2012 Open Enrollment
Health and Dental Insurance Plan Information
Monthly Insurance Rates:Health, Dental, and Post Retirement
Flexible Spending Accounts
Voluntary Short Term Disabiltiy (STD) Insurance
Voluntary Supplemental Term Life Insurance
Optional Vision Coverage
Human Resources Benefits Contacts
Open Enrolllment Forms and Documents
It is very important that you take time to review this information closely as
you make your health care choices for 2012.
the Open Enrollment period benefit eligible employees have the opportunity to
evaluate your health insurance needs and make changes in your health plan
coverage for the following plan year.
2012 Open Enrollment will be October 28, 2011, to November 10th,
At this time you may:
- Apply for health insurance coverage
- Change your current health insurance coverage.
- Add or drop dependents to your health insurance coverage
- Enroll in the flexible benefit plan. Note: You must enroll in this plan
- Enroll in a health savings account (as long as you elect the CDHP/HSA health
option) and make an election for 2012
- Enroll in, drop or change coverage in the voluntary supplemental life insurance
- Enroll in, drop or change coverage in the optional vision plan.
- Enroll in the voluntary short-term disability plan
In 2012, the University will offer four healthcare plans:
Anthem Blue Access 300
Buy-Up Plan; Anthem Blue Access 500 Core Plan;
Anthem Consumer-driven High
Deductible Health plan (CDHP) with a Health Savings account (HSA) called Lumenos
CDHP/HSA; and Welborn HMO. Each of these options includes prescription drug
coverage through the medical provider and dental coverage through
Resources, Inc. (HRI). A
2012 Insurance Comparison Overview sheet
is available for
you to compare the benefits of the different health plans.
If you are a current
participant in one of the Anthem plans or the Welborn HMO, you may change your
coverage without providing evidence of insurability. If you previously waived
coverage for yourself and/or your dependents, Anthem requires submission of a
Certificate of Health Coverage to waive the pre-existing condition waiting
period. Enrollment forms will be available at the Open Enrollment Kick-Off and
Benefits Informational Fair on October 28, 2011, or may be obtained from the
Human Resources Department in the Wright Administration Building, Room FA 166.
Open Enrollment will be
your only opportunity to elect or change your medical, dental, vision, or
related Section 125 Flexible Benefit Plan coverage elections and/or enroll or
drop dependents or your own coverage on these plans for the 2012 calendar year.
You may only make changes outside of the open enrollment period if you have a
qualified family status change and notify the Human Resources benefit staff of
that change within 30 days of the change.
Enrollment forms must be
completed by November 10, 2011, to ensure coverage effective January 1, 2012.
Your current health
insurance coverage will be continued unless you complete a form to change your
Benefits under the USI benefit plan(s) are provided pursuant to insurance
contracts between USI and the insurance companies. If the terms of this
enrollment document conflict with the terms of the insurance contract, the terms
of the insurance contract will control, unless superseded by applicable law.
PLEASE READ THIS IMPORTANT INFORMATION. OPEN ENROLLMENT WILL TAKE PLACE FRIDAY,
OCTOBER 28, 2011, THROUGH THURSDAY, NOVEMBER 10, 2011.
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HEALTH and DENTAL INSURANCE PLAN INFORMATION
ANTHEM BLUE ACCESS 300 BUY-UP PLAN – No Plan Design Changes for 2012
In-network deductible – $300 individual and $600 family
Non-network deductible – $600 individual and $1,200 family
In–network out-of-pocket maximum – $1,500 individual and $3,000 family
Non–network out-of-pocket maximum – $3,000 individual and $6,000 family
In-network co-insurance - 80%/20% and non-network co-insurance
Prescription retail co-payments - $10/24/40/70 / mail order co-payments
$20/48/80/140 (90 day supply)
ANTHEM BLUE ACCESS 500 CORE PLAN – No Plan Design Changes for 2012
In-network deductible – $500 individual and $1,000 family
Non-network deductible - $1,000 individual and $2,000 family
In-network out-of-pocket maximum- $2500 individual and $5,000 family
Non-network out-of-pocket maximum – $5,000 individual and $10,000 family
In-network co-insurance – 80%/20%,
and non-network co-insurance – 60%/40%
Prescription retail co-payments $10/40/60/80/ mail order co-payments
$20/80/120/160 (90 day supply)
CONSUMER-DRIVEN HIGH DEDUCTIBLE HEALTH PLAN WITH HEALTH SAVINGS ACCOUNT
- This plan offers 100% preventative care coverage and extra wellness benefits
- Deductible – $1,500 for single coverage and $3,000 for any level of family
coverage (employee plus child; employee-spouse or family) in-network and
out-of-network combined for this non-embedded deductible
- Out-of-pocket maximum – $3,000 for single coverage and $6,000 for any level of
family coverage (employee plus child; employee-spouse, or family); $6,000 for
single coverage and $12,000 for any level of family coverage out-of-network
