MedLink Care Management 510 N. Elam Avenue, Suite # 301 Greensboro, NC

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1 Dear Cone Health Plan Member: Thank you for expressing interest in the Cone Healthy Pregnancy Program. The Cone Health Plan offers a discounted maternity benefit after completion of the Healthy Pregnancy program. The program consists of taking classes taught by the Women s Hospital education staff. After completion of the program, you will qualify for a $100 discounted maternity benefit. The benefit will cover your prenatal healthcare and delivery costs, after your annual deductible is paid. To register for the program, please log onto click on the For Employees section, find the information for Healthy Pregnancy Program offers $100 copay and enroll online. You will receive an response 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. Please bring this form with you to every class so your attendance can be validated on it. You will also find in this packet detailed information on the Cone Health Plan Maternity Benefits. Keep this information for future reference on tests, procedures or anything else that is covered under the healthcare plan. MedLink Care Management is the facilitator of this program. At the end of all of the required classes, please mail, fax or scan via the class completion record form back to the Medlink office and your attendance in the program will be verified. If you have any questions regarding the Healthy Pregnancy Program or the discounted maternity benefit, please call the Moses Cone Human Resources Benefits Line at (336) or MedLink at HealthyPregnancyProgram@conehealth.com. Sincerely, Geronda C. Pulliam, RN Geronda C. Pulliam, RN, MS, CCM Cone Health MedLink Care Manager Facilitator of the Healthy Pregnancy Program (336) MedLink Care Management 510 N. Elam Avenue, Suite # 301 Greensboro, NC

2 MedLink Healthy Pregnancy Program Information For First Time Pregnancies-Required Classes Your Healthy Pregnancy-For first time pregnant employees and partners (MedLink will register you for this class) This class includes information on your changing body, healthy nutrition and baby safety. Please sign up to start classes as soon as you find out that you are pregnant to get the maximum benefit of the information given. ****Please note: You must take the 1st class or start taking classes by the 22 week of pregnancy to receive the necessary information and discounted maternity benefit. Class Schedule -only attend this class one time/one date May 14, 2012 Women s Hospital Classroom # 1 & 2, 7-9 pm July 18, 2012 Women s Hospital Classroom # 5 & 6, 7-9 pm Sept. 17, 2012 Women s Hospital Classroom # 5 & 6, 7-9 pm Birth and Baby Series (This class can be taken as early as 22 weeks-sign up online) This series of five weekly classes help you and your labor partner prepare for childbirth and parenting. Topics include care and safety of your baby, birthing options, cesarean birth, a tour of The Women s Hospital and pain management skills. Condensed Birth and Baby (sign up online) 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 Saturday and includes lunch on Saturday. Breastfeeding Basics (this class can be taken as early as 16 weeks-sign up online) Learn about first feeding experiences and signs to look for to assure you that breastfeeding is going well. To Sign-Up for Classes Online, Go to Click on Classes and Support Groups on the left side of the screen. Click on the drop down box for the class titles and click the FIND button. Fill in the appropriate boxes or look in the drop down boxes to enroll in your classes VERY IMPTANT On the Last Name lines, type in your name, leave a few spaces then type MCHP. [Moses Cone Health Plan] This will identify you as a plan member and the fees will be waived. To sign up for classes by phone call or For Cone Health Benefit questions Benefits@conehealth.com or call **If at any time, your OBGYN physician places you on bed rest, please call MedLink at for further instructions in the program. **If you are diagnosed with Gestational Diabetes, please call MedLink at the telephone number above for other classes available. 2

