New HDHP Rx claim process is FREE of claim forms and receipts!

BEST Life has a great new and easy way to apply eligible prescription purchases to your High Deductible Health Plan!  We now process your HDHP Rx claims electronically – and you will not need to do a thing. 

 Our new claims process is as easy as 1, 2, 3:

1. Use your CVS Caremark Discount Only card at any CVS Caremark pharmacy to receive discounts at the time of purchase.
2. Relax as we take care of the rest. Your purchases are now sent electronically to the BEST Life Claims Department directly from your CVS Caremark pharmacy.  We will no longer need you to complete a claim form or mail in your receipts.
3. Receive your Explanation of Benefits in the mail.  Review this document to see how your eligible prescription purchases are applied to your High Deductible Health Plan’s deductible, then coinsurance.

Please note:  This new process only applies to prescription purchased through CVS Caremark. You will be required to submit a claim form for prescription purchased from a non-participating pharmacy.

Have questions about your benefits? Contact BEST Life Customer Service at 800.433.0088, or via email at cs@bestlife.com, 7 am – 5 pm PST, Monday – Friday.

New Discounts for Jenny Craig Weight Loss Programs

BEST Life’s plans include access to discount programs offered through the BEST Employers Association (“BEA”).  In February, BEA has launched the addition of Jenny Craig to the Gold Star Advantage Discount Program.

Save on Jenny Craig and lose weight!

BEA’s new discount program provides members the option to try a Jenny Craig program free for 30 days*, or to receive 25% off a premium program*. Jenny Craig programs include At Home or In-Centre services, personalized one-on-one consultations, and Jenny’s Cuisine®, a line of food to help participants meet their weight goals. Jenny Craig is a national company and has helped millions of people lose weight.

In addition, members who enroll on our email list will receive monthly health tips or offers from Jenny Craig and other discount programs sent through BEA. These flyers can be used as employee stuffers and serve as a great reminder of the value BEA brings to BEST Life members. To sign up , visit www.beassoc.org/sign-up.html.

For details on the Jenny Craig program visit http://www.beassoc.org/benefits.html.

*Plus the cost of food. Plus the cost of shipping, if applicable. Restrictions apply.

BEST Life Plans Come with Useful Discount Programs

BEST Life’s plans also include access to some useful discount programs offered through the BEST Employers Association (“BEA”).  Here is an explanation of what these discount programs can offer. 

Please note that as long as the employer is offering a BEST Life plan, all employees of that organization are considered members of the BEST Employers Association.

BEA currently offers 6 discount programs and has plans to expand by adding more health or personal related products and services.

Association Sponsored Services include:

• HealthScreen Lab Services– Offers discounts on a variety of health and wellness blood chemistry tests.  Helps members monitor their health.  No doctor’s order is necessary and tests can be ordered directly online.
• EyeMed Vision Care– Discounts on eye exams, eyewear and eye correction surgery.
• QualSight– Offers 40 to 50% off the average national charge for LASIK surgery through a QualSight provider.
• Global Medical Conextions– For dental and medical treatment not eligible or covered by insurance.  Offers members a way to obtain costly medical services at up to 70% less the US retail hospital price when performed in another country.
• Sears Commercial– Offers discounts on brand name appliances, exercise equipment, televisions and more.
• Car Rentals through Avis – Offers discounts when cars are rented at any Avis location.

For more information and to check for updates, please visit the BEST Employers Association website at www.beassoc.org.

What is Personal Dental?

Personal Dental is BEST Life’s new line of dental plans.  These dental plans are sold through the BEST Employers Association (“BEA”) and are available directly to individuals and families residing in California. 

Personal Dental provides an affordable alternative and are designed for individuals not eligible for coverage on an employer plan. Dependent children who reach the age limit on an employer plan, or for individuals whose COBRA coverage has ended, may all purchase a Personal Dental plan.

Why choose Personal Dental?

As we’ve demonstrated in an earlier article, the cost of dental care can be expensive. Having dental insurance can help save you money and make it affordable for you to go to the dentist.

If you need dental coverage, live in California and are ineligible for group insurance,  Personal Dental may be the alternative you are looking for!

Personal Dental Plan Highlights: 

• A selection of two indemnity plans that increase coverage over 2 to 3 years, and two scheduled reimbursement plans
• No deductibles for preventive care
• $50 yearly deductible for basic and major services
• Coverage for preventive, basic and major services
• Preventive care covered at 100% or 80%, or at a reimbursed amount
• Coverage for sealants, fluoride treatment and space maintainers for children
• Optional access to a PPO network of 18,359 dental offices in California 
• Optional access to a national PPO network for children living outside of California or for those traveling

Where can I purchase Personal Dental?

