COMPASS OUTREACH
SPRING 2014
SPRING 2014
SERVICE. STABILITY. SECURITY.
SERVICE. STABILITY. SECURITY.
1768 Business Center Drive Suite 3500 Reston, VA 20190 (571) 449-2366 (866) 368-7227
INSIDE THIS ISSUE:
www.compassrosebenefits.com
Health Care: Medicare... 4-5
Buzz Worthy News......... 2-3
Health Care: Actives.... 6-7
Proud to provide quality insurance solutions for over 65 years!
COMPASS OUTREACH
Family Life...................... 8-9 Specialty Products..... 10-11
Health Coverage at Your Fingertips Every year, Compass Rose Benefits Group strives to make it easier for our members to access and manage their health coverage. In January 2014, we launched our very first online Member Portal! Currently available to all health plan members, the new portal is a way for members to view plan information, Explanation of Benefits (EOBs), claims status* and order new ID cards. In addition, the portal provides members with useful tools and educational resources to help maximize benefit coverage. We encourage all health plan members to participate. To join the online experience, members can register by visiting www.compassrosebenefits.com. Upon completing the registration form, members will receive an email within 3-5 business days with their unique login information. Upon registration completion, members will have secured access to their personalized member portal account!
WELCOME PAGE: After logging in, members will start on the welcome page. Navigation •buttons will allow members to quickly move around popular sections of the portal. Members are only a click away from accessing their UMR member portal to view claims and EOBs. MY PROFILE: Members can view account •information and brochures, print claim forms and
COMPASS CONNECTION Compass Rose Contact Information: Medical Claims UMR
UMR P.O. Box 8095 Wausau, WI 54402
(888) 438-9135
Pre-certifications
UMR
(866) 494-4502
We would like to congratulate CRBG
Express Scripts Express Scripts (877) 438-4449 P.O. Box 747000 www.express-scripts.com/Pharmacy Cincinnati, OH 45274 Lab Program LabCorp (888) 438-9135 Dental and Vision Discount Program
Careington International Corporation (800) 290-0523 7400 Gaylord Parkway www.compassrosebenefits.com/Careington Frisco, TX 75034
Compass Rose Benefits Group
Compass Rose Benefits Group 1768 Business Center Dr., Suite 3500 Reston, VA 20190
Social Networks
www.twitter.com/CRBGinsurance www.compassrosebenefits.com/Pinterest www.facebook.com/CRBGinsurance www.compassrosebenefits.com/LinkedIn
(866) 368-7227 askcrbg@compassrosebenefits.com www.compassrosebenefits.com
member, Joyce R. who was the Grand Prize winner of a $565 Visa gift card during our 65th Anniversary Celebration!
find in-network providers using the “Find a Doctor” link. To update your profile, please call UMR at (888) 438-9135 or click the button in the sidebar to access the online Change of Address form.** BENEFITS & COVERAGE: This section is •equipped with a variety of quick-links for on the
spot answers to members’ specific benefit questions. Members can also familiarize themselves with added benefit programs included with the health plan, such as a Lab Program, Dental and Vision Discount Program and a Smoking Cessation Benefit Program.
Members can read the online version of Compass connection, eCompass. • NEWSROOM: CONTACT US: This page lists all contact information for health plan members and •providers who have questions about coverage and/or prescription drugs.
to all those who
We are excited to meet the needs of our members and we would love to hear about your experience with the portal! To provide feedback, please email us at feedback@compassrosebenefits.com.
participated!
For questions regarding the member portal, please call Member Services at (866) 368-7227.
Thank you again
*Any claims prior to 1/1/14 will not be available to view online. **Please note that it may take 3-5 business days before your new information is updated in the portal.
BUZZ WORTHY NEWS COMPASS OUTREACH
BUZZ WORTHY NEWS
Community Outreach Right at Home
Useful Information From UMR
Compass Rose Benefits Group understands the importance of giving back to the community. “Although we live in an affluent area, people struggle day-to-day,” said Marsha Sanders, Performance Improvement Specialist at Compass Rose. “The goal is to serve those who are less fortunate in any way we can.”
This past December, new identification cards were sent with our new Claims Payer information. UMR, a UnitedHealthcare company, is now responsible for processing medical claims, handling pre-certifications, benefit inquiries and providing medical management services.
Embry Rucker Community Shelter (ERCS) is a residential shelter in Reston, VA that offers safe emergency housing for families, single men and women, as well as assists residents with the transition to stable housing. Job training is available, as is medical assistance and drop-in services such as hot meals, laundry and shower facilities for individuals in need. In October, CRBG employees made 300 sandwiches to help ERCS feed residents within the Reston community for three days! Donating efforts continued during December, when CRBG employees contributed coats, hats, gloves, clothing and other winter accessories for the ERCS Winter Coat Closet Drive. In total, ERCS distributed more than 5,000 coats and over 1,300 winter accessories to community members. CRBG also donated $400 to ERCS’ Thanksgiving Food Drive, to help families with stressed budgets and financial challenges. To learn more about the Embry Rucker Community Shelter and their community outreach efforts, visit www.cornerstonesva.org.
You only receive two (2) health plan member ID cards per household. However, you can request additional ID cards at any time by calling a UMR Member Services Representative at (888) 438-9135 or ordering through the online portal.
Below are some important tips on the new ID cards:
are not specific to you or your dependents. Meaning, if you • IDare cards the primary policyholder, your name will be listed on each card along with the name(s) of your spouse and child(ren).*
of the amount of cards you request, your spouse AND • Regardless your children will all be listed as dependents on every card you receive.* takes approximately 7-10 business days to receive newly • Itrequested card(s). is a new address for submitting claims. Claims incurred on or • There after January 1, 2014 should be submitted to UMR, PO Box 8095, Wausau, WI 54402-8095. *This does not apply to Medicare members whose dependents do not have Medicare.
