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2019 Option Period

2019 Option Period

 

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2019 Benefit Options Guide 2019 Former Employees, Surviving Dependents, COBRA Participants Benefit Options Guide 2019 Medicare Supplement and MAPD Benefit Options Guide
2019 Benefit Options Guide Presentation    
Tobacco-Free Attestation Tobacco-Free Attestation 2019 Former Employee Medicare and Medicare Advantage Prescription Drug (MA-PD) Plans Monthly Premiums
2019  Current Employee Monthly Premiums 2019 Former Employee and Surviving Dependents Monthly Premiums Retiree Option Period Meeting Schedule
Current Employee Cumulative Premiums 2019 COBRA Monthly Premiums Plan Changes
Plan Changes Plan Changes Medicare Advantage Prescription Drug Plan Comparisons
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    Aetna
    BlueLincs    
    CommunityCare
    GlobalHealth

MAPD ZIP Code Service Areas
Plan Contact Information Plan Contact Information Plan Contact Information
Beneficiary Designation Form Retiree Option Period Meeting Schedule Beneficiary Designation Form
Life Insurance Application Beneficiary Designation Form Application for Medicare Advantage Precription Drug (MA-PD) Plan
    Application for Medicare Supplement With Prescription Drug Plan
TRICARE 2019 Option Period Enrollment/Change Form - Former Employees and Surviving Dependents 2019 Option Period Enrollment/Change Form - Former Employees and Surviving Dependents
  2019 Option Period Enrollment/Change Form - COBRA  2019 Option Period Enrollment/Change Form - COBRA  Medicare
     

Option Period information will be added as it becomes available.

 

Frequently Asked Questions

What is Option Period?

Option Period is the annual enrollment period when current and former employees can make plan elections for the upcoming year.

Current Employees

During Option Period, current employees can make the following changes for themselves and their dependents:

  • Enroll in plans.
  • Change plans or drop coverage.
  • Increase or decrease life insurance coverage.
  • Add or drop eligible family members from coverage

Former Employees

During Option Period, former employees can:

  • Change health and/or dental plans currently in place.
  • Drop coverage and/or dependents.
  • Decrease life insurance coverage.
  • Enroll in or change vision plans.

When are the premium rates set?

Premiums for the next plan year are adopted in August.

Can I enroll online?

Online enrollment is not available through EGID.

Note: Only current state employees with the Human Capital Management Employees Benefits Department (EBD), a division of the Office of Management and Enterprise Services, can make Option Period changes to coverage online. Contact your benefits coordinator at work for more information.

What is the HealthChoice High Deductible Health Plan (HDHP) and how does it work?

The HealthChoice High Deductible Health Plan is a qualified high deductible health plan intended for use with a Health Savings Account (HSA). Proof of enrollment in an HSA is not required.

Note: Not available to Medicare eligible former employees.

Refer to the HealthChoice Health Handbook for information on covered services, claim procedures, eligibility and plan exclusions and limitations.

Does HealthChoice offer a Health Savings Account (HSA)?

While you can establish your HSA anywhere you choose, the Employees Group Insurance Division (EGID) contracts with American Fidelity Health Services Administration to make establishing and keeping a Health Savings Account (HSA) easier and more convenient for HealthChoice High Deductible Health Plan members. The monthly maintenance fee is waived as long as you continue to participate through EGID.

How is the HealthChoice High Deductible Health Plan (HDHP) different from the HealthChoice High, High Alternative, Basic, and Basic Alternative Plans?

The High Deductible Health Plan (HDHP) is a qualified high deductible health plan intended to be used with a Health Savings Account (HSA). 

Deductibles

  • A higher deductible.
  • The deductible must be met before any benefits, other than preventive services, are paid by the plan.
  • If you have family (2 or more) coverage, the entire family deductible must be met before any benefits, other than preventive services, are paid for any covered family member.
  • Medical and pharmacy expenses combined apply to the deductible and network out-of-pocket maximum.

Copays

  • You must meet the deductible before copays will apply.

Calendar Year Out-of-Pocket Maximum

  • Out-of-pocket maximums are individual $6,000 and family of two or more $12,000.
  • Only network medical and pharmacy preferred copays and coinsurance combined count toward the individual or family out-of-pocket maximum.
  • If you have family (2 or more) coverage, the entire family out-of-pocket maximum must be met before network benefits are paid at 100 percent of allowable fees for any family member.

What are the premiums for the plans offered through EGID?

