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2018 SUMMER ENROLLMENT BROCHUREWWW.HEALTHSELECTOFTEXAS.COM

2 2018 Summer Enrollment Brochure

TABLE OF CONTENTS

4 Important Information 5 Coverage Options – HealthSelect of Texas 6 Coverage Options – Consumer Directed HealthSelect 7 Health Savings Account 8 Health Plans Comparison Chart 10 Selecting a Primary Care Physician 11 Options for Care 12 Mental Health and Wellbeing 13 Virtual Visits 14 Weight Management Programs 15 Wellness Resources 16 Stay Connected 17 Resources for You


Welcome HealthSelect ParticipantsYour health is important. Health care is more than just knowing where to go when you get sick. It’s also about knowing how to stay well. In this brochure, you will find information about your medical benefits, health and wellness programs, resources available to you and incentive programs. We are here to help you every step of the way.

HealthSelectSM of Texas and Consumer Directed HealthSelectSM are managed by the Employees Retirement System of Texas (ERS). ERS sets plan benefits and pays claims. Blue Cross and Blue Shield of Texas (BCBSTX) manages the provider network, processes claims and provides customer service.

The 2019 health plan year begins on September 1, 2018 and runs through

August 31, 2019.


• If you have questions about your medical benefits, where to get care or your claims, call a BCBSTX Personal Health Assistant toll-free at (800) 252-8039, Monday–Friday 7 a.m. - 7 p.m. central time (CT) and Saturday 7 a.m. - 3 p.m. CT.

• The HealthSelect network includes more than 50,000 doctors and other providers. To receive the highest level of benefits and help you keep your health care costs down, be sure your providers are in your plan’s network.

• To find a network provider (doctor, hospital, lab, medical professional, etc.), visit www.healthselectoftexas.com and click “Find a Doctor/Hospital” or call a BCBSTX Personal Health Assistant toll-free at (800) 252-8039, Monday–Friday 7 a.m. - 7 p.m. CT and Saturday 7 a.m. - 3 p.m. CT.

• If you are enrolled in HealthSelect of Texas, you must obtain referrals from your primary care physician (PCP) before seeing specialists for care.

• BCBSTX must approve certain covered health services before you receive them. This is called a prior authorization. Find more details about referrals and prior authorizations at www.healthselectoftexas.com. Go to the “Medical Benefits” tab, then “Referrals and Prior Authorizations.”

• If you are enrolled in HealthSelect of Texas, HealthSelect Out-of-State, or HealthSelect Secondary, virtual visits are available at no cost to you. Consumer Directed HealthSelect participants will be required to meet their annual deductible before visits are covered, subject to coinsurance after the deductible is met.

• Weight management programs Naturally Slim® and Real Appeal® are available to eligible HealthSelect participants at no cost.1

• The Well onTarget® web portal provides a wealth of resources to support your health and wellness through a range of interactive, educational features.

• For more information about your prescription drug coverage, visit www.healthselectoftexas.com and click “Prescription Drug Benefits.”

Look for these icons throughout this brochure

1 See eligibility requirements on page 14.

Activities that will earn you Blue Points®

Tips on maximizing your benefits

Tips for cost savings

IMPORTANT INFORMATION


• BCBSTX must approve certain covered health services before you receive them. This is called a prior authorization. Find more details about referrals and prior authorizations at www.healthselectoftexas.com. Go to the “Medical Benefits” tab, then “Referrals and Prior Authorizations.”

• If you are enrolled in HealthSelect of Texas, HealthSelect Out-of-State, or HealthSelect Secondary, virtual visits are available at no cost to you. Consumer Directed HealthSelect participants will be required to meet their annual deductible before visits are covered, subject to coinsurance after the deductible is met.

• Weight management programs Naturally Slim® and Real Appeal® are available to eligible HealthSelect participants at no cost.1

• The Well onTarget® web portal provides a wealth of resources to support your health and wellness through a range of interactive, educational features.

• For more information about your prescription drug coverage, visit www.healthselectoftexas.com and click “Prescription Drug Benefits.”

Look for these icons throughout this brochure

1 See eligibility requirements on page 14.

Activities that will earn you Blue Points®

Tips on maximizing your benefits

Tips for cost savings

COVERAGE OPTIONS – HEALTHSELECT OF TEXAS

HealthSelect℠of Texas Health coverage options to meet your needs

HealthSelect of Texas is a point-of-service health plan available to active employees, non-Medicare-eligible retirees and their eligible dependents who live or work in the State of Texas.