Prior Authorization for Prescription Drugs: Now Through Express Scripts Prescription prior-authorization is an advance approval process required for certain medications to verify medical necessity, quantity limit rules, plan provisions and safety. There are some drugs that require prior authorization and are not covered unless you receive approval through a coverage review. Medications that may be covered with limits, such as length of treatment or for certain uses, require approval through a review. During this review, Express Scripts may ask your doctor for additional information before the medication may be covered under your plan. If coverage is approved, you pay your normal copayment for the medication. If coverage is not approved, you will be responsible for the full cost of the medication. To find out if your prescription medication needs prior authorization, view the online formulary at www.compassrosebenefits.com/Formulary or call ESI at (877) 438-4449.
2
Summary Annual Report for Compass Rose Benefits Group (CRBG) The Employee Retirement Income Security Act (ERISA) of 1974 is a consumer protection act that is intended to protect the assets of individuals that have contributed to pension or other welfare benefit plans. In 2012, CRBG took the necessary steps to become ERISA compliant for non-FEHB products. ERISA requires that plans adhere to specific fiduciary guidelines and to provide members with an annual summary. Below is the 2012 Annual Summary. This is a summary of the annual report for the Compass Rose Benefits Group Plan (Employee Identification Number 52-6048633) for calendar year 2012. The annual report has been filed with the Department of Labor as required under the Employee Retirement Income Security Act of 1974 (ERISA). INSURANCE INFORMATION The plan has contracts with New York Life Insurance Company, Starline Group, and Mutual of Omaha. They pay certain life, death, accidental death and dismemberment, disability, and long-term care claims incurred under the terms of the plans. The total contributions received for the plan year ending December 31, 2012 totaled approximately $254,201. BASIC FINANCIAL INFORMATION The value of the net plan assets for the plan year ending December 31, 2012 totaled $20,806,434. The Plan had a Net Income of $2,112,944 that consisted of earning on investments of $2,507,087 [includes unrealized gains/losses from investments totaling ($37,312)]; contributions of $254,201; and other income of $3,137,604. The Plan had expenses totaling $3,785,948 which consisted of administrative expenses of $2,208,375 and programs expenses of $1,577,573. Plan participants or beneficiaries totaled 26,531 at the end of the plan year.
3
BUZZ WORTHY NEWS COMPASS OUTREACH
BUZZ WORTHY NEWS
Community Outreach Right at Home
Useful Information From UMR
Compass Rose Benefits Group understands the importance of giving back to the community. “Although we live in an affluent area, people struggle day-to-day,” said Marsha Sanders, Performance Improvement Specialist at Compass Rose. “The goal is to serve those who are less fortunate in any way we can.”
This past December, new identification cards were sent with our new Claims Payer information. UMR, a UnitedHealthcare company, is now responsible for processing medical claims, handling pre-certifications, benefit inquiries and providing medical management services.
Embry Rucker Community Shelter (ERCS) is a residential shelter in Reston, VA that offers safe emergency housing for families, single men and women, as well as assists residents with the transition to stable housing. Job training is available, as is medical assistance and drop-in services such as hot meals, laundry and shower facilities for individuals in need. In October, CRBG employees made 300 sandwiches to help ERCS feed residents within the Reston community for three days! Donating efforts continued during December, when CRBG employees contributed coats, hats, gloves, clothing and other winter accessories for the ERCS Winter Coat Closet Drive. In total, ERCS distributed more than 5,000 coats and over 1,300 winter accessories to community members. CRBG also donated $400 to ERCS’ Thanksgiving Food Drive, to help families with stressed budgets and financial challenges. To learn more about the Embry Rucker Community Shelter and their community outreach efforts, visit www.cornerstonesva.org.
You only receive two (2) health plan member ID cards per household. However, you can request additional ID cards at any time by calling a UMR Member Services Representative at (888) 438-9135 or ordering through the online portal.
Below are some important tips on the new ID cards:
are not specific to you or your dependents. Meaning, if you • IDare cards the primary policyholder, your name will be listed on each card along with the name(s) of your spouse and child(ren).*
of the amount of cards you request, your spouse AND • Regardless your children will all be listed as dependents on every card you receive.* takes approximately 7-10 business days to receive newly • Itrequested card(s). is a new address for submitting claims. Claims incurred on or • There after January 1, 2014 should be submitted to UMR, PO Box 8095, Wausau, WI 54402-8095. *This does not apply to Medicare members whose dependents do not have Medicare.
Prior Authorization for Prescription Drugs: Now Through Express Scripts Prescription prior-authorization is an advance approval process required for certain medications to verify medical necessity, quantity limit rules, plan provisions and safety. There are some drugs that require prior authorization and are not covered unless you receive approval through a coverage review. Medications that may be covered with limits, such as length of treatment or for certain uses, require approval through a review. During this review, Express Scripts may ask your doctor for additional information before the medication may be covered under your plan. If coverage is approved, you pay your normal copayment for the medication. If coverage is not approved, you will be responsible for the full cost of the medication. To find out if your prescription medication needs prior authorization, view the online formulary at www.compassrosebenefits.com/Formulary or call ESI at (877) 438-4449.
2
Summary Annual Report for Compass Rose Benefits Group (CRBG) The Employee Retirement Income Security Act (ERISA) of 1974 is a consumer protection act that is intended to protect the assets of individuals that have contributed to pension or other welfare benefit plans. In 2012, CRBG took the necessary steps to become ERISA compliant for non-FEHB products. ERISA requires that plans adhere to specific fiduciary guidelines and to provide members with an annual summary. Below is the 2012 Annual Summary. This is a summary of the annual report for the Compass Rose Benefits Group Plan (Employee Identification Number 52-6048633) for calendar year 2012. The annual report has been filed with the Department of Labor as required under the Employee Retirement Income Security Act of 1974 (ERISA). INSURANCE INFORMATION The plan has contracts with New York Life Insurance Company, Starline Group, and Mutual of Omaha. They pay certain life, death, accidental death and dismemberment, disability, and long-term care claims incurred under the terms of the plans. The total contributions received for the plan year ending December 31, 2012 totaled approximately $254,201. BASIC FINANCIAL INFORMATION The value of the net plan assets for the plan year ending December 31, 2012 totaled $20,806,434. The Plan had a Net Income of $2,112,944 that consisted of earning on investments of $2,507,087 [includes unrealized gains/losses from investments totaling ($37,312)]; contributions of $254,201; and other income of $3,137,604. The Plan had expenses totaling $3,785,948 which consisted of administrative expenses of $2,208,375 and programs expenses of $1,577,573. Plan participants or beneficiaries totaled 26,531 at the end of the plan year.
