Agenda
• Health Premium Overall Rate Changes for 2011 • Basic Premium Changes by Region
• National Healthcare Reform
• Health Partners – Overview and Benefit Changes - Anthem Blue Cross – Blue Shield of California
- Medco Health Solutions – Kaiser Permanente
• Open Enrollment – Key Dates • Questions and Answers
2011 Premium Overall Rate Changes
Total Program (State and Contracting Agencies) • Overall premium increase of 9.1%• Overall premium increase for Basic plans of 10.6% • Overall premium increase for Medicare plans of 3.4%
2011 Basic Premium Changes
Southern California Regions
Basic Premium Changes – Los Angeles Area
(Los Angeles, San Bernardino, Ventura counties)Health Plan Percent Change (+/-)
Blue Shield Access+ 17.01%
Blue Shield NetValue 16.17%
Kaiser CA 5.04%
PERS Choice 9.67%
PERS Select 2.73%
PERSCare 1.97%
Basic Premium Changes – Other Southern CA Regions
Health Plan Percent Change (+/-)
Blue Shield Access+ 17.02%
Blue Shield NetValue 16.17%
Kaiser CA 5.05%
PERS Choice 9.19%
PERS Select 2.28%
National Healthcare Reform
• Currently, CalPERS is on target to implement all 2010/2011 provisions, including
- Extension of dependent coverage up to age 26
- Elimination of lifetime limits for PERS Select and PERS Choice - Changes to annual limits
- Early Retiree Reinsurance Program (ERRP)
Health Plan Partners
Plan Overview and Changes
PPO Plan Options
• PERSCare- Longest standing plan design
- Full Anthem Blue Cross PPO network access
- Highest level of coverage
• PERS Choice
- Most popular plan by enrollment
- Full Anthem Blue Cross PPO network access - Competitive coverage, competitive premium
PPO Plan Options
(continued)• PERS Select
- New plan design introduced January 2008
- Subset of Anthem Blue Cross PPO network
- Same coverage as PERS Choice available, lowest premium
PPO Plan Comparison
• Similarities between PPO Plans- $500 Calendar Year Deductible
- $20 Office Visit Co-pay
- 100% Routine/Preventive coverage - $50 Emergency Room Deductible
PPO Plan Comparison
(continued)• Differences between PPO Plans
- 90% coverage on PERSCare; 80% coverage on PERS Choice and PERS Select
- $3500 Physical Therapy Maximum on PERS Choice and PERS Select; No Maximum on PERSCare
- Chiropractic & Acupuncture limited to 15 visits on PERS Choice
and PERS Select; 20 visits on PERSCare
How the PPO Plans Work
• Services that do not apply to the $500 calendar year deductible
- Physician office visits - Routine/preventive visits - Prescriptions
• For other services, your deductible does apply. After the Deductible is met the percentage based benefit (90% or 80%) will begin
How the PPO Plans Work
(continued)• The Coinsurance (10% or 20%) will apply towards the Calendar Year Maximum Out of Pocket ($2000 or $3000) • Services for Non-Participating Providers are reimbursed at
60%. The 40% Coinsurance does not apply towards a Maximum Out of Pocket
PPO Plans Medical Benefits Changes Summary
PERSCare PERS Choice PERS Select Lifetime maximum coveragelimit of $2 million being
removed ✔ ✔
Introducing Value Based Purchasing design for hip and
knee joint replacement surgery ✔ ✔ ✔
Introducing Narrow Hospital Network to produce additional
premium savings ✔
Value Based Purchasing Design (VBPD)
• This pilot program targets hip and knee jointreplacement surgery
• These expensive procedures are rapidly growing in frequency
• PPO hospital charges for hip and knee joint replacement surgery vary greatly between facilities – even in the same zip codes – without any clinical evidence of differences in quality or outcomes
Value Based Purchasing Design (VBPD)
(continued)• Benefits for these procedures at facilities designated in the VBPD pilot will apply in accordance to the member’s plan • Benefits for these procedures not performed by a VBPD
pilot facility will be limited to $30,000 per procedure • Total of 44 hospitals chosen as Value Based Purchasing
Narrow Hospital Network (PERS Select)
• Billed charges for PPO hospitals vary greatly with nocorrelation in quality of care or outcomes • Two Tiered Hospital Benefits
- Inpatient and Outpatient services at Tier One hospitals will be covered at the existing Par coinsurance (80%) and maximum out of pocket plan provisions ($3,000/$6,000)
- Inpatient and Outpatient services at Tier Two hospitals will be
covered at a lower coinsurance (70%) and higher maximum out of pocket plan provisions ($6,000/$12,000)
Narrow Hospital Network (PERS Select)
(continued)• The value of using more cost effective Tier One hospitals produced lower 2011 premium rates
