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Medical Health Plan for Plan Year 2010
The ManateeChoice Health System is administered by independent contractors within Employee Health Benefits. Employees are able to have “people to people” communication with Manatee Service Center staff by phone, walk-in or by appointment. The staff is provided by a Third Party Health Administrator and supervised by the Employee Health Benefits Manager. The staff includes Customer Service Representatives, Registered Nurse Advocates, Clinical Pharmacist, Wellness Specialist Advocates and support staff; specializing in nutrition, exercise, lifestyle assistance and health education.
Participants have the choice to enroll in one of three Health Plans based upon completing specific Qualifying Events.
The “YourChoice” Health Plan Levels for 2010 are:
- BEST - Highest Level of Reimbursement (co-pay, no deductible, no co-insurance)
- BETTER - Middle Level of Reimbursement (deductible & co-insurance applies)
- BASIC - Lowest Level of Reimbursement (deductible & co-insurance applies)
The only difference between the three plans is the Level of Reimbursement (Refer to the Reimbursement Levels).
*The level is determined by the co-pay, deductible or co-insurance, and the maximum out of pocket expense not including the deductible.
All three plans have:
- Identical Prescription Benefits with identical cost sharing
- Identical Medical Benefits with different cost sharing
- Identical Lifestyle Assessment & Modification Program (LAMP) Benefits with identical cost sharing
- Choice to utilize the Manatee Health Network or Non-Manatee Health Network Providers with different cost sharing
- Choice to utilize or not to utilize “YourChoice” Medical Management Programs and Guidelines
- Choice to utilize the Member Advocacy Program
2011 Plan Design Change
Effective for the 2011 Qualifying Event Period - Sept. 1, 2009 to Aug. 31, 2010
The changes below do not apply to the current 2010 Plan
- September 15, 2009 the County Commission approved adding a 4th plan to the 2011 Health Plan. This change does not apply to the current enrollment process. The four plans for 2011 will then be the BASIC, BETTER, BEST and ULTIMATE plans. The ULTIMATE will be better than the BEST in terms of out-of-pocket expense.
- The NEW ULTIMATE plan will have the lowest out-of-pocket expense. The BEST Plan Level of Reimbursement is changing and will have a slightly higher out-of-pocket expense than currently. There will be no change to the BETTER and BASIC plans. The Levels of Reimbursement for each plan will be announced at a later date.
- Qualifying Events for the 2011 Ultimate Plan are identical to the present BEST Plan except members must be nicotine free in order to qualify for the ULTIMATE PLAN as confirmed by the Cotinine Lab Test. LAMP will continue to offer a variety of options to assist members in becoming nicotine free. No changes have been made to the current BEST, BETTER, and BASIC Plan Qualifying Events.
Click Here for Qualifying Event details
 2011 Levels of Reimbursement
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