HomeMy WebLinkAboutMINUTES - 04141992 - 1.64 r_ 1 , s4
TO: BOARD OF SUPERVISORS Contra
FROM: Joseph J. Tonda, Risk Manager .
Costa
County
DATE: April 14, 1992 o'.' ::(W.
(()L.
SUBJECT: lst Choice Health Plan - Amendment to Plan Document
SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION
RECOMMENDATION
Amend the 1st Choice Health Plan, the self-funded employees' indemnity
health plan, effective April 1, 1992 to comply with the agreement as
negotiated between the County and the Contra Costa County Health Care
Coalition as follows:
I . Add to Part Two: Benefits, Section C, Payment Provisions (page 13)
add as follows: Subsection 4, Maximum Benefits.. Benefits for
outpatient physical therapy visits are limited to an aggregate of 50
visits per calendar year per Member.
Add to Part Five: Exclusions and Limitations (page 39) , add as
follows: Subsection LL. Benefits for outpatient physical therapy
visits are limited to an aggregate of 50 visits per calendar year
per Member.
II. Amend Part Two: Benefits, Section D. 14, Pap Smears and Mammograms
(page 24) to read as follows:
14. Notwithstanding the exclusion of routine tests from covered
benefits in Part Five (BB) below, laboratory, test and office
visit fees for annual pap smears for female members are covered
expenses. Professional fees for screening or diagnostic
mammography are covered expenses pursuant to Insurance Code
Section 10123 . 81: a baseline mammogram for women age 35 through
39, a mammogram for women 40 through 49 every two years or more
frequently on the recommendation of the woman' s physician, and a
mammogram every year for women age 50 and over.
CONTINUED ON ATTACHMENT: X YES SIGNATURE:
RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF ARD OMMI E
APPROVE OTHER
SIGNATURE(S):
ACTION OF BOARD ON q 9 z APPROVED AS RECOMMENDED X OTHER
VOTE OF SUPERVISORS
I HEREBY CERTIFY THAT THIS IS A TRUE
UNANIMOUS(ABSENT �� ) AND CORRECT COPY OF AN ACTION TAKEN
AYES: '!NOES: AND ENTERED ON THE MINUTES OF THE BOARD
ABSENT: ABSTAIN: OF SUPERVISORS ON THE DATE SHOWN.
CC: Risk Management (Benefits Div. ) ATTESTED
County Administrator PHIL BATCHELOR,CLERK OF THE BOARD OF
County Counsel SUPERVISORS AND COUNTY ADMINISTRATOR
Auditor-Controller
BY DEPUTY
M382 (10/88)
III . Add Part Two: Benefits, Section D, Covered Expenses, Subsection 18,
y:
19 and 20 (page 26) to read as follows:
18. Non-Preferred Provider Emergency Room Physician and Radiologist.
a. Services provided by a non-preferred emergency room
physician shall be fully covered when the services are
provided at a preferred provider hospital subject to a $25
co-payment by the Member. The $25 co-payment does not apply
to the Member' s annual out-of-pocket expense until the
annual out-of-pocket limit is reached.
b. Services provided by a non-preferred radiologist shall be
fully covered when the services are provided at a preferred
provider hospital subject a $25 co-payment by the Member.
The $25 co-payment does not apply to the Member' s annual
out-of-pocket expense until the annual out-of-pocket limit
is reached.
19. Routine Vision Examinations.
Services of a Physician (M.D. ) or licensed Optometrist (O.D. )
for routine vision .examination shall be fully covered subject to
a $10 co-payment by the Member: for Members 0 through 17 and 40
or over, every twelve months, and every twenty-four months for
Members age 18 to 39.
20. Diabetic Training Programs.
Diabetic training programs prescribed by the treating physician
for diabetes treatment is a covered expense limited to a
lifetime maximum of $300 in payments per Member under the
preferred/non-preferred provider provisions of the Plan.
IV. Amend Part Three: Programs Affecting Benefits, Section D,
Prescription Drug Program (page 32) to read as follows:
D. Prescription Drug Program
1 . Prescription drugs and medicine referenced in Part Two
D. 5.h. , and provided by a preferred pharmacy, shall be
covered in full and without claim requirements when the
Member makes a $2. 00 co-payment to the pharmacy for each
generic prescription drug or medicine and generic refill
received. In those cases in which there is no generic
equivalent or the Member' s physician or Member requests a
brand name prescription drug, the co-payment shall be $5. 00.
A list of Preferred Pharmacies is available to Members upon
request of the Contra Costa County Employee Benefits
Division.
2. Prescription drugs and medicine referenced in Part Two
D. 5.h. and provided by a non-preferred pharmacy, shall be
reimbursed when the Member or pharmacy submits a claim for
each prescription drug or medicine refill received. Payment
is provided for 80 percent of the covered expense incurred
by the Member.
3 . Injectable drugs referenced in Part Two D. 5.h. , excluding
insulin, shall be covered limited to a 50 percent co-payment
for each injectable drug prescribed.
V. Amend Part Five: Exclusions and Limitations, Section AA.2 (page 38)
to read as follows:
2. Health education services, nutritional counseling or food
supplements. Notwithstanding this exclusion, diabetic training
programs prescribed by the treating physician for diabetes
treatment is a covered expense as set forth in Part Two, Section
D. 20 above, limited to a lifetime maximum of $300 in payments
per Member.
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VI . Amend Part Five: Exclusions and Limitations, Section BB (page 38 )
to read as follows:
BB. Routine physical examinations or tests which do not directly
treat an actual illness, injury or condition, including those
required for employment or by government authority.
Notwithstanding this exclusion, well-baby care is a covered
expense as provided in Part Two D.10 and school or sports
physicals as provided in Part Two D. 15 are covered expenses.
Also notwithstanding this subparagraph, annual office visit and
pap smear tests as provided under Part Two D.14 and mammograms
(as set forth in Insurance Code section 10123 . 51 or any later
controlling statue) are covered expenses.
VII. Amend Part Five: Exclusions and Limitations, Sections D,. F (page
35) and T (page 37) are amended as follows:
D. Any charge for services of a non-preferred hospital,
non-preferred physician or non-preferred pharmacy in excess of a
customary and . reasonable charge. Notwithstanding this
limitation, non-preferred emergency room physician services are
covered expenses as provided in Part Two, Section D. 18 .a.
F. Any charge for services of non-preferred anesthetist or for
non-preferred outpatient diagnostic radiology and laboratory
services in excess of a customary and reasonable . charge.
Notwithstanding this limitation, non-preferred radiologists
services are covered expenses as provided in Part Two, Section
D. 18.b.
T. Optometric services . except as provided in Part Two, Section
D. 19, radial keratotomy, eye exercise including orthoptics,
eyeglasses, contact lenses or frames.
BACKGROUND
The proposed amendments are necessary to make the plan document
consistent with the agreements negotiated between the County and the
Health Care Coalition.
FISCAL IMPACT
Except for the vision examination benefit, the amended benefit changes
are not expected to have any significant fiscal impact to the plan. The
vision examination costs will be dependent upon plan utilization. Plan
expenses will be paid from the 1st Choice Trust Fund.
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