2019 medical benefit plans University of Nebraska Sign

2019 medical benefit plans University of Nebraska

Sign up for your 2019 benefits 10/29/2018 – 11/16/2018 Today you’ll learn more about: • 2019 Medical plan options • Enhancements to current benefits • Services available from UMR • Teladoc © 2018 United Health. Care Services, Inc. Proprietary information of United Health. Care Services, Inc. Do not distribute or reproduce without express permission of United Health. Care Services, Inc.

What’s new for 2019 • UMR will administer current medical plans, as well as a new Qualified High Deductible Health Plan. • Preferred tier benefit with Nebraska Medical Center. • Increased preventive benefits. • Infertility treatment benefits. 3 © 2018 United Health. Care Services, Inc. Proprietary information of United Health. Care Services, Inc. Do not distribute or reproduce without express permission of United Health. Care Services, Inc.

Your medical benefits at a glance – LOW Deductible and benefit percentage Low Option Preferred Tier In-network Out-of-network In-network and out-of-network charges are combined to satisfy the deductible and co-insurance out-of-pocket. Deductible • Individual • Family Coinsurance Percentage applied to covered medical expenses Out of pocket maximum Includes deductible • Individual • Family $1, 350 $2, 600 $1, 550 $3, 100 $1, 950 $3, 900 Plan pays 85% Plan pays 70% Plan pays 55% $3, 650 $7, 300 $4, 050 $8, 100 $4, 850 $9, 700 After satisfying the coinsurance and out-of-pocket limit, the Plan pays 100% of eligible charges. Preventive Regular Preventive Enhanced 4 < age 2 – 100% Age 2+ 100% to $250, then deductible & coinsurance < age 2 – 100% Age 2+ 100% to $400, then deductible & coinsurance © 2018 United Health. Care Services, Inc. Proprietary information of United Health. Care Services, Inc. Do not distribute or reproduce without express permission of United Health. Care Services, Inc.

Your medical benefits at a glance – BASIC Deductible and benefit percentage Basic Option Preferred Tier In-network Out-of-network In-network and out-of-network charges are combined to satisfy the deductible and co-insurance out-of-pocket. Deductible • Individual • Family Coinsurance Percentage applied to covered medical expenses Out of pocket maximum Includes deductible • Individual • Family $300 $600 $450 $900 $650 $1, 300 Plan pays 85% Plan pays 70% Plan pays 55% $1, 750 $3, 500 $2, 050 $4, 100 $2, 650 $5, 300 After satisfying the coinsurance and out-of-pocket limit, the Plan pays 100% of eligible charges. Preventive Regular Preventive Enhanced 5 < age 2 – 100% Age 2+ 100% to $250, then deductible & coinsurance < age 2 – 100% Age 2+ 100% to $400, then deductible & coinsurance © 2018 United Health. Care Services, Inc. Proprietary information of United Health. Care Services, Inc. Do not distribute or reproduce without express permission of United Health. Care Services, Inc.

Your medical benefits at a glance HIGH Deductible and benefit percentage High Option Preferred Tier In-network Out-of-network In-network and out-of-network charges are combined to satisfy the deductible and co-insurance out-of-pocket. Deductible • Individual • Family Coinsurance Percentage applied to covered medical expenses Out of pocket maximum Includes deductible • Individual • Family $200 $400 $300 $600 $450 $900 Plan pays 90% Plan pays 80% Plan pays 65% $1, 500 $3, 000 $1, 700 $3, 400 $2, 150 $4, 300 After satisfying the coinsurance and out-of-pocket limit, the Plan pays 100% of eligible charges. Preventive Regular Preventive Enhanced 6 < age 2 – 100% Age 2+ 100% to $250, then deductible & coinsurance < age 2 – 100% Age 2+ 100% to $400, then deductible & coinsurance © 2018 United Health. Care Services, Inc. Proprietary information of United Health. Care Services, Inc. Do not distribute or reproduce without express permission of United Health. Care Services, Inc.

Your medical benefits at a glance QHDHP Deductible and benefit percentage Qualified High Deductible Health Plan Preferred Tier In-network Out-of-network In-network and out-of-network charges are combined to satisfy the deductible and co-insurance out-of-pocket. Deductible • Individual • Family Coinsurance Percentage applied to covered medical expenses Out of pocket maximum Includes deductible • Individual • Family $2, 700 $5, 400 $10, 800 Plan pays 100% Plan pays 80% Plan pays 70% $2, 700 $5, 400 $3, 600 $7, 200 $14, 400 After satisfying the coinsurance and out-of-pocket limit, the Plan pays 100% of eligible charges. Preventive 7 © 2018 United Health. Care Services, Inc. Proprietary information of United Health. Care Services, Inc. Do not distribute or reproduce without express permission of United Health. Care Services, Inc. 100% Preferred Tier and In-Network Ded & Coins Out of Network

HSA eligibility requirements A health savings account (HSA) is a bank account opened and owned by you. Use it to save money tax free to pay for qualified expenses. In order to contribute to an HSA: • You must be enrolled in a qualified, high deductible health care plan • You may not be covered under any other type of medical plan (such as a spouse’s plan) • You may not be enrolled in Medicare • You may not be claimed as a dependent on someone else’s tax return © 2018 United Health. Care Services, Inc. 8 Proprietary information of United Health. Care Services, Inc. Do not distribute or reproduce without express permission of United Health. Care Services, Inc. 8

Finding a network provider Choose the option that’s easiest for you! 99 © 2018 United Health. Care Services, Inc. Proprietary information of United Health. Care Services, Inc. Do not distribute or reproduce without express permission of United Health. Care Services, Inc. • Visit umr. com/Uof. NE to find a provider. • Call UMR toll-free at 844. 659. 5059 and ask a representative for help.