3
HEALTH CARE NEWS
HEALTH CARE NEWS
How to Read Your Member ID Card – MEDICARE Members FRONT
1. Name of your health plan. 2. The new Claims Payer for the Compass Rose Health Plan. 3. An internal UMR number. 4. A unique number assigned to you and your covered family members. This number is important for accurate claims processing.
1 3 4
1. The new Claims Payer for the Compass Rose Health Plan.
2 5
6
2. The mailing address for claims incurred on or after January 1, 2014.
10
7
8
12
9
13
6. Name of the insured.
BACK
9. The required out-of-pocket expenses owed to your provider at the time of your appointment. This does not apply to Medicare Part B. 10. The plan’s Pharmacy Benefit Manager, Express Scripts.
15
16
11. The numbers your pharmacist will use to process your prescription(s) at the pharmacy.
17
18
13. **Please note: The UnitedHealthcare logo is NOT printed on members’ ID cards with Medicare coverage. 14. The date the card was printed. 15. The URL that members use to access our member portal. 16. The number you call for questions regarding your medical claims and benefits.
20
21
27
22 23
24
2 6
7
9
10
25 26
21. The mailing address for claims incurred on or after January 1, 2014. 22. The number your provider calls for claim and benefit inquiries.
6. Hospital, physician or other healthcare provider that performed the services.
12
13
14
15
16
17
19
7. Account number assigned by the hospital, physician or other healthcare provider. 8. The unique claim control number UMR assigns to each claim received.
16. Refers to codes used to explain charges that were not payable – see note section (#18).
9. Services and/or procedures that were performed by the hospital, physician or other healthcare provider.
17. If applicable, this is the amount you are responsible to pay to the hospital, physician or other healthcare provider.
10. Date(s) services were performed. 11. The amount billed for the services provided.
17. An optional online tool to manage your ESI Prescriptions.
24. An optional online tool to manage your ESI Prescription Benefit Plan.
13. Refers to codes used to explain charges that were not payable – see note section (#18).
18. The number you call for prescription inquiries.
25. The number your pharmacist or doctor calls for prescription inquiries.
14. In most cases, the amount equals approximately 80% of the Medicare Approved amount (#12).
26. The Lab provider for 100% covered outpatient laboratory testing.
15. The amount paid by the Compass Rose Health Plan; usually equals 20% of the Medicare Approved amount (#12).
27. A network for discounts on out-of-network claims.
11
8
18
12. The Medicare approved amount.
20. An online resource that providers can use for contract and/or pricing issues.
Jane B. Doe Y22345678 Jane B. Doe
5
4
23. The number your provider calls for pre-certifications.
19. A number used by many providers to file claims electronically.
4
5. This box includes member information for whom the claim was processed.
14
19
3
4. The URL for Compass Rose Benefits Group’s website.
7. Indicates your coverage type—medical. 8. The name(s) of the dependents—spouse and children are listed.
1
3. The number you call for questions regarding your medical claims and benefits.
11
5. A unique number that categorizes our entire member population.
12. A unique number that categorizes our entire member population for pharmacy claims.
How to Read Your EOB – MEDICARE Members
18. Explains codes provided in the “See Notes Section” columns (#13 and #16). Lists the specific code and its definition. 19. This box provides the benefit period and benefit levels, amounts applied to individual/family deductibles and out-of-pocket maximums.
To view these documents online, visit www.compassrosebenefits.com/MedMember
5
HEALTH CARE NEWS
HEALTH CARE NEWS
How to Read Your Member ID Card – MEDICARE Members FRONT
1. Name of your health plan. 2. The new Claims Payer for the Compass Rose Health Plan. 3. An internal UMR number. 4. A unique number assigned to you and your covered family members. This number is important for accurate claims processing.
1 3 4
1. The new Claims Payer for the Compass Rose Health Plan.
2 5
6
2. The mailing address for claims incurred on or after January 1, 2014.
10
7
8
12
9
13
6. Name of the insured.
BACK
9. The required out-of-pocket expenses owed to your provider at the time of your appointment. This does not apply to Medicare Part B. 10. The plan’s Pharmacy Benefit Manager, Express Scripts.
15
16
11. The numbers your pharmacist will use to process your prescription(s) at the pharmacy.
17
18
13. **Please note: The UnitedHealthcare logo is NOT printed on members’ ID cards with Medicare coverage. 14. The date the card was printed. 15. The URL that members use to access our member portal. 16. The number you call for questions regarding your medical claims and benefits.
20
21
27
22 23
24
2 6
7
9
10
25 26
21. The mailing address for claims incurred on or after January 1, 2014. 22. The number your provider calls for claim and benefit inquiries.
6. Hospital, physician or other healthcare provider that performed the services.
12
13
14
15
16
17
19
7. Account number assigned by the hospital, physician or other healthcare provider. 8. The unique claim control number UMR assigns to each claim received.
16. Refers to codes used to explain charges that were not payable – see note section (#18).
9. Services and/or procedures that were performed by the hospital, physician or other healthcare provider.
17. If applicable, this is the amount you are responsible to pay to the hospital, physician or other healthcare provider.