If you are enrolled in HealthSelect of Texas, you need to choose a (PCP) to receive the highest level of benefits and help you keep your health care costs down. Your PCP coordinates your care and manages any referrals you may need to see specialists. You need to designate a PCP for you or your eligible dependents within 60 days of the first day you have HealthSelect coverage, or you will have to pay out-of-network charges, even if you see a provider who is in the HealthSelect network. For example, instead of a $25 copay for an in-network PCP office visit, you will have to meet an out-of-network deductible before HealthSelect pays any of the cost. You also will be responsible for 40% coinsurance after you meet your out-of-network deductible.

HealthSelect Out-of-StateLiving or working out of state?

HealthSelect Out-of-State is available only to active employees, non-Medicare-eligible retirees and their eligible dependents living or working outside the State of Texas.

• Benefits are the same as HealthSelect of Texas.

• You don’t have to meet a deductible for in-network services. You will have a copay for certain services like PCP and specialist office visits.

• You are not required to select a PCP; however, having a PCP is important to managing your overall health.

• You do not need a referral to see a specialist.

• When seeking care, be sure to use a network provider. To find an out-of-state provider, visit www.healthselectoftexas.com, click on “Find a Doctor/Hospital,” look for HealthSelect Out-of-State and click “Search.”

Find an in-network PCP:

Go to www.healthselectoftexas.com and click “Log In” in the top right corner. If you already have a Blue Access for MembersSM account, log in using your username and password. Otherwise, register for Blue Access for Members following the instructions on the screen. Once you’re logged in, go to the “Doctors and Hospitals” tab and click “Select Primary Care Physician.”

OR

Call a BCBSTX Personal Health Assistant toll-free at (800) 252-8039, Monday–Friday, 7 a.m. - 7 p.m. CT and Saturday, 7 a.m. - 3 p.m. CT.

Save money by only seeing providers in your plan’s network.

Plan Decision Tool: Need help deciding which plan is right for you?

Use the Plan Decision Tool. Go to www.healthselectoftexas.com and click “HealthSelect Plans”, then “Plan Decision Tool.”


Consumer Directed HealthSelect℠Consumer Directed HealthSelect is a high-deductible health plan paired with a health savings account (HSA)1 available to active employees, non-Medicare-eligible retirees and their eligible dependents. With a high deductible health plan, you pay the full cost for your health care and prescriptions (except preventive care) until you meet the deductible.

• The monthly premium for dependent coverage is lower than HealthSelect of Texas.

• You have access to the same provider network as HealthSelect of Texas participants.

• You are not required to select a PCP; however, having a PCP is important to managing your overall health.

• You do not need a referral to see a specialist.

• You can use your HSA to pay for qualified medical expenses, including your deductible and coinsurance.

• If you are eligible for Medicare, you are not eligible for this plan.

1 Participants enrolled in any part of Medicare (Part A, B, C and/or D), receive benefits under TRICARE or TRICARE for Life, or have a health care flexible spending account (like a TexFlex health care account) in the same plan year are not eligible for an HSA.

How Consumer Directed HealthSelect works • You pay for health care services and prescription drugs

out-of-pocket (except preventive services) until you meet your annual deductible.

• There is an in-network and out-of-network annual deductible.

» The in-network deductible is $2,100 for an individual or $4,200 for a family for covered health services and prescriptions.

» The out-of-network deductible is $4,200 for an individual or $8,400 for a family.2

• After you’ve met your deductible, the plan plays 80% (you pay 20%) of covered, in-network services and prescriptions. If you go out-of-network, the plan only pays 60% (you pay 40% of the allowed amount) for covered services and prescriptions.

• Preventive services, like annual check-ups or vaccinations, are covered at 100% when you see a network provider, even if you have not met your deductible.

• You can use money in your HSA to pay for qualified medical expenses, including covered medical and prescription drug expenses.3

2 Preventive care is covered at 100% when appropriately coded as preventive care per the Af fordable Care Act guidelines.

3 HSA contributions and limits may change from year to year, or based on eligibility requirements and the participant ’s age. Maximums are set by the IRS and include both pre-tax and post-tax contributions to an HSA. HSAs have tax and legal implications. BCBSTX does not provide legal or tax advice. Tax-related statements, if any, may have been writ ten in connection with the promotion or marketing of the transaction(s) or matter(s) addressed by these materials. You should seek advice based on your particular circumstances from an independent advisor regarding the tax consequences of specific health insurance plan or products.

Preventive care is covered at no cost to you when you see an in-network provider.

