2023 AtlantiCare Benefits Booklet

First page 1 Next page Last page

There’s something for everyone

2023 Benefits Workbook

Important decisions deserve a little homework. Before you enroll, make a commitment to take the time to understand all of your options and decide what’s best for you, your family and your health. The purpose of this Benefits Workbook is to provide you with important information to help you make the right choices that fit the needs of you and your family. AtlantiCare provides employees with a comprehensive and competitive benefits package to provide coverage to you and your family. It is important for you to make informed decisions and adopt healthy habits. This workbook highlights the 2023 benefits offered to you and your family. Please review all plans offered to recognize the difference in options available so you can decide which is best for your needs. Before choosing a plan, please check with your providers to verify their participation in the plan you are considering. Many of the providers being utilized by AtlantiCare employees and their dependents participate in all plans. Our own AtlantiCare providers and affiliates continue to be the lowest option. Please visit the Human Resources portal on The Starfish for participating physicians, facilities and other services for all plans.

Dear AtlantiCare Family,

The health and well-being of you and your families is key to your success as a member of the AtlantiCare team. We believe that begins with choosing the medical and wellness benefits that keep you actively engaged with your health. On the following pages, you will find information about the medical plans and wellness benefits available to you and your loved ones as part of the AtlantiCare family. Please review them carefully, explore all of your options and choose the plans that work best for your unique situation. The Benefits team has worked hard to create a robust program that provides you with a variety of plans and options. I am proud of our continuing efforts to design comprehensive, affordable and meaningful options for you and your family. They allow you to plan for routine care while also preparing you for unanticipated emergencies. Building healthy communities together begins at home. As our region’s healthcare leader, we lead by example. By taking care of ourselves, we are best able to care for those who turn to us in their time of need.

Keep making a difference,

Lori Herndon, MBA, BSN, RN President and CEO AtlantiCare

What’s New for 2023

TABLE OF CONTENTS WELCOME.................2 WHAT’S NEW. ...........3 SERVICE CENTERS AND WEBSITES..........4 HOW TO ENROLL....5-6 MEDICAL..............7-14 PRESCRIPTION DRUG. ................15-17 ADDITIONAL MEDICAL PLAN RESOURCES........18-22 DENTAL...............23-24 VISION.....................25 LIFECENTER..............26 LIFE INSURANCE. .....27 DISABILITY...............28 VOLUNTARY OFFERINGS. ........29-32 SPENDING ACCOUNTS. ............33 RETIREMENT BENEFITS..................34 WELLNESS. .........35-38 LEGAL NOTICES...39-41 GLOSSARY..........42-43 FAQs...................44-46 CONTACTS.........47-48 FORMS................49-58

WHATS NEW FOR 2023 • Horizon Medical - Employee contribution rates increases (pg.10)

Discount Shopping • Check out hundreds on deals and savings plus some deals from local businesses, exclusively for AtlantiCare! Click on the “Discount Shopping” tab on the Starfish to learn more. Health & Wellbeing Resources • See a listing of resources available at AtlantiCare and in the community (pg. 52) 2023 Wellness Activity Checklist • The Wellness Activities and credit amounts have changed. Please review on page 49. • Now earn credits for attending: - Health Engagement Wellness Seminars - Attending the LifeCenter - Enrollment in the Patient Portal

- Tier 2 copays and coinsurance - see table below (pg.13) - In keeping with ACA IRS limits, out-of-pocket maximums change to $7,350 for single coverage and $14,700 for family coverage (pg.13) - Mental Health Office Visits continue to be covered at 100% after a $10 copay for Inner Circle and Tier 2 levels of coverage. These visits are not subject to the deductible. • Employee Assistance Program (EAP) - Employees and eligible family members have access to this confidential wellness benefit (pg. 18) • Prescription - Non-Specialty - Brand preferred prescriptions at Non-AtlantiCare (retail) Pharmacies copay increase from $35 to $50 (pg. 15) • Telehealth - Additional Telehealth program features - still only a $5 copay! (pg.19) • Spending Accounts - Health Flexible Spending Account (FSA) maximum change to $2,850 (pg. 33)

Engaged Plan

PPO Plan

Tier 2 Copay Changes

2022

2023

2022 $750 $750 $500

2023

Room & Board

$1,250 $1,000

$1,500 $1,250 $1,000

$1,000 $1,000

Outpatient Surgery (hospital based) Outpatient Surgery (surgical based)

