680 likes | 815 Views
2010 Open Enrollment Update & UPlan Changes For Calendar Year 2011. What’s in this presentation?. What’s New for 2011 Open Enrollment Basics UPlan Pharmacy Program Changes Flexible Spending Accounts 2011 UPlan Rate Information UPlan Life Insurance Changes and Rates
E N D
2010 Open Enrollment Update & UPlan ChangesFor Calendar Year 2011
What’s in this presentation? • What’s New for 2011 • Open Enrollment Basics • UPlan Pharmacy Program Changes • Flexible Spending Accounts • 2011 UPlan Rate Information • UPlan Life Insurance Changes and Rates • Wellness Program Highlights for 2011 • Other UPlan Information • Open Enrollment Resources • 2011 Plan Rates (charts)
What’s new for the 2010 Open Enrollment? • New Pharmacy Benefit Manager – Prime Therapeutics LLC • Changes in eligible expenses for reimbursement in the Health Care FSA • Increase in Dental benefits annual per person maximum from $1,500 to $1,800 • Increase in Life Insurance Rates for optional life insurance • Online scheduling for flu shots at campus clinics and at the Employee Health & Benefit Fairs: www.bhs.umn.edu/public-health/flu.htm
What is Open Enrollment? • Your annual opportunity to review your benefit elections: November 1–30, 2010 • Employees make changes online at: http://hrss.umn.edu/ • Additional information on Employee Benefits Website at: www.umn.edu/ohr/benefits/openenroll
What benefits can I change? • Add or cancel Medical or elect a different plan option • Add or cancel Dental or elect a different plan option • Add, change, or cancel your dependents • Elect to participate in the Health Care or Dependent Daycare Flexible Spending Accounts
What other benefits can I change? • Elect to participate in Voluntary Long-term Disability coverage (Civil Service and Represented Staff employees), or • Increase or decrease your Long-term Disability benefit amount
What if I do not want to change anything this year? • You do not need to go online and change your elections • Unless you are an FSA participant and want to have an account for 2011 • To change your clinic election, call your health plan directly 2010 is a voluntary Open Enrollment – no changes required
Who can I cover on my UPlan Medical & Dental Plans? • Yourself • Your spouse or registered same-sex domestic partner • Your dependent child or children to age 26 • Unmarried or married • But not the spouse of a married child • Click below to review detailed Dependent Eligibility Definition www.umn.edu/ohr/benefits/eligibility/index.html
Will we receive Open Enrollment booklets this year? • Open Enrollment booklets will be online • Open Enrollment details will be covered in a newsletter in late October, mailed to campus address • A limited number of booklets will be sent to: • Employees who do not regularly use a computer for their jobs • Employees who are on a leave of absence • Early Retirees • Former employees on COBRA • Former employees on separation agreements
Will I get new cards for 1/1/2011? • You will receive a new pharmacy card from Prime Therapeutics that will replace your RxAmerica/CVS Caremark card. Bring it to the pharmacy for prescriptions on or after 1/1/2011 • You will receive a new card if you enroll in a new plan • Medica, HealthPartners medical plan, and Delta Dental will issue new cards • HealthPartners dental plans will not issue new cards
Will flu shots be available this year? • Seasonal Flu Shots will be available this year • Flu shots will be available at campus flu clinics and the Employee Health & Benefits Fairs • Seasonal Flu shots available at MinuteClinic • No copay for flu shots at your own medical clinic • Flu shots at retail locations are full price and will likely not be billed to your medical plan • On the Twin Cities campus: schedule appointment for flu shot online at: www.bhs.umn.edu/public-health/flu.htm
What are the pharmacy changes for 2011? • Prime Therapeutics LLC, will be the new Pharmacy Benefit Manager (PBM) on January 1, 2011 • Replaces CVS Caremark (formerly RxAmerica) • New cards will be mailed in December with information regarding Specialty Medications and Mail Order Service, MTM • Working to transfer all CVS Caremark Mail Order prescriptions (with open refills) and Prior Authorizations to Prime Therapeutics
Who is Prime Therapeutics LLC? • New Pharmacy Benefit Manager chosen in a scheduled Request for Proposal (RFP) process • Headquartered in Eagan, Minnesota • Broad Minnesota and National pharmacy network • Network of 60,000 pharmacies that include Walgreens, Target, Walmart, CVS, other chains and many small retail pharmacies. • Includes HealthPartners pharmacies • Mail order facility in Irving, Texas
