SUMMER ENROLLMENT 2 0 1 9

Resources for You

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• Answer questions about benefits

• Assist with prior authorizations and referrals

• Explain health care costs and options for

care

• Locate in-network options

• Schedule or cancel appointments

• Help you use self-service tools

• Connect you to other resources

• Clinicians

• Community resources

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BCBSTX

Personal Health Assistants

Call toll-free: (800) 252-8039

Monday–Friday: 7 a.m. - 7 p.m.

Saturday: 7 a.m. - 3 p.m. CT

Blue Cross®, Blue Shield® and the Cross and Shield Symbols are registered service marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans

Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association

Custom Website

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• Find a provider

• Get plan information

• Use the plan decision tool to find the best plan for your needs

• Get the latest news and updates

• Learn about health and wellness resources

• Download forms and documents

Website for HealthSelect participants

www.heal thselectof texas.com

Educational Materials

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• Visit the HealthSelect

site to access helpful

fliers and educational

materials

• Make the most of

your benefits with

fliers on options for

care, maternal health

and virtual visits

www.healthselectoftexas.com

Blue Access for MembersSM

• View your claims and download EOBs

• Find an in-network doctor, hospital or other provider

• Change or select a primary care provider

• Check the costs of doctors and services covered under your plan

• Download a temporary ID card

• Confirm prior authorizations and referrals are in place

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www.healthselectoftexas.com

Dedicated Participant Portal

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Dashboard See claims and EOBs Live chat

BCBSTX App – Text BCBSTXAPP to 33633

Mobile Access

Coverage Options and Benefits

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Plan Updates

• Beginning January 1, 2020, the total in-

network out-of-pocket maximum for all

HealthSelect plans is increasing:

• from $6,650 to $6,750 for individuals

• from $13,300 to $13,500 for families

• These changes align with the IRS 2019

guidelines for group benefit plans.

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HealthSelect of Texas

• No deductible for in-network care

• $500 per person/$1,500 per family deductible for out-of-network

• Primary care provider (PCP) is required for in-

network benefits

• Copay applies to certain services like primary

care and specialists.

• Referral from PCP is required before seeing

an in-network specialist

• Services that don’t require PCP referral:

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• Chiropractors

• Convenience care

clinics

• Mental health

counseling

• OB/GYN

• Ophthalmologists

• Optometrists

• Occupational,

physical and

speech therapy

• Routine eye exams

• Urgent care

• Virtual visits

HealthSelect Out-of-State

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• For active employees, non-Medicare-eligible

retirees and their eligible dependents living or

working outside of Texas

• Benefits are the same as HealthSelect of Texas

• No deductible for in-network services

• A copay will apply to certain services like

primary care and specialist office visits

• No PCP required, no referral needed to see a

specialist

• Not required to designate a PCP or obtain PCP referrals to specialists

• Has a high deductible that must be met before the plan begins to pay for any

services (except in-network preventive care)

• The State of Texas contributes pre-tax dollars to a health savings account (HSA):

For individuals: $45 month/$540 annual and for families: $90 month/$1,080

annual

• Funds in the HSA can be used to pay for qualified covered medical and prescription

drug expenses

Consumer Directed HealthSelect

Annual Deductible In-Network Out-of-Network

Individual $2,100 $4,200

Family $4,200 $8,400

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Medical ID Cards

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• New participants

• Currently enrolled participants changing plans or who have name changes

• Participants in HealthSelect of Texas who select or change primary care providers on file with BCBSTX

• Participants who update their name or the name of a covered dependent

Medical ID cards are not auto-generated

annually, they are only mailed to:

After you enroll in a HealthSelect plan, you will receive your new medical ID card in 7-10 business days

• The Plan Decision Tool, available on the HealthSelect website is designed to help you

decide which plan to enroll in.

• The tool can be found on the HealthSelect website. Visit www.healthselectoftexas.com and

click on the Summer Enrollment banner. Click on the Plan Decision Tool link and follow the

prompts once the tool opens.

Choose a Plan

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Plan Decision Tool

Why Should I Select a PCP?

