- A Letter from the Chairman
- The CEBT Board -Meet Misty
- Meet your Admin Team
- What's New
- COBRA Administration-24 Hour Flex
- Surgery Plus
- How to be better Consumers of Healthcare-Health Care Bluebook
- Health Center News-Healthy Like Me, Meet Mary
- IT Updates
- FYI-UMR Site Upgrades, Legislative News, Reminders of benefits changes, and Community Updates
A Letter from the Chairman
From the Desk of the CEBT Chairman.
Welcome to the new CEBT Newsletter!
It has been a few years since CEBT produced a newsletter, but we thought now was a good time to resurrect the idea to increase our communications with all our members along with all of our other communication methods.
CEBT has updated its website, as well as, implemented an app for use on smartphones. Checkout the web page at www.cebt.org, where you can find information about your plan benefits, see who the Board of Trustees are, telephone numbers for who to call when you need help, and check out all the new services that CEBT offers its members. The smartphone app also provides access to the same information in a friendly user format, as does the web page, for you to access your information when needed. They are wonderful tools!
CEBT continues to grow, adding new employer groups and their employees. Of course we lose a few who make other decisions for whatever reasons, and we hate to see them go. However, at the last Board of Trustees meeting, the data showed that 18 new employers joined CEBT, representing 1156 employees. We are excited to welcome them aboard and make them part of our great team.
One of the core values of CEBT is customer service. The CEBT Board evaluates any changes to any of our health plans and the impact that it will have on its members. The Board also wants to offer options for employers to choose from to build plans that meets their employees and employers needs. Please let us know how we can better serve you.
CEBT Board of Trustees
THE CEBT BOARD
The CEBT Board of Trustees is comprised of seven members chosen from CEBT employer groups throughout the state. The Board strives to have representation for different types of public employers (i.e. education, municipalities, counties, and special districts) as well as from different sized employers. The Board members are:
Ed Vandertook, CEBT Board Chairman-North Park School District Superintendent
Joe Royer, CEBT Board Trustee -Widefield School District Superintendent - Retired
Brian Lessman, CEBT Board Trustee -Windsor School District Superintendent - Retired
Lorraine Haywood, CEBT Board Treasurer-Health District of Northern Larimer County, Finance Director
Twyla Jensen, CEBT Board Trustee-Pioneers Medical Center, Director of Human Resources
Bob Foster, CEBT Board Secretary-Lewis Palmer School District # 38, Director of Personnel & Student Services
Misty Manchester, CEBT Board Trustee-Cañon City Schools (Fremont SD Re-1), Director of Human Resources
Misty Manchester is the newest Board Member of CEBT as of last July. She currently works as the Director of Human Resources for Cañon City Schools, who joined the Trust back in 2009. In this newsletter we would Like to highlight her and share a little about who she is and her background. Please read on to get to know Misty.
Misty Manchester grew up in the San Luis Valley where she attended Adams State College (now Adams State University) for her degree. She is married to Scott who is the Athletics/Activities Director at the local high school. Together they have two children, Zachary and Zoe. Zachary is a Junior at Western Colorado University where he plays football, and Zoë is a Sophomore in high school. They have lived in Cañon City for just over 26 years, and 24 of those years Misty has worked for Cañon City Schools in a variety of different roles. Misty began as an Executive Secretary in Human Resources for 9 years and then moved to Payroll/Benefits Accountant position for 3 ½ years. She then took on the role of Accounting/Payroll Coordinator for 5 years, and has now been in the role of Human Resources Director for the past 6 years. Through the various roles within the District, she has been very involved in building benefit structure/programs for employees. Initially, she was a source of information for new employees coming into the district, and then she moved into the Business Services Department where she was more involved as a part of their District’s insurance committee. Cañon City Schools medical insurance program was self-funded at the time, and Misty was a part of the committee that was in charge of selecting the company they would use for the benefits program. Misty has attended the CEBT Board meetings since 2010 and always had a desire to contribute to the Trust by serving as a Board Member. Misty’s background in Business Services-Human Resources, and her experience serving as a member of a self-funded insurance committee has provided her with the knowledge necessary to serve the employers and members of the Trust.