Visit the Personal Dental website at www.beassoc.org/PersonalDental/ to download a brochure and application.  If you need assistance, visit http://www.beassoc.org/personaldental/directory.html to review a directory of insurance agents.  Just select the one nearest you and he or she will answer any questions you may have.

BEST Life Wins Third Place in Sandcastle Competition!

 

On October 2nd, BEST Life competed in the Newport Beach Sandcastle Competition, an event held annually at the Corona del Mar State Beach in Southern California. This was the first time BEST Life has competed in and sponsored a sandcastle competition.  Out of twenty-six teams, BEST Life won third place.  That’s pretty good for a first try!

A side view provides a close-up of the details imprinted on the Sandcastle.

“The weather was perfect: warm, but not too hot, and we had a great team of people,” stated Jennifer Bolton, National Sales Manager for BEST Life. “We worked well together and were able to sculpt a pretty large sandcastle!  The hard work obviously paid off.  We’re proud of what we achieved that day.”

Employees and their family members volunteered and spent the day at the beach mixing sand and water.  “The right consistency keeps the sand stable enough to sculpt,” explained Joe Perez, who planned and oversaw the design of the sandcastle.

“My family had a great time,” stated Irene Rochefort. “The kids had a blast shoveling the sand and forming turrets and walls.  We look forward to doing this again next year.”

The trophy BEST Life has won is currently on display at the Irvine office. We thank and congratulate all employees who participated. Go team!

Left to right starting at the top: Irene Rochefort with niece Charlie, Kevin Dickey, Jennifer Bolton with daughter Makena, and Joe Perez with wife Tiffany.

Why does the cost of health care services vary by zip code?

As you shop around for health care and dental services, you may notice that the cost for these services vary by zip code.  What one dentist would charge in one area for the exact same services, may be more or less what a dentist would charge in another area. What one hospital charges for services may be charged differently by another hospital.

 In this article, we explore why costs vary by zip code.

Demand and the Cost of Living

Location can mean everything. Many reasons can factor into why a residential area can be more expensive compared to others.  Here are just a few:

The cost of living can be more expensive in certain cities compared to others (think Beverly Hills, California vs. San Antonio, Texas).  Providing health or dental care may be more expensive because the property the office is built on is expensive, too. This can work the other way as well.

Population density: there may be more dentists/physicians per resident in well-populated areas, or just a few available in small towns. While health care providers may charge what is reasonable for their residents, they may charge slightly higher if there are too many patients that need their services.

Demand may be high: the health of a town’s population is a major factor. An unhealthy population would require more health care services, which could raise the costs of services for everyone. (Top 5 most expensive health care markets.)

The type of care available in your area. Hospitals and providers who specialize in a specific area of medicine or dentistry may require state-of-the-art technology, may be located in a more expensive area, or may just be high in demand.  It all depends what is available in your area.

What’s your doctor’s specialty? Specialists are health care providers or dentists that focus on treating one specific disease, illness, or region of your body. Services by a specialist may cost more because the treatment that is required may be more involved.  Your treatment may require the use of specialized software or technology, the use of an operating room, surgery, anesthesia, chemotherapy, etc.

General Dentists and General Physicians on the other hand focus on your whole being and on preventive care. This may work for your basic health needs, yet if your health changes, like expecting a baby, there may be a time when your health requires a specialist.

In most cases, your General Dentist or Physician will refer you to a specialist.

How can I save money?

There are several things you can do to save money:

If you can, use a PPO Network Provider. One easy way to save on your out-of-pocket costs is to select a provider in the BEST Life PPO network. Providers who participate in a BEST Life PPO network have agreed to accept a discounted rate for their services. Using a PPO Network Provider can save you anywhere from 5% up to 57%, depending on the service.  Our networks include general practitioners and specialists.

If you are on a medical plan, BEST Life offers a regional network specializing in providing care in your area, and PHCS Healthy Directions for services outside your area. 

Please note that the PHCS Healthy Directions secondary network is not available to PHCS members.  These members already use one of the largest national networks in the country.  PHCS Healthy Directions is available to Utah Beech Street members outside of Utah only.

Dental plan members have the option of using DenteMax (one of the largest national networks in the country) or, depending on their state and plan, a regional network. While BEST Life selects regional networks for the concentrated number of access points offered in a state, there may be situations where the DenteMax network can provide the needed extra access. 

