1 / 19

Summer Enrollment Plan Year 2018

Learn about the upcoming changes to the ERS Group Benefits Plan for Plan Year 2018, including transition to new TPA BCBSTX for medical benefits. Details on provider networks, referrals, care management, and more.

aguayo
Download Presentation

Summer Enrollment Plan Year 2018

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Summer Enrollment Plan Year 2018

  2. MIDWESTERN STATE UNIVERSITYHuman Resources Department ERS Group Benefits Plan (GBP) - Plan Year 2018 Summer Enrollment June 26 – July 28, 2017 MSU On-line keying phase July 9 – July 22 Completion of forms in HR June 26 – July 27 All changes are effective 9/1/2017

  3. ERS Group Benefits Plan (GBP) - Plan Year 2018Plan Year Changes Effective 09/01/2017 UPCOMING CHANGES BCBSTX New TPA For Medical HealthSelect Rates Dependent Eligibility Prescription Drugs Other Changes Summer Enrollment Links Questions

  4. ERS Group Benefits Plan (GBP) - Plan Year 2018BCBSTX New TPA for Medical Employees Retirement System (ERS) • Establishes the plan design by determining copays, coinsurance, and deductibles Blue Cross Blue Shield of Texas (BCBSTX) • Manage the provider network • Process claims • Oversee wellness and disease management programs • Provide customer service • ID cards received in late August – update providers 9/1/2017 • Any deductibles or coinsurance already paid will transfer from UHC to BCBXTX on 9/1/2017.

  5. ERS Group Benefits Plan (GBP) - Plan Year 2018BCBSTX New TPA for Medical What do I need to do? • If enrolled in the HealthSelect plan, make sure your PCP and any specialists are in the HealthSelect network by going to the provider finder at www.bcbstx.com/hs or by calling BCBSTX at 1-800-252-8039 • If PCP is still in the network as of 9/1/2017, your designation will transfer from UHC to BCBSTX and will be printed on your new medical ID card • If PCP or specialist is not in the network, you need to nominate your doctor(s) by form on the BCBSTX website, “Publications and Forms”, “Nominate a Provider” or call BCBSTX. THIS IS IMPORTANT!

  6. ERS Group Benefits Plan (GBP) - Plan Year 2018BCBSTX New TPA for Medical What do I need to do (cont’d)? • If PCP does not join the network, you may need to designate a new PCP. If a PCP is not designated, you will pay more for medical services. BCBSTX will send out a letter to anyone who’s current designated PCP is no longer in network as of 9/1/2017. • Consumer Directed High Deductible Plan and HealthSelect Out-of-State participants do not need to designate a PCP, but you will save money by seeing network providers. Go to http://www.bcbstx.com/hs to make sure your doctor(s) are in the network.

  7. ERS Group Benefits Plan (GBP) - Plan Year 2018BCBSTX New TPA for Medical Referrals and Prior Authorizations • If issued by UHC prior to 9/1/2017, will transfer to BCBSTX • If provider is still in the HealthSelect network, referrals and prior authorizations will be honored through original expiration date • If provider is no longer in the network, referrals and prior authorizations will be honored for 90 days or end date of referral, whichever is sooner. • Beginning 9/1/2017, all new referrals and prior authorizations will need to be issued by BCBSTX • If you are uncertain as to the status of your referrals, call BCBSTX at 1-800-252-8039.

  8. ERS Group Benefits Plan (GBP) - Plan Year 2018BCBSTX New TPA for Medical Currently enrolled in a care management program with UHC? • You will automatically be enrolled in a BCBSTX care management program. • You will receive a letter for BCBSTX notifying you of enrollment, but you can opt out. • You may receive a phone call from a BCBSTX nurse who will review the care plan with you and answer any questions you may have regarding the plan.

  9. ERS Group Benefits Plan (GBP) - Plan Year 2018BCBSTX New TPA for Medical Transition of care • If currently receiving care for a chronic illness or an acute medical condition, or if you are in your second or third trimester of pregnancy, you may be able to continue in-network health care services from current provider if he/she is no longer in the HealthSelect network after 9/1/2017. • You will need to complete the on-line Transition of Care form and fax it to BCBSTX at 1-972-766-9601. If your doctor(s) are not in the network at this time, fax this form ASAP. • You should receive a phone call from a BCBSTX within 5 business days after submitting the Transition of Care form. You will also receive a written reply indicating the decision made by BCBSTX regarding your transition of care benefits. Questions regarding completion of the form or the transition of care process should be directed to BCBSTX at 1-800-252-8039.