$750

$700

Service Centers and Websites

TABLE OF CONTENTS WELCOME.................2 WHAT’S NEW. ...........3 SERVICE CENTERS AND WEBSITES..........4 HOW TO ENROLL....5-6 MEDICAL..............7-13 PRESCRIPTION DRUG. ................14-16 ADDITIONAL MEDICAL PLAN RESOURCES........17-19 DENTAL...............20-22 VISION.....................23 LIFECENTER..............24 LIFE INSURANCE. .....25 DISABILITY...............26 VOLUNTARY OFFERINGS. ........27-30 SPENDING ACCOUNTS. ............31 RETIREMENT BENEFITS..................32 WELLNESS. .........33-36 LEGAL NOTICES..37-39 GLOSSARY..........40-41 FAQs...................42-44 CONTACTS.........45-46 FORMS................47-53

AtlantiCare Benefits Service Center 1-800-211-3252 Monday through Friday, 8:00 am – 6:00 pm Saturday, 8:00 am – 5:00 pm You can access the AtlantiCare Benefits Service/Enrollment Site to make your elections via myadp.com . Navigate to the Benefits tab and click Health and Welfare. For more information, see How to Enroll on page 5. Chat and Co-browsing available Monday through Friday 8:00 am to 8:00 pm EST, excluding all major U.S. holidays. Access via myadp.com . FSA Employee Benefits Center 1-800-307-0230 Monday through Friday, 8:30 am – 5:30 pm myflexdollars.com See Contacts on page 47 for specific benefit policies. Wellness Customer Service Team 609-677-7507 Monday through Friday, 7:30 am – 4:00 pm wellness@atlanticare.org Check for important dates and information on Open Enrollment and other Benefits events throughout the year on The Starfish Calendar. Call the Wellness Customer Service Team for inquiries related to wellness credits, programs and resources.

How To Enroll

? WHO CAN BE COVERED Eligible dependents include:

Spend time to learn about your benefit options so you can make the best decisions for you and your family based on your needs.

Make Sure You… • Read this Benefits Workbook • Review your dependent information

• Your spouse or domestic partner *If you would like to add a domestic partner as a dependent, you will need to complete the online portal process, including dependent verification, to get your domestic partner verified and added. You will be required to provide documentation confirming registry of domestic partnership with a local government. Note that domestic partners are eligible for only medical, prescription drug, dental and vision insurance. • Dependent children, including adopted children, foster children in your care and stepchildren. Children are eligible • Children over age 26 with mental or physical impairments may be eligible – physician certifications must be provided. ! CHANGING YOUR COVERAGE DURING THE YEAR QUALIFYING LIFE EVENTS (QLE) If you experience a Qualifying Life Event, you have 30 days to make the necessary changes to your benefits. You can make changes through myadp.com or call the AtlantiCare Benefits Service Center ( 1-800-211-3252 ). Documentation must be submitted to confirm the event, or your old elections will be activated. Examples of a QLE include: • Adoption • Birth of a child • Marriage • Divorce • Death of a dependent until the end of the year of their 26th birthday. • Other minor children if you are a legal guardian

• Use the decision tool found on the enrollment website to help you decide which plans are best for you and your family • Consider participating in flexible spending accounts and other voluntary offerings • Review the 2023 Wellness Activity Checklist • Confirm your elections!!! Your elections will be enforced for the full plan year unless you experience a Qualifying Life Event. The choices you make during Open Enrollment will go into effect on January 1, and remain until December 31, unless you have a qualified life event. Newly eligible employees must actively elect to either participate in or waive benefits. Those who fail to confirm enrollment within 30 days will be automatically enrolled in the Horizon Engaged Plan – ‘Employee Only,’ Tobacco surcharge and the Basic Dental Plan – ‘Employee Only.’ The choices you make as a new hire are effective the first of the month after you are hired, until December 31.

• Employee/dependent lose other coverage • Employee/dependent gain other coverage

How To Enroll

u Login to myadp.com

u Click Benefits on the left side. An Annual Enrollment / New Hire tile will appear, informing you how many days you have to enroll.

u Click ENROLL NOW u Select your 2023 Elections. u Review Benefits Summary. Click Confirm Elections . A confirmation message will appear (below).

u Read the message and click I AGREE . u Download to save or print your confirmation statement (above).

