Quick reference guide

Discounts on non-covered services at select providers — .... Low copays on customizable options like scratch resistant and no-glare .... anti-reflec...

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Blue Cross and Blue Shield of Minnesota

Dental and   Vision plans Quick reference guide Large group 51+ enrollees

Better Together You and your clients already know Blue Cross and Blue Shield of Minnesota for our medical plans. Now one of the most trusted names in health care brings you dental and vision plans, too. We offer a wide range of plans to fit the needs of any large group. Your customers can also bundle dental or vision plans with Blue Cross medical for greater savings and easier plan administration.

Minimum enrollment requirements for Bundled Savings Program

Bundled Savings program Designed for groups of 51 – 1000 eligible employees, our Bundled Savings program can save your customers money when they bundle a fully insured Blue Cross dental or vision plan with a fully insured Blue Cross medical plan

Dental plans: The greater of 10 enrolled or 20 percent participation of eligible employees

Here’s how the program works:

The effective date of the vision or dental plan must be between June 2017 and May 2018

• •

➜➜

➜➜

Dental credit = $2 per contract per month Vision credit = $1 per contract per month

Credits earned in the first year are applied to the customer’s billing invoice in the second year Enrollment in a Blue Cross medical plan must equal 50 percent or more of the total eligible employees Employers must maintain a minimum enrollment requirements for dental and vision plans. See details at right.

Administrative ease of bundling

➜➜

One enrollment and implementation process

➜➜

One account management team

➜➜

➜➜

One customer service line for employers and employees One member website

seamless experience

ION

➜➜

One integrated bill when medical and dental/vision are all fully insured

1 IMPLEMENTAT

When your customers bundle a Blue Cross dental or vision plan with a Blue Cross medical plan, they enjoy:

pport team 1 su

process

➜➜

Vision plans: 15 contracts

Employers earn annual credit based on the average number of employees who sign up for a dental or vision plan

ME NT

➜➜

pr oc

LL

➜➜

e s s

RO N E 1

Our dental plans Our dental plans are flexible and can be customized to fit the needs of any large group. Employers can also choose plans that offer comprehensive benefits or opt for those that provide only preventive and diagnostic coverage. Employers can also offer core and buy-up plan designs to give employees more choice in coverage. Currently, our dental plans are available on a fully insured basis. We plan to introduce self-insured dental plans later in 2017. Dental plans can be offered with or without a Blue Cross medical plan.

networks on your own:

Access to the large and growing United Concordia Advantage 2.0 national network, with 1,622 unique providers

Dentists that provide discounts

and 11,287 access points

an (■) symbol next to their

100 percent coverage for in-network preventive care to promote

name in the Find A Dentist

early detection and treatment of oral health issues ➜➜

You can also explore our dental

findadentist

All Blue Cross Dental plans provide:

➜➜

Explore our dental networks

Visit bluecrossmn.com/

THE BLUE CROSS ADVANTAGE ➜➜

Self-in sured dental coming pl ans so o n !

for non-covered services have

search tool.

Discounts on non-covered services at select providers —

9 out of 10 participate ➜➜

Preventive Incentive option. With this benefit, preventive services

do not count toward a member’s annual out-of-pocket maximum.

Which dental plan is right for your clients? Value Plan employers

Preferred Plan employers

Freedom Plan employers

Are interested in a plan focused on preventive and basic dental care

Want a benefit that encourages employees to seek service within the plan network

Want the simplicity of offering a traditional dental plan

Are new to offering a dental plan

Want to provide a full range of dental benefits to their employees

Want comprehensive dental benefits and equal coinsurance in and out of network

Have a limited budget Want to offer a low-cost option alongside a traditional plan design United Concordia Companies, Inc. is an independent company providing dental benefit management services and access to the Advantage Plus 2.0 network. Each dental provider is an independent contractor and not our agent. It is up to the member to confirm provider participation in their network prior to receiving services.

Blue Cross Dental plans at a glance Our dental plans are currently offered on a fully insured basis only and can be customized to fit the needs of any large group. Employers can also offer more than one plan to give employees more choice in coverage.

Value

preferred

freedom













Major Restorative Services (All plans cover TMJ at 50%)





Optional orthodontia





Incentive PPO plan design



Standard

Premium





Feature/Benefit Routine preventive care Optional Preventive Incentive



Basic Restorative Services

✔ (Some services)

stretch your benefit

dollars



Preventive Incentive promotes overall health

With this optional benefit, preventive dental services do not count toward a member’s annual maximum. This incents employees to get preventive dental care and preserves their benefit dollars for restorative services, if needed. That’s important, because research shows a link between oral health and overall health.

Dental ID cards Members will receive a separate dental ID card and should present it to the dental office at the time of service. The dental ID card contains the identifier ‘Den’ as shown below. Members may print additional or replacement dental ID cards from the member website at bluecrossmnonline.com.

