Open Enrollment for 2019Changes to Select AlaskaCare Benefits that take effect on
January 1st, 2019

Open Enrollment is now closed.
Changes will go into effect Jan 1, 2019.

AlaskaCare Benefits
Voluntary Benefits
Enroll
FAQs
  1. Introduction
  2. 2019 Medical Plan Options and Rates
  3. Choosing Your Coverage
  4. Reduced Deductibles
  5. OptumRx® Pharmacy Manager
  6. Expanded Habilitative Services
  7. Health Flexible Spending Account (HFSA)
  8. Surgery Plus Supplemental Coverage
  9. Dental Benefits
  10. Vision Benefits (VSP)
  11. Life Insurance
  12. Teladoc® Phone Services

Introduction to Select AlaskaCare Benefits

This enrollment guide outlines the choices available to you under the State of Alaska Select Benefits plan, commonly referred to as AlaskaCare. In addition to enrolling when you are first eligible or during annual Open Enrollment, benefits may be changed within 30 days of a qualified change in family or employment status.

Select Benefits allows you to choose your benefit plans. Because you may have different needs than your coworkers and friends, you can create a personal benefit program from a range of benefits and levels of coverage. Best of all, you can spend your dollars for benefits that better meet your needs. Here's how it works:

  • You consider the monthly cost of each option and decide which benefits to purchase. Use the Health Plan Cost Comparison Tool [XLSM] to help you make an informed decision.
  • If you make selections that require a monthly employee contribution, that amount will be taken through pretax payroll deductions. This means deductions are withheld from your pay before federal income taxes are applied. The monthly employee contribution amount is divided in half and deducted from your paychecks in equal amounts throughout the benefit year.

The online enrollment system will automatically calculate your monthly employee contribution amount as you make selections, allowing you to change your choices until you are satisfied with the choices and cost.

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2019 Medical Plan Coverage and Rates

You will need to make elections based on the Select Benefit options listed below. Please review these carefully to ensure the options you select are best for you and your family. Follow the links for more details about these important benefits. You may enroll in or change these benefits for the first 30 days of first being hired into an eligible position; following a qualified change in family or employment status or during the Open Enrollment. Please note the 30 days includes the first day of employment, status change, etc.

Carefully review the different benefit options, discuss your benefit needs with your spouse if applicable, and contact the Division if you have questions. Benefits needs are different for everyone. Make sure the decisions you make during open enrollment will be a good fit for you and your family for the next year. The following available benefit options vary in cost and provide different benefit levels.

Your Select AlaskaCare Benefits choices:
AlaskaCare Health
  • Employee and Family, Employee Only, and Opt-Out *
  • Three levels of medical coverage
  • Two levels of dental plans
  • Optional vision plan
  • Health Flexible Spending Account (HFSA) *

 * You must elect this benefit each Open Enrollment period; it will not automatically continue from one benefit year to the next. Limitations to this plan may apply; refer to the AlaskaCare Select Benefits Information Booklet for greater details about this plan.

AlaskaCare offers a menu of medical plan options so you can find the best fit for you and your family.

Glossary of Important Terms
  • Deductible is the amount you pay each benefit year before a portion of your costs are paid by your AlaskaCare medical plan benefits. You pay the full cost of your eligible health expenses until you meet your deductible. The amount you pay for your deductible depends on the plan you select.
  • Coinsurance is the percentage of covered expenses paid by AlaskaCare once you meet your deductible.
  • Out-of-pocket limit is a cap which AlaskaCare has set to protect you from large expenses. If you reach the out-of-pocket limit, AlaskaCare will then pay 100% of your eligible expenses for the rest of the calendar year. A separate out-of-pocket limit applies to medical benefits and pharmacy benefits.
  • Health Reimbursement Arrangement (HRA)** is a tax-free medical reimbursement plan funded by the employer for members enrolled in the Consumer Choice plan. The balance of the HRA is applied towards the Consumer Choice deductible each benefit year until the HRA is exhausted.

