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June 2012

Benefits 2012/2013 - - An HR Liaison Presentation. June 2012. Ellen Gerescher. Employee Benefits Manager A&M System Office. Contract Renewals. The System Benefits Office administers the System benefit plans and has fiduciary responsibility for sound management of the premium resources

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June 2012

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  1. Benefits 2012/2013 - - An HR Liaison Presentation • June 2012 Ellen Gerescher Employee Benefits Manager A&M System Office

  2. Contract Renewals • The System Benefits Office administers the System benefit plans and has fiduciary responsibility for sound management of the premium resources • Renewed contracts with both BlueCross BlueShield and Medco will result in significant savings • Lower administrative fees, greater network discount savings

  3. Benefit Changes for 9-1-12 Tobacco User Additional Premium Consolidation of Health plans Dependent Audit

  4. What constitutes a tobacco user? This can be defined many different ways.  The A&M System will follow the standard used by the ERS in order to be consistent with other State entities.  A tobacco user is someone who has utilized tobacco more than five times in the previous three months.

  5. Two Years of Changes • Changes for 2011-12 • Merged two A&M Care plans into one plan • Changes for 2012-13 • Merging the Scott & White Health Plan into the A&M Care Plan

  6. Behind the Consolidation • Larger, single risk pool eliminates selection bias and adverse selection • SWHP enrollment has decreased over the past several years • Costs have increased • Members aged • Costs for doctors outside the clinic increased • Plan design continued to mirror that of the A&M Care plan

  7. Transitioning from Scott & White • While plan choice may be gone ---- physician choice remains • Decrease in monthly premiums • Virtually all S&W doctors are in the BlueCross BlueShield network • BCBS phone number for Scott & White members with questions: 1-866-231-5581

  8. Transitioning (cont.) • The Scott & White pharmacies are in the Medco network • Medco website for information about coverage for specific drugs: http://www.medcohealth.com/consumer/site/openenrollment?accessCode=TAMRXBEN14597

  9. New for the A&M Care Plan Starting August 1, your A&M UIN will be your BlueCross BlueShield ID Number, beginning with TXW (for employees) and ZGB (for retirees) – all existing members will get new ID cards Benefits Value Advisor – service that helps employees by locating providers, providing cost estimates, scheduling procedures, etc.

  10. New for the Grad Plan • Expanded to be compliant with Federal Healthcare reform • No plan-year maximum for drug coverage • Preventive care provided at 100% • No pre-existing coverage limitation for members under age 19

  11. Dependent Audit Approximately 10,000 employees with dependent medical coverage audited Approximately 750 dependents dropped; however many dropped voluntarily Audit continues for those with dependents on dental, vision and dependent life only

  12. Thank You! Ellen Gerescher System Benefits Administration Egerescher@tamus.edu 979.458.6330

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