2025 Medical Plans
Names of the 4 new medical plans for 2025
BILH Network Premier HMO
Flex HMO
Flex Plus HMO
Access PPO
When a prescription must be approved before it can be filled
What is a prior authorization?
True or False: EOI is required to newly enroll in STD during OE
True!
True or False: EOI is required to enroll in Supplemental Life for the first time during OE
True!
Plan year maximum for Dental High
What is $5,000?
True or False: All BILH medical plans require a PCP
False - the PPO does not require a PCP
What MTM stands for
What is Medication Therapy Management?
True or False: EOI is required to increase your STD plan level during OE
False!
True or False: EOI is required to newly enroll in spouse life during OE
True!
Bonus: What is the GI if already enrolled in Spouse Life but want to increase? (+200 points!)
Eyemed services that cannot be covered in the same plan year
What is prescription lenses and contacts?
What happens when an employee is enrolled in medical in 2024 but does not participate during OE
What is the medical plan will default to the BILH Network Premier HMO?
Step that is required when filling a GLP-1 for weight loss but NOT for diabetes
What is an MTM or CDTM visit?
True or False: EOI is required to enroll in the buy-up LTD option during OE?
False!
When EOI is required to increase your Supplemental Life during OE
What is an increase above $500k or over 2 plan increments?
Deadline to submit FSA expenses
What is March 31 of the following plan year?
The plans that offer out-of-network coverage
What is Access PPO/ Basic Out of Area PPO?
The list of drugs that are covered by BILH's pharmacy drug coverage is called
What is the drug formulary?
How EOI approvals are entered into Workday
What is the UNUM weekly feedback API?
How EOI approvals are entered into Workday
What is manual entry from weekly reports? Bonus: plan to switch to Voya API
Plans that offer a benefit "boost" for services at BILH
What is Critical Illness, Hospital Indemnity, and Accident Insurance?
The plans with the lowest annual deductibles
What is the Flex Plus HMO and the Access PPO?
The reason BILH is requiring MTM/CDTM visits for GLP-1 medications
What is provider credentialing and/or to keep employee cost down?
The process to complete EOI for disability
After OE is finalized, the link to complete UNUM EOI online will be available under announcements on the Workday homepage
The process to complete EOI for Life
After OE is finalized, a file goes to Voya and employees receive an email or mailed notice with the link or paper form instructions
True or False: an employee's eligibility for the "under $60k" rates is based on their salary as of 1/1/2025
False!