10. Date(s) services were performed. 11. The amount billed for the services provided.
17. An optional online tool to manage your ESI Prescriptions.
24. An optional online tool to manage your ESI Prescription Benefit Plan.
13. Refers to codes used to explain charges that were not payable – see note section (#18).
18. The number you call for prescription inquiries.
25. The number your pharmacist or doctor calls for prescription inquiries.
14. In most cases, the amount equals approximately 80% of the Medicare Approved amount (#12).
26. The Lab provider for 100% covered outpatient laboratory testing.
15. The amount paid by the Compass Rose Health Plan; usually equals 20% of the Medicare Approved amount (#12).
27. A network for discounts on out-of-network claims.
11
8
18
12. The Medicare approved amount.
20. An online resource that providers can use for contract and/or pricing issues.
Jane B. Doe Y22345678 Jane B. Doe
5
4
23. The number your provider calls for pre-certifications.
19. A number used by many providers to file claims electronically.
4
5. This box includes member information for whom the claim was processed.
14
19
3
4. The URL for Compass Rose Benefits Group’s website.
7. Indicates your coverage type—medical. 8. The name(s) of the dependents—spouse and children are listed.
1
3. The number you call for questions regarding your medical claims and benefits.
11
5. A unique number that categorizes our entire member population.
12. A unique number that categorizes our entire member population for pharmacy claims.
How to Read Your EOB – MEDICARE Members
18. Explains codes provided in the “See Notes Section” columns (#13 and #16). Lists the specific code and its definition. 19. This box provides the benefit period and benefit levels, amounts applied to individual/family deductibles and out-of-pocket maximums.
To view these documents online, visit www.compassrosebenefits.com/MedMember
5
HEALTH CARE NEWS COMPASS OUTREACH
HEALTH CARE NEWS
How to Read Your Member ID Card – ACTIVE Members FRONT
1. Name of your health plan. 2. The new Claims Payer for the Compass Rose Health Plan. 3. An internal UMR number. 4. A unique number assigned to you and your covered family members. This number is important for accurate claims processing.
1. The new Claims Payer for the Compass Rose Health Plan.
1 2 3 4
5 6
2. The mailing address for claims incurred on or after January 1, 2014.
10
7
8
12
9 13
6. Name of the insured.
BACK
9. The required out-of-pocket expenses owed to your provider at the time of your appointment. This does not apply to Medicare Part B. 10. The plan’s Pharmacy Benefit Manager, Express Scripts.
15
16
11. The numbers your pharmacist will use to process your prescription(s) at the pharmacy.
17
18
13. Your nationwide Preferred Provider Organization (PPO) network of doctors, hospitals and labs. **Please note: If you are a Medicare A & B, you will NOT see this logo on your ID card. 14. The date the card was printed. 15. The URL that members use to access our member portal. 16. The number you call for questions regarding your medical claims and benefits.
20
21
24
27
25 26
21. The mailing address for claims incurred on or after January 1, 2014. 22. The number your provider calls for claim and benefit inquiries. 23. The number your provider calls for pre-certifications.
17. An optional online tool to manage your ESI Prescriptions. 18. The number you call for prescription inquiries.
25. The number your pharmacist or doctor calls for prescription inquiries.
20. An online resource that providers can use for contract and/or pricing issues.
22 23
24. An optional online tool to manage your ESI Prescription Benefit Plan.
19. A number used by many providers to file claims electronically.
6
5. This box includes member information for whom the claim was processed.
14
19
3
2
4
6
7
9
10
Jon A. Doe Y12345678 Jon A. Doe
5
11
8
12 13 14
15
16
17
18
19
4. The URL for Compass Rose Benefits Group’s website.
7. Indicates your coverage type—medical. 8. The name(s) of the dependents—spouse and children are listed.
1
3. The number you call for questions regarding your medical claims and benefits.
11
5. A unique number that categorizes our entire member population.
12. A unique number that categorizes our entire member population for pharmacy claims.
How to Read Your EOB – ACTIVE Members
20
6. Hospital, physician or other healthcare provider that performed the services.
23
24
21 22
7. Account number assigned by the hospital, physician or other healthcare provider. 8. The unique claim control number UMR assigns to each claim received.
17. Amount actually payable by the health plan.
9. Services and/or procedures that were performed by the hospital, physician or other healthcare provider.
19. If applicable, this is the amount you are responsible to pay to the hospital, physician or other healthcare provider.
10. Date(s) services were performed. 11. Amount billed for the services provided. 12. Amount not payable as explained in the “See Notes Section” (#20) column. 13. Refers to codes used to explain charges that were not payable – see note section (#20). 14. Amount applied to the deductible.
26. The Lab provider for 100% covered outpatient laboratory testing.
15. Charges allowed for payment—this is the difference between the “Amount Billed” (#11) and the “Amount Not Payable” (#12) and/or “Less Deductible” (#14) columns.
27. A network for discounts on out-of-network claims.
16. Percentage at which the allowable charges are paid.
18. Amount the health plan paid to the provider.
20. Explains codes provided in the “See Notes Section” (#13) column. Lists the specific code and its definition. 21. Provider or facility the check was issued to. 22. This box provides the benefit period and benefit levels, amounts applied to individual/family deductibles and out-of-pocket maximums. 23. The date the payment was issued to the hospital, physician or other healthcare provider. 24. The total amount paid by your health plan.
To view these documents online, visit www.compassrosebenefits.com/Active
7
HEALTH CARE NEWS COMPASS OUTREACH
HEALTH CARE NEWS
How to Read Your Member ID Card – ACTIVE Members FRONT
1. Name of your health plan. 2. The new Claims Payer for the Compass Rose Health Plan. 3. An internal UMR number. 4. A unique number assigned to you and your covered family members. This number is important for accurate claims processing.
1. The new Claims Payer for the Compass Rose Health Plan.
1 2 3 4
5 6
2. The mailing address for claims incurred on or after January 1, 2014.
10
7
8
12
9 13
6. Name of the insured.
BACK
9. The required out-of-pocket expenses owed to your provider at the time of your appointment. This does not apply to Medicare Part B. 10. The plan’s Pharmacy Benefit Manager, Express Scripts.
15
16
11. The numbers your pharmacist will use to process your prescription(s) at the pharmacy.
17
18
13. Your nationwide Preferred Provider Organization (PPO) network of doctors, hospitals and labs. **Please note: If you are a Medicare A & B, you will NOT see this logo on your ID card. 14. The date the card was printed. 15. The URL that members use to access our member portal. 16. The number you call for questions regarding your medical claims and benefits.
20
21
24
27
25 26
21. The mailing address for claims incurred on or after January 1, 2014. 22. The number your provider calls for claim and benefit inquiries. 23. The number your provider calls for pre-certifications.
