Benefits Information for 7/1/18-6/30/19 plan year
Medical and Rx Plans:Effective July 1st, a new plan option Open Choice 3 is available to District Employees.* Open Choice 3 is a lower cost option for employee health insurance. It is a partial deductible style plan and some categories of coverages will have to meet a deductible in lieu of a standard co-pay arrangement. The deductible is applicable only to ambulance, blood/blood products, DME, home health care, hospice, infusion therapy, diagnostic/x-ray/lab services, prosthetics, and private duty nursing. Prentative care remains fully covered under this new plan. Please check out the comparison chart below and this Aetna presentation (slides 6-7) to see the differences in the new plan. Aetna PresentationThis chart contains a comparison of the 4 medical plans available July 1, 2018 (OC1, OC2, POS, OC3): Comparison Chart - Med. Plans 18-19Rx BCMS POS (**)BMCS Open Choice 3 Deductible Plan - new for 2018-19Rx Open Choice (same as OC2)Mail Order Rx: Mail Order is no longer required. Filling prescriptions at the pharmacy are the same cost as mail order.(*) Eligibility may be limited to some employees due to collective bargaining.(**) Rx Plan for POS has been slightly amended for ESPA, Secretary, and Confidential Secretary Groups to include a $30 non-formulary co-pay. Plan summary will be posted when received from CVS.
Lab Work Cost Comparisons:
Know before you go: All members should be aware of the costs associated with lab work. Members on the Open Choice 3 should especially be cognizant of the different costs that may be incurred based solely on where the work is done.
Quest Diagnostics is Aetna’s preferred lab vendor which allows Aetna members to receive low contracted rates. Quest is almost always the lowest cost. Check out these comparisons showing that the same test at an area in-network hospital may be a thousand ($1,000) dollars more than at a Quest lab. Lab Comparison - Quest/Aria - Lab Comparison- Quest/Doylestown - Lab Comparison- Quest/StMary
Remember to use the member payment estimator tool located in Navigator (Aetna’s secured member portal) to research lab services as well as many other lower cost options for MRIs, CT scans, etc.
District Health Plans - 7/1/2017-6/30/2018Summary of Benefits Coverage Documents in SBD Format-Coverage Period 7/1/17 – 6/30/18