Select Alaska Benefits

** HRA only applies to Consumer Choice plan. With the Economy and Standard plans, you pay 100% of the deductible amount.

Preventive Care — At No Cost

All AlaskaCare employee medical plan options will pay covered preventive services in full when received from an network provider. In-network preventive care services are not subject to deductibles or coinsurance.

See the Preventive Care Coverage Information Flyer [PDF] and the Women’s Preventive Care Coverage Information Flyer [PDF] for additional information on covered preventive services.

All other covered medical benefits are subject to the deductible and coinsurance.

AlaskaCare 2019 Active Employee Premiums
-- Consumer Choice Economy Standard
Medical Monthly Employee Premiums:
SU, CEA, Exempt, AVTCTA
Employee Only $24.00 $60.00 $140.00
Employee and Family $68.00 $160.00 $399.00
Medical Monthly Employee Premiums:
IBU, MEBA, Correctional Officers, TEAME
Employee Only $24.00 $0.00 $140.00
Employee and Family $68.00 $0.00 $399.00
Deductible
Individual $2,400 $500 $300
Family $4,800 $1,000 $600
Coinsurance 1 2
of the Allowable Amount 70% 70% 80%
Annual Out-of-Pocket Limit 3
Individual In-Network $5,400 $2,750 $1,750
Individual
Out-of-Network
$10,800 $5,500 $3,500
Dental Monthly Employee Premiums
Employee Only -- $0.00 $35.00
Employee and Family -- $0.00 $98.00
Vision Monthly Employee Premiums
Employee Only -- -- $14.00
Employee and Family -- -- $38.00

1 See section 2.1.1 of the plan booklet for a list of coinsurance exceptions, such as 100% for in-network preventive care, or reduced coinsurance levels for receiving services at some out-of-network facilities.
2 Coinsurance will be 30% of covered charges for dependents that are covered by a State employee health trust and that coverage: has been waived, pays less than 70% of covered expenses, or has an individual out-of-pocket maximum, including deductibles, of more than $3,500.
3 Out-of-Network for facility services outside of Alaska or in the Municipality of Anchorage. See plan documents for other exclusions.

Effective: Jan. 1 - Dec. 31, 2019

Premiums are subject to change.

COBRA and LWOP EE
Plan Rate
Medical, Standard $1,007.78
Medical, Economy $584.18
Medical, Consumer $505.26
Dental, Standard $55.73
Dental, Economy $24.52
Vision, Managed $13.45
Effective: Jan. 1 - Dec. 31, 2019
COBRA and LWOP EE + FAMILY
Plan Rate
Medical, Standard $2,761.45
Medical, Economy $1,554.92
Medical, Consumer $1,330.50
Dental, Standard $146.91
Dental, Economy $58.18
Vision, Managed $32.96
Effective: Jan. 1 - Dec. 31, 2019

 * Under the authority of 2 AAC 39.920, Select Benefits will only pay 30 percent of covered charges for your dependents if your spouse or children are covered by a State employee health trust and that coverage:

  • has been waived,
  • pays less than 70 percent of covered expenses, or
  • has an individual out-of-pocket maximum, including deductible, of more than $3,500

This applies to any dependent covered by Select Benefits where the trust plan would normally pay first if you hadn't reduced or waived coverage. When your spouse or the parent of any of your children selects coverage under a State employee health trust, they must ensure they are electing a plan that covers at least themselves and any dependents for which they have primary responsibility and that coverage provides full family coverage. Failure to do so will result in lower coverage for your dependents in the coming year.

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Choosing your Medical Coverage

There are many things to consider when choosing which Medical Plan is the best fit for your family. Please review the comparison chart, and use Health Plan Cost Comparison Tool [XLSM] to help you make the best decision for you and your family.

Below are some examples to help illustrate how different circumstances may impact benefits to help you determine which benefit election may be the right choice for you.