10 © 2018 United Health. Care Services, Inc. Proprietary information of United Health. Care Services, Inc. Do not distribute or reproduce without express permission of United Health. Care Services, Inc.

11 © 2018 United Health. Care Services, Inc. Proprietary information of United Health. Care Services, Inc. Do not distribute or reproduce without express permission of United Health. Care Services, Inc.

Look up care where you live Search by category: 12 © 2018 United Health. Care Services, Inc. Proprietary information of United Health. Care Services, Inc. Do not distribute or reproduce without express permission of United Health. Care Services, Inc. • People: Doctors and other health care providers • Places: Hospitals, clinics, imaging centers • Services and Treatments: Office visits, surgeries • Care by Condition: Area of the body, type of illness • Cost Estimates: For common conditions

Look for provider ratings for quality and cost United. Health Premium symbols look like this: Premium Care Physician Quality Not Evaluated When you receive care from a Premium provider, you may pay less in out of pocket costs for your visit. 13 © 2018 United Health. Care Services, Inc. Proprietary information of United Health. Care Services, Inc. Do not distribute or reproduce without express permission of United Health. Care Services, Inc. Does Not Meet Quality

If your current doctor isn’t in the network You may continue to receive care at the innetwork benefit level until June 30, 2019 if you are actively receiving treatment for: 14 • Late-term or risky pregnancy • Organ transplants • Inpatient care during transition • Behavioral health • Post-surgical care © 2018 United Health. Care Services, Inc. Proprietary information of United Health. Care Services, Inc. Do not distribute or reproduce without express permission of United Health. Care Services, Inc. After June 30 th Find a network provider at umr. com/Uof. NE

Go to Teladoc for these health issues General health Specialty care ‒ Colds or flu ‒ Dermatology (skin conditions) ‒ Allergies ‒ $75 per consultation ‒ Strains and sprains ‒ Digestive issues ‒ Sinus problems ‒ Pediatric care ‒ $45 per consultation To get a consult: Visit Teladoc. com or call 1 -800 -Teladoc (835 -2362) 15 © 2018 United Health. Care Services, Inc. Proprietary information of United Health. Care Services, Inc. Do not distribute or reproduce without express permission of United Health. Care Services, Inc.

Activate your member ID card Call the number and peel off the sticker 16 © 2018 United Health. Care Services, Inc. Proprietary information of United Health. Care Services, Inc. Do not distribute or reproduce without express permission of United Health. Care Services, Inc.

How to read your ID card Your member ID number Your group health plan number Family members covered under your plan Your pharmacy benefits information Your medical provider network 17 © 2018 United Health. Care Services, Inc. Proprietary information of United Health. Care Services, Inc. Do not distribute or reproduce without express permission of United Health. Care Services, Inc.

The back of your ID card Your number to call for prior authorization Your numbers for customer service and Teladoc Your number to call for pharmacy questions Your secondary network 18 © 2018 United Health. Care Services, Inc. Proprietary information of United Health. Care Services, Inc. Do not distribute or reproduce without express permission of United Health. Care Services, Inc.

A digital ID card on umr. com • View your member ID information on your computer or mobile device • Have your doctor scan the on-screen bar code for your benefits information • Print a temporary replacement card • Fax a copy of your card to your doctor’s office 19 © 2018 United Health. Care Services, Inc. Proprietary information of United Health. Care Services, Inc. Do not distribute or reproduce without express permission of United Health. Care Services, Inc.

Signing up for umr. com 1 Visit umr. com on your desktop computer or tablet device 2 Click Login/Register to sign up Helpful hints • Have your UMR member ID card handy • Spouses and adult children must create their own online account • You must provide a valid email address • Select a username and password you can remember © 2018 United Health. Care Services, Inc. Proprietary information of United Health. Care Services, Inc. Do not distribute or reproduce without express permission of United Health. Care Services, Inc.

See your benefits information anytime, anywhere With umr. com you can: • Check your benefits and see what’s covered • Look up what you owe and how much you’ve paid • Find a doctor in your network • Learn about medical conditions and your treatment options • Access tools and trusted resources to help you live a healthier life 21 © 2018 United Health. Care Services, Inc. Proprietary information of United Health. Care Services, Inc. Do not distribute or reproduce without express permission of United Health. Care Services, Inc.

