Health plan update [Vol. 2, no. 2 (Oct. 30, 2001)]

Health Plan Update
A Publication of the Board of Regents of the University System of Georgia October 30, 2001 Volume 2, No. 2
Open Enrollment 2001: You're the Director
University System of Georgia employees only have until Nov. 15 to make decisions regarding changes to their health-care benefits for 2002.
Anyone planning changes to these benefits who has not already done so is urged to fill out the health-care election form included in the Open-Enrollment Information Packet and turn it in to your Human Resources Office. Your current health-care benefits will remain in effect for the coming year if you do not turn in this form.
Contact Human Resources if you have any questions about benefits. You'll also find helpful information and links to the various vendors under contract with the University System at the website at the bottom of this page.
Are You Retired and Nearing Age 65?
The University System of Georgia strongly recommends that all employees who have recently retired and retirees who are are approaching age 65 apply for Medicare Part A and Part B. The Social Security Administration determines eligibility for these benefits.
Active employees with spouses eligible for Medicare should have them apply for Parts A and B as well.
Members of the University System's health plans who meet the eligibility requirements for participation under both Medicare Part A and Part B will receive primary health-care coverage from Medicare and secondary coverage from their respective USG health plan.
For more information, visit the USG employee benefits website at
www.usg.edu/admin/humres/benefits/

Open Enrollment 2001: You're the Director!

Know Your Network:

PPO Members Encouraged to Use In-Network Providers

If you participate in the Preferred Provider Organization (PPO) plan, you need to know that MRN/Georgia First's service area will change on Jan. 1, 2002.
The MRN/Georgia First network currently has health-care providers throughout Georgia and in selected areas bordering Georgia in Alabama, Florida, South Carolina and Tennesee. With the addition of a new national PPO network on Jan. 1, MRN/Georgia First will limit its coverage to all of Georgia and the border communities of Chattanooga, Tenn., and Phenix City, Ala.
The Chattanooga service area includes four zip codes in Bradley County and 28 zip codes in Hamilton County, while the Phenix City service area includes four zip codes in Russell County.
The new national PPO network, provided by Beech Street Corporation, includes all zip codes in the United States other than those included in the MRN/Georgia First PPO network.
You also need to understand that there are three types of providers to choose from in the PPO, and the level of coverage you receive will vary according to your choices.
GEORGIA IN-NETWORK PROVIDERS are doctors and hospitals located in the MRN/ Georgia First service area who specifically par-
ticipate in MRN/ Georgia First. The services received from these providers gen-
erally are covered at 90 percent of the network rate.

NATIONAL IN-NETWORK PROVIDERS are Beech Street doctors and hospitals located outside of the MRN/Georgia First service area. The services received from these providers generally are covered at 80 percent of the network rate.
OUT-OF-NETWORK PROVIDERS are doctors and hosptials:
x located in MRN/Georgia First's service area who are not affiliated with MRN/Georgia First (including Beech Street providers located in this service area); and
x affiliated with neither MRN/Georgia First nor Beech Street.
Any non-emergency services received from these providers generally are covered at 60 percent of the network rate and are subject to balance billing.
Here are some other considerations to keep in mind that may affect your choice of health-care providers within the PPO:
x Members who use both Georgia in-network (MRN/Georgia First) and out-of-network providers will have to meet two separate deductibles ($300/individual and $900/family innetwork; $400/individual and $1,200/family out-of-network) and two stop-loss limits ($1,000/ individual and $2,000/family innetwork; $2,000/ individual and $4,000/ family out-of-network).
x Members who use both national in-network (Beech Street) providers and out-of-network providers will have to meet a combined maximum deductible of $400/individual or $1,200/family and a combined maximum stop loss limit of $2,000 or $4,000/family.