The Joint Labor Management Committee on Health Insurance held its fall Assembly meeting on Tuesday, October 10, to review the features of this year’s open enrollment for 2018 and to hear updates from the Plan Administrator (121 Benefits) for health and other reimbursement accounts (HRA, MDEA, and others) and the Pharmacy Benefits Manager (CVS Caremark). The Joint Labor Management Committee is a collaborative committee with representatives from MMB / MnState and public sector unions, including the IFO, whose purpose is to seek ways to improve health and contain costs.
Open Enrollment – What is Open for 2018?
Important news regarding Open Enrollment is that for the first time in a very long time, supplemental life insurance and short-term disability will be open for enrollment for 2018, during this year’s open enrollment period, October 26 – November 8, 2017.
During open enrollment, faculty may increase their own life insurance or add or increase a spouse’s life insurance without having to provide evidence of insurability, i.e., without evidence of good health that is normally required to increase or add life insurance. You may also add or increase child life insurance at the same time.
In addition, the short-term disability benefit will be open during the October 26 – November 8 open enrollment period. If you do not currently have Short Term Disability, you may enroll in coverage without providing evidence of insurability and without limitation based on pre-existing conditions. You may also increase the amount of coverage during this period without providing the evidence of good health that is normally required to add or increase short-term disability.
Supplemental life insurance and short-term disability are rarely open for enrollment without having to provide evidence of good health so this is an exceptional time-sensitive opportunity for current employees to secure these additional benefits.
Also, new this year, employees may waive their own medical coverage by providing evidence of other coverage.
As in most plan years, several clinics and medical provider systems will be changing cost levels in 2018, and therefore, all employees should look up their current clinic’s cost level for 2018 on the SEGIP website.
Fourteen clinics and medical systems will be in a higher cost level in 2018. The largest medical provider that will change to a higher cost level is the HealthPartners clinics, which will move from a cost level 1 to a cost level 2 for 2018. In addition, there are some clinics that will move from a cost level 2 to level 3 or 4, and employees will need to select a different primary clinic for 2018 to avoid experiencing the higher copays and other costs associated with cost levels 3 and 4.
Some clinics that will be in a higher cost level in 2018 through their current plan administrator but will be available at a lower cost through a different plan administrator. If your clinic will be in a higher cost level for 2018, check what the cost level will be for your same clinic under a different plan administrator. Open enrollment is the only time you are permitted to change your plan administrator from among Blue Cross Blue Shield, Health Partners, and Preferred One. Fairview clinics under plan administrator Blue Cross Blue Shield will move from cost level 2 to level 3 in 2018. However, you may remain in Fairview clinics and change to HealthPartners as your plan administrator, and you your clinic will remain at a cost level 2 for 2018 or if you are in the Mankato Area Mayo Clinic Health System under Blue Cross Blue Shield, your clinic will change from cost level 2 to cost level 4, however, you can remain in the Mankato Area Mayo Clinic Health System at cost level 2 if you change plan administrators to Preferred One.
At least ten clinics/medical systems will move to a lower cost level in 2018, and over 9,600 participants will be in a lower cost level in 2018 if they stay in the same clinic under the same plan administrator.
What is Happening to Dental Plan Improvements?
Because the legislative Subcommittee on Employee Relations voted against the union contracts containing the negotiated dental plan improvements, dental insurance improvements will not be available as of January 1, 2018, and the current plan will remain in effect. As a result, single premiums for dental insurance will remain at $5. There will be a small increase of about 2% in dental premiums for dependent coverage, to $38.98 per month.
Dental plan improvements will be included in union contracts that will be before the legislature in 2018. After union contracts containing dental plan improvements are approved by the legislature, SEGIP will conduct a separate open enrollment period for dental coverage, to allow employees to enroll, add or remove dependents or change dental plan providers (between State Dental Plan-Delta Dental and HealthPartners State of MN Dental Plan) before the negotiated plan improvements and single premium increases go into effect.
Prescription Drugs – New Pharmacy Benefits Manager for 2018
CVC Caremark will be taking over from Navitus as the Pharmacy Benefits Manager as of January 1, 2018.
CVS Caremark Mail Service will replace WellDyne for obtaining prescriptions by mail order. CVS Caremark is working with Navitus to have all existing prescriptions for mail refills to be transferred over automatically. Those who do not have any mail refills remaining will have to contact their doctor for a new prescription. CVS Caremark will be mailing information in early December regarding the transition of prescriptions. SEGIP participants who are on maintenance medications will be able to submit a 90-day prescription to CVS Caremark Mail Service and receive a 90-day supply for the cost of two copays, and in addition, participants on maintenance medications will be able to get a 90-day supply at a CVS retail pharmacy for the price of 2 copays.
CVS Caremark’s website offers a drug cost tool which allows you to compare pharmacy prices and determine lowest cost options, including the cost of filling prescriptions by mail or at any retail pharmacy, and the cost of a 30-day supply and a 90-day supply of medications.
121 Benefits Will Continue as Administrator for Health, Dependent Care, and Transit Expense Accounts
A new 5-year contract was executed with 121 Benefits to continue as the plan administrator for Health Reimbursement Arrangement (HRA) Accounts, Medical/Dental Expense Accounts (MDEA), Dependent Care Expense Accounts (DCEA), and Transit Expense Accounts (TEA).
121 Benefits now has a Mobile App available to access your account, check balances, submit claims for MDEA, DCEA, HRA and TEA, view claims requiring receipts, and snap a photo of a receipt and submit as a new claim or add to an existing claim or debit card transaction.
Users of Transit Expense Accounts should be aware that the IRS regulations have changed regarding how mass transit commuter purchases will be reimbursed. Beginning in 2018, employees will have to make their purchase directly from a transit vendor, using their 121 Benefits debit card.
Joint Labor Management Committee’s Focus on Health Improvements
As a result of the joint labor management committee’s focus on managing risk and improving heath for SEGIP participants with chronic diseases, participants with Type I and Type II diabetes will benefit from the Advantage Value for Diabetes pilot project, begin January 1, 2018. The joint committee will continue its goal to improve wellness programs and will be seeking feedback and gathering information on options, before the RFP for the wellness vendor contract opens next year.