Benefits

UHD Annual Benefits Enrollment begins July 10

The Employees Retirement System of Texas (ERS), which administers health and other insurance benefits for State of Texas employees, will hold its annual enrollment period for Plan Year 2016-2016 from July 10 to July 24, 2015.1 Prior to the annual enrollment period, ERS will mail a Personal Benefits Enrollment Statement to all benefits-eligible employees.

During the annual enrollment period, employees can make changes to their benefits portfolios without qualifying life event. If you don’t want to change your benefits, don’t do anything. Your current benefits will remain the same for the upcoming academic year (9/1/2015 to 8/31/2016).

For your convenience, you may make changes to your benefits portfolio during the annual enrollment period of July 10 to July 24, 2015, in one of three ways:

  • online 24/7 directly with ERS at www.ers.state.tx.us;
  • by calling ERS during normal business hours at (866) 399-6908 or;
  • Through Employment Services and Operations (ESO) by scheduling an appointment with Paula Jannett at x-8463 or jannettp@uhd.edu and completing the required 2016 annual enrollment form (attached).

Below is a summary of the plans covered by ERS and any applicable changes.

Medical Insurance:

HealthSelect of Texas:SM

  • Premium rates will increase by approximately 7.3%.
  • An overall out-of-pocket maximum limit of $6,450 for individuals and $12,900 for families will go into effect on September 1, 2015.
  • Beginning January 1, 2016, HealthSelectSM of Texas medical and pharmacy deductibles, coinsurance and copays are included in the total network out-of-pocket maximum.
  • Referrals will no longer be required to see ophthalmologists, regardless of whether the service is an annual preventive eye exam, a diagnostic exam or treatment.
  • Coinsurance and inpatient hospital copay maximums stay the same.
  • The mental health office visit copay is reduced from $40 to $25. As a reminder, HealthSelect is administered by UnitedHealthCare Services. The new rates are listed below.

KelseyCare powered by Community Health Choice

  • Starting September 1, 2015, KelseyCare powered by Community Health Choice will be available to eligible participants in the Houston area. This is administered by KelseyCare
  • Health Maintenance Organization (HMO)

Prescription Drugs:

  • Starting January 1, 2016, prescription drug deductibles and copays will be included in the total network out-of-pocket maximum for HealthSelectSMof Texas. Currently, out-of-pocket prescription costs aren’t included in the maximum.
  • Prescription drug deductibles are now based on the calendar year rather than plan year, in alignment with any medical deductibles.
  • The PY15 prescription deductibles that started on September 1, 2014 will carry through December 31, 2015. This will give participants more time before they have to spend out of pocket to meet the deductibles. The annual prescription drug deductible will remain at $50 per person per calendar year
HealthSelect of TexasSM Full-Time Employee
  Coverage FY 15 Total Premium FY 16 Total Premium FY 15 State Pays FY 16State Pays FY 15 Employee Pays FY 16Employee Pays Total Increase to Employee % Increase
Member Only $537.66 $576.54 $537.66 $576.54 $0.00 $0.00 $0.00 0%
Member & Spouse $1,153.42 $1,237.02 $845.54 $906.78 $307.88 $330.24 $22.36 7.30%
Member & Child(ren) $949.94 $1,018.78 $743.80 $797.66 $206.14 $221.12 $14.98 7.30%
Member & Family $1,565.70 $1,679.26 $1,051.68 $1,127.90 $514.02 $551.36 $37.34 7.30%
HealthSelect of TexasSM  Part-Time Employee
  Coverage FY15 Total Premium FY16 Total Premium FY 15 State Pays FY 16State Pays FY 15 Employee Pays FY 16Employee Pays Total Increase to Employee % Increase
Member Only $537.66 $576.54 $268.83 $288.27 $268.83 $288.27 $19.44 7.30%
Member & Spouse $1,153.42 $1,237.02 $422.77 $453.39 $730.65 $783.63 $52.98 7.30%
Member & Child(ren) $949.94 $1,018.78 $371.90 $398.83 $578.04 $619.95 $41.91 7.30%
Member & Family $1,565.70 $1,679.26 $525.84 $563.95 $1,039.86 $1,115.31 $75.45 7.30%
KelseyCare Full-Time Employee KelseyCare Part-Time Employee
  Coverage FY 16 Total Premium  FY 16State Pays FY 16Employee Pays FY 16 Total Premium FY 16State Pays FY 16Employee Pays
Member Only $483.98 $483.98 $0.00 $483.98 $241.99 $241.99
Member & Spouse $1,038.02 $761.00 $277.02 $1,038.02 $380.50 $657.52
Member & Child(ren) $854.94 $669.46 $185.48 $854.94 $334.73 $520.21
Member & Family 1,408.98 $946.48 $462.50 $1,408.98 $473.24 $935.74

Dependent Eligibility Verification:

Employees who add dependents in GBP health coverage, will be asked to provide documentation that those dependents are eligible for coverage. If the participants do not respond or send the required documents, all of their unverified dependents will lose all GBP insurance, including health, dental and dependent term life. Documents dated after the dependent was enrolled will not be accepted, even if the date is before the coverage begin date. This verification happens on an ongoing basis as employees add new dependents to their coverage.

