Plan. Medical Mutual of Ohio Overview

Transcription

1 Pla Medical Mutual of Ohio Overview

2 welcome Welcome to Medical Mutual Service ad value set Medical Mutual of Ohio apart. A trusted isurer for more tha 75 years, our missio remais uchaged: to fiace ad maage beefits that improve the health ad wellbeig of our members. Medical Mutual puts the customer first. As a mutual health isurace compay, we are owed ad operated for the beefit of our members, with products ad services desiged ad priced i our customers best iterests. Ulike publicly traded isurace compaies that must operate to maximize their fiacial retur, we do ot aswer to stockholders ad Wall Street aalysts. Headquartered i Clevelad, Medical Mutual has sales, service ad iformatio techology offices i 12 locatios across Ohio, ad 2,600 Ohio-based employees who pride themselves o their service to our customers ad commuities. Every year, our employees cotribute thousads of hours as commuity voluteers supportig more tha 200 charities. Our award-wiig Customer Service departmet hadles thousads of calls a day, resolvig early 95 percet of calls durig iitial cotact. We also process thousads of claims each day, with 99 percet accuracy. Accredited product quality, customer cofidece. NCQA Medical Mutual of Ohio is accredited at the highest level for our commercial maaged care products by the Natioal Committee for Quality Assurace (NCQA), recogizig our commitmet to providig quality healthcare to our members ad our icorporatio of quality improvemets ito our busiess structure. We have also eared the NCQA Welless & Health Promotio Accreditatio, which evaluates how well we maage all parts of our welless ad health promotio program for cotiuous improvemet of the quality of services, materials ad activities provided to eligible idividuals. URAC I additio to NCQA, Medical Mutual is accredited by URAC, a o-profit orgaizatio that establishes stadards for the maaged care idustry, for our Health Utilizatio Maagemet ad Case Maagemet programs. Medical Mutual 1

3 health plas Health Plas Available for You Superior pla flexibility, excellet coverage ad affordable rates are three good reasos to select health coverage with Medical Mutual, which has teamed up with your area Chamber of Commerce to provide you with the comprehesive healthcare beefits traditioally foud at larger compaies. The Alliace of Ohio Chambers Pla parters your compay with other chamber member compaies that employ two or more people, givig you the opportuity to obtai competitive rates with Medical Mutual health plas. The Alliace of Ohio Chambers Pla is available i the followig couties: Alle Clito Hacock Mercer Shelby Auglaize Darke Hardi Motgomery Uio Butler Fayette Loga Preble Va Wert Champaig Greee Madiso Putam Warre Clark Hamilto Miami Seeca To see if your chamber is active with The Alliace of Ohio Chambers, cotact your chamber directly or visit AlliaceofOhioChambers.com. The Alliace of Ohio Chambers Pla offers a variety of group ad acillary group products for you ad your employees. Group Products Medical Mutual offers a selectio of products withi the Ohio HealthPool Small Group Beefit Plas to choose from based o a group s eeds. SuperMed Plus Double Deductible Suite Plas (with Rx) SuperMed Plus Triple Deductible Suite Plas (with Rx) SuperMed Plus Cosumer Suite Plas Health Savigs Accout (HSA) Health Reimbursemet Accout (HRA) SuperMed Share All of our products offer access to our proprietary SuperMed Network, a extesive etwork of doctors ad hospitals that provides the foudatio for the popular health plas we offer, with etworks coverig all 50 states. Members who are travelig receive the same reliable care ad customer service we are recogized for i Ohio. 2 Medical Mutual

