Newspaper Page Text
The Lee County Ledger, Wednesday, October 5, 2011, Page 15A
Choose Carefully During Open Enrollment
Special to the Ledger
With the economy weigh
ing heavily on the wallets
of consumers, and health
care reform still confus
ing to many. Insurance
Commissioner Ralph T.
Hudgens urges consumers
who are part of a group
health plan to be prepared
to make the right choices
during health insurance
open enrollment.
“It’s the time of year
when many companies
across the country hold
open enrollment periods
for their group health
insurance plans,” Hudgens
said. “Consider the options
carefully to be sure you
and your family are prop
erly covered.”
Open enrollment refers
to the period of time dur
ing which all members of
your group health insur
ance plan have the oppor
tunity to enroll in certain
benefit programs. During
this period, insurance car
riers are required to accept
all applicants of the group
without underwriting or
evidence of insurability.
Open enrollment is gener
ally only held once a year,
so if you miss it, you likely
will not be able to enroll in
your employer-sponsored
health insurance program
until next year. Certain
exceptions apply for new
employees or employees
with life-changing events.
Make sure to check with
your human resources
department to see when
your company’s open
enrollment period begins
and ends, and when your
policy goes into effect.
There are many differ
ent types of major medical
plans typically offered by
employers. For help under
standing the fundamen
tal differences between
preferred provider orga
nizations (PPO), health
maintenance organizations
(HMO), point of service
plans (POS) or indemnity
plans, visit our website
at http://www.oci.ga.gov/
ConsumerService/ FAQ_
Health.aspx.
Before making a choice:
Check to see if your cur
rent physicians and area
hospitals are in the plan’s
network. Using network
providers generally will
save money on your health
care.
Check to see if spouses
or dependents are covered.
Some plans will cover
spouses and other depen
dents, while other plans
will not.
Read all of the plan ma
terials thoroughly. Doing
so will tell you what your
rights and responsibilities
are under each plan.
Review any pre-existing
condition exclusions
and prior authorization
requirements in the plan
materials.
If you take prescription
medications, check them
against the list of approved
drugs in each plan booklet.
If any part of a plan is
unclear to you, ask for help
from your human re
sources department or the
insurance carrier.
If you are not satisfied
with the answers to your
questions, contact Hud
gens’ Consumer Services
Division for help and ad
vice at 1-800-656-2298.
In this uncertain market,
it’s important to carefully
evaluate your healthcare
costs when making your
annual enrollment deci
sions. While one option
might have high monthly
premiums and a low
deductible, and another
might have a low premium
but more out-of-pocket
1
Submitted Photos
Second grade students in Mrs. Scott’s and Mrs. Paul’s classes learned
about seasons during a lesson taught by Mr. Johnny Golden. Students
used poke berries to talk about the life cycle of a plant in the four
seasons. Then the students were able to use the pigment from the
berries to write words using a feather.
Friendship Baptist Church
Prepares for Activities
Special to the Ledger at 963 highway 32 west of Palmyra Rd. and Hwy
It’s the time of year Leesburg on the corner 32.
for fall festivals and
Friendship Baptist
Church wants you to save
Saturday, October 22,
2011 and attend our fall
harvest festival begin
ning at 10:00 am.
There will be activities
through out the day, end
ing at 4:00 pm. On Sun
day, October 23rd there
will be a special concert
at the 11:00 am service
featuring the group
Dayspring. At 12 noon a
covered dish lunch will
be served with the church
furnishing the meat. De
tails for all the activities
and fun will follow in the
Lee County Ledger in
two weeks. Make plans
to join us we’re located
A/mcow i
eNeW
Fall
Flags
And
Mail
Box
Covers
See 1km At.
Llvi & Company
3105 Ledo Rd., Albany 435-0356
expenses, it could be mis
leading which plan is best
for you until you do the
figures.
To pick the best coverage,
first calculate your health
care costs from recent
years and try to estimate
what your costs might be
for the coming year. Don’t
forget to include the cost of
doctor’s visits, daily medi
cations and any procedures
you might be planning.
Next, make a list of the
premiums, out-of-pocket
expenses and benefits
under each plan. Co-pay-
ments, deductibles and
additional charges for well
ness care or specialists (e.g.
chiropractic care, cosmetic
surgery, etc.) are examples
of out-of-pocket expenses
that you are responsible to
pay. Remember, if you use
a medical provider that is
out-of-network, you will
generally pay more out-of-
pocket expenses. Include
these fees in your calcula
tions.
Finally, decide how much
you can afford to pay. Other
things to keep in mind:
Check for any annual
limits and prior authoriza
tion requirements.
Some prescription
medications have higher
co-payments than others
and they might vary from
plan to plan. Mail-order
options might be available
for maintenance drugs at a
lower cost to you.
See if the cost for
dependent coverage has
increased. Some employers
are raising costs now that
coverage is available for
dependents through age 26.
Ask if your employer
offers a wellness program
or incentives for healthy
behaviors such as exer
cising regularly or not
smoking. Many employers
offer incentives to employ
ees committed to living a
healthier life.
• Check to determine
whether there are any
spousal surcharges to cover
a spouse
If your dependents have
health insurance coverage
through their employer,
school or the Veteran’s
Administration, compare
their costs and benefits to
the family plans you are
considering to ensure that
you choose the best plan
for every member of your
family. Make the same
type of comparisons for
any dental or vision care
plans that you are offered.
Once enrolled in a health
plan, you will not be able
to make changes until
the next open enrollment
period, unless there is a
life changing event such
as divorce, a job change,
marriage or the birth or
adoption of a baby.
If you do not receive
insurance cards and/or
enrollment information,
contact your HR adminis
trator, or call the insurance
company.
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