Dental Plans

State of Texas Dental Choice Plan

There have been some benefits enhancements

  • Premium rates will increase by 3.0%
  • Exclude Preventive Services from Annual maximums,
  • Add an Extended Maximum to pay 40% for all the services after $1,500 standard Annual Maximum is reached,
    Include four periodontal cleanings per year (does not cross reduce two routine cleanings per year),
  • Remove Crown Exclusion from Attrition and Abrasion and
  • Cover Emergency Oral Exams on the same day as Palliative Treatment.

Human Dental DHMO Plan

  • Premium rates will decrease by 3.8%.
  • There will be no changes to the DHMO plan.

State of Texas Dental Discount Plan

  • There will be no plan or premium changes to the State of Texas Dental Discount Plan.

* The State of Texas Dental Discount Plan is not dental insurance but a discount program for dental services. Under this plan, participating dentists have agreed to accept a discounted fee from participants as payment-in-full for dental services performed. Evidence of Insurability (EOI) is not required to enroll in the dental discount plan. Health coverage opt out credit does not apply to this plan.

State of Texas Dental ChoiceSM Humana Dental DHMO Plan State of Texas Dental Discount Plan*
Coverage FY15 Total Premium FY16 Total Premium  Increase to Employee FY15 Total Premium FY16 Total Premium Decrease to Employee FY15 Total Premium FY16 Total Premium Increase to Employee
Member Only $23.58 $24.28 $0.70 $9.96 $9.59 $0.37 $2.25 $2.25 $0.00
Member & Spouse $47.16 $48.56 $1.40 $19.93 $19.17 $0.76 $4.50 $4.50 $0.00
Member & Child(ren) $56.60 $58.28 $1.68 $23.91 $23.01 $0.90 $5.40 $5.40 $0.00
Member & Family $80.18 $82.56 $2.38 $33.88 $32.59 $1.29 $7.65 $7.65 $0.00

Tobacco User Fee

If you and/or a family member is enrolled in medical insurance and is certified as a tobacco user or has not certified as a non-user, you will pay additional fees. ERS requires that all participants who have turned 18 since August 31, 2014 or who will turn 18 before September 1, 2015, certify whether or not they use tobacco. As a reminder, the monthly Tobacco User Fee is $30 per person, up to a maximum of $90 for covered dependents. A tobacco user is defined as a person who uses any form of tobacco, including cigarette, pipe, cigar, or smokeless tobacco. If you have not certified, you will be prompted to certify during this enrollment period.

Optional Term Life

  • There will be no changes to the plan or premiums.
  • Some employees may see a premium difference if they have a salary or age category change as of September 1, 2015.
  • Evidence of Insurability (EOI) will still be required

Basic Term Life, Dependent Term Life, and AD&D

  • There will be no changes to the plan or premiums.
  • Evidence of Insurability (EOI) will still be required.

Short Term and Long-Term Disability

  • There will be no changes to the plan or premiums.
  • Some employees may see a premium difference if they have a salary change as of September 1, 2015. Evidence of Insurability (EOI) will still be required.

TexFlex Flexible Spending Accounts

  • Beginning in Plan Year 2016, ADP, LLC will be the new third party administrator for TexFlex. In late August, ADP will mail TexFlex debit cards to every health care participant. The cards must be activated before use and can be used beginning September 1, 2015.
  • There is an administrative fee holiday for Plan Year 2016 for both health care and dependent care accounts. Participants will not have to pay the $12 annual administrative fee for each account.
  • There will no longer be a two-and-a half month grace period for reimbursable health expenses. Instead, participants will be able to carry over up to $500 in unspent health care account funds to the next plan year.
  • The maximum health care annual contribution to your (health) account is $2,550 and $5,000 for your dependent care account.
  • Dependent care account participants will continue to have a Grace Period, which allows them to use their Plan Year 2015 money through November 15, 2015.
  • Dependent care account participants are not eligible to use the TexFlex debit card starting September 1, 2015
  • You will automatically be re-enrolled in TexFlex accounts at your same annual contribution level—unless you make a change during annual enrollment.

Information Sessions

Employment Services and Operations (ESO) will host two information sessions to summarize the changes in employee benefits for the upcoming Plan Year (9/1/15 to 8/31/16). We have invited Aflac, MetLife and to speak about their services. These sessions are scheduled as follows:

Tuesday July 6, 2015 2pm-4pm N602
Wednesday July 8, 2015 2pm-4pm N602

1 These dates are set by ERS and cannot be changed or extended by ESO.

Please note that this information is subject to change.

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