Some areas of a state may have more providers participating in DenteMax’s network; a member who is traveling may need emergency care; or a member’s child is going to college in another state where the regional network is not offered. In all these examples, members can select a DenteMax provider and still save on their out-of-pocket costs.

Regardless of which network you use, always call the network provider and confirm that he or she is in the network before setting up an appointment. 

Always try to use your “In-Network Benefits”. If you are on a medical or dental PPO plan, going in-network will provide you with more coverage.  Your plan may cover a percentage more, you may have a lower co-pay or lower deductible, and in some cases preventive care may be covered 100%. 

Your Certificate of Insurance or Schedule of Benefits will provide you with the benefits and explain how your in-network benefits work.  Or, if you need assistance, you may contact our Customer Service Department and they can explain how your plan works. Contact Customer Service at 1-800-433-0088 or at cs@bestlife.com.

Shop around. The great thing about PPO and Indemnity plans is the freedom they give you to choose any medical or dental provider.  Now that you are aware of why health care costs may vary, shop around when you can.  If you are unhappy with the quality or cost of the service you received, you may select another provider at any time.

Keep in mind that a high price does not always equate to high quality.  Studies have shown that quality is not always the main factor driving costs.  For example, an Urgent Care Unit may not be the same as a hospital, but may provide less expensive and just as effective treatment for certain illnesses. (Read the Dartmouth Institute’s Study: Health Care Spending, Quality and Outcomes: More Isn’t Always Better.)

BEST Life lists a few non-affiliated websites you can go to for pricing (Treatment Cost Calculators), or you can always rely on recommendations from friends or from your favorite dentist or physician.

Preventive Services for Non-Grandfathered Health Plans

BEST Life’s Non-Grandfathered Health Plans offer preventive services 100% coverage, whether those services are provided in-network or out-of-network.  To better explain what exactly is covered by these plans, BEST Life had created new a educational flyer for our members. This Preventive Services flyer is available in the Member portal of the BEST Life website and is included in the Health Resource Center.

How are services determined to be preventive?

The Patient Protection and Affordable Care Act (“PPACA”) requires non-grandfathered plans to cover what the U.S. Preventive Services Task Force rates as an A or B Preventive Service.  This provided the first list of preventive services.   However, the U.S. Department of Human and Health Services (“HHS”) can also determine what preventive services should be covered, and these services can change at any time.  

As recently as August 1, 2011, the HHS adopted new Guidelines for Women’s Preventive Services based on recommendations by the Institute of Medicine and new scientific evidence.  Starting with new health plans effective August 1, 2012, additional services like support for renting breastfeeding equipment, contraception and domestic violence screening will be considered preventive and be covered at 100%.

Even though the new guidelines include woman’s wellness visits, our plans already cover these and pap smears at 100%.

BEST Life is currently evaluating how these new guidelines affect Non-Grandfathered plans and will implement them in August 2012. 

Any changes to the Non-Grandfathered Plans will also include updates to the Preventive Services flyers.  So you may want to check back with us for these updates.

How are Preventive Services covered?

Your doctor will recommend preventive services based on your age, gender, health, and risk for developing disease.  Preventive services are covered at 100%  as long as that is the main purpose of the visit.  Services performed to diagnose a specific illness or injury you have at the time of the visit is not considered preventive and will not be covered.  (Think of the difference between a routine annual physical versus an office visit to determine if you have allergies or a sinus infection.)

For this reason, we recommend that you do not combine sick visits with your wellness visit.

Your doctor will schedule a follow-up visit for any illnesses identified as a result of the preventive care you receive. These follow-up visits are covered under your plan as a regular office visit.  In this case, a co-payment, deductible and coinsurance may apply.  Please see your Certificate of Insurance for details.

If you have questions about how preventive services are covered on your plan, our Customer Service Department is available to help.  They can be contacted Monday through Friday, 7 am to 5 pm PST at 1-800-433-0088 or via email at cs@bestlife.com.

What are “Ancillary Benefits”?

You may have seen this term while looking for group insurance. “Ancillary Benefits” refer to benefits that are used to supplement group health insurance. These can include the three most sought-after employee benefits: dental, vision and life insurance.

 

Why offer ancillary benefits?

Employees still need oral and vision care.  Offering a health plan is not enough to keep employees healthy.

Research continues to show that dental and vision plans can be effective preventive healthcare tools that may lower medical claims costs in the long run.  Early symptoms of high blood pressure, diabetes and other diseases can be detected in an eye exam before showing up in a physical. (For details read Dr. Ella Faktorovish’s article “How an eye exam can save your life“.

