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2014 Benefit Plan. Blue Health and Savings Plan. Bayer Corporation. 2014 Plan Offering. Bayer has a consumer driven health plan through Anthem Blue Cross Blue Shield called Blue Health and Savings Plan that is coupled with a Health Savings Account (HSA).

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2014 plan offering
2014 Plan Offering
  • Bayer has a consumer driven health plan through Anthem Blue Cross Blue Shield called Blue Health and Savings Planthat is coupled with a Health Savings Account (HSA).
  • This plan is designed to help you learn more about your health care options and take greater control of your health care spending (called consumer driven health plans).
  • The Blue Health and Savings Plan provides….
    • Medical coverage through Anthem Blue Cross and Blue Shield
    • Pharmacy coverage through Caremark
    • Access to your HSA account through PayFlex
preventive care coverage at 100 includes
Preventive Care Coverage at 100% Includes:
  • Wellness exam – all ages – covered in accordance with AMA guidelines.
  • Immunizations (including those required for school), flu and pneumonia injections are covered.
  • Annual medical diabetes eye exams
  • Preventive office labs and independent lab services
  • Preventive Mammography
  • Preventive Pap smear and related lab fees with OB/GYN office
  • Preventive Colorectal screenings (colonoscopy, sigmoidoscopy or colorectal exam)
  • Prostate specific antigen (PSA) screening
  • Other preventive exams or tests as determined to be Medically Necessary.
  • Note: Preventive care is covered at 100%, both In-Network and Out-of-Network (up to the allowed amount).
healthcare reform women s preventive care
Healthcare Reform: Women’s Preventive Care
  • Required by The Affordable Care Act (ACA or health care reform law)
  • The following services are covered, with no cost share:
    • Well-woman visits for women to obtain the recommended preventive services that are age and developmentally appropriate
    • Screening for gestational diabetes
    • Testing for human papillomavirus (HPV) in women
    • Counseling for sexually transmitted infections for all women
    • Screening and counseling for human immunodeficiency virus (HIV) for all women
    • FDA-approved contraception methods and contraceptive counseling, as prescribed, including sterilization procedures, and patient education and counseling for women*
      • Includes surgically implanted IUD devices, such as Mirena

Continued…

healthcare reform women s preventive care1
Healthcare Reform: Women’s Preventive Care
      • Facility charges for sterilization performed at the same time as a maternity stay will only be covered at 100% if the primary purpose of the facility stay was for the sterilization procedure.
      • If the primary purpose was maternity delivery, the facility stay will not be covered as preventive, but will be covered as maternity or medical.
      • Male sterilization is not covered at 100%, under this provision.
      • Sterilization reversals are not covered.
    • Breastfeeding support, supplies and counseling, including breast pumps (rental and purchase) and breast pump supplies
      • Breast pumps are limited to 1 per year and must be obtained from an In-Network DME supplier.
    • Screening and counseling for interpersonal and domestic violence
  •  *Medical contraceptives and sterilization (office and facility-based medical and surgical procedures) are covered under the medical plan. Please check with Caremark for the coverage of pharmacy prescription contraceptives.
what is the blue health and savings account
What is the Blue Health and Savings Account?
  • The Blue Health and Savings Plan provides….
    • Medical coverage through Anthem Blue Cross and Blue Shield
    • Pharmacy coverage through Caremark
    • Access to your HSA account through PayFlex
      • Health Savings Accounts (HSA) are tax-advantaged interest bearing checking accounts
      • The HSA money can be used to help pay the cost of out-of-pocket medical and prescription drug expenses or for long term investment purposes
      • HSAs must be coupled with an HSA-compatible high deductible health plan (HDHP) in order to make contributions to the account
how the blue health and savings plan works
How the Blue Health and Savings Plan Works

Preventive Care

100%

HSA Funded by you to help satisfy annual deductible and save for future medical expenses

Annual Deductible

Traditional Health Coverage

  • Stay healthy with Preventive Care coverage
  • Youmake contributions to your account to use toward your deductible and/or co-insurance to pay for medical care and prescription drugs
  • Once you have satisfied your annual deductible, Traditional Health Coverage then covers additional expenses (similar to a PPO)
  • An annual out-of-pocket maximum protects you from large medical expenses
insurance terminology
Insurance Terminology
  • Deductible– The amount you must pay each year before the plan begins paying
    • Example: You may have to pay $1,600 before the plan will pay a benefit
  • Copayment – A flat fee you pay each time you receive health care treatment
    • Example: You may pay $20 each time you visit your doctor; $40 for a specialist
    • Note: Copayments are not applicable for the Blue Health & Savings Plan
  • Coinsurance – A percentage paid of allowable charges by the insurance provider and you after the deductible amount has been paid
    • Example: Insurance may pay 90% of allowable charges for a hospital bill and you may be responsible for 10% after you meet your deductible
  • Out-of-Pocket Maximum –The most you will pay out of your own pocket for health care services during the calendar year for coinsurance. The Out-of-Pocket Maximum includes the deductible.
    • Example: Once you pay $3,000 within a calendar year, the plan will pay 100% of all services in that year
blue health and savings plan details at a glance
Blue Health and Savings Plan Details At-a-Glance

