{"id":3163,"date":"2023-08-10T20:22:21","date_gmt":"2023-08-10T20:22:21","guid":{"rendered":"https:\/\/ffbenefits.ffga.com\/stpetershealth-2\/medical-city-muni\/"},"modified":"2024-11-15T04:08:00","modified_gmt":"2024-11-15T04:08:00","slug":"medical","status":"publish","type":"page","link":"https:\/\/ffbenefits.ffga.com\/stpetershealth-2\/medical\/","title":{"rendered":"Medical"},"content":{"rendered":"\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-38qqqj-05e26a96febc398abca15b492ebe33e8\">\n.avia-section.av-38qqqj-05e26a96febc398abca15b492ebe33e8{\nbackground-color:#76b153;\nbackground-image:unset;\n}\n<\/style>\n<div id='av_section_1'  class='avia-section av-38qqqj-05e26a96febc398abca15b492ebe33e8 main_color avia-section-default avia-no-border-styling  avia-builder-el-0  el_before_av_three_fifth  avia-builder-el-first  avia-bg-style-scroll container_wrap sidebar_right'  ><div class='container av-section-cont-open' ><main  role=\"main\" itemprop=\"mainContentOfPage\"  class='template-page content  av-content-small alpha units'><div class='post-entry post-entry-type-page post-entry-3163'><div class='entry-content-wrapper clearfix'>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-lnxwolxn-8f2a0f2862dded49b3a8fb9989686b98\">\n#top .av-special-heading.av-lnxwolxn-8f2a0f2862dded49b3a8fb9989686b98{\npadding-bottom:10px;\ncolor:#ffffff;\n}\nbody .av-special-heading.av-lnxwolxn-8f2a0f2862dded49b3a8fb9989686b98 .av-special-heading-tag .heading-char{\nfont-size:25px;\n}\n.av-special-heading.av-lnxwolxn-8f2a0f2862dded49b3a8fb9989686b98 .special-heading-inner-border{\nborder-color:#ffffff;\n}\n.av-special-heading.av-lnxwolxn-8f2a0f2862dded49b3a8fb9989686b98 .av-subheading{\nfont-size:15px;\n}\n<\/style>\n<div  class='av-special-heading av-lnxwolxn-8f2a0f2862dded49b3a8fb9989686b98 av-special-heading-h1 custom-color-heading  avia-builder-el-1  avia-builder-el-no-sibling  av-linked-heading'><h1 class='av-special-heading-tag'  itemprop=\"headline\"  >Medical Insurance<\/h1><div class=\"special-heading-border\"><div class=\"special-heading-inner-border\"><\/div><\/div><\/div>\n<\/div><\/div><\/main><!-- close content main element --><\/div><\/div><div id='after_section_1'  class='main_color av_default_container_wrap container_wrap sidebar_right'  ><div class='container av-section-cont-open' ><div class='template-page content  av-content-small alpha units'><div class='post-entry post-entry-type-page post-entry-3163'><div class='entry-content-wrapper clearfix'>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-e8ote-e899b39894645e30ecb0a21538019451\">\n.flex_column.av-e8ote-e899b39894645e30ecb0a21538019451{\n-webkit-border-radius:0px 0px 0px 0px;\n-moz-border-radius:0px 0px 0px 0px;\nborder-radius:0px 0px 0px 0px;\npadding:0px 0px 0px 0px;\n}\n<\/style>\n<div class='flex_column av-e8ote-e899b39894645e30ecb0a21538019451 av_three_fifth  avia-builder-el-2  el_after_av_section  el_before_av_two_fifth  avia-builder-el-first  first flex_column_div av-zero-column-padding '     ><section  class='av_textblock_section av-dd8hi-c603fbe3067319bfa8ababe0773d150b'  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock'  itemprop=\"text\" ><p>St. Peter\u2019s Health offers a wide array of benefits to employees and their families, including Medical, Prescription, Dental, Vision, Life\/Disability, and supplemental options like Critical Illness and Accident Insurance. On top of these traditional benefits, we also offer up to a 6% contribution for 403b retirement plan participants; a free family membership to Capital City Health Club; educational scholarships through the Fred C. Olson Learning &amp; Development Institute; and an expanding childcare center dedicated to serving St. Peter\u2019s families.