April 11, 2017
Dear Select Choice Network Participant,
Benefit Open Enrollment is upon us and we feel that it is important to reach out to employees who will be directly
impacted by some medical plan changes taking effect July 1, 2017.
Currently, Eden Prairie Schools offers medical plans in two HealthPartners networks:
 Open Access: A broad network with access to national coverage
 Select Choice: A narrow network requiring a “home” clinic and referrals for specialty care
Effective July 1, 2017, Eden Prairie Schools will only offer the HealthPartners Open Access Network. Select Choice plans
will be discontinued. This decision was made after much analysis and consideration and we would like to provide you
with a detailed explanation to help you understand the reason for the change.
Background Information
Medical insurance can be very complicated to understand. Provided below is a list of definitions to assist in your
understanding of our upcoming change:
Premium
Claim
Provider
Network
Cost to carry insurance. The district contributes to the cost of your premium and you are responsible
for any remaining amount. Premiums are found on your paycheck and are used to pay for
administrative fees and claims.
Cost incurred when you access care. Oftentimes you pay a portion of your claim and the plan pays a
portion as well. You receive an Explanation of Benefits (EOB) from HealthPartners when a claim is
incurred.
The person or entity you access for care (i.e. your doctor). Providers contract with insurance
companies and typically offer discounts on services through these contracts.
Choice of providers available to you to receive care. Eden Prairie Schools currently offers two
HealthPartners networks: Open Access (broad) and Select Choice (narrow).
For many years, Eden Prairie Schools has offered three different plan designs, each with two different network options.
When an employee has chosen the narrower Select Choice network, they have agreed to narrow their choice of innetwork providers in order to pay a cheaper cost for their premium.
Why the change?
In 2016, the District began contracting with OneDigital to provide benefit consulting services which include analyzing
and presenting summarized claims data each month to the District Insurance Committee. (Note: Claims data never
includes specific employee names or personal information.) In our 2016-17 plan year, it was discovered that although
Select Choice participants are receiving significantly cheaper premiums than Open Access participants, the cost of
services are not actually discounted to match. In fact, providers contracted in both the Select Choice and Open Access
networks do not offer better discounts to participants with Select Choice coverage.
This became alarming because claim cost for Select Choice participants was similar to Open Access, but much less
premium was received to pay for claims. It became obvious that a significant increase to premiums would be necessary
to cover the cost of claims, so OneDigital provided options to the District Insurance Committee to consider when looking
at the continuation, adjustment, or elimination of our Select Choice plan options.
It was discovered that in order for Select Choice premiums to align with actual claim cost, an estimated 18% increase
would have been necessary in 2017-18 for all Select Choice plans. This would have resulted in Select Choice premiums
costing about the same as Open Access, but Select Choice participants would still be limited to the narrower network.
The decision was carefully made to eliminate the Select Choice network to provide all employees with the broader Open
Access network.
What will my choices be for 2017-18?
The three Open Access plans still available for the upcoming 2017-18 plan year are:
 Traditional $500 deductible – $30 Copay
 Three for Free $1000 deductible – 75% Coinsurance*
 Three for Free $1500 deductible – 75% Coinsurance*
*VEBA (HRA) contributions exist in some bargaining agreements for employees enrolled in a Three for Free plan.
Open Access Network Highlights
The Open Access Network provides great benefit opportunities:
 Largest choice of clinics and doctors that HealthPartners offers
 No Primary Care Clinic needed
 No referrals required for specialty care
 Opportunity to shop service costs with many different providers
 Access to the CIGNA national network when traveling or for covered dependents who live out of state
What will I need to do for Open Enrollment?
Open Enrollment runs from April 17 – May 1, 2017. It is recommended that you complete an Open Enrollment Form this
year to formally elect your new plan effective July 1, 2017. However, if a form is not received from you, coverage will not
be lost. The plan you currently carry will just be mapped to the Open Access version.
 Example: If you currently carry Select Choice Traditional coverage in 2016-17 and do not complete a form during
Open Enrollment, your coverage will automatically change to Open Access Traditional coverage effective July 1,
2017.
What if I have questions?
A number of different options are available to provide you with education, resources, and answers to questions you may
have. Please see below:
Open Enrollment Meetings
Eden Prairie Schools Website
Human Resources
Corporate Health Systems (CHS)
aka OneDigital
You are welcome to attend an Open Enrollment meeting! Meetings are full of
important benefit information and will also give you an opportunity to ask
questions of OneDigital and HealthPartners. If you wish to attend, please refer to
the Eden Prairie Schools website for dates, times, and locations.
www.edenpr.org
Departments > Human Resources > Post-Employment Benefit Information
Katy Stromberg
952-975-7035 or [email protected]
Kymm Thomas
952-873-7150 or [email protected]