HomeMy WebLinkAboutCPA HEALTH PLAN B PLAN B
C�MMUNICATIO►N FUR RETIREES AND/CfR
DEPENDENTS
NEED 2�' 4_ HEALTH BOOKLETS ONLY TO BE ATTACHED TO
CITY COMMUNICATION ALONG WITH SUMMARY SHEET...
TO BE MAII.ED TO: CITY OF PORT ARTHUR
HUMAN RESOURCES DEPT/PAT DAVIS
444 4TH STREET, ROOM 1U3
P.O. BOX 1089
PORT ARTHUR, TEXAS 77641-1089
(409) 983-8214
DELORIS "BOBB�IE" PRINCE, MAYOR ;�� STEPI-IEN FIT'LGIBBONS
MORRIS ALBRIGH'T, lll, MAY'OR PRO TEM CITY MANAGER
Enerp,y
COUNCIL VIE:Mfi1�:RS: City of ��ty TERRI HANKS
JACK ('HATMArJ, ,IR. � � CITY SECRETARY
ELIZABETH "Ll:�° SEGLF.R ��
MARTI'V FLOOD �-�� VAL TIZENO
.IOHN BEARD, J[t. O)'1 rth u r CITY ATTORNEY
ROBERT E. W[LILIAMSON
0. KAY WISE TC.xQS
7'HOMAS J. HENllERSUV
DEA►R RE'TIItEE AND/OR DEPENDENT(S):
On ��eptember 29, 2010, the Mayor and City Council approved a Resolution accepting Blue
Cross and Blue Shield of Te�s' (BCBS) renewal proposal to continue providing Third :Party
Adm�inistrative Services for the City's self-funded major medical program for the plan year
beginning 11/1/2010 through 10/31/2011. Delineated below are plan amendments as folli�ws:
EFFECTIVE NOYEMBER 1. ZDIO
�> 10'� PREMIUM INCREA.SE FOR ALL IMf'ACTED RETIREES AND/UR DEPEND,ENI'S
(SEERATE CHART ON&ACK).
�> CHANGE IN IN-NETWORK DEDUC77BLE FROM $S00 TO �1,000
WDNIDUAL/$1,500 TO $3,000 FAMILY,• OUT-OF-NETWORK DEDUC77BLE FROM
$1, D00 TO $2, 000 INDNID UAI✓�3, 000 TO $6, 000 F�MILY.
�� CHANGE IN IN-NETWORK C06HARE STOPLOSS MAXIMUM FROM $2,500
INDNIDUAL/$5,000 FAMIL,Y PER CALENDAR YEAR TO $3,500
INDIVIDUAL/�7,000 FAMII.Y PER CALENDAR YEAR; OUT-OF-NETWORK
COSHARE STOPLOSS MAXIMUM FROM �3,000 INDMDUAL/$9,� FAMII,Y' PER
CALENDAR YEAR TO $4,000 INDNIDUAL/$12,000 FAMII.,Y PER CALENfDAR
YEAR.
-� CHANGE IN IN-NETWORK OFFICE VISIT COPAYS FROM $25 PER VISIST 'TO A
DUAL COPAY PLAN -- $35 PRIMARY CARE PHYSICIAN VISiTS &$50 SPECIA,LIST
OFFICE VISTTS.
;� CHANGE IN EMERGENCY ROOM COPAY FROM $100 TO $150; URGENT C'ARE
COPAY $75.
;+� CHANGE IN PRESCRIPTION COPAYS FROM $10 GENERIG$30 PREFEFtRED
BRAND/$50 NON-PREFERRED BRAND TO $15/GENERIG$35 PREFERRED
BRAND/$60 NON-PREFERRED BRAND.
;+� INCL ZISION OF PATIENT' PROTECTIDN AFFORDAB�LITY CARE ACT
PROYISIONSINACCORDANCF WITHLF.GISLA77vE REQUIRF,MF,NI'S.
;� UPDATED HEALTH ID CARDS WILL BE MAILED FROM THE BLUF_ CROSS & i4LUE
SHIELD OF TEXAS' (BCBS) HOME OFFICE BY NOVEMBER 1, 2010; HOW�s'VER,
Yc�UR CURRENT HEALTH ID CARDS MAY BE UTILIZED DZ7RING THE INTERIM
PF_RIOD.
All i�nquiries in this regard can be made by contacting the Human Resources Office at (409)
983-�8214.
P.O. BOX ]089 ' PORT ARTHUR, TEXAS 77641-1089 • 409/983-8115 ' FAX 409/983-8291
City of Port Arthur Health Insurance Rates
(Blue Cross Blue Shield of Texas/Third Party Administrator)
Effective November 1, 2010
7 i � ! . i� 3 f�� s i" � ��{ 9 3 s i! a t? I �# I� I � i
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� � �1G�'�'�' �i ���;�`��l �:��#' �
�k'�"��� �+��� ��!"�'�'� ��'�'1!"� � S ��,���' ���"#'�'1��1' �:tl�"1" �'���'�I� � � �`���� .
Retiree Under 65 $ 205.81 �,� ���� �� �;������,�,��� �� " '
�°
Retiree<65 & 1 Dependent $ 723•�� z � `'����������° ����'����,�= s
Retiree<65 dc 2+ Dependents $ 811.51 � '' � �' � � �" � � ��; � � � � ,�; �.�� . � �
Retiree<65 � Medicare Oependent $ 368.76 �� ��� � �, �:� �,� � �; � , � � � �; � , ���
Medicare Retiree $ 162.94 ``� � `���>° ��£� � ` � �
°� � i,; � „ �- �= � �:, .� � � �> �;
Medicare Retiree � 1 Dependent $ 456.53 ��� ��_'� � ��,� ������ ������; � a �
��
Medicare Retiree b 2+ Dependents $ 539.07 � u �� ���
w �.� . . ..
Mediccre Retiree � Medicare Dependent $ 325.89 �`�'��� �, ����