Incentive Programs

TWO HEALTH INSURANCE INCENTIVE PROGRAMS:

BILLING ERROR & MOTHER-TO-BE

 Billing Error – You are encouraged to examine hospital and doctor bills for accuracy to ensure you received all the services for which you were charged. If you find an error on your bill, the Plan will pay you 50 percent of the money you saved the plan. There is a minimum incentive payment of $25 and a maximum of $1,000. This incentive applies only to covered charges for inpatient hospital care, outpatient surgery in an ambulatory care facility, services received from clinics and related tests. You are responsible for auditing the charges, requesting corrected billings from providers and submitting all documentation to the Bureau of Personnel for processing. To determine whether you qualify for the billing error incentive, you must send copies of the incorrect bill, the corrected bill, and a brief explanation of the error to the Bureau of Personnel. For every incentive dollar paid out, the health plan has realized a savings of about $3.00. Keep looking for those errors.

Note: With DRG-based billing (see the Summary Plan Description), itemized charges do not affect your hospital bill. Therefore, the Billing and Processing Error Incentive Program does not apply.

Mother-To-Be Incentive – If you or your covered spouse is expecting, you should enroll in the "Our Healthy Baby" prenatal program during the first three months of the pregnancy. To enroll, call 1-888-821-2242. The purpose of the program is to help bring pregnancies to full term and prevent the high costs of premature births. Once the baby is born and added to the Health Plan, you will receive a $100 US Savings Bond -- if you enrolled within the first three months of the pregnancy.

After you enroll, you will be mailed special educational materials to help you or your spouse maintain good prenatal health.

Important Note: Enrollment in the Mother-to-Be Prenatal Program does not automatically add your baby to the Health Plan. To do this, you must notify the Human Resources Office within 90 days of the birth and pay required contributions. Failure to enroll the child within the 90-day enrollment period means your baby is not covered by the Plan. You will not be able to add the child until the next annual enrollment period or until you have another qualifying family status change. In addition, evidence of insurability may be required when you add the baby to your coverage

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