Notes From The CEBT Chairman
The CEBT Board of Trustees held their quarterly spring Board Meeting on April 30, 2021. During this meeting the Board heard several reports that include updates on: CEBT's Investments, CVS/Caremark prescription audit, financial reports, disease management opportunities, COVID Vaccine reports, status of Trustee terms, and the American Rescue Plan Act/COBRA Subsidies. Please see below for a brief summary of these items.
CEBT's investment partner, PFM Asset Management, reported good news that that the economic outlook is good with the labor market and beginning to rebound strongly. Additionally, Federal Reserves are elevated, and economic recovery is gaining momentum.
The results of a recent audit of Prescription Benefit Management of CVS/Caremark were presented. Overall, the audit found that there was a 95.59% claim processing accuracy, and 99.79% claim payment accuracy. An action plan is being implemented to address any of the audit findings and correct any shortcomings that were identified.
The financial statements and utilization of the CEBT plans were reviewed, as typically done at each meeting. As a result of the COVID pandemic, the number of medical claims are down from what would be expected this time of year. A big question is, what will the claims experience be when we “get back to normal”? Will we see a spike in the number of elective surgeries or other claims that were postponed due to the pandemic?
A new program by Omada Health was presented providing information on digital care management with a focus on disease prevention related to diabetes hypertension, behavioral health, and musculoskeletal. The Board was interested to hear more information on this program at the upcoming Summer Conference in July.
As part of monitoring and analysis of COVID related data, the Board was informed of the COVID vaccination rate administered through the CEBT plan. The data showed that roughly 4,200 CEBT members are fully vaccinated.
Each year, the CEBT Trustee terms are reviewed for renewal or eligibility of renewal. Trustees that retire or otherwise cease to be eligible for the CEBT plan are term limited by the Trust Agreement. By majority vote of the other Trustees, such Trustee can be allowed to complete their current term and serve one additional term. For Board member appointments and renewals the current roster is:
Lastly, the Board was informed about the required distribution of notices to be delivered to Assistance-eligible Individuals (AEI) under the American Rescue Plan Act (ARPA) COBRA Subsidy. This new law is a federal subsidy where employers will pay 100% of the cost of COBRA continuation for up to 6 months for individuals who have had an involuntary termination or reduction of hours. The cost of these premiums will be offset to the employer by the quarterly Medicare payroll tax.
Hopefully this brief recap of the recent Board meeting is valuable to you as a participating CEBT member. Let us know if there are any topics you'd like to hear more about. Please stay well.
Willis Towers Watson Team
Customer Service Representatives
Do you have questions on your health, dental or vision benefits with CEBT? Do you need direction on where to go to find an in-network provider or ordering an ID card? Maybe you have a question regarding a claim or bill, or you are having issues getting a prescription filled? We are here for you.
Our Customer Service Representatives (CSR) are available for you Monday – Thursday 7:30 am to 4:30 pm and 7:30 am to 4:00 pm on Friday by calling toll free (800) 332-1168 or (303) 773-1373. The Team consists of Reece Baer (Team Lead), Amy Doyle, Andrea Rivera, Barb Mason, Chevon Menard, Jenelle Kandel and Michael Fritz – and have a combined total of 25 years of customer service experience. Our CSR Team can also help answer questions and concerns regarding the Triad EAP, Teladoc, SurgeryPlus and Healthcare Bluebook (HCBB) programs.
If you need additional assistance, Elisa Correll, our CEBT Subject Matter Expert (SME) is available to CEBT members. Let us hear from you and help you navigate your health care needs.
July 1 Benefit Changes
As we quickly approach yet another bi-annual renewal under the CEBT Plan, there are a few upcoming benefit plan changes that you will want to make note of. Here is a quick summary of what changes you will see come July 1st:
CEBT Medical Plan Changes
- Hospice Care: Benefits on all PPO plans will change from deductible/coinsurance to 100% coverage for in-network services. Out-of-network services will be subject to deductible first and covered at 60% of usual and customary.
