New Options Offer Better Access, Lower Cost for Flu Shots

We’re pleased to announce an expansion of our flu shot coverage for the 2008 flu season. Beginning this year, PacificSource members can enjoy greater access and less out-of-pocket expense for flu vaccinations by utilizing flu shot clinics at select retail pharmacy chains or their county health department.

Pharmacies

PacificSource and CVS/Caremark^® have contracted with pharmacies at Albertsons, Bi-Mart (Amerisource), Fred Meyer, and Safeway for direct billing on flu shot clinics.

• Members must have a pharmacy benefit and show their PacificSource member ID card to receive this benefit. (This benefit is not available on Short Term Medical policies.)
• The flu shot is free to members; any copay and/or deductible will be waived.
• If a member receives a flu shot from a pharmacy other than the chains listed above, the member will need to submit their receipt for reimbursement, subject to the nonparticipating provider benefit, even if the pharmacy is part of the CVS/Caremark^® network.

County Health Departments

Flu shots will be covered at the participating provider benefit level, even if the health department is a nonparticipating provider or out of our service area.

• The flu shot will be paid under the immunization benefit of the member's health policy.
• Applicable copays and/or deductibles apply. These are listed in the benefit summary section of the member’s handbook under “participating providers.”

Employer-sponsored Flu Shot Clinics

As in past years, groups with 100 or more covered employees and medical coverage through PacificSource are eligible for reimbursement if certain criteria are met.

• A Flu Shot Clinic Request Form must be received and approved by PacificSource prior to the flu shot clinic.
• If coverage is approved, benefits will be paid up to $25 per injection for covered employees.
• Interested groups may contact their Client Service Representative for more information.

Other Flu Shots

Flu shots obtained from the member’s physician or from other flu shot clinics will continue to be covered under the member's medical plan.

• Benefits are paid under the preventive care/immunization benefit.
• Applicable copays and deductibles apply.
• Participating or nonparticipating provider provisions apply.
• Our 2008 flu shot allowances are based on Medicare rates.

For more information, you may contact your PacificSource Client Service Representative.

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2009 HSA Amounts and FAQ Available

The 2009 Indexed amounts for HSAs have been released by the U.S. Treasury Department and Internal Revenue Service.

• The maximum annual HSA contribution for an eligible individual with self-only coverage will be $3,000.
• For family coverage, the maximum annual HSA contribution will be $5,950.
• Catch-up contributions for individuals who are 55 or older will increase by statute to $1,000 for 2009 and all years going forward.
• Individuals who are eligible on the first day of the last month of the taxable year (December for most taxpayers) will be allowed the full annual contribution (plus catch-up contribution, if 55 or older by year end) regardless of the number of months the individual was eligible in the year. For those who are no longer eligible individuals on that date, both the HSA contribution and catch-up contribution will apply pro rata based on the number of months of the year a taxpayer is an eligible individual.

Notice 2008-59 (51 KB PDF) was also recently released by the Treasury and contains more than 40 new frequently asked questions and answers that cover a wide range of HSA topics, including:

• Who is an Eligible Individual
• Issues related to High Deductible Health Plans
• Contributions
• Distributions
• Establishing an HSA

The notice also includes information about:

• Employer clinics: Question 10 explains that individuals can still be eligible to participate in a high-deductible health insurance plan linked to an HSA even if they have access to free or discounted healthcare provided by their employer’s on-site clinic, as long as the clinic does not provide significant medical care. For example, an employee could receive physicals, immunizations, and first aid from their employer's on-site clinic and still be eligible.
• Contributions made in error: Questions 23 and 24 of the notice describe when an employer may request a refund of HSA contributions made in error. For example, if an employer contributes on behalf of an employee, and then discovers that the employee was not actually eligible, the employer may request a refund from the financial institution holding the account. Amounts not recouped before the end of the tax year need to be included on the employee’s W-2 form.
• Distributions for Medicare Part D: Questions 29 and 30 explain that premiums for Medicare Part D for the account beneficiary, their spouse, or their dependents are qualified medical expenses only if the account beneficiary has attained age 65.

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New Sales Flier Lists Participating Hospitals

We’ve created a new sales flier, The PacificSource Network: Hospitals to specify participating hospitals and medical centers in our service area. For your convenience, facilities are grouped by general geographic region—Portland metro, Oregon coast, Willamette Valley, southern Oregon, central Oregon, Columbia Gorge, eastern Oregon, southwest Washington, and western Idaho. The flier is available in the For Agents/Materials area of our Web site, or contact us for printed copies.

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Large Groups Learn about Upcoming Technology Upgrade

This week, our Client Service and Membership Representatives began meeting with large group administrators to discuss the changes they can expect when we transition them to our new claims system this fall.

The representatives will distribute copies of a Technology Upgrade billing insert (1 MB PDF), which will also be included with the large group August billing statements, which mail this month. The flier introduces our new claims system, and provides an overview of the new billing statements and procedures, group and member numbers, and member ID cards.

As you will recall, we transitioned our small group and individual business to the new claims system last summer. We are currently performing rigorous testing to ensure the transition is as smooth as possible for our remaining clients this fall. We will share more specific information about the timing as we complete testing and confirm our implementation dates.

We’ll inform enrolled members directly about their ID cards and changes to InTouch for Members. In addition, we are in the process of developing several communication tools that groups can use to communicate to their employees. This “Communication Toolkit” will include payroll stuffers, posters, e-mail scripts, and sample newsletter articles. As these materials are completed, we will make them available online.

Please feel free to contact us if you have any questions.

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Healthy at Heart^™ and Diabetes Control Network Discontinued

We have discontinued our Healthy at Heart and Diabetes Control Network disease management programs and have stopped enrolling new participants. Due to recent program cost increases, we determined that these programs would no longer be cost-effective to offer. We are actively researching similar programs and will let you know as soon as we have found suitable replacements. The programs will continue for current participants until each of their program periods (program years) are complete. Please recycle any Healthy at Heart and Diabetes Control Network fliers that you may have on hand. We’ve updated our sales materials and member benefit materials to reflect this change; you’ll find them in the For Agents/Materials area of our Web site, or contact us for printed copies.

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OAHU Events

OAHU State Convention 2008
August 6–8, Redmond, Oregon, Eagle Crest Resort
Eight hours of continuing education credits have been applied for. For more information, visit the Oregon Association of Health Underwriters Web site at www.orahu.org.

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Upcoming Community Events

PacificSource is proud to sponsor Northwest community events that support healthy communities and health-focused organizations. We hope you will join us in supporting these events:

PacificSource Representatives were on hand to answer questions at the Eugene 08 Festival during the 2008 U.S. Olympic Team Trials—Track & Field. PacificSource was proud to be an event sponsor.

Relay For Life—American Cancer Society
July 12 through 13, Tigard/Tualatin, Oregon

Catholic Community Services of Lane County Annual Dinner and Auction
July 17, Eugene, Oregon

Bike MS 2008
July 19 through 20, Sweet Home, Oregon

Relay For Life—American Cancer Society
July 25 through 26, Eugene, Oregon, Lane Community College

Music on the Halfshell
Tuesdays through August 12, Roseburg, Oregon, Stewart Park

Munch & Music Concert Series
Thursdays through August 14, Bend, Oregon, Drake Park

Grants Pass Concerts in the Park
Tuesdays through August 26, Grants Pass, Oregon, Riverside Park

Alive After Five Summer Concert Series
Wednesdays through September 24, Boise, Idaho, The Grove Plaza

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