WellPath Changing Emergency Room Benefits

Effective July 1, 2009, WellPath is changing the emergency room (ER) benefits for all Coventry Preferred PPO and WellPath HMO/POS plans. The changes are being made in order to maintain balance between plan and member costs.

For all WellPath HMO/POS plans with a deductible of less than $500 and for all Coventry Preferred PPO plans, the ER copayment will increase to $250. For WellPath HMO/POS plans with a deductible of $500 or more, all ER allowed expenses will be subject to deductible and coinsurance.

The ER benefit has been unchanged over the past four years as costs have continued to climb. The standard copayment of $150 currently covers only 10% of the current cost of this benefit, and without further changes, the copayment amount would cover even less over the next several years. Further, over-utilization has caused ER benefits to become one of the steepest trending among benefit plan offerings.

These benefit changes have become necessary in order for WellPath to remain competitive in the marketplace and keep overall plan costs at a minimum for member employers.

Should you have any additional questions about these benefit changes, please contact our office at 919-403-1986.

Important Notice: Hill, Chesson & Woody does not engage in the practice of law, accounting, or medicine. Therefore, the contents of this communication should not be regarded as a substitute for legal, tax, or medical advice.

May 20, 2009

Hill, Chesson & Woody
Employee Benefit Services

194 Finley Golf Course Road, Suite 200,
Chapel Hill, NC 27517
Phone: 919.403.1986
Fax: 919.869-2063

www.hcwbenefits.com