2009 Open Enrollment
Wednesday, November 5 –
Tuesday, November 18, 2008
Questions & Answers
Questions and answers regarding the Advantage Health Benefits Plan
Q1. What is the Advantage Health Plan and how does it work?
A1. The state implemented Advantage to address rapidly rising health care costs and to
maintain access to as many health care providers for state employees as possible. Under
Advantage, Primary Care Clinic (PCC) systems available to employees are placed in cost
levels according to their actual, risk-adjusted costs of delivering care and as negotiated in
bargaining to meet geographic access needs. Employees and their covered dependents are
free to select providers of their choice in their area and to change their selection during
the year within the same health carrier. The amount employees and covered dependents
pay out-of-pocket for copays, deductibles, and coinsurance varies according to the cost
level of the Primary Care Clinic (PCC) in which they have enrolled. The lower the cost
level of their designated PCC, the lower the out-of-pocket costs for Advantage members.
Q2. How will Advantage change for 2009?
A2. The main changes to Advantage for 2009 include:
Changes in the cost levels to which some clinics have been assigned;
An increase in the premium cost of 3.5%;
Employees must again take the health assessment during open enrollment and
agree to accept a health coaching call to receive the $5.00 reduction in the
illness/injury office visit copay for 2009. Unlike previous years, all Advantage
Health Plan participants will take the same health assessment through
Q3. What is a health assessment? And, what is a health coaching call?
A3. A health assessment is a survey that asks a series of questions about your health,
lifestyle, and health history. The questions are easy to answer and cover topics such as