Meet the Taylor Family

David and Katie Taylor are in their late 40s with two children Emma (age 10) and Liam (age 14). Katie is in the Supervisory bargaining unit. They have family coverage under AlaskaCare and no other coverage. In this example, the Taylor family would pay less out-of-pocket if they choose the Economy plan.

  • About the Taylors’ Health
    • The Taylors see their family doctor annually to receive preventive care.
    • They are a healthy active family, but had some unexpected health issues during the year. Liam was involved in a snowboarding accident and taken to the emergency room. He was discharged and instructed to begin physical therapy for a neck injury.
    • With his accident Liam met his individual deductible, and the Taylors continued to pay coinsurance for his eligible expenses during the calendar year until he reached the individual out-of-pocket maximum.
    • All services were received in-network.
-- Consumer Choice Economy Standard
Total Annual Premiums $816 $1,920 $4,788
Total Estimated Member Claim Costs $5,550 $2,900 $1,900
State of Alaska Contribution to HRA ($1500) $0 $0
Combined Total Estimated Annual OOP Costs $4,866 $4,820 $6,688
Combined Total Estimated Monthly OOP Costs $405.50 $401.67 $557.33
Meet the Clark Family

Andrew and Sophie Clark are in their mid-30s and have one child, 9-year-old Noah. Andrew is a legislative employee. They have family coverage under AlaskaCare and no other coverage. In this example, the Clark family would pay less out-of-pocket if they choose the Consumer Choice plan.

  • About the Clarks’ Health
    • The Clarks see their family doctor annually to receive preventive care.
    • They are a healthy active family, but Sophie has chronic condition that requires monitoring through periodic medical office visits and testing. In addition, Noah had two unanticipated doctor visits, one for a severe sore throat with fever; the other for an earache.
    • Neither Noah or Sophie met the full deductible.
    • All services were received in-network.
-- Consumer Choice Economy Standard
Total Annual Premiums $816 $1,920 $4,788
Total Estimated Member Claim Costs $3,006 $1,606 $1,084
State of Alaska Contribution to HRA ($1,500) $0 $0
Combined Total Estimated Annual OOP Costs $2,322 $3,526 $5,872
Combined Total Estimated Monthly OOP Costs $193.50 $293.83 $489.33<
What about you? What will your healthcare needs be in the coming year?

Although you may not be able to fully predict the answer this question, consider if you have a chronic condition such as high blood pressure, or are planning a scheduled procedure. You might be able to calculate the expected costs to determine which plan may be the greater value for you or your family. Also, consider what would happen if you experience and unanticipated medical event? Would you and your family be able to absorb these unexpected out-of-pocket costs?

Compare the annual cost of the premiums and out-of-pocket maximums for each plan when deciding which plan may be the best fit for you. Please see our Health Plan Cost Comparison Tool [XLSM] for help comparing the different costs.

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Reduced Deductibles

Effective January 1, 2019 AlaskaCare is reducing the individual deductible across all health plans by $100 and the family deductible by $200.

This reduction is possible because of cost savings initiatives implemented over the past two years and excellent plan experience.

Keep an eye out for more opportunities to save money through a value-based benefits design, focusing on helping members manage, detect, and prevent disease.

Value-based benefit design is a way to provide higher levels of coverage for services that are proven to be effective. The plan already incorporates some elements of value-based design, such as waiving the deductible and coinsurance for recommended preventive screenings and incentivizing members to use generics medication by offering lower copayments compared to brand name drugs.

We are interested in your feedback! In February or March, you will receive a survey from AlaskaCare designed to help us understand the plan benefits you value most for you and your family. Please take a few moments to complete this survey when it arrives.

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OptumRx® Pharmacy Manager

AlaskaCare is pleased to announce OptumRx® has been selected as the new pharmacy benefit manager effective January 1, 2019.

Watch the mail for your welcome kit, which includes new identification cards. Beginning January 1, 2019, you will need to present your new member ID card to fill prescriptions at a retail pharmacy.