- Claim Errors: The plan pays a benefit reward for identifying claim errors on facility claims. The current benefit is 50% of the claim error up to a limit of $1,250. The new benefit reward limit will be increased to $2,500
CEBT Delta Dental Plan Changes (All Plans)
- Bone Graft at time of implant placement: This benefit is currently not covered and will be moved to Major/Restorative services with coverage at 50%
- Periodontal Maintenance: This benefit is currently covered under the Basic/Restorative coverage level at 80% and will be moved to Diagnostic and Preventative coverage level at 100%
CEBT VSP Vision Plan Changes (Plans B & C)
Starting July 1st, both VSP Plans (B & C) will move from the Signature VSP network to the Choice VSP network resulting in some benefit enhancements. This network change should have minimal impact on current providers, and will not impact how you currently seek coverage. Since VSP does not issue ID cards for these plans, you should not expect a card in the mail. You will continue to give providers your personal information (i.e. Name, Date of Birth or Social Security Number) for them to look up your benefits. Most of the benefits on the current plans are staying the same, with a few enhancements as listed below:
- Adding Standard Progressives Coverage in Full
- Adding Walmart as an affiliate (in network provider)
- Adding UV coverage in Full
- Adding Adult Polycarbonate covered in Full
Updated VSP plan documents will be posted on cebt.org closer to July. Be sure to check out the full benefit descriptions for more detailed information.
Telemedicine Benefit Reminder
For those on the HDHP plans, the cost share will continue to be temporarily waived for the use of Teladoc and CEBT Health & Wellness Centers through June 30th, 2022.
Kaiser Permanente Service Area Consolidation
Kaiser Permanente has long been divided into three distinct markets across Colorado: Southern, Denver/Boulder & Northern service areas. With Kaiser's growth over the years, the three separate service areas have become an administrative challenge. Effective July 1st, 2021 KPCO will consolidate all three service markets into one. The footprint will remain the same with no zip code or county additions or removals.
This consolidation will help to deliver a simplified and improved member experience as members will be able to visit any Kaiser Permanente location throughout Colorado without the limitations of where you live, or the area in which you were enrolled. Members enrolled in a CEBT-KP Plan will receive new ID cards on or around July 1st, as the phone number to the Member Services Contact Center will also be consolidated into one number.
CEBT Kaiser Medical Plan Changes
All Kaiser Plans
- Breast Imaging: Expanded coverage for breast cancer screening services applying no cost share for diagnostic imaging that requires further evaluation or supplemental imaging within the same calendar year based on factors including high risk breast density.
- Expanded Preventive Screening Services: Provided at no cost share for members diagnosed with specific chronic conditions: A1c testing for individuals diagnosed with diabetes; LDL testing for individuals diagnosed with heart disease; INR testing for individuals diagnosed with liver disease and/or bleeding disorders; Retinopathy screening for individuals diagnosed with diabetes
KP-DHMO & KP-HDHP Plans
- Diabetic Supplies: Peak flow meters are provided with no deductible requirement; applicable coinsurance will still apply. Glucometers and associated supplies including test strips, lancets, and control solution are provided with no deductible requirement; applicable coinsurance will still apply
- Urgent Care Copayment: The Copayment will cover the Urgent Care visit and other services received during the visit. Member will still owe applicable cost share for services such as, but not limited to X-rays, laboratory tests and office administered drugs.
CEBT-Delta Dental Network Growth
CEBT made a thoughtful decision to begin using the Delta Dental of Colorado network in January of 2019. There has been positive feedback from employers and members with some enhanced benefits like the Right Start 4Kids and Prevention First programs. Members have also seen deeper discounts and the elimination of balance billing for those who stay within the Delta Dental PPO or Premier Networks.
Delta Dental's provider network is the largest in the nation and continues to grow as they work to bring even more providers into the network for the benefit of their members. There are now more PPO and Premier providers in Garfield and Summit Counties for you to choose from. To find out if your dentist is participating, please visit the Delta Dental of Colorado website and use the Find a Dentist search tool.
If you have questions about your Dental benefits, you can contact CEBT's Customer Service team at (800) 332-1168 or (303) 773-1373 Monday through Thursday 7:30 a.m. to 4:30 p.m. or Friday's from 7:30 a.m. to 4:00 p.m.
Mental Health Awareness Month
CEBT Resources and Reminder of Benefits from UMR, Kaiser, and Triad
May is Mental Health Awareness Month, and we wanted to remind you of your mental health benefits if you are enrolled in a CEBT medical plan.
