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3.B.
Employee Benefit Trust Board Meeting
Meeting Date:
12/15/2021
Department Head:
Maria Munoz
Submitted By:
Maria Munoz, HR Benefits Coordinator, Human Resources Department

ITEM:

Discussion and possible action on any and all matters regarding Complex Imaging and lab services.(Susan Posada, Broker and Consultant)

SUMMARY:

Laboratory and Complex imaging services in the local Yuma area are increasingly high, and its expensive costs are directly affecting the members as well as the plan. By creating Stand-alone providers the members can directly go to these clinics and receive lab and complex imaging services by paying a $25.00 co-pay only, instead of going through the YRMC providers and paying co-pay, co-insurance and deductible. Stand-Alone Providers list:
Imaging
-South County Diagnostic Services - 151 S. Oak Avenue, Suite 5, San Luis, AZ
-SimonMed Imaging - 2500 S. 8th Avenue, Ste 103, Yuma, AZ
Labs
- Labcorp (3 locations)
     1) 1951 W. 25th Street, Ste F, Yuma, AZ
     2) 2435 Ave A Yuma, AZ
     3) 1240 W 24th Street, Yuma AZ
- Sonora Quest Laboratory - 2270 S. Ridgeview Dr., Yuma AZ

Diagnostic X-ray and Lab—US Plan
  • $15 co-pay primary care       
  • $25 co-pay contracted standalone provider: No deductible
  • No charge if using a facility through E-surgeries
  •   20% after deductible at a hospital
Complex – MRI, CT and PET Scan—US Plan (Prior Authorization Required)
  •  No charge if using a facility through E-surgeries
  •  $25 co-pay at contracted standalone provider. No deductible
  •    20% after deductible at a hospital

ESurgeries program continues to be in effect and is currently working on contracting with local providers.
 

RECOMMENDATION / SUGGESTED MOTION:

I MOVE TO AMEND THE BENEFITS PLAN TO ALLOW FOR STAND-ALONE IMAGING AND LAB SERVICES PROVIDERS AND AUTHORIZE STAFF TO TAKE ALL ACTIONS NEEDED TO ACCOMPLISH IT.

Fiscal Impact

Fiscal Impact:

N/A

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