3 For second time or more pregnancies-required classes Choose 1 in each section Section #1 Your Healthy Pregnancy CBL This CBL includes information on your changing body, healthy nutrition and baby safety. Sign up and take the CBL as you would any other CBL in the system (Titled Healthy Pregnancy Program 2010). MedLink will have a record of your CBL completion. Section #2 Refresher Childbirth- For those that have other children or if Childbirth Preparation classes were taken within the last 2-5 years. (Sign up online for this class.) This three-week course reviews the basics of the birth process, breathing and relaxation techniques and baby care, and includes a tour of The Women s Hospital and the Big Brother/Big Sister class. Cesarean Birth and Vaginal Birth After Cesarean (Sign up online) This class is for mothers and their partners who know they are having a repeat Cesarean birth. Please note this class does not include portions of the Refresher Childbirth class (the sibling tours). Section #3 Breastfeeding Basics (this class can be taken as early as 16 weeks-sign up online) Learn about first feeding experiences and signs to look for to assure you that breastfeeding is going well. Breastfeeding beyond the Basics, sign up online (Must have taken a breastfeeding class before) Teaches about pumping and storing breast milk, introducing a bottle, returning to work and choosing a supportive daycare. If you have not taken a breastfeeding class before, please register for Breastfeeding Basics. To Sign-Up for Classes Online: Go to Click on Classes and Support Groups on the left side of the screen. Click on the drop down box for the class titles and click the FIND button. Fill in the appropriate boxes or look in the drop down boxes to enroll in your classes VERY IMPTANT On the Last Name line, type in your name, leave a few spaces then type MCHP. [Moses Cone Health Plan] This will identify you as a plan member and the fees will be waived. To sign up for classes by phone call or For Cone Health Benefit questions Benefits@conehealth.com or call **If at any time, your OBGYN physician places you on bedrest, please call MedLink for further instructions in the program. **If you are diagnosed with Gestational Diabetes, please call MedLink for other classes available. 3

4 Cone Health System Healthy Pregnancy Program 2012 Class Dates: Your Healthy Pregnancy Class (first class for first time pregnancies-attend one date only) May 14, 2012 in CR 1&2 July 18, 2012 in CR 5&6 September 17, 2012 in CR 5&6 November 14, 2012in CR 1&2 Baby Maybe Class-Preconception class (not required for the program) April 2, 2012 in CR 1 June 11, 2012 in CR 4 October 18, 2012 in CR1 4

5 Healthy Pregnancy Program For first time pregnancy Class Completion Record **** (Must be signed by class educator at each class attended) Full Name (Please print) Dates classes are taken AND instructor signature SECTION #1 o Your Healthy Pregnancy SECTION #2 Birth & Baby Condensed Birth & Baby / SECTION #3 Breastfeeding Basics **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 MedLink at Cone Health System 510 N. Elam Ave, Suite 301 Greensboro, NC Fax: # HealthyPregnancyProgram@conehealth.com Please call # if you have questions. 5

6 Healthy Pregnancy Program For Second or more pregnancy Class Completion Record **** (Must be signed by class educator at each class attended) Full Name (Please print) Dates classes are taken AND instructor signature SECTION #1 Your Healthy Pregnancy CBL (MedLink will have a record of your CBL completion) SECTION #2 Refresher Childbirth Cesarean Birth and Vaginal Birth After Cesarean SECTION #3 Breastfeeding Basics Breastfeeding Beyond the Basics **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 MedLink at Cone Health System 510 N. Elam Ave, Suite 301 Greensboro, NC Fax: # HealthyPregnancyProgram@conehealth.com Please call if you have questions. 6

7 Other Classes That Are Available To Take These are not required for the program but are free to Cone Health insured Fit for Two: Maternity Health and Fitness 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. Class meets at The Club at Green Valley. Call for more information and registration. Infant CPR Learn resuscitation techniques for infants and young children who are choking and/or experiencing respiratory and cardiac arrest. Pain Relief in Childbirth: Medical Options Discover medical pain relief options during labor, vaginal birth and Cesarean birth. Big Brother/Big Sister 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 6, but any age is welcome. Boot Camp for New Dads Experienced dads, who have been trained as coaches, teaches dads-to-be how to hold, comfort, diaper, swaddle and play with their infant. Call for more information and registration. Baby and Me (birth to crawling) Discuss newborn and infant parenting along with family adjustment issues with other new mothers. Led by a registered nurse. Call for dates and times. Infant Massage Discover the joy of communicating with your baby through touch. Massage enhances bonding and helps babies relax and sleep better. 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. Also, tour Women s Hospital so you will be in the know when the special day arrives Breastfeeding Support Group- Have questions about breastfeeding? This support group is led by a certified lactation consultant and meets every Tuesday between 11 a.m. and noon. There is no charge. Feelings After Birth Support Group-This group provides support for new mothers experiencing anxiety, sadness, crying or trouble adjusting after their baby's birth. It meets every Tuesday from 10 to 11 a.m. A registered nurse trained in childbirth education leads the group. Consultation services are provided through Cone Behavioral Health Hospital. Gestational Diabetes Classes- Available through the Cone Health Nutrition and Diabetes Management Center. Please call # to inquire and schedule a 2 hour FREE class. 7