- EPO Plans: Applicable office visit copay for an in network provider, no visit limit (based on medical necessity)
- PPO Plans: Applicable office visit copay for an in network provider, no visit limit (based on medical necessity)
- HDHP Plans: Pay full cost of visit until you meet your deductible, then 80/20 coverage for in network provider (plan pays 80%, you pay 20%), up until you reach your out of pocket maximum
- Kaiser HMO Plans: Applicable office visit copay for Kaiser provider, no charge for virtual visit
- Kaiser DHMO Plans: Applicable office visit copay for Kaiser provider and 20% coinsurance for other covered services received during visit, no charge for virtual visit
- Kaiser HDHP Plans: Deductible then 20% coinsurance, no charge for virtual visits
Don’t forget, you also have the Triad Employee Assistance Program! Under this benefit, you have six confidential counseling sessions per issue per year. These sessions are available to you, your spouse or domestic partner, and dependents 26 and under. Family and couples counseling options are also available. Visit www.triadeap.com to find a counselor that best meets your needs. Pre-authorization is required. You can also call Triad Monday - Friday between 8 am and 6 pm (MST) at 877-679-1100.
CEBT Health and Wellness Centers
The CEBT Health & Wellness Centers want to make sure you’re feeling your best all year round. Your mind is just as important as your body in your overall health. One in five Americans suffer from mental illness each year, and 30-50 percent of people experience a behavioral health condition with disruptive symptoms. If you’re experiencing a challenge with your mental health, you’re not alone. One-on-one health coaching is available at the CEBT Health & Wellness Centers, where your provider will help you discover new strategies to help you improve your health and wellbeing. Call your center or go online to my.marathon-health.com to schedule your appointment today. Employees, spouses, and dependents ages 2 and older who are on the CEBT medical plan are eligible to use any of the CEBT Health & Wellness Centers. There is no cost or copay for any visit type for CEBT members on a PPO or EPO plan. Members on an HDHP will pay no cost or copay for virtual visits until June 2022. Those on an HDHP plan are also eligible for free in-person preventive visits and chronic condition visits, but will pay $45 for sick visits.
CEBT Health & Wellness Centers Locations
- Widefield: 930 Leta Drive | 719-551-5808
- Rifle: 707 Wapiti Avenue, Suite 201-A | 970-440-8085
- Glenwood Springs: 1901 Grand Avenue, Suite 200 | 970-440-8087
- Gypsum: 35 Lindbergh Drive, Suite 110 | 970-431-2871
- Loveland: 2889 N. Garfield Avenue | 970-744-2866
- Greeley: 4675 W. 20th Street Road, Unit B | 970-373-4625
With May being National Mental Health Awareness month, Triad has supplied some resources to increase awareness for those struggling, and to help reduce the stigma for seeking help.
- Mental Health Self-Assessment: Online screening is one of the quickest and easiest ways to determine whether you are experiencing symptoms of a mental health condition. Mental health conditions, such as depression or anxiety, are real, common, and treatable. And recovery is possible. Use the Mental Health American screening tool, it's completely confidential, and free. Take the test
- Mental Health and Children: The 2021 State of mental health in America found that 9.7% of youth in the U.S. have severe major depression. The CDC has valuable information on the most common mental health issues impacting youth as well as tips for recognizing symptoms.
- Addressing Anxiety In An Uncertain World Webinar: Learn how to recognize and manage anxiety to actively combat the physical and mental effects in a practical way. Available on-demand on triadeap.com beginning May 19.
Are you evaluating your surgeon for quality? All SurgeryPlus providers have been rigorously screened to be part of the exclusive network of surgical providers. Surgeons in the SurgeryPlus network must meet these standards:
Don’t forget that if you are enrolled in one of CEBT’s medical plans and use SurgeryPlus, it can save you money. If you are on an EPO or PPO plan, your deductible and/or coinsurance are waived for your procedure. If you are on an HDHP, your deducible is reduced and coinsurance is waived. Kaiser plans are not eligible for the SurgeryPlus benefit.
Wellness/Preventative Benefit Reminders
Spring is the perfect time to do some cleaning and catching up in our lives- to re-evaluate and take time to accomplish the things we have been putting off. Sometimes, we get so busy that we forget to pay attention to one of the most important things in life: our health. One of the easiest and most beneficial things a person can do to maintain good health is to stay on top of preventative care. Being proactive about our health can help to catch potential problems early. In turn, this can lead to easier treatment, lower medical expenses, and a longer lifespan. Preventative care under your CEBT Plan is no cost for you and covered at 100% by your plan. Here are some examples of your preventative benefits:
- Annual physicals
- Vaccines: Flu, Hepatitis A, Tetanus, Shingles, Pneumonia, HPV, COVID
- For Women: BRCA testing & counseling, breast exams, mammograms, well-woman visits
- For Men: Digital Rectal Exam (DRE), Prostate Specific Antigen (PSA)
- For Children: Behavioral screening, Developmental screening, Tuberculin testing
- Screenings: Alcohol Misuse, Tobacco, Depression, Cholesterol, Diabetes, Hepatitis B&C, Obesity, Syphilis, HIV, Lung Cancer
- Routine Vision Exams
- Diet Counseling
- Routine Colonoscopies or Cologuard (no age limit)
- Generic Statins
Be sure to visit cebt.org and click on Benefit Booklets to find full lists of Preventative Benefits for Men, Women and Children.