COVERAGE OPTIONS – CONSUMER DIRECTED HEALTHSELECT


Be ready for out-of-pocket costs with a Health Savings Account (HSA)

1 IRS Publication 502, Medical and Dental Expenses ht tps://www.irs.gov/publications/p502

An HSA is like a regular savings account, letting you save money for future use. Unlike a regular savings account, you contribute pre-tax money to an HSA and can use it only to pay for qualified medical expenses.1

• The State of Texas will add pre-tax dollars to your HSA account every month. In Fiscal Year 2019, the state will contribute $45 per month ($540 per year) for individual coverage and $90 per month ($1,080 per year) for family coverage to your HSA.

• Your unused HSA balance will carry over from year to year, so you won’t lose money in your account at the end of the year. Any dollars in your account can be used on your health care at any time now or in the future.

• You can make tax-free contributions to your HSA through payroll deductions and independently.

• HSAs are portable. If you change to a different health plan or change employers, the money in your HSA stays with you.

• Your HSA is administered by a separate bank – not BCBSTX. Go to the Consumer Directed HealthSelect page on www.healthselectoftexas.com for more information about your HSA bank account.

HEALTH SAVINGS ACCOUNT


HEALTH PLANS COMPARISON CHARTEffective September 1, 2018

5/26/2017Chart_2017_Comparison

Employee and Non-Medicare-Eligible RetireeHEALTH PLANS COMPARISON CHART

Effective September 1, 2017

Benefi ts

HealthSelectSM of Texas Consumer Directed HealthSelectSM

In-Area HealthSelectOut-of-State Network Non-Network

Network Non-Network Network Non-Network

Annual deductible None $500 per person1

$1,500 per family1 None $500 per person1

$1,500 per family1

$2,100 per person1

$4,200 per family1

$4,200 per person1 $8,400 per family1

Out-of-pocket coinsurance maximum2

$2,000 per personper calendar year1



$7,000 per personper calendar year1 None None

Total out-of-pocket maximum(including deductibles, coinsurance and copays)4,5

**$6,650 per person1 $13,300 per family1 None **$6,650 per person1

$13,300 per family1 None **$6,650 per person1 $13,300 per family1 None

Primary care physician required Yes No No No No No

Primary care physicians’ offi ce visit $25 copay 40%* $25 copay 40%* 20%** 40%*

Mental health care

a. Outpatient physician or mental health provider offi ce visits

$25 copay 40%* 20% 40%* 20%** 40%*

b. Hospital Mental health inpatient stay9

$150/day copay plus 20% ($750 copay max, up to 5 days per hospital stay. $2,250 copay max per calendar year per person)

$150/day copay plus 40%* ($750 copay max, up to 5 days per hospital stay. $2,250 copay max per calendar year per person)

$150/day copay plus 20% ($750 copay max, up to 5 days per hospital stay. $2,250 copay max per calendar year per person)

$150/day copay plus 40%* ($750 copay max, up to 5 days per hospital stay. $2,250 copay max per calendar year per person)

20%** 40%*

c. Outpatient facility care (partial hospitalization/ day treatment and extensive outpatient treatment)7

20% 40%* 20% 40%* 20%** 40%*

Physicals# No charge 40%* No charge 40%* No charge 40%*

Specialty physicians’ offi ce visits $40 40%* $40 40%* 20%** 40%*

Routine eye exam, one per year per participant

$40 40%* $40 40%* 20%** 40%*

Routine preventive care# No charge 40%* No charge 40%* No charge 40%*

Diagnostic x-rays, lab tests, and mammography

20% 40%* 20% 40%* 20%** 40%*

Offi ce surgery and diagnostic procedures 20% 40%* 20% 40%* 20%** 40%*

High-tech radiology (CT scan, MRI, and nuclear medicine)7,8,9

$100 copay plus 20%

$100 copay plus 40%*

$100 copay plus 20%

$100 copay plus 40%* 20%** 40%*

Urgent care clinic $50 copay plus 20% 40%* $50 copay

plus 20% 40%* 20%** 40%*


HEALTH PLANS COMPARISON CHARTEffective September 1, 2018

Benefi ts

HealthSelectSM of Texas Consumer Directed HealthSelectSM

In-Area HealthSelectOut-of-State Network Non-Network

Network Non-Network Network Non-Network

Maternity Care doctor charges only#; inpatient hospital copays will apply

No charge for routine prenatal appointments$25 or $40 for fi rst post-natal visit6

40%*

No charge for routine prenatal appointments$25 or $40 for fi rst post-natal visit6

40%*

No charge for routine prenatal appointments 20%** for fi rst post-natal visit

40%*

Chiropractic Care

a. Coinsurance 20%; $40 copay plus 20% with offi ce visit 40%* 20%; $40 copay plus

