CHCGA - Coventry Health Care of Georgia

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TABLE OF CONTENTSWhat’s New for 2007? ...............................................2-3Associate Eligibility ...................................................... 4Dependent Eligibility ................................................... 4Changes During a Plan Year ....................................... 5Medical Plans .............................................................6-7Medical Plans Comparison .....................................8-10Prescription Drug Coverage ...................................... 11Dental Plans ................................................................ 12Vision Care................................................................... 13Healthcare Flexible Spending Account .................... 14Dependent Care Flexible Spending Account .... 14-15Life Insurance .............................................................. 15Other Valuable Benefits ............................................. 16Disability Income ....................................................... 16HealthQuest ................................................................. 16Retirement Benefits .................................................... 16Paid Time Off and Extended Illness Bank .............. 17Benefits Contact Information .................................... 18Addendum .................................................................. 19This brochure is only an overview of our benefit plans. Completedescriptions of the plans and their provisions are available to you. Ifany information in this brochure conflicts with the detailed plandocuments, the plan documents are the authority. Though the Systemintends to continue providing these plans, the System reserves the rightto make changes at any time.
WHAT’S NEW FOR 2007Due to plan changes, all associates must review their benefits and participatein the on-line enrollment process.Medical Plan Changes• Coventry will administer the Patient Driven Health Plan, formerlyknown as the Definity Plan, effective January 1, 2007. Changes to theplan include:– A co-pay for prescription drugs will apply. Co-pay amounts will be $12 forgeneric drugs, $30 for brand name drugs, and $60 for non-formularydrugs. CareMark will be the Pharmacy Benefit Manager.– The reimbursement process under the Health Reimbursement Account(HRA) will be enhanced, allowing you more choice in how you manageyour account.• There are some changes for the medical plan for 2007. Two of thechanges involve Coventry administering our two health plan choices.Coventry has made arrangements with Emory Healthcare to add the Emoryphysicians and hospitals to the Coventry HMO Network. Emory Healthcareincludes:- The Emory University Hospital- The Emory Clinic- Emory Crawford Long Hospital- Emory Children’s Center- Wesley Woods Center- Emory John’s Creek and- Emory Adventist Hospital.With the addition of these hospitals and physicians to Coventry’s HMO Network,you will now be able to access them as an In-Network provider for boththe HMO Plan and the new Patient Driven Plan. Please know that EmoryEastside and Emory Dunwoody are not Emory Healthcare facilities. These areHCA hospitals that purchased the rights to use the Emory name. Thesehospitals were already in the Coventry network. In addition, EmoryDunwoody has announced they will be closing to become Emory John’s Creekin early 2007.Dental Plan Changes• Delta Dental will be the new dental insurance provider for 2007. Theplan designs will remain the same with the following enhancements:– Plan One DeltaCare DMO offers more dentists from which to choose (noout-of-network benefits available).2– Plan Two Basic Delta Dental PPO and Plan Three Advance Delta DentalPPO Plan will have a provider network. You can use the dentist of yourchoice, but by selecting a Delta Dental network dentist, your out-of-pocketcosts will be reduced.
Page 4 and 5: Vision Plan Changes• Beginning in
Page 6 and 7: CHANGES DURING A PLAN YEARThe decis
Page 8 and 9: Medical PlansGHS offers two medical
Page 10 and 11: HEALTH PLANS COMPARISONSUMMARY HMO
Page 12 and 13: PRESCRIPTION DRUG BENEFITIf you enr
Page 14 and 15: VISION CAREIf you enroll in the Cov
Page 16 and 17: Other Important Information• IRS
Page 18 and 19: • $1 per $1 on the first 1% of pa
Page 20: ADDENDUMCoventry Patient Driven Hea
Page 24 and 25: Patient Driven Health Plan continue
Page 26 and 27: ExpressScripts Prescription Drug Pl
Page 30 and 31: Dental Plan One continued...29
Page 38: For Dental Plans Two and Three cont
Page 43 and 44: 42Note: Patient Driven Health Plan
Page 45: 44NOTES

CHCGA - Coventry Health Care of Georgia

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