What we already know by jolinmilioncherie


									Making Plans for FY13 Insurance elections

      Rita Garland, UM Benefits Specialist, HRS
      Terri Phillips, Assoc Vice President, HRS
 April 30, 2012
 May 23, 2012

MUS health insurance is a self funded plan:
 We cover 100% of the costs of medical, dental,
 and vision coverage through the revenues
 received by the plan – we are not an insurance
 company – we are an employee benefit plan.
 During FY2013 our benefit plan is projected
 to spend $70 million to provide medical,
 dental, and prescription drug coverage to our
 MUS  Employee Group Benefit Plan provides medical,
 dental, and prescription drug benefits for 18,000
 individuals (including our 8,400 employees and
 Ourbenefit plan is funded through the employer
 contribution (generally 80%) and premium
 contributions for dependents and retirees (about
 Lastyear we made significant adjustments to our
 plan which have successfully narrowed the gap
 between funding and expenditures.

 Our administrative expenses are currently about 5%
 of plan costs (commercial insurance is capped at
 15%) – it would cost us more money to buy
 conventional insurance.

 The employer contribution (state share) will remain
 at $733 for the coming plan year.
   The Montana University System (MUS) uses
    the state share (currently $733.00) to pay the
    full cost of covering a single employee, and
    to subsidize a portion of the cost of
    dependent and retiree coverage for those on
    the plan.
   The amount of subsidy, and how it is
    allocated, will continue to be reviewed by the
    Inter Units Benefit Committee (IUBC) and
    adjusted as necessary.
Benefit                 Part of Insurance   Add Dependents?
Medical                 Mandatory for EE          No

Dental Plan             Mandatory for EE          No

Life Insurance          Mandatory for EE          No

Long Term Disability    Mandatory for EE          No

Vision Plan             optional                  Yes

Supplemental AD&D       optional                  Yes

Optional Supplemental   optional                  No
Life Insurance
Optional Supplemental   optional                  Yes
Dependent Life Ins
   Long Term Care with UNUM (pg 27 Choices book):
•   UNUM sells Long Term Care insurance;
•   UNUM has decided to exit that market BUT has
    determined that they will continue to hold and service
    the clients they currently have;
•   Existing groups who have LTC policies with UNUM will
    remain unchanged. The MUS plan with UNUM will
    continue to be offered as it has in the past.
•   MUS will continue to monitor the status and financial
    health of UNUM and the group LTC product.
   Managed Care Plans
   NEW! PacificSource is a new managed care plan – this
    plan has acquired a portion of the New West Health
    Services business.
   If you are currently covered by New West then you
    will automatically roll to PacificSource as your managed
    care plan – they will have the same provider network
    as New West (although we always advise you to check
    every year and make sure that your providers are still
    included on the plan you wish to choose).
   You can choose to move to one of the other medical
    plans if you do not want PacificSource.
   Managed Care Plans:
   Add Acupuncture and Naturopathic benefit
    (15 visits per year combined).
   Add Bariatric Surgery benefit (must meet
    criteria – contact MUS benefits office for
   Add Travel benefits (requires prior
    authorization – previously was only available
    for transplants)
   All Plans:
   Moms enrolled in the WellBaby program will be
    provided a breast pump as part of that program.
   Generic oral contraceptives will be covered at
   Dental Plan:
   An updated fee schedule for diagnostic and
    preventive services will be implemented.
   Premium plan – most preventive and diagnostic
    codes no longer count toward the $1,500
    maximum benefit.
   Basic plan only covers preventive care – no
    extractions of impacted teeth are covered on this
 NEW! Adoption assistance flexible spending
  account will be available.
 QCC Oncology program ends June 30, 2012 –
  contact MUS Benefits office for more
 Vision Plan – 11.5% rate reduction – benefits
  are unchanged
 Flex Administration fee - $2.50 per month
  beginning with new plan year.
 IRS change to regulations - can only put
  $2,500 into a Flex Health account.
Healthy Montana Kids is available for MUS
The State of Montana will enroll the children of Montana
 University System and State of Montana employees in the
 Healthy Montana Kids program.
This is a graduated program based on household income
 and number of dependents – it could provide savings for
 your family.
For more information, contact your campus HR office or
 go to www.hmk.mt.gov or call 1-877-543-7669.

   The MUS plan does maintain a hardship fund for members
    who are not able to enroll in the Healthy Montana Kids plan.
   You must apply for Healthy Montana Kids and be rejected by
    that plan in order to apply for the hardship fund.
   If you received benefits from the hardship fund in the past
    plan year you must re-apply for that fund again this coming
    plan year – it is not an automatic continuation from the prior
    year. HRS has contacted current recipients to reapply.

   Criteria and forms are at http://www.mus.edu/choices/
This year our plan is in a “Closed Enrollment” year
   You cannot add any dependents to either medical or dental
    plans unless you have a qualifying event (see next slide). If
    you have a qualifying event you must go to the UM Human
    Resources office to make a change.
   You can delete a dependent from your medical or dental
    plan during this change period BUT you will not be able to
    add them back on in the future unless you have a qualifying
    event (or until such time that we have another open
    enrollment period).
   You can add a dependent to vision. You will need to go to
    the UM Human Resources office to do so. Complete the
    rest of your CHOICES online.