17. An optional online tool to manage your ESI Prescriptions. 18. The number you call for prescription inquiries.
25. The number your pharmacist or doctor calls for prescription inquiries.
20. An online resource that providers can use for contract and/or pricing issues.
22 23
24. An optional online tool to manage your ESI Prescription Benefit Plan.
19. A number used by many providers to file claims electronically.
6
5. This box includes member information for whom the claim was processed.
14
19
3
2
4
6
7
9
10
Jon A. Doe Y12345678 Jon A. Doe
5
11
8
12 13 14
15
16
17
18
19
4. The URL for Compass Rose Benefits Group’s website.
7. Indicates your coverage type—medical. 8. The name(s) of the dependents—spouse and children are listed.
1
3. The number you call for questions regarding your medical claims and benefits.
11
5. A unique number that categorizes our entire member population.
12. A unique number that categorizes our entire member population for pharmacy claims.
How to Read Your EOB – ACTIVE Members
20
6. Hospital, physician or other healthcare provider that performed the services.
23
24
21 22
7. Account number assigned by the hospital, physician or other healthcare provider. 8. The unique claim control number UMR assigns to each claim received.
17. Amount actually payable by the health plan.
9. Services and/or procedures that were performed by the hospital, physician or other healthcare provider.
19. If applicable, this is the amount you are responsible to pay to the hospital, physician or other healthcare provider.
10. Date(s) services were performed. 11. Amount billed for the services provided. 12. Amount not payable as explained in the “See Notes Section” (#20) column. 13. Refers to codes used to explain charges that were not payable – see note section (#20). 14. Amount applied to the deductible.
26. The Lab provider for 100% covered outpatient laboratory testing.
15. Charges allowed for payment—this is the difference between the “Amount Billed” (#11) and the “Amount Not Payable” (#12) and/or “Less Deductible” (#14) columns.
27. A network for discounts on out-of-network claims.
16. Percentage at which the allowable charges are paid.
18. Amount the health plan paid to the provider.
20. Explains codes provided in the “See Notes Section” (#13) column. Lists the specific code and its definition. 21. Provider or facility the check was issued to. 22. This box provides the benefit period and benefit levels, amounts applied to individual/family deductibles and out-of-pocket maximums. 23. The date the payment was issued to the hospital, physician or other healthcare provider. 24. The total amount paid by your health plan.
To view these documents online, visit www.compassrosebenefits.com/Active
7
FAMILY LIFE
FAMILY LIFE
Take the First Step
It is Time to Focus
Among older adults, one of the leading causes of injury or hospitalization is a result of falling. According to the Centers for Disease Control and Prevention, one in every three adults ages 65 or older falls every year. Injuries caused from falling can lead to long-term consequences such as hip fractures and traumatic brain injuries (TBI). These injuries can significantly impact a person’s health and lifestyle. It is important that the seriousness of fall-related injuries be understood by anyone with older family members as well.
Business Insider and Cisco predicted that by 2017, each person will own an average of five internet devices! While it may seem worthwhile to own a cell phone, iPad, Kindle and computer, these devices are starting to take a toll on our vision. Since technology is not slowing down anytime soon, it is important to understand how to prevent damaging effects from occurring if your eyes never leave the screen.
4
While older adults are at a higher risk of falling, there are ways to prevent it from happening. Take the first step by reading the tips below on how you can reduce the risks of fall-related injuries!
DIFFERENT WAYS TO PREVENT FALLS: Exercise – Keeping fit is important, and one program in particular that can increase strength and balance is yoga. Medications – Some medications cause side effects such as drowsiness or dizziness and make falls more likely to occur. Check medications and read the warning labels on each bottle. Check Eyes and Ears – Having annual vision and hearing check-ups is extremely important in keeping older adults on their feet. Hazard-Free Homes – Eliminate tripping hazards, increase lighting, keep stairways clear, install grab bars in key places, wear sturdy shoes and/or non-slip socks, etc.
SOURCE: www.cdc.gov
re s a re e r tu he rac 10, t — f hip 20 res of s. In ractu twice l % 95 y fal hip f was r e n Ov sed b 8,000 ome u ca re 25 for w we rate en. the t of m tha
The average cost of a fall related injury is
15 Every an ds secon ult is ad older in an d treate ency g emer a fallfor room injury. d relate
$19,000
all of h w re ple seve , hip o e to p ns . of rate ratio mas) % e e -30 od lac rau 20 fer m (i.e. ead t suf uries s or h inj cture fra
Protect Your Eyes – On average, humans blink 18 1. Blink! times per minute; however, studies show we blink half as much while using computers and other electronic devices. your eyes – Sleep deprivation 2. Rest can increase a person’s risk of vision problems. After a long day of staring at a computer, it is extremely important to rest your eyes. If not, eye irritation can lead to swelling and infection— especially if you wear contacts.
The most common vision problems stem from computer usage, especially while at the workplace. “Computer Vision Syndrome (CVS)” is the effects your eyes and body feel after spending hours in front of a computer screen. While it has been reported that the symptoms associated with CVS significantly reduce once a person stops using the computer, depending on the individual, it is not always a guaranteed solution. In order to avoid visual discomfort, we have provided tips to help minimize the impact of CVS. SOURCE: www.businessinsider.com
20-20-20 Rule – Every 20 3. The minutes, look at something 20 feet away for 20 seconds. Lighting – Adjust lighting. A 4. Mood person should avoid bright, overhead
Reminder: As a member of the Compass Rose Health Plan, we offer discounts on exceptional eye care services such as eye exams, glasses, contacts and LASIK. To learn more, visit www.compassrosebenefits.com/Careington.
lighting, keep desk lights shining down, try to keep window light off to the side (not behind you) and move the screen to avoid glares or reflections.
Beyond the Winter Cold When cold temperatures set in and people begin moving activities inside, germs are not the only thing to worry about; winter allergies can interrupt a person’s health and day-to-day lifestyle as well.
29 Every
minutes, an older adult dies from a fall.
Membership Interaction In an effort to better serve our members, CRBG will be traveling to various locations in 2014 to meet with our members and discuss relevant topics, ideas and information. What do you want to hear about? Tell us by visiting www.compassrosebenefits.com/2014 and taking our quick survey!