• With identical coverage as PERS Choice available, 2011 PERS Select premiums will be approximately 13% lower than PERS Choice
• Total 159 hospitals chosen within Tier One
Locating a Provider at www.anthem.com/ca/calpers
• Click “Find a Doctor”link on the home page and follow the prompts
Website and Wellness Services
• 360°Health Services- ConditionCare: Asthma, Diabetes, COPD, CAD, HF - Future Moms
- 24/7 NurseLine coupled with comprehensive Audio Library • SpecialOffers Discount Programs
- Complementary and Alternative Care: massage therapy, acupuncture, chiropractic
- Club Memberships: Curves, Bally’s, Anytime Fitness - Weightloss: Jenny Craig, Weight Watchers - Smoking Cessation Program
Website and Wellness Services
(continued)• On-Line Resources @ www.anthem.com/ca/calpers - WebMD
- MyAnthem • MyHealth Record • Claims status • Treatment Cost Advisor
• Anthem Care Comparison - Hospital Comparison Tool
- Healthy Living
About Medco
• Provides pharmacy benefit management services for approximately 65 million Americans
• In 2009, managed 695 million prescriptions (103 million prescriptions through mail service), operating at better than Six Sigma quality levels
• Partners with approx. 60,000 retail pharmacies nationwide • In 2009, 27.5 million prescriptions were processed through
medco.com
• 12,000+ of the new prescriptions each week are ePrescription
About Medco
(continued)• In 2010, Medco captured the No. 1 position in the Health Care sector on Fortune’s Most Admired Companies List for the third consecutive year. In this sector, Medco ranked No. 1 in five attributes: innovation, use of corporate assets, quality of management, financial soundness, and quality of products/services.
• Medco pharmacists are specialists, trained to support patients with specific conditions such as diabetes, asthma and cardiovascular disease
Prescription Benefit Basics – Drug Types
• Preferred brand medications- Brand preferred by the plan based on an independent clinical review board decision
- Original manufacturer still holds patent
- No generics available yet
Prescription Benefit Basics – Drug Types
(continued)• Non-preferred brands
- Brand not preferred by the plan based on an independent clinical review board decision
- Alternative generics and/or brand medications are available
- Example: Prilosec
• Generic medications
- Usually available from many manufacturers
- Less costly than brand medications - Example: acyclovir
Prescription Benefit Basics – Drug Types
(continued)• OTC (over-the-counter)
- Not covered by CalPERS except diabetic test strips, insulin, and lancets
- Several key prescription drugs were recently approved for OTC sale, including Claritin, Prilosec, and Zyrtec
- New for 2011: Prescription medications with an OTC equivalent
are not covered
Prescription Benefit Basics – Drug Types
(continued)• Specialty drugs
- Many require injection or IV infusion
- May require special safety monitoring, patient training and coordination of care
- Unique requirements for handling and storage
- Often used to treat patients living with severe, chronic conditions, such as multiple sclerosis, pulmonary hypertension, and hemophilia
Prescription Co-pays
Retail (30/34 day supply) Mail Order (90 day supply) Maintenance medications after 2ndrefill Generic drugs $5 $10 $10Preferred brand drugs $15 $25 $25
Non-preferred brand drugs $45 $75 $75
Lifestyle medications* 50% 50% 50%
* Medications such as Viagra, Levitra and Cialis
Prescription Co-pays
(continued)• Out-of-pocket (OOP) maximum at mail is $1,000 per calendar year; once a member incurs a $1,000 at mail, the mail service co-pay is $0 for the remainder of the year
- New for 2011, non-preferred medications will be excluded from the
OOP maximum
• Prior authorization may be required for some medications. • Upon approval, some non-preferred medications are eligible for a
partial co-pay waiver
- New for 2011, if granted, the non-preferred co-pay at retail is $40 and at mail is $70
Prescription Co-pays
(continued)• Refer to medco.com for preferred drug status and to identify other preferred medications and savings opportunities
Preferred Drug List (Formulary)
• A formulary is a list of generic and brand-name drugs that are preferred by the plan
- The formulary list offers member choice while helping to keep the
cost of the prescription drug benefit affordable
• The list is developed by a clinical committee of national medical experts
- The committee meets at least quarterly to make updates.