Medical

You have two choices in Medical Plan coverage: • Horizon Engaged Plan • Horizon Preferred Provider (PPO) Plan

You have two choices in medical plan options administered by Horizon Blue Cross Blue Shield: Horizon Engaged Plan and Horizon Preferred Provider (PPO). Horizon Blue Cross Blue Shield Blue Card provides access to one of the broadest networks in the country. Both options include access to AtlantiCare Inner Circle physicians and you pay less when you are able to use these providers. Horizon Engaged Plan The Horizon Engaged Plan offers a lower biweekly contribution in return for your commitment to engage in your health. You will have the opportunity to complete activities to earn wellness credits that will reduce the deductible up to $2,000 for single coverage and up to $4,000 for spouse or family coverage (wellness credits do not apply to children) that will be applied the following year . For a complete description of activities, please refer to the “Wellness” section in this booklet. You will need to complete these activities by their specific due date to earn the associated wellness credits. Features • Wellness credits earned reduce the deductible. • Two-tiered network of providers – AtlantiCare Tier (Inner Circle) and Blue Cross Blue Shield (Tier 2) • Providers in both tiers are considered in-network providers but pay differently. This means that the same services are covered in both tiers, but when you utilize AtlantiCare and its affiliates, you pay less out-of-pocket. • When you use the Blue Cross Blue Shield Tier you have additional costs. In some cases, the additional costs could be up to $1,500 copay and then 30% of the cost of services. • This plan does not cover physicians and facilities who do not participate in the national Blue Cross Blue Shield network. • If services are not available at AtlantiCare, your responsibility will be at the Tier 2 level of coverage – which is the primary.

Horizon Preferred Provider Plan (PPO) The Horizon Preferred Provider Plan includes the same benefits and provider network as the Horizon Engaged Plan but also offers coverage for physicians and facilities outside of the national Blue Cross Blue Shield network. This plan is the most expensive when it comes to how much you contribute each pay period. However, your pay cost can be reduced if you complete wellness activities. By completing wellness activities, you can earn up to $750 for single coverage and up to $1,500 for spouse or family coverage (wellness credits do not apply to children that will be applied the following year ). Earned wellness credits are applied to the total cost of your medical contribution and divided over 26 pay periods for the following year. For a complete description of activities, please refer to the “Wellness” section in this booklet. You will need to complete these activities by their specific due date to earn the associated wellness credits. Features • Wellness credits earned reduce your contributions. • Includes the same benefits and provider networks as the Horizon Engaged Plan, but also offers coverage for physicians and facilities outside of the national Blue Cross Blue Shield network.

Medical

! YOU’RE NOW IN CONTROL OF YOUR HEALTH RECORDS

Horizon Preferred Provide Plan (PPO) continued • Utilizing AtlantiCare and its affiliates for service will result in the lowest out-of-pocket cost. • Some services performed through a Blue Cross Blue Shield network provider will be covered at 70% after the deductible is met. • When you use the Blue Cross Blue Shield network, services will usually be paid at 50% after the deductible is met. • If services are not available at AtlantiCare, your responsibility will be at the Tier 2 or Out-of-Network level of coverage. For both plans, visit https://www.horizonblue.com/atlanticare/ to find a participating physician, facility or other service provider.

With our HealtheLife Patient Portal, you can securely access your health information and communicate with your AtlantiCare Physician Group providers. Manage all your health information in one place at no cost! For further information, go to page 22 or visit www.atlanticare.org/patient-portal/ .

The Plans At A Glance

HORIZON ENGAGED HORIZON PPO

Has AtlantiCare Network

Has “Out-of-Network” Providers

Has High Copays When Using Non-AtlantiCare Facilities.

Lowest Contributions

Wellness Credits Reduce Deductible

Wellness Credits Reduce Contributions

Access to Telehealth Benefit

Medical

SPOUSE & PARTNER PREFERRED CHOICE PREMIUM AtlantiCare continuously balances the need to offer meaningful and comprehensive employee benefits with the need to remain financially sound in the current healthcare environment. To achieve this balance, we require a Spouse and Partner Preferred Choice Premium. This premium will be applied to your bi-weekly contribution if your spouse/partner chooses to obtain medical coverage through AtlantiCare when they have the option of obtaining benefits through their own employer. This premium will not be applied if your spouse/partner is not offered benefits through their employer, is not currently employed or also works at AtlantiCare. The premium is $75 per paycheck if your base salary is less than $110,000, and $125 per paycheck if your base salary is $110,000 or more. AtlantiCare will conduct audits throughout the year, during which you will be asked to supply documentation (i.e., a letter from employer or tax return showing no income) if you have indicated that your spouse/partner is not eligible for medical coverage by their own employer. This acknowledgment is considered a legal process and should be treated as such. If your spouse is self-employed and not obtaining benefits through their business, they will need to supply proof of self-employment.

