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.

If both you and your spouse are benefit-eligible employees of the county:

  • An employee cannot be covered both as an employee and a dependent.
  • Only one employee may cover their child/ren.
Expand all information

Health plan options

Health insurance is offered to eligible employees and dependents. It provides medical and pharmacy benefits, plus preventive dental for children to age 19. 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 $1,300 a year in premiums compared to the standard plan premiums.
  • Two free copays per member per year after the deductible is satisfied. Includes office visits and urgent care for illness or injury.
  • Special concierge phone line to provide assistance, referral information and to answer any questions about your network.

Summary of benefits

HealthPartners / Park Nicollet and Fairview / North Memorial / HealthEast

HCMC / Northpoint

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

1. Choose a network: be sure to use the PreferredOne provider search to confirm all your providers are in your chosen network.

2. Review coverage summary

3. To add or drop health, dental or vision coverage for you and/or your dependents after a qualifying life event (see below) you will need to:

  • Scan any required documentation for your life event and save on your computer
  • Log in to APEX and navigate to My Pay and Benefits>Benefits>Life Events
  • Enter the date of your life event and click OK
  • Read the information on the Welcome Page and follow the directions to update your information

For more information on adding or dropping coverage, see the benefits eligibility and enrollment page.

Health plan option: Standard

Plan administrator: PreferredOne

This health insurance plan offers comprehensive benefits through a broad network of providers. 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.

Summary of benefits

How it works

  • Review the network
  • Check provider tiering — some are changing for 2017
  • Review coverage summary
  • A life event 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.

Premiums

Due to increased medical claims costs on our plan, as well as the overall increased cost of healthcare, health premiums will be increasing for 2017. Premiums are deducted from the first and second paycheck each month on a pre-tax basis.

Advantage plan costs for 2017

Fairview / North Memorial / HealthEast OR HealthPartners / Park Nicollet

Coverage tiers County costs Employee cost
Single $648.76/month $51.86/month
Single + spouse $1,297.22/month $349.20/month
Single + child/ren $993.76/month $267.34/month
Family (employee, spouse, children) $1,528.08/month $384.18/month

Advantage plan costs for 2017

Hennepin County Medical Center / NorthPoint

Coverage tiers County cost Employee cost
Single $638.82/month $18.72/month
Single + spouse $1,285.12/month $260.04/month
Single + child/ren $984.34/month $199.18/month
Family (employee, spouse, children) $1,528.08/month $280.10/month

Standard plan costs for 2017

Coverage tiers County cost Employee cost
Single $666.32/month $85.00/month
Single + spouse $1,321.50/month $444.04/month
Single + child/ren $1,012.38/month $339.98/month
Family (employee, spouse, children) $1,571.46/month $494.62/month

Save money

Reduce your health care costs

Reduce your copay by participating in the health insurance incentive program.

Visit the Be Well Clinic where no office visit copay or deductible is required. (Prescription drug copays do apply)

Use online care for 30 of the most common conditions. There are no copays or deductibles.

  • Virtuwell (Advantage - HealthPartners / Park Nicollet, Standard)
  • Zipnosis (Advantage - Fairview / North Memorial/ HealthEast, Standard)
  • E-visits (Advantage - Hennepin County Medical Center / NorthPoint)
  • MDLive (all plans)

Pay less on prescriptions by:

Health club membership discount

Trade time for fitness

Provider contact information

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

Advantage — HealthPartners / Park Nicollet

  • 952-967-7108 or 800-861-1868
  • 7 a.m.–7 p.m., Monday–Friday

Advantage — Fairview / North Memorial / HealthEast

  • 612-672-2952 or 855-821-4832
  • 24/7

Advantage — Hennepin County Medical Center / NorthPoint

  • 612-873-5700
  • 7:30 a.m.–9 p.m., Monday–Friday
  • 8:30 a.m.–5 p.m., Saturday and Sunday

Health plan administrator: PreferredOne

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

Pharmacy

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

Health plan changes for 2017

Advantage Plan — HealthPartners / Park Nicollet and Fairview / North Memorial / HealthEast

There is a $150 single person deductible or $300 family deductible for medical services. A deductible is the amount of money you must pay for your medical expenses before your insurance will cover the costs of your medical care: hospital stays, emergency room visits, doctor visits, etc.

