FY2011 Health Benefits Booklet

Table of Contents
Introduction......................................................................ii
What’s New.................................................................... 1
A Word About Program Requirements .................1
Enrollment Instructions................................................ 2
Before You Call the IVR System..................................2
How to Enroll..........................................................................3
If You Do Not Call the IVR............................................4
Special Instructions ...............................................................4
Benefits Overview.......................................................... 5
Who is Eligible ........................................................................5
Duplicate Coverage ............................................................6
Your Cost ..................................................................................6
Eligibility and Subsidy...........................................................8
Required Documentation for Dependents......... 12
When Coverage Begins.................................................. 14
Enrollment and Changes Outside of
Open Enrollment................................................................ 15
Making Mid-Year Changes ............................................ 16
When Coverage Ends..................................................... 17
Medical Benefits............................................................18
Your Choices........................................................................18
How the Plans Work....................................................... 18
Plan Comparison Charts................................................ 19
Aetna.....................................................................................19
CareFirst..............................................................................23
UnitedHealthcare........................................................... 28
For More Information...................................................... 33
Mental Health/Substance Abuse Benefits...............34
Your Choices........................................................................34
How the Plans Work....................................................... 34
For More Information...................................................... 36
Prescription Drug Benefits ........................................37
How the Plan Works....................................................... 37
For More Information...................................................... 41
Attention
m e d i c a r e-eligible
p a r t i c i p a n t s
If you (and/or your
dependents) have Medicare
or will become eligible for
Medicare in the next 12
months, a federal law gives
you more choices about your
prescription drug coverage
through Medicare Part D.
The State Prescription Drug
plan coverage is creditable
coverage compared to
the Medicare Part D plan
coverage. This means the
State’s prescription drug
plan offers benefits that are
as good, if not better, than
the benefits available under
the standard Medicare Part
D coverage. Please refer to
the Notice of Creditable
Coverage located in the
section on Medicare that
begins on page 72.
i
INTRODUCTION
To enroll, call the Interactive Voice Response (IVR)
system at: 410-669-3893 or 1-888-578-6434
during Open Enrollment. Phone lines are open
24 hours a day, seven days a week from April 14 through
April 28, and again from May 12 through May 19.
People who are deaf, hard of hearing or have a
speech disability, please use Relay or 711.
To enroll in Long Term Care Insurance,
see page 55.
t h i s g u i d e i s n o t a c o n t r a c t
This guide is a summary of general benefits available
to State of Maryland eligible Active Employees
and Retirees. Wherever conflicts occur between
the contents of this guide and the contracts, rules,
regulations, or laws governing the administration
of the various programs, the terms set forth in the
various program contracts, rules, regulations, or
laws shall prevail. Space does not permit listing
all limitations and exclusions that apply to each
plan. Before using your benefits, call the plan for
information. Benefits provided can be changed at
any time without consent of the participants.