- Co-insurance – after deductible, 90%/10% co-insurance in-network or
70%/30% co-insurance non-network, until maximum out-of-pocket is reached
- Prescription drugs – subject to deductible and co-insurance: in-network Rx
retail and mail order co-insurance is 10% after deductible; non-network Rx
retail & mail order co-insurance is 30% after deductible
- Enhanced wellness incentives with rewards include: Health Risk Assessments,
MyHealth Coach, Healthy Lifestyles, ComplexCare, and Comprehensive Medical
- On-line consumer tools, including comparative prescription drug shopping
- A Health Savings Account (HSA) that allows both employer and employee to make
tax-free contributions for use toward qualified healthcare expenses in 2012 and
- University Contributions to your Health Savings Account (HSA) are as follows:
- For single members, initial funding of $250 and a regular contribution of $450
paid over 12 months, for a total of $700 in annual funding in 2012
- For all levels of family membership, initial funding of $450 and a regular
contribution of $950 paid 12 months for a total of $1,400 in annual funding in
- Newly eligible participants entering after January 1 will receive initial
funding plus pro-rated regular contributions for the period in the plan
Wellness Initiatives for the Anthem Plans
Wellness initiatives will continue with the Anthem Blue Access Plans as steps
toward controlling claims expense. These programs include:
- 24/7 NurseLine: Access to a 24/7 NurseLine in which experienced registered
nurses provide information concerning general health questions and guidance with
critical health issues.
- Future Moms: Support from trained obstetrical nurses to provide maternity
management to help expectant parents have a healthy pregnancy and delivery.
- ConditionCare: Assistance from registered nurses for members to better manage
and improve chronic health conditions.
- MyHealthAdvantage: Utilizes integrated information systems and data analytics to
enhance early detection of potential health issues for participants. MyHealth
Advantage provides members and their doctors with information about
evidence-based standards that can facilitate better health care choices.
WELBORN HMO PLAN – No Plan Design Changes for
- Must use Welborn Health Plan provider (Deaconess Only); no out-of-network
- Deductible – $250 individual and $500 family
- Out-of-pocket maximum – $1,500 Individual and $3,000 Family
- In-network co-insurance – 80%/20% and non-network co-insurance – 60%/40%
Prescription retail co-payments $15/35/50 / mail order co-payments $30/70/100
(90 day supply)
HEALTH REFORM CHANGES REMAIN IN AFFECT FOR
ALL USI HEALTH PLANS
Dependent child coverage has been extended to age 26. Children will be covered
until the end of their birth month in which they turn age 26.
No pre-existing conditions for children under age 19 in the Anthem plans.
Welborn already has no pre-existing condition exclusions for any members,
100% preventative coverage for all conditions identified as nationally
recommended preventative services.
No lifetime plan maximums or annual limits on essential benefits. No referrals
required for OB/GYN services for the Welborn plan; Anthem already has a
no-referral plan design.
Emergency services coverage will not require preauthorization, be limited to
in-network providers or impose higher cost sharing for out-of-network services
in the Welborn plan; Anthem already has this feature.
Both Anthem and Welborn will continue to conduct appeals processes for these
insured plans; and the insurers will adapt those processes to conform to all
requirements of health reform. USI health plans will not retroactively terminate
coverage, except in limited situations, such as when the covered individual
commits fraud against the plan or makes intentional misrepresentations. When
rescission is permitted for other reasons, USI’s health plans will provide the
required prior notice of 30 days.
HEALTH RESOURCES, INC.
DENTAL PLAN – No Plan Design Changes for 2012
- 100% for preventive and 50% for restorative services
- Must use a Health Resources, Inc., provider
- Dependent limiting age extended to age 26 to match medical plans
- The University and its insured employees continue to contribute to a fund for
future retiree health benefits (VEBA Trust)
- Employees continue to pay 25% or $2.12 for single coverage and $5.50 for all
other coverage levels.
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MONTHLY INSURANCE RATES: Health, Dental and
Click on the Individual Health Plan Links below for Bi-weekly Rates
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FLEXIBLE BENEFIT SPENDING ACCOUNTS
Flexible Benefit Spending Accounts allow you to set aside pre tax dollars to pay
for certain un-reimbursed medical and dental expenses, and dependent care
expenses. The spending account limit for the un-reimbursed medical and dental
expense reimbursement plan remains at $6,000 per year. The dependent care plan
remains at the federal maximum allowance of $5,000 per year. Summary plan
descriptions are available in the Human Resources Department.