  10. ERS Group Benefits Plan (GBP) - Plan Year 2018BCBSTX New TPA for Medical HealthSelect out-of-state plan • Applies to members and eligible dependents who live or work outside of Texas; work or home address must be outside the state of Texas. • No longer a $200 per person or $600 per family deductible if accessing in-network services. • Copay for in-network PCP/Specialist visits instead of coinsurance. • Health Select Out-of-State provider finder tool

  11. ERS Group Benefits Plan (GBP) - Plan Year 2018 Comparison of FY17 and FY18 Member Cost HealthSelect FT Member Premium FY17 FY18 Change Member Only $0.00 $0.00 $0.00 Member Spouse $353.68 $356.32$2.64 Member Children $236.80 $238.58$1.78 Member Family $590.48 $594.90 $4.42 HealthSelect PT Member Premium FY17 FY18 Change Member Only $308.65 $310.95$2.30 Member Spouse $839.17 $845.43$6.26 Member Children $663.85 $668.82 $4.97 Member Family $1194.37 $1203.30 $8.93

  12. ERS Group Benefits Plan (GBP) - Plan Year 2018 Comparison of FY17 and FY18 Member Cost Consumer Directed HealthSelect FT Member Premium FY17 FY18 Change Member Only $0.00 $0.00 $0.00 Member Spouse $318.32 $320.68$2.36 Member Children $213.12 $214.72$1.60 Member Family $531.44 $535.40 $3.96 Consumer Directed HealthSelect PT Member Premium FY17 FY18 Change Member Only $308.65$310.95$2.30 Member Spouse $803.81 $809.79$5.98 Member Children $640.17 $644.96$4.79 Member Family $1135.33 $1143.80 $8.47

  13. ERS Group Benefits Plan (GBP) - Plan Year 2018Dependent Eligibility Process Enrolling dependents in medical? • You must verify eligibility of any new dependent added to medical. • Aon Hewitt will mail a letter outlining steps needed to verify eligibility. • Must submit documentation to Aon Hewitt by deadline. • If documentation is not sent by deadline or if dependent is found ineligible, dependent is dropped from coverage by ERS. • Questions should be directed to Aon Hewitt at 1-800-987-6605.

  14. ERS Group Benefits Plan (GBP)-Plan Year 2018Prescription Coverage – Optum Rx • Optum Rx, a subsidiary of UHC, will remain as drug administrator • Copays and deductible remain the same • New ID card will be received in late August with a new phone number listed on the back of the card

  15. ERS Group Benefits Plan (GBP)-Plan Year 2018State of Texas Dental Choice PlanComparison of FY17 and FY18 Member Cost State of Texas Dental Choice – 3% increase Member Costs FY17 FY18 Change Member Only$26.61 $27.41 $0.80 Member Spouse$53.22 $54.82 $1.60 Member Children$63.86 $65.78 $1.92 Member Family$90.47 $93.19 $2.72

  16. ERS Group Benefits Plan (GBP) - Plan Year 2018Other Changes • Short Term Disability premiums decrease approximately 1% - $0.26 per $100 of monthly salary, capped at $10,000 monthly. • TexFlex Healthcare annual maximums increase to $2,600 Note: Remember that TexFlex yearly pledges will roll to the new plan year. If you want to change your yearly pledge amount or stop TexFlex, you must make the change in ERS on-line or by completing a form in HR by July 27th at 5 pm. If you are currently maximizing at the $2,550 amount, and you want to continue to maximize, you must make the change in ERS on-line to $2,600.

  17. ERS Group Benefits Plan (GBP) - Plan Year 2018General Information MSU Summer Enrollment Page ERS Summer Enrollment Page

  18. ERS Group Benefits Plan (GBP) - Plan Year 2018 QUESTIONS ?

More Related