Geronda C. Pulliam, RN. Dear Cone Health Insurance Plan Member,

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1 Dear Cone Health Insurance Plan Member, Thank you for expressing interest in the Cone Healthy Pregnancy Program. The Cone Health insurance plan offers a discounted maternity benefit after completion of this program to those that are covered under the insurance Choice plan. The benefit consists of taking classes at several different Cone Health System locations (Women s hospital, MedCenter Kernersville and The Birthplace at Alamance Regional). After completion of the program, you will qualify for a $100 discounted maternity benefit copay, which is to be paid to the delivering Cone Health hospital. This benefit will cover most of your prenatal healthcare and delivery costs. Please note, High-Deductible Health Plan members are not eligible to participate in the Healthy Pregnancy Program as there is a deductible to be paid with that plan. To register for the program, please log onto click on the For Employees section at the bottom of the page. You will be directed to the Employee page where you will find the information for the Healthy Pregnancy Program. You will be able to enroll and submit a registration form online. An confirmation will be sent to you with this program packet attached, verifying receipt of your registration. In this packet, there is detailed information on the Healthy Pregnancy Program for first time and second time or more pregnancies. It includes instructions on how to register for the required classes online or via telephone. Also included, is a class completion record form. Bring this form with you to every class so your attendance can be validated by the instructor. You will also find in this packet detailed information on the Cone Health insurance plan Maternity Benefits. Keep this information for future reference on tests, procedures or any other coverage under the healthcare plan. Triad Healthcare Network (THN) Care Management facilitates this program. When you have taken all of the required classes, mail, fax or scan via the class completion record form back to the THN Care Management office and your attendance in the program will be verified. UMR insurance will also be notified of your participation and your claims will be paid appropriately. If you have any questions regarding the Healthy Pregnancy Program or the discounted maternity benefit, please call the THN Care Management office at # , the pregnancy program at HealthyPregnancyProgram@conehealth.com, or you can also call your main campus human resources department for further details. Sincerely, Geronda C. Pulliam, RN Geronda C. Pulliam, RN, BSN, MS, CCM Assistant Clinical Director THN Care Management at Cone Health Facilitator of the Healthy Pregnancy Program (336) If it is unreasonably difficult due to a medical condition for you to achieve the standards for the Incentive under this program, or if it is medically inadvisable for you to attempt to achieve the standards for the incentive under this program, call us at (336) , and we will work with you to develop another way to qualify for the incentive. 1

2 Healthy Pregnancy Program Class Information For First Time Pregnancies-Required Classes Your Healthy Pregnancy-For first time pregnancies (THN Care Management will register you for this class). This class includes information on your changing body, healthy nutrition and baby safety. It is only taught at Women s Hospital of Greensboro. Please note: It is recommended to take a class before 22 weeks of pregnancy to start receiving the necessary information. Class Schedule-only attend this class one time/one date September 8, 2015 Women s Hospital Classroom # 1 & 2, 7pm 9pm November 9, 2015 Women s Hospital Classroom # 1 & 2, 7 pm-9 pm January 13, 2016 Women s Hospital Classroom # 1 & 2, 4 pm-6 pm Birth and Baby Series or Prepared Childbirth (ARMC) This series of five consecutive weekly classes help you and your labor partner prepare for childbirth and parenting. Topics include caring for your baby, childbirth options, cesarean birth, pain management and comfort techniques. The class includes a tour of The Women s Hospital or The Birthplace at ARMC. Classes are also available at Cone Health MedCenter Kernersville. OR Condensed Birth and Baby Class or Weekend Childbirth Blitz (ARMC) (Please note, these classes fill up fast) This class covers the care and safety of your new baby and the basics of labor and childbirth. The class meets on Friday night and all day Saturday (at Women s hospital) or Saturday and Sunday (at ARMC). AND Breastfeeding Your Baby Class or Breastfeeding and Infant Nutrition (ARMC) Learn about what to expect the first days of breastfeeding your newborn, common fears and challenges during the first few weeks and months and beyond. There will also be information on returning to work or school, collection and storage of milk. This class meets for two consecutive weeks. To Sign-Up for Classes Online, go to Under Online Tools, on the right side of the screen, click on Register for a class. Select Pregnancy & Childbirth under Categories. Choose a date and click on the desired class. You will be able to register online. If you have any questions about registering for classes call For the Birthplace at Alamance Regional, go to Under I d Like To, Click on Register for a class on the right side of the screen. Select Pregnancy & Childbirth under Categories. Choose a date and click on the desired class. You will be able to register online. If you have questions about registering for classes, call **If at any time, your OB/GYN provider places you on bed rest, or you are diagnosed with Gestational Diabetes, please call THN Care Management at # for further instructions and opportunities in the program. 2

