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Open Enrollment October 29 to November 16 Plan Year 2013

Open Enrollment October 29 to November 16 Plan Year 2013. UHR Office of Employee Benefits. Topics We Will Cover. Medical Plan Prescription Plan Davis Vision Flexible Spending Accounts Tax Deferred Savings . UVa Health Plan Enhancements:.

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Open Enrollment October 29 to November 16 Plan Year 2013

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  1. Open Enrollment October 29 to November 16Plan Year 2013 UHR Office of Employee Benefits

  2. Topics We Will Cover • Medical Plan • Prescription Plan • Davis Vision • Flexible Spending Accounts • Tax Deferred Savings

  3. UVa Health Plan Enhancements: • Preventive services will be covered at 100%, no office visit copay for preventive care at any participating provider. • Telemedicine services will be covered when provided by UVa providers. • Enhanced disease management programs with dedicated staff for UVa health plan participants.

  4. UVa Health Plan Enhancements: • Lower out of pocket costs when using UVa providers • Continue with reduced copays on Primary Care, Specialist Care, Maternity Care, and Mental Health Office Visits • For the Low Plan, the deductible is waived when using UVaproviders • Where it applies, for the High Plan, the deductible is also waived for UVaproviders

  5. UVa Health Plan: • Certain co-pays in the High plan are lowered for UVaproviders and increased for other in-network providers: • Inpatient Hospital – • decrease from $300 to $200 for UVa admissions • increase from $300 to $400 for non-UVa admissions • Outpatient Procedures – • decrease from $125 to $100 for services at UVa • increase from $125 to $200 for non-UVa services • Home Health- • Paid in full for UVa providers • Increase from paid in full to deductible and 10% for non UVa providers

  6. UVa Health Plan Rates: • Premiums for active employees in the Low Premium Plan remain the same • Modest increase in premiums for active employees in the High Premium ($3/month for single, $12/month for family) • Premiums for retirees increase in both plans

  7. UVaHEALTH PLAN Active Premiums 2013

  8. Prescription Plan changes • Change terminology from Generic, Preferred Brand, and Non-Preferred Brand to Tier 1, Tier 2, and Tier 3 • Tier 1 most current generics and some cost- effective brand drugs • Tier 2 most brand drugs, or more costly or less desirable generics • Tier 3 non-preferred brand drugs and some more costly generics

  9. Prescription Plan Enhancements • Certain generic drugs will be covered at 100%: • birth control (Tier 1 and Tier 2 generics) • aspirin for appropriate populations • fluoride for children under 5 • folic acid for appropriate populations • iron supplement for children under 1

  10. Prescription Plan Enhancements • HealthyRx program When a participant is identified for a disease management program and engages at the highest level, prescription copayments for Tier 1 and Tier 2 drugs will be reduced: Retail: Tier 1 $0, Tier 2 $15 Mail Order: Tier 1 $0, Tier 2 $30

  11. Prescription Plan Enhancements • Expand Smoking Cessation Program • Waive Rx copayments for tobacco cessation drugs when enrolled in the Quit for Life Program • Provide coverage for 3 cycles of Chantix (each cycle is 180 days)

  12. Prescription Plan changes • Retail Costs (30-day Supply) • Tier 1 $6.00 • Tier 2 20% costsharing after deductible (minimum $26, max $100) • Tier 3 20% costsharing after deductible (minimum $52, max $100) For prescriptions filled at UVa, there will be no minimum dollar requirement.

  13. Prescription Changes: Specialty Change to a three tier structure Tier 1 20% costsharing (minimum $100, max $200) Tier 2 20% costsharing (minimum $150, max $250) Tier 3 20% costsharing (minimum $200, max $300) Lower cost sharing if using UVaSpecialty Pharmacies Tier 1 20% costsharing(max $50) Tier 2 20% costsharing(max $100) Tier 3 20% costsharing(max $150)

  14. Mail Order Changes: Mail Order (90-day supply) Tier 1 $14 Tier 2 20%cost sharing (minimum $65, maximum $300) Tier 3 20%cost sharing (minimum $130, maximum $300)

  15. UVaHealth Plan:Things to Consider • Monthly cash flow • Average annual health costs • Tolerance for unexpected/unplanned expenses • Participation in the Flexible Spending Account Program • Have an opportunity to change next year

  16. UVA Health Plan:What Do You Do • If you wish to change programs, make your changes on line through Benefits@UVa self-service or PeopleSoft self-service • Complete all Open Enrollment changes by Friday November 16th

  17. UVaHealth Plan:Reminder about dependents Drop ineligible dependents – On an audit completed in 2012, 6% of audited dependents were found to be ineligible. Now is the time to remove former spouse and/or relatives other than legal spouse and children Children who turn 26 this year will be automatically dropped 12/31/2012 Additional audits scheduled for 2013

  18. Other Open Enrollment Items • Vision Insurance • Davis Vision • Flexible Spending Accounts • Chard Snyder • Tax Deferred Savings Plan

  19. Davis Vision Insurance • Automatic re-enrollment if you are currently enrolled in Davis Vision Insurance; must make change on line to drop coverage • Who is eligible? Benefits-eligible academic and Medical Ctr employees Do not have to be enrolled in the Health Plan to enroll in the Vision Plan • Once each calendar year you can receive • Eye Examination for glasses with a $30.00 copay • Spectacle lenses and frames OR • Contact lenses (enhanced formulary) Employee only $6.29 per month Employee and child $11.01 per month Employee and spouse $11.33 per month Family $17.62 per month

  20. Flexible Spending Accounts:General • You must re-enroll each year and now enroll on-line using Benefits@UVa or PeopleSoft • Programs are use or lose • Debit card or claim form with direct deposit • On-line account info available • $2.75 per month administrative fee • Changes limited based on qualifying events • If you are enrolled in 2012 and elect to re-enroll in 2013, you will use your current debit card. New debit cards will be issued.

  21. Flexible Spending Accounts:Health • Minimum: $240; • New 2013 Maximum: $2500.00 • Grace period until March 15th2014 to incur claims ; until April 30th to file claims • Can be used for: • Drug copays • Vision care • Certain OTC costs (OTC medicines require prescription and manual claims submission) • Uncovered dental • Chiropractic services

  22. Flexible Spending Accounts:Health, cont’d • Cannot be used for: • Cosmetic surgery • Premiums • Vitamins and herbal supplements

  23. Flexible Spending Accounts:Dependent Care • Minimum: $240, Maximum: Depends on tax status • Can be used for: • Before & after school programs • Nursery school, preschool, in-home care • Summer camp (not overnight) • Adult daycare

  24. Flexible Spending Accounts:Dependent Care, cont’d • Can not be used for: • Child support payments • Educational supplies or activity fees • Private school tuition (after preschool) • The Dependent Care program is intended to allow both parents to work or attend school full-time.

  25. Tax Deferred Savings: • The 2013 IRS limits will be released later this fall. • A post-tax Roth 403b will be available in 2013; stay tuned for more details.

  26. Questions? • Contact the UHR Service Center • E:mail: openenrollment@virginia.edu • Mail: PO Box 400127; C’ville 22904-4127 • Phone: 434/982-0123 or MC 243-3344 All changes must be made on line by Friday November 16

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