Medical

2023 Medical Plan Bi-Weekly Contribution Rates

Full-Time

Part-Time

$0-49,999k $50-109,999k $110,000-199,999k

$200k+

$0-49,999k $50-109,999k $110,000-199,999k $200k+

Horizon Engaged Plan

Employee

$40.68 $49.22

$90.73

$100.36 $81.21 $93.61

$181.45

$200.70

Employee + Spouse

$69.65 $84.29

$155.37

$171.86 $139.08 $160.30

$310.73

$343.69

Employee + Child(ren)

$56.14 $67.94

$125.26

$138.53 $112.10 $129.21

$250.45

$277.03

Family

$111.23 $134.59

$248.09

$274.45 $222.08 $255.97

$496.18

$548.82

Horizon PPO

Employee

$161.94 $178.54

$222.53

$231.85 $191.77 $211.43

$345.10

$360.65

Employee + Spouse

$277.33 $305.76

$381.08

$397.03 $328.42 $362.07

$592.82

$617.63

Employee + Child(ren)

$223.53 $246.46

$307.18

$320.05 $264.72 $291.84

$477.81

$497.81

Family

$442.85 $488.24

$608.54

$634.01 $524.42 $578.16

$946.62

$986.26

*$25 surcharge will be added to your bi-weekly deductions if you utilize tobacco products. A Spouse & Partner Preferred Choice Premium may also apply. See page 9 for details. ** Note, salary changes may result in changes to your contribution rate

Medical

Make The Most Of Your Medical Benefits • Consider the “Engaged Plan.” The contributions are low cost, and unless you have many physicians who are out of network, the Horizon Engaged Plan’s Blue Card network should meet your needs. • Preventive Care at No Cost – Preventive care is comprised of a variety of clinical services and programs, including annual doctor’s checkups, annual immunizations and screenings. Make sure your provider codes all eligible claims as preventive care in order to be eligible for 100% coverage. • Out-of-Pocket Maximums – You are protected from catastrophic medical expenses by the annual out-of-pocket maximum. When your out-of-pocket expenses (deductibles, copays and coinsurances) reach the out-of-pocket maximum, the plan pays the full cost for any covered care you receive for the rest of the year. • Contact Horizon before a procedure to determine what you can expect to pay and to ensure any pre-authorizations have been completed. • Consider participating in Flexible Spending Accounts to supplement your out-of-pocket expenses. • Complete wellness activities to earn credits to reduce your deductible if your enrolled in the Horizon Engaged plan, buy down your bi-weekly contributions if you are enrolled in the Horizon PPO plan. or if you waive, it will be applied a Health Reimbursement Account (HRA) paid on an FSA card. • Utilize an AtlantiCare Primary Care Plus provider. In both medical plans, these providers are only a $10 copay for office visits, compared to a $50 copay for primary care providers that are not AtlantiCare Primary Care Plus designated. Wellness credits will be earned for using one of these providers for your Annual Preventative Care Visit. To earn this designation, our providers have taken meaningful steps toward the patient-centered medical home model, which means offering same- or next-day urgent appointments, implementing a common electronic medical record, collaborating with AtlantiCare Care Managers for complex patients and allowing hospitalists to care for patients admitted to ARMC. To find an AtlantiCare Primary Care Plus provider, call the AtlantiCare Access Center at 1-888-569-1000 or visit www.atlanticare.org .

Waiving Benefits If you waive your medical benefits, $12.50 per pay* will be deposited into a Healthcare Reimbursement Account (HRA). See Spending Accounts on page 34 for more information. In addition, your earned wellness credits from 2022 of up to $750 will also be deposited into this account that will be applied the following year . See Wellness starting on page 33 for a list of wellness activities and their values. Please visit https://myatlanticare.org to view your online wellness activity checklist or call Health Engagement at 1-609-677-7507 if you have questions about your wellness activities. *If you are covered by another AtlantiCare employee and you waive medical coverage, you will not be eligible for the waiver benefit.

Medical

What if AtlantiCare does not provide the service I require? AtlantiCare is able to provide you with enhanced benefits when you utilize our services because the dollars spent for these services stay within AtlantiCare. While AtlantiCare offers most services, not all services are provided at the AtlantiCare Inner Circle level. If you require services outside of AtlantiCare you will still have access to these services. However, depending on the plan you choose, you will be required to pay for them at the Horizon (Tier 2) benefit level. If the service can only be provided through an out-of-network provider, please contact Horizon to file an appeal prior to receiving the service. Never assume your provider is referring you to an Inner Circle provider. Please contact Horizon Customer Service at 1-800-355-2583 for verification of provider’s tier level or by downloading the Horizon Blue Cross Blue Shield app.

