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Throughout the week of Oct. 27, faculty and staff will be receiving information packets detailing the options in The University of Akron Group Benefit Program approved by the Board of Trustees at its Oct. 22 meeting.
“More than a year of work has gone into building the components of the new program,” says Desnay Lohrum, director of benefits administration. “We had a committee made up of representatives from our area as well as Faculty Senate’s Well-Being Committee and Planning and Budget Committee to study a number of issues — such as quality of care and reasonable costs.”
The consulting firm of Watson Wyatt & Company was retained to help the committee develop the Request for Proposal sent out by the Department of Purchasing to organizations that provide the types of coverage needed. The firm and the campus team then reviewed all the proposals and made their recommendations to the Board.
The University will continue to define the contributions made toward benefits, and individual employees will determine how the “choice dollars” assigned to them will be spent. Also remaining the same are the program’s four major health carriers as well as the co-pays for office visits.
Medical Mutual of Ohio is the carrier for both the comprehensive and preferred provider coverage, and also will oversee Flexible Spending Accounts and COBRA Administration. The three health maintenance organizations are Hometown Health Network (Akron General Network), Summa Care HMO (Summa Health Systems) and Kaiser Permanente HMO. Except for the comprehensive medical plan, none of these other plans require contributions from employees for their own coverage.
However, there are several major changes to the Group Benefit Program, which becomes effective on Jan. 1, 2004 and continues through Dec. 31, 2005.
For the first time, employees will be asked to make a monthly contribution toward the cost of dependent coverage.
The 2004 Personal Enrollment Forms in the Group Benefit Program packets being mailed out have been tailored to show the required employee contributions based on each employee’s actual salary as of Sept. 1, 2003, for all plans offered on an annual basis. It will not necessary to add any other dollar amounts to the health plan contributions.
Employees who choose an HMO will pay 1.5 percent to cover a spouse or children, and 2.25 percent to cover a spouse and children. Employees who elect for preferred provider plan coverage will pay 1.9 percent for a spouse or children, and 2.8 percent for a spouse and children.
Those employees who choose the comprehensive plan will pay the same percentages as those in the PPO for the same level coverage, including the employee, and they will be assessed 100 percent of the cost difference between the comprehensive plan and the preferred provider plan. Retiree dependents under the age 65 in the comprehensive plan also will contribute to their coverage costs.
Here are the other major changes to the Group Benefit Program:
* Standard Insurance Company has been awarded a contract to provide the University’s dental coverage. The plan will be the same as what is now in place, with a choice of using providers in-network or out-of-network. Standard also will be the carrier for employee life insurance, dependent life insurance, accidental death and dismemberment, and long-term disability.
* Envision Pharmaceutical Services, headquartered in Aurora, will provide prescription drug coverage for both the PPO and comprehensive plans. Co-pays will increase. For a 30-day supply at a retail drugstore, the co-pay for generic drugs will be 10 percent of the cost — minimum, $7; maximum, $15. For brand-name drugs, co-pays are set at 20 percent of the cost — minimum, $12; maximum, $35. The same percentages apply for 90-day supplies by mail order. The cost of generic drugs will be a minimum of $18 with a maximum of $40. Brand-name drug co-pays will be a minimum of $30 and a maximum of $80.
* Flexible spending accounts — the maximum for contributions has been increased from $2,000 to $3,500. Also, the IRS now allows over-the-counter medications to be submitted through the flexible account. (This does not include nutritional or dietary supplements.)
* Preventative services — Medical Mutual’s PPO and comprehensive plans will now include a preventive colonoscopy benefit — one every five years, beginning at the age of 50. Also, individuals age 50 and older can get one in-network routine physical a year with a $12 co-pay. The lab tests ordered with those in-network exams can include a chest X-ray, complete blood count, urinalysis, comprehensive metabolic panel, cholesterol screening, electrocardiogram and a prostrate specific antigen test. Any tests ordered are paid at 90 percent after the deductible is met.
* New I.D. cards — employees in the PPO and comprehensive plans will have I.D. cards from Medical Mutual and Envision.
“Through the competitive bidding process, we are seeing cost decreases in the employee-paid benefits — vision, and short-term and long-term disability,” says Lohrum. “The majority of people also will see a decrease in life insurance costs.”
Lohrum emphasizes that it is important that all employees return their completed benefit packets by the Nov. 19 deadline. All forms have to be submitted to the various carriers by Dec. 12 so I.D. cards can be issued by Jan. 1, 2004.
“We’ll be taking questions during normal business hours, and any individual who requires more assistance can schedule an appointment — we’ll spend as much time with them as they need,” says Lohrum.
For more information, here are the carriers’ Web sites:
Medical Mutual of Ohio — www.mmoh.com
SummaCare — www.summacare.com
Kaiser Permanente — www.kaiserpermanente.org
HomeTown Health Network — www.hometownhealthnet.com
Envision Pharmaceutical Services — www.envisionrx.com
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