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Your primary care provider:

• Will get to know you - your health

history, your medications, your overall

lifestyle

• Can treat many non-urgent health

issues like ear infections, rashes,

allergies, fevers, colds, flu and more

• Will coordinate your overall care

including routine medical and

preventive care

• Will manage your referrals to

specialists for HealthSelect

of Texas participants

How to Select a PCP

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• Use Blue Access for Members:

• Go online to www.healthselectoftexas.com

• Click “Log In” in the top right corner

• If you already have a Blue Access for

Members account, log in using your

username and password. Otherwise, register

for Blue Access for Members following the

instructions on the screen

• Once logged in, go to the “Doctors

and Hospitals” tab and click “Select

“Primary Care Physician”

Speak with a BCBSTX Personal Health

Assistant:

• Call toll-free at (800) 252-8039,

Monday–Friday, 7 a.m. - 7 p.m. and

Saturday, 7 a.m. - 3 p.m. CT

Value-added Programs and

Incentives

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• Virtual visits*: Doctor On Demand®, MDLIVE®

• 24/7 Nurseline: Call a BCBSTX nurse toll-free

at (800) 581-0368

• Weight management programs**:

Naturally Slim® and Real Appeal®

• Well onTarget ® : Online portal to access

programs and take the Health Assessment

• Blue PointsSM***: Get rewarded

for healthy activities

*In the event of an emergency, this service should not take the place of an emergency room or urgent care center. MDLIVE and Doctor On Demand doctors do not take the place of your primary care doctor. Internet/Wi-Fi connection is needed for computer access.

Data charges may apply. Check your cellular data or internet service provider’s plan for details. Non-emergency medical service in Idaho, Montana and New Mexico is limited to interactive audio/video (video only). Non-emergency medical service in Arkansas is

limited to interactive audio/video (video only) for initial consultation. Service availability depends on location at the time of consultation. Medical virtual visits are subject to the terms and conditions of your benefit plan, including benefits, limi tations, and exclusions.

Mental health virtual visits are subject to the terms and conditions of your mental health office visit benefit of your plan, including benefits, limitations and exclusions. Claims for medications prescribed as part of mental health virtual visits are treated the same as

those prescribed during a mental health office visit. The telemedicine services made available through Doctor On Demand are provided by licensed physicians practicing within a group of independently owned professional practices collectively known as “Doctor On

Demand Professionals.” These professional practices provide services via the Doctor On Demand telehealth platform. Doctor On Demand, Inc. does not itself provide any physician, mental health or other healthcare provider services.

MDLIVE and Doctor On Demand operate subject to state regulations and may not be available in certain states. MDLIVE and Doctor On Demand are not insurance products nor prescription fulfillment warehouses. MDLIVE and Doctor On Demand do not guarantee

that a prescription will be written. MDLIVE and Doctor On Demand do not prescribe DEA-controlled substances, non-therapeutic drugs and certain other drugs that may be harmful because of their potential for abuse. MDLIVE and Doctor On Demand physicians

reserve the right to deny care for potential misuse of services. MDLIVE is a separate company that operates and administers the virtual visits program for Blue Cross and Blue Shield of Texas. MDLIVE is solely responsible for its operations and for those of its

contracted providers. MDLIVE® and the MDLIVE logo are registered trademarks of MDLIVE, Inc., and may not be used without written permission. Doctor on Demand is an independent company that operates and administers the virtual visit program for Blue Cross

and Blue Shield of Texas. Doctor on Demand is solely responsible for its operations and for those of its contracted providers.

**Naturally Slim and Real Appeal are independent companies that contract directly with ERS to provide wellness services for the HealthSelect of Texas and Consumer Directed HealthSelect plans. They are solely responsible for the products and services that they

provide.

***Blue Points Program Rules are subject to change without prior notice. See the Program Rules on the Well onTarget Member Wellness Portal at wellontarget.com for further information.

Get more information: www.healthselectoftexas.com

BCBSTX Personal Health Assistants

Toll-free: (800) 252-8039

Monday - Friday: 7 a.m. - 7 p.m.

Saturday: 7 a.m. - 3 p.m. CT

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For Additional Assistance

Employees Retirement System of Texas

Toll-free: (866) 399-6908

Monday - Friday: 7:30 a.m. - 5:30 p.m.

or online at www.ers.texas.gov