Prescriptions are subject to the deductible and coinsurance

being a wise consumer
Being a Wise Consumer
  • Visit a retail health clinic, walk-in doctor’s office or urgent care center for some health problems
    • Say you have a health problem that isn’t an emergency (like a low fever, upset stomach, rash or sprain), but you can’t see your regular doctor. Instead of the emergency room (ER), think about going to an in-network retail clinic, walk-in doctor’s office or urgent care center. Here’s why:
      • They can take less time than an ER.
      • Most are open nights and weekends.
      • They cost about the same as a regular doctor’s visit.
      • And you could save $75 to $240.*
  • The “find a doctor” feature on anthem.com makes it easy to find lower-cost care near your home or work. If you’re looking for a retail health clinic, choose the “Other Health Professionals” category.  
  • Call 911 or go to the ER if you think you could put your health at serious risk by delaying care.
being a wise consumer1
Being a Wise Consumer
  • Know your options for having lab work done
      • When you need to get lab work (such as a blood test, urine test, Pap test or biopsy), your doctor might send you to a hospital lab. But keep in mind that your plan’s network includes other options. A lab that isn’t located in or part of a hospital could be a good choice for you because:
        • They’re often less expensive than hospital labs — you might even have lower coinsurance for outside labs.
        • Many have flexible hours (like early morning for when you’ve been fasting).
        • And you could save up to 20%.*
360 health programs
360 Health Programs
  • 360° Health is our approach to surrounding you with the resources, tools, guidance and support to help you manage your health
    • Care Advocacy Program
    • ConditionCare Programs
    • 24/7 NurseLine
anthem com homepage
Anthem.com Homepage

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Anthem.com public site:

  • Register for secure account access
  • Take an interactive tour of online features
estimate your cost online tools
Estimate Your Cost – Online Tools

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Estimate Your Cost tool displays cost of care data for doctor visits, radiology, surgeries and more then calculates an out-of-pocket cost estimate based on member-specific benefit data

Search results display facilities with the lowest cost option first

Out-of-Pocket cost calculations and the ability to perform a side-by-side comparison

personal service
Personal Service
  • We're here to serve you.
    • Integrated customer service and claim team
    • Dedicated Customer Service team for Bayer Corporation: (800) 635-0964
    • Extended service hours from 8:00 AM to 8:00 PM Eastern

Get answers and information 24/7 online and through our interactive voice response system.

important information
Important Information

Regardless of which Health and Savings plan a member signs up for, their Health Savings Account (HSA) will be administered by Payflex.

Any member questions related to Health Savings Account (HSA) administration should be directed to Payflex member services.

legal
Legal

The Anthem National Accounts business unit serves members of: Anthem Blue Cross Life and Health Insurance Company and Blue Cross of California using the trade name Anthem Blue Cross in California; using the trade name Anthem Blue Cross and Blue Shield for the following companies in: Colorado and Nevada: Rocky Mountain Hospital and Medical Service, Inc.; Connecticut: Anthem Health Plans, Inc.; Georgia: Blue Cross and Blue Shield of Georgia, Inc. and Blue Cross Blue Shield Healthcare Plan of Georgia, Inc.; Indiana: Anthem Insurance Companies, Inc.; Kentucky: Anthem Health Plans of Kentucky, Inc.; Maine: Anthem Health Plans of Maine, Inc.; Missouri (excluding 30 counties in the Kansas City area): RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits; New Hampshire: Anthem Health Plans of New Hampshire, Inc.; Ohio: Community Insurance Company; Virginia (excluding the City of Fairfax, the Town of Vienna and the area east of State Route 123): Anthem Health Plans of Virginia, Inc.; Wisconsin: Blue Cross Blue Shield of Wisconsin (“BCBSWi”), which underwrites or administers the PPO and indemnity policies; Compcare Health Services Insurance Corporation (“Compcare”), which underwrites or administers the HMO policies; and Compcare and BCBSWi collectively, which underwrite or administer the POS policies. In 28 eastern and southeastern counties in New York, Empire Blue Cross Blue Shield, the trade name of Empire HealthChoice Assurance, Inc., underwrites and/or administers the PPO, EPO, POS and indemnity policies. Independent licensees of the Blue Cross and Blue Shield Association. ® ANTHEM and 360° Health are registered trademarks of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association.