Will there be changes for Specialty Medications? • Fairview Specialty Pharmacy will become the exclusive provider of most specialty medications • They offer convenient delivery of medications and additional support for members • Members in the Twin Cities will be able to use any Fairview pharmacy in the network, as well as the home specialty delivery • Statewide, Fairview will ship medications and in Duluth, St. Mary’s and St. Luke’s pharmacies will participate
What is a Specialty Medication? • Prescribed for complex or ongoing medical conditions • Usually are injected or infused • Have unique storage or shipment requirements • Need education or additional support by a healthcare professional • Often not stocked at retail pharmacies
Am I eligible for the Medication Therapy Management Program? Medication Therapy Management Members with four or more medications for chronic conditions UPlan-paid consultations with MTM Pharmacist $8 copay reductions for all Generic Plus and Brand medications for six months HSA members pay full cost of MTM consultations www.umn.edu/ohr/benefits/
How do I contact Prime Therapeutics and Fairview Specialty Pharmacy? • Prime Therapeutics Customer Service: • 1-800-727-6181 • Fairview Specialty Pharmacy Customer Service: • 1-877-509-5115 and 612-672-5289
What are Flexible Spending Accounts? • The UPlan includes: • Health Care Flexible Spending Account • Dependent Daycare Flexible Spending Account • Your contributions to both accounts are made with pre-tax dollars • No Federal, state, or Social Security taxes are taken No FSA Enrollment = No FSA for 2011
How much can I contribute to a Flexible Spending Account? • Health Care FSA • Minimum: $100 • Maximum: $5,000 • Dependent Daycare FSA • $5,000 maximum per family www.umn.edu/ohr/benefits/openenroll
What else do I need to know about Flexible Spending Accounts for 2011? • 2011 contributions are made during the calendar year • 2011 claims can be incurred between January 1, 2011, and March 15, 2012 • “Use it or lose it” • Any amount remaining after March 15, 2012, is forfeited Note: 2010 claims can be incurred through March 15, 2011
Are there any changes for Flexible Spending Accounts for 2011? • Section 9003 of the Affordable Care Act established a new uniform definition of qualified medical expenses effective on January 1, 2011 • Reimbursement will be made only if the medicine or drug (1) requires a prescription, (2) is available over the counter (OTC) and individual obtains prescription, or (3) is insulin • New rule affects purchases made in the 2½ month grace period (1/1 to 3/15/11): must have a prescription for OTC medication beginning 1/1/11 • Note: Insulin does not require a prescription
Are there any other changes for Flexible Spending Accounts for 2011? • New rule does not affect reimbursement for OTC supplies and devices, such as contact lenses and lens cleaning solutions, eyeglasses, prescription and office copays, bandages, blood sugar test kits, and out-of-pocket dental charges • Be conservative in estimating your health care account contributions for 2011: do not include amounts for OTC medications unless you will have a prescription from your physician
How are rates determined for UPlan Medical options? • UPlan: self-insured program • Actuarial consultant: helps set rates • Costs reflect actual cost of care: for employees, early retirees, and dependents • Costs include: Medical and pharmacy claims, external administrative fees, special insurance for high claims, internal costs, MEDEX, wellness program
How is the Base Plan the Key to Employee Cost? • For Medical, employees pay: • 10% of Base Plan for Employee Only • 15% of Base Plan for Family Coverage • Everything above the U’s Base Plan rate contribution for “buy-up” (higher cost) plans • Costs vary by Employee/Family tier • Rate Information: • Next section of this presentation. • U & Your Benefits Newsletter — October 2010
What are the employee Medical rate changes for 2011? • Medical Rates • Increase is 7.5 percent • Same percent increase applies to all plans
Are the same Medical Plans available in 2011? All Medical plans remain the same: • Medica Elect & Essential – Twin Cities & Duluth (Base Plan in Twin Cities and Duluth) • Medica Choice Regional – Greater Minnesota (Base Plan for Greater MN) • U Classic Plus by HealthPartners • Insights by Medica (tiered network) • Medica Choice National (open network) • Medica Health Savings Account (HSA) Plan