8 GOING TO HAVE A BABY? FMLA INFMATION The FMLA Specialist is Brenda Jones, Human Resources, The FMLA Specialist for Annie Penn, Penn Nursing Center and Rockingham Physician Practices is Elaine Hicks, If you are not having complications, call Brenda or Elaine about two months before your due date to obtain your FMLA paperwork. If you begin having complications, call either one of them immediately. Go to Human Resources on your campus to pick up your FMLA paperwork, from Brenda or Elaine, and take to your doctor for completion. Once FMLA paperwork is completed, take your forms to HR, back to Brenda or Elaine. You will be notified that your forms are received and if you qualify for FMLA (employed in the MC Health System for one full year and worked 1250 hours in the last 12 months). When you start your leave or deliver your baby, call Brenda or Elaine to finalize your FMLA. They will go over Short Term Disability, PAL, and Kronos. If you want to add your baby to your medical coverage, please call the Cone Health System Benefits Hot Line at within 30 days after the child is born. You will also need to fax a birth certificate to UMR eligibility department, # with your insurance ID number. 8

9 CONE HEALTH PLAN MATERNITY BENEFIT PRENATAL PROGRAM Benefit Completed MCHS Delivery global charges 100% after $100 co-pay STD Completed PPO Not Completed MCHS 90% STD 80% STD 80% STD Prenatal visits 100% STD 90% STD 80% STD 80% STD Pediatrician in hospital visit 100% STD 90% STD 80% STD 80% STD Circumcision 100% STD 90% STD 80% STD 80% STD Anesthesia 100% STD 90% STD 80% STD 80% STD Midwife services 100% STD 90% STD 80% STD 80% STD Not Completed PPO Perinatologist MD 100% STD 90% STD 80% STD 80% STD Neonatal MD charges 80% STD 90% STD 80% STD 80% STD Delivery Room & Board 100% STD 80% STD 95% STD 80% STD Newborn Nursery & Ancillaries 100% STD 80% STD 95% STD 80% STD Neonatal Room & Board & 95% STD 80% STD 95% STD 80% STD Ancillaries Lactation consultation 100% STD & max 80% STD & max 95% STD & max 80% STD & max Ultrasounds (physician 100% STD 90% STD MD or 80% STD MD or 80% STD ordered) 80% STD facility 95% STD facility Amnio & other tests 100% STD 90% STD MD or 80%S TD MD or 80% STD 80% STD facility 95% STD facility Genetic testing 100% STD 90% STD MD or 80% STD MD or 80% STD 80% STD facility 95% STD facility Lab tests 100% STD 90% STD MD or 80% STD MD or 80% STD 80% STD facility 95% STD facility Emergency Dept. visit 100% STD ER Co-payments ER Co-payments ER Co-payments Maternity Admissions/ Emergency Dept. visit * Breast Pump rental or purchase Ultrasound (photo op) 3 D 100% STD N/A 95% STD N/A 80% STD 80% STD 80% STD 80% STD Not Covered (unless medical) Not Covered Not Covered Not Covered Prenatal vitamins Refer to PBM Refer to PBM Refer to PBM Refer to PBM 17 Alpha P-Hydroxyprogesterone (to prevent preterm labor). Zero copay if obtained from the Cone Health outpatient pharmacy. Home Health Nursing visits related to maternity issues-100% STD (effective 1/1/2012) *See Plan enrollment related to newborn enrollment within 31 days of birth. (Next Page) 9

10 Plan Enrollment The Benefits Department provides you with information about your coverage and an enrollment process prior to the date you become eligible for coverage. Carefully review the material and complete the enrollment process as defined by the Benefits Department. If you or eligible dependent requests coverage within 31 days of eligibility, simply complete the enrollment process as defined by the Benefits Department. If you or an eligible dependent wants to make application 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. (See Changes in Plan Elections on a Pre-Tax Basis and Special Enrollment Periods.) If you or your spouse has a newborn, the child s coverage begins the day of birth, provided you enroll the child within 31 days of that event. If you or any of your covered dependents become covered by Medicare or other group coverage, notify the Benefits Department Once you add your child as a dependent, UMR insurance needs a birth certificate faxed to the eligibility department, # Please include your insurance ID# for the child s hospital bill to be covered. If you purchase a breast pump from the following: Every Women s Place at the Women s Hospital, Advanced Home Care, Guilford Medical Equipment, or Carolina Apothecary, 80% of the cost will be reimbursed to you. Fax the receipt to UMR insurance claims department at # with your name and insurance ID# and a note that you participated in the Cone Healthy Pregnancy program. 10