Allergies are the fifth leading chronic disease among all ages, currently affecting 50 million Americans. Although allergies are typically associated with spring and summer, winter is no exception. When temperatures drop, windows are shut, heating systems are cranked up and pets are spending more time inside. Without much warning, common indoor allergens such as mold, dust mites and animal dander make their presence known. Surprisingly, it is not uncommon for people to mistake allergies for a cold. Symptoms of the two are very similar; however, someone with a cold may feel achy and feverish for only a few days, while someone with allergies is more likely to experience watery, itchy eyes, a scratchy throat and tiredness for an extended period of time (10 days or longer). If you are someone who suffers from winter allergies, maintaining a clean home is the easiest way to reduce allergic reactions. Washing all bedding regularly, maintaining low indoor humidity to kill mold and dust-mites and vacuuming carpets are three simple ways you can control the effects of winter allergies. Get cozy by the fire and wait out winter in the comfort of your own home. Send your allergy symptoms south for the winter! SOURCE: Asthma and Allergy Foundation of America (AAFA)
8
9
FAMILY LIFE
FAMILY LIFE
Take the First Step
It is Time to Focus
Among older adults, one of the leading causes of injury or hospitalization is a result of falling. According to the Centers for Disease Control and Prevention, one in every three adults ages 65 or older falls every year. Injuries caused from falling can lead to long-term consequences such as hip fractures and traumatic brain injuries (TBI). These injuries can significantly impact a person’s health and lifestyle. It is important that the seriousness of fall-related injuries be understood by anyone with older family members as well.
Business Insider and Cisco predicted that by 2017, each person will own an average of five internet devices! While it may seem worthwhile to own a cell phone, iPad, Kindle and computer, these devices are starting to take a toll on our vision. Since technology is not slowing down anytime soon, it is important to understand how to prevent damaging effects from occurring if your eyes never leave the screen.
4
While older adults are at a higher risk of falling, there are ways to prevent it from happening. Take the first step by reading the tips below on how you can reduce the risks of fall-related injuries!
DIFFERENT WAYS TO PREVENT FALLS: Exercise – Keeping fit is important, and one program in particular that can increase strength and balance is yoga. Medications – Some medications cause side effects such as drowsiness or dizziness and make falls more likely to occur. Check medications and read the warning labels on each bottle. Check Eyes and Ears – Having annual vision and hearing check-ups is extremely important in keeping older adults on their feet. Hazard-Free Homes – Eliminate tripping hazards, increase lighting, keep stairways clear, install grab bars in key places, wear sturdy shoes and/or non-slip socks, etc.
SOURCE: www.cdc.gov
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The average cost of a fall related injury is
15 Every an ds secon ult is ad older in an d treate ency g emer a fallfor room injury. d relate
$19,000
all of h w re ple seve , hip o e to p ns . of rate ratio mas) % e e -30 od lac rau 20 fer m (i.e. ead t suf uries s or h inj cture fra
Protect Your Eyes – On average, humans blink 18 1. Blink! times per minute; however, studies show we blink half as much while using computers and other electronic devices. your eyes – Sleep deprivation 2. Rest can increase a person’s risk of vision problems. After a long day of staring at a computer, it is extremely important to rest your eyes. If not, eye irritation can lead to swelling and infection— especially if you wear contacts.
The most common vision problems stem from computer usage, especially while at the workplace. “Computer Vision Syndrome (CVS)” is the effects your eyes and body feel after spending hours in front of a computer screen. While it has been reported that the symptoms associated with CVS significantly reduce once a person stops using the computer, depending on the individual, it is not always a guaranteed solution. In order to avoid visual discomfort, we have provided tips to help minimize the impact of CVS. SOURCE: www.businessinsider.com
20-20-20 Rule – Every 20 3. The minutes, look at something 20 feet away for 20 seconds. Lighting – Adjust lighting. A 4. Mood person should avoid bright, overhead
Reminder: As a member of the Compass Rose Health Plan, we offer discounts on exceptional eye care services such as eye exams, glasses, contacts and LASIK. To learn more, visit www.compassrosebenefits.com/Careington.
lighting, keep desk lights shining down, try to keep window light off to the side (not behind you) and move the screen to avoid glares or reflections.
Beyond the Winter Cold When cold temperatures set in and people begin moving activities inside, germs are not the only thing to worry about; winter allergies can interrupt a person’s health and day-to-day lifestyle as well.
29 Every
minutes, an older adult dies from a fall.
Membership Interaction In an effort to better serve our members, CRBG will be traveling to various locations in 2014 to meet with our members and discuss relevant topics, ideas and information. What do you want to hear about? Tell us by visiting www.compassrosebenefits.com/2014 and taking our quick survey!
Allergies are the fifth leading chronic disease among all ages, currently affecting 50 million Americans. Although allergies are typically associated with spring and summer, winter is no exception. When temperatures drop, windows are shut, heating systems are cranked up and pets are spending more time inside. Without much warning, common indoor allergens such as mold, dust mites and animal dander make their presence known. Surprisingly, it is not uncommon for people to mistake allergies for a cold. Symptoms of the two are very similar; however, someone with a cold may feel achy and feverish for only a few days, while someone with allergies is more likely to experience watery, itchy eyes, a scratchy throat and tiredness for an extended period of time (10 days or longer). If you are someone who suffers from winter allergies, maintaining a clean home is the easiest way to reduce allergic reactions. Washing all bedding regularly, maintaining low indoor humidity to kill mold and dust-mites and vacuuming carpets are three simple ways you can control the effects of winter allergies. Get cozy by the fire and wait out winter in the comfort of your own home. Send your allergy symptoms south for the winter! SOURCE: Asthma and Allergy Foundation of America (AAFA)
8
9
SPECIALTY OUTREACH PRODUCTS COMPASS
SPECIALTY PRODUCTS
Were You TARGETed?
A Costly Purchase
“Cash or credit” is a phrase that has been replaced by “debit or credit,” and in today’s world, those two words have brought increasing problems to customers of major retail stores. One in particular is Target, which experienced the second largest storewide security breach in United States’ history.
