Out-of-network changes include:
Physician Office Visit for Primary Care/Specialist was 70% after deductible. For 2012 it will be 50% after deductible, a 20% benefit reduction.
True Emergency ER visit copays were equal in 2011. In or out of network provided 80% coverage after a $300 copay, waived if the y were admitted to the hospital. Neutral true emergency care is history. Any out-of-network ER visit gets 50% coverage, a decline of 30%.
Skilled nursing, home health and hospice out-of-network benefits fell from 70% coverage to 50%. Outpatient mental health did likewise.
The City of San Angelo cut out-of-network benefits to get savings. Either city workers/retirees will change doctors or they will bear a heavier burden through increased out-of-pocket costs.
Feel free to compare 2012 benefits to 2011 via the documents below:
COSA Approved Plan Design 2012
COSA Health Benefits 2011