The following plans will be offered:

• AvMed Point of Service (POS)

• AvMed High Option HMO

• AvMed Low Option HMO

• JMH Health Plan High Option HMO

• JMH Health Plan Low Option HMO

For Medicare-Eligible Retirees, the County will continue to offer the

following plans:

• High Option Plan with Prescriptions

• High Option Plan without Prescriptions

• Low Option Plan

The Point of Service (POS) benefits are the same as under the current CIGNA POS plan. The only change is that employees will no longer be required to get a referral from their primary care physicianin order to see a participating specialist.  The High Option HMO plan was designed to closely resemble theexisting HMO programs. The High Option HMO has the same plan design as the current AvMed HMO.The Low Option HMO is a new plan. It includes a gatekeeper, which means you will be required to obtain a referral from your PCP to see participating specialists. It also includes other cost sharing featuressuch as higher copayments than the High Option HMO in exchange for lower biweekly premiums.The Plans for Medicare Eligible Retirees will continue with the existing benefit designs.

The County emphasized that maintaining access to their employees' current medical providers was very important. As part of the evaluation process, the County compared our network against the listof providers that are currently utilized by employees, retirees and dependents in all of the current health plans. AvMed achieved a 99.1% match. Therefore, it is anticipated that in most instances yourdoctor(s) will be part of the new plan.

Yes. In addition to the traditional network offered by AvMed, AvMed has leased the Beech Street network of providers. Beech Street has a large national network of providers, including many local providerswho are not part of the current AvMed network. Most of the doctors in the Beech Street network will now be considered network providers under the POS, High Option HMO and Low Option HMO program.

Please go to http://www.avmed.org/go/mdpht/welcome.asp

Log on to http://www.avmed.org/go/mdpht/welcome.asp and follow the instructions to look up participating providers by name or by zip code(s) of interest or you may call 1-800-682-8633.

A process called Transition of Services will be provided to enable those patients who have certain medical conditions that are being treated by a "non participating" AvMed provider to continue to receiveuninterrupted care until a safer transfer of care to an AvMed provider is arranged. Examples of medical conditions that are eligible for Transition of Services benefits include, but are not limited to:

• Any pregnancy beyond the first trimester on the plan effective date

• Newly diagnosed or relapsed cancer in the middle of treatment

• Trauma

• Recent major surgery

• Chronic illnesses

• Hospital confinement on the plan effective date

• Conditions which require intense medical treatment

You may obtain a Transition of Services form open enrollment regional meetings, which will be conducted throughout the County from October 15 to November 16, 2007. You may also obtain a Transition of Services form from the County's open enrollment benefits website in mid October 2007 or by calling AvMed at 1-800-682-8633.

You may refill your existing prescription whether or not the prescribing physician participates in the AvMed or Beech Street network. Just be sure that your requested drug is on the covered drug list and that you purchase it at a participating pharmacy or through the mail order program. You should also advise the pharmacy that you are an AvMed member and provide your new member number when youcall for a refill. For a list of participating pharmacies, go to  http://www.avmed.org/go/mdpht/welcome.asp

AvMed uses Medco as the mail order provider. Look for the mail order form in the envelope provided in your open enrollment package or call AvMed at 1-800-682-8633. If you are not currently using Medco as your mail order pharmacy, you will need a new prescription written for up to a 90-day supply.

AvMed is working with the County to develop a customized preferred drug list. The AvMed Point of Service (POS) Plan will utilize the current Cigna POS drug list. The list for the High Option and Low Option HMOs is being developed based on the drugs currently covered under the AvMed, Humana and VISTA programs. The customized drug list will be available for viewing by mid October 2007 by logging on to http://www.avmed.org/go/mdpht/welcome.asp or by calling 1-800-682-8633.

Additional information will be distributed to you during the annual open enrollment process. Regional meetings will be scheduled throughout the County to answer questions and assist you in determining which option works best for you. You may contact either AvMed at 1-800-682-8633 during open enrollment or the BenefitsAdministration Unit at 305-375-4288.