Via Benefits Post-Employment Benefits Concierge
We are pleased to announce that effective May 1, 2021 Willis Towers Watson (WTW) rolled out a new service to assist former CEBT members, ages 50 and up, in finding post-employment medical, dental, and vision benefits. We understand that after leaving employment the last thing you want to worry about it is figuring out what you are going to do for healthcare coverage. This is why WTW will be partnering with Via Benefits, a free resource that offers an online marketplace and personal shopping assistance to help individuals evaluate and enroll in plans that will fit their needs and budget. The plans offered will include pre-age 65 plans from the public exchange as well as post-65 Medicare Advantage plans and Medicare Supplemental plans.
How will Via Benefits assist you?
You will have access to online tools and resources to help you understand your options after employment ends (often used to plan for health care coverage in retirement)
- Assistance with enrolling in and shopping for a plan that best meets your needs and budget
- Personalized guidance by plan specialists
- Ongoing customer support (lifetime advocacy post-enrollment)
What are the benefits?
You will have more options and flexibility to choose coverage that is right for you, long-term stability, and potential for cost savings. In addition through Via Benefits you will get access to:
Who is eligible?
All CEBT members are eligible. However, employees who terminate on or after May 1, 2021 and who are age 50 and up will be mailed informational packets by Via Benefits.
What plans will be offered?
The plans offered will include Pre-65 plans from the individual marketplace as well as Post-65 Medicare Advantage plans and Medicare Supplemental plans.
Will there be a cost?
This service is no cost to you or your employer.
How do you enroll?
You are not required to utilize this service and enrollment is not automatic. You will receive information about Via Benefits by mail, but will need to contact Via Benefits if you are interested and wish to enroll. Phone: (833) 414-1452
To shop and review plans you will visit one of the following sites:
- Pre-65: marketplace.viabenefits.com/ColoradoPublicEmployers
- Medicare: my.viabenefits.com/ColoradoPublicEmployers
How long does enrollment take?
Most people are able to complete their enrollment in one call, and most calls average slightly more than one hour. Calls may be shorter if a personal profile is completed in advance. You will receive an enrollment guide that will provide information on the online tools available through Via Benefits.
The goal of offering this service is simply to support former CEBT members through the transition of finding and enrolling in health coverage by providing assistance with navigating the complexities of the individual market, making the process as straightforward as possible. We hope you are as excited about this new service as we are and we look forward to providing you with the resources to help make an informed and confident decision about your healthcare coverage.
CEBT COBRA Administration (24HourFlex/Alerus)
Group health plans such as CEBT provide COBRA continuation coverage for employees and their dependents who terminate coverage due to a loss in benefit eligibility. For individuals who choose to continue their benefits after a loss of coverage, CEBT has partnered with an outside organization, 24HourFlex, to assist with the administration of notices, enrollment and payments.
24HourFlex has recently undergone a merger and now goes by the name of Alerus. There are no other changes to this merger other than the name of the organization. If you and/or your dependents experience a loss of coverage you can now expect to receive a notice of specific rights from Alerus.
CEBT Wants to Hear From You
"Providing quality health benefit options at a competitive cost with superior service."
CEBT always strives to provide the best service for its members. Knowing what works great or how to improve helps to grow the relationships that are built through our partnerships. Feedback is always welcomed at CEBT.
If you have suggestions for topics or stories that you would like to see in these newsletters, please email Stacy Vogel on the CEBT Communications Team at email@example.com to get your ideas published.
Created with images by Couleur - "crocus backlighting sunlight" • MabelAmber - "lane tree tree lined lane" • Nietjuh - "desk smartphone iphone" • geralt - "call center headset woman" • gsibergerin - "sulphur anemone pulsatilla blossom" • Hans - "tooth brushes hygiene dental care" • TotalShape - "mental health mental wellness mind" • chezbeate - "nature thorns leaf" • corgaasbeek - "architecture buildings hospital" • silviarita - "water fruits raspberries" • analogicus - "sauerland germany landscape" • zapCulture - "field flowers sky" • Myriams-Fotos - "greeting card thank you card lavender"