 Qualifying Events occur:

 Upon hire, new employees will have 30 days to enroll eligible dependents
 Within 63 days of a family status change (marriage, divorce, legal separation,
  attestation of a domestic partnership, death, etc.) plan members may enroll or
  drop a dependent
 Within 63 days of the birth, adoption, or affidavit of intent to adopt, plan
  members may add a dependent child
 Within 63 days of the loss of eligibility for reasons other than non-payment of
  premiums (e.g. loss of job, elimination of other coverage, becoming ineligible for
  programs such as Medicaid or HMK, or other significant adverse event), plan
  members may add a dependent
Remember, if you delete an
 eligible dependent during
this enrollment period from
your medical or dental plan
you will not be able to add
  them back in the future
without a qualifying event!
 Managed  Care copays (flat dollar amounts that you
 pay for services) remain the same – for example:
 $15/office visit for in network providers.
         from an out-of-network provider have a
 Services
 35% coinsurance on any plan.
 An out-of-network provider can balance bill the
 difference between the allowable amount and the
 amount they charge.
 Make  a list of the medical providers (hospitals
 and doctors) that you currently use or
 anticipate using in the plan year ahead
 (July 1, 2012 – June 30, 2013).
 Look up your medical providers (hospitals and
 doctors) in the various networks to see if
 they are member providers. Make note of the
 plans that have all or most of your providers
 “in network.”
 Compare  the monthly medical premium for
 each plan that has your providers “in
 Consider if you would switch medical
 providers, if needed, to choose a less
 expensive plan.
 The pharmacy plan (URx) is the same for all
 medical plans so it does not factor into your
                 Employee    Employee &        Employee &         Employee &
                             Spouse            Children           Family

Traditional      673         905               882                1137

Blue Cross       575         774               754                972
Managed Care

Pacific Source   591         795               774                998
Managed Care

Allegiance       612         823               802                1033
Managed Care

                            Actual rates are printed in the CHOICES booklets pg 4
              Traditional Plan   Traditional Plan   Managed         Managed
              In Network         Out of Network     Care in         Care Out of
                                                    Network         Network

Annual        $1,000/person      $1,000/person      $ 500/person    $ 750/person
Deductible    $2,250/family      $2,250/family      $1,000/family   $1,750/family
                                 Combined with                      Separate from
                                  in-network                          in network
Annual        $5,000/person      $5,000/person      $2,500/person $4,250/person
Coinsurance   $11,250/family     $11,250/family     $5,000/family $9,500/family
Max                              Combined with                      Separate from
                                  in-network                          in network
              St. Patrick        Community
              Hospital is “In    Medical Center
              Network”           is “Out of
   The schedule of Annual Benefit Election events and
    important dates was sent out as an email – please
    post/share that information in your department with
    those without email access. It is also on the HRS
   Choices workbooks were sent through campus mail
    April 16, 2012.
   If you need to add a dependent to your vision plan you
    will need to talk with UM Human Resources directly –
    this cannot be done on-line.
 YouMUST complete the on-line process if you have a
 Flex account and want to continue your Flex account.
 Come  to LA139 Computer Lab for on-line election
 assistance – check the emailed schedule or HRS
 website for scheduled times in the lab.
       follow the instructions for using on-line election
 Please
 process that are available on the HRS website.
 Youwill log in to Cyberbear using your NetID number
 and password.
           on-line election process – hit the
 “Complete”
 complete button when you are done.
 Print   out a signature page.
 Reviewthe information on your signature page
 to make sure it is what you signed up for
 When  you are sure your selections are correct on
 the signature page then sign the page and submit it
 to HRS.
 Signedsignature pages are due on Friday, June 1,
 2012, in HRS EL 252 by 5pm.
1.   The medical plan monthly costs have
     changed – the plan you were in last year
     may no longer be the best plan for you.
2.   If you want to have a Flex Health account or
     Flex Dependent Care account you MUST
     sign up for that EVERY year – it does not roll
     forward automatically.
3.   The health care providers that you use may or may
     not still be “in network” for the plan you were in
     last year. Providers change.
4.   Your goal is to stay “in network” to make the best
     use of your money – going “out of network” will
     cost you more.
5.   Check your mailing address while in Cyberbear
     and make sure that it is correct.
6.   If you have excess employer contribution that you
     want to put into a flexible spending account you
     MUST MAKE that election – it does not happen
7.   New West is no longer a managed care option – if
     you make no selection you will be automatically
     moved to PacificSource – use this opportunity to
     make an informed choice.
  Stay “in-network” – you will experience a
                better benefit
Allegiance (Traditional and Managed Care)
1-877-778-8600, www.abpmtpa.com/mus
Blue Cross/Blue Shield 1-800-820-1674,
Pacific Source 1-877-590-1596,
MAPP 1-888-873-8049 (*)

(*) retiree plan only
   Take this opportunity to make sure that your
    listed beneficiaries are correct:

   For final wages, sick and annual leave payouts:
    verify your Decedents Warrant form

   For Retirement or Supplemental Retirement
    Accounts: complete forms specific to plan

   For Life Insurance and AD&D: check/update
    choices online

This is very vital information when it is needed!
 New Lab Vendor -It Starts With Me –
  They will be on-campus May 30, 31 & June 1.
  To complete the UM WellCheck process – see
  HRS website for information on registering.
 Look shortly for email information on
  WellHeart and WellWeight program.
 Take Control – Diabetes Program – email for
  info at takecontrolmt@gmail.com
 For more Wellness information – check out

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