Benefits

ERS announces 2017-18 benefit plans and changes

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 2017-2018 from July 9 to July 22, 2017.1 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 a 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 (9/1/2017 to 8/31/2018).

For your convenience, you may make changes to your benefits portfolio during the annual enrollment period of July 9 to July 22, 2017, in one of three ways:

  • Online 24/7 at http://www.ers.state.tx.us/
  • By calling ERS during normal business hours at (866) 399-6908
  • Through Employment Services and Operations (ESO) by scheduling an appointment with Paula Jannett at x-8463 or jannettp@uhd.edu and completing the required 2017 Annual Enrollment Form

 


Medical Insurance

HealthSelectSM of Texas

  • Premium rates will increase by approximately 0.08%.
  • Effective 9/1/2017, BlueCross and BlueShield of Texas (BCBSTX) will administer the HealthSelectSM of Texas plan.
  • HealthSelect of Texas participants must designate a primary care provider (PCP). If a participant’s PCP will continue to be in the BCBSTX HealthSelect network as of September 1, 2017, they do not need to designate their PCP again. The current PCP selection information will be automatically passed from the current medical TPA, UnitedHealthcare, to BCBSTX this summer.
  • New ID cards will be mailed in August; however, participants should use the current UnitedHealthcare plan ID cards until August 31, 2017.
  • OptumRx will continue to administer the HealthSelect Prescription Drug program. OptumRx will mail new prescription drug plan ID cards in August. Participants should use their current cards until August 31.

KelseyCare powered by Community Health Choice

  • KelseyCare powered by CHC is a HMO available to employees and eligible dependents in limited Texas counties (Brazoria, Fort Bend, Galveston, Harris and Montgomery).
  • No new service areas were designated for KelseyCare powered by Community Health Choice.

Consumer Directed HealthSelectSM  

  • Premium rates will increase by approximately 0.08%.
  • Effective 9/1/2017, BCBSTX will administer the Consumer Directed HealthSelectSM
  • No referrals or PCP determination necessary.
  • New ID cards will be mailed in August; however, participants should use the current UnitedHealthcare plan ID cards until August 31, 2017.
  • This is a high-deductible health insurance plan paired with a health savings account (HSA). The monthly premium is a little lower than HealthSelect of Texas, but participants must pay the full cost of their care (with the exception of preventive care, such as annual checkups and vaccinations) until they meet the annual deductible. (See deductible amounts below.) This includes non-preventive doctor visits, prescriptions, hospital stays and any other type of health service or product that is not preventive.
  • If employees enroll in Consumer Directed HealthSelect, they need to open a HSA as soon as possible so state contributions and other funds can be deposited into the account.

Deductibles

Plan Year 2018 deductible* Individual coverage Family coverage
In-Network $2,100 $4,200
Out-of-Network $4,200 $8,400

*Deductibles run on a calendar-year basis and will reset on January 1, 2018.

Health Savings Account (HSA)

  • Optum Bank will continue to administer the health savings account (HSA) program. After August 31, employees will no longer be able to view their HSA balance through the UnitedHealthcare website at myuhc.com/hs. Employees can log in to their HSA account directly from Optum Bank’s website at http://www.optumbank.com and view their balance.
  • Participants can use their HSA funds for qualified medical expenses for themselves, their spouses and their eligible dependents. The IRS definition of qualified medical expenses.
  • Participants can also make pre-tax contributions to their HSA through payroll deductions. The IRS sets the maximum contribution amount each year. The annual maximum contribution limit for 2017 is $3,400 for individuals and $6,750 for families.
  • The HSA balance carries over from one year to the next, there is no use-it-or-lose-it rule and account holders can keep the funds if they change health plans or leave state employment.
  • The state’s contribution to every eligible member’s HSA is $540 a year for an individual or $1,080 for a family. For some people, it could be a great way to save money and lower their taxable income. But they will be responsible for all of their non-preventive health care costs until they meet the annual deductible
  • Once employees open an account, they will get a debit card from Optum Bank to pay for health expenses. They will have access only to the amount of money that has accumulated in their HSA but not funds pledged to be deposited in the future. Employees should review IRS guidelines or consult a tax advisor to make sure they are eligible to participate in a HSA.
Health and prescription services Plan pays Participants pay
Annual maximum contribution $3,350 $6,750
Annual state contribution $540 $1,080
Annual  maximum participant contribution $2,810 $5,670

Tobacco User Fee

Texas state law authorizes higher health care premiums for people who use tobacco. ERS requires all health plan participants age 18 and older certify whether or not they use tobacco. Dependents who turn 18 by September 1, 2017, must certify this summer. Those who already certified their tobacco use need not re-certify unless their tobacco use status has changed. The monthly Tobacco User Premium has not changed for tobacco users or those that did not certify. . Employees can certify themselves and their eligible dependents through ERS Online.