Premiums are for a calendar year. If you change employment status during the year, e.g., current employee to pre-Medicare former employee, your premiums will change to those matching your new employment status. Age-rated life insurance premiums change as your age increases and are based on your age as of Jan. 1 of the current plan year.

To find the current premiums, visit the Premium web page.

I have HealthChoice health and dental coverage. Will I receive an ID card for each plan?

For HealthChoice Plans

No. For HealthChoice Plans, new members are mailed an ID card for health and/or dental coverage and a separate ID card for prescription benefits. 

Do I have to return my Option Period Enrollment Form?

Current Employees

Check with your insurance/benefits coordinator about the need to return your form even if you are not making any changes. Your insurance/benefits coordinator sets the deadline for you to return your Option Period Enrollment/Change Form.

Former Employees

If you are making changes to your coverage, your Option Period Enrollment/Change Form must be postmarked by Dec. 7. If you are not making changes to your coverage, you are not required to return your form.

Current Employees and Pre-Medicare Former Employees

To enroll or remain enrolled in the HealthChoice High or Basic Plan for upcoming Plan Year, you must attest that you and your covered dependents are tobacco-free by completing the HealthChoice High and Basic Plans Tobacco-Free Attestation.

What is the deadline for turning in my Option Period Enrollment/Change Form?

Education, Local Government, and State Employees with non-Employees Benefits Department (EBD) of Human Capital Management, a division of the Office of Management and Enterprise Services Employers

Your insurance coordinator at work determines when your Option Period Enrollment/Change Form is to be completed and returned. Check with your coordinator about the need to return your form even if you are not making any changes.

State Employees with EBD Employers

You must complete and return your Option Period Form to your benefits coordinator or complete your benefit elections online by Oct. 31. For online enrollment information, contact your benefits coordinator. If you are enrolling in a HealthChoice High, High Alternative, Basic, or Basic Alternative plan, the Tobacco-Free Attestation must be completed as part of the enrollment process.

Former Employees, Survivors and COBRA Participants

If making changes, your Option Period Enrollment/Change Form must be postmarked by Dec. 7 and mailed to:

EGID
P.O. Box 58010
Oklahoma City, OK 73157

Pre-Medicare former employees, survivors and COBRA participants, must complete the Tobacco-Free Attestation, if applicable, as part of the enrollment process.

When and how will I receive my Option Period materials?

Education, Local Government, and State Employees with non-Employees Benefits Department (EBD) of Human Capital Management Employers

Your Option Period packet is either mailed to you or distributed to you by your insurance coordinator at work.

State Employees with EBD Employers

Contact your benefits coordinator at work for information about your Option Period materials.

Pre-Medicare Former Employees

Your Option Period packet will be mailed to you and will include information on how to access your Option Period guide.

Medicare-Eligible Former Employees

Option Period materials, including Option Period Enrollment/Change Forms, will be mailed to you.

If you do not receive your Option Period materials, please contact your insurance coordinator or EGID Member Services at 405-717-8780 or toll-free 800-752-9475. TDD users call 405-949-2281 or toll-free TDD 866-447-0436.

How do I get information on the plans offered through EGID?

Plan information can be found in your Option Period materials and on the EGID webpage of the OMES website. If you need additional information, plan contact numbers can be found on the Contact Information pages of your guide and also on the Helpful Numbers page of the
OMES website.

What if I need to change my Option Period elections after I've returned my form?

Education and Local Government Employees and State Employees with non-Employees Benefits Department (EBD) of Human Capital Management Employers

Prior to Nov. 1, you can make changes to your original Option Period elections by contacting your insurance coordinator to complete a blank Option Period Enrollment/Change Form. Please write "Supersede" at the top of the form.

State Employees with EBD Employers

You must contact your benefits coordinator to complete a new Option Period Form. Please write "Supersede" at the top of the form. If you are making your benefit elections online, you can make changes to your online enrollment through Oct. 30.

Former Employees, Survivors and COBRA Participants

Prior to the Dec. 7, deadline, you can make changes to your original Option Period elections by:

  • Calling member services at 405-717-8780 or toll-free 800-752-9475. TDD users call 405-949-2281, or toll-free 866-447-0436 and requesting a form.
  • Downloading a blank form from the OMES website and mailing it to EGID.*
  • Writing to EGID at 3545 N.W. 58th St., Ste. 600, Oklahoma City, OK, 73112.*

*Whether sending in a form or just making your request in writing, you must write "Supersede" at the top. This "supersede" form must be postmarked no later than Dec. 7.

I am a retired employee and will turn 65 on or after the first of the new plan year, how do I complete my Option Period Enrollment Form?