! HELPFUL TIP If you know that you will need services performed at a

non-AtlantiCare facility, utilize your Flexible Spending Account (FSA) to help you budget for the expense and reduce your taxable income at the same time. Interested in a FSA? Enroll during your New Hire enrollment period or the annual enrollment period.

Horizon Blue connects you to care and support wherever you are!

The Horizon Blue app offers 24/7 connection to all the ins and outs of your plan. We’re always looking for ways to make things more convenient for you.

Search for Horizon Blue in the App Store or Google Play, or scan this QR code to download the app.

Medical

Compare 2023 Plan Choices

Horizon Engaged Plan

PPO Plan

Medical Services

Inner Circle

Tier 2

Inner Circle

Tier 2

Out-of-Network

Deductible (per person/per family)

$2,000/$4,000

$2,500/$5,000*

N/A

$1,000/$2,000

$2,000/$4,000

*Wellness credits can reduce deductible to $500/1,000

Out-of-Pocket Maximum after Deductible (per person/per family)

$7,350/$14,700

$9,200/$18,400

Facility Benefits

Covered 100% after deductible

Covered 100% after $1,500 copay/visit and deductible

Covered 100% after deductible

Covered 100% after $1,000 copay/visit

$2,000 copay/visit then covered 50%; no deductible

Room & Board / Ancillary

Outpatient Facility Benefits

Covered 100% after $25 copay and deductible Covered 100% after $25 copay and deductible Covered 100% after deductible Covered 100% after deductible Covered 100% after deductible

Outpatient Surgery (Hospital Based)

Covered 70% after $1,250 copay/visit and deductible

Covered 100% after $25 copay

Covered 100% after $1,000 copay/visit

$2,000 copay/visit then covered 50%; no deductible

Outpatient Surgery (Surgical Center)

Covered 70% after $1,000 copay/visit and deductible

Covered 100% after $25 copay

Covered 100% after $700 copay/visit

Covered 50% after deductible

Physician Services

Covered 70% after deductible Covered 70% after deductible Covered 70% after deductible Covered 100% after $50 copay/visit; all other services rendered in the office covered 70% after deductible Covered 100% after $65 copay/visit; all other services rendered in the office covered 70% after deductible

Covered 50% after deductible Covered 50% after deductible Covered 50% after deductible

Surgeon

Covered 70% after deductible

Covered 100%

Anesthesia

Covered 70% after deductible

Covered 100%

Inpatient Physician Visit

Covered 70% after deductible

Covered 100%

Covered 100% after $50 copay/visit and wellness deductible; all other services rendered in the office covered 70% after deductible

Covered 100% after $10 copay and deductible

Physician Office Visits - Primary Care

Covered 100% after $10 copay/visit

Covered 50% after deductible

Covered 100% after $65 copay/visit and wellness deductible; all other services rendered in the office covered 70% after deductible

Covered 100% after $10 copay and deductible

Physician Office Visits - Specialist

Covered 100% after $10 copay/visit

Covered 50% after deductible

Physician Office Visits - Routine Well Care

Covered 100%

Covered 100% Covered 100%

This chart is meant as an overview only. For detailed information, please refer to the Summary Plan Description posted under “Benefit Information” on the HR Portal: Benefits Tab. * For Engaged Plan only, the deductible can be reduced through wellness credits. ** AtlantiCare also covers some services for gender assignment. Check the plan document for more information.

Medical

Compare 2023 Plan Choices

Horizon Engaged Plan

PPO Plan

Medical Services

Inner Circle

Tier 2

Inner Circle

Tier 2

Out-of-Network

Supplemental Services

Covered 100% after $5 copay/visit

Covered 100% after $20 copay/visit

Covered 100% after $5 copay/visit

Covered 100% after $20 copay/visit Covered 100% after $50 copay/visit and deductible; all other services rendered in the office covered 70% after deductible Office and freestanding clinic: Covered 100% after $50 copay/visit and deductible Facility: Covered 70% after deductible Office and freestanding clinic: Covered at 70% after deductible for services performed at a freestanding facility or in an Office Facility: Covered 70% after deductible Covered 100% after $150 copay

Covered 100% after $20 copay/visit

Telemedicine

Covered 100% after $20 copay and deductible

Covered 100% after $50 copay/visit and deductible; all other services rendered in the office covered 70% after deductible

