Dear Cone Health Insurance 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. Please note, the Cone Health insurance annual deductible begins every year on January 1 and you may have to pay 2 deductibles depending on your due date. To register for the program, please log onto www.conehealth.com, click on the For Employees section at the left side bottom of the page, find the information for MedLink and the Healthy Pregnancy Program. You will be able to complete and submit a registration form and enroll online. You will receive an email confirmation with this attached program packet 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 by the instructor. You will also find in this packet detailed information on the Cone Health Plan Maternity Benefits. Please keep this information for future reference on tests, procedures or any other coverage 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 email the class completion record form back to the Medlink office and your attendance in the program will be verified. UMR insurance will also be notified of your participation so your claims will be paid appropriately. If you have any questions regarding the Healthy Pregnancy Program or the discounted maternity benefit, please call the MedLink Care Management offices at # 336-852-3871 or email 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) 852-3871 1
Healthy Pregnancy Program Class Information For First Time Pregnancies-Required Classes ***Please note: You must take a class by 22 weeks of pregnancy to receive the necessary information and discounted maternity benefit. Your Healthy Pregnancy-For first time pregnancies (MedLink will register you for this class). This class includes information on your changing body, healthy nutrition and baby safety. Class Schedule -only attend this class one time/one date January 16, 2013 Women s Hospital Classroom # 5 & 6, 7-9 pm March 21, 2013 Women s Hospital Classroom # 5 & 6, 7-9 pm May 18, 2013 Women s Hospital Classroom # 3, 9-11 am Birth and Baby Series (This class can be taken as early as 26 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. OR 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 all day Saturday (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 www.conehealth.com. Click on Online Tools, on the right side of the screen. Click on Register for a class and find the category of the class title. Once you locate the class, there will be alternate dates available, click the Register Online box. Fill in the appropriate boxes to enroll in your classes. You will be asked to put in your employee ID number to determine you are an employee. VERY IMPORTANT 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 832-6682 or 832-6848. For Cone Health Benefit questions email Benefits@conehealth.com or call 336-832-8777. **If at any time, your OBGYN physician places you on bed rest, or you are diagnosed with Gestational Diabetes, please call MedLink at # 336-852-3871 for further instructions in the program. 2
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 OR 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 email this form to: Healthy Pregnancy Program MedLink at Cone Health System 510 N. Elam Ave, Suite 301 Greensboro, NC 27403 Fax: # 336-297-2260 E-mail: HealthyPregnancyProgram@conehealth.com Please call # 336-852-3871 if you have questions. 3
For second time or more pregnancies-required classes Please note: You must begin taking classes by 30 weeks of pregnancy to receive the necessary information and discounted maternity benefit. Section #1-CBLs 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. Pregnancy and Nutrition CBL This CBL includes information on healthy nutrition for pregnancies, Titled 2012 Pregnancy and Nutrition, Guidelines for a Healthy Diet. MedLink will receive a record of your CBL completions. 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. OR Cesarean Birth and Vaginal Birth After Cesarean (Sign up online) This class is for mothers and their partners who know they are having a planned or 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: Only if you have taken the Breastfeeding Basics class before. (Sign up online). Teaches about pumping and storing breast milk, introducing a bottle, returning to work and choosing a supportive daycare. To Sign-Up for Classes Online: Go to www.conehealth.com. Click on Online Tools, on the right side of the screen. Click on Register for a class and find the category of the class title. Once you locate the class, there will be alternate dates available, click the Register Online box. Fill in the appropriate boxes to enroll in your classes. You will be asked to put in your employee ID number to determine you are an employee. VERY IMPORTANT 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 832-6682 or 832-6848 For Cone Health Benefit questions email Benefits@conehealth.com or call 336-832-8777. **If at any time, your OBGYN physician places you on bed rest, or you are diagnosed with Gestational Diabetes, please call MedLink at # 336-852-3871 for further instructions in the program 4
Healthy Pregnancy Program For Second or more pregnancies 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 completions) Pregnancy and Nutrition CBL SECTION #2 OR Refresher Childbirth Cesarean Birth and Vaginal Birth After Cesarean SECTION #3 Breastfeeding Basics Breastfeeding Beyond the Basics (only if Breastfeeding Basics has been taken before) **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 email this form to: Healthy Pregnancy Program MedLink at Cone Health System 510 N. Elam Ave, Suite 301 Greensboro, NC 27403 Fax: # 336-297-2260 E-mail: HealthyPregnancyProgram@conehealth.com Please call 336-852-3871 if you have questions. 5