“The school district came on board with CEBT in 2009, which was the best decision our school district made! We have a great working relationship with the staff there at Willis Towers Watson. It is a true partnership!” ~ Misty Manchester
Meet Your WTW Administrative Team
The CEBT administrative team, employed by Willis Towers Watson, is here to work for you to ensure that your experience is as pleasant as possible. We are here to provide you with an optimum experience and will use our strong interpersonal and communication skills to help answer all your questions and concerns about your benefits. The CEBT administrative team consists of twenty-eight employees.
Customer Service & IT
Employees are able to call the customer service line to address all of their claim/benefit questions. The customer service line is open Monday – Thursday from 7:30 – 4:30 and Fridays 7:30 – 4:00. When a member calls for benefit information, the phone is answered by one of CEBTs three receptionists who transfers the call to one of our customer service representatives for immediate resolution. Even during peak hours, the average wait time to speak with a representative is only 2-3 minutes. The receptionist team also prepares supplies for employers such as new-hire packets and open enrollment materials.
The Customer Service Representatives are highly skilled at explaining to members coverage options, claim resolution, claim status, Explanation of Benefits, deductibles, and max out-of-pocket.
Our external representatives are able to provide support to clients by traveling to meetings when assistance is needed for open enrollment presentations, new hire orientation, benefit fairs, or site visits.
Our system administrator maintains the customer service platform and online enrollment system to ensure there are not any technological glitches.
Bookeeping & Accounting
The Membership and Premium Accounting Representatives (MPA) are responsible for the group’s eligibility and billing. Each member group is assigned a dedicated MPA representative who enrolls members, processes qualifying events, addresses carrier / vendor service issues, and sends out and reconciles monthly invoices. They work closely with the Employer Groups to train and assist in using the online system and staying up to date with eligibility rules and healthcare regulations.
The Accounting team performs financial functions related to the collection, accuracy, recording, analysis and presentation of a business, organization, and Trust’s financial operations.
Consulting, Brokerage, and Account Management
These experienced professionals are your trusted advisors, empowered to deliver all of CEBT and Willis Towers Watson. They coordinate and execute the ongoing creation, maintenance, and delivery of reporting deliverables for CEBT clients. The producers conduct annual reviews of utilization and rates, plan design, cost containment concepts, cash flow concepts such as self-funding, developing managed care networks. They also provide the service of assisting the client through the bidding process including plan specifications and cost analysis, insurance carrier negotiations and contract implementation.
The Account Managers perform day-to-day service and troubleshooting for CEBT clients and assists in coordinating resources and solutions to meet the client’s needs. Account Managers coordinate renewals and placement activities associated with marketing and negotiation which includes bid preparation, RFP response analysis, and RFP results presentation.
- COBRA Administration services will be provided by 24HourFlex and paid for by CEBT for all CEBT groups and products effective 4/1/2019.
- Remove the copay for one session on both PPO and EPO Plans for the Diabetic Self-Management benefit, effective 7/1/2019.
- Prior authorization for infusions (Injectable Medications, Home Infusions and Chemotherapy) on the PPO and HD plans.
- $50 copay per Urgent Care visit on PPO, and then 100% for all plans
- Surgery Plus+ -A supplemental benefit that reduces out-of-pocket costs and provides top-quality care for non-emergent surgeries.
- Health Care Bluebook Cost Estimator-A cost comparison/transparency tool that allows members to shop and compare cost of services and quality of care for certain procedures. **This tool is already available, but will be enhanced, for groups under the Rocky Mountain Health Plans Network.
COBRA Administration-24 Hour Flex
COBRA Administration through 24HourFlex is now live! Effective 4/1/2019 COBRA Administration Services are now provided by 24HourFlex and paid for by CEBT. Employers, or current third party administrators will no longer be responsible for sending COBRA Specific Rights Notice and Election forms to qualified beneficiaries (terminated employees and/or dependents), or collecting monthly premium for CEBT products. Employers will still be responsible for getting the COBRA General Rights Notices to new employees as part of their onboarding process, but 24HourFlex will handle the rest!
Employees will now be sending all payments directly to 24 hour flex, and all communications to and from the qualified beneficiary will go through 24HourFlex upon termination of their coverage. Employees who were on COBRA before 4/1/2019 should have received a takeover letter from 24HourFlex with instructions on where to mail future payments and coupon book of reminders of when payment is due.