20% with offi ce visit 40%* 20%** 40%*

b. Maximum benefi t per visit $75 $75 $75 $75 $75 $75

c. Maximum visits Each participant Per calendar year

30 30 30 30 30 30

Inpatient hospital(semi-private room and day’s board, and intensive care unit)9

$150/day copay plus 20% ($750 copay max-up to 5 days per hospital stay, $2,250 copay max per calendar year per person)

$150/day copay plus 40%* ($750 copay max-up to 5 days per hospital stay, $2,250 copay maxper calendar year per person)

$150/day copay plus 20% ($750 copay max-up to 5 days per hospital stay, $2,250 copay max per calendar year per person)

$150/day copay plus 40%* ($750 copay max-up to 5 days per hospital stay, $2,250 copay max per calendar year per person)

20%** 40%*

Emergency care$150 plus 20% (if admitted copay will apply to hospital copay)

$150 plus 20% (if admitted copay will apply to hospital copay)12

$150 plus 20% (if admitted copay will apply to hospital copay)

$150 plus 20% (if admitted copay will apply to hospital copay)12

20%** 20%**12

Outpatient surgery other than in physician’s offi ce9

$100 copay plus 20%

$100 copay plus 40%*

$100 copay plus 20%

$100 copay plus 40%* 20%** 40%*

Bariatric surgery9,10,11

a. Deductible $5,000 b. Coinsurance 20% c. Lifetime max $13,000

Not covereda. Deductible $5,000 b. Coinsurance 20% c. Lifetime max $13,000

Not covered Not covered Not covered

Hearing aids Plan pays up to $1,000 per ear every three years (no deductible).

Plan pays up to $1,000 per ear every three years (after deductible is met).

Durable medical equipment9 20% 40%* 20% 40%* 20%** 40%*

Ambulance services (non-emergency)9 20% 20% 20% 20% 20%** 20%**

*Note: 40% coinsurance after you meet the annual out-of-network deductible **Note: 20% coinsurance after you meet the annual in-network deductible1 Applies to calendar year, January 1 - December 31. 2 Does not include copays. 3 Applies to plan year, September 1 - August 31. 4 Out-of-pocket maximums are not mutually exclusive from other out-of-pocket limits. This means that a participant’s total network out-of-pocket maximum could contain a combination of coinsurance and/or copayments. 5 Includes medical and prescription drug copays, coinsurance and deductibles. Excludes non-network and bariatric services. 6 Copay depends on whether treatment is given by PCP or specialist. 7 Outpatient testing only. Does not apply to inpatient services. 8 No copay if high-tech radiology is performed during ER visit or inpatient admission.

9 Preauthorization required. 10 Active employees only; see health plan for additional requirements/limitations. 11 The deductible and coinsurance paid for bariatric surgery does not apply to the total out-of-pocket maximum. 12 Benefi ts shown do not apply to out-of-network freestanding ERs. For information about this coverage, see the Master Benefi t Plan Document. # Under the Affordable Care Act, certain preventive and women’s health services are paid at 100% (at no cost to the participant) dependent upon physician billing and diagnosis. In some cases, the participant will still be responsible for payment on some services.


SELECTING A PRIMARY CARE PHYSICIAN

Having an in-network primary care physician (PCP) can help you control costs, save time, and improve your overall health. HealthSelect of Texas participants must choose an in-network PCP to get the highest level of benefits and save the most money. HealthSelect Out-of-State and Consumer Directed HealthSelect participants may also benefit from having an in-network PCP, even though it is not required.

Why should I select a PCP? • Seeing a PCP is one of your most convenient and lowest-

cost options for care. If you’re sick, it’s easier to schedule an appointment as an established patient than to find a doctor accepting new patients. Plus, visits to your in-network PCP are less expensive than visits to urgent care centers or specialists.

• When you have a PCP, you have access to a doctor that knows you and your medical history. Your PCP can help you take care of your preventive health needs, as well as many non-emergency health issues, including colds, flus, rashes and allergies.

PCPs for HealthSelect of Texas Participants

To receive in-network benefits, HealthSelect of Texas participants must obtain referrals from their PCP before seeing specialists for care. If you do not have a referral on file before you see a specialist, you will pay more, because your visit will be considered out-of-network.

Remember, you can change your PCP at any time. If you have not selected a PCP or if you want to change your PCP, follow the instructions below.

To select or to change your PCP:

You do not need a referral for: • Chiropractic visits

• Covered vision care, including routine and diagnostic eye exams

• Mental health counseling

• OB/GYN visits

• Occupational therapy, physical therapy or speech therapy1

• Virtual visits, urgent care centers or convenience care clinics

1 Treatment plans beyond the initial visit for occupational therapy, physical therapy and speech therapy require prior authorization.