<\/p>\n<p>Every year, we manage rising healthcare costs by making thoughtful changes to our benefits plan designs rather than just passing increases along to our employees. For example, the tiered benefits program we created in 2024 allows us to deeply discount any care received from a St. Peter\u2019s provider or facility because we can control those costs. <strong>When you choose St. Peter\u2019s, you\u2019re getting a discount!<\/strong> Many employees still have the misconception<br \/>\nthat Tier 2 (Allegiance Network Tier) means they\u2019re being penalized with higher costs, but these costs are actually standard network rate. Getting care from St. Peter\u2019s in Tier 1 is actually a discount, because we can choose to do that for our employees.<\/p>\n<p>Because we recognized that St. Peter\u2019s does not provide every kind of specialist, service or treatment, we implemented a \u201cService Level Request\u201d process with this tiered program so employees can request care from a non-St. Peter\u2019s provider or facility be billed at Tier 1 if St. Peter\u2019s does not offer it. This year, [200+] requests have been reviewed and the vast majority processed at Tier 1. With so many of these requests, we\u2019ve decided to decrease the burden of the Service Level Request and instead create an additional \u201cFriendlies\u201d tier for 2025. Like the St. Peter\u2019s Tier, the \u201cFriendlies\u201d Tier will be discounted from standard Allegiance network rates and include non-St. Peter\u2019s providers and facilities that offer essential specialties, services or higher levels of care that St.Peter\u2019s does not provide. For providers or services not included in the St. Peter\u2019s or Friendlies tiers, you\u2019ll still need to submit a form to request coverage at the Tier 2 level.<\/p>\n<table style=\"height: 359px\" width=\"472\">\n<tbody>\n<tr>\n<td width=\"132\"><strong>2024 Tier Structure<\/strong><\/td>\n<td width=\"168\"><strong>Provider\/Facilities<\/strong><\/td>\n<td width=\"132\"><strong>2025 Tier Structure<\/strong><\/td>\n<td width=\"168\"><strong>Providers\/Facilities<\/strong><\/td>\n<\/tr>\n<tr>\n<td width=\"132\">Tier 1<\/td>\n<td width=\"168\">SPH and Select Friendlies<\/td>\n<td width=\"132\">Tier 1<\/td>\n<td width=\"168\">SPH Only Providers<\/td>\n<\/tr>\n<tr>\n<td width=\"132\">Tier 2<\/td>\n<td width=\"168\">Allegiance Network<\/td>\n<td width=\"132\">Tier 2 (new)<\/td>\n<td width=\"168\">Friendly Providers<\/td>\n<\/tr>\n<tr>\n<td width=\"132\">Out of Network<\/td>\n<td width=\"168\">Out of Network Providers<\/td>\n<td width=\"132\">Tier 3<\/td>\n<td width=\"168\">Allegiance Network<\/td>\n<\/tr>\n<tr>\n<td width=\"132\"><\/td>\n<td width=\"168\"><\/td>\n<td width=\"132\">Out of Network<\/td>\n<td width=\"168\">Out of Network Providers<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><strong>NEW FOR 2025:<\/strong><br \/>\n<strong>Premium Changes:<\/strong> Last year, we faced a 20% increase in premiums to offset the increase in our costs to offer health insurance. Instead, we made thoughtful changes to plan designs, implemented the St. Peter\u2019s discount tier, and shifted most of the premium increases to higher earners. As a result, we ended up reducing premiums for 60% of our plan participants! This year, to keep up with inflation we are introducing another slight increase in premiums based on your income level. On average, total premiums will be 4% higher than last year, with lower increases for those with lower incomes.