While on the topic of Identity Theft, you may have heard people say, “My life is on my phone,” and that is probably not an exaggeration. We spend a lot of time with our electronic devices–the longer we have them, the more vulnerable we become to identity theft. However, by taking the necessary precautions before recycling the device, your chances of identity theft can be greatly reduced.
In 2013, highly skilled hackers removed encrypted data from Target computer systems. The company’s chief executive later attributed the breach to malware–or “malicious software”–in its credit-card reading system. Information pertaining to card numbers, names, addresses (mailing and e-mail), PIN numbers, phone numbers and possibly other sensitive material, were all said to have been compromised. Although reports of Target’s major financial and personal data breach is not new news, many predict this large-scale security breach is just the beginning.
Before replacing any personal electronic device, whether it is a computer, cell phone, tablet or copier/printer, it is very important to dispose of the data stored within each device. Software is available to clear your computer’s hard drive, while your cell phone’s manual most likely provides directions for deleting the memory. A digital copy of all documents is saved on the hard drive of copiers and printers, so be sure to consult the manual for directions on deleting content. You can also purchase software to overwrite and clean the hard drive.
While efforts by credit card companies continue making headway to try and prevent future attacks on customers’ accounts, we caution our members to think about the potential risks they could face without identity theft protection.
So, prior to signing the dotted line for your new electronic device, wipe out any possibility of someone stealing your identity. For added protection against identity theft, check out www.compassrosebenefits.com/Identity.
Through our partnership with LegalShield, we offer members an Identity Theft Protection Plan. Coverage includes continuous monitoring of your credit, a detailed analysis of your credit report and credit score, as well as alerts and updates on any suspicious activity. As an added layer of security, you also receive unlimited access to the Licensed Investigators at Kroll. They can help with threats that may not appear with regular credit monitoring.
Creating a Safety Net: Why Life Insurance Makes Sense Purchasing life insurance can be your personal “safety net” against life’s uncertainties and now is the time to be prepared. The Compass Rose Group Term Life Insurance Plan, underwritten by New York Life Insurance Company*, caters exclusively to the unique needs of ACTIVE Federal employees of the Intelligence Community, Department of Defense and Department of State.
In the event you fall victim to identity theft, the experts at Kroll will assist you with the restoration process, doing the bulk of the work for you. At Compass Rose Benefits Group, we know that credit and debit cards are convenient–we are familiar with the simplicity of swiping plastic; however, we also recognize the need to shield our membership. With the Compass Rose Identity Theft Protection Plan, you can avoid the uphill battle of identity fraud. Protect yourself and/or your family from identity theft–it will be the safest purchase you will ever make! Members can purchase Identity Theft Protection as a stand-alone plan for $12.95 a month. Members can purchase both products, Legal Protection ($15.95) and Identity Theft Protection ($9.95) for just $25.90 per month. Compass Rose Benefits Group offers Legal Protection and Identity Theft Protection for all active and retired civilian employees of the Intelligence Community, the Department of Defense and the Department of State. For more information, please visit www.compassrosebenefits.com/Legal.
10
REASON #1:
REASON #2:
REASON #3:
Life Insurance is not about you, it is about those you leave behind. The primary purpose of group term life insurance is to protect your family upon your death. When you purchase life insurance, you help provide your loved ones with a secure financial foundation.
First, you need to determine the amount of coverage you need. To determine the proper amount of life insurance needed, an online calculator can be helpful. We have built a fun and easy-to-use tool that shows you how much coverage you can apply for compared to what you personally spend of coffee each week. Visit www.compassrosebenefits.com/Coffee for more details.**
When it comes to purchasing life insurance, waiting can cost you. Life insurance premiums are based in part on age, which means any new coverage will cost more the older you become. Basically, the younger you are, the lower your premiums will be! For example, at age 25, you can apply for up to $500,000 of coverage for a little over $20/month.
Protection for your loved ones
Options for your lifestyle
SOURCE: www.newyorklife.com, Viewing date: January 6, 2014 *51 Madison Avenue, NY, NY 10010 on Policy Form GMR-ER-P. **Including plan features, costs, eligibility, renewability, limitations and exclusions.
Time is money
Bates#: 528683
11
SPECIALTY OUTREACH PRODUCTS COMPASS
SPECIALTY PRODUCTS
Were You TARGETed?
A Costly Purchase
“Cash or credit” is a phrase that has been replaced by “debit or credit,” and in today’s world, those two words have brought increasing problems to customers of major retail stores. One in particular is Target, which experienced the second largest storewide security breach in United States’ history.
While on the topic of Identity Theft, you may have heard people say, “My life is on my phone,” and that is probably not an exaggeration. We spend a lot of time with our electronic devices–the longer we have them, the more vulnerable we become to identity theft. However, by taking the necessary precautions before recycling the device, your chances of identity theft can be greatly reduced.
In 2013, highly skilled hackers removed encrypted data from Target computer systems. The company’s chief executive later attributed the breach to malware–or “malicious software”–in its credit-card reading system. Information pertaining to card numbers, names, addresses (mailing and e-mail), PIN numbers, phone numbers and possibly other sensitive material, were all said to have been compromised. Although reports of Target’s major financial and personal data breach is not new news, many predict this large-scale security breach is just the beginning.
Before replacing any personal electronic device, whether it is a computer, cell phone, tablet or copier/printer, it is very important to dispose of the data stored within each device. Software is available to clear your computer’s hard drive, while your cell phone’s manual most likely provides directions for deleting the memory. A digital copy of all documents is saved on the hard drive of copiers and printers, so be sure to consult the manual for directions on deleting content. You can also purchase software to overwrite and clean the hard drive.
While efforts by credit card companies continue making headway to try and prevent future attacks on customers’ accounts, we caution our members to think about the potential risks they could face without identity theft protection.
So, prior to signing the dotted line for your new electronic device, wipe out any possibility of someone stealing your identity. For added protection against identity theft, check out www.compassrosebenefits.com/Identity.
Through our partnership with LegalShield, we offer members an Identity Theft Protection Plan. Coverage includes continuous monitoring of your credit, a detailed analysis of your credit report and credit score, as well as alerts and updates on any suspicious activity. As an added layer of security, you also receive unlimited access to the Licensed Investigators at Kroll. They can help with threats that may not appear with regular credit monitoring.
