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A new telehealth option for 2020

December 4, 2019

Beginning January 1, 2020, State Health Plan members, including our Medicare-primary members, will have access to a telehealth option through MUSC Health Virtual Care. MUSC Health Virtual Care is available at no cost to members and there is no cost to the State Health Plan. Members can opt for non-video visits or video visits. Common conditions treated include allergies, pink eye, sinus infections, skin rashes, sore throat, urinary tract infections and flu.

 

A member does not need to be a South Carolina resident; however, a member must be in South Carolina at the time of the visit. Members ages 18 and older can create an account. Members can also add dependents to their account. Visits for dependent children under age 18 must be completed by a parent. Beginning in January, members can go to www.MUSChealth.org/virtual-care to start a visit.

 

Lower copayment for preferred insulin in 2020

December 2, 2019

Beginning January 1, 2020, the Patient Assurance Program will enable State Health Plan members to get a 30-day supply of their preferred insulin for $25 (90-day supply for $75) at a network pharmacy or through home delivery from Express Scripts Pharmacy. On or after January 1, 2020, members can see if their insulin medications are eligible for the reduced copayment by logging in to their account at express-scripts.com or by calling Express Scripts at 855.612.3128.

 

PEBA releases request for proposal for State ORP

November 22, 2019

The South Carolina Public Employee Benefit Authority (PEBA) has released a request for proposal (RFP) for the State Optional Retirement Program (State ORP). The RFP is located here. Please see the RFP for instructions on asking questions or requesting additional information.

 

Deferred Comp fee to reduce in 2020

October 15, 2019

Empower Retirement was awarded the recordkeeping contract for Deferred Comp beginning January 1, 2020. As part of the new contract, the annual recordkeeping fee that participants pay on their account will decrease next year. Participants currently pay 0.0975 percent of their account balance, which is divided and deducted quarterly. Beginning in January 2020, the annual recordkeeping fee will be 0.065 percent.

 

Tobacco-use premium now includes e-cigarettes

October 8, 2019

An electronic cigarette, or e-cigarette, is a hand-held, battery-operated device that emits both vaporized nicotine and non-nicotine solutions for inhalation. E-cigarette usage has become more prevalent the past few years, and has most recently become a significant health concern because of conditions believed to be associated with such use.

 

Accordingly, PEBA has updated the Certification Regarding Tobacco and E-cigarette Use form to include e-cigarettes. Subscribers who use e-cigarettes, or cover dependents who use e-cigarettes, need to complete a new form. Similar to those who use tobacco, subscribers and their covered dependents who use e-cigarettes can complete the Quit for Life® smoking cessation program.

 

PEBA releases request for proposal for Basic and Supplemental Long Term Disability insurance

September 27, 2019

The South Carolina Public Employee Benefit Authority (PEBA) has released a request for proposal (RFP) for Basic and Supplemental Long Term Disability insurance. The RFP is located here. Please see the RFP for instructions on asking questions or requesting additional information.

 

State Vision Plan will change to EyeMed's Select provider network

September 25, 2019

Beginning January 1, 2020, the State Vision Plan will change to EyeMed's Select provider network from the Insight provider network. State Vision Plan members can maximize their vision benefits by using a provider in the Select Network. If they use an out-of-network provider, the vision plan will pay at a lesser rate.

 

PEBA awards contract for Deferred Compensation Program

August 2, 2019

The South Carolina Public Employee Benefit Authority (PEBA) has awarded the contract to provide recordkeeping, administration, communication, education, custodial trustee services and investment management services (Deferred Compensation Program) to Great-West Life & Annuity Insurance Company. The award is located here.

