UnitedHealthcare Announces New Plans Under
GA-23111
For Former Railroad Employees and their Eligible Dependents
(not eligible for Medicare)
UnitedHealthcare
is pleased to announce that for the upcoming open enrollment for 2008, three
new benefit plans are available under GA-23111. These new benefit plans, called
Plans A, B and C, provide new options with different costs and plan designs
allowing individuals to select the plan best suited for their needs.
Special Enrollment Period – April and
May 2008
Due
to the addition of these three new plans, a special two month open enrollment period is being offered for this
year only. The open enrollment period will begin
April 1st and run through May
31st with the coverage you select effective June 1, 2008. After
this 2008 enrollment period, the next open enrollment will be May 2010. (Note that this 2008 expanded enrollment
period also applies to other Plans under GA-23111 such as Plan E and Plan F.)
Plan Design of Plans A, B, and C
Some
of the services provided by these new plans are outlined below. Please review the accompanying chart for more
details.
While
all of the benefits offered by each plan are the same, they differ in the
following areas:
·
Annual Deductible
·
Annual
Out-of-Pocket Maximum
·
Percentage of Eligible
Expenses Covered
·
Monthly Cost
You pay a separate monthly cost for yourself and for
your dependents. The monthly cost for your dependents is inclusive of all of
your eligible dependents (spouse, children under age 19, students age 19 to 25,
and incapacitated children age 19 and over).
The monthly cost for each of the new plans effective
June 1, 2008 is:
·
Plan A - $250
·
Plan B - $325
·
Plan C - $400
|
Current
Enrollees in GA-23111 Plans B or C Need to Take Action Current Plans B and C will be replaced by these new options.
If you are currently enrolled in Plans
B or C, you need to select a
new plan or the following will occur, effective June 1, 2008: ·
Current Plan B
enrollees will automatically default to the new Plan A ·
Current Plan C
enrollees will automatically default to the new Plan C Note: Any current enrollees in Plan B or C who do
not wish to continue their participation in one of the new plans can contact
the |
Obtaining Additional Information on
Plans A, B, and C
If
you are interested in enrolling under any of the new benefit plans, please
contact UnitedHealthcare at 800-842-5252. One of UnitedHealthcare’s Customer Care
Professionals would be happy to
provide you with the following:
|
UnitedHealthcare GA-23111
Plans A, B, and C Benefit Summaries |
|||
|
Benefit |
Plan A |
Plan B |
Plan C |
|
Monthly
cost |
$250 |
$325 |
$400 |
|
Annual
deductible |
$1,000 |
$750 |
$500 |
|
Annual
out of pocket limit |
$15,000 |
$10,000 |
$7,500 |
|
Lifetime
maximum benefit |
$500,000 |
$500,000 |
$500,000 |
|
Inpatient
hospital services* (includes maternity & inpatient mental health and
substance abuse services) Surgical
procedures (surgeon, anesthesiology & facility; ambulatory surgical
center and outpatient surgical center) |
50% of eligible
expenses after satisfying deductible. |
60% of eligible
expenses after satisfying deductible. |
70% of eligible
expenses after satisfying deductible. |
|
Medical
services/ physician’s office visits |
50%
of eligible expenses after satisfying deductible. 100% of eligible expenses
w/out deductible for Mammography and Pap Smear. |
60%
of eligible expenses after satisfying deductible. 100% of eligible expenses
w/out deductible for Mammography and Pap Smear. |
70%
of eligible expenses after satisfying deductible. 100% of eligible expenses
w/out deductible for Mammography and Pap Smear. |
|
Outpatient
mental health and substance abuse services |
75%
of eligible expenses after satisfying deductible for first 40 visits in
Calendar Year (CY); 60% thereafter. |
75%
of eligible expenses after satisfying deductible for first 40 visits in
Calendar Year (CY); 60% thereafter. |
75%
of eligible expenses after satisfying deductible for first 40 visits in
Calendar Year (CY); 60% thereafter. |
|
Outpatient
rehabilitation (physical, occupational, speech therapy and chiropractic)
|
50%
of eligible expenses after satisfying deductible. Limited to 30 visits per CY.
Exception: CY visit limit does not apply to services for a child under age 21
with a congenital or birth defect. |
60%
of eligible expenses after satisfying deductible. Limited to 30 visits per CY.
Exception: CY visit limit does not apply to services for a child under age 21
with a congenital or birth defect. |
70%
of eligible expenses after satisfying deductible. Limited to 30 visits per CY.
Exception: CY visit limit does not apply to services for a child under age 21
with a congenital or birth defect. |
|
Allergy/acupuncture
services |
50%
of eligible expenses after satisfying deductible. |
60%
of eligible expenses after satisfying deductible. |
70%
of eligible expenses after satisfying deductible. |
|
Emergency
room services |
50%
of eligible expenses after satisfying deductible. |
60%
of eligible expenses after satisfying deductible. |
70%
of eligible expenses after satisfying deductible. |
|
Durable
medical equipment* |
50%
of eligible expenses after satisfying deductible. |
60%
of eligible expenses after satisfying deductible. |
70%
of eligible expenses after satisfying deductible. |
|
Prescription
drugs (this benefit provides for a discount program; this is not insurance) |
UnitedHealth
Allies (UHA) Discount RX Program - discount savings avg. 25% to 35% or higher
on commonly prescribed generic/brand name Rx’s bought at a participating
retail location or UHA mail-order service. |
UnitedHealth
Allies (UHA) Discount RX Program - discount savings avg. 25% to 35% or higher
on commonly prescribed generic/brand name Rx’s bought at a participating retail
location or UHA mail-order service. |
UnitedHealth
Allies (UHA) Discount RX Program - discount savings avg. 25% to 35% or higher
on commonly prescribed generic/brand name Rx’s bought at a participating
retail location or UHA mail-order service.
|
|
Home
health care services* |
50%
of eligible expenses after satisfying deductible up to 30 visits per CY. |
60%
of eligible expenses after satisfying deductible up to 30 visits per CY. |
70%
of eligible expenses after satisfying deductible up to 30 visits per CY. |
|
Hospice
facility* |
50%
of eligible expenses after satisfying deductible. |
60%
of eligible expenses after satisfying deductible. |
70%
of eligible expenses after satisfying deductible. |
|
Skilled
nursing facility* (SNF) |
50%
of eligible expenses after satisfying deductible for up to 31 days per stay
in SNF. |
60%
of eligible expenses after satisfying deductible for up to 31 days per stay
in SNF. |
70%
of eligible expenses after satisfying deductible for up to 31 days per stay
in SNF. |
|
Emergency
ambulance services |
50%
of eligible expenses after satisfying
deductible in the event of an emergency.
|
60%
of eligible expenses after satisfying deductible in the event of an
emergency. |
70%
of eligible expenses after satisfying deductible in the event of an emergency.
|
* Requires prior notification – Care
Coordination must be contacted to determine whether the purchase, rental of
equipment (over $1,000) or services provided are medically appropriate.