<\/p>\n<p><strong>Open Enrollment:<\/strong> Open enrollment runs from November 1 to November 27. More details about enrollment support and sessions will follow. This year\u2019s enrollment is passive, meaning if you don\u2019t make changes, you\u2019ll keep your current benefits\u2014except for Health Savings Account contributions, which you\u2019ll need to update if you want to keep contributing pre-tax dollars.<\/p>\n<p><strong>Physical Therapy Updates:<\/strong> Based off your feedback, we implemented a flat copay of $75 on the PPO plan instead of the requirement to hit the deductible first.<\/p>\n<p><strong>Enhanced Wellness Incentive:<\/strong> We increased the wellness incentive from 10% to 20% and everyone will receive this discount for 2025. Because of this shift, we are providing everyone with the wellness discount for the 2025 Plan year. We are also inviting qualified individuals to participate in the Lifestyle Medicine Program. For these individuals, participation will be required to maintain the wellness discount for the 2026 Plan Year.<\/p>\n<p><strong>Voluntary Benefit Changes:<\/strong> We\u2019re partnering with new vendors which for you means lower costs than what was offered in 2024 along with even better service!<\/p>\n<p><strong>Rightway Service Updates:<\/strong> We will be removing the Rightway concierge service for 2025. Thanks to your feedback, what was intended to be an added level of customer service ended up causing more confusion than it was worth.<\/p>\n<p><strong>Network Information:<\/strong> St. Peter\u2019s Health plans do not cover any Benefis providers, except in emergencies. Care at St. Peter\u2019s will always be less expensive for you than outside providers. Any labs or x-rays done outside St. Peter\u2019s will be billed at Tier 3 (standard Allegiance network rate). To check your provider\u2019s tier, visit the Allegiance website.<\/p>\n<p><strong>As we continually make changes to ensure we\u2019re offering competitive benefits, we routinely review what other employers in our region and health <\/strong><strong>systems our size around the country are offering. We\u2019re pleased to report that St. Peter\u2019s<br \/>\n<\/strong>&#8211; 90% of all health systems have a \u201cnarrow network\u201d option, similar to our St. Peter\u2019s discount and Friendlies tiers.<br \/>\n&#8211; Our Tier 1 (St. Peter\u2019s) deductible and OOP costs are better than 75% of all the health plans we surveyed. And, access to the range of<br \/>\nproviders in our Tier 1 benefits is equal to or larger than 90% of the narrow networks surveyed.<br \/>\n&#8211; Our Tier 1 (St. Peter\u2019s) HDHP deductible is the lowest of all the plans surveyed.<br \/>\n&#8211; Only St. Peter\u2019s has tiered premiums based on salary\/income where lower income members pay far less than higher income members.<br \/>\n&#8211; Our copay for Emergency Room care is the lowest in all the plans we surveyed.<br \/>\n&#8211; Only St. Peter\u2019s offers free generic prescriptions.<br \/>\n&#8211; Only St. Peter\u2019s offers a $500 maximum OOP cost for delivering a baby \u2013 new for 2025 when you deliver at St. Peter\u2019s!<\/p>\n<\/div><\/section><\/div>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-3ycpu-d59c1670fe39606bd68326dd98528212\">\n.flex_column.av-3ycpu-d59c1670fe39606bd68326dd98528212{\n-webkit-border-radius:0px 0px 0px 0px;\n-moz-border-radius:0px 0px 0px 0px;\nborder-radius:0px 0px 0px 0px;\npadding:0px 0px 0px 0px;\n}\n<\/style>\n<div class='flex_column av-3ycpu-d59c1670fe39606bd68326dd98528212 av_two_fifth  avia-builder-el-4  el_after_av_three_fifth  el_before_av_heading  flex_column_div av-zero-column-padding '     ><p>\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-ll5m1v2x-4c625b5f98afc0dcffed1e5a3389074c\">\n.iconbox.av-ll5m1v2x-4c625b5f98afc0dcffed1e5a3389074c .iconbox_icon{\nbackground-color:#33a8d5;\n}\n<\/style>\n<article  class='iconbox iconbox_top av-ll5m1v2x-4c625b5f98afc0dcffed1e5a3389074c  avia-builder-el-5  el_before_av_iconlist  avia-builder-el-first  main_color'  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class=\"iconbox_content\"><header class=\"entry-content-header\"><div class=\"iconbox_icon heading-color\" aria-hidden='true' data-av_icon='\ue854' data-av_iconfont='entypo-fontello'><\/div><h3 class='iconbox_content_title '  itemprop=\"headline\" >ALLEGIANCE<\/h3><\/header><div class='iconbox_content_container '  itemprop=\"text\" ><p>Medical Plan Support: Allegiance<br \/>\n855-999-4293<\/p>\n<p><a href=\"https:\/\/www.askallegiance.com\/SPH\">Allegiance | St. Peter&#8217;s Health (askallegiance.com)<\/a><\/p>\n<p><a href=\"https:\/\/urldefense.com\/v3\/__https:\/www.askallegiance.com\/ProviderSearch\/Search?group=0010791__;!!A8fipfCF_kbM7aav!D49bnbEeuHiL5TL5xBKXfRiWAIEAOBzOSxn4rJnuVMv-UXEXsL1lwIUlII4FP7DAmmzKsF1P5bGttN7sJQXpMwh5$\">Allegiance &#8211; Provider Search (askallegiance.com)<\/a><\/p>\n<p>Pharmacy Benefit Support: Optum RX<\/p>\n<p>800-356-3477<\/p>\n<p><a href=\"https:\/\/www2.optumrx.com\/\">https:\/\/www2.optumrx.com\/<\/a><\/p>\n<\/div><\/div><footer class=\"entry-footer\"><\/footer><\/article><br \/>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-jv9m4793-f45269f73c00437eb217be7eeea34b08\">\n#top .avia-icon-list-container.av-jv9m4793-f45269f73c00437eb217be7eeea34b08 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href=\"\/wp-content\/uploads\/sites\/2635\/2024\/11\/OptumRx-January-2025-B2C-Cycle-Premium_HPGOO.pdf\">OptumRx January 2025 B2C Cycle Premium_HPGOO<\/a><\/p>\n<p><a href=\"\/wp-content\/uploads\/sites\/2635\/2024\/11\/OptumRx-Jan.12025-B2B-Cycle-Premium-HPGOO-Formulary-Exclusion-List.pdf\">OptumRx Jan.1,2025 B2B Cycle Premium HPGOO Formulary Exclusion List<\/a><\/p>\n<p><a href=\"\/wp-content\/uploads\/sites\/2635\/2024\/11\/OptumRx-January-2025-B2C-Cycle-HDHP-Drug-Lists_Premium_with_Brands_and_Generics.pdf\">OptumRx January 2025 B2C Cycle HDHP Drug Lists_Premium_with_Brands_and_Generics<\/a><\/p>\n<\/div><\/div><footer class=\"entry-footer\"><\/footer><\/article><div class=\"iconlist-timeline\"><\/div><\/li>\n<\/ul><\/div><\/p><\/div>\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-74er1-73ee971b6bbe3a7e650e5e95d1715679\">\n#top .av-special-heading.av-74er1-73ee971b6bbe3a7e650e5e95d1715679{\npadding-bottom:10px;\n}\nbody 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class=\"avia_playpause_icon\"><\/div><\/div><\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":12,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-3163","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/ffbenefits.ffga.com\/stpetershealth-2\/wp-json\/wp\/v2\/pages\/3163","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ffbenefits.ffga.com\/stpetershealth-2\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/ffbenefits.ffga.com\/stpetershealth-2\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/ffbenefits.ffga.com\/stpetershealth-2\/wp-json\/wp\/v2\/users\/12"}],"replies":[{"embeddable":true,"href":"https:\/\/ffbenefits.ffga.com\/stpetershealth-2\/wp-json\/wp\/v2\/comments?post=3163"}],"version-history":[{"count":20,"href":"https:\/\/ffbenefits.ffga.com\/stpetershealth-2\/wp-json\/wp\/v2\/pages\/3163\/revisions"}],"predecessor-version":[{"id":3566,"href":"https:\/\/ffbenefits.ffga.com\/stpetershealth-2\/wp-json\/wp\/v2\/pages\/3163\/revisions\/3566"}],"wp:attachment":[{"href":"https:\/\/ffbenefits.ffga.com\/stpetershealth-2\/wp-json\/wp\/v2\/media?parent=3163"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}