*Tobacco Premium Alternative

Tobacco users may be able to participate in an alternative to the Tobacco User Premium, if it complies with their doctors’ recommendations. For more information about this alternative, members can review the ERS tobacco policy FAQs, visit the tobacco policy page or contact ERS toll-free at (877) 275-4377.


Dental Plans

State of Texas Dental Choice Plan

  • Premium rates will increase by 3%.
  • There will be no changes to the plan.

Humana Dental DHMO Plan

  • There will be no plan or premium changes.
  • Employees and covered dependents enrolling in the DHMO must select a primary care dentist (PCD) to receive benefits.

State of Texas Dental Discount Plan

  • There will be no plan or premium changes.
  • The State of Texas Dental Discount Plan is not dental insurance but a discount program for dental services. Health coverage opt out credit does not apply to this plan.

State of Texas Vision Insurance Plan

  • There will be no plan or premium changes.

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, 2017.

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

  • There will be no changes to the plan or premiums.

Short-Term and Long-Term Disability

  • Short-term and long-term disability insurance carrier remains Reed Group Management LLC (ReedGroup).
  • Short-term disability premium is reduced while long-term disability premium remains the same.
  • Some employees may see a change in their premium if they have a salary change as of September 1, 2017.

TexFlex Flexible Spending Accounts (FSA)

Earlier this plan year, WageWorks, Inc. finalized the acquisition of ADP, LLC’s Spending Account business. This includes the administration of the TexFlex Flexible Spending Accounts and Commuter Spending Accounts. ERS has been working with WageWorks and ADP to ensure a smooth transition for TexFlex participants.

There are three types of the TexFlex FSAs: the health care account, dependent care account and the limited flexible spending account (LFSA). The LFSA is only available to employees enrolled in Consumer Directed HealthSelect with a health savings account (HSA).

  • There is an administrative fee holiday for Plan Year 2018 for both health care and dependent care accounts.
  • Participants will not have to pay the $12 annual administrative fee for each account.
  • FSA participants can use the debit card at no cost this year.

Health Care Account

  • The maximum annual election increases from $2,550 to $2600 in Plan Year 2018.
  • TexFlex annual elections will remain the same in Plan Year 2018, unless participants make a change to their elections during Summer Enrollment.
  • Participants can continue to carryover up to $500 of unused health care account funds into the next year.

Dependent Care Account

  • The maximum annual election remains at $5,000 in Plan Year 2018.The maximum contribution is $5,000.
  • Employees TexFlex annual elections will remain the same in Plan Year 2018, unless they make a change to their elections during Summer Enrollment.
  • Participants continue to have a Grace Period through November 15, 2017, in which they can use their Plan Year 2017 funds.

Limited Flexible Spending Account (LFSA)

  • The maximum annual election increases from $2,550 to $2600 in Plan Year 2018.
  • Only employees enrolled in Consumer Directed HealthSelect can enroll in an LFSA.
  • The TexFlex limited flexible spending account (LFSA) lets participants set aside money on a pre-tax basis—for both themselves and their eligible dependents to pay for dental and vision expenses only.
  • The annual minimum election for PY18 is $180 ($15 per month) and a maximum of $2600.

TexFlex Commuter Spending Accounts (CSA)

  • There are two types of CSAs, the parking account and the transit account.
  • Employees can enroll in or change contributions to a parking or transit CSA during Summer Enrollment or at any time throughout the year.
  • The maximum contribution amount for calendar year 2018 is:
    • $255 for the CSA parking account
    • $255 for the CSA transit account

Note: Since both accounts are pre-tax benefits, the IRS determines the maximum contribution amount and the limit may change from year to year.


Dependent Eligibility Verification

Employees must verify that any dependents they enroll in health insurance are eligible for coverage. This starts with certifying dependent children online. This online certification is legally binding. Providing false information could result in the loss of benefits for the employee and the dependents. Intentionally providing false information may lead to criminal penalties.

In addition to online certification of dependent children, ERS has contracted with Aon Hewitt to verify that every dependent enrolled in health coverage – including spouses – is eligible. After an employee enrolls dependents, Aon Hewitt will mail a letter that outlines the steps in the verification process, lists the dependents who need to be verified, documentation needed and deadlines for submitting documentation. For example, to enroll a common-law spouse, an employee must provide a Declaration of Informal Marriage with a registration date prior to the date of the spouse’s enrollment. If the employee does not provide the documentation or if the dependent is found ineligible, the dependent will be dropped from coverage. Employees with questions about dependent verification can contact the Aon Hewitt Dependent Verification Center toll-free at (800) 987-6605.


