International Teams - StatesideEffective July 1, 2013
Agenda
• Introduction to GuideStone• Medical plans• Resources and helpful tips for your family• How to enroll
GuideStone’s ministry is serving you
• Our insurance plans give you value and share your Christian values
• Serving ministry employees for 94 years• Industry-leading provider networks• One of the four agencies of the Southern Baptist
Convention • Service is at the core of who we are
◦ Free wellness and educational resources for your family◦ Discounts on medical care and prescription drugs◦ Invested in your ministry’s — and your family’s — well-being
GuideStone brings together best-in-class
Medical Benefits Prescription Drug Benefits
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Best-in-Class: Highmark Blue Cross Blue Shield
• One of the largest provider networks in the country with more than 90% of doctors and 80% of physicians
• Expansive network affords GuideStone participants provider discounts of often more than 50%
• Dedicated customer service line for GuideStone participants
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Best-in-Class: Express Scripts
• Listed at number 60 on Fortune 500 list for 2012• Price a medication online and compare retail to
mail-order before you buy• Save money through the online Pharmacy®
Health Choice 2000PPO Medical Plan
Health Choice 2000Highmark BCBS National PPO Network
Medical Benefits In-network Out-of-network
Primary care co-pay $25 50% (after deductible)
Wellness / preventive care Covered at 100% Not covered
Specialist co-pay $45 50% (after deductible)
Vision exam $25 50% (after deductible)
Annual deductible (individual / family) $2,000 / $4,000 $4,000 / $8,000
Plan pays / you pay(after deductible)
80% / 20% 50% / 50%
Annual co-insurance maximum $5,000 $10,000
Health Choice 2000 Prescription Benefits
Prescription BenefitsRetail:
30-day supplyMail Order:
90-day supply
Generic co-pay $15 $35
Preferred drug co-pay* $35 $90
Non-preferred drug co-pay* $50 $125
Specialty drug$50 co-pay (First fill at
retail; subsequent fills only by mail.)
$50 co-pay(30-day supply)
*If a preferred or non-preferred drug is purchased when a generic is available, you must pay the generic co-payment and the difference in cost between the preferred/non-preferred drug and its generic equivalent.
Health Saver 3000High Deductible Medical Plan(federally-qualified)
What is a federally-qualified HDHP?
• Plan design defined by federal government• Designed to be paired with a Health Savings Account
(HSA)• Participants must first meet the deductible, then
medical or prescription drug claims are paid by GuideStone
• Exception: Eligible, in-network preventive care covered at 100% (not subject to deductible)
Health Saver 3000 Highmark BCBS National PPO Network
Medical Benefits In-network Out-of-network
Annual deductible (individual / family) $3,000 / $6,000 $6,000 / $12,000
Plan pays / you pay(After deductible)
100% / 0% 60% / 40%
Primary care visit 100% (after deductible) 60% (after deductible)
Specialist visit 100% (after deductible) 60% (after deductible)
Vision exam 100% (after deductible) 60% (after deductible)
Annual out-of-pocket maximum N/A $8,000 / $15,000
Wellness / preventive care 100% no deductible Not covered
*Your deductible is met by both medical and prescription drug expenses.
Health Saver 3000Prescription benefits
Prescription Benefits Retail: 30-day Supply Mail Order: 90-day Supply
Deductible —individual / family $3,000/$6,000 $3,000/$6,000
Generic drug 100% after deductible 100% after deductible
Preferred drug 100% after deductible1 100% after deductible1
Non-preferred drug 100% after deductible1 100% after deductible1
Specialty drug100% after deductible (First fill at retail; subsequent fills
only by mail.)
100% after deductible (30-day supply)
1 If a preferred or non-preferred drug is purchased when a generic is available, the cost difference between the preferred/non-preferred drug and its generic equivalent will not apply to the participant’s deductible or out-of-pocket expenses. After the deductible is met, the participant must pay the cost difference between the preferred/non-preferred drug and its generic equivalent if available.
Resources and helpful tipsfor you and your family
How to Save money withyour medical and prescription drug planYou can save money with your medical plan when you:
• Use in-network providers• Get your preventive care (covered at 100%)• Compare your provider bills to your Explanation of
Benefits (EOB)You can save money with your prescription drug plan when you:
• Purchase generics when available• Use mail order
Note: Please have current prescriptions refilled for at least a 30 day supply to support a smooth transition to the new prescription drug plan
Wellness benefitPer Preventive Care Schedule
• The Preventive Care Schedule is based on recommendations by the CDC and American Cancer Society and includes services required under healthcare reform (PPACA).
◦ Scheduled, in-network services are covered at 100% and are not subject to co-pay, co-insurance or deductible.
◦ Specific recommendations are based on age and gender.◦ Well-child visits and immunizations are covered up to age 18.◦ Women’s preventive health services, including approved generic
oral contraceptives, gestational diabetes screening and breastfeeding support, are covered.
◦ Expanded immunizations for at-risk patients are covered.
Did you know?Three-quarters of American healthcare expenditures are linked to preventable, chronic or lifestyle-related conditions. Regular preventive care and a healthy lifestyle can dramatically reduce your healthcare costs!
How to Find a vision provider www.GuideStoneInsurance.org
How will my lab and x-ray benefits be paid?Highmark BCBS National PPO Network
• Wellness visit at in-network provider or wellness-related visit to network out-patient hospital or free-standing facility: For covered services, preventive lab and x-ray will be covered at 100%, per the Preventive Care Schedule.
• X-Ray or lab work during visit to in-network primary care physician: If you visit a network physician and they send the diagnostic x-ray or laboratory work to a facility (either in- or out-of-network) for processing, you’ll pay an office visit co-pay or the applicable office visit charges.
• Free-standing facility: If you go to a free-standing x-ray or lab facility for diagnostic, you will be charged the deductible and co-insurance. Note: this facility may be adjacent to or within the same suite as your doctor’s office.
Understanding PrescriptionDrug classifications• Generic — Generic prescription drugs are listed by their chemical
name. These drugs are similar to brand name drugs with expired patents, which usually means the drug is less expensive.
• Preferred — Preferred prescription drugs are brand name medications on your formulary. These drugs are commonly prescribed and selected to be on your formulary to help control your plan’s costs.
• Non-preferred — Non-preferred prescription drugs are not on your formulary.
• Specialty — Specialty prescription drugs are used to treat complex, chronic or special health conditions.
How to price your medicationswww.Express-Scripts.com
A new place to learnwww.GuideStone.org/LearningCenter
Variety of useful topics plus links to your provider websites
Healthcare Reformwww.GuideStone.org/HealthReform
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How to EnrollPlease complete the enrollment form provided by your administrator. You will also find instructions in your enrollment material explaining what to do to access benefits before you receive your ID card.
Your benefits administrator will be providing your deadline for enrollment. If you have any questions regarding enrollment/changes of your employee benefits, please notify your benefits administrator
This information only highlights the depth of coverage and benefits you can receive when you protect yourself with GuideStone Financial Resources. Limitations and exclusions apply. This material is a general summary of the plans. The official plan documents and contracts set forth the eligibility rules, limitations, exclusions and benefits. These alone govern and control the actual operation of the plan. In the event of a conflict with the description in this material, the terms of the official plan documents and contracts will control its operation.
GuideStone Financial Resources of the Southern Baptist Convention reserves the right to change or cancel these programs at any time. This material does not imply an employment contract or guarantee of benefits. Medical underwriting could be required.