Health insurance

Health insurance is offered to benefit earning employees and eligible dependents. It provides medical care and pharmacy benefits for illness. Costs for care and treatment depend on your plan and if health insurance incentive activities were completed.

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Health plan options

Health insurance is offered to eligible employees and dependents. It provides medical care and pharmacy benefits. Your out-of-pocket costs for care and treatment depend on your plan and if health insurance incentive activities were completed.

Health plan option: Advantage

Plan administrator: PreferredOne

This health insurance plan offers employees comprehensive coverage provided through a limited network of physicians, clinics and hospitals. The plan has both in-network and out-of-network benefits. There are no referrals needed to specialists within your network.

Additional benefits of the plan include:

  • Lower premiums - singles save nearly $400 and families almost $1,100 a year in premiums compared to the standard plan premiums.
  • Three free copays per member per year: includes office visits, urgent care or online care for illness or injury.
  • Special concierge phone line to provide assistance, referral information and to answer any questions about your network.

Is HCMC covered under the Advantage network?

Yes, beginning in 2015 HCMC is covered under the Advantage-HCMC/NorthPoint plan. HCMC is not included in the provider network of the other two Advantage networks.

What's the catch?

There is no catch. Because your care is provided through a narrower network, the county believes care will be more coordinated, the quality will be better and costs will be less, with fewer duplicate services or unnecessary care. The entire expected savings has been passed on to our employees in lower premiums for 2015.

Network/tiers

With Advantage you select the network that is right for you. You are able to see any provider in that network for the same co-pay; there are no tiers. If you see a provider not in your network, you will be charged at the out-of-network level of benefits.

How it works

  • Choose a network: be sure to use the PreferredOne provider search to confirm all your providers are in your chosen network:
    • Fairview / North Memorial / HealthEast (FV/NM/HE)
    • HealthPartners / Park Nicollet (HP/PN)
    • Hennepin County Medical Center / NorthPoint (HCMC/NP) - new for 2015
  • Review coverage summary
  • Enroll:
    • All family members must be enrolled in the same network.
    • A family status change only allows the adding or dropping of dependents to the health plan you are currently enrolled in. You must wait until the next open enrollment to change your health plan.
    • To add or drop coverage after a qualifying event, submit the family status change form (DOCX) and the required documentation. The effective date of coverage can be found on the family status change form.

Health plan option: Standard

Plan administrator: PreferredOne

This health insurance plan offers comprehensive benefits in and out-of-network. The provider network is tiered based on quality and cost ratings. The tier of the provider you see will determine your out-of-pocket costs, such as deductibles and copays. Each covered family member may use providers in any tier. There are no referrals; you have access to all the providers within the network.

How it works:

  • Review the network
  • Check provider tiering
  • Effective 1/1/15 HCMC will no longer be at $0 copay
  • Review coverage summary
    • A family status change only allows the adding or dropping of dependents to the health plan you are currently enrolled in. You must wait until the next open enrollment to change your health plan.

    Additional information - both plans

    If you added a spouse to health insurance during open enrollment, both the employee's and spouse's health incentive for 2015 is dependent on the employee having completed the 2014 incentive requirement.

    Health plan changes for 2015

    As a result of changes to the Affordable Care Act (ACA), the following pharmacy changes will be effective January 1, 2015:

    • 100% coverage for tobacco cessation medications:
      • Limited to two attempts per year
      • Covers prescription and over-the-counter medications, such as Zyban, Nicoderm patch, Nicorrette gum, Chantix, for a 90-day treatment regimen
    • 100% coverage for medications for risk reduction of primary breast cancer in women:
      • For women who are at increased risk for breast cancer
      • Includes tamoxifen and raloxifene

    Premiums

    Premiums are deducted from the first and second paycheck each month on a pre-tax basis.

    Advantage plan costs for 2015

    Fairview / North Memorial / HealthEast OR HealthPartners / Park Nicollet

    Coverage tiers County costs Employee cost
    Single $587.88/month $41.86/month
    Single + spouse $1,166.02/month $313.82/month
    Single + child/ren $893.16/month $240.34/month
    Family (employee, spouse, children) $1,386.40/month $345.34/month

    Advantage plan costs for 2015

    Hennepin County Medical Center / NorthPoint

    Coverage tiers County cost Employee cost
    Single $587.88/month $8.72/month
    Single + spouse $1,166.02/month $235.96/month
    Single + child/ren $893.16/month $180.68/month
    Family (employee, spouse, children) $1,386.40/month $254.20/month

    Standard plan costs for 2015

    Coverage tiers County cost Employee cost
    Single $587.88/month $75.00/month
    Single + spouse $1,166.02/month $391.70/month
    Single + child/ren $893.16/month $300.00/month
    Family (employee, spouse, children) $1,386.40/month $436.48/month


    Save money

    Reduce your health care costs by taking advantage of the following programs and options:

    • Reduce your copay by participating in the health insurance incentive program.
    • Visit the Be Well Clinic where no copay is required.
    • Pay less on prescriptions by:
    • Try online diagnosis and treatment for colds, coughs, and allergies using
      • Virtuwell (Advantage - HealthPartners / Park Nicollet, Standard)
      • Zipnosis (Advantage - Fairview / North Memorial/ HealthEast, Standard)
      • E-visits (Advantage - Hennepin County Medical Center / NorthPoint

    Provider contact information

    Contact providers to schedule appointments, discuss care coordination and obtain other information.

    HealthPartners / Park Nicollet

    952-967-7108

    800-861-1868

    7 a.m. - 7 p.m.

    Fairview / North Memorial / HealthEast

    612-672-2952

    855-821-4832

    24/7

    Hennepin County Medical Center / NorthPoint

    612-873-5700

    Health plan administrator: PreferredOne

    • Visit PreferredOne online or
    • Call 763-847-4477 (Toll free: 1-800-379-7727) Monday - Friday, 7 a.m. - 7 p.m.

    Pharmacy

    To search for a participating pharmacy or view pharmacy benefit information:

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