Are the same Dental Plans available in 2011? • All Dental options remain the same for 2011 • The base plan choices are: • Delta Dental PPO for the Twin Cities and Duluth • Delta Dental Premier for Greater Minnesota www.umn.edu/ohr/benefits/openenroll
What other Dental Plan options are available in 2011? • All other plans also remain the same: • Delta Dental Premier • HealthPartners Dental • HealthPartners Dental Choice • University Choice Check with Delta Dental or HealthPartners to see whether your dentist is in the plan you are considering
What are the employee Dental rate changes for 2011? • Dental Rates • There is an increase of 3.4% due to an increase in the out of pocket maximum. In 2011, the annual maximum benefit will increase from $1,500 to $1,800 • Same % increase applies to all plans
UPlan Life Insurance Changes and Rates Effective January 1, 2011
Are there changes to the UPlan Life Insurance Rates? • Rates for Additional Employee and Spouse/Same Sex Domestic Partner Insurance will increase by 10% in most age divisions on January 1, 2011 • New rates are based on the claims experience of the University program • Rates are guaranteed for three years
What Wellness Programs will continue in 2011? Wellness Assessment: January through April 2011 Health Improvement Programs Phone-based Health Coaching In-person Health Coaching – Twin Cities, Duluth, and Morris Online Healthy Living Programs and 10,000 Steps® walking program $65 Reward for Employee & Spouse/SSDP Fitness Rewards Program $20 monthly subsidy for health club participants Farmers Market: Minneapolis and Duluth
Are the Weight Management Programs offered again in 2011? Weight Management Programs for 2011 Create your Weight — offered through Fairview on Twin Cities Campus Weight Watchers at Work — offered on The Twin Cities and coordinate campuses with at least 20 participants enrolled You pay up front: Wellness Program will reimburse you in full if you attend 80% of sessions (Costs: $180 to $200) You can be reimbursed for up to three sessions per year; six total lifetime reimbursements HIP (Health Improvement Program) available at UMD at no cost-Weight Management Focused Program Details available at: www.wellness.umn.edu
Would you like to be a Wellness Advocate for your Department? Wellness Advocates Program: Looking for Wellness Advocate from each College, Department Lead departmental Wellness initiatives Wellness Program to provide support, materials, and training Plus special programs for wellness advocates Interested? Email to well@umn.edu
Who can enroll in Long-term Disability during Open Enrollment? Civil Service and Represented Staff Employees May enroll in or change the amount of Long-term Disability during Open Enrollment. Maximum Benefit: 60% of salary up to $5,000 per month. Pre-existing Condition Limit: Disabilities related to medical issues during past 12 months will not be covered for 24 months. www.umn.edu/ohr/benefits/openenroll
When can I enroll in Short-term Disability? You can enroll or increase your Short-term Disability at any time during the year New Short-term Disability enrollments or increases will require proof of good health See Website for details on how to apply www.umn.edu/ohr/benefits/disability/shortterm
What else do I need to know about the UPlan for this year? Open Enrollment – November 2010 Social Security Numbers Required for UPlan Members ages 45 & up CMS / Medicare Requirement Potential denial of claims if SSN is not provided Contact the Employee Benefits Service Center for more information.
Enrolling Online If hired before December 1, new employees may make two elections to participate in FSA for 2010 and 2011 Multiple elections can be made online but not at the same time; wait a day between enrollments Benefits will send an e-mail to affected employees Employees with appointments ending prior to January 1, 2011, cannot enroll online — they are not anticipated to be active employees in 2011
Open Enrollment Communications Employees with registered same-sex domestic partners will receive a letter and instructions for Open Enrollment. Elections can be made online, if registered, or on paper Materials are sent to employees on leave of absence & to those with no computer access An e-mail will be sent on November 1 to announce the start of open enrollment A final reminder e-mail will be sent near the end of November