Covered 100% after $20 copay and deductible

Urgent Care

Covered 100% after $60 copay

Covered 100% after $150 copay and deductible

Covered 100% after $150 copay

Emergency Services

Covered 100% after $150 copay

Office and freestanding clinic: Covered 100% after $50 copay/visit and deductible

Covered 100% after $10 copay and deductible

Covered 100% after $10 copay/visit

Covered 50% after deductible

Diagnostic X-ray

Facility: Covered 70% after deductible

Covered at 70% after deductible for services performed at a freestanding facility or in an Office Facility: Covered 70% after deductible

Covered 100% after $10 copay and deductible

Diagnostic hi-tech imaging

Covered 100% after $10 copay/visit

Covered 50% after deductible

Covered 100% after $10 copay/visit and deductible

Covered 100% after $50 copay/visit and deductible

Covered 100% after $10 copay/visit

Covered 70% after deductible

Covered 50% after deductible

Diagnostic Tests

This chart is meant as an overview only. For detailed information, please refer to the Summary Plan Description posted under “Benefit Information” on the HR Portal: Benefits tab.

Vision care expense benefit for all plans (no network limitations) Routine Vision Exam annually $70 Eyeglasses and/or Contact Lenses every two years $60 Must submit a claim form for reimbursement.

*For Engaged Plan only, the deductible can be reduced through wellness credits. **AtlantiCare also covers some services for gender assignment. Check the plan document for more information.

Prescription Drug

Regardless of which medical plan option you choose, you automatically receive prescription drug coverage through MedImpact. You do not need to enroll separately in the prescription plan. Prescription coverage is included as part of the Medical plan enrollment. Your prescription plan information can be found on your prescription ID card.

Should you need a replacement ID card, please call MedImpact Customer Service at 1-833-229-3595 .

Refer to the table below for the copay amounts you will pay under the Prescription Drug plan. The maximum amount that you will pay for prescriptions per year: Single $1,750/Family $3,500. For more information about prescription benefits, see Prescription Plan FAQs on page 46.

Non-Specialty Medications

AtlantiCare Pharmacy (Retail & Mail Order) Generic Brand Preferred Brand Non-Preferred

Copays for 30/90-day supply $10/$20 $20/$40 $50/$100

Non-AtlantiCare Retail Pharmacy Generic Brand Preferred Brand Non-Preferred Specialty Medications AtlantiCare Retail Pharmacy Generic Brand Preferred Brand Non-Preferred

Copays for 30-day supply 15% 30% 100%

Minimum $15 $50 N/A

Copays (up to 30-day supply) $10 $20 $50

*Other Specialty Pharmacy Generic Brand Preferred Brand Non-Preferred

Copays (up to 30-day supply) 10% 20% 30%

Maximum $150 $150 $150

*If the AtlantiCare Pharmacy is unable to fill your request, they will direct you to contact MedImpact Customer Service for assistance in obtaining your medication.

Prescription Drug

Always consider using the AtlantiCare Pharmacy first, because it typically provides the least out-of-pocket cost.

AtlantiCare Pharmacy (Retail and Mail Order) The AtlantiCare Pharmacy offers AtlantiCare employees and their covered dependents the opportunity to fill prescriptions at a reduced cost. Medications can be filled for as little as $10 (generic) or $20 (brand name preferred) for a 30-day supply. Medication copay costs will double for a 90-day supply. There are three AtlantiCare Pharmacy locations:

Atlantic City AtlantiCare HealthPlex, 1401 Atlantic Ave. Tel: 1-609-441-7088 Fax: 1-609-441-7089 Hours of Operation: Monday through Friday, 8:00 am to 6:00 pm

Galloway 54 West Jimmie Leeds Road

Tel: 1-609-404-7444 Fax: 1-609-404-7445 Hours of Operation: Monday through Friday, 8:00 am to 6:00 pm Saturday, 9:00 am to 4:00 pm

Manahawkin 517 Route 72W

Tel: 1-609-704-6800 Fax: 1-609-704-6801 Hours of Operation: Monday through Friday, 9:00 am to 5:00 pm

? DID YOU KNOW?

AtlantiCare Pharmacy provides an online site to manage your prescription needs, order refills, transfer prescriptions from other pharmacies and much more. Visit https://atlanticare.refillmyrx.com to register and start managing your prescriptions today.

In the case of an emergency, you may use the AtlantiCare Community Pharmacy located inside the ARMC City and Mainland campuses. Hours of operation are Monday through Friday, 8:00 am to 8:00 pm, and Saturday and Sunday, 9:00 am to 6:00 pm. Please note, you may utilize these pharmacies for emergencies only. They do not carry enough supply for employees’ daily usage.

