Post on 15-Dec-2015
transcript
June 2012
Benefits 2012/2013 - - An HR Liaison Presentation
Employee Benefits Manager A&M System Office
Ellen Gerescher
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
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Benefit Changes for 9-1-12
• Tobacco User Additional Premium• Consolidation of Health plans • Dependent Audit
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.
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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
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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
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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
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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
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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.
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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
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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
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Thank You!
Ellen GerescherSystem Benefits Administration
Egerescher@tamus.edu979.458.6330
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