2025 Insurance Information

I have created an EACS Insurance Benefits Google doc which lists all of the links and contact info from the 2025 Benefit Booklet. 

​​​Information summary from Insurance Meeting on 11/14/24 at Annex:

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The three plans – PPO, HDHP Opt. 1, and HDHP Opt. 2 – are still through Signature Care and have not changed as far as what is covered, the provider discounts, etc. If you are comfortable with the current plan you are on, stay on it. If you are considering changing plans, and want more information on which one is best for you, Jen Rose is happy to sit with you to talk about your specific needs. (I have also put together a PPO vs. HDHP comparison, if interested.)

PHP-TPA is taking over for Employee Plans. This is the Third Party Administrator who handles the claims and sends out the Explanation of Benefits (EoBs). They will send out new insurance ID cards after enrollment and they have an online member portal and member app for us to keep track of claims. They will be who you contact with claim questions or when you want to verify if a provider/facility is in-network.

PHP will also take over the FSAs. New cards will be mailed to those who participate in an FSA (for PPO insurance only. The HSAs have not changed. These will still be through UMB.)

Change with the In-Network vs. Out-of-Network options

Our current insurance has two “tiers”: in-network and out-of-network.

The new system will have three tiers:

Tier 1: EPO (Exclusive Provider Organization) Parkview providers and facilities (This would be the same as the current “in-network”.)

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Tier 2: Signature Care Facilities (These are facilities which are partnered with Parkview and not individual providers .)

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Tier 3: Non-Preferred Providers (This would be the same as the old “out-of-network”.)

In this new 3-tier system, the coverage of services along with the provider discounts will be the same as our current plan. The difference is how the amounts you pay will be applied to the deductibles in each tier.

If all of your services are through Tier 1 providers and facilities, all of the claims will go towards the Tier 1 deductible. If you go to a Tier 2 facility, those claims will go towards the Tier 2 deductible. What is still not clear is whether the Tier 2 deductible counts towards the Tier 1 deductible. (Jen Rose is looking into the answer.)  We were told that the Tier 1 deductible DOES GO TOWARDS the Tier 2 deductible, so you don’t have to start all over. (I have requested that Signature Care/PHP provide an example scenario of claims so we can better understand.)

How to tell if your provider is a Tier 1 provider or is out-of-network

Parkview Select Care 3-Tier Directory -
https://www.parkview.com/employer-solutions/select-care/parkview-select-care-3-tier-directory 

Signature Care has a searchable Provider Directory at http://www.Parkview.com/SignatureCareDirectory

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Signature Care EPO Network - Top-Tier (Tier #1) Facilities - www.parkview.com/employer-solutions/signature-care/epo-top-tier-facilities 

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• IMPORTANT: Lutheran Health Physicians and Fort Wayne Orthopedics providers will continue to be in network through December 31, 2024 and appear in the following directory.

• Effective January 1, 2025, all Lutheran Health Physicians and Fort Wayne Orthopedics providers WILL NO LONGER BE PARTICIPATING IN SIGNATURE CARE.

• For a list of providers impacted by this change, click here.

To make certain your physician, ancillary, hospital or other healthcare provider is currently a preferred provider, always ask the provider before you receive care, check online, or contact PHP-TPA.

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