MINNEAPOLIS POLICE RELIEF ASSOCIATION

2008 Medica Health Plan Design Options and Rates

Medica provides medical coverage for City employees and retired members under 65. Below is a benefit comparison of the four Medica plans available to you. The single and family premium rates for 2008 are noted at the bottom of the plan comparison. If you would like to make a change for 2008, you will need to complete a Medica application and return it to the MPRA office by Friday, November 30, 2007. Forms are available by calling 612-378-1449 or 1-800-484-9729, #9356.

Please contact Medica at (952) 945-8000 or 1-800-952-3455 with questions regarding coverage and plan designs.

City of Minneapolis

2008 Retiree Medical Plan Options

Plan Name	1 Medica Elect/ Essential		2 Medica Elect/Essential		3 Passport from Medica (Medica Choice with United Health Care Options PPO)		4 Passport from Medica (Medica Choice with United Health Care Options PPO)
Plan Type	Care system model Clinic # required		Care system model Clinic # required		Open Access		Open Access
	In-Network	Out-of-Network	In-Network	Out-of-Network	In-Network	Out-of-Network	In-Network	Out-of-Network
Calendar Year Deductible	$250/person $500/family	$1000/person $2000/family	$750/person $1500/family	$1000/person $2000/family	$500/person $1000/family	$1000/person $2000/family	$1000/person $2000/family	$1500/person $3000/family
Annual Out-of-Pocket Max	$1000/person $2000/family	$2000/person $4000/family	$1000/person $2000/family	$2000/person $4000/family	$1500/person $3000/family	$2000/person $4000/family	$1500/person $3000/family	$2000/person $4000/family
Lifetime Maximum	Unlimited	$2 million	Unlimited	$2 million	Unlimited	$2 million	Unlimited	$2 million
Preventative Care	100% coverage		100% coverage		100% coverage		100% coverage
	Member/Patient Responsibility		Member/Patient Responsibility		Member/Patient Responsibility		Member/Patient Responsibility
Office Visits Illness or Injury Chiropractic Care Mental Health & Substance Abuse	Deductible 10% Deductible 10% Deductible 10%	Deductible 40% Deductible 40% Deductible 40%	20% 20% 20%	Deductible 40% Deductible 40% Deductible 40%	Deductible 20% Deductible 20% Deductible 20%	Deductible 40% Deductible 40% Deductible 40%	Deductible 20% Deductible 20% Deductible 20%	Deductible 40% Deductible 40% Deductible 40%
Prescription Drugs Retail (up to a 34-day supply)	Formulary Only $12 copay	Deductible 40% or $12 whichever is greater	Formulary/ Non-Formulary: 20% $10 min - $30 max	Deductible 40% or $30 whichever is greater	Formulary/ Non-Formulary: 20% $10 min - $40 max	Deductible 40% or $40 whichever is greater	Formulary/Non-Formulary: 20% $10 min - $40 max	Deductible 40% or $40 whichever is greater
Prescription Drugs Mail order (up to a 93-day supply)	Formulary Only $24 copay	No coverage	Formulary/ Non-Formulary: $40 copay	No coverage	Formulary/ Non-Formulary: $50 copay	No coverage	Formulary/Non-Formulary: $50 copay	No coverage
	All Specialty Drugs must be filled at Walgreen�s Specialty Pharmacy
Inpatient Hospital Services	Deductible 10%	Deductible 40%	Deductible 20%	Deductible 40%	Deductible 20%	Deductible 40%	Deductible 20%	Deductible 40%
Outpatient Hospital Services	Deductible 10%	Deductible 40%	Deductible 20%	Deductible 40%	Deductible 20%	Deductible 40%	Deductible 20%	Deductible 40%
Lab and Pathology	Deductible 10%	Deductible 40%	20%	Deductible 40%	Deductible 20%	Deductible 40%	Deductible 20%	Deductible 40%
X-Ray and Other Imaging	Deductible 10%	Deductible 40%	20%	Deductible 40%	Deductible 20%	Deductible 40%	Deductible 40%	Deductible 40%
Emergency Care Urgent Care Hospital ER	Deductible 10% Deductible 10%	In-network deductible 20%	20% Deductible 20%	In-network deductible 20%	Deductible 20% Deductible 20%	Covered as in-network benefit	Deductible 20% Deductible 20%	Covered as in-network benefit
Monthly Premium Single Family	$394.18 $1,393.72		$376.81 $1,337.05		$421.19 $1,484.99		$329.86 $1,161.44

This health care plan may not cover all your health care expenses; read your Certificate of Coverage carefully to determine which expenses are covered. This is a benefit summary only and does not outline all of your benefits. If there is a discrepancy between information in this summary and your Certificate of Coverage, the Certificate of Coverage will take precedence in determining your benefits.

