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By Larry B. Dendy
ldendy@uga.edu
Current and retired university employees will have about a month--from Oct. 16 to Nov. 16--to choose a health insurance plan from among several options that offer varying levels of service but have one common feature: higher costs.
The University System Board of Regents approved the options last month as part of an effort by the state to offset a large deficit that has built up in the current insurance plan. The regents set Oct. 16-Nov. 16 as the open enrollment period in which all System personnel must select a plan, which will become effective Jan. 1.
The choices provided by the regents for employees and retirees of UGA and other System institutions include:
• the current indemnity plan, administered by Blue Cross Blue Shield, that UGA personnel have been under for about six years;
• A new PPO (Preferred Provider Organization) plan that offers many of the features of the indemnity plan and includes 90 percent of the physicians and hospitals in the indemnity plan. The PPO has a network of providers of mental health and substance abuse services.
• A new PPO “consumer choice” plan that allows customers to pay higher fees in order to use a physician or hospital not in the PPO network.
• The Blue Choice HMO and Blue Choice HMO consumer choice plans. Detailed information about these plans is not yet available.
The regents have also contracted with the firm of Express Scripts to provide a pharmacy benefit program, which will be available with the indemnity and PPO insurance options. The Blue Choice HMO will have a separate pharmacy plan. The program has no annual out-of-pocket limit for a calendar year, and doesn’t require that a deductible be satisfied. Prescription costs under the plan are $10 co-payment for generics; $20 co-payment for preferred brands; and, for non-preferred brands, 20 percent of the drug’s cost with a minimum payment of $35 and a maximum of $75.
A meeting to discuss the available information about the health insurance and pharmacy plan will be held Oct. 10 at 2:30 p.m. in the law school auditorium. David Williamson, director of employee benefits in the Human Resources Division, says additional information will be provided in later meetings that will be held around campus and at UGA facilities in other parts of the state prior to and during the open enrollment period. A schedule of additional meetings will be announced later.
During the open enrollment period, all UGA employees and retirees must send to Human Resources an enrollment card on which they choose either the indemnity, PPO, PPO consumer choice, Blue Choice HMO or Blue Choice HMO consumer choice plan. This includes people who want to continue their current indemnity plan coverage. Anyone who does not send in the card will automatically be assigned to the PPO plan, where available. The PPO is available throughout Georgia and in portions of bordering states.
The state hopes as many as 70 percent of University System personnel will choose the PPO, which can provide health coverage at lower costs through pooled resources. The State Department of Community Health estimates the state can save more than $70 million over three years through the PPO.
Premiums for the new plans vary according to the number of people covered, but will be higher than premiums for the current indemnity plan. In general, the indemnity plan premium will increase sharply on Jan. 1. PPO premiums will be close to the current indemnity fees. The PPO consumer choice premiums generally fall somewhere between the PPO and the new indemnity rates.
For all plans, employees and retirees will continue paying about 25 percent of the overall cost and the regents will pay about 75 percent.
Williamson says the regents are finalizing informational materials for the insurance options. The materials may not be available until just prior to the open enrollment period. Human Resources will post the most current information on its Web site (www.busfin.uga.edu/human_resources/whatsnew_ins.html). The site now contains charts that compare coverage provided by the indemnity, PPO, PPO consumer choice and HMO plans, as well as costs for each plan. Information about the pharmacy program is also on the site. |
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