You can either call a BCBSTX Personal Health Assistant toll-free at (800) 252-8039 or go online and follow these instructions:1. Go to www.healthselectoftexas.com

2. Click on “Log In” in the upper right-hand corner. If you already have a Blue Access for Members℠ account, log in. If you do not have an account yet, click “Register Now” and use your medical ID card to create an account.

3. Once you’re logged in, go to the “Doctors and Hospitals” tab.

4. Click “Select Primary Care Physician” and enter information about your location and what you’re looking for in a PCP.


PCPs for HealthSelect of Texas Participants

To receive in-network benefits, HealthSelect of Texas participants must obtain referrals from their PCP before seeing specialists for care. If you do not have a referral on file before you see a specialist, you will pay more, because your visit will be considered out-of-network.

Remember, you can change your PCP at any time. If you have not selected a PCP or if you want to change your PCP, follow the instructions below.

To select or to change your PCP:

OPTIONS FOR CARE

Sometimes it’s easy to know when you should go to an emergency room (ER), such as when you have severe chest pain or unstoppable bleeding. At other times, it’s less clear.

Where do you go when you have an urgent situation that’s not life threatening? You have choices and options for care. And it’s important to know when to use each option because some can be very expensive for you and you’ll be paying bills long after you’ve recovered.

Doctor’s Office — $

Generally, it’s the best place to go for non-emergency care. Your doctor knows you and your medical history and can treat you, or refer you to a specialist if needed.

Virtual Visits — $0

If you cannot see your regular doctor, virtual visits can be a convenient option for non-emergency medical care. And they are available at no cost to you if you are enrolled in HealthSelect of Texas, HealthSelect Out-of-State, and HealthSelect Secondary. Consumer Directed HealthSelect participants must meet their annual deductible and then coinsurance will apply. Learn more on page 13.

Retail Health Clinic — $$

You will see these in pharmacies and stores. You do not need an appointment and they can provide treatment for minor medical issues usually at a lower cost than urgent care.

Urgent Care — $$$

If you need x-rays or stitches and you can’t get in to your doctor, urgent care can provide immediate non-emergency treatment.

Hospital Emergency Room — $$$$

If your situation is life threatening, go to the nearest hospital or call 911. True emergencies are covered at the in-network level of benefits.

H

If you are enrolled in HealthSelect of Texas or HealthSelect Out-of-State, when you seek care at an out-of-network freestanding ER that is not affiliated with a hospital, you will pay more:1 • $300 copay

• No deductible if true emergency but out-of-network deductible applies if not a true emergency

• The plan pays 80% of the out-of-network allowable amount if true emergency and 60% of the out-of-network allowable amount if not a true emergency.

• Even if your visit is a true emergency, you may be responsible for any difference between the amount billed by the facility and the out-of-network allowable amount which could be significant.

Freestanding Emergency Room: The highest cost care — $$$$$$

You may see a standalone emergency room in the middle of a retail shopping mall or in your neighborhood. Most freestanding emergency rooms (ERs) facilities and providers are not affiliated with a hospital and are out-of-network. This means you will pay a significant amount out-of-pocket.

Freestanding ERs can be confused with urgent care clinics or hospital-based ERs. While they might look like inviting and convenient facilities for care, your costs will be high.

In many cases, if you are in a true emergency, a freestanding ER will have to transfer you to a real hospital. This means you’ll receive bills from two emergency facilities including additional transportation and ambulance fees.

Get answers day or night with 24/7 Nurseline

If you’re not sure where to go for care, call the 24/7 Nurseline and speak with a registered nurse toll-free at (800) 581-0368. Call any time, any day of the year.2

1 Consumer Directed HealthSelect and HealthSelect Secondary participants should refer to the Master Benefit Plan Document.

2 For medical emergencies, call 911. 24/7 Nurseline is not a substitute for a doctor’s care. Talk to your doctor about any health questions or concerns.


MENTAL HEALTH AND WELLBEING

HealthSelect of Texas and Consumer Directed HealthSelect plans offer mental health benefits1 to support your well-being. HealthSelect plans include coverage for both inpatient and outpatient treatment.

Referrals are not required for mental health care for any of the HealthSelect plans. However, prior authorization may be required for some intensive therapy programs and inpatient treatment.

Your mental health benefits might be used for: • Office visits to a licensed counselor

• Inpatient intensive therapy program for addiction

• Outpatient intensive therapy for a severe mental health disorder

Mental health services can be used to treat a variety of concerns, including the following:

1 BCBSTX contracts with Magellan Healthcare to manage mental health benefits. Magellan processes mental health claims, manages the mental health provider network and operates a customer service center for HealthSelectSM℠of Texas and Consumer Directed HealthSelectSM. BCBSTX manages mental health benefits and claims processing for HealthSelectSM℠Out-of-State and HealthSelectSM Secondary participants.