- Medco notifies patients when there will be a change in status of their drug that will result in a higher copay.
Preferred Drug List (Formulary)
(continued)• Members can refer to www.medco.comor call member services to determine if a specific drug is preferred.
Getting Started with Mail Prescriptions
• Ask doctor to prescribe for 90 day supply and refills for up to 1 year, if appropriate
• Send prescription to Medco
- Doctors – send via fax or electronic transmission (eRx)
- Patients – send via mail
• Mail order form and address available by calling 800-939-7091 or by visiting www.medco.com/calpers
Getting Started with Mail Prescriptions
(continued)• Delivery timing
- Members should have at least a 14 day supply of medication on hand when ordering
- New prescriptions delivered 8 days and refills 3-5 days after order is received
• Payment
- Can be made by credit card, check, money order or e-check
- Standard shipping is free
• Pharmacists are available 24/7 to speak with patients
Getting Started with Mail Prescriptions
(continued)• Refills can be ordered by phone (800-939-7091) or www.medco.com/calpers or you can join Medco’s Worry Free Refill program
• Packaging
- Most orders are sent via U.S. mail in a tamper proof envelope - Some medications that are refrigerated or frozen will arrive in
special packaging
- Includes a literature pack
Getting Information about the Prescription Benefit
Before January 1
st• What type of information can I get before January 1st? - Copays and other prescription benefit highlights - Compare prescription medication costs
- Use My Rx Choices, Medco’s tool to identify savings opportunities - Find a local, participating retail pharmacy
- Determine the formulary or preferred drug status of your medications
Getting Information about the Prescription Benefit
Before January 1
st(continued)• How can I get information?
- Call Medco Member Services at 1-800-939-7091
• Press “1” to speak to an Open Enrollment representative
- Visit the open enrollment website at www.medco.com/calpers
• You may then select information about the plan from the right hand side of the web page; you will be taken to the open enrollment website for the benefit you selected.
Member Support
• Member Service – 800-939-7091 • New member materials • Periodic communications
- Letters to remind members to use My Rx Choices, announce new generics, introduce new prior authorization edits and more
• Medco website –www.medco.com/calpers • Brochures – open enrollment, benefit fairs
Medco.com Features
• Medco Health Store™- Enhanced online drugstore that offers over 25,000 nonprescription health, wellness and personal care products.
• “For Your Dr. Visit”
- Members may view and print a personalized prescription history,
pharmacy benefit overview, formulary guide and a new prescription fax form to share with their physician.
Medco.com Features
(continued)• My Rx Choices - Provides members with
personalized reports that compare medications they are taking on an ongoing basis to any lower cost alternatives available under your plan.