You are strongly encouraged to attend one of the Retiree Option Period Meetings for Medicare eligible members to learn more about your options.

Your Option Period form should be completed with the coverage options you wish to enroll in for the next plan year. Keep in mind, the medical plan you choose will impact your Medicare coverage options when you turn 65. 

Will I receive any confirmation for the Option Period changes I made?

Yes. If you make changes to your coverage, you will receive a Confirmation Statement from the Employees Group Insurance Division (EGID) or if you are a state employee, a Confirmation of Benefits Statement from the Employees Benefits Department (EBD). The statement identifies:

  • Your coverage for the upcoming plan year.
  • The effective date of your coverage.
  • Your monthly premium (before any contribution from your employer or retirement system).

The statement allows you to review the changes to your coverage so that errors can be identified and corrected.

You should report errors on your statement as soon as possible. To report errors:

  • Current employees should contact their insurance/benefits coordinator at work.
  • Former employees, survivors and COBRA participants should call HealthChoice Member Services directly at 405-717-8780 or toll-free 800-752-9475. TDD users call 405-949-2281 or toll-free 866-447-0436.

Once corrections are made, an amended statement is sent to you.

Note: If you do not make changes to your coverage during Option Period, and you are not automatically enrolled in one of the HealthChoice alternative plans, you will not receive a Confirmation Statement. Please keep your Option Period Enrollment/Change Form as proof of your coverage.

Will the amount being drafted from my bank account automatically change when my coverage or premiums change?

Yes. You will receive a letter advising you of the new amount that will be drafted from your account.

I didn't get my Option Period materials, what do I do?

Current Employees
Contact your insurance/benefits coordinator at work if you did not receive your Option Period packet which includes:

  • Your personalized Option Period Enrollment/Change Form.
  • Monthly Premium Chart.
  • Plan Contact Information.

The Employee Benefit Options Guide and the Benefits Enrollment Guide are both available on the OMES website. The Employee Benefit Options Guide can be found on the EGID webpage. The Benefits Enrollment Guide for state employees can be found on the EBD webpage.

Former Employees, Survivors and COBRA Participants
Option Period materials are available by:

  • Calling EGID Member Services at 405-717-8780 or toll-free 800-752-9475; TDD users call 405-949-2281 or toll-free 866-447-0436 to have materials mailed to you

Please confirm your email and mailing address with EGID Member Services.

Note: If you retired or are retiring after Oct. 1 of the current year, please contact EGID Member Services for the appropriate materials.

Will I get a new ID card after Option Period?

If you are a new HealthChoice member or have added or dropped a spouse and/or dependents, you will receive a new ID card. If you are a current HealthChoice member, you will not receive a new medical or pharmacy ID card.

HealthChoice High, High Alternative, Basic, Basic Alternative Plans, and High Deductible Health Plan

To request additional or replacement medical and/or dental ID cards, call the HealthChoice medical and dental claims administrator toll-free at 800-323-4314. TDD users call 711 or toll-free 800-545-8279.

To request additional or replacement pharmacy ID cards, call the HealthChoice pharmacy benefit manager at 877-720-9375 or TDD 711.

HealthChoice Medicare Supplement Plan

To request additional or replacement medical and/or dental ID cards, call the medical and dental claims administrator toll-free at 800-323-4314. TDD users call 711 or toll-free 800-545-8279.

To request additional or replacement pharmacy ID cards, call the pharmacy benefit manager at 866-275-5253 or TDD 711.

When do my Option Period changes go into effect?

Option Period elections are effective on Jan. 1 of the new plan year.

What is the difference between the HealthChoice Alternative Plans and the regular HealthChoice plans?

The HealthChoice alternative plans are designed for tobacco users. The individual deductibles for these plans are $250 higher than the regular plans. All other benefits, limits and exclusions are the same.

If a tobacco-free attestation or reasonable alternative is not completed and submitted, you and your dependents will be enrolled in the corresponding HealthChoice Alternative plan.

What is the HealthChoice Tobacco-Free Attestation?

To enroll or remain enrolled in the HealthChoice High or Basic Plan for upcoming Plan Year, you must attest that you and your covered dependents are tobacco-free by completing the online HealthChoice High and Basic Plans Tobacco-Free Attestation.

You can access the attestation on the EGID Option Period webpage.

If you cannot access the attestation, contact your benefits/insurance coordinator or call HealthChoice Member Services at 405-717-8780 or toll-free 800-752-9475. TDD users call 405-949-2281 or toll-free 866-447-0436.