Rate & Coverage Histories

Quick Links:
» History at a Glance
» 2016-17 Plan Year
» 2015-16 Plan Year
» 2014-15 Plan Year
» 2013-14 Plan Year
» 2012-13 Plan Year
» 2011-12 Plan Year
» 2010-11 Plan Year
» 2009-10 Plan Year
» 2008-09 Plan Year
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History at a Glance

Plan Year      Rate Change %      National Trend % ~      New Employer Groups
2016-17      7.5      7.8      4
2015-16      0.0      3.9      13
2014-15      1.2*      5.3      9
2013-14      0.0      4.1      9
2012-13      5.0      6.1      13
2011-12      8.5      8.5      5
2010-11      6.0      6.9      0
2009-10      5.0      6.3      8
2008-09      5.0      6.0      5

* Only the Employee Only coverage tier was increased
~ National Trend % data from ...
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2016-17 Plan Year

Rate Increase: 7.5%
National Trend: 7.8%
New Employer Groups Added: 4 (as of July 1st, 2016)

Benefit Changes:
    In-Network Deductible
    » Increased to $750
    Out-of-Network Deductible
    » Decreased to $750
    Medical Network
    » Medical network changed from the BlueCross - BlueChoice network to the BluePreferred network
    ConnectDME - Medical Equipment
    » ConnectDME has been made the Health Plan’s vendor for medical equipment
    » ConnectDME provides medical equipment and supplies for Free
    CatapultHealth - Health Screenings
    » CatapultHealth has been made the Health Plan’s vendor for on-site Wellness Screenings
    » Screenings remain free to the Member and Group
    » Any member or spouse receiving a screening will receive a $250 reduction in medical deductible at the start of the following plan year
    MDLIVE - Telehealth
    » MDLIVE - Telehealth provides $0 office visit co-pays for non-emergency face-to-face primary care services through mobile app or web interface. Or, $0 office visit co-pays for behavioral health services through the same mobile app or web interface
    Pre Service or Procedure Member Care
    » The Benefits Value Advisor is a free and optional service for use prior to receiving medical services or procedures. Assists with locating providers offering the higher quality outcomes and lowest out-of-pocket costs. Also, offers help and support in multiple related areas linked to the condition, service or procedure.
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2015-16 Plan Year

Rate Increase: 0.0%
National Trend: 3.9%
New Employer Groups Added: 13

Benefit Changes:
    Specialty Drugs Coverage
    » Split into 3 cost tiers, Generics $10, Preferred Brands $60, Non-Preferred Brands $100
    Rx In-Network Out-of-Pocket Limit
    » Created Annual In-Network Out-of-Pocket Maximum for Rx of $1,900 per individual per plan year
    » Up to a maximum of $5,700 for a family of 3 or more
    Rx Drug Exclusions
    » Some Brand Name Drug Exclusions applied where direct theta-peutic alternatives exist.
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2014-15 Plan Year

Rate Increase: 1.5% (Only on Employee Only Coverage Tier)
National Trend: 5.3%
New Employer Groups Added: 9

Benefit Changes:
    Medical In-Network Out-of-Pocket Limit
    » Created and set at $2,500 per individual per plan year, up to a maximum of $7,500 for a family of 3 or more
    Medical In-Network & Out-of-Network Cost-Sharing
    » Separated
    Wigs or Other Scalp Prostheses'
    » Removed $150 plan year maximum
    Dependent Maternity Care
    » Now covered
    Co-Pay for Specialty Medications
    » Co-Pay increased from $40 to $60
    Nexium Over-The-Counter
    » Now covered at a $0 Co-Pay (with a prescription)
    Nasacort Over-The-Counter
    » Now covered at a $5 Co-Pay (with a prescription)
    Pre-Existing Conditions
    » No longer considered
     Domestic Partnerships
    » The Health Plan will now cover same-gender Domestic Partnerships
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2013-14 Plan Year

Rate Increase: 0.0%
National Trend: 4.1%
New Employer Groups Added: 9

Benefit Changes:
    Contraception Co-Pay
    » Reduced from $10 to $0
    Smoking Cessation Drugs
    » Added Coverage of 6-months each plan year at a $0 Co-Pay
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2012-13 Plan Year

Rate Increase: 5.0%
National Trend: 6.1%
New Employer Groups Added: 13

Benefit Changes:
    Office Visit Co-Pay
    » Reduced from $25 to $20
    Member Co-Share
    » Reduced from 30%/$3,000 to 20%/$2,000
    Dependent Child Deductible
    » Added Reimbursement of amounts paid over $250
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2011-12 Plan Year

Rate Increase: 8.5%
National Trend: 8.5%
New Employer Groups Added: 5

Benefit Changes:
    Rx Brand Name Deductible
    » Added at $50
    Out-of-Network Deductible
    » Added at $1,000
    Office Visit Co-Pay
    » Added at $25, or $50 for Specialists
    Member Co-Share
    » Increased from 20%/$2,000 to 30%/$3,000
    Lifetime & Plan Year Maximums
    » Removed - No Limit
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2010-11 Plan Year

Rate Increase: 6.0%
National Trend: 6.9%
New Employer Groups Added: 0

Benefit Changes:
    Deductible
    » Increased from $400 to $500
    Generic Rx Co-Pay
    » Increased from $5 to $10
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2009-10 Plan Year

Rate Increase: 5.0%
National Trend: 6.3%
New Employer Groups Added: 8

Benefit Changes:
    No Changes Made
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2008-09 Plan Year

Rate Increase: 5.0%
National Trend: 6.0%
New Employer Groups Added: 5

Benefit Changes:
    No Changes Made
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