 

S.C. Supreme Court ruling on common law marriage may impact insurance benefits eligibility

July 25, 2019

The South Carolina Supreme Court recently ruled to prospectively abolish common law marriage, effective July 24, 2019. Common law marriage was defined as longtime couples who publicly held themselves out to be married but did not have a marriage license. The ruling means that, beginning July 24, 2019, citizens can no longer enter into a common law marriage in South Carolina. Existing common law marriages remain valid and have not been impacted. Beginning July 24, 2019, a subscriber cannot cover his or her spouse unless he or she is married and has a marriage license on file.

 

As a result of this ruling, the Common Law Marriage Affidavit is no longer available on PEBA’s website. A subscriber whose common-law spouse was covered by PEBA-administered insurance benefits prior to July 24, 2019, and for whom an affidavit is on file with PEBA, is not impacted by this ruling. If you have any questions, please call our Customer Contact Center at 803.737.6800 or 888.260.9430.

 

PEBA releases request for proposal for Deferred Compensation Program

April 11, 2019

The South Carolina Public Employee Benefit Authority (PEBA) has released a Request for Proposal (RFP) to provide recordkeeping, administration, communication, education, custodial trustee services and investment management services (Deferred Compensation Program). The RFP is located here. Please see the RFP for instructions on asking questions or requesting additional information.

 

Intent to sole source TRICARE Supplement Plan

March 8, 2019

The South Carolina Public Employee Benefit Authority (PEBA) intends to offer a voluntary group TRICARE Supplement Health Insurance plan to its TRICARE eligible subscribers as a health plan option for plan year 2020. The voluntary group TRICARE Supplement Health Insurance plan will be offered to TRICARE eligible subscribers through the PEBA's Section 125 cafeteria plan in order that subscribers may pay premiums on a pretax basis, in accordance with federal law and regulations. Additional information is located here.

 

PEBA releases request for proposal for Dental and Dental Plus

March 5, 2019

The South Carolina Public Employee Benefit Authority (PEBA) has released a Request for Proposal (RFP) to Provide Claims Administration Services for the Self-Funded State Dental Plan, and Accompanying Insurance for the State’s Voluntary Supplemental Dental Product, Dental Plus. The RFP is located here. Please see the RFP for instructions on asking questions or requesting additional information.

 

Your how-to guide for your MSA

 February 20, 2019

As a Medical Spending Account (MSA) participant, you are setting aside money from your paycheck pretax to pay for out-of-pocket health care expenses. We want to make sure you understand how to monitor your account, access your funds and provide documentation to ASIFlex, if needed.

 

How do I access my account?

ASIFlex offers an online participant portal that allows you to access your account balance, read messages from ASIFlex, file and view the status of a claim and submit documentation. Create your account by visiting www.asiflex.com/SCMoneyPlus and selecting Participant Login from the Account Login menu option. Once you've created your account, you can download the ASIFlex mobile app to manage your account and submit claims on-the-go. The app is available for download in the App Store and Google Play. Just search for "ASIFlex Self Service."

 

From your account, you can also update your communication preferences. Go green by signing up for email and text alerts. You can also set up direct deposit for your reimbursements.

 

How do I access my MSA funds?

You have access to your total election amount, even though you'll contribute to your account each paycheck. You can find a comprehensive list of eligible expenses online. As you have eligible expenses, you can use your ASIFlex Card or pay for the expense out of your pocket and submit a claim for reimbursement. If you opt to submit a claim, there are several ways you can do that.

  • ASIFlex mobile app: Just snap a picture of your itemized statement of service(s) or insurance explanation of benefits (EOB) and submit a claim via the app.
  • ASIFlex Online: Sign in to your online account to submit a claim.
  • Toll-free fax or mail: Download and complete a claim form. Then, submit it with your itemized statement of service(s) or EOB. Be sure to keep a copy for your records.

If approved, reimbursement will be made to you within three business days following receipt of a complete claim.

 

What is auto-adjudication and how does it work?

