UnitedHealthcare EPO & POS: UnitedHealthcare EPO CVS/caremark (Non- Medicare Members) CVS/SilverScript (Medicare Members) Delta Dental PPO NVAVision Medical Necessity is a new program that conducts a pre-service review using evidence-based guidelines to determine benefit coverage for services, tests or procedures that are medically appropriate for an individual member. When seeking services from a UnitedHealthcare in-network provider, your provider will facilitate the Prior Authorization process for you. However, it is your responsibility to ensure that the provider received Prior Authorization before a service is rendered. When seeking services from an out-of-network provider, you are responsible for obtaining prior authorization by contacting UnitedHealthcare Artificial Insemination and InVitro Fertilization coverage will now be the same as the POS In-Network coverage. Diabetes Care™—Diabetes continues to be one of our top 5 complex chronic conditions throughout our WSSC population. As such, we are adding a new program, Transform Diabetes Care™, that will improve members’ health outcomes, lower pharmacy costs and improve medication adherence, A1c control and lifestyle management. The Center for Medicare and Medicaid Services (CMS) is planning to remove Social Security Numbers from Medicare identification numbers to reduce the risk of identity theft. CMS will begin an initiative to transition all Medicare beneficiaries to a randomly generated Medicare Beneficiary Identifier (MBI) which will replace the Social Security number based Medicare Claim Number that currently appears on Medicare ID cards. Medicare expects it will take up to 12 months to complete the transition to new MBIs, and will begin issuing new ID cards with the MBI beginning April of 2018. As a result, not every Medicare participant will be changed in April. When you get your new Medicare ID card, you should provide a copy to your health care providers to ensure they have the correct current information to process any claims with Medicare. There will be no need to provide a copy of the new Medicare ID card to WSSC if you are already enrolled in Medicare. That information will be provided to WSSC from the medical and prescription drug plan(s). NOTE: If you are newly enrolled in Medicare, WSSC will need a copy of your Medicare ID card to ensure that our plans are able to coordinate benefits. General Anesthesia and IV Sedation will now be covered as a standard benefit. This will be the last year that new enrollments will be allowed in the vision plan. After 2018, if you are not en- rolled, you cannot enroll in the future. Highlights of Plan Changes for 2018 2 • Open Enrollment Period is October 16–November 13, 2017. • During Open Enrollment, you have the following options: • Elect vision coverage (if currently enrolled in medical). This is the last year that we will allow new enrollments into the Vision plan. After 2018 if you are not enrolled, you cannot enroll in the future. • Change to a different health and/or dental plan. • Change coverage levels by adding or removing dependents.** • Waive health, dental and/or vision coverage for the 2018 Plan Year. • Update beneficiary information for Basic and Supplemental Life Insurance (if applicable). • Continue, decrease or waive Supplemental Life Insurance (if applicable). • All changes become effective January 1, 2018. • If you are enrolling a dependent age 19–26 for the first time, you are required to complete an affidavit. Please see page 6 for information on dependent coverage. • Medical, Dental and Vision selections will be done on the Benefits Request Form that is enclosed with your open enrollment book. IF YOU ARE NOT MAKING ANY CHANGES, YOU DO NOT NEED TO SEND YOUR FORM BACK. • If you are changing plans, you should receive your new ID cards no later than January 1, 2018. Otherwise, you will not receive a new card. • Once Open Enrollment closes, your selections are binding and cannot be changed, modified or canceled unless you have a qualified change of life event. See Change of Life Event section on page 7 for further details. Important Things To Remember **PLEASE NOTE: Any benefits change to add or remove dependents requires legal documentation before benefits will be available. See Insurance Coverage for Dependents section on page 6.