4 Acillary Group Products Life Isurace Life ad disability coverage is easy ad affordable through Cosumers Life Isurace Compay, a subsidiary of Medical Mutual. With quality plas ad flexible cost-sharig optios, Cosumers Life makes addig life ad disability to a group s beefits package simple ad cost-effective. Group term life, accidetal death ad dismembermet, depedet life, short-term disability ad log-term disability plas are available to groups. We also offer volutary beefit products, which employers ca provide to employees at o cost to the compay ad are similar i structure to a group-sposored pla. Flexible Spedig Through FlexSave, Medical Mutual s flexible spedig accout product, members ca set aside a portio of each paycheck ito a accout before payig icome taxes ad get reimbursed tax-free for certai qualified expeses, such as healthcare, depedet care ad commutig costs. Group Detal Through SuperDetal, our PPO detal product, we offer a variety of flexible plas that use DeteMax, a leadig atiowide detal etwork. I additio, we offer Traditioal Detal pla desigs with o etwork restrictios ad reimbursemets based o selected fee schedules. Group Visio With SuperMed Visio, our PPO visio product, groups ca select from a variety of plas that use the EyeMed or VSP etworks. Each etwork is atiowide ad offers may cost-effective optios for choosig doctors ad providers for glasses ad other visio services. We also offer a umber of Traditioal Visio pla desigs with o etwork restrictios ad reimbursemets based o selected fee schedules. Prescriptio Drugs Medical Mutual s pharmacy beefit maager, Medco Health Solutios, Ic., serves the eeds of more tha 60 millio people. Medco s pharmacy services are desiged to improve the quality of care ad lower total healthcare costs for both compaies ad for idividuals served by Medicare Part D prescriptio drug plas. Our plas typically iclude a formulary, geeric icetive ad home delivery icetive for cost-effectiveess. Medical Mutual 3

5 fudig optios Fudig Optios $ SuperMed Health Savigs Accouts (HSAs) Medical Mutual offers HSA-compatible health plas, which ca be combied with HSAs. Employees ca use the fuds saved i these tax-advataged savigs accouts to pay for curret or future eligible healthcare expeses. SuperMed HSAs ca provide cost-savigs to groups ad members. This optio offers: Access to the SuperMed etwork of doctors ad hospitals A tax-advataged method for groups to help fud employees healthcare Access to a tax-free paymet of qualified out-of-pocket health expeses for members No mothly or set-up bakig fees if a member chooses a bak that parters with Medical Mutual Fuds i a HSA ca be used for: Deductibles, copays ad coisurace directly related to a medical pla Prescriptio drugs Detal services, icludig braces, bridges ad crows Visio care, icludig glasses ad Lasik eye surgery Other qualified medical expeses Retiremet savigs SuperMed Health Reimbursemet Accouts (HRAs) SuperMed HRAs are high-deductible health plas paired with employer-fuded HRAs that help employees meet their health pla deductibles. This product, offered as a solutio to groups, features: Access to the SuperMed etwork of doctors ad hospitals Flexible pla desigs that allow employers to choose how the HRA works together with the high-deductible health pla Oe Explaatio of Beefits with HRA ad claims activity for seamless admiistratio Network-oly HRAs Direct paymet to providers, ot employees SuperMed Share SuperMed Share is a iovative shared fudig pla that helps fully isured groups with 51 or more eligible employees reduce their premiums. It allows employers to share i the fudig of medical costs, while offerig the same great beefits to their employees. The result could be sigificat savigs for the employer. By self-fudig a portio of the health coverage, fully isured groups ca take advatage of lower premiums ad employees have lower deductibles tha with a high-deductible health pla. Selffudig ca apply for all services office visits, copays, outpatiet ad ipatiet services or oly for services that qualify for a deductible. 4 Medical Mutual

6 web tools Iteractive Web Tools Employers EmployerLik, our most popular tool, lets group officials quickly take care of their dayto-day health pla duties. EmployerLik users ca: Pay mothly bills olie Add ad cacel employees Update employees persoal ad depedet data Order idetificatio cards View Certificate Booklets Members Located o MedMutual.com, My Health Pla is exclusively for registered members. Through the site, members ca: view Explaatios of Beefits (EOBs), order ew or replacemet ID cards, dowload a Certificate Booklet, appeal a claim ad much more. Quicke Health Expese Tracker Aother useful feature o My Health Pla is Quicke Health Expese Tracker SṂ Free for members, Quicke Health Expese Tracker allows them to: Pay their doctor bills olie Track deductibles ad out-of-pocket maximums Easily uderstad claims ad their overall healthcare costs Quicke Health Expese Tracker protects persoal health iformatio with the same ecryptio ad privacy safeguards that protect millios of TurboTax ad Quicke customers. Provider Search Tool ad Treatmet Cost Estimator Searchig for doctors ad medical facilities is easier tha ever with our robust Provider Search tool, which allows members to search by ame, specialty, geder ad more. The tool is also itegrated with our Treatmet Cost Estimator to help members make cost-effective choices by fidig out how much certai services will cost with participatig providers. SuperWell Health Resource Ceter The SuperWell Health Resource Ceter is a health ad welless sectio o My Health Pla that offers tools, support ad iformatio to help members research ad lear about health topics. The Health Resource Ceter features: iteractive tools ad quizzes, a searchable health ecyclopedia, a clickable symptom checker tool, Decisio Poits ad Virtual Health Guides. Medical Mutual 5

