows you to save on child
from 2007 to 2008.                or elder care expenses such as babysitting, daycare, or in-home care for an
                                  older dependent by setting aside pre-tax dollars from your paycheck. DCAP
                                  reimburses your dependent care expenses so you and your spouse can work.
                                  All the details are available at www.asiflex.com/pebb. Read more about
                                  DCAP in our July 2008 issue.




                                                    Page 6
                          For more information, go to www.pebb.hca.wa.gov.


Who has a claim
on your life insurance?
Your PEBB life insurance        also can provide you with
is intended to be there for     a copy of the form if you
your beneficiaries in a time    are unable to go to the
of need. But who are your       Web site.
beneficiaries?                  While on the Web site,
Employees first select their    you can also find the Life
beneficiaries—often a           Insurance Change form.
spouse, domestic partner,       Use this form to enroll
or child—when first             your spouse or other
starting a job (if your         eligible dependent, or to
employer participates in        change your coverage.
PEBB life insurance). As        You can also submit this        New employees and
the years pass, our lives       form to your personnel,         retirees can now find
can change in significant       payroll, or benefits office.
ways and the people we          However, some changes           enrollment packets online
first listed as beneficiaries   require approval from           New employees and prospective retirees have
may no longer be the best       ReliaStar, our insurance        another way to find the same information
choice, perhaps due to          provider. Read the              that’s found in the PEBB Program’s printed new
divorce or family loss.         instructions on the Life        employee or new retiree packets. Just go online
If you have had a life          Insurance Change form           to www.pebb.hca.wa.gov, and select either “New
change that requires a          carefully.                      Employee?” or “New Retiree?” These links provide
change in beneficiary,                                          information on PEBB medical and dental coverage,
it’s a good idea to check         How to change                 as well as other available options.
your primary and                  your life insurance           In addition, the online “packets” provide links to
secondary beneficiaries.          beneficiary                   other sources of information not included in the
Your personnel, payroll                                         printed versions, such as:
                                  1. Go to the forms
or benefits office can                                          • The health plans’ Web sites—View medical and
                                     page on PEBB’s Web
tell you who is listed                                            dental plans’ provider directories and Certificates
                                     site: www.pebb.hca.
as beneficiaries on your                                          of Coverage for a complete list of benefits,
                                     wa.gov/forms.
policy and assist in                                              limitations, and exclusions. Some medical plans’
updating that information.        2. Scroll down to
                                     the Miscellaneous            Web sites also include their drug formulary,
You can update your life                                          which is a list of drugs that the plan will cover.
insurance information any            category.
time during the year.             3. Select the Change of       • Benefits comparison tools—Compare the
                                     Beneficiary form.            benefits of the medical and dental plans you’re
If you do need to make a                                          considering in a side-by-side format.
beneficiary change, you           4. You can type directly
will need to complete the            on the form then           • Dependent forms—Complete and return
Beneficiary Designation              print it and sign it, or     if you’re adding a family member to your
form, which is available             print it and fill it out     coverage, such as a student dependent over age
on the PEBB Web site. You            by hand.                     19, extended dependent, or a dependent with a
can fill out the form on                                          disability.
                                  5. Bring the completed
the Web site, then print                                        If you prefer the printed packet, employees can still
                                     form to your
and deliver it to your                                          get one by contacting your personnel, payroll, or
                                     personnel, payroll, or
personnel, payroll, or                                          benefits office.
                                     benefits office.
benefits office. This office


                                                        Page 7
                                   PEBB’s Web site | www.pebb.hca.wa.gov




  Inside this issue
      • How your health plan’s web site can be a great resource ............................................... Page 1

      • Nine state agencies will pilot a project to help workers stay healthy............................. Page 2

      • When can you change you PEBB benefits? ....................................................................... Page 3

      • How the Health Care Authority is improving health care ............................................. Page 4

      • What your state health coverage costs .............................................................................. Page 5

      • How to save money on out-of-pocket medical and dental expenses .............................. Page 6

      • Find out who are your life insurance beneficiaries ........................................................... Page 7



 To obtain this document in another format or to request special accommodations, call our Americans with Disabilities Act (ADA)
Coordinator at 360-923-2805. TTY users (deaf, hard of hearing, or speech impaired), call 360-923-2701 or toll-free 1-888-923-5622.




                                                                                                                    HCA 50-658 (4/08)
                                                                                                           Olympia, WA 98504
                                                                                                           P.O. Box 42684

								
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