Cone Health System Healthy Pregnancy Program 2013 Class Dates All classes are held in the Women s Hospital Education department Your Healthy Pregnancy Class- first class for first time pregnancies, attend one date only (You must take a class before 22 weeks to receive the discounted maternity benefit) January 16, 2013, 7-9 pm, classroom # 5&6 March 21, 2013, 7-9 pm, classroom # 5&6 May 18, 2013, 9 am-11 am, classroom # 3 July 9, 2013, 11 am-1 pm, classroom # 1&2 September 7, 2013, 9 am-11am, classroom # 3 November 12, 2013, 7 pm-9 pm, classroom # 1&2 Baby Maybe Class-Preconception information class (not required for the program) February 18, 2013, 7-9 pm, classroom # 4 April 14, 2013, 7-9 pm, classroom # 5 June 15, 2013, 9:30-11:30 am, classroom # 5 October 23, 2013, 7-9 pm, classroom # 6 Lactation Rooms are available on 4 of the Cone Health main campuses (Please check in your building for an appropriate place to pump once you return to work) Moses Cone Hospital- 3 rd floor near the solarium Women s Hospital-Exercise and relaxation room, ground floor Wesley Long Hospital-4 East relaxation room Annie Penn-2 nd floor near the Employee Health office Behavioral Health Hospital-TBD 6
Other Classes That Are Available These are not required for the program but are free to Cone Health Plan members 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. Classes meet at The Green Valley Medical Center Building, 719 Green Valley Road, Suite 107. Please register at www.conehealth.com/new-baby-classes. 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, teach dads-to-be how to hold, comfort, diaper, swaddle and play with their infant. Call # 336-832- 6682 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. This class meets every Thursday from 11am-12 noon and is led by a registered nurse, babies are welcomed. Call # 336-832-6860 for dates. 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 RN who is a Certified Lactation Consultant and meets every Tuesday between 11 a.m. and 12:30 pm. There is no charge, please call # 336-832-6860 for more information. 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. Please call # 336-832-6848 for more information. Gestational Diabetes Class- A 2 hour FREE class is available through the Cone Health Nutrition and Diabetes Management Center. Please call # 832-3236 to inquire and schedule an appointment, and tell them you are in the Healthy Pregnancy Program. 7
FMLA INFORMATION For Maternity Leave The FMLA Specialist is Brenda Jones, Human Resources, 336-832-8751. The FMLA Specialist for Annie Penn, Penn Nursing Center and Rockingham Physician Practices is Elaine Hicks, 336-951-4682 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 and take to your doctor for completion. Once FMLA paperwork is completed, take your forms back to HR. 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 Human Resources to finalize your FMLA. They will go over Short Term Disability, PAL, and Kronos. 8
CONE HEALTH PLAN MATERNITY BENEFIT PRENATAL PROGRAM Benefit Completed w/delivery @ MCHS Delivery global charges 100% after $100 co-pay STD Completed w/delivery @ PPO Not Completed w/delivery @ 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 w/delivery @ PPO Perinatologist MD 100% STD 90% STD 80% STD 80% STD Neonatal MD charges 90% 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 & Ancillaries Lactation consults (2 allowed post D/C) Ultrasounds (physician ordered) 95% STD 80% STD 95% STD 80% STD 100% STD & max 80% STD & max 95% STD & max 80% STD & max 100% STD 90% STD MD or 80% STD facility 80% STD MD or 95% STD facility 80%S TD MD or 95% STD facility 80% STD MD or 95% STD facility 80% STD MD or 95% STD facility 80% STD Amnio & other tests 100% STD 90% STD MD or 80% STD facility 80% STD Genetic testing 100% STD 90% STD MD or 80% STD 80% STD facility Lab tests 100% STD 90% STD MD or 80% STD 80% STD facility Emergency Dept. visit 100% STD ER Co-payments ER Co-payments ER Co-payments (related to pregnancy) Maternity Admissions/ 100% STD N/A 95% STD N/A Emergency Dept. visit * Breast Pump rental or 80% STD 80% STD 80% STD 80% STD purchase (see below) Ultrasound 3D photos (medically necessary only) Prenatal vitamins (available at Cone outpatient pharmacy) Not Covered Not Covered Not Covered Not Covered 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
Cone Health/UMR Insurance Plan Enrollment Information If you want to add your baby to the Cone Health UMR insurance plan for medical coverage, please call the Cone Health System Benefits Hot Line at # 336-832-8777 within 31 days after the child is born. You will also need to fax a birth certificate to the UMR eligibility department, at # 513-619-3059 with your name and insurance ID number. If you want the baby s hospital bill to be covered 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 purchase a breast pump from the following stores: Every Women s Place at the Women s Hospital, Advanced Home Care, Guilford Medical Supply, or Carolina Apothecary, 80% of the cost will be reimbursed to you. Fax the receipt or invoice (all information) to the UMR insurance claims department at # 877-293-4926 with your name and insurance ID # and a note that you participated in the Cone Healthy Pregnancy program. Breast pumps purchased at retail stores will not be reimbursed (Walmart, Target, Babies R Us). 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 or other insurance groups coverage, please notify the Cone Health Benefits Department at # 336-832-8777. The Cone Health System Benefits Department can provide you with any further detailed information about you or your family coverage, the enrollment process or other benefits. Please call the Benefits Line at # 336-832-8777 for further information. 10