3 Healthy Pregnancy Program For First Time Pregnancy Required Classes Class Completion Record (Must be signed by class instructor at each class) Full Name (Please print) Date of Birth SECTION #1 Your Healthy Pregnancy UMR ID# Dates classes are taken AND instructor signature SECTION #2 (Choose One) OR Birth & Baby Or Prepared Childbirth (ARMC) Condensed Birth and Baby Or Weekend Childbirth Blitz (ARMC) SECTION #3 (Choose One) Breastfeeding Your Baby Or Breastfeeding & Infant Nutrition (ARMC) **Upon completion of the classes, keep a copy of this form for yourself. This is the document that is used to ensure that the maternity discount will be applied. Mail, send via interoffice mail, fax or scan via this form to the address below: Healthy Pregnancy Program THN Care Management 510 N. Elam Ave, Suite 301 Greensboro, NC Fax: # HealthyPregnancyProgram@conehealth.com Please call # if you have questions.

4 For Second Time or More Pregnancies-Required classes Please note: It is required that you begin taking classes by 32 weeks of pregnancy to receive the necessary information for the discounted maternity benefit. HealthStream (HLC) computer based learning is found on Cone Connects under the Quick Links section. Both PowerPoint HLCs with tests in this section are required. Sign up and take the HLC programs as you would any other HLC in the system. THN Care Management will receive a record of these completions. Your Healthy Pregnancy HLC This HLC includes information on your changing body, healthy nutrition and baby safety. It is titled 2013HealthyPregnancyProgram. AND Pregnancy and Nutrition HLC This HLC includes information on healthy nutrition for pregnancies, titled 2012PregnancyAndNutrition_GuidelinesForAHealthyDiet. The following are onsite classes that are required Refresher Birth & Baby Class or Childbirth Preparation Refresher Course (ARMC) Expecting another baby? This 2 week course reviews both vaginal and cesarean birth, breathing and relaxation techniques. For those that have attended a Birth & Baby class or Childbirth Preparation class in the past. This class includes a tour of Women s Hospital or the Birthplace at ARMC. AND Breastfeeding Your Baby Class or Breastfeeding and Infant Nutrition (ARMC) Learn about what to expect the first days of breastfeeding your newborn, common fears and challenges during the first few weeks and months and beyond. There will also be information on returning to work or school, collection and storage of milk. This class meets for two consecutive weeks. To Sign-Up for Classes Online, go to Under Online Tools, on the right side of the screen, click on Register for a class. Select Pregnancy & Childbirth under Categories. Choose a date and click on the desired class. You will be able to register online. If you have any questions about registering for classes call For the Birthplace at Alamance Regional, go to Under I d Like To, Click on Register for a class on the right side of the screen. Select Pregnancy & Childbirth under Categories. Choose a date and click on the desired class. You will be able to register online. If you have questions about registering for classes, call **If at any time, your OBGYN physician places you on bed rest, or you are diagnosed with Gestational Diabetes, please call THN Care Management at # for further instructions and opportunities in the program. 4

5 Healthy Pregnancy Program For Second or more pregnancies Class Completion Record (Must be signed by class instructor at each class attended) Full Name (Please print) Date of Birth UMR ID# SECTION #1 Dates classes are taken AND instructor signature Your Healthy Pregnancy HLC And Pregnancy and Nutrition HLC (THN Care Management will have a record of your completions) SECTION #2 Refresher Birth & Baby OR Childbirth Preparation Refresher Course (ARMC) SECTION #3 Breastfeeding Your Baby OR Breastfeeding and Infant Nutrition (ARMC) **Upon completion of the classes, keep a copy of this form for yourself. This is the document that is used to ensure that the maternity discount will be applied. Mail, send via interoffice mail, fax or scan via this form to: Healthy Pregnancy Program THN Care Management 510 N. Elam Ave, Suite 301 Greensboro, NC Fax: # HealthyPregnancyProgram@conehealth.com Please call if you have questions.