Blue Shield’s two HMO plans
We need your help to eliminate the confusion between our two plans…
• Access+ – the premium, fully-loaded HMO that’s predictable and cost-effective
- Most appropriate for solo subscribers who use their plan, families with older children, and those looking for flexibility
• NetValue – the value HMO that accommodates choice - Most appropriate for families with young children, solo subscribers
Access+ network
• The premium, fully-loaded HMO with no deductible that’s predictable and cost-effective available throughout California
- Choice of over 11,000 primary care physicians statewide - Over 300 hospitals statewide
- Over 21,500 specialists statewide - Self-referral through Access+ Specialist
Access+ Benefit Highlights
• Physician Services- $ 0 charge for preventative care
- $15 office visit copay for primary doctor, and specialist care
- $ 30 copay for self-referral specialist visits
• Diagnostic Testing (Lab, X-Ray) - $0 Co-pay
• Hospitalization
- No charge inpatient or outpatient
Access+ Benefit Highlights
• Prescriptions- For short-term or acute illness from a retail pharmacy, for a 30-day supply: $5 generic, $15 brand, $45 non-formulary
- For maintenance drugs from a retail pharmacy, for a 30-day supply after the first 3 months: $10 generic, $25 brand name, $75 non-formulary
- For maintenance drugs by mail, up to a 90-day supply: $10 generic,
NetValue network
• The value HMO with no deductible that accommodates choice - Available to almost 80% of CalPERS Blue Shield members. In 2011
NetValue will be offered in 23 counties, including Santa Clara, Santa Cruz and the balance of San Mateo
- The NetValue network is comprised of the most efficient providers - Because of the more efficient network, members pay a lower monthly
premium without sacrificing quality of care
- NetValue has created the competition needed to drive some providers to reduce their rates and/or referral patterns in order to participate in this product; in some cases medical groups have re-negotiated rates in order to meet the criteria to be included in the network
Blue Shield 65+
• Blue Shield 65+ is a GMA-PD health plan that has replaced the Blue Shield Medicare COB plan in all or parts of Fresno, Kern, Los Angeles, Madera, Orange, Riverside, San Bernardino, San Luis Obispo and Ventura counties • The plan provides health benefits to anyone eligible for
Medicare who enrolls in and receives services from the plan instead of receiving their benefits and care through the traditional fee-for-service Medicare program
Blue Shield 65+
(continued)• To participate members must be enrolled in both Medicare Parts A and B and receive all Medicare-covered benefits through Blue Shield 65+
• Members choose a primary care physician and receive services from Blue Shield’s network of providers, similar to a traditional HMO
• The plan administers and delivers both medical and prescription drug coverage
2011 Benefit Changes
• The only medical benefit change for Blue Shield plans will be the introduction of a $250 hospital co-pay for upper and lower endoscopy, cataract surgery, and spinal injection when an outpatient hospital is used in lieu of an ambulatory surgery center – Blue Shield contracts with over 446 ambulatory surgery centers throughout California
• Exclude the non-formulary brand prescription co-pay from the $1000 maximum out-of-pocket (OOP) mail-order spend for members
2011 Benefit Changes
(continued)• Change the partial co-pay waiver for non-formulary brand drugs. Non-formulary brand retail co-pays will increase from $30 to $40; mail order co-pays will increase from $45 to $70 • Establish a 50 percent coinsurance for drugs used for erectile
dysfunction
Valuable Services for Members
• Access+ Specialist• Access+ Satisfaction • Nurse Help 24/7 • Life Referrals 24/7 • Ask A Pharmacist • Healthy Lifestyle Rewards • Travel coverage • Away From Home Care
• Health management programs
• Ratings & Review • Ask & Answer
• blueshield.ca.com/calpers • Hospital Comparison Tool • Drug Interaction Checker • Symptom Checker
Valuable Services for Members
(continued)• Surgery – before and after • Hearing and visual resources • Patient Ally
• Health library
Members Save Money and Get Healthy
• Acupuncture, Chiropractic and Massage therapy services – 25% or more off the usual and customary fees
• Online discounts on heath-improvement products including vitamins, herbal supplements, homeopathic remedies, diet and sports nutrition, yoga and fitness equipment, personal body care and health and wellness books, audio and DVD products
Members Save Money and Get Healthy
(continued)• Vision – 20% off the published retail prices when an in-network provider is used including routine eye examinations, frames and lenses, tints and coatings, non-prescription sunglasses
• LASIK laser vision – 15% discount when an in-network provider is used
• Weight Watchers discounts • 24 Hour Fitness discounts • Drugstore.com discounts
Useful Tools for You and Members
• Custom newsletter for CalPERS HBOs, In The Know, with articles and information you can use in your own newsletters • Custom newsletter for CalPERS members, Shield Connect,
with benefit information as well as helpful tips and tools • Our dedicated CalPERS Member Services staff is
available to help 7 a.m. to 7 p.m., Monday through Friday at 800-334-5847
• Dedicated CalPERS HBO Priority Services staff to expedite your needs
Useful Tools for You and Members
(continued)• A series of informative and educational Webinars for HBOs and members
• A comprehensive “Find a Provider” online tool that identifies physicians by location, specialty and IPA, hospital affiliation and ambulatory surgery centers
• Dedicated Blue Shield Account Management Team
How Do Members Find a Doctor?