Prescription Drug

Retail Pharmacies (non-AtlantiCare) You can utilize your MedImpact prescription card to access retail pharmacies nationwide. While most large chains participate in the network, we do have some exclusions. To find a participating pharmacy, or to see if your medication is covered, visit the MedImpact Member portal at https://www.medimpact.com/web/login When you utilize these pharmacies, please consider the following: • Your copay may be higher than what you would pay at your AtlantiCare Pharmacy. • If your medications are not categorized as generic or preferred brand, you may be responsible for the full cost of the prescription. • Any medication obtained from a non-AtlantiCare Pharmacy will only be filled for up to a 30-day supply (90-day supply not available). • Maintenance medications can only be refilled one time at a non-AtlantiCare pharmacy. • AtlantiCare pharmacy offers mail order service for all active employees and their dependents at no additional cost.

Specialty Medications AtlantiCare Pharmacy will process your specialty medications. Please note, specialty medications may require prior authorization, so please plan accordingly. If the AtlantiCare Pharmacy is unable to fill your request, they will direct you to contact MedImpact Customer Service for assistance in obtaining your medication.

? DID YOU KNOW

Members can request ID cards via MedImpact Customer Service ( 1-833-229-3595 ) and have the option to print a temporary ID card from the member website by logging onto www.medimpact.com until their new ID card is mailed to them.

Medications are delivered within 2-3 days. Mail order forms can be found on the HR Portal: Benefits tab on The Starfish or by calling the Galloway pharmacy at 609-404-7444 .

Additional Medical Plan Resources

AtlantiCare Health Services - FQHC*

If you have a medical condition such as diabetes, rheumatoid arthritis, congestive heart failure, cardiovascular disease or chronic obstructive pulmonary disease (COPD), you know how difficult it is to manage and coordinate all of the providers and finances involved in your care. Our staff is ready to help improve your health, simplify your life and reduce your out-of-pocket medical expenses.

The resources described here are available to you and your family regardless of which medical plan you elect. • Your physician copays will be waived and most of your medications will be completely free. Medications include Levemir, Humira, Lantus, Novolog, Januvia, Enbrel and others. What’s different about receiving care at these locations? • You will be at the center of a team working together to coordinate and manage your care. • Your personal health coach will be by your side every step of the way, and will also keep the care team informed of your care plan and progress. • The sites listed feature a convenient, on-site pharmacy where you can fill your prescriptions right after your appointment.

There are two convenient locations to provide and coordinate care for you:

Health Services

1401 Atlantic Ave. Suite 2500 and Suite 2600 Atlantic City, NJ 08401 Hours: Monday through Friday: 8:30 am to 6:30 pm 1-888-569-1000

54 Jimmie Leeds Road Suite 8 Galloway, NJ 08205 Hours: Monday through Thursday: 8:00 am to 6:00 pm 1-609-404-7300

*(Federally Qualified Health Center)

Additional Medical Plan Resources

AtlantiCare Access Center Nurse Triage AtlantiCare offers telephonic nurse triage when your AtlantiCare Physician Group (APG) primary care provider practice is not available. After hours, a nurse is available to answer any questions related to your medical care. The hours vary by practice. However, they are typically available from 4:00 pm – 8:30 pm daily, including holidays and weekends. When you call you will speak with a registered nurse (with an average of 30 years experience) who will assess and evaluate your symptoms or injury over the phone, provide physician- approved medical information so you can make an informed decision about where and when to seek treatment, recommend next steps and, if necessary, refer you to the appropriate care and resources. Care Management As part of your benefits, our Nurse Care Managers are available to help you understand your healthcare options by: • Coordinating your healthcare services • Helping you understand and use your benefits in the most efficient way • Directing you to community resources, support groups, and health and wellness programs when appropriate • Navigating the healthcare system when dealing with a complex medical illness This is a free benefit as part of your affiliation with our APG primary care practices.

Telehealth Benefit AtlantiCare offers care through telehealth in Primary Care, Behavioral Health, OB/GYN, Specialty Care areas and Surgical Services. Your copay is $5. AtlantiCare also offers some special programs featuring the AtlantiCare Physician Group Primary Care Virtual Program. With the Virtual Care program, you’ve never been more connected to care, with same day primary care virtual visits with an AtlantiCare provider. This program is also offering the opportunity for some eligible employees, spouses or dependents between the ages of 20-40 to establish care with our Virtualist program dedicated to virtual care first. With the Virtualist providers as your primary care provider, you receive care virtually, including your employee annual wellness via telehealth appointments with this practice. To inquire about this offering, call the Access Center at 1-888-569-1000 . To schedule a telehealth appointment you can call 1-866-569-1000 or visit http://providers.atlanticare.org to book your appointment online.

