Committee discusses Lafayette clinic access, POS option and exceptions for dependents

Committee members asked how a network change would affect employees who receive care at Lafayette clinics. Casey and Wendy explained that "the Lafayette clinic is considered in network for the traditional network" but would be excluded under the Dean focus network; affected employees could elect the POS plan to retain coverage for out-of-network visits at lower reimbursement.

Staff also noted exceptions for out-of-area dependents. Casey said the carrier makes allowances for dependents who live outside the service area — for example, college students — and those dependents may still be eligible for in-network coverage even when the employee is enrolled in an HMO. The committee discussed how those coverage and referral rules could affect scheduling of planned procedures and whether staff should survey employees about upcoming care needs; staff agreed to include such questions in the planned survey and to reconfirm enrollment statuses for the 41 impacted members.