CalPERS presents Open Enrollment for 2006 by cnolynne

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									             CalPERS     presents
 Company
 LOGO      Open Enrollment for 2006




                    Its that time again…
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                          What’s Open Enrollment?

   Open Enrollment is a time when eligible
   CalPERS members:

 Enroll in a health plan
 Change health plans
 Add eligible family members who were not enrolled
  during an initial enrollment period
 Wait until changes take effect January 1, 2007


    Note: Deletions or cancellations regarding dependents may be done
           routinely when a qualifying event occurs during the year.
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                    CalPERS Open Enrollment 2006



  Starting - September 1 through September 29, 2006


            Look at what’s new

            See what’s changed

            Read about on-line self service features




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                                 Mailing Dates
              DOCUMENTS                          TIMEFRAMES


      Health Plan Statements, Rate                         July 31
       Sheet and Open Enrollment                          August 1
                  News                                    August 4



           Employer 2% Mailing                              July 30
        Health Program Guide, Health    Note:
                                            The 2% represents additional materials sent to
       Benefit Summary Quality Report   EMPLOYERS as reserve stock for extra or new
                                        requests.




             Open Enrollment                            End of July
              Circular Letter
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                             What’s new this year?

  CalPERS has combined and streamlined publications:

            Understanding Medicare
            Health Program Handbook
            Health Plan Decision Guide (State members )
               (Contracting Agencies, who are subject to regional pricing rates)


   Into a NEW CalPERS Health Program Guide




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                            What’s Changed?


      Annual Member Health Plan Statement
       Contains personal health benefit information on file,
       such as:


           √ Your current health plan
           √ Family enrolled under your health plan
           √ Your eligibility ZIP CODE



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                       Open Enrollment News

   The NEW PUBLICATION provides important
   information about CalPERS health plans and our
   annual Open Enrollment Period
       More options:
             Request special publications with the CalPERS postcard
             Use Rate Sheets
             Keep current on changes to your Annual Member Health
             Plan Statement
             Discover CalPERS website tools:
                 Health Plan Search by ZIP Code
                 Health Plan Chooser
                 Access Open Enrollment publications on-line
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                             On-line Tools

• Health Plan Chooser

    √ Offers information about health plans, cost, doctor
      availability, member satisfaction and hospital affiliation.


• Health Plan Search by ZIP Code
    √ Provides information about CalPERS health plans
      using your ZIP Code for home or work address.



            Retirees need to use a home address
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                     Changing Health Plans

 Convenient self-service...for retired members and
   EMPLOYER’S (employees)...

     CHOICES:

     Hear Interactive Voice Response System (IVR)
      connect directly to health plan carriers
     Speak to an agent in the Contact Center
     Call 1- 888- CalPERS (call 1-888-225-7377)
     Visit CalPERS Website (retirees) NO PASSWORD required



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           Regions for Contracting Agencies (PA)




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               PPO Benefit Changes for 2007


            PERSChoice and PERSCare are changing
           some Basic Plan benefits (chart on next slide)



           Medicare
           members are        CalPERS & PPO’s want members
           not affected       to utilize the most cost-efficient
                              measures when using benefits,
                              such as:
                               outpatient vs. inpatient
                               urgent care vs. emergency
                                 room, etc.



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                          PPO Basic Plan Benefit Changes


                            PERSCare and PERSChoice

            TEXT          TEXT                     TEXT
                  Services                                 Benefit TEXT
                                                                   Change

   Imaging services                                   Pre-authorization required

   Introduction of urgent care                              Preferred network



           Preferred Network is defined as the Preferred Providers Organization's (PPO’s)
                      physicians, hospitals and benefits system of regulations.




5/1/2009                                                                                    12
                     Healthy Lifestyle Rewards for 2007

    Blue Shield makes the “Healthy Lifestyle Rewards” Program available to CalPERS
    members. Facts about the Healthy Lifestyle Rewards…

          is it?
     What TEXT              TEXT An interactive online program for healthy
                                          TEXT               TEXT
                                    habits:
                                              •regular exercise
                                              •good nutrition
                                              •stress management
                                              •non-smoking
     What is the cost?              No cost to CalPERS members


     Who may participate?           All CalPERS BLUE SHIELD enrollees


     Any rewards?                   Up to $200 a year for members participating in
                                    the program



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                    How do I participate in Healthy Rewards?


 CalPERS members should follow 5 steps:

 1.        Register on www.mylifepath.com
 2.        Agree to the terms of participation
 3.        Take the online Health Risk Assessment survey
           (“HRA” asks questions about a member’s level of
           physical activity and eating habits)
 4.        Select a customized program that may lead to a
           better lifestyle
 5.        Log in weekly for helpful tools, tips, advice and
           support for your program


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                    Serving Customers is # 1 !

             Available August 4 , 2006
           Order from the CalPERS Website :

  CalPERS Health Program Guide

  Health Benefit Summary

  Quality Report

 REMINDER : CalPERS provides each employer with an ...
                                    OPEN ENROLLMENT PACKAGE

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                    Open Enrollment Materials


   DO EMPLOYERS NEED MORE BOOKLETS ?

           There are 3 ways to order...


       1. Email: Public_Agency-Requests@calpers.ca.gov

       2. Telephone: (916) 795-1493

       3. Fax: (916) 795- 3281




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              Multiple ways for members to reach us


• Internet           www.calpers.ca.gov

• Telephone        1-888–CalPERS (225-7377)
           TTY for Speech & Hearing Impaired: (916) 795-3240



• Mail           Health Benefits Branch
                    Open Enrollment
                    PO Box 942714
                 Sacramento CA 94229-2714
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                             QUESTION TIME…




                  ?
           TEXT       TEXT




5/1/2009                                      18

								
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