Health insurance also does not provide income protection in the event of a death.  Life insurance can help employees protect their loved ones by providing a monetary benefit to cover the cost of a funeral or a debt.

Group life insurance has a high-perceived value as well!  According to the U.S. Bureau of Labor Statistics, as of 2010, 96 percent of employees who had access to group life insurance took advatange of it.

Ancillary benefits have the advantage of being affordable, too.

Purchasing these benefits at a group level is more affordable than if purchased on an individual basis.  Cost is limited for three reasons:

• As group insurance products, the risk is spread through a large population, which keeps premiums reasonably priced.
• If your business takes advantage of Section 125 of the IRS code, premiums are paid with pre-tax dollars.
• The cost can either be completely covered by the employer or shared with the employees by arranging an employer-employee split.

BEST Life offers a range of affordable ancillary benefits for groups with 2 or more employees enrolling.  Learn more about our group insurance products.

 

How does ancillary employee benefits work?

There are two ways ancillary benefits can be funded: voluntary or employer-contributory.  On employer-contributory ancillary benefits, the employer usually pays 50 to 100 percent of the premiums.  On voluntary plans, the employer may contribute 0 to 49 percent of the premiums.

Learn how offering voluntary plans can make business sense.

Through payroll deduction, employees pay whatever portion of the premiums that the employer does not cover.  Then when an employee uses their benefits, a claim is submitted and benefits are paid directly to the network-contracted provider or to the member (if a network provider is not used).  For life insurance claims, the beneficiary is paid directly (in the event of a death).

There are many reasons why an employer may contribute more or less of the cost of an ancillary benefit. Companies may only cover the full cost of their health plan, and let employees choose to purchase a voluntary dental or vision plan.  Others may find that offering employer-contributory anicllary plans encourages more employees to enroll.

The key is to know what works best for your business.  Discussing your company and employees’ needs with your insurance agent can help determine the best combination of these benefits.

Whichever you decide, offering ancillary benefits can be a win-win proposition:

Benefits to Employers

• Lower employer FICA contributions if your business takes advantage of Section 125 so that employees can use pre-tax dollars for these benefits
• The value of ancillary benefits is high among employees and would enhance the employer’s reputation among employees.
• Offering ancillary benefits make your business more competitive in the employment marketplace.  With them, you can compete with other employers who may already provide these value-added benefits.
• Employers do not pay for voluntary ancillary benefits or can share the cost with employees to keep costs down while  pleasing employees.

Benefits to Employees

• They can use pre-tax dollars to pay for ancillary benefits, thus lowering their taxable income.
• The cost is affordable.  Risk is spread amont a large group of people to keep the premiums reasonable.
• Ancillary products respond to workers’ needs to access important benefits, such as dental insurance, vision insurance and group term life insurance.
• With ancillary dental and vision benefits, workers can get preventative care, not just care when a problem develops.
• They can enjoy the peace of mind and security that comes with ancillary benefits and group insurance.

Sources: http://www.bls.gov/news.release/ebs2.t05.htm; http://www.towerswatson.com/research/3946

Employer Question and Answer on HIPAA Compliance

Here’s a great question to answer for employers:

When do I need a HIPAA Authorization Form from an employee?  

Before we move forward, please note that this article explains BEST Life’s business practices to comply with the HIPAA Privacy Rule, and is not a source for legal information or advice. 

For an explanation on how BEST Life discloses or uses protected health information (“PHI”) please review BEST Life’s Privacy Statement. 

For specific details on the HIPAA Privacy Rule, we recommend reading the Summary of the HIPAA Privacy Rule posted on the US Department of Health and Human Services Website, or consulting with your legal counsel.

When do I use an Authorization Form?

You will need an authorization when you need information about an employee or dependent from an insurance company.

The HIPAA Privacy Rule, which explains when protected health information can be disclosed and by whom, was created for insurance companies, health care providers, and claims clearinghouses or other type of administrative companies hired by an insurance carrier or health care provider.  The Privacy Rule does not apply to employers or employee records kept by the employer.  It does apply when that information is being sent to or provided by the insurance company (this will be explained later in this article).

If you need protected health information (“PHI”) about an employee, you may ask the employee directly without a signed HIPAA Authorization Form. 

If you need PHI about an employee to be disclosed by BEST Life, you will need a signed HIPAA Authorization Form.

The protected health information insurance companies can disclose to employers is limited.

