Evolution of Network Benefits in Open Forum
NETWORK CHANGE – BENEFITS OPEN FORUM
Current
•
2 Separate Networks
•
OSF Direct Access Network – 192 Employees
•
Cottage (HFN) Network – 117 Employees
BENEFITS OPEN FORUM
EVOLUTION OF THE NETWORK
2017
•
One
Network – Blue Cross Blue Shield of IL
•
85% of Doctors and Hospitals Nationwide
•
OSF St Mary’s In-Network
•
Cottage Hospital
Billed
as if in-network
•
97-99% Success Rate resolving customer service issues
with the first phone call
•
Deeper Hospital Discounts
•
Greater savings for employees
BENEFITS OPEN FORUM
EVOLUTION OF THE NETWORK
COTTAGE HOSPITAL BCBS WAIVER PROGRAM
•
If service provided is covered under health plan, Cottage
Hospital will waive the difference between in-network and
out-of-network benefits.
•
Employee is only responsible for in-network deductibles or
co-insurance
BENEFITS OPEN FORUM
COTTAGE HOSPITAL BCBS WAIVER PROGRAM
•
Adjustments only include items
billed by Cottage Hospital
•
Physicians, anesthesiologists, and ER doctors bill separately
•
Most are in-network with Blue Cross Blue Shield
BENEFITS OPEN FORUM
COTTAGE HOSPITAL BCBS WAIVER PROGRAM
BENEFITS OPEN FORUM
HIGH DEDUCTIBLE EXHIBIT
BENEFITS OPEN FORUM
HIGH DEDUCTIBLE EXHIBIT
BENEFITS OPEN FORUM
PPO
EXHIBIT
BENEFITS OPEN FORUM
PPO
EXHIBIT
QUESTIONS?
Evolution of network benefits through an open forum, highlighting changes in coverage, savings for employees, success rates in customer service, and waiver programs for in-network services. Learn about high deductible scenarios for different hospital settings and adjustments in billing practices at Cottage Hospital. Dive into the details of how Cottage Hospital works with Blue Cross Blue Shield to provide enhanced healthcare benefits for employees and their families."
Uploaded on Feb 17, 2025 | 0 Views
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Presentation Transcript
BENEFITS OPEN FORUM EVOLUTION OF THE NETWORK Current 2 Separate Networks OSF Direct Access Network 192 Employees Cottage (HFN) Network 117 Employees
BENEFITS OPEN FORUM EVOLUTION OF THE NETWORK 2017 One Network Blue Cross Blue Shield of IL 85% of Doctors and Hospitals Nationwide OSF St Mary s In-Network Cottage Hospital Billed as if in-network 97-99% Success Rate resolving customer service issues with the first phone call Deeper Hospital Discounts Greater savings for employees
BENEFITS OPEN FORUM COTTAGE HOSPITAL BCBS WAIVER PROGRAM If service provided is covered under health plan, Cottage Hospital will waive the difference between in-network and out-of-network benefits. Employee is only responsible for in-network deductibles or co-insurance
BENEFITS OPEN FORUM COTTAGE HOSPITAL BCBS WAIVER PROGRAM Adjustments only include items billed by Cottage Hospital Physicians, anesthesiologists, and ER doctors bill separately Most are in-network with Blue Cross Blue Shield
BENEFITS OPEN FORUM HIGH DEDUCTIBLE EXHIBIT Birth at Cottage Hospital - High Deductible Family Cost Employee Portion Physician $3,000 $2,600 (Family Deductible)+ $40 (10% Coinsurance ) Hospital $4,000 mother $400 (10% coinsurance) $1,000 baby $100 (10% coinsurance) Anesthesiologist $1,000 $100 (10% coinsurance) Total Out of Pocket $3,240 Total In-Network Deductible Met $2,600 Total Out of Network Deductible Met $5,000 Total towards Out of Pocket Max $2,740
BENEFITS OPEN FORUM HIGH DEDUCTIBLE EXHIBIT Birth at OSF Hospital - High Deductible Family Cost Employee Portion Physician $3,000 $2,600 (Family Deductible)+ $40 (10% Coinsurance ) Hospital $4,000 mother $400 (10% coinsurance) $1,000 baby $100 (10% coinsurance) Anesthesiologist $1,000 $100 (10% coinsurance) Total Out of Pocket $3,240 Total In-Network Deductible Met $2,600 Total Out of Network Deductible Met $0 Total towards Out of Pocket Max $3,240
BENEFITS OPEN FORUM PPO EXHIBIT Birth at Cottage Hospital PPO Family Cost Employee Portion Physician $3,000 $1,500 (Family Deductible)+ $150 (10% Coinsurance ) Hospital $4,000 mother $400 (10% coinsurance) $1,000 baby $100 (10% coinsurance) Anesthesiologist $1,000 $100 (10% coinsurance) Total Out of Pocket $2,250 Total In-Network Deductible Met $1,500 Total Out of Network Deductible Met $5,000 Total towards Out of Pocket Max $1,750
BENEFITS OPEN FORUM PPO EXHIBIT Birth at OSF Hospital PPO Family Cost Employee Portion Physician $3,000 $1,500 (Family Deductible)+ $150 (10% Coinsurance ) Hospital $4,000 mother $400 (10% coinsurance) $1,000 baby $100 (10% coinsurance) Anesthesiologist $1,000 $100 (10% coinsurance) Total Out of Pocket $2,250 Total In-Network Deductible Met $1,500 Total Out of Network Deductible Met $0 Total towards Out of Pocket Max $2,250