• Alcohol and drug use

• Anger management

• Anxiety

• Bipolar disorder

• Depression

• Domestic violence

• Financial stress

• Grief

• Post-traumatic stress disorder (PTSD)

• Schizophrenia and schizoaffective disorder

• Suicidal thinking

• Stress

How to get careThere are many types of mental health providers that offer a range of mental health care, but your PCP is a great place to start talking about mental health. They can tell you about mental health support nearby, recommend a mental health provider or even prescribe medication.

Though input from your PCP can be helpful, if you know what type of care you are seeking, you can find an in-network provider without checking with your PCP first. To make the most of your benefits and help you save money, be sure to choose an in-network provider.

To talk with a counselorYou can get help with a mental health or substance use issue, any time. Call the 24/7 HealthSelect Mental Health Line at (800) 442-4093 to talk with a counselor about mental health or substance use issues.

Choose a mental health provider:

Visit www.healthselectoftexas.com and clicking “Find a Doctor/Hospital” to access the Provider Finder.

OR

Call a BCBSTX Personal Health Assistant toll-free at (800) 252-8039, Monday–Friday, 7 a.m. - 7 p.m. CT and Saturday, 7 a.m. - 3 p.m. CT.

If you’re not sure where to start, your in-network PCP can talk with you about a course of action and may recommend a provider or prescribe medication.


VIRTUAL VISITS

HealthSelect offers you convenient options for care. With virtual visits, you can consult a board-certified doctor anytime online or by phone. Doctors can diagnose simple, non-emergency medical health conditions and prescriptions can be sent directly to your pharmacy.1

1 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. Vir tual visits are subject to the terms and conditions of your benefit plan, including benefits, limitations, and exclusions. 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 plat form. 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 writ ten. 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 and Doctor On Demand are independent companies that operate and administer the vir tual visit program and are solely responsible for their operations and that of their contracted providers. MDLIVE® and the MDLIVE logo areregistered trademarks of MDLIVE, Inc. and may not be used without writ ten permission.

Get treatment for:

• Allergies

• Bladder/Urinary Tract Infection

• Bronchitis

• Cold and flu

• Headache

• Nausea

• Pink Eye

• Sore throat

• Rash

Create your virtual visits account now and be ready when you need it.

Doctor On Demand®

• Doctorondemand.com

• (800) 997-6196

MDLIVE®

• Mdlive.com/healthselect

• (800) 770-4622 TTY: (800) 770-5531

Virtual visits are available at no cost to you if you are enrolled in HealthSelect of Texas, HealthSelect Out-of-State, or HealthSelect Secondary. If you are enrolled in Consumer Directed HealthSelect, you will be required to meet the annual deductible before visits are covered, subject to coinsurance after the deductible is met.

Get started using virtual visits:

1. You have the same benefit with two virtual visit providers: Doctor On Demand and MDLIVE. The choice is yours.

2. Go online to Doctor On Demand or MDLIVE OR download their apps from Google Play or the App Store.

3. Have your medical ID card handy to set up your account.

4. When you are ready for a virtual visit, choose a doctor. You can schedule an appointment now, or for a time in the future that’s more convenient for you.

5. Consult by phone or video with a board-certified doctor.


Managing weight is difficult for many people, but a support system can make it easier. Your HealthSelect medical benefits include access to two online weight management programs.1 If you meet certain eligibility requirements, you can apply for enrollment in Naturally Slim® and Real Appeal® at no cost to you.2

You are eligible if you are:

1 Naturally Slim and Real Appeal are available at no cost to eligible employees, covered spouses and dependents, 18 or older, enrolled in HealthSelect of Texas, HealthSelect Out-of-State or Consumer Directed HealthSelect, who have a BMI of 23 or higher (excludes Medicare primary participants).

2 Participants may choose either program, but can only participate in one program at any given time.3 Naturally Slim and Real Appeal are independent companies that provide wellness services for HealthSelect of Texas and Consumer Directed HealthSelect. They are solely responsible for the products and services that they provide.

Your acceptance is not guaranteed.

• an employee or dependent enrolled in HealthSelect of Texas, HealthSelect Out-of-State or Consumer Directed HealthSelect (excludes Medicare primary participants),

• 18 or older, and

• have a BMI of 23 or higher.3

Focuses on changing your eating habits so you can still eat the foods you love while losing weight and improving your health.

Log on when it’s convenient for a series of ten weekly sessions hosted by Naturally Slim nutrition and health specialists.

To enroll, go to www.naturallyslim.com/healthselect

Helps you take small steps that lead to lasting weight loss. Program can be tailored to your goals, preferences and lifestyle.

