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For Employers (formerly PacificSource Benefit Matters)

 

October 16, 2017

 

New for 2018: Expanded Benefits and Programs

New Telemedicine Service, Teladoc®, Offers Access Option

We will partner with Teladoc to provide virtual doctor visits for our members. The Teladoc service will provide a convenient option for members living in a remote location or who have a difficult time traveling to the doctor.

Members will be able to speak to a licensed doctor by web, phone, or mobile app. And with the Teladoc mobile app, members can schedule a doctor visit, manage their medical history, or even send their prescription to the nearest pharmacy.

Teladoc is a national network of U.S. board-certified physicians and pediatricians that a person can see on-demand 24/7. For a virtual visit with Teladoc, members pay the same as they would a regular office visit.

Gym Discount Program Changes to Active&Fit®

Beginning January 1, members can sign up for a gym membership with Active&Fit. It has a wide network of gyms that are accessible with your membership. GlobalFit® will be discontinued. Members will enjoy multi-facility access to more than 8,500 fitness facilities nationwide for a $25 initiation fee and a $25 monthly fee. For example, a person can go to a 24 Hour Fitness on a Monday, a LA Fitness on a Tuesday, and a YMCA on a Wednesday. Members can receive a free guest pass to try out a fitness facility before enrolling.

Hospital-based Education Program Expands

Hospital-based education classes will be reimbursable up to $150 per member per plan year. There will no longer be a per-class dollar limit. We will also add first aid, CPR, babysitting, and financial planning classes to this benefit enhancement. Note that health screenings are still excluded from the reimbursement. See our hospital-based education page for details. 

Teladoc  

 


Prepare for Flu Season

Peak flu season can begin as early as October and last through May. That means the best time to get the flu shot is right now. You can help your employees and their families prepare for flu season by encouraging them to use their PacificSource benefits and get their flu shots. The earlier the better—it takes about two weeks for the flu shot to be most effective.

Your employees can get a flu shot at no cost to them when they visit a participating provider or pharmacy. Participating providers and pharmacies are listed on our website at PacificSource.com/flu.

Posters and fliers for your workplace

Colorful posters, fliers, payroll stuffers, and table tents can help you promote flu prevention in your workplace. Download these materials for free from our website at PacificSource.com/flu

Workplace flu clinic

You can host an on-site flu vaccine clinic for covered employees, regardless of company size. 

  • One vaccine per member per flu season is covered. The high dose vaccine is not available at these clinics.
  • You can arrange for flu vaccine clinics by contacting one of our participating flu vaccine clinic vendors directly—there’s no need for employers to submit a PacificSource Flu Shot Clinic form. Please see our list of contracted Employer Flu Vaccination Clinic Participating Providers on our website at PacificSource.com/flu.

Please note, you must use a vendor that has a current agreement with us to provide this service; no other vendors will be reimbursed.

If you have questions about your company’s flu shot benefits, or hosting a flu shot clinic at your workplace, contact your PacificSource Client Service Representative.

Whooping cough—the other vaccine

Whooping cough (pertussis) is still a concern. The best way to prevent pertussis is to get a vaccination. However, you may be surprised to learn that the vaccination wears off over time. Preteen children and adults may need a booster.

All PacificSource medical plans have pertussis vaccine coverage under your medical plan’s immunization benefit. Check your plan’s specific benefit, but the vaccine is covered by most plans at little or no cost to members. DTaP (diphtheria, tetanus, and pertussis) is covered for children under age 7, and Tdap (diphtheria, tetanus, and pertussis) booster is covered for children ages 11 to 18 and adults ages 19 to 64.

Mom with sick child  

 


Reminder: Medicare Part D Notices

All employers are required to provide a notice of creditable (or noncreditable) prescription drug coverage to Medicare-eligible individuals covered under a health plan before the enrollment period begins. The Medicare annual enrollment period is October 15 through December 7.

Annually, PacificSource evaluates our standard benefit designs by applying the actuarial value test for creditable coverage determination. We use this information to create our Creditability Determination (matrix) document, which you may use as a starting point to determine whether your prescription drug plan satisfies the requirements of creditable coverage. You will need to consult the pharmacy benefit summary to determine the plan’s description of benefits. If you’re unable to determine your plan’s Medicare Part D creditability from the materials provided, you may request additional information from your sales representative. 

View our Medicare Part D Creditability Matrix at PacificSource.com in Employers > Forms and Materials. Select your state, select Manage Employee Coverage, and then scroll down to the Medicare Part D Notices heading.

 


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