Benefits

Annual Benefits Open Enrollment closes this week

The moment you’ve been waiting for is nearly here! ERS Annual Enrollment for Plan Year 2020 runs from July 1 – 13.

The Employees Retirement System of Texas (ERS), which administers health and other insurance benefits for State of Texas employees, will hold its summer enrollment period for Plan Year 2019-2020 from July 1 to July 13, 2019.1 Prior to the annual enrollment period, ERS will mail a Personal Benefits Enrollment Statement to all benefits-eligible employees.

IMPORTANT NOTICE ABOUT INSURANCE: Health and other insurance benefits for employees are subject to change based on available state funding. The Texas Legislature determines the level of funding for such benefits and has no continuing obligation to provide those benefits beyond each fiscal year.

During the annual enrollment period, employees can make changes to their benefits portfolios without a qualifying life event. If you do not want to change your benefits, don’t do anything and your current benefits will remain the same for the upcoming academic year (9/1/2019 to 8/31/2020).

For your convenience, you can make changes to your benefits portfolio during the annual enrollment period of July 1 to July 13, 2019, in one of three ways:


It pays to stay in the network! All health plans are network-based, which means participants will pay less if they see an in-network provider. Participants should make sure a provider is in their plan network before scheduling visits or procedures. Even if a hospital is in the network, doctors and other providers who practice at that hospital may not be.


Medical Insurance

HealthSelectSM of Texas

  • Administrator remains Blue Cross and Blue Shield of Texas (BCBSTX).
  • Premium rates will remain the same.
  • The total in-network out-of-pocket maximums are increasing from $6,650 to $6,750 for individuals and $13,300 to $13,500 for families.
  • HealthSelect of Texas participants must designate a primary care provider (PCP).
  • OptumRx will continue to administer the HealthSelect Prescription Drug program.

Consumer Directed HealthSelectSM 

  • Administrator remains BCBSTX.
  • Premium rates will remain the same.
  • The total in-network out-of-pocket maximums are increasing from $6,650 to $6,750 for individuals and $13,300 to $13,500 for families.
  • No referrals or PCP determination necessary.
  • 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, participants will need to open a HSA as soon as possible so state contributions and other funds can be deposited into the account.
Plan Year 2020 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, 2019.

Health Savings Account (HSA)

  • Optum Bank will continue to administer the HSA.
  • 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 2020 is $3,500 for individuals and $7,000 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 participants 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 participants 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. Participants 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 participants are eligible to participate in a HSA.

KelseyCare powered by Community Health Choice

  • Will no longer be offered through the Texas Employees Group Benefit Program (GBP).
  • Participants who are enrolled in the HMO will be moved to the HealthSelect of Texas medical plan and will automatically become a participant in the HealthSelectSM Prescription Drug Program.
  • Participants will get two identification cards—one for medical benefits and one for their prescription drug benefits.

Dental Plans

Effective September 1, 2019, Delta Dental will be the new TPA for the State of Texas Dental Choice plan. DeltaCare USA, an affiliate of Delta Dental, will administer the DHMO.

No dental plan ID cards

Dentists who participate in the Delta Dental networks should not require ID cards. With this in mind and to keep costs as low as possible, ERS is asking employees who enroll in dental insurance to download a digital card to their smartphones using the Delta Dental app. Participants who want a card can print their dental insurance information from their Delta Dental online account.

On or after September 1, when the participants or their eligible dependents schedule an appointment, they need to let the office staff know about the change to Delta Dental. The office verifies their enrollment in the Delta Dental system. Participants probably will need to provide only their name and date of birth. However, because eligible dependents will not have their own Delta Dental account and cannot access a digital ID card through the app, they may need to provide the policyholder’s name, date of birth and/or social security number or enrollee ID.

State of Texas Dental Choice Plan

  • Premium rates will decrease.
  • There will be no plan changes.

DeltaCare DHMO Plan

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

State of Texas Dental Discount Plan

  • Will no longer be offered through the GBP.
  • Employees currently enrolled in the State of Texas Dental Discount Plan can continue dental coverage for themselves and their dependents by enrolling in the State of Texas Dental Choice Plan or DeltaCare USA DHMO during Summer Enrollment.

State of Texas Vision Insurance Plan

  • Premium rates will decrease.
  • The member’s copay for an annual eye exam will remain $15.
  • Participants can have their annual eye exam at any time during the plan year.
  • The health insurance Opt-Out Credit can be applied toward State of Texas Vision, in addition to dental and AD&D insurance.

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, 2019.

Basic Term Life, Dependent Term Life & AD&D

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

Short-Term & Long-Term Disability

  • There will be no changes to the plan or premiums.
  • Some employees may see a change in their premium if they have a salary change as of September 1, 2019.

TexFlex Flexible Spending Accounts (TexFLex)

TexFlex, administered by WageWorks, Inc., is a flexible spending account (FSA) and a commuter spending account that lets participants set aside money from their paychecks, pre-tax, to use for eligible out-of-pocket expenses.

There are three types of the TexFlex FSAs: health care, dependent day care and the limited flexible spending account (LFSA).

  • The administrative fee holiday is still in effect for Plan Year 2020. Participants will not have to pay the $12 annual administrative fee for each account.
  • Participants continue to have a Grace Period through November 15, 2019, in which to use their Plan Year 2019 funds.
  • Annual elections will remain the same in Plan Year 2020 unless the participant makes a change to their elections during Summer Enrollment.

Health Care Account

  • The maximum annual election increases from $2,650 to $2,700 in Plan Year 2020.
  • Participants can continue to carryover up to $500 of unused health care account funds into the next year.
  • The annual minimum election for PY20 is $180 ($15 per month) and a maximum of $2700.

Dependent Care Account

  • The maximum annual election remains at $5,000 in Plan Year 2020.

Limited Flexible Spending Account (LFSA)

  • The maximum annual election increases from $2,650 to $2700 in Plan Year 2020.
  • 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 to pay for dental and vision expenses only.

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

FY2019 Rates

 

 

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

This site uses Akismet to reduce spam. Learn how your comment data is processed.