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| Volume 3, Issue 15: July 28, 2008 |
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Oregon CoDeduct Value Plans Help Stretch Coverage Dollars Employers faced with rising costs and tight budgets may wonder how they can afford to offer healthcare coverage. Our new, low-cost CoDeduct Value 70% and CoDeduct Value 80% plans provide a way that they can offer their employees essential coverage and stay within their health insurance budget. The streamlined CoDeduct plans, some with unbundled benefits, feature higher out-of-pocket limits (depending on the deductible) and more deductible choices—from $300 through $7,500. Employees enjoy the benefits of group health coverage, while taking greater responsibility for the cost of their own healthcare. For example, in most cases, advanced imaging services require a per-test copay in addition to the medical deductible. These one-page comparisons highlight the differences between our CoDeduct and CoDeduct Value plans:
Our CoDeduct Value 70% and CoDeduct Value 80% plans are currently available to small groups (2–50 eligible employees) and will be available to large groups beginning October 1. Large groups that renew prior to October 1 can request to make an off-renewal move to one of these plans after they become available. Visit our Oregon Plan Summaries page in the For Agents area of our Web site for details, and feel free to contact us for additional information. Please Submit September New Groups or Renewals by August 15 This fall, we will transition our non-SEHI medical groups and all dental-only groups to our new claims system. Because of the preparation required to ensure an efficient, seamless transition for your groups, we will need your assistance. We ask that you submit September non-SEHI new groups or renewals by August 15. From August 22 to September 8, we will be unable to enter new large groups, or change benefits or eligibility for current groups not yet converted to our new system. (This temporary freeze of our old system’s benefits and eligibility data will not affect new SEHI groups, or groups already transitioned to our new claims system.) While we will have some processes in place to assist with emergency situations, any affected groups not received by August 15 may be subject to delays. Thank you for your cooperation. Your assistance will help us ensure accurate data conversion into the new system, prevent errors, and keep our turnaround times on track. As always, if you have any questions or concerns, you are welcome to contact us. Employee Waiting Period Clarified for New Small Groups We found that we previously misinterpreted the OAR regulation (OAR 836-053-0021 (1) (b)) concerning small group enrollment and incorrectly allowed new small groups ( 2-50 employees) to enroll all employees, regardless of whether or not each employee met the probationary waiting period. Beginning in August, we will revise our Oregon new group enrollment policy as follows:
Our Request for Oregon Group Insurance Form has been updated with language that reflects this change. We have made minor changes to the Request for Idaho Group Insurance Form as well. This policy will now be consistent for both Oregon and Idaho groups.
If you have questions, please feel free to contact us. Members Saving Money by Choosing Generics With prices for many products—from gas to granola—on the rise, consumers are looking for every opportunity to save money. That makes generics more important than ever, since they can offer substantial savings over their brand equivalents. Some of our members are already saving money by choosing generics. Here are a few interesting statistics from the first quarter 2008 for PacificSource members using Caremark®:
As you might guess, groups whose plan provisions require members to pay the difference between generic and brand drugs have a higher generic dispensing rate. In addition, groups that have a three-tier drug plan, with at least a $10 to $15 differential between generic and brand drugs, tend to have a higher generic dispensing rate as well. If you have a large employer that has a non-standard pharmacy plan that has no incentives for a member to select generics, they may save premium and improve their pharmacy claims experience by implementing a tiered copay structure or a generic incentive provision. We encourage our members to choose generics whenever possible, and provide educational member information and resources, including:
To all of you who are helping educate groups and members about generics, we would like to say “keep up the good work!” Through these efforts we can make a positive impact on the lives of the members we serve. If you would like printed copies of any of our materials, please contact your Client Service Representative. PacificSource Sponsors CE Classes in Portland August 26 Classes in Portland (Six credit hours total)
Invitations will be e-mailed with class and registration details. Class space is limited, so be sure to register as soon as you receive your invitation. Please e-mail Marketing Agent Coordinator Candice Manning (Wilkins) to register or for more information. For details, check our 2008 schedule in the For Agents/Prof’l Development section of our Web site. OAHU State Convention 2008 Idaho Fraud Awareness Week 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:
Evening at the Chateau—The Arc of Lane County Sand Dollar Auction—The Rinehart Clinic Music on the Halfshell Grants Pass Concerts in the Park Alive After Five Summer Concert Series Munch & Music Concert Series |
Questions? You’re always welcome to contact us! |
Eugene Bend Boise Medford |
Portland Manley Services Select Benefit Administrators |