6 Other Classes That Are Available These are not required for the program but are FREE to Cone Health insurance plan members. Call # or # (ARMC) to register for these classes or support groups. A Natural Childbirth-This series of 5 classes is for expectant parents who want to learn and practice natural methods of coping with the process of labor and childbirth. Recommended stage of pregnancy is weeks of gestation. Waterbirth This informational class will help you discover whether water birth is the right fit for you. Education about water birth itself, supplies you would need and how to assemble your support team is what you can expect from this class. Breastfeeding on the Go Learn how to continue your breastfeeding relation while you are apart from your baby. This class will address ways to maintain your milk supply, pumping strategies and milk storage. We recommend attending this class after breastfeeding has been established. This class is not a substitute for the Breastfeeding Your Baby class. Caring for Baby- This class is for pregnant and adoptive parents who want to learn and practice the most up-to-date newborn care for their babies. The focus is on birth through the first 6 weeks of life. Fit for Two: Yoga and Pilates Specially trained instructors help you tone up and exercise safely, both before and after you give birth. Learn about stress management, relaxation techniques and various pregnancy and postpartum topics. Classes meet at The Green Valley Medical Center Building, 719 Green Valley Road, Suite 107. Please register at Infant and Child CPR or Newborn Essentials (ARMC) Learn resuscitation techniques for infants and young children who are choking and/or experiencing respiratory and cardiac arrest Big Brother/Big Sister or Preparing Big Brother & Sister (ARMC) Let your children share the joy of a new brother or sister in this special class designed just for them. Activities include discussing how families care for babies and touring the newborn nursery. This class is designed for children ages 2 to 8. Daddy Boot Camp (Also ARMC) Experienced dads, who have been trained as coaches, teaches dads-to-be how to hold, comfort, diaper, swaddle and play with their infant while being able to support the new mom. Baby and Me (birth to crawling) Discuss newborn and infant parenting along with family adjustment issues with other new mothers. Each week is a new speaker or baby-centered activity. Led by a Registered Nurse, this class meets every Thursday at 11am. Grandparent Love- Be an informed grandparent. Learn the latest in infant care, what great equipment to have on-hand when the baby visits, and ways to support your child in his/her new parenting role. This class also involves a tour of Women s Hospital.

7 Marvelous Multiples- Expecting twins, triplets, or more? This class covers the differences in labor, birth, parenting, and breastfeeding issues that face multiples parents. Infant Massage (ARMC) - Learn specific massage strokes that can foster an emotional bond and communication between you and your baby. This class is taught by a certified infant massage instructor. Classes are held in the ARMC Pediatric Rehab Clinic at 3906 S. Church St. in Burlington. Breastfeeding Support Group or Mom s Express Club (ARMC) - Have questions or concerns about breastfeeding, or just need some support? This Mom support group meets every Tuesday at 11 a.m. at Women s Hospital or the 1 st and 3 rd Thursday at 10:30 am at Alamance Regional. These groups are led by a Certified Lactation Consultant. Feelings After Birth Support Group-This support group meets every Tuesday at 10 a.m. It is Moms supporting other Moms through the sometimes difficult adjustment that follows a baby s birth. Gestational Diabetes Class- a 2 hour FREE class is available through the Cone Health Nutrition and Diabetes Management Center. Please call # to inquire and schedule an appointment, and tell them you are in the Healthy Pregnancy Program. Lactation Rooms are available on some of the Cone Health main campuses (Check at your location for a secure and private place to pump once you return to work) Moses Cone Hospital- Room # 4574, code 145 Women s Hospital-Exercise and relaxation room, ground floor Wesley Long Hospital-4 East relaxation room Annie Penn Hospital -2nd floor near the Employee Health office Behavioral Health Hospital- ground floor through the exercise room Alamance Regional Medical Center- Express Lounge, Main corridor of the bed tower on the 2nd floor LiveLifeWell Healthy Rewards Program Once you have completed the Healthy Pregnancy Program, you can also claim the Healthy Pregnancy badge with the Cone Health LiveLifeWell Healthy Rewards Program, under the section Category 3. **By earning this Healthy Pregnancy badge, you will meet the requirements for Category 3: Weight Smart, which is worth $50. The deadline for claiming this badge is September 1, 2015 with a payout date of September 28, 2015.

8 FMLA INFORMATION For Maternity Leave Beginning August 1, 2015, the Cone Health system s FMLA and LOA will be managed by a new company named Matrix. Employees should contact Matrix directly for intermittent FMLA and FMLA related to maternity leave. Your directors, managers and supervisors will have detailed information about this group. Contact Matrix at # ; Website or Mobile App: Download the mobile app by snapping the correct QR code (Android or ios) or search Matrix eservices on your smartphone or tablet s app store. For more information, search Lincoln Financial will still manage short and long term disability. 8

