What the change to Regence means for you

During open enrollment, you will have the option of electing KingCare^SM or SmartCare Connect, powered by Group Health, just as you have in the past. If you are a deputy sheriff, you will have the option of electing SmartCare Connect or the Deputy Sheriff Plan, which will continue to be administered by Aetna, based on your collective bargaining agreement.

The shift from Aetna to Regence will happen automatically for all employees who enroll in KingCare^SM. All of the KingCare^SM services you’ve been receiving will continue when Regence begins administering claims on Jan. 1, 2012. You will continue to receive your prescription drug coverage from Express Scripts.

If you choose SmartCare Connect, you can take advantage of Group Health’s nationally recognized coordinated care with access to all of your services in one place. Plus, you can access all of your records online and even email your doctor. For more information about Group Health, visit www.ghc.org.

More about the change to Regence

KingCare^SM is a self-insured plan, which means that King County covers the cost of your medical care after you pay coinsurance or copays. To handle the claims processing, the county hires a third-party administrator, which is who you or your doctor submits claims to.

For the past decade, the county has contracted with Aetna to serve as its third-party administrator for KingCare^SM. Every five years, the county conducts the necessary procurement process to select the third-party administrator that offers the best pricing and overall services for the county.

In 2011, the county selected Regence based on the information the company provided and projected savings of $6 million/year to manage KingCare^SM. The selection of Regence through this procurement process will not change the KingCare^SM benefits you currently receive.

Your new network

With Regence, you will have access to an extensive network of health care providers and the worldwide Blue Cross and Blue Shield network of providers. But, you will need to check with your health care providers to see if they are part of the Regence network, which is very comparable to the Aetna network in physicians, clinics and hospitals. On Oct. 24, 2011, you will be able to review the list of Regence network providers by reading these instructions before visiting www.myhealthtoolkitrgw.com. This website is also where you will be able to set up your personal account profile, access your claims online, find health and wellness information and more, beginning Jan. 1.

While most health care providers will remain the same, there may be fewer providers for some services. For example, there are fewer alternative medicine providers, such as massage therapists and acupuncturists. Of course, you can always use your same health care providers with Regence. However, as with Aetna, under the terms of the plan, if your doctor is not a Regence network provider, you will pay more for the services you receive, you will pay the provider directly, and you will have to file your own claim with Regence for reimbursement. Reimbursement will be paid at the out-of-network rate on usual and customary charges, not billed charges. Learn more by reading your plan booklet and Benefits at a Glance at www.kingcounty.gov/employees/benefits/YourKingCountyBenefits.

Your new card

If you stay with or choose KingCare^SM during open enrollment, you will receive a Regence ID card in December. The card will have your Regence ID number and your name as the subscriber. Unlike the Aetna ID cards, the Regence cards will not list names of your dependents. You will receive two cards if you cover a spouse or domestic partner. You and any of your enrolled dependents may use a card with your name on it. After Jan. 1, you will be able to order additional cards online at www.myhealthtoolkitrgw.com.

Where to get more information

Return to this page before and during open enrollment for updates. A Regence phone number just for county employees will become available on Dec. 1.

Contacting Aetna

Throughout 2012, you may continue to contact Aetna for services you received in 2011. Aetna will continue to provide customer service for benefits or services that were provided before Jan. 1, 2012.