FY 2018 RATES

                                                            HealthSelectSM of Texas Full-Time Employee                        
 Coverage FY 17 Total Premium FY 18 Total Premium FY 17 State Pays FY 18  State  Pays FY 17 Employee Pays FY 18 Employee Pays Total Increase to Employee % Increase
Member Only $617.30 $621.90 $617.30 $621.90 $0.00 $0.00 $0.00 0%
Member & Spouse $1,324.66 $1,334.54 $970.98 $978.22 $353.68 $356.32 $2.64 0.8%
Member & Child(ren) $1,090.90 $1,099.06 $854.10 $860.48 $236.80 $238.58 $1.78 0.8%
Member & Family $1,798.26 $1,811.70 $1,207.78 $1,216.80 $590.48 $594.90 $4.42 0.8%

HealthSelectSM of Texas Part-Time Employee

Member Only $617.30 $621.90 $308.65 $310.95 $308.65 $310.95 $2.30 0.8%
Member & Spouse $1,324.66 $1,334.54 $485.49 $489.11 $839.17 $845.43 $6.26 0.8%
Member & Child(ren) $1,090.90 $1,099.06 $427.05 $430.24 $663.85 $668.82 $4.97 0.8%
Member & Family $1,798.26 $1,811.70 $603.89 $608.40 $1,194.37 $1,203.30 $8.93 0.8%

KelseyCare  Full-Time Employee

Member Only $483.98 $483.98 $483.98 $483.98 $0.00 $0.00 $0.00 0%
Member & Spouse $1,038.02 $1,038.02 $761.00 $761.00 $277.02 $277.02 $0.00 0%
Member & Child(ren) $854.94 $854.94 $669.46 $669.46 $185.48 $185.48 $0.00 0%
Member & Family 1,408.98 1,408.98 $946.48 $946.48 $462.50 $462.50 $0.00 0%

KelseyCare  Part-Time Employee

Member Only $483.98 $483.98 $241.99 $241.99 $241.99 $241.99 $0.00 0%
Member & Spouse $1,038.02 $1,038.02 $380.50 $380.50 $657.52 $657.52 $0.00 0%
Member & Child(ren) $854.94 $854.94 $334.73 $334.73 $520.21 $520.21 $0.00 0%
Member & Family 1,408.98 1,408.98 $473.24 $473.24 $935.74 $935.74 $0.00 0%

Consumer Directed HealthSelect of TexasSM  Full-Time Employee

Member Only $617.30 $621.90 $617.30 $621.90 $0.00 $0.00 $0.00 0%
Member & Spouse $1,289.30 $1,298.90 $970.98 $978.22 $318.32 $320.68 $2.36 0.8%
Member & Child(ren) $1,067.22 $1,075.20 $854.10 $860.48 $213.12 $214.72 $1.60 0.8%
Member & Family 1,739.22 $1,752.00 $1,207.78 $1,216.80 $531.44 $535.40 $3.96 0.8%

Consumer Directed HealthSelect of TexasSM  Part-Time Employee

Member Only $617.30 $621.90 308.65 $310.95 $308.65 $310.95 $2.30 0.8%
Member & Spouse $1,289.30 $1,298.90 485.49 $489.11 $803.81 $809.79 $5.98 0.8%
Member & Child(ren) $1,067.22 $1,075.20 427.05 $430.24 $640.17 $644.96 $4.79 0.8%
Member & Family 1,739.22 $1,752.00 603.89 $608.40 $1,135.33 $1,143.80 $8.47 0.8%

 


 

State of Texas Dental ChoiceSM Humana Dental DHMO Plan State of Texas Dental Discount Plan*
Coverage FY17 Total Premium FY18 Total Premium Increase to Employee FY17 Total Premium FY18 Total Premium Increase to Employee FY17 Total Premium FY18 Total Premium Increase to Employee
Member Only $26.61 $27.41 $0.80 $9.59 $9.59 $0.00 $2.25 $2.25 $0.00
Member & Spouse $53.22 $54.82 $1.60 $19.17 $19.17 $0.00 $4.50 $4.50 $0.00
Member & Child(ren) $63.86 $65.78 $1.92 $23.01 $23.01 $0.00 $5.40 $5.40 $0.00
Member & Family $90.47 $93.19 $2.72 $32.59 $32.59 $0.00 $7.65 $7.65 $0.00

 


 

State of Texas Vision Plan
Coverage FY17 Total Premium FY18 Total Premium Increase to Employee
Member Only $6.69 $6.69 $0.00
Member & Spouse $13.38 $13.38 $0.00
Member & Child(ren) $14.38 $14.38 $0.00
Member & Family $21.07 $21.07 $0.00

 

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