The deductible does NOT apply to the following:

  • Preventive services
  • Be Well Clinic visits
  • Online care
  • Allergy injections
  • Prescription drugs
  • Office visits for mental health/substance abuse

There are 2 free office visit copays after satisfying the deductible.

Office visit copay for the following services will increase by $5 per visit:

  • Illness / injury
  • Occupational therapy / physical therapy / speech therapy
  • Chiropractic / acupuncture
  • Scheduled outpatient hospital non-surgical
  • Urgent care
  • Convenience care – example Target Clinic
  • Allergy testing

Office visit copay for the following services will increase by $10 per visit:

  • Home health care
  • Non-preventive dental services

Generic drug copay will increase from $20 to $25 per prescription.

Brand drug copay will increase from $40 to $50 per prescription.

Out of network services:

  • The single person deductible increases from $500 to $1000, and the family deductible increases from $1,500 to $3,000 and is completely separate from the in-network deductible.
  • The out of pocket maximum increases from $2500 to $3500 and is completely separate from the in-network out of pocket maximum.

Advantage Plan — HCMC / Northpoint

There are 2 free office visit copays.

Office visit copay for the following services will increase from $0 to $5 per visit (with incentive) at HCMC/NorthPoint facilities. Other in-network providers will increase by $5:

  • Illness / injury
  • Occupational therapy / physical therapy / speech therapy
  • Chiropractic / acupuncture
  • Scheduled outpatient hospital non-surgical
  • Urgent care
  • Convenience care – example Target Clinic
  • Allergy testing

Office visit copay for the following services will increase by $10 per visit:

  • Home health care
  • Non-preventive dental services

Generic drug copay will increase from $20 to $25 per prescription.

Brand drug copay will increase from $40 to $50 per prescription.

Out of network services:

  • The single person deductible increases from $500 to $1000, and the family deductible increases from $1,500 to $3,000 and is completely separate from the in-network deductible.
  • The out of pocket maximum increases from $2500 to $3500 and is completely separate from the in-network out of pocket maximum.

Standard Plan

There is a $150 single person deductible and $300 family deductible increase for medical services in each tier. A deductible is the amount of money you must pay for your medical expenses before your insurance will cover the costs of your medical care: hospital stays, emergency room visits, ambulance, doctor visits, etc.

The deductible does not apply to the following:

  • Preventive services
  • Be Well Clinic visits
  • Online care
  • Allergy injections
  • Prescription drugs
  • Tier 1 office visits for mental health/substance abuse

Office visit copay for the following services will increase by $5 per visit:

  • Illness / injury
  • Occupational therapy / physical therapy / speech therapy
  • Chiropractic / acupuncture
  • Home health care
  • Non-preventive dental services
  • Scheduled outpatient hospital non-surgical
  • Urgent care
  • Convenience care – example Target Clinic
  • Allergy testing

Office visit copay for the following services will increase by $10 per visit:

  • Home health care
  • Non-preventive dental services
  • Urgent care
  • Mental health/substance abuse (Tiers 2 and 3)

Generic drug copay will increase from $20 to $25 per prescription.

Brand drug copay will increase from $40 to $50 per prescription.

Out of network services:

  • The single person deductible increases from $500 to $1000, and the family deductible increases from $1,500 to $3,000 and is completely separate from the in-network deductible.
  • The out of pocket maximum increases from $2500 to $3500 and is completely separate from the in-network out of pocket maximum.

Top tiering changes for 2017

Health plan 2017 tiering 2016 tiering
Entira 1 2
HealthPartners Clinics 1 2
Northwest Family Physicians 2 1
Collapse all information
Top