9 Maternity Benefit Prenatal Program-Choice Plan 2015 Benefit Delivery Global Charges Completed Program With Delivery at Women s or ARMC 100% pre-term care $100 copay due to hospital at delivery then 100% Completed Program with Delivery at a United Healthcare Choice Plus Provider Did Not Complete Program with Delivery at Women s or ARMC 60% 80% 60% Prenatal Visits 100% 60% 80% 60% Pediatrician in Hospital Visits 100% 80% 80% 80% Circumcision 100% 80% 80% 80% Anesthesia 100% 80% 80% 80% Midwife Services 100% 80% 80% 80% Perinatologist Services Neonatal Physician Services Delivery Room & Board Newborn Nursery & Ancillaries Neonatal Room & Board & Ancillaries 100% 80% 80% 80% 80% 80% 80% 80% Did not Complete Program with Delivery at a United Healthcare Choice Plus Provider (not CH) $100 copay due to 60% $500 copay then 80% $1,000 copay then hospital then 100% 60% 100% 60% 80% 60% $500 copay then 80% $1,000 copay then 60% $500 copay then 80% $1,000 copay then 60% Intravenous Therapy 100% 60% 80% 60% Lactation Consultation Ultrasounds Physician Charges (Must be Physician Ordered) Ultrasounds Facility charges (Must be Physician Ordered) Amniocentesis & Other Tests Physician Charges Amniocentesis & Other Tests Facility Charges Genetic Testing Physician Charges 100% 60% 80% 60% 100% 80% 80% 80% 100% 60% 80% 60% 100% ** 80% 80% 80% 100%** 60% 80% 60% 100% ** 60% 80% 60% ** In-network labs and testing are covered at 100% under the health plan. There is no coverage for any out-of-network testing or services per the general guidelines of the Cone Health insurance plan. Please check with your provider to determine if labs will be done at an in-network lab or facility. 9

10 Benefit Lab Tests Physician Charges Lab Tests Facility Charges Emergency Department Visit Maternity Admissions Unit (ER Dept Visit) Breast Pump Purchase Ultrasound (Photo Op) 3-D Prenatal Vitamins Home Health Nursing Visits Related to Maternity Issues Completed Program with Delivery at Women s or ARMC Completed Program with Delivery at a United Healthcare Choice Plus Provider Did Not Complete Program with Delivery at Women s or ARMC 100% ** 80% 80% 80% 100% ** 60% 80% 60% Did Not Complete with Delivery at a United Healthcare Choice Plus Provider 100% ER Co-Payments ER Co-Payments ER Co-Payments 100% N/A 80% N/A 100% 100% 100% 100% Not Covered Not Covered Not Covered Not Covered See Prescription Drug Benefit See Prescription Drug Benefit See Prescription Drug Benefit 100% 100% 100% 100% See Prescription Drug Benefit 17 P-Hydroxyprogesterone/Makena (to prevent pre-term labor) is covered at Zero Copay if obtained from a Cone Health Outpatient Pharmacy. ** In-network labs and testing are covered at 100% under the health plan. There is no coverage for any out-of-network testing or services per the general guidelines of the Cone Health insurance plan. Please check with your provider to determine if labs will be done at an in-network lab or facility. *See insurance plan information related to newborn enrollment within 31 days of birth. (Next Page) 10

11 Cone Health/UMR Insurance Plan Enrollment Information If you want to add your baby to the Cone Health UMR insurance plan for medical coverage, call the Cone Health System Benefits Hot Line at # or the Alamance Regional Human Resources Department at within 31 days after the child is born. You will also need to fax a birth certificate to the UMR eligibility department, at # (877) with your name and UMR insurance ID number. If you want the baby s hospital bill to be paid under the Healthy Pregnancy Program discounted maternity benefit, you will need to add the baby to your Cone Health insurance plan within 31 days after birth (see above). Once you add the baby to your insurance plan, the coverage begins the day the baby is born. If you add your baby to a different insurance plan, that other plan should pay for the baby s hospital bill from birth- not the Cone Health insurance plan. As a benefit of the Affordable Care Act, breast pumps are covered by insurance at 100%. If you would like to breastfeed and want to receive a breast pump at the time of delivery before leaving the hospital (from Women s or Alamance), contact a lactation consultant. You will receive a Medela breast pump and be educated on how to use it. The consultant or representative will collect your information (name, DOB and insurance ID number) and process according to the health plan guidelines. If you or an eligible dependent wants to apply for coverage more than 31 days from the date of eligibility, you must wait until the next annual enrollment period or until you incur a change in status. If you our any of your covered dependents become covered by Medicare, Medicaid or a different insurance group, please notify your main campus Human Resources department. The Cone Health System Benefits Department can provide you with any further detailed information about you or your family insurance coverage, the enrollment process or other benefits. Please call the Benefits Line at # or Alamance Regional HR department at # for further information. 11