Definitions

Plan Type

Network and access model for each plan. Plans 1 and 2 require you and each family member to select a primary care clinic at the point of enrollment. Plans 3 and 4 are open access network plans in which a primary care clinic selection is not required.

Calendar Year Deductible

The fixed dollar amount you must pay on a calendar year basis before claims for health services or supplies are reimbursable. When members in an enrolled family unit (an employee and his/her dependent(s) have together paid the family deductible for benefits received during the calendar year, then all members of the family unit are considered to have satisfied their deductible for that calendar year.

Annual Out-of-Pocket Maximum

Accumulation of copayments, coinsurance and deductibles. When members in an enrolled family unit (an employee and his/her dependent(s) have together satisfied the family out-of-pocket maximum for benefits received during the calendar year, then all members of the family unit are considered to have satisfied the family out-of-pocket maximum for that calendar year.

Lifetime Maximum

The dollar amount your plan will pay for eligible health care expenses in a member�s lifetime. Each member has a separate lifetime maximum.

Preventive Care

Preventive health care when there is no existing condition or complaint about your health, regardless of the reason the office visit was scheduled. Services include: health education and supervision services provided during office visit, immunizations, early disease detection services (including physicals), routine screening procedures for cancer.

Prescription Drugs

Formulary: Medica�s preferred list of drugs (includes generic and brand name), some OTC drugs and supplies that are used for dispensing some drugs. Non-Formulary: Any drug or supplies not on the Formulary List.

Prescription unit equals up to 34-consecutive day supply (unless limited by drug manufacturer�s packaging or Medica�s appropriate use guidelines), up to 34-day supply per type of insulin or 3 cycles or oral contraceptives.

Mail Order Drugs: Prescription unit equals up to a 93-day consecutive supply (unless limited by drug manufacturer�s packaging or Medica�s appropriate use guidelines). Mail order drugs may be obtained through BioScrip or Walgreens Mail services.

Specialty Drugs: All Specialty Drugs (to see list go to www.Medica.com and click on Pharmacy) must be obtained through Walgreens Specialty Pharmacy (a separate mail order program)

X-ray and Other Imaging

In addition to standard x-rays, other imaging includes (but not limited to) enhanced imaging such as CT, MRI and PET scans.

Finding a Network Provider

Plans 1 and 2

Call Medica customer service at 952-945-8000 and identify yourself as a City of Minneapolis retiree OR

Go to www.medica.com

Click on �Find a Doctor� (on the left hand side of the page)
In the section labeled �Network Selection Option�, click on the drop down arrow and select �Medica Elect� or �Medical Essential� and click on �Submit�
If you are looking for a national provider, click on �Travel Benefit � UnitedHealthCare Options PPO� and click on �Submit�

Finding a Network Provider

Plans 3 and 4

Call Medica customer service at 952-945-8000 and identify yourself as a City of Minneapolis retiree OR

Go to www.medica.com

Click on �Find a Doctor� (on the left hand side of the page)
In the section labeled �Network Selection Option�, click on the drop down arrow and select �Medica Choice with United Health Care Options PPO-Insurance� and click on �Submit�

2008 Senior Health Care Products � Medicare Eligible Benefit Comparisons

At this time you have the opportunity to change or enroll in one of the three MPRA 2008 Senior plans. Below is a benefit comparison of the three plans offered by the MPRA. You must have Medicare Parts A & B to join one of the three plans. If you elect to change from your current coverage, please contact the MPRA office and we will send you out an enrollment form. Enrollment forms need to be completed and submitted to the Pension Office by Friday, November 30, 2007. You do not need to complete a medical change form to keep your current coverage. If you have any questions about any other different benefit levels, or need assistance with any of the below plans, please call their Customer Service Department.

By having coverage with the MPRA through the three plans below, the Medicare Prescription Drug Coverage (Part D) is part of your already comprehensive set of benefits.

&nbs