ST. CATHERINE’S CENTER FOR CHILDREN OPEN ENROLLMENT 7/1/2020
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ST. CATHERINE’S CENTER FOR CHILDREN
OPEN ENROLLMENT 7/1/2020
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BSNENY.com/stcatherines
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Benefits at a Glance
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Information Regarding Coronavirus (COVID-19)
• The cost of the COVID-19 test and treatment is fully covered for our members
• If you feel sick, utilize telehealth options either through your primary care doctor or Doctor On Demand®
• Visit bsneny.com/coronavirus for the most up to date information, answers to frequently asked questions, or to take a COVID-19 self assessment
Your 2020 Plan Options
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Strong Local Access with the Best National Network
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Seamless Experience Regardless of Location
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Centers of Excellence Contracted NationwideBlue Distinction® Specialty Care
MORE THAN4,500 BDC AND BDC+DESIGNATIONS AWARDED
TO MORE THAN1,900 FACILITIESAND PROVIDERS
ACROSS ALL TOP 50 METROPOLITAN STATISTICAL AREAS
Bariatric surgery
Cancer care
Cardiac care
Cellular immunotherapy — CAR-T
Fertility care
Knee and hip replacement
Maternity care
Spine surgery
Transplants
More than 20% average savings per episode
BlueCross BlueShield Association and registry data, BDC/BDC+ eligible facilities vs. relevant comparison group. Results based on most recent designation cycle for each specialty.
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More Than 65 Free Checkups and Preventive Health Services
Visit bsneny.com/preventive for a complete list of preventive services.
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Preventive Drug List
More than 450 preventive medications covered at $0 member cost-share (not subject to the deductible)
Includes brand-name andgeneric medications
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EX Network: How It Works
*Counties include: Albany, Clinton, Columbia, Essex, Fulton, Greene, Montgomery, Rensselaer, Saratoga, Schenectady, Schoharie, Warren, and Washington.
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Benefit Summary POS 266 EX POS 250D POS 6228 EX EPO 8000
HSA-qualified No N/A Yes Yes
Deductible N/A $750/$1,500 $3,000/$6,000 $5,000/$10,000
Coinsurance N/A 20% N/A 30%
Out-of-pocket maximum $6,300/$12,700 $3,000/$6,000 $5,000/$10,000 $6,350/$12,700
In-Network Services
PCP/specialist office visit $25/$40 $30/ $50 $30/ $50 after deductible 30% after deductible
Telemedicine $25 $30 $30 after deductible 30% after deductible
Inpatient hospitalization $500 20% after deductible $500 after deductible 30% after deductible
Outpatient surgery (facility) $200 20% coinsurance only $200 after deductible 30% after deductible
Emergency room/urgent care $150 20% after deductible $150 after deductible 30% after deductible
Prescription drugs copay $10/$30/$50 $10/$50/$75 $10/$50/$75after deductible
$15/$50/50% after deductible
Prescription mail order 2 copays 2 copays 2 copays 2 copays
Out-of-Network ServicesDeductible $2,000/$4,000 $4,000/$8,000 $5,000/$10,000 N/A
Coinsurance 30% 50% 40% N/A
Out-of-pocket maximum $6,350/$12,700 $10,000/$20,000 $10,000/$20,000 N/A
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Lab Services through Quest Diagnostics®
• Members must use Quest Diagnostics for lab services to process in-network.• If members use a lab service other than Quest, they are responsible for the retail cost
of their services. • Visit bsneny.com/findadoctor to find a location near you or to schedule
an appointment.
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Register Online at bsneny.com/stcatherines
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Seeking Care: You Have Options
Some plans require that you have a primary care physician (PCP) to enroll.
You have many ways to seek the care you need when you need it. Knowing where to go in certain situations can help you save time and money.
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TruHearing®
Hear better. Feel better. Save thousands.
With TruHearing, you get: • Exclusive savings — average savings of $980 per aid compared to national average prices• Quality and choice — a wide variety of the latest digital hearing aids from top
manufacturers• Personal care — professional care from local providers at over 5,000 locations nationwide
Hearing aid purchases include:• Three follow-up visits with a provider for fitting and adjustments• 45-day trial• Three-year manufacturer warranty for repairs and one-time loss-and-damage replacement• 48 free batteries per hearing aid (not included with rechargeable models)
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Accredo Specialty Pharmacy
24/7 assistance
Regular follow-up
Refill reminders
Drug safety monitoring
Accredo will mail your specialty medications to your home or location of choice.
Our preferred specialty pharmacy
Member Tools and Resources
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Welvie®
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Resources for Getting (and Staying) Healthy
Health coachingDevelop a personalized health
plan with one-on-one health coaching from registered nurses, nutritionists, and
exercise experts.
Disease managementDisease management helps you make positive health changes through programs focused on
behavioral health, asthma, diabetes, cardiac care, and more.
Case managementCase management helps you make informed health care decisions for
transplants, palliative care, pregnancy,
and behavioral health.
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Free Community Wellness Programs
Visit bsneny.com/communitywellness for a complete list of classes.
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GlobalFit®
Get discounts on gym memberships and health-related products and services including:
• Exclusive savings to more than 8,000 national, regional, and local gyms
• Gym privileges while traveling • Discounts on Jenny Craig, Zumba, and home
fitness equipment • The latest deals on flights, hotels, car rentals,
and more
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Your Wellness Card
On the EPO 8000 plan onlyThe wellness card helps you live a healthier lifestyle with a
$250 annual allowance for a variety of products and services.
Fitness centersGym memberships
Personal training sessionsFitness classes
Health food stores(GNC, Vitamin World)
Nutritional supplementsHealth products
Acupuncture treatmentsMassage therapyChiropractic visits
WW (Weight Watchers)Races and fun walksSports programs
Camps and club services
Next Steps
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Action Items
• Make sure employees let you know about any changes (adding or removing dependents, canceling coverage, etc.).
• Employees need to follow your procedure on how changes are submitted.
• Make sure all contact information is accurate (phone numbers, email addresses, etc.).
BlueShield of Northeastern New York is a division of HealthNow New York Inc., an independent licensee of the Blue Cross and Blue Shield Association. The Blue Shield® and Shield Symbols are registered service marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans. Quest Diagnostics®, EyeMed®, Welvie®, Wellframe®, Doctor On Demand®, TruHearing®, Express Scripts®, and GlobalFit® are independent companies.
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