Please check back on the Frequently Asked Questions. As common questions come in, they will be added here.
Will I have a copay at my doctor’s office?
There are no copays with any of the plans offered in 2018. You will be responsible for all charges, up to your deductible, then insurance will start to pay. The CareATC and HSA options provide a basic level of health care to help mitigate the impact of deductibles. All plans will include preventive services that are free without deductible charges.
What is the $1,500 Health Savings Plan (HSA)?
For the first time, the City will be contributing $1,500, or $57.70 every pay check, into an HSA account for employees who choose this option. This money can go toward doctor visits, prescriptions, lab fees, testing, etc., as well as dental and vision services. You can allocate additional funding from your check to be paid into your account. Any balance in the account will roll over from year to year. It’s important to note that the contribution will only be available for use as it is saved to your HSA account throughout the year.
Where will I get my medications now?
If you are enrolled in the CareATC option, their formulary offers many generic medications free of charge when filled at their dispensary. If you are on the HSA Plan or your medication is not covered by the CareATC formulary, you can use any pharmacy that takes Blue Cross/Blue Shield. We encourage you to compare prices between pharmacies. Also, ask your doctor for generic medications and discount cards or coupons for the medications you use.
Will I have a separate deductible for my medications?
No, all medical and pharmaceutical costs apply toward your $3,000/$6,000 deductible. After you have met your deductible, insurance starts to pay.
The plan calls for all employees to have $3,000/$6,000 deductibles. Can you explain what that means?
This is the amount you pay for covered health care services before your insurance starts to pay. For individuals, that amount is $3,000, and $6,000 total for all family members; however, family plans do contain individual limits of $3,000 per person. If you are a CareATC participant, the services you receive at CareATC will be free and not count toward your deductible.
Are the CareATC Primary Care Centers the same as the minor illness clinics we have now?
No. The CareATC Primary Care Centers provide comprehensive medical care, including wellness exams, disease management, lab work, X-rays (at two locations), and onsite pharmacies. The minor illness clinic in City Hall will no longer be available.
I see a specialist for a medical condition. Will I still be able to see them if I use the CareATC option?
Absolutely. You will still be able to visit your specialist. Insurance will pay more if they are in the BCBS networks. You will be responsible for the medical costs related to those visits, along with any testing and lab work, up to your deductible. After you have met your deductible, insurance will start to pay.
My hospital is no longer in-network. Can I still use them?
Yes, however, you will be responsible for higher deductibles, higher out-of-pocket limits and a co-insurance rate (50/50 co-insurance). Out-of-network services are also subject to “balance billing,” where the service provider may bill you the difference between what your insurance reimburses and what the provider chooses to charge.
I have a Flexible Spending Account this year. Will any balance I have roll over?
Each year, $500 from your account will roll over to the next plan year. This transfer is not complete until April of each year, but employees can swipe their debit cards to use all available funds before April.
May I Spend My HSA money As it Accrues?
You can spend or reimburse HSA money that’s been saved to your account at any time. If you spend $1,000 on expenses in January and you are saving $100 each paycheck, you can reimburse those expenses with $100 every pay period.
Why are FSAs Paired with HSAs Limited to Vision and Dental?
The City of Tulsa must conform to IRS regulations for HSAs. All of the limitations and rules mirror federal law.
Why Doesn’t CareATC See Children Younger Than Two-Years-Old?
CareATC does not staff pediatricians at this time.
Why is the $420 Credit Disappearing?
We eliminated the $420 credit offered to employees who do not take a medical plan to focus on providing comprehensive medical services to employees who enroll in a City medical plan. In 2017, 60 percent of employees eligible for the credit used some of the $420, and most of these employees failed to use the entire amount.
Is CareATC a Health Insurance Company?
No, CareATC is a company that provides employers access to high-quality primary care services. For instance, they have long-term partnerships with BAMA and Quiktrip. CareATC is one of two options within the network you choose (either Hillcrest or Saint Francis). No matter which option or network you choose, BlueCross BlueShield is our insurance provider.
Do I need to have a referral to see another doctor?
No, you can choose your doctor without referrals of any kind.
Where is CareATC Located?
There are six convenient locations in the Tulsa metro area.You can review regional locations in the brochure located at www.cityoftulsa.org/2018benefits. CareATC is also available nationally. Once the plan year begins January 1, 2018, you can search for national locations online or through the mobile app. When traveling out-of-state, you can only make appointments by phone.
My Prescriptions are Increasing Dramatically on the New Plan; What Should I Do?
First, evaluate what you’re spending on your current plan. Add the prescription deductible and your copays for each prescription for each month of the year. You might not spend more money on the new plans. Second, review Dr. Berry's Health and Wellness article for low-cost alternatives and don't forget to check CareATC's formulary! Third, some drugs are considered preventive, which means they’re covered 100 percent after the deductible. Most contraception is free before the deductible.
How Do I Find Coverage Outside of the Tulsa Region?
Most of the coverage in Oklahoma, but outside of Tulsa, is Tier 2 on either plan. You can easily see this coverage by visiting the BlueOptions Select link at www.cityoftulsa.org/2018benefits. Tip: Any Ardent/Hillcrest affiliate in Tier 2 on this plan is Tier 1 on the Tulsa Blue Network plan. Please note Oklahoma is not as accessible as Tulsa.
Why is the Family Deductible So High?
The family deductible in 2014 was $5,000, and the current average deductible is $7,900. In 2018 the deductible is $6,000 for families, but there is a limit of $3,000 per person. Most employees will not meet both of their $3,000 deductibles.