You may speak to a Care Manager by calling 1-609-272-6297 .

Both Nurse Triage and Care Management are offered as free benefits . All medical and personal information is confidential and may only be shared with those involved in your care.

Additional Medical Plan Resources

EMPLOYEE ASSISTANCE PROGRAM Feeling stressed, overwhelmed, need to talk?

There are many reasons to call the Employee Assistance Program. There is no need to enroll, as this is offered as a benefit for all full, part-time and per diem employees and their immediate family members 18 and older. The Employee Assistance Program (EAP) is a wellness benefit that helps people cope with problems that affect your quality of life. This is a free and CONFIDENTIAL benefit to help you when you are experiencing problems that may affect your ability to function, both on the job and at home. EAP offers confidential, brief intervention services both over the phone and in person, seminars, conflict resolution, employee wellness trainings and support. In addition, EAP is able to help with treatment needs and any referrals that are needed for treatment.

The EAP services are provided by Master’s Level Counselors: • 24/7 toll-free EAP telephone line providing easy access to professional assistance • Free and Confidential

• Work/Life Balance • Anxiety and Stress • Depression • Substance Use • Communication Issues • Grief and Loss • Relationship Issues • Anger Management • Trainings and Seminars

Several convenient locations throughout Atlantic County. 24 hours a day, 7 days a week for support Service’s offered telephonically, virtually or in person.

WE ARE HERE TO HELP!

To learn more or to make an appointment, call 1-800-260-0808

CARE THAT’S BUILT ENTIRELY AROUND YOUR LIFE We build healthy communities together every day. So when you need care, we’re here for you. Because you, your family and friends deserve quality care, close to home. AtlantiCare’s diverse roster of services and providers is growing daily, offering a full spectrum of care you can trust for you and your loved ones. And, with more than 100 locations serving five counties, you can get the right care at just the right time for you. Think AtlantiCare First when searching for your healthcare needs.

• Audiology • Bariatric • Behavioral Health • Breast Surgery Services available:

• Palliative Care • Pediatrics • Pharmacies • Primary Care • Radiology • Rheumatology • Spine Services

• Emergency Departments (Pomona, Atlantic City and Hammonton) • Federally Qualified Health Center (primary and preventative care for those with or without insurance) • Gynocologic Oncology • Home Care • Hospice Care • Infectious Disease Treatment • LifeConnection • Maternal Fetal Medicine (care for momand baby) • Neurology • NICU • OB/GYN • Occupational Health • Orthopaedics • Pain Management

TELEHEALTH APPOINTMENTS AVAILABLE For more information visit www.atlanticare.org/telehealth. *Telehealth available for many services. SCHEDULE APPOINTMENTS ONLINE To schedule an appointment online with a provider visit www.atlanticare.org/bookonline.

• Cancer Care • Cardiology • Clinical Labs • COVID-19 Long Haul Clinic • COVID Testing Center

• Surgical Oncology • Surgical Services • Thoracic • Trauma Center • Urgent Care • Urogynecology • Urology • Vascular • Wound Healing *List as of October 2022

(available at all Urgent Care locations; check www.atlanticare.org/urgentcare for updates) • Diabetes • Diagnostic Testing • Ear, Nose, Throat (ENT) • Endocrinology

• Elective Surgeries • Family Planning • Fitness Center

Call 1-888-569-1000 or visit www.atlanticare.org.

Page 2 Page 3 Page 4 Page 5 Page 6 Page 7 Page 8 Page 9 Page 10 Page 11 Page 12 Page 13 Page 14 Page 15 Page 16 Page 17 Page 18 Page 19 Page 20 Page 21 Page 22 Page 23 Page 24 Page 25 Page 26 Page 27 Page 28 Page 29 Page 30 Page 31 Page 32 Page 33 Page 34 Page 35 Page 36 Page 37 Page 38 Page 39 Page 40 Page 41 Page 42 Page 43 Page 44 Page 45 Page 46 Page 47 Page 48 Page 49 Page 50 Page 51 Page 52 Page 53 Page 54 Page 55 Page 56 Page 57 Page 58 Page 59

Made with FlippingBook flipbook maker