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NEWS AND ALERTS: IMPORTANT NOTICES

Annual Enrollment is Oct. 28 – Nov. 8

There are no significant plan design changes and there is no action required to keep what you already have. However, we encourage you to review your options closely to get the most out of your health care coverage. Learn more about 2020 benefits by visiting BSWHealth.com/Benefits.

Log in to People Placeto complete enrollment

Expecting the Best Maternity Program – NEW, effective Jan. 1, 2020

Our new maternity program for expectant moms covered by BSWH Employee Plan offers:

  • 24/7 access to a nurse
  • Active support for high-risk pregnancy
  • Planning for delivery
  • Postpartum depression screening and help following delivery
  • Return-to-work planning

Enroll through your doctor, case manager or by emailing CaseManagement@BSWHealth.org

Maternity Bundled Copay* - NEW, effective Jan. 1, 2020

We are adding a bundled copay to our plan design to cover mom and well-baby expenses for the SEQA, EQA and PPO plans.

  • SEQA/EQA Plan: $400 copay for all expenses related to maternity/delivery care and baby’s postnatal services
  • PPO Tier 1 Plan: $1,200 copay applies for all expenses related to maternity/delivery care and baby’s postnatal services

*Copay applies to the facility claim. All other services billed with a maternity/delivery diagnosis code will be paid at 100%, including well-baby (hospital) charges and prenatal services.

Contracted Pharmacy Changes

Preferred generic copay will increase from $5 to $10 for a 30-day supply.

Changes to the Health Reimbursement Account (HRA)

This message applies to active BSWH Employee Plan members who have HRA funds available. You can review your balance by logging in to the member portal. See notice here.

Group Value Formulary

Prescription drugs are a major driver of overall healthcare spending. Effective Jan. 1, 2019 the Baylor Scott and White Health Employee plan will have a new drug list called the Group Value Formulary.

Out-of-Area (OOA) Coverage - Only available with the PPO and HSA plans

Provides a modified Tier 2 benefit coverage for employees and covered dependents who live 40 or more miles from the nearest Tier 1 acute care hospital and visit Tier 2 providers for inpatient and outpatient care. The modified benefit is - 80% vs. 50%, after Tier 2 deductible. To ensure claims process correctly, employees and dependents must notify our Customer Advocacy Center at 1-844-843-3229 prior to receiving care.

Prior Authorization and new eviCore program

Prior authorization for certain services is required for all plans. Refer to the Tools and Resources section of our website to make sure you know what services might require prior authorization. Plan ahead: the standard time needed to receive a prior authorization is fifteen days (except in an emergency). Learn more about the eviCore Prior Authorization Program.

Baylor Scott & White Quality Alliance (BSWQA) HealthAccess

Need help finding Tier 1 providers and schedule appointments? Contact BSWQA HealthAccess at 1-844-279-7589 for assistance.

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