Open Enrollment October 29 to November 16
Plan Year 2013
UHR Office of Employee Benefits
Topics We Will Cover
Medical Plan Prescription PlanDavis Vision Flexible Spending AccountsTax Deferred Savings
UVa Health Plan Enhancements:Preventive services will be covered at 100%, no office visit copay for preventive care at any participating provider.
Telemedicine services will be covered when provided by UVa providers.
Enhanced disease management programs with dedicated staff for UVa health plan participants.
UVa Health Plan Enhancements:
Lower out of pocket costs when using UVa providers
Continue with reduced copays on Primary Care, Specialist Care, Maternity Care, and Mental Health Office Visits For the Low Plan, the deductible is waived when using UVa providersWhere it applies, for the High Plan, the deductible is also waived for UVa providers
UVa Health Plan: Certain co-pays in the High plan are lowered for UVa providers and increased for other in-network providers:
Inpatient Hospital – decrease from $300 to $200 for UVa admissionsincrease from $300 to $400 for non-UVa admissions
Outpatient Procedures – decrease from $125 to $100 for services at UVa increase from $125 to $200 for non-UVa services
Home Health-Paid in full for UVa providersIncrease from paid in full to deductible and 10% for non UVa providers
UVa Health Plan Rates:
Premiums for active employees in the Low Premium Plan remain the same
Modest increase in premiums for active employees in the High Premium ($3/month for single, $12/month for family)
Premiums for retirees increase in both plans
UVa HEALTH PLAN Active Premiums 2013
2013 Low Premium
Program
2013 High Premium
Program
Employee SingleEE + childEE + spouseFamilyDouble State
$12$47$54
$116$80
$51$177$205$394$357
Prescription Plan changes
Change terminology from Generic, Preferred Brand, and Non-Preferred Brand to Tier 1, Tier 2, and Tier 3
Tier 1 most current generics and some cost- effective brand drugsTier 2 most brand drugs, or more costly or less desirable genericsTier 3 non-preferred brand drugs and some more costly generics
Prescription Plan Enhancements
Certain generic drugs will be covered at 100%:
birth control (Tier 1 and Tier 2 generics)aspirin for appropriate populations fluoride for children under 5 folic acid for appropriate populationsiron supplement for children under 1
Prescription Plan Enhancements
HealthyRx programWhen a participant is identified for a disease
management program and engages at the highest level, prescription copayments for Tier 1 and Tier 2 drugs will be reduced:
Retail: Tier 1 $0, Tier 2 $15Mail Order: Tier 1 $0, Tier 2 $30
Prescription Plan EnhancementsExpand Smoking Cessation Program
Waive Rx copayments for tobacco cessation drugs when enrolled in the Quit for Life Program
Provide coverage for 3 cycles of Chantix (each cycle is 180 days)
Prescription Plan changesRetail Costs (30-day Supply)
Tier 1 $6.00Tier 2 20% costsharing after deductible
(minimum $26, max $100)Tier 3 20% costsharing after deductible
(minimum $52, max $100)
For prescriptions filled at UVa, there will be no minimum dollar requirement.
Prescription Changes: Specialty
Change to a three tier structureTier 1 20% costsharing (minimum $100, max $200)Tier 2 20% costsharing (minimum $150, max $250)Tier 3 20% costsharing (minimum $200, max $300)
Lower cost sharing if using UVa Specialty PharmaciesTier 1 20% costsharing (max $50)Tier 2 20% costsharing (max $100)Tier 3 20% costsharing (max $150)
Mail Order Changes:
Mail Order (90-day supply)
Tier 1 $14
Tier 2 20%cost sharing(minimum $65, maximum $300)
Tier 3 20%cost sharing (minimum $130, maximum $300)
UVa Health Plan:Things to Consider
Monthly cash flowAverage annual health costsTolerance for unexpected/unplanned expenses Participation in the Flexible Spending Account ProgramHave an opportunity to change next year
UVA Health Plan:What Do You Do
If you wish to change programs, make your changes on line through Benefits@UVa self-service or PeopleSoft self-service
Complete all Open Enrollment changes by Friday November 16th
UVa Health Plan:Reminder about dependentsDrop ineligible dependents – On an audit completed in 2012, 6% of audited
dependents were found to be ineligible. Now is the time to remove former spouse and/or relatives other than legal spouse and children
Children who turn 26 this year will be automatically dropped 12/31/2012
Additional audits scheduled for 2013
Other Open Enrollment Items
Vision InsuranceDavis Vision
Flexible Spending Accounts Chard Snyder
Tax Deferred Savings Plan
Davis Vision Insurance
Automatic re-enrollment if you are currently enrolled in Davis Vision Insurance; must make change on line to drop coverageWho is eligible?Benefits-eligible academic and Medical Ctr employeesDo not have to be enrolled in the Health Plan to enroll in the Vision PlanOnce each calendar year you can receive
Eye Examination for glasses with a $30.00 copaySpectacle lenses and frames OR Contact lenses (enhanced formulary)
Employee only $6.29 per monthEmployee and child $11.01 per monthEmployee and spouse $11.33 per monthFamily $17.62 per month
Flexible Spending Accounts:General
You must re-enroll each year and now enroll on-line using Benefits@UVa or PeopleSoftPrograms are use or loseDebit card or claim form with direct depositOn-line account info available$2.75 per month administrative feeChanges limited based on qualifying eventsIf you are enrolled in 2012 and elect to re-enroll in 2013, you will use your current debit card. New debit cards will be issued.
Flexible Spending Accounts:Health
Minimum: $240; New 2013 Maximum: $2500.00Grace period until March 15th 2014 to incur claims ; until April 30th to file claimsCan be used for:
Drug copaysVision careCertain OTC costs (OTC medicines require prescription and manual claims submission) Uncovered dentalChiropractic services
Flexible Spending Accounts:Health, cont’d
Cannot be used for:Cosmetic surgeryPremiumsVitamins and herbal supplements
Flexible Spending Accounts:Dependent Care
Minimum: $240, Maximum: Depends on tax statusCan be used for:
Before & after school programsNursery school, preschool, in-home careSummer camp (not overnight)Adult daycare
Flexible Spending Accounts:Dependent Care, cont’d
Can not be used for:Child support paymentsEducational supplies or activity feesPrivate school tuition (after preschool)
The Dependent Care program is intended to allow both parents to work or attend school full-time.
Tax Deferred Savings:
The 2013 IRS limits will be released later this fall.
A post-tax Roth 403b will be available in 2013; stay tuned for more details.
Questions?
Contact the UHR Service CenterE:mail: [email protected]: PO Box 400127; C’ville 22904-4127Phone: 434/982-0123 or MC 243-3344All changes must be made on line by Friday November 16