Member ID

Name ELIZABETH SAMPLENAME ID # 000000000000 Svc Type

GRP

Den

Care Type

All dental cards will have this abbreviation.

XXXXXXXX

FREEDOM

Dentist finder tool Members can search online for in-network dentists by logging in to their account at bluecrossmnonline.com. If they want to view Find a Dentist without logging in, they may visit bluecrossmn.com/findadentist.

What is needed for a dental quote? Dental: Groups 51 – 149

Dental: Groups 150+

➜➜

Census

➜➜

Census

➜➜

Company information

➜➜

Company information

➜➜

Legal name

➜➜

Legal name

➜➜

Address, ZIP code

➜➜

Address, ZIP code

➜➜

Effective date

➜➜

Effective date

➜➜

Incumbent benefit summary, if available

➜➜

➜➜

Incumbent carrier information, if available

➜➜

Incumbent rates, if available

➜➜

Incumbent carrier information

➜➜

Commission

➜➜

Incumbent rates, if available

➜➜

Commission

➜➜

Two years of paid claims and enrollment

Incumbent benefit summary or summary plan description booklet

Our VISION plans Our vision plans give members more ways to save on eyewear and access to a large national provider network. Members can also choose to see an optometrist or ophthalmologist in private practice or at top retailers, including Visionworks, Costco, Walmart and Sam’s Club.*

THE BLUE CROSS ADVANTAGE All Blue Cross Vision plans offer: ➜➜

Access to the Davis Vision Network, with more than 50,000 providers nationwide

➜➜

Discounts on eyeglasses and contact lenses at in-network providers and retailers

➜➜

Low copays on customizable options like scratch resistant and no-glare lenses

EXAMPLE MEMBER SAVINGS OF $263 Retail cost (average)

Member cost

Davis Vision Exclusive Collection Frame (designer tier)

$165

$0

Single vision lenses

$78

$10

One-year breakage warranty

$30

$0

Total:

$273

$10

Eyewear

enhanced frame allowance When they choose frame options from Visionworks, employees realize even greater savings with an enhanced frame allowance included in all of our plans.

Which vision plan is right for your clients? Value Enhanced Plan employers

*

Value Standard Plan employers

Premier Enhanced Plan employers

Are looking for an eyewear-only plan

Are looking for value

Want to include an eye exam with their vision plan

Want the lowest cost plan

Want to include an eye exam with their vision plan

Want to offer lower copays and discounts on eyeglass frames

Want the benchmark frame allowance

Want an above-benchmark frame allowance

Retail partners of Davis Vision.

Davis Vision is an independent company providing vision benefit management services and access to their network. Each vision provider is an independent contractor and not our agent. It is up to the member to confirm provider participation in their network prior to receiving services. Davis Vision and Visionworks are divisions of HVHC Inc.

Blue Cross vision plans at a glance Our vision plans are available on a fully insured and voluntary or contributory basis. They can be offered with fully insured or self-insured Blue Cross medical plans or on their own. Employers can choose a plan with or without an annual eye exam benefit.

Value Enhanced

Value Standard

Premier Enhanced (richest benefit see chart on next page)

Feature/Benefit Preventive exam





Discounts on eyewear







Discounts on lens enhancements (Lens enhancement benefit consistent across all plans)







Why choose a vision plan that includes eye exams? While we offer both plans with and without an eye exam, we encourage groups to include an eye exam with their vision plan to: ➜➜

Encourage members to get preventive eye exams that can lead to early detection of chronic

conditions like high blood pressure and diabetes ➜➜

Ensure a more seamless member experience, since retail vision shops readily accept eyewear

prescriptions obtained within the vision plan network but may not accept a prescription from a medical plan

Vision underwriting guidelines Vision: Groups 51 – 1,000*

Underwriting guidelines for large groups apply to both voluntary and non-voluntary policies: ➜➜

Minimum enrollment requirement of 15 contracts

➜➜

Rates are guaranteed for 36 months

➜➜

For employer contributions greater than 80 percent, rating will be non-voluntary

➜➜

Rates include 10 percent commission

➜➜

Group must be headquartered in Minnesota

*Note: Groups larger than 1,000 employees are individually rated.

eyewear only Value Enhanced Option 1

Option 2

exam and eyewear Value Standard Option 1

Premier Enhanced

Option 2

Option 1

Option 2

Out-of-network reimbursements Eye exam: $40, if applicable

In-network benefit eye exam – One exam every 12 months Eye exam - Includes dilation when recommended by eye care professional

Exam not covered

100% after $10 copay

100% after $10 copay

Frames: $50

100% after $10 copay

Lenses: - Single vision: $40 - Bifocal/progressive: $60 - Trifocal: $80 - Lenticular: $100 - Visually required: $225

prescription glasses – Benefit available for eyeglass lenses OR contact lenses once every 12 months Lenses - Single vision, lined bifocal, trifocal, lenticular, polycarbonate (dependent children) Frames Two frame frequency options available under each plan Davis Vision Exclusive Collection* - Fashion level - Designer level - Premier level Non-Davis Vision Exclusive Collection - Visionworks stores - Frames available from other participating retailers

