Points to Consider
Before making the decision to change health plans, employees should consider the following:
- Differences in plan provisions, such as maximum benefit limitations, hospital services, provider choices, co-pays, deductibles, and prescription benefits.
- Differences in monthly premiums.
- Differences in ancillary services, such as laboratory tests and x-rays.
- Personal health care needs of the insured employee and dependents.
You and your dependent(s) must be covered on the same health care plan. If both you and your spouse are insured employees, either or both of you may elect health coverage for dependents; however, the same dependent cannot be enrolled under both spouses for the same type of coverage (health, dental or life).
You may change from the current plan you are on to any other available health care plan; Quality Care Health Plan (QCHP) or one of the Managed Care Plans (MCP): Health Maintenance Organization (HMO) or Open Access Plan (OAP).
If your current Managed Care Plan is being discontinued, you must enroll in another available health insurance plan or your coverage will be defaulted to the QCHP.
Enrolling in one of the health insurance plans automatically enrolls you in the Vision Plan, at no additional cost.
If you select an HMO plan, you must select a Primary Care Physician (PCP). When entering your information, you will be required to enter your PCP's identification number. This number can be found in your plan's Provider Directory. Most of the HMO plans have current information about their PCP's on their websites. See our Health Plan websites link for available information. Keep in mind that HMOs require you to go through your PCP before seeing a Specialist.
If you wish to change your PCP, this change can only be made by calling your insurance plan's Customer Service department directly. This phone number can be found in the Benefit Choice Options booklet.
In most cases, HMO benefits are not available for you or your dependents if you reside outside the service area. This would include children attending college away from home. A Managed Care Plans map is available for reference. If you have concerns about specific benefit limitations or exclusions, contact the health plan directly.
When enrolling in a MCP, keep in mind that you may be required to pay co-pays at the time of visit.
Plan provisions for the QCHP, HMO, or OAP plans
Similarities between the plans
Health insurance monthly premiums
Health plan websites
HMO plan codes map