The moment you’ve been waiting for is finally here! ERS Annual Enrollment for Plan Year 2015 runs from July 14 – 27.
For two weeks, ERS opens an enrollment window and allows UHD employees to enroll in or make changes to health, dental, life, disability and accidental death & dismemberment coverage and add or drop dependents from their plans. This is also the time to add or modify a TexFlex Flexible Spending Account.
To make changes, employees have three options. The first and preferred method is to simply go online to www.ers.state.tx.us, and sign in to your online account. The second is by contacting ERS via toll-free number at 866-399-6908, and the last option is by contacting Erica Morales, ESO Director of Benefits and Compensation, at firstname.lastname@example.org or ext. 8443.
Any adjustments made during open enrollment take effect on September 1, 2014. However, before modifying your benefits, it is important you understand the new changes. The following are changes to UHD group health and dental plans.
Group Health Changes
- Tier 1 generic drugs decrease from $15 a prescription to $10.
- The plan went from having no out-of-pocket maximum to having a limit of $6,350 for individuals and $12,700 for families.
- Inpatient mental health services will no longer have pricing tiers based on the number of inpatient days. All inpatient mental healthcare performed by network providers will now be covered at 80%.
- Outpatient professional mental health services will have a $40 copay instead of a 20% patient responsibility. Also, there’s no longer a limit on the number of outpatient treatment days.
- Outpatient mental health facility benefits will change to $100 plus a 20% patient payment. There is also no longer benefit tiers or a limit on days of treatment.
- The hearing aid benefit will increase from $500 to $1,000 per ear every 36 months.
- Breast pumps for nursing mothers will be covered at 100% of the retail cost and can be purchased anywhere pumps are sold. Only one pump will be reimbursed per delivery, and participants must file a paper claim with a copy of the receipt for reimbursement.
- Group health premiums increase by 6.89% for Plan Year 2015 due to increased drug costs and usage. The new premiums will apply on September 1.
To find out more about this year’s plan, check out the HealthSelect 2015 Annual Enrollment Brochure. For information on the new Plan Year 2015 monthly premium rates for both full-time and part-time employees, go to http://wp.me/PwR1i-ob.
- Premiums will increase by 7%, but no other plan changes will occur.
State of Texas Dental Choice Plan
- Preventative services will no longer be included in annual maximums.
- Once the standard annual maximum of $1,500 per person is reached, the plan will then continue to pay 40% for all covered services for the remainder of the plan year.
- Four periodontal cleanings are covered per year and will no longer cross reduce two regular routine cleanings in the same plan year.
- Attrition and abrasion repairs will now be covered, including crowns if necessary.
- Emergency oral exams will be covered on the same day as palliative treatment.
Note: Premiums rates for this plan will stay the same. In addition to the DHMO and PPO dental options currently offered, a “New” State of Texas Dental Discount Plan option is now available. Below are highlights of the program.
State of Texas Dental Discount Plan
- Administered by Careington.
- It is not dental insurance, but a discount plan that has the participant pay a reduced fee at the time of service.
- Discounts only apply to participating dental providers.
- Low cost monthly plan rates start at $2.25 per month for member only.
- No primary care dentist is required. Members can choose from participating providers at any time. No pre-authorization is required.
- No annual maximums or benefit restrictions apply.
- Members cannot participate in another ERS dental insurance plan at the same time. However, if your dental insurance is not provided through ERS, you can still enroll in the discount plan.
- Cosmetic services are included.
For more information, go to http://www.careington.com/ers. Find plan rates here. You can also find participating providers and review their fee schedules by going to http://www.careington.com/ers/feeschedule.html. Find and compare Plan Year 2015 dental plan premiums for all options at http://wp.me/PwR1i-or.
Good news! There are no changes this year to any of the following optional insurance plans:
- Optional Term Life
- Basic Term Life
- Dependent Term Life
- Voluntary AD&D
- Long-Term Disability
- Short-Term Disability
Even though no changes occur with the optional coverage plans, please note that evidence of insurability is still required.
This story is the first of a two-part series on Plan Year 2015 Annual Benefits Enrollment. Next week we will review upcoming TexFlex Flexible Spending Accounts and retirement changes.