Participate in weekly online group sessions led by a Transformation Coach.

To enroll, go to www.healthselect.realappeal.com

Learn more about tools and programs available to help you meet your weight management goals by visiting www.healthselectoftexas.com and selecting the “Weight Management” page.

WEIGHT MANAGEMENT PROGRAMS


WELLNESS RESOURCES

Well onTarget®

Well onTarget is an online wellness portal that offers personalized resources and incentives to support you on your wellness journey. Get the support you need to make healthy choices while being rewarded for your hard work!

The Well onTarget experience starts with your personal login.

1. Go to www.healthselectoftexas.com

2. Click on “Log In” in the upper right-hand corner. If you already have a Blue Access for Members account, log in. If you do not have an account yet, click “Register Now” and use your medical ID card to create an account.

3. Once you’re logged in to Blue Access for Members, click “Well onTarget” under the Quick Links on the left.

Well onTarget offers: • Health Assessment

• Food and exercise diary

• Symptom checker

• Wellness coaching

• Self-directed health and wellness courses courses on losing weight, quitting tobacco and managing stress

Health AssessmentThe Health Assessment (HA), sometimes referred to as the Health Risk Assessment, uses adaptable questions to learn more about you. After you take the HA, you will get a personal wellness report. This confidential report offers you tips for living your healthiest life.

Blue Points®

Blue Points can help motivate you to maintain a healthy lifestyle. Earn points for participating in wellness activities. You can redeem points in the online shopping mall. The program gives you points instantly, so you can use them right away.

Fitness ProgramFitness can be easy, fun and affordable. The Fitness Program is a flexible membership program that gives you unlimited access to a nationwide network of more than 9,000 fitness centers. If you want, you can choose one gym close to home and one near work. And you can visit gyms while you’re on vacation or traveling for work.

It’s easy to join the Fitness Program! Just call the toll-free number (888) 762-BLUE (2583) Monday—Friday, 8 a.m. - 9 p.m. in any continental U.S. time zone.1

Other program perks include: • No long-term contract: Membership is month to

month. Monthly fees are $25 per month per member, with a one-time enrollment fee of $25 per member.

• Blue Points: Get 2,500 points for joining the Fitness Program. Earn additional points for weekly visits.

• Web resources: You can go online to locate gyms and track your visits.

• Health and wellness discounts: Save money through a nationwide complementary and alternative medicine network of 40,000 health and well-being providers, such as massage therapists, personal trainers and nutrition counselors.

1 The Fitness Program is provided by Healthways, Inc., an independent contractor that administers the Prime Network of fitness centers. The Prime Network is made up of independently owned and operated fitness centers.

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.

If your employer allows you to receive wellness incentives for completion of a health assessment, take the OnMyWay Health Assessment and provide your Benefits/Wellness Coordinator with a certificate of completion.

Look for this icon to see which healthy activities will earn you Blue Points!


STAY CONNECTED

HealthSelect websiteThis website is dedicated to HealthSelect plan participants and has the most up-to-date information about your health plan benefits, value-added programs, resources and tools. Using the HealthSelect website, you can:

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

• Log in to your Blue Access for MembersSM account to find coverage and benefits information, Explanation of Benefits statements (EOBs), change your PCP, or chat with a BCBSTX Personal Health Assistant

• Read important news and information about your health plan

Blue Access for MembersBlue Access for Members is your secure online participant portal where you can: • View your claims and EOBs

• Find in-network doctors, hospitals and other providers

• Select and change your PCP

• Check the costs of services covered under your plan

• Download a temporary ID card

• Confirm your prior authorizations and referrals on file

1 BCBSTX Personal Health Assistants do not take the place of your doctor. Personal Health Assistants are available by chat Monday – Friday 8 a.m. - 5 p.m. CT.

BCBSTX AppWith the BCBSTX Mobile App, your benefits are at your fingertips, wherever you are.

You can: • Find an in-network doctor, hospital or urgent care

facility near you

• Chat with a BCBSTX Personal Health Assistant1

• View prior authorizations and referrals

• Check the status or history of a claim

• Request a temporary ID card or save a digital copy to your phone

Text BCBSTXAPP to 33633 to get a link to download the app.


RESOURCES FOR YOU

BCBSTX Personal Health AssistantsPersonal Health Assistants are here to help you understand and use your health plan benefits. Call them to:

• Answer questions about benefits

• Assist with prior authorizations and referrals

• Provide information about programs and benefits available to you

• Help you locate an in-network provider

• Explain health care costs and options for care

• Provide you with cost estimates for services

• Schedule or cancel doctor’s appointments

• Help you use self-service tools

• Connect you to other resources

1 For medical emergencies, call 911. 24/7 Nurseline is not a substitute for a doctor’s care. Talk to your doctor about any health questions or concerns.2 Mental health benefits for HealthSelect Out-of-State and HealthSelect Secondary are managed by BCBSTX.