Creating a Safety Net: Why Life Insurance Makes Sense Purchasing life insurance can be your personal “safety net” against life’s uncertainties and now is the time to be prepared. The Compass Rose Group Term Life Insurance Plan, underwritten by New York Life Insurance Company*, caters exclusively to the unique needs of ACTIVE Federal employees of the Intelligence Community, Department of Defense and Department of State.
In the event you fall victim to identity theft, the experts at Kroll will assist you with the restoration process, doing the bulk of the work for you. At Compass Rose Benefits Group, we know that credit and debit cards are convenient–we are familiar with the simplicity of swiping plastic; however, we also recognize the need to shield our membership. With the Compass Rose Identity Theft Protection Plan, you can avoid the uphill battle of identity fraud. Protect yourself and/or your family from identity theft–it will be the safest purchase you will ever make! Members can purchase Identity Theft Protection as a stand-alone plan for $12.95 a month. Members can purchase both products, Legal Protection ($15.95) and Identity Theft Protection ($9.95) for just $25.90 per month. Compass Rose Benefits Group offers Legal Protection and Identity Theft Protection for all active and retired civilian employees of the Intelligence Community, the Department of Defense and the Department of State. For more information, please visit www.compassrosebenefits.com/Legal.
10
REASON #1:
REASON #2:
REASON #3:
Life Insurance is not about you, it is about those you leave behind. The primary purpose of group term life insurance is to protect your family upon your death. When you purchase life insurance, you help provide your loved ones with a secure financial foundation.
First, you need to determine the amount of coverage you need. To determine the proper amount of life insurance needed, an online calculator can be helpful. We have built a fun and easy-to-use tool that shows you how much coverage you can apply for compared to what you personally spend of coffee each week. Visit www.compassrosebenefits.com/Coffee for more details.**
When it comes to purchasing life insurance, waiting can cost you. Life insurance premiums are based in part on age, which means any new coverage will cost more the older you become. Basically, the younger you are, the lower your premiums will be! For example, at age 25, you can apply for up to $500,000 of coverage for a little over $20/month.
Protection for your loved ones
Options for your lifestyle
SOURCE: www.newyorklife.com, Viewing date: January 6, 2014 *51 Madison Avenue, NY, NY 10010 on Policy Form GMR-ER-P. **Including plan features, costs, eligibility, renewability, limitations and exclusions.
Time is money
Bates#: 528683
11
COMPASS OUTREACH
SPRING 2014
SPRING 2014
SERVICE. STABILITY. SECURITY.
SERVICE. STABILITY. SECURITY.
1768 Business Center Drive Suite 3500 Reston, VA 20190 (571) 449-2366 (866) 368-7227
INSIDE THIS ISSUE:
www.compassrosebenefits.com
Health Care: Medicare... 4-5
Buzz Worthy News......... 2-3
Health Care: Actives.... 6-7
Proud to provide quality insurance solutions for over 65 years!
COMPASS OUTREACH
Family Life...................... 8-9 Specialty Products..... 10-11
Health Coverage at Your Fingertips Every year, Compass Rose Benefits Group strives to make it easier for our members to access and manage their health coverage. In January 2014, we launched our very first online Member Portal! Currently available to all health plan members, the new portal is a way for members to view plan information, Explanation of Benefits (EOBs), claims status* and order new ID cards. In addition, the portal provides members with useful tools and educational resources to help maximize benefit coverage. We encourage all health plan members to participate. To join the online experience, members can register by visiting www.compassrosebenefits.com. Upon completing the registration form, members will receive an email within 3-5 business days with their unique login information. Upon registration completion, members will have secured access to their personalized member portal account!
WELCOME PAGE: After logging in, members will start on the welcome page. Navigation •buttons will allow members to quickly move around popular sections of the portal. Members are only a click away from accessing their UMR member portal to view claims and EOBs. MY PROFILE: Members can view account •information and brochures, print claim forms and
COMPASS CONNECTION Compass Rose Contact Information: Medical Claims UMR
UMR P.O. Box 8095 Wausau, WI 54402
(888) 438-9135
Pre-certifications
UMR
(866) 494-4502
We would like to congratulate CRBG
Express Scripts Express Scripts (877) 438-4449 P.O. Box 747000 www.express-scripts.com/Pharmacy Cincinnati, OH 45274 Lab Program LabCorp (888) 438-9135 Dental and Vision Discount Program
Careington International Corporation (800) 290-0523 7400 Gaylord Parkway www.compassrosebenefits.com/Careington Frisco, TX 75034
Compass Rose Benefits Group
Compass Rose Benefits Group 1768 Business Center Dr., Suite 3500 Reston, VA 20190
Social Networks
www.twitter.com/CRBGinsurance www.compassrosebenefits.com/Pinterest www.facebook.com/CRBGinsurance www.compassrosebenefits.com/LinkedIn
(866) 368-7227 askcrbg@compassrosebenefits.com www.compassrosebenefits.com
member, Joyce R. who was the Grand Prize winner of a $565 Visa gift card during our 65th Anniversary Celebration!
find in-network providers using the “Find a Doctor” link. To update your profile, please call UMR at (888) 438-9135 or click the button in the sidebar to access the online Change of Address form.** BENEFITS & COVERAGE: This section is •equipped with a variety of quick-links for on the
spot answers to members’ specific benefit questions. Members can also familiarize themselves with added benefit programs included with the health plan, such as a Lab Program, Dental and Vision Discount Program and a Smoking Cessation Benefit Program.
Members can read the online version of Compass connection, eCompass. • NEWSROOM: CONTACT US: This page lists all contact information for health plan members and •providers who have questions about coverage and/or prescription drugs.
to all those who
We are excited to meet the needs of our members and we would love to hear about your experience with the portal! To provide feedback, please email us at feedback@compassrosebenefits.com.
participated!
For questions regarding the member portal, please call Member Services at (866) 368-7227.
Thank you again
*Any claims prior to 1/1/14 will not be available to view online. **Please note that it may take 3-5 business days before your new information is updated in the portal.