Auto-adjudication is when card transactions are automatically substantiated following IRS guidelines and using available data. IRS guidelines allow the following items to be auto-adjudicated and will not require follow-up documentation:

  • Flat dollar copayments under PEBA's insurance plans, such as a $14 physician office copayment or $9 prescription copayment.
  • Identified recurring expenses at the same provider for the same dollar amount each month that has been substantiated once.
  • Prescriptions or over-the-counter health care products purchased at pharmacies or merchants that identify which products are qualified health care items.
  • Claim data reported from BlueCross BlueShield of South Carolina (BlueCross) and EyeMed that match the amount of an ASIFlex Card transaction.

ASIFlex receives claims data weekly from BlueCross for health and dental claims, and from EyeMed for vision claims. ASIFlex will auto-adjudicate as many card transactions as possible using the data it receives, but can only do so if a transaction amount is equal to the amount shown on the file. If the card transaction does not exactly match the insurance claim data, you will need to provide follow-up documentation.

 

It's important to remember using the ASIFlex Card is not a completely paperless process; there are times when you will need to submit documentation. IRS regulations require you to retain appropriate documentation each time you use the card in case you need to substantiate a transaction. Carry the ASIFlex Wallet Card with you to show your provider. Each time you use the debit card, ask the provider for an itemized statement of the service(s) provided in case you need to submit documentation. The itemized statement must include the following:

  • Provider name;
  • Patient name;
  • Date of service (not just the date paid);
  • Description of service; and
  • Dollar amount owed.

 

How do I know if documentation is required?

ASIFlex will only receive data once your provider submits a claim to BlueCross or EyeMed. If ASIFlex does not have data for you or the amount does not match your card transaction, you will be notified.

 

There are two ways you will know if documentation is required:

  1. ASIFlex sends your first notification at least 10 days after receiving notice of your card transaction. You'll have 52 days to submit documentation and will receive three requests for documentation. If a transaction is not substantiated within 52 days, your card will be deactivated.
  2. You can log in to your participant account to view your account statement. Transactions that require documentation will be highlighted and you will have a secure message.

If you choose to pay your provider after you receive a final bill, ASIFlex will look back at insurance claims data it has received in the last 120 days to attempt to auto-adjudicate the transaction.

 

If you believe that a card transaction matches an insurance claim, but it is still highlighted online, you can call ASIFlex at 833.SCM.PLUS (833.726.7587) and ask them to match the insurance claim data with the card transaction.

 

What else should I keep in mind?

You must submit valid claims incurred by December 31, 2019, before March 31, 2020, for reimbursement. However, if you don't use all your funds, you can carry over up to $500 in unused funds into 2020. You will forfeit unused funds over $500.

 

Where can I get more information?

You can review your account statement and read messages by logging in to your participant portal. You can also find a variety of resources, including forms and useful links, online at www.asiflex.com/SCMoneyPlus. More information is available in the MSA FAQs and ASIFlex Card FAQs.

 

Who do I contact if I need help?

ASIFlex is your best contact if you need help with your MSA or have questions about something you see in your portal. You can reach them at 833.SCM.PLUS (833.726.7587). Customer Service is available Monday - Friday, 8 a.m. to 8 p.m., and Saturday, 10 a.m. to 2 p.m., ET.

 

You can also email ASIFlex at asi@asiflex.com.

 

State Health Plan premiums remain among nation's lowest

February 12, 2019

Composite premiums for the State Health Plan are the fourth lowest in the nation, according to the lastest analysis of what public employers and employees are paying for health insurance. The Plan's composite premium is 20.2 percent lower than the South regional average and 30.1 percent lower than the national average of other state plans.

 

Learn more about how the Plan compares to other plans around the nation in the 2019 50-State Survey. You can also check out the State Health Plan benchmarks.

 

PEBA releases bid for Group Vision Benefits

January 7, 2019

The South Carolina Public Employee Benefit Authority (PEBA) has released an Invitation for Bid (IFB) to Provide Group Vision Benefits. The IFB is located here. Please see the IFB for instructions on asking questions or requesting additional information.

 

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