Get answers day or night with 24/7 Nurseline

Speak with a registered nurse toll-free at (800) 581-0368. If you’re not sure where to go for care, or you just have a question, calling the 24/7 Nurseline may be your answer. Call any time, any day of the year.1

24/7 Mental Health Support HotlineYour medical plan offers mental health benefits to support your emotional and psychological well-being. Call (800) 442-4093 to talk with a counselor about mental health or substance use issues. Mental health benefits for HealthSelect of Texas and Consumer Directed HealthSelect participants are managed by Magellan Healthcare, which means you may be transferred to Magellan for additional information about your mental health benefits.2

Care Management CliniciansBCBSTX clinicians are available to help you achieve your health goals. They can provide support, point you to local resources, coordinate with your physicians and answer your questions to help empower you to properly manage your health condition.

When you engage with our clinicians, you have a dedicated resource providing support to you and your family.

Whether you have an upcoming surgery and have questions, recently had a surgery and need follow up support, or if you are managing a condition or are recently diagnosed, a BCBSTX clinician can support you.

If you have questions about conditions such as asthma, cancer, COPD, diabetes or cardiac conditions, contact BCBSTX toll-free at (800) 252-8039 and ask to speak with a clinician.

Call a BCBSTX Personal Health Assistant toll-free (800) 252-8039 Monday–Friday 7 a.m. - 7 p.m. CT and Saturday 7 a.m. - 3 p.m. CT


Health care coverage is important for everyone. We provide free communication aids and services for anyone with a disability or who needs language assistance.

We do not discriminate on the basis of race, color, national origin, sex, gender identity, age or disability.

To receive language or communication assistance free of charge, please call us at 855-710-6984.

Office of Civil Rights Coordinator Phone: 855-664-7270 (voicemail) 300 E. Randolph St. TTY/TDD: 855-661-6965 35th Floor Fax: 855-661-6960 Chicago, Illinois 60601 Email: [email protected]

You may file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, at: U.S. Dept. of Health & Human Services Phone: 800-368-1019 200 Independence Avenue SW TTY/TDD: 800-537-7697 Room 509F, HHH Building 1019 Complaint Portal: https://ocrportal.hhs.gov/ocr/portal/lobby.jsf Washington, DC 20201 Complaint Forms: http://www.hhs.gov/ocr/office/file/index.html

If you believe we have failed to provide a service, or think we have discriminated in another way, contact us to fi le a grievance.

bcbstx.com

NON-DISCRIMINATION POLICY


bcbstx.com

LANGUAGE ASSISTANCE

CONTACT INFORMATIONWe’re Here to HelpCustomer Service: Personal Health Assistants

BCBSTX Personal Health Assistants are trained to help you and your covered family members plan for better health care.

Mental Health

Your medical plan offers mental health benefits to support your emotional and psychological well-being. Call a Personal Health Assistant toll-free at (800) 252-8039 if you have questions about your benefits or need help finding an in-network mental health provider.1

Prescription Drugs

For information regarding prescription drug benefits for active employees and their dependents, call the HealthSelect Prescription Drug Program at (855) 828-9834.

1 Mental health benefits for HealthSelect of Texas and Consumer Directed HealthSelect participants are managed by Magellan Healthcare, which means you may be transferred to Magellan for additional information about your mental health benefits. Mental health benefits for HealthSelect Out-of-State and HealthSelect Secondary participants are managed by BCBSTX.

www.healthselectoftexas.comMagellan Healthcare, Inc., an independent company, manages mental health benefits for the HealthSelectSM of Texas and Consumer Directed HealthSelectSM plans.

BCBSTX contracts with Magellan Healthcare, an independent company, to manage mental healthbenefits. Magellan processes mental health claims, manages the mental health provider network and operates a customer service center for HealthSelectSM of Texas and Consumer Directed HealthSelectSM.

BCBSTX manages mental health benefits and claims processing for HealthSelectSM Out-of-State and HealthSelectSM Secondary participants.

Blue Cross and Blue Shield of Texas is the third-party administrator for the HealthSelectSM of Texas and Consumer Directed HealthSelectSM 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.

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

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Call toll-free (800) 252-8039 Monday–Friday 7 a.m. - 7 p.m. CT and Saturday 7 a.m. - 3 p.m. CT

2018 summer enrollment brochure...services. you will have a copay for certain services like pcp and...

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