100% after $10 copay

1 every 12 months

1 every 24 months

100% after $25 copay

1 every 12 months

1 every 24 months

1 every 12 months

1 every 24 months

100%; no copay 100%; no copay 100%; $25 copay

100%; no copay 100%; no copay 100%; $25 copay

100%; no copay 100%; no copay 100%; no copay

No copay; plan pays up to $180 plus 20% of remaining costs** No copay; plan pays up to $130 plus 20% of remaining costs**

No copay; plan pays up to $180 plus 20% of remaining costs** No copay; plan pays up to $130 plus 20% of remaining costs**

No copay; plan pays up to $200 plus 20% of remaining costs** No copay; plan pays up to $150 plus 20% of remaining costs**

Contact lenses (Elective): $105 and private

eyeglass enhancements – Member charges - Tinting of plastic lenses - Scratch-resistant coating - Polycarbonate lenses - Dependent children, monocular patients and those with a prescription of +/- 6.00 diopters or greater - Adults - Ultraviolet coating - Anti-reflective coating - Progressive lenses - High index lenses - Polarized lenses - Plastic photochromic lenses - Scratch protection plan

Member pays $0 Member pays $0

Member pays $0 Member pays $0

Member pays $0

Member pays $0

Member pays $30 Member pays $12 Standard: $35 / Premium: $48 / Ultra: $60 Standard: $50 / Premium: $90 / Ultra: $140 Member pays $55 Member pays $75 Member pays $65 Single vision: $20 / Multifocus vision: $40

Member pays $30 Member pays $12 Standard: $35 / Premium: $48 / Ultra: $60 Standard: $50 / Premium: $90 / Ultra: $140 Member pays $55 Member pays $75 Member pays $65 Single vision: $20 / Multifocus vision: $40

contact lens – Benefit available for eyeglass lenses OR contact lenses once every 12 months Collection contact lenses† - Disposable - Non-disposable

up to 4 boxes/multi-packs up to 2 boxes/multi-packs

up to 4 boxes/multi-packs up to 2 boxes/multi-packs

up to 8 boxes/multi-packs up to 4 boxes/multi-packs

- Evaluation, fitting and follow-up care

100% after $10 copay

100% after $25 copay

100% after $10 copay

Non-collection contact lens allowance†† - Evaluation, fitting and follow-up care for standard lenses

Plan pays up to $130 plus 15% of remaining costs**

Plan pays up to $130 plus 15% of remaining costs**

Plan pays up to $150 plus 15% of remaining costs**

100% after $10 copay

100% after $25 copay

100% after $10 copay

$10 copay; after copay, plan pays up to $60 plus 15% of remaining costs**

$25 copay; after copay, plan pays up to $60 plus 15% of remaining costs**

$10 copay; after copay, plan pays up to $60 plus 15% of remaining costs**

100%

100%

100%

100% after $10 copay

100% after $25 copay

100% after $10 copay

- Evaluation, fitting and follow-up care for specialty lenses Visually required contact lenses (preauthorization required) - Materials - Evaluation, fitting and follow-up care

*Davis Vision Exclusive Collection available at most independent providers and private practice locations. Collection is subject to change. ** Additional discount not available at Costco, Walmart and Sam’s Club. †Available in private practice locations. ††Available in participating retail locations. These plans provide vision coverage only. The vision plan’s benefit booklet will contain more details on standard plan exclusions and frequency limitations.

Vision ID cards Vision plan members will receive a separate ID card and should use it when they want to access routine eye exam and eyeglass and contacts benefits under that plan. The vision ID card contains the identifier ‘Vis’ as shown below. Members may print additional or replacement vision ID cards from the member website at bluecrossmnonline.com.

Member ID

Name ELIZABETH SAMPLENAME ID # 000000000000 Svc Type

GRP

Vis

Care Type

XXXXXXXX

VALUE

All vision cards will have this abbreviation.

vision doctor finder tool Members can also search online for in-network providers at bluecrossmn.com/findaneyedoctor.

Questions about your dental or vision plans? Need a quote? Contact your Blue Cross representative.

NOTES

As Minnesota’s health care leader, we live fearless. We believe good health is for everyone — not just our members. It’s a big vision. And that’s why we’re investing in the communities we serve and empowering individuals to make smart choices about their health. Live fearless with the peace of mind that comes from knowing you’re protected by the strength and stability of Blue Cross. We invite you to join us.

Blue Cross® and Blue Shield® of Minnesota and Blue Plus® are nonprofit independent licensees of the Blue Cross and Blue Shield Association. M00287 (6/17)

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