Talk to someone who speaks your language • Get help in Spanish from a UMR customer first representative • Or get interpretation service assistance for more than 200 other languages © 2018 United Health. Care Services, Inc. Proprietary information of United Health. Care Services, Inc. Do not distribute or reproduce without express permission of United Health. Care Services, Inc.

Make sure certain services Services that need prior authorization include: ‒ Hospitalizations ‒ Transplants and transplantrelated services ‒ Durable medical equipment ‒ Over $500 for rental ‒ Behavioral health stays ‒ Over $1, 500 for purchase ‒ Home health care ‒ Over $1, 000 for prosthetics ‒ Infertility treatment ‒ Clinical trials (QHDHP only) © 2018 United Health. Care Services, Inc. 23 Proprietary information of United Health. Care Services, Inc. Do not distribute or reproduce without express permission of United Health. Care Services, Inc. 23

Choose the right health care setting Ty pe of care Wait time Teladoc 17 minutes Consults by phone or online video for routine ailments. for doctor to respond Retail clinic/convenient care clinic 15 minutes Clinics located in retail stores, supermarkets and pharmacies. Urgent care/ walk in clinic Evening and weekend treatment for illnesses or injuries. Clinical care (your doctor’s office) or less $45 per consultation $89 per service 20 to 30 minutes $156 1 week $166 See your primary care provider for preventive and ongoing care. or longer for an appointment Emergency room (ER) 3 to 12 hours Visit the ER only for serious illnesses or injuries. Your health plan may not cover non-emergency ER visits. Cost** for non-critical cases visit cost $570 visit cost © 2018 United Health. Care Services, Inc. 24 Proprietary information of United Health. Care Services, Inc. Do not distribute or reproduce without express permission of United Health. Care Services, Inc. 24

What happens after you receive care © 2018 United Health. Care Services, Inc. 25 Proprietary information of United Health. Care Services, Inc. Do not distribute or reproduce without express permission of United Health. Care Services, Inc. 25

Understanding your EOB The type of service you received How much the service cost How much your benefits plan paid How much you may owe (if anything) Your code definition Your plan maximums and how close you are to meeting them © 2018 United Health. Care Services, Inc. 26 Proprietary information of United Health. Care Services, Inc. Do not distribute or reproduce without express permission of United Health. Care Services, Inc. 26

You may be asked if you’ve been in an accident If a recent medical claim was the result of an injury. A third party may be responsible for part of the costs. If your claim is NOT accident related. UMR will process the claim according to your benefits plan. Accident details To provide information, select the Accident details tile after you log on to umr. com, or call 888 291 3774. © 2018 United Health. Care Services, Inc. Proprietary information of United Health. Care Services, Inc. Do not distribute or reproduce without express permission of United Health. Care Services, Inc.

Expert support when care gets complex Nurse case managers guide patients through complicated medical events. • Reviewing your treatment needs • Helping you understand your benefits options • Coordinating care among different providers • Communicating issues to your medical plan © 2018 United Health. Care Services, Inc. Proprietary information of United Health. Care Services, Inc. Do not distribute or reproduce without express permission of United Health. Care Services, Inc.

Expert help for your chronic condition UMR nurse coaches provide on one support for: ‒ Asthma ‒ Heart failure ‒ Diabetes ‒ Heart disease ‒ Chronic obstructive pulmonary disease (COPD) Enroll by calling: 866 575 2540 or visit umr. com © 2018 United Health. Care Services, Inc. 29 Proprietary information of United Health. Care Services, Inc. Do not distribute or reproduce without express permission of United Health. Care Services, Inc. 29

We love healthy babies – and healthy moms Moms to be receive: • Resources promoting prenatal health and healthy lifestyle habits • One-on-one calls with a nurse throughout pregnancy • And help identifying any personal risk factors Enroll by calling: 800 808 4424 or visit umr. com © 2018 United Health. Care Services, Inc. Proprietary information of United Health. Care Services, Inc. Do not distribute or reproduce without express permission of United Health. Care Services, Inc.

Talk to a nurse and earn a reward Your gift for completing the program: • $25 reward card for enrolling early and completing the program • Your choice from a selection of books on pregnancy, childbirth or infant care © 2018 United Health. Care Services, Inc. 31 Proprietary information of United Health. Care Services, Inc. Do not distribute or reproduce without express permission of United Health. Care Services, Inc. 31

Chat online with UMR customer service We’ve made it easier for you to get the answers you need – fast • Simply log in to umr. com and click the Live Chat icon in the top navigation bar • Team members are available 24 hours a day, seven days a week (excluding major holidays) © 2018 United Health. Care Services, Inc. 32 Proprietary information of United Health. Care Services, Inc. Do not distribute or reproduce without express permission of United Health. Care Services, Inc. 32

Thank you! We look forward to the opportunity to serve you. If you have any questions, please contact: Dedicated Plan Advisors: 1 844 659 5059 Mon Fri 7 am 7 pm or umr. com/Uof. NE 33 © 2018 United Health. Care Services, Inc. Proprietary information of United Health. Care Services, Inc. Do not distribute or reproduce without express permission of United Health. Care Services, Inc.