Changes to Priority Health plans for 2009

Important changes for 2009

The following changes are effective Jan. 1, 2009.

1. More options for HealthbyChoice Incentives^SM plans
   We’re making the following additions to our HealthbyChoice Incentives plan offerings:
   
   • 2 new HMO options
   • 5 new POS options
   • $15/$50 Rx rider available for all HealthbyChoice Incentives plans
2. New HSA combined-deductible options for PPO (companies with 51+ employees)
   If you have PriorityHSA^SM built on a PPO platform, there are new design options that will unite the in-network and out-of-network deductibles into one combined deductible.
• Deductible options will be $1,500/$3,000 and $2,500/$5,000
• Deductible amounts met (both in and out-of-network) will accumulate toward the combined deductible
• Out-of-pocket maximums will be calculated separately and will include amounts met in the deductible
3. FSA available for small groups in 2009 (companies with 50 or fewer employees)
   PriorityFSA^SM supplements your medical plan and allows employees to set aside tax-free dollars to pay for dependent care and certain health care expenses that aren’t covered by the health plan. Employees may enroll in medical flex accounts, dependent care reimbursement accounts, or both.
   
   Note: Employees with an HSA can enroll only in a limited PriorityFSA plan.
4. Higher deductibles available for all commercial products
   Our PPO, POS and HMO plans will have more deductible options in 2009:
   
   • $4,000/$8,000
   • $5,000/$10,000
5. New Preventive Health Care Guidelines for 2009
   Our new Preventive Health Care Guidelines for 2009 (938KB PDF) contain the suggested screenings and immunizations members may receive during routine physical exams. More prevention can mean healthier employees, less utilization and lower costs.
   
6. Varicose vein treatment covered at 50%
   In order to be consistent across the state and ensure alignment with the certificate of coverage (COC), varicose vein treatment will be covered at 50% for all products. Your employees that have received these services in the past may see an increase in their out-of-pocket expense. As always, members should carefully check their COC or call Customer Service before seeking treatment.

Important reminders

1. No more HRA fees
   PriorityHRA^SM is now an even better cost-control option. Effective 7/1/2008, we:
   
   • Eliminated the $500 setup fee and the monthly maintenance fee for new HRA groups
   • Eliminated the monthly maintenance fee for renewing groups (monthly maintenance fees were $4 per employee per month for companies of more than 20 and $75 per month for companies of less than 20)
2. Diplomat Specialty Pharmacy now our specialty Rx vendor
   Over the past six months, we've consolidated our specialty pharmacy services with Diplomat Specialty Pharmacy. Your employees who received their specialty prescriptions through Curascript or Walgreens have been transitioned to Diplomat.
   
   You can be confident your employees will enjoy great service from Diplomat, a local Michigan provider and the largest independent specialty pharmacy in the nation. Learn more about Diplomat.
   
3. New HSA minimum deductibles for 2009
   The IRS released the following 2009 HSA minimums and maximums:
   
   • 2009 calendar year contribution limit: $3,000 single; $5,950 family
   • High-deductible health plan minimum deductible*: $1,150 single; $2,300 family
   • Out-of-pocket maximum*: $5,800 single; $11,600 family
   • Age 55+ catch-up contribution: $1,000 single; $2,000 if both spouses age 55 or older**

*Applies to plans starting on or after 1/1/09
**Requires the establishment of two separate HSAs

Contact the employer services representative for your region with any questions about these changes.