The IRS ruled that over-the-counter (OTC) drugs are NO LONGER an allowable
expense. Some OTC items can be claimed like vitamins and certain medication if
you obtain a prescription from your doctor stating these are medically
necessary. However, a few non-medical OTC items that remain reimbursable are
contact lens solution, bandages, and other first aid items. Please keep this in
mind when determining the annual election for 2012. Examples of reimbursable
medical expenses include eyeglasses, contact lenses, co-payments for doctor’s
visits, deductibles, and other costs (health, dental, or vision) not covered by
Employees may use 2011 funds remaining in their medical flexible spending
accounts at the calendar year end for expenses through March 15, 2012. Any
remaining 2011 balances not exhausted by March 15, 2012 will be lost.
Additionally, employees may use 2012 funds remaining in their flexible spending
accounts at the calendar year end for purchases through March 15, 2013. The
grace period/carry-over of account balances will only apply to un-reimbursed
medical and dental expenses. The dependent care flexible spending account must
be exhausted within the particular calendar year for which those expenses were
Please note that if you enroll in the Lumenos CDHP/HSA you are NOT eligible to
participate in the Medical Flexible Spending Account. Instead, you may defer
tax-free funds into your Health Savings Account.
CURRENT FLEXIBLE SPENDING ACCOUNT PARTICIPANTS
Employees currently enrolled in flexible benefit spending accounts need to
complete a new
Section 125 Plan Enrollment Form, even if allocation amounts
remain unchanged for calendar year 2012. These enrollment forms should be
completed and returned to the Human Resources Department, FA166, by November 10,
Benefit elections for current participants in the Flexible Benefit Premium Only
Plan for pre-tax premium contributions will continue, unless you choose to
change your election.
Employees interested in establishing a Flexible Benefit Spending Account for
2012 will need to complete a
Section 125 Plan Enrollment Form.
Health Care Cost Estimation Worksheet and
Dependent Care Cost Estimation Worksheet allow you to estimate the amount of
out-of-pocket health care expenses for 2012. Enrollment forms should be
completed and returned to the Human Resources Department, Wright Administration
Building, FA166, by November 10, 2011.
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VOLUNTARY SHORT-TERM DISABILITY (STD)
Short Term Disability insurance helps provide a partial income replacement for
temporarily disabled benefit eligible employees. From October 28, 2011, through
November 10, 2011, you have the opportunity to enroll in this coverage at the
employee meetings we are holding or you can enroll online at
www.standard.com/enroll any time during the enrollment period. This benefit is a
supplement to the University’s sick pay benefit that will be of special interest
to those (like short-service faculty and staff) with limited sick banks. To take
full advantage of this plan, you should enroll at this first eligibility
opportunity since late enrollees have a reduced benefit during the first 12
months after enrollment. Additional information, including rates, will be
available shortly on the Human Resources website.
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VOLUNTARY SUPPLEMENTAL TERM LIFE INSURANCE
Voluntary Supplemental Term Life Insurance offers you the option to purchase
additional term life insurance at group rates on a payroll deduction basis for
yourself, your spouse, and/or dependent children. You may be eligible to
purchase up to $500,000 or eight times annual earnings, whichever is less, for
yourself and up to half that amount for your spouse. There are four levels of
coverage for dependent children. The life insurance program is offered through
Prudential Life Insurance Company. Please note that this insurance plan is
strictly voluntary and is offered as a supplement to the University-provided
life insurance. An
Evidence of Insurability (EOI) form must be completed when
applying at any other time than upon hire.
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This is a stand-alone vision plan that is separate from your medical coverage.
There are no changes to the plan design, and the rates did not increase for
2012. Anthem’s Blue View vision plan offers increased network size with retail
chain access to top four national chains, eliminates frame restrictions and
contact lens formulary, and provides 40% discounts on complete pairs of
eyeglasses after funded benefits are used. While the plan allows participant
choice of facility/provider in or outside the network, and retail and private
practices are both included, there are maximum limitations on reimbursement. The
maximum benefit is received by going to a network facility/provider to ensure
contracted discounts. You do not have to participate in the University medical
insurance plan to enroll in the optional vision plan.
2012 VISION INSURANCE MONTHLY RATES
Click Here for Bi-weekly Rates
Employee + Child(ren)
Employee + Spouse
You can access the vision provider network at
www.anthem.com by selecting "Find a
Doctor" then "View National Vision Provider Directory" and then selecting the
plan "Blue View Vision".
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HUMAN RESOURCES BENEFITS CONTACTS
Employees should contact the benefit representatives in the Human Resources
Department with any questions concerning the 2012 Open Enrollment. The Human
Resources Department is in the Wright Administration Building, Room FA166.
THAT ALL OPEN ENROLLMENT FORMS MUST BE COMPLETED AND RECEIVED IN HUMAN RESOURCES
NO LATER THAN NOVEMBER 10, 2011, TO BE EFFECTIVE JANUARY 1, 2012.
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Forms and Documents
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