A pharmacy benefit manager (PBM) is a company the Division hires to process AlaskaCare pharmacy claims. Today, these claims are processed by Aetna and CVS/Caremark. Aetna and CVS/Caremark will continue to process pharmacy claims through December 31, 2018. Medical, vision and dental claims will continue to be processed by Aetna and Moda, respectively.

Your pharmacy benefits, including copays, will remain the same, but you may notice some small administrative changes like where drugs fall on the formulary and the list of medications requiring preauthorization. The Division is working to ensure members will be contacted ahead of time if they are impacted by these changes.

Starting October 31st, you can call OptumRx® at (855) 409-6999, TTY 711 for help:

  1. Finding a network pharmacy near you
  2. Reviewing the formulary to see if your medications are changing
  3. Ensure your mail order medications are transitioned
  4. Set refill reminders and more.

In addition, beginning January 1, 2019 you can accomplish these tasks by setting up your online account at optumrx.com, or downloading the OptumRx® App.

For more information please review the following documents:

Retail pharmacies

OptumRx®’s retail pharmacy network includes most pharmacies in Alaska. For a list of participating pharmacies near you, use the Pharmacy Locator Tool on the OptumRx® App, at optumrx.com or call a health care advocate at (855) 409-6999, TTY 711. Phone lines will open October 31st.

Medication home delivery

You can receive maintenance medication through the mail through OptumRx® home delivery. Enroll in OptumRx® home delivery to get up to a 90-day supply of the medications you take regularly. Your medication will come right to your mailbox. To start home delivery, log in to optumrx.com, use the OptumRx® App or call (855) 409-6999, TTY 711. If you are currently enrolled in the Aetna mail order program, any remaining prescription fills will be transferred to OptumRx® automatically.

BriovaRx specialty pharmacy

Specialty medications can be important to maintaining or improving your health — and your quality of life. BriovaRx®, the OptumRx® specialty pharmacy, provides resources and personalized, condition specific support to help you manage your condition.

In addition, you can save money using BriovaRx®. This is the only specialty pharmacy in which you can get up to a 90-day supply for a $20 copay for generics, $50 copay for preferred brand-name, or $100 copay for non-preferred brand name specialty medications.

Beginning January 1, 2019 call BriovaRx® at 855-4BRIOVA or (855) 427-4682 to enroll in this specialty pharmacy program. If you are currently receiving medication from the Aetna specialty pharmacy, any remaining prescription fills will be transferred to BriovaRx® automatically.

Note: If you are eligible for Medicare and enrolled in the AlaskaCare Retiree Medicare Prescription Drug Plan (PDP), your specialty scripts will not automatically be transferred. If you would like your specialty prescriptions transferred to BriovaRx®, please contact OptumRx and they will be happy to assist you.

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Expanded Coverage for Habilitative Services

Effective August 1, 2018 AlaskaCare has expanded habilitative services for pervasive developmental delays such as ASD.

Habilitative services can include occupational therapy, speech therapy and other service, including early intensive behavioral interventions such as applied behavioral analysis for treatment of Autism Spectrum Disorder (ASD). **Please note that applied behavioral analysis does require precertification.

Not all habilitative services are covered. Those services provided in an educational or training setting, to teach sign language, or vocational rehabilitation or employment counseling are not covered by the health plan.

For additional information on habilitative services covered under AlaskaCare contact the Aetna Concierge at (855) 784-8646.

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Health Flexible Spending Account (HFSA)

With the Select Benefits Health Flexible Spending Accounts (HFSA), you can set aside money to pay for certain health care expenses on a tax-free basis. You must contribute in whole dollar amounts. The contribution amount you elect will be deducted from your paycheck in equal amounts throughout the year.

2019 Health Flexible Spending Account Rates
Minimum Monthly Amount $25.00
Maximum Monthly Amount $225.00
Effective: Jan. 1 - Dec. 31, 2019

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