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State Health Plan Changes for 2014

The State Health Plan has a new focus on wellness, which is reflected in its 2014 Blue OptionSM plan offerings.  The Basic 70/30 plan stays as it is today, along with a modified Enhanced 80/20 plan with Affordable Care Act (ACA) benefits, and a new consumer-driven health plan (CDHP) 85/15 plan, which also has ACA benefits.

Here are some key highlights for you and your office staff to be aware of when seeing State Health Plan members in 2014:

  • The Enhanced and CDHP plans have opportunities for members to reduce their monthly premiums by completing a health assessment, selecting a primary care physician/practice, and attesting to not smoking (or being in a smoking cessation program) during their open enrollment.

 

  • Members who use their selected primary care practice or seek care from designated hospitals or specialists can also benefit from reduced copayments on the Enhanced plan or HRA contributions on the CDHP plan.

 

  • Members can choose the Basic 70/30 plan if they do not wish to participate in one of the new incentive programs with designated providers.

 

  • Specialists (specialty categories for 2014 are general surgery, OB/GYN, gastroenterology, orthopedics, cardiology, and neurology) and hospitals are designated for the State Health Plan when they have met our low-cost AND high-quality benchmarks, or they are designated as a critical-access hospital.

 

  • Practices should be sure to check member ID cards at each visit, as well as check eligibility and benefits for the most up-to-date information.  The member’s chosen primary care physician/practice will be listed on the ID card.

If you have any questions, please call the Provider Blue LineSM at 1.800.214.4844.