Employers, If you receive any election notices and the member is contacting you to enroll, please refer them to 24HourFlex Member Support. Phone: (303) 369-7889 or (800) 651-4855 Email: COBRA@24hourflex.com
If employees are looking to make a payment please have them send to the 24HourFlex payment address below. 24HourFlex PO Box 2440 Omaha, NE 68103-2440
For more information on Cobra, qualifying events, member portal login information, how to make payments, and how to terminate your Cobra coverage click the Find Out More button below.
SurgeryPlus is a comprehensive benefit that unlocks access to a premier network of high-performing surgeons for each individualized need. This supplemental benefit will be available to our members 7/1/2019. If eligible, members will receive a surgery plus ID card. Would you like help planning your surgery while also ensuring that you receive top-quality care and lower costs? Through SurgeryPlus, there is rigorous credentialing of both the surgeon and the facility to make sure that you are in good hands. This service will help with finding the best fitting Surgeon of Excellence, scheduling appointments, coordinating services/transferring records, and following up to ensure complete member satisfaction. This is a full-concierge service that will create a better experience for you and reduce complications in the stressful planning of a surgery. To learn More about SurgeryPlus, contact 855-200-6675.
How to be better consumers of Healthcare
Healthcare Bluebook coming to you 7/1/2019
Helping employees think differently about their health care choices and responsibilities as consumers is an ongoing struggle in the world of employers. Teaching employees to research and compare the cost of services and explore less expensive alternatives can drive down cost for both employees and the Trust. CEBT is offering a number of resources to enable you the consumer to become informed by learning how to understand your medical needs and treatment options.
One of the tools CEBT offers plan members is a cost estimator tool called Healthcare Bluebook that is used to keep healthcare cost down. With this tool you are able to search any procedure in advance to find the average cost within your specific area. You are able to use Healthcare Bluebook's fair price information to compare procedure costs and make decisions about your healthcare. This tool will help in saving out of pockets costs every time you receive medical care. By using a Fair Price (Green) facility, you can save big bucks on care, and get a reward. As part of our goal to enhance consumerism and awareness, there is no additional cost for these tools through CEBT.
CEBT Health & Wellness Center News
" It is great to be able to leave the facility with meds in hand without leaving any money behind---much easier than seeing the Dr., getting the script, heading to the pharmacy to fill the script and then heading home. Love being able to get common need meds at the point of contact with the medical professional.”~Derrick Wiemer, Eagle County Schools
If your employer group is eligible, the CEBT Health & Wellness Centers can provide you a wide range of primary care solutions including: acute (sick) care, preventative exams, vaccines, labs and screenings, prescription management, and health and wellness coaching (among other things). Services are provided by Marathon Health and are available at no cost to eligible employees, spouses, and dependents age two and older who are enrolled in a CEBT PPO or EPO medical plan. Members enrolled in the HDHP plans pay a small fee for acute visits at the time of service according to IRS regulations. Eligible members can use any of the six locations across Colorado including: Greeley, Loveland, Widefield (Colorado Springs), Rifle, Glenwood Springs, and Gypsum.
Healthy Like Me-How did you do it?
At Marathon Health, their goal is to achieve your optimum health. To reach this goal CEBT Health and Wellness Center staff are licensed to diagnose, treat, and prescribe for a wide variety of common illnesses and injuries. In addition to sick care, you have access to a full range of health assessment and coaching services. If you have partnered with Marathon Health to improve your health, we want to hear about it! From all the great stories submitted, Marathon Health will pick 10 to publish and promote. Winners will each receive $250. For your chance to win, submit your story by May 31, 2019 at www.marathon-health.com/healthylikeme or at your health center. Check out below for a spotlight feature of one of our very own CEBT members who benefited from Marathon's health coaching services and was a Healthy Like Me winner in 2018.
“I was at my heaviest. I hated how I felt and it was hard to do things I loved. In 2016, Marathon Health started the Maintain Don’t Gain challenge that focused on healthy eating over the holiday season. Thanks to Marathon Health’s support, I was able to lose weight without feeling deprived. When the challenge ended, I joined another weight-loss support group in the spring. I worked with Nicole Stalter, NP and Lauren Gueriera, NP at the CEBT Health & Wellness Center at Glenwood Springs each week to keep me on track. With their help, I’ve changed my relationship with food. I’m not on a diet, I’m now mindful of what I eat. Since the challenge, I have lost 38 lbs and can do things I love again, including exercise. This Thanksgiving, I ran my first 5k. I quit smoking in 2016, and exercising has help[ed me remain smoke-free. My journey has even encouraged my family to exercise!”