According to the Privacy Rule, an insurance company may disclose the following protected health information to the employer:

• Enrollment or disenrollment
• Summary health information to obtain premium bids, or to modify, amend or terminate the group health plan
• Summary health information is defined as claims history, claims expenses, or types of claims experience of individuals and that is stripped of all individual identifiers other than five digit zip code
• Protected health information of the group health plan’s enrollees to perform plan administration functions

Anything outside of the above situation will require an authorization form signed by the insured to be submitted to BEST Life. 

What about asking my insurance agent to get the information about an employee?

BEST Life can provide insurance agents with the same information we can provide to an employer for the purposes we listed above.   The insurance agent would still need a signed authorization form to obtain specific information about an insured individual from BEST Life.

How do I get an Authorization Form?

BEST Life has an Authorization Form you can use.  You can download a copy here or request BEST Life Customer Service to email you one.

The Authorization Form can only be used for one specific activity or event and must be signed by the insured.  An expiration date or description of the event is required.  Once the authorization has expired or the event that triggered the need for this form is over, BEST Life will no longer be authorized to disclose protected health information.  A new Authorization Form will need to be submitted after the original authorization has expired, if necessary.

The insured has the right to revoke given authorization at any time or refuse to sign the authorization form.  The rights of the individual are provided on the second page of the Authorization Form.

For any more questions about our process, please contact BEST Life’s Privacy Officer by writing to: BEST Life Privacy Officer, 2505 McCabe Way, Irvine, CA 92614 or by telephone at (949) 253-4080.

For all other assistance, contact BEST Life Customer Service, Monday through Friday 7 am to 5pm PST at 1-800-433-0088 or via email at cs@bestlife.com.

Source: US Department of Health and Human Services: http://www.hhs.gov/ocr/privacy/

Does it make sense to offer voluntary dental, vision or life insurance?

Health plans usually take center stage in employee benefits programs… which is why we are bringing the spotlight to the other, just as important, components of an employee benefits package: voluntary plans.

What are voluntary plans?
Voluntary plans are dental, vision and term life benefits offered at group rates.  They are called “voluntary” because the employer does not cover the full cost of these plans.  Instead employees are given the choice to “voluntarily” cover them at their own expense.

Employers use voluntry plans to offer employees dental, vision and life insurance at group rates, which are lower than what employees would pay if they purchased these plans on an individual basis.

What are the advantages of voluntary plans?
Voluntary plans offer many benefits to both the employee and to the employers:

1. They can fill in the gaps of a limited employee benefits package. If benefits are currently limited to health and dental, adding additional insurance would help address other employee needs. Some health plans may not provide coverage for eye exams or eyewear.  A voluntary vision plan would fill this need and help preserve eyesight.

Employees can purchase more life insurance if a voluntary plan is offered alongside an employer-sponsored life plan.

2. Pre-taxed dollars can be used to pay for these plans. The cost of voluntary plans can be conveniently deducted from paychecks with pre-tax dollars, which can help employees save on their purchase.

3. Offers desirable benefits and gives employees a reason to stick around. Employees value benefits like dental and vision.  According to Taylor Nelson/Sofres Itnersearch*, 80 percent of Americans surveyed felt dental benefits are “very important/somewhat important” for hiring employers to provide employees.

Employers who offer a variety of benefits look more attractive to current employees and to new hires, and this can help encourage company loyalty by increasing employee satisfaction. 

4. Encourages preventive care. Employees who have dental benefits get dental care more compared to those who do not have dental insurance.  According to a 2007 National American Dental Plan (“NADP”) Consumer Survey, people who do not have dental coverage are 2.5 times more likely to not visit their dentist. 

Bad oral hygiene can be very costly as oral infection has been tied to cardiovascular disease, diabetes and others. 

Vision plans are an important prevention tool as well.  Signs of disease like high blood pressure and diabetes may be caught early in an eye exam. 

Early detection from an eye or oral exam can help lower a company’s medical costs in the long term.

5. Protection for families during the event of a death or serious injury. Group term life insurance provides an inexpensive way to have money available during the event of a death.  Most term life policies include Accidental Death and Dismemberment, which provides a benefit in the event of a serious injury or death due to an accident. 

By having both benefits, $15,000 or even $30,000, depending on the plan selected by the employer, can help financially protect a family from a diminished household income… and a peace of mind.

The more employees enroll, the more the group saves. BEST Life is currently offering special rates for voluntary dental and vision plans.  Companies with more than 60% of their employees enrolled in a voluntary dental or vision plan will receive the same rates and waiting periods offered on employer-sponsored plans.  This offer is valid through December 2011 effective dates.

Download our special offer and provide this to your insurance agent.  Or share this article with a friend.

*Taylor Nelson Sofres Intersearch survey, May 2002.