Members have two options to find and choose a Primary Care Physician or a specialist
1. They can call our dedicated CalPERS Member Services team at 800-334-5847 and have a custom directory mailed or emailed to them
2. They can go to our dedicated CalPERS website at
www.blueshieldca.com/calpersand find a physician using our online tool
How Do Members Find a Doctor?
(continued)• A change of their Primary Care Physician must be made through Member Services or online at blueshieldca.com • Members can change their primary care physician as often
as once a month and do not need to wait for open enrollment
About Kaiser Permanente
• Kaiser Permanente provides services directly to our members through an integrated medical care program • Health Plan, Plan Hospitals, and the Medical Group work
together to provide our members with convenient access to quality care
About Kaiser Permanente
(continued)• Our medical care program gives you access to all of the covered Services you may need:
–Routine care with your own personal Plan Physician –Specialty Care
–Hospital Care
–Laboratory and Pharmacy Services –Urgent and Emergency Care
–Healthy Living Programs
Who We Are
• 8.7 million members • 13,729 physicians • 157,000 employees • 32 hospitals • 416 medical officesNational Model of Health Care Delivery
“[Kaiser Permanente is] actually one of the models of high-quality, cost-efficient care that's out there right now, partly because they maintain such a stable base of patients and they construct a whole team approach that has proven to be very effective… If we could actually get our health-care system across the board to hit the efficiency levels of a Kaiser Permanente… we actually would have solved our problems.”
President Barack Obama, in an interview with Time Magazine for a July 30, 2009 cover story
2011 Basic Plan Benefits
Service Benefit
Physician services $15 per visit Hospital services No charge
Emergency care $50 per Emergency Department visit This Copayment does not apply if you are held for observation in a hospital unit outside the Emergency Department or if admitted directly to the hospital as an inpatient
X-ray and lab tests No charge
2011 Basic Plan Benefits
(continued)Service Benefit
Online service features (Available through My Health Manager at kp.org/calpers)
•E-mail your doctor’s office: No charge •Take a total health assessment: No charge •View most lab test results: No charge •Schedule routine appointments: No charge •View portions of your medical record:
No charge
•Order prescription refills: No extra charge for delivery
2011 Basic Plan Benefits
(continued)Service Benefit
Prescription drugs (Includes covered outpatient items in accord with our drug formulary guidelines)
• Up to a 30-day supply from a Plan pharmacy: $5 generic/$15 brand
• Up to a 100-day supply by mail-order service: $10 generic/$30 brand
• Drugs prescribed for treatment of sexual dysfunction, now covered at 50% coinsurance for up to a 100-day supply from a Plan pharmacy or by mail-order service
2011 Basic Plan Benefits
(continued)Service Benefit
Routine preventive care • Periodic health exam: No charge • Scheduled prenatal care and first postpartum
visit: No charge
• Well-child visits (0–23 months): No charge • Vaccines (immunizations): No charge • Eye refraction exam: No charge
(Eyeglasses and contact lenses following cataract surgery, in accord with Medicare guidelines, No charge)
2011 Basic Plan Benefits
(continued)Service Benefit
Mental Health Outpatient visits: $15 per individual visit; $7 per group visit
Inpatient psychiatric hospitalization: No charge Hearing services Routine preventive hearing tests: No charge
Hearing aid(s): $1,000 allowance every 36 months
Allergy services Allergy injection visits: No charge Allergy testing visits: $15 per visit
2011 Senior Advantage Plan Benefits
Service Benefit
Physician services $10 per visit Hospital services No charge
Emergency care $50 per Emergency Department visit This Copayment does not apply if you are held for observation in a hospital unit outside the Emergency Department or if admitted directly to the hospital as an inpatient
X-ray and lab tests No charge
Chiropractic Care $10 per visit, up to 20 visits per calendar year
Service Benefit
Online service features (Available through My Health Manager at kp.org/calpers)
•E-mail your doctor’s office: No charge •Take a total health assessment: No charge •View most lab test results: No charge •Schedule routine appointments: No charge •View portions of your medical record:
No charge
•Order prescription refills: No extra charge for delivery
2011 Senior Advantage Plan Benefits
(continued)2011 Senior Advantage Plan Benefits
(continued)Service Benefit
Prescription drugs (Includes covered outpatient items in accord with our drug formulary guidelines)
• Up to a 30-day supply from a Plan pharmacy: $5 generic/$15 brand
• Up to a 100-day supply by mail-order service: $10 generic/$30 brand
• Drugs prescribed for treatment of sexual dysfunction, now covered at 50% coinsurance for up to a 100-day supply from a Plan pharmacy or by mail-order service
2011 Senior Advantage Plan Benefits
(continued)Service Benefit
Routine Preventive Care • Periodic health exam: $10 per visit • Scheduled prenatal care and first postpartum
visit: $10 per visit
• Vaccines (immunizations): No charge • Eye refraction exam and glaucoma screening:
$10 per visit
–$175 allowance for eyeglasses/contact lenses every 24 months (Eyeglasses and contact
lenses following cataract surgery, in accord with Medicare guidelines, No charge)
2011 Senior Advantage Plan Benefits
(continued)Service Benefit
Mental Health • Outpatient visits –$10 per individual visit –$5 per group
•Inpatient psychiatric hospitalization: No charge Hearing Services •Routine preventive hearing test: $10 per visit
•Hearing aid(s): $1,000 allowance every 36 months
Allergy Services •Allergy injection visits: $3 per visit •Allergy testing visits: $10 per visit
Medicare Part B – Only Plan for CalPERS Members
• If the member currently has Part B they may enroll into the KaiserPermanente Senior Advantage (KPSA) plan immediately –Member must complete and submit the KPSA Election Form –Their KPSA membership will become effective the first of the month
following the date of signature on the election form • Benefits
–Richer benefits than Basic plan –Possible lower monthly premiums
–State may pay Part B premium for State retirees
Dependent Care Coverage
• Starting January 1, 2011, dependent children will be eligible to remain covered until age 26
• If you have any dependents who lost coverage because of their age, you’ll be able to re-enroll them during open enrollment, as long as they’re younger than 26
New Member Checklist
• Register for secure access to kp.org • Find a facility nearest you • Choose a personal physician • Learn how to get care • Get support for healthy living• Transfer your medical records and prescriptions Learn more at kp.org/newmember
Choose a Great Doctor
• Each member of your family is encouraged to have his/her own personal plan physician for routine and preventive care, treatment of illness, and referral to a specialist when needed. • To see our physicians’ profiles,
go to kp.org/chooseyourdoctor
–Review their credentials, including educational background and board certifications, and read their personal statements to ensure just the right fit.
My Health Manager Tour
• Take the My Health Manager Tour and learn how to: –E-mail your doctor’s office for free, saving time, gas, and money –Order prescription refills, most of which can be mailed to you—
at no extra charge
–Schedule or cancel routine appointments to fit your busy and ever-changing schedule
–View most lab test results and get summaries of your office visits online –Help take care of a family member, like a child or parent, using the
features above –kp.org/experience
My Health Manager Tour
(continued)• You can register for secure access to the members-only features of My Health Manager at kp.org/calpers. Connect to your health information with one click, 24 hours a day.
Empowering Our Customers
• 3.5 Million Customers online • 11 million emails sent to physicians • 6 million prescriptions filled • 31 million test results viewedEmpowering Our CalPERS Customer Online
• 197,832 members registered on kp.org• 651,915 emails sent to physicians • 512,471 prescriptions filled • 1,604,109 test results viewed
Healthy Living Rewards Program
• Take the total health assessment online and you will be eligible to win a 160GB iPod or a $500 gift certificate to a sporting goods store or spafinder.com
–It’s free for CalPERS members and you can complete it in minutes from the comfort of your home
–You’ll receive a customized health improvement plan to help you get inspired and take charge of your health
–Attach the results to your personal electronic health record, and your doctor can help monitor your progress
–That’s it! You’ll be automatically entered into the quarterly drawing— and on your way to a healthier you
CalPERS Online Health Management Programs
• We also offer the following customized online programs tohelp CalPERS members reach their health goals –Lose weight with Balance™
–Eat healthy with Nourish™ –Reduce stress with Relax™
–Quit smoking with Breathe™
–Manage chronic conditions with Care for Your Health™
–Manage diabetes with Care for Diabetes™
CalPERS Online Health Management Programs
(continued)
–Manage depression with Overcoming Depression™ –Get a good night's sleep with Overcoming Insomnia™ –Manage back pain with Care for Your Back™
Discount Programs for CalPERS Members
• Weight Watchers® - Lose some extra pounds, at a healthydiscount. We've teamed with Weight Watchers® to help you save money on regular online membership fees.
• 10,000 Steps® Program - Use a pedometer to count your steps each day, then track your progress online. You'll get the support you need every step of the way.
• Health and Fitness Programs - Enjoy discounts on massage therapy, acupuncture, chiropractic care, and select fitness club memberships. (Programs vary by region.)
Portable Electronic Medical Record
• Copy of patient’s medical information • Ideal for travel and college students • Encrypted and password protected • Cost is $5 for flash drive (free updates)
CalPERS Members in Northern California can purchase their password-protected portable electronic medical record (PEMR) on a flash drive
We are here for your Health
• Member Services Call Center–Phone hours
• Monday through Friday, 7 a.m. to 7 p.m. • Saturday and Sunday, 7 a.m. to 3 p.m.
–English: 1-800-464-4000 (toll free)
–Spanish: 1-800-788-0616 (toll free)
–Chinese dialects: 1-800-757-7585 (toll free)
–TTY for the deaf, hard of hearing, or speech impaired:
1-800-777-1370
We are here for your Health
(continued)• Senior Advantage Member Services –English: 1-800-443-0815
–TTY: 1-800-777-1370
Open Enrollment Key Dates
• August 16th and August 23rd- Mailing waves of Open Enrollment member packages
• August 30th – October 8th
- Open Enrollment Health Fairs conducted • September 13th – October 8th
- Open Enrollment period for the 2011 health plan year
Summary
• Health Premium Overall Rate Changes for 2011 • Basic Premium Changes by Region
• National Healthcare Reform
• Health Plan Partners – Overview & Benefit Changes - Anthem Blue Cross – Blue Shield of California
- Medco Health Solutions – Kaiser Permanente
• Open Enrollment – Key Dates
Helpful Websites and Phone Numbers
• CalPERS- www.calpers.ca.gov - 888 CalPERS
(or 888-225-7377) • Anthem Blue Cross
- www.anthem.com/ca/calpers - (877) 737-7776
• Blue Shield of California - www.blueshieldca.com/calpers - (800) 334-5847 • Kaiser Permanente - www.kp.org/calpers - (800) 464-4000 • Medco - www.medco.com/calpers - (800) 939-7091