Why are there so many logos on my medical insurance card?
As you may know, CEBT is the organization that administers benefits for members who work at public entities in Colorado. CEBT partners with third party administrators to process claims, provide access to local networks and customer service representatives. Here’s how it all fits together:
- CEBT is a self-funded, governmental multiple employer trust that provides employee benefits for 354 public entities and insures more than 29,000 members across Colorado. CEBT collects insurance premiums and pays medical claims.
- Willis Towers Watson is the broker / administrator for the Trust. WTW handles the day-to-day operations, eligibility, proposals, claims and service requests for the participating groups and members.
- UMR is a third party that processes medical claims, reviews records to determine medical necessity and manages pre-authorization for major services like advance imaging and surgery. The CEBT customer service team has a direct line of communication with UMR and is able to help sort out any problems providers or members have with their medical claims.
- United Health Care & Rocky Mountain Health Plans are health care provider networks. A provider network is made up of doctors, hospitals and other health care providers contracted to charge a certain amount for specific services. Going to an in network provider lowers costs making health care more affordable for members.
Do I need a referral to see a specialist?
Answer: No, you do not need a referral to see a specialist on any of our plans! For the best benefit just make sure to choose a specialist that is in your network.
Are my deductible and copays included in my out-of-pocket maximum?
Answer: Yes, both your deductible and copays are included in your out-of-pocket maximum. Once your out of pocket maximum has been reached, everything in network is covered at 100%.
UMR Site Upgrades
- Expanded additional benefits details: It’s not uncommon for members to call in to find out what’s included in their benefits and how much money they’ve spent toward their maximum. With our enhanced additional benefits details, they can now visit umr.com for quick, up-to-date information about what types of benefits are available with their plan, how much money they’ve spent, how many visits they’ve used along with how much money and/or visits they have left on their plan.
- Redesigned member homepage benefits “snapshot”: We’ve refreshed the design of the personalized member homepage to give more at-a-glance information about important benefit details including group number, member ID and plans. This snapshot also shows you and your members exactly where they stand with individual and family deductibles and out-of-pocket costs. They can also easily view plan documents and edit their personal information.
- More information in medical claims details area: Members can now visit the claims details screen to see if a medical claim was processed at an in- or out-of-network level and the cost associated with it. This feature offers more transparency for members and helps them better understand their claims.
Click below to learn more about these enhancements and other exciting umr.com enhancements!
Governor Polis has signed an executive order establishing “The Office of Saving People Money on Health Care.” The order has laid out initiatives for the General Assembly and Division of Insurance promoting inter agency collaboration to develop cost saving strategies and policies. The Office seeks to create a roadmap for lowering health care costs. Some ideas from the executive order call for increased transparency in hospital pricing, prescription drug cost reduction programs, and looking toward innovation and efficiencies to cut costs. The goal is to decrease cost and increase access to quality affordable health care across Colorado.
Reminders of changes effective 01/01/2019
- RMHP Network members now have access to the UnitedHealthcare Options Network instead of Aetna Signature Network when choosing an out of state provider.
- Dental Plans A, B, C moved from UMR to Delta Dental for claims processing and network providers.
- Dependents dropping outside open enrollment on medical, dental, or vision require proof of qualifying event documents in order to drop (30 day grace period).
- The two year waiting period to re-enroll in dental or vision has been removed. Employees no longer need to wait two years to add dental or vision. Re-enrollment is allowed at the next open enrollment, or with a qualifying event.
Updates in the CEBT online community
- As of 4/10/2019, Employees now have the ability to view their username and change their password. Once the employee logs into Communities they will see the newest feature Login Info on the left hand side of the navigation pane. The employee will be able to view and update their username or change their password by selecting the action button they wish to do.
- Another change in April is where an employee can add dependents. The WTW team noticed many employees would add their dependents demographic information into their Manage Profile page, but were missing the step to add their dependents to the benefits they wanted them covered on. In order to eliminate some of the confusion, employees can only edit their current covered dependents information on the Manage Profile page. In order to add a dependent to their plan they will have to go through either the New-Hire button, Open Enrollment button, or the Life Event button. Once they choose the button that corresponds with the change they are trying to make they will see an add dependent option on the Benefits page. They will click this button, fill in the demographic information, and press save. In order to add the dependent to the plan the employee will need to check mark the box next to the newly added dependent's name on each benefit they wish to add them too.