7 welless Welless Features Medical Mutual is dedicated to the good health of our customers ad their employees. To ecourage groups ad their employees to get well ad stay well, we offer the SuperWell Program, a comprehesive suite of iitiatives desiged to promote healthy lifestyle behaviors. The SuperWell Program helps members uderstad their health, make lifestyle chages ad reduce their risk for developig chroic coditios. Lifestyle choice remais the biggest overall health threat to idividuals ad employers alike. The SuperWell Program icludes iitiatives to assist members with importat behavior chages to improve their well-beig. To meet the welless eeds of employers ad employees i all demographics, Medical Mutual offers two welless product optios, SuperWell Essetial ad SuperWell Impact: SuperWell Essetial SuperWell Essetial provides employers of all sizes with core iitiatives to help their employees lear more about their overall health, determie their risks for developig chroic coditios ad participate i programs to improve uhealthy behaviors by makig healthier choices. SuperWell Essetial is available to every member who has elected Medical Mutual health coverage. SuperWell Impact SuperWell Impact icludes all of the beefits of SuperWell Essetial as well as additioal elemets for employers with 51 or more eligible employees who choose to offer a more comprehesive corporate welless program. Groups selectig Impact sig a cotract committig to developig a full-service worksite welless program ad allowig Medical Mutual to coduct the ecessary measuremets ad reportig. Both employers ad employees gai advatages by participatig i the SuperWell Program: Employer Beefits Help keep employees healthy Help reduce abseteeism Help improve productivity Help cotrol healthcare beefit costs Employee Beefits Healthy, more active lifestyles Improved sese of well-beig Reduced medical care expeses Prevetio or early detectio of medical coditios 6 Medical Mutual

8 SuperWell Essetial iitiatives iclude, but are ot limited to: Health Assessmet The Health Assessmet is a olie questioaire that collects i-depth data about each member s past health history, curret medical iformatio ad daily health habits. Upo completio, a report is geerated that icludes a persoalized set of recommeded behavior chages to improve their overall health. To access the Health Assessmet, members should log o to My Health Pla o MedMutual.com. SuperWell Extras Members have access to SuperWell Extras, which offers discouts o a variety of items, icludig baby products, fitess clubs, spas, hearig aids, drugstore items ad healthy products. By loggig o to My Health Pla o MedMutual.com, members ca search for discouts o health ad welless products to fid uique items that fit their lifestyle. SuperWell Fitess Discout Program To help members save moey while stayig fit, our SuperWell Fitess Discout Program provides access to atioal ad local fitess clubs. The program icludes discouted membership rates or promotioal offers. Members ca log i to My Health Pla ad visit Fitess uder the Health & Welless tab to fid out more. SuperWell QuitLie Program SuperWell QuitLie is available to help tobacco users give up the habit for good by providig oe-o-oe coachig, a persoalized quit pla ad educatioal materials. I additio, a four- to eight-week supply of icotie replacemet therapy is available to maximize their chaces of quittig. To eroll i the SuperWell QuitLie Program, please call The Chef s Garde Brig vegetables, herbs ad micro grees straight from the garde to your home. Members have access to The Chef s Garde, a family-ru farm that grows healthy, utritious produce usig evirometally friedly practices. Members purchase produce from The Chef s Garde by loggig o to My Health Pla o MedMutual.com. Boxes rage i price from $25 to $30. O average, orders arrive i less tha a week. Weight Watchers Reimbursemet To help members reach their health ad weight maagemet goals, we offer a special reimbursemet for completig a Weight Watchers meetig series. Members age 18 ad older ca participate i a At Work or Local (commuity) Meetigs series ad be reimbursed up to $150 of their registratio fees per caledar year. To eroll ad qualify for the registratio reimbursemet, members must call Medical Mutual 7

9 otes Notes For more iformatio about Medical Mutual ad our products, please cotact your Medical Mutual represetative or broker, or visit MedMutual.com. 8 Medical Mutual

10 2010